anomalies and curiosities of medicine-第141部分

按键盘上方向键 ← 或 → 可快速上下翻页，按键盘上的 Enter 键可回到本书目录页，按键盘上方向键 ↑ 可回到本页顶部！
————未阅读完？加入书签已便下次继续阅读！


ots；　worms；　leeches；　centipedes；　and　even　lizards。　Zacutus　Lusitanus　tells　of　a　person　who　died　in　two　days　from　the　effects　of　a　leech　which　was　inadvertently　introduced　into　the　nasal　fossa；　and　there　is　a　somewhat　similar　case　of　a　military　pharmacist；　a　member　of　the　French　army　in　Spain；　who　drank　some　water　from　a　pitcher　and　exhibited；　about　a　half　hour　afterward；　a　persistent　hemorrhage　from　the　nose。　Emaciation　progressively　continued；　although　his　appetite　was　normal。　Three　doctors；　called　in　consultation；　prescribed　bleeding；　which；　however；　proved　of　no　avail。　Three　weeks　afterward　he　carried　in　his　nostril　a　tampon　of　lint；　wet　with　an　astringent　solution；　and；　on　the　next　day；　on　blowing　his　nose；　there　fell　from　the　right　nostril　a　body　which　he　recognized　as　a　leech。　Healey　gives　the　history　of　four　cases　in　which　medicinal　leeches　were　removed　from　the　mouth　and　posterior　nares　of　persons　who　had；　for　some　days　previously；　been　drinking　turbid　water。　Sinclair　mentions　the　removal　of　a　leech　from　the　posterior　nares。

In　some　regions；　more　particularly　tropical　ones；　there　are　certain　flies　that　crawl　into　the　nostrils　of　the　inhabitants　and　deposit　eggs；　in　the　cavities。　The　larvae　develop　and　multiply　with　great　rapidity；　and　sometimes　gain　admission　into　the　frontal　sinus；　causing　intense　cephalalgia；　and　even　death。

Dempster　reports　an　instance　of　the　lodgment　of　numerous　live　maggots　within　the　cavity　of　the　nose；　causing　sloughing　of　the　palate　and　other　complications。　Nicholson　mentions　a　case　of　ulceration　and　abscess　of　the　nostrils　and　face　from　which　maggots　were　discharged。　Jarvis　gives　the　history　of　a　strange　and　repeated　hemorrhage　from　the　nose　and　adjacent　parts　that　was　found　to　be　due　to　maggots　from　the　ova　of　a　fly；　which　had　been　deposited　in　the　nose　while　the　patient　was　asleep。　Tomlinson　gives　a　case　in　which　maggots　traversed　the　Eustachian　tube；　some　being　picked　out　of　the　nostrils；　while　others　were　coughed　up。　Packard　records　the　accidental　entrance　of　a　centipede　into　the　nostril。　There　is　an　account　of　a　native　who　was　admitted　to　the　Madras　General　Hospital；　saying　that　a　small　lizard　had　crawled　up　his　nose。　The　urine　of　these　animals　is　very　irritating；　blistering　any　surface　it　touches。　Despite　vigorous　treatment　the　patient　died　in　consequence　of　the　entrance　of　this　little　creature。

There　have　been　instances　among　the　older　writers　in　which　a　pea　has　remained　in　the　nose　for　such　a　length　of　time　as　to　present　evidences　of　sprouting。　The　Ephemerides　renders　an　instance　of　this　kind；　and　Breschet　cites　the　history　of　a　young　boy；　who；　in　1718；　introduced　a　pea　into　his　nostril；　in　three　days　it　had　swollen　to　such　an　extent　as　to　fill　the　whole　passage。　It　could　not　be　extracted　by　an　instrument；　so　tobacco　snuff　was　used；　which　excited　sneezing；　and　the　pea　was　ejected。

Vidal　and　the　Ephemerides　report　several　instances　of　tolerance　of　foreign　bodies　in　the　nasal　cavities　for　from　twenty　to　twenty…five　years。　Wiesman；　in　1893；　reported　a　rhinolith；　which　was　composed　of　a　cherry…stone　enveloped　in　chalk；　that　had　been　removed　after　a　sojourn　of　sixty　years；　with　intense　ozena　as　a　consequence　of　its　lodgment。　Waring　mentions　the　case　of　a　housemaid　who　carried　a　rhinolith；　with　a　cherry…stone　for　a　nucleus；　which　had　been　introduced　twenty…seven　years　before；　and　which　for　twenty…five　years　had　caused　no　symptoms。　Grove　describes　a　necrosed　inferior　turbinated　bone；　to　which　was　attached　a　coffee…grain　which　had　been　retained　in　the　nostril　for　twenty　years。；　Hickman　gives　an　instance　of　a　steel　ring　which　for　thirteen　and　a　half　years　had　been　impacted　in　the　nasopharyngeal　fossa　of　a　child。　It　was　detected　by　the　rhinoscope　and　was　removed。　Parker　speaks　of　a　gunbreech　bolt　which　was　removed　from　the　nose　after　five　years'　lodgment。　Major　mentions　the　removal　of　a　foreign　body　from　the　nose　seven　years　after　its　introduction。

Howard　removed　a　large　thimble　from　the　posterior　nares；　although　it　had　remained　in　its　position　for　some　time　undetected。　Eve　reports　a　case　in　which　a　thimble　was　impacted　in　the　right　posterior　nares。　Gazdar　speaks；　of　a　case　of　persistent　neuralgia　of　one…half　of　the　face；　caused　by　a　foreign　body　in　the　nose。　The　obstruction　was　removed　after　seven　years'　lodgment　and　the　neuralgia　disappeared。　Molinier　has　an　observation　on　the　extraction　of　a　fragment　of　a　knife…blade　which　had　rested　four　years　in　the　nasal　fossae；　where　the　blade　had　broken　off　during　a　quarrel。

A　peculiar　habit；　sometimes　seen　in　nervous　individuals；　is　that　of　〃swallowing　the　tongue。〃　Cohen　claims　that　in　some　cases　of　supposed　laryngeal　spasm　the　tongue　is　swallowed；　occluding　the　larynx；　and　sometimes　with　fatal　consequences。　There　are　possibly　a　half　score　of　cases　recorded；　but　this　anomaly　is　very　rare；　and　Major　is　possibly　the　only　one　who　has　to　a　certainty　demonstrated　the　fact　by　a　laryngoscopic　examination。　By　the　laryngoscope　he　was　enabled　to　observe　a　paroxysm　in　a　woman；　in　which　the　tongue　retracted　and　impinged　on　the　epiglottis；　but　quickly　recovered　its　position。　Pettit　mentions　suffocation　from　〃tongue　swallowing；〃　both　with　and　without　section　of　the　frenum。　Schobinger　cites　a　similar　instance；　due　to　loosening　of　the　frenum。

Analogous　to　the　foregoing　phenomenon　is　the　habit　of　〃tongue　sucking。〃　Morris　mentions　a　young　lady　of　fifteen　who　spontaneously　dislocated　her　jaw；　owing　indirectly　to　this　habit。　Morris　says　that　from　infancy　the　patient　was　addicted　to　this　habit；　which　was　so　audible　as　to　be　heard　in　all　parts　of　the　room。　The　continued　action　of　the　pterygoid　muscles　had　so　preternaturally　loosened　the　ligaments　and　muscular　structures　supporting　the　joint　as　to　render　them　unable　to　resist　the　violent　action　of　〃tongue　sucking〃　even　during　sleep。

Injuries　to　the　Tongue。Hobbs　describes　a　man　of　twenty…three　who；　while　working；　had　a　habit　of　protruding　his　tongue。　One　day　he　was　hit　under　the　chin　by　the　chain　of　a　crane　on　a　pier；　his　upper　teeth　inflicting　a　wound　two　inches　deep；　three　inches　from　the　tip；　and　dividing　the　entire　structure　of　the　tongue　except　the　arteries。　The　edges　of　the　wound　were　brought　into　apposition　by　sutures；　and　after　the　removal　of　the　latter　perfect　union　and　complete　restoration　of　the　sensation　of　taste　ensued。　Franck　mentions　regeneration　of　a　severed　tongue；　and　Van　Wy　has　seen　union　of　almost　entirely　severed　parts　of　the　tongue。　De　Fuisseaux　reports　reunion　of　the　tongue　by　suture　after　almost　complete　transverse　division。

There　is　an　account　of　a　German　soldier　who；　May　2；　1813；　was　wounded　at　the　battle　of　Gross…Gorschen　by　a　musket　ball　which　penetrated　the　left　cheek；　carrying　away　the　last　four　molars　of　the　upper　jaw　and　passing　through　the　tongue；　making　exit　on　the　left　side；　and　forcing　out　several　teeth　of　the　left　lower　jaw。　To　his　surprise；　thirty　years　afterward；　one　of　the　teeth　was　removed　from　an　abscess　of　the　tongue。　Baker　speaks　of　a　boy　of　thirteen　who　was　shot　at　three　yards　distance。　The　bullet　knocked　out　two　teeth　and　passed　through　the　tongue；　although　it　produced　no　wound　of　the　pharynx；　and　was　passed　from　the　anus　on　the　sixth　day。　Stevenson　mentions　a　case　of　an　organist　who　fell　forward　when　stooping　with　a　pipe　in　his　mouth；　driving　its　stem　into　the　roof　of　the　pharynx。　He　complained　of　a　sore　throat　for　several　days；　and；　after　explanation；　Stevenson　removed　from　the　soft　palate　a　piece　of　clay　pipe　nearly　1　1/4　inches　long。　Herbert　tells　of　a　case　resembling　carcinoma　of　the　tongue；　which　was　really　due　to　the　lodgment　of　a　piece　of　tooth　in　that　organ。

Articulation　Without　the　Tongue。Total　or　partial　destruction　of　the　tongue　does　not　necessarily　make　articulation　impossible。　Banon　mentions　a　man　who　had　nothing　in　his　mouth　representing　a　tongue。　When　he　was　young；　he　was　attacked　by　an　ulceration　destroying　every　vestige　of　this　member。　The　epiglottis；　larynx；　and　pharynx；　in　fact　the　surrounding　structures　were　normal；　and　articulation；　which　was　at　first　lost；　became　fairly　distinct；　and　deglutition　was　never　interfered　with。　Pare　gives　a　description　of　a　man　whose　tongue　was　completely　severed；　in　consequence　of　which　he　lost　speech　for　three　years；　but　was　afterward　able　to　make　himself　understood　by　an　ingenious　bit　of　mechanism。　He　inserted　under　the　stump　of　the　tongue　a　small　piece　of　wood；　in　a　most　marvelous　way　replacing　the　missing　member。　Articulation　with　the　absence　of　some　constituent　of　the　vocal　apparatus　has　been　spoken　of　on　page　254。

Hypertrophy　of　the　Tongue。It　sometimes　happens　that　the　tongue　is　so　large　that　it　is　rendered　not　only　useless　but　a　decided　hindrance　to　the　performance　of　the　ordinary　functions　into　which　it　always　enters。　Ehrlich；　Ficker；　Klein；　Rodforffer；　and　the　Ephemerides；　all　record　instances　in　which　a　large　tongue　was　removed　either　by　ligation　or　amputation。　Von　Siebold　records　an　instance　in　which　death　was　caused　by　the　ligature　of　an　abnormally　sized　tongue。　There　is　a　modern　record　of　three　cases　of　enormous　tongues；　the　result　of　simple　hypertrophy。　In　one　case　the　tongue　measured　6　1/4　inches　from　the　angle　of　the　mouth　about　the　sides　and　tip　to　the　opposite　angle；　necessitating　amputation　of　the　protruding　portion。

Carnochan　reports　a　case　in　which　hypertrophy　of　the　tongue　was　reduced　to　nearly　the　normal　size　by　first　tying　the　external　carotid；　and　six　weeks　later　the　common　carotid　artery。　Chalk　mentions　partial　dislocation　of　the　lower　jaw　from　an　enlarged　tongue。　Lyford　speaks　of　enlargement　of　the　tongue　causing　death。

The　above　conditions　are　known　as　macroglossia；　which　is　a　congenital　hypertrophy　of　the　tongue　analogous　to　elephantiasis。　It　is　of　slow　growth；　and　as　the　organ　enlarges　it　interferes　with　deglutition　and　speech。　It　may　protrude　over　the　chin　and　reach　even　as　far　down　as　the　sternum。

The　great　enlargement　may　cause　deformities　of　the　teeth　and　lower　jaw；　and　even　present　itself　as　an　enormous　tumor　in　the　neck。　The　protruding　tongue　itself　may　ulcerate；　possibly　bleed；　and　there　is　constant　dribbling　of　saliva。　The　disease　is　probably　due　to　congenital　defect　aggravated　by　frequent　attacks　of　glossitis；　and　the　treatment　consists　in　the　removal　of　the　protrudi