anomalies and curiosities of medicine-第49部分

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sed；　and　there　were　found　numerous　openings　of　sweat　glands；　from　which　drops　of　perspiration　escaped　when　the　patient　was　sweating。

Dermoid　cysts　of　the　thorax　are　rare。　Bramann　reported　a　case　in　which　a　dermoid　cyst　of　small　size　was　situated　over　the　sternum　at　the　junction　of　the　manubrium　with　the　gladiolus；　and　a　similar　cyst　in　the　neck　near　the　left　cornu　of　the　hyoid　bone。　Chitten　removed　a　dermoid　from　the　sternum　of　a　female　of　thirty…nine；　the　cyst　containing　11　ounces　of　atheromatous　material。　In　the　Museum　of　St。　Bartholomew's　Hospital　in　London　there　is　a　congenital　tumor　which　was　removed　from　the　anterior　mediastinum　of　a　woman　of　twenty　one；　and　contained　portions　of　skin；　fat；　sebaceous　material；　and　two　pieces　of　bone　similar　to　the　superior　maxilla；　and　in　which　several　teeth　were　found。　Dermoids　are　found　in　the　palate　and　pharynx；　and　open　dermoids　of　the　conjunctiva　are　classified　by　Sutton　with　the　moles。　According　to　Senn；　Barker　collected　sixteen　dermoid　tumors　of　the　tongue。　Bryk　successfully　removed　a　tumor　of　this　nature　the　size　of　a　fist。　Wellington　Gray　removed　an　enormous　lingual　dermoid　from　the　mouth　of　a　negro。　It　contained　40　ounces　of　atheromatous　material。　Dermoids　of　the　rectum　are　reported。　Duyse　reports　the　history　of　a　case　of　labor　during　which　a　rectal　dermoid　was　expelled。　The　dermoid　contained　a　cerebral　vesicle；　a　rudimentary　eye；　a　canine　and　a　molar　tooth；　and　a　piece　of　bone。　There　is　little　doubt　that　many　cases　of　fetus　in　fetu　reported　were　really　dermoids　of　the　scrotum。

Ward　reports　the　successful　removal　of　a　dermoid　cyst　weighing　30　pounds　from　a　woman　of　thirty…two；　the　mother　of　two　children　aged　ten　and　twelve；　respectively。　The　report　is　briefly　as　follows：　〃The　patient　has　always　been　in　good　health　until　within　the　last　year；　during　which　time　she　has　lost　flesh　and　strength　quite　rapidly；　and　when　brought　to　my　hospital　by　her　physician；　Dr。　James　of　Williamsburg；　Kansas；　was　quite　weak；　although　able　to　walk　about　the　house。　A　tumor　had　been　growing　for　a　number　of　years；　but　its　growth　was　so　gradual　that　the　patient　had　not　considered　her　condition　critical　until　quite　recently。　The　tumor　was　diagnosed　to　be　cystoma　of　the　left　ovary。　Upon　opening　the　sac　with　the　trocar　we　were　confronted　by　complications　entirely　unlooked　for；　and　its　use　had　to　be　abandoned　entirely　because　the　thick　contents　of　the　cyst　would　not　flow　freely；　and　the　presence　of　sebaceous　matter　blocked　the　instrument。　As　much　of　the　fluid　as　possible　was　removed；　and　the　abdominal　incision　was　enlarged　to　allow　of　the　removal　of　the　large　tumor。　An　ovarian　hematoma　the　size　of　a　large　orange　was　removed　from　the　right　side。　We　washed　the　intestines　quite　as　one　would　wash　linen；　since　some　of　the　contents　of　the　cyst　had　escaped　into　the　abdominal　cavity。　The　abdomen　was　closed　without　drainage；　and　the　patient　placed　in　bed　without　experiencing　the　least　shock。　Her　recovery　was　rapid　and　uneventful。　She　returned　to　her　home　in　four　weeks　after　the　operation。

〃The　unusual　feature　in　this　case　was　the　nature　of　the　contents　of　the　sac。　There　was　a　large　quantity　of　long　straight　hair　growing　from　the　cyst　wall　and　an　equal　amount　of　loose　hair　in　short　pieces　floating　through　the　tumor…　contents；　a　portion　of　which　formed　nuclei　for　what　were　called　'moth…balls；'　of　which　there　were　about　1　1/2　gallons。　These　balls；　or　marbles；　varied　from　the　size　of　moth…balls；　as　manufactured　and　sold　by　druggists；　to　that　of　small　walnuts。　They　seemed　to　be　composed　of　sebaceous　matter；　and　were　evidently　formed　around　the　short　hairs　by　the　motion　of　the　fluid　produced　by　walking　or　riding。　There　was　some　tissue　resembling　true　skin　attached　to　the　inner　wall　of　the　sac。〃

There　are　several　cases　of　multiple　dermoid　cysts　on　record；　and　they　may　occur　all　over　the　body。　Jamieson　reports　a　case　in　which　there　were　250；　and　in　Maclaren's　case　there　were　132。　According　to　Crocker；　Hebra　and　Rayer　also　each　had　a　case。　In　a　case　of　Sangster；　reported　by　Politzer；　although　most　of　the　dermoids；　as　usual；　were　like　fibroma…nodules　and　therefore　the　color　of　normal　skin；　those　over　the　mastoid　processes　and　clavicle　were　lemon…yellow；　and　were　generally　thought　to　be　xanthoma　until　they　were　excised；　and　Politzer　found　they　were　typical　dermoid　cysts　with　the　usual　contents　of　degenerated　epithelium　and　hair。

Hermaphroditism。Some　writers　claim　that　Adam　was　the　first　hermaphrodite　and　support　this　by　Scriptural　evidence。　We　find　in　some　of　the　ancient　poets　traces　of　an　Egyptian　legend　in　which　the　goddess　of　the　moon　was　considered　to　be　both　male　and　female。　From　mythology　we　learn　that　Hermaphroditus　was　the　son　of　Hermes；　or　Mercury；　and　Venus　Aphrodite；　and　had　the　powers　both　of　a　father　and　mother。　In　speaking　of　the　foregoing　Ausonius　writes；　〃Cujus　erat　facies　in　qua　paterque　materque　cognosci　possint；　nomen　traxit　ab　illis。〃　Ovid　and　Virgil　both　refer　to　legendary　hermaphrodites；　and　the　knowledge　of　their　existence　was　prevalent　in　the　olden　times。　The　ancients　considered　the　birth　of　hermaphrodites　bad　omens；　and　the　Athenians　threw　them　into　the　sea；　the　Romans；　into　the　Tiber。　Livy　speaks　of　an　hermaphrodite　being　put　to　death　in　Umbria；　and　another　in　Etruria。　Cicero；　Aristotle；　Strabonius；　and　Pliny　all　speak　concerning　this　subject。　Martial　and　Tertullian　noticed　this　anomaly　among　the　Romans。　Aetius　and　Paulus　Aegineta　speak　of　females　in　Egypt　with　prolonged　clitorides　which　made　them　appear　like　hermaphrodites。　Throughout　the　Middle　Ages　we　frequently　find　accounts；　naturally　exaggerated；　of　double…sexed　creatures。　Harvey；　Bartholinus；　Paullini；　Schenck；　Wolff；　Wrisberg；　Zacchias；　Marcellus　Donatus；　Haller；　Hufeland；　de　Graff；　and　many　others　discuss　hermaphroditism。　Many　classifications　have　been　given；　as；　e。g。；　real　and　apparent；　masculine；　feminine；　or　neuter；　horizontal　and　vertical；　unilateral　and　bilateral；　etc。　The　anomaly　in　most　cases　consists　of　a　malformation　of　the　external　genitalia。　A　prolonged　clitoris；　prolapsed　ovaries；　grossness　of　figure；　and　hirsute　appearance　have　been　accountable　for　many　supposed　instances　of　hermaphrodites。　On　the　other　hand；　a　cleft　scrotum；　an　ill…developed　penis；　perhaps　hypospadias　or　epispadias；　rotundity　of　the　mammae；　and　feminine　contour　have　also　provoked　accounts　of　similar　instances。　Some　cases　have　been　proved　by　dissection　to　have　been　true　hermaphrodites；　portions　or　even　entire　genitalia　of　both　sexes　having　been　found。

Numerous　accounts；　many　mythical；　but　always　interesting；　are　given　of　these　curious　persons。　They　have　been　accredited　with　having　performed　the　functions　of　both　father　and　mother；　notwithstanding　the　statements　of　some　of　the　best　authorities　that　they　are　always　sterile。　Observation　has　shown　that　the　sexual　appetite　diminishes　in　proportion　to　the　imperfections　in　the　genitalia；　and　certainly　many　of　these　persons　are　sexually　indifferent。

We　give　descriptions　of　a　few　of　the　most　famous　or　interesting　instances　of　hermaphroditism。　Pare　speaks　of　a　woman　who；　besides　a　vulva；　from　which　she　menstruated；　had　a　penis；　but　without　prepuce　or　signs　of　erectility。　Haller　alludes　to　several　cases　in　which　prolonged　clitorides　have　been　the　cause　of　the　anomaly。　In　commenting　on　this　form　of　hermaphroditism　Albucasiusus　describes　a　necessary　operation　for　the　removal　of　the　clitoris。

Columbus　relates　the　history　of　an　Ethiopian　woman　who　was　evidently　a　spurious　female　hermaphrodite。　The　poor　wretch　entreated　him　to　cut　off　her　penis；　an　enlarged　clitoris；　which　she　said　was　an　intolerable　hindrance　to　her　in　coitus。　De　Graff　and　Riolan　describe　similar　cases。　There　is　an　old　record　of　a　similar　creature；　supposing　herself　to　be　a　male；　who　took　a　wife；　but　previously　having　had　connection　with　a　man；　the　outcome　of　which　was　pregnancy；　was　shortly　after　marriage　delivered　of　a　daughter。　There　is　an　account　of　a　person　in　Germany　who；　for　the　first　thirty　years　of　life；　was　regarded　as　feminine；　and　being　of　loose　morals　became　a　mother。　At　a　certain　period　she　began　to　feel　a　change　in　her　sexual　inclinations；　she　married　and　became　the　father　of　a　family。　This　is　doubtless　a　distortion　of　the　facts　of　the　case　of　Catherine　or　Charles　Hoffman；　born　in　1824；　and　who　was　considered　a　female　until　the　age　of　forty。　At　puberty　she　had　the　instincts　of　a　woman；　and　cohabitated　with　a　male　lover　for　twenty　years。　Her　breasts　were　well　formed　and　she　menstruated　at　nineteen。　At　the　age　of　forty…six　her　sexual　desires　changed；　and　she　attempted　coitus　as　a　man；　with　such　evident　satisfaction　that　she　married　a　woman　soon　afterward。　Fitch　speaks　of　a　house…servant　with　masculine　features　and　movements；　aged　twenty…eight；　and　5　feet　and　9　inches　tall；　who　was　arrested　by　the　police　for　violating　the　laws　governing　prostitution。　On　examination；　well…developed　male　and　female　organs　of　generation　were　found。　The　labia　majora　were　normal　and　flattened　on　the　anterior　surface。　The　labia　minora　and　hymen　were　absent。　The　vagina　was　spacious　and　the　woman　had　a　profuse　leukorrhea。　She　stated　that　several　years　previously　she　gave　birth　to　a　normal　child。　In　place　of　a　clitoris　she　had　a　penis　which；　in　erection；　measured　5　1/4　inches　long　and　3　5/8　inches　in　circumference。　The　glans　penis　and　the　urethra　were　perfectly　formed。　The　scrotum　contained　two　testicles；　each　about　an　inch　long；　the　mons　veneris　was　sparsely　covered　with　straight；　black　hair。　She　claimed　functional　ability　with　both　sets　of　genitalia；　and　said　she　experienced　equal　sexual　gratification　with　either。　Semen　issued　from　the　penis；　and　every　three　weeks　she　had　scanty　menstruation；　which　lasted　but　two　days。

Beclard　showed　Marie…Madeline　Lefort；　nineteen　years　of　age；　1　1/2　meters　in　height。　Her　mammae　were　well　developed；　her　nipples　erectile　and　surrounded　by　a　brown　areola；　from　which　issued　several　hairs。　Her　feet　were　small；　her　pelvis　large；　and　her　thighs　like　those　of　a　woman。　Projecting　from　the　vulva　was　a　body　looking　like　a　penis　7　cm。　long　and　slightly　erectile　at　times；　it　was　imperforate　and　had　a　mobile　prepuce。　She　had　a　vulva　with　two　well…shaped　labia　as　shown　by　the　accompanying　illustration。　She　menstruated　slightly　and　had　an　ope