The woman who vomited pins

Belford hospitalIn 1873 The Lancet reported this case from Belford Hospital, an institution which had been founded eight years earlier, and the first to serve the largely rural population around Fort William in Scotland. This was probably the strangest case anybody concerned had dealt with:

Catherine M, aged twenty, a nurse-maid, was admitted on August 30th, 1872. The patient stated that, while employed fixing clothes to a line the previous day she, having four or five large pins in her mouth, had accidentally swallowed them. She complained of a constant jagging pain in the precordial region. Having remained in hospital eleven days, during which time she vomited five pins (an emetic having been administered every second day), she was dismissed cured. 

‘Precordial’ means, literally, ‘in front of the heart’; i.e., in the middle of the chest. All now seemed well; but it was not.

After being four days at home she again experienced the jagging pain in the precordial region, and her mistress having administered large quantities of warm water, she vomited two pins. From this time her stomach remained very irritable, and she was constantly vomiting – having great pain while retching – till on October 20th she vomited no fewer than twenty-three pins.

Crikey.

For nine days after this date a needle came out at a spot over the origin of the sterno-cleido-mastoid muscle behind the left ear – one needle each day. On September 20th two needles came out of the left nostril in succession, each needle being in three pieces. Blood flowed freely from her nose and mouth.

This is starting to sound like a scene from The Exorcist.

On October 26th she applied for re-admission into hospital, which was granted. On the first two days of her residence in hospital a needle came out each day behind the left ear. On November 2nd, at a spot on the front of the right forearm, about two inches from the elbow-joint, a needle came out, the broken-off point of which issued at the same spot next day. On November 4th another needle, minus the point, came out at the same spot. She remained in hospital for some weeks after this date, and the irritation having left her stomach, and her general health being excellent, she was dismissed, returning to her service, and, so far as is known, having kept quite well since.

The patient was cured and dismissed, but a mystery remained: how had had dozens of pins got into her body in the first place?

She is and always has been a strong healthy girl, without the slightest tendency to hysteria. Seventy-five pins in all were vomited, all of which have been carefully kept. The pins are such as are sold by weight, not in paper. They are all quite clean and bent at an acute angle. One of them is what is called a safety pin. It came up in three pieces. The needles are blackened and slightly eroded. Two of them are threaded, the threads being, in each instance, about three inches long. Before a needle made its appearance pain was felt, shifting along till the needle made its exit. Thirteen needles in all came out. Of the nine which issued behind the ear, eight came out about an hour after breakfast, whilst the ninth appeared an hour after dinner, probably from the action of the muscles of the jaw.

Naturally enough, the doctors’ first thought was that this condition might be self-inflicted. But the facts seemed to dictate otherwise.

The girl was repeatedly cross-examined with a view to ascertaining how the pins and needles came to be swallowed. Except in the instance of the five pins swallowed while hanging up clothes to dry, she is not aware of ever having swallowed pins. She had, however, been in the constant habit of putting pins into her mouth from childhood, and often fell asleep, after undressing the children at night, with half-a-dozen pins in her mouth. Her present mistress said that she had observed the habit in her nurse-maid, and that one morning she had found the girl asleep with half-a-dozen pins between her cheeks and her teeth. The fact of all the pins being bent is a curious one. Probably she would chew them, as it were. She has a beautiful set of teeth.

Dr Wright Hutchison, the doctor in charge of the case, concluded that this explanation was quite plausible: 

The history of the case is almost incredible, but, from what was observed in hospital, and from the evidence of her mistress, which is thoroughly reliable, there can be no doubt about its being bona fide.

The editor of The Lancet was not so sure. In a sceptical note preceding the case report he puts forward an alternative which – to me, at least – seems more convincing:

It would be interesting to know whether the patient in this case was left-handed, for it is to be remarked that the needles were discharged from those parts of the body into which they could be best introduced by the left hand – e.g., behind the left ear, from the left nostril, and right forearm. Further, the fact that all the pins were bent at an acute angle seems to point to an intentional bending rather than an accidental one produced by biting the pins, for it would hardly be possible to bend a pin at an acute angle by means of the teeth only.

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