The privy spider

This painful case was recorded in the American Journal of the Medical Sciences in 1839. The author, Dr Isaac Hulse, was the surgeon in charge of the US Navy hospital in Pensacola, Florida:

On the 7th of August last, Mr. Q. of this place, while in the privy, perceived himself to be stung by a spider on the glans penis. The pain, which was not great at the moment, continued to increase till 1 P. M., an hour after the accident, when it had become extreme, and I was called to see the patient. I found him lying upon a cot, and writhing under the most acute suffering.

Poor fellow. It is perhaps worth observing that the glans, the tip of the penis, is densely packed with nerve endings.

The place where the sting was made, showed no marks of irritation nor swelling.

The doctor then ran to the apothecary’s to fetch some medicine.

My absence lasted but a few minutes, and on my return, I found him vomiting with great violence, and complaining of deep-seated pain in the abdomen, extending up into the chest, and of sensations of choking and suffocation. The vessels of the neck and face were greatly distended, and of a dark hue.

This being the 1830s, the ancient remedies of bloodletting and purging the bowels (giving laxatives) were still very much in vogue.

I opened a vein in the arm and let blood copiously through a large orifice, and commenced immediately to give aqua ammoniae and laudanum in doses of a teaspoonful of each every ten minutes, which were ejected as often from the stomach.

Hardly surprising. A mixture of ammonia and laudanum does not sound terribly palatable even for a patient in perfect health.

Pains and spasms along the spine and extremities now came on, and the agony and anxiety were, if possible, increased. Strong volatile liniment, tinct. cantharides, and spirits terebinth. were alternately applied to every part of the body by the patient’s numerous friends who had assembled round him, and common injections were administered as frequently as they conveniently could be, with a view to open the bowels.

The ‘common injections’ were simple enemas. The other substances applied to his body included ammonia, turpentine, and cantharidin. The latter is a chemical secreted by several types of beetle, a skin irritant which tends to provoke blistering. The point of this treatment was – in theory, at least – to draw any toxins out of the patient’s body via any route possible.

At 3 P.M. the paroxysms of pain came on at longer intervals, and the vomiting was less urgent, but the intensity of the pain when present, was undiminished. The principal medicine relied on, viz. the ammoniae and laudanum, were continued every half hour, and at about 5 o’clock, after the exhibition of fifteen injections, fecal evacuations were obtained from the bowels.

Fifteen enemas sounds an awful lot to endure in a single day, doesn’t it? Mind you, it was probably a minor inconvenience compared with a spider bite on the penis. Nevertheless, the doctor’s obsession with the patient’s bowels continued.

The patient became much easier in the course of the evening, and was able to retain a dose of castor oil, which purged him freely; but the pain in the legs continued through the night, which he passed without sleep. On the subsequent day, sinapisms were applied to the legs without effect, and the evening brought little or no mitigation of the pain.

Sinapisms were mustard plasters. They were a treatment used as part of the doctrine of counter-irritation – the idea being that deliberately producing irritation in one part of the body reduced the pain experienced in another.

Veins were now opened in both feet, which were placed in warm water, and the blood was allowed to flow till an impression was made on the pulse.

Not a good idea, since the alteration in the pulse may indicate a significant reduction in the total circulating volume of blood.

In an hour after the bleeding, the patient enjoyed perfect ease; he slept well that night, and on the following day was able to walk about the house. He recovered in health very speedily.

A fact that almost certainly had nothing to do with the medical treatment he received. Today, doctors would want to administer an antivenom (if one were available) and also liquids and electrolytes if the patient was not able to retain food or drink. The therapeutic measures adopted were a positive threat to the patient’s wellbeing.

I saw several spiders in the place where he received the sting. They were of large size, of a dark brown colour, covered with hairs over the legs and body.

I would love to know what species of spider this was – but the doctor’s description is difficult to reconcile with the facts of the case. There aren’t any brown, hairy venomous spiders endemic to Florida, so what was it? I suppose the privy might have been infested with stowaways from a naval vessel recently returned from South America. But I suspect the culprit was in fact the most notorious spider native to Florida, the southern black widow.

Although the black widow’s physical appearance (black and glossy) is obviously at odds with the doctor’s description, the symptoms produced by its bite are strikingly similar. The bite often feels trivial, little more than a pinprick, and for some time afterwards the patient may feel no pain. But after a couple of hours, muscular cramps set in, sometimes followed by abdominal pain, nausea and difficulty in breathing. So I wouldn’t be at all surprised if this was a black widow bite – but what do I know? Experts in spider bites and their treatment are very welcome to leave a comment below.