A seaman's wager
Authors: J. C. Goddard
Journal: Journal of the Royal Society of Medicine (2003)

On 6 December 1805 HMS Isis, a 50 gun man-of-war, was stationed in home waters off Spithead when the ship's surgeon, Benjamin Lara, noted the addition to the sick-list of Able Seaman John Cummings. Cummings, a 29-year-old American, presented with 'excessive pain in the stomach and intestines, incapacity of retaining anything in the stomach and pain on walking or standing erect'. On questioning, he admitted to 'having swallowed on the preceding day 19 or 20 clasp knives and one clasp knife case, the latter of which was soon rejected, but the former retained'.1 Lara's journal ends before the completion of Cummings' clinical episode and the subsequent journal is lost. The end of the story, however, can be found in the library of the Royal Society of Medicine.

Benjamin Lara, the surgeon, subsequently described the case in a letter dated 27 March 1809 and addressed to Dr Curry, a physician at Guy's Hospital. After Curry's death, this letter and other papers pertaining to the case, including the patient's own description of his story, were discovered by Alexander Marcet. Dr Alexander John Gaspard Marcet MD FRS (1770–1822) (Figure 1), likewise a Guy's man and a friend of the late Dr Curry, was a founding member and first secretary of the Medical and Chirurgical Society of London which subsequently became the Royal Society of Medicine. Marcet presented the case of John Cummings to the Society and this lecture and copies of both accounts are preserved in the Society's Transactions.2



Figure 1

Alexander John Gaspard Marcet, MD FRS (1770–1822). Painting by Sir Henry Raeburn, RA, which hangs in the dining room of The Royal Society of Medicine. (Reproduced by kind permission of The Royal Society of Medicine, London)



In Cummings' own account of his illness, he revealed that this was not the first time he had swallowed knives. While stationed in France in 1799 he had watched a mountebank pretending to swallow knives in a circus near Havre de-Grace. He later bragged that he could do this in reality, and his shipmates wagered he could not. He swallowed four knives with no obvious ill effect, although only three of the four were seen again.

Some six years later he was stationed in Boston, USA. His current shipmates did not believe his story and under the influence of grog (rum and water) he began again. After swallowing fourteen knives, he was admitted to Charleston Hospital with abdominal pain. After a few days the knives had all passed safely through and his symptoms resolved, just in time for him to sail back with his ship to France.

His next ship was the Betty of Philadelphia. Early in the voyage back from France to the USA she was stopped by the Royal Navy and he was impressed into service aboard HMS Isis. On 4 December 1805, drunk once again, he swallowed his final twenty knives and two days later he reported to Benjamin Lara. He was given castor oil and 'glysters' (enemas) of thick water-gruel, and opium for the pain. When the symptoms continued, a dose of 30 or 40 drops of sulphuric acid daily was tried in an attempt to dissolve the iron. Finally he was given 'murinated tincture of iron', but this made his pain worse. After remaining on the sick list for three months he 'felt the knives drop into his bowel and felt much relieved' and was discharged back to light duties.

In June 1806, Cummings vomited one side of a knife handle; in November and again the following February he passed more pieces. Although Lara was transferred off HMS Isis in November 1806 his successor, Mr Peter Kelly, kept him informed of the patient's progress. Cummings continued to pass pieces of iron and knife handles; each ejection was accompanied by considerable pain and in one instance the vomiting of two pounds of blood. He was finally discharged from the ship, as unfit, in June 1807.

After leaving HMS Isis, Cummings travelled immediately to London and presented himself to Guy's Hospital for treatment. His admitting physician, Dr Babbington, did not believe his story and discharged him after a few days. He was readmitted in August, however, his condition much deteriorated. Examining the patient with Sir Astley Cooper, Babbington 'after minute discussion' asked for the opinion of the surgeon Mr Lucas. Lucas performed a rectal examination and felt one of the knives in the rectum.

Although he was again discharged on 28 October 1807, Cummings was readmitted in September 1808, this time under the care of Dr Curry. He was given more acid, mucilage and opium but slowly deteriorated, suffering bouts of pain and indigestion and having difficulty eating. He finally died in March 1809 'in a state of extreme emaciation'.

The necropsy was conducted by Mr Travers, surgeon and anatomy demonstrator at Guy's, supervised by Mr Lucas. The abdominal cavity was noted to have a 'black ferruginous' tinge from the iron knives. A knife blade and a knife back-spring were found in the intestines. The spring had chronically eroded through into the peritoneum, transfixing the colon near the left kidney but without causing peritonitis. The blade was wedged across the rectum, its end embedded in the pelvic wall. Thirty to forty fragments of wood, metal and horn were found when the stomach was opened.

The case was presented to the Medical and Chirurgical Society of London by Alexander Marcet on 19 March 1822, just a few months before his own death. He displayed the pieces taken from Cummings' stomach to the audience in a glass case (Figure 2).



Figure 2

Fragments of knives found in the stomach of John Cummings. Displayed to the members of the Medical and Chirurgical Society of London on 19 March 1822. The items on the bottom row were expelled whilst he was on board HMS Isis. The spring that transfixed ...