A regular feature of any hospital accident and emergency department is the patient who turns up in an embarrassing and self-inflicted predicament. When questioned about the nature of the injury and how it came about, they come up with an utterly implausible explanation. One example: “I was standing on a chair in the nude, trying to close the window, and fell on to a broom handle”.

This case, reported in 1850 in the Boston Medical and Surgical Journal, is a particularly entertaining example of an embarrassing predicament with an unlikely-sounding explanation. The thing is, I’m inclined to believe the patient’s account of events leading up to the injury. This case report was submitted by Dr A.B. Shipman of Syracuse, New York:

A few months ago I was called in great haste to a young gentleman, who was in a most ludicrous yet painful condition. I found, on examination, a bottle, holding about a pint, with a short neck and small mouth, firmly attached to his body by the penis, which was drawn through the neck and projected into the bottle, being swollen and purple. The bottle, which was a white one, with a ground-glass stopper and perfectly transparent, had an opening of three fourths of an inch in diameter only: and the penis being much swollen rendered its extraction utterly impossible. The patient was greatly frightened, and so urgent for its removal that he would give me no account of its getting into its present novel situation, but implored me to liberate it instantly, as the pain was intense and the mental anguish and fright intolerable.

I think if I turned up at a hospital in such a condition I would also be hoping for treatment first, explanation second.

Seeing no hopes of getting an explanation in his present predicament, and after endeavoring to pull the penis out with my fingers, without success, I seized a large knife lying on the table, and with the back of it I struck a blow on the neck of the bottle, shivering it to atoms and liberating the penis in an instant, much to the delight of the terrified youth. The glans penis was enormously swollen and black, as was the prepuce; both were vesicated [blistered], as though scalding water or fire had been applied to them. He complained of smarting and pain in the penis, after the bottle was removed; and inflammation, swelling and discoloration continued for a number of days, but by scarification and cold applications, subsided; yet not without great apprehensions on the part of the patient, and a good degree of real pain in the penis.

The reader is probably anxious to know, by this time, how a penis, belonging to a live man, found its way into so unusual a place as the mouth of a bottle.

I have no doubt that everybody who has ever read this case report in the 165 years since it was written has wondered exactly this.

I was extremely curious myself; but the fright and perturbation of the patient’s mind, and his apprehensions of losing his penis entirely, either by the burn, swelling, inflammation, or by my cutting it off to get it out of the bottle, all came upon him at once and overwhelmed him with fear.

That’s one possible reason for his reticence, certainly.

Now for the explanation. A bottle in which some potassium had been kept in naphtha, and which had been used up in experiments, was standing in his room; and wishing to urinate without leaving his room, he pulled out the glass stopper and applied his penis to its mouth. The first jet of urine was followed by an explosive sound and flash of fire, and quick as thought the penis was drawn into the bottle with a force and tenacity which held it as firmly as if in a vice. The burning of the potassium created a vacuum instantaneously, and the soft yielding tissue of the penis effectually excluding the air, the bottle acted like a huge cupping glass to this novel portion of the system. The small size of the mouth of the bottle compressed the veins, while the arteries continued to pour their blood into the glans, prepuce, etc. From this cause, and the rarefied air in the bottle, the parts swelled and puffed up to an enormous size.

Do stop giggling; this must have been a very serious situation. It’s definitely not at all funny.

How much potassium was in the bottle at the time is not known, but it is probable that but a few grains were left, and those broken off from some of the larger globules, and so small as to have escaped the man’s observation. I was anxious to test the matter (though not with the same instruments which the patient had done)…

I’m glad to hear that, at least.

…and for that purpose took a few small particles of potassium, mixed with about, a tea-spoonful of naphtha, and placed them in a pint bottle. Then I introduced some urine with a dash, while the end of one of my fingers was inserted into the mouth of the bottle, but not so tightly as to completely close it, and the result was a loud explosion like a percussion cap, and the finger was drawn forcibly into the bottle and held there strongly — thus verifying, in some degree, this highly interesting philosophical experiment, which so frightened my friend and patient.

This does seem strangely plausible. In case you haven’t seen what happens when a stream of urine – or water, at least – hits a piece of potassium, it looks much like this.

The novelty of this accident is my apology for spending so many words in reporting it, while its ludicrous character will, perhaps, excite a smile; but it was anything but a joke at the time to the poor sufferer, who imagined in his fright that if his penis was not already ruined, breaking the bottle to liberate it would endanger its integrity by the broken spicules cutting or lacerating the parts.

Quite. He has my sympathy. And I’m definitely not laughing.