There are some ocular injuries from lightning on record. In these cases

the lesions have consisted of detachment of the retina, optic atrophy,

cataract, hemorrhages into the retina, and rupture of the choroid,

paralysis of the oculomotor muscles, and paralysis of the optic nerve.

According to Buller of Montreal, such injuries may arise from the

mechanic violence sustained by the patient rather than by the thermal

or chemic action of the current. Buller describes a case of

lightning-stroke in which the external ocular muscles, the crystalline

lens, and the optic nerve were involved. Godfrey reports the case of

Daniel Brown, a seaman on H.M.S. Cambrian. While at sea on February 21,

1799, he was struck both dumb and blind by a lightning-stroke. There

was evidently paralysis of the optic nerve and of the oculomotor

muscles; and the muscles of the glottis were also in some manner

deprived of motion.

That an amputation can be perfectly performed by a lightning-stroke is

exemplified in the case of Sycyanko of Cracow, Poland. The patient was

a boy of twelve, whose right knee was ankylosed. While riding in a

field in a violent storm, a loud peal of thunder caused the horse to

run away, and the child fell stunned to the ground. On coming to his

senses the boy found that his right leg was missing, the parts having

been divided at the upper end of the tibia. The wound was perfectly

round and the patella and femur were intact. There were other signs of

burns about the body, but the boy recovered. Some days after the injury

the missing leg was found near the place where he was first thrown from

the horse.

The therapeutic effect of lightning-stroke is verified by a number of

cases, a few of which will be given. Tilesius mentions a peculiar case

which was extensively quoted in London. Two brothers, one of whom was

deaf, were struck by lightning. It was found that the inner part of the

right ear near the tragus and anti-helix of one of the individuals was

scratched, and on the following day his hearing returned. Olmstead

quotes the history of a man in Carteret County, N.C., who was seized

with a paralytic affection of the face and eyes, and was quite unable

to close his lids. While in his bedroom, he was struck senseless by

lightning, and did not recover until the next day, when it was found

that the paralysis had disappeared, and during the fourteen years which

he afterward lived his affection never returned. There is a record of

a young collier in the north of England who lost his sight by an

explosion of gunpowder, utterly destroying the right eye and fracturing

the frontal bone. The vision of the left eye was lost without any

serious damage to the organ, and this was attributed to shock. On

returning from Ettingshall in a severe thunder storm, he remarked to

his brother that he had seen light through his spectacles, and had

immediately afterward experienced a piercing sensation which had passed

through the eye to the back of the head. The pain was brief, and he was

then able to see objects distinctly. From this occasion he steadily

improved until he was able to walk about without a guide.

Le Conte mentions the case of a negress who was struck by lightning

August 19, 1842, on a plantation in Georgia. For years before the

reception of the shock her health had been very bad, and she seemed to

be suffering from a progressive emaciation and feebleness akin to

chlorosis. The difficulty had probably followed a protracted

amenorrhea, subsequent to labor and a retained placenta In the course

of a week she had recovered from the effects of lightning and soon

experienced complete restoration to health; and for two years had been

a remarkably healthy and vigorous laborer. Le Conte quotes five similar

cases, and mentions one in which a lightning-shock to a woman of

twenty-nine produced amenorrhea, whereas she had previously suffered

from profuse menstruation, and also mentions another case of a woman of

seventy who was struck unconscious; the catamenial discharge which had

ceased twenty years before, was now permanently reestablished, and the

shrunken mammae again resumed their full contour.

A peculiar feature or superstition as to lightning-stroke is its

photographic properties. In this connection Stricker of Frankfort

quotes the case of Raspail of a man of twenty-two who, while climbing a

tree to a bird's nest, was struck by lightning, and afterward showed

upon his breast a picture of the tree, with the nest upon one of its

branches. Although in the majority of cases the photographs resembled

trees, there was one case in which it resembled a horse-shoe; another,

a cow; a third, a piece of furniture; a fourth, the whole surrounding

landscape. This theory of lightning-photographs of neighboring objects

on the skin has probably arisen from the resemblance of the burns due

to the ramifications of the blood-vessels as conductors, or to peculiar

electric movements which can be demonstrated by positive charges on

lycopodium powder.

A lightning-stroke does not exhaust its force on a few individuals or

objects, but sometimes produces serious manifestations over a large

area, or on a great number of people. It is said that a church in the

village of Chateauneuf, in the Department of the Lower Alps, in France,

was struck by three successive lightning strokes on July 11, 1819,

during the installation of a new pastor. The company were all thrown

down, nine were killed and 82 wounded. The priest, who was celebrating

mass, was not affected, it is believed, on account of his silken robe

acting as an insulator. Bryant of Charlestown, Mass., has communicated

the particulars of a stroke of lightning on June 20, 1829, which

shocked several hundred persons. The effect of this discharge was felt

over an area of 172,500 square feet with nearly the same degree of

intensity. Happily, there was no permanent injury recorded. Le Conte

reports that a person may be killed when some distance--even as far as

20 miles away from the storm--by what Lord Mahon calls the "returning

stroke."

Skin-grafting is a subject which has long been more or less familiar to

medical men, but which has only recently been developed to a

practically successful operation. The older surgeons knew that it was

possible to reunite a resected nose or an amputated finger, and in

Hunter's time tooth-replantation was quite well known. Smellie has

recorded an instance in which, after avulsion of a nipple in suckling,

restitution was effected. It is not alone to the skin that grafting is

applicable; it is used in the cornea, nerves, muscles, bones, tendons,

and teeth. Wolfer has been successful in transplanting the mucous

membranes of frogs, rabbits, and pigeons to a portion of mucous

membrane previously occupied by cicatricial tissue, and was the first

to show that on mucous surfaces, mucous membrane remains mucous

membrane, but when transplanted to skin, it becomes skin. Attempts

have been made to transplant a button of clear cornea of a dog, rabbit,

or cat to the cornea of a human being, opaque as the result of

ophthalmia, and von Hippel has devised a special method of doing this.

Recently Fuchs has reported his experience in cornea-grafting in

sections, as a substitute for von Hippel's method, in parenchymatous

keratitis and corneal staphyloma, and though not eminently successful

himself, he considers the operation worthy of trial in cases that are

without help, and doomed to blindness.

John Hunter was the first to perform the implantation of teeth; and

Younger the first to transplant the teeth of man in the jaws of man;

the initial operation should be called replantation, as it was merely

the replacement of a tooth in a socket from which it had accidentally

or intentionally been removed. Hunter drilled a hole in a cock's comb

and inserted a tooth, and held it by a ligature. Younger drilled a hole

in a man's jaw and implanted a tooth, and proved that it was not

necessary to use a fresh tooth. Ottolengni mentions the case of a man

who was struck by a ruffian and had his two central incisors knocked

out. He searched for them, washed them in warm water, carefully washed

the teeth-sockets, and gently placed the teeth back in their position,

where they remained firmly attached. At the time of report, six years

after the accident, they were still firmly in position. Pettyjohn

reports a successful case of tooth-replantation in his young daughter

of two, who fell on the cellar stairs, completely excising the central

incisors. The alveolar process of the right jaw was fractured, and the

gum lacerated to the entire length of the root. The teeth were placed

in a tepid normal saline solution, and the child chloroformed, narcosis

being induced in sleep; the gums were cleaned antiseptically, and 3 1/2

hours afterward the child had the teeth firmly in place. They had been

out of the mouth fully an hour. Four weeks afterward they were as firm

as ever. By their experiments Gluck and Magnus prove that there is a

return of activity after transplantation of muscle. After excision of

malignant tumors of muscles, Helferich of Munich, and Lange of New

York, have filled the gap left by the excision of the muscle affected

by the tumor with transplanted muscles from dogs. Gluck has induced

reproduction of lost tendons by grafting them with cat-gut, and

according to Ashhurst, Peyrot has filled the gaps in retracted tendons

by transplanting tendons, taken in one case from a dog, and in another

from a cat.

Nerve-grafting, as a supplementary operation to neurectomy, has been

practiced, and Gersung has transplanted the nerves of lower animals to

the nerve stumps of man.

Bone-grafting is quite frequently practiced, portions from a recently

amputated limb, or portions removed from living animals, or bone-chips,

may be used. Senn proposed decalcified bone-plates to be used to fill

in the gaps. Shifting of the bone has been done, e.g., by dividing a

strip of the hard palate covered with its soft parts, parallel to the

fissure in cleft palate, but leaving unsevered the bony attachments in

front, and partially fracturing the pedicle, drawing the bony flaps

together with sutures; or, when forming a new nose, by turning down

with the skin and periosteum the outer table of the frontal bone, split

off with a chisel, after cutting around the part to be removed.

Trueheart reports a case of partial excision of the clavicle,

successfully followed by the grafting of periosteal and osseous

material taken from a dog. Robson and Hayes of Rochester, N.Y., have

successfully supplemented excision of spina bifida by the

transplantation of a strip of periosteum from a rabbit. Poncet hastened

a cure in a case of necrosis with partial destruction of the periosteum

by inserting grafts taken from the bones of a dead infant and from a

kid. Ricketts speaks of bone-grafting and the use of ivory, and remarks

that Poncet of Lyons restored a tibia in nine months by grafting to the

superior articular surface. Recently amalgam fillings have been used

in bone-cavities to supplant grafting.

In destructive injuries of the skin, various materials were formerly

used in grafting, none of which, however, have produced the same good

effect as the use of skin by the Thiersch Method, which will be

described later.

Rodgers, U.S.N., reports the case of a white man of thirty-eight who

suffered from gangrene of the skin of the buttocks caused by sitting in

a pan of caustic potash. When seen the man was intoxicated, and there

was a gangrenous patch four by six inches on his buttocks. Rodgers used

grafts from the under wing of a young fowl, as suggested by Redard,

with good result. Vanmeter of Colorado describes a boy of fourteen with

a severe extensive burn; a portion beneath the chin and lower jaw, and

the right arm from the elbow to the fingers, formed a granulating

surface which would not heal, and grafting was resorted to. The

neck-grafts were supplied by the skin of the father and brother, but

the arm-grafts were taken from two young puppies of the Mexican

hairless breed, whose soft, white, hairless skin seemed to offer itself

for the purpose with good prospect of a successful result. The outcome

was all that could be desired. The puppy-grafts took faster and proved

themselves to be superior to the skin-grafts. There is a case reported

in which the skin of a greyhound seven days old, taken from the

abdominal wall and even from the tail, was used with most satisfactory

results in grafting an extensive ulcer following a burn on the left leg

of a boy of ten. Masterman has grafted with the inner membrane of a

hen's egg, and a Mexican surgeon, Altramirano, used the gills of a cock.

Fowler of Brooklyn has grafted with the skin from the back and abdomen

of a large frog. The patient was a colored boy of sixteen, who was

extensively burned by a kerosene lamp. The burns were on the legs,

thighs, buttocks, and right ankle, and the estimated area of burnt

surface was 247.95 square inches. The frog skin was transferred to the

left buttocks, and on the right buttocks eight long strips of white

skin were transferred after the manner of Thiersch. A strip of human

skin was placed in one section over the frog skin, but became necrotic

in four days, not being attached to the granulating surface. The man

was discharged cured in six months. The frog skin was soft, pliable,

and of a reddish hue, while the human white skin was firm and rapidly

becoming pigmented. Leale cites the successful use of common warts in a

case of grafting on a man of twenty who was burned on the foot by a

stream of molten metal. Leale remarks that as common warts of the skin

are collections of vascular papillae, admitting of separation without

injury to their exceptionally thick layer of epidermis, they are

probably better for the purposes of skin-grafting than ordinary skin of

less vitality or vascularity. Ricketts has succeeded in grafting the

skin of a frog to that of a tortoise, and also grafting frog skin to

human skin. Ricketts remarks that the prepuce of a boy is remarkably

good material for grafting. Sponge-grafts are often used to hasten

cicatrization of integumental wounds. There is recorded an instance in

which the breast of a crow and the back of a rat were grafted together

and grew fast. The crow dragged the rat along, and the two did not seem

to care to part company.

Relative to skin-grafting proper, Bartens succeeded in grafting the

skin of a dead man of seventy on a boy of fourteen. Symonds reports

cases of skin-grafting of large flaps from amputated limbs, and says

this method is particularly available in large hospitals where they

have amputations and grafts on the same day. Martin has shown that,

after many hours of exposure in the open air at a temperature of nearly

32 degrees F., grafts could be successfully applied, but in such

temperatures as 82 degrees F., exposure of from six to seven hours

destroyed their vitality, so that if kept cool, the limb of a healthy

individual amputated for some accident, may be utilized for grafting

purposes.

Reverdin originated the procedure of epidermic grafting. Small grafts

the size of a pin-head doing quite as well as large ones.

Unfortunately but little diminution of the cicatricial contraction is

effected by Reverdin's method. Thiersch contends that healing of a

granulated surface results first from a conversion of the soft,

vascular granulation-papillae, by contraction of some of their elements

into young connective-tissue cells, into "dry, cicatricial papillae,"

actually approximating the surrounding tissues, thus diminishing the

area to be covered by epidermis; and, secondly, by the covering of

these papillae by epidermic cells. Thiersch therefore recommends that

for the prevention of cicatricial contraction, the grafting be

performed with large strips of skin.

Harte gives illustrations of a case of extensive skin-grafting on the

thigh from six inches above the great trochanter well over the median

line anteriorly and over the buttock. This extent is shown in Figure

228, taken five months after the accident, when the granulations had

grown over the edge about an inch. Figure 229 shows the surface of the

wound, six and one-half months after the accident and three months

after the applications of numerous skin-grafts.

Cases of self-mutilation may be divided into three classes:--those in

which the injuries are inflicted in a moment of temporary insanity from

hallucinations or melancholia; with suicidal intent; and in religious

frenzy or emotion. Self-mutilation is seen in the lower animals, and

Kennedy, in mentioning the case of a hydrocephalic child who ate off

its entire under lip, speaks also of a dog, of cats, and of a lioness

who ate off their tails. Kennedy mentions the habit in young children

of biting the finger-nails as an evidence of infantile trend toward

self-mutilation. In the same discussion Collins states that he knew of

an instance in India in which a horse lay down, deliberately exposing

his anus, and allowing the crows to pick and eat his whole rectum. In

temporary insanity, in fury, or in grief, the lower animals have been

noticed by naturalists to mutilate themselves.

Self-mutilation in man is almost invariably the result of meditation

over the generative function, and the great majority of cases of this

nature are avulsions or amputations of some parts of the genitalia. The

older records are full of such instances. Benivenius, Blanchard,

Knackstedt, and Schenck cite cases. Smetius mentions castration which

was effected by using the finger-nails, and there is an old record in

which a man avulsed his own genitals. Scott mentions an instance in

which a man amputated his genitals and recovered without subsequent

symptoms. Gockelius speaks of self-castration in a ruptured man, and

Golding, Guyon, Louis, Laugier, the Ephemerides, Alix, Marstral, and

others, record instances of self-castration. In his Essays Montaigne

mentions an instance of complete castration performed by the individual

himself.

Thiersch mentions a case of a man who circumcised himself when

eighteen. He married in 1870, and upon being told that he was a father

he slit up the hypogastrium from the symphysis pubis to the umbilicus,

so that the omentum protruded; he said his object was to obtain a view

of the interior. Although the knife was dirty and blunt, the wound

healed after the removal of the extruding omentum. A year later he laid

open one side of the scrotum. The prolapsed testicle was replaced, and

the wound healed without serious effect. He again laid open his abdomen

in 1880, the wound again healing notwithstanding the prolapse of the

omentum. In May of the same year he removed the right testicle, and

sewed the wound up himself. Four days later the left was treated the

same way. The spermatic cord however escaped, and a hematoma, the size

of a child's head, formed on account of which he had to go to the

hospital. This man acted under an uncontrollable impulse to mutilate

himself, and claimed that until he castrated himself he had no peace of

mind.

There is a similar report in an Italian journal which was quoted in

London. It described a student at law, of delicate complexion, who at

the age of fourteen gave himself up to masturbation. He continually

studied until the age of nineteen, when he fell into a state of

dulness, and complained that his head felt as if compressed by a circle

of fire. He said that a voice kept muttering to him that his generative

organs were abnormally deformed or the seat of disease. After that, he

imagined that he heard a cry of "amputation! amputation!" Driven by

this hallucination, he made his first attempt at self-mutilation ten

days later. He was placed in an Asylum at Astino where, though closely

watched, he took advantage of the first opportunity and cut off

two-thirds of his penis, when the delirium subsided. Camp describes a

stout German of thirty-five who, while suffering from delirium tremens,

fancied that his enemies were trying to steal his genitals, and seizing

a sharp knife he amputated his penis close to the pubes. He threw the

severed organ violently at his imaginary pursuers. The hemorrhage was

profuse, but ceased spontaneously by the formation of coagulum over the

mouth of the divided vessels. The wound was quite healed in six weeks,

and he was discharged from the hospital, rational and apparently

content with his surgical feat.

Richards reports the case of a Brahman boy of sixteen who had

contracted syphilis, and convinced, no doubt, that "nocit empta dolore

voluptus," he had taken effective means of avoiding injury in the

future by completely amputating his penis at the root. Some days after

his admission to the hospital he asked to be castrated, stating that he

intended to become an ascetic, and the loss of his testes as well as of

his penis appeared to him to be an imperative condition to the

attainment of that happy consummation. Chevers mentions a somewhat

similar case occurring in India.

Sands speaks of a single man of thirty who amputated his penis. He

gave an incomplete history of syphilis. After connection with a woman

he became a confirmed syphilophobe and greatly depressed. While

laboring under the hallucination that he was possessed of two bodies he

tied a string around the penis and amputated the organ one inch below

the glans. On loosening the string, three hours afterward, to enable

him to urinate, he lost three pints of blood, but he eventually

recovered. In the Pennsylvania Hospital Reports there is an account of

a married man who, after drinking several weeks, developed mania a

potu, and was found in his room covered with blood. His penis was

completely cut off near the pubes, and the skin of the scrotum was so

freely incised that the testicles were entirely denuded, but not

injured. A small silver cap was made to cover the sensitive urethra on

a line with the abdominal wall.

There is a record of a tall, powerfully-built Russian peasant of

twenty-nine, of morose disposition, who on April 3d, while reading his

favorite book, without uttering a cry, suddenly and with a single pull

tore away his scrotum together with his testes. He then arose from the

bank where he had been sitting, and quietly handed the avulsed parts to

his mother who was sitting near by, saying to her: "Take that; I do not

want it any more." To all questions from his relatives he asked pardon

and exemption from blame, but gave no reason for his act. This patient

made a good recovery at the hospital. Alexeef, another Russian, speaks

of a similar injury occurring during an attack of delirium tremens.

Black details the history of a young man of nineteen who went to his

bath-room and deliberately placing his scrotum on the edge of the tub

he cut it crossways down to the wood. He besought Black to remove his

testicle, and as the spermatic cord was cut and much injured, and

hemorrhage could only be arrested by ligature, the testicle was

removed. The reason assigned for this act of mutilation was that he had

so frequent nocturnal emissions that he became greatly disgusted and

depressed in spirit thereby. He had practiced self-abuse for two years

and ascribed his emissions to this cause. Although his act was that of

a maniac, the man was perfectly rational. Since the injury he had had

normal and frequent emissions and erections.

Orwin mentions the case of a laborer of forty who, in a fit of remorse

after being several days with a prostitute, atoned for his

unfaithfulness to his wife by opening his scrotum and cutting away his

left testicle with a pocket knife. The missing organ was found about

six yards away covered with dirt. At the time of infliction of this

injury the man was calm and perfectly rational. Warrington relates the

strange case of Isaac Brooks, an unmarried farmer of twenty-nine, who

was found December 5, 1879, with extensive mutilations of the scrotum;

he said that he had been attacked and injured by three men. He swore to

the identity of two out of the three, and these were transported to ten

years' penal servitude. On February 13, 1881, he was again found with

mutilation of the external genitals, and again said he had been set

upon by four men who had inflicted his injury, but as he wished it kept

quiet he asked that there be no prosecution. Just before his death on

December 31, 1881, he confessed that he had perjured himself, and that

the mutilations were self-performed. He was not aware of any morbid

ideas as to his sexual organs, and although he had an attack of

gonorrhea ten years before he seemed to worry very little over it.

There is an account of a Scotch boy who wished to lead a "holy life,"

and on two occasions sought the late Mr. Liston's skilful aid in

pursuance of this idea. He returned for a third time, having himself

unsuccessfully performed castration.

A case of self-mutilation by a soldier who was confined in the

guard-house for drunkenness is related by Beck. The man borrowed a

knife from a comrade and cut off the whole external genital apparatus,

remarking as he flung the parts into a corner: "Any----fool can cut his

throat, but it takes a soldier to cut his privates off!" Under

treatment he recovered, and then he regretted his action.

Sinclair describes an Irishman of twenty-five who, maniacal from

intemperance, first cut off one testicle with a wire nail, and then the

second with a trouser-buckle. Not satisfied with the extent of his

injuries he drove a nail into his temple, first through the skin by

striking it with his hand, and then by butting it against the

wall,--the latter maneuver causing his death.

There is on record the history of an insane medical student in Dublin

who extirpated both eyes and threw them on the grass. He was in a state

of acute mania, and the explanation offered was that as a "grinder"

before examination he had been diligently studying the surgery of the

eye, and particularly that relating to enucleation. Another Dublin case

quoted by the same authority was that of a young girl who, upon being

arrested and committed to a police-cell in a state of furious

drunkenness, tore out both her eyes. In such cases, as a rule, the

finger-nails are the only instrument used. There is a French case also

quoted of a woman of thirty-nine who had borne children in rapid

succession. While suckling a child three months old she became much

excited, and even fanatical, in reading the Bible. Coming to the

passage, "If thy right eye offend thee, pluck it out, etc.," she was so

impressed with the necessity of obeying the divine injunction that she

enucleated her eye with a meat-hook. There is mentioned the case of a

young woman who cut off her right hand and cast it into the fire, and

attempted to enucleate her eyes, and also to hold her remaining hand in

the fire. Haslam reports the history of a female who mutilated herself

by grinding glass between her teeth.

Channing gives an account of the case of Helen Miller, a German Jewess

of thirty, who was admitted to the Asylum for Insane Criminals at

Auburn, N.Y., in October, 1872, and readmitted in June, 1875, suffering

from simulation of hematemesis. On September 25th she cut her left

wrist and right hand; in three weeks she became again "discouraged"

because she was refused opium, and again cut her arms below the elbows,

cleanly severing the skin and fascia, and completely hacking the

muscles in every direction. Six weeks later she repeated the latter

feat over the seat of the recently healed cicatrices. The right arm

healed, but the left showed erysipelatous inflammation, culminating in

edema, which affected the glottis to such an extent that tracheotomy

was performed to save her life. Five weeks after convalescence, during

which her conduct was exemplary, she again cut her arms in the same

place. In the following April, for the merest trifle, she again

repeated the mutilation, but this time leaving pieces of glass in the

wounds. Six months later she inflicted a wound seven inches in length,

in which she inserted 30 pieces of glass, seven long splinters, and

five shoe-nails. In June, 1877, she cut herself for the last time. The

following articles were taken from her arms and preserved: Ninety-four

pieces of glass, 34 splinters, two tacks, five shoe-nails, one pin, and

one needle, besides other things which were lost,--making altogether

about 150 articles.

"Needle-girls," etc.--A peculiar type of self-mutilation is the habit

sometimes seen in hysteric persons of piercing their flesh with

numerous needles or pins. Herbolt of Copenhagen tells of a young Jewess

from whose body, in the course of eighteen months, were extracted 217

needles. Sometime after 100 more came from a tumor on the shoulder. As

all the symptoms in this case were abdominal, it was supposed that

during an epileptic seizure this girl had swallowed the needles; but as

she was of an hysteric nature it seems more likely they had entered the

body through the skin. There is an instance in which 132 needles were

extracted from a young lady's person. Caen describes a woman of

twenty-six, while in prison awaiting trial, succeeding in committing

suicide by introducing about 30 pins and needles in the chest region,

over the heart. Her method was to gently introduce them, and then to

press them deeper with a prayer-book. An autopsy showed that some of

the pins had reached the lungs, some were in the mediastinum, on the

back part of the right auricle; the descending vena cave was

perforated, the anterior portion of the left ventricle was transfixed

by a needle, and several of the articles were found in the liver.

Andrews removed 300 needles from the body of an insane female. The

Lancet records an account of a suicide by the penetration of a

darning-needle in the epigastrium. There were nine punctures in this

region, and in the last the needle was left in situ and fixed by

worsted. In 1851 the same journal spoke of an instance in which 30 pins

were removed from the limbs of a servant girl. It was said that while

hanging clothes, with her mouth full of pins, she was slapped on the

shoulder, causing her to start and swallow the pins. There is another

report of a woman who swallowed great numbers of pins. On her death one

pound and nine ounces of pins were found in her stomach and duodenum.

There are individuals known as "human pin-cushions," who publicly

introduce pins and needles into their bodies for gain's sake.

The wanderings of pins and needles in the body are quite well known.

Schenck records the finding of a swallowed pin in the liver. Haller

mentions one that made its way to the hand. Silvy speaks of a case in

which a quantity of swallowed pins escaped through the muscles, the

bladder, and vagina; there is another record in which the pins escaped

many years afterward from the thigh. The Philosophical Transactions

contain a record of the escape of a pin from the skin of the arm after

it had entered by the mouth. Gooch, Ruysch, Purmann, and Hoffman speak

of needle-wanderings. Stephenson gives an account of a pin which was

finally voided by the bladder after forty-two years' sojourn in a

lady's body. On November 15, 1802, the celebrated Dr. Lettsom spoke of

an old lady who sat on a needle while riding in a hackney coach; it

passed from the injured leg to the other one, whence it was extracted.

Deckers tells of a gentleman who was wounded in the right

hypochondrium, the ball being taken thirty years afterward from the

knee. Borellus gives an account of a thorn entering the digit and

passing out of the body by the anus.

Strange as it may seem, a prick of a pin not entering a vital center or

organ has been the indirect cause of death. Augenius writes of a tailor

who died in consequence of a prick of a needle between the nail and

flesh of the end of the thumb. Amatus Lusitanus mentions a similar

instance in an old woman, although, from the symptoms given, the direct

cause was probably tetanus. In modern times Cunninghame, Boring, and

Hobart mention instances in which death has followed the prick of a

pin: in Boring's case the death occurred on the fifth day.

Manufacture of Crippled Beggars.--Knowing the sympathy of the world in

general for a cripple, in some countries low in the moral scale,

voluntary mutilation is sometimes practiced by those who prefer begging

to toiling. In the same manner artificial monstrosities have been

manufactured solely for gain's sake. We quite often read of these

instances in lay-journals, but it is seldom that a case comes under the

immediate observation of a thoroughly scientific mind. There is,

however, on record a remarkable instance accredited to Jamieson of

Shanghai who presented to the Royal College of Surgeons a pair of feet

with the following history: Some months previously a Chinese beggar had

excited much pity and made a good business by showing the mutilated

stumps of his legs, and the feet that had belonged to them slung about

his neck. While one day scrambling out of the way of a constable who

had forbidden this gruesome spectacle, he was knocked down by a

carriage in the streets of Shanghai, and was taken to the hospital,

where he was questioned about the accident which deprived him of his

feet. After selling the medical attendant his feet he admitted that he

had purposely performed the amputations himself, starting about a year

previously. He had fastened cords about his ankles, drawing them as

tightly as he could bear them, and increasing the pressure every two or

three days. For a fortnight his pain was extreme, but when the bones

were bared his pains ceased. At the end of a month and a half he was

able to entirely remove his feet by partly snapping and partly cutting

the dry bone. Such cases appear to be quite common in China, and by

investigation many parallels could elsewhere be found.

The Chinese custom of foot-binding is a curious instance of

self-mutilation. In a paper quoted in the Philadelphia Medical Times,

January 31, 1880, a most minute account of the modus operandi, the

duration, and the suffering attendant on this process are given.

Strapping of the foot by means of tight bandages requires a period of

two or three years' continuance before the desired effect is produced.

There is a varying degree of pain, which is most severe during the

first year and gradually diminishes after the binding of all the joints

is completed. During the binding the girl at night lies across the

bed, putting her legs on the edge of the bed-stead in such a manner as

to make pressure under the knees, thus benumbing the parts below and

avoiding the major degree of pain. In this position, swinging their

legs backward and forward, the poor Chinese girls pass many a weary

night. During this period the feet are unbound once a month only. The

operation is begun by placing the end of a long, narrow bandage on the

inside of the instep and carrying it over the four smaller toes,

securing them under the foot. After several turns the bandage is

reversed so as to compress the foot longitudinally. The young girl is

then left for a month, and when the bandage is removed the foot is

often found gangrenous and ulcerated, one or two toes not infrequently

being lost. If the foot is thus bound for two years it becomes

virtually dead and painless. By this time the calf disappears from lack

of exercise, the bones are attenuated, and all the parts are dry and

shrivelled. In after-life the leg frequently regains its muscles and

adipose tissue, but the foot always remains small. The binding process

is said to exert a markedly depressing influence upon the emotional

character of the subject, which lasts through life, and is very

characteristic.

To show how minute some of the feet of the Chinese women are, Figure I

of the accompanying plate, taken from a paper by Kenthughes on the

"Feet of Chinese Ladies" is from a photograph of a shoe that measured

only 3 1/4 inches anteroposteriorly. The foot which it was intended to

fill must have been smaller still, for the bandage would take up a

certain amount of space. Figure II is a reproduction of a photograph of

a foot measuring 5 1/2 inches anteroposteriorly, the wrinkled

appearance of the skin being due to prolonged immersion in spirit. This

photograph shows well the characteristics of the Chinese foot--the

prominent and vertically placed heel, which is raised generally about

an inch from the level of the great toe; the sharp artificial cavus,

produced by the altered position of the os calcis, and the downward

deflection of the foot in front of the mediotarsal joint; the straight

and downward pointing great toe, and the infolding of the smaller toes

underneath the great toe. In Figure III we have a photograph of the

skeleton of a Chinese lady's foot about five inches in anteroposterior

diameter. The mesial axis of the os calcis is almost directly vertical,

with a slight forward inclination, forming a right angle with the bones

in front of the mediotarsal joint. The upper three-quarters of the

anterior articular surface of the calcis is not in contact with the

cuboid, the latter being depressed obliquely forward and downward, the

lower portion of the posterior facet on the cuboid articulating with a

new surface on the under portion of the bone. The general shape of the

bone closely resembles that of a normal one--a marked contrast to its

wasted condition and tapering extremity in paralytic calcaneus.

Extension and flexion at the ankle are only limited by the shortness of

the ligaments; there is no opposition from the conformation of the

bones. The astragalus is almost of normal shape; the trochlea is

slightly prolonged anteriorly, especially on the inner side, from

contact with the tibial articular surface. The cartilage on the exposed

posterior portion of the trochlea seems healthy. The head of the

astragalus is very prominent on the outer side, the scaphoid being

depressed downward and inward away from it. The anterior articular

surface is prolonged in the direction of the displaced scaphoid. The

scaphoid, in addition to its displacement, is much compressed on the

planter surface, being little more than one-half the width of the

dorsal surface. The cuboid is displaced obliquely downward and forward,

so that the upper part of the posterior articular surface is not in

contact with the calcis.

A professional leg-breaker is described in the Weekly Medical Review of

St. Louis, April, 1890. This person's name was E. L. Landers, and he

was accredited with earning his living by breaking or pretending to

break his leg in order to collect damages for the supposed injury.

Moreover, this individual had but one leg, and was compelled to use

crutches. At the time of report he had succeeded in obtaining damages

in Wichita, Kansas, for a supposed fracture. The Review quotes a

newspaper account of this operation as follows.--

"According to the Wichita Dispatch he represented himself as a

telegraph operator who was to have charge of the postal telegraph

office in that city as soon as the line reached there. He remained

about town for a month until he found an inviting piece of defective

sidewalk, suitable for his purpose, when he stuck his crutch through

the hole and fell screaming to the ground, declaring that he had broken

his leg. He was carried to a hospital, and after a week's time, during

which he negotiated a compromise with the city authorities and

collected $1000 damages, a confederate, claiming to be his nephew,

appeared and took the wounded man away on a stretcher, saying that he

was going to St. Louis. Before the train was fairly out of Wichita,

Landers was laughing and boasting over his successful scheme to beat

the town. The Wichita story is in exact accord with the artistic

methods of a one-legged sharper who about 1878 stuck his crutch through

a coal-hole here, and, falling heels over head, claimed to have

sustained injuries for which he succeeded in collecting something like

$1500 from the city. He is described as a fine-looking fellow, well

dressed, and wearing a silk hat. He lost one leg in a railroad

accident, and having collected a good round sum in damages for it,

adopted the profession of leg-breaking in order to earn a livelihood.

He probably argued that as he had made more money in that line than in

any other he was especially fitted by natural talents to achieve

distinction in this direction. But as it would be rather awkward to

lose his remaining leg altogether he modified the idea and contents

himself with collecting the smaller amounts which ordinary fractures of

the hip-joint entitle such an expert 'fine worker' to receive.

"He first appeared here in 1874 and succeeded, it is alleged, in

beating the Life Association of America. After remaining for some time

in the hospital he was removed on a stretcher to an Illinois village,

from which point the negotiations for damages were conducted by

correspondence, until finally a point of agreement was reached and an

agent of the company was sent to pay him the money. This being

accomplished the agent returned to the depot to take the train back to

St. Louis when he was surprised to see the supposed sufferer stumping

around on his crutches on the depot platform, laughing and jesting over

the ease with which he had beaten the corporation.

"He afterward fell off a Wabash train at Edwardsville and claimed to

have sustained serious injuries, but in this case the company's

attorneys beat him and proved him to be an impostor. In 1879 he

stumbled into the telegraph office at the Union Depot here, when Henry

C. Mahoney, the superintendent, catching sight of him, put him out,

with the curt remark that he didn't want him to stick that crutch into

a cuspidor and fall down, as it was too expensive a performance for the

company to stand. He beat the Missouri Pacific and several other

railroads and municipalities at different times, it is claimed, and

manages to get enough at each successful venture to carry him along for

a year or eighteen months, by which time the memory of his trick fades

out of the public mind, when he again bobs up serenely."

Anomalous Suicides.--The literature on suicide affords many instances

of self-mutilations and ingenious modes of producing death. In the

Dublin Medical Press for 1854 there is an extraordinary case of

suicide, in which the patient thrust a red-hot poker into his abdomen

and subsequently pulled it out, detaching portions of the omentum and

32 inches of the colon. Another suicide in Great Britain swallowed a

red-hot poker. In commenting on suicides, in 1835, Arntzenius speaks of

an ambitious Frenchman who was desirous of leaving the world in a

distinguished manner, and who attached himself to a rocket of enormous

size which he had built for the purpose, and setting fire to it, ended

his life. On September 28, 1895, according to the Gaulois and the New

York Herald (Paris edition) of that date, there was admitted to the

Hopital St. Louis a clerk, aged twenty-five, whom family troubles had

rendered desperate and who had determined to seek death as a relief

from his misery. Reviewing the various methods of committing suicide

he found none to his taste, and resolved on something new. Being

familiar with the constituents of explosives, he resolved to convert

his body into a bomb, load it with explosives, and thus blow himself to

pieces. He procured some powdered sulphur and potassium chlorate, and

placing each in a separate wafer he swallowed both with the aid of

water. He then lay down on his bed, dressed in his best clothes,

expecting that as soon as the two explosive materials came into contact

he would burst like a bomb and his troubles would be over. Instead of

the anticipated result the most violent collicky pains ensued, which

finally became so great that he had to summon his neighbors, who took

him to the hospital, where, after vigorous application with the

stomach-pump, it was hoped that his life would be saved. Sankey

mentions an epileptic who was found dead in his bed in the Oxford

County Asylum; the man had accomplished his end by placing a round

pebble in each nostril, and thoroughly impacting in his throat a strip

of flannel done up in a roll. In his "Institutes of Surgery" Sir

Charles Bell remarks that his predecessor at the Middlesex Hospital

entered into a conversation with his barber over an attempt at suicide

in the neighborhood, during which the surgeon called the "would-be

suicide" a fool, explaining to the barber how clumsy his attempts had

been at the same time giving him an extempore lecture on the anatomic

construction of the neck, and showing him how a successful suicide in

this region should be performed. At the close of the conversation the

unfortunate barber retired into the back area of his shop, and

following minutely the surgeon's directions, cut his throat in such a

manner that there was no hope of saving him. It is supposed that one

could commit suicide by completely gilding or varnishing the body, thus

eliminating the excretory functions of the skin. There is an old story

of an infant who was gilded to appear at a Papal ceremony who died

shortly afterward from the suppression of the skin-function. The fact

is one well established among animals, but after a full series of

actual experiments, Tecontjeff of St. Petersburg concludes that in

this respect man differs from animals. This authority states that in

man no tangible risk is entailed by this process, at least for any

length of time required for therapeutic purposes. "Tarred and

feathered" persons rarely die of the coating of tar they receive. For

other instances of peculiar forms of suicide reference may be made to

numerous volumes on this subject, prominent among which is that by

Brierre de Boismont, which, though somewhat old, has always been found

trustworthy, and also to the chapters on this subject written by

various authors on medical jurisprudence.

Religious and Ceremonial Mutilations.--Turning now to the subject of

self-mutilation and self-destruction from the peculiar customs or

religious beliefs of people, we find pages of information at our

disposal. It is not only among the savage or uncivilized tribes that

such ideas have prevailed, but from the earliest times they have had

their influence upon educated minds. In the East, particularly in

India, the doctrines of Buddhism, that the soul should be without fear,

that it could not be destroyed, and that the flesh was only its

resting-place, the soul several times being reincarnated, brought about

great indifference to bodily injuries and death. In the history of the

Brahmans there was a sect of philosophers called the Gymnosophists, who

had the extremest indifference to life. To them incarnation was a

positive fact, and death was simply a change of residence. One of these

philosophers, Calanus, was burned in the presence of Alexander; and,

according to Plutarch, three centuries later another Gymnosophist named

Jarmenochegra, was similarly burned before Augustus. Since this time,

according to Brierre de Boismont, the suicides from indifference to

life in this mystic country are counted by the thousands. Penetrating

Japan the same sentiment, according to report, made it common in the

earlier history of that country to see ships on its coasts, filled with

fanatics who, by voluntary dismantling, submerged the vessels little by

little, the whole multitude sinking into the sea while chanting praises

to their idols. The same doctrines produced the same result in China.

According to Brucker it is well known that among the 500 philosophers

of the college of Confucius, there were many who disdained to survive

the loss of their books (burned by order of the savage Emperor

Chi-Koung-ti), and throwing themselves into the sea, they disappeared

under the waves. According to Brierre de Boismont, voluntary mutilation

or death was very rare among the Chaldeans, the Persians, or the

Hebrews, their precepts being different from those mentioned. The

Hebrews in particular had an aversion to self-murder, and during a

period in their history of 4000 years there were only eight or ten

suicides recorded. Josephus shows what a marked influence on suicides

the invasion of the Romans among the Hebrews had.

In Africa, as in India, there were Gymnosophists. In Egypt Sesostris,

the grandest king of the country, having lost his eyesight in his old

age, calmly and deliberately killed himself. About the time of Mark

Anthony and Cleopatra, particularly after the battle of Actium, suicide

was in great favor in Egypt. In fact a great number of persons formed

an academy called The Synapothanoumenes, who had for their object the

idea of dying together. In Western Europe, as shown in the ceremonies

of the Druids, we find among the Celts a propensity for suicide and an

indifference to self-torture. The Gauls were similarly minded,

believing in the dogma of immortality and eternal repose. They thought

little of bodily cares and ills. In Greece and Rome there was always an

apology for suicide and death in the books of the philosophers. "Nil

igitur mors est, ad nos neque pertinet hilum; quando quidem natura

animi mortalis habetur!" cries Lucretius. With the advent of

Christianity, condemning as it did the barbarous customs of

self-mutilation and self-murder, these practices seem to disappear

gradually; but stoicism and indifference to pain were exhibited in

martyrdom. Toward the middle ages, when fanaticism was at its height

and the mental malady of demoniacal possession was prevalent, there was

something of a reversion to the old customs. In the East the Juggernaut

procession was still in vogue, but this was suppressed by civilized

authorities; outside of a few minor customs still prevalent among our

own people we must to-day look to the savage tribes for the

perpetuation of such practices.

In an excellent article on the evolution of ceremonial institutions

Herbert Spencer mentions the Fuegians, Veddahs, Andamanese, Dyaks,

Todas, Gonds, Santals, Bodos, and Dhimals, Mishmis, Kamchadales, and

Snake Indians, as among people who form societies to practice simple

mutilations in slight forms. Mutilations in somewhat graver forms, but

still in moderation, are practiced by the Tasmanians, Tamaese, the

people of New Guinea, Karens, Nagas, Ostiaks, Eskimos, Chinooks,

Comanches, and Chippewas. What might be called mixed or compound

mutilations are practiced by the New Zealanders, East Africans, Kondes,

Kukas, and Calmucks. Among those practising simple but severe

mutilations are the New Caledonians, the Bushmen, and some indigenous

Australians. Those tribes having for their customs the practice of

compound major mutilations are the Fiji Islanders, Sandwich Islanders,

Tahitians, Tongans, Samoans, Javanese, Sumatrans, natives of Malagasy,

Hottentots, Damaras, Bechuanas, Kaffirs, the Congo people, the Coast

Negroes, Inland Negroes, Dahomeans, Ashantees, Fulahs, Abyssinians,

Arabs, and Dakotas. Spencer has evidently made a most extensive and

comprehensive study of this subject, and his paper is a most valuable

contribution to the subject. In the preparation of this section we have

frequently quoted from it.

The practice of self-bleeding has its origin in other mutilations,

although the Aztecs shed human blood in the worship of the sun. The

Samoiedes have a custom of drinking the blood of warm animals. Those of

the Fijians who were cannibals drank the warm blood of their victims.

Among the Amaponda Kaffirs there are horrible accounts of kindred

savage customs. Spencer quotes:--"It is usual for the ruling chief on

his accession to be washed in the blood of a near relative, generally a

brother, who is put to death for the occasion." During a Samoan

marriage-ceremony the friends of the bride "took up stones and beat

themselves until their heads were bruised and bleeding." In Australia a

novitiate at the ceremony of manhood drank a mouthful of blood from the

veins of the warrior who was to be his sponsor.

At the death of their kings the Lacedemonians met in large numbers and

tore the flesh from their foreheads with pins and needles. It is said

that when Odin was near his death he ordered himself to be marked with

a spear; and Niort, one of his successors, followed the example of his

predecessor. Shakespeare speaks of "such as boast and show their

scars." In the olden times it was not uncommon for a noble soldier to

make public exhibition of his scars with the greatest pride; in fact,

on the battlefield they invited the reception of superficial

disfiguring injuries, and to-day some students of the learned

universities of Germany seem prouder of the possession of scars

received in a duel of honor than in awards for scholastic attainments.

Lichtenstein tells of priests among the Bechuanas who made long cuts

from the thigh to the knee of each warrior who slew an enemy in battle.

Among some tribes of the Kaffirs a kindred custom was practiced; and

among the Damaras, for every wild animal a young man destroyed his

father made four incisions on the front of his son's body. Speaking of

certain Congo people, Tuckey says that they scar themselves principally

with the idea of rendering themselves agreeable to the women of their

tribe. Among the Itzaex Indians of Yucatan, a race with particularly

handsome features, some are marked with scarred lines, inflicted as

signs of courage.

Cosmetic Mutilations.--In modern times there have been individuals

expert in removing facial deformities, and by operations of various

kinds producing pleasing dimples or other artificial signs of beauty.

We have seen an apparatus advertised to be worn on the nose during the

night for the purpose of correcting a disagreeable contour of this

organ. A medical description of the artificial manufacture of dimples

is as follows:--"The modus operandi was to make a puncture in the skin

where the dimple was required, which would not be noticed when healed,

and, with a very delicate instrument, remove a portion of the muscle.

Inflammation was then excited in the skin over the subcutaneous pit,

and in a few days the wound, if such it may be called, was healed, and

a charming dimple was the result." It is quite possible that some of

our modern operators have overstepped the bounds of necessity, and

performed unjustifiable plastic operations to satisfy the vanity of

their patients.

Dobrizhoffer says of the Abipones that boys of seven pierce their

little arms in imitation of their parents. Among some of the indigenous

Australians it is quite customary for ridged and linear scars to be

self-inflicted. In Tanna the people produce elevated scars on the arms

and chests. Bancroft recites that family-marks of this nature existed

among the Cuebas of Central America, refusal being tantamount to

rebellion. Schomburgk tells that among the Arawaks, after a Mariquawi

dance, so great is their zeal for honorable scars, the blood will run

down their swollen calves, and strips of skin and muscle hang from the

mangled limbs. Similar practices rendered it necessary for the United

States Government to stop some of the ceremonial dances of the Indians

under their surveillance.

A peculiar custom among savages is the amputation of a finger as a

sacrifice to a deity. In the tribe of the Dakotas the relatives of a

dead chief pacified his spirit by amputating a finger. In a similar

way, during his initiation, the young Mandan warrior, "holding up the

little finger of his left hand to the Great Spirit," ... "expresses his

willingness to give it as a sacrifice, and he lays it on the dried

buffalo skull, when another chops it off near the hand with a blow of

the hatchet." According to Mariner the natives of Tonga cut off a

portion of the little finger as a sacrifice to the gods for the

recovery of a superior sick relative. The Australians have a custom of

cutting off the last joint of the little finger of females as a token

of submission to powerful beings alive and dead. A Hottentot widow who

marries a second time must have the distal joint of her little finger

cut off; another joint is removed each time she remarries.

Among the mutilations submitted to on the death of a king or chief in

the Sandwich Islands, Cook mentions in his "Voyages" the custom of

knocking out from one to four front teeth.

Among the Australian tribes the age of virility and the transition into

manhood is celebrated by ceremonial customs, in which the novices are

subjected to minor mutilations. A sharp bone is used for lancing their

gums, while the throw-stick is used for knocking out a tooth.

Sometimes, in addition to this crude dentistry, the youth is required

to submit to cruel gashes cut upon his back and shoulders, and should

he flinch or utter any cry of pain he is always thereafter classed with

women. Haygarth writes of a semi-domesticated Australian who said one

day, with a look of importance, that he must go away for a few days, as

he had grown to man's estate, and it was high time he had his teeth

knocked out. It is an obligatory rite among various African tribes to

lose two or more of their front teeth. A tradition among certain

Peruvians was that the Conqueror Huayna Coapae made a law that they and

their descendants should have three front teeth pulled out in each jaw.

Cieza speaks of another tradition requiring the extraction of the teeth

of children by their fathers as a very acceptable service to their

gods. The Damaras knock out a wedge-shaped gap between two of their

front teeth; and the natives of Sierra Leone file or chip their teeth

after the same fashion.

Depilatory customs are very ancient, and although minor in extent are

still to be considered under the heading of mutilations. The giving of

hair to the dead as a custom, has been perpetuated through many tribes

and nations. In Euripides we find Electra admonishing Helen for sparing

her locks, and thereby defrauding the dead. Alexander the Great shaved

his locks in mourning for his friend, Hephaestion, and it was supposed

that his death was hastened by the sun's heat on his bare head after

his hat blew off at Babylon. Both the Dakota Indians and the Caribs

maintain the custom of sacrificing hair to the dead. In Peru the custom

was varied by pulling out eyelashes and eyebrows and presenting them to

the sun, the hills, etc. It is said this custom is still in

continuance. When Clovis was visited by the Bishop of Toulouse he gave

him a hair from his beard and was imitated by his followers. In the

Arthurian legends we find "Then went Arthur to Caerleon; and thither

came messages from King Ryons who said, 'even kings have done me

homage, and with their beards I have trimmed a mantle. Send me now thy

beard, for there lacks yet one to the finishing of the mantle.'" The

association between short hair and slavery arose from the custom of

taking hair from the slain. It existed among the Greeks and Romans, and

was well known among the indigenous tribes of this continent. Among the

Shoshones he who took the most scalps gained the most glory.

In speaking of the prisoners of the Chicimecs Bancroft says they were

often scalped while yet alive, and the bloody trophies placed on the

heads of their tormentors. In this manner we readily see that long hair

among the indigenous tribes and various Orientals, Ottomans, Greeks,

Franks, Goths, etc., was considered a sign of respect and honor. The

respect and preservation of the Chinese queue is well known in the

present day. Wishing to divide their brother's kingdom, Clothair and

Childebert consulted whether to cut off the hair of their nephews, the

rightful successors, so as to reduce them to the rank of subjects, or

to kill them. The gods of various people, especially the greater gods,

were distinguished by their long beards and flowing locks. In all

pictures Thor and Samson were both given long hair, and the belief in

strength and honor from long hair is proverbial. Hercules is always

pictured with curls. According to Goldzhier, long locks of hair and a

long beard are mythologic attributes of the sun. The sun's rays are

compared to long locks or hairs on the face of the sun. When the sun

sets and leaves his place to the darkness, or when the powerful summer

sun is succeeded by the weak rays of the winter sun, then Samson's long

locks, through which alone his strength remains, are cut off by the

treachery of his deceitful concubine Delilah (the languishing,

according to the meaning of the name). The beaming Apollo was,

moreover, called the "Unshaven;" and Minos cannot conquer the solar

hero, Nisos, until the latter loses his golden hair. In Arabic

"Shams-on" means the sun, and Samson had seven locks of hair, the

number of the planetary bodies. In view of the foregoing facts it seems

quite possible that the majority of depilatory processes on the scalp

originated in sun-worship, and through various phases and changes in

religions were perpetuated to the Middle Ages. Charles Martel sent

Pepin, his son, to Luithprand, king of the Lombards, that he might cut

his first locks, and by this ceremony hold for the future the place of

his illustrious father. To make peace with Alaric, Clovis became his

adopted son by offering his beard to be cut. Among the Caribs the hair

constituted their chief pride, and it was considered unequivocal proof

of the sincerity of their sorrow, when on the death of a relative they

cut their hair short. Among the Hebrews shaving of the head was a

funeral rite, and among the Greeks and Romans the hair was cut short in

mourning, either for a relative or for a celebrated personage.

According to Krehl the Arabs also had such customs. Spencer mentions

that during an eruption in Hawaii, "King Kamahameha cut off part of his

own hair" ... "and threw it into the torrent (of lava)."

The Tonga regarded the pubic hairs as under the special care of the

devil, and with great ceremony made haste to remove them. The female

inhabitants of some portions of the coast of Guinea remove the pubic

hairs as fast as they appear. A curious custom of Mohammedan ladies

after marriage is to rid themselves of the hirsute appendages of the

pubes. Depilatory ointments are employed, consisting of equal parts of

slaked lime and arsenic made into a paste with rose-water. It is said

that this important ceremony is not essential in virgins. One of the

ceremonies of assuming the toga virilis among the indigenous

Australians consists in submitting to having each particular hair

plucked singly from the body, the candidate being required not to

display evidences of pain during the operation. Formerly the Japanese

women at marriage blackened their teeth and shaved or pulled out their

eyebrows.

The custom of boring the ear is very old, mention of it being made in

Exodus xxi., 5 and 6, in which we find that if a Hebrew servant served

for six years, his freedom was optional, but if he plainly said that he

loved his master, and his wife and children, and did not desire to

leave their house, the master should bring him before the judges; and

according to the passage in Exodus, "he shall also bring him to the

door or unto the doorpost, and his master shall bore his ear through

with an awl; and he shall serve him forever." All the Burmese, says

Sangermano, without exception, have the custom of boring their ears.

The days when the operations were performed were kept as festivals. The

ludicrous custom of piercing the ears for the wearing of ornaments,

typical of savagery and found in all indigenous African tribes, is

universally prevalent among our own people.

The extremists in this custom are the Botocudos, who represent the most

cruel and ferocious of the Brazilian tribes, and who especially cherish

a love for cannibalism. They have a fondness for disfiguring themselves

by inserting in the lower parts of their ears and in their under lips

variously shaped pieces of wood ornaments called peleles, causing

enormous protrusion of the under lip and a repulsive wide mouth, as

shown in Figure 230.

Tattooing is a peculiar custom originating in various ways. The

materials used are vermilion, indigo, carbon, or gunpowder. At one time

this custom was used in the East to indicate caste and citizenship.

Both sexes of the Sandwich Islanders have a peculiar tattooed mark

indicative of their tribe or district. Among the Uapes, one tribe, the

Tucanoes, have three vertical blue lines. Among other people tattooed

marks indicated servility, and Boyle says the Kyans, Pakatans, and

Kermowits alone, among the Borneo people, practised tattooing, and adds

that these races are the least esteemed for bravery. Of the Fijians the

women alone are tattooed, possibly as a method of adornment.

The tattooing of the people of Otaheite, seen by Cook, was surmised by

him to have a religious significance, as it presented in many instances

"squares, circles, crescents, and ill-designed representations of men

and dogs." Every one of these people was tattooed upon reaching

majority. According to Carl Bock, among the Dyaks of Borneo all of the

married women were tattooed on the hands and feet, and sometimes on the

thighs. The decoration is one of the privileges of matrimony, and is

not permitted to unmarried girls. Andrew Lang says of the Australian

tribes that the Wingong or the Totem of each man is indicated by a

tattooed representation of it on his flesh. The celebrated American

traveler, Carpenter, remarks that on his visit to a great prison in

Burmah, which contains more than 3000 men, he saw 6000 tattooed legs.

The origin of the custom he was unable to find out, but in Burmah

tattooing was a sign of manhood, and professional tattooers go about

with books of designs, each design warding off some danger. Bourke

quotes that among the Apaches-Yumas of Arizona the married women are

distinguished by several blue lines running from the lower lip to the

chin; and he remarks that when a young woman of this tribe is anxious

to become a mother she tattoos the figure of a child on her forehead.

After they marry Mojave girls tattoo the chin with vertical blue lines;

and when an Eskimo wife has her face tattooed with lamp-black she is

regarded as a matron in society. The Polynesians have carried this

dermal art to an extent which is unequaled by any other people, and it

is universally practiced among them. Quoted by Burke, Sullivan states

that the custom of tattooing continued in England and Ireland down to

the seventh century. This was the tattooing with the woad. Fletcher

remarks that at one time, about the famous shrine of Our Lady of

Loretto, were seen professional tattooers, who for a small sum of money

would produce a design commemorative of the pilgrim's visit to the

shrine. A like profitable industry is pursued in Jerusalem.

Universal tattooing in some of the Eastern countries is used as a means

of criminal punishment, the survival of the persecuted individual being

immaterial to the torturers, as he would be branded for life and

ostracized if he recovered. Illustrative of this O'Connell tells of a

case in Hebra's clinic. The patient, a man five feet nine inches in

height, was completely tattooed from head to foot with all sorts of

devices, such as elephants, birds, lions, etc., and across his

forehead, dragons. Not a square of even a quarter inch had been exempt

from the process. According to his tale this man had been a leader of a

band of Greek robbers, organized to invade Chinese Tartary, and,

together with an American and a Spaniard, was ordered by the ruler of

the invaded province to be branded in this manner as a criminal. It

took three months' continuous work to carry out this sentence, during

which his comrades succumbed to the terrible agonies. During the

entire day for this extended period indigo was pricked in this

unfortunate man's skin. Accounts such as this have been appropriated by

exhibitionists, who have caused themselves to be tattooed merely for

mercenary purposes. The accompanying illustration represents the

appearance of a "tattooed man" who exhibited himself. He claimed that

his tattooing was done by electricity. The design showing on his back

is a copy of a picture of the Virgin Mary surrounded by 31 angels.

The custom of tattooing the arms, chest, or back is quite prevalent,

and particularly among sailors and soldiers. The sequences of this

custom are sometimes quite serious. Syphilis has been frequently

contracted in this manner, and Maury and Dulles have collected 15 cases

of syphilis acquired in tattooing. Cheinisse reports the case of a

young blacksmith who had the emblems of his trade tattooed upon his

right forearm. At the end of forty days small, red, scaly elevations

appeared at five different points in the tattooed area. These broke

down and formed ulcers. When examined these ulcers presented the

peculiarities of chancres, and there was upon the body of the patient a

well-marked syphilitic roseola. It was ascertained that during the

tattooing the operator had moistened the ink with his own saliva.

Hutchinson exhibited drawings and photographs showing the condition of

the arms of two boys suffering from tuberculosis of the skin, who had

been inoculated in the process of tattooing. The tattooing was done by

the brother of one of the lads who was in the last stages of phthisis,

and who used his own saliva to mix the pigment. The cases were under

the care of Murray of Tottenham, by whom they had been previously

reported. Williams has reported the case of a militiamen of seventeen

who, three days after an extensive tattooing of the left forearm,

complained of pain, swelling, and tenderness of the left wrist. A day

later acute left-sided pneumonia developed, but rapidly subsided. The

left shoulder, knee, and ankle were successively involved in the

inflammation, and a cardiac bruit developed. Finally chorea developed

as a complication, limited for a time to the left side, but shortly

spreading to the right, where rheumatic inflammation was attacking the

joints. The last, however, quickly subsided, leaving a general, though

mild chorea and a permanently damaged heart.

Infibulation of the male and female external genital organs for the

prevention of sexual congress is a very ancient custom. The Romans

infibulated their singers to prevent coitus, and consequent change in

the voice, and pursued the same practice with their actors and dancers.

According to Celsus, Mercurialis, and others, the gladiators were

infibulated to guard against the loss of vigor by sexual excesses. In

an old Italian work there is a figure of an infibulated musician--a

little bronze statue representing a lean individual tortured or

deformed by carrying an enormous ring through the end of the penis. In

one of his pleasantries Martial says of these infibulated singers that

they sometimes break their rings and fail to place them back--"et cujus

refibulavit turgidum faber peruem." Heinsius considers Agamemnon

cautious when he left Demodocus near Clytemnestra, as he remarks that

Demodocus was infibulated. For such purposes as the foregoing

infibulation offered a more humane method than castration.

Infibulation by a ring in the prepuce was used to prevent premature

copulation, and was in time to be removed, but in some cases its

function was the preservation of perpetual chastity. Among some of the

religious mendicants in India there were some who were condemned to a

life of chastity, and, in the hotter climates, where nudity was the

custom, these persons traveled about exposing an enormous preputial

ring, which was looked upon with adoration by devout women. It is said

these holy persons were in some places so venerated that people came on

their knees, and bowing below the ring, asked forgiveness--possibly for

sexual excesses.

Rhodius mentions the usage of infibulation in antiquity, and Fabricius

d'Aquapendente remarks that infibulation was usually practiced in

females for the preservation of chastity. No Roman maiden was able to

preserve her virginity during participation in the celebrations in the

Temples of Venus, the debauches of Venus and Mars, etc., wherein vice

was authorized by divine injunction; for this reason the lips of the

vagina were closed by rings of iron, copper, or silver, so joined as to

hinder coitus, but not prevent evacuation. Different sized rings were

used for those of different ages. Although this device provided against

the coitus, the maiden was not free from the assaults of the Lesbians.

During the Middle Ages, in place of infibulation, chastity-girdles were

used, and in the Italian girdles, such as the one exhibited in the

Musee Cluny in Paris, both the anus and vulva were protected by a steel

covering perforated for the evacuations. In the Orient, particularly in

India and Persia, according to old travelers, the labia were sewed

together, allowing but a small opening for excretions. Buffon and Brown

mention infibulation in Abyssinia, the parts being separated by a

bistoury at the time of marriage. In Circassia the women were protected

by a copper girdle or a corset of hide and skin which, according to

custom, only the husband could undo. Peney speaks of infibulation for

the preservation of chastity, as observed by him in the Soudan. Among

the Nubians this operation was performed at about the age of eight with

great ceremony, and when the time for marriage approached the vulva had

to be opened by incision. Sir Richard Buxton, a distinguished traveler,

also speaks of infibulation, and, according to him, at the time of the

marriage ceremony the male tries to prove his manhood by using only

Nature's method and weapon to consummate the marriage, but if he failed

he was allowed artificial aid to effect entrance. Sir Samuel Baker is

accredited in The Lancet with giving an account in Latin text of the

modus operandi of a practice among the Nubian women of removing the

clitoris and nymphae in the young girl, and abrading the adjacent walls

of the external labia so that they would adhere and leave only a

urethral aperture.

This ancient custom of infibulation is occasionally seen at the present

day in civilized countries, and some cases of infibulation from

jealousy are on record. There is mentioned, as from the Leicester

Assizes, the trial of George Baggerly for execution of a villainous

design on his wife. In jealousy he "had sewed up her private parts."

Recently, before the New York Academy of Medicine, Collier reported a

case of pregnancy in a woman presenting nympha-infibulation. The

patient sought the physician's advice in the summer of 1894, while

suffering from uterine disease, and being five weeks pregnant. She was

a German woman of twenty-eight, had been married several years, and was

the mother of several children. Collier examined her and observed two

holes in the nymphae. When he asked her concerning these, she

reluctantly told him that she had been compelled by her husband to wear

a lock in this region. Her mother, prior to their marriage, sent her

over to the care of her future husband (he having left Germany some

months before). On her arrival he perforated the labia minora, causing

her to be ill several weeks; after she had sufficiently recovered he

put on a padlock, and for many years he had practiced the habit of

locking her up after each intercourse. Strange to relate, no physician,

except Collier, had ever inquired about the openings. In this

connection the celebrated Harvey mentions a mare with infibulated

genitals, but these did not prevent successful labor.

Occasionally infibulation has been used as a means of preventing

masturbation. De la Fontaine has mentioned this fact, and there is a

case in this country in which acute dementia from masturbation was

cured by infibulation. In this instance the prepuce was perforated in

two opposite places by a trocar, and two pewter sounds (No. 2) were

introduced into the wounds and twisted like rings. On the eleventh day

one of the rings was removed, and a fresh one introduced in a new

place. A cure was effected in eight weeks. There is recent mention made

of a method of preventing masturbation by a cage fastened over the

genitals by straps and locks. In cases of children the key was to be

kept by the parents, but in adults to be put in some part of the house

remote from the sleeping apartment, the theory being that the desire

would leave before the key could be obtained.

Among some peoples the urethra was slit up as a means of preventing

conception, making a meatus near the base of the penis. Herodotus

remarks that the women of a certain portion of Egypt stood up while

they urinated, while the men squatted. Investigation has shown that

the women were obliged to stand up on account of elongated nymphae and

labia, while the men sought a sitting posture on account of the

termination of the urethra being on the inferior side of the base of

the penis, artificially formed there in order to prevent conception. In

the Australian Medical Gazette, May, 1883, there is an account of some

of the methods of the Central Australians of preventing conception. One

was to make an opening into the male urethra just anterior to the

scrotum, and another was to slit up the entire urethra so far as to

make but a single canal from the scrotum to the glans penis. Bourke

quotes Palmer in mentioning that it is a custom to split the urethra of

the male of the Kalkadoon tribe, near Cloncurry, Queensland, Australia

Mayer of Vienna describes an operation of perforation of the penis

among the Malays; and Jagor and Micklucho-Maclay report similar customs

among the Dyaks and other natives of Borneo, Java, and Phillipine

Islands.

Circumcision is a rite of great antiquity. The Bible furnishes frequent

records of this subject, and the bas-reliefs on some of the old

Egyptian ruins represent circumcised children. Labat has found traces

of circumcision and excision of nymphae in mummies. Herodotus remarks

that the Egyptians practiced circumcision rather as a sanitary measure

than as a rite. Voltaire stated that the Hebrews borrowed circumcision

from the Egyptians; but the Jews claimed that the Phoenicians borrowed

this rite from the Israelites.

Spencer and others say that in the early history of the Christian

religion, St. Paul and his Disciples did not believe in circumcision,

while St. Peter and his followers practiced it. Spencer mentions that

the Abyssinians take a phallic trophy by circumcision from the enemy's

dead body. In his "History of Circumcision," Remondino says that among

the modern Berbers it is not unusual for a warrior to exhibit virile

members of persons he has slain; he also says that, according to

Bergman, the Israelites practiced preputial mutilations; David brought

200 prepuces of the Philistines to Saul. Circumcision is practiced in

nearly every portion of the world, and by various races, sometimes

being a civil as well as a religious custom. Its use in surgery is too

well known to be discussed here. It might be mentioned, however, that

Rake of Trinidad, has performed circumcision 16 times, usually for

phimosis due to leprous tuberculation of the prepuce. Circumcision, as

practiced on the clitoris in the female, is mentioned on page 308.

Ceremonial Ovariotomy.--In the writings of Strabonius and Alexander ab

Alexandro, allusion is made to the liberties taken with the bodies of

females by the ancient Egyptians and Lydians. Knott says that ablation

of the ovaries is a time-honored custom in India, and that he had the

opportunity of physically examining some of the women who had been

operated on in early life. At twenty-five he found them strong and

muscular, their mammary glands wholly undeveloped, and the normal

growth of pubic hairs absent. The pubic arch was narrow, and the

vaginal orifice practically obliterated. The menses had never appeared,

and there seemed to be no sexual desire. Micklucho-Maclay found that

one of the most primitive of all existing races--the New

Hollanders--practiced ovariotomy for the utilitarian purpose of

creating a supply of prostitutes, without the danger of burdening the

population by unnecessary increase. MacGillibray found a native

ovariotomized female at Cape York who had been subjected to the

operation because, having been born dumb, she would be prevented from

bearing dumb children,--a wise, though primitive, method of preventing

social dependents.

Castration has long been practiced, either for the production of

eunuchs, or castrata, through vengeance or jealousy, for excessive

cupidity, as a punishment for crime, in fanaticism, in ignorance, and

as a surgical therapeutic measure (recently, for the relief of

hypertrophied prostate). The custom is essentially Oriental in origin,

and was particularly used in polygamous countries, where the mission of

eunuchs was to guard the females of the harem. They were generally

large, stout men, and were noted for their vigorous health. The history

of eunuchism is lost in antiquity. The ancient Book of Job speaks of

eunuchs, and they were in vogue before the time of Semiramis; the King

of Lydia, Andramytis, is said to have sanctioned castration of both

male and female for social reasons. Negro eunuchs were common among the

Romans. All the great emperors and conquerors had their eunuchs.

Alexander the Great had his celebrated eunuch, Bagoas, and Nero, his

Sporus, etc. Chevers says that the manufacture of eunuchs still takes

place in the cities of Delhi, Lucknow, and Rajpootana. So skilful are

the traveling eunuch-makers that their mortality is a small fraction of

one per cent. Their method of operation is to encircle the external

genital organs with a tight ligature, and then sweep them off at one

stroke. He also remarks that those who retain their penises are of but

little value or trusted. He divided the Indian eunuchs into three

classes: those born so, those with a penis but no testicles, and those

minus both testicles and penis. Curran describes the traveling

eunuch-makers in Central India, and remarks upon the absence of death

after the operation, and invites the attention of gynecologists and

operators to the successful, though crude, methods used. Curran says

that, except those who are degraded by practices of sexual perversions,

these individuals are vigorous bodily, shrewd, and sagacious, thus

proving the ancient descriptions of them.

Jamieson recites a description of the barbarous methods of making

eunuchs in China. The operators follow a trade of eunuch-making, and

keep it in their families from generation to generation; they receive

the monetary equivalent of about $8.64 for the operation. The patient

is grasped in a semi-prone position by an assistant, while two others

hold the legs. After excision the wounded parts are bathed three times

with a hot decoction of pepper-pods, the wound is covered with paper

soaked in cold water, and bandages applied. Supported by two men the

patient is kept walking for two or three hours and then tied down. For

three days he is allowed nothing to drink, and is not allowed to pass

his urine, the urethra being filled with a pewter plug. It generally

takes about one hundred days for the wound to heal, and two per cent of

the cases are fatal. There is nocturnal incontinence of urine for a

long time after the operation.

Examples of castration because of excessive cupidity, etc.,--a most

unwarranted operation,--are quite rare and are usually found among

ecclesiastics. The author of "Faustin, or le Siecle Philosophique,"

remarked that there were more than 4000 castrated individuals among the

ecclesiastics and others of Italy. The virtuous Pope Clement XIV

forbade this practice, and describes it as a terrible abuse; but in

spite of the declaration of the Pope the cities of Italy, for some

time, still continued to contain great numbers of these victims. In

France an article was inserted into the penal code providing severe

punishment for such mutilations. Fortunately castration for the

production of "castrata," or tenor singers, has almost fallen into

disuse. Among the ancient Egyptians and Persians amputation of the

virile member was inflicted for certain crimes of the nature of rape.

Castration as a religious rite has played a considerable role. With

all their might the Emperors Constantine and Justinian opposed the

delirious religion of the priests of Cybele, and rendered their offence

equivalent to homicide. At the annual festivals of the Phrygian Goddess

Amma (Agdistis) it was the custom of young men to make eunuchs of

themselves with sharp shells, and a similar rite was recorded among

Phoenicians. Brinton names severe self-mutilators of this nature among

the ancient Mexican priests. Some of the Hottentots and indigenous

Australians enforced semicastration about the age of eight or nine.

The Skoptzies, religious castrators in Russia, are possibly the most

famous of the people of this description. The Russian government has

condemned members of this heresy to hard labor in Siberia, but has been

unable to extinguish the sect. Pelikan, Privy Counsel of the

government, has exhaustively considered this subject. Articles have

appeared in Le Progres Medical, December. 1876. and there is an

account in the St. Louis Clinical Record, 1877-78. The name Skoptzy

means "the castrated," and they call themselves the "White Doves." They

arose about 1757 from the Khlish or flagellants. Paul I caused

Sseliwanow, the true founder, to return from Siberia, and after seeing

him had him confined in an insane asylum. After an interview, Alexander

I transferred him to a hospital. Later the Councillor of State,

Jelansky, converted by Sseliwanow, set the man free and soon the

Skoptzies were all through Russia and even at the Court. The principal

argument of these people is the nonconformity of orthodox believers,

especially the priests, to the doctrines professed, and they contrast

the lax morals of these persons with the chaste lives, the abstinence

from liquor, and the continual fasts of the "White Doves." For the

purpose of convincing novices of the Scriptural foundation of their

rites and belief they are referred to Matthew xix., 12: "and there be

eunuchs which have made themselves for the kingdom of Heaven's sake,"

etc.; and Mark ix., 43-47; Luke xxiii., 29: "blessed are the barren,"

etc., and others of this nature. As to the operation itself, pain is

represented as voluntary martyrdom, and persecution as the struggle of

the spirit of darkness with that of light. They got persons to join the

order by monetary offers. Another method was to take into service young

boys, who soon became lost to society, and lied with effrontery and

obstinacy. They had secret methods of communicating with one another,

and exhibited a passion for riches, a fact that possibly accounts for

their extended influence. The most perfect were those "worthy of

mounting the white horse," the "bearers of the Imperial seal," who were

deprived of the testicles, penis, and scrotum. The operation of

castration among these people was performed at one stroke or at two

different times, in the former case one cicatrix being left, and in the

latter two. The greater number--those who had submitted to the "first

purification," conferring upon them the "lesser seal"--had lost

testicles and scrotum. These people are said to have lost the "keys of

hell," but to retain the "key of the abyss" (female genitals). As

instruments of excision the hot iron, pieces of glass, old wire,

sharpened bone, and old razors are used. Only nine fatal cases

resulting from the operation are known. At St. Petersburg Liprandi knew

a rich Skoptzy who constantly kept girls--mostly Germans--for his own

gratification, soon after having entered into the "first purification."

Few of them were able to remain with him over a year, and they always

returned to their homes with health irretrievably lost. Women members

of the order do not have their ovaries removed, but mutilation is

practiced upon the external genitals, the mammae, and nipples. The

first ablation is obtained by applying fire or caustics to the nipples,

the second by amputation of the breasts, one or both, the third by

diverse gashes, chiefly across the breast, and the fourth by resection

of the nymphae or of the nymphae and clitoris, and the superior major

labia, the cicatrices of which would deform the vulva. Figure 232

represents the appearance of the external genital organs of a male

Skoptzy after mutilation; Figure 233 those of a female.

Battey speaks of Skoptzies in Roumania who numbered at the time of

report 533 persons. They came from Russia and practiced the same

ceremonies as the heretics there.