Physician Pietro Pfanner who had known Saint Gemma since her childhood examined her claims of stigmata. He observed hysterical behaviour and suspected she may have suffered from a form of neurosis. Pfanner examined Gemma and noted spots of blood on the palms of her hands but when he ordered the blood to be wiped away with a wet towel there was no wound. He concluded the phenomenon was self-inflicted. This was confirmed on another occasion by Gemma's fostermother Cecilia Giannini who observed a sewing needle on the floor next to her.