anomalies and curiosities of medicine-第5部分

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p　chagrin；　and　was　afflicted　with　melancholia。　He　had　menstruated　for　three　years　in　this　manner：　a　fluid　exuded　from　the　sebaceous　glands　of　the　deep　fossa　behind　the　corona　glandis；　this　fluid　was　of　the　same　appearance　as　the　menstrual　flux。　The　quantity　was　from　one　to　two　ounces；　and　the　discharge　lasted　from　three　to　six　days。　At　this　time　the　student　was　twenty…two　years　of　age；　of　a　lymphatic　temperament；　not　particularly　lustful；　and　was　never　the　victim　of　any　venereal　disease。　The　author　gives　no　account　of　the　after…life　of　this　man；　his　whereabouts　being；　unfortunately；　unknown　or　omitted。

Vicarious　Menstruation　in　the　Male。This　simulation　of　menstruation　by　the　male　assumes　a　vicarious　nature　as　well　as　in　the　female。　Van　Swieten；　quoting　from　Benivenius；　relates　a　case　of　a　man　who　once　a　month　sweated　great　quantities　of　blood　from　his　right　flank。　Pinel　mentions　a　case　of　a　captain　in　the　army　（M。　Regis）；　who　was　wounded　by　a　bullet　in　the　body　and　who　afterward　had　a　monthly　discharge　from　the　urethra。　Pinel　calls　attention　particularly　to　the　analogy　in　this　case　by　mentioning　that　if　the　captain　were　exposed　to　fatigue；　privation；　cold；　etc。；　he　exhibited　the　ordinary　symptoms　of　amenorrhea　or　suppression。　Fournier　speaks　of　a　man　over　thirty　years　old；　who　had　been　the　subject　of　a　menstrual　evacuation　since　puberty；　or　shortly　after　his　first　sexual　intercourse。　He　would　experience　pains　of　the　premenstrual　type；　about　twenty…four　hours　before　the　appearance　of　the　flow；　which　subsided　when　the　menstruation　began。　He　was　of　an　intensely　voluptuous　nature；　and　constantly　gave　himself　up　to　sexual　excesses。　The　flow　was　abundant　on　the　first　day；　diminished　on　the　second；　and　ceased　on　the　third。　Halliburton；　Jouilleton；　and　Rayman　also　record　male　menstruation。

Cases　of　menstruation　during　pregnancy　and　lactation　are　not　rare。　It　is　not　uncommon　to　find　pregnancy；　lactation；　and　menstruation　coexisting。　No　careful　obstetrician　will　deny　pregnancy　solely　on　the　regular　occurrence　of　the　menstrual　periods；　any　more　than　he　would　make　the　diagnosis　of　pregnancy　from　the　fact　of　the　suppression　of　menses。　Blake　reports　an　instance　of　catamenia　and　mammary　secretion　during　pregnancy。　Denaux　de　Breyne　mentions　a　similar　case。　The　child　was　born　by　a　face…presentation。　De　Saint…Moulin　cites　an　instance　of　the　persistence　of　menstruation　during　pregnancy　in　a　woman　of　twenty…four；　who　had　never　been　regular；　the　child　was　born　at　term。　Gelly　speaks　of　a　case　in　which　menstruation　continued　until　the　third　month　of　pregnancy；　when　abortion　occurred。　Post；　in　describing　the　birth　of　a　two…pound　child；　mentions　that　menstruation　had　persisted　during　the　mother's　pregnancy。　Rousset　reports　a　peculiar　case　in　which　menstruation　appeared　during　the　last　four　months　of　pregnancy。

There　are　some　cases　on　record　of　child…bearing　after　the　menopause；　as；　for　instance；　that　of　Pearson；　of　a　woman　who　had　given　birth　to　nine　children　up　to　September；　1836；　after　this　the　menses　appeared　only　slightly　until　July；　1838；　when　they　ceased　entirely。　A　year　and　a　half　after　this　she　was　delivered　of　her　tenth　child。　Other　cases；　somewhat　similar；　will　be　found　under　the　discussion　of　late　conception。

Precocious　menstruation　is　seen　from　birth　to　nine　or　ten　years。　Of　course；　menstruation　before　the　third　or　fourth　year　is　extremely　rare；　most　of　the　cases　reported　before　this　age　being　merely　accidental　sanguineous　discharges　from　the　genitals；　not　regularly　periodical；　and　not　true　catamenia。　However；　there　are　many　authentic　cases　of　infantile　menstruation　on　record；　which　were　generally　associated　with　precocious　development　in　other　parts　as　well。　Billard　says　that　the　source　of　infantile　menstruation　is　the　lining　membrane　of　the　uterus；　but　Camerer　explains　it　as　due　to　ligature　of　the　umbilical　cord　before　the　circulation　in　the　pulmonary　vessels　is　thoroughly　established。　In　the　consideration　of　this　subject；　we　must　bear　in　mind　the　influence　of　climate　and　locality　on　the　time　of　the　appearance　of　menstruation。　In　the　southern　countries；　girls　arrive　at　maturity　at　an　earlier　age　than　their　sisters　of　the　north。　Medical　reports　from　India　show　early　puberty　of　the　females　of　that　country。　Campbell　remarks　that　girls　attain　the　age　of　puberty　at　twelve　in　Siam；　while；　on　the　contrary；　some　observers　report　the　fact　that　menstruation　does　not　appear　in　the　Esquimaux　women　until　the　age　of　twenty…three；　and　then　is　very　scanty；　and　is　only　present　in　the　summer　months。

Cases　of　menstruation　commencing　within　a　few　days　after　birth　and　exhibiting　periodical　recurrence　are　spoken　of　by　Penada；　Neues　Hannoverisehes　Magazin；　Drummond；　Buxtorf；　Arnold；　The　Lancet；　and　the　British　Medical　Journal。　

Cecil　relates　an　instance　of　menstruation　on　the　sixth　day；　continuing　for　five　days；　in　which　six　or　eight　drams　of　blood　were　lost。　Peeples　cites　an　instance　in　Texas　in　an　infant　at　the　age　of　five　days；　which　was　associated　with　a　remarkable　development　of　the　genital　organs　and　breasts。　Van　Swieten　offers　an　example　at　the　first　month；　the　British　Medical　Journal　at　the　second　month；　Conarmond　at　the　third　month。　Ysabel；　a　young　slave　girl　belonging　to　Don　Carlos　Pedro　of　Havana；　began　to　menstruate　soon　after　birth；　and　at　the　first　year　was　regular　in　this　function。　At　birth　her　mamma　were　well　developed　and　her　axillae　were　slightly　covered　with　hair。　At　the　age　of　thirty…two　months　she　was　three　feet　ten　inches　tall；　and　her　genitals　and　mammae　resembled　those　of　a　girl　of　thirteen。　Her　voice　was　grave　and　sonorous；　her　moral　inclinations　were　not　known。　Deever　records　an　instance　of　a　child　two　years　and　seven　months　old　who；　with　the　exception　of　three　months　only；　had　menstruated　regularly　since　the　fourth　month。　Harle　speaks　of　a　child；　the　youngest　of　three　girls；　who　had　a　bloody　discharge　at　the　age　of　five　months　which　lasted　three　days　and　recurred　every　month　until　the　child　was　weaned　at　the　tenth　month。　At　the　eleventh　month　it　returned　and　continued　periodically　until　death；　occasioned　by　diarrhea　at　the　fourteenth　month。　The　necropsy　showed　a　uterus　1　5/8　inches　long；　the　lips　of　which　were　congested；　the　left　ovary　was　twice　the　size　of　the　right；　but　displayed　nothing　strikingly　abnormal。　Baillot　and　the　British　Medical　Journal　cite　instances　of　menstruation　at　the　fourth　month。　A　case　is　on　record　of　an　infant　who　menstruated　at　the　age　of　six　months；　and　whose　menses　returned　on　the　twenty…eighth　day　exactly。　Clark；　Wall；　and　the　Lancet　give　descriptions　of　cases　at　the　ninth　month。　Naegele　has　seen　a　case　at　the　eighteenth　month；　and　Schmidt　and　Colly　in　the　second　year。　Another　case　is　that　of　a　child；　nineteen　months　old；　whose　breasts　and　external　genitals　were　fully　developed；　although　the　child　had　shown　no　sexual　desire；　and　did　not　exceed　other　children　of　the　same　age　in　intellectual　development。　This　prodigy　was　symmetrically　formed　and　of　pleasant　appearance。　Warner　speaks　of　Sophie　Gantz；　of　Jewish　parentage；　born　in　Cincinnati；　July　27；　1865；　whose　menses　began　at　the　twenty…third　month　and　had　continued　regularly　up　to　the　time　of　reporting。　At　the　age　of　three　years　and　six　months　she　was　38　inches　tall；　38　pounds　in　weight；　and　her　girth　at　the　hip　was　33　1/2　inches。　The　pelvis　was　broad　and　well　shaped；　and　measured　10　1/2　inches　from　the　anterior　surface　of　the　spinous　process　of　one　ilium　to　that　of　the　other；　being　a　little　more　than　the　standard　pelvis　of　Churchill；　and；　in　consequence　of　this　pelvic　development；　her　legs　were　bowed。　The　mammae　and　labia　had　all　the　appearance　of　established　puberty；　and　the　pubes　and　axillae　were　covered　with　hair。　She　was　lady…like　and　maidenly　in　her　demeanor；　without　unnatural　constraint　or　effrontery。　A　case　somewhat　similar；　though　the　patient　had　the　appearance　of　a　little　old　woman；　was　a　child　of　three　whose　breasts　were　as　well　developed　as　in　a　girl　of　twenty；　and　whose　sexual　organs　resembled　those　of　a　girl　at　puberty。　She　had　menstruated　regularly　since　the　age　of　two　years。　Woodruff　describes　a　child　who　began　to　menstruate　at　two　years　of　age　and　continued　regularly　thereafter。　At　the　age　of　six　years　she　was　still　menstruating；　and　exhibited　beginning　signs　of　puberty。　She　was　118　cm。　tall；　her　breasts　were　developed；　and　she　had　hair　on　the　mons　veneris。　Van　der　Veer　　mentions　an　infant　who　began　menstruating　at　the　early　age　of　four　months　and　had　continued　regularly　for　over　two　years。　She　had　the　features　and　development　of　a　child　ten　or　twelve　years　old。　The　external　labia　and　the　vulva　in　all　its　parts　were　well　formed；　and　the　mons　veneris　was　covered　with　a　full　growth　of　hair。　Sir　Astley　Cooper；　Mandelshof；　the　Ephemerides；　Rause；　Geoffroy…Saint…Hilaire；　and　several　others　a　report　instances　of　menstruation　occurring　at　three　years　of　age。　Le　Beau　describes　an　infant　prodigy　who　was　born　with　the　mammae　well　formed　and　as　much　hair　on　the　mons　veneris　as　a　girl　of　thirteen　or　fourteen。　She　menstruated　at　three　and　continued　to　do　so　regularly；　the　flow　lasting　four　days　and　being　copious。　At　the　age　of　four　years　and　five　months　she　was　42　1/2　inches　tall；　her　features　were　regular；　the　complexion　rosy；　the　hair　chestnut；　the　eyes　blue…gray；　her　mamma　the　size　of　a　large　orange；　and　indications　that　she　would　be　able　to　bear　children　at　the　age　of　eight。　Prideaux　cites　a　case　at　five；　and　Gaugirau　Casals；　a　doctor　of　Agde；　has　seen　a　girl　of　six　years　who　suffered　abdominal　colic；　hemorrhage　from　the　nose；　migraine；　and　neuralgia；　all　periodically；　which；　with　the　association　of　pruritus　of　the　genitals　and　engorged　mammae；　led　him　to　suspect　amenorrhea。　He　ordered　baths；　and　shortly　the　menstruation　appeared　and　became　regular　thereafter。　Brierre　de　Boismont　records　cases　of　catamenia　at　five；　seven；　and　eight　years；　and　Skene　mentions　a　girl　who　menstruated　at　ten　years　and　five　months。　She　was　in　the　lowest　grade　of　society；　living　with　a　drunken　father　in　a　tenement　house；　and　was　of　wretched　physical　constitution；　quite　ignorant；　and　of　low　moral　character；　as　evinced　by　her　specific　vaginitis。　Occurring　from　nine　years　to　the　ordinary　time　of　puberty；　many　cases　are　recorded。

Instances　of　protracted　menstruation　are；　a