Anomalies And Curiosities Of Medicine Part 30

Recent Instances of Longevity.--There was a man who died in Spain at the advanced age of one hundred and fifty-one, which is the most extraordinary instance from that country. It is reported that quite recently a Chinese centenarian pa.s.sed the examination for the highest place in the Academy of Mandarins. Chevreul, born in 1786, at Angers, has only recently died after an active life in chemical investigation.

Sir Moses Montefiore is a recent example of an active centenarian.

In the New York Herald of April 21, 1895, is a description and a portrait of Noah Raby of the Piscataway Poor Farm of New Jersey, to whom was ascribed one hundred and twenty-three years. He was discharged from active duty on the "Brandywine," U.S.N., eighty-three years ago.

He relates having heard George Was.h.i.+ngton speak at Was.h.i.+ngton and at Portsmouth while his s.h.i.+p was in those places. The same journal also says that at Wichita, Kansas, there appeared at a munic.i.p.al election an old negress named Mrs. Harriet McMurray, who gave her age as one hundred and fifteen. She had been a slave, and a.s.serted that once on a visit to Alexandria with her master she had seen General Was.h.i.+ngton.

From the Indian Medical Record we learn that Lieutenant Nicholas Lavin of the Grand Armee died several years ago at the age of one hundred and twenty-five, leaving a daughter of seventy-eight. He was born in Paris in 1768, served as a hussar in several campaigns, and was taken a prisoner during the retreat from Moscow. After his liberation he married and made his residence in Saratoff.

CHAPTER IX.

PHYSIOLOGIC AND FUNCTIONAL ANOMALIES.

In considering the anomalies of the secretions, it must be remembered that the ingestion of certain kinds of food and the administration of peculiar drugs in medicine have a marked influence in coloring secretions. Probably the most interesting of all these anomalies is the cla.s.s in which, by a compensatory process, metastasis of the secretions is noticed.

Colored Saliva.--Among the older writers the Ephemerides contains an account of blue saliva; Huxham speaks of green saliva; Marcellus Donatus of yellow, and Peterman relates the history of a case of yellow saliva. d.i.c.kinson describes a woman of sixty whose saliva was blue; besides this nothing was definitely the matter with her. It seemed however, that the color was due to some chemic-pencil poisoning rather than to a pathologic process. A piece of this aniline pencil was caught in the false teeth. Paget cites an instance of blue saliva due to staining the tongue in the same manner. Most cases of anomalous coloring of this kind can be subsequently traced to artificial substances unconsciously introduced. Crocker mentions a woman who on was.h.i.+ng her hands constantly found that the water was stained blue, but this was subsequently traced to the accidental introduction of an orchid leaf. In another instance there was a woman whose linen was at every change stained brown; this, however, was found to be due to a hair-wash that she was in the habit of using.

Among the older writers who have mentioned abnormal modes of exit of the urine is Baux, who mentions urine from the nipples; Paullini and the Ephemerides describe instances of urination from the eyes.

Blancard, the Ephemerides, Sorbalt, and Vallisneri speak of urination by the mouth. Arnold relates the history of a case of dysuria in which urine was discharged from the nose, b.r.e.a.s.t.s, ears, and umbilicus; the woman was twenty-seven years old, and the dysuria was caused by a prolapsed uterus. There was an instance of anomalous discharge of urine from the body reported in Philadelphia many years ago which led to animated discussion. A case of dysuria in which the patient discharged urine from the stomach was reported early in this century from Germany.

The patient could feel the acc.u.mulation of urine by burning pain in the epigastrium. Suddenly the pain would move to the soles of the feet, she would become nauseated, and large quant.i.ties of urine would soon be vomited. There was reported the case of an hysterical female who had convulsions and mania, alternating with anuria of a peculiar nature and lasting seven days. There was not a drop of urine pa.s.sed during this time, but there were discharges through the mouth of alkaline waters with a strong ammoniacal odor.

Senter reports in a young woman a singular case of ischuria which continued for more than three years; during this time if her urine was not drawn off with the catheter she frequently voided it by vomiting; for the last twenty months she pa.s.sed much gravel by the catheter; when the use of the instrument was omitted or unsuccessfully applied the vomitus contained gravel. Carlisle mentions a case in which there was vomiting of a fluid containing urea and having the sensible properties of urine. Curious to relate, a cure was effected after ligature of the superior thyroid arteries and sloughing of the thyroid gland. Vomiting of urine is also mentioned by Coley, Domine, Liron, Malago, Zeviani, and Yeats. Marsden reports a case in which, following secondary papular syphilis and profuse spontaneous ptyalism, there was vicarious secretion of the urinary const.i.tuents from the skin.

Instances of the anomalous exit of urine caused by congenital malformation or fistulous connections are mentioned in another chapter.

Black urine is generally caused by the ingestion of pigmented food or drugs, such as carbolic acid and the anilines. Amatus Lusita.n.u.s, Bartholinus, and the Ephemerides speak of black urine after eating grapes or damson plums. The Ephemerides speaks of black urine being a precursor of death, but Piso, Rhodius, and Schenck say it is anomalous and seldom a sign of death. White urine, commonly known as chyluria, is frequently seen, and sometimes results from purulent cyst.i.tis. Though containing sediment, the urine looks as if full of milk. A case of this kind was seen in 1895 at the Jefferson Medical College Hospital, Philadelphia, in which the chyluria was due to a communication between the bladder and the thoracic duct.

Ackerman has spoken of metastasis of the tears, and Dixon gives an instance in which crying was not attended by the visible shedding of tears. Salomon reports a case of congenital deficiency of tears.

Blood-stained tears were frequently mentioned by the older writers.

Recently Cross has written an article on this subject, and its a.n.a.logy is seen in the next chapter under hemorrhages from the eyes through the lacrimal duct.

The s.e.m.e.n.--The older writers spoke of metastasis of the seminal flow, the issue being by the skin (perspiration) and other routes. This was especially supposed to be the case in satyriasis, in which the preternatural exit was due to superabundance of s.e.m.e.n, which could be recognized by its odor. There is no doubt that some people have a distinct seminal odor, a fact that will be considered in the section on "Human Odors."

The Ephemerides, Schurig, and Hoffman report instances of what they call fetid s.e.m.e.n (possibly a complication of urethral disease). Paaw speaks of black s.e.m.e.n in a negro, and the Ephemerides and Schurig mention instances of dark s.e.m.e.n. Blancard records an instance of preternatural exit of s.e.m.e.n by the bowel. Heers mentions a similar case caused by urethral fistula. Ingham mentions the escape of s.e.m.e.n through the t.e.s.t.i.c.l.e by means of a fistula. Demarquay is the authority on b.l.o.o.d.y s.e.m.e.n.

Andouard mentions an instance of blue bile in a woman, blue flakes being found in her vomit. There was no trace of copper to be found in this case. Andouard says that the older physicians frequently spoke of this occurrence.

Rhodius speaks of the sweat being sweet after eating honey; the Ephemerides and Paullini also mention it. Chromidrosis, or colored sweat, is an interesting anomaly exemplified in numerous reports. Black sweat has been mentioned by Bartholinus, who remarked that the secretion resembled ink; in other cases Galeazzi and Zacutus Lusita.n.u.s said the perspiration resembled sooty water. Phosph.o.r.escent sweat has been recorded. Paullini and the Ephemerides mention perspiration which was of a leek-green color, and Borellus has observed deep green perspiration. Marcard mentions green perspiration of the feet, possibly due to stains from colored foot-gear. The Ephemerides and Paullini speak of violet perspiration, and Bartholinus has described perspiration which in taste resembled wine.

Sir Benjamin Brodie has communicated the history of a case of a young girl of fifteen on whose face was a black secretion. On attempting to remove it by was.h.i.+ng, much pain was caused. The quant.i.ty removed by soap and water at one time was sufficient to make four basins of water as black as if with India ink. It seemed to be physiologically a.n.a.logous to melanosis. The cessation of the secretion on the forehead was followed by the ejection of a similar substance from the bowel, stomach, and kidney. The secretion was more abundant during the night, and at one time in its course an erysipelas-eruption made its appearance. A complete cure ultimately followed.

Purdon describes an Irish married woman of forty, the subject of rheumatic fever, who occasionally had a blue serous discharge or perspiration that literally flowed from her legs and body, and accompanied by a miliary eruption. It was on the posterior portions, and twelve hours previous was usually preceded by a moldy smell and a p.r.i.c.kly sensation. On the abdomen and the back of the neck there was a yellowish secretion. In place of catamenia there was a discharge reddish-green in color. The patient denied having taken any coloring matter or chemicals to influence the color of her perspiration, and no remedy relieved her cardiac or rheumatic symptoms.

The first English case of chromidrosis, or colored sweat, was published by Yonge of Plymouth in 1709. In this affection the colored sweating appears symmetrically in various parts of the body, the parts commonly affected being the cheeks, forehead, side of the nose, whole face, chest, abdomen, backs of the hands, finger-tips, and the flexors, flexures at the axillae, groins, and popliteal s.p.a.ces. Although the color is generally black, nearly every color has been recorded. Colcott Fox reported a genuine case, and Crocker speaks of a case at Shadwell in a woman of forty-seven of naturally dark complexion. The bowels were habitually sluggish, going three or four days at least without action, and latterly the woman had suffered from articular pains. The discolored sweat came out gradually, beginning at the sides of the face, then spreading to the cheeks and forehead. When seen, the upper half of the forehead, the temporal regions, and the skin between the ear and malar eminence were of a blackish-brown color, with slight hyperemia of the adjacent parts; the woman said the color had been almost black, but she had cleaned her face some. There was evidently much fat in the secretion; there was also seborrhea of the scalp.

Was.h.i.+ng with soap and water had very little effect upon it; but it was removed with ether, the skin still looking darker and redder than normal. After a week's treatment with saline purgatives the discoloration was much less, but the patient still had articular pains, for which alkalies were prescribed; she did not again attend. Crocker also quotes the case of a girl of twenty, originally under Mackay of Brighton. Her affection had lasted a year and was limited to the left cheek and eyebrow. Six months before the patch appeared she had a superficial burn which did not leave a distinct scar, but the surface was slightly granular. The deposit was distinctly fatty, evidently seborrheic and of a sepia-tint. The girl suffered from obstinate constipation, the bowels acting only once a week. The left side flushed more than the right In connection with this case may be mentioned one by White of Harvard, a case of unilateral yellow chromidrosis in a man.

Demons gives the history of a case of yellow sweat in a patient with three intestinal calculi.

Wilson says that cases of green, yellow, and blue perspiration have been seen, and Hebra, Rayer, and Fuchs mention instances. Conradi records a case of blue perspiration on one-half the s.c.r.o.t.u.m. Chojnowski records a case in which the perspiration resembled milk.

Hyperidrosis occurs as a symptom in many nervous diseases, organic and functional, and its presence is often difficult of explanation. The following are recent examples: Kustermann reports a case of acute myelitis in which there was profuse perspiration above the level of the girdle-sensation and none at all below. Sharkey reports a case of tumor of the pons varolii and left crus cerebri, in which for months there was excessive generalized perspiration; it finally disappeared without treatment. Hutchinson describes the case of a woman of sixty-four who for four years had been troubled by excessive sweating on the right side of the face and scalp. At times she was also troubled by an excessive flow of saliva, but she could not say if it was unilateral.

There was great irritation of the right side of the tongue, and for two years taste was totally abolished. It was normal at the time of examination. The author offered no explanation of this case, but the patient gave a decidedly neurotic history, and the symptoms seem to point with some degree of probability to hysteria. Pope reports a peculiar case in which there were daily attacks of neuralgia preceded by sweating confined to a bald spot on the head. Rockwell reports a case of unilateral hyperidrosis in a feeble old man which he thought due to organic affection of the cervical sympathetic.

Dupont has published an account of a curious case of chronic general hyperidrosis or profuse sweating which lasted upward of six years. The woman thus affected became pregnant during this time and was happily delivered of an infant, which she nursed herself. According to Dupont, this hyperidrosis was independent of any other affection, and after having been combated fruitlessly by various remedies, yielded at last to fluid extract of aconitin.

Myrtle relates the case of a man of seventy-seven, who, after some flying pains and fever, began to sweat profusely and continued to do so until he died from exhaustion at the end of three months from the onset of the sweating. Richardson records another case of the same kind.

Crocker quotes the case of a tailor of sixty-five in whom hyperidrosis had existed for thirty-five years. It was usually confined to the hands and feet, but when worst affected the whole body. It was absent as long as he preserved the horizontal posture, but came on directly when he rose; it was always increased in the summer months. At the height of the attack the man lost appet.i.te and spirit, had a p.r.i.c.king sensation, and sometimes minute red papules appeared all over the hand. He had tried almost every variety of treatment, but sulphur did the most good, as it had kept the disease under for twelve months. Latterly, even that failed.

Bachman reports the history of a case of hyperidrosis cured by hypnotism.

Unilateral and localized sweating accompanies some forms of nervous disturbance. Mickle has discussed unilateral sweating in the general paralysis of the insane. Ramskill reports a case of sweating on one side of the face in a patient who was subject to epileptic convulsions.

Takacs describes a case of unilateral sweating with proportionate nervous prostration. Bartholow and Bryan report unilateral sweating of the head. Cason speaks of unilateral sweating of the head, face, and neck. Elliotson mentions sweat from the left half of the body and the left extremities only. Lewis reports a case of unilateral perspiration with an excess of temperature of 3.5 degrees F. in the axilla of the perspiring side. Mills, White, Dow, and Duncan also cite instances of unilateral perspiration. Boquis describes a case of unilateral perspiration of the skin of the head and face, and instances of complete unilateral perspiration have been frequently recorded by the older writers,--Tebure, Marcellus Donatus, Paullini, and Hartmann discussing it. Hyperidrosis confined to the hands and feet is quite common.

Instances of b.l.o.o.d.y sweat and "stigmata" have been known through the ages and are most interesting anomalies. In the olden times there were people who represented that in their own persons they realized at certain periods the agonies of Gethsemane, as portrayed in medieval art, e.g., by pictures of Christ wearing the crown of thorns in Pilate's judgment hall. Some of these instances were, perhaps, of the nature of compensatory hemorrhage, subst.i.tuting the menses or periodic hemorrhoids, hemoptysis, epistaxis, etc., or possibly purpura. Extreme religious frenzy or deep emotions might have been the indirect cause of a number of these bleeding zealots. There are instances on record in which fear and other similar emotions have caused a sweating of blood, the expression "sweating blood" being not uncommon.

Among the older writers, Ballonius, Marcolini, and Riedlin mention b.l.o.o.d.y sweat. The Ephemerides speaks of it in front of the hypochondrium. Paullini observed a sailor of thirty, who, falling speechless and faint during a storm on the deck of his s.h.i.+p, sweated a red perspiration from his entire body and which stained his clothes. He also mentions b.l.o.o.d.y sweat following coitus. Aristotle speaks of b.l.o.o.d.y sweat, and Pellison describes a scar which periodically opened and sweated blood. There were many cases like this, the scars being usually in the location of Christ's wounds.

De Thou mentions an Italian officer who in 1552, during the war between Henry II of France and Emperor Charles V, was threatened with public execution; he became so agitated that he sweated blood from every portion of the body. A young Florentine about to be put to death by an order of Pope Sixtus V was so overcome with grief that he shed b.l.o.o.d.y tears and sweated blood. The Ephemerides contains many instances of b.l.o.o.d.y tears and sweat occasioned by extreme fear, more especially fear of death. Mezeray mentions that the detestable Charles IX of France, being under constant agitation and emotion, sank under a disorder which was accompanied by an exudation of blood from every pore of his body.

This was taken as an attempt of nature to cure by bleeding according to the theory of the venesectionists. Fabricius Hilda.n.u.s mentions a child who, as a rule, never drank anything but water, but once, contrary to her habit, drank freely of white wine, and this was soon followed by hemorrhage from the gums, nose, and skin.

There is a case also related of a woman of forty-five who had lost her only son. One day she fancied she beheld him beseeching her to release his soul from purgatory by prayers and fasting every Friday. The following Friday, which was in the month of August, and for five succeeding Fridays she had a profuse b.l.o.o.d.y perspiration, the disorder disappearing on Friday, March 8th, of the following year. Pooley says that Maldonato, in his "Commentaries of Four Gospels," mentions a healthy and robust man who on hearing of his sentence of death sweated blood, and Zacchias noted a similar phenomenon in a young man condemned to the flames. Allusion may also be made to St. Luke, who said of Christ that in agony He prayed more earnestly, "and His sweat was, as it were, great drops of blood falling down to the ground."

Pooley quotes the case of a young woman of indolent habit who in a religious fanatical trance sweated blood. The stigmatists were often imposters who artificially opened their scars, and set the example for the really peculiar cases of b.l.o.o.d.y sweat, which among ignorant people was considered evidence of sympathy with the agony of the Cross.

Probably the best studied case on record is that of Louise Lateau of Bois d'Haine, which, according to Gray, occurred in 1869 in a village of Belgium when the girl was at the age of twenty-three; her previous life had offered nothing remarkable. The account is as follows: "One Friday Louise Lateau noticed that blood was flowing from one side of her chest, and this recurred every Friday. On each Thursday morning an oval surface about one inch in length on the back of each hand became pink in color and smooth, whilst a similar oval surface on the palm of each hand became of the same hue, and on the upper surface of each foot a pinkish-white square appeared. Examined under a magnifying gla.s.s, the epidermis appeared at first without solution of continuity and delicate. About noon on Thursday a vesicle formed on the pink surfaces containing clear serum. In the night between Thursday and Friday, usually between midnight and one o'clock, the flow of blood began, the vesicle first rupturing. The amount of blood lost during the so called stigmata varied, and some observers estimated it at about one and three-quarter pints. The blood itself was of a reddish color, inclining to violet, about the hue therefore, of capillary blood, coagulating in the usual way, and the white and red corpuscles being normal in character and relative proportion. The flow ceased on Sat.u.r.days. During the flow of the blood the patient was in a rapt, ecstatic condition.

The facial expression was one of absorption and far-off contemplation, changing often to melancholy, terror, to an att.i.tude of prayer or contrition. The patient herself stated that at the beginning of the ecstasy she imagined herself surrounded by a brilliant light; figures then pa.s.sed before her, and the successive scenes of the crucifixion were panoramically progressive. She saw Christ in person--His clothing, His wounds, His crown of thorns, His cross--as well as the Apostles, the holy women, and the a.s.sembled Jews. During the ecstasy the circulation of the skin and heart was regular, although at times a sudden flash or pallor overspread the face, according with the play of the expression. From midday of Thursdays, when she took a frugal meal, until eight o'clock on Sat.u.r.day mornings the girl took no nourishment, not even water, because it was said that she did not feel the want of it and could not retain anything upon her stomach. During this time the ordinary secretions were suspended."

Fournier mentions a statesman of forty-five who, following great Cabinet labors during several years and after some worriment, found that the day after indulging in s.e.xual indiscretions he would be in a febrile condition, with pains in the thighs, groins, legs, and p.e.n.i.s.

The veins of these parts became engorged, and subsequently blood oozed from them, the flow lasting several days. The p.e.n.i.s was the part most affected. He was under observation for twenty months and presented the same phenomena periodically, except that during the last few months they were diminished in every respect. Fournier also mentions a curious case of diapedesis in a woman injured by a cow. The animal struck her in the epigastric region, she fell unconscious, and soon after vomited great quant.i.ties of blood, and continued with convulsive efforts of expulsion to eject blood periodically from every eight to fifteen days, losing possibly a pound at each paroxysm. There was no alteration of her menses. A physician gave her astringents, which partly suppressed the vomiting, but the hemorrhage changed to the skin, and every day she sweated blood from the chest, back of the thighs, feet, and the extremities of the fingers. When the blood ceased to flow from her skin she lost her appet.i.te, became oppressed, and was confined to her bed for some days. Itching always preceded the appearance of a new flow.

There was no dermal change that could be noticed.

Fullerton mentions a girl of thirteen who had occasional oozing of blood from her brow, face, and the skin under the eyes. Sometimes a pound of clots was found about her face and pillow. The blood first appeared in a single clot, and, strange to say, lumps of fleshy substance and minute pieces of bone were discharged all day. This latter discharge became more infrequent, the bone being replaced by cartilaginous substance. There was no pain, discoloration, swelling, or soreness, and after this strange anomaly disappeared menstruation regularly commenced. Van Swieten mentions a young lady who from her twelfth year at her menstrual periods had hemorrhages from pustules in the skin, the pustules disappearing in the interval.

Schmidt's Jahrbucher for 1836 gives an account of a woman who had diseased ovaries and a rectovesicov.a.g.i.n.al fistula, and though sometimes catamenia appeared at the proper place it was generally arrested and hemorrhage appeared on the face. Chambers mentions a woman of twenty-seven who suffered from b.l.o.o.d.y sweat after the manner of the stigmatists, and Petrone mentions a young man of healthy antecedents, the sweat from whose axillae and p.u.b.es was red and very pungent.

Petrone believes it was due to a chromogenic micrococcus, and relieved the patient by the use of a five per cent solution of caustic potash.

Chloroform, ether, and phenol had been tried without success. Hebra mentions a young man in whom the blood spurted from the hand in a spiral jet corresponding to the direction of the duct of the sweat-gland. Wilson refers to five cases of b.l.o.o.d.y sweat.

There is a record of a patient who once or twice a day was attacked with swelling of the s.c.r.o.t.u.m, which at length acquired a deep red color and a stony hardness, at which time the blood would spring from a hundred points and flow in the finest streams until the s.c.r.o.t.u.m was again empty.

Hill describes a boy of four who during the sweating stage of malaria sweated blood from the head and neck. Two months later the skin-hemorrhages ceased and the boy died, vomiting blood and with b.l.o.o.d.y stools.

Postmortem sweating is described in the Ephemerides and reported by Hasenest and Schneider. Bartholinus speaks of b.l.o.o.d.y sweat in a cadaver.

In considering the anomalies of lactation we shall first discuss those of color and then the extraordinary places of secretion. Black milk is spoken of by the Ephemerides and Paullini. Red milk has been observed by Cramer and Viger. Green milk has been observed by Lanzonius, Riverius, and Paullini. The Ephemerides also contains an account of green milk. Yellow milk has been mentioned in the Ephemerides and its cause ascribed to eating rhubarb.

It is a well-known fact that some cathartics administered to nursing mothers are taken from the breast by their infants, who, notwithstanding its indirect mode of administration, exhibit the effects of the original drug. The same is the case with some poisons, and instances of lead-poisoning and a.r.s.enic-poisoning have been seen in children who have obtained the toxic substance in the mother's milk.

There is one singular case on record in which a child has been poisoned from the milk of its mother after she had been bitten by a serpent.

Paullini and the Ephemerides give instances of milk appearing in the perspiration, and there are numerous varieties of milk-metastasis recorded Dolaeus and Nuck mention the appearance of milk in the saliva.

Autenreith mentions metastasis of milk through an abdominal abscess to the thigh, and Balthazaar also mentions excretion of milk from the thigh. Bourdon mentions milk from the thigh, l.a.b.i.a, and v.u.l.v.a. Klein speaks of the metastasis of the milk to the lochia. Gardane speaks of metastasis to the lungs, and there is another case on record in which this phenomenon caused asphyxia. Schenck describes excretion of milk from the bladder and uterus. Jaeger in 1770 at Tubingen describes the metastasis of milk to the umbilicus, Haen to the back, and Schurig to a wound in the foot. Knackstedt has seen an abscess of the thigh which contained eight pounds of milk. Hauser gives the history of a case in which the kidneys secreted milk vicariously.