anomalies and curiosities of medicine-第83部分

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t　a　later　period。　The　increased　growth　affected　the　entire　right　half　of　the　body；　including　the　face；　but　was　most　noticeable　in　the　leg；　thigh；　and　buttock。　Numerous　telangiectatic　spots　were　scattered　irregularly　over　the　body；　but　most　thickly　on　the　right　side；　especially　on　the　outer　surface　of　the　leg。　The　accompanying　illustration　represents　the　child's　appearance　at　the　time　of　report。

Jacobson　reports　the　history　of　a　female　child　of　three　years　with　nearly　universal　giant　growth　（Riesenwuchs）。　At　first　this　case　was　erroneously　diagnosed　as　acromegaly。　The　hypertrophy　affected　the　face；　the　genitals；　the　left　side　of　the　trunk；　and　all　the　limbs。

Milne　records　a　case　of　hemihypertrophy　in　a　female　child　of　one　year。　The　only　deviation　from　uniform　excess　of　size　of　the　right　side　was　shown　in　the　forefinger　and　thumb；　which　were　of　the　same　size　as　on　the　other　hand；　and　the　left　side　showed　no　overgrowth　in　any　of　its　members　except　a　little　enlargement　of　the　second　toe。　While　hypertrophy　of　one　side　is　the　usual　description　of　such　cases；　the　author　suggests　that　there　may　be　a　condition　of　defect　upon　the　other　side；　and　he　is　inclined　to　think　that　in　this　case　the　limb；　hand；　and　foot　of　the　left　side　seemed　rather　below　the　average　of　the　child's　age。　In　this　case；　as　in　others　previously　reported；　there　were　numerous　telangiectatic　spots　of　congestion　scattered　irregularly　over　the　body。　Milne　also　reported　later　to　the　Sheffield　Medico…Chirurgical　Society　an　instance　of　unilateral　hypertrophy　in　a　female　child　of　nineteen　months。　The　right　side　was　involved　and　the　anomaly　was　believed　to　be　due　to　a　deficiency　of　growth　of　the　left　side　as　well　as　over…development　of　the　right。　There　were　six　teeth　on　the　right　side　and　one　on　the　left。

Obesity。The　abnormality　of　the　adipose　system；　causing　in　consequence　an　augmentation　of　the　natural　volume　of　the　subject；　should　be　described　with　other　anomalies　of　size　and　stature。　Obesity　may　be　partial；　as　seen　in　the　mammae　or　in　the　abdomen　of　both　women　and　men；　or　it　may　be　general；　and　it　is　of　general　obesity　that　we　shall　chiefly　deal。　Lipomata；　being　distinctly　pathologic　formations；　will　be　left　for　another　chapter。

The　cases　of　obesity　in　infancy　and　childhood　are　of　considerable　interest；　and　we　sometimes　see　cases　that　have　been　termed　examples　of　〃congenital　corpulency。〃　Figure　167　represents　a　baby　of　thirteen　months　that　weighed　75　pounds。　Figure　168　shows　another　example　of　infantile　obesity；　known　as　〃Baby　Chambers。〃　Elliotson　describes　a　female　infant　not　a　year　old　which　weighed　60　pounds。　There　is　an　instance　on　record　of　a　girl　of　four　who　weighed　256　pounds　Tulpius　mentions　a　girl　of　five　who　weighed　150　pounds　and　had　the　strength　of　a　man。　He　says　that　the　acquisition　of　fat　did　not　commence　until　some　time　after　birth。　Ebstein　reports　an　instance　given　to　him　by　Fisher　of　Moscow　of　a　child　in　Pomerania　who　at　the　age　of　six　weighed　137　pounds　and　was　46　inches　tall；　her　girth　was　46　inches　and　the　circumference　of　her　head　was　24　inches。　She　was　the　offspring　of　ordinary…sized　parents；　and　lived　in　narrow　and　sometimes　needy　circumstances。　The　child　was　intelligent　and　had　an　animated　expression　of　countenance。

Bartholinus　mentions　a　girl　of　eleven　who　weighed　over　200　pounds。　There　is　an　instance　recorded　of　a　young　girl　in　Russia　who　weighed　nearly　200　pounds　when　but　twelve。　Wulf；　quoted　by　Ebstein；　describes　a　child　which　died　at　birth　weighing　295　ounces。　It　was　well　proportioned　and　looked　like　a　child　three　months　old；　except　that　it　had　an　enormous　development　of　fatty　tissue。　The　parents　were　not　excessively　large；　and　the　mother　stated　that　she　had　had　children　before　of　the　same　proportions。　Grisolles　mentions　a　child　who　was　so　fat　at　twelve　months　that　there　was　constant　danger　of　suffocation；　but；　marvelous　to　relate；　it　lost　all　its　obesity　when　two　and　a　half；　and　later　was　remarkable　for　its　slender　figure。　Figure　169　shows　a　girl　born　in　Carbon　County；　Pa。；　who　weighed　201　pounds　when　nine　years　old。　McNaughton　describes　Susanna　Tripp；　who　at　six　years　of　age　weighed　203　pounds　and　was　3　feet　6　inches　tall　and　measured　4　feet　2　inches　around　the　waist。　Her　younger　sister；　Deborah；　weighed　119　pounds；　neither　of　the　two　weighed　over　7　pounds　at　birth　and　both　began　to　grow　at　the　fourth　month。　On　October；　1788；　there　died　at　an　inn　in　the　city　of　York　the　surprising　〃Worcestershire　Girl〃　at　the　age　of　five。　She　had　an　exceedingly　beautiful　face　and　was　quite　active。　She　was　4　feet　in　height　and　larger　around　the　breast　and　waist；　her　thigh　measured　18　inches　and　she　weighed　nearly　200　pounds。　In　February；　1814；　Mr。　S。　Pauton　was　married　to　the　only　daughter　of　Thomas　Allanty　of　Yorkshire；　although　she　was　but　thirteen　she　was　13　stone　weight　（182　pounds）。　At　seven　years　she　had　weighed　7　stone　（98　pounds）。　Williams　mentions　several　instances　of　fat　children。　The　first　was　a　German　girl　who　at　birth　weighed　13　pounds；　at　six　months；　42　pounds；　at　four　years；　150　pounds；　and　at　twenty　years；　450　pounds。　Isaac　Butterfield；　born　near　Leeds　in　1781；　weighed　100　pounds　in　1782　and　was　3　feet　13　inches　tall。　There　was　a　child　named　Everitt；　exhibited　in　London　in　1780；　who　at　eleven　months　was　3　feet　9　inches　tall　and　measured　around　the　loins　over　3　feet。　William　Abernethy　at　the　age　of　thirteen　weighed　22　stone　（308　pounds）　and　measured　57　inches　around　the　waist。　He　was　5　feet　6　inches　tall。　There　was　a　girl　of　ten　who　was　1。45　meters　（4　feet　9　inches）　high　and　weighed　175　pounds。　Her　manners　were　infantile　and　her　intellectual　development　was　much　retarded。　She　spoke　with　difficulty　in　a　deep　voice；　she　had　a　most　voracious　appetite。

At　a　meeting　of　the　Physical　Society　of　Vienna　on　December　4；　1894；　there　was　shown　a　girl　of　five　and　a　half　who　weighed　250　pounds。　She　was　just　shedding　her　first　teeth；　owing　to　the　excess　of　fat　on　her　short　limbs　she　toddled　like　an　infant。　There　was　no　tendency　to　obesity　in　her　family。　Up　to　the　eleventh　month　she　was　nursed　by　her　mother；　and　subsequently　fed　on　cabbage；　milk；　and　vegetable　soup。　This　child；　who　was　of　Russian　descent；　was　said　never　to　perspire。

Cameron　describes　a　child　who　at　birth　weighed　14　pounds；　at　twelve　months　she　weighed　69　pounds；　and　at　seventeen　months　98　pounds。　She　was　not　weaned　until　two　years　old　and　she　then　commenced　to　walk。　The　parents　were　not　remarkably　large。　There　is　an　instance　of　a　boy　of　thirteen　and　a　half　who　weighed　214　pounds。　Kaestner　speaks　of　a　child　of　four　who　weighed　82　pounds；　and　Benzenberg　noted　a　child　of　the　same　age　who　weighed　137。　Hildman；　quoted　by　Picat；　speaks　of　an　infant　three　years　and　ten　months　old　who　had　a　girth　of　30　inches。　Hillairet　knew　of　a　child　of　five　which　weighed　125　pounds。　Botta　cites　several　instances　of　preternaturally　stout　children。　One　child　died　at　the　age　of　three　weighing　90　pounds；　another　at　the　age　of　five　weighed　100　pounds；　and　a　third　at　the　age　of　two　weighed　75　pounds。

Figure　170　represents　Miss　〃Millie　Josephine〃　of　Chicago；　a　recent　exhibitionist；　who　at　the　reputed　age　of　thirteen　was　5　feet　6　inches　tall　and　weighed　422　pounds。

General　Remarks。It　has　been　chiefly　in　Great　Britain　and　in　Holland　that　the　most　remarkable　instances　of　obesity　have　been　seen；　especially　in　the　former　country　colossal　weights　have　been　recorded。　In　some　countries　corpulency　has　been　considered　an　adornment　of　the　female　sex。　Hesse…Wartegg　refers　to　the　Jewesses　of　Tunis；　who　when　scarcely　ten　years　old　are　subjected　to　systematic　treatment　by　confinement　in　narrow；　dark　rooms；　where　they　are　fed　on　farinaceous　foods　and　the　flesh　of　young　puppies　until　they　are　almost　a　shapeless　mass　of　fat。　According　to　Ebstein；　the　Moorish　women　reach　with　astonishing　rapidity　the　desired　embonpoint　on　a　diet　of　dates　and　a　peculiar　kind　of　meal。

In　some　nations　and　families　obesity　is　hereditary；　and　generations　come　and　go　without　a　change　in　the　ordinary　conformation　of　the　representatives。　In　other　people　slenderness　is　equally　persistent；　and　efforts　to　overcome　this　peculiarity　of　nature　are　without　avail。

Treatment　of　Obesity。Many　persons；　the　most　famous　of　whom　was　Banting；　have　advanced　theories　to　reduce　corpulency　and　to　improve　slenderness；　but　they　have　been　uniformly　unreliable；　and　the　whole　subject　of　stature…development　presents　an　almost　unexplored　field　for　investigation。　Recently；　Leichtenstein；　observing　in　a　case　of　myxedema　treated　with　the　thyroid　gland　that　the　subcutaneous　fat　disappeared　with　the　continuance　of　the　treatment；　was　led　to　adopt　this　treatment　for　obesity　itself　and　reports　striking　results。　The　diet　of　the　patient　remained　the　same；　and　as　the　appetite　was　not　diminished　by　the　treatment　the　loss　of　weight　was　evidently　due　to　other　causes　than　altered　alimentation。　He　holds　that　the　observations　in　myxedema；　in　obesity；　and　psoriasis　warrant　the　belief　that　the　thyroid　gland　eliminates　a　material　having　a　regulating　influence　upon　the　constitution　of　the　panniculus　adiposus　and　upon　the　nutrition　of　the　skin　in　general。　There　were　25　patients　in　all；　in　22　the　effect　was　entirely　satisfactory；　the　loss　of　weight　amounting　to　as　much　as　9。5　kilos　（21　pounds）。　Of　the　three　cases　in　which　the　result　was　not　satisfactory；　one　had　nephritis　with　severe　Graves'　disease；　and　the　third　psoriasis。　Charrin　has　used　the　injections　of　thyroid　extract　with　decided　benefit。　So　soon　as　the　administration　of　the　remedy　was　stopped　the　loss　of　weight　ceased；　but　with　the　renewal　of　the　remedy　the　loss　of　weight　again　ensued　to　a　certain　point；　beyond　which　the　extract　seemed　powerless　to　act。　Ewald　also　reports　good　results　from　this　treatment　of　obesity。

Remarkable　Instances　of　Obesity。From　time　immemorial　fat　men　and　women　have　been　the　object　of　curiosity　and　the　number　who　have　exhibited　themselves　is　incalculable。　Nearly　every　circus　and　dime　museum　has　its　example；　and　some　of　the　most　famous　have　in　this　way　been　able　to　accumulate　fortunes。

Athenaeus　has　written　quite　a　long　discourse　on　persons　of　note　who　in　the　olden　times　were　distinguished　for　their　obesity。　He　quotes　a　description　of　Denys；　the　tyrant　of　Heraclea；　who　was　so　enormous　that　he　was　in　constant