anomalies and curiosities of medicine-第99部分

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d　sometimes　devoured　an　entire　sheep。　He　swallowed　dirt；　clay；　pebbles；　and　glass；　and　was　addicted　to　intoxication　by　brandy。　He　lived　sixty　years　in　this　manner　and　then　he　became　abstemious；　he　died　at　seventy…nine。　His　omentum　was　very　lean；　but　the　liver　covered　all　his　abdominal　viscera。　His　stomach　was　very　large　and　thick；　but　the　intestines　were　very　narrow。

Ely　had　a　patient　who　was　addicted　to　chalk…eating；　this　ha　said　invariably　relieved　his　gastric　irritation。　In　the　twenty…five　years　of　the　habit　he　had　used　over　1/2　ton　of　chalk；　but　notwithstanding　this　he　always　enjoyed　good　health。　The　Ephemerides　contains　a　similar　instance；　and　Verzascha　mentions　a　lime…eater。　Adams　mentions　a　child　of　three　who　had　an　instinctive　desire　to　eat　mortar。　This　baby　was　rickety　and　had　carious　teeth。　It　would　pick　its　preferred　diet　out　of　the　wall；　and　if　prevented　would　cry　loudly。　When　deprived　of　the　mortar　it　would　vomit　its　food　until　this　substance　was　given　to　it　again。　At　the　time　of　report　part　of　the　routine　duties　of　the　sisters　of　this　boy　was　to　supply　him　with　mortar　containing　a　little　sand。　Lime…water　was　substituted；　but　he　insisted　so　vigorously　on　the　solid　form　of　food　that　it　had　to　be　replaced　in　his　diet。　He　suffered　from　small…pox；　on　waking　up　in　the　night　with　a　fever；　he　always　cried　for　a　piece　of　mortar。　The　quantity　consumed　in　twenty…four　hours　was　about　1/2　teacupful。　The　child　had　never　been　weaned。

Arsenic　Eaters。It　has　been　frequently　stated　that　the　peasants　of　Styria　are　in　the　habit　of　taking　from　two　to　five　grains　of　arsenious　acid　daily　for　the　purpose　of　improving　the　health；　avoiding　infection；　and　raising　the　whole　tone　of　the　body。　It　is　a　well…substantiated　fact　that　the　quantities　taken　habitually　are　quite　sufficient　to　produce　immediate　death　ordinarily。　But　the　same　might　be　easily　said　of　those　addicted　to　opium　and　chloral；　a　subject　that　will　be　considered　later。　Perverted　appetites　during　pregnancy　have　been　discussed　on　pages　80　and　81。

Glass…eaters；　penknife…swallowers；　and　sword…swallowers；　being　exhibitionists　and　jugglers；　and　not　individuals　with　perverted　appetites；　will　be　considered　in　Chapter　XII。

Fasting。The　length　of　time　which　a　person　can　live　with　complete　abstinence　from　food　is　quite　variable。　Hippocrates　admits　the　possibility　of　fasting　more　than　six　days　without　a　fatal　issue；　but　Pliny　and　others　allow　a　much　longer　time；　and　both　the　ancient　and　modern　literature　of　medicine　are　replete　with　examples　of　abstinence　to　almost　incredible　lengths　of　time。　Formerly；　and　particularly　in　the　Middle　Ages　when　religious　frenzy　was　at　its　highest　pitch；　prolonged　abstinence　was　prompted　by　a　desire　to　do　penance　and　to　gain　the　approbation　of　Heaven。

In　many　religions　fasting　has　become　a　part　of　worship　or　religions　ceremony；　and　from　the　earliest　times　certain　sects　have　carried　this　custom　to　extremes。　It　is　well　known　that　some　of　the　priests　and　anchorites　of　the　East　now　subsist　on　the　minimum　amount　of　food；　and　from　the　earliest　times　before　the　advent　of　Christianity　we　find　instances　of　prolonged　fasting　associated　with　religious　worship。　The　Assyrians；　the　Hebrews；　the　Egyptians；　and　other　Eastern　nations；　and　also　the　Greeks　and　Romans；　as　well　as　feasting　days；　had　their　times　of　fasting；　and　some　of　these　were　quite　prolonged。

At　the　present　day　religious　fervor　accounts　for　but　few　of　our　remarkable　instances　of　abstinence；　most　of　them　being　due　to　some　form　of　nervous　disorder；　varying　from　hysteria　and　melancholia　to　absolute　insanity。　The　ability　seen　in　the　Middle　Ages　to　live　on　the　Holy　Sacrament　and　to　resist　starvation　may　possibly　have　its　analogy　in　some　of　the　fasting　girls　of　the　present　day。　In　the　older　times　these　persons　were　said　to　have　been　nourished　by　angels　or　devils；　but　according　to　Hammond　many　cases　both　of　diabolical　abstinence　from　food　and　of　holy　fasting　exhibited　manifest　signs　of　hysteric　symptoms。　Hammond；　in　his　exhaustive　treatise　on　the　subject　of　〃Fasting　Girls；〃　also　remarks　that　some　of　the　chronicles　detail　the　exact　symptoms　of　hysteria　and　without　hesitation　ascribe　them　to　a　devilish　agency。　For　instance；　he　speaks　of　a　young　girl　in　the　valley　of　Calepino　who　had　all　her　limbs　twisted　and　contracted　and　had　a　sensation　in　her　esophagus　as　if　a　ball　was　sometimes　rising　in　her　throat　or　falling　into　the　stomacha　rather　lay　description　of　the　characteristic　hysteric　〃lump　in　the　throat；〃　a　frequent　sign　of　nervous　abstinence。

Abstinence；　or　rather　anorexia；　is　naturally　associated　with　numerous　diseases；　particularly　of　the　febrile　type；　but　in　all　of　these　the　patient　is　maintained　by　the　use　of　nutrient　enemata　or　by　other　means；　and　the　abstinence　is　never　complete。

A　peculiar　type　of　anorexia　is　that　striking　and　remarkable　digestive　disturbance　of　hysteria　which　Sir　William　Gull　has　called　anorexia　nervosa。　In　this　malady　there　is　such　annihilation　of　the　appetite　that　in　some　cases　it　seems　impossible　ever　to　eat　again。　Out　of　it　grows　an　antagonism　to　food　which　results　at　last；　and　in　its　worst　forms；　in　spasm　on　the　approach　of　food；　and　this　in　its　turn　gives　rise　to　some　of　those　remarkable　cases　of　survival　for　long　periods　without　food。　As　this　goes　on　there　may　be　an　extreme　degree　of　muscular　restlessness；　so　that　the　patients　wander　about　until　exhausted。　According　to　Osler；　who　reports　a　fatal　case　in　a　girl　who；　at　her　death；　only　weighed　49　pounds；　nothing　more　pitiable　is　to　be　seen　in　medical　practice　than　an　advanced　case　of　this　malady。　The　emaciation　and　exhaustion　are　extreme；　and　the　patient　is　as　miserable　as　one　with　carcinoma　of　the　esophagus；　food　either　not　being　taken　at　all　or　only　upon　urgent　compulsion。

Gull　mentions　a　girl　of　fourteen；　of　healthy；　plump　appearance；　who　in　the　beginning　of　February；　1887；　without　apparent　cause　evinced　a　great　repugnance　to　food　and　soon　afterward　declined　to　take　anything　but　a　half　cup　of　tea　or　coffee。　Gull　saw　her　in　April；　when　she　was　much　emaciated；　she　persisted　in　walking　through　the　streets；　where　she　was　the　object　of　remark　of　passers…by。　At　this　time　her　height　was　five　feet　four　inches；　her　weight　63　pounds；　her　temperature　97　degrees　F。；　her　pulse　46；　and　her　respiration　from　12　to　14。　She　had　a　persistent　wish　to　be　moving　all　the　time；　despite　her　emaciation　and　the　exhaustion　of　the　nutritive　functions。

There　is　another　class　of　abstainers　from　food　exemplified　in　the　exhibitionists　who　either　for　notoriety　or　for　wages　demonstrate　their　ability　to　forego　eating；　and　sometimes　drinking；　for　long　periods。　Some　have　been　clever　frauds；　who　by　means　of　artifices　have　carried　on　skilful　deceptions；　others　have　been　really　interesting　physiologic　anomalies。

Older　Instances。Democritus　in　323　B。C。　is　said　to　have　lived　forty　days　by　simply　smelling　honey　and　hot　bread。　Hippocrates　remarks　that　most　of　those　who　endeavored　to　abstain　five　days　died　within　that　period；　and　even　if　they　were　prevailed　upon　to　eat　and　drink　before　the　termination　of　their　fast　they　still　perished。　There　is　a　possibility　that　some　of　these　cases　of　Hippocrates　were　instances　of　pyloric　carcinoma　or　of　stenosis　of　the　pylorus。　In　the　older　writings　there　are　instances　reported　in　which　the　period　of　abstinence　has　varied　from　a　short　time　to　endurance　beyond　the　bounds　of　credulity。　Hufeland　mentions　total　abstinence　from　food　for　seventeen　days；　and　there　is　a　contemporary　case　of　abstinence　for　forty　days　in　a　maniac　who　subsisted　solely　on　water　and　tobacco。　Bolsot　speaks　of　abstinence　for　fourteen　months；　and　Consbruch　mentions　a　girl　who　fasted　eighteen　months。　Muller　mentions　an　old　man　of　forty…five　who　lived　six　weeks　on　cold　water。　There　is　an　instance　of　a　person　living　in　a　cave　twenty…four　days　without　food　or　drink；　and　another　of　a　man　who　survived　five　weeks'　burial　under　ruins。　Ramazzini　speaks　of　fasting　sixty…six　days；　Willian；　sixty　days　（resulting　in　death）；　von　Wocher；　thirty…seven　days　（associated　with　tetanus）；　Lantana；　sixty　days；　Hobbes；　forty　days；　Marcardier；　six　months；　Cruikshank；　two　months；　the　Ephemerides；　thirteen　months；　Gerard；　sixty…nine　days　（resulting　in　death）；　and　in　1722　there　was　recorded　an　instance　of　abstinence　lasting　twenty…five　months。　

Desbarreaux…Bernard　says　that　Guillaume　Granie　died　in　the　prison　of　Toulouse　in　1831；　after　a　voluntary　suicidal　abstinence　of　sixty…three　days。

Haller　cites　a　number　of　examples　of　long　abstinence；　but　most　extraordinary　was　that　of　a　girl　of　Confolens；　described　by　Citois　of　Poitiers；　who　published　a　history　of　the　case　in　the　beginning　of　the　seventeenth　century。　This　girl　is　said　to　have　passed　three　entire　years；　from　eleven　to　fourteen；　without　taking　any　kind　of　aliment。　In　the　〃Harleian　Miscellanies〃　is　a　copy　of　a　paper　humbly　offered　to　the　Royal　Society　by　John　Reynolds；　containing　a　discourse　upon　prodigious　abstinence；　occasioned　by　the　twelve　months'　fasting　of　a　woman　named　Martha　Taylor；　a　damsel　of　Derbyshire。　Plot　gives　a　great　variety　of　curious　anecdotes　of　prolonged　abstinence。　Ames　refers　to　〃the　true　and　admirable　history　of　the　maiden　of　Confolens；〃　mentioned　by　Haller。　In　the　Annual　Register；　vol。　i。；　is　an　account　of　three　persons　who　were　buried　five　weeks　in　the　snow；　and　in　the　same　journal；　in　1762；　is　the　history　of　a　girl　who　is　said　to　have　subsisted　nearly　four　years　on　water。　In　1684　four　miners　were　buried　in　a　coal…pit　in　Horstel；　a　half　mile　from　Liege；　Belgium；　and　lived　twenty…four　days　without　food；　eventually　making　good　recoveries。　An　analysis　of　the　water　used　during　their　confinement　showed　an　almost　total　absence　of　organic　matter　and　only　a　slight　residue　of　calcium　salts。　

Joanna　Crippen　lay　six　days　in　the　snow　without　nutriment；　being　overcome　by　the　cold　while　on　the　way　to　her　house；　she　recovered　despite　her　exposure。　Somis；　physician　to　the　King　of　Sardinia；　gives　an　account　of　three　women　of　Piedmont；　Italy；　who　were　saved　from　the　ruins　of　a　stable　where　they　had　been　buried　by　an　avalanche　of　snow；　March　19；　1765。　thirty…seven　days　before。　Thirty　houses　and　22　inhabitants　were　buried　in　this　catastrophe；　and　these　three　women；　together　with　a　child　of　two；　were　sheltered　in　a　stable　ove