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Saturday, September 17, 2022

Crop rotation

From Wikipedia, the free encyclopedia

Crop rotation is the practice of growing a series of different types of crops in the same area across a sequence of growing seasons. It reduces reliance on one set of nutrients, pest and weed pressure, and the probability of developing resistant pests and weeds.

Growing the same crop in the same place for many years in a row, known as monocropping, gradually depletes the soil of certain nutrients and selects for a highly competitive pest and weed community. Without balancing nutrient use and diversifying pest and weed communities, the productivity of monocultures is highly dependent on external inputs. Conversely, a well-designed crop rotation can reduce the need for synthetic fertilizers and herbicides by better using ecosystem services from a diverse set of crops. Additionally, crop rotations can improve soil structure and organic matter, which reduces erosion and increases farm system resilience.

History

Agriculturalists have long recognized that suitable rotations — such as planting spring crops for livestock in place of grains for human consumption — make it possible to restore or to maintain productive soils. Ancient Near Eastern farmers practiced crop rotation in 6000 BC without understanding the chemistry, alternately planting legumes and cereals.

Two-field systems

Under a two-field rotation, half the land was planted in a year, while the other half lay fallow. Then, in the next year, the two fields were reversed. In China both the two-field and three-field system had been used since the Eastern Zhou period. From the times of Charlemagne (died 814), farmers in Europe transitioned from a two-field crop rotation to a three-field crop rotation.

Three-field systems

From the end of the Middle Ages until the 20th century, Europe's farmers practiced a three-field rotation, where available lands were divided into three sections. One section was planted in the autumn with rye or winter wheat, followed by spring oats or barley; the second section grew crops such as peas, lentils, or beans; and the third field was left fallow. The three fields were rotated in this manner so that every three years, one of the fields would rest and lie fallow. Under the two-field system, if one has a total of 600 acres (2.4 km2) of fertile land, one would only plant 300 acres. Under the new three-field rotation system, one would plant (and therefore harvest) 400 acres. But the additional crops had a more significant effect than mere quantitative productivity. Since the spring crops were mostly legumes, they increased the overall nutrition of the people of Northern Europe.

Four-field rotations

Farmers in the region of Waasland (in present-day northern Belgium) pioneered a four-field rotation in the early 16th century, and the British agriculturist Charles Townshend (1674–1738) popularised this system in the 18th century. The sequence of four crops (wheat, turnips, barley and clover), included a fodder crop and a grazing crop, allowing livestock to be bred year-round. The four-field crop rotation became a key development in the British Agricultural Revolution. The rotation between arable and ley is sometimes called ley farming.

Modern developments

George Washington Carver (1860s–1943) studied crop-rotation methods in the United States, teaching southern farmers to rotate soil-depleting crops like cotton with soil-enriching crops like peanuts and peas.

In the Green Revolution of the mid-20th century the traditional practice of crop rotation gave way in some parts of the world to the practice of supplementing the chemical inputs to the soil through topdressing with fertilizers, adding (for example) ammonium nitrate or urea and restoring soil pH with lime. Such practices aimed to increase yields, to prepare soil for specialist crops, and to reduce waste and inefficiency by simplifying planting, harvesting, and irrigation.

Crop choice

A preliminary assessment of crop interrelationships can be found in how each crop:

  1. contributes to soil organic matter (SOM) content
  2. provides for pest management
  3. manages deficient or excess nutrients
  4. how it contributes to or controls for soil erosion
  5. interbreeds with other crops to produce hybrid offspring, and
  6. impacts surrounding food webs and field ecosystems

Crop choice is often related to the goal the farmer is looking to achieve with the rotation, which could be weed management, increasing available nitrogen in the soil, controlling for erosion, or increasing soil structure and biomass, to name a few. When discussing crop rotations, crops are classified in different ways depending on what quality is being assessed: by family, by nutrient needs/benefits, and/or by profitability (i.e. cash crop versus cover crop). For example, giving adequate attention to plant family is essential to mitigating pests and pathogens. However, many farmers have success managing rotations by planning sequencing and cover crops around desirable cash crops. The following is a simplified classification based on crop quality and purpose.

Row crops

Many crops which are critical for the market, like vegetables, are row crops (that is, grown in tight rows). While often the most profitable for farmers, these crops are more taxing on the soil. Row crops typically have low biomass and shallow roots: this means the plant contributes low residue to the surrounding soil and has limited effects on structure. With much of the soil around the plant exposed to disruption by rainfall and traffic, fields with row crops experience faster break down of organic matter by microbes, leaving fewer nutrients for future plants.

In short, while these crops may be profitable for the farm, they are nutrient depleting. Crop rotation practices exist to strike a balance between short-term profitability and long-term productivity.

Legumes

A great advantage of crop rotation comes from the interrelationship of nitrogen-fixing crops with nitrogen-demanding crops. Legumes, like alfalfa and clover, collect available nitrogen from the atmosphere and store it in nodules on their root structure. When the plant is harvested, the biomass of uncollected roots breaks down, making the stored nitrogen available to future crops.

In addition, legumes have heavy tap roots that burrow deep into the ground, lifting soil for better tilth and absorption of water.

Grasses and cereals

Cereal and grasses are frequent cover crops because of the many advantages they supply to soil quality and structure. The dense and far-reaching root systems give ample structure to surrounding soil and provide significant biomass for soil organic matter.

Grasses and cereals are key in weed management as they compete with undesired plants for soil space and nutrients.

Green manure

Green manure is a crop that is mixed into the soil. Both nitrogen-fixing legumes and nutrient scavengers, like grasses, can be used as green manure. Green manure of legumes is an excellent source of nitrogen, especially for organic systems, however, legume biomass does not contribute to lasting soil organic matter like grasses do.

Planning a rotation

There are numerous factors that must be taken into consideration when planning a crop rotation. Planning an effective rotation requires weighing fixed and fluctuating production circumstances: market, farm size, labor supply, climate, soil type, growing practices, etc. Moreover, a crop rotation must consider in what condition one crop will leave the soil for the succeeding crop and how one crop can be seeded with another crop. For example, a nitrogen-fixing crop, like a legume, should always precede a nitrogen depleting one; similarly, a low residue crop (i.e. a crop with low biomass) should be offset with a high biomass cover crop, like a mixture of grasses and legumes.

There is no limit to the number of crops that can be used in a rotation, or the amount of time a rotation takes to complete. Decisions about rotations are made years prior, seasons prior, or even at the last minute when an opportunity to increase profits or soil quality presents itself.

Implementation

Crop rotation systems may be enriched by the influences of other practices such as the addition of livestock and manure, intercropping or multiple cropping, and is common in organic cropping systems.

Incorporation of livestock

Introducing livestock makes the most efficient use of critical sod and cover crops; livestock (through manure) are able to distribute the nutrients in these crops throughout the soil rather than removing nutrients from the farm through the sale of hay.

Mixed farming or the practice of crop cultivation with the incorporation of livestock can help manage crops in a rotation and cycle nutrients. Crop residues provide animal feed, while the animals provide manure for replenishing crop nutrients and draft power. These processes promote internal nutrient cycling and minimize the need for synthetic fertilizers and large-scale machinery. As an additional benefit, the cattle, sheep and/or goat provide milk and can act as a cash crop in the times of economic hardship.

Intercropping

Multiple cropping systems, such as intercropping or companion planting, offer more diversity and complexity within the same season or rotation. An example of companion planting is the three sisters, the inter-planting of corn with pole beans and vining squash or pumpkins. In this system, the beans provide nitrogen; the corn provides support for the beans and a "screen" against squash vine borer; the vining squash provides a weed suppressive canopy and a discouragement for corn-hungry raccoons.

Double-cropping is common where two crops, typically of different species, are grown sequentially in the same growing season, or where one crop (e.g. vegetable) is grown continuously with a cover crop (e.g. wheat). This is advantageous for small farms, which often cannot afford to leave cover crops to replenish the soil for extended periods of time, as larger farms can. When multiple cropping is implemented on small farms, these systems can maximize benefits of crop rotation on available land resources.

Organic farming

Crop rotation is a required practice, in the United States, for farm seeking organic certification. The “Crop Rotation Practice Standard” for the National Organic Program under the U.S. Code of Federal Regulations, section §205.205, states

Farmers are required to implement a crop rotation that maintains or builds soil organic matter, works to control pests, manages and conserves nutrients, and protects against erosion. Producers of perennial crops that aren’t rotated may utilize other practices, such as cover crops, to maintain soil health.

In addition to lowering the need for inputs (by controlling for pests and weeds and increasing available nutrients), crop rotation helps organic growers increase the amount of biodiversity their farms. Biodiversity is also a requirement of organic certification, however, there are no rules in place to regulate or reinforce this standard. Increasing the biodiversity of crops has beneficial effects on the surrounding ecosystem and can host a greater diversity of fauna, insects, and beneficial microorganisms in the soil as found by McDaniel et al 2014 and Lori et al 2017. Some studies point to increased nutrient availability from crop rotation under organic systems compared to conventional practices as organic practices are less likely to inhibit of beneficial microbes in soil organic matter.

While multiple cropping and intercropping benefit from many of the same principals as crop rotation, they do not satisfy the requirement under the NOP.

Benefits

Agronomists describe the benefits to yield in rotated crops as "The Rotation Effect". There are many benefits of rotation systems. The factors related to the increase are broadly due to alleviation of the negative factors of monoculture cropping systems. Specifically, improved nutrition; pest, pathogen, and weed stress reduction; and improved soil structure have been found in some cases to be correlated to beneficial rotation effects.

Other benefits of rotation cropping systems include production cost advantages. Overall financial risks are more widely distributed over more diverse production of crops and/or livestock. Less reliance is placed on purchased inputs and over time crops can maintain production goals with fewer inputs. This in tandem with greater short and long term yields makes rotation a powerful tool for improving agricultural systems.

Soil organic matter

The use of different species in rotation allows for increased soil organic matter (SOM), greater soil structure, and improvement of the chemical and biological soil environment for crops. With more SOM, water infiltration and retention improves, providing increased drought tolerance and decreased erosion.

Soil organic matter is a mix of decaying material from biomass with active microorganisms. Crop rotation, by nature, increases exposure to biomass from sod, green manure, and various other plant debris. The reduced need for intensive tillage under crop rotation allows biomass aggregation to lead to greater nutrient retention and utilization, decreasing the need for added nutrients. With tillage, disruption and oxidation of soil creates a less conducive environment for diversity and proliferation of microorganisms in the soil. These microorganisms are what make nutrients available to plants. So, where "active" soil organic matter is a key to productive soil, soil with low microbial activity provides significantly fewer nutrients to plants; this is true even though the quantity of biomass left in the soil may be the same.

Soil microorganisms also decrease pathogen and pest activity through competition. In addition, plants produce root exudates and other chemicals which manipulate their soil environment as well as their weed environment. Thus rotation allows increased yields from nutrient availability but also alleviation of allelopathy and competitive weed environments.

Carbon sequestration

Studies have shown that crop rotations greatly increase soil organic carbon (SOC) content, the main constituent of soil organic matter. Carbon, along with hydrogen and oxygen, is a macronutrient for plants. Highly diverse rotations spanning long periods of time have shown to be even more effective in increasing SOC, while soil disturbances (e.g. from tillage) are responsible for exponential decline in SOC levels. In Brazil, conversion to no-till methods combined with intensive crop rotations has been shown an SOC sequestration rate of 0.41 tonnes per hectare per year.

In addition to enhancing crop productivity, sequestration of atmospheric carbon has great implications in reducing rates of climate change by removing carbon dioxide from the air.

Nitrogen fixing

Rotating crops adds nutrients to the soil. Legumes, plants of the family Fabaceae, for instance, have nodules on their roots which contain nitrogen-fixing bacteria called rhizobia. During a process called nodulation, the rhizobia bacteria use nutrients and water provided by the plant to convert atmospheric nitrogen into ammonia, which is then converted into an organic compound that the plant can use as its nitrogen source. It therefore makes good sense agriculturally to alternate them with cereals (family Poaceae) and other plants that require nitrates. How much nitrogen made available to the plants depends on factors such as the kind of legume, the effectiveness of rhizobia bacteria, soil conditions, and the availability of elements necessary for plant food.

Pathogen and pest control

Crop rotation is also used to control pests and diseases that can become established in the soil over time. The changing of crops in a sequence decreases the population level of pests by (1) interrupting pest life cycles and (2) interrupting pest habitat. Plants within the same taxonomic family tend to have similar pests and pathogens. By regularly changing crops and keeping the soil occupied by cover crops instead of lying fallow, pest cycles can be broken or limited, especially cycles that benefit from overwintering in residue. For example, root-knot nematode is a serious problem for some plants in warm climates and sandy soils, where it slowly builds up to high levels in the soil, and can severely damage plant productivity by cutting off circulation from the plant roots. Growing a crop that is not a host for root-knot nematode for one season greatly reduces the level of the nematode in the soil, thus making it possible to grow a susceptible crop the following season without needing soil fumigation.

This principle is of particular use in organic farming, where pest control must be achieved without synthetic pesticides.

Weed management

Integrating certain crops, especially cover crops, into crop rotations is of particular value to weed management. These crops crowd out weed through competition. In addition, the sod and compost from cover crops and green manure slows the growth of what weeds are still able to make it through the soil, giving the crops further competitive advantage. By slowing the growth and proliferation of weeds while cover crops are cultivated, farmers greatly reduce the presence of weeds for future crops, including shallow rooted and row crops, which are less resistant to weeds. Cover crops are, therefore, considered conservation crops because they protect otherwise fallow land from becoming overrun with weeds.

This system has advantages over other common practices for weeds management, such as tillage. Tillage is meant to inhibit growth of weeds by overturning the soil; however, this has a countering effect of exposing weed seeds that may have gotten buried and burying valuable crop seeds. Under crop rotation, the number of viable seeds in the soil is reduced through the reduction of the weed population.

In addition to their negative impact on crop quality and yield, weeds can slow down the harvesting process. Weeds make farmers less efficient when harvesting, because weeds like bindweeds, and knotgrass, can become tangled in the equipment, resulting in a stop-and-go type of harvest.

Preventing soil erosion

Crop rotation can significantly reduce the amount of soil lost from erosion by water. In areas that are highly susceptible to erosion, farm management practices such as zero and reduced tillage can be supplemented with specific crop rotation methods to reduce raindrop impact, sediment detachment, sediment transport, surface runoff, and soil loss.

Protection against soil loss is maximized with rotation methods that leave the greatest mass of crop stubble (plant residue left after harvest) on top of the soil. Stubble cover in contact with the soil minimizes erosion from water by reducing overland flow velocity, stream power, and thus the ability of the water to detach and transport sediment. Soil Erosion and Cill prevent the disruption and detachment of soil aggregates that cause macropores to block, infiltration to decline, and runoff to increase. This significantly improves the resilience of soils when subjected to periods of erosion and stress.

When a forage crop breaks down, binding products are formed that act like an adhesive on the soil, which makes particles stick together, and form aggregates. The formation of soil aggregates is important for erosion control, as they are better able to resist raindrop impact, and water erosion. Soil aggregates also reduce wind erosion, because they are larger particles, and are more resistant to abrasion through tillage practices.

The effect of crop rotation on erosion control varies by climate. In regions under relatively consistent climate conditions, where annual rainfall and temperature levels are assumed, rigid crop rotations can produce sufficient plant growth and soil cover. In regions where climate conditions are less predictable, and unexpected periods of rain and drought may occur, a more flexible approach for soil cover by crop rotation is necessary. An opportunity cropping system promotes adequate soil cover under these erratic climate conditions. In an opportunity cropping system, crops are grown when soil water is adequate and there is a reliable sowing window. This form of cropping system is likely to produce better soil cover than a rigid crop rotation because crops are only sown under optimal conditions, whereas rigid systems are not necessarily sown in the best conditions available.

Crop rotations also affect the timing and length of when a field is subject to fallow. This is very important because depending on a particular region's climate, a field could be the most vulnerable to erosion when it is under fallow. Efficient fallow management is an essential part of reducing erosion in a crop rotation system. Zero tillage is a fundamental management practice that promotes crop stubble retention under longer unplanned fallows when crops cannot be planted. Such management practices that succeed in retaining suitable soil cover in areas under fallow will ultimately reduce soil loss. In a recent study that lasted a decade, it was found that a common winter cover crop after potato harvest such as fall rye can reduce soil run-off by as much as 43%, and this is typically the most nutritional soil.

Biodiversity

Increasing the biodiversity of crops has beneficial effects on the surrounding ecosystem and can host a greater diversity of fauna, insects, and beneficial microorganisms in the soil as found by McDaniel et al 2014 and Lori et al 2017. Some studies point to increased nutrient availability from crop rotation under organic systems compared to conventional practices as organic practices are less likely to inhibit of beneficial microbes in soil organic matter, such as arbuscular mycorrhizae, which increase nutrient uptake in plants. Increasing biodiversity also increases the resilience of agro-ecological systems.

Farm productivity

Crop rotation contributes to increased yields through improved soil nutrition. By requiring planting and harvesting of different crops at different times, more land can be farmed with the same amount of machinery and labour.

Risk management

Different crops in the rotation can reduce the risks of adverse weather for the individual farmer.

Challenges

While crop rotation requires a great deal of planning, crop choice must respond to a number of fixed conditions (soil type, topography, climate, and irrigation) in addition to conditions that may change dramatically from year to the next (weather, market, labor supply). In this way, it is unwise to plan crops years in advance. Improper implementation of a crop rotation plan may lead to imbalances in the soil nutrient composition or a buildup of pathogens affecting a critical crop. The consequences of faulty rotation may take years to become apparent even to experienced soil scientists and can take just as long to correct.

Many challenges exist within the practices associated with crop rotation. For example, green manure from legumes can lead to an invasion of snails or slugs and the decay from green manure can occasionally suppress the growth of other crops.

Conjoined twins

From Wikipedia, the free encyclopedia

Conjoined twins
Other namesSiamese twins, monstra duplicia
Conjoined X-ray.jpg
X-ray of conjoined twins, Cephalothoracopagus.
SpecialtyMedical genetics 
SymptomsBodies fused
ComplicationsDepends on type
Usual onsetBeginning of pregnancy
DurationLifelong
Typessee article
CausesIncomplete fission
TreatmentSurgery, symptomatic care
PrognosisDepends on type; Occasionally may survive

Conjoined twins – sometimes popularly referred to as Siamese twins – are twins joined in utero. A very rare phenomenon, the occurrence is estimated to range from 1 in 49,000 births to 1 in 189,000 births, with a somewhat higher incidence in Southwest Asia and Africa. Approximately half are stillborn, and an additional one-third die within 24 hours. Most live births are female, with a ratio of 3:1.

Two theories exist to explain the origins of conjoined twins. The more generally accepted theory is fission, in which the fertilized egg splits partially. The other theory, no longer believed to be the basis of conjoined twinning, is fusion, in which a fertilized egg completely separates, but stem cells (which search for similar cells) find similar stem cells on the other twin and fuse the twins together. Conjoined twins share a single common chorion, placenta, and amniotic sac, although these characteristics are not exclusive to conjoined twins, as there are some monozygotic but non-conjoined twins who also share these structures in utero.

Chang and Eng Bunker (1811–1874) were brothers born in Siam (now Thailand) who traveled widely for many years and were labeled as The Siamese Twins. Chang and Eng were joined at the torso by a band of flesh, cartilage, and their fused livers. In modern times, they could have been easily separated. Due to the brothers' fame and the rarity of the condition, the term "Siamese twins" came to be associated with conjoined twins.

Causes

There are two theories about the development of conjoined twins. The first is that a single fertilized egg does not fully split during the process of forming identical twins. If the zygote division occurs after two weeks of the development of the embryonic disc, it results in the formation of conjoined twins. The second theory is that a fusion of two fertilized eggs occurs earlier in development.

Partial splitting of the primitive node and streak may result in the formation of conjoined twins. These twins are classified according to the nature and degree of their union. Occasionally, monozygotic twins are connected only by a common skin bridge or by a common liver bridge. The type of twins formed depends on when and to what extent abnormalities of the node and streak occurred. Misexpression of genes, such as Goosecoid, may also result in conjoined twins. Goosecoid activates inhibitors of BMP4 and contributes to regulation of head development. Over- or underexpression of this gene in laboratory animals results in severe malformations of the head region, including duplications, similar to some types of conjoined twins.

Types

Conjoined twins are typically classified by the point at which their bodies are joined. The most common types of conjoined twins are:

  • Thoraco-omphalopagus (28% of cases): Two bodies fused from the upper chest to the lower chest. These twins usually share a heart and may also share the liver or part of the digestive system.
  • Thoracopagus (18.5%): Two bodies fused from the upper chest to lower belly. The heart is always involved in these cases. As of 2015, separation of a genuinely shared heart has not offered survival to two twins; a designated twin may survive if allotted the heart, sacrificing the other twin.
  • Omphalopagus (10%): Two bodies fused at the lower abdomen. Unlike thoracopagus, the heart is never involved in these cases; however, the twins often share a liver, digestive system, diaphragm and other organs.
  • Parasitic twins (10%): Twins that are asymmetrically conjoined, resulting in one twin that is small, less formed, and dependent on the larger twin for survival.
  • Craniopagus (6%): Fused skulls, but separate bodies. These twins can be conjoined at the back of the head, the front of the head, or the side of the head, but not on the face or the base of the skull.

Other, less common types of conjoined twins include:

  • Cephalopagus: Two faces on opposite sides of a single, conjoined head; the upper portion of the body is fused while the bottom portions are separate. These twins generally cannot survive due to severe malformations of the brain. Also known as janiceps (after the two-faced Roman deity Janus).
  • Syncephalus: One head with a single face but four ears, and two bodies.
  • Cephalothoracopagus: Bodies fused in the head and thorax. In this type of twins, there are two faces facing in opposite directions, or sometimes a single face and an enlarged skull.
  • Xiphopagus: Two bodies fused in the xiphoid cartilage, which is approximately from the navel to the lower breastbone. These twins almost never share any vital organs, with the exception of the liver. A famous example is Chang and Eng Bunker.
  • Ischiopagus: Fused lower half of the two bodies, with spines conjoined end-to-end at a 180° angle. These twins have four arms; one, two, three or four legs; and typically one external set of genitalia and anus.
  • Omphalo-Ischiopagus: Fused in a similar fashion to ischiopagus twins, but facing each other with a joined abdomen akin to omphalopagus. These twins have four arms, and two, three, or four legs.
  • Parapagus: Fused side by side with a shared pelvis. Twins that are dithoracic parapagus are fused at the abdomen and pelvis, but not the thorax. Twins that are diprosopic parapagus have one trunk and two faces. Twins that are dicephalic parapagus have one trunk and two heads, and have two (dibrachius), three (tribrachius), or four (tetrabrachius) arms.
  • Craniopagus parasiticus: Like craniopagus, but with a second bodiless head attached to the dominant head.
  • Pygopagus or Iliopagus: Two bodies joined at the pelvis.
  • Rachipagus: Twins joined along the back of their bodies, with fusion of the vertebral arches and the soft tissue from the head to the buttocks.

Management

Separation

Surgery to separate conjoined twins may range from very easy to very difficult depending on the point of attachment and the internal parts that are shared. Most cases of separation are extremely risky and life-threatening. In many cases, the surgery results in the death of one or both of the twins, particularly if they are joined at the head or share a vital organ. This makes the ethics of surgical separation, where the twins can survive if not separated, contentious. Alice Dreger of Northwestern University found the quality of life of twins who remain conjoined to be higher than is commonly supposed. Lori and George Schappell and Abby and Brittany Hensel are notable examples.

The first record of separating conjoined twins took place in the Byzantine Empire in the 900s. One of the conjoined twins had already died, so the doctors of the town attempted to separate the dead twin from the surviving twin. The result was partly successful as the remaining twin lived for three days after separation. The next case of separating conjoined twins was recorded in 1689 in Germany several centuries later. The first recorded successful separation of conjoined twins was performed in 1689 by Johannes Fatio. In 1955, neurosurgeon Harold Voris (1902-1980) and his team at Mercy Hospital in Chicago performed the first successful operation to separate craniopagus twins (conjoined at the head), which resulted in long-term survival for both. The larger girl was reported in 1963 as developing normally, but the smaller girl was permanently impaired.

In 1957, Bertram Katz and his surgical team made international medical history performing the world's first successful separation of conjoined twins sharing a vital organ. Omphalopagus twins John Nelson and James Edward Freeman (Johnny and Jimmy) were born in Youngstown, Ohio, on April 27, 1956. The boys shared a liver but had separate hearts and were successfully separated at North Side Hospital in Youngstown, Ohio, by Bertram Katz. The operation was funded by the Ohio Crippled Children's Service Society.

Recent successful separations of conjoined twins include that of the separation of Ganga and Jamuna Shreshta in 2001, who were born in Kathmandu, Nepal, in 2000. The 97-hour surgery on the pair of craniopagus twins was a landmark one which took place in Singapore; the team was led by neurosurgeons Chumpon Chan and Keith Goh. The surgery left Ganga with brain damage and Jamuna unable to walk. Seven years later, Ganga Shrestha died at the Model Hospital in Kathmandu in July 2009, at the age of eight, three days after being admitted for treatment of a severe chest infection.

Infants Rose and Grace Attard, conjoined twins from Malta, were separated in the United Kingdom by court order Re A over the religious objections of their parents, Michaelangelo and Rina Attard. The twins were attached at the lower abdomen and spine. The surgery took place in November 2000, at St Mary's Hospital in Manchester. The operation was controversial because Rose, the weaker twin, would die as a result of the procedure as her heart and lungs were dependent upon Grace's. However, if the operation had not taken place, it was certain that both twins would die. Grace survived to enjoy a normal childhood.

In 2003, two 29-year-old 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. Their complex case was accepted only because technologically advanced graphical imagery and modeling would allow the medical team to plan the risky surgery. However, an undetected major vein hidden from the scans was discovered during the operation. The separation was completed but both women died while still in surgery.

In 2019 Safa and Marwa Ullah were separated at Great Ormond Street Hospital in London, England. The twins, born January 2017 were joined at the top of the head with separate brains and a cylindrical shared skull with the twins each facing in opposite directions to one another. The surgery was jointly led by neurosurgeon Owase Jeelani and plastic surgeon Professor David Dunaway. The surgery presented particular difficulties due to a number of shared veins and a distortion in the shape of the girls' brains, causing them to overlap. The distortion would need to be corrected in order for the separation to go ahead. The surgery utilized a team of more than 100 including bio engineers, 3D modelers and a virtual reality designer. The separation was completed in February 2019 following a total of 52 hours of surgery over three separate operations. As of July 2019, both girls remain healthy and the family planned to return to their home in Pakistan in 2020.

History

Conjoined brothers from Nuremberg Chronicle (1493)
 
Conjoined twin sisters from Nuremberg Chronicle (1493)
 
Moche ceramics depicting conjoined twins. 300 CE Larco Museum Collection Lima, Peru

The Moche culture of ancient Peru depicted conjoined twins in their ceramics dating back to 300 CE. Writing around 415 CE, St. Augustine of Hippo, in his book, City of God, refers to a man "double in his upper, but single in his lower half—having two heads, two chests, four hands, but one body and two feet like an ordinary man."

According to Theophanes the Confessor, a Byzantine historian of the 9th century, around 385/386 CE, "in the village of Emmaus in Palestine, a child was born perfectly normal below the navel but divided above it, so that it had two chests and two heads, each possessing the senses. One would eat and drink but the other did not eat; one would sleep but the other stayed awake. There were times when they played with each other, when both cried and hit each other. They lived for a little over two years. One died while the other lived for another four days and it, too, died."

In Arabia, the twin brothers Hashim ibn Abd Manaf and 'Abd Shams were born with Hashim's leg attached to his twin brother's head. Legend says that their father, Abd Manaf ibn Qusai, separated his conjoined sons with a sword and that some priests believed that the blood that had flowed between them signified wars between their progeny (confrontations did occur between Banu al'Abbas and Banu Ummaya ibn 'Abd Shams in the year 750 AH). The Muslim polymath Abū al-Rayhān al-Bīrūnī described conjoined twins in his book Kitab-al-Saidana.

The English twin sisters Mary and Eliza Chulkhurst, who were conjoined at the back (pygopagus), lived from 1100 to 1134 (or 1500 to 1534) and were perhaps the best-known early historical example of conjoined twins. Other early conjoined twins to attain notice were the "Scottish brothers", allegedly of the dicephalus type, essentially two heads sharing the same body (1460–1488, although the dates vary); the pygopagus Helen and Judith of Szőny, Hungary (1701–1723), who enjoyed a brief career in music before being sent to live in a convent; and Rita and Cristina of 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 because England had already 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. They are believed to have died around this time, though some sources claim they survived until 1940, living in seclusion in Italy.

Notable people

Born 19th century and earlier

Chang and Eng Bunker, watercolor on ivory, 1835 or 1836
  • Mary and Eliza Chulkhurst, alleged names of the Biddenden Maids (per tradition, born in the 12th century) of Kent, England. They are the earliest set of conjoined twins whose names are (purportedly) known.
  • Lazarus and Joannes Baptista Colloredo (1617 — after 1646), autosite-and-parasite pair
  • Helen and Judith of Szony (Hungary, 1701 — 1723), pygopagus.
  • Chang and Eng Bunker (1811–1874). The Bunker twins were born of Chinese origin in Siam (now Thailand), and the expression Siamese twins is derived from their case. They were joined by the areas around their xiphoid cartilages, but over time, the connective tissue stretched.
  • Millie and Christine McCoy (July 11, 1851 – October 8, 1912), (oblique pygopagus). The McCoy twins were born into slavery in Columbus County, North Carolina, United States. They went by the stage names "The Two-Headed Nightingale" and "The Eighth Wonder of the World" and had an extensive career before retiring to the farm on which they were born.
  • Giacomo and Giovanni Battista Tocci (1875? — 1912?), (dicephalus tetrabrachius dipus)
  • Josefa and Rosa Blazek (January 20, 1878 — March 30, 1922), pygopagus. The Blazek twins were born in Skrejšov, Bohemia (now the Czech Republic). They began performing in public exhibitions at the age of 13, and their act later included Rosa's son Franz. The sisters died in Chicago, Illinois.

Born 20th century

Born 21st century

Conjoined twin lambs
  • Carl and Clarence Aguirre, born with vertical craniopagus in Silay City, Negros Occidental, on April 21, 2002. They were successfully separated on August 4, 2004.
  • Tabea and Lea Block, from Lemgo, Germany, were born as craniopagus twins joined on the tops of their heads on August 9, 2003. The girls shared some major veins, but their brains were separate. They were separated on September 16, 2004, although Tabea died about 90 minutes later.
  • Sohna and Mohna from Amritsar, India. Born in New Delhi on June 14, 2003. They have two hearts, arms, kidneys and spinal cords while share liver, gall bladder and legs.
  • Anastasia and Tatiana Dogaru, born outside Rome in Lazio, Italy, on January 13, 2004. As craniopagus twins, the top of Tatiana's head is attached to the back of Anastasia's head.
  • Lakshmi Tatma (born 2005) was an ischiopagus conjoined twin born in Araria district in the state of Bihar, India. She had four arms and four legs, resulting from a joining at the pelvis with a headless undeveloped parasitic twin.
  • In 2005 a set of conjoined triplets was detected, characterized as tricephalus, tetrabrachius, and tetrapus parapagothoracopagus, and the pregnancy interrupted at 22 weeks.
  • Kendra and Maliyah Herrin, ischiopagus twins separated in 2006 at age 4.
  • Krista and Tatiana Hogan, Canadian twins conjoined at the head. Born October 25, 2006. Share part of their brain and can pass sensory information and thoughts between each other.
  • Trishna and Krishna from Bangladesh were born in December 2006. They are craniopagus twins, joined on the tops of their skulls and sharing a small amount of brain tissue. In 2009, they were separated in Melbourne, Australia.
  • Maria and Teresa Tapia, born in the Dominican Republic on April 8, 2010. Conjoined by the liver, pancreas, and a small portion of their small intestine. Separation occurred on November 7, 2011, at Children's Hospital of Richmond at VCU.
  • Aung Myat Kyaw and Aung Khant Kyaw (born in May 2011, Mandalay, Myanmar), connected at pelvis.
  • Jesus and Emanuel de Nazaré are dicephalic parapagus twins born in Pará, Brazil on December 19, 2011.
  • Zheng Han Wei and Zheng Han Jing, born in China on August 11, 2013. Conjoined by their sternum, pericardium, and liver. In 2014, they were separated in Shanghai, China, at the Shanghai Children's Medical Center.
  • Asa and Eli Hamby were born in 2014 in Georgia but died less than two days after birth due to heart failure. The twins were dicephalic parapagus having two heads but being conjoined at the torso, arms and legs. They had separate spinal columns but one heart making postnatal operations impossible.
  • Jadon and Anias McDonald, born in September 2015. Conjoined by the head. Successfully separated at Children's Hospital of Montefiore Medical Center by James T. Goodrich in October 2016.
  • Erin and Abby Delaney, born in Philadelphia, Pennsylvania on July 24, 2016. Conjoined by the head. They were successfully separated at Children's Hospital of Philadelphia on June 16, 2017.
  • Marieme and Ndeye Ndiaye, twin girls born in Senegal in 2017, living in Cardiff, UK in 2019.
  • Safa and Marwa Bibi, twin girls born in Hayatabad, Pakistan on January 17, 2017, conjoined by the head. Successfully separated at Great Ormond Street Hospital in February 2019.
  • Callie and Carter Torres, born January 30, 2017, in Houston Texas, from Blackfoot Idaho. They are Omphalo-Ischiopagus conjoined twins, attached by their pelvic area and sharing all organs from the belly button down with just one leg each.
  • Yiğit and Derman Evrensel, twin boys born on June 21, 2018, Antalya, Turkey. They are craniopagus twins and were separated at Great Ormond Street Hospital in 2019 by the same surgeons that separated Safa and Marwa Bibi.
  • Ervina and Prefina, born June 29, 2018, in the Central African Republic. They were separated on June 5, 2020, at the Bambino Gesù Pediatric Hospital in Rome, Italy.
  • Mercy and Goodness Ede, born August 13, 2019, conjoined by the chest and abdomen. Successfully separated at the National Hospital in Abuja, Nigeria in November 2019.
  • Marie-Cléa and Marie-Cléanne Papillon, born in Mauritius in 2019. Conjoined from neck to abdomen, but also from heart which had seven rooms, instead of four. Marie-Cléa did not survive the surgery to separate the two.
  • Susannah and Elizabeth Castle, born April 22, 2021, and separated December 10, 2021 in Philadelphia, Pennsylvania.

In fiction

Conjoined twins have been the focus of several noteworthy works of entertainment, including:

  • Stuck on You (2003 film), a 2003 American comedy film screen written and directed by the Farrelly brothers and starring Matt Damon and Greg Kinnear as conjoined twin brothers, whose conflicting aspirations provide both conflict and humorous situations, in particular when one of them wishes to move to Hollywood to pursue a career as an actor.
  • Alone, a Thai horror film following Pim after the death of her sister Ploy and their subsequent separation.
  • Blood Sisters focuses on a French Canadian model who has a separated conjoined twin.
  • Irish author Sarah Crossan won the Carnegie Medal for her verse novel, One. The story follows the life and survival of conjoined twin sisters. The book also won The Bookseller's 2016 prize for young adult fiction and the Irish Children's Book of the Year.
  • Tarot: Witch of the Black Rose graphic novel debut the ghost twin, She/they are constant companion(s) of Skeleton Man, her protector.
  • The Broadway musical Side Show depicts the lives of real-life conjoined twins Daisy and Violet Hilton, portrayed in the original Broadway production by Alice Ripley and Emily Skinner.
  • Reiko the Zombie Shop, 1990s women's horror manga, bonus chapters focus on unexpectedly life of Noriko and her "sister". Summoners Dr. Zero can resurrect and control fuse zombies called medicinal death.
  • MA GI & CA L., a conjoined magical alternative android, from psychology horror manga Magical Girl Apocalypse.
  • In the TV series The Addams Family, there are extended family members of the Addams Family who are mentioned to have two heads. In "Mother Lurch Visits the Addams Family," Morticia Addams mentions that she has a Cousin Slimy who has two good heads on his shoulder. In "Progress and the Addams Family," Morticia was making a knitted hat for Cousin Plato where Gomez Addams has stated that his left head is size 6 and his right head is size 8 3/4. In "Lurch's Little Helper," Morticia made a portrait of Cousin Crimp who has a male head and a female head.
  • Tamil actor Suriya portrays Vimalan and Akilan, conjoined twins in the 2012 film, Maattrraan.
  • The book The Girls, by Canadian novelist Lori Lansens, published in 2005, is the fictional autobiography of Canadian craniopagus twins Rose and Ruby Darlen with Slovakian background.
  • Irish author Sarah Crossan won the Carnegie Medal for her verse novel, One. The story follows the life and survival of conjoined twin sisters. The book also won The Bookseller's 2016 prize for young adult fiction and the Irish Children's Book of the Year.
  • In Lilo & Stitch: The Series, Swapper are Ischiopagus twin green stubby limbed lizard-like experiment with black eyes, purple markings on his back and three purple-tipped tendrils on each head that can emit a green ray from each head's eyes. The ray will swap the minds and voices of the targets, and the only means of returning to normal is through Swapper choosing to do so. Because Swapper is two heads on the same body, Swapper is two beings cooperating as one, though their personalities mirror each other: they can be indecisive at times but usually work well together.
  • In Big-Top Pee-wee, the Cabrini Circus has some conjoined twins named Ruth and Dot (portrayed by Helen Infield Siff and Carol Infield Sender).
  • In The Addams Family and Addams Family Values, there are conjoined twins named Flora and Fauna Amor (portrayed by Darlene and Maureen Sue Levin) who were once dates to Gomez Addams and Uncle Fester. Both films also featured a two-headed relative named Dexter and Donald Addams (portrayed by Douglas Brian Martin and Steven M. Martin).
  • In The Addams Family cartoon in 1992, the episode "N.J. Addams" featured Aunt Noggin who was a two-headed person who wears a Victorian dress. One head is black and speaks in a Jamaican accent and the other head is Caucasian and speaks in a Brooklyn accent.
  • The Farrelly brothers film Stuck on You depicts Bob and Walt Tenor, conjoined twins portrayed by Matt Damon and Greg Kinnear. 2003.
  • In Midnighter issue #13, Shock & Awe is a superheroine working for Los Angeles Strike Force.
  • Delilah and Jezebel in video games Bully.
  • CatDog depicts Cat and Dog, a hybrid of a dog and cat who are brothers.
  • On a LeapFrog Enterprises commercial advertising the Leapster from 2007, a boy is constantly playing video games from the console itself. The more he praises the Leapster, the more he grows extra heads.
  • Zaphod Beeblebrox is a character from Douglas Adams' Hitchhiker's Guide to the Galaxy, who has a second head along with a third arm.
  • Vaka-Waka and Nurp-Naut in Cartoon Network and The Lego Group's Mixels.
  • Fender and Bender (also known individually as HeadBanger) are characters in the 90's television series Toxic Crusaders, based on The Toxic Avenger films by Troma Entertainment. Fender is supposed to be a Mad Scientist while Bender is a Surfer.
  • Dragon Tales, a children's show, depicts Zak and Wheezie (voiced by Jason Michas and Kathleen Barr) as a two-headed dragon that are brother and sister making them dicephalic parapagus twins.
  • In the Canadian mobile game My Singing Monsters, a bird-like species known as the Quibble is made up of elements Air and Water. The two-headed species plays a piano and has different colored feathers on both heads.
  • The Simpsons features Hugo in "Treehouse of Horror VII", who is Bart Simpson's conjoined twin. They were separated at birth by Dr. Hibbert and Hugo was imprisoned in the Simpsons' attic.
  • The Oblongs, depicts Biff Oblong (Randy Sklar) and Chip Oblong (Jason Sklar)—17-year-old conjoined twins who are attached at the waist and share a middle leg due to their valley's pollution and radiation.
  • In the DC Comics series Hitman, villain Moe and Joe Dubelz is a conjoined twin gangster. Moe was alive at the time of introduction, but Joe had already died and is, in fact, undergoing putrefaction.
  • In the episode "Humbug" of The X-Files, Vincent Schiavelli portrayed a circus performer named Lanny, with an underdeveloped conjoined twin named Leonard. The episode also includes a reference to Chang and Eng.
  • The Prophet of Yonwood has a reference to Chang and Eng when the main character, Nickie, finds a picture of them in her great-grandfather's old house in Siam.
  • In the anime Naruto, Sakon (左近) and his conjoined twin brother Ukon (右近) are the strongest of the Sound Four and count as one member due to their abilities to merge bodies and kill an opponent at a cellular level. They both serve as antagonists.
  • The Broadway musical Side Show depicts the lives of real-life conjoined twins Daisy and Violet Hilton, portrayed in the original Broadway production by Alice Ripley and Emily Skinner.
  • The American medical drama Grey's Anatomy featured several cases of conjoined twins.
  • The 2001 movie Not Another Teen Movie depicts Kara and Sara Fratelli, conjoined twins portrayed by Samaire Armstrong and Nectar Rose.
  • The musical group Evelyn, Evelyn depicts a pair of conjoined twin sisters—often referred to as "The Evelyn Sisters"—in many of their songs and music videos. The fictional sisters are shown to be child prostitutes in the music video for "Sandy Fishnets", and the song "Evelyn, Evelyn" describes their longing for privacy and to be separated from one another.
  • The Bride with White Hair, a 1993 Hong Kong movie, features conjoined twin villains.
  • The animated series Duckman featured Eric T. Duckman's sons Charles (voiced by Dana Hill in 1994–1996, Pat Musick in 1997) and Mambo (voiced by E. G. Daily) who are dicephalic parapagus twins where their heads share a body.
  • Fran Bow, a 2015 indie psychological horror game, includes Clara and Mia Buhalmet, a set of mentally ill conjoined twins, as characters. They were surgically sewn together, much like an experiment performed by Josef Mengele, also known as the Angel of Death, in which a pair of twins were sewn together back to back by blood vessels and organs, in an attempt to create conjoined twins.
  • The Peach Tree, a Korean novel and film, portrays conjoined twin brothers falling in love with the same woman.
  • The 1999 movie Twin Falls Idaho portrays conjoined twin brothers who are played by two non-conjoined identical twin brothers, one of whom directed the film, and both of whom co-wrote the screenplay.
  • In the fourth season of the American television series American Horror Story titled American Horror Story: Freak Show, the main character Bette and Dot Tattler (Sarah Paulson in a dual role) are a dicephalic parapagus twin where their two heads are side by side on one torso. This performance is done with the help of CGI.
  • In season two, episode eight of Rick and Morty, Michael and Pichael Thompson (voiced by Justin Roiland) are depicted as conjoined twins hosting separate TV shows at the same time.
  • In the Cirque Du Soleil show Kurios: Cabinetes des Curiosities, a pair of conjoined twins are among the Seeker's collection. They later split during an aerial straps duo and reunite for the rest of the show.
  • The bilingual film Chaarulatha stars Priyamani as a conjoined twin.
  • In the Disney-distributed movie Jagga Jasoos, starring Ranbir Kapoor and Katrina Kaif, Basheer Alexander is shown with two heads.
  • On the television series Ruby Gloom, the characters Frank and Len are conjoined twins who comprise a rock group called RIP.
  • In the film Monsters University, two of the members of the fictitious fraternity Oozma Kappa are named Terri and Terry Perry (voiced by Sean Hayes and Dave Foley). They are dicephalic parapagus twins where they have four arms and share the same tentacles that are in place of their legs.
  • In the children's cartoon Steven Universe, the Rutile twins are conjoined.
  • Fire and Water are conjoined twins in Chris Abani's 2014 novel The Secret History of Las Vegas.
  • The Knick portrays conjoined twins Zoya and Nika, who share a liver. They are successfully separated by the doctors.
  • Brian Aldiss's 1977 novel Brothers of the Head depicts conjoined twins who become rock stars. In the 2005 film version, they are played by non-conjoined identical twins Harry Treadaway and Luke Treadaway.
  • The 2006 remake of The Hills Have Eyes briefly shows a photo of a set of twins, who have Cephalothoracopagus/Janiceps. This particular case, was caused by Agent Orange.
  • Admirals Watson and Crick are presumably conjoined twins joined at the torso in the 2015 children's show Miles from Tomorrowland.
  • In the Ultimate Marvel reality of Marvel Comics, Syndicate is two conjoined twins in Ultimate X-Men. They were created by Brian K. Vaughn and Steve Dillon, and first appeared in Ultimate X-Men #58. They were killed during the crossover event Ultimatum.
  • In the horror video game Dead by Daylight, the playable characters “The Twins” are a brother and sister who are conjoined twins. However, the brother is able to detach from the sister.

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