[Headband and Initial from Crooke: A Description of the Body of Man. London, 1631.]

ANNALS OF MEDICAL HISTORY Volume IX Summer , 1927 Number 2

THE STIGMATA OF ST. * By E. B. KRUMBHAAR, M.D.

PHILADELPHIA, PA.

HET seven hun- nineteen centuries; but^these must certainly dredth anniver- be taken strongly into account in any con- sary of the death sideration of the famous stigmata. Neither of St. Francis of can we more than mention that strange Assisi, which oc- combination of poverty and asceticism curred on the (Brother Ass the body) with mysticism 3rd of October, and joyousness (the Jongleur of God) 1926, brings which made up St. Francis’ life after his vividly before us conversion and helps us today in any effort not only one of to comprehend the nature of stigmata. The the most remarkable figures of historic great order of the or Friars times, whose spiritual influence on millions Minor, which was founded for St. Francis has been incalculably great for many cen- by Innocent hi in 1209, already by 1220 turies and still continues, but also one of had developed along such different lines the most striking and best attested “mir- than he had anticipated that he resigned the acles” that include marked changes in the office of minister general and gladly retired human body, of which the Christian world to his more appropriate life of saintly is aware. example, another incident that throws light We cannot pause here to discuss the on the make-up of the man. tremendous nature of the stimulus and the Two years before his death, St. Francis intense mental make-up which transformed went with Brothers Masseo, Angelo and the swashbuckling young Assisan reveller Leo to the Mt. AIvcrna (also called Monte from a typical product of his day into the della Vcrnia or La Verna) in the neighboring most Christ-like figure that has appeared in Apennines near Arezzo, a mountain that * From the Laboratories of the Philadelphia Gen- had been given to the order as a retreat by eral Hospital. Read before the Section on Medical Orlando, Count of Chiusi in 1213. It is History of the College of Physicians, Oct. 28, 1926. known that at this time Francis was much concerned over the future of the order and Jesus Christ, the Crucified, the which had his own inability to guide it along the lines shown himself to him in the likeness of a ; he had mapped out; he “was even more and thus his hands and feet appeared to be absorbed than usual in his ardent desire to pierced through the middle with nails and the suffer for Jesus and with him.” After a heads of them were in the palms of his hands “Lent” of forty days, spent almost entirely and the soles of his feet outside the flesh and in fasting, prayer and meditation on his their points came out on the back of his hands and feet, so that they seemed bent back and favorite subject, the Crucifixion, and in riveted in such fashion that under the bend and great bodily weakness and exhaustion, he riveting which all stood out above the flesh, might had a on the morning of September 14, easily be put a finger of the hand, as in a ring, 1224, which Sabatier describes as follows: and the heads of the nails were round and black.

In the rays of the rising sun . . . he suddenly Likewise in the right side appeared an image of perceived a strange figure. A seraph with out- a wound made by a lance, unhealed and red and spread wings flew towards him from the edge bleeding, which afterwards oft-times dropped of the horizon and bathed his soul in raptures blood from the sacred breast of St. Francis unutterable. In the centre of the vision appeared and stained with blood his tunic and hose. a cross and the seraph was nailed upon it. When In the account also of Thomas of Cclano, the vision disappeared he felt sharp sufferings mingling with the ecstasy of the first moments. the ’s first biographer (1228), he is Stirred to the very depths of his being, he was pictured as considering anxiously what the anxiously seeking the meaning of it all, when he vision might mean: “And when he could perceived on his body the “Stigmata1 of the find nothing by which it might be under- Crucified.” stood and the novelty of the vision over- whelmed his heart, there began to appear In the language of the Fioretti: [Coeperunt apparere signa clavorum] in his Straightway in the hands and feet of St. hands and feet signs of nails such as he Francis began to appear the marks of the nails, had just seen in the holy Crucified One who in such wise as he had seen them in the body of stood over him.” Bonavcntura2 (1263) also ’oTty/za means a spot or mark, but is used in med- 2 From Vita Sancti Francisci of Saint Bona- icine to designate a variety of marks, e. g., stigmata ventura: “Manus enim et pedes in ipso medio ciavis of degeneration. confixae videbantur, clavorum capitibus in interiore uses the expression “began to appear” panions (Leo, Ruffino, Angelo, Elias) bore and the Three Companions (1246) tell the prompt witness that the stigmata existed story almost in the same words. Though and that they were seen by many after his all but the earliest account may well have death, but none actually says: “1 have seen been borrowed from its predecessor, still them myself.” it is apparent that it was not considered The day after St. Francis’ death, Elias of that the stigmata sprang miraculously into Cortona, the acting superior of the order, full-llcdgcd existence. wrote a circular letter in which it is clearly Francis seldom if ever referred to this stu- implied that he had himself seen the pendous occurrence. According to Bona- stigmata. Bonaventura says that the Saint’s ventura, a small child at the time of the friend, Pope Alexander iv, had seen the

occurrence and writing some forty years mysterious wounds. Ruffino was said to have later, Francis after returning to the Portiun- touched the wound in the side, but nowhere cula, related the occurrence to his com- docs this appear in his own writing. In panions in response to their earnest requests, the two years of St. Francis’ life following but this was apparently the only time that the stigmatization his mode of existence he did so and this rests on the authority of was greatly changed. It is said that he wore Bonaventura alone. Several of Francis’ com- his sleeves long to conceal the marks on his parte manuum ct superiore peclum apparentibus et hands (how different from some of his modern eorum acuminibus existentibus ex adverso. Erantque imitators!) and was no longer able to walk in clavorum capita in manibus et pedibus rotunda et comfort on account of the marks on his soles. nigra—ipsa vero acumina oblonga retorta et quasi However, he never again mentioned them rcpercussa, quae de ipsa carne surgentia carnem reli- to his friends and there is no detailed descrip- quam excedebant. Dextrum quoque Iatus quasi tion of their appearance after his death. Iancea transfixum rubra cicatrice obductum erat, quod saepe sanguinem sacrum effundens, tunicam et The stigmata thus seem, without being femoralia respergebant.” (xm.) actually proved, to be sufficiently well docu- mentcd with contemporary evidence to To have the incident brought home even admit of but little doubt but that on that more closely, a modern historic morning St. Francis acquired cer- should visit the treasury of the Church at tain marks on his hands, feet and side more Assisi and see as I have what is asserted to or less resembling the stigmata of Christ’s be the actual parchment used to cover the crucifixion, which stayed with him till his “wound in his side,” worn through in its death two years later. The story is cer- center and still bearing the signs of the ser-

ous exudate and also the contemporary attestation of his favorite disciple, Brother Leo, who is said to have removed the parch- ment from the Saint’s dead body. Yhe accompanying illustration of this document, in his and St. Francis’ handwriting, was found on Brother Leo’s body after his death. Kept ever since in the same treasury, these small parchments bridge the gap of seven centuries and bring one marvelously close tainly not a “late legendary accretion,” as to those soul-stirring events. In Brother Chesterton0 has pointed out, and few will be Leo’s handwriting in red ink is written in found to agree with a cynical suggestion Latin: that has been made that St. Francis having The Blessed Francis two years before his been worsted in a fight with his friend death kept a forty day fast in the Alverna in Domenico di Gusman, his followers invented honor of the blessed Virgin Mary, Mother of the story to mask the signs of the conflict. God, and of the Blessed the Archangel, 3 Chesterton, G. K. Saint Francis of Assisi. from the Assumption of the blessed Virgin Mary Lond., 1924. to the feast of St. Michael in September; and the hand of the Lord was laid upon him. After St. Francis’ hands, feet and side after he had the vision and speech he had with the seraph had his vision and that he tried to keep his and the impression of Christ’s stigmata on his secret to himself, not exploit it. The chief body, he made these praises which are written argument in favor of pious fraud seems to below on the sheet, and he wrote them with his be the belief that such an event is otherwise own hand, giving thanks to God for the favor an impossibility; just as the cure of the that had been conferred upon him [in Francis’ handwriting], “The Lord bless thee and guard advanced paretic is impossible, in the words thee. Show his face to thee and have mercy upon thee—turn his face to thee and give thee peace.” And the blessed Francis wrote with his own hand this blessing for me, Brother Leo [again in Francis’ handwriting]: “The Lord bless thee, Brother Leo.” And in the same way, he made the sign T together with the head with his own hand. The marks on the hands and feet of St. Francis were apparently dark fleshy ex- crescences on both dorsal and palmar sur- faces, resembling the flattened head of the nail on the palmar side. It is said that St. Clara, for whom Francis founded the “Sec- ond Order” of Franciscans, the nuns called the “Clares,” tried after his death to remove one of the stigmata as a memento of her friend, but that it was firmly attached to the surrounding tissue. The wound in the side, corresponding to Christ’s wound on the cross, constantly exuded a small amount of serous fluid, as the worn parchment covering of one sceptic who wrote on this subject. at Assisi bears mute but eloquent witness. And yet we are today, apparently, seeing Extensive though the evidence for the the cure of paresis and even greater wonders stigmata is, when one considers it over a accomplished by scientific medicine. As space of seven centuries, nevertheless it is Voltaire, I think, put it, the of to- entirely inadequate as a basis for a patho- day are the commonplaces of tomorrow; or logical diagnosis, even if medical knowledge in Chestertonian paradox: “A man in Vol- were sufficiently advanced today to give a taire’s time did not know what he complete answer in the presence of adequate would next have to throw up. A man in our data. It would seem that such a phe- time does not know what miracle he will nomenon must be either (i) a miracle; (2) next have to swallow.” On the other hand, artificially produced; or (3) a natural patho- pious frauds were not unknown in the his- logical lesion. If miraculous, and it is to be tory of the Church of that time, when all noted that even the Roman religious matters were on a very different does not make belief in the stigmata an plane than they arc today. One has only to article of faith, it is then beyond the field of read the same Franciscan authorities who scientific inquiry and need not detain us gave the accounts of the stigmata to meet here. In regard to the second possibility, certain narrations which must be explained as previously indicated, there is strong evi- on the first or second of our three theories. dence that some physical change occurred in In the later “stigmatized,” fraud is usually prominent, either as a pure imposture to our own generation) and yet few will deny gain notoriety, or as the charaeteristic that some such power exists. Skin vesicles accompaniment of the hysterical nature are said to have been produced by the which must underlie such phenomena, even unaided power of suggestion during hypno- if found to have a “natural” origin. St. sis, and even on one occasion a bloody exud- Francis was undoubtedly highly emotional ate from a previous dermographia in the and neurotic, perhaps even hysteric, and same state.5 It requires but a slight exten- his companions so emotionally saturated sion, therefore, if such reports are true, with the new idea that they might be to include autogenous production of similar expected to sec events in a highly colored phenomena. Granted the production of light. But the verdict of History is, I think blebs in given localities, following intense mental stimuli, probably as a result of vaso- motor changes, .it becomes less difficult to add to this concept a bloody effusion in specified areas, or in the case of fleshy protuberances, such as St. Francis’ seemed to be, a hyperkeratosis or even a pigmented nevus or papilloma, which as it grew older and darker might easily simulate a nail. Rosenow has claimed even more minute localization in the elective affinities of bacteria and Maud Slye similar refine- ments in spontaneous tumor formation. Cutaneous horns, of extensive distribution and varieties are far from uncommon6 and while the etiology of such conditions is rightly, definitely against either him or his largely unknown, it is by no means improb-* intimates being considered wilful impostors.4 able that neurotrophic influences, and these We arc thus brought to the consideration perhaps partly regulated by the mind, may of the stigmata as possibly natural patho- play an important role. It is significant logical phenomena. Certainly most unusual that the early descriptions speak of the ones, just as the history of stigmatization stigmata of St. Francis as “beginning to includes very few if any authentic cases, appear,” i.e. it was not believed that they and none recorded in the preceding twelve instantaneously sprang full-formed into centuries of the Christian era. But who dare being, which would constitute an occurrence brand them as absolutely impossible, even much more difficult for the ordinary mind without invoking miraculous supervention? to comprehend. We arc in almost total ignorance of the Following the stigmatization of St. limitations of the power of mind over body Francis, other examples soon became numer- (a reason perhaps for the exuberant growth ous. Dr. Imbert Gourbeyre,7 a most credu- of a certain therapcutico-religious sect of lous individual, has collected 145 cases of 4 At the meeting at which this paper was presented 5 Bourru, H., and Burot, P. Hemorrhagie de la Dr. C. W. Barr made the interesting suggestion peau provoquee par la suggestion en somnambu- that St. Francis in a spirit of self-castigation, but Iisme. Compt. rend. Soc. de biol., Par., 1885, 8s., 11, with no desire to defraud or to exalt himself over his 461. fellows, may have inflicted the wounds upon himself 6 Gould, G. M., and Pyle, W. L. Anomalies and in ’s stigmata and that only after Curiosities of Medicine. Phila., 1897, pp. 226,286, 338. his death did the legend grow of their 7 Gourbeyre I. Les Stigmatisees. Par., 1873, 1, origin. His secretive attitude toward his stigmata 268, La Stigmatisation, 1’extase divine et les miracles would be quite in keeping with such an explanation. de Lourdes. Par., 1894. persons who had received the stigmata, was stillborn. She was an ascetic and eight of whom he said were living at the ecstatic from the age of seven, saw visions time he wrote. Alexander Macalister,8 pro- and in her seventeenth year took the habit fessor of anatomy in the University of of the Dominican tertiaries. In a post- Cambridge, in his article on stigmatization communion ecstasy on the fourth Sunday in in the eleventh edition of the Encyclopedia Lent, 1475, she received the full stigmata, Britannica enumerates ninety instances but in response to her prayer for the sake of (eighteen males, seventy-two females ) and humility the marks were not made visible! about thirty more, of which there are no It is hardly surprising then, especially in particulars recorded. The earliest of these view of the intense rivalry between the was apparently Ida of Louvain (1300), on Dominicans and Franciscans, that her stig- whom the marks appeared as colored circles, mata were not universally recognized and and soon after Gertrude von Oosten of that Franciscans especially were loath to Delft (1344, colored scars). The greatest see their Saint share his chief glory with one variety was encountered: Some had all of a rival order. Termination of the discus- five of the classical marks (full stigmatiza- sions required bulls from two Popes (Six- tion), others but one or two. Some had open tus iv and Innocent vm), according to wounds, others merely bloody exudates in which representation of the stigmata in all the classical spots, occasionally varied with pictures of St. Catherine and any expression the forehead (from the crown of thorns) of belief in them was absolutely forbidden. and in one case at least (Angela della Pace, The case that has excited the most 1634, fully stigmatized at nine) with the interest and study in modern times is that sponge and hyssop in the mouth (a benign of Louise Lateau, a Belgian peasant girl, neoplasm? lymphedema?). The wounds were born January 30, 1850, of poverty-stricken sometimes fetid and some “emitted the parents. She was chlorotic, did not men- odor of violets”! struate till eighteen, was a recluse and A second group, more obviously neurotic, soon became an ecstatic and saw visions. felt the pains of stigmatization, but did not In March, 1868, she began to bleed from the exhibit any of the physical signs. A third mouth and the next month seemed so sick group, from the earlier post-Franciscan that on April 15 the last sacrament was centuries, where the stigmata were said to given. Menses, however, were established on have been found on the heart without bodily April 19, and two days later she was able surface markings, might perhaps be better to take a long walk to church. The stigmata considered as misguided interpretations of began to appear on Friday, April 24, 1868, pathological lesions at a period when very with bleeding from the left side of her chest, little was known of morbid anatomy. and thereafter reappeared every Friday for Although it would be tiresome and rela- several years. On the second Friday blood tively useless to discuss these cases in detail, exuded from the dorsal surfaces of both feet, a few perhaps merit some further attention.9 in addition to that from the wound in the One of the most famous is Saint Catherine side; on the third from both dorsal and of Siena, the youngest of twenty-five chil- palmar surfaces of both hands as well. This dren and one of twins, the other of which continued regularly every week with other additions, such as the forehead and between 8 Macalister, A. Stigmatization. Encyclopedia the shoulders, and was estimated to amount Britannica, Ed. 11. to about 250 gms. per week. Warlomont,10 9 The cases of Christine de Stumbele, Veronica who was commissioned by the Royal Giuliani, Vitaline Gagnon, Palma d’Oria, Maria K. and Louise Lateau are narrated in some detail in Academy of Medicine of Belgium to make a Hammond, W. A. Nervous Derangement. N. Y., 10 Warlomont. Louise Lateau, Rapport Medicale, 1883, p. 154, Chapter on Stigmatization. * etc. Bruxelles and Paris, 1875. scientific investigation of the case, after wise perfectly normal. They believed, how- careful observation and taking measures to ever, that it was not a case of true hemidro- prevent artificial production of the hemor- sis but rather of a hemorrhagic exudate due rhages, was convinced that the weekly stig- to some condition such as angioneurotic matization and ecstasy (hystero-catalepsy) edema, and that the stigmata, which were both real; though other claims made by appeared on the dorsal and plantar surfaces the girl, such as that she had not slept, of the feet and the anterior surfaces of the drunk, or eaten for four years, and had no elbow, were due to trophic and vasomotor passage of urine or feces for over three, were disturbances. I have not been able to see the proved to be false and fraudulently sup- original descriptions to find the exact nature ported by her. The combination in an of these lesions. Even with the little that we hysteric of true pathological signs with know of the mimicking capacity of angio- fraudulent attempts to augment them with neurotic edema and other neurotrophic dis- simulated phenomena is by no means orders, such an explanation (explaining impossible and should not necessarily lead little though it does), should as I have pre- the searcher for the true state of the matter viously indicated, not be rejected as into denouncing the whole occurrence as incomprehensible. In the case of fraudulent. Fraud in some features, how- of Foggia, an “exceptionally calm and com- ever, cannot but suggest that the whole posed individual,” who is still living and has business may be fraudulent and there is some a good family and past medical history, Pro- evidence that such was the case here.11 For fessor Bignami,13 an agnostic, did not con- instance, though hemorrhages continued sider that the superficial scars on the hands even when the hands were bandaged, paper and feet and the form of a cross on the left lining the bandages was said to reveal nu- breast were artificially produced. He merous pinpricks. In the debate that followed thought it possible to account for them Warlomont’s report, adherents were found naturally, as due to necrosis of the epi- both for the miraculous and the natural thelium of neurotic origin, probably pathological viewpoints; but the Academy attributable to unconscious suggestion. perhaps wisely decided to leave the matter It will be interesting to see whether the undecided. solemn celebrations attending St. Francis’ A very recent occurrence, studied by anniversary may perhaps cause a sufficient Professor Bianchi,12 offers an interesting stimulus to some religious devotee to pro- comparison to the Franciscan story. In a duce similar phenomena that can perhaps young girl, aged twenty-eight, from Cosenza be studied from the start in such an (Montalto Offugo), periodic sanguineous intensive and objective manner that more sweats and “stigmata” were observed to light can be thrown on the nature of the appear every Friday in March from 1923 occurrence. on! Careful study has convinced Fabrizio In the meantime, we, like the Belgian and Turano and others who have seen this Academy, should leave the matter unde- case that these phenomena were not cided. My own preference is to feel that “faked” and that the subject was other- lesions which might fairly be called stigmata of the crucifixion are not beyond the realms 11 Boens, H. Fin de la Comedie de Boisd’ Haine. of pathological possibility; and that in Bruxelles, 1876; Louise Lateau ou les Mysteres de some cases, including that of St. Francis, Bois d’Haine devoiles. Bruxelles, 1875. Boens first the evidence, while not enough to constitute considered that the stigmata were the natural hem- orrhages of a hemophiliac. actual proof, is sufficient to impress 12 Bianchi. Congr. degli Alienisti, Trieste, Sept., strongly the unbiased student. 1925. Quoted by Del Gaudio, A. Le Stimmate di S. 13 Quoted by H. Thurston, S. J., The Month, 1923, Francesco d’Assisi. Ref. 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Rinascenza Med., demic mistiche del medio-evo-Palermo. I9A5- Renan , A. Nouvelles etudes d’histoire religieuse. Gemelli , F. A. Le Stimmate di S. Francisco nel Sabatier , Vie de Saint Francois d’Assise. Appendix. giudizio della Scienza. Vita e. Pensiero, Aug., Tamas sia , N. San Francisco d’Assisi e la sua 1924. Ieggenda. Padua, 1906.