anomalies and curiosities of medicine-第193部分

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en　into　disuse。　Among　the　ancient　Egyptians　and　Persians　amputation　of　the　virile　member　was　inflicted　for　certain　crimes　of　the　nature　of　rape。

Castration　as　a　religious　rite　has　played　a　considerable　role。　With　all　their　might　the　Emperors　Constantine　and　Justinian　opposed　the　delirious　religion　of　the　priests　of　Cybele；　and　rendered　their　offence　equivalent　to　homicide。　At　the　annual　festivals　of　the　Phrygian　Goddess　Amma　（Agdistis）　it　was　the　custom　of　young　men　to　make　eunuchs　of　themselves　with　sharp　shells；　and　a　similar　rite　was　recorded　among　Phoenicians。　Brinton　names　severe　self…mutilators　of　this　nature　among　the　ancient　Mexican　priests。　Some　of　the　Hottentots　and　indigenous　Australians　enforced　semicastration　about　the　age　of　eight　or　nine。

The　Skoptzies；　religious　castrators　in　Russia；　are　possibly　the　most　famous　of　the　people　of　this　description。　The　Russian　government　has　condemned　members　of　this　heresy　to　hard　labor　in　Siberia；　but　has　been　unable　to　extinguish　the　sect。　Pelikan；　Privy　Counsel　of　the　government；　has　exhaustively　considered　this　subject。　Articles　have　appeared　in　Le　Progres　Medical；　December。　1876。　and　there　is　an　account　in　the　St。　Louis　Clinical　Record；　1877…78。　The　name　Skoptzy　means　〃the　castrated；〃　and　they　call　themselves　the　〃White　Doves。〃　They　arose　about　1757　from　the　Khlish　or　flagellants。　Paul　I　caused　Sseliwanow；　the　true　founder；　to　return　from　Siberia；　and　after　seeing　him　had　him　confined　in　an　insane　asylum。　After　an　interview；　Alexander　I　transferred　him　to　a　hospital。　Later　the　Councillor　of　State；　Jelansky；　converted　by　Sseliwanow；　set　the　man　free　and　soon　the　Skoptzies　were　all　through　Russia　and　even　at　the　Court。　The　principal　argument　of　these　people　is　the　nonconformity　of　orthodox　believers；　especially　the　priests；　to　the　doctrines　professed；　and　they　contrast　the　lax　morals　of　these　persons　with　the　chaste　lives；　the　abstinence　from　liquor；　and　the　continual　fasts　of　the　〃White　Doves。〃　For　the　purpose　of　convincing　novices　of　the　Scriptural　foundation　of　their　rites　and　belief　they　are　referred　to　Matthew　xix。；　12：　〃and　there　be　eunuchs　which　have　made　themselves　for　the　kingdom　of　Heaven's　sake；〃　etc。；　and　Mark　ix。；　43…47；　Luke　xxiii。；　29：　〃blessed　are　the　barren；〃　etc。；　and　others　of　this　nature。　As　to　the　operation　itself；　pain　is　represented　as　voluntary　martyrdom；　and　persecution　as　the　struggle　of　the　spirit　of　darkness　with　that　of　light。　They　got　persons　to　join　the　order　by　monetary　offers。　Another　method　was　to　take　into　service　young　boys；　who　soon　became　lost　to　society；　and　lied　with　effrontery　and　obstinacy。　They　had　secret　methods　of　communicating　with　one　another；　and　exhibited　a　passion　for　riches；　a　fact　that　possibly　accounts　for　their　extended　influence。　The　most　perfect　were　those　〃worthy　of　mounting　the　white　horse；〃　the　〃bearers　of　the　Imperial　seal；〃　who　were　deprived　of　the　testicles；　penis；　and　scrotum。　The　operation　of　castration　among　these　people　was　performed　at　one　stroke　or　at　two　different　times；　in　the　former　case　one　cicatrix　being　left；　and　in　the　latter　two。　The　greater　numberthose　who　had　submitted　to　the　〃first　purification；〃　conferring　upon　them　the　〃lesser　seal〃had　lost　testicles　and　scrotum。　These　people　are　said　to　have　lost　the　〃keys　of　hell；〃　but　to　retain　the　〃key　of　the　abyss〃　（female　genitals）。　As　instruments　of　excision　the　hot　iron；　pieces　of　glass；　old　wire；　sharpened　bone；　and　old　razors　are　used。　Only　nine　fatal　cases　resulting　from　the　operation　are　known。　At　St。　Petersburg　Liprandi　knew　a　rich　Skoptzy　who　constantly　kept　girlsmostly　Germansfor　his　own　gratification；　soon　after　having　entered　into　the　〃first　purification。〃　Few　of　them　were　able　to　remain　with　him　over　a　year；　and　they　always　returned　to　their　homes　with　health　irretrievably　lost。　Women　members　of　the　order　do　not　have　their　ovaries　removed；　but　mutilation　is　practiced　upon　the　external　genitals；　the　mammae；　and　nipples。　The　first　ablation　is　obtained　by　applying　fire　or　caustics　to　the　nipples；　the　second　by　amputation　of　the　breasts；　one　or　both；　the　third　by　diverse　gashes；　chiefly　across　the　breast；　and　the　fourth　by　resection　of　the　nymphae　or　of　the　nymphae　and　clitoris；　and　the　superior　major　labia；　the　cicatrices　of　which　would　deform　the　vulva。　Figure　232　represents　the　appearance　of　the　external　genital　organs　of　a　male　Skoptzy　after　mutilation；　Figure　233　those　of　a　female。　

Battey　speaks　of　Skoptzies　in　Roumania　who　numbered　at　the　time　of　report　533　persons。　They　came　from　Russia　and　practiced　the　same　ceremonies　as　the　heretics　there。



CHAPTER　XV。

ANOMALOUS　TYPES　AND　INSTANCES　OF　DISEASE。

Tumors。In　discussing　tumors　and　similar　growths　no　attempt　will　be　made　to　describe　in　detail　the　various　types。　Only　the　anomalous　instances　or　examples；　curious　for　their　size　and　extent　of　involvement；　will　be　mentioned。　It　would　be　a　difficult　matter　to　decide　which　was　the　largest　tumor　ever　reported。　In　reviewing　literature　so　many　enormous　growths　are　recorded　that　but　few　can　be　given　here。　Some　of　the　large　cystic　formations　have　already　been　mentioned；　these　are　among　the　largest　tumors。　Scrotal　tumors　are　recorded　that　weighed　over　200　pounds；　and　a　limb　affected　with　elephantiasis　may　attain　an　astonishing　size。　Delamater　is　accredited　with　a　report　of　a　tumor　that　weighed　275　pounds；　the　patient　only　weighing　100　pounds　at　death。　Benign　tumors　will　be　considered　first。

Pure　adenoma　of　the　breast　is　a　rare　growth。　Gross　was　able　to　collect　but　18　examples；　but　closely　allied　to　this　condition　is　what　is　known　as　diffuse　hypertrophy　of　the　breast。　In　some　parts　of　the　world；　particularly　in　India　and　Africa；　long；　dependent　breasts　are　signs　of　beauty。　On　the　other　hand　we　learn　from　Juvenal　and　Martial　that；　like　ourselves；　the　Greeks　detested　pendant　and　bulky　breasts；　the　signs　of　beauty　being　elevation；　smallness；　and　regularity　of　contour。　In　the　Grecian　images　of　Venus　the　breasts　are　never　pictured　as　engorged　or　enlarged。　The　celebrated　traveler　Chardin　says　that　the　Circassian　and　Georgian　women　have　the　most　beautiful　breasts　in　the　world；　in　fact　the　Georgians　are　so　jealous　of　the　regular　contour　and　wide　interval　of　separation　of　their　breasts　that　they　refuse　to　nourish　their　children　in　the　natural　manner。

The　amount　of　hypertrophy　which　is　sometimes　seen　in　the　mammae　is　extraordinary。　Borellus　remarks　that　he　knew　of　a　woman　of　ordinary　size；　each　of　whose　mammae　weighed　about　30　pounds；　and　she　supported　them　in　bags　hung　about　her　neck。　Durston　reports　a　case　of　sudden　onset　of　hypertrophy　of　the　breast　causing　death。　At　the　postmortem　it　was　found　that　the　left　breast　weighed　64　pounds　and　the　right　40　pounds。　Boyer　successfully　removed　two　breasts　at　an　interval　of　twenty…six　days　between　the　two　operations。　The　mass　excised　was　one…third　of　the　total　body…weight。

Schaeffer　speaks　of　hypertrophied　mammae　in　a　girl　of　fourteen；　the　right　breast　weighing　3900　grams　（136　1/2　oz。）　and　the　right　3500　grams　（122　1/2　oz。）。　Hamilton　reports　a　case　of　hypertrophied　glands　in　a　woman　of　thirty…two；　which；　within　the　short　space　of　a　year；　reached　the　combined　weight　of　52　pounds。　They　were　successfully　excised。　Velpeau；　Billroth；　and　Labarracque　have　reported　instances　of　the　removal　of　enormously　hypertrophied　mammae。　In　1886　Speth　of　Munich　described　a　hypertrophy　of　the　right　breast　which　increased　after　every　pregnancy。　At　the　age　of　twenty…six　the　woman　had　been　five　times　pregnant　in　the　space　of　a　little　over　five　years；　and　at　this　time　the　right　breast　hung　down　to　the　anterior　superior　spine　of　the　ilium。　It　weighed　20　pounds；　and　its　greatest　circumference　was　25　inches。　There　was　no　milk　in　this　breast；　although　the　left　was　in　perfect　lactation。　This　case　was　one　of　pure　hypertrophy　and　not　an　example　of　fibro…adenoma；　as　illustrated　by　Billroth。　Warren　figures　a　case　of　diffused　hypertrophy　of　the　breast　which　was　operated　on　by　Porter。　The　right　breast　in　its　largest　circumference　measured　38　inches　and　from　the　chest…wall　to　the　nipple　was　17　inches　long；　the　circumference　at　the　base　being　23　inches；　the　largest　circumference　of　the　left　breast　was　28　inches；　its　length　from　the　chest…wall　to　the　nipple　was　14　inches；　and　its　circumference　at　the　base　23　inches。　The　skin　was　edematous　and　thickened。　Throughout　both　breasts　were　to　be　felt　hardened　movable　masses；　the　size　of　oranges。　Microscopic　examination　showed　the　growth　to　be　a　diffused　intracanalicular　fibroma。　A　peculiar　case　was　presented　before　the　Faculty　at　Montpellier。　The　patient　was　a　young　girl　of　fifteen　and　a　half　years。　After　a　cold　bath；　just　as　the　menses　were　appearing；　it　was　found　that　the　breasts　were　rapidly　increasing　in　size；　she　was　subsequently　obliged　to　leave　service　on　account　of　their　increased　size；　and　finally　the　deformity　was　so　great　as　to　compel　her　to　keep　from　the　public　view。　The　circumference　of　the　right　breast　was　94　cm。　and　of　the　left　105　cm。；　the　pedicle　of　the　former　measured　67　cm。　and　of　the　latter　69　cm。；　only　the　slightest　vestige　of　a　nipple　remained。　Removal　was　advocated；　as　applications　of　iodin　had　failed；　but　she　would　not　consent　to　operation。　For　eight　years　the　hypertrophy　remained　constant；　but；　despite　this　fact；　she　found　a　husband。　After　marriage　the　breasts　diminished；　but　she　was　unable　to　suckle　either　of　her　three　children；　the　breasts　becoming　turgid　but　never　lactescent。　The　hypertrophy　diminished　to　such　a　degree　that；　at　the　age　of　thirty…two；　when　again　pregnant；　the　circumference　of　the　right　breast　was　only　27　cm。　and　of　the　left　33　cm。　Even　thus　reduced　the　breasts　descended　almost　to　the　navel。　When　the　woman　was　not　pregnant　they　were　still　less　voluminous　and　seemed　to　consist　of　an　immense　mass　of　wrinkled；　flaccid　skin；　traversed　by　enormous　dilated　and　varicose　blood…vessels；　the　mammary　glands　themselves　being　almost　entirely　absent。

Diffuse　hypertrophy　of　the　breast　is　occasionally　seen　in　the　male　subject。　In　one　case　reported　from　the　Westminster　Hospital　in　London；　a　man　of　sixty；　after　a　violent　fall　on　the　chest；　suffered　enormous　enlargement　of　the　mammae；　and　afterward　atrophy　of　the　testicle　and　loss　of　sexual　desire。

The　names　goiter；　struma；　and　b