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Excerpt ​

Excerpt from Anomalies and Curiosities of Medicine, by George M. Gould

The following case is probably the only instance in which the patient,
suffering from vesical calculus, tried to crush and break the stone
himself. J. B., a retired draper, born in 1828, while a youth of
seventeen, sustained a fracture of the leg, rupture of the urethra, and
laceration of the perineum, by a fall down a well, landing astride an
iron bar. A permanent perineal fistula was established, but the patient
was averse to any operative remedial measure. In the year 1852 he
became aware of the presence of a calculus, but not until 1872 did he
ask for medical assistance. He explained that he had introduced a
chisel through his perineal fistula to the stone, and attempted to
comminute it himself and thus remove it, and by so doing had removed
about an ounce of the calculus. The physician started home for his
forceps, but during the interval, while walking about in great pain,
the man was relieved by the stone bursting through the perineum,
falling to the floor, and breaking in two. Including the ounce already
chiselled off, the stone weighed 14 1/2 ounces, and was 10 5/8 inches
in its long circumference. B. recovered and lived to December, 1883,
still believing that he had another piece of stone in his bladder.

In Holden's "Landmarks" we are told that the operation of dividing the
Achilles tendon was first performed by an unfortunate upon himself, by
means of a razor. According to Patterson, the late Mr. Symes told of a
patient in North Scotland who, for incipient hip-disease, had the
cautery applied at the Edinburgh Infirmary with resultant great relief.
After returning home to the country he experienced considerable pain,
and despite his vigorous efforts he was unable to induce any of the men
to use the cautery upon him; they termed it "barbarous treatment." In
desperation and fully believing in the efficacy of this treatment as
the best means of permanently alleviating his pain, the crippled
Scotchman heated a poker and applied the cautery himself.

We have already mentioned the marvelous instances of Cesarean sections
self-performed, and in the literature of obstetric operations many of
the minor type have been done by the patient herself. In the foregoing
cases it is to be understood that the operations have been performed
solely from the inability to secure surgical assistance or from the
incapacity to endure the pain any longer. These operations were not the
self-mutilations of maniacs, but were performed by rational persons,
driven to desperation by pain.

Explanation ​

Detailed Explanation of the Excerpt from Anomalies and Curiosities of Medicine by George M. Gould ​

Context of the Source ​

Anomalies and Curiosities of Medicine (1896) is a two-volume compilation of bizarre, extreme, and unusual medical cases collected by George M. Gould (1848–1922) and Walter L. Pyle (1871–1921). The work serves as a historical record of medical oddities, self-surgeries, rare conditions, and extraordinary patient behaviors from the 19th and early 20th centuries. It reflects the limitations of medical knowledge at the time, the desperation of patients in pain, and the extreme measures some took when professional help was unavailable or rejected.

The excerpt provided focuses on self-performed medical interventions, particularly cases where patients, driven by unbearable suffering, resorted to drastic—and often dangerous—methods to alleviate their conditions.

Breakdown and Analysis of the Excerpt ​

1. The Case of J. B. (Vesical Calculus – Bladder Stone) ​

Summary:

  • A retired draper, J. B. (born 1828), suffered a severe injury at age 17 after falling down a well and landing on an iron bar, causing:
    • A fractured leg
    • A ruptured urethra (the tube carrying urine from the bladder)
    • A lacerated perineum (the area between the anus and genitals)
  • This led to a permanent perineal fistula (an abnormal opening), but he refused surgical treatment.
  • In 1852 (age 24), he discovered he had a bladder stone (vesical calculus) but did not seek help until 1872 (age 44)—20 years later.
  • During this time, he attempted to remove the stone himself by:
    • Inserting a chisel through his fistula into his bladder.
    • Chiseling away at the stone, removing about 1 ounce of it.
  • When he finally saw a doctor, the physician left to fetch forceps, but before returning, the stone burst through the perineum, fell out, and broke in two.
  • The total weight of the stone was 14½ ounces (about 410 grams), with a circumference of 10⅝ inches (27 cm)—an enormously large bladder stone.
  • J. B. recovered and lived until 1883, though he still believed another stone remained in his bladder.

Themes & Significance:

  • Medical Desperation & Self-Treatment: J. B.’s case illustrates the extremes to which people would go when medical care was inaccessible, rejected, or deemed ineffective. His 20-year delay in seeking help suggests either fear of surgery, distrust of doctors, or sheer stubbornness.
  • Pain as a Motivator: His self-surgery with a chisel was not an act of madness but of rational desperation—he could not endure the pain and saw no other option.
  • Medical Ignorance & Risk: The fact that he survived such a dangerous procedure is astonishing. Most attempts at self-surgery in this era ended in infection, sepsis, or death.
  • The Body’s Strange Resilience: The stone bursting out naturally is a rare phenomenon, possibly due to pressure necrosis (tissue death from prolonged compression).

Literary Devices:

  • Clinical Detachment: The tone is matter-of-fact, almost dryly humorous, which contrasts with the horror of the situation. This was common in 19th-century medical writing, where emotional distance was prioritized.
  • Irony: The doctor’s absence when the stone finally expelled itself is almost comically timed.
  • Hyperbole (Exaggeration for Effect): The size of the stone (14½ oz, 10⅝ inches) is emphasized to shock the reader, reinforcing the extraordinary nature of the case.

2. The Case of the Self-Applied Achilles Tendon Surgery ​

Summary:

  • From Holden’s Landmarks, we learn of a man who cut his own Achilles tendon with a razor.
  • This was likely an attempt to relieve pain or correct a deformity, though the exact reason is unclear.

Themes & Significance:

  • Extreme Self-Reliance: Like J. B., this man took direct, violent action against his own body rather than seek help.
  • Lack of Anesthesia & Sterility: Such procedures would have been excruciating and high-risk for infection.

3. The Scotchman Who Cauterized His Own Hip ​

Summary:

  • A Scottish man with incipient hip disease received cauterization (burning tissue with a hot iron) at the Edinburgh Infirmary, which gave him relief.
  • Later, when the pain returned, no one in his rural village would perform the procedure, calling it "barbarous."
  • Driven by pain, he heated a poker and cauterized himself.

Themes & Significance:

  • Cultural Distrust of Medicine: The villagers’ rejection of cauterization as "barbarous" reflects folk medicine’s skepticism toward painful but effective treatments.
  • Faith in Medical Science: The man’s belief in cauterization (despite its brutality) shows how desperation overrides fear.
  • Rural vs. Urban Medicine: In remote areas, medical knowledge was scarce, forcing people into DIY solutions.

Literary Devices:

  • Anecdotal Style: The story is told briefly but vividly, making the man’s act seem both shocking and darkly admirable.
  • Contrast: The civilized hospital treatment vs. the primitive self-application highlights the gap between medical progress and accessibility.

4. Self-Performed Cesarean Sections & Obstetric Operations ​

Summary:

  • The text mentions women performing their own C-sections (or other obstetric procedures) when no help was available.
  • These were not acts of insanity but of sheer necessity—either to save their own lives or their unborn children’s.

Themes & Significance:

  • Maternal Desperation: Childbirth in the 19th century was extremely dangerous; if a woman was alone or doctors refused to help, self-surgery was a last resort.
  • Gender & Medical Autonomy: Women, often excluded from medical decision-making, sometimes had to take control in life-or-death situations.
  • Historical Reality vs. Myth: While some legendary cases (like the 14th-century "Mother of Colchester") are debated, the text presents these as documented medical anomalies.

Literary Devices:

  • Generalization for Impact: By grouping these cases together, Gould emphasizes the pattern of desperation-driven self-surgery.
  • Appeal to Authority: Citing Holden, Patterson, and Symes lends credibility to these extraordinary claims.

Overarching Themes in the Excerpt ​

  1. Human Endurance & Desperation

    • The cases show how unbearable pain can drive rational people to extreme, self-destructive acts.
    • These were not suicidal gestures but calculated risks for survival.

  2. Medical Limitations of the 19th Century

    • Surgery was primitive, painful, and risky—many preferred to avoid doctors unless absolutely necessary.
    • Anesthesia was not widely available until the mid-1800s, making procedures torturous.
    • Antiseptics were just emerging (Lister’s carbolic acid, 1860s), so infection was a major killer.

  3. Self-Reliance vs. Medical Authority

    • The patients in these cases rejected or lacked access to professional help, forcing them into DIY medicine.
    • This reflects a distrust of doctors, fear of surgery, or geographical isolation.

  4. The Body as a Battleground

    • The excerpt treats the body as a mechanical problem to be fixed by force (chisels, razors, pokers).
    • There’s a detached, almost industrial view of medicine—pain is an obstacle to be overcome, not a signal to seek help.

  5. The Line Between Rationality and Madness

    • Gould explicitly states that these were not acts of insanity but of clear-minded desperation.
    • This challenges the Victorian-era stigma that self-harm or extreme medical acts were signs of lunacy.

Literary & Historical Significance ​

  • Medical History: The excerpt provides real-world examples of how pre-modern medicine forced people into dangerous self-treatment.
  • Psychological Insight: It reveals the depths of human suffering and the lengths people will go to for relief.
  • Cultural Attitudes Toward Pain: The stoicism of these patients reflects 19th-century ideals of endurance, where complaining was weakness.
  • Narrative Style: Gould’s clinical, almost amused tone makes the cases both fascinating and horrifying, a hallmark of medical oddity literature.

Conclusion: Why This Excerpt Matters ​

This passage is more than just a collection of grotesque medical stories—it’s a window into the brutal realities of 19th-century healthcare. It shows:

  • How pain and fear could override rational decision-making.
  • The extremes of human resilience in the face of medical neglect.
  • The evolution of surgery from barbaric necessity to regulated science.

Gould’s work serves as a reminder of how far medicine has come—and how desperation can turn ordinary people into their own surgeons.

Would you like any further analysis on a specific aspect, such as the psychological state of these patients or the historical medical context?