Hematidrosis misdiagnosed as religious stigmata: demystifying an old Guinness world record case

Hematidrosis (haematidrosis, hematohidrosis, or simply sweats of blood) is a rare condition that deserves to be known by clinicians in order to avoid unwarranted exams, to reassure the patient and family members and lastly avoid wrong interpretations as it may mislead pious individuals. Cases of hematidrosis are rare, but been recorded during the XIXth and the XXth century [1].  The number of reported cases has increased due to a better recognition [2-6]. Some case of the past have most likely been misinterpreted as religious stigmata, with potential consequences on the patient’s psyche and keep alive a form of public fantasy on this intriguing phenomenon as illustrated by numerous books on that topic [7]. In this respect, I wish to revisit a case of “religious stigmata” reported 40 years ago that was most likely a case of hematidrosis [8].

In 1974, an unusual case of “stigmata” in an otherwise healthy 10-year-old Afro-American Baptist girl was reported in the Archives of General Psychiatry [8]. In fact, Cloretta Robinson, is still considered to be the first case of “non-Catholic” stigmatic according to the Guinness world record [9].

Briefly, she developed episodes of bleeding of the palms and feet mainly, but also of the forehead and the right thorax, 3 weeks prior to Easter Sunday.  Bleeding episodes were spontaneous, transient, on normal skin, lasted a few minutes, without any feelings of ecstasy or rapture and stopped after Good Friday. Laboratory findings were unremarkable. No cytology was performed on the dried blood. Lack of any underlying lesions and various witnesses during the bleeding ruled out self-inflicted lesions. Transient limited auditory hallucinations were reported, but no psychotic or neurotic disease was diagnosed. The girl displayed a high religiosity, but had no knowledge of the stigmata phenomenon or St Francis of Assisi before the beginning of the symptoms.  The final diagnosis was “a psychological induced bleeding (…) during a time of intense religious preoccupation”. The girl never developed any new recurrent episode after the Good Friday of the year 1972. The next Easter was uneventful.

The diagnosis made by Early & Lifschutz was close to the reality, and their clinical description matched perfectly the diagnosis of “hematidrosis” [1-6]. Interestingly the authors used unconsciously the term “wet blood” in their description. Hematidrosis is usually triggered by an intense emotional stress such as fear of death or a violent trauma (rape attempt, witness of abduction or of the murder of someone…). No such stress was found here. However, before the episode, the girl had read a religious book and watched a television movie, both about the Christ’s crucifixion. Both had deeply involved her emotionally [8]. Besides, during one appointment with the physician, she drew pictures of St Francis of Assisi from a book she had brought with her [8]. The authors did not mention how did she get such book, but one can assume that an adult may have made a link between her symptoms and St Francis of Assisi and given her a book about him. As a consequence, she identified with him. Overall, such factors added to the proximity of Easter Sunday and a strong personal and familial religiosity may have precipitated a form of stress which would have triggered hematidrosis. It appears then understandable that the “evocative” bleeding localization, in a context of religiosity, may have easily misled devotes into wrong interpretations.

This case illustrates that nowadays cases of “stigmata” can be explained in the light of modern medicine.  “Spontaneous” does not mean necessarily “miraculous”, even in a pious environment.

References

1. Zubige FT. The Crucifixion of Jesus, Completely Revised and Expanded: A Forensic Inquiry. New York, NY : M. Evans and Company, Inc. 2005
2. Holoubek JE, Holoubek AB. Blood, sweat and fear. « A classification of hematidrosis ». J Med 1996;27:115-133.
3. Kluger N, Cribier B. Stigmata: From Saint-Francis of Assisi to idiopathic haematidrosis. Ann Dermatol Venereol 2013;140:771-7.
4. Manonukul J, Wisuthsarewong W, Chantorn R, Vongirad A, Omeapinyan P. Hematidrosis: a pathologic process or stigmata. A case report with comprehensive histopathologic and immunoperoxidase studies. Am J Dermatopathol. 2008;30:135-139.
5. Uber M, Robl R, Abagge KT, et al. Hematohidrosis: insights in the pathophysiology. Int J Dermatol 2015;54:e542-3.
6. http://biomedicales.blogs.sciencesetavenir.fr/tag/stigmates [accessed 12.12.2016]
7. Harrisson T. Stigmata: A Medieval Mystery in a Modern Age. Penguin books, 1993.
8. Early LF, Lifschutz JE. A case of stigmata. Arch Gen Psychiatry 1974;30:197-200.
9. First known stigmata. http://www.guinnessworldrecords.com/world-records/first-known-stigmata [accessed 24.10.2016]