Life Science Tools of the Trade

In researching (and I use the term in its modern sense, roughly meaning “looking on the internet for approximately three minutes) in order to find something to contribute to a discussion about inappropriate scientific article titles, I came across this absolute gem of a paper:

All’s Well That Ends Well: Shakespeare’s treatment of anal fistula. Cosman BC. Dis Colon Rectum. 1998 Jul;41(7):914-24. PMID 9678380

I had no idea, really, although I suppose that in a journal called ’Diseases of the Colon and Rectum’, I shouldn’t be surprised. With morbid fascination, I read the abstract:

Textual and contextual evidence suggests that the French king’s fistula, a central plot device in Shakespeare’s play All’s Well That Ends Well, is a fistula-in-ano.

Really? I’m fairly certain I’ve seen this play performed, at least in a television adaptation. It was a long time ago, and certainly long before I began to be interested in gastrointestinal disorders, but I would have thought I would remember references to the French king’s backside. And I’ve already learned something else:  I don’t think I’ve ever come across the term ‘fistula-in-ano’ before.

Reading on:

Anal fistula was known to the lay public in Shakespeare’s time.

I suppose that makes sense. I hadn’t really thought about it.

In addition, Shakespeare may have known of the anal fistula treatise of John Arderne, an ancestor on Shakespeare’s mother’s side. Shakespeare’s use of anal fistula differs from all previous versions of the story, which first appeared in Boccaccio’s Decameron and from its possible historical antecedent, the fistula of Charles V of France.

Ok, now the author’s getting serious. Or the article’s getting silly. One or the other. Onward:

This difference makes sense given the conventions of Elizabethan comedy, which included anal humor.

Again, I hadn’t thought about it - but no surprise there, really.

It is also understandable when one looks at what wounds in different locations mean in European legend. In this light, it is not surprising that subsequent expurgations treat Boccaccio’s and Shakespeare’s fistulas differently, censoring only Shakespeare’s.

Well, ok - they removed the reference to the King’s bum. I’m not really surprised. Other ‘wounds’ were much more socially acceptable, I suppose. After all, we’re talking about a culture that endorsed public beheadings.

Cosman’s abstract ends with this screechingly funny statement:

This reading has implications for the staging of All’s Well That Ends Well, and for our view of the place of anal fistulas in cultural history.

Indeed it does. I shall never view the cultural history of anal fistulas in the same way again. Or perhaps at all. And I’m certainly going to be paying closer attention the next time I see All’s Well That Ends Well performed. Paying closer attention, but ready to run for the door if the King’s nether ailments are about to be revealed.

It’s a good thing there are curated literature search engines, like PubMed. Otherwise, how would I ever find these things?