May 4, 2021 • 43 mins
The poor appendix. Despite findings that it serves a purpose, many people still cast it off as a second rate organ and the Rodney Dangerfield of organs. We aim to correct that notion.
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Episode Transcript
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Speaker 1 (00:01):
Welcome to Stuff you should know, a production of I
Heart Radio. Hey you, welcome to the podcast. I'm Josh Clark.
There's Charles w Chuke Bryant's willing away in some champagne.
You're sorry, sparkling my shando and so it's from NAPA.
(00:21):
And there's Jerry over there, Jerry Scudder champagne too. We're
all just hanging out. We're gonna talk to you guys
while we wait for the shrimp cocktail with aw literally
and that makes this stuff you should know. That's right. Uh,
we're back in the same room everybody for the first
time in about fourteen months. And Jerry brought in champagne
and frozen shrimp cocktail. There's a story behind that. Go
(00:43):
ahead and say it. You go ahead and say, I
don't remember you were the shrimp you first started it,
Like I feel like twelve years ago we we we
were tracking to hit number one on iTunes in like
two thousand and eight, I think at the beginning of
two thousand no nine maybe whatever, and um, I was like,
(01:05):
I want a shrimp cocktail in the in the recording
studio when we hit number one. We hit number one,
came and went stayed number one, hit number one again.
No shrimp cocktail. This is the shrimp cocktail from two
thousand nine. Yeah, finally has made an appearance, and it's frozen.
It might literally be from two thousand It might be.
(01:26):
It's turning. The veins are turning kind of purple as
it thaws. I can't wait to eat the shrimp cocktail. Yeah,
we're having shampagne. Jerry classed it up basically, I feel
I feel it was a nice homecoming she did. But
the three of us are fully backs. Were in a
room together. The microphones don't have fake years attached to them. Yeah,
I mean that joke won't make sense to you now,
(01:48):
But we recorded another episode before this one, but it
was getting released later, so this technically our second episode.
It just put that in your button and smoke it
in your hat. What do you talk about? Have a
weird urged a curse? I don't know why. I think
you just did so, Jerry Beppe bp P p peep.
But it's it's great to be back together in a
(02:10):
little weird um, but not as weird as I thought
it would be. That first one was weird because we're
in a different room. Yeah, we got all the weirdness
out in a weird situation, it would have been weird regardless.
But now we're back in in Studio one A. That
was a really good move. Jerry, did you plan it
like that to get the jitters out? Jerry thumbs up.
Jerry's real. Everybody she chooses not to talk. Jerry's let
(02:32):
her hair grow out. I know she got a ponytail,
but the first time I've ever seen it's got an
even more peppery, no salty in a salt and pepper way.
It doesn't get more peppery unless you make a you know,
a move to make it so. And she looks like
a wealthy retiree who drives a Maseratti and knows their
(02:53):
way around the club. You know what I mean, That's
what Jerry looks like. She looks distinguished but also foxy. Yeah.
So I spent my last January of losing twenty five
pounds and then COVID hit and now I have gained backunds.
I'm exactly where I was. Is that right? Exactly to
(03:15):
the pound? And it makes me really angry. Oh no,
just go with you. Oh I know, but I just,
you know, let me get back together. I was like, man,
I'm doing so good. I'm so good pandemic And I
was like, well, now I can eat and drink all
I want because it's sad. So you lost the weight
before the pandemic hit, Yeah, I hit it hard in
January to junior March January one probably, yeah, okay, And
(03:40):
like I was working with a trainer, like you know,
so I was having to go to her every like
three days a week, and just you know, I was
making the right decisions and tracking and and the weight disappears.
And then COVID hit and I just started making all
the wrong decisions and let myself do that. Yeah, that
happened to all of us, myself included. I went through
what you went through where I lost a bunch of
(04:02):
weight and I managed to keep it off. And then
COVID hit and I was still doing okay, doing okay,
maybe eating a little more than usual, like I'm not
gonna let it happen though, and I was. I wasn't.
And then our book hit, and that's what got me.
When we were writing it and working on a two
hours a day every day, I was eating so much weight.
(04:23):
I gained book weight, and I actually I have not
been this big since I don't know when. Man, but
I still got it. So I'm I'm doing what I can.
You look the same? I do? Well? Then I what
I started two weeks ago was kicked in. I guess
if I look the same, well, you look great. Great,
everyone looks and feels great. Yeah, let's talk about the appendix,
(04:44):
the Rodney Dangerfield of organs. This is one of my
favorite articles that we've done in a while. Yeah, and
you know how I often complain about science. This is
a kind of science I love. Yeah. Understandable, Yeah, body science, understandable.
Super cool. This factors into our hygiene hypothesis episode, our
(05:07):
human microbiome episode, digestive system episode. Yeah, it all sort
of fits together. In that little worm like organ, it's
an organ, right, yeah, it's an organ. Yeah. A lot
of people thought it was a vestigial organ. They're wrong, right,
But that weird little thing, uh, hanging out there, just
(05:30):
going just wiggling around like a little worm is really
kind of cool and fascinating. And I love that it
has a great story behind its lack of usefulness and
then turns out usefulness. And it's just agreed, this is
really good stuff. It's smashed bang stuff. You should know.
That's right. Let's talk about it. So um, like you said,
(05:50):
the appendix is like this little worm like thing that
dangles off the bottom of the ascending coal and large intestine.
Coal in large intestine and large bowl are the one
and the same. So when you hear people say bowl,
they're typically talking about that colon large intestine. It's all
the same thing, which I found confusing until I looked
(06:11):
it up and found okay, it's all that um two
to four inches long the appendix right generally, although the
biggest one was pulled out of a seventy two year
old Croatian man named Sofranco August during his autopsy, and
his was ten inches or twenty six centimeters long. What
do you think they were like in that autopsy? They're like, wow,
(06:33):
I think that the medical examiner's staff had a T
shirt made up that Sofranco August was buried in that said,
I've got the biggest appendix ever. Maybe, I mean that's
crazy because when you, like I encourage you look up
a picture of the appendix, it is it looks like
a little worm and it's hanging there on this little
bulbous pouch called the sikum, and the Sikim is kind
(06:55):
of like where it's it's the part in between this
all Intestine and Large Intestine where there there's an agreement
that takes place, basically where the small Intestine it is like,
all right, listen, I'll take all this food and I'll
make it into clime, but I am not going into
the fecal zone. Now you handle the fecal stuff, colon,
(07:17):
And the colon says, fine, here's my buddy, the secum.
It'll it'll service a little halfway house. You can pass
everything along to me. I will broke rate, you won't
get any poop on you Small Intestine, and I'll send
it to the Large Intestine. But off of that Secum
is dangling this this little dude yeah, which as far
as anybody could ever tell, had nothing to do with digestion,
(07:40):
which makes it really weird because everything else around here
has to do with digestion. That's just what they do,
that's their their their trade. And the appendix is just
hanging out and people just thought, Okay, this this thing
doesn't make any sense. But the fact that is attached
there and doesn't seem to have to do with digestion,
(08:00):
made people for a very long time think that it
was a vestigial organ right, which we'll get into the
specifics of one man who really championed that idea in
a way that frankly made a lot of sense, and
you can see why it took that many years for
anyone to really poke around further into it. Yeah, because
you're just like, yeah, you just explained it's sure. But
(08:20):
there are other mammals that have secums, uh, and in
some mammals, especially herbivores, that can be really big relative
to their body size, because in herbivores it acts as
the the predigestion house for plants, and since they're eating
tons of plants, they have large secums. Yeah, plant fiber
is really really good for you, but it's also really
hard to digest a lot of cellulose um. And that's
(08:43):
that large intestine coming into play again, because in the
stomach and the small intestine there's um, a microbiota, a microbiome,
which we talked about in that one episode the Human
Microbiome Project. Um. There's some in the small intestine. I
think there's far far less even in the stomach, but
in the large intestine. That's where it really shines. And
(09:03):
those microbes, the pathogens, the virus is the fung guy
all of the and the bacteria most of all. They
all kind of work or fight or play and digest
this stuff. They break it down so that we can
absorb it. They turn it into fiber. Um dietary fiber
uh keeps you from absorbing a lot of sugar or
(09:25):
fats or whatever at once. Um insoluble fiber bulks your
stool up, so it really kind of gets everything out
of the coal and really cleanses it when you finally poop.
Hand gestures. Yeah, I've missed you seeing my hand gestures
now that I think, even when we're recording at home, Um,
(09:46):
I forgot what it's like to be seeing so um.
So the large intestine has this microbiome that that lives
in there, and just just remember that. That's a big
important point. Yeah, put a pin in that, but not
literally because that would be dangerous. Um. Out of the
three sixty one mammal species, only about fifty of us
(10:08):
have an appendix or something like an appendix. Obviously, the
great apes do, rabbits, possums, wombats weirdly square poop. Did
they really comes out in cubes? Really? Yes? I can't
tell if you're messing with me right now? Wait, hold on,
keep talking. You're thinking of the square watermelons in Japan,
maybe thinking of all of bees. I'm pretty sure wombats
(10:30):
have square all right, a rare in show check. But
dogs and cats don't have appendix, cows don't, oranges don't,
sheep don't. Oh yeah, little poop poop cubes square. Yeah,
it looks like those ice cube chocolates. How do they?
How does that happen? How do they? Yeah? How does
that work? Um? I don't have time to read that,
but it looks like there's a science alert from January
(10:52):
that says wombats are the only animals that poop cubes
and now we know how Okay, well that's a definite
short stuff. Okay, we'll do it. Look for that soon.
Uh So, back to the vestigial organ aspect. Charles Darwin
is the person who came out and said, hey, I've
been looking at these And by the way, that was
named officially by an anatomous named Phelippe Verhan in seventeen ten.
(11:18):
Appendix vermiformists, which means worm shaped detachment, and I think
the first appendix removals in seventeen thirty five. But Darwin
was the one who said, hey, everybody, I've been looking
at these herbivores and they've got these really big Secum's
giant for this, for this reason that Josh just described
(11:38):
future Josh and he said, so, here's the deal is,
when we see a bunch of plants, we had humongous
secombs as well. And as our diet changed and we
got away from plants, you know, our body started to
change along with it, and that seek them just kind
of shrank. And the appendix is just a little shriveled
up piece of that formerly large secum and it's just dangling.
(11:59):
They're doing nothing. Isn't that amazing? And everyone until two
thousand seven said it sounds right to me. Darwin's got
it right. It does. I mean, it totally makes sense
and seems completely believable. Yes, But now that I know
it was wrong, I questioned every single thing he ever
thought of or set. Welcome to our world, Darwin, So
you guys messed up that one thing. I just don't
(12:21):
know I believe anything. May we hear that like every
week too? Don't we it's fun so um. But yeah,
it went for We went for well over a hundred
and fifty years of just everyone believing that the appendix
was a totally useless fastigial organ that had no function
whatsoever any longer. And so it was fine if you
(12:42):
just took it out, which is we'll see like people
do a lot actually and it is fine for the
most part, which we're lucky that it's fine. But also
I think if if it weren't fine, we would have
figured out very quickly, like, oh wait, this is you're
not supposed to do that. So the fact that we
were able to remove the appendix later on, um without
(13:02):
a problem, um, just kind of lent to this, let's
support to the idea that it was a Vista gi organ. Right. Um,
But it turns out it does serve some function. We'll
start talking about that. I think after a break, what
do you think, Chuck? That was so smooth? Thank you
so much smoother in person? All right, we're back from
(13:42):
our break. Um, who knows what amazing as you guys
just heard. But I'm envious of you because we didn't
hear it. We just have a moment of silence in
between that's right. Uh, And now we can talk about
the microbiome a little more. And if you want to
look into our Human Microbiome Project works show that was
it's when fourteen there are trillion cells in the body.
(14:04):
About thirty trillion of those are human cells with DNA
and the rest of those hundred trillion are the microbiome.
That isn't just amazing and it's really there's something about
the digestive system that just frankly turns us both on
a little bit. Yeah, there were these animations that can
I remember who made them? Um many many years ago? Yes,
(14:24):
but the animator just understood us on a level that
even I'm like, I'm like, oh, I didn't know myself.
Just little shorts from clips show. They did one about
a four and a half minute clip from how the
digestive system works, which is worth looking up on YouTube.
It's where I watched it the other day. They are
they were just gifted and talented. It's one of my
(14:45):
favorite little things that we ever that someone ever did
for us. I want to say, Nick Nick sounds right? Okay,
I think it was Nick. I hope it's Nick Nick.
Please like right in if you still listen. Nick moved on. Okay, well, anyway,
they were really great. What Nick's work, and if it
wasn't Nick, Nick's new nickname is Nick. That's right, Okay,
(15:07):
So um, Yes, the digestive system does get us jazz,
and in particular the microbiome, which we wouldn't have a
digestive system, or at least one that functions, because again,
those bacteria help us break down stuff that we would
normally have trouble breaking down, help us form poop all
of that stuff. And there's a it's a symbiotic relationship
because in breaking those those things down, like that plant
(15:30):
fiber for instance, they're eating, they're happy, they're reproducing, but
then the byproducts and the stuff that they break open
make that stuff bioavailable for us, so we can kind
of get the nutrients and all that stuff from it
as well. It's a beautiful relationship. Not all bacteria is good, though, No,
there's the bad stuff. And we should point out that
(15:50):
most of this bacteria is in that large intestine, uh,
the in the stomach and the small intestine. Most of
it's killed off by gastric acid. But the bad bacteria
is if you eat some bad chicken or if you
have you ever done that? Yes, yeah, you know me.
I've had all manner of stomach issues over the years.
(16:12):
Where where did you get your bad chicken? I don't remember.
I don't remember specifically, but I know I've had bad
food before that made me sick. And in my case
in Guatemala, if you remember, you and Jerry both well,
it was not me. You know what, we were even
closing our mouth in the shower. We're being so careful.
But on that last night it was the ice, the
(16:33):
mixed drinks. I forgot the ice is made from water,
and that water was not good for Americans. And I
stayed home that night so I didn't get diarrhea. It
was worth it though, Jerry and I had such a
good time. So yeah, I got bad sick after our
guatte trip. But that's the bad bacteria, and and that's
how it can get into your body. And your body
(16:55):
is solution to this, uh as Jerry can affirm, is
is diarrhea. It's your body's way of saying, we're just
gonna flush you out human being. Just get rid of everything,
get rid of all the stuff. But that's gonna take
a lot of the good stuff with it, and that's
no good because if you have all the good bacteria
or a large amount of good bacteria leaving your body,
(17:16):
then that can leave you very vulnerable to nutritional deficiencies
and other bad stuff. Sure, yeah, because I mean, like
a lot of the neurotransmitters that make your brain function
correctly or produced in your gut from the function of
the bacteria. Like, there's a lot of bad things that
can happen if you don't have a balanced microbiome in
your gut. Right. So Interroduke University in two thousand seven,
(17:38):
I guess someone was staring at a picture of the
human body from the inside out and locked in on
that appendix and they're like, it's just sitting there attached
to the scumb It's got to do something right. And
they did some studying and testing I know exactly you
(17:58):
like me, and they figured out this theory that this
is a safe house essentially for that good bacteria. It's
got a really rich uh biofilm, which is we've talked
about biofilm in a bunch of episodes. I feel like
it's like coating on the inside of the blindings of
all kinds of things. Yeah, it keeps bacteria from being destroyed.
(18:19):
It's like a protective mucus get exactly, which is you
know that sounds gross, but it's a really a good thing.
And the appendix is just lousy with this great biofilm.
And they said, I think we think the Duke University
blue devils think that this is a safe house for
that good bacteria. Because when the body is being flushed
out with diarrhea from his illness, the appendix is down
(18:41):
there at the end of the cul de sact. It's
not even getting affected, basically, right. And so when that
bacteria leaves and takes the good with it, the appendix says, hi,
I'm here, look at all my good bacteria friends, go
forth and do your work. Exactly, goes bloop and pushes
all like a big hunk of mucasy bacteria or bacteria
ridden mucus into your large intestine to recallonized, which is amazing.
(19:04):
And and all of a sudden, the science world was
turned upside down because they thought they and it turns
out they did find a use for the appendix. Yeah. Um,
and not only uh is it a storehouse they found
for bacteria, the good bacteria that make up our microbio.
It's also a place where um lymphocytes and other immune
(19:27):
cells are produced. Like it's called limphoid tissue, where like
T cells, B cells. I think there's one called T
natural killer cells, which you don't want to mess with
the iced tea. Yeah, or um the uh Woody Harrelson
and Julia Juliet lewis of immune cells. Um, they're produced
(19:51):
in the appendix right. Um, So when the recollonization process
is going on, you could still have bad bugs in
are but to prevent them from taking hold, those immune
cells come in and just wipe them out while the
good stuff comes back in and recolonizes. So the appendix
is a really apparently a very useful organ It has
(20:12):
a use after all. Yeah, but you can still live
without it. That's the weird thing. Why why if it
produces this really important function, why would we still be
able to live without it? I don't know. Oh, well,
well we'll talk about it later. Well, now, what I
didn't see anywhere was like if you have if you
(20:35):
live you know in an adverse way because you don't
have your appendix, Like does that make you more susceptible
to certain things? If you have that food borne illness
or right, okay, So here's the other thing. Um, the
there was more support from the fact that you can
have your appendix remove so there's more support for the
(20:57):
idea that the appendix plays a role um and isn't vestigial,
from the fact, weirdly that if you remove it, at
least in the developed world, you're you're still gonna be
okay without it. Okay, it makes no sense. It's a paradox.
But then when they looked into the paradox there, like, actually,
this does make sense because of that hygiene hypothesis that
(21:19):
you mentioned earlier. Should we dive into it? All right? Uh? Well,
hygiene hypothesis in a nutshell, And I recommend you listen
to that episode because it was really good, but is
sort of it goes a little something like this, uh
and developing. I'm sorry. In the developed world are immune
systems can be overactive, and that's why we have things
(21:42):
like allergy allergies, especially food borne allergies to like peanuts
and trimp that's sitting here in front of us thawing
out slowly because our immune system really wants to do something.
It is not good at Netflix and chill it likes
to really be act of and if you've got clean
water and really good fresh food and you know your
(22:03):
body didn't have to worry about that kind of stuff,
it starts to attack your body in other ways just
because it wants something to do. Right. It's like one
of those people at work who, like, you know, break
something and then fixes it just to show they're working.
Do people do that? There's gotta be some people out
there we like nudge of vase off their desk or
what right at the at the base putting back together plane? Okay,
(22:27):
but there haven't been any breaks for a while, so
I'm just trying to see how that would happen at
our office, Like how does somebody break a podcast? Uh,
you can break in RSS feed or something like that,
or maybe an I T person who like screws up
the system, so everyone's like, you gotta help us fix it, right,
kind of like that? What about this? What about somebody
who organizes things when they're already a certain way, but
(22:48):
they just have too much idle time, so they organize
stuff and all of a sudden there's a problem. That's
kind of what I'm talking about. So um with the
hygiene hypothesis. The idea as far as it relates to
the appendix is that because we live in this very
sanitary version of the world where we don't get hookwork,
because we don't wear bare feet and poop outside, are
(23:11):
drinking water is clean, we don't have like giardia in
it typically um. Because we're not exposed to this stuff,
our immune system is on high alert. So it attacks
not just peanuts, but also potentially the appendix too, because
it's just sitting there. It is just sitting there, but
also remember it's a storehouse of bacteria. It's also a
(23:31):
storehouse of um. The lymph system, so it's producing immune cells.
And apparently, if you're a kid and you get appendicitist,
which we'll talk about in a minute, all that whole thing,
the number one cause of that is overproduction of limp cells.
So it's possible that your immune system says, uh, this,
(23:53):
this part of the body is producing a lot of
weird immune cells are way more than it should. There's
a lot of bacteria here. I hadn't noticed before. Let's
go attack it. That your immune system attacks your appendix
and causes inflammation and then that creates the Appendicitis that
can be dangerous later. That sounds very weird. Why would
anybody say that, Well, Chuck, turns out that there's a
(24:14):
paradox that goes hand in hand with developing countries. Huh. Well, yeah,
I mean they've seen this kind of proven out in
developing countries is as they've become more developed and more industrialized,
their rate of appendicitis has gone way up, and their
body previous to that industrialization is maybe getting water that's
(24:37):
not great for them or food that might carry some
sort of food born illness. So their immune system is like,
we're we we love this person in this culture because
we're always busy flushing this system out with with diarrhea
and we're just hard at work and we don't have
time to to create some fake peanut allergy or to
go after the appendix is not sitting there around do
(25:00):
and anything. So they're it's just it's busy, and they've
seen as they become more industrialized, Uh, appendicitiss have gone
up and sort of lock step with that. Yeah, it
happened in the United States and Europe in the beginning
of the twentieth century. There was a big spy Like
before that, there was no such thing. As appendicitis basically, Um,
there was, but it was very very rare, and then huge,
(25:21):
an enormous spike, and then it plateaus and stabilizes. I
think in both Western and Eastern Europe and the US
were hovered around a hundred cases per hundred thousand people
of appendicitis these days UM over in like I think uh,
South Korea UM around that time, no appendicitis. Later in
the twentieth century, early twenty one century, as their development
(25:43):
just went through the roof huge cases, a huge increase
of appendicitis UM and there you can just kind of
follow it around the world. As development comes, appendicitis goes up,
and they think that it's this hygiene hypoths that explains it.
So you've got the safe house theory that the pendix
actually does have a purpose and a role, and then
you have the hygiene hypothesis that explains, um, why appendicitis
(26:08):
is a thing in developed countries. Well, should we take
a break and dig into appendicitis? I think we should.
It's going to be awfully painful and gross. I'll bet
(26:37):
the ads everyone heard were just astounding. So we've been
dancing around the appendicitis kind of this whole episode It
was identified for the first time in six by Reginald
Fitz and before that they just said, you know, if
you've got an abdominal illness and you die because of it,
it's you know, it's just you had a bad stomach
(27:00):
ache that killed you. Sorry. Yeah. So sad Dave wrote
one of my favorite lines in the history of stuff
you should know articles. He said, fits was the first
to finger the appendix is the culprit. I was like, man,
finger the appendix. That's a that's a spinal tap record.
That's gross. But you actually probably could finger the appendix
because it is like it's like a little pouch. Just
(27:23):
to just think about finger sized. Yeah, you can figure
a whole forearm into uh. So Franco August appendix. Oh man,
that's an intr so uh appendix, everyone the appendix. Everybody
grow up, Calm down, calm down. Um. So the appendicitis
happens because basically I mentioned it was a cul de sac.
(27:44):
It's a it's the end of the road situation once
you get to the far end of the appendix. But
that other end that connects to the sikum is very
narrow and the opening is not that bigg and it
can get clogged up with bacteria. It can get clogged
up with certain kinds of seeds to go through your
body undigested hay seeds. Hay seed. Sure, it can get
this is really gross. But it can get clogged with vecaliths,
(28:08):
which are stone like pieces of petrified feces. My friend
I saw that. That is the number one reason appendicitis
and adults. Uh, it's a hard word to say, but
they you know, that's what happened. The opening blocks, bacteria
builds up, it gets inflamed, and inflammation is that sort
of enemy of all the human body. And you start
(28:30):
to get fever and nausea, you've got pain. You might
get a pain in your sort of lower right side
of your gut. Yeah, because that's where your appendix is.
Like if you make a L shape with your thumb
and forefinger, like the loser put exactly. I didn't want
to say it, but okay, we're gonna get some email
about that. Um the if you take the thumb and
(28:52):
put it in your navel and point your finger to
your hip, Okay, that is like in the little um.
The is where your appendix is. Okay, where your thumb
and yeah, the little webbing. Yeah, all right, Well that's
if you get a pain there and you are nauseous
and you might have a fever, then get thee to
(29:12):
a hospital emergency room because you might have advanced appendicitis.
At that point, you might have an appendectomy quick like
they can do them super fast. Um, if you get
it really really early, they might concure it with just antibiotics,
which is great. But I think eighteen eighty seven, the
very year after FITS identified the disease in six is
(29:35):
when they had their first appendex tomy, which means they
had been happening the whole time. They finally just said,
oh wait a minute, I think it's the appendix is
why all these people are dying from the stomach pains.
So maybe we can start removing this little useless dangle. Yeah.
I think it was a guy named Thomas Morton. Yeah,
Thomas Morton was the surgeon who looks like he lost
(29:55):
his brother and son. It was from mysterious stomach ailments,
but it was probably ruptured appendixes and that's what happens
at ruptures and then leaks bad stuff into your intestines
and your your toast. Yeah. So so when the appendix
is infected and it leaks that stuff. It perforates is
what they called burst is another way to put it,
(30:16):
depending I think on how bad it is. All of
the infected pus. If there's fecalists in there, that whatever
bacteria they have with them, um, all that stuff it bills, right,
it spills into your abdomen, and your abdomen has an
inner has an abdominal wall, and it has an inner
(30:38):
coating called the peritonium. And the peritonium um is not
to be infected with anything. It's very delicate. It doesn't
like gross stuff. Keep all that and the appendix and
the intestines and all that large intestine. But when your
appendix bursts and releases all that stuff, it gets your
paritonium infect and your paritonium is like a highway straight
(30:58):
to your blood vessels, straight into your organs. And so
all of a sudden, your infection goes from your appendix,
which you can deal with, to your piritonium being infected,
which means your blood and then your organs are infected,
which means you can go into shock and you're you
have a like cascading system failure. That's why it's such
an emergency when you when you have like a pendicitis,
(31:22):
because it may rupture and that can be problematic. Yeah,
and you can still die from that. I think the
surgery itself in the mortality rate from an appendectomy was
now it's down to point well, it's one tenth of
one percent whatever that is. That's pretty low, and that
was since the mid fifties. But that's the that's the
(31:44):
mortality rate for the appendectomy, right, for appendicitis. I think overall,
maybe worldwide it's um I think point two to point
eight percent, which means to between two and eight of
every to and eight people who get appendicitis, out of
every thousand people who get a pendicitis. There's kind to
(32:06):
be an easier way to say this. Uh, they die
from it, they buy the farm. Not many, but that's significant.
If you're you know, eight people out of a thousand,
that's one. I wanted that to be point eight. And
I think the mortality rate is lowest in young people obviously,
although young people between ten and thirty are the most
(32:27):
likely to have an ependectomy, I think, right, yes, which
is interesting, that's weird. Um, the reason that it's lowest
and very young people is The common knowledge among um
doctors and in the medical field is that the appendix
has played a role for a long time, but it's
just part of your immune system when you're very young.
(32:47):
I have the impression that that is old school thinking,
That is pre bacteria safe house thinking. What that young
kids don't get it because they just have killer immune systems. Yeah,
And that the appendix is just on fire and it's
just happily working, and that it can become problematic after
it stops providing it its function. The idea is that
(33:08):
the younger you are, the more vulnerable you are to
dying from diarrheal diseases, for infections, and so you would
have a healthier immune system. And kids do have like
just as hopped up immune system. But I think the
medical understanding up until recently is that that the appendix
plays a part of that, right, but that it stops
(33:29):
functioning as you get older, and then you're vulnerable to appendicitis,
and then after you make it out of the danger zone,
you can just basically coast and get fecal with all
day long blocking up your appendix and it doesn't matter.
The new thinking is that, no, it's the storehouse for stuff.
We just don't need it anymore because we don't really
get diarrheal infections here in the developed world. Right, yeah, okay,
(33:54):
that makes sense. But appendicitis is a thing, and if
you do go to if you do have symptoms that
seems weird, generalized pain around your navel or where your
appendix is, you should go to the doctor. The thing is,
as this new idea that the appendix actually does serve
a function um has has, at least in some quarters,
(34:17):
created this call for doctors to stop doing what are
called negative appendectomies, where it's like, oh, you got stomach pain,
let's take your appendix out and right, because supposedly a
non perforated appendix may actually resolve itself, like it may
go and like spit that set out and like go
back to normal or whatever. Right, um, And you don't
(34:39):
want to just lose your appendix willy nilly, for no.
For one, you're undergoing surgery. There's always complications in rest
of the point is, though, don't just stay home the
the this one paper I read was like, you're better
off for the physician to wait and see in the hospital.
Keep you in the hospital under observation. So that if
(35:00):
do need emergency surgery, you're there, um and then it
may resolve itself on its own if it hasn't perforated
already or um, and that that's that's preferable to just
removing the appendix. Don't be like I can still play
my street hockey game later, right. Yeah. I think they
were saying, like, it's not up to you the patient,
(35:20):
like just go to the hospital. I'm talking to the
doctors right now. The paper was saying, of course, you know,
don't remove the appendix if it if it doesn't need removing.
Are we at Harry Yudini? Yeah, so this is a
little addendum. Uh. I kind of think it's like an appendix.
I kind of think we should do uh Harry Judini
episode at some point, you bet, don't you think? Yeah,
(35:41):
should we talk about this now at all? I think
we should do Houdini around HALLOWEENI okay, okay, that sounds fantastic.
I tried to think it's something to rhyme with Weenie. No,
it's like a thumbs up like Magnafini. Oh that's great.
That was Yeah, all right, I'm gonna stop it right
there by using good Well, people really don't know that.
(36:05):
I just left the room for like fifteen minutes trying
to think of something and keep the magic of editing.
Jerry didn't do like the star wipes. Uh. So there
have been a few people who have died from a
ruptured appendix. They believe that bring him young. The Mormon
prophet did Um Charles Floyd the only person that Lewis
and clark journey expedition to die. I didn't remember that,
(36:28):
did you. I think I remember just mentioning. I do
remember one person die and we're like, what was his problem?
Why did he screw everything up? And it's hiss appendix.
So Harry Houdini did die of an appendicitis. And I
don't think we even said, uh, Perry and IDAs, Yeah
we did, did we say that was the actual words?
(36:49):
That's the Oh I don't know. But that's the affection
of the peritonium. Yeah, that's the name of it. Though. Yeah,
and that's what you do. You're like, you don't die
from your appendix, person, because again, like, yeah, it provides
a funk, but it's not it doesn't keep you alive.
It's not like your heart bursting, right, It's it's the
parent of the paratoneum getting infected that kills you. So
Houdini did die of that. But you know, the old
(37:11):
story is that he had come off stage. He was
backstage in his green room and uh, presumably having smart
food and beef jerky. If you're at the stuff, you
should know show everywhere from opening the bottle. Oh, man,
I can't wait to do that again. Uh, but I
can't wait because I'm not doing that anytime soon. Still
(37:31):
want to get on a plane, you know, not quite yet,
but we're looking forward to that for sure. But you know,
there are these college students came backstage and one of
them was like, I heard that anyone can put you
in the stomach and that you, uh, you can make
your stomach strong and it won't even hurt you. And
I'm a pretty good stomach puncher. He goes, well, that
is sort of true. And the guy punches him before
(37:52):
he even has a chance to really prepare and say, sure,
bring it, and uh that the sucker punch and that
burst as appended, and that's how he died. And that
story is just a little blurry around the edges as
how that went down exactly right. Yeah, So there there
were there were eyewitnesses, and they did say that this
(38:13):
guy um did punch Houdini. It's conflicting whether or not
Houdini gave the guy permission to punch him. And I
were the guy just started punching um. But there was
a young man named Joscelyn Gordon white Head, white Head,
Whodini's last words were done in by it guy named Jocelyn.
(38:36):
I didn't see that. One account was that he was
still laying on the couch and the and the guy
started wailing on his stomach. Well, yeah, because he he
had injured his ankle the the I think night before,
a couple of days before, so he was reclining on
the couch. I guess somebody was sketching him. Was basically
like that scene in Titanic. Yeah, he was like and
(38:59):
um and the guy started drawing right Uh, and then
the guy punches him while he that happened. Uh. The
question the thing that's that's that's sketchy is whether or
not that guy punched Udini. In the appendix and Jodie's
appendix ruptured where otherwise wouldn't have they think that that happened.
(39:20):
Very very rarely appendicitis prodom by blood trauma. Um, they
think that he probably had appendicitis already. This guy punched
Harry Houdini in his inflamed appendix, and that that created problems.
So the guy definitely killed Houdini one way or the other.
It's just did Houdini already have appendicitis or not? And
(39:41):
he probably did? Most most scholars say yes, there's just
no way this this little guy from McGill University. I mean,
come on, the Canadian Harvard, give me a break. Yeah. Um,
that that he burst Houdini's appendix. Yeah. I was had
a weird brief Houdini obsession when I was a little kid.
(40:03):
Oh yeah, I think I did a you know, some
sort of visual report, you know when you would just
do not even maybe it was a book report, an
interpretive dance. Is that what you're saying. Yeah, that's what
it was. But yeah it was on Judini, and I
was just for a little while, I just was really
Hudini obsessed and then kind of magic obsessed. Oh yeah,
and then you have one of those kids at a
magic phase. Did you have a kid. I may have
(40:25):
had a kid. Did you go to like the trick
shops magic shops? Yeah, there was one called Eddie's Trick
Shop here in the Stone Mountain. Then I went to
That's awesomes were great deck of fake cards or some
nice fake vomit or yeah, and you always looked up
to the person behind the counter and then you grew
up and you're like, oh, that's a used to work.
They're kind of thing. Yeah, it was the magic shop
(40:47):
and then the place that sold sold old mad magazines.
Those were the two greatest places on the planet. When
you're a certain age, you know, yeah, you got anything
else about Appendix appendicitis Judini, this is a good I
quite enjoyed this experience. I did too, Thanks to you
guys for listening. And uh, since we don't have anything
else about the appendix, that means it's time for a
(41:09):
listener mail. I'm gonna call this great idea from a
ten year old listener and this one, this one is
genuinely going in the two do file. Uh, dear, and
this is short and sweet deer Chuck Bryant and Josh Clark. Hi,
my name is Jack and I'm ten years old and
from hi Watha, Iowa. And I listen to your podcasts
while I'm mo. My dad introduced me to your podcast
(41:31):
and they've been great. My favorite one so far was
probably Titanic. It's really interesting. Before I listened to that one,
I wasn't really interested in the Titanic, but when I listen,
I got more interested. I was wondering if you ever
thought doing one on child labor It was after am
the Grass, So okay, yeah, I learned about it in
school and want to know more about it. Thank you
for all your great podcast. And then it's from Jack
(41:54):
and that is is on brand of stuff you should
know episode as I've ever heard. Yeah, but also coming
from child Laborer, it really kind of has a certain
like glow to it, you know. Yeah, I think, uh,
that's a great idea. I wonder if this kid is
just like, I'm gonna get my parents back for this
maybe because do you remember wanting to mow the grass
(42:15):
when you were ten? Totally and then you started to
about the third or fourth time, You're like, I've made
a terrible mistake. Well, it'll depend that, but it also
depended on the kind of mo word that your parents
stuck you with. We did have a writer for a
short time, so that was kind of pre go card
car driving. Yeah, it's like driving, Yeah, but with it
blade spinning at thousands of RPMs right beneath like sure,
(42:39):
just put that nine year old in the sea right,
Who is that again? That was Jack? Jack? Thank you,
great name, great idea, great person all around, Coming soon
like you can. You can count on that one, Jack.
If you want to get in touch with this like
Jack did with the Great Idea, we are always open
for those. Take your idea, wrap it up, spank it
lightly on the bottom, and send it off to Stuff
(43:00):
podcast at i heeart radio dot com. Stuff you Should
Know is a production of I Heart Radio. For more
podcasts my heart Radio, visit the i heart Radio app,
Apple Podcasts, or wherever you listen to your favorite shows.
H
Welcome to Stuff you should know, a production of I
Heart Radio. Hey you, welcome to the podcast. I'm Josh Clark.
There's Charles w Chuke Bryant's willing away in some champagne.
You're sorry, sparkling my shando and so it's from NAPA.
(00:21):
And there's Jerry over there, Jerry Scudder champagne too. We're
all just hanging out. We're gonna talk to you guys
while we wait for the shrimp cocktail with aw literally
and that makes this stuff you should know. That's right. Uh,
we're back in the same room everybody for the first
time in about fourteen months. And Jerry brought in champagne
and frozen shrimp cocktail. There's a story behind that. Go
(00:43):
ahead and say it. You go ahead and say, I
don't remember you were the shrimp you first started it,
Like I feel like twelve years ago we we we
were tracking to hit number one on iTunes in like
two thousand and eight, I think at the beginning of
two thousand no nine maybe whatever, and um, I was like,
(01:05):
I want a shrimp cocktail in the in the recording
studio when we hit number one. We hit number one,
came and went stayed number one, hit number one again.
No shrimp cocktail. This is the shrimp cocktail from two
thousand nine. Yeah, finally has made an appearance, and it's frozen.
It might literally be from two thousand It might be.
(01:26):
It's turning. The veins are turning kind of purple as
it thaws. I can't wait to eat the shrimp cocktail. Yeah,
we're having shampagne. Jerry classed it up basically, I feel
I feel it was a nice homecoming she did. But
the three of us are fully backs. Were in a
room together. The microphones don't have fake years attached to them. Yeah,
I mean that joke won't make sense to you now,
(01:48):
But we recorded another episode before this one, but it
was getting released later, so this technically our second episode.
It just put that in your button and smoke it
in your hat. What do you talk about? Have a
weird urged a curse? I don't know why. I think
you just did so, Jerry Beppe bp P p peep.
But it's it's great to be back together in a
(02:10):
little weird um, but not as weird as I thought
it would be. That first one was weird because we're
in a different room. Yeah, we got all the weirdness
out in a weird situation, it would have been weird regardless.
But now we're back in in Studio one A. That
was a really good move. Jerry, did you plan it
like that to get the jitters out? Jerry thumbs up.
Jerry's real. Everybody she chooses not to talk. Jerry's let
(02:32):
her hair grow out. I know she got a ponytail,
but the first time I've ever seen it's got an
even more peppery, no salty in a salt and pepper way.
It doesn't get more peppery unless you make a you know,
a move to make it so. And she looks like
a wealthy retiree who drives a Maseratti and knows their
(02:53):
way around the club. You know what I mean, That's
what Jerry looks like. She looks distinguished but also foxy. Yeah.
So I spent my last January of losing twenty five
pounds and then COVID hit and now I have gained backunds.
I'm exactly where I was. Is that right? Exactly to
(03:15):
the pound? And it makes me really angry. Oh no,
just go with you. Oh I know, but I just,
you know, let me get back together. I was like, man,
I'm doing so good. I'm so good pandemic And I
was like, well, now I can eat and drink all
I want because it's sad. So you lost the weight
before the pandemic hit, Yeah, I hit it hard in
January to junior March January one probably, yeah, okay, And
(03:40):
like I was working with a trainer, like you know,
so I was having to go to her every like
three days a week, and just you know, I was
making the right decisions and tracking and and the weight disappears.
And then COVID hit and I just started making all
the wrong decisions and let myself do that. Yeah, that
happened to all of us, myself included. I went through
what you went through where I lost a bunch of
(04:02):
weight and I managed to keep it off. And then
COVID hit and I was still doing okay, doing okay,
maybe eating a little more than usual, like I'm not
gonna let it happen though, and I was. I wasn't.
And then our book hit, and that's what got me.
When we were writing it and working on a two
hours a day every day, I was eating so much weight.
(04:23):
I gained book weight, and I actually I have not
been this big since I don't know when. Man, but
I still got it. So I'm I'm doing what I can.
You look the same? I do? Well? Then I what
I started two weeks ago was kicked in. I guess
if I look the same, well, you look great. Great,
everyone looks and feels great. Yeah, let's talk about the appendix,
(04:44):
the Rodney Dangerfield of organs. This is one of my
favorite articles that we've done in a while. Yeah, and
you know how I often complain about science. This is
a kind of science I love. Yeah. Understandable, Yeah, body science, understandable.
Super cool. This factors into our hygiene hypothesis episode, our
(05:07):
human microbiome episode, digestive system episode. Yeah, it all sort
of fits together. In that little worm like organ, it's
an organ, right, yeah, it's an organ. Yeah. A lot
of people thought it was a vestigial organ. They're wrong, right,
But that weird little thing, uh, hanging out there, just
(05:30):
going just wiggling around like a little worm is really
kind of cool and fascinating. And I love that it
has a great story behind its lack of usefulness and
then turns out usefulness. And it's just agreed, this is
really good stuff. It's smashed bang stuff. You should know.
That's right. Let's talk about it. So um, like you said,
(05:50):
the appendix is like this little worm like thing that
dangles off the bottom of the ascending coal and large intestine.
Coal in large intestine and large bowl are the one
and the same. So when you hear people say bowl,
they're typically talking about that colon large intestine. It's all
the same thing, which I found confusing until I looked
(06:11):
it up and found okay, it's all that um two
to four inches long the appendix right generally, although the
biggest one was pulled out of a seventy two year
old Croatian man named Sofranco August during his autopsy, and
his was ten inches or twenty six centimeters long. What
do you think they were like in that autopsy? They're like, wow,
(06:33):
I think that the medical examiner's staff had a T
shirt made up that Sofranco August was buried in that said,
I've got the biggest appendix ever. Maybe, I mean that's
crazy because when you, like I encourage you look up
a picture of the appendix, it is it looks like
a little worm and it's hanging there on this little
bulbous pouch called the sikum, and the Sikim is kind
(06:55):
of like where it's it's the part in between this
all Intestine and Large Intestine where there there's an agreement
that takes place, basically where the small Intestine it is like,
all right, listen, I'll take all this food and I'll
make it into clime, but I am not going into
the fecal zone. Now you handle the fecal stuff, colon,
(07:17):
And the colon says, fine, here's my buddy, the secum.
It'll it'll service a little halfway house. You can pass
everything along to me. I will broke rate, you won't
get any poop on you Small Intestine, and I'll send
it to the Large Intestine. But off of that Secum
is dangling this this little dude yeah, which as far
as anybody could ever tell, had nothing to do with digestion,
(07:40):
which makes it really weird because everything else around here
has to do with digestion. That's just what they do,
that's their their their trade. And the appendix is just
hanging out and people just thought, Okay, this this thing
doesn't make any sense. But the fact that is attached
there and doesn't seem to have to do with digestion,
(08:00):
made people for a very long time think that it
was a vestigial organ right, which we'll get into the
specifics of one man who really championed that idea in
a way that frankly made a lot of sense, and
you can see why it took that many years for
anyone to really poke around further into it. Yeah, because
you're just like, yeah, you just explained it's sure. But
(08:20):
there are other mammals that have secums, uh, and in
some mammals, especially herbivores, that can be really big relative
to their body size, because in herbivores it acts as
the the predigestion house for plants, and since they're eating
tons of plants, they have large secums. Yeah, plant fiber
is really really good for you, but it's also really
hard to digest a lot of cellulose um. And that's
(08:43):
that large intestine coming into play again, because in the
stomach and the small intestine there's um, a microbiota, a microbiome,
which we talked about in that one episode the Human
Microbiome Project. Um. There's some in the small intestine. I
think there's far far less even in the stomach, but
in the large intestine. That's where it really shines. And
(09:03):
those microbes, the pathogens, the virus is the fung guy
all of the and the bacteria most of all. They
all kind of work or fight or play and digest
this stuff. They break it down so that we can
absorb it. They turn it into fiber. Um dietary fiber
uh keeps you from absorbing a lot of sugar or
(09:25):
fats or whatever at once. Um insoluble fiber bulks your
stool up, so it really kind of gets everything out
of the coal and really cleanses it when you finally poop.
Hand gestures. Yeah, I've missed you seeing my hand gestures
now that I think, even when we're recording at home, Um,
(09:46):
I forgot what it's like to be seeing so um.
So the large intestine has this microbiome that that lives
in there, and just just remember that. That's a big
important point. Yeah, put a pin in that, but not
literally because that would be dangerous. Um. Out of the
three sixty one mammal species, only about fifty of us
(10:08):
have an appendix or something like an appendix. Obviously, the
great apes do, rabbits, possums, wombats weirdly square poop. Did
they really comes out in cubes? Really? Yes? I can't
tell if you're messing with me right now? Wait, hold on,
keep talking. You're thinking of the square watermelons in Japan,
maybe thinking of all of bees. I'm pretty sure wombats
(10:30):
have square all right, a rare in show check. But
dogs and cats don't have appendix, cows don't, oranges don't,
sheep don't. Oh yeah, little poop poop cubes square. Yeah,
it looks like those ice cube chocolates. How do they?
How does that happen? How do they? Yeah? How does
that work? Um? I don't have time to read that,
but it looks like there's a science alert from January
(10:52):
that says wombats are the only animals that poop cubes
and now we know how Okay, well that's a definite
short stuff. Okay, we'll do it. Look for that soon.
Uh So, back to the vestigial organ aspect. Charles Darwin
is the person who came out and said, hey, I've
been looking at these And by the way, that was
named officially by an anatomous named Phelippe Verhan in seventeen ten.
(11:18):
Appendix vermiformists, which means worm shaped detachment, and I think
the first appendix removals in seventeen thirty five. But Darwin
was the one who said, hey, everybody, I've been looking
at these herbivores and they've got these really big Secum's
giant for this, for this reason that Josh just described
(11:38):
future Josh and he said, so, here's the deal is,
when we see a bunch of plants, we had humongous
secombs as well. And as our diet changed and we
got away from plants, you know, our body started to
change along with it, and that seek them just kind
of shrank. And the appendix is just a little shriveled
up piece of that formerly large secum and it's just dangling.
(11:59):
They're doing nothing. Isn't that amazing? And everyone until two
thousand seven said it sounds right to me. Darwin's got
it right. It does. I mean, it totally makes sense
and seems completely believable. Yes, But now that I know
it was wrong, I questioned every single thing he ever
thought of or set. Welcome to our world, Darwin, So
you guys messed up that one thing. I just don't
(12:21):
know I believe anything. May we hear that like every
week too? Don't we it's fun so um. But yeah,
it went for We went for well over a hundred
and fifty years of just everyone believing that the appendix
was a totally useless fastigial organ that had no function
whatsoever any longer. And so it was fine if you
(12:42):
just took it out, which is we'll see like people
do a lot actually and it is fine for the
most part, which we're lucky that it's fine. But also
I think if if it weren't fine, we would have
figured out very quickly, like, oh wait, this is you're
not supposed to do that. So the fact that we
were able to remove the appendix later on, um without
(13:02):
a problem, um, just kind of lent to this, let's
support to the idea that it was a Vista gi organ. Right. Um,
But it turns out it does serve some function. We'll
start talking about that. I think after a break, what
do you think, Chuck? That was so smooth? Thank you
so much smoother in person? All right, we're back from
(13:42):
our break. Um, who knows what amazing as you guys
just heard. But I'm envious of you because we didn't
hear it. We just have a moment of silence in
between that's right. Uh, And now we can talk about
the microbiome a little more. And if you want to
look into our Human Microbiome Project works show that was
it's when fourteen there are trillion cells in the body.
(14:04):
About thirty trillion of those are human cells with DNA
and the rest of those hundred trillion are the microbiome.
That isn't just amazing and it's really there's something about
the digestive system that just frankly turns us both on
a little bit. Yeah, there were these animations that can
I remember who made them? Um many many years ago? Yes,
(14:24):
but the animator just understood us on a level that
even I'm like, I'm like, oh, I didn't know myself.
Just little shorts from clips show. They did one about
a four and a half minute clip from how the
digestive system works, which is worth looking up on YouTube.
It's where I watched it the other day. They are
they were just gifted and talented. It's one of my
(14:45):
favorite little things that we ever that someone ever did
for us. I want to say, Nick Nick sounds right? Okay,
I think it was Nick. I hope it's Nick Nick.
Please like right in if you still listen. Nick moved on. Okay, well, anyway,
they were really great. What Nick's work, and if it
wasn't Nick, Nick's new nickname is Nick. That's right, Okay,
(15:07):
So um, Yes, the digestive system does get us jazz,
and in particular the microbiome, which we wouldn't have a
digestive system, or at least one that functions, because again,
those bacteria help us break down stuff that we would
normally have trouble breaking down, help us form poop all
of that stuff. And there's a it's a symbiotic relationship
because in breaking those those things down, like that plant
(15:30):
fiber for instance, they're eating, they're happy, they're reproducing, but
then the byproducts and the stuff that they break open
make that stuff bioavailable for us, so we can kind
of get the nutrients and all that stuff from it
as well. It's a beautiful relationship. Not all bacteria is good, though, No,
there's the bad stuff. And we should point out that
(15:50):
most of this bacteria is in that large intestine, uh,
the in the stomach and the small intestine. Most of
it's killed off by gastric acid. But the bad bacteria
is if you eat some bad chicken or if you
have you ever done that? Yes, yeah, you know me.
I've had all manner of stomach issues over the years.
(16:12):
Where where did you get your bad chicken? I don't remember.
I don't remember specifically, but I know I've had bad
food before that made me sick. And in my case
in Guatemala, if you remember, you and Jerry both well,
it was not me. You know what, we were even
closing our mouth in the shower. We're being so careful.
But on that last night it was the ice, the
(16:33):
mixed drinks. I forgot the ice is made from water,
and that water was not good for Americans. And I
stayed home that night so I didn't get diarrhea. It
was worth it though, Jerry and I had such a
good time. So yeah, I got bad sick after our
guatte trip. But that's the bad bacteria, and and that's
how it can get into your body. And your body
(16:55):
is solution to this, uh as Jerry can affirm, is
is diarrhea. It's your body's way of saying, we're just
gonna flush you out human being. Just get rid of everything,
get rid of all the stuff. But that's gonna take
a lot of the good stuff with it, and that's
no good because if you have all the good bacteria
or a large amount of good bacteria leaving your body,
(17:16):
then that can leave you very vulnerable to nutritional deficiencies
and other bad stuff. Sure, yeah, because I mean, like
a lot of the neurotransmitters that make your brain function
correctly or produced in your gut from the function of
the bacteria. Like, there's a lot of bad things that
can happen if you don't have a balanced microbiome in
your gut. Right. So Interroduke University in two thousand seven,
(17:38):
I guess someone was staring at a picture of the
human body from the inside out and locked in on
that appendix and they're like, it's just sitting there attached
to the scumb It's got to do something right. And
they did some studying and testing I know exactly you
(17:58):
like me, and they figured out this theory that this
is a safe house essentially for that good bacteria. It's
got a really rich uh biofilm, which is we've talked
about biofilm in a bunch of episodes. I feel like
it's like coating on the inside of the blindings of
all kinds of things. Yeah, it keeps bacteria from being destroyed.
(18:19):
It's like a protective mucus get exactly, which is you
know that sounds gross, but it's a really a good thing.
And the appendix is just lousy with this great biofilm.
And they said, I think we think the Duke University
blue devils think that this is a safe house for
that good bacteria. Because when the body is being flushed
out with diarrhea from his illness, the appendix is down
(18:41):
there at the end of the cul de sact. It's
not even getting affected, basically, right. And so when that
bacteria leaves and takes the good with it, the appendix says, hi,
I'm here, look at all my good bacteria friends, go
forth and do your work. Exactly, goes bloop and pushes
all like a big hunk of mucasy bacteria or bacteria
ridden mucus into your large intestine to recallonized, which is amazing.
(19:04):
And and all of a sudden, the science world was
turned upside down because they thought they and it turns
out they did find a use for the appendix. Yeah. Um,
and not only uh is it a storehouse they found
for bacteria, the good bacteria that make up our microbio.
It's also a place where um lymphocytes and other immune
(19:27):
cells are produced. Like it's called limphoid tissue, where like
T cells, B cells. I think there's one called T
natural killer cells, which you don't want to mess with
the iced tea. Yeah, or um the uh Woody Harrelson
and Julia Juliet lewis of immune cells. Um, they're produced
(19:51):
in the appendix right. Um, So when the recollonization process
is going on, you could still have bad bugs in
are but to prevent them from taking hold, those immune
cells come in and just wipe them out while the
good stuff comes back in and recolonizes. So the appendix
is a really apparently a very useful organ It has
(20:12):
a use after all. Yeah, but you can still live
without it. That's the weird thing. Why why if it
produces this really important function, why would we still be
able to live without it? I don't know. Oh, well,
well we'll talk about it later. Well, now, what I
didn't see anywhere was like if you have if you
(20:35):
live you know in an adverse way because you don't
have your appendix, Like does that make you more susceptible
to certain things? If you have that food borne illness
or right, okay, So here's the other thing. Um, the
there was more support from the fact that you can
have your appendix remove so there's more support for the
(20:57):
idea that the appendix plays a role um and isn't vestigial,
from the fact, weirdly that if you remove it, at
least in the developed world, you're you're still gonna be
okay without it. Okay, it makes no sense. It's a paradox.
But then when they looked into the paradox there, like, actually,
this does make sense because of that hygiene hypothesis that
(21:19):
you mentioned earlier. Should we dive into it? All right? Uh? Well,
hygiene hypothesis in a nutshell, And I recommend you listen
to that episode because it was really good, but is
sort of it goes a little something like this, uh
and developing. I'm sorry. In the developed world are immune
systems can be overactive, and that's why we have things
(21:42):
like allergy allergies, especially food borne allergies to like peanuts
and trimp that's sitting here in front of us thawing
out slowly because our immune system really wants to do something.
It is not good at Netflix and chill it likes
to really be act of and if you've got clean
water and really good fresh food and you know your
(22:03):
body didn't have to worry about that kind of stuff,
it starts to attack your body in other ways just
because it wants something to do. Right. It's like one
of those people at work who, like, you know, break
something and then fixes it just to show they're working.
Do people do that? There's gotta be some people out
there we like nudge of vase off their desk or
what right at the at the base putting back together plane? Okay,
(22:27):
but there haven't been any breaks for a while, so
I'm just trying to see how that would happen at
our office, Like how does somebody break a podcast? Uh,
you can break in RSS feed or something like that,
or maybe an I T person who like screws up
the system, so everyone's like, you gotta help us fix it, right,
kind of like that? What about this? What about somebody
who organizes things when they're already a certain way, but
(22:48):
they just have too much idle time, so they organize
stuff and all of a sudden there's a problem. That's
kind of what I'm talking about. So um with the
hygiene hypothesis. The idea as far as it relates to
the appendix is that because we live in this very
sanitary version of the world where we don't get hookwork,
because we don't wear bare feet and poop outside, are
(23:11):
drinking water is clean, we don't have like giardia in
it typically um. Because we're not exposed to this stuff,
our immune system is on high alert. So it attacks
not just peanuts, but also potentially the appendix too, because
it's just sitting there. It is just sitting there, but
also remember it's a storehouse of bacteria. It's also a
(23:31):
storehouse of um. The lymph system, so it's producing immune cells.
And apparently, if you're a kid and you get appendicitist,
which we'll talk about in a minute, all that whole thing,
the number one cause of that is overproduction of limp cells.
So it's possible that your immune system says, uh, this,
(23:53):
this part of the body is producing a lot of
weird immune cells are way more than it should. There's
a lot of bacteria here. I hadn't noticed before. Let's
go attack it. That your immune system attacks your appendix
and causes inflammation and then that creates the Appendicitis that
can be dangerous later. That sounds very weird. Why would
anybody say that, Well, Chuck, turns out that there's a
(24:14):
paradox that goes hand in hand with developing countries. Huh. Well, yeah,
I mean they've seen this kind of proven out in
developing countries is as they've become more developed and more industrialized,
their rate of appendicitis has gone way up, and their
body previous to that industrialization is maybe getting water that's
(24:37):
not great for them or food that might carry some
sort of food born illness. So their immune system is like,
we're we we love this person in this culture because
we're always busy flushing this system out with with diarrhea
and we're just hard at work and we don't have
time to to create some fake peanut allergy or to
go after the appendix is not sitting there around do
(25:00):
and anything. So they're it's just it's busy, and they've
seen as they become more industrialized, Uh, appendicitiss have gone
up and sort of lock step with that. Yeah, it
happened in the United States and Europe in the beginning
of the twentieth century. There was a big spy Like
before that, there was no such thing. As appendicitis basically, Um,
there was, but it was very very rare, and then huge,
(25:21):
an enormous spike, and then it plateaus and stabilizes. I
think in both Western and Eastern Europe and the US
were hovered around a hundred cases per hundred thousand people
of appendicitis these days UM over in like I think uh,
South Korea UM around that time, no appendicitis. Later in
the twentieth century, early twenty one century, as their development
(25:43):
just went through the roof huge cases, a huge increase
of appendicitis UM and there you can just kind of
follow it around the world. As development comes, appendicitis goes up,
and they think that it's this hygiene hypoths that explains it.
So you've got the safe house theory that the pendix
actually does have a purpose and a role, and then
you have the hygiene hypothesis that explains, um, why appendicitis
(26:08):
is a thing in developed countries. Well, should we take
a break and dig into appendicitis? I think we should.
It's going to be awfully painful and gross. I'll bet
(26:37):
the ads everyone heard were just astounding. So we've been
dancing around the appendicitis kind of this whole episode It
was identified for the first time in six by Reginald
Fitz and before that they just said, you know, if
you've got an abdominal illness and you die because of it,
it's you know, it's just you had a bad stomach
(27:00):
ache that killed you. Sorry. Yeah. So sad Dave wrote
one of my favorite lines in the history of stuff
you should know articles. He said, fits was the first
to finger the appendix is the culprit. I was like, man,
finger the appendix. That's a that's a spinal tap record.
That's gross. But you actually probably could finger the appendix
because it is like it's like a little pouch. Just
(27:23):
to just think about finger sized. Yeah, you can figure
a whole forearm into uh. So Franco August appendix. Oh man,
that's an intr so uh appendix, everyone the appendix. Everybody
grow up, Calm down, calm down. Um. So the appendicitis
happens because basically I mentioned it was a cul de sac.
(27:44):
It's a it's the end of the road situation once
you get to the far end of the appendix. But
that other end that connects to the sikum is very
narrow and the opening is not that bigg and it
can get clogged up with bacteria. It can get clogged
up with certain kinds of seeds to go through your
body undigested hay seeds. Hay seed. Sure, it can get
this is really gross. But it can get clogged with vecaliths,
(28:08):
which are stone like pieces of petrified feces. My friend
I saw that. That is the number one reason appendicitis
and adults. Uh, it's a hard word to say, but
they you know, that's what happened. The opening blocks, bacteria
builds up, it gets inflamed, and inflammation is that sort
of enemy of all the human body. And you start
(28:30):
to get fever and nausea, you've got pain. You might
get a pain in your sort of lower right side
of your gut. Yeah, because that's where your appendix is.
Like if you make a L shape with your thumb
and forefinger, like the loser put exactly. I didn't want
to say it, but okay, we're gonna get some email
about that. Um the if you take the thumb and
(28:52):
put it in your navel and point your finger to
your hip, Okay, that is like in the little um.
The is where your appendix is. Okay, where your thumb
and yeah, the little webbing. Yeah, all right, Well that's
if you get a pain there and you are nauseous
and you might have a fever, then get thee to
(29:12):
a hospital emergency room because you might have advanced appendicitis.
At that point, you might have an appendectomy quick like
they can do them super fast. Um, if you get
it really really early, they might concure it with just antibiotics,
which is great. But I think eighteen eighty seven, the
very year after FITS identified the disease in six is
(29:35):
when they had their first appendex tomy, which means they
had been happening the whole time. They finally just said,
oh wait a minute, I think it's the appendix is
why all these people are dying from the stomach pains.
So maybe we can start removing this little useless dangle. Yeah.
I think it was a guy named Thomas Morton. Yeah,
Thomas Morton was the surgeon who looks like he lost
(29:55):
his brother and son. It was from mysterious stomach ailments,
but it was probably ruptured appendixes and that's what happens
at ruptures and then leaks bad stuff into your intestines
and your your toast. Yeah. So so when the appendix
is infected and it leaks that stuff. It perforates is
what they called burst is another way to put it,
(30:16):
depending I think on how bad it is. All of
the infected pus. If there's fecalists in there, that whatever
bacteria they have with them, um, all that stuff it bills, right,
it spills into your abdomen, and your abdomen has an
inner has an abdominal wall, and it has an inner
(30:38):
coating called the peritonium. And the peritonium um is not
to be infected with anything. It's very delicate. It doesn't
like gross stuff. Keep all that and the appendix and
the intestines and all that large intestine. But when your
appendix bursts and releases all that stuff, it gets your
paritonium infect and your paritonium is like a highway straight
(30:58):
to your blood vessels, straight into your organs. And so
all of a sudden, your infection goes from your appendix,
which you can deal with, to your piritonium being infected,
which means your blood and then your organs are infected,
which means you can go into shock and you're you
have a like cascading system failure. That's why it's such
an emergency when you when you have like a pendicitis,
(31:22):
because it may rupture and that can be problematic. Yeah,
and you can still die from that. I think the
surgery itself in the mortality rate from an appendectomy was
now it's down to point well, it's one tenth of
one percent whatever that is. That's pretty low, and that
was since the mid fifties. But that's the that's the
(31:44):
mortality rate for the appendectomy, right, for appendicitis. I think overall,
maybe worldwide it's um I think point two to point
eight percent, which means to between two and eight of
every to and eight people who get appendicitis, out of
every thousand people who get a pendicitis. There's kind to
(32:06):
be an easier way to say this. Uh, they die
from it, they buy the farm. Not many, but that's significant.
If you're you know, eight people out of a thousand,
that's one. I wanted that to be point eight. And
I think the mortality rate is lowest in young people obviously,
although young people between ten and thirty are the most
(32:27):
likely to have an ependectomy, I think, right, yes, which
is interesting, that's weird. Um, the reason that it's lowest
and very young people is The common knowledge among um
doctors and in the medical field is that the appendix
has played a role for a long time, but it's
just part of your immune system when you're very young.
(32:47):
I have the impression that that is old school thinking,
That is pre bacteria safe house thinking. What that young
kids don't get it because they just have killer immune systems. Yeah,
And that the appendix is just on fire and it's
just happily working, and that it can become problematic after
it stops providing it its function. The idea is that
(33:08):
the younger you are, the more vulnerable you are to
dying from diarrheal diseases, for infections, and so you would
have a healthier immune system. And kids do have like
just as hopped up immune system. But I think the
medical understanding up until recently is that that the appendix
plays a part of that, right, but that it stops
(33:29):
functioning as you get older, and then you're vulnerable to appendicitis,
and then after you make it out of the danger zone,
you can just basically coast and get fecal with all
day long blocking up your appendix and it doesn't matter.
The new thinking is that, no, it's the storehouse for stuff.
We just don't need it anymore because we don't really
get diarrheal infections here in the developed world. Right, yeah, okay,
(33:54):
that makes sense. But appendicitis is a thing, and if
you do go to if you do have symptoms that
seems weird, generalized pain around your navel or where your
appendix is, you should go to the doctor. The thing is,
as this new idea that the appendix actually does serve
a function um has has, at least in some quarters,
(34:17):
created this call for doctors to stop doing what are
called negative appendectomies, where it's like, oh, you got stomach pain,
let's take your appendix out and right, because supposedly a
non perforated appendix may actually resolve itself, like it may
go and like spit that set out and like go
back to normal or whatever. Right, um, And you don't
(34:39):
want to just lose your appendix willy nilly, for no.
For one, you're undergoing surgery. There's always complications in rest
of the point is, though, don't just stay home the
the this one paper I read was like, you're better
off for the physician to wait and see in the hospital.
Keep you in the hospital under observation. So that if
(35:00):
do need emergency surgery, you're there, um and then it
may resolve itself on its own if it hasn't perforated
already or um, and that that's that's preferable to just
removing the appendix. Don't be like I can still play
my street hockey game later, right. Yeah. I think they
were saying, like, it's not up to you the patient,
(35:20):
like just go to the hospital. I'm talking to the
doctors right now. The paper was saying, of course, you know,
don't remove the appendix if it if it doesn't need removing.
Are we at Harry Yudini? Yeah, so this is a
little addendum. Uh. I kind of think it's like an appendix.
I kind of think we should do uh Harry Judini
episode at some point, you bet, don't you think? Yeah,
(35:41):
should we talk about this now at all? I think
we should do Houdini around HALLOWEENI okay, okay, that sounds fantastic.
I tried to think it's something to rhyme with Weenie. No,
it's like a thumbs up like Magnafini. Oh that's great.
That was Yeah, all right, I'm gonna stop it right
there by using good Well, people really don't know that.
(36:05):
I just left the room for like fifteen minutes trying
to think of something and keep the magic of editing.
Jerry didn't do like the star wipes. Uh. So there
have been a few people who have died from a
ruptured appendix. They believe that bring him young. The Mormon
prophet did Um Charles Floyd the only person that Lewis
and clark journey expedition to die. I didn't remember that,
(36:28):
did you. I think I remember just mentioning. I do
remember one person die and we're like, what was his problem?
Why did he screw everything up? And it's hiss appendix.
So Harry Houdini did die of an appendicitis. And I
don't think we even said, uh, Perry and IDAs, Yeah
we did, did we say that was the actual words?
(36:49):
That's the Oh I don't know. But that's the affection
of the peritonium. Yeah, that's the name of it. Though. Yeah,
and that's what you do. You're like, you don't die
from your appendix, person, because again, like, yeah, it provides
a funk, but it's not it doesn't keep you alive.
It's not like your heart bursting, right, It's it's the
parent of the paratoneum getting infected that kills you. So
Houdini did die of that. But you know, the old
(37:11):
story is that he had come off stage. He was
backstage in his green room and uh, presumably having smart
food and beef jerky. If you're at the stuff, you
should know show everywhere from opening the bottle. Oh, man,
I can't wait to do that again. Uh, but I
can't wait because I'm not doing that anytime soon. Still
(37:31):
want to get on a plane, you know, not quite yet,
but we're looking forward to that for sure. But you know,
there are these college students came backstage and one of
them was like, I heard that anyone can put you
in the stomach and that you, uh, you can make
your stomach strong and it won't even hurt you. And
I'm a pretty good stomach puncher. He goes, well, that
is sort of true. And the guy punches him before
(37:52):
he even has a chance to really prepare and say, sure,
bring it, and uh that the sucker punch and that
burst as appended, and that's how he died. And that
story is just a little blurry around the edges as
how that went down exactly right. Yeah, So there there
were there were eyewitnesses, and they did say that this
(38:13):
guy um did punch Houdini. It's conflicting whether or not
Houdini gave the guy permission to punch him. And I
were the guy just started punching um. But there was
a young man named Joscelyn Gordon white Head, white Head,
Whodini's last words were done in by it guy named Jocelyn.
(38:36):
I didn't see that. One account was that he was
still laying on the couch and the and the guy
started wailing on his stomach. Well, yeah, because he he
had injured his ankle the the I think night before,
a couple of days before, so he was reclining on
the couch. I guess somebody was sketching him. Was basically
like that scene in Titanic. Yeah, he was like and
(38:59):
um and the guy started drawing right Uh, and then
the guy punches him while he that happened. Uh. The
question the thing that's that's that's sketchy is whether or
not that guy punched Udini. In the appendix and Jodie's
appendix ruptured where otherwise wouldn't have they think that that happened.
(39:20):
Very very rarely appendicitis prodom by blood trauma. Um, they
think that he probably had appendicitis already. This guy punched
Harry Houdini in his inflamed appendix, and that that created problems.
So the guy definitely killed Houdini one way or the other.
It's just did Houdini already have appendicitis or not? And
(39:41):
he probably did? Most most scholars say yes, there's just
no way this this little guy from McGill University. I mean,
come on, the Canadian Harvard, give me a break. Yeah. Um,
that that he burst Houdini's appendix. Yeah. I was had
a weird brief Houdini obsession when I was a little kid.
(40:03):
Oh yeah, I think I did a you know, some
sort of visual report, you know when you would just
do not even maybe it was a book report, an
interpretive dance. Is that what you're saying. Yeah, that's what
it was. But yeah it was on Judini, and I
was just for a little while, I just was really
Hudini obsessed and then kind of magic obsessed. Oh yeah,
and then you have one of those kids at a
magic phase. Did you have a kid. I may have
(40:25):
had a kid. Did you go to like the trick
shops magic shops? Yeah, there was one called Eddie's Trick
Shop here in the Stone Mountain. Then I went to
That's awesomes were great deck of fake cards or some
nice fake vomit or yeah, and you always looked up
to the person behind the counter and then you grew
up and you're like, oh, that's a used to work.
They're kind of thing. Yeah, it was the magic shop
(40:47):
and then the place that sold sold old mad magazines.
Those were the two greatest places on the planet. When
you're a certain age, you know, yeah, you got anything
else about Appendix appendicitis Judini, this is a good I
quite enjoyed this experience. I did too, Thanks to you
guys for listening. And uh, since we don't have anything
else about the appendix, that means it's time for a
(41:09):
listener mail. I'm gonna call this great idea from a
ten year old listener and this one, this one is
genuinely going in the two do file. Uh, dear, and
this is short and sweet deer Chuck Bryant and Josh Clark. Hi,
my name is Jack and I'm ten years old and
from hi Watha, Iowa. And I listen to your podcasts
while I'm mo. My dad introduced me to your podcast
(41:31):
and they've been great. My favorite one so far was
probably Titanic. It's really interesting. Before I listened to that one,
I wasn't really interested in the Titanic, but when I listen,
I got more interested. I was wondering if you ever
thought doing one on child labor It was after am
the Grass, So okay, yeah, I learned about it in
school and want to know more about it. Thank you
for all your great podcast. And then it's from Jack
(41:54):
and that is is on brand of stuff you should
know episode as I've ever heard. Yeah, but also coming
from child Laborer, it really kind of has a certain
like glow to it, you know. Yeah, I think, uh,
that's a great idea. I wonder if this kid is
just like, I'm gonna get my parents back for this
maybe because do you remember wanting to mow the grass
(42:15):
when you were ten? Totally and then you started to
about the third or fourth time, You're like, I've made
a terrible mistake. Well, it'll depend that, but it also
depended on the kind of mo word that your parents
stuck you with. We did have a writer for a
short time, so that was kind of pre go card
car driving. Yeah, it's like driving, Yeah, but with it
blade spinning at thousands of RPMs right beneath like sure,
(42:39):
just put that nine year old in the sea right,
Who is that again? That was Jack? Jack? Thank you,
great name, great idea, great person all around, Coming soon
like you can. You can count on that one, Jack.
If you want to get in touch with this like
Jack did with the Great Idea, we are always open
for those. Take your idea, wrap it up, spank it
lightly on the bottom, and send it off to Stuff
(43:00):
podcast at i heeart radio dot com. Stuff you Should
Know is a production of I Heart Radio. For more
podcasts my heart Radio, visit the i heart Radio app,
Apple Podcasts, or wherever you listen to your favorite shows.
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