anomalies and curiosities of medicine-第9部分

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vide　it；　and　even　that　is　not　always　sufficient；　and　the　Cesarean　operation　only　can　terminate　the　obstructed　delivery；　we　cannot　surmise　how　conception　could　have　been　possible。　Staples　records　a　case　of　pregnancy　and　parturition　with　congenital　stricture　of　the　vagina。　Maisonneuve　mentions　the　successful　practice　of　a　Cesarean　operation　in　a　case　of　congenital　occlusion　of　the　vagina　forming　a　complete　obstruction　to　delivery。　Verdile　records　an　instance　of　imperforate　vagina　in　which　rectovaginal　wall　was　divided　and　the　delivery　effected　through　the　rectum　and　anus。　Lombard　mentions　an　observation　of　complete　occlusion　of　the　vagina　in　a　woman；　the　mother　of　4　living　children　and　pregnant　for　the　fifth　time。　Thus；　almost　incredible　to　relate；　it　is　possible　for　a　woman　to　become　a　mother　of　a　living　child　and　yet　preserve　all　the　vaginal　evidences　of　virginity。　Cole　describes　a　woman　of　twenty…four　who　was　delivered　without　the　rupture　of　the　hymen；　and　Meek　remarks　on　a　similar　case。　We　can　readily　see　that；　in　a　case　like　that　of　Verdile；　in　which　rectal　delivery　is　effected；　the　hymen　could　be　left　intact　and　the　product　of　conception　be　born　alive。

A　natural　sequence　to　the　subject　of　impregnation　without　entrance　is　that　of　artificial　impregnation。　From　being　a　matter　of　wonder　and　hearsay；　it　has　been　demonstrated　as　a　practical　and　useful　method　in　those　cases　in　which；　by　reason　of　some　unfortunate　anatomic　malformation　on　either　the　male　or　the　female　side；　the　marriage　is　unfruitful。　There　are　many　cases　constantly　occurring　in　which　the　birth　of　an　heir　is　a　most　desirable　thing　in　a　person's　life。　The　historic　instance　of　Queen　Mary　of　England；　whose　anxiety　and　efforts　to　bear　a　child　were　the　subject　of　public　comment　and　prayers；　is　but　an　example　of　a　fact　that　is　occurring　every　day；　and　doubtless　some　of　these　cases　could　be　righted　by　the　pursuance　of　some　of　the　methods　suggested。

There　have　been　rumors　from　the　beginning　of　the　century　of　women　being　impregnated　in　a　bath；　from　contact　with　cloths　containing　semen；　etc。；　and　some　authorities　in　medical　jurisprudence　have　accepted　the　possibility　of　such　an　occurrence。　It　is　not　in　the　province　of　this　work　to　speculate　on　what　may　be；　but　to　give　authoritative　facts；　from　which　the　reader　may　draw　his　own　deductions。　Fertilization　of　plants　has　been　thought　to　have　been　known　in　the　oldest　times；　and　there　are　some　who　believe　that　the　library　at　Alexandria　must　have　contained　some　information　relative　to　it。　The　first　authentic　account　that　we　have　of　artificial　impregnation　is　that　of　Schwammerdam；　who　in　1680　attempted　it　without　success　by　the　fecundation　of　the　eggs　of　fish。　Roesel；　his　scholar；　made　an　attempt　in　1690；　but　also　failed；　and　to　Jacobi；　in　1700；　belongs　the　honor　of　success。　In　1780；　Abbe　Spallanzani；　following　up　the　success　of　Jacobi；　artificially　impregnated　a　bitch；　who　brought　forth　in　sixty…two　days　3　puppies；　all　resembling　the　male。　The　illustrious　John　Hunter　advised　a　man　afflicted　with　hypospadias　to　impregnate　his　wife　by　vaginal　injections　of　semen　in　water　with　an　ordinary　syringe；　and；　in　spite　of　the　simplicity　of　this　method；　the　attempt　was　followed　by　a　successful　issue。　Since　this　time；　Nicholas　of　Nancy　and　Lesueur　have　practised　the　simple　vaginal　method；　while　Gigon；　d'Angouleme　（14　cases）；　Girault　（10　cases）；　Marion　Sims；　Thomas；　Salmon；　Pajot；　Gallard；　Courty；　Roubaud；　Dehaut；　and　others　have　used　the　more　modern　uterine　method　with　success。

A　dog…breeder；　by　syringing　the　uterus　of　a　bitch；　has　succeeded　in　impregnating　her。　Those　who　are　desirous　of　full　information　on　this　subject；　as　regards　the　modus　operandi；　etc。；　are　referred　to　Girault；　this　author　reports　in　full　several　examples。　One　case　was　that　of　a　woman；　aged　twenty…five；　afflicted　with　blenorrhea；　who；　chagrined　at　not　having　issue；　made　repeated　forcible　injections　of　semen　in　water　for　two　months；　and　finally　succeeded　in　impregnating　herself；　and　was　delivered　of　a　living　child。　Another　case　was　that　of　a　female；　aged　twenty…three；　who　had　an　extra　long　vaginal　canal；　probably　accounting　for　the　absence　of　pregnancy。　She　made　injections　of　semen；　and　was　finally　delivered　of　a　child。　He　also　reports　the　case　of　a　distinguished　musician　who；　by　reason　of　hypospadias；　had　never　impregnated　his　wife；　and　had　resorted　to　injections　of　semen　with　a　favorable　result。　This　latter　case　seems　hardly　warranted　when　we　consider　that　men　afflicted　with　hypospadias　and　epispadias　have　become　fathers。　Percy　gives　the　instance　of　a　gentleman　whom　he　had　known　for　some　time；　whose　urethra　terminated　a　little　below　the　frenum；　as　in　other　persons；　but　whose　glans　bulged　quite　prominently　beyond　it；　rendering　urination　in　the　forward　direction　impossible。　Despite　the　fact　that　this　man　could　not　perform　the　ejaculatory　function；　he　was　the　father　of　three　children；　two　of　them　inheriting　his　penile　formation。

The　fundamental　condition　of　fecundity　being　the　union　of　a　spermatozoid　and　an　ovum；　the　object　of　artificial　impregnation　is　to　further　this　union　by　introducing　semen　directly　to　the　fundus　of　the　uterus。　The　operation　is　quite　simple　and　as　follows：　The　husband；　having　been　found　perfectly　healthy；　is　directed　to　cohabit　with　his　wife；　using　a　condom。　The　semen　ejaculated　is　sucked　up　by　an　intrauterine　syringe　which　has　been　properly　disinfected　and　kept　warm。　The　os　uteri　is　now　exposed　and　wiped　off　with　some　cotton　which　has　been　dipped　in　an　antiseptic　fluid；　introduced　to　the　fundus　of　the　uterus；　and　some　drops　of　the　fluid　slowly　expressed　into　the　uterus。　The　woman　is　then　kept　in　bed　on　her　back。　This　operation　is　best　carried　out　immediately　before　or　immediately　after　the　menstrual　epoch；　and　if　not　successful　at　the　first　attempt　should　be　repeated　for　several　months。　At　the　present　day　artificial　impregnation　in　pisciculture　is　extensively　used　with　great　success。　

｛footnote｝　The　following　extraordinary　incident　of　accidental　impregnation；　quoted　from　the　American　Medical　Weekly　by　the　Lancet；　is　given　in　brief；　not　because　it　bears　any　semblance　of　possibility；　but　as　a　curious　example　from　the　realms　of　imagination　in　medicine。

L。　G。　Capers　of　Vicksburg；　Miss。；　relates　an　incident　during　the　late　Civil　War；　as　follows：　A　matron　and　her　two　daughters；　aged　fifteen　and　seventeen　years；　filled　with　the　enthusiasm　of　patriotism；　stood　ready　to　minister　to　the　wounds　of　their　countrymen　in　their　fine　residence　near　the　scene　of　the　battle　of　R；　May　12；　1863；　between　a　portion　of　Grant's　army　and　some　Confederates。　During　the　fray　a　gallant　and　noble　young　friend　of　the　narrator　staggered　and　fell　to　the　earth；　at　the　same　time　a　piercing　cry　was　heard　in　the　house　near　by。　Examination　of　the　wounded　soldier　showed　that　a　bullet　had　passed　through　the　scrotum　and　carried　away　the　left　testicle。　The　same　bullet　had　apparently　penetrated　the　left　side　of　the　abdomen　of　the　elder　young　lady；　midway　between　the　umbilicus　and　the　anterior　superior　spinous　process　of　the　ilium；　and　had　become　lost　in　the　abdomen。　This　daughter　suffered　an　attack　of　peritonitis；　but　recovered　in　two　months　under　the　treatment　administered。

Marvelous　to　relate；　just　two　hundred　and　seventy…eight　days　after　the　reception　of　the　minie…ball；　she　was　delivered　of　a　fine　boy；　weighing　8　pounds；　to　the　surprise　of　herself　and　the　mortification　of　her　parents　and　friends。　The　hymen　was　intact；　and　the　young　mother　strenuously　insisted　on　her　virginity　and　innocence。　About　three　weeks　after　this　remarkable　birth　Dr。　Capers　was　called　to　see　the　infant；　and　the　grandmother　insisted　that　there　was　something　wrong　with　the　child's　genitals。　Examination　showed　a　rough；　swollen；　and　sensitive　scrotum；　containing　some　hard　substance。　He　operated；　and　extracted　a　smashed　and　battered　minie…ball。　The　doctor；　after　some　meditation；　theorized　in　this　manner：　He　concluded　that　this　was　the　same　ball　that　had　carried　away　the　testicle　of　his　young　friend；　that　had　penetrated　the　ovary　of　the　young　lady；　and；　with　some　spermatozoa　upon　it；　had　impregnated　her。　With　this　conviction　he　approached　the　young　man　and　told　him　the　circumstances；　the　soldier　appeared　skeptical　at　first；　but　consented　to　visit　the　young　mother；　a　friendship　ensued　which　soon　ripened　into　a　happy　marriage；　and　the　pair　had　three　children；　none　resembling；　in　the　same　degree　as　the　first；　the　heroic　pater　familias。


Interesting　as　are　all　the　anomalies　of　conception；　none　are　more　so　than　those　of　unconscious　impregnation；　and　some　well…authenticated　cases　can　be　mentioned。　Instances　of　violation　in　sleep；　with　subsequent　pregnancy　as　a　result；　have　been　reported　in　the　last　century　by　Valentini；　Genselius；　and　Schurig。　Reports　by　modern　authorities　seem　to　be　quite　scarce；　though　there　are　several　cases　on　record　of　rape　during　anesthesia；　followed　by　impregnation。　Capuron　relates　a　curious　instance　of　a　woman　who　was　raped　during　lethargy；　and　who　subsequently　became　pregnant；　though　her　condition　was　not　ascertained　until　the　fourth　month；　the　peculiar　abdominal　sensation　exciting　suspicion　of　the　true　nature　of　the　case；　which　had　previously　been　thought　impossible。

There　is　a　record　of　a　case　of　a　young　girl　of　great　moral　purity　who　became　pregnant　without　the　slightest　knowledge　of　the　source；　although；　it　might　be　remarked；　such　cases　must　be　taken　〃cum　grano　salis。〃　Cases　of　conception　without　the　slightest　sexual　desire　or　pleasure；　either　from　fright；　as　in　rape；　or　naturally　deficient　constitution；　have　been　recorded；　as　well　as　conception　during　intoxication　and　in　a　hypnotic　trance；　which　latter　has　recently　assumed　a　much　mooted　legal　aspect。　As　far　back　as　1680；　Duverney　speaks　of　conception　without　the　slightest　sense　of　desire　or　pleasure　on　the　part　of　the　female。

Conception　with　Deficient　Organs。Having　spoken　of　conception　with　some　obstructive　interference；　conception　with　some　natural　or　acquired　deficiency　of　the　functional；　organic；　or　genital　apparatus　must　be　considered。　It　is　a　well…known　fact　that　women　exhibiting　rudimentary　development　of　the　uterus　or　vagina　are　still　liable　to　become　pregnant；　and　many　such　cases　have　been　recorded；　but　the　most　peculiar　cases　ar