anomalies and curiosities of medicine-第60部分

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　foot　in　height。　There　was　a　proverb　in　Marseilles；　〃Apas　mai　de　sen　que　Borghini；〃　meaning　in　the　local　dialect；　〃Thou　hast　no　more　wit　than　Borghini。〃　This　man；　whose　fame　became　known　all　over　France；　was　not　able；　as　he　grew　older；　to　maintain　the　weight　of　his　head；　but　carried　a　cushion　on　each　shoulder　to　prop　it　up。　Fournier　also　quotes　the　history　of　a　man　who　died　in　the　same　city　in　1807　at　the　age　of　sixty…seven。　His　head　was　enormous；　and　he　never　lay　on　a　bed　for　thirty　years；　passing　his　nights　in　a　chair；　generally　reading　or　writing。　He　only　ate　once　in　twenty…four　or　thirty　hours；　never　warmed　himself；　and　never　used　warm　water。　His　knowledge　was　said　to　have　been　great　and　encyclopedic；　and　he　pretended　never　to　have　heard　the　proverb　of　Borghini。　There　is　related　the　account　of　a　Moor；　who　was　seen　in　Tunis　early　in　this　century；　thirty…one　years　of　age；　of　middle　height；　with　a　head　so　prodigious　in　dimensions　that　crowds　flocked　after　him　in　the　streets。　His　nose　was　quite　long；　and　his　mouth　so　large　that　he　could　eat　a　melon　as　others　would　an　apple。　He　was　an　imbecile。　William　Thomas　Andrews　was　a　dwarf　seventeen　years　old；　whose　head　measured　in　circumference　35　inches；　from　one　external　auditory　meatus　to　another；　27　1/4　inches；　from　the　chin　over　the　cranial　summit　to　the　suboccipital　protuberance；　37　1/2　inches；　the　distance　from　the　chin　to　the　pubes　was　20　inches；　and　from　the　pubes　to　the　soles　of　the　feet；　16；　he　was　a　monorchid。　James　Cardinal；　who　died　in　Guy's　Hospital　in　1825；　and　who　was　so　celebrated　for　the　size　of　his　head；　only　measured　32　1/2　inches　in　head…circumference。

The　largest　healthy　brains　on　record；　that　is；　of　men　of　prominence；　are　those　of　Cuvier；　weighing　64　1/3　ounces；　of　Daniel　Webster；　weighing　63　3/4　ounces　（the　circumference　of　whose　head　was　23　3/4　inches）；　of　Abercrombie；　weighing　63　ounces；　and　of　Spurzheim；　weighing　55　1/16　ounces。　Byron　and　Cromwell　had　abnormally　heavy　brains；　showing　marked　evidence　of　disease。

A　curious　instance　in　this　connection　is　that　quoted　by　Pigne；　who　gives　an　account　of　a　double　brain　found　in　an　infant。　Keen　reports　finding　a　fornix　which；　instead　of　being　solid　from　side　to　side；　consisted　of　two　lateral　halves　with　a　triangular　space　between　them。

When　the　augmentation　of　the　volume　of　the　cranium　is　caused　by　an　abundant　quantity　of　serous　fluid　the　anomaly　is　known　as　hydrocephaly。　In　this　condition　there　is　usually　no　change　in　the　size　of　the　brain…structure　itself；　but　often　the　cranial　bones　are　rent　far　asunder。　Minot　speaks　of　a　hydrocephalic　infant　whose　head　measured　27　1/2　inches　in　circumference；　Bright　describes　one　whose　head　measured　32　inches；　and　Klein；　one　43　inches。　Figure　93　represents　a　child　of　six　whose　head　circumference　was　36　inches。　Figure　94　shows　a　hydrocephalic　adult　who　was　exhibited　through　this　country。

There　is　a　record　of　a　curious　monster　born　of　healthy　half…caste　African　parents。　The　deformity　was　caused　by　a　deficiency　of　osseous　material　of　the　bones　of　the　head。　There　was　considerable　arrest　of　development　of　the　parietal；　temporal；　and　superior　maxillary　bones；　in　consequence　of　which　a　very　small　amount　of　the　cerebral　substance　could　be　protected　by　the　membranous　expansion　of　the　cranial　centers。　The　inferior　maxilla　and　the　frontal　bone　were　both　perfect；　the　ears　were　well　developed　and　the　tongue　strong　and　active；　the　nostrils　were　imperforate　and　there　was　no　roof　to　the　mouth　nor　floor　to　the　nares。　The　eyes　were　curiously　free　from　eyelashes；　eyelids；　or　brows。　The　cornea　threatened　to　slough。　There　was　double　harelip　on　the　left　side；　the　second　and　third　fingers　of　both　hands　were　webbed　for　their　whole　length；　the　right　foot　wanted　the　distal　phalanx　of　the　great　toe　and　the　left　foot　was　clubbed　and　drawn　inward。　The　child　swallowed　when　fed　from　a　spoon；　appeared　to　hear；　but　exhibited　no　sense　of　light。　It　died　shortly　after　the　accompanying　sketch　was　made。

Occasionally　a　deficiency　in　the　osseous　material　of　the　cranium　or　an　abnormal　dilatation　of　the　fontanelles　gives　rise　to　a　hernia　of　the　meninges；　which；　if　accompanied　by　cerebrospinal　fluid　in　any　quantity；　causes　a　large　and　peculiarly　shaped　tumor　called　meningocele。　If　there　is　a　protrusion　of　brain…substance　itself；　a　condition　known　as　hernia　cerebri　results。

Complete　absence　of　the　inferior　maxilla　is　much　rarer　in　man　than　in　animals。　Nicolas　and　Prenant　have　described　a　curious　case　of　this　anomaly　in　a　sheep。　Gurlt　has　named　subjects　presenting　the　total　or　partial　absence　of　the　inferior　maxilla；　agnathes　or　hemiagnathes。　Simple　atrophy　of　the　inferior　maxilla　has　been　seen　in　man　as　well　as　in　the　lower　animals；　but　is　much　less　frequent　than　atrophy　of　the　superior　maxilla。　Langenbeck　reports　the　case　of　a　young　man　who　had　the　inferior　maxilla　so　atrophied　that　in　infancy　it　was　impossible　for　him　to　take　milk　from　the　breast。　He　had　also　almost　complete　immobility　of　the　jaws。　Boullard　reports　a　deformity　of　the　visage；　resulting　in　a　deficiency　of　the　condyles　of　the　lower　jaw。　Maurice　made　an　observation　on　a　vice　of　conformation　of　the　lower　jaw　which　rendered　lactation　impossible；　probably　causing　the　death　of　the　infant　on　this　account。　Tomes　gives　a　description　of　a　lower　jaw　the　development　of　the　left　ramus　of　which　had　been　arrested。　Canton　mentions　arrest　of　development　of　the　left　perpendicular　ramus　of　the　lower　jaw　combined　with　malformation　of　the　external　ear。

Exaggerated　prominence　of　the　maxillaries　is　called　prognathism；　that　of　the　superior　maxilla　is　seen　in　the　North　American　Indians。　Inferior　prognathism　is　observed　in　man　as　well　as　in　animals。　The　bull…dog；　for　example；　displays　this；　but　in　this　instance　the　deformity　is　really　superior　brachygnathism；　the　superior　maxilla　being　arrested　in　development。

Congenital　absence　of　the　nose　is　a　very　rare　anomaly。　Maisonneuve　has　seen　an　example　in　an　individual　in　which；　in　place　of　the　nasal　appendix；　there　was　a　plane　surface　perforated　by　two　small　openings　a　little　less　than　one　mm。　in　diameter　and　three　mm。　apart。

Exaggeration　in　volume　of　the　nose　is　quite　frequent。　Ballonius　speaks　of　a　nose　six　times　larger　than　ordinary。　Viewing　the　Roman　celebrities；　we　find　that　Numa；　to　whom　was　given　the　surname　Pompilius；　had　a　nose　which　measured　six　inches。　Plutarch；　Lyourgus；　and　Solon　had　a　similar　enlargement；　as　had　all　the　kings　of　Italy　except　Tarquin　the　Superb。

Early　in　the　last　century　a　man；　Thomas　Wedders　（or　Wadhouse）；　with　a　nose　7　1/2　inches　long；　was　exhibited　throughout　Yorkshire。　This　man　expired　as　he　had　lived；　in　a　condition　of　mind　best　described　as　the　most　abject　idiocy。　The　accompanying　illustration　is　taken　from　a　reproduction　of　an　old　print　and　is　supposed　to　be　a　true　likeness　of　this　unfortunate　individual。

There　are　curious　pathologic　formations　about　the　nose　which　increase　its　volume　so　enormously　as　to　interfere　with　respiration　and　even　with　alimentation；　but　these　will　be　spoken　of　in　another　chapter。

There　have　been　some　celebrities　whose　noses　were　undersized。　The　Duc　de　Guise；　the　Dauphin　d'Auvergne；　and　William　of　Orange；　celebrated　in　the　romances　of　chivalry；　had　extremely　short　noses。

There　are　a　few　recorded　cases　of　congenital　division　of　the　nose。　Bartholinus；　Borellus；　and　the　Ephemerides　speak　of　duplex　noses。　Thomas　of　Tours　has　observed　congenital　fissure　of　the　nose。　Rikere　reports　the　case　of　an　infant　of　three　weeks　who　possessed　a　supernumerary　nose　on　the　right　nasal　bone　near　the　inner　canthus　of　the　eye。　It　was　pear…shaped；　with　its　base　down；　and　was　the　size　of　the　natural　nose　of　an　infant　of　that　age；　and　air　passed　through　it。　Hubbell；　Ronaldson；　and　Luscha　speak　of　congenital　occlusion　of　the　posterior　nares。　Smith　and　Jarvis　record　cases　of　congenital　occlusion　of　the　anterior　nares。

Anomalies　in　size　of　the　mouth　are　not　uncommon。　Fournier　quotes　the　history　of　a　man　who　had　a　mouth　so　large　that　when　he　opened　it　all　his　back　teeth　could　be　seen。　There　is　a　history　of　a　boy　of　seventeen　who　had　a　preternaturally…sized　mouth；　the　transverse　diameter　being　6　1/2　inches。　The　mother　claimed　that　the　boy　was　born　with　his　foot　in　his　mouth　and　to　this　fact　attributed　his　deformity。　The　negro　races　are　noted　for　their　large　mouths　and　thick　lips。　A　negro　called　〃Black　Diamond；〃　recently　exhibited　in　Philadelphia；　could　put　both　his　fists　in　his　mouth。

Morgan　reports　two　cases　of　congenital　macrostoma　accompanied　by　malformation　of　the　auricles　and　by　auricular　appendages。　Van　Duyse　mentions　congenital　macrostoma　with　preauricular　tumors　and　a　dermoid　of　the　eye。　Macrostoma　is　sometimes　produced　by　lateral　fissures。　In　other　cases　this　malformation　is　unilateral　and　the　fissure　ascends；　in　which　instance　the　fissure　may　be　accompanied　by　a　fistula　of　the　duct　of　Stensen。　Sometimes　there　is　associated　with　these　anomalies　curious　terminations　of　the　salivary　ducts；　either　through　the　cheek　by　means　of　a　fistula　or　on　the　anterior　part　of　the　neck。

Microstoma。There　are　a　few　cases　on　record　in　which　the　mouth　has　been　so　small　or　ill…defined　as　not　to　admit　of　alimentation。　Molliere　knew　an　individual　of　forty　whose　mouth　was　the　exact　size　of　a　ten…centime　piece。

Buchnerus　records　a　case　of　congenital　atresia　of　the　mouth。　Cayley；　Smith；　Sourrouille；　and　Stankiewiez　of　Warsaw　discuss　atresia　of　the　mouth。　Cancrum　oris；　scarlet　fever；　burns；　scurvy；　etc。；　are　occasional　causes　that　have　been　mentioned；　the　atresia　in　these　instances　taking　place　at　any　time　of　life。

Anomalies　of　the　Lips。The　aboriginal　tribes　are　particularly　noted　for　their　large　and　thick　lips；　some　of　which　people　consider　enormous　lips　signs　of　adornment。　Elephantiasis　or　other　pathologic　hypertrophy　of　the　labial　tissues　can　produce　revolting　deformity；　such　as　is　seen　in　Figure　100；　representing　an　individual　who　was　exhibited　several　years　ago　in　Philadelphia。　We　have　in　English　the　expression；　〃pulling　a　long　lip。〃　Its　origin　is　said　to　date　back　to　a　semimythical　hero　of　King　Arthur's　time；　who；　〃when　sad　at　heart　and　melancholic；〃　would　let　one　of　his　lips　drop　below　his　waist；　while　he　turned　the　other　up　like　a　cap　on　his　head。

Blot　records　a　case　of　monstrou