Funtabulously Frivolous Friday Five 073

Followers of R&R in the FASTLANE will have noted in the third edition that Joe Lex recommended reading Danzl’s quirky, weird and wonderful  1992 masterwork on ‘flatology’:

“A classic paper on an unpleasant subject – farts.  Danzl approaches this sticky subject with tongue firmly planted in cheek, but he’s done his homework well.  This remains the classic article on this unmentionable topic.”

This week’s FFFF is dedicated to the science of flatology, and doubles as a study guide for Danzl’s exposition. Assiduous FFFFers will also recall a question regarding ‘son et lumiere’ sign from the 71st FFFF, which is also of great import to this topic.

Without further ado, here is this weeks funtabulously frivolous flatological friday five!

Danzl DF. Flatology. J Emerg Med. 1992 Jan-Feb;10(1):79-88. Review. PMID: 1629596.

Question 1

What did the Roman Emperor Constantine outlaw in 315 AD?

  • The free public passage of flatus.
  • In doing so he repealed an earlier decree permitting this activity, made by the Emperor Claudius.

Question 2

What is the ‘normal’ quantity of flatus generated daily?

  • 400 to 2,400 mL daily in a healthy human at sea level, who eats a ‘typical’ (non-flatulogenic) diet.
  • This results in an average of 14 ‘daily flatus events’ in ‘young, normoflatulogenic males’. However there is wide variation in this frequency. A 28 year old male reportedly achieved 70 such events in a 4 hour period (termed ‘status flatus’ by Danzl) resulting in a submission to the Guiness Book of World Records. On the otherhand, in a study of the effects of bean consumption, 28% of families denied ever having passed flatus…

Question 3

What is HAFE?

  • High Altitude Flatus Explosion (HAFE) was described by Auerbach and Miller in 1981.
  • HAFE typically has marked clinical significance at altitudes greater than 11,000 ft. Mountaineers are frequent victims (perpetrators?) but this particularly noxious demonstration of Boyle’s law also affects astronauts, high altitude airplane passengers and ascending divers.
  • When the ‘explosion’ part of HAFE fails to occur, there is a risk of ‘trapped gas dysbarism‘. A case was described by Bason and colleagues in 1980 following a chamber flight to 40,000 feet. Failure of therapeutic belching and rectal release necessitated hyperbaric treatment…

Question 4

What is Hindenburg Syndrome?

  • A somewhat politically incorrect term for the ignition of combustible gases generated in the alimentary tract.
  • The condition has been held responsible for a number of operating theatre fires and explosions. Surgeons tend to attribute the condition to over vigorous ventilation by anesthetists, whereas anesthetists point to the wanton use of lasers and diathermy equipment by their surgical colleagues.

Question 5

This man performed at the Moulin Rouge from 1892 to 1914. Due to his abilities he could blow out a candle from a distance of 1 foot. Who was he, what was the nature of his performance and how did he do it?

  • He is Joseph Pujol, better known as Le Pétomane (péter is French for ‘to break wind’, -mane means ‘maniac’)
  • Pujol was a musician of sorts. Through a combination of anal sphincteric relaxation and decreased intra-abdominal pressure he ‘inhaled’ air into his rectum. The controlled release of this gas allowed him to hit the right notes: the tighter the anal sphincter tone on exhalation, the higher the pitch.
  • according to Danzl, his encore ‘sing along’ reliably got the audience on their feet…

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Comments

  1. says

    Hi guys,

    Thanks for providing your website still for free, it´s my no.1 resource for EM. I just started nofame4u as the first german website with EM themes. As there is currently no specialty of EM in Germany there are only very few resources here, most of them focused only on prehospital. Just one question: How do you install the Q&A formats on the site? What kind of program do you use for this? Is it a extra one or integrated by your webspace provider.

    Thanx for a short reply and for the great work you do each day.
    Lars

    • says

      I wonder if a similar phenomenon explains the Yeti myth in the Himalayas?

      The constant growling in these regions that follows trekkers at high altitudes (who are continually challenging their unacclimated alimentary systems with a steady stream of dal bhaat) may have a more prosaic explanation…

      Chris

  2. says

    The classic paper “Does Beano prevent gas?” (J Fam Pract 1994 Nov;39:441-5) used 19 volunteers and a cross-over design to measure the effect of Beano (alpha-galactosidase) on the number of flatulence events following a meal of chili. Episodes were documented by each volunteer using a diary. Obviously more work needs to be done on this, since the methodology was subjective and not completely quantitative. The study should be repeated using a peak-flow meter.

    • says

      The study clearly needs to be repeated with the subjects ensconced in a closed system so that the volume of gas produced could be calculated from the change in pressure according to Boyle’s law. I can’t see any drawbacks for the participants, can you?
      Chris

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