Wednesday, January 21, 2009

Hugh Montgomery III and Iron Man


Hugh Montgomery III (1625 - 1663) was the grandson of the first Hugh Montgomery, the Viscount of the Great Ardes (one of the two Founding Fathers of the Ulster-Scots). Hugh III had a very strange health condition.

His heart was "...plainly discernable..." - he had a bad fall as a child which left him with an injury and abcess on his left side. It never healed properly, and by the time he was 19 there was "...a very large open cavity in his side, through which the lungs, as it was believed, could both be seen and touched..." When King Charles I heard about this, he demanded to see it, and Montgomery was brought to the royal court as something of an oddity. Montgomery wore a protective plate over the wound, and when Dr William Harvey (one of the greatest physicians of the time, and the man who discovered blood circulation) inspected it, he said:

"...I found a large open space in the chest, into which I could readily introduce three of my fingers and my thumb; which done I straightway perceived a certain protuberant fleshy part, affected with an alternating extrusive and intrusive movement; this part I touched gently. Amazed with the novelty of such a state, I examined everything again and again, and when I had satisfied myself, I saw that it was a case of old and extensive ulcer, beyond the reach of art, but brought by a miracle to a kind of cure, the interior being invested by a membrane, and the edges protected by a tough skin.

But the fleshy part (which I, at first sight, took for a mass of granulations, and others had always regarded as a portion of the lung,) from its pulsating motions, and the rhythm they observed with the pulse—when the fingers of one of my hands were applied to it, those of the other to the artery at the wrist—as well as from their discordance with the respiratory movements, I saw was no portion of the lung I was handling, but the apex of the heart! covered over with a layer of fungous flesh by way of external defence, as commonly happens in old foul ulcers. The servant of this young man was in the habit daily of cleansing the cavity from its accumulated sordes by means of injections of tepid water; after which the plate was applied, and with this in its place, the young man felt adequate to any exercise or expedition, and, in short, he led a pleasant life in perfect safety.

Instead of a verbal answer, therefore, I carried the young man himself to the king, that his majesty might, with his own eyes, behold this wonderful case; that, in a man alive and well, he might, without detriment to the individual, observe the movement of the heart, and with his proper hand even touch the ventricles, as they contracted And his most excellent majesty, as well as myself, acknowledged that the heart was without the sense of touch; for the youth never knew when we touched his heart, except by the sight or the sensation he had through the external integument. We also particularly observed the movements of the heart, viz., that in the diastole it was retracted and withdrawn; whilst in the systole it emerged protruded; and the systole of the heart took place at the moment the piastole or pulse in the wrist was perceived; to conclude, the heart struck the walls of the chest, and became prominent at the time it bounded upwards and underwent contraction on itself..."

(Quoted from The Montgomery Manuscripts)

For those of you who haven't seen it, the movie Iron Man is an adaptation of the Marvel Comics superhero, who has a tiny nuclear reactor implanted inside his chest to keep him alive. It's a good job Montgomery III didn't have access to Iron Man's technology otherwise the Ulster Presbyterians of the 1600s would have been in real trouble... Adair's Narrative tells his devious story. Here's the Iron Man trailer, which is now out on DVD - just £5.98 on Amazon!