anomalies and curiosities of medicine-第36部分

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hs；　triplets；　once　in　7910；　and　quadruplets；　once　in　371；126。　Recent　statistics　supplied　by　the　Boards　of　Health　of　New　York　and　Philadelphia　place　the　frequency　of　twin　births　in　these　cities　at　1　in　every　120　births；　while　in　Bohemia　twins　occur　once　in　about　60　births；　a　proportion　just　twice　as　great。　Of　150；000　twin　pregnancies　studied　by　Veit；　in　one…third　both　children　were　boys；　in　slightly　less　than　one…third　both　were　girls；　in　the　remaining　third　both　sexes　were　represented。

Authentic　records　of　5　and　6　at　a　birth　are　extremely　rare　and　infinitesimal　in　proportion。　The　reputed　births　in　excess　of　6　must　be　looked　on　with　suspicion；　and；　in　fact；　in　the　great　majority　of　reports　are　apochryphal。

The　examples　of　multiple　births　of　a　single　pregnancy　will　be　taken　up　under　their　respective　numbers；　several　examples　of　each　being　given；　together　with　the　authorities。　Many　twin　and　triplet　brothers　have　figured　prominently　in　history；　and；　in　fact；　they　seem　especially　favored。　The　instance　of　the　Horatii　and　the　Curatii；　and　their　famous　battle；　on　which　hung　the　fate　of　Rome　and　Alba；　is　familiar　to　every　one；　their　strength　and　wisdom　being　legendary　with　the　Romans。

Twins　and　triplets；　being　quite　common；　will　not　be　considered　here；　although　there　are　2　cases　of　interest　of　the　latter　that　deserve　citation。　Sperling　reports　2　instances　of　triplets；　in　the　first　there　was　1　placenta　and　chorion；　2　amnions；　and　the　sex　was　the　same；　in　the　second　case；　in　which　the　sexes　were　different；　there　were　3　placentas；　3　chorions；　and　3　amnions。　What　significance　this　may　have　is　only　a　matter　of　conjecture。　Petty　describes　a　case　of　triplets　in　which　one　child　was　born　alive；　the　other　2　having　lost　their　vitality　three　months　before。　Mirabeau　has　recently　found　that　triple　births　are　most　common　（1　to　6500）　in　multiparous　women　between　thirty　and　thirty…four　years　of　age。　Heredity　seems　to　be　a　factor；　and　duplex　uteruses　predispose　to　multiple　births。　Ross　reports　an　instance　of　double　uterus　with　triple　pregnancy。

Quadruplets　are　supposed　to　occur　once　in　about　every　400；000　births。　There　are　72　instances　recorded　in　the　Index　Catalogue　of　the　Surgeon　General's　Library；　U。　S。　A。；　up　to　the　time　of　compilation；　not　including　the　subsequent　cases　in　the　Index　Medicus。　At　the　Hotel…Dieu；　in　Paris；　in　108；000　births；　covering　a　period　of　sixty　years；　mostly　in　the　last　century；　there　was　only　one　case　of　quadruplets。　The　following　extract　of　an　account　of　the　birth　of　quadruplets　is　given　by　Dr。　De　Leon　of　Ingersoll；　Texas：

〃I　was　called　to　see　Mrs。　E。　T。　Page；　January　10；　1890；　about　4　o'clock　A。M。；　found　her　in　labor　and　at　full　time；　although　she　assured　me　that　her　'time'　was　six　weeks　ahead。　At　8　o'clock　A。M。　I　delivered　her　of　a　girl　baby；　I　found　there　were　triplets；　and　so　informed　her。　At　11　A。M。　I　delivered　her　of　the　second　girl；　after　having　rectified　presentation；　which　was　singular；　face；　hands；　and　feet　all　presented；　I　placed　in　proper　position　and　practised　'version。'　This　child　was　'still…born；'　and　after　considerable　effort　by　artificial　respiration　it　breathed　and　came　around　'all　right。'　The　third　girl　was　born　at　11。40　A。M。　This　was　the　smallest　one　of　the　four。　In　attempting　to　take　away　the　placenta；　to　my　astonishment　I　found　the　feet　of　another　child。　At　1　P。M。　this　one　was　born；　the　head　of　this　child　got　firmly　impacted　at　the　lower　strait；　and　it　was　with　a　great　deal　of　difficulty　and　much　patient　effort　that　it　was　finally　disengaged；　it　was　blocked　by　a　mass　of　placenta　and　cords。　The　first　child　had　its　own　placenta；　the　second　and　third　had　their　placenta；　the　fourth　had　also　a　placenta。　They　weighed　at　birth　in　the　aggregate　19　1/2　pounds　without　clothing；　the　first　weighed　6　pounds；　the　second　5　pounds；　the　third　4　1/2　pounds；　the　fourth　4　pounds。　Mrs。　Page　is　a　blonde；　about　thirty…six　years　old；　and　has　given　birth　to　14　children；　twins　three　times　before　this；　one　pair　by　her　first　husband。　She　has　been　married　to　Page　three　years；　and　has　had　8　children　in　that　time。　I　have　waited　on　her　each　time。　Page　is　an　Englishman；　small；　with　dark　hair；　age　about　twenty…six；　and　weighs　about　115　pounds。　They　are　in　St。　Joseph；　Mo。；　now；　having　contracted　with　Mr。　Uffner　of　New　York　to　travel　and　exhibit　themselves　in　Denver；　St。　Joseph；　Omaha；　and　Nebraska　City；　then　on　to　Boston；　Mass。；　where　they　will　spend　the　summer。〃

There　is　a　report　from　Canada　of　the　birth　of　4　living　children　at　one　time。　The　mother；　a　woman　of　thirty…eight；　of　small　stature；　weighing　100　pounds；　had　4　living　children　of　the　ages　of　twelve；　ten；　eight；　and　seven　years；　respectively。　She　had　aborted　at　the　second　month；　and　at　full　term　was　delivered　of　2　males；　weighing；　respectively；　4　pounds　9　1/4　ounces　and　4　pounds　3　ounces；　and　of　2　females；　weighing　4　pounds　3　ounces　and　3　pounds　13　3/4　ounces；　respectively。　There　was　but　one　placenta；　and　no　more　exhaustion　or　hemorrhage　than　at　a　single　birth。　The　father　weighed　169　pounds；　was　forty…one　years　old；　and　was　5　feet　5　inches　tall；　healthy　and　robust。　The　Journal　of　St。　Petersburg；　a　newspaper　of　the　highest　standard；　stated　that　at　the　end　of　July；　1871；　a　Jewish　woman　residing　in　Courland　gave　birth　to　4　girls；　and　again；　in　May；　1872；　bore　2　boys　and　a　girl；　the　mother　and　the　7　children；　born　within　a　period　of　ten　months；　were　doing　well　at　the　time　of　the　report。　In　the　village　of　Iwokina；　on　May　26；　1854；　the　wife　of　a　peasant　bore　4　children　at　a　birth；　all　surviving。　Bousquet　speaks　of　a　primiparous　mother；　aged　twenty…four；　giving　birth　to　4　living　infants；　3　by　the　breech　and　1　by　the　vertex；　apparently　all　in　one　bag　of　membranes。　They　were　nourished　by　the　help　of　3　wet…nurses。　Bedford　speaks　of　4　children　at　a　birth；　averaging　5　pounds　each；　and　all　nursing　the　mother。

Quintuplets　are　quite　rare；　and　the　Index　Catalogue　of　the　Surgeon　General's　Library；　U。　S。　A。；　gives　only　19　cases；　reports　of　a　few　of　which　will　be　given　here；　together　with　others　not　given　in　the　Catalogue；　and　from　less　scientific　though　reliable　sources。　In　the　year　1731　there　was　one　case　of　quintuplets　in　Upper　Saxony　and　another　near　Prague；　Bohemia。　In　both　of　these　cases　the　children　were　all　christened　and　had　all　lived　to　maturity。　Garthshore　speaks　of　a　healthy　woman；　Margaret　Waddington；　giving　birth　to　5　girls；　2　of　which　lived；　the　2　that　lived　weighed　at　birth　8　pounds　12　ounces　and　9　pounds；　respectively。　He　discusses　the　idea　that　woman　was　meant　to　bear　more　than　one　child　at　a　birth；　using　as　his　argument　the　existence　of　the　double　nipple　and　mamma；　to　which　might　be　added　the　not　infrequent　occurrence　of　polymazia。

In　March；　1736；　in　a　dairy　cellar　in　the　Strand；　London；　a　poor　woman　gave　birth　to　3　boys　and　9　girls。　In　the　same　journal　was　reported　the　birth　at　Wells；　Somersetshire；　in　1739；　of　4　boys　and　a　girl；　all　of　whom　were　christened　and　were　healthy。　Pare　in　1549　gives　several　instances　of　5　children　at　a　birth；　and　Pliny　reports　that　in　the　peninsula　of　Greece　there　was　a　woman　who　gave　birth　to　quintuplets　on　four　different　occasions。　Petritus；　a　Greek　physician；　speaks　of　the　birth　of　quintuplets　at　the　seventh　month。　Two　males　and　one　female　were　born　dead；　being　attached　to　the　same　placenta；　the　others　were　united　to　a　common　placenta　and　lived　three　days。　Chambon　mentions　an　instance　of　5　at　a　birth。　Not　far　from　Berne；　Switzerland；　the　wife　of　John　Gelinger；　a　preacher　in　the　Lordship　of　Berne；　brought　forth　twins；　and　within　a　year　after　she　brought　forth　quintuplets；　3　sons　and　2　daughters。　There　is　a　similar　instance　reported　in　1827　of　a　woman　of　twenty…seven　who；　having　been　delivered　of　twins　two　years　before；　was　brought　to　bed　with　5　children；　3　boys　and　2　girls。　Their　length　was　from　15　1/2　to　16　1/2　inches。　Although　regularly　formed；　they　did　not　seem　to　have　reached　maturity。　The　mother　was　much　exhausted；　but　recovered。　The　children　appeared　old…looking；　had　tremulous　voices；　and　slept　continually；　during　sleep　their　temperatures　seemed　very　low。

Kennedy　showed　before　the　Dublin　Pathological　Society　5　fetuses　with　the　involucra；　the　product　of　an　abortion　at　the　third　month。　At　Naples　in　1839　Giuseppa　Califani　gave　birth　to　5　children；　and　about　the　same　time　Paddock　reported　the　birth　in　Franklin　County；　Pa。；　of　quintuplets。　The　Lancet　relates　an　account　of　the　birth　of　quintuplets；　2　boys　and　3　girls；　by　the　wife　of　a　peasant　on　March　1；　1854。　Moffitt　records　the　birth　at　Monticello；　Ill。；　of　quintuplets。　The　woman　was　thirty…five　years　of　age；　examination　showed　a　breech　presentation；　the　second　child　was　born　by　a　foot…presentation；　as　was　the　third；　but　the　last　was　by　a　head…presentation。　The　combined　weight　was　something　over　19　pounds；　and　of　the　5；　3　were　still…born；　and　the　other　2　died　soon　after　birth。　The　Elgin　Courant　（Scotland）；　1858；　speaks　of　a　woman　named　Elspet　Gordon；　at　Rothes；　giving　birth　to　3　males　and　2　females。　Although　they　were　six　months'　births；　the　boys　all　lived　until　the　following　morning。　The　girls　were　still…born。　One　of　the　boys　had　two　front　teeth　when　born。　Dr。　Dawson　of　Rothes　is　the　obstetrician　mentioned　in　this　case。

The　following　recent　instance　is　given　with　full　details　to　illustrate　the　difficulties　attending　the　births　of　quintuplets。　Stoker　has　reported　the　case　of　a　healthy　woman；　thirty…five　years　old；　5　feet　1　inch　high；　and　of　slight　build；　whom　he　delivered　of　5　fetuses　in　the　seventh　month　of　pregnancy；　none　of　the　children　surviving。　The　patient's　mother　had　on　two　occasions　given　birth　to　twins。　The　woman　herself　had　been　married　for　six　years　and　had　borne　4　children　at　full　term；　having　no　difficulty　in　labor。　When　she　came　under　observation　she　computed　that　she　had　been　pregnant　for　six　months；　and　had　had　her　attention　attracted　to　the　unusually　large　size　of　her　abdomen。　She　complained　of　fixed　pain　in　the　left　side　of　the　abdomen　on　which　side　she　thought　she　was　larger。　Pains　set　in　with　regularity　and　the　labor　lasted　eight　and　three…quarter　hours。　After　the　rupture　of　the　membranes　the　first　child　presented　by　the　shoulder。　Version　was　readily　performed；　the　child　was　dead　（recently）。　Examination　after　the　birth　of　the　first　child　disclosed　the　existence　of