Impaled on a stake

How about this for a lucky escape?  It’s the sort of grisly farm accident which might be featured in a medical documentary like 24 Hours in A&E, with one significant difference. Anybody unlucky enough to be impaled by a stake today could expect major surgery and a lengthy hospital stay – but this patient made a total recovery after little more than bed rest.

This remarkable tale appeared in the New England Journal of Medicine and Surgery in 1825, where it was reported by a Dr Woodbury, from Bedford in New Hampshire:

On the afternoon of July 24, 1823, I was called to visit Miss E. M. who had been engaged in taking away rye in the sheaf on the beams of a barn. By some misstep she fell the distance of seven or eight feet, and struck directly on the end of a stake, erect, in a cart below; from which situation one man was not able to extricate her. So completely was the girl transfixed with the stake, that it was necessary to break it off at its insertion in the cart body; and it was carried with the girl upon it, some distance from the barn before it was taken from her.

As you’d imagine, being impaled like some sort of human kebab inflicted some appalling injuries.

The stake first struck on the tuberosity of the ischium [the bottom of the hip bone], and passed laterally into the anus, up the rectum about two inches, thence through it on its left side, up the body in an oblique direction, and out of the left breast, about three inches from the nipple. It lacerated the sphincter ani, and fractured three ribs in its passage. A light substance held at the orifice of the upper wound, was, in common respiration, considerably affected; and by coughing, or by a long inspiration and expiration, a light piece of cloth was much shaken.

The stake passed through her body twenty-seven inches; it was three inches in circumference at the least end, and five inches at the largest end. It came out of her breast six or seven inches, so that she kept hold of it with both hands while the stake was in her. The stake was made out of a young hemlock, and the bark with the knots were just stripped off. It is now in my possession.

A macabre sort of souvenir of an admittedly extraordinary incident.

This was a healthy girl in the fifteenth year of her age, of a large size, had menstruated one year; and had the appearance of a woman in every respect.

When Dr Woodbury arrived at the scene, the girl’s family despaired of her life.

On my arrival I found her on a bed with no covering but her common clothes; her friends thought her dying; I was requested not to do much for her, for fear she would die in more pain. Her pulse were scarcely perceptible, her breathing short and hurried, with a cold sweat on her skin; she had an extremely ghastly countenance; she did not incline to say any thing, but submitted to the examination without any apparent concern or sensation. She made no complaint, and said she had no pain, but was somewhat faint. There was but a trifling hemorrhage from the wounds.

The doctor applied a dressing to her wounds, and gave her a cup of tea with oil of lavender. Not exactly a radical intervention, but it’s hard to know what more he could have done.

She soon began to breathe better, her pulse began to be more perceptible, and her skin grew more moist and warm. I now left her for the night, this being about nine o’clock in the evening, with directions that if she should get relief to let me have information, thinking that she could not survive many hours.

The following day Dr Woodbury found his patient still alive, although now complaining of pain in her abdomen.

She talked freely, said she felt better, and was hungry. Had not had any stool, nor passed any water since the accident.

The doctor dressed her wounds, gave her a dose of castor oil and took a pint of blood from her arm. For food she was given a thin gruel: water which had had Indian meal boiled in it.

July 26th. — The oil had not operated, had no discharge of water, complained of soreness of the abdomen, with some swelling above the pubis, with a distinct line of inflammation in the direction which the stake took. Her cough produced more pain at the time of coughing than it had done before. Pulse 110, with hardness. Took away one pint of blood from the arm, and drew away three pints of urine with the catheter.

The following day she was not much improved.  But then affairs took a happier turn:

July 28th. — Found my patient better in every respect, could turn herself in bed without any assistance for the first time since the accident. From this time to the completion of her cure, there was no uncommon or unnatural appearance observed. The patient evidently improved daily. I drew off her urine seventeen days in succession, after which it became unnecessary. In her first attempt to walk her body inclined a little to the left, but she soon became erect. Six weeks from the time of the accident the patient was able to attend school fifty rods from home. I bled her during confinement five times; and she subsisted these seventeen days wholly on water in which Indian meal had been boiled. She now enjoys the finest health.

That, as they say, is not a bad outcome.