Anomalies And Curiosities Of Medicine Part 15

(28) that has six fingers on the right side, the man will take the lukunu of the house;

(29) that has six very small toes on both feet, he shall not go to the lukunu;

(30) that has six toes on each foot, the people of the world will be injured (calamity to the troops);

(31) that has the heart open and that has no skin, the country will suffer from calamities;

(32) that has no p.e.n.i.s, the master of the house will be enriched by the harvest of his field;

(33) that wants the p.e.n.i.s and the umbilicus, there will be ill-will in the house, the woman (wife) will have an overbearing eye (be haughty); but the male descent of the palace will be more extended.

When a woman gives birth to an infant--

(34) that has no well-marked s.e.x, calamity and affliction will seize upon the land; the master of the house shall have no happiness;

(35) whose a.n.u.s is closed, the country will suffer from want of nourishment;

(36) whose right t.e.s.t.i.c.l.e (?) is absent, the country of the master (king) will perish;

(37) whose right foot is absent, his house will be ruined and there will be abundance in that of the neighbor;

(38) that has no feet, the ca.n.a.ls of the country will be cut (intercepted) and the house ruined;

(39) that has the right foot in the form of a fish's tail, the booty of the country of the humble will not be imas sa bir;

(40) whose hands and feet are like four fishes' tails (fins), the master (king) shall perish (?) and his country shall be consumed;

(41) whose feet are moved by his great hunger, the house of the su su shall be destroyed;

(42) whose foot hangs to the tendons of the body, there will be great prosperity in the land;

(43) that has three feet, two in their normal position (attached to the body) and the third between them, there will be great prosperity in the land;

(44) whose legs are male and female, there will be rebellion;

(45) that wants the right heel, the country of the master (king) will be destroyed.

When a woman gives birth to an infant--

(46) that has many white hairs on the head, the days of the king will be prolonged;

(47) that has much ipga on the head, the master of the house will die, the house will be destroyed;

(48) that has much pinde on the head, joy shall go to meet the house (that has a head on the head, the good augury shall enter at its aspect into the house);

(49) that has the head full of hali, there will be ill-will toward him and the master (king) of the town shall die;

(50) that has the head full of siksi the king will repudiate his masters;

(51) that has some pieces of flesh (skin) hanging on the head, there shall be ill-will;

(52) that has some branches (?) (excrescences) of flesh (skin) hanging on the head, there shall be ill-will, the house will perish;

(53) that has some formed fingers (horns?) on the head, the days of the king will be less and the years lengthened (in the duration of his old age);

(54) that has some kali on the head, there will be a king of the land;

(55) that has a ---- of a bird on the head, the master of the house shall not prosper;

(56) that has some teeth already through (cut), the days of the king will arrive at old age, the country will show itself powerful over (against) strange (feeble) lands, but the house where the infant is born will be ruined;

(57) that has the beard come out, there will be abundant rains;

(58) that has some birta on the head, the country will be strengthened (reinforced);

(59) that has on the head the mouth of an old man and that foams (slabbers), there will be great prosperity in the land, the G.o.d Bin will give a magnificent harvest (inundate the land with fertility), and abundance shall be in the land;

(60) that has on one side of the head a thickened ear, the first-born of the men shall live a long time (?);

(61) that has on the head two long and thick ears, there will be tranquility and the pacification of litigation (contests);

(62) that has the figure in horn (like a horn?)..."

As ancient and as obscure as are these records, Ballantyne has carefully gone over each, and gives the following lucid explanatory comments:--

"What 'ears like a lion' (No. 1) may have been it is difficult to determine; but doubtless the direction and shape of the auricles were so altered as to give them an animal appearance, and possibly the deformity was that called 'orechio ad ansa' by Lombroso. The absence of one or both ears (Nos. 2 and 3) has been noted in recent times by Virchow (Archiv fur path. Anat. x.x.x., p. 221), Gradenigo (Taruffi's 'Storia della Teratologia,' vi., p. 552), and others. Generally some cartilaginous remnant is found, but on this point the Chaldean record is silent. Variations in the size of the ears (Nos. 4 and 5) are well known at the present time, and have been discussed at length by Binder (Archiv fur Psychiatrie und Nervenkrankheiten, xx., 1887) and others.

The exact malformation indicated in Nos. 6 and 7 is, of course, not to be determined, although further researches in a.s.syriology may clear up this point. The 'round ear' (No. 8) is one of Binder's types, and that with a 'wound below' (No. 9) probably refers to a case of fistula auris congenita (Toynbee, 'Diseases of the Ear,' 1860). The instance of an infant born with two ears on the right side (No. 10) was doubtless one of cervical auricle or preauricular appendage, whilst closure of the external auditory meatus (No. 11) is a well-known deformity.

"The next thirteen cases (Nos. 12-24) were instances of anomalies of the mouth and nose. The 'bird's beak' (No. 12) may have been a markedly aquiline nose; No. 13 was a case of astoma; and Nos. 14 and 15 were instances of stenosis or atresia of the anterior nares. Fetuses with absence of the maxillae (Nos. 16 and 17) are in modern terminology called agnathous. Deformities like that existing in Nos. 20 and 21 have been observed in paracephalic and cyclopic fetuses. The coincident absence of nose and p.e.n.i.s (No. 21) is interesting, especially when taken in conjunction with the popular belief that the size of the former organ varies with that of the latter. Enlargement of the upper lip (No. 22), called epimacrochelia by Taruffi, and absence of the lips (No. 23), known now under the name of brachychelia, have been not unfrequently noticed in recent times. The next six cases (Nos. 25-30) were instances of malformations of the upper limb: Nos. 25, 26. and 27 were probably instances of the so-called spontaneous or intrauterine amputation; and Nos. 28, 29, and 30 were examples of the comparatively common deformity known as polydactyly. No. 31 was probably a case of ectopia cordis.

"Then follow five instances of genital abnormalities (Nos. 32-36), consisting of absence of the p.e.n.i.s (epispadias?), absence of p.e.n.i.s and umbilicus (epispadias and exomphalos?), hermaphroditism, imperforate a.n.u.s, and nondescent of one t.e.s.t.i.c.l.e. The nine following cases (Nos.

37-45) were anomalies of the lower limbs: Nos. 37, 38, and 42 may have been spontaneous amputations; Nos. 39 and 40 were doubtless instances of webbed toes (syndactyly), and the deformity indicated in No. 45 was presumably talipes equinus. The infant born with three feet (No. 43) was possibly a case of parasitic monstrosity, several of which have been reported in recent teratologic literature; but what is meant by the statement concerning 'male and female legs' it is not easy to determine.

"Certain of the ten following prodigies (Nos. 46-55) cannot in the present state of our knowledge be identified. The presence of congenital patches of white or gray hair on the scalp, as recorded in No. 46, is not an unknown occurrence at the present time; but what the Chaldeans meant by ipga, pinde, hali riksi, and kali on the head of the new-born infant it is impossible to tell. The guess may be hazarded that cephalhematoma, hydrocephalus, meningocele, nevi, or an excessive amount of vernix caseosa were the conditions indicated, but a wider acquaintance with the meaning of the cuneiform characters is necessary before any certain identification is possible. The 'pieces of skin hanging from the head' (No. 51) may have been fragments of the membranes; but there is nothing in the accompanying prediction to help us to trace the origin of the popular belief in the good luck following the baby born with a caul. If No. 53 was a case of congenital horns on the head, it must be regarded as a unique example, unless, indeed, a form of fetal ichthyosis be indicated.

"The remaining observations (No. 56-62) refer to cases of congenital teeth (No. 56) to deformity of the ears (Nos. 60 and 61), and a horn (No. 62)."

From these early times almost to the present day similar significance has been attached to minor structural anomalies. In the following pages the individual anomalies will be discussed separately and the most interesting examples of each will be cited. It is manifestly evident that the object of this chapter is to mention the most striking instances of abnormism and to give accompanying descriptions of a.s.sociate points of interest, rather than to offer a scientific exposition of teratology, for which the reader is referred elsewhere.

Congenital defect of the epidermis and true skin is a rarity in pathology. Pastorello speaks of a child which lived for two and a half hours whose hands and feet were entirely dest.i.tute of epidermis; the true skin of those parts looked like that of a dead and already putrefying child. Hanks cites the history of a case of antepartum desquamation of the skin in a living fetus. Hochstetter describes a full-term, living male fetus with cutaneous defect on both sides of the abdomen a little above the umbilicus. The placenta and membranes were normal, a fact indicating that the defect was not due to amniotic adhesions; the child had a club-foot on the left side. The mother had a fall three weeks before labor.

Abnormal Elasticity of the Skin.--In some instances the skin is affixed so loosely to the underlying tissues and is possessed of so great elasticity that it can be stretched almost to the same extent as India rubber. There have been individuals who could take the skin of the forehead and pull it down over the nose, or raise the skin of the neck over the mouth. They also occasionally have an a.s.sociate muscular development in the subcutaneous tissues similar to the panniculus adiposus of quadrupeds, giving them preternatural motile power over the skin. The man recently exhibited under the t.i.tle of the "Elastic-Skin Man" was an example of this anomaly. The first of this cla.s.s of exhibitionists was seen in Buda-Pesth some years since and possessed great elasticity in the skin of his whole body; even his nose could be stretched. Figure 70 represents a photograph of an exhibitionist named Felix Wehrle, who besides having the power to stretch his skin could readily bend his fingers backward and forward. The photograph was taken in January, 1888.

In these congenital cases there is loose attachment of the skin without hypertrophy, to which the term dermatolysis is restricted by Crocker.

Job van Meekren, the celebrated Dutch physician of the seventeenth century, states that in 1657 a Spaniard, Georgius Albes, is reported to have been able to draw the skin of the left pectoral region to the left ear, or the skin under the face over the chin to the vertex. The skin over the knee could be extended half a yard, and when it retracted to its normal position it was not in folds. Seiffert examined a case of this nature in a young man of nineteen, and, contrary to Kopp's supposition, found that in some skin from over the left second rib the elastic fibers were quite normal, but there was transformation of the connective tissue of the dermis into an unformed tissue like a myxoma, with total disappearance of the connective-tissue bundles. Laxity of the skin after distention is often seen in multipara, both in the b.r.e.a.s.t.s and in the abdominal walls, and also from obesity, but in all such cases the skin falls in folds, and does not have a normal appearance like that of the true "elastic-skin man."

Occasionally abnormal development of the scalp is noticed. McDowall of twenty-two. On each side of the median line of the head there were five deep furrows, more curved and shorter as the distance from the median line increased. In the ill.u.s.tration the hair in the furrows is left longer than that on the rest of the head. The patient was distinctly microcephalic and the right side of the body was markedly wasted. The folds were due to hypertrophy of the muscles and scalp, and the same sort of furrowing is noticed when a dog "p.r.i.c.ks his ears." This case may possibly be considered as an example of reversion to inferior types. Cowan records two cases of the foregoing nature in idiots. The first case was a paralytic idiot of thirty-nine, whose cranial development was small in proportion to the size of the face and body; the cranium was oxycephalic; the scalp was lax and redundant and the hair thin; there were 13 furrows, five on each side running anteroposteriorly, and three in the occipital region running transversely. The occipitofrontalis muscle had no action on them. The second case was that of an idiot of forty-four of a more degraded type than the previous one. The cranium was round and bullet-shaped and the hair generally thick. The scalp was not so lax as in the other case, but the furrows were more crooked. By tickling the scalp over the back of the neck the two median furrows involuntarily deepened.