Henry Fryer was a surgeon from the market town of Stamford in Lincolnshire. When he died in 1823 he left £7,500 in his will for the foundation of a new hospital – and almost two centuries on, the Stamford and Rutland Hospital is still very much open.
Fryer was in his early thirties and near the beginning of his career when this case report of his was published in the Medical Facts and Observations in 1797:
In March last I was desired to attend Mrs. M. The person who came for me informed me that the patient, a few weeks before, had fallen downstairs upon her face, by which fall she had hurt her breast, and then first acknowledged that she had, many years before, thrust several pins into her breasts.
An arresting introduction to a new patient. Mr Fryer’s case report gives no further details of the woman’s medical history. Either he did not ask her about it, or he deemed it irrelevant to his report.
Upon examination I found I could very readily shake about a great number of pins (which seemed of different sizes, as well as shapes) not only in each breast, but also in the skin upon the scrobiculus cordis.
The ‘scrobiculus cordis’ is known today as the epigastric fossa, colloquially the pit of the stomach.
On farther inquiry I learned that about sixty years ago, when between fifteen and sixteen years old, she had been in some degree deranged, and had at that time forced these pins into the skin, but had never felt any inconvenience from them till now, when she had fallen down; and, I suppose, some of the pins being pressed hard against the skin, as they lay between the skin and the ribs, with scarcely any adipose substance intervening, had occasioned the pain. She was perfectly rational at this time, and gave me the above account herself.
The ingestion or self-insertion of pins and needles seems to have been a common form of self-harm in the eighteenth and nineteenth centuries. I’ve documented numerous examples on this blog, including a young Danish woman who had almost 300 needles removed from various parts of her body. Overwhelmingly the patients tended to be young and female, often adolescents – and postpartum depression appears to have been a trigger in some cases, too.
As she pointed readily to those pins which gave her pain, I made a small opening with a lancet, and took out three, one crooked, the others straight; they were turned very black, and I had some difficulty in detaching them. I saw her again in a few days, when the wound was nearly healed, but she complained then of some others; I therefore made another small opening, and removed two more pins, after which she would not consent to have any more taken away, as she said that she then felt no pain from them.
That’s five pins removed; but how many more were there?
The number of pins still remaining I can by no means guess at; but it is so considerable, that I can feel them strike against each other upon taking hold of either of her breasts, particularly as her skin hangs loosely from her, she being now very thin; and also upon laying my hand upon the skin between her breasts, I can feel them in lumps, lying in every direction.
Sixty years is a long time, and the woman’s physique might have altered quite considerably since her youth. As the natural processes of ageing progressed, the pins which had been snugly enveloped by muscle and subcutaneous fat came together in clumps and became palpable through the skin. It’s just surprising that they didn’t cause a problem sooner.