If you have suffered through a long car ride in which the driver refuses to stop for a bathroom break, you may have felt as if your eyeballs were floating. Possibly you feared that no amount of willpower would prevent you from experiencing an embarrassing spillage. As bad as it got, it’s doubtful you came close to the experience of Maria Burton, the woman who urinated out of nearly every conceivable part of her body.

The bizarre case was documented by Dr. Salmon Augustus Arnold in “Case of Paruria Erratica, or Uroplania” in the October 1825 issue of The New England Journal of Medicine. Dr. Arnold chronicles his treatment of “Maria Burton, aged 27 years, of sound constitution,” who was in good health until she suffered a prolapsed uterus. She experienced a common side effect of this condition in which her bladder became prolapsed, thus hindering her ability to urinate. Her physicians inserted a catheter into her bladder each day. This helped with her condition, but then thing things took a decidedly odd turn.

First, the Right Ear

Dr. Arnold writes: “In September 1822, soon after I first saw her, the urine not having been drawn off by the catheter for seventy-two hours, found an outlet by the right ear, oozing drop by drop, and continued for several hours after the bladder had been emptied. The next day at five o’clock P.M. it again commenced and continued about as long as on the day preceding, but a larger quantity was discharged. This was projected on a heated shovel and gave out that odour so peculiar to this secretion, indicating the presence of urea.”

The method of using a heated shovel is probably no longer used by your physician. In those days, it was a reasonably quick way of assessing the composition of a substance through smell.

“It continued to be discharged once a day for several days, oozing out guttatim [drop-by-drop], commencing earlier, increasing in quantity and being discharged in less time; then twice a day at three and seven o’clock P. M., varying but very little for some days, then three times a day at two, nine, and eleven o’clock P. M., and so continuing, then four times a day, at ten o’clock A.M. and from eight to eleven o’clock P.M., increasing gradually in quantity and being discharged in less time until a pint was discharged in fifteen minutes in a stream, about the size of a crow quill, then becoming more irregular being discharged every few hours, and increasing in quantity until eighty ounces were discharged in twenty-four hours.”

The average person urinates 1.6 – 4 pints (800-2,000 ml) per day. Burton, incredibly, was producing four pints each day out of her eye. This, unsurprisingly, carried a few side effects. Throughout the ordeal, her psychological symptoms swayed dramatically. At times she was in severe pain, to the degree that she had to be restrained to prevent her from self-harm. Other times, she exhibited euphoria, during which she would sing, laugh, and talk incoherently. Sometimes she lay in a catatonic state.

Hearing Waterfalls and Losing Vision

Burton’s problems were only just beginning. The symptoms started to move to her right eye, affecting her vision. She also began to hear the sound of rushing water — which makes sense, considering how much liquid was rushing out of her ear.

“The discharge from the ear was accompanied by a severe pain over the right eye and about the right ear, with a distressing sensation of fulness. The pain commenced early in the morning, and continued to increase in violence until after the discharge from the ear, by which it was relieved.”

“The sight of the right eye was soon destroyed, and frequently that of the left was so impaired that she could not distinguish any object across the room, but the latter is now entirely restored. The hearing of the right ear is so much impaired, that she cannot distinguish sounds, and there is a constant confused noise heard by her like the roaring of a distant waterfall. For a short time previously to the discharge from the ear, there is a very audible noise, resembling that produced by water slowly dropping into a vessel, which may be heard at the distance of several feet. She has no power excepting by an inclined position of the head over the discharge, previously to which there is a very painful sensation of fullness and a burning heat about the right ear.”

Moving On to the Left Ear

The increased sound of the dripping of water and of waterfalls was a precursor for the body’s next urine release:

“The next outlet the urine found was by the left ear, a few moments previously to which discharge, a similar noise is heard to that noticed in the right ear, she cannot hear distinctly for ten or fifteen minutes previously, and after the urine passes off. This discharge is very irregular, sometimes three or four times a week, and then is discontinued for months.”

The Eyes Are the Waterfalls of the Soul

One can only imagine the horror of Maria Burton as she lay in her bed, peeing from both ears, suffering extreme bouts of pain, and losing her vision. Anyone would be excused for shedding a tear at this time. When she wiped the moisture from her eyes, however, she discovered something truly horrifying.

“Soon after the discharge from the left ear, the urine found another outlet by the left eye, which commenced weeping in the morning and continued for several hours, producing considerable inflammation; it continued three days and then ceased; sufficient of the discharge was saved to test its properties, in these, and in appearance it did not differ from the discharge of the ear. In the summer of 1824, it recommenced and continued daily for about six weeks. An account of the quantity of this discharge may be found in the appendix.”

Dr. Arnold’s reference to the appendix is a 17-page catalog of all of the places from which Burton secreted urine over the course of medical treatment. It can be found at the end of his article.

More Than She Could Stomach

The poor woman endured this horrifying turn of events for several weeks. Her doctors had no idea what was causing it. It was more than she could stomach — quite literally.

“On the 10th of March, 1823, urine began to be discharged in great quantities from the stomach, unmixed with its contents. The greatest quantify was generally discharged in the morning before taking food, but it was frequently discharged soon after food had been taken, with which it was often entirely unmixed. This discharge has been more regular than from the left ear and eyes, but less so than from the other outlets.”

In other words, she is peeing from her ears and eyes. Now she is vomiting urine, too. Well, at least there’s nowhere else it can come from, right?

Something Less Pleasant than the Milk of Human Kindness

“On the 21st April, the right breast became tense and swollen, with considerable pain, and evidently contained a fluid, a few drops of which oozed from the nipple. The swelling and pain continued about twenty-four hours and then entirely ceased for about a week, when it again returned, and there was discharged a light yellow fluid resembling urine. On the 29th, one ounce was caught in a nipple shell which by analysis was found to contain urea. This discharge has been very regular up to this time. Urine has been discharged occasionally from the left breast, an account of which may be found in the Appendix. November 20th, 1823, the urine from the breast became milky, having the appearance of milk considerably diluted with water; this continued until December 12th, when it gradually resumed its usual colour.”

This is getting ridiculous. For those who are keeping track, Maria Burton is peeing from her ears, eyes, mouth, and breasts. Surely, that’s the extent of this strange tale, isn’t it?

But wait… there’s more.

Contemplating the Navel

“May 10th, 1823, The abdomen about the hypogastric and umbilical region became violently and spasmodically contracted into hard bunches, and a sharp pain was felt shooting up from the bladder to the umbilicus, around which there was a severe twisting pain; in a few days subsequently a loud noise was heard, similar to that produced by drawing a cork from a bottle, and immediately afterward urine spirted out from the navel as from a fountain. This discharge has since continued
and has rarely been interrupted for many days.”

As if all of her problems weren’t enough, Maria Burton suddenly became a fountain of urine, with her belly button as the primary spout. Weird beyond belief, to be sure, but at least the phenomenon is moving downward. Perhaps this is an indication that she will soon resume urinating from the place she is supposed to do so.

What’s Next? Who Nose?

“Nature wearied in her irregularities, made her last effort, which completed the phenomena of this case, and established a discharge of urine from the nose. This discharge commenced on the 30th of July 1823, oozing in the morning guttatim [drop by drop] and increasing in quantity every day until it ran off in a considerable stream. It continued daily for about two months, when it ceased until the summer of 1824, and then again commenced and continued almost daily for some months, since which it has entirely ceased.”

Again, back to the scorecard: urine from ears, eyes, mouth, breasts, navel, and nose. Not to be indelicate, but since there was urine in her stomach, we can reasonably conclude that when it was not being vomited through her mouth, it was discharged at the other end of her body. In other words, Maria Burton basically was peeing from everywhere except the one place she was supposed to, and she needed catheterization to the bladder for that to happen.

Was it Really Urine?

Clearly something abnormal was coming from this woman’s body. Can we know whether it was really urine? Dr. Arnold addresses this question:

“All the fluids discharged were found by analysis to contain urea. The following is the analysis of the fluid discharged from the right ear, made in New-Haven, under the direction of Professor Silliman. ‘Alkaline Sulphates were indicated by muriate of Barytes and Acetic acid; Muriates were detected by Nitrate and Acetate of Silver, and by Nitrate of Mercury; Phosphates were ascertained to exist by the addition of caustic, ammonia and Lime water. Urea was obtained in the usual manner by evaporating the fluid and re-dissolving in Alcohol and again evaporating.’”

In other words, the liquids certainly contained urine. He also shows that they were not exclusively urine. Other substances were included:

“The urine discharged from the ear was, during the first six months hotter than that from the bladder, producing by its heat pain in the external ear.”

“The urine from the bladder turned black when not drawn off at the usual period, and deposited a sediment resembling black sand. Sometimes after this black sediment was precipitated the fluid would be of a dingy yellow colour, at other times it would be as black as ink. The urine from the bladder was frequently very high coloured before it turned black, but frequently turned black when it was as perfectly limpid as spring water, and on several occasions it has been noticed that when it was most limpid the largest quantity of black sediment was precipitated. The discharges from the other outlets have occasionally all turned black; a more particular account of which may be found in the Appendix. They differ however in one respect from the discharge from the bladder, since from the bladder it has never come off black, while it frequently has from all the other outlets. This changing of colours in all the discharges from the different outlets at the same time, is a most convincing proof of the identity of the fluids discharged.”

“Since the obstruction of the catamenia there has been a discharge of blood supposed to be vicarious, it has generally come on every five or eight weeks; sometimes at the regular period. For the first two years there was a discharge of blood occasionally from the stomach and lungs. It has since been discharged from the stomach and lungs, from the right and left ear, oftener from the left; from the right and left breast, more frequently from the left; from the navel, and from the nose. From the nose and the right ear it has generally been mixed with urine, nearly three fourths urine, from the left ear with about equal parts urine and blood, from the stomach and lungs, with the contents of the stomach and the secretions of the fauces, from the left breast and navel it has generally been unmixed with any other fluid. It was frequently foetid—the colour always dark—it sometimes, though not generally coagulated.”

Dr. Arnold continues in his explanation of the analysis of the fluids by describing the variation of their appearance and composition, depending on the frequency of their expulsion from the body. The full details can be found in his article if you are curious. For our part, we are questioning the wisdom of waiting until breakfast to finish writing this piece.

How Did it End?

Fortunately for Maria Burton, she got better-ish.

“This great disturbance in the system continued to increase for nearly six months, and it was the opinion of all who saw the patient that she could not survive from day to day; after which period it gradually abated, and she is now when the urine is freely discharged, so much relieved that she is able to walk about her room, and during the summer of 1824, frequently rode out. The discharges from the right ear, the right breast and navel, continue daily, but they are not so great nor so frequent as they were a year since, from the bladder the quantity is as usual, from the stomach, nose, and eye, there has for some months been no discharge.”

In other words, she continued to pee from her right ear, right breast, and belly button, but not nearly as much as she used to. You and I might be horrified at the prospect of living life under those conditions, but Maria was probably delighted to be in remission from urine coming from her mouth, nose, and eye.

Her condition may not have made her the ideal dinner companion, but perhaps it was compensated for by providing a no-fail conversation starter.

Did It Really Happen?

Dr. Arnold clearly recognized there would be some skepticism about his report. This no doubt prompted him to keep detailed records as he offered medical treatment. He also enlisted the assistance of a colleague to independently witness the phenomenon and verify that it wasn’t all an elaborate hoax:

“The quantity of urine, discharged from all the outlets was so great, and so much beyond what has been thought possible, that I was apprehensive there might have been some deception—to remove every doubt I and my friend Dr. Webb, who, at my request had occasionally attended her, remained with her four hours alternately during nearly twenty four hours, and the quantity discharged during this time was as large as it had been for several days previous to, and after this period. There never has been any doubt, that these fluids which have been proved to be urine, were actually discharged from the ear and the other outlets, since the fact has been proved day after day by ocular demonstration.”

“By ocular demonstration” is Dr. Arnold’s 19th century way (and much more impressive manner) of saying, “Look, I saw it with my own eyes, ok?”

Could it really have happened? Some of what Dr. Arnold described could be caused by the prolapsed bladder. The urine from the navel, for example, is explainable because of a remnant of the umbilical cord called the urachus. It drains urine from the bladder of a fetus in the first months of pregnancy. It typically disappears at birth but occasionally remains and can become reanimated.

As for the urine from everywhere else? That is a bit harder to explain. There have been no other documented cases quite like that of Maria Burton. Perhaps she was one of the greatest con artists of all time, although it is hard to see why she would want to go to all that trouble. There is also the possibility that out of the billions of people who have been born, one of them was a living fountain of urine.