anomalies and curiosities of medicine-第61部分

按键盘上方向键 ← 或 → 可快速上下翻页，按键盘上的 Enter 键可回到本书目录页，按键盘上方向键 ↑ 可回到本页顶部！
————未阅读完？加入书签已便下次继续阅读！


w　his　waist；　while　he　turned　the　other　up　like　a　cap　on　his　head。

Blot　records　a　case　of　monstrous　congenital　hypertrophy　of　the　superior　lip　in　an　infant　of　eight　months。　Buck　successfully　treated　by　surgical　operations　a　case　of　congenital　hypertrophy　of　the　under　lip；　and　Detmold　mentions　a　similar　result　in　a　young　lady　with　hypertrophy　of　the　lip　and　lower　part　of　the　nose。　Murray　reports　an　undescribed　malformation　of　the　lower　lip　occurring　in　one　family。

Hare…lip　may　be　unilateral　or　double；　and　may　or　may　not　include　the　palatine　arch。　In　the　worst　cases　it　extends　in　fissures　on　both　sides　to　the　orbit。　In　other　cases　the　minimum　degree　of　this　deformity　is　seen。

Congenital　absence　of　the　tongue　does　not　necessarily　make　speech；　taste；　or　deglutition　impossible。　Jussieu　cites　the　case　of　a　girl　who　was　born　without　a　tongue　but　who　spoke　very　distinctly。　Berdot　describes　a　case　in　which　the　tongue　was　deficient；　without　apparent　disturbance　of　any　of　the　functions。　Riolan　mentions　speech　after　loss　of　the　tongue　from　small…pox。

Boddington　gives　an　account　of　Margaret　Cutting；　who　spoke　readily　and　intelligibly；　although　she　had　lost　her　tongue。　Saulquin　has　an　observation　of　a　girl　without　a　tongue　who　spoke；　sang；　and　swallowed　normally。　Aurran；　Bartholinus；　Louis；　Parsons；　Tulpius；　and　others　mention　speech　without　the　presence　of　a　tongue。

Philib　reports　a　case　in　which　mutism；　almost　simulating　that　of　one　congenitally　deaf；　was　due　to　congenital　adhesions　of　the　tongue　to　the　floor　of　the　buccal　cavity。　Speech　was　established　after　removal　of　the　abnormal　adhesion。　Routier　speaks　of　ankylosis　of　the　tongue　of　seventeen　years'　duration。

Jurist　records　such　abnormal　mobility　of　the　tongue　that　the　patient　was　able　to　project　the　tongue　into　the　nasopharynx。　Wherry　and　Winslow　record　similar　instances。

There　have　been　individuals　with　bifid　tongues；　after　the　normal　type　of　serpents　and　saurians；　and　others　who　possessed　a　supernumerary　tongue。　Rev。　Henry　Wharton；　Chaplain　to　Archbishop　Sancroft；　in　his　journal；　written　in　the　seventeenth　century；　says　that　he　was　born　with　two　tongues　and　passed　through　life　so；　one；　however；　gradually　atrophying。　In　the　polyclinic　of　Schnitzer　in　Vienna　in　1892　Hajek　observed　in　a　lad　of　twelve　an　accessory　tongue　2。4　cm。　in　length　and　eight　mm。　in　breadth；　forming　a　tumor　at　the　base　of　the　normal　tongue。　It　was　removed　by　scissors；　and　on　histologic　examination　proved　to　be　a　true　tongue　with　the　typical　tissues　and　constituents。　Borellus；　Ephemerides；　Eschenbach；　Mortimer；　Penada；　and　Schenck　speak　of　double　tongues；　and　Avicenna　and　Schenck　have　seen　fissured　tongues。　Dolaeus　records　an　instance　of　double　tongue　in　a　paper　entitled　〃De　puella　bilingui；〃　and　Beaudry　and　Brothers　speak　of　cleft　tongue。　Braine　records　a　case　in　which　there　was　a　large　hypertrophied　fold　of　membrane　coming　from　each　side　of　the　upper　lip。

In　some　cases　there　is　marked　augmentation　of　the　volume　of　the　tongue。　Fournier　has　seen　a　juggler　with　a　tongue　so　long　that　he　could　extrude　it　six　inches　from　his　mouth。　He　also　refers　to　a　woman　in　Berlin　with　a　long　tongue；　but　it　was　thinner　than　that　of　a　cat。　When　she　laughed　it　hung　over　her　teeth　like　a　curtain；　and　was　always　extremely　cold　to　the　touch。　In　the　same　article　there　is　a　description　of　a　man　with　a　very　long　neck　who　could　touch　his　tongue　to　his　chest　without　reclining　his　head。　Congenital　and　acquired　hypertrophy　of　the　tongue　will　be　discussed　later。

Amatus　Lusitanus　and　Portal　refer　to　the　presence　of　hair　on　the　tongue；　and　later　there　was　an　account　of　a　medical　student　who　complained　of　dyspepsia　and　a　sticky　sensation　in　the　mouth。　On　examination　a　considerable　growth　of　hair　was　found　on　the　surface　of　the　tongue。　The　hairs　would　be　detached　in　vomiting　but　would　grow　again；　and　when　he　was　last　seen　they　were　one　inch　long。　Such　are　possibly　nevoid　in　formation。

The　ordinary　anomalies　of　the　palate　are　the　fissures；　unilateral；　bilateral；　median；　etc。：　they　are　generally　associated　with　hare…lip。　The　median　fissure　commencing　between　the　middle　incisors　is　quite　rare。

Many　curious　forms　of　obturator　or　artificial　palate　are　employed　to　remedy　congenital　defects。　Sercombe　mentions　a　case　in　which　destruction　of　the　entire　palate　was　successfully　relieved　by　mechanical　means。　In　some　instances　among　the　lower　classes　these　obturators　are　simple　pieces　of　wood；　so　fashioned　as　to　fit　into　the　palatine　cleft；　and　not　infrequently　the　obturator　has　been　swallowed；　causing　obstruction　of　the　air…passages　or　occluding　the　esophagus。

Abnormalism　of　the　Uvula。Examples　of　double　uvula　are　found　in　the　older　writers；　and　Hagendorn　speaks　of　a　man　who　was　born　without　a　uvula。　The　Ephemerides　and　Salmuth　describe　uvulae　so　defective　as　to　be　hardly　noticeable。　Bolster；　Delius；　Hodges；　Mackenzie　of　Baltimore；　Orr；　Riedel；　Schufeldt；　and　Tidyman　are　among　observers　reporting　bifurcated　and　double　uvula；　and　they　are　quite　common。　Ogle　records　instances　of　congenital　absence　of　the　uvula。

Anomalies　of　the　Epiglottis。Morgagni　mentions　a　man　without　an　epiglottis　who　ate　and　spoke　without　difficulty。　He　thought　the　arytenoids　were　so　strongly　developed　that　they　replaced　the　functions　of　the　missing　organ。　Enos　of　Brooklyn　in　1854　reported　absence　of　the　epiglottis　without　interference　with　deglutition。　Manifold　speaks　of　a　case　of　bifurcated　epiglottis。　Debloisi　records　an　instance　of　congenital　web　of　the　vocal　bands。　Mackenzie　removed　a　congenital　papillomatous　web　which　had　united　the　vocal　cords　until　the　age　of　twenty…three；　thus　establishing　the　voice。　Poore　also　recorded　a　case　of　congenital　web　in　the　larynx。　Elsberg　and　Scheff　mention　occlusion　of　the　rima　glottidis　by　a　membrane。

Instances　of　duplication　of　the　epiglottis　attended　with　a　species　of　double　voice　possess　great　interest。　French　described　a　man　of　thirty；　by　occupation　a　singer　and　contortionist；　who　became　possessed　of　an　extra　voice　when　he　was　sixteen。　In　high　and　falsetto　tones　he　could　run　the　scale　from　A　to　F　in　an　upper　and　lower　range。　The　compass　of　the　low　voice　was　so　small　that　he　could　not　reach　the　high　notes　of　any　song　with　it；　and　in　singing　he　only　used　it　to　break　in　on　the　falsetto　and　produce　a　sensation。　He　was　supposed　to　possess　a　double　epiglottis。　

Roe　describes　a　young　lady　who　could　whistle　at　will　with　the　lower　part　of　her　throat　and　without　the　aid　of　her　lips。　Laryngeal　examination　showed　that　the　fundamental　tones　were　produced　by　vibrations　of　the　edges　of　the　vocal　cords；　and　the　modifications　were　effected　by　a　minute　adjustment　of　the　ventricular　bands；　which　regulated　the　laryngeal　opening　above　the　cord；　and　pressing　firmly　down　closed　the　ventricle　and　acted　as　a　damper　preventing　the　vibrations　of　the　cords　except　in　their　middle　third。　Morgan　in　the　same　journal　mentions　the　case　of　a　boy　of　nineteen；　who　seemed　to　be　affected　with　laryngeal　catarrh；　and　who　exhibited　distinct　diphthongia。　He　was　seen　to　have　two　glottic　orifices　with　associate　bands。　The　treatment　was　directed　to　the　catarrh　and　consequent　paresis　of　the　posterior　bands；　and　he　soon　lost　his　evidences　of　double　voice。　

｛footnote｝　The　following　is　a　description　of　the　laryngeal　formation　of　a　singer　who　has　recently　acquired　considerable　notice　by　her　ability　to　sing　notes　of　the　highest　tones　and　to　display　the　greatest　compass　of　voice。　It　is　extracted　from　a　Cleveland；　Ohio；　newspaper：　〃She　has　unusual　development　of　the　larynx；　which　enables　her　to　throw　into　vibration　and　with　different　degrees　of　rapidity　the　entire　length　of　the　vocal　cords　or　only　a　part　thereof。　But　of　greatest　interest　is　her　remarkable　control　over　the　muscles　which　regulate　the　division　and　modification　of　the　resonant　cavities；　the　laryngeal；　pharyngeal；　oral；　and　nasal；　and　upon　this　depends　the　quality　of　her　voice。　The　uvula　is　bifurcated；　and　the　two　divisions　sometimes　act　independently。　The　epiglottis　during　the　production　of　the　highest　notes　rises　upward　and　backward　against　the　posterior　pharyngeal　wall　in　such　a　way　as　almost　entirely　to　separate　the　pharyngeal　cavities；　at　the　same　time　that　it　gives　an　unusual　conformation　to　those　resonant　chambers。〃


Complete　absence　of　the　eyes　is　a　very　rare　anomaly。　Wordsworth　describes　a　baby　of　seven　weeks；　otherwise　well　formed　and　healthy；　which　had　congenital　absence　of　both　eyes。　The　parents　of　this　child　were　in　every　respect　healthy。　There　are　some　cases　of　monstrosities　with　closed；　adherent　eyelids　and　absence　of　eyes。　Holmes　reports　a　case　of　congenital　absence　of　both　eyes；　the　child　otherwise　being　strong　and　perfect。　The　child　died　of　cholera　infantum。　He　also　reports　a　case　very　similar　in　a　female　child　of　American　parents。　In　a　girl　of　eight；　of　German　parents；　he　reports　deficiency　of　the　external　walls　of　each　orbit；　in　addition　to　great　deformity　of　the　side　of　the　head。　He　also　gives　an　instance　of　congenital　paralysis　of　the　levator　palpebrae　muscles　in　a　child　whose　vision　was　perfect　and　who　was　otherwise　perfect。　Holmes　also　reports　a　case　of　enormous　congenital　exophthalmos；　in　which　the　right　eye　protruded　from　the　orbit　and　was　no　longer　covered　by　the　cornea。　Kinney　has　an　account　of　a　child　born　without　eyeballs。　The　delivery　was　normal；　and　there　was　no　history　of　any　maternal　impression；　the　child　was　otherwise　healthy　and　well　formed。

Landes　reports　the　case　of　an　infant　in　which　both　eyes　were　absent。　There　were　six　fingers　on　each　hand　and　six　toes　on　each　foot。　The　child　lived　a　few　weeks。　In　some　instances　of　supposed　absence　of　the　eyeball　the　eye　is　present　but　diminutive　and　in　the　posterior　portion　of　the　orbit。　There　are　instances　of　a　single　orbit　with　no　eyes　and　also　a　single　orbit　containing　two　eyes。　Again　we　may　have　two　orbits　with　an　absence　of　eyes　but　the　presence　of　the　lacrimal　glands；　or　the　eyes　may　be　present　or　very　imperfectly　developed。　Mackenzie　mentions　cases　in　which　the　orbit　was　more　or　less　completely　wanting　and　a　mass　of　cellular　tissue　in　each　eye。

Cases　of　living　cyclopia；　or　individuals　with　one　eye　in　the　center　of　the　forehead　after　the　manner　of　the　mythical　Cyclops；　are　quite　rare。　Vallentini　in　1884　reports　a　case　o