The cure of Thomas Tipple

In 1840 an American physician, Dr Pliny Earle, visited the Hunterian Museum of the Royal College of Surgeons in London. He wrote an account of what he saw there, subsequently published in The American Journal of the Medical Sciences.  It’s a document of great value, not least because he describes a number of exhibits which were destroyed when a German incendiary bomb fell on the building in 1941. One of them was a partial human skeleton, which in 1840 shared a pedestal with an ex-elephant. The skeleton belonged to the late Thomas Tipple; Dr Earle relates his story: 

Thomas Tipple, arriving at the house of John Overton, at Stratford, near London, on the evening of the 13th June, 1812, and the groom being absent, took off his coat and began to unharness the horse. Being undoubtedly not very well versed in the trade of an ostler, he commenced by taking off the bridle. This being removed, the horse sprang forwards, and the end of one of the shafts of the gig struck Tipple upon the left breast, pierced the parietes [chest wall], traversed a portion of the thorax, came out upon the right side, and penetrated the sheathing of the house.

The first persons who arrived upon the spot, after the accident, were Edward and Henry Lawrence. They testify that they found him standing upon tiptoe, with both his arms extended. Although thus completely impaled, he was able to put his hand upon the end of the shaft and assist in drawing himself off.

This reminds me of the first film I ever saw in a cinema, Flash Gordon (1980), in which Ming the Merciless is impaled on the sharpened nosecone of his own rocket.

Being released he respired two or three times without difficulty, and there was no inordinate agitation of the body. The wound did not bleed very freely, and the patient went into the house, took off his vest and walked up two flights of stairs.

Let’s just pause to remind ourselves that he had just been impaled through the chest and pinned to the wall of a house. It’s amazing that he was conscious, let alone able to walk up two flights of stairs.

His servants undressed him; his condition was worsening, as he had a tendency to faint, and a ‘trickling of blood upon the lungs’ was causing breathing difficulties.

He sat in his bed until, upon being bled, that difficulty was relieved. The venesection was prescribed by William Maiden, a surgeon, who was called upon about nine o’clock. He found a hemorrhage from the wound on the left side of the thorax, made by the iron on the under side of the shaft of the gig. Air was also issuing from the wound, indicating a severe lesion of the vesicles of the lungs. The quantity of blood taken from the vein was about four pounds avoirdupois.

Four pounds is a colossal amount: around 1.7 litres or 3 pints, between a fifth and a quarter of the total volume in his body.

The patient was permitted to drink a little cold water. At eleven o’clock, Sir William Blizzard arrived, and upon an examination of the patient, found the wounds to be each about four inches in length, while the left shoulder and chest were slightly emphysematous. Anticipating a reaction of the circulation, which he presumed would be hastened by the venesection, and which might occasion a profuse hemorrhage from the wounds, he prognosticated a fatal termination before morning.

This seems a reasonable assumption, given the nature of the wound and the fact that the doctors had greatly impaired his chances of recovery by removing a large proportion of his circulation. However:

This man by careful management finally recovered under Sir William Blizzard.

 The ‘careful management’ involved a vegetable diet, the regular use of laxatives and Epsom salts.

Thomas Tipple was thirty-four years of age when he received this remarkable wound. His digestion, at the time, was impaired, but it was much improved after his recovery. His general physical strength was less after the accident, and there remained a soreness of the chest, and a liability to difficult respiration upon making any inordinate exertion. During the first five years immediately following his recovery, it required less exercise than formerly to put him ‘out of breath.’

Later he developed gout and rheumatism, and his health gradually declined despite further treatment by his physicians.

He lost his strength, became pallid, and suffered so much from dyspnoea that he was bled about a week previous to his decease. Relief was obtained, but the action of the heart became feeble, and great distress was depicted in his countenance. Sunday, March 2, 1823, He was assisted in going down stairs, when, upon attempting to speak his voice failed and he suddenly expired. 

An autopsy was subsequently performed: the doctors were curious to know what injuries Tipple had suffered during the accident. They found that several ribs were broken, and some of them had been depressed into the thoracic cavity – presumably, piercing the lungs. The American doctor’s report contains one final gem:

The extremity of the shaft which inflicted the wound is also preserved in the museum. It penetrated the body to the distance of twenty-one inches. The portion of that length is five inches in circumference, in the middle, and six at the larger extremity. The tug-iron underneath is three and a half inches in length. This undoubtedly entered the lungs.  

Alas, these artefacts have not survived, presumably destroyed in the German air raid.  Thomas Tipple lived for 11 years after his accident, despite receiving no surgical treatment. Truly a remarkable recovery.