Rapid Responses to:

EDITOR'S CHOICE: Tony Delamothe Orthopaedic gorillas no more BMJ 2007; 335: 0 [Full text]

Rapid Responses: Submit a response to this article

Rapid Responses published:

Orthopaedic Gorillas - no more since 2004

Paul Crossman   (23 December 2007)

Orthopaedic Gorillas, Comparative Perspective in Hominoids

Agustín Arranz   (13 February 2008)

Orthopaedic Gorillas - no more since 2004 23 December 2007
Paul Crossman, Consultant Orthopaedic Surgeon Southern General Hospital, Glasgow, G51 4TF Send response to journal: Re: Orthopaedic Gorillas - no more since 2004	Dear Sir As a consultant orthopaedic surgeon, I read your article "Orthopaedic gorillas no more" slowly but with interest. As a point of information I can reveal that the question of gorillas in orthopaedics was studied at the Royal College of Surgeons in 2004. Specifically addressed was the question of whether the apes could be trained to do orthopaedics. It was felt that the intellectual capacity would probably be adequate, the male gorilla enjoying a cranial capacity of over 500ml (Schultz AH, The life of primates, Weidenfeld and Nicolson, 1969) . This contrasted with that of the male chimpanzee, averaging just under 400ml, and since the latter could be expected to produce the works of Shakespeare given a typewriter (as explained by Huxley), mastery of a corpus of knowledge sufficient, say, to write an Oxford Textbook was considered within the capability of the gorilla. The main problem for the gorilla would be using tools, such as powered drills and saws, the hand being poorly adapted for this. This has been know for some time. Sir Charles Bell described the similar situation in the case of the chimpanzee "paw": "the remarkable peculiarity is the smallness of the thumb; it extends no further than to the root of the fingers. On the length, strength, free lateral motion, and perfect mobility of the thumb, depends teh power of the human hand" (Bell C, The hand, William Pickering 1833). Bell also noted the lack of a powerful forearm flexor to the thumb, flexor pollicis longus, in primates; a meta-ananlysis on the arrangement of forearm digital flexors in apes has been published (Straus WL, 1942). The differences in hand anatomy would be such that the apes would have difficulty even using tools designed to suit the ape hand. The College group considering the matter, probably as part of a government initiative (reasoning along the lines of "Surely a monkey could be trained to be a doctor"), to introduce competition and consider alternatives to traditional service provision noted that while the anatomy of the hand would preclude performance of surgical operations, there may be other spheres in which non-human primates could contribute. Perhaps those specialities in which mental activity predominates in day to day practice? Reports of chimpanzees forming what appeared to be "war parties" and of apes throwing unpleasant material at those around them also led to some speculation that, while chimpanzees and gorillas were apes rather than monkeys, possibly either may be suited to political roles, although consideration of this was outside the terms of reference for those gathered. In short, it has been known for a short while now that gorillas would be unsuited to orthopaedics, and I welcome the implicit recognition of this in your article. Competing interests: None declared
Orthopaedic Gorillas, Comparative Perspective in Hominoids 13 February 2008
Agustín Arranz, Consultant Orthopaedic Surgeon Hospital Comarcal del Noroeste de Murcia, 30400 Caravaca de la Cruz Send response to journal: Re: Orthopaedic Gorillas, Comparative Perspective in Hominoids	Gentlemen, I am very interested in your question of gorillas in Orthopaedics.As you know, some part of the brain have been more closely associated with higher cognitive function than others.Creative thinking, planning of future action, decision-making, artistic expresion working memory, language and motor control are function atributed mostly to the frontal lobes of the brain in hominoids. Our present knowledge of the structure of the frontal lobe in the gorilla´s brain, we can identify a complex fissural pattern(32% frontal lobe in 550 cc., Stephan et al, 1981)).The anteriormost portion of the right hemisphere was found to be wider and protude anteriorly.Gorillas presented right preponderance. In short, the gorilla and bonobo patterns are closer to the human pattern with more than half of the specimens studied, presenting a right frontal advantage in cognitive functions and emotional behavior. References: Taylor,S. et al:The mentalities of gorillas and orangutans,Comparative Perspective.Cambridge University Press. ISBN 0-521- 58027-7 Competing interests: None declared