anomalies and curiosities of medicine-第64部分

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Parvin　describes　a　〃turtle…man〃　as　an　ectromelian；　almost　entering　the　class　of　phocomelians　or　seal…like　monsters；　the　former　term　signifies　abortive　or　imperfect　formation　of　the　members。　The　hands　and　feet　were　normally　developed；　but　the　arms；　forearms；　and　legs　are　much　shortened。

The　〃turtle…woman〃　of　Demerara　was　so　called　because　her　mother　when　pregnant　was　frightened　by　a　turtle；　and　also　from　the　child's　fancied　resemblance　to　a　turtle。　The　femur　was　six　inches　long；　the　woman　had　a　foot　of　six　bones；　four　being　toes；　viz。；　the　first　and　second　phalanges　of　the　first　and　second　toes。　She　had　an　acetabulum；　capsule；　and　ligamentum　teres；　but　no　tibia　or　fibula；　she　also　had　a　defective　right　forearm。　She　was　never　the　victim　of　rachitis　or　like　disease；　but　died　of　syphilis　in　the　Colonial　Hospital。　In　her　twenty…second　year　she　was　delivered　of　a　full…grown　child　free　of　deformity。

There　was　a　woman　living　in　Bavaria；　under　the　observation　of　Buhl；　who　had　congenital　absence　of　both　femurs　and　both　fibulas。　Almost　all　the　muscles　of　the　thigh　existed；　and　the　main　attachment　to　the　pelvis　was　by　a　large　capsular　articulation。　Charpentier　gives　the　portrait　of　a　woman　in　whom　there　was　a　uniform　diminution　in　the　size　of　the　limbs。　Debout　portrays　a　young　man　with　almost　complete　absence　of　the　thigh　and　leg；　from　whose　right　hip　there　depended　a　foot。　Accrell　describes　a　peasant　of　twenty…six；　born　without　a　hip；　thigh；　or　leg　on　the　right　side。　The　external　genital　organs　were　in　their　usual　place；　but　there　was　only　one　testicle　in　the　scrotum。　The　man　was　virile。　The　rectum　instead　of　opening　outward　and　underneath　was　deflected　to　the　right。

Supernumerary　Limbs。Haller　reports　several　cases　of　supernumerary　extremities。　Plancus　speaks　of　an　infant　with　a　complete　third　leg；　and　Dumeril　cites　a　similar　instance。　Geoffroy…Saint…Hilaire　presented　to　the　Academie　des　Sciences　in　1830　a　child　with　four　legs　and　feet　who　was　in　good　health。　Amman　saw　a　girl　with　a　large　thigh　attached　to　her　nates。　Below　the　thigh　was　a　single　leg　made　by　the　fusion　of　two　legs。　No　patella　was　found　and　the　knee　was　anchylosed。　One　of　the　feet　of　the　supernumerary　limb　had　six　toes；　while　the　other；　which　was　merely　an　outgrowth；　had　two　toes　on　it。

According　to　Jules　Guerin；　the　child　named　Gustav　Evrard　was　born　with　a　thigh　ending　in　two　legs　and　two　imperfect　feet　depending　from　the　left　nates。

Tucker　describes　a　baby　born　in　the　Sloane　Maternity　in　New　York；　October　1；　1894；　who　had　a　third　leg　hanging　from　a　bony　and　fleshy　union　attached　to　the　dorsal　spine。　The　supernumerary　leg　was　well　formed　and　had　a　left　foot　attached　to　it。　Larkin　and　Jones　mention　the　removal　of　a　meningocele　and　a　supernumerary　limb　from　an　infant　of　four　months。　This　limb　contained　three　fingers　only；　one　of　which　did　not　have　a　bony　skeleton。

Pare　says　that　on　the　day　the　Venetians　and　the　Genevois　made　peace　a　monster　was　born　in　Italy　which　had　four　legs　of　equal　proportions；　and　besides　had　two　supernumerary　arms　from　the　elbows　of　the　normal　limbs。　This　creature　lived　and　was　baptized。

Anomalies　of　the　Feet。Hatte　has　seen　a　woman　who　bore　a　child　that　had　three　feet。　Bull　gives　a　description　of　a　female　infant　with　the　left　foot　double　or　cloven。　There　was　only　one　heel；　but　the　anterior　portion　consisted　of　an　anterior　and　a　posterior　part。　The　anterior　foot　presented　a　great　toe　and　four　smaller　ones；　but　deformed　like　an　example　of　talipes　equinovarus。　Continuous　with　the　outer　edge　of　the　anterior　part　and　curving　beneath　it　was　a　posterior　part；　looking　not　unlike　a　second　foot；　containing　six　well…formed　toes　situated　directly　beneath　the　other　five。　The　eleven　toes　were　all　perfect　and　none　of　them　were　webbed。

There　is　a　class　of　monsters　called　〃Sirens〃　on　account　of　their　resemblance　to　the　fabulous　creatures　of　mythology　of　that　name。　Under　the　influence　of　compression　exercised　in　the　uterus　during　the　early　period　of　gestation　fusion　of　the　inferior　extremities　is　effected。　The　accompanying　illustration　shows　the　appearance　of　these　monsters；　which　are　thought　to　resemble　the　enchantresses　celebrated　by　Homer。

Anomalies　of　the　Hand。Blumenbach　speaks　of　an　officer　who；　having　lost　his　right　hand；　was　subsequently　presented　by　his　wife　with　infants　of　both　sexes　showing　the　same　deformity。　Murray　cites　the　instance　of　a　woman　of　thirty…eight；　well　developed；　healthy；　and　the　mother　of　normal　children；　who　had　a　double　hand。　The　left　arm　was　abnormal；　the　flexion　of　the　elbow　imperfect；　and　the　forearm　terminated　in　a　double　hand　with　only　rudimentary　thumbs。　In　working　as　a　charwoman　she　leaned　on　the　back　of　the　flexed　carpus。　The　double　hand　could　grasp　firmly；　though　the　maximum　power　was　not　so　great　as　that　of　the　right　hand。　Sensation　was　equally　acute　in　all　three　of　the　hands。　The　middle　and　ring　fingers　of　the　supernumerary　hand　were　webbed　as　far　as　the　proximal　joints；　and　the　movements　of　this　hand　were　stiff　and　imperfect。　No　single　finger　of　the　two　hands　could　be　extended　while　the　other　seven　were　flexed。　Giraldes　saw　an　infant　in　1864　with　somewhat　the　same　deformity；　but　in　which　the　disposition　of　the　muscles　and　tendons　permitted　the　ordinary　movements。

Absence　of　Digits。Maygrier　describes　a　woman　of　twenty…four　who　instead　of　having　a　hand　on　each　arm　had　only　one　finger；　and　each　foot　had　but　two　toes。　She　was　delivered　of　two　female　children　in　1827　and　one　in　1829；　each　having　exactly　the　same　deformities。　Her　mother　was　perfectly　formed；　but　the　father　had　but　one　toe　on　his　foot　and　one　finger　on　his　left　hand。

Kohler　gives　photographs　of　quite　a　remarkable　case　of　suppression　and　deformity　of　the　digits　of　both　the　fingers　and　toes。

Figure　123　shows　a　man　who　was　recently　exhibited　in　Philadelphia。　He　had　but　two　fingers　on　each　hand　and　two　toes　on　each　foot；　and　resembles　Kohler's　case　in　the　anomalous　digital　conformation。

Figure　124　represents　an　exhibitionist　with　congenital　suppression　of　four　digits　on　each　hand。

Tubby　has　seen　a　boy　of　three　in　whom　the　first；　second；　and　third　toes　of　each　foot　were　suppressed；　the　great　toe　and　the　little　toe　being　so　overgrown　that　they　could　be　opposed。　In　this　family　for　four　generations　15　individuals　out　of　22　presented　this　defect　of　the　lower　extremity。　The　patient's　brothers　and　a　sister　had　exactly　the　same　deformity；　which　has　been　called　〃lobster…claw　foot。〃

Falla　of　Jedburgh　speaks　of　an　infant　who　was　born　without　forearms　or　hands；　at　the　elbow　there　was　a　single　finger　attached　by　a　thin　string　of　tissue。　This　was　the　sixth　child；　and　it　presented　no　other　deformity。　Falla　also　says　that　instances　of　intrauterine　digital　amputation　are　occasionally　seen。

According　to　Annandale；　supernumerary　digits　may　be　classified　as　follows：

（1）　A　deficient　organ；　loosely　attached　by　a　narrow　pedicle　to　the　hand　or　foot　（or　to　another　digit）。

（2）　A　more　or　less　developed　organ；　free　at　its　extremity；　and　articulating　with　the　head　or　sides　of　a　metacarpal；　metatarsal；　or　phalangeal　bone。

（3）　A　fully　developed　separate　digit。

（4）　A　digit　intimately　united　along　its　whole　length　with　another　digit；　and　having　either　an　additional　metacarpal　or　metatarsal　bone　of　its　own；　or　articulating　with　the　head　of　one　which　is　common　to　it　and　another　digit。

Superstitions　relative　to　supernumerary　fingers　have　long　been　prevalent。　In　the　days　of　the　ancient　Chaldeans　it　was　for　those　of　royal　birth　especially　that　divinations　relative　to　extra　digits　were　cast。　Among　the　ancients　we　also　occasionally　see　illustrations　emblematic　of　wisdom　in　an　individual　with　many　fingers；　or　rather　double　hands；　on　each　arm。

Hutchinson；　in　his　comments　on　a　short…limbed；　polydactylous　dwarf　which　was　dissected　by　Ruysch；　the　celebrated　Amsterdam　anatomist；　writes　as　follows。

〃This　quaint　figure　is　copied　from　Theodore　Kerckring's　'Spicilegium　Anatomicum；'　published　in　Amsterdam　in　1670。　The　description　states　that　the　body　was　that　of　an　infant　found　drowned　in　the　river　on　October　16；　1668。　It　was　dissected　by　the　renowned　Ruysch。　A　detailed　description　of　the　skeleton　is　given。　My　reason　for　now　reproducing　the　plate　is　that　it　offers　an　important　item　of　evidence　in　reference　to　the　development　of　short…limbed　dwarfs。　Although　we　must　not　place　too　much　reliance　on　the　accuracy　of　the　draughtsman；　since　he　has　figured　some　superfluous　lumbar　vertebrae；　yet　there　can　be　no　doubt　that　the　limbs　are　much　too　short　for　the　trunk　and　head。　This　remark　especially　applies　to　the　lower　limbs　and　pelvis。　These　are　exactly　like　those　of　the　Norwich　dwarf　and　of　the　skeleton　in　the　Heidelberg　Museum　which　I　described　in　a　recent　number　of　the　'Archives。'　The　point　of　extreme　interest　in　the　present　case　is　that　this　dwarfing　of　the　limbs　is　associated　with　polydactylism。　Both　the　hands　have　seven　digits。　The　right　foot　has　eight　and　the　left　nine。　The　conditions　are　not　exactly　symmetrical；　since　in　some　instances　a　metacarpal　or　metatarsal　bone　is　wanting；　or；　to　put　it　otherwise；　two　are　welded　together。　It　will　be　seen　that　the　upper　extremities　are　so　short　that　the　tips　of　the　digits　will　only　just　touch　the　iliac　crests。

〃This　occurrence　of　short　limbs　with　polydactylism　seems　to　prove　conclusively　that　the　condition　may　be　due　to　a　modification　of　development　of　a　totally　different　nature　from　rickets。　It　is　probable　that　the　infant　was　not　at　full　term。　Among　the　points　which　the　author　has　noticed　in　his　description　are　that　the　fontanelle　was　double　its　usual　size；　that　the　orbits　were　somewhat　deformed；　that　the　two　halves　of　the　lower　jaw　were　already　united；　and　that　the　ribs　were　short　and　badly　formed。　He　also；　of　course；　draws　attention　to　the　shortness　of　the　limbs；　the　stoutness　of　the　long　bones；　and　the　supernumerary　digits。　I　find　no　statement　that　the　skeleton　was　deposited　in　any　museum；　but　it　is　very　possible　that　it　is　still　in　existence　in　Amsterdam；　and　if　so　it　is　very　desirable　that　it　should　be　more　exactly　described；〃

In　Figure　126；　A　represents　division　of　thumb　after　Guyot…Daubes；　shows　a　typical　case　of　supernumerary　fingers；　and　C　pictures　Morand's　case　of　duplication　of　several　toes。

Forster　gives　a　sk