The Second Book of General Ignorance (28 page)

Leading his army to victory on the battlefield? Laying waste to a Roman city? Murdered by a scheming henchman? No. Attila the Hun – the greatest warrior of his age, the man the Romans called
flagellum Dei
, ‘the scourge of God’, died in bed. Of a nosebleed.

We know this from the Roman historian Priscus, who visited Attila’s court in
AD
448. According to his account, Attila was celebrating his marriage to a young Gothic woman called Ildico and retired to bed
drunk. Next morning his new wife was found weeping over his corpse. The blood vessels in his nose had burst while he slept and he had drowned in his own gore. Attila was about forty-seven years old and he had led the Hunnish army for almost twenty years.

Attila owed much of his success to the devastating speed and manoeuvrability of his troops. Unlike other land armies of the time, they could fight in any weather, not just in summer. In a battle or siege Hun archers could unleash 50,000 arrows in the first ten minutes. But Attila was more than just a ruthless general: he was also a shrewd negotiator. As city after city fell, he liked to pose as a reasonable man, accepting gold in exchange for his victims’ future security and building an empire on fear, like a mafia boss or a drugs baron. He didn’t want land or power, just obedience and booty. Because of this pragmatic approach, even today his name means barbarism and chaos for some people, but heroic defiance for others.

To manage his set of shifting alliances, Attila had to make sure there was always a plentiful supply of gold (which meant more fighting to acquire it). From his base in Hungary he switched his military focus from the Persians to the Eastern Romans in Constantinople, and then to the Western Romans in Italy and Gaul. Finally, in
AD
451, at the battle of Châlons in Gaul, the Huns clashed head-on with the Roman forces of the West. Such was the range of Attila’s deal-making skills that almost every tribe in mainland Europe found themselves on one side or the other.

This battle marked the beginning of the end for both the Huns and the old Roman Empire. The Romans and their Gothic allies won, but only just: the Roman legions were decimated and never fought again. Rome was sacked once more in 455 (this time by Vandals) and the Empire relocated to Constantinople, where it stayed for the next 800 years. The complex network of allegiances Attila had built up didn’t
survive his death two years later and, a year after that, the much-reduced Hun army suffered their final defeat and were scattered, never to return.

Attila’s personal style was modest in comparison to the gold-bedecked gangsters around him. He used wooden goblets and plates, dressed simply, and his sword carried no decoration. Not so his funeral. He was buried in a gaudy triple-walled coffin, with a layer each of gold, silver and iron, all of them stuffed full of treasure.

He died somewhere in what is now Hungary, but his grave has never been found. To ensure its location remained secret, all the men in the burial party were killed when they returned to camp.

Don’t tilt your head back!

This can divert the nosebleed into the throat. Swallowing blood irritates the stomach and can lead to nausea and vomiting, or if it finds its way into the lungs it can choke you – as Attila the Hun found to his cost. The best treatment is to sit down with your back straight and lean
forward
. Keeping your head above your heart lessens the bleeding. Leaning forward helps drain the blood from your nose.

According to the
British Medical Journal
you can stop the bleeding by using your thumb and index finger to squeeze the soft part of your nose for five to ten minutes. This helps the blood to clot. A cold compress or ice pack placed across the bridge of your nose also helps. If the nosebleed lasts for more than 20 minutes – or if it was caused by a bang on the head – you should go to the doctor.

The scientific term for a nosebleed is epistaxis, which is Greek for ‘dripping from above’. The two most common causes of nosebleeds are being punched in the face and nosepicking. The web of blood vessels in your nose can also rupture owing to sharp changes in air pressure or temperature caused by cold weather or central heating, or if you blow your nose too hard.

Almost all nosebleeds occur in the front section of the nose, under the nose bone or septum. This is known as Kiesselbach’s area, and it’s vulnerable because four facial arteries connect there. Wilhelm Kiesselbach (1839–1902) was a German ear, nose and throat specialist who wrote the definitive textbook on the subject called
Nosenbluten
(German for ‘nosebleeds’).

High levels of the hormone oestrogen during a woman’s period can lead to an increase in blood pressure causing nasal blood vessels to inflate and burst. This is no mere nosebleed. It goes by the alarming name of ‘vicarious menstruation’.

Nothing. It’s physically impossible to swallow your own tongue.

The airway of an unconscious person can sometimes briefly become blocked as the muscle of their tongue becomes limp and it collapses into the back of their throat. However, it will
return to its normal position in a few seconds. The tongue is kept in place by a small piece of tissue underneath called the frenulum linguae (from Latin
frenulum
, ‘little bridle’, and
lingua
, ‘tongue’), which stops it being swallowed.

The idea that the tongue is in danger of being swallowed dates back to the early years of first aid in the late nineteenth century. First-aiders were taught that, if someone fainted or was having a fit, they should use forceps to pull the tongue forward, or, if none were available, to grab it with their fingers, using a handkerchief. Some well-meaning (but misguided) people still do this today, inserting pieces of wood – or even their wallets – into the mouths of people who are having fits. This is not a good idea. It stops the patient from being able to breathe.

If someone faints, don’t start stuffing the contents of your pockets down their throat, put them into the recovery position: lay them on one side, with their chin tilted up so they can breathe clearly.

Swallowing occurs about 2,000 times a day. Except for the initial conscious decision to do it, it is an automatic process that involves twelve separate muscle movements. Alzheimer’s patients and victims of strokes sometimes lose the ability to swallow. They are helped to relearn how to do it by speech therapists. This is because speech uses exactly the same combination of muscles as swallowing.

When someone is close to death, the swallowing reflex often fails. This leads to a build up of saliva and mucus in the back of the throat, causing the so-called ‘death rattle’. Before writing the patient off, however, check their airway for wallets.

Don’t worry: it won’t cause arthritis. At worst, it might leave you with a limp handshake.

We know this because of the selfless dedication of Dr Donald L. Unger, an octogenarian physician from California. Warned as a child by his mother that if he didn’t stop cracking
his knuckles he would end up with arthritis, he embarked on an experiment, cracking the knuckles of his left hand (but not those of his right) every day for more than sixty years. His conclusion was that knuckle-cracking had no serious effect. At the end of the experiment, he claims, he ‘looked up to the heavens and said: “Mother, you were wrong, you were wrong, you were wrong.”’ His efforts won him the 2009 IgNobel prize for Medicine, a parody of the Nobel Prize started in 1991 and awarded annually for improbable research that ‘first makes us laugh and then makes us think’.

This is not to say that knuckle-cracking is entirely harmless: it can make your joints swell and inflame your ligaments, and, over time, can reduce the strength of your grip.

Our finger joints, like most moving joints in our bodies, are called synovial joints because they contain a strange liquid called synovial fluid whose job is to cushion and lubricate the joint. But it doesn’t ‘flow’ as most bodily fluids do: it has a thick, gel-like consistency, rather like egg white (hence the word
synovial
, from the Greek
syn-,
‘with’, and Latin
ovum
, ‘egg’). Between each joint is a capsule, filled with synovial fluid and sealed by a membrane. When you pull the bones apart, the membrane stretches. This reduces the pressure inside the capsule and, as the fluid moves to fill the vacuum, bubbles of carbon dioxide form. The ‘pop’ that we hear is the bubbles
forming
(not bursting) inside the capsule.

If you X-ray a joint just after it has been cracked, the bubbles of carbon dioxide are clearly visible. The joint can’t be cracked again until they’ve dissolved back into the fluid, which explains why you can’t crack the same knuckle repeatedly.

The cracking of knuckles (and the creaking of joints) has a scientific name:
crepitus
, from the Latin
crepare
, ‘to crack’.

Arthritis comes from the Greek
arthron,
‘joint’, and -
itis,
a suffix denoting ‘inflammation’. It’s been around as long as
animals have had articulated skeletons (there is evidence that some dinosaurs’ ankle joints were arthritic). The first evidence of human arthritis can be found in ancient Egyptian mummies that date back to 4500
BC
.

Arthritis comes in over a hundred different forms and afflicts all ages and ethnic groups. After stress, it’s responsible for more lost working days in the UK than any other medical condition, at an estimated annual cost of
£
5.8 billion. A quarter of all adult Britons consult their GP each year with arthritis-related complaints.

Cracked knuckles are responsible for none of them.