Lesion of horror

Just before Christmas we rounded up a chimney-sweep and got the flue above the wood-burning stove reamed out in anticipation of the arrival of all our direct descendants.  We'd been finding absurd excuses to avoid this chore for several many years but the prospect of having everyone standing out in the yard in their pyjamas as all our worldly possessions contributed to global warming was too much.  I was at work on the day, but the sweep came with all his modern kit; swept the soot into a single handy bag; sealed up some orifices on the stove that were potentially leaking CO into the living room; blocked off an unused flue in the bedroom; tidied up and left.  Consequently we all survived the holiday!

If his predecessor had come 300 years ago, his equipment would have consisted of a set of brushes and a small boy. It was standard practice to send the boy either up or down the chimney giving the sides a real good scrub - paying particular attention to the corners - rather than hopefully pushing a brush about on the end of a long flexible rod.  The latter gets at the low-hanging soot but leaves the inaccessible accumulation to accumulate.  You'd think that, so long as the young feller didn't fall or get stuck and suffocate (both of which were occupational hazards), that sending boys up chimneys was quite a good solution to the problem.  Inevitably, we are prejudiced to have a rather rose-tinted view of sweeps since Dick van Dyke and Julie Andrews danced about the rooftops, lightly sooted, singing chim-chim-cheroo in Mary Poppins. Not a bad life for a young chap?

But because the sweeps-boys were clothed, another occupation hazard went unseen until the most famous physician-surgeon of his day Sir Percivall Pott (who was born almost exactly 300 years ago on 6th Jan 1714) noticed that a disproportionate number of these young chaps were cut off in their prime from metastasizing cancer of the scrotum.  Nobody would claim that the male "parts", even when young, are pretty to look at: Des Bishop has gone out on the TV to refer to the/his scrotum as "a crinkled turkey-gizzard" in a discussion about his dealing with testicular cancer - which should be compulsory viewing for all my male readers because your life time risk is about 1:200 and it's treatable if diagnosed early. You have a spare! Ugly or not in the natural state, scrotal carcinomas are truly frightening to view and I'm now sorry to have encountered pictures in my research.

ANNyway, in 1775 Pott published his epidemiological findings and thus became the first person in modern(ish) medicine to identify an occupational malignancy caused by an environmental carcinogen. Actually John Hill could have been the first to identify an environmental carcinogen-of-lifestyle in noting that snuff takers were prone to hideously painful nasal cancers.  Pott's hypothesis, which has stood up well over the last 250 years, is that the cancer "seems to derive its origin from a lodgement of soot in the rugae of the scrotum." to cause what medics now refer to as a squamous cell carcinoma. It's not all of the soot, of course, but a complex aromatic molecule called benzopyrene that causes the damage by jamming into and then mutating DNA in the affected cells which then grow out of control. Sam Kean has a nice essay bringing Pott and his carcinoma up to date by showing the involvement of lesions induced in the gene p53 on chromosome 17 of the human genome. Pott's report led directly to the Chimney Sweepers Act (1788) which required chimney-boys to be at least eight (8)! years old (and go to church on Sundays) but the practice of sending minors up chimneys wasn't finally outlawed in England until 1875.