Thursday, November 14, 2013

Self-castration: a case from 1947

The following case report of self-castration was published in the Medical Memoranda section of the British Medical Journal in 1949. Talk about crazy behavior. I wonder whether the patient might have been an undiagnosed schizophreniac as well as an epileptic.

"A man aged 34 was brought to the casualty department by ambulance on July 10, 1947, at 8.50 p.m. He stated that he had removed both his testicles with a razor two hours previously : he was an epileptic, and had been told that castration would effect a cure. He appeared to be healthy and robust, and in complete possession of his senses. He had a severe lacerated wound of the scrotum, which was not bleeding very severely. He was not at all shocked, and was very garrulous. He seemed quite well satisfied with his action, which he had been contemplating for some time. This was evidenced by such statements as, "Well, I have done it now, doctor."

On examination the scrotum had a large lacerated wound on the anterior wall, which had been literally ripped open. Both compartments of the scrotum were filled with blood clot, making it difficult to assess the amount of trauma to the cord and soft tissues. He had his testicles in a small cloth bag, which he stated was his "money bag," and this was rolled up in the front of his vest. He produced these with an air of great satisfaction. The calmness with which his actions were performed was very remarkable.

In order to gain sanction for the necessary operation the patient was solemnly asked if he would sign the following statement: "I .. ... state that I cut my testicles out to-night with a razor blade, and I consent to an operation." This was done before operation to provide legal cover in the even of any subsequent action after the patient had realized his deformity.

At operation the lacerated ends and the bleeding-points of the spermatic cord were secured and ligated and the scrotum was closed with a small drainage tube. He was treated with penicillin and made a good recovery from the effects of the operation. The wound healed within two weeks.

In view of the comment excited by the case, and as he was obviously an undesirable patient to keep in the general ward of a hospital - he made no secret of his act, and was indeed rather proud of himself - he was transferred to the county mental home next day. He was subsequently shown at a clinical meeting, when his attitude had not changed."

Human testicles. Image from: Wikipedia

Source: Bisset RDN (1949) Self-castration. Br Med J. 2(4618): 59. 

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