anomalies and curiosities of medicine-第197部分

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In　the　records　of　enormous　dropsies　much　material　of　interest　is　to　be　found；　and　a　few　of　the　most　interesting　cases　on　record　will　be　cited。　In　the　older　times；　when　the　knowledge　of　the　etiology　and　pathology　of　dropsies　was　obscure；　we　find　the　records　of　the　most　extraordinary　cases。　Before　the　Royal　Society；　in　1746；　Glass　of　Oxford　read　the　report　of　a　case　of　preternatural　size　of　the　abdomen；　and　stated　that　the　dropsy　was　due　to　the　absence　of　one　kidney。　The　circumference　of　the　abdomen　was　six　feet　four　inches；　and　the　distance　from　the　xiphoid　to　the　os　pubis　measured　four　feet　1/2　inch。　In　this　remarkable　case　30　gallons　of　fluid　were　drawn　off　from　the　abdomen　after　death。　Bartholinus　mentions　a　dropsy　of　120　pounds；　and　Gockelius　one　of　180　pounds；　there　is　recorded　an　instance　of　a　dropsy　of　149　pounds。　There　is　an　old　record　of　a　woman　of　fifty　who　had　suffered　from　ascites　for　thirty　years。　She　had　been　punctured　154　times；　and　each　time　about　20　pints　were　drawn　off。　During　each　of　two　pregnancies　she　was　punctured　three　or　four　times；　one　of　her　children　was　still　living。　It　has　been　said　that　there　was　a　case　in　Paris　of　a　person　who　was　punctured　300　times　for　ascites。　Scott　reports　a　case　of　ascites　in　which　928　pints　of　water　were　drawn　off　in　24　successive　tappings；　from　February；　1777；　to　May；　1778。　Quoted　by　Hufeland；　Van　Wy　mentions　1256　pounds　of　fluid　being　drawn　from　the　abdomen　of　a　woman　in　five　years。　Kaltschmid　describes　a　case　of　ascites　in　which；　in　12　paracenteses；　500　pounds　of　fluid　were　removed。　In　1721　Morand　reported　two　cases　of　ascites　in　one　of　which；　by　the　means　of　57　paracenteses；　970　pounds　of　fluid　were　drawn　off　in　twenty…two　months。　In　the　other　case　1708　pounds　of　fluid　issued　in　ten　months。　There　is　a　record　of　484　pounds　of　〃pus〃　being　discharged　during　a　dropsy。

The　Philosophical　Transactions　contain　the　account　of　a　case　of　hydronephrosis　in　which　there　were　240　pounds　of　water　in　the　sac。　There　are　several　cases　on　record　in　which　ovarian　dropsies　have　weighed　over　100　pounds；　and　Blanchard　mentions　a　uterine　dropsy　of　80　pounds。

The　Ephemerides　contains　an　account　of　a　case　of　hydrocephalus　in　which　there　were　24　pounds　of　fluid；　and　similar　cases　have　been　noted。

Elliotson　reports　what　he　calls　the　largest　quantity　of　pus　from　the　liver　on　record。　His　patient　was　a　man　of　thirty…eight；　a　victim　of　hydatid　disease　of　the　liver；　from　whom　he　withdrew　one　gallon　of　offensive　material。

Lieutaud　cites　a　case；　reported　by　Blanchard；　in　which；　in　a　case　of　hydatid　disease；　the　stomach　contained　90　pounds　of　fluid。

Ankylosis　of　the　articulations；　a　rare　and　curious　anomaly；　has　been　seen　in　the　human　fetus　by　Richaud；　Joulin；　Bird；　and　Becourt。　Ankylosis　of　all　the　joints；　with　muscular　atrophy；　gives　rise　to　a　condition　that　has　been　popularly　termed　〃ossified　man。〃　A　case　of　this　nature　is　described；　the　patient　being　a　raftsman；　aged　seventeen；　who　suffered　with　inflammatory　symptoms　of　the　right　great　toe；　which　were　followed　in　the　next　ten　years　by　progressive　involvement　of　all　the　joints　of　the　extremities；　and　of　the　vertebrae　and　temporo…maxillary　articulations；　with　accompanying　signs　of　acute　articular　rheumatism。　At　the　age　of　thirty…one　the　pains　had　subsided；　leaving　him　completely　disabled。　All　the　joints　except　the　fingers　and　toes　had　become　ankylosed；　and　from　nonusage　the　muscles　had　atrophied。　There　were　no　dislocations；　anesthesia；　or　bedsores；　and　the　viscera　were　normal；　there　were　apparently　no　gouty　deposits；　as　an　examination　of　the　urine　was　negative。

J。　R。　Bass；　the　well…known　〃ossified　man〃　of　the　dime　museums；　has　been　examined　by　many　physicians；　and　was　quite　intelligent　and　cheerful　in　spite　of　his　complete　ankylosis。　Figure　269　represents　his　appearance　in　1887。

Percy　speaks　of　a　man　named　Simoore；　born　in　1752；　who　at　the　age　of　fifteen　was　afflicted　with　ankylosis　of　all　the　joints；　and　at　different　angles　He　was　unable　to　move　even　his　jaw；　and　his　teeth　had　to　be　extracted　in　order　to　supply　him　with　nourishment。　Even　his　ribs　were　ankylosed；　his　chest　puffed　up；　and　the　breathing　was　entirely　abdominal。　In　spite　of　his　infirmities；　after　his　pains　had　ceased　he　lived　a　comparatively　comfortable　life。　His　digestion　was　good；　and　his　excretory　functions　were　sufficient。　The　urine　always　showed　phosphates；　and　never　the　slightest　sign　of　free　phosphoric　acid。　He　still　retained　his　sexual　feeling；　and　occasionally　had　erections。　This　man　died　in　1802　at　the　age　of　fifty；　asphyxia　being　the　precursor　of　death。　His　skeleton　was　deposited　in　the　Museum　of　the　ecole　de　Medecine　de　Paris。　In　the　same　Museum　there　was　another　similar　skeleton；　but　in　this　subject　there　was　motion　of　the　head　upon　the　first　vertebra；　the　lower　jaw　was　intact；　and　the　clavicle；　arms；　and　some　of　the　digits　of　the　right　hand　were　movable。

An　ossified　man　has　been　recently　found　and　exhibited　to　the　Paris　Academy　of　Medicine。　He　is　a　Roumanian　Jew　of　thirty　who　began　to　ossify　twelve　years　ago；　first　up　the　right　side　of　his　back；　then　down　the　left　side。　He　has　hardened　now　to　the　nape　of　the　neck；　his　head　is　turned　to　the　left；　and　the　jaws　are　ankylosed。　He　can　still　move　his　arms　and　legs　a　little　with　great　difficulty。

Akin　to　the　foregoing　condition　is　what　is　known　as　petrifaction　or　ossification　of　portions　of　the　living　human　body　other　than　the　articulations。　Of　the　older　writers　Hellwigius；　Horstius；　and　Schurig　speak　of　petrifaction　of　the　arm。　In　the　Philosophical　Transactions　there　was　a　case　recorded　in　which　the　muscles　and　ligaments　were　so　extensively　converted　into　bone　that　all　the　joints　were　fixed；　even　including　the　vertebrae；　head；　and　lower　jaw。　In　a　short　time　this　man　was；　as　it　were；　one　single　bone　from　his　head　to　his　knees；　the　only　joints　movable　being　the　right　wrist　and　knee。　For　over　a　century　there　has　been　in　the　Trinity　College　at　Dublin　the　skeleton　of　a　man　who　died　about　20　miles　from　the　city　of　Cork。　The　muscles　about　the　scapula；　and　the　dorsum　of　the　ilium　（the　glutei）　were　converted　into　great　masses　of　bone；　equal　to　the　original　muscles　in　thickness　and　bulk。　Half　of　the　muscles　of　the　hips　and　thighs　were　converted　into　bone；　and　for　a　long　time　this　specimen　was　the　leading　curiosity　of　the　Dublin　Museum。　In　the　Isle　of　Man；　some　years　ago；　there　was　a　case　of　ossification　which　continued　progressively　for　many　years。　Before　death　this　man　was　reduced　to　almost　a　solid　mass　of　bony　substance。　With　the　exception　of　one　or　two　toes　his　entire　frame　was　solidified。　He　was　buried　in　Kirk　Andreas　Churchyard；　and　his　grave　was　strictly　guarded　against　medical　men　by　his　friends；　but　the　body　was　finally　secured　and　taken　to　Dublin　by　Dr。　McCartney。　

Calculi。In　reviewing　the　statistics　of　vesical　calculi；　the　strangest　anomalies　in　their　size　and　weight　have　been　noticed。　Among　the　older　writers　the　largest　weights　have　been　found。　Le　Cat　speaks　of　a　calculus　weighing　over　three　pounds；　and　Morand　is　accredited　with　having　seen　a　calculus　which　weighed　six　pounds。　In　his　statistics　in　1883　Cross　collected　reports　on　704　stones；　and　remarked　that　only　nine　of　these　weighed　above　four　ounces；　and　only　two　above　six；　and　that　with　the　last　two　the　patient　succumbed。　Of　those　removed　successfully　Harmer　of　Norwich　reports　one　of　15　ounces；　Kline；　one　of　13　ounces　30　grains；　Mayo　of　Winchester；　14　ounces　two　drams；　Cheselden；　12　ounces；　and　Pare　in　1570　removed　a　calculus　weighing　nine　ounces。　Sir　Astley　Cooper　remarks　that　the　largest　stone　he　ever　saw　weighed　four　ounces；　and　that　the　patient　died　within　four　hours　after　its　removal。　Before　the　Royal　Society　of　London　in　1684　Birch　reported　an　account　of　a　calculus　weighing　five　ounces。　Fabricius　Hildanus　mentions　calculi　weighing　20　and　21　ounces；　Camper；　13　ounces；　Foschini；　19　ounces　six　drams；　Garmannus；　25　ounces；　Greenfield；　19　ounces；　Heberden；　32　ounces；　Wrisberg；　20　ounces；　Launai；　51　ounces；　Lemery；　27　ounces；　Paget；　in　Kuhn's　Journal；　27　ounces　（from　a　woman）；　Pauli；　19　ounces；　Rudolphi；　28　ounces；　Tozzetti；　39　ounces；　Threpland；　35　ounces；　and　there　is　a　record　of　a　calculus　weighing　over　six　pounds。　There　is　preserved　in　Trinity　College；　Cambridge；　a　stone　weighing　34　ounces　taken　from　the　bladder　of　the　wife　of　Thomas　Raisin；　by　Gutteridge；　a　surgeon　of　Norwich。　This　stone　was　afterward　sent　to　King　Charles　II　for　inspection。　In　his　〃Journey　to　Paris〃　Dr。　Lister　said　that　he　saw　a　stone　which　weighed　51　ounces；　it　had　been　taken　from　one　of　the　religious　brothers　in　June；　1690；　and　placed　in　the　Hopital　de　la　Charite。　It　was　said　that　the　monk　died　after　the　operation。　There　is　a　record　of　a　calculus　taken　from　the　bladder　of　an　individual　living　in　Aberdeen。　This　stone　weighed　two　pounds；　three　ounces；　and　six　drams。　In　the　Hunterian　Museum　in　London　there　is　a　stone　weighing　44　ounces；　and　measuring　16　inches　in　circumference。　By　suprapubic　operation　Duguise　removed　a　stone　weighing　31　ounces　from　a　patient　who　survived　six　days。　A　Belgian　surgeon　by　the　name　of　Uytterhoeven；　by　the　suprapubic　method　extracted　a　concretion　weighing　two　pounds　and　measuring　6　1/2　inches　long　and　four　wide。　Frere　Come　performed　a　high　operation　on　a　patient　who　died　the　next　day　after　the　removal　of　a　24…ounce　calculus。　Verduc　mentions　a　calculus　weighing　three　pounds　three　ounces。　It　was　said　that　a　vesical　calculus　was　seen　in　a　dead　boy　at　St。　Edmund's　which　was　as　large　as　the　head　of　a　new…born　child。　It　has　been　remarked　that　Thomas　Adams；　Lord　Mayor　of　London；　who　died　at　the　age　of　eighty…two；　had　in　his　bladder　at　the　time　of　his　death　a　stone　which　filled　the　whole　cavity；　and　which　was　grooved　from　the　ureters　to　the　urethral　opening；　thus　allowing　the　passage　of　urine。　Recent　records　of　large　calculi　are　offered：　by　Holmes；　25　ounces；　Hunter；　25　ounces；　Cayley；　29　ounces；　Humphrys；　33　ounces；　Eve；　44　ounces；　and　Janeway；　51　ounces。　Kirby　has　collected　reports　ol　a　number　of　large　vesical　calculi。

Barton　speaks　of　stone　in　the　bladder　in　very　young　children。　There　is　a　record　of　a　stone　at　one　month；　and　another　at　three　years。　Todd　describes　a　stone　in　the　bladder　of　a　child　of　sixteen　months。　May　removed　an　enormous　stone　from　a　young　girl；　which