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An unusual case of mayhem
AN UNUSUAL MUTILATION
OF EXTERNAL ALBERT
Visiting
Surgeon,
CASE OF MAYHEM
Presbyterian
S.
GENITALIA
HARDEN,
Hospital,
M.D.,
Associate
NEWARK,
T
Crimes
HE
describe
Acts
mayhem
of
New
N.
BY ANGRY PARAMOUR F.A.C.S.
Visiting
Surgeon,
Newark City Hospital
J.
broke into the house. A hurry caI1 was sent to the hospita1 to which she was quickly removed. Later the poIice found two sharp razors in
Jersey’
as foIIows:
Any person who, from premeditative design, evinced by lying in wait for the purpose, or in any manner, or with intent to kill, maim or disfigure, shah cut out or disable the tongue, put out an eye, cut off or sht the Iip, cut off, sIit or destroy a nose or ear, or cut off or disabIe any limb of another, wiIlfuIIy and on purpose, shaI1 be guiIty of a high misdemeanor.
To those
of us working
hospitaIs
it
unusua1
ease
is
not
to appear
however, in reporting unable to find any record perpetrated
upon
in Iarge
uncommon from
time
general for
the
to time;
this case we are of a simiIar attack
a femaIe.
ness and mora1 depravity h ave few paraIIeIs.
For fiendishit appears to
An investigation made by the poIice disclosed that the victim, a white woman, thirty years of age, had for the past three years intimateIy known her paramour, frequently staying at his home. About one year ago she contracted syphihs and in due time infected her lover. At the time of the crime both were under treatment. On the day of the assault she arrived at his home and compIained of not feehng weI1, removed her hat and Iay down upon the bed. ApparentIy without any provocation he struck her on the Ieft side of the face rendering her unconscious. On recovering consciousness she experienced a severe burning pain over the externa1 genitals. PIacing her hand upon the parts she found them covered with bIood. As she was too weak to arise from the bed, she attracted the attention of the neighbors by hurling a bottIe through the window. This had the desired effect, as severai of the neighbors
’ Laws of
1~08, Chapter
45, Section
I 12.
FIG. I. Mayhem: external genitals cut off by angry paramour. Portion of externa1 genitals found, by poIice, in frying pan on kitchen table. Specimen measured 3 X 3% inches in size and included Iarger part of mans veneris, upper parts of labia major:,. and minora and clitoris. Urethra escaped injury. (Offrce of Chief Medical Examiner, Essex Co. (Newark), N. J.)
the kitchen and aIso a considerable portion of the external genitalia Iying in a frying pan on the kitchen tabIe (Fig. I). On admission to the hospital, the patient was a we11 deveIoped femaIe, extremely paIe and apparentIy suffering from loss of blood. A Iarge pear-shaped avuIsion of the pubic region extending from the hair Iine of the mons veneris incIuding the cIitoris and upper onethird of the vulva was found. That portion of the wound over the mons extended down to and exposed the OS pubis. In the lower part of the right hypogastrium was a deep cut with a protrusion of severa inches of omentum. There was profuse bIeeding from both wounds.
453
‘454
American
JournaI of Surgery
Harden-Mayhem
The patient on arrivaI at the hospita1 was immediateIy taken to the operating room where bIeeding from the wound of the genitaLa was controIIed by deep sutures of catgut. The abdomen was opened and thoroughIy expIored for any injuries to the bIadder or intestines. As none were found, the abdomen was cIosed. An intravenous injection of 740 C.C. of saIine was given and the patient returned to the ward. The foIIowing day a bIood transfusion of 500 C.C. was given. The patient’s condition improved rapidly. The wound of the genitaIia became infected and was treated with saIine irrigations and hot sitz baths. Thirty-two days after the injury, the infection being under contro1, a pIastic repair of the pudenda1 region was performed. Under constant saline irrigation a Iinear incision was made at the margin of the abdomina wound on both sides and the superior border, the granuIations removed with a curet and the incisions were undermined for a suff~cient distance to aIIow the wound margins to be approximated. As there was some tension on the sutures, it was deemed advisabIe to make a few counter incisions paraIIe1 to the first incisions and then sew them IongitudinaIIy, thus reIieving the tension upon the sutures. This procedure was most satisfactory as the
SEPTEMBER. ,935
wound surfaces approximated with no tension. As there were no Iabia or cIitoris remaining, the same technique was foIIowed to within a centimeter of the urethra1 orifice and a self retaining catheter inserted. The vagina1 wall was then dissected out to the extent of about 0.5 cm. and the adjacent skin, which had evidentIy been severed but not removed as in the upper portion, was undermined and the two margins were brought together with interrupted siIkworm gut sutures to within a centimeter of the urethra1 opening. Recovery was more or Iess uneventfu1 with the exception of a Iow grade infection around one of the vagina1 sutures. This was cIeared up by hot sitz baths. The patient was discharged forty days after her admission to the hospita1. While from the esthetic viewpoint it Ieft much to be desired, to quote, it was “a couvert.” UnfortunateIy we have never had the opportunity to foIIow up this most interesting case as the patient had departed for parts unknown, nor was any arrest made as her Iover too vanished. However, a recent poIice report states that they have become re-united. So as the Bard of Avon says, “aII’s we11 that ends weI1.”
OF EXTERNAL ALBERT
Visiting
Surgeon,
CASE OF MAYHEM
Presbyterian
S.
GENITALIA
HARDEN,
Hospital,
M.D.,
Associate
NEWARK,
T
Crimes
HE
describe
Acts
mayhem
of
New
N.
BY ANGRY PARAMOUR F.A.C.S.
Visiting
Surgeon,
Newark City Hospital
J.
broke into the house. A hurry caI1 was sent to the hospita1 to which she was quickly removed. Later the poIice found two sharp razors in
Jersey’
as foIIows:
Any person who, from premeditative design, evinced by lying in wait for the purpose, or in any manner, or with intent to kill, maim or disfigure, shah cut out or disable the tongue, put out an eye, cut off or sht the Iip, cut off, sIit or destroy a nose or ear, or cut off or disabIe any limb of another, wiIlfuIIy and on purpose, shaI1 be guiIty of a high misdemeanor.
To those
of us working
hospitaIs
it
unusua1
ease
is
not
to appear
however, in reporting unable to find any record perpetrated
upon
in Iarge
uncommon from
time
general for
the
to time;
this case we are of a simiIar attack
a femaIe.
ness and mora1 depravity h ave few paraIIeIs.
For fiendishit appears to
An investigation made by the poIice disclosed that the victim, a white woman, thirty years of age, had for the past three years intimateIy known her paramour, frequently staying at his home. About one year ago she contracted syphihs and in due time infected her lover. At the time of the crime both were under treatment. On the day of the assault she arrived at his home and compIained of not feehng weI1, removed her hat and Iay down upon the bed. ApparentIy without any provocation he struck her on the Ieft side of the face rendering her unconscious. On recovering consciousness she experienced a severe burning pain over the externa1 genitals. PIacing her hand upon the parts she found them covered with bIood. As she was too weak to arise from the bed, she attracted the attention of the neighbors by hurling a bottIe through the window. This had the desired effect, as severai of the neighbors
’ Laws of
1~08, Chapter
45, Section
I 12.
FIG. I. Mayhem: external genitals cut off by angry paramour. Portion of externa1 genitals found, by poIice, in frying pan on kitchen table. Specimen measured 3 X 3% inches in size and included Iarger part of mans veneris, upper parts of labia major:,. and minora and clitoris. Urethra escaped injury. (Offrce of Chief Medical Examiner, Essex Co. (Newark), N. J.)
the kitchen and aIso a considerable portion of the external genitalia Iying in a frying pan on the kitchen tabIe (Fig. I). On admission to the hospital, the patient was a we11 deveIoped femaIe, extremely paIe and apparentIy suffering from loss of blood. A Iarge pear-shaped avuIsion of the pubic region extending from the hair Iine of the mons veneris incIuding the cIitoris and upper onethird of the vulva was found. That portion of the wound over the mons extended down to and exposed the OS pubis. In the lower part of the right hypogastrium was a deep cut with a protrusion of severa inches of omentum. There was profuse bIeeding from both wounds.
453
‘454
American
JournaI of Surgery
Harden-Mayhem
The patient on arrivaI at the hospita1 was immediateIy taken to the operating room where bIeeding from the wound of the genitaLa was controIIed by deep sutures of catgut. The abdomen was opened and thoroughIy expIored for any injuries to the bIadder or intestines. As none were found, the abdomen was cIosed. An intravenous injection of 740 C.C. of saIine was given and the patient returned to the ward. The foIIowing day a bIood transfusion of 500 C.C. was given. The patient’s condition improved rapidly. The wound of the genitaIia became infected and was treated with saIine irrigations and hot sitz baths. Thirty-two days after the injury, the infection being under contro1, a pIastic repair of the pudenda1 region was performed. Under constant saline irrigation a Iinear incision was made at the margin of the abdomina wound on both sides and the superior border, the granuIations removed with a curet and the incisions were undermined for a suff~cient distance to aIIow the wound margins to be approximated. As there was some tension on the sutures, it was deemed advisabIe to make a few counter incisions paraIIe1 to the first incisions and then sew them IongitudinaIIy, thus reIieving the tension upon the sutures. This procedure was most satisfactory as the
SEPTEMBER. ,935
wound surfaces approximated with no tension. As there were no Iabia or cIitoris remaining, the same technique was foIIowed to within a centimeter of the urethra1 orifice and a self retaining catheter inserted. The vagina1 wall was then dissected out to the extent of about 0.5 cm. and the adjacent skin, which had evidentIy been severed but not removed as in the upper portion, was undermined and the two margins were brought together with interrupted siIkworm gut sutures to within a centimeter of the urethra1 opening. Recovery was more or Iess uneventfu1 with the exception of a Iow grade infection around one of the vagina1 sutures. This was cIeared up by hot sitz baths. The patient was discharged forty days after her admission to the hospita1. While from the esthetic viewpoint it Ieft much to be desired, to quote, it was “a couvert.” UnfortunateIy we have never had the opportunity to foIIow up this most interesting case as the patient had departed for parts unknown, nor was any arrest made as her Iover too vanished. However, a recent poIice report states that they have become re-united. So as the Bard of Avon says, “aII’s we11 that ends weI1.”