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Thursday, September 11, 2014

The Woman Who Claimed She Urinated a Bullet

While urinating a worm is physically possible as described in a recent blog post, there is an early medical report from 1668 of a woman urinating something even more incredible…a bullet. The story goes like this.

A large, pale, woman by the name of G. Eliot in Suffolk, England was tormented with intestinal problems for many years. She was persuaded by a neighbor who had similar problems to swallow two bullets.  It is not stated what the logic was behind how swallowing bullets would supposedly help. The woman claimed that she felt better initially after swallowing the bullets but that the pains returned and increased.

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After 15 years of continued symptoms, she presented to Dr. Nathan Fairfax’s pharmacy.  He prescribed her something called Lady Hollands powder that was mixed into a hot drink. She vomited over night.  When using the bathroom the next morning (which was referred to as the chamber pot), she urinated when a thwang was heard on the side of the vessel.  This reportedly surprised her and led her to wonder what it could be. So she poured the urine and saw a heavy gravelly stone that was yellow-red in color and as big as the end of a thumb. However, this is based solely on self-report.  She reportedly took a hammer, knocked off the outer crust, and found a bullet enclosed in it. She then reportedly cut it a little with a knife and found lead within it.

Dr. Fairfax asked her if she had ever urinated bullets before and she said no, including the other bullet. Recollecting back to when she swallowed the two bullets, she stated that she checked her feces slightly for days afterwards and never found the bullets and so she gave up. She stated that the bullet was smaller compared to when she originally swallowed it.  Before and since that time, she stated that she urinated an abundance of red gravel.

Ms. Eliot stated that when she voided the bullet that it felt like a kidney stone but that it lasted longer (i.e., weeks),  caused her to bow forwards, and led to vomiting.  She claimed to feel it move lower from the kidney to the bladder.  Dr. Fairfax asked her if she was sure that the bullet came from the urine and she assured him that it was and that she was not mistaken. Dr. Fairfax stated that the bullet did have a gravelly coat. Since she passed the bullet, she stated that she still had kidney stone pains but not as bad as before.

Dr. Fairfax stated the tale strengthened his belief that there must have been a passage from the stomach to the bladder but in reality, there is no such passage.  He believed that nature had found a way to finally rid the body of something it found offensive. Basically, his argument was that the body works in mysterious ways.

This story is a good lesson that highlights the problem that arises when health care professionals rely on self-report , despite claims that the self-report is definitely not mistaken. What this woman described is actually anatomically impossible. There is no known mechanism by which someone can swallow a bullet or any other foreign object and have it passed from the stomach to the kidneys. When solid objects and liquid enters the stomach from the esophagus it goes directly to the small intestines. The blood picks up excess fluid and is filtered by the kidneys but there is no way for the blood to transfer a solid object from the small intestine to the blood and into the kidneys.

Thus, either Ms. Eliot made the story up and showed the doctor a bullet that was not the one she swallowed or she or Dr. Fairfax misperceived the middle of a kidney stone as a bullet. Incidentally, there is no report in the modern medical literature of a foreign object being passed out of the body through the urine.

Fairfax, N. (1668). An Extract of a Letter, Written by Dr. Nathan. Fairfax to the Publisher, about a Bullet Voided by Urine, Philosophical Transactions, 40, 803-805.

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