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Gospel of Matthew linked to bizarre trail of self-mutilations

June 13, 2012
Special to World Science  

It hap­pens only spo­rad­ic­ally—a bit more than eve­ry three years on av­er­age, judg­ing by pub­lished med­i­cal re­ports—but that makes it no less dis­turb­ing each time for hos­pi­tal staff faced with the situa­t­ion.

“It” may be de­scribed by cit­ing the most re­cent ex­am­ple, re­ported in a med­i­cal jour­nal last month: that of a 62-year-old man whom physi­cians dubbed Mr. P to pro­tect his pri­va­cy. Mr. P showed up at the emer­gen­cy room of St. Joseph’s Hos­pi­tal and Med­i­cal Cen­ter in Phoe­nix, Ariz., com­plain­ing of a case of “Mat­thew 19:12.” Asked to clar­i­fy, he just kept re­peat­ing the same thing: Mat­thew 19:12.

The nurse on du­ty searched the In­ter­net for Mat­thew 19:12. The re­sult was, to put it mild­ly, wor­ri­some. The Bib­li­cal verse, as she learn­ed, reads as fol­lows.

For there are some eu­nuchs, which were so born from their moth­er’s womb; and there are some eu­nuchs, which were made eu­nuchs of men; and there be eu­nuchs, which have made them­selves eu­nuchs for the king­dom of heav­en’s sa­ke. He that is able to re­ceive it, let him re­ceive it.

As it quickly be­came clear, Mr. P had made this hos­pi­tal vis­it un­ac­com­pa­nied by his pe­nis. That, he ex­plained, he had flushed down the toi­let three days ago af­ter sev­er­ing it with a pock­et knife. His tes­ti­cles were al­so ab­sen­t—re­moved four years ear­li­er at Mr. P’s re­quest by a doc­tor in Mex­i­co. 

Matthew 19:12
For there are some eu­nuchs, which were so born from their moth­er’s womb; and there are some eu­nuchs, which were made eu­nuchs of men; and there be eu­nuchs, which have made them­selves eu­nuchs for the king­dom of heav­en’s sa­ke. He that is able to re­ceive it, let him re­ceive it.

Mat­thew 18:8
Where­fore if thy hand or thy foot of­fend thee, cut them off, and cast them from thee: it is bet­ter for thee to en­ter in­to life halt or maimed, rath­er than hav­ing two hands or two feet to be cast in­to ev­er­last­ing fire.

Mat­thew 5:30
And if thy right hand of­fend thee, cut it off and cast it from thee: for it is profita­ble for thee that one of thy mem­bers should per­ish, and not that thy whole body should be cast in­to hell.

Mat­thew 5:29
But if thy right eye of­fend thee, pluck it out and cast it from thee: for it is profita­ble for thee that one of thy mem­bers should per­ish, and not that thy whole body should be cast in­to hell.

Al­though his speech and thoughts ap­peared mud­dled, Mr. P did state that he had “done this be­cause his pe­nis had caused him to sin and as an eu­nuch he could be clos­er to God as de­scribed in Mat­thew 19:12,” three re­search­ers af­fil­i­at­ed with St. Joseph’s wrote in a re­port de­scrib­ing the in­ci­dent. Mr. P al­so claimed to have pon­dered the de­ci­sion for months be­fore act­ing.

Mr. P re­ceived ur­gent treat­ment at St. Joseph’s, in­clud­ing a skin graft on­to the stump. He was then con­fined to a lo­cal psy­chi­at­ric hos­pi­tal by court or­der, leav­ing lit­tle but ques­tions be­hind.

The three in­ves­ti­ga­tors pro­ceeded to search an on­line med­i­cal lit­er­a­ture database, PubMed, for oth­er cases of this na­ture. They dis­cov­ered that the Bi­ble—in­deed, the Gos­pel of Mat­thew spe­cif­ic­ally—has left a trail of self-mutila­t­ions in­spired largely by four of its verses. 

The bloody toll list­ed in case re­ports dat­ing back to 1967—PubMed does­n’t go back much fur­ther—in­cluded three par­tially or fully am­pu­tat­ed pe­nises; four pairs of cas­trat­ed tes­ti­cles; three am­pu­tat­ed hands and 11 se­verely dam­aged eye­balls. Saws, cir­cu­lar saws, screw­drivers and pen­cils were among the tools used for the hor­ri­fy­ing pro­ce­dures, al­though sev­er­al pa­tients put out their eyes with their fin­gers alone.

“Our lit­er­a­ture re­view re­vealed 16 pa­tients in ad­di­tion to [Mr. P] who had in­jured them­selves in con­nec­tion with spe­cif­ic re­li­gious tex­t,” the re­search­ers wrote. Their re­view of the cases is pub­lished in the May 29 on­line is­sue of the re­search jour­nal Psy­cho­so­mat­ics.

All but one of the pa­tients were di­ag­nosed with psy­chi­at­ric disor­ders or psy­chot­ic disor­ders or had sub­stance abuse is­sues, they wrote; Mr. P., for ex­am­ple, “had a long his­to­ry of se­vere bi­po­lar ill­ness marked by hyper-re­li­gious delu­sions.” 

And eve­ry case was con­nect­ed with at least one of four verses in Mat­thew’s Gos­pel: 19:12, 18:8, 5:29 and 5:30. The three lat­ter verses are more cryp­tic than the first, ref­er­enced by Mr. P. What they have in com­mon is that they ap­pear to sug­gest that if a hand, foot or right eye are some­how of­fen­sive, cut­ting them off is the way to go, be­cause at least, that much less of the body will end up in Hell.

“Sev­eral bib­li­cal verses ref­er­ence self-mutila­t­ion as metaphoric acts of sac­ri­fice or con­tri­tion,” wrote the re­search­ers, who in­clud­ed psy­chi­a­trist Ja­son P. Ca­plan of St. Joseph’s and the Creighton Uni­vers­ity School of Med­i­cine in Oma­ha, Neb. “Some in­di­vid­u­als may in­ter­pret these pas­sages lit­er­ally and act on them, caus­ing sig­nif­i­cant in­ju­ry and even in­ad­vert­ent death.”

“Psy­chi­a­trists should be aware of the con­tent of these four verses to aid in timely di­ag­no­sis and in­ter­ven­tion if they were to arise in dis­cus­sion with a pa­tien­t,” they added. “It is in­ter­est­ing to note that no cases cite the Gos­pel of Mark de­spite very si­m­i­lar con­tent (i.e., Mark 9:43, which reads ‘And if thy hand of­fend thee, cut it off: it is bet­ter for thee to en­ter in­to life maimed, than hav­ing two hands to go in­to hell, in­to the fire that nev­er shall be quenched’).”

“In­di­vid­u­als who ra­t­ion­al­ize their ac­tions through bib­li­cal pas­sages ap­pear to have a se­ries of fea­tures that make them a un­ique co­hort with spe­cif­ic chal­lenges re­gard­ing prog­no­sis and treat­ment,” Ca­plan and col­leagues wrote. Many of them have no re­grets about their ac­tions; de­lib­er­ately de­stroy the body part to pre­vent its re­at­tach­ment; re­sist ef­forts to suc­cess­fully re­at­tach it when that is pos­sible; and are un­co­op­er­a­tive with oth­er as­pects of treat­ment, they added. 

A 37-year-old man was quot­ed in the 1967 re­port say­ing: “Even if I do get cer­ti­fied [in­sane] and in the eyes of the world I am mad it is far bet­ter for me to have cleansed my­self.”

“Ideas of ref­er­ence (spe­cif­ic­ally, that the Bi­ble di­rectly re­fers to them) is a re­peat­ed theme in this group, un­der­scor­ing a com­mon thread of psy­chot­ic disor­ders,” Ca­plan and col­leagues wrote. “Guilt over sex­u­al acts or de­sires is anoth­er re­cur­rent the­me… Re­cent homosex­u­al ex­pe­ri­ences oc­curred in three of the cases of gen­i­tal self-mutila­t­ion.” Four of the 17 self-mutilators were fe­males; they had poked out their eyes or, in one case, am­pu­tat­ed a hand.

Many pa­tients had self-am­pu­tat­ed af­ter failed at­tempts to per­suade doc­tors to do the deed, the re­search­ers wrote, in­di­cat­ing a need for doc­tors pre­sented with such re­quests to re­fer cases to a psy­chi­a­trist im­me­di­ate­ly.

Ca­plan dis­closed in the pa­per that he is af­fil­i­at­ed with Al­iso Viejo, Calif.-based Avanir Phar­ma­ceu­ti­cals. The re­port did not rec­om­mend any spe­cif­ic drug treat­ments, how­ev­er. As for how Mr. P is do­ing cur­rent­ly, Ca­plan said he does­n’t know. “Once they leave the acute care hos­pi­tal, we get no fur­ther up­date,” he wrote in an e­mail.


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It happens only sporadically, a bit more than every three years on average, but that makes it no less disturbing each time for hospital staff faced with the situation. “It” may be described by citing the most recent example, reported in medical literature last month: that of a 62-year-old man whom physicians dubbed Mr. P to protect his privacy. Mr. P showed up at the emergency room of St. Joseph’s Hospital and Medical Center in Phoenix, Ariz., complaining of a case of “Matthew 19:12.” Asked to clarify, he just kept repeating the same thing: Matthew 19:12. The nurse on duty searched the Internet for Matthew 19:12. The result was, to put it mildly, worrisome. The Biblical verse, as she learned, reads as follows. For there are some eunuchs, which were so born from their mother’s womb; and there are some eunuchs, which were made eunuchs of men; and there be eunuchs, which have made themselves eunuchs for the kingdom of heaven’s sake. He that is able to receive it, let him receive it. As it quickly became clear, Mr. P had made this hospital visit unaccompanied by his penis. That, he explained, he had flushed down the toilet three days ago after severing it with a pocket knife. His testicles were also absent—removed four years earlier at Mr. P’s request by a doctor in Mexico. Although his speech and thoughts appeared muddled, Mr. P did state that he had “done this because his penis had caused him to sin and as an eunuch he could be closer to God as described in Matthew 19:12,” three researchers affiliated with St. Joseph’s wrote in a report describing the incident. Mr. P also claimed to have pondered the decision for months before acting. Mr. P. received urgent medical treatment at St. Joseph’s, including a skin graft onto the stump. He was then locked up in a local psychiatric hospital by court order, leaving little but questions behind. The three investigators proceeded to search an online medical literature database, PubMed, for other cases of this nature. They discovered that the Bible—indeed, the Gospel of Matthew specifically—has left a trail of self-mutilations inspired largely by four of its verses. The bloody toll listed in case reports dating back to 1967—PubMed doesn’t go back much further—included three partially or fully amputated penises; four pairs of castrated testicles; three amputated hands and 11 severely damaged eyeballs. Saws, circular saws, screwdrivers and pencils were among the tools used for the horrifying procedures, although several patients put out their eyes with their fingers alone. “Our literature review revealed 16 patients in addition to [Mr. P] who had injured themselves in connection with specific religious text,” the researchers wrote. Their review of the cases is published in the May 29 online issue of the research journal Psychosomatics All but one of the patients were diagnosed with psychiatric disorders or psychotic disorders or had substance abuse issues, they wrote; Mr. P., for example, “had a long history of severe bipolar illness marked by hyper-religious delusions.” And every case was connected with at least one of four verses in Matthew’s Gospel: 19:12, 18:8, 5:29 and 5:30. The three latter verses are more cryptic than the first, referenced by Mr. P. What they have in common is that they appear to suggest that if a hand, foot or right eye are somehow offensive, cutting them off is the way to go, because at least, that much less of the body will end up in Hell. “Several biblical verses reference self-mutilation as metaphoric acts of sacrifice or contrition,” wrote the researchers, who included psychiatrist Jason P. Caplan of St. Joseph’s and the Creighton University School of Medicine in Omaha, Neb. “Some individuals may interpret these passages literally and act on them, causing significant injury and even inadvertent death.” “Psychiatrists should be aware of the content of these four verses to aid in timely diagnosis and intervention if they were to arise in discussion with a patient,” they added. “It is interesting to note that no cases cite the Gospel of Mark despite very similar content (i.e., Mark 9:43, which reads ‘And if thy hand offend thee, cut it off: it is better for thee to enter into life maimed, than having two hands to go into hell, into the fire that never shall be quenched’).” “Individuals who rationalize their actions through biblical passages appear to have a series of features that make them a unique cohort with specific challenges regarding prognosis and treatment,” Caplan and colleagues wrote. Many of them have no regrets about their actions; deliberately destroy the body part to prevent its reattachment; resist efforts to successfully reattach it if that does occur; and are uncooperative with other aspects of treatment, they added. A patient was quoted in the 1967 report saying: “Even if I do get certified [insane] and in the eyes of the world I am mad it is far better for me to have cleansed myself.” “Ideas of reference (specifically, that the Bible directly refers to them) is a repeated theme in this group, underscoring a common thread of psychotic disorders,” Caplan and colleagues wrote. “Guilt over sexual acts or desires is another recurrent theme… Recent homosexual experiences occurred in three of the cases of genital self-mutilation.” Four of the 17 self-mutilators were females; they had poked out their eyes or, in one case, amputated a hand. Many patients had self-amputated after failed attempts to persuade doctors to do the deed, the researchers wrote, indicating a need for doctors presented with such requests to refer cases to a psychiatrist immediately. Caplan disclosed in the paper that he is affiliated with Aliso Viejo, Calif.-based Avanir Pharmaceuticals. The report did not recommend any specific drug treatments, however. As for how Mr. P is doing currently, Caplan said he doesn’t know. “Once they leave the acute care hospital, we get no further update,” he wrote in an email.