anomalies and curiosities of medicine-第223部分

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　a　peculiar　fact　was　that　if　given　white　gloves　he　would　carefully　put　them　on　and　commence　a　pantomime　of　the　actions　of　a　singer；　looking　over　his　music；　bowing；　assuming　his　position；　and　then　singing。

It　is　particularly　in　hypnotic　subjects　that　manifestations　of　automatism　are　most　marked。　At　the　suggestion　of　battle　an　imaginary　struggle　at　once　begins；　or　if　some　person　present　is　suggested　as　an　enemy　the　fight　is　continued；　the　hypnotic　taking　care　not　to　strike　the　person　in　question。　Moll　conceded　that　this　looked　like　simulation；　but　repetition　of　such　experiments　forced　him　to　conclude　that　these　were　real；　typical　hypnoses；　in　which；　in　spite　of　the　sense…delusions；　there　was　a　dim；　dreamy　consciousness　existing；　which　influenced　the　actions　of　the　subject；　and　which　prevented　him　from　striking　at　a　human　being；　although　hitting　at　an　imaginary　object。　Many　may　regard　this　behavior　of　hypnotics　as　pure　automatism；　and　Moll　adds　that；　as　when　walking　in　the　street　while　reading　we　automatically　avoid　knocking　passers…by；　so　the　hypnotic　avoids　hitting　another　person；　although　he　is　dimly　or　not　at　all　aware　of　his　existence。

Gibbs　reports　a　curious　case　of　lack　of　integrity　of　the　will　in　a　man　of　fifty…five。　When　he　had　once　started　on　a　certain　labor　he　seemed　to　have　no　power　to　stop　the　muscular　exercise　that　the　task　called　forth。　If　he　went　to　the　barn　to　throw　down　a　forkful　of　hay；　he　would　never　stop　until　the　hay　was　exhausted　or　someone　came　to　his　rescue。　If　sent　to　the　wood…pile　for　a　handful　of　wood；　he　would　continue　to　bring　in　wood　until　the　pile　was　exhausted　or　the　room　was　full。　On　all　occasions　his　automatic　movements　could　only　be　stopped　by　force。

At　a　meeting　in　Breslau　Meschede　rendered　an　account　of　a　man　who　suffered　from　simple　misdirection　of　movement　without　any　mental　derangement。　If　from　his　own　desire；　or　by　direction　of　others；　he　wanted　to　attempt　any　muscular　movement；　his　muscles　performed　the　exact　opposite　to　his　inclinations。　If　he　desired　to　look　to　the　right；　his　eyes　involuntarily　moved　to　the　left。　In　this　case　the　movement　was　not　involuntary；　as　the　muscles　were　quiet　except　when　called　to　action　by　the　will；　and　then　they　moved　to　the　opposite。

Presentiment；　or　divination　of　approaching　death；　appearing　to　be　a　hypothetic　allegation；　has　been　established　as　a　strong　factor　in　the　production　of　a　fatal　issue　in　many　cases　in　which　there　was　every　hope　for　a　recovery。　In　fact　several　physicians　have　mentioned　with　dread　the　peculiar　obstinacy　of　such　presentiment。　Hippocrates；　Romanus；　Moller；　Richter；　Jordani；　and　other　older　writers　speak　of　it。　Montgomery　reports　a　remarkable　case　of　a　woman　suffering　from　carcinoma　of　the　uterus。　He　saw　her　on　October　6；　1847；　when　she　told　him　she　had　a　strong　presentiment　of　death　on　October　28th。　She　stated　that　she　had　been　born　on　that　day；　her　first　husband　had　died　on　October　28th；　and　she　had　married　her　second　husband　on　that　day。　On　October　27th　her　pulse　began　to　fail；　she　fell　into　a　state　of　extreme　prostration；　and　at　noon　on　the　28th　she　died。　In　substantiation　of　the　possibility　of　the　influence　of　presentiment　Montgomery　cites　another　case　in　which　he　was　called　at　an　early　hour　to　visit　a　lady；　the　mother　of　several　children。　He　found　her　apparently　much　agitated　and　distressed；　and　in　great　nervous　excitement　over　a　dream　she　had　had；　in　which　she　saw　a　handsome　monument　erected　by　some　children　to　their　mother。　She　had　awakened　and　became　dreadfully　apprehensive；　she　could　not　tell　as　to　what。　The　uneasiness　and　depression　continued；　her　pulse　continued　to　grow　weak；　and　she　died　at　twelve　that　night　without　a　struggle。　Andrews　has　made　several　observations　on　this　subject；　and　concludes　that　presentiment　of　death　is　a　dangerous　symptom；　and　one　which　should　never　be　overlooked。　One　of　his　cases　was　in　a　man　with　a　fractured　leg　in　the　Mercy　Hospital　at　Pittsburg。　The　patient　was　in　good　health；　but　one　day　he　became　possessed　of　a　cool；　quiet；　and　perfectly　clear　impression　that　he　was　about　to　die。　Struck　with　his　conviction；　Andrews　examined　his　pulse　and　general　condition　minutely；　and　assured　the　patient　there　was　not　the　slightest　ground　for　apprehension。　But　he　persisted；　and　was　attacked　by　pneumonia　three　days　later　which　brought　him　to　the　verge　of　the　grave；　although　he　ultimately　recovered。　In　another　instance　a　young　man　of　ruddy　complexion　and　apparent　good　health；　after　an　operation　for　varicocele；　had　a　very　clear　impression　that　he　would　die。　Careful　examination　showed　no　reason　for　apprehension。　After　five　or　six　days　of　encouragement　and　assurance；　he　appeared　to　be　convinced　that　his　reasoning　was　foolish；　and　he　gave　up　the　idea　of　death。　About　the　ninth　day　the　wound　presented　a　healthy；　rosy　appearance；　and　as　the　patient　was　cheerful　he　was　allowed　to　leave　his　bed。　After　a　few　hours　the　nurse　heard　the　noise　of　labored　breathing；　and　on　investigation　found　the　patient　apparently　in　a　dying　condition。　He　was　given　stimulants　and　regained　consciousness；　but　again　relapsed；　and　died　in　a　few　moments。　At　the　necropsy　the　heart　was　found　healthy；　but　there　were　two　or　three　spots　of　extravasated　blood　in　the　brain；　and　evidences　of　cerebral　congestion。　Vos　remarks　that　he　remembers　a　case　he　had　when　dressing　for　Mr。　Holden　at　St。　Bartholomew's　Hospital：　〃A　man　who　had　been　intemperate　was　rolling　a　sod　of　grass；　and　got　some　grit　into　his　left　palm。　It　inflamed；　he　put　on　hot　cow…dung　poultices　by　the　advice　of　some　country　friends。　He　was　admitted　with　a　dreadfully　swollen　hand。　It　was　opened；　but　the　phlegmonous　process　spread　up　to　the　shoulder；　and　it　was　opened　in　many　places；　and　at　last；　under　chloroform；　the　limb　was　amputated　below　the　joint。　The　stump　sloughed；　and　pus　pointing　at　the　back　of　the　neck；　an　opening　was　again　made。　He　became　in　such　a　weak　state　that　chloroform　could　not　be　administered；　and　one　morning　he　had　such　a　dread　of　more　incisions　that；　saying　to　us　all　standing　round　his　bed；　'I　can　bear　it　no　more；　I　must　now　die；'　he　actually　did　die　in　a　few　minutes　in　our　presence。　His　was　the　last　arm　that　Mr。　Holden　ever　amputated　at　St。　Bartholomew's。〃


CHAPTER　XVIII。

HISTORIC　EPIDEMICS。

A　short　history　of　the　principal　epidemics；　including　as　it　does　the　description　of　anomalous　diseases；　many　of　which　are　now　extinct；　and　the　valuable　knowledge　which　finally　led　to　their　extinction；　the　extraordinary　mortalities　which　these　epidemics　caused；　and　many　other　associate　points　of　interest　would　seem　fitting　to　close　the　observations　gathered　in　this　volume。　As　the　illustrious　Hecker　says；　in　the　history　of　every　epidemic；　from　the　earliest　times；　the　spirit　of　inquiry　was　always　aroused　to　learn　the　machinery　of　such　stupendous　engines　of　destruction；　and　even　in　the　earliest　times　there　was　neither　deficiency　in　courage　nor　in　zeal　for　investigation。　〃When　the　glandular　plague　first　made　its　appearance　as　a　universal　epidemic；　whilst　the　more　pusillanimous；　haunted　by　visionary　fears；　shut　themselves　up　in　their　closets；　some　physicians　at　Constantinople；　astonished　at　the　phenomena　opened　the　boils　of　the　deceased。　The　like　has　occurred　both　in　ancient　and　modern　times；　not　without　favorable　results　for　Science；　nay；　more　mature　views　excited　an　eager　desire　to　become　acquainted　with　similar　or　still　greater　visitations　among　the　ancients；　but；　as　later　ages　have　always　been　fond　of　referring　to　Grecian　antiquity；　the　learned　of　those　times；　from　a　partial　and　meagre　predilection；　were　contented　with　the　descriptions　of　Thucydides；　even　where　nature　had　revealed；　in　infinite　diversity；　the　workings　of　her　powers。〃

There　cannot　but　be　a　natural　interest　in　every　medical　mind　to…day　in　the　few　descriptions　given　of　the　awful　ravages　of　the　epidemics　which；　fortunately；　in　our　enlightened　sanitary　era；　have　entirely　disappeared。　In　the　history　of　such　epidemics　the　name　of　Hecker　stands　out　so　prominently　that　any　remarks　on　this　subject　must　necessarily；　in　some　measure；　find　their　origin　in　his　writings；　which　include　exhaustive　histories　of　the　black　death；　the　dancing　mania；　and　the　sweating　sickness。　Few　historians　have　considered　worthy　of　more　than　a　passing　note　an　event　of　such　magnitude　as　the　black　death；　which　destroyed　millions　of　the　human　race　in　the　fourteenth　century　and　was　particularly　dreadful　in　England。　Hume　has　given　but　a　single　paragraph　to　it　and　others　have　been　equally　brief。　Defoe　has　given　us　a　journal　of　the　plague；　but　it　is　not　written　in　a　true　scientific　spirit；　and　Caius；　in　1562；　gave　us　a　primitive　treatise　on　the　sweating　sickness。　It　is　due　to　the　translation　of　Hecker's　〃Epidemics　of　the　Middle　Ages〃　by　Babbington；　made　possible　through　the　good　offices　of　the　Sydenham　Society；　that　a　major　part　of　the　knowledge　on　this　subject　of　the　English…reading　populace　has　been　derived。

The　Black　Death；　or；　as　it　has　been　known；　the　Oriental　plague；　the　bubonic　plague；　or　in　England；　simply　the　plague；　and　in　Italy；　〃la　Mortalega〃　（the　great　mortality）　derived　its　name　from　the　Orient；　its　inflammatory　boils；　tumors　of　the　glands；　and　black　spots；　indicative　of　putrid　decomposition；　were　such　as　have　been　seen　in　no　other　febrile　disease。　All　the　symptoms　were　not　found　in　every　case；　and　in　many　cases　one　symptom　alone　preceded　death。　Although　afflicted　with　all　the　manifestations　of　the　plague；　some　patients　recovered。　According　to　Hecker　the　symptoms　of　cephalic　affliction　were　seen；　many　patients　were　stupefied　and　fell　into　a　deep　sleep；　or　became　speechless　from　palsy　of　the　tongue；　while　others　remained　sleepless　and　without　rest。　The　fauces　and　tongue　were　black　and　as　if　suffused　with　blood；　no　beverage　could　assuage　the　burning　thirst；　so　that　suffering　continued　without　alleviation　until　death；　which　many　in　their　despair　accelerated　with　their　own　hands。　Contagion　was　evident；　for　attendants　caught　the　disease　from　their　parents　and　friends；　and　many　houses　were　emptied　of　their　inhabitants。　In　the　fourteenth　century　this　affection　caused　still　deeper　sufferings；　such　as　had　not　been　hitherto　experienced。　The　organs　of　respiration　became　the　seats　of　a　putrid　inflammation；　blood　was　expectorated；　and　the　breath　posse