anomalies and curiosities of medicine-第198部分

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ved　an　enormous　stone　from　a　young　girl；　which　had　its　nucleus　in　a　brass　penholder　over　three　inches　long。

Multiple　Vesical　Calculi。Usually　the　bladder　contains　a　single　calculus；　but　in　a　few　instances　a　large　number　of　stones　have　been　found　to　coexist。　According　to　Ashhurst；　the　most　remarkable　case　on　record　is　that　of　the　aged　Chief　Justice　Marshal；　from　whose　bladder　Dr。　Physick　of　Philadelphia　is　said　to　have　successfully　removed　by　lateral　lithotomy　more　than　1000　calculi。　Macgregor　mentions　a　case　in　which　520　small　calculi　coexisted　with　a　large　one　weighing　51　ounces。　There　is　an　old　record　of　32　stones　having　been　removed　from　a　man　of　eighty…one；　a　native　of　Dantzic；　16　of　which　were　as　large　as　a　pigeon's　egg。　Kelly　speaks　of　228　calculi　in　the　bladder　of　a　man　of　seventy…three；　12　being　removed　before　death。　The　largest　weighed　111　grains。　Goodrich　took　96　small　stones　from　the　bladder　of　a　lad。　Among　the　older　records　of　numerous　calculi　Burnett　mentions　70；　Desault；　over　200；　the　Ephemerides；　120；　Weickman；　over　100；　Fabricius　Hildanus；　2000　in　two　years；　and　there　is　a　remarkable　case　of　10；000　in　all　issuing　from　a　young　girl。　Greenhow　mentions　60　stones　removed　from　the　bladder。　An　older　issue　of　The　Lancet　contains　an　account　of　lithotrity　performed　on　the　same　patient　48　times。

Occasionally　the　calculi　are　discharged　spontaneously。　Trioen　mentions　the　issue　of　a　calculus　through　a　perineal　aperture；　and　there　are　many　similar　cases　on　record。　There　is　an　old　record　of　a　stone　weighing　five　ounces　being　passed　by　the　penis。　Schenck　mentions　a　calculus　perforating　the　bladder　and　lodging　in　the　groin。　Simmons　reports　a　case　in　which　a　calculus　passed　through　a　fistulous　sore　in　the　loins　without　any　concomitant　passage　of　urine　through　the　same　passage。　Vosberg　mentions　a　calculus　in　a　patent　urachus；　and　calculi　have　occasionally　been　known　to　pass　from　the　umbilicus。　Gourges　mentions　the　spontaneous　excretion　of　a　five…ounce　calculus；　and　Thompson　speaks　of　the　discharge　of　two　calculi　of　enormous　size。

Of　the　extravesical　calculi　some　are　true　calculi；　while　others　are　simply　the　result　of　calcareous　or　osseous　degeneration。　Renal　and　biliary　calculi　are　too　common　to　need　mention　here。　There　are　some　extraordinary　calculi　taken　from　a　patient　at　St。　Bartholomew's　Hospital　and　deposited　in　the　museum　of　that　institution。　The　patient　was　a　man　of　thirty…eight。　In　the　right　kidney　were　found　a　calculus　weighing　36　1/2　ounces；　about　1000　small　calculi；　and　a　quantity　of　calcareous　dust。　In　the　left　kidney　there　was　a　calculus　weighing　9　3/4　ounces；　besides　a　quantity　of　calcareous　dust。　The　calculi　in　this　case　consisted　chiefly　of　phosphate　of　magnesium　and　ammonium。　Cordier　of　Kansas　City；　Mo。；　successfully　removed　a　renal　calculus　weighing　over　three　ounces　from　a　woman　of　forty…two。　The　accompanying　illustration　shows　the　actual　size　of　the　calculus。

At　the　University　College　Hospital；　London；　there　are　exhibited　485　gall…stones　that　were　found　postmortem　in　a　gall…bladder。　Vanzetti　reports　the　removal　of　a　preputial　calculus　weighing　224　grams。　Phillipe　mentions　the　removal　of　a　calculus　weighing　50　grams　from　the　prepuce　of　an　Arab　boy　of　seven。　Croft　gives　an　account　of　some　preputial　calculi　removed　from　two　natives　of　the　Solomon　Islands　by　an　emigrant　medical　officer　in　Fiji。　In　one　case　22　small　stones　were　removed；　and　in　the　other　a　single　calculus　weighing　one　ounce　110　grains。　Congenital　phimosis　is　said　to　be　very　common　among　the　natives　of　Solomon　Islands。

In　September；　1695；　Bernard　removed　two　stones　from　the　meatus　urinarius　of　a　man；　after　a　lodgment　of　twenty　years。　Block　mentions　a　similar　case；　in　which　the　lodgment　had　lasted　twenty…eight　years。　Walton　speaks　of　a　urethral　calculus　gradually　increasing　in　size　for　fifty　years。　Ashburn　shows　what　he　considers　the　largest　calculus　ever　removed　from　the　urethra。　It　was　2　1/8　inches　long；　and　1　1/4　inches　in　diameter；　it　was　white　on　the　outside；　very　hard；　and　was　shaped　and　looked　much　like　a　potato。　Its　dry　weight　was　660　grains。　At　one　end　was　a　polished　surface　that　corresponded　with　a　similar　surface　on　a　smaller　stone　that　lay　against　it；　the　latter　calculus　was　shaped　like　a　lima　bean；　and　weighed　60　grains。　Hunt　speaks　of　eight　calculi　removed　from　the　urethra　of　a　boy　of　five。　Herman　and　the　Ephemerides　mention　cases　of　calculi　in　the　seminal　vesicles。

Calcareous　degeneration　is　seen　in　the　ovary；　and　Peterman　speaks　of　a　stone　in　the　ovary。　Uterine　calculi　are　described　by　Cuevas　and　Harlow；　the　latter　mentions　that　the　calculus　he　saw　was　egg…shaped。　There　is　an　old　chronicle　of　a　stone　taken　from　the　womb　of　a　woman　near　Trent；　Somersetshire；　at　Easter；　1666；　that　weighed　four　ounces。　The　Ephemerides　speaks　of　a　calculus　coming　away　with　the　menstrual　fluid。

Stones　in　the　heart　are　mentioned　by　medical　writers；　and　it　is　said　that　two　stones　as　large　as　almonds　were　found　in　the　heart　of　the　Earl　of　Balcarres。

Morand　speaks　of　a　calculus　ejected　from　the　mouth　by　a　woman。

An　old　record　says　that　stones　in　the　brain　sometimes　are　the　cause　of　convulsions。　D'Hericourt　reports　the　case　of　a　girl　who　died　after　six　months'　suffering；　whose　pineal　gland　was　found　petrified；　and　the　incredible　size　of　a　chicken's　egg。　Blasius；　Diemerbroeck；　and　the　Ephemerides；　speak　of　stones　in　the　location　of　the　pineal　gland。

Salivary　calculi　are　well　known；　they　may　lodge　in　any　of　the　buccal　ducts。　There　is　a　record　of　the　case　of　a　man　of　thirty…seven　who　suffered　great　pain　and　profuse　salivation。　It　was　found　that　he　had　a　stone　as　large　as　a　pigeon's　egg　under　his　tongue。

Umbilical　calculi　are　sometimes　seen；　and　Deani　reports　such　a　case。　There　is　a　French　record）　of　a　case　of　exstrophy　of　the　umbilicus；　attended　with　abnormal　concretions。

Aetius；　Marcellus　Donatus；　Scaliger；　and　Schenck　mention　calculi　of　the　eyelids。

There　are　some　extraordinary　cases　of　retention　and　suppression　of　urine　on　record。　Actual　retention　of　urine；　that　is；　urinary　secretion　passed　into　the　bladder；　but　retention　in　the　latter　viscus　by　inanition；　stricture；　or　other　obstruction；　naturally　cannot　continue　any　great　length　of　time　without　mechanically　rupturing　the　vesical　walls；　but　suppression　of　urine　or　absolute　anuria　may　last　an　astonishingly　extended　period。　Of　the　cases　of　retention　of　urine；　Fereol　mentions　that　of　a　man　of　forty…nine　who　suffered　absolute　retention　of　urine　for　eight　days；　caused　by　the　obstruction　of　a　uric　acid　calculus。　Cunyghame　reports　a　ease　of　mechanic　obstruction　of　the　flow　of　urine　for　eleven　days。　Trapenard　speaks　of　retention　of　urine　for　seven　days。　Among　the　older　writers　Bartholinus　mentions　ischuria　lasting　fourteen　days；　Cornarius；　fourteen　days；　Rhoclius；　fifteen　days；　the　Ephemerides；　ten；　eleven；　and　twelve　days。　Croom　notes　a　case　of　retention　of　urine　from　laceration　of　the　vagina　during　first　coitus。　Foucard　reports　a　case　of　retention　of　urine　in　a　young　girl　of　nineteen；　due　to　accumulation　of　the　menstrual　fluid　behind　an　imperforate　hymen。

The　accumulation　of　urine　in　cases　of　ischuria　is　sometimes　quite　excessive。　De　Vilde　speaks　of　16　pints　being　drawn　off。　Mazoni　cites　a　case　in　which　15　pounds　of　urine　were　retained；　and　Wilson　mentions　16　pounds　of　urine　being　drawn　off。　Frank　reports　instances　in　which　both　12　and　30　pounds　of　urine　were　evacuated。　There　is　a　record　at　the　beginning　of　this　century　in　which　it　is　stated　that　31　pounds　of　urine　were　evacuated　in　a　case　of　ischuria。

Following　some　toxic　or　thermic　disturbance；　or　in　diseased　kidneys；　suppression　of　urine　is　quite　frequently　noticed。　The　older　writers　report　some　remarkable　instances：　Haller　mentions　a　case　lasting　twenty…two　weeks；　Domonceau；　six　months；　and　Marcellus　Donatus；　six　months。

Whitelaw　describes　a　boy　of　eight　who；　after　an　attack　of　scarlet　fever；　did　not　pass　a　single　drop　of　urine　from　December　7th　to　December　20th　when　two　ounces　issued；　after　vesication　over　the　kidneys。　On　January　2d　two　ounces　more　were　evacuated；　and　no　more　was　passed　until　the　bowel　acted　regularly。　On　January　5th　a　whole　pint　of　urine　passed；　after　that　the　kidneys　acted　normally　and　the　boy　recovered。　It　would　be　no　exaggeration　to　state　that　this　case　lasted　from　December　5th　to　January　5th；　for　the　evacuations　during　this　period　were　so　slight　as　to　be　hardly　worthy　of　mention。

Lemery　reports　observation　of　a　monk　who　during　eight　years　vomited　periodically　instead　of　urinating　in　a　natural　way。　Five　hours　before　vomiting　he　experienced　a　strong　pain　in　the　kidneys。　The　vomitus　was　of　dark…red　color；　and　had　the　odor　of　urine。　He　ate　little；　but　drank　wine　copiously；　and　stated　that　the　vomiting　was　salutary　to　him；　as　he　suffered　more　when　he　missed　it。

Bryce　records　a　case　of　anuria　of　seventeen　days'　standing。　Butler　speaks　of　an　individual　with　a　single　kidney　who　suffered　suppression　of　urine　for　thirteen　days；　caused　by　occlusion　of　the　ureter　by　an　inspissated　thrombus。　Dubuc　observed　a　case　of　anuria　which　continued　for　seventeen　days　before　the　fatal　issue。　Fontaine　reports　a　case　of　suppression　of　urine　for　twenty…five　days。　Nunneley　showed　the　kidneys　of　a　woman　who　did　not　secrete　any　urine　for　a　period　of　twelve　days；　and　during　this　time　she　had　not　exhibited　any　of　the　usual　symptoms　of　uremia。　Peebles　mentions　a　case　of　suspension　of　the　functions　of　the　kidneys　more　than　once　for　five　weeks；　the　patient　exhibiting　neither　coma；　stupor；　nor　vomiting。　Oke　speaks　of　total　suppression　of　urine　during　seven　days；　with　complete　recovery；　and　Paxon　mentions　a　case　in　a　child　that　recovered　after　five　days'　suppression。　Russell　reports　a　case　of　complete　obstructive　suppression　for　twenty　days　followed　by　complete　recovery。　Scott　and　Shroff　mention　recovery　after　nine　days'　suppression。

The　most　persistent　constipation　may　exist　for　weeks；　or　even　months；　with　fair　health。　The　fact　seemed　to　be　a　subject　of　much　interest　to　the　older　writers。　De　Cabalis　mentions　constipation　lasting　thirty…seven　days；　Caldani；　sixty…five　days；　Lecheverel；　thirty…four　days；　and　Pomma；　eight　months；　Sylvaticus；　thirty　months；　Baillie；　fifteen　weeks；　Blanchard；　six　weeks；　Smetius；　five　mouths；　Trioen；　three　mo