Welcome, Mütter fans and medical history enthusiasts, to the latest issue of , The Center for Education's ongoing series that offers you an inside perspective on the Mütter Museum as told by our dedicated team of museum docents.
Last time, opened our series with a look at Chevalier Jackson, a Fellow of the College of Physicians of Philadelphia who collected over 2,000 swallowed objects he extracted from patients. Today, we turn the reigns over to Joe Walsh. Joe first visited the Mütter Museum in 1975. He became a docent in 2013 following a 34-year career as an OB/GYN physician. When he isn't giving tours at the Mütter Museum, he is applying his love of science, history, and education at the Franklin Institute and in a for the .
Take it away, Joe!
My goal on tours is to make connections between the items, rather than have a linear trip through disconnected items. The Worden Room, often considered the "side room" on the lower level contains several fascinating objects which have connections that may not be immediately obvious at first glance. This post discusses two fascinating objects: the oral tumor removed from President Grover Cleveland and a necklace made of genital warts.
Grover Cleveland's Tumor and The Genital Wart Necklace
President Grover Cleveland noticed a rough surface inside his mouth in 1893. His physicians felt the area was an oral cancer and needed an immediate operation. However, there were significant political considerations, as Cleveland was a supporter of the Gold Standard and wanted to repeal the Sherman Silver Purchase Act. His Vice President did not share those views, so Cleveland was reluctant to hand over power, even temporarily. The surgery was conducted in secret aboard the Oneida, a boat owned by his friend Commodore Elias Benedict. The tumor may be seen in a case in the center of the Worden Room.
The necklace of genital warts was created not to be worn as jewelry but to allow easier study of the warts suspended in liquid in the storage jar from a string. The collection from an unknown donor is from the 19th Century. Treatment at the time included an injection with cocaine to provide pain relief followed by the application of “powerful caustics” such as nitric or chromic acid. Modern treatments involve numbing with local anesthetic and then removal via surgery, cryotreatment, or laser treatment.
What's the Connection?
Cleveland's verrucous carcinoma has a controversial association with , but in the years since, many oral cancers have definitively become confirmed as associated with HPV. It has been known that HPV is associated with cervical cancer since 1982. Genital warts are caused by certain strains of HPV and are often the first external manifestation of the presence of the virus. HPV can be transmitted through sexual contact and can rarely lead to female and male genital cancers and anogenital cancers.
The HPV vaccine is the only vaccination that helps protect both men and women from many different types of cancer associated with exposure to strains of HPV. About 150 strains of HPV have been identified, but the vast majority of cancers are caused by 40 of those strains. The initial vaccine, Gardasil by Merck, was made available for people with cervixes between the ages 9 and 26 in 2006. Gardasil covered four subtypes of the virus.
In 2011, the CDC recommended that boys also be vaccinated. In 2014, the latest vaccine, Gardasil 9, which covers 9 subtypes of HPV was approved. In 2018 the Gardasil-9 vaccine, the only one currently available, was recommended up to age 45, expanding the age group targeted for vaccination.
HPV-related cervical and vaginal cancers have decreased since the introduction of the vaccine, but rates for oro-pharyngeal and anal related cancers have increased.
Thanks, Joe, for your insights. If you want to hear more from our docents, check out Lindsay's piece on Chevalier Jackson as well as an interview with several of our docents about . To learn more about Grover's Cleveland's secret surgery, check out .
References:
Memento Mütter, accessed July 2, 2020.
University of Arizona Health Sciences Library, accessed July 2, 2020.
KFF, accessed July 2, 2020.