anomalies and curiosities of medicine-第59部分

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uring　the　routine　examination。　It　was　easily　removed；　having　been　situated　in　a　small　depression　at　the　junction　of　the　floor　and　external　wall　of　the　nasal　cavity；　22　mm。　from　the　external　nares。　This　patient　had　all　her　teeth；　they　were　placed　somewhat　far　from　each　other。　The　tooth　resembled　a　milk　canine；　the　end　of　the　imperfect　root　was　covered　with　a　fold　of　mucous　membrane；　with　stratified　epithelium。　The　speaker　suggested　that　part　of　the　mucous　membrane　of　the　mouth　with　its　tooth…germ　had　become　impacted　between　the　superior　and　premaxillary　bones　and　thus　cut　off　from　the　cavity　of　the　mouth。　Another　speaker　criticised　this　fetal　dislocation　and　believed　it　to　be　due　to　an　inversiona　development　in　the　wrong　directionby　which　the　tooth　had　grown　upward　into　the　nose。　The　same　speaker　also　pointed　out　that　the　stratified　epithelium　of　the　mucous　membrane　did　not　prove　a　connection　with　the　cavity　of　the　mouth；　as　it　is　known　that　cylindric　epithelium…cells　after　irritative　processes　are　replaced　by　flat　ones。〃

Delpech　saw　a　young　man　in　1829　who　had　an　opening　in　the　palatine　vault　occasioned　by　the　extraction　of　a　tooth。　This　opening　communicated　with　the　nasal　fossa　by　a　fracture　of　the　palatine　and　maxillary　bones；　the　employment　of　an　obturator　was　necessary。　It　is　not　rare　to　see　teeth；　generally　canine；　make　their　eruption　from　the　vault　of　the　palate；　and　these　teeth　are　not　generally　supernumerary；　but　examples　of　vice　and　deviation　of　position。　Fanton…Touvet；　however；　gives　an　example　of　a　supernumerary　tooth　implanted　in　the　palatine　arch。　Branch　a　describes　a　little　negro　boy　who　had　two　large　teeth　in　the　nose；　his　dentition　was　otherwise　normal；　but　a　portion　of　the　nose　was　destroyed　by　ulceration。　Roy　describes　a　Hindoo　lad　of　fourteen　who　had　a　tooth　in　the　nose；　supposed　to　have　been　a　tumor。　It　was　of　the　canine　type；　and　was　covered　with　enamel　to　the　junction　with　the　root；　which　was　deeply　imbedded　in　the　side　and　upper　part　of　the　antrum。　The　boy　had　a　perfect　set　of　permanent　teeth　and　no　deformity；　swelling；　or　cystic　formation　of　the　jaw。　This　was　clearly　a　case　of　extrafollicular　development　and　eruption　of　the　tooth　in　an　anomalous　position；　the　peculiarity　being　that　while　in　other　similar　cases　the　crown　of　the　tooth　shows　itself　at　the　floor　of　the　nasal　cavity　from　below　upward；　in　this　instance　the　dental　follicle　was　transposed；　the　eruption　being　from　above　downward。　Hall　cites　an　instance　in　which　the　right　upper　canine　of　a　girl　erupted　in　the　nose。　The　subject　showed　marked　evidence　of　hereditary　syphilis。　Carver　describes　a　child　who　had　a　tooth　growing　from　the　lower　right　eyelid。　The　number　of　deciduous　teeth　was　perfect；　although　this　tooth　was　canine　it　had　a　somewhat　bulbulous　fang。

Of　anomalies　of　the　head　the　first　to　be　considered　will　be　the　anencephalous　monsters　who；　strange　to　say；　have　been　known　to　survive　birth。　Clericus　cites　an　example　of　life　for　five　days　in　a　child　without　a　cerebrum。　Heysham　records　the　birth　of　a　child　without　a　cerebrum　and　remarks　that　it　was　kept　alive　for　six　days。　There　was　a　child　born　alive　in　Italy　in　1831　without　a　brain　or　a　cerebellumin　fact；　no　cranial　cavityand　yet　it　lived　eleven　hours。　A　somewhat　similar　case　is　recorded　in　the　last　century。　In　the　Philosophical　Transactions　there　is　mentioned　a　child　virtually　born　without　a　head　who　lived　four　days；　and　Le　Duc　records　a　case　of　a　child　born　without　brain；　cerebellum；　or　medulla　oblongata；　and　who　lived　half　an　hour。　Brunet　describes　an　anencephalous　boy　born　at　term　who　survived　his　birth。　Saviard　delivered　an　anencephalous　child　at　term　which　died　in　thirty…six　hours。　Lawrence　mentions　a　child　with　brain　and　cranium　deficient　that　lived　five　days。　Putnam　speaks　of　a　female　nosencephalous　monster　that　lived　twenty…nine　hours。　Angell　and　Elsner　in　March；　1895；　reported　a　case　of　anencephaly；　or　rather　pseudencephaly；　associated　with　double　divergent　strabismus　and　limbs　in　a　state　of　constant　spastic　contraction。　The　infant　lived　eight　days。　Geoffroy…Saint…Hilaire　cites　an　example　of　anencephaly　which　lived　a　quarter　of　an　hour。　Fauvel　mentioned　one　that　lived　two　hours；　and　Sue　describes　a　similar　instance　in　which　life　persisted　for　seven　hours　and　distinct　motions　were　noticed。　Malacarne　saw　life　in　one　for　twelve　hours；　and　Mery　has　given　a　description　of　a　child　born　without　brain　that　lived　almost　a　full　day　and　took　nourishment。　In　the　Hotel…Dieu　in　Paris　in　1812　Serres　saw　a　monster　of　this　type　which　lived　three　days；　and　was　fed　on　milk　and　sugared　water；　as　no　nurse　could　be　found　who　was　willing　to　suckle　it。

Fraser　mentions　a　brother　and　sister；　aged　twenty　and　thirty；　respectively；　who　from　birth　had　exhibited　signs　of　defective　development　of　the　cerebellum。　They　lacked　power　of　coordination　and　walked　with　a　drunken；　staggering　gait；　they　could　not　touch　the　nose　with　the　finger　when　their　eyes　were　shut；　etc。　The　parents　of　these　unfortunate　persons　were　perfectly　healthy；　as　were　the　rest　of　their　family。　Cruveilhier　cites　a　case　of　a　girl　of　eleven　who　had　absolutely　no　cerebellum；　with　the　same　symptoms　which　are　characteristic　in　such　cases。　There　is　also　recorded　the　history　of　a　man　who　was　deficient　in　the　corpus　callosum；　at　the　age　of　sixty…two；　though　of　feeble　intelligence；　he　presented　no　signs　of　nervous　disorder。　Claude　Bernard　made　an　autopsy　on　a　woman　who　had　no　trace　of　olfactory　lobes；　and　after　a　minute　inquiry　into　her　life　he　found　that　her　sense　of　smell　had　been　good　despite　her　deficiency。

Buhring　relates　the　history　of　a　case　somewhat　analogous　to　viability　of　anencephalous　monsters。　It　was　a　bicephalous　child　that　lived　thirty…two　hours　after　he　had　ligated　one　of　its　heads。　

｛footnote｝　The　argument　that　the　brain　is　not　the　sole　organ　of　the　mind　is　in　a　measure　substantiated　by　a　wonderful　case　of　a　decapitated　rooster；　reported　from　Michigan。　A　stroke　of　the　knife　bad　severed　the　larynx　and　removed　the　whole　mass　of　the　cerebrum；　leaving　the　inner　aspect　and　base　of　the　skull　exposed。　The　cerebrum　was　partly　removed；　the　external　auditory　meatus　was　preserved。　Immediately　after　the　decapitation　the　rooster　was　left　to　its　supposed　death　struggles；　but　it　ran　headless　to　the　barn；　where　it　was　secured　and　subsequently　fed　by　pushing　corn　down　its　esophagus；　and　allowing　water　to　trickle　into　this　tube　from　the　spout　of　an　oil…can。　The　phenomena　exhibited　by　the　rooster　were　quite　interesting。　It　made　all　the　motions　of　pecking；　strutted　about；　flapped　its　wings；　attempted　to　crow；　but；　of　course；　without　making　any　sound。　It　exhibited　no　signs　of　incoordination；　but　did　not　seem　to　hear。　A　ludicrous　exhibition　was　the　absurd；　sidelong　pas　seul　made　toward　the　hens。


Ward　mentions　an　instance　of　congenital　absence　of　the　corpora　callosum。　Paget　and　Henry　mention　cases　in　which　the　corpora　callosum；　the　fornix；　and　septum　lucidum　were　imperfectly　formed。　Maunoir　reports　congenital　malformation　of　the　brain；　consisting　of　almost　complete　absence　of　the　occipital　lobe。　The　patient　died　at　the　twenty…eighth　month。　Combettes　reports　the　case　of　a　girl　who　died　at　the　age　of　eleven　who　had　complete　absence　of　the　cerebellum　in　addition　to　other　minor　structural　defects；　this　was　probably　the　case　mentioned　by　Cruveilhier。　

Diminution　in　volume　of　the　head　is　called　microcephaly。　Probably　the　most　remarkable　case　on　record　is　that　mentioned　by　Lombroso。　The　individual　was　called　〃l'homme…oiseau；〃　or　the　human　bird；　and　his　cranial　capacity　was　only　390　c。c。　Lombroso　speaks　of　another　individual　called　〃l'homme…lapin；〃　or　man…rabbit；　whose　cranium　was　only　slightly　larger　than　that　of　the　other；　measuring　490　mm。　in　circumference。　Castelli　alludes　to　endemic　microcephaly　among　some　of　the　peoples　of　Asia。　We　also　find　it　in　the　Caribbean　Islands；　and　from　the　skulls　and　portraits　of　the　ancient　Aztecs　we　are　led　to　believe　that　they　were　also　microcephalic。

Two　creatures　of　celebrity　were　Maximo　and　Bartola；　who　for　twenty…five　years　have　been　shown　in　America　and　in　Europe　under　the　name　of　the　〃Aztecs〃　or　the　〃Aztec　children〃。　They　were　male　and　female　and　very　short；　with　heads　resembling　closely　the　bas…reliefs　on　the　ancient　Aztec　temples　of　Mexico。　Their　facial　angle　was　about　45　degrees；　and　they　had　jutting　lips　and　little　or　no　chin。　They　wore　their　hair　in　an　enormous　bunch　to　magnify　the　deformity。　These　curiosities　were　born　in　Central　America　and　were　possibly　half　Indian　and　Negro。　They　were　little　better　than　idiots　in　point　of　intelligence。

Figure　92　represents　a　microcephalic　youth　known　as　the　〃Mexican　wild　boy；〃　who　was　shown　with　the　Wallace　circus。

Virchow　exhibited　a　girl　of　fourteen　whose　face　was　no　larger　than　that　of　a　new…born　child；　and　whose　head　was　scarcely　as　large　as　a　man's　fist。　Magitot　reported　a　case　of　a　microcephalic　woman　of　thirty　who　weighed　70　pounds。

Hippocrates　and　Strabonius　both　speak　of　head…binding　as　a　custom　inducing　artificial　microcephaly；　and　some　tribes　of　North　American　Indians　still　retain　this　custom。

As　a　rule；　microcephaly　is　attended　with　associate　idiocy　and　arrested　development　of　the　rest　of　the　body。　Ossification　of　the　fontanelles　in　a　mature　infant　would　necessarily　prevent　full　development　of　the　brain。　Osiander　and　others　have　noticed　this　anomaly。　There　are　cases　on　record　in　which　the　fontanelles　have　remained　open　until　adulthood。

Augmentation　of　the　volume　of　the　head　is　called　macrocephaly；　and　there　are　a　number　of　curious　examples　related。　Benvenuti　describes　an　individual；　otherwise　well　formed；　whose　head　began　to　enlarge　at　seven。　At　twenty…seven　it　measured　over　37　inches　in　circumference　and　the　man's　face　was　15　inches　in　height；　no　other　portion　of　his　body　increased　abnormally；　his　voice　was　normal　and　he　was　very　intelligent。　He　died　of　apoplexy　at　the　age　of　thirty。　

Fournier　speaks　of　a　cranium　in　the　cabinet　of　the　Natural　History　Museum　of　Marseilles　of　a　man　by　the　name　of　Borghini；　who　died　in　1616。　At　the　time　he　was　described　he　was　fifty　years　old；　four　feet　in　height；　his　head　measured　three　feet　in　circumference　and　one　foot　in　height。　There　was　a　proverb　in　Marseilles；　〃Apas　mai　de　sen　que　Borghini；〃　meaning　in　the　l