If the endoscopist retrieves and then collects, he also makes something out of his findings. Rosamond Purcell identifies a strange collection of “(carefully ordered) needles” dating to the mid-nineteenth century, removed from the body of an insane woman addicted to morphine. The needles are assembled “tidily,” and Purcell remarks the “peculiar sensibility of whoever arranged the morbid collection with such care”: “It is as though the needles, once a source of frantic and fruitless anticipation, might now be used methodically by a person mending clothes, as if the gruesomeness of their history could at least be somewhat tempered by presentation.”
Extreme acts of swallowing seem to engender equally peculiar extreme “crafts”—of mounting, exhibiting, or transforming the items and their etiology into works of, for lack of a better term, “art.” Each fbdy collection serves its own conscious and unconscious, ascribed and denied, practical and imaginative purpose, but it’s hard not to notice an affinity between fbdy displays that originate in acts of mental instability or hysteria, especially when the patients-subjects-swallowers are women and the physicians-operators-collectors-artists are men.
Sometime between the years 1927 and 1929, an unnamed woman (we might consider her a sort of never-to-be-hailed Unknown Soldier on the battlefields of the history of psychiatry) undertook a swallowing project of mammoth proportions that eventually precipitated her death. Other patients in the ghastly-sounding State Lunatic Asylum No. 2 in St. Joseph, Missouri, witnessed her swallowing Things, and she was rushed into surgery, but without the benefit of Chevalier Jackson or any of his disciples, she died on the operating table. The hospital’s surgeon discovered enough hardware in her stomach and bowels to constitute a collection in itself: 453 nails, 9 bolts, 115 hairpins, 42 screws, assorted buttons, pebbles, and 942 various pieces of metal, including earrings, silverware handles, and salt and pepper shaker tops. Is it quality or quantity that matters? To me, the choice of salt and pepper shaker tops seems more significant than the number of bolts consumed. I wonder if a special pathological category should be reserved for the person who counts the Things and records them in a ledger, bent on getting the number right. Imagine the number of times whoever counted the nails, exasperated, had to start over, until, checking and double-checking, he was able to breathe a sigh of relief and say, “Now we know.” But what do we know?
It’s strange to find a short article on these things in Self, a magazine focused on fitness, health, and nutrition for women, but even more startling to find it featured on “extreme craft” blogspots. Here it’s not the act of swallowing that is the focus but what Dr. Ralph Edwards, a pathologist at the hospital in the 1920s, did afterward with the swallowed things: he sewed them onto a large piece of cloth, then ordered and arranged them to approximate a pattern. What is now called the “stomach contents display” is on view in the Glore Psychiatric Museum.
Sometime in 1968, George Glore, a lifetime employee of the Missouri Department of Mental Health, began to assemble a collection of mental health ephemera that he exhibited in an abandoned ward of the state hospital to celebrate Mental Health Awareness Week. The museum that grew out of this collection offers a one-of-a-kind tour of centuries-old treatment devices for the insane, who appear as mannequins in the assorted little-shop-of-horrors exhibits. The stomach contents display, though, distinguishes itself to this day as the museum’s most talked-about item, no doubt for some of the same reasons that the Chevalier Jackson collection is among the Mütter’s most popular exhibits—they both assert a Ripley’s Believe It or Not appeal. Just as powerful as, if not more so than, the fact of the things and the unnamed woman’s acts, however, is the truly weird suggestion of Edwards’s arrangement of the objects swallowed: neither a meticulous cartography, documentary, or cabinet of wonders, the stomach contents’ afterimage resembles nothing so much as a pulsating mandala (see figure 27).
Buttons cluster in the center of the design like an archetypal navel; pins and needles swirl in carefully composed circles as if to suggest the hub of the universe itself. More than ordering disorder, the fbdies-turned-mandala translates the Things swallowed into a form of the sublime, however cheap and raggedy, for it’s surely not transcendent and is hardly beautiful, though it does seem on par with the terrible and awful. Foreign bodies swallowed fasten on our imaginations, but the pathologist’s mandala seems to say, “It’s too difficult to make meaning out of this.” However the patient hoped for her disorder to act upon herself or her interlocutor, whatever it was she was making or making of herself by such acts, it is subsumed by the force and weirdness of the pathologist’s design.
Fig. 27. “The Stomach Contents Display.” The St. Joseph Museums, Inc./Glore Psychiatric Museum, St. Joseph, Missouri.
It’s not a competition, nor is it a you-say-po-TAY-toh, I-say-po-TAH-toh sort of difference, this affinity and distance between the act of swallowing and the act of assembling. Nor do I think Edwards fancied himself a Jungian in his off-hours or hoped to treat other patients in the asylum with the soothing effects of a meditative prayer wheel. At best, he was trying to tame something wild; at worst, he let the remarkable nature of her act—the titillating aspect of its extremity—override whatever the patient was trying to say. He was inspired but not informed. He extracted the showy, the monstrum, from inside the monstrous; he translated the abominable act into a transcendent symbol rather than an exorbitant sign. As if to say let’s take this moment of hysterical departure to a point before you were born and after you have died and hang it here, and marvel at it.
Chevalier Jackson’s collection has the power to occlude others, just as, in some sense, identifying collections the world over risks normalizing his. For every robust and fanciful foreign body collection, there are no doubt dozens more quiet and banal versions languishing behind closed doors. In the Mütter Museum itself, one outspoken foreign body collection is on permanent display (Jackson’s), while another lies hidden in a recess of the archive (see figure 28). Two mica-like, nearly translucent, razor-thin slivers approximating the porous sheath that is human skin stand upright inside beakerlike containers. Charred black flecks coat the containers’ rims—traces, the museum’s administrative coordinator explains to me, of a sealant made of pitch that has since flaked off. The specimen dates back to 1840s Philadelphia. It consists of rows of pins and needles—but the pins seem sharper than the ones we use nowadays, and the eyes of the needles are so fine as to require a magnifying glass for threading them. The pins are also headless—recommending thimbles on more than thumbs, lest you risk pricks and cuts and bloodstains. They’re filamental as fishbones and wispy as a lock of hair. They’ve been separated out, the pins from the needles, and mounted, which is to say, mildly etched and glued into isinglass in neat rows of six. Today they’ve lost some of their adhesiveness and are deteriorating; unloosed, a few lie detached from their mounting at the bottom of the jar. The ones still adhering to their surface seem like splinters caught under a nail; their placement in evenly paced rows upon a backing makes the specimens resemble a still-playable musical instrument, kind of like a Jew’s harp, requiring both a finger and a mouth.
Fig. 28. Pins and needles extracted from the body of a “young hysterical female” by Thomas Dent Mütter sometime in the late 1840s, mounted on isinglass. Collection of the Mütter Museum, The College of Physicians of Philadelphia.
Oh, but here’s the most astonishing detail: they were extracted by Thomas Dent Mütter himself, and the slips of pinned and needled isinglass could have been his calling cards—they’re just the right size. Like the Glore extravaganza, this more modestly delicate display also references a case of purposeful ingestion, the only data on the case being its specimen number drawn on a label yellowed with glue, 13410, and a sentence in one of the museum’s catalogs: “Needles and pins removed by Dr. Mütter from different portions of the body of a young hysterical female, 1849.”
What compelled Mütter to keep or dump, mount or discard? Unlike so many of his specimens, this o
ne is not anatomical per se, but a trace of a will. What exactly could this neatly separated display teach? Mütter was among the earliest practitioners of plastic surgery and of operations to treat scalds and burns. This case might testify to a delicate incursion into the skin—“Look, I extracted them whole!” What else do we know about Mütter? In a posthumous reminiscence by the famous Dr. Samuel D. Gross, we learn that he was married to a woman considerably younger than he; that he died young, at forty-eight, and that “no children blessed their union.” That he was “the pink of neatness.” That he had a strong and clear voice and cut a distinctly physical figure on the streets of Philadelphia, where people couldn’t help but notice “his tall grey horse, his low carriage, and his servant in livery.” Chair of surgery at Jefferson Medical College for a time, he was nevertheless not, from Gross’s point of view, to be counted among the finer surgeons who were his peers. Though he “wielded his knife” with grace and self-possession, he was “deficient in boldness,” according to Gross. Moreover, he had “no fondness for authorship,” and “did not possess much ability as a writer.” Gross tells us that neither was Mütter much of a reader: “His library was small,” writes Gross, “and he did not read much beyond what was necessary to enable him to keep abreast of the knowledge required for his lectures.” I sense that Mütter was a kind of showman: he was “fond of anecdotes and had always a good supply on hand for ready use,” Gross adds. In other words, he was a collector, and one wonders if he would have been remembered by medical history if not for his museum. Perhaps he went at medical knowledge through the door of things rather than ideas.
Like the woman in the Glore case, next to nothing is known about Mütter’s 1840s “hysterical female.” What remains of her act is this specimen in a jar. If the Missourian woman’s collection is weighty, if it astounds us for its heft and shape and magnitude, the Philadelphia woman’s pins and needles bespeak uncanny transport. Today they might appear no more than corroding stripes on a translucent card, but this kind of ingestion hints at waywardness, of a body’s giving itself over to multiple forms of departure and arrival.
Beneath a photograph of the specimen by Rosamond Purcell for the book Mütter Museum of the College of Physicians of Philadelphia, we read: “Pins and needles that have been ingested orally may work themselves out through the walls of the gastrointestinal tract and become lodged elsewhere in the body.” In his own treatise on fbdies in the airways, not the foodways, Samuel Gross caught that peculiarly menacing effect of the ways, once inside the body, certain kinds of foreign bodies can move:
Finally, the foreign body occasionally, though very rarely, escapes through the walls of the chest, by retracing, as it were, its former steps, or retraversing the route by which it entered. In some instances, again, also very uncommon, it forms a new passage, just as tubercular matter sometimes does. Lastly, the extraneous substance may leave the lung, and pass into the cavity of the pleura, where it may either become encysted, or, as more generally happens, excite fatal inflammation.
Once inside the body, it’s anybody’s guess what path a pin or needle will follow; so light, they seem to swim. The horror of these particular things ingested isn’t only that they’re sharp, but that, carried through the body’s interiors without benefit of peristalsis, they are errant and directionless—we don’t know where or how they’ll reemerge.
How can I make a pin once ingested or a spoon handle mean? How can we reattach the thing not to cloth or isinglass but to history, to story, to the body, to the mind? There must be clues that we’re missing that tell what couldn’t be told. I might swallow a spoon handle because I’m using it to make myself throw up rather than to shovel something in. I might be redressing spoons as implements to scoop the body with. J. Marion Sims, the so-called Father of American Gynecology, invented the first speculum by bending back a kitchen spoon. Maybe I’m turning the spoon against itself as enemy rather than against the man, though it’s he who is now required to fish it out of me.
As for “pins and needles,” therein lies a tale. Of nervousness, excitement, and anticipation—it’s the path that nerve-ways take or fail to when shut off. They’re the implements of women’s work, the tools for mending and of livelihood, of social staying, of gender placement: if I pierce myself, will something open that is otherwise shut? Can I imagine myself as a cloth in need of stitching, in need of being fastened, or held in place, pieced together again? Tell me a story while I work, of a girl sent on an errand to her grandmother’s house who meets a wolf who asks which path she’ll take—the one of “pins or needles”? Give me an ending in which she neither ends up in the belly of the beast, nor is rescued by a huntsman, but frees herself to take the deepest path into the darkest unmapped wood, the way of pins, the way of needles. Early versions of “Little Red Riding Hood” proposed these paths to the girl—a choice between the pleasure principle and the reality principle, according to Bruno Bettelheim. “Don’t amuse yourself along the way,” some versions of the story have the mother tell the girl, certainly don’t eat the pins and needles, but our hysteric does.
Every doctor makes something out of what the patient gives him: a diagnosis, an interpretation, a treatment method. A mandala, a specimen, a collection. When the swallowing of fbdies is intentional, the case is rife with things we dare not understand. Our own unconscious processes, for example, as well as the patient’s, re-inspiriting the body, its pleasures and its perils. The body as a place of egress and entrance, as receiver and begetter, as consumer and producer, as me and not-me, as that which goes into me and that which goes out of me—my words and yours.
But besides this quality of the stomach, there is another more strange, when
some can eat and digest coals, sand, lime, pitch, ashes, and such like
trash. This is called by Physitians a disease, under the name of Pica, Citta,
Malacia; but I think it proceeds not only from a distemper in the stomach,
and malignant acide humors impacted in the membranes thereof; but also,
and that chiefly, from some occult quality.
—ALEXANDER ROSS, Arcana Microcosmi (1652), book 2, chapter 8
Foreign bodies stretch the viscera in ways doctors supposed was not possible, but they stretch our imaginations too, and the limits of our credulity; subsequently, they make interesting demands on our language.
Multiple foreign bodies. Numerous collections. A panoply of orifices. Competing accounts. The language that Chevalier Jackson lent to his endoscopic practice was sober in comparison to so many ecstatically charged books on the subject before and since his remaking of the field. I can take the strange-but-true National Enquirer approach to foreign-body ingestion, I can write with more or less of a lilt, unironically or fascinatedly. Of course, Jackson’s tonal control hardly ever lets a stray fantasy or impulse enter into his prose. His purchase on the impossible borderlands of foreign-body lodgment is always a hermeneutic one: an occasion for a disquisition on a mechanical problem and the particular instrumentarium it calls into being; the implements and methods required to cross a seemingly impassable bridge; the tools and technique and wherewithal that need to be invented so as not to get lost in a pitch-dark wood.
Once in, how do I get out? Once in, how does it get out? These are the questions upon which Jackson’s prose tirelessly touches down, and they provide enough investigation for a lifetime, but they cannot temper the generative nature of the foreign-body phenomenon, the uncontrollable and the inexhaustible, the perpetual fund to which the caught foreign body gives rise.
At the time of Samuel D. Gross’s own Practical Treatise on Foreign Bodies in the Air Passages in 1854, only a handful of books and papers from France, Germany, and the United States existed on the subject, according to Gross. The very first thing that Gross notes isn’t the particular nature of each case’s specific challenge but the amplitude beyond measure, the “exceedingly diversified character” of fbdy things caught, the endless endlessness, the everything and all-full-nes
s that the human body can incidentally ingest. The mid-nineteenth century represented a different material landscape than the one we inhabit now, but history books cannot really compete with the picture made by the sounds of the names of things swallowed by people in 1854. Breathe in the ferule of the rib of an umbrella containing a piece of whalebone, breathe out persimmon seed; breathe in some sewing silk, breathe out a tamarind seed. Breathe in a sprig of cedar, cowrie shell, a plum-drupe. Breathe out a fiddle-peg, some locks of tow, or millepods. In me are caught some beech-nut burrs, ears of grass, and rye and barley. Some pipe-stems, worsted yarn, and button-foils. There are artificial teeth with their blocks and pivots, a puff-dart, a piece of feather “nearly two inches in length and still furnished with some of its plumage”; the berry of the bladder-senna; a pellet of paper, such as is used for enveloping “sugar kisses” “about the size of a dime and with very sharp angles.”
The names are enchanting. but they spell out forms of death that are sadly similar and an array of crude and gruesome attempts at cures. A person might be treated with emetics, “sternutatories” (sneeze-producers), the inhalation of iodine, or, with the intuitively sound but unfortunately ridiculous inversion of the body. Surgery was so often fatal, but the alternative was “leeches and blisters ... applied several times to the right side of the chest” (this, for a person who had inhaled a nail); the regulation of the bowels with castor oil or calomel and rhubarb; the control of the cough with “occasional doses of hyoscyamus,” derived from a genus of plants named henbane or hog bean and belonging to the nightshade family. Known for its hallucinatory, sedating, and hypnotic effects, henbane contains the colorless, crystalline, and highly poisonous alkaloid hyoscyamine.
Several decades after Gross’s treatise, a French surgeon named Alfred Poulet compiled his own two-volume Treatise on Foreign Bodies in Surgical Practice, though he admits that two volumes is hardly enough to contain “all the curiosities of this kind, which are little known and scattered throughout the annals of science.” The thing about foreign-body work is that it is beyond us, not only in its vastness and measure, in its multifarious-ness and its refusal to adhere to any norm. It is beyond our understanding, and therefore has the potential to severely strain a doctor’s confidence. “Take a student who has passed through all the medical grades, and is on the eve of entering civil or military service: place him in the presence of even the simplest cases of foreign bodies—a small stone or a pea in the ear, a metallic splinter in the cornea, or a catheter broken in the urethra—and the anxiety and embarrassment which he manifests will show how insufficient is his surgical knowledge on this point.” This is how Poulet announces the impetus behind his book, but the resulting two volumes don’t so much impart surgical knowledge as they pursue off-limit realms of the Gargantuan and Lilliputian. We could be reading Rabelais or Swift, or the bizarre mythology of an as-yet-undiscovered culture.
Mary Cappello Page 18
