Fasting Girls: Their Physiology and Pathology

by William A. Hammond

Watcher No. 7. Thomas Davies, who had been the greatest sceptic of all, was strongly convinced. He watched Sarah Jacob twelve days, and was quite positive that nothing could have been given her during his watch. He watched her with all possible care, and was very cautious to be in a prominent place, where Sarah Jacob's mouth was always in sight.

Evidence, however, was given which went to show that the watching was very imperfectly performed; that occasionally the watchers left before their time had expired; that intoxicating liquors were taken by them to the house, and that one of them was drunk while there. It was also shown that the father and mother had free access to the bed, while the watchers were absolutely prohibited from examining it. It is therefore with entire justification that Dr. Fowler states that the watching "was the greatest possible farce and mockery."

After the report of the watchers the notoriety of Sarah Jacob of course became still greater; crowds came to visit her, and among others the Rev. Frederic Rowland Young went to see her, and made an unsuccessful effort to cure her by laying on of hands. When Dr. Fowler visited her, August 30th, 1869, on getting out at the nearest railway station, he was met by little boys bearing placards with the words "Fasting Girl," and "This is the shortest way to Llethernoryadd-ucha," on them. In his letter to the Times, giving an account of his visit, Dr. Fowler says:—

"The first impression was most unfavorable, and to a medical man the appearances were most suspicious. The child was lying on a bed decorated as a bride, having around her head a wreath of flowers, from which was suspended a smart ribbon, the ends of which were joined by a small bunch of flowers, after the present fashion of ladies' bonnet strings. Before her, at proper reading distance, was an open Welsh book, supported by two other books on her body. The blanket covering was clean, tidy, and perfectly smooth. Across the fire-place, which was nearly opposite the foot of her bed, was an arrangement of shelves, well stocked with English and Welsh books, the gifts of various visitors to the house. The child is thirteen years of age, and is undoubtedly very pretty. Her face was plump, and her cheeks and lips of a beautiful rosy color. Her eyes were bright and sparkling, the pupils were very dilated, in a measure explicable by the fact of the child's head and face being shaded from the window-light by the projecting side of the cupboard bedstead. There was that restless movement and frequent looking out at the corners of the eyes so characteristic of simulative disease. Considering the lengthened inactivity of the girl, her muscular development was very good, and the amount of fat layer not inconsiderable. My friend stated that she looked even better than she did about a twelvemonth ago. There was a slight perspiration over the surface of the body. The pulse was perfectly natural, as were also the sounds of the lungs and heart, so far as I was enabled to make a stethoscopic examination. Having received permission to do this, I proceeded to make the necessary derangement of dress, when the girl went off into what the mother called a fainting fit. This consisted of nothing but a little and momentary hysterical crying and sobbing. The color never left the lips or cheeks. The pulse remained of the same power. Consciousness could have been but slightly diminished, inasmuch as on my then opening the eyelids I perceived a distinct upward and other movement of the eyeballs. Each percussion stroke of my examination, and even the pressure of the stethoscope, produced an expression of pain, which elicited a natural sympathy from the mother, and an assertion that a continuance of such examination would bring on further fits. On percussing the region of the stomach, I most distinctly perceived the sound of gurgling, which we know to be caused by the admixture of air and fluid in motion. The most positive assertion of the parents was subsequently made that saving a fortnightly moistening of her lips with cold water, the child had neither ate nor drank anything for the last twenty-three months. The whole region of the belly was tympanitic, and the muscular walls of this cavity were tense and drum-like—a condition not infrequently concomitant of a well-known class of nervous disorders. The child's intellectual faculties and special senses were perfectly healthy. Before her illness she was very much devoted to religious reading. This devotion has lately considerably increased. She is a member of the Church of England, and has been confirmed."

Dr. Fowler then adds some other interesting particulars, all going to show the impossibility of the girl's being the subject of any exhausting disease, or of even having been continuously in bed, as her parents asserted, for nearly two years; and then says:—

"The whole case is in fact one of simulative hysteria, in a young girl having the propensity to deceive very strongly developed. Therewith may be probably associated the power or habit of prolonged fasting. Both patient and mother admitted the occasional occurrence of the choking sensation called globus hystericus."

This letter excited renewed discussion in the newspapers, and a second public meeting was called to make arrangements for a second watching. At this meeting it was decided to bring down from Guy's Hospital, London, several trained nurses, who were to conduct the watching; and the following resolutions were adopted, as expressing the terms under which the inquiry was to be conducted:—

1. It would be advisable, before taking any steps in the matter, to obtain a written legal guarantee from the father of Sarah Jacob sanctioning the necessary proceedings. 2. That the duty of the nurses shall be to watch Sarah Jacob with a view to ascertain whether she partakes of any kind of food, and at the end of a fortnight to report upon the case before the local committee in Carmarthenshire, and, if required, at Guy's Hospital. 3. That two nurses shall be constantly awake and on the watch in the girl's room, night and day. 4. It would be advisable for the nearest medical practitioner to watch the progress of the case; and it will be absolutely necessary for him to be prepared against any serious symptoms of exhaustion, supervening on the strict enforcement of the watching, and to act according to his judgment. 5. That the room in which the girl sleeps shall be bared of all unnecessary furniture, and all possible places in the room for the concealment of food shall be closed and kept under the continual scrutiny of the watchers. 6. That if considered desirable by the local medical practitioner, or by the nurses, the bedstead on which the girl now lies shall be replaced by a single iron one. 7. That the bed on which the parents now sleep, in Sarah Jacob's room, shall be given up absolutely to the nurses. 8. That the parents be not allowed to sleep in the same room as the girl; that if they cannot at all times be prevented from approaching her, they should be previously searched (their pockets and other recesses of clothing as well as the interior of their mouths); and that no wetted towels or other such articles be allowed to be used about the girl by the parents, or any other person save the nurses; that the children of the family, and in fact every other person whatever (except the nurses), have similar restraints put upon them. 9. That the nurses have the sole management of preparing the room, bed, and patient, prior to the commencement of the watching. 10. That, as it is asserted the action of the bowels and bladder is entirely suspended, special attention must be directed to these organs.

Four experienced women nurses were accordingly deputed from Guy's Hospital to take the entire charge of Sarah Jacob, and to watch her for fourteen days. They were instructed not to prevent her having food if she asked for it, but they were to see that she got none without their knowledge. On the 9th of December, 1869, at 4 P.M., the room was cleared of people and the watching began.

In the first place it was ascertained that the girl had repeated evacuations of urine, and once, at least, of fæces.