Dangerous diamonds from Benvenuto to Bollywood (the myths and medicine of diamond ingestion)

Is it dangerous to lick a diamond? Can I die from swallowing a diamond? What happens if you eat diamond dust? Is diamond harmful or helpful for health? These are some of the questions about diamond ingestion and toxicity that appear on the internet. Isn’t the answer clear cut?

Learning objectives

1. Explore the origins and evolution of the diamond toxicity story

2. Consider the influence of diamond myth, legend and folklore on medicine

3. Reflect on how culture and (mis)information continues to perpetuate certain ideas


In his outrageous autobiography, the charismatic and unreliable Benvenuto Cellini (1500-1571) recounts his colourful life. Not only was he a great artist, his autobiography is considered as one of the most notorious ever written. Among the many references to unscrupulous and and incompetent doctors, Cellini also has to contend with the seemingly innumerable people trying to murder him. Apparently, all in a normal day’s work for the amazing Cellini. Spoiler alert… if you’re planning on reading his autobiography, something I thoroughly recommend, I will be discussing a small part of his story in this post.

Cellini’s relentless bragging knows few bounds, extending even to the realm of toxicology:

…Durante of Brescia, whom I’ve already mentioned, plotted with that soldier – the one who had been a chemist in Prato – to mix with my food some substance of a poisonous nature, with a deadly but not instant effect: it was to take effect at the end of four or five months. They were planning together to put some powdered diamond into my food. This, although not at all poisonous itself, is so incredibly hard that when pounded it still retains its sharp edges. The diamond isn’t like other stones, which lose their sharp edges and become almost rounded, for it keeps its sharpness even when powdered. As a result of this, when it enters the stomach along with one’s food, in the process of digestion the diamond becomes embedded in the lining of the stomach and in the bowels. Then, little by little, as fresh food comes in and presses it forward, before very long the diamond pierces one’s inside; and the result is death.

The Autobiography of Benvenuto Cellini

Was Cellini right in his assertion of the harmful effects of ingesting diamond? Fortuitously for him, he didn’t actually ingest diamond powder as his cheapskate poisoner decided to use another stone instead. But what if he had really swallowed diamond powder, is it as lethal as he reports? What is fascinating is that the idea of diamond as a toxic material has a long history before and beyond Benvenuto and his adventures. Yet it wasn’t always like this.

Diamonds were originally thought to possess healing qualities. Pliny the Elder (AD 23/24 – 79) is often cited as highlighting the health benefits of diamonds. In his Natural History he states “adamas [diamond] overcomes and neutralises poisons, dispels delirium and banishes groundless perturbations of  the mind”. But hold on… despite this quote being reputably about diamonds, the meaning may have been lost in time and translation. The etymology of the word diamond is interesting, deriving from the Latin adamas, a hypothetical hardest material that later came to be synonymous with diamond. Pliny refers to “adamas” and it is not definite that he meant diamond. Indeed, consider this excerpt from A System of Mineralogy: Comprising the Most Recent Discoveries published no so recently in 1844:

This name [adamas] was applied by the ancients to several minerals differing much in their physical qualities. A few of those are quarts, specular, iron ore, emery, and other substances of rather high degrees of hardness, which cannot now be identified. It is doubtful that Pliny had any acquaintance with the real diamond.

A System of Mineralogy: Comprising the Most Recent Discoveries


In contrast to Pliny and his influence in the West, the myth of The Valley of Diamonds may have shaped a different opinion in the East. Variations are plenty, but in summary the story describes a deep valley full of valuable diamonds but also snakes. In order to retrieve the gems, fresh meat is thrown into the valley. The diamonds adhere/pierce the meat which is subsequently picked up by birds. Once the birds have taken the meat to their nest or a more accessible area, they are scared away and the valuable diamonds separated from the meat. The myth in various forms is found in Chinese, Indian, Persian and Arabic sources. It has been said that the myth also includes the idea that if diamonds and snakes were in continuous close contact, that the snake venom would somehow permeate the diamond making them poisonous.

Some of the numerous incarnations of the Valley of Diamonds tale including The Adventure Boys, The Arabian Nights, and the Catalan Atlas of Abraham Cresques

The Valley of Diamonds tale, in its many incarnations is sometimes reported to have been brought from the East to the West by individuals such as Alexander the Great (356-323 BCE) who is sometimes told as the person retrieving the diamonds and Marco Polo (1254-1324) who even includes it in his Travels. The earliest known written version is said to have been by Epiphanius of Salamis (c310-403) but Herodotus (c484BCE-c425) wrote a very similar tale in his History that substitutes cinnamon for the diamonds.


Questions

How does folklore and mythology influence modern medicine?


Suspicion regarding the alleged toxicity of diamond was pointed out by Al-Biruni (973-1050). He cites the anecdotal evidence or an experiment where a dog was administered a diamond. He reports “It was affected neither at the time nor was any effect noted later. It is all idle talk, without any substance.”


Hildegard of Bingen (1098-1179) is reputed to have said that sucking on a diamond would prevent lying as well as aid fasting by fooling hunger. On a related note, during the middle ages, “taking a diamond to bed, breathing on it while fasting or wearing it next to the skin were all accepted remedies for sickness. It was also recommended that liars and scolds suck on a diamond to cure them of their bad habits.”


Questions

What factors perpetuate medical myths?


From chewing gum taking seven years to digest to sleeping with an electric fan on causing death, each culture has its own variation of these tales and one can ponder on what influences them to develop and then disseminate or dissipate. Perhaps it would have been reasonable to assume that with all the information we now have at our disposal, many of these myths may have died out. Conversely, this information age has allowed some of these ideas to gain traction and resonate even louder than before. The reputation of statins could be one example that is currently in gestation with recent evidence suggesting the idea of taking a statin is enough to cause a ‘nocebo’ effect. Anyway, I digress, back to diamonds. 

There appears to have been a sea change in the 16th century where the idea of the diamonds and toxicity appears to have become more widespread, at least in the West. Whether this was because of the Renaissance and increased cultural exchange between the East and West or perhaps the rediscovery of long lost texts (thanks Byzantium) is purely a convenient postulation put forward by myself. In any case, the idea of diamonds as a lethal substance isn’t just confined to sixteenth century Renaissance artists like our beloved Benvenuto. Scattered throughout history there are various characters associated with the lethality of diamond ingestion including:

Emperor Frederick II (1194-1250) is associated with a diamond powder overdose, although dysentery is reported to be the likely cause of death.

Sultan Bejazet II (1447-1512) is sometimes reported to have been poisoned by his son Selim who added diamond dust to his food

Pope Clement VII (1478-1534) was given 40,000 ducats worth of gem stones, including diamond dust, by his physicians to treat a stomach illness. He died soon afterwards of an intestinal issue.

Paracelsus (1493-1541), a pioneer of toxicology, is rumoured to have died from diamond dust. What a coincidence.

Catherine de Medici (1519-1589) is said to have employed diamond dust to eliminate her enemies. Apparently testing her poisonous mixtures by pretending to help those in poverty,  this powder of succession may have actually been mostly arsenic.

Thomas Overbury (1581-1613) was said to have been poisoned with various substances, diamond powder being one of the potential attempts. Again, an animal tale but this time involving a cat who suffered no ill effects following ingestion of the powder is sometimes told.


Questions

How heavily is our medical training and professional behaviour influenced by the Western canon?


During the time of our beloved Benvenuto things are rather muddled. Consider the following dichotomy: while Cellini describes the potential harms of diamond dust, it seems that his contemporary Pope Clement VII was given a combination preparation as a medication. The Renaissance period certainly seems an important time for the cultural fascination of diamond toxicity. Considerable ambiguity surrounding the nature and circumstances of death of a number of well-known victims has invoked a mysterious aura about the nature of diamonds in health that has extended to the present and has perhaps been somewhat romanticised. Perhaps the idea of diamond toxicity, a revered gemstone of high value used for nefarious purposes, is just far more interesting than the reality.

Medal of Pope Clement VII by Benvenuto Cellini

Garcia de Orta (1501-1568) perhaps highlights the cultural transmission of ideas between East and West. A Portugese physician working mainly in Goa, he acknowledges that the common belief at the time was that diamond dust was poisonous but contests this. Dysentery makes another appearance as he recounts the story of a wife who unsuccessfully attempted to poison her chronically dysenteric husband with diamond powder. Indeed, Orta pragmatically points out that swallowing diamonds is the most common means of stealing them and that these thieves don’t become ill as a consequence. He highlights the incongruity of the contemporary beliefs contrasting the concern that diamonds could be used as a poison that whereas in India diamonds were also being used medicinally by injecting them into the bladder to shatter vesical calculi.

Characteristically, Voltaire (1694-1778) also took a swipe at the idea of diamond as a poison. He considers the death of Henrietta of England in 1670, rumoured to have been poisoned with diamond powder:

The poison, added he, was a diamond reduced to powder, and strewed over strawberries, instead of sugar. The court and city were of opinion that the princess was poisoned with a glass of succory water; after which she felt insupportable pangs, and in a short time died in convulsions.

But the malice of mankind, and a love for the marvellous, were the sole causes of this general persuasion. There could have been no poison in the glass of water, since madam de la Fayette and another person drank the remainder of it, without being in the lease affected. The powder of diamond is no more poisonions than the powder of coral.

(In a note about diamond Voltaire adds) Small bits of diamond and glass might, by their sharp points, pierce and tear the coats of the intestines: but then it would be impossible to swallow them, and the person would soon be rendered sensible to the danger by the excoriation of the palate and throat. The powder, if very fine could not do any hurt, and would rather be a remedy, like the filings of iron. Those physicians who have added diamond to the number of potions, should have made a distinction between a diamond reduced to very fine powder, and a diamond fiercely pounded.

Excerpt from The Works of Mr. de Voltaire. Translated from the French. With Notes. By T. Francklin, D.D., T. Smollett, M.D., and Others. A New Edition, Volume 8 (https://books.google.co.uk/books?id=r7d_zzduWisC&dq)

We see a characteristic Enlightenment take on the issue and Voltaire wants doctors to take note: the physical properties of the diamond in terms of particle size are an important factor in how useless our treatments generally appear to be. Likewise, an anonymous correspondence in 1875 to Notes and Queries which states, “the only possible way it [diamond powder] in could be injurious would be as a mechanical irritant to the mucous membrane of the stomach”. Thanks Voltaire.

So what is to be? Did our medical predecessors regard diamond as a healing potion, harmful poison or perhaps both? One source seems to cite the quality of the diamond as the important distinguishing feature: flawed diamonds being poisonous whereas flawless diamonds being beneficial. I’ll leave you to decide whether or not this idea was an ingenious medieval marketing ploy.

Returning to the Indian subcontinent, a supposed location of the Valley of Diamonds, William Crooke (1848 – 1923), a member of the Bengal Civil Service writing at the beginning of the 20th century, explained that diamond dust “is believed in South India to be at once the least painful, the most active and infallible of all poisons. It was kept as a last resort in times of danger.” Confusion prevails as other reports note that dusting decaying teeth with diamond powder was once a common treatment for tooth decay in India.

And India remains important stop for our diamond story. More modern incarnations of the poisonous diamond appear to have manifested in cinema, especially resonant for those who grew up watching 1970s Bollywood films. Look at this clip from the movie Muqaddar Ka Sikandar, the Bollywood blockbuster of 1978 that was one of the top grossing movies of the decade in India and was also a hit in the Soviet Union:

Still from Muqaddar Ka Sikandar taken from https://youtu.be/NvJQ6o41nm0?t=9294

Although unclear, it seems that scenes like these have fuelled a belief that that licking a diamond can cause death. On closer inspection, it seems that the ring in the Muqaddar Ka Sikandar clip is either coated in a poison or a compartment ring with a poison inside. Let’s consider both options.

With regards to licking, there is a suggestion that centuries ago (particularly in the Indian subcontinent) the agents of the ruling elite wore diamond rings which were coated (or by some other means processed with) cyanide which could be licked in order to commit suicide if aprehended by an enemy.

Alternatively, compartment rings, also sometimes known as locket, vessel, pillbox poison or even Borgia rings (more Italian Renaissance connections) are rings that have a small container under a hinged cover. The cover may even be thin to allow the wearer to bite through to the contents underneath. These compartments have been used throughout history for various reasons ranging from the protection that a part of a holy relic may bring the wearer through to the hair or portraits of loved ones. However, they are perhaps most notorious for concealing poison either to assist suicide or to commit murder. Lucrezia Borgia (1480-1519) is rumoured to have possessed of concealment ring that she used to poison drinks.

Perhaps this is where the modern confusion regarding diamonds arises: is someone licking a coated diamond or biting through and/or ingesting the deadly contents of a compartment ring? To an observer they may all appear the same, with the diamond itself to blame.

Lucrezia Borgia wondering who took her ring. Image from https://commons.wikimedia.org/wiki/File:Lucretia_Borgia_by_Pinturicchio.jpg

But it isn’t just Bollywood that has been intrigued by the ingestion of diamonds. The 1976 movie Marathon Man has a scene where an individual is forced to ingest diamonds, although he dies shortly after through other means. A case of literary foreshadowing? More recently, perhaps the increasing number of Hollywood celebrities having real diamonds inserted into their teeth or a diamond grill may add some counterweight to the 1970s movie based diamond ingestion myths. In yet another cultural phenomenon beyond my limited comprehension, the concept of eating diamonds also has some kind of resonance with a subset of minecraft fans.

So what about diamond ingestion within the realm of modern medicine? Well, not much information appears to be available. Presumably this is because diamonds are not only now marketed across media as a best friend but that they last forever when used to market the idea of an everlasting relationship. Certainly not a go-to toxin for amateur poisoners who like to keep their costs minimal. You can still obtain products said to contain diamond dust. Tibetan ‘precious pills’ are said to contain a number of things, including diamond dust and are used for a number of ailments.

Precious pills. From https://www.men-tsee-khang.org/medicine/rinchen-pills/drangjor.htm

Overall, however, diamond dust is today generally associated with mortality and morbidity, albeit inadvertently. Inhalation of gemstone dust can cause a range of respiratory issues such as silicosis. The modern physicians mentioned in The New Monthly Magazine in 1847 apparently did show that there is a slow but inevitable death in grinding stones and metal without ventilation, but this referred to respiratory diseases rather than gastrointestinal conditions. An article from the 1950s highlighted that intraperitoneal injection of diamond dust in mice could cause ‘slight’ fibrosis although not in rat lungs. However, co-administration with quartz caused many more lesions. Even today, additional confusion arises as diamond mine workers in South Africa seem to be at risk of developing asbestos-related diseases since diamond and asbestos deposits are located close to each other.

Perhaps cynical, maybe the myth of diamond toxicity was an idea promoted to discourage the theft of this valuable jewel. This would have been useful to the elite diamond owning communities of antiquity as well the mining corporations of today. There is a suggestion that the rumour of swallowing diamonds as being poisonous is perpetuated in diamond mines to deter the theft of uncut stones. I don’t know, but the respiratory illnesses sound bad enough.

Of course, the value of diamonds make them an attractive prospect for smuggling and occasionally we see news reports of such cases or even accidental swallowing of engagement rings hidden in champagne flutes during wedding proposals and so forth:

Smuggler caught in South Africa after swallowing 220 diamonds (YouTube)

Briton accused Of Swallowing Stolen Diamond (YouTube)

How one woman accidentally swallowed her engagement ring (BBC)

Tampa woman accidentally swallows $5,000 diamond at charity event (YouTube)

So is diamond ingestion harmful at all? Consider this relatively modern source regarding the ingestion of foreign objects:

The spectrum of gastrointestinal (GI) foreign bodies includes food bolus impaction in the esophagus, nonfood objects that are swallowed, and various objects that may be inserted into the rectum. The risk depends upon the type of object and its location. Fortunately, 80% to 90% of ingested foreign bodies will pass without intervention. Objects with sharp edges or pointed tips have the highest risk of complications, up to 35%. All objects impacted in the esophagus require urgent or emergent treatment.

Foreign bodies, Gastrointest Endosc Clin N Am . 2007 Apr;17(2):361-82, vii. doi: 10.1016/j.giec.2007.03.002.

The odds seem to generally be favourable, although the consequences of being unlucky could be catastrophic. Diamond isn’t specified, although the property of sharpness increases the risk of complication.

Elsewhere, the information specifically on diamonds is light. There are two very similar entries I found. The first is from a toxicology module from Khalsa College, Delhi, India:

Powdered glass, diamond powder, needles, etc. may cause pain in abdomen, nausea and vomiting, may injure tissue and causes bleeding… Diamond dust is possibly the most awful poison in existence. If someone consumes diamond dust, the regular peristaltic motion of the digestive tract causes these minute fragments of the world’s hardest substance to imbed themselves along the alimentary canal, the natural motions of the inner body causing them to work deeper and deeper until the internal organs are pierced and shredded.

Forensic Science Paper No.10: Forensic Toxicology Module No.23: Miscellaneous Poisons

The second is from an excellent post by Freitas that references Hutchkinson, who apparently is writing informally:

…perhaps the most terrible poison in existence. Every other poison has a principle behind its action – cyanides attack, alkaloids destroy, barbiturates deaden, glycosides deteriorate, ricin and abrin phytotoxins agglutinate. Diamond dust abrades… If one ingests diamond dust, the natural peristaltic motion of the digestive tract causes these tiny splinters of the world’s hardest substance to imbed themselves along the alimentary canal, the natural motions of the inner body causing them to work deeper and deeper until your internal organs are perforated and ripped apart. This goes on from anywhere between 2-6 months, until the victim is dead. The pain accompanying this can only be imagined by the few. A large amount of diamond dust would probably feel similar to having a Portuguese Man-O-War living inside of you. Even in its earliest stages, the difficulties behind diagnosis can well be imagined. The only way to extricate the tiny diamond splinters is surgery, wherein each particle would have to be located and removed individually, an impossible feat.

Nanomedicine, Volume IIA: Biocompatibility, 15.1.1 Mechanical Damage from Ingested Diamond

Frieitas reports undertaking an informal experiment in 1995 where diamond grit was pounded and examined with a scanning electron microscope upon which many particles possessed a “fishhook” edge contrasting with the smooth looking unpounded diamond. He adds: “pounded grit tended to cling to human skin, especially in the narrowest creases of the fingers, producing a slight itching sensation, whereas unpounded grit generally does not.” Perhaps the blaggard Cellini was right after all.


Questions

What would you do if a patient told you they had ingested a diamond?


Unfortunately, if you’re reading this having ingested diamond dust, the possibility of slow and immensely painful peritonitis probably isn’t really the outcome you hoped to find. Frieitas proposes further investigation regarding ingestion so you might be able to get that publication you’ve always hoped for. In any case, Frieitas notes in a personal communication in 2005 that he has been told that dogs and cats (which once again make an appearance in the story of diamonds) fed diamond powder mixed in food didn’t experience any toxic effects. Of course, diamond dental burs/drills are now commonly used in human dentistry don’t last forever when used. Please share your experiences in the comments section below if you’re still alive.

Hutchkinson also touches on the difficulty of diagnosis but Freitas is keen to note that diamond would be visible radiologically. Really? I know it must be getting a little repetitive (sorry) but again, this issue is also more (or perhaps less) opaque that it may seem.

It is often said that an x-ray can differentiate a real from a fake diamond. There is an urban myth that a female radiographer accidently had her hand imaged while immobilising a patient only to find her supposed diamond engagement ring was actually fake due to the lucency of the stone. In a very insightful article by Piotto, Gent and Bibbo note this myth and outline the history of diamonds and radiology. They report that diamonds are more radiolucent than their cubic zirconia counterparts, useful if you’re trying to differentiate between a real diamond and an imitation. I imagine diamond dust embedded within the alimentary tract must be exceptionally challenging to spot on radiographic imaging. If you have any experience of this, please let me know.

A radiograph of a caregiver holding a child’s lower leg for a foot radiograph shows a diamond ring (arrow). A diamond, unlike cubic zirconia, is radiolucent. Diamonds appear radiolucent because they are composed of carbon which attenuates the x-ray beam to a lesser degree than high anatomic number elements such as lead or Zirconium. Image from cincykidsrad: https://www.instagram.com/p/B8j9xdCp5C2/?igshid=vpo3wgtzxzai

Medicine seems to be finally outpacing the shadow of the Renaissance; the idea of diamond being beneficial to health is coming back into fashion. Diamond as a medical material is considered bioinert, neither causing coagulation nor producing a significant immune or inflammatory response making it a future prospect for the (very thin) coating of bodily implants such as arterial stents. Nanodiamonds show potential as drug delivery vehicles. However, although cells apparently take up nanodiamond without obvious toxicity, their clearance (if any) has not yet been demonstrated.


Summary

Diamonds have a long association with healing and/or toxicity. They are embedded within many different cultures and questions about their real effect on health remain strangely pertinent to some even today. The Renaissance and a possible exchange or rediscovery of ideas around this time is particularly notable as perpetuating contradictory thoughts about the property of diamonds in relation to health. Inexorably linked with wealth, they are unreliably cited in the deaths of a number of prominent individuals throughout history. This has created a mystique around their properties that echoes today in our information era. New avenues for their use in healthcare are being researched. The cultural value of these specifically arranged carbon atoms goes beyond their true physical and chemical properties and the diamond toxicity story remains unfinished. Perhaps diamonds really are forever?


Further resources

Diamonds in mythology and folklore
https://issuu.com/scottprint0/docs/diamonds_in_mythology_and_folklore_

Nanomedicine, Volume IIA: Biocompatibility. 15.1.1 Mechanical Damage from Ingested Diamond
http://www.nanomedicine.com/NMIIA/15.1.1.htm

Myth busting – in the world of x-rays
https://www.minnisjournals.com.au/articles/Radapr07_pp3.pdf

The curative powers of diamond
https://www.ucl.ac.uk/~ucftbsp/sophiaissue4-web.pdf

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