Note III.

ON AGONY AND BLOODY SWEAT.

"Of all the maladies which affect cutaneous transpiration, diapedesis, or sweating of blood" — says Dr. Millingen, — "is the most singular; so much so indeed, that its existence has been doubted, although several well authenticated cases are on record, both in the ancient and modern annals of medicine. It is mentioned by Theophrastus, Aristotle, and Lucan. . . . . . . The base Charles ix. of France sank under this disorder, as stated by Mezeray. The same historian relates the case of a governor of a town taken by storm, who was condemned to die, but was seized with a profuse sweating of blood the moment he beheld the scaffold. Lombard mentions a general who was affected in a similar manner on losing a battle. The same writer tells us of a nun who was so terrified when falling into the hands of a ruthless banditti, that blood oozed from every pore. Henry ab Heer records the case of a man, who not only laboured under diapedesis, but small worms [also] accompanied the bloody secretion. In the Memoirs of the Society of Arts of Haarlem, we read of the case of a sailor who, falling down during a storm, was raised from the deck streaming with blood. At first it was supposed that he had been wounded, but on close examination the blood was found to flow from the surface of the body . . . . . . Dr. Fournier relates the case of a magistrate who was attacked with diapedesis after any excitement, whether of a pleasurable or painful nature . . . . . . The case of Catherine Merlin, of Chamberg, is well authenticated, and worthy of being recorded. She was a woman forty-six years of age, strong and hale. She received a kick from a bullock in the epigastric region, [pit of the stomach,] that was followed by vomiting of blood. This discharge having been suddenly stopped by her medical attendants, the blood made its way through the pores of various parts of her body, every limb being affected in turn. The sanguineous discharge was invariably preceded by a prickly and itching sensation. Frequently this exudation proceeded from the scalp. The discharge usually occurred twice in the twenty-four hours, and on pressing the skin the flow of blood could be accelerated and increased." — Dr. Millingen's explanation of bloody sweat, although brief, is judicious- — "It is probable" — says he, — "that this strange disorder arises from a violent commotion of the nervous system, turning the streams of blood out of their natural course, and forcing the red particles into the cutaneous excretories. A mere relaxation of the fibres could not produce so powerful a revulsion. It may also arise in cases of extreme debility, in connexion with a thinner condition of the blood."¹ — It is in like manner remarked by Schwencke, that a dissolved state of the blood cannot in all instances be assigned as the cause. — "Nee tamen omnis eruptio sanguinea quae vulgo creditur a dissolutione sanguinis fieri talis est, ut ex sequenti historia satis singulari patebit. Puella quindecim annorum, a tribus annis jam menstruam purgationem largiter, imo nimium passa, ex quinque retro annis convulsionibus correpta, tenuis habitus, acris ingenii, et facile animo mota, extra paroxysmum bene valens, quacunque diei atque noctis hora, per quoscunque superficiei corporis locos subinde sanguinem fundebat per cutim erumpentem, idque vel brevi post convulsiones, vel eodem simul cum convulsionibus tempore, nee ulla corporis pars est quae banc evacuationem non experta est; namque ex oculis, naribus, auribus, labiis, lingua, mammis, ano, et omnibus extremitatibus, instar sudoris profluebat. Prsedicebat saepissime ex quanam parte sanguis proflueret; erantque signa prsesagii ordinaria, anxietas, voniitus, gravitas, pruritus, et calor partis, fere nullo cum tumore; tumque dein ex ea parte sanguinis sudoris specie expulsio fiebat, brevi sponte cessans; neque ullum vitium aut vestigium sudoris sanguinei relictum animadvertebatur, quamvis aliquando viginti quatuor horarum spatio ante paroxysmum sanguinis eruptionem praediceret. Per quinque annos hunc effectum durasse norunt multi, quern tamen ex dissolutione, prsesertim putrefaciente, fuisse natum nemo concedet, praecipue si attento percipiat animo atque perpendat, post paroxysmum eam bene valuisse, eamque sudoris sanguinei evacuationem sequuta fuisse nulla alia symptomata, sed et omnis generis earn medicamenta deglutivisse." — A case very similar to the foregoing is quoted in the Medico-Chirurgical Review, from the French "Transactions Medicales" for November, 1830. — "A young woman aged twenty-one years, irregular in menstruation, and of indolent habits, and obstinate temper, had been much irritated by some reflections made by her parents, on account of her abjuring the Protestant religion. She left her paternal roof, and after wandering about for some time, took up her residence in an hospital. She was then suffering violent attacks of hysteria, attended with general convulsions, and exquisite sensibility in the pubic and hypogastric regions, [lower part of the belly.] After paroxysms of hysteria, which sometimes lasted twenty-four or thirty-six hours, this female fell into a kind of ecstacy, in which she lay with her eyes fixed, sensibility and motion suspended. Sometimes she muttered a prayer, but the most remarkable phenomenon was an exudation of blood from the cheeks and the epigastrium, [pit of the stomach,] in the form of perspiration. The blood exuded in drops, and tinged the linen. The cutaneous surface appeared injected in those parts whence the blood escaped, being red, and showing a network of arborescent vessels. This bloody perspiration took place whenever the hysteric paroxysm lasted a considerable time. This state continued for three months, and ultimately gave way, it is said, to local bleeding . . . . . . together with strong revulsive measures."² — Such cases are valuable, by proving the possibility and actual occurrence of bloody sweat which, although attested by authors of the highest eminence and credibility, some persons have on speculative grounds disputed, or denied. Thus Baron Haller declares that passions of the mind sometimes force blood from the skin, and infers that the sudoriferous tubes are not much smaller than the capillary blood-vessels. — "Sanguis ipse in summo aestu, in motu vehementi, a vita vinolenta, ex terrore et anxietate, [in Servatoris exemplo,] ex dissolutione sanguinis, variisque causis per sudoris vias sequi, etiam minime malo eventu; manifesto argumento vasa sudorifera arteriolis rubris non valde minora esse, summa violentia sanguinem indigere, ut in ea succedat." — "Affectus animi, qui nihil mutant nisi nervorum stricturas, miras secretionum mutationes faciunt, sanguinem per cutis vasa expellunt, bilemque."³

For the satisfaction of those readers who love to ascertain the authenticity and value of the evidence submitted to them, the original accounts of most of the cases of bloody sweat mentioned in the text are here subjoined, with two or three additional ones. The first are from the German Ephemerides. — "Prseter naturam aliquos sanguinem sudasse annotarunt Aristoteles, lib. iij. de part, animal, cap. v.; et lib. iij. de histor, animal, cap. xvj.; Rondelet, de dignosc. morb. cap. xj.; Fernel. lib. vj. de part, morb, et symptom, cap. iv.; Marcellus Donatus, lib. j. de medic, histor. mirab. cap. ij.; Mercurialis, lib. iv. variar. lect. cap. xij.; Greg. Horstius, lib. j. part. ij.; Obs. 15; Thomas Bartholinus, cent. ij. epist. xij. p. 440. Henricus Ab Heer, Observ. 23, meminit cujusdam nobilis, qui sanguinem, cumque eo pedicillos ruberrimos sudaviu" — "Juvenis quidam studiosus, cum propter insolentias nocturnas et alia tentata carceri injiceretur, talem timorem et anxietatem cordis passus est ac si ad mortem usque deliquisset, ut sparsim in pectore manibus et brachiis guttulae sanguinis erumperent et transudarent. Re ad inclytum magistratum delata, jussus sum eum visitare, et historiam explorare: quae omnia cum oculis meis vidissem, et incarceratum in periculo vitse constitutum deprehendissem, ad instantiam meam (poena quidem reservata) dimissus, et tenuior factus sanguis, sublata omni anxietate, ad pristinum statum reductus est." — "Observatum fuit puellulum, dum duo sui fratres majores laqueo suspenderentur, quia delicti erat particeps, et in poena juxta patibulum spectaculo adstabat, sanguinem toto corpore sudasse." — "Joachimus Scacerna, Ferrariensis, anno aetatis sexagesimo secundo, alioquin sanus, vexabatur forti animi pathemate ob criminationem alicujus, ut asserebat, testificationis falsse; qua de re mense Novembris sub meridiem mihi obviam factus, et lugens, suum narrabat infortunium, et consilium poscebat, veritus ne in carcerem conjiceretur. Ego interim, misertus ejus calamitatis, observavi ex oculis lachrymas exire rubicundas, ad instar sanguinis, Eum consolatus discessi. Postea vero a satellitibus in carcerem ductus, sanguineas effundens lachrymas, dolore cordis vexatus, rigore in toto corpore afficitur, et exinde maligna febri, quae trium dierum spatio ilium necavit."⁴ — In another volume of the same work is related the case of a boy, twelve years of age, who was relieved from a severe comatose and convulsive disorder by a bloody sweat, which broke out August the 2nd, 1746. After describing this occurrence, the author, J. C. Schilling, observes; — "Quum deinde mensis hujus die 17° sudor hie cessasset, acerbissimi recurrerunt capitis dolores, pectoris oppressiones et anxietates, immo aliquot motuum convulsivorum paroxysmi, quos sanguinis excreatio et ejectio cum tussi sequuta, itemque sanguinis per alvum secessio; quales excretiones sanguinis, modo per os, modo per alviim, modo per pores cutis hinc inde, ad sequinoctium hujus anni vernale usque et ultra alternatim ssepius recurrerunt; et, licet puer per aliquot interdum hebdomadas liber fuerit, non prius tamen quam post illud tempus prorsus convaluit. Jam vero, quae singularis Dei gratia est, optime valet."⁵

The two cases of bloody sweat from mental emotion mentioned by De Thou are, in his own words, as follows. The first is that of the commander at Monte-Maro in Piedmont, who was treacherously seized and threatened with an ignominious death by the general of the besieging army. — "Capta Dragonera, Magio negotium datum ut Montem-Marinum, munitissimum locum, aggrederetur; qui secum ducto Augusto, Saluciarum principis notho filio, eo tendit; evocatoque quasi ad colloquium prsesidiariorum duce ab Augusto, qujcum arctissima intercedebat amicitia, Magius ex compacto superveniens eum comprehendi jussit; et ut locum dederet hortatus, cum nihil proficeret, postremo minas addidit, et ipsum vinctum quasi ad supplicium in oppidi conspectum deduci imperavit. Tarn miserabili spectaculo victi oppidani, ut ducem suum periculo eximerent, deditionem fecere. Observatum tarn indignae mortis vehementi metu adeo concussum animo eum fuisse, ut sanguineum sudorem toto corpore funderet." — The second case is that of the Florentine youth at Rome, who for a trifling offence was publicly executed by order of Pope Pius the Sixth. — "Insigne severitatis signum dedit in causa juvenis cujusdam Florentini; qui, quod in heri sui pedibus in Transtiberina regione latrunculatoribus de asino quid postulantibus, aut exsequi volentibus, sola denegatione simpliciter restiterat, quanquam. postea non aquarii qui amissum asinum reposcebat, sed heri sui eum fuisse constitisset, nihilominus ad mortem damnatus est, ita Sixto volente ac jiibente; nam quo minus recuperatores in juvenem mortis sententiam ferrent urbana lex obstabat, quae quenquam ob ejusmodi crimina ante vicesimum annum completum morte affici vetat. Cum duceretur ad supplicium juvenis, multorum commiserationem excitavit; ipse prse doloris vehementia lachrymas cruentas fundere, et sanguinem pro sudore toto corpore mittere visus est; quod multi pro certo documento acceperunt naturae festinati crudeliter judicii severitatem impugnantis, et de magistratu ipso, quasi percussore, ultionem reposcentis."⁶

Next come the somewhat similar instances furnished by Maldonato, Zacchias, and Schenck. In illustration of the bloody sweat of Christ the former observes; — "Audio de his qui viderunt aut cognoverunt ante annos duos, Lutetise Parisiorum, hominem robustum et bene valentem, audita in se capitali sententia, sudore sanguineo fuisse perfu sum." — After distinguishing between real and fictitious cases of this kind, Zacchias remarks; — "Si ergo talia symptomata abessent, per artem procuratum fuisse talem audorem asset suspicandum; qui tamen non ita extra naturam est, quin aliquando observatum sit ilium ex ingenti animi an gore in iis qui morte damnati sunt prorupisse; ut in juvene Belba, igni destinato, non multis abhinc annis quicunque voluit adnotavit; et notavit etiam Cardanus, De subtilitate, et alibi." — The case of the nun, to which Dr. Millingen seems to have referred, is thus described in the work of Schenck a Grafenberg. — "Soror qusedam religiosa, cum incidisset in militum manus, et evaginatos gladios ac macherulas vibratas mortem intentantes videret, adeo territa fuit et commota, ut sanguis ab omnibus corporis partium meatibus manaret; ita ut, in oculis hostium exanguis efFecta, vitam finiret mortalem." — To these may be added the original account given by De Mezeray, concerning the death of Charles IX. of France. After mentioning the various projects which this unprincipled but active monarch contemplated during his last illness, the historian observes: — "Mais c'etoit en vain qu'il faisoit tous ces grands projets; le ciel en avoit autrement dispose. II se consumoit a petit feu, et pour ainsi dire, il fondoit a vue d'oeil. Tous les remedes de ses medecins pallioient son mal, mais ils ne le guerissoient pas; et apres que la vigueur de sa jeunesse et la grandeur de son courage eurent longtemps combattii contre sa maladie, il en fut enfin abattu au lit dans le chateau de Vincennes, vers le huitieme jour de Mai, [1574.] La nature fit d'etranges efforts pendant les deux dernieres semaines de sa vie. II tressailloit et se roidissoit avec une extreme violence. II s'agitoit et se remuoit sans cesse, et le sang lui jaillissoit par tous les conduits, memo par les pores, de sorte qu'on le trouva une fois qui baignoit dedans."⁷

The statement that the agony of Christ was a violent conflict between opposite mental emotions, and that his sweat was literally mixed with blood in a half-coagulated state, is strongly confirmed by the consideration that Luke, the only sacred writer by whom the awful scene is described, was a physician, and that the terms which he employs, and which occur in no other part of the New Testament, are strictly medical. Their proper import is attested by all the lexicons, as for example by that of Castello.— "Agonia, ἀγωνία, angorem significat, et verbum ἀγωνιᾷν, juxta Galen, lib. 2, de symptom, caus. cap. 5, ad finem, affectum aninii compositum ex ira et timore; ilia quidem sanguinem et spiritum foras agente et fundente, hoc vero utrumque ad vitae principium et interiora, cum refrigeratione eorum quae in summo corpore sunt, reducente et eontrahente. Derivatur ab ἀγὼν, certamen, lucta. Unde et ἀγωνία certamen quandoque significat. . . . . Ad summam, Agonia significat in genere colluctationem diversorum affectuum animi inter se contrariorum."— *'Thrombos. θρόμβος, Vide Grumus. — Grumus, θρόμβος, est liquidse rei in ijnam massam concretje et coagulatae frustum. Ad lac et sanguinem translata vox est medicis; imprimis Hippocrates frequenter de sanguine usus est concreto; 4. aph. 80. Coac. t. 123, lib. 5. Epid. v. 5." — A similar account of these words is given in Poole's Synopsis, at the note on Luke, chap. 22, v. 41. — "’Αγὼν est certamen, periculum, labor. Hinc ἀγωνία, quse est horror quo homo corripi solet in gravi discrimine. Proprie usurpatur de eo motu animi ad grave periculum, quitamen fortitudinem non expectoret. Vide Porphyrium ad illud Homeri; Τρῶας μὲν τρόμος, &c. — Cum esset in aestu. — Significat a.ya)via summam Christ! angustiam, luctantis et cum terroribus mortis, et cum ter ribili Patris irati judicio. . . . . . . ὡσεὶ θρόμβοι αἵματος καταΒαίνοντες: quasi grumi, vel guttae, Vulg. Grumi sunt guttse ampliores sive crassiores sanguinis descendentes, &c., vel decurrentes, fluvii aut torrentis more . . . . . . Est enim θρόμβος Galeno τὸ αἷμα πεπηγὸς, sanguis concretus, qui Latinis grumus in Glossario, et in vetere Onomastico. . . . . . Docet Aristoteles, 3 de histor. animal, accedere nonnullis ἱδρῶσαι αἱματώδει περιττώματα sudare sanguineo excremento, propter malum corporis habitum, et defectum caloris . . . . . . Ἀγωνιῶντες autem maxime sudant, inquit Aristot. Problem, Sect. 2 De sudore. Idemque testamur Artemidorus, Philostratus, et Philo. Sed illud quasi non significat hunc non fiiisse vere guttas aqueas mistas sanguine; quod etiam fieri possit per naturam vim intas patientera, ac proinde per poros ejicientem una cum aqua sanguinem, praesertim ubi corpus rarum est ac delicatum, et sanguis subtilis, ut in Christo indubie erat." — Schleusner in like manner remarks that the adverbs ὡς and ὡσει sometimes denote reality, and gives the following references respecting the use of θρόμβοι , in the sense of clots of blood. In scriptis medicorum Grsecorum admodum frequenter vox dpofjilBoe de gutta spissi et coagulati sanguinis, et de sanguine coagulato in universum usurpatur. v. c. Dioscorid. I, c. 102; Hesych. θρόμβος ; αἷμα παχὺ, πεπηγὸς, ὡς βουνοί· Confer. Fsesii Œcon. Hippocr. p. 167."

1) Dr. Millingen, Curiosities of Medical Experience, vol. ii. pp. 338-342.

2) Schwencke, Hœmatologia, pp. 130, 13; — Medico-Chirurgical Review, from July to October, 1831, p. 496.

3) Haller, Element. Physiolog. Corp. Human. tol. v. p. 50; — Primse Linese Physiol ogise, p. 126.

4) Ephemerid. Acad. Natur. Curios, Ann. 2, p. 34; — Dec. ij. Ann. 10. p. 354; — Dec. iij. Ann. 7 and 8; Append, p. 124; Edit. 2da. Norimb. vol, j. p. 84.

5) Ephemerid. Acad. Natur. Curios, edit. 2da. vol. j. p. 84; — vol. viij. p. 425, &c.

6) Thuanus, Hist, sui Temp, vol. j. p. 373; vol. iv. p. 300.

7) Joannes Maldonatus, Comment, in quatuor Evangelist, p. 601; — Paulus Zacehias, Quaestiones Medico-legales, lib. iij. p. 154; — Joannes Schenck à Grafenberg, Observ, Medic. &c. lib. iij. p. 458; — De Mezeray, Histoire de France, vol. iij. p. 306.