anomalies and curiosities of medicine-第26部分

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f　urine　as　provocative　of　abortion；　Sulzberger；　Meyer；　and　Albertus　all　mention　odors；　and　Vesti　gives　as　a　plausible　cause　the　odor　of　carbonic　vapor。　The　Ephemerides　mentions　singultus　as　a　cause　of　abortion。　Mauriceau；　Pelargus；　and　Valentini　mention　coughing。　Hippocrates　mentions　the　case　of　a　woman　who　induced　abortion　by　calling　excessively　loud　to　some　one。　Fabrieius　Hildanus　speaks　of　abortion　following　a　kick　in　the　region　of　the　coccyx。　Gullmannus　speaks　of　an　abortion　which　he　attributes　to　the　woman's　constant　neglect　to　answer　the　calls　of　nature；　the　rectum　being　at　all　times　in　a　state　of　irritation　from　her　negligence。　Hawley　mentions　abortion　at　the　fourth　or　fifth　month　due　to　the　absorption　of　spirits　of　turpentine。　Solingen　speaks　of　abortion　produced　by　sneezing。　Osiander　cites　an　instance　in　which　a　woman　suddenly　arose；　and　in　doing　so　jolted　herself　so　severely　that　she　produced　abortion。　Hippocrates　speaks　of　extreme　hunger　as　a　cause　of　abortion。　Treuner　speaks　of　great　anger　and　wrath　in　a　woman　disturbing　her　to　the　extent　of　producing　abortion。

The　causes　that　are　observed　every　day；　such　tight　lacing；　excessive　venery；　fright；　and　emotions；　are　too　well　known　to　be　discussed　here。

There　has　been　reported　a　recent　case　of　abortion　following　a　viper…bite；　and　analogues　may　be　found　in　the　writings　of　Severinus　and　Oedman；　who　mention　viper…bites　as　the　cause；　but　there　are　so　many　associate　conditions　accompanying　a　snake…bite；　such　as　fright；　treatment；　etc。；　any　one　of　which　could　be　a　cause　in　itself；　that　this　is　by　no　means　a　reliable　explanation。　Information　from　India　an　this　subject　would　be　quite　valuable。

The　Ephemerides　speak　of　bloodless　abortion；　and　there　have　been　modern　instances　in　which　the　hemorrhage　has　been　hardly　noticeable。

Abortion　in　a　twin　pregnancy　does　not　necessarily　mean　the　abortion　or　death　of　both　the　products　of　conception。　Chapman　speaks　of　the　case　of　the　expulsion　of　a　blighted　fetus　at　the　seventh　month；　the　living　child　remaining　to　the　full　term；　and　being　safely　delivered；　the　placenta　following。　Crisp　says　of　a　case　of　labor　that　the　head　of　the　child　was　obstructed　by　a　round　body；　the　nature　of　which　he　was　for　some　time　unable　to　determine。　He　managed　to　push　the　obstructing　body　up　and　delivered　a　living；　full…term　child；　this　was　soon　followed　by　a　blighted　fetus；　which　was　11　inches　long；　weighed　12　ounces；　with　a　placenta　attached　weighing　6　1/2　ounces。　It　is　quite　common　for　a　blighted　fetus　to　be　retained　and　expelled　at　term　with　a　living　child；　its　twin。

Bacon　speaks　of　twin　pregnancy；　with　the　death　of　one　fetus　at　the　fourth　month　and　the　other　delivered　at　term。　Beall　reports　the　conception　of　twins；　with　one　fetus　expelled　and　the　other　retained；　Beauchamp　cites　a　similar　instance。　Bothwell　describes　a　twin　labor　at　term；　in　which　one　child　was　living　and　the　other　dead　at　the　fifth　month　and　macerated。　Belt　reports　an　analogous　case。　Jameson　gives　the　history　of　an　extraordinary　case　of　twins　in　which　one　（dead）　child　was　retained　in　the　womb　for　forty…nine　weeks；　the　other　having　been　born　alive　at　the　expiration　of　nine　months。　Hamilton　describes　a　case　of　twins　in　which　one　fetus　died　from　the　effects　of　an　injury　between　the　fourth　and　fifth　months　and　the　second　arrived　at　full　period。　Moore　cites　an　instance　in　which　one　of　the　fetuses　perished　about　the　third　month；　but　was　not　expelled　until　the　seventh；　and　the　other　was　carried　to　full　term。　Wilson　speaks　of　a　secondary　or　blighted　fetus　of　the　third　month　with　fatty　degeneration　of　the　membranes　retained　and　expelled　with　its　living　twin　at　the　eighth　month　of　uterogestation。

There　was　a　case　at　Riga　in　1839　of　a　robust　girl　who　conceived　in　February；　and　in　consequence　her　menses　ceased。　In　June　she　aborted；　but；　to　her　dismay；　soon　afterward　the　symptoms　of　advanced　pregnancy　appeared；　and　in　November　a　full…grown　child；　doubtless　the　result　of　the　same　impregnation　as　the　fetus；　was　expelled　at　the　fourth　month。　In　1860　Schuh　reported　an　instance　before　the　Vienna　Faculty　of　Medicine　in　which　a　fetus　was　discharged　at　the　third　month　of　pregnancy　and　the　other　twin　retained　until　full　term。　The　abortion　was　attended　with　much　metrorrhagia；　and　ten　weeks　afterward　the　movements　of　the　other　child　could　be　plainly　felt　and　pregnancy　continued　its　course　uninterrupted。　Bates　mentions　a　twin　pregnancy　in　which　an　abortion　took　place　at　the　second　month　and　was　followed　by　a　natural　birth　at　full　term。　Hawkins　gives　a　case　of　miscarriage；　followed　by　a　natural　birth　at　full　term；　and　Newnham　cites　a　similar　instance　in　which　there　was　a　miscarriage　at　the　seventh　month　and　a　birth　at　full　term。

Worms　in　the　Uterus。Haines　speaks　of　a　most　curious　casethat　of　a　woman　who　had　had　a　miscarriage　three　days　previous；　she　suffered　intense　pain　and　a　fetid　discharge。　A　number　of　maggots　were　seen　in　the　vagina；　and　the　next　day　a　mass　about　the　size　of　an　orange　came　away　from　the　uterus；　riddled　with　holes；　and　which　contained　a　number　of　dead　maggots；　killed　by　the　carbolic　acid　injection　given　soon　after　the　miscarriage。　The　fact　seems　inexplicable；　but　after　their　expulsion　the　symptoms　immediately　ameliorated。　This　case　recalls　a　somewhat　similar　one　given　by　the　older　writers；　in　which　a　fetus　was　eaten　by　a　worm。　Analogous　are　those　cases　spoken　of　by　Bidel　of　lumbricoides　found　in　the　uterus；　by　Hole；　in　which　maggots　were　found　in　the　vagina　and　uterus；　and　Simpson；　in　which　the　abortion　was　caused　by　worms　in　the　wombif　the　associate　symptoms　were　trustworthy。

We　can　find　fabulous　parallels　to　all　of　these　in　some　of　the　older　writings。　Pare　mentions　Lycosthenes'　account　of　a　woman　in　Cracovia　in　1494　who　bore　a　dead　child　which　had　attached　to　its　back　a　live　serpent；　which　had　gnawed　it　to　death。　He　gives　an　illustration　showing　the　serpent　in　situ。　He　also　quotes　the　case　of　a　woman　who　conceived　by　a　mariner；　and　who；　after　nine　months；　was　delivered　by　a　midwife　of　a　shapeless　mass；　followed　by　an　animal　with　a　long　neck；　blazing　eyes；　and　clawed　feet。　Ballantyne　says　that　in　the　writings　of　Hippocrates　there　is　in　the　work　on　〃Diseases〃；　which　is　not　usually　regarded　as　genuine；　a　some　what　curious　statement　with　regard　to　worms　in　the　fetus。　It　is　affirmed　that　flat　worms　develop　in　the　unborn　infant；　and　the　reason　given　is　that　the　feces　are　expelled　so　soon　after　birth　that　there　would　not　be　sufficient　time　during　extrauterine　life　for　the　formation　of　creatures　of　such　a　size。　The　same　remark　applies　to　round　worms。　The　proof　of　these　statements　is　to　be　found　in　the　fact　that　many　infants　expel　both　these　varieties　of　parasites　with　the　first　stool。　It　is　difficult　to　know　what　to　make　of　these　opinions；　for；　with　the　exception　of　certain　cases　in　some　of　the　seventeenth　and　eighteenth　century　writers；　there　are　no　records　in　medicine　of　the　occurrence　of　vermes　in　the　infant　at　birth。　It　is　possible　that　other　things；　such　as　dried　pieces　of　mucus；　may　have　been　erroneously　regarded　as　worms。



CHAPTER　III。

OBSTETRIC　ANOMALIES。

General　Considerations。In　discussing　obstetric　anomalies　we　shall　first　consider　those　strange　instances　in　which　stages　of　parturition　are　unconscious　and　for　some　curious　reason　the　pains　of　labor　absent。　Some　women　are　anatomically　constituted　in　a　manner　favorable　to　child…birth；　and　pass　through　the　experience　in　a　comparatively　easy　manner；　but　to　the　great　majority　the　throes　of　labor　are　anticipated　with　extreme　dread；　particularly　by　the　victims　of　the　present　fashion　of　tight　lacing。

It　seems　strange　that　a　physiologic　process　like　parturition　should　be　attended　by　so　much　pain　and　difficulty。　Savages　in　their　primitive　and　natural　state　seem　to　have　difficulty　in　many　cases；　and　even　animals　are　not　free　from　it。　We　read　of　the　ancient　wild　Irish　women　breaking　the　pubic　bones　of　their　female　children　shortly　after　birth；　and　by　some　means　preventing　union　subsequently；　in　order　that　these　might　have　less　trouble　in　child…birthas　it　were；　a　modified　and　early　form　of　symphysiotomy。　In　consequence　of　this　custom　the　females　of　this　race；　to　quote　an　old　English　authority；　had　a　〃waddling；　lamish　gesture　in　their　going。〃　These　old　writers　said　that　for　the　same　reason　the　women　in　some　parts　of　Italy　broke　the　coccyxes　of　their　female　children。　This　report　is　very　likely　not　veracious；　because　this　bone　spontaneously　repairs　itself　so　quickly　and　easily。　Rodet　and　Engelmunn；　in　their　most　extensive　and　interesting　papers　on　the　modes　of　accouchement　among　the　primitive　peoples；　substantiate　the　fear；　pain；　and　difficulty　with　which　labor　is　attended；　even　in　the　lowest　grades　of　society。

In　view　of　the　usual　occurrence　of　pain　and　difficulty　with　labor；　it　seems　natural　that　exceptions　to　the　general　rule　should　in　all　ages　have　attracted　the　attention　of　medical　men；　and　that　literature　should　be　replete　with　such　instances。　Pechlin　and　Muas　record　instances　of　painless　births。　The　Ephemerides　records　a　birth　as　having　occurred　during　asphyxia；　and　also　one　during　an　epileptic　attack。　Storok　also　speaks　of　birth　during　unconsciousness　in　an　epileptic　attack；　and　Haen　and　others　describe　cases　occurring　during　the　coma　attending　apoplectic　attacks。　King　reports　the　histories　of　two　married　women；　fond　mothers　and　anticipating　the　event；　who　gave　birth　to　children；　apparently　unconsciously。　In　the　first　case；　the　appearance　of　the　woman　verified　the　assertion；　in　the　second；　a　transient　suspension　of　the　menstrual　influence　accounted　for　it。　After　some　months　epilepsy　developed　in　this　case。　Crawford　speaks　of　a　Mrs。　D。；　who　gave　birth　to　twins　in　her　first　confinement　at　full　term；　and　who　two　years　after　aborted　at　three　months。　In　December；　1868；　a　year　after　the　abortion；　she　was　delivered　of　a　healthy；　living　fetus　of　about　five　or　six　months'　growth　in　the　following　manner：　While　at　stool；　she　discovered　something　of　a　shining；　bluish　appearance　protruding　through　the　external　labia；　but　she　also　found　that　when　she　lay　down　the　tumor　disappeared。　This　tumor　proved　to　be　the　child；　which　had　been　expelled　from　the　uterus　four　days　before；　with　the　waters　and　membranes　intact；　but　which　had　not　been　recogni