anomalies and curiosities of medicine-第8部分

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　be　if　she　lives　to　an　advanced　age。　Another　interesting　case　of　this　nature　is　that　of　Mrs。　C。；　born　1854；　married　in　1867；　and　who　had　a　daughter　ten　months　after。　This　daughter　married　in　1882；　and　in　March；　1883；　gave　birth　to　a　9…pound　boy。　The　youthful　grandmother；　not　twenty…nine；　was　present　at　the　birth。　This　case　was　remarkable；　as　the　children　were　both　legitimate。

Fecundity　in　the　old　seems　to　have　attracted　fully　as　much　attention　among　the　older　observers　as　precocity。　Pliny　speaks　of　Cornelia；　of　the　family　of　Serpios；　who　bore　a　son　at　sixty；　who　was　named　Volusius　Saturnius；　and　Marsa；　a　physician　of　Venice；　was　deceived　in　a　pregnancy　in　a　woman　of　sixty；　his　diagnosis　being　〃dropsy。〃　Tarenta　records　the　history　of　the　case　of　a　woman　who　menstruated　and　bore　children　when　past　the　age　of　sixty。　Among　the　older　reports　are　those　of　Blanchard　of　a　woman　who　bore　a　child　at　sixty　years；　Fielitz；　one　at　sixty；　Ephemerides；　one　at　sixty…two；　Rush；　one　at　sixty；　Bernstein；　one　at　sixty　years；　Schoepfer；　at　seventy　years；　and；　almost　beyond　belief；　Debes　cites　an　instance　as　taking　place　at　the　very　advanced　age　of　one　hundred　and　three。　Wallace　speaks　of　a　woman　in　the　Isle　of　Orkney　bearing　children　when　past　the　age　of　sixty。　We　would　naturally　expect　to　find　the　age　of　child…bearing　prolonged　in　the　northern　countries　where　the　age　of　maturity　is　later。　Capuron　cites　an　example　of　child…birth　in　a　woman　of　sixty；　Haller；　cases　at　fifty…eight；　sixty…three；　and　seventy；　Dewees；　at　sixty…one；　and　Thibaut　de　Chauvalon；　in　a　woman　of　Martinique　aged　ninety　years。　There　was　a　woman　delivered　in　Germany；　in　1723；　at　the　age　of　fifty…five；　one　at　fifty…one　in　Kentucky；　and　one　in　Russia　at　fifty。　Depasse　speaks　of　a　woman　of　fifty…nine　years　and　five　months　old　who　was　delivered　of　a　healthy　male　child；　which　she　suckled；　weaning　it　on　her　sixtieth　birthday。　She　had　been　a　widow　for　twenty　years；　and　had　ceased　to　menstruate　nearly　ten　years　before。　In　St。　Peter's　Church；　in　East　Oxford；　is　a　monument　bearing　an　inscription　recording　the　death　in　child…birth　of　a　woman　sixty…two　years　old。　Cachot　relates　the　case　of　a　woman　of　fifty…three；　who　was　delivered　of　a　living　child　by　means　of　the　forceps；　and　a　year　after　bore　a　second　child　without　instrumental　interference。　She　had　no　milk　in　her　breasts　at　the　time　and　no　signs　of　secretion。　This　aged　mother　had　been　married　at　fifty…two；　five　years　after　the　cessation　of　her　menstruation；　and　her　husband　was　a　young　man；　only　twenty…four　years　old。

Kennedy　reports　a　delivery　at　sixty…two　years；　and　the　Cincinnati　Enquirer；　January；　1863；　says：　〃Dr。　W。　McCarthy　was　in　attendance　on　a　lady　of　sixty…nine　years；　on　Thursday　night　last；　who　gave　birth　to　a　fine　boy。　The　father　of　the　child　is　seventy…four　years　old；　and　the　mother　and　child　are　doing　well。〃　Quite　recently　there　died　in　Great　Britain　a　Mrs。　Henry　of　Gortree　at　the　age　of　one　hundred　and　twelve；　leaving　a　daughter　of　nine　years。

Mayham　saw　a　woman　seventy…three　years　old　who　recovered　after　delivery　of　a　child。　A　most　peculiar　case　is　that　of　a　widow；　seventy　years　old；　a　native　of　Garches。　She　had　been　in　the　habit　of　indulging　freely　in　wine；　and；　during　the　last　six　months；　to　decided　excess。　After　an　unusually　prolonged　libation　she　found　herself　unable　to　walk　home；　she　sat　down　by　the　roadside　waiting　until　she　could　proceed；　and　was　so　found　by　a　young　man　who　knew　her　and　who　proposed　helping　her　home。　By　the　time　her　house　was　reached　night　was　well　advanced；　and　she　invited　him　to　stop　over　night；　finding　her　more　than　affable；　he　stopped　at　her　house　over　four　nights；　and　the　result　of　his　visits　was　an　ensuing　pregnancy　for　Madame。

Multiple　births　in　the　aged　have　been　reported　from　authentic　sources。　The　Lancet　quotes　a　rather　fabulous　account　of　a　lady　over　sixty…two　years　of　age　who　gave　birth　to　triplets；　making　her　total　number　of　children　13。　Montgomery；　Colomb；　and　Knehel；　each；　have　recorded　the　birth　of　twins　in　women　beyond　the　usual　age　of　the　menopause；　and　there　is　a　case　recorded　of　a　woman　of　fifty…two　who　was　delivered　of　twins。

Impregnation　without　completion　of　the　copulative　act　by　reason　of　some　malformation；　such　as　occlusion　of　the　vagina　or　uterus；　fibrous　and　unruptured　hymen；　etc。；　has　been　a　subject　of　discussion　in　the　works　of　medical　jurisprudence　of　all　ages；　and　cases　of　conception　without　entrance　of　the　penis　are　found　in　abundance　throughout　medical　literature；　and　may　have　an　important　medicolegal　bearing。　There　is　little　doubt　of　the　possibility　of　spermatozoa　deposited　on　the　genitalia　making　progress　to　the　seat　of　fertilization；　as　their　power　of　motility　and　tenacity　of　life　have　been　well　demonstrated。　Percy　reports　an　instance　in　which　semen　was　found　issuing　from　the　os　uteri　eight　and　one…half　days　after　the　last　intercourse；　and　a　microscopic　examination　of　this　semen　revealed　the　presence　of　living　as　well　as　dead　spermatozoa。　We　have　occasional　instances　of　impregnation　by　rectal　coitus；　the　semen　finding　its　way　into　an　occluded　vaginal　canal　by　a　fistulous　communication。

Guillemeau；　the　surgeon　of　the　French　king；　tells　of　a　girl　of　eighteen；　who　was　brought　before　the　French　officials　in　Paris；　in　1607；　on　the　citation　of　her　husband　of　her　inability　to　allow　him　completion　of　the　marital　function。　He　alleged　that　he　had　made　several　unsuccessful　attempts　to　enter　her；　and　in　doing　so　had　caused　paraphimosis。　On　examination　by　the　surgeons　she　was　found　to　have　a　dense　membrane；　of　a　fibrous　nature；　entirely　occluding　the　vagina；　which　they　incised。　Immediately　afterward　the　woman　exhibited　morning　sickness　and　the　usual　signs　of　pregnancy；　and　was　delivered　in　four　months　of　a　full…term　child；　the　results　of　an　impregnation　occasioned　by　one　of　the　unsuccessful　attempts　at　entrance。　Such　instances　are　numerous　in　the　older　literature；　and　a　mere　citation　of　a　few　is　considered　sufficient　here。　Zacchias；　Amand；　Fabricius　Hildanus；　Graaf；　the　discoverer　of　the　follicles　that　bear　his　name；　Borellus；　Blegny；　Blanchard；　Diemerbroeck；　Duddell；　Mauriceau；　a　Reyes；　Riolan；　Harvey；　the　discoverer　of　the　circulation　of　the　blood；　Wolfius；　Walther；　Rongier；　Ruysch；　Forestus；　Ephemerides；　and　Schurig　all　mention　cases　of　conception　with　intact　hymen；　and　in　which　there　was　no　entrance　of　the　penis。　Tolberg　has　an　example　of　hymen　integrum　after　the　birth　of　a　fetus　five　months　old；　and　there　is　recorded　a　case　of　tubal　pregnancy　in　which　the　hymen　was　intact。

Gilbert　gives　an　account　of　a　case　of　pregnancy　in　an　unmarried　woman；　who　successfully　resisted　an　attempt　at　criminal　connection　and　yet　became　impregnated　and　gave　birth　to　a　perfectly　formed　female　child。　The　hymen　was　not　ruptured；　and　the　impregnation　could　not　have　preceded　the　birth　more　than　thirty…six　weeks。　Unfortunately；　this　poor　woman　was　infected　with　gonorrhea　after　the　attempted　assault。　Simmons　of　St。　Louis　gives　a　curious　peculiarity　of　conception；　in　which　there　was　complete　closure　of　the　vagina；　subsequent　conception；　and　delivery　at　term。　He　made　the　patient's　acquaintance　from　her　application　to　him　in　regard　to　a　malcondition　of　her　sexual　apparatus；　causing　much　domestic　infelicity。

Lawson　speaks　of　a　woman　of　thirty…five；　who　had　been　married　ten　months；　and　whose　husband　could　never　effect　an　entrance；　yet　she　became　pregnant　and　had　a　normal　labor；　despite　the　fact　that；　in　addition　to　a　tough　and　unruptured　hymen；　she　had　an　occluding　vaginal　cyst。　Hickinbotham　of　Birmingham　reports　the　history　of　two　cases　of　labor　at　term　in　females　whose　hymens　were　immensely　thickened。　H。　Grey　Edwards　has　seen　a　case　of　imperforate　hymen　which　had　to　be　torn　through　in　labor；　yet　one　single　act　of　copulation；　even　with　this　obstacle　to　entrance；　sufficed　to　impregnate。　Champion　speaks　of　a　woman　who　became　pregnant　although　her　hymen　was　intact。　She　had　been　in　the　habit　of　having　coitus　by　the　urethra；　and　all　through　her　pregnancy　continued　this　practice。

Houghton　speaks　of　a　girl　of　twenty…five　into　whose　vagina　it　was　impossible　to　pass　the　tip　of　the　first　finger　on　account　of　the　dense　cicatricial　membrane　in　the　orifice；　but　who　gave　birth；　with　comparative　ease；　to　a　child　at　full　term；　the　only　interference　necessary　being　a　few　slight　incisions　to　permit　the　passage　of　the　head。　Tweedie　saw　an　Irish　girl　of　twenty…three；　with　an　imperforate　os　uteri；　who　had　menstruated　only　scantily　since　fourteen　and　not　since　her　marriage。　She　became　pregnant　and　went　to　term；　and　required　some　operative　interference。　He　incised　at　the　point　of　usual　location　of　the　os；　and　one　of　his　incisions　was　followed　by　the　flow　of　liquor　amnii；　and　the　head　fell　upon　the　artificial　opening；　the　diameter　of　which　proved　to　be　one　and　a　half　or　two　inches；　the　birth　then　progressed　promptly；　the　child　being　born　alive。

Guerard　notes　an　instance　in　which　the　opening　barely　admitted　a　hair；　yet　the　patient　reached　the　third　month　of　pregnancy；　at　which　time　she　induced　abortion　in　a　manner　that　could　not　be　ascertained。　Roe　gives　a　case　of　conception　in　an　imperforate　uterus；　and　Duncan　relates　the　history　of　a　case　of　pregnancy　in　an　unruptured　hymen；　characterized　by　an　extraordinary　ascent　of　the　uterus。　Among　many；　the　following　modern　observers　have　also　reported　instances　of　pregnancy　with　hymen　integrum：　Braun；　3　cases；　Francis；　Horton；　Oakman；　Brill；　2　cases；　Burgess；　Haig；　Hay；　and　Smith。　

Instances　in　which　the　presence　of　an　unruptured　hymen　has　complicated　or　retarded　actual　labor　are　quite　common；　and　until　the　membrane　is　ruptured　by　external　means　the　labor　is　often　effectually　obstructed。　Among　others　reporting　cases　of　this　nature　are　Beale；　Carey；　Davis；　Emond　Fetherston；　Leisenring；　Mackinlay；　Martinelli；　Palmer；　Rousseau；　Ware；　and　Yale。　

There　are　many　cases　of　stricture　or　complete　occlusion　of　the　vagina；　congenital　or　acquired　from　cicatricial　contraction；　obstructing　delivery；　and　in　some　the　impregnation　seems　more　marvelous　than　cases　in　which　the　obstruction　is　only　a　thin　membranous　hymen。　Often　the　obstruction　is　so　dense　as　to　require　a　large　bistoury　to　divide　it；　and　even　that　is　not　always　sufficient；　and　the　Cesarean　operation　only　can　terminate　the　o