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Types of conjoined twins There are several different types of conjoined twin: In some cases, parts of the brain have been known to be shared between conjoined twins joined at the head. Occasionally one of the twins will fail to develop properly, effectively acting as a parasite upon the normally developed twin: this condition is known as parasitic twinning or asymmetric conjoined twins. One twin may absorb the other, which is known as inclusion twinning. Natural death of the twins can occur within hours or a few days. Conjoined twins in history The earliest known case of conjoined twins dates from the year 945, when a pair of conjoined twin brothers from Armenia were brought to Constantinople for medical evaluation. The English twin sisters Mary and Eliza Chulkhurst, who were conjoined at the back (pygopagus), lived from 1100 to 1134 and were perhaps the best-known early example of conjoined twins. Other early conjoined twins to attain notoriety were the "Scottish brothers", allegedly twins of the dicephalus type, essentially two heads sharing the same body (1460–1488, although the dates vary); the pygopagus Helen and Judith of Szony, Hungary (1701–1723), who enjoyed a brief career in music before being sent to live in a convent; and Rita and Cristina Parodi of Sardinia, born in 1829. Rita and Cristina were dicephalus tetrabrachius (one body with four arms) twins and although they died at only eight months of age, they gained much attention as a curiosity when their parents exhibited them in Paris. Several sets of conjoined twins lived during the nineteenth century and made careers for themselves in the performing arts, though none achieved quite the same level of fame and fortune as Chang and Eng. Most notably, Millie and Christine McCoy (or McKoy), pygopagus twins, were born into slavery in North Carolina in 1851. They were sold to a showman, J.P. Smith, at birth, but were soon kidnapped by a rival showman. The kidnapper fled to England but was thwarted when England banned slavery. Smith traveled to England to collect the girls and brought with him their mother, Monimia, from whom they had been separated. He and his wife provided the twins with an education and taught them to speak five languages, play music, and sing. For the rest of the century the twins enjoyed a successful career as "The Two-Headed Nightingale" and appeared with the Barnum Circus. In 1912 they died of tuberculosis, 17 hours apart. Giovanni and Giacomo Tocci, from Locana, Italy, were immortalized in Mark Twain's short story "Those Extraordinary Twins" as fictitious twins Angelo and Luigi. The Toccis, born in 1877, were dicephalus tetrabrachius twins, having one body with two legs, two heads, and four arms. From birth they were forced by their parents to perform and never learned to walk, as each twin controlled one leg (in modern times physical therapy allows twins like the Toccis to learn to walk on their own). They are said to have disliked show business. In 1886, after touring the United States, the twins returned to Europe with their family, where they fell very ill. They are believed to have died around this time, though some sources claim they survived until 1940, living in seclusion in Italy. Conjoined twins who appeared in the public eye during the 20th and 21st centuries include: Separating conjoined twins Some pairs, depending on the degree of conjunction—in particular, the degree to which they share internal organs—can be separated by surgery. The first known successful separation was performed by Johannes Fatio in Basel in 1689. In July 2003 two women from Iran, Ladan and Laleh Bijani, who were joined at the head but had separate brains (craniopagus) were surgically separated in Singapore, despite surgeons' warnings that the operation could be fatal to one or both. Both women died during surgery. In 2001 Gnags and Jamuna from Nepal, twins born fused at the head, were separated in Singapore. The success of this surgery was the impetus for Ladan and Laleh Bijani to approach Singaporean doctors for help. Though both the Nepalese girls are alive, one has cerebral palsy and is completely bedridden. The other is said to be coping fine. One ethical issue with separation is when the operation will result in the death of one twin (for example, in the case where they are sharing a heart). A notable case was that of Re A, involving the Attard sisters, Gracie and Rosie Attard, the daughters of Rina and Michaelangelo Attard of the Maltese island of Gozo. The twins were known to the world media as "Mary" and "Jodie" to protect the privacy of the family during their ordeal. Despite the opposition of the Attards, the High Court of Justice of England and Wales ruled that the twins should be separated, even though this would (and did in 2001) cause the death of Rosie ("Mary"), the weaker twin. More recently, an attempt was made to separate the German conjoined twins Lea and Tabea Block. Tabea died on September 16, 2004 just minutes after having been separated from her twin sister. In February 2005, the Egyptian girl Manar Maged was separated from her parasitic twin Islaam, who died when the separation was carried out. Manar survived the initial operation but died from a brain infection a year later in March 2006. Dr Yarlagadda Nayudamma, from Guntur, India, has successfully separated four sets of twins free of cost at the Guntur Medical College. The operated pairs are: Ram & Laxman (1992), Anjali & Geetanjali (1993), Rekha & Surekha (1998) and Veena & Vani (2004). All of them are fine and the last three pairs are attending school. Saudi Arabia is known for its remarkable success rate in conjoined twin separation surgeries. Since 1990, the medical teams at the King Abdul Aziz Medical City in Riyadh have been responsible for at least 9 separations, with a 100% success rate. All surgeries were successful and the twins survived long after surgery, except for one case in which one of the twins had congenital heart disease and died 6 months later. Nationalities of separated twins include Polish, Filipino and Egyptian. Criticism of the term As elaborated upon by the Rotten Library, the use of "conjoined" to describe said condition is in dispute: ..Unfortunately, the term is completely inaccurate, since "conjoined" means "to join or become joined together, or to unite," which is exactly the opposite of what happens in these cases. Siamese twins can't be "conjoined" because they were never separated in the first place, which leaves us in a semantic quandary that can only be resolved by a swift and totally arbitrary ruling... * See also | ||||||||||
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