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ANOMALIES and CURIOSITIES of MEDICINE

Being an encyclopedic collection of rare and extraordinary cases,
and of the most striking instances of abnormality in all branches
of medicine and surgery, derived from an exhaustive research of
medical literature from its origin to the present day,
abstracted, classified, annotated, and indexed.

by GEORGE M. GOULD, A.M., M.D. and WALTER L. PYLE, A.M., M.D.

PREFATORY AND INTRODUCTORY.

----

Since the time when man's mind first busied itself with subjects
beyond his own self-preservation and the satisfaction of his
bodily appetites, the anomalous and curious have been of
exceptional and persistent fascination to him; and especially is
this true of the construction and functions of the human body.
Possibly, indeed, it was the anomalous that was largely
instrumental in arousing in the savage the attention, thought,
and investigation that were finally to develop into the body of
organized truth which we now call Science. As by the aid of
collected experience and careful inference we to-day endeavor to
pass our vision into the dim twilight whence has emerged our
civilization, we find abundant hint and even evidence of this
truth. To the highest type of philosophic minds it is the usual
and the ordinary that demand investigation and explanation. But
even to such, no less than to the most naive-minded, the strange
and exceptional is of absorbing interest, and it is often through
the extraordinary that the philosopher gets the most searching
glimpses into the heart of the mystery of the ordinary. Truly it
has been said, facts are stranger than fiction. In monstrosities
and dermoid cysts, for example, we seem to catch forbidden sight
of the secret work-room of Nature, and drag out into the light
the evidences of her clumsiness, and proofs of her lapses of
skill,--evidences and proofs, moreover, that tell us much of the
methods and means used by the vital artisan of Life,--the loom,
and even the silent weaver at work upon the mysterious garment of
corporeality.

"La premiere chose qui s'offre a l' Homme quand il se regarde,
c'est son corps," says Pascal, and looking at the matter more
closely we find that it was the strange and mysterious things of
his body that occupied man's earliest as well as much of his
later attention. In the beginning, the organs and functions of
generation, the mysteries of sex, not the routine of digestion or
of locomotion, stimulated his curiosity, and in them he
recognized, as it were, an unseen hand reaching down into the
world of matter and the workings of bodily organization, and
reining them to impersonal service and far-off ends. All
ethnologists and students of primitive religion well know the
role that has been played in primitive society by the genetic
instincts. Among the older naturalists, such as Pliny and
Aristotle, and even in the older historians, whose scope included
natural as well as civil and political history, the atypic and
bizarre, and especially the aberrations of form or function of
the generative organs, caught the eye most quickly. Judging from
the records of early writers, when Medicine began to struggle
toward self-consciousness, it was again the same order of facts
that was singled out by the attention. The very names applied by
the early anatomists to many structures so widely separated from
the organs of generation as were those of the brain, give
testimony of the state of mind that led to and dominated the
practice of dissection.

In the literature of the past centuries the predominance of the
interest in the curious is exemplified in the almost ludicrously
monotonous iteration of titles, in which the conspicuous words
are curiosa, rara, monstruosa, memorabilia, prodigiosa, selecta,
exotica, miraculi, lusibus naturae, occultis naturae, etc., etc.
Even when medical science became more strict, it was largely the
curious and rare that were thought worthy of chronicling, and not
the establishment or illustration of the common, or of general
principles. With all his sovereign sound sense, Ambrose Pare has
loaded his book with references to impossibly strange, and even
mythologic cases.

In our day the taste seems to be insatiable, and hardly any
medical journal is without its rare or "unique" case, or one
noteworthy chiefly by reason of its anomalous features. A curious
case is invariably reported, and the insertion of such a report
is generally productive of correspondence and discussion with the
object of finding a parallel for it.

In view of all this it seems itself a curious fact that there has
never been any systematic gathering of medical curiosities. It
would have been most natural that numerous encyclopedias should
spring into existence in response to such a persistently dominant
interest. The forelying volume appears to be the first thorough
attempt to classify and epitomize the literature of this nature.
It has been our purpose to briefly summarize and to arrange in
order the records of the most curious, bizarre, and abnormal
cases that are found in medical literature of all ages and all
languages--a thaumatographia medica. It will be readily seen that
such a collection must have a function far beyond the
satisfaction of mere curiosity, even if that be stigmatized with
the word "idle." If, as we believe, reference may here be found
to all such cases in the literature of Medicine (including
Anatomy, Physiology, Surgery, Obstetrics, etc.) as show the most
extreme and exceptional departures from the ordinary, it follows
that the future clinician and investigator must have use for a
handbook that decides whether his own strange case has already
been paralleled or excelled. He will thus be aided in determining
the truth of his statements and the accuracy of his diagnoses.
Moreover, to know extremes gives directly some knowledge of
means, and by implication and inference it frequently does more.
Remarkable injuries illustrate to what extent tissues and organs
may be damaged without resultant death, and thus the surgeon is
encouraged to proceed to his operation with greater confidence
and more definite knowledge as to the issue. If a mad cow may
blindly play the part of a successful obstetrician with her
horns, certainly a skilled surgeon may hazard entering the womb
with his knife. If large portions of an organ,--the lung, a
kidney, parts of the liver, or the brain itself,--may be lost by
accident, and the patient still live, the physician is taught the
lesson of nil desperandum, and that if possible to arrest disease
of these organs before their total destruction, the prognosis and
treatment thereby acquire new and more hopeful phases.

Directly or indirectly many similar examples have also clear
medicolegal bearings or suggestions; in fact, it must be
acknowledged that much of the importance of medical jurisprudence
lies in a thorough comprehension of the anomalous and rare cases
in Medicine. Expert medical testimony has its chief value in
showing the possibilities of the occurrence of alleged extreme
cases, and extraordinary deviations from the natural. Every
expert witness should be able to maintain his argument by a full
citation of parallels to any remarkable theory or hypothesis
advanced by his clients; and it is only by an exhaustive
knowledge of extremes and anomalies that an authority on medical
jurisprudence can hope to substantiate his testimony beyond
question. In every poisoning case he is closely questioned as to
the largest dose of the drug in question that has been taken with
impunity, and the smallest dose that has killed, and he is
expected to have the cases of reported idiosyncrasies and
tolerance at his immediate command. A widow with a child of ten
months' gestation may be saved the loss of reputation by mention
of the authentic cases in which pregnancy has exceeded nine
months' duration; the proof of the viability of a seven months'
child may alter the disposition of an estate; the proof of death
by a blow on the epigastrium without external marks of violence
may convict a murderer; and so it is with many other cases of a
medicolegal nature.

It is noteworthy that in old-time medical literature--sadly and
unjustly neglected in our rage for the new--should so often be
found parallels of our most wonderful and peculiar modern cases.
We wish, also, to enter a mild protest against the modern egotism
that would set aside with a sneer as myth and fancy the
testimonies and reports of philosophers and physicians, only
because they lived hundreds of years ago. We are keenly
appreciative of the power exercised by the myth-making faculty in
the past, but as applied to early physicians, we suggest that the
suspicion may easily be too active. When Pare, for example,
pictures a monster, we may distrust his art, his artist, or his
engraver, and make all due allowance for his primitive knowledge
of teratology, coupled with the exaggerations and inventions of
the wonder-lover; but when he describes in his own writing what
he or his confreres have seen on the battle-field or in the
dissecting room, we think, within moderate limits, we owe him
credence. For the rest, we doubt not that the modern reporter is,
to be mild, quite as much of a myth-maker as his elder brother,
especially if we find modern instances that are essentially like
the older cases reported in reputable journals or books, and by
men presumably honest. In our collection we have endeavored, so
far as possible, to cite similar cases from the older and from
the more recent literature.

This connection suggests the question of credibility in general.
It need hardly be said that the lay-journalist and newspaper
reporter have usually been ignored by us, simply because
experience and investigation have many times proved that a
scientific fact, by presentation in most lay-journals, becomes in
some mysterious manner, ipso facto, a scientific caricature (or
worse !), and if it is so with facts, what must be the effect
upon reports based upon no fact whatsoever? It is manifestly
impossible for us to guarantee the credibility of chronicles
given. If we have been reasonably certain of unreliability, we
may not even have mentioned the marvelous statement. Obviously,
we could do no more with apparently credible cases, reported by
reputable medical men, than to cite author and source and leave
the matter there, where our responsibility must end.

But where our proper responsibility seemed likely never to end
was in carrying out the enormous labor requisite for a reasonable
certainty that we had omitted no searching that might lead to
undiscovered facts, ancient or modern. Choice in selection is
always, of course, an affair de gustibus, and especially when,
like the present, there is considerable embarrassment of riches,
coupled with the purpose of compressing our results in one handy
volume. In brief, it may be said that several years of exhaustive
research have been spent by us in the great medical libraries of
the United States and Europe in collecting the material herewith
presented. If, despite of this, omissions and errors are to be
found, we shall be grateful to have them pointed out. It must be
remembered that limits of space have forbidden satisfactory
discussion of the cases, and the prime object of the whole work
has been to carefully collect and group the anomalies and
curiosities, and allow the reader to form his own conclusions and
make his own deductions.

As the entire labor in the preparation of the forelying volume,
from the inception of the idea to the completion of the index,
has been exclusively the personal work of the authors, it is with
full confidence of the authenticity of the reports quoted that
the material is presented.

Complete references are given to those facts that are
comparatively unknown or unique, or that are worthy of particular
interest or further investigation. To prevent unnecessary loading
of the book with foot-notes, in those instances in which there
are a number of cases of the same nature, and a description has
not been thought necessary, mere citation being sufficient,
references are but briefly given or omitted altogether. For the
same reason a bibliographic index has been added at the end of
the text. This contains the most important sources of information
used, and each journal or book therein has its own number, which
is used in its stead all through the book (thus, 476 signifies
The Lancet, London; 597, the New York Medical Journal; etc.).
These bibliographic numbers begin at 100.

Notwithstanding that every effort has been made to conveniently
and satisfactorily group the thousands of cases contained in the
book (a labor of no small proportions in itself), a complete
general index is a practical necessity for the full success of
what is essentially a reference-volume, and consequently one has
been added, in which may be found not only the subjects under
consideration and numerous cross-references, but also the names
of the authors of the most important reports. A table of contents
follows this preface.

We assume the responsibility for innovations in orthography,
certain abbreviations, and the occasional substitution of figures
for large numerals, fractions, and decimals, made necessary by
limited space, and in some cases to more lucidly show tables and
statistics. From the variety of the reports, uniformity of
nomenclature and numeration is almost impossible.

As we contemplate constantly increasing our data, we shall be
glad to receive information of any unpublished anomalous or
curious cases, either of the past or in the future.

For many courtesies most generously extended in aiding our
research-work we wish, among others, to acknowledge our especial
gratitude and indebtedness to the officers and assistants of the
Surgeon-General's Library at Washington, D.C., the Library of the
Royal College of Surgeons of London, the Library of the British
Museum, the Library of the British Medical Association, the
Bibliotheque de Faculte de Medecine de Paris, the Bibliotheque
Nationale, and the Library of the College of Physicians of
Philadelphia.

GEORGE M. GOULD.
PHILADELPHIA, October, 1896. WALTER L. PYLE.

TABLE OF CONTENTS.

CHAPTER PAGES
I. GENETIC ANOMALIES . . . . . . . . . . . . . . . . . . .17-49

II. PRENATAL ANOMALIES . . . . . . . . . . . . . . . . . 50-112

III. OBSTETRIC ANOMALIES . . . . . . . . . . . . . . . 113-143

IV. PROLIFICITY . . . . . . . . . . . . . . . . . . . . 144-160

V. MAJOR TERATA . . . . . . . . . . . . . . . . . . . . 161-212

VI. MINOR TERATA . . . . . . . . . . . . . . . . . . . 213-323

VII. ANOMALIES OF STATURE, SIZE, AND DEVELOPMENT . . . 324-364

VIII. LONGEVITY . . . . . . . . . . . . . . . . . . . . 365-382

IX. PHYSIOLOGIC AND FUNCTIONAL ANOMALIES . . . . . . . 383-526

X. SURGICAL ANOMALIES OF THE HEAD AND NECK . . . . . . 527-587

XI. SURGICAL ANOMALIES OF THE EXTREMITIES . . . . . . . 588-605

XII. SURGICAL ANOMALIES OF THE THORAX AND ABDOMEN . . . 606-666

XIII. SURGICAL ANOMALIES OF THE GENITOURINARY SYSTEM . .667-696

XIV. MISCELLANEOUS SURGICAL ANOMALIES . . . . . . . . . 697-758

XV. ANOMALOUS TYPES AND INSTANCES OF DISEASE . . . . . .759-822

XVI. ANOMALOUS SKIN-DISEASES . . . . . . . . . . . . . .823-851

XVII. ANOMALOUS NERVOUS AND MENTAL DISEASES . . . . . . 852-890

XVIII. HISTORIC EPIDEMICS . . . . . . . . . . . . . . . 891-914

ANOMALIES AND CURIOSITIES OF MEDICINE.

CHAPTER I.

GENETIC ANOMALIES.

Menstruation has always been of interest, not only to the student
of medicine, but to the lay-observer as well. In olden times
there were many opinions concerning its causation, all of which,
until the era of physiologic investigation, were of superstitious
derivation. Believing menstruation to be the natural means of
exit of the feminine bodily impurities, the ancients always
thought a menstruating woman was to be shunned; her very presence
was deleterious to the whole animal economy, as, for instance,
among the older writers we find that Pliny remarks: "On the
approach of a woman in this state, must will become sour, seeds
which are touched by her become sterile, grass withers away,
garden plants are parched up, and the fruit will fall from the
tree beneath which she sits." He also says that the menstruating
women in Cappadocia were perambulated about the fields to
preserve the vegetation from worms and caterpillars. According to
Flemming, menstrual blood was believed to be so powerful that the
mere touch of a menstruating woman would render vines and all
kinds of fruit-trees sterile. Among the indigenous Australians,
menstrual superstition was so intense that one of the native
blacks, who discovered his wife lying on his blanket during her
menstrual period, killed her, and died of terror himself in a
fortnight. Hence, Australian women during this season are
forbidden to touch anything that men use. Aristotle said that the
very look of a menstruating woman would take the polish out of a
mirror, and the next person looking in it would be bewitched.
Frommann mentions a man who said he saw a tree in Goa which
withered because a catamenial napkin was hung on it. Bourke
remarks that the dread felt by the American Indians in this
respect corresponds with the particulars recited by Pliny. Squaws
at the time of menstrual purgation are obliged to seclude
themselves, and in most instances to occupy isolated lodges, and
in all tribes are forbidden to prepare food for anyone save
themselves. It was believed that, were a menstruating woman to
step astride a rifle, a bow, or a lance, the weapon would have no
utility. Medicine men are in the habit of making a "protective"
clause whenever they concoct a "medicine," which is to the effect
that the "medicine" will be effective provided that no woman in
this condition is allowed to approach the tent of the official in
charge.

Empiricism had doubtless taught the ancient husbands the dangers
of sexual intercourse during this period, and the after-results
of many such connections were looked upon as manifestations of
the contagiousness of the evil excretions issuing at this period.
Hence at one time menstruation was held in much awe and
abhorrence.

On the other hand, in some of the eastern countries menstruation
was regarded as sacred, and the first menstrual discharge was
considered so valuable that premenstrual marriages were
inaugurated in order that the first ovum might not be wasted, but
fertilized, because it was supposed to be the purest and best for
the purpose. Such customs are extant at the present day in some
parts of India, despite the efforts of the British Government to
suppress them, and descriptions of child-marriages and their evil
results have often been given by missionaries.

As the advances of physiology enlightened the mind as to the true
nature of the menstrual period, and the age of superstition
gradually disappeared, the intense interest in menstruation
vanished, and now, rather than being held in fear and awe, the
physicians of to-day constantly see the results of copulation
during this period. The uncontrollable desire of the husband and
the mercenary aims of the prostitute furnish examples of modern
disregard.

The anomalies of menstruation must naturally have attracted much
attention, and we find medical literature of all times replete
with examples. While some are simply examples of vicarious or
compensatory menstruation, and were so explained even by the
older writers, there are many that are physiologic curiosities of
considerable interest. Lheritier furnishes the oft-quoted history
of the case of a young girl who suffered from suppression of
menses, which, instead of flowing through the natural channels,
issued periodically from vesicles on the leg for a period of six
months, when the seat of the discharge changed to an eruption on
the left arm, and continued in this location for one year; then
the discharge shifted to a sore on the thumb, and at the end of
another six months again changed, the next location being on the
upper eyelid; here it continued for a period of two years.
Brierre de Boismont and Meisner describe a case apparently
identical with the foregoing, though not quoting the source.

Haller, in a collection of physiologic curiosities covering a
period of a century and a half, cites 18 instances of
menstruation from the skin. Parrot has also mentioned several
cases of this nature. Chambers speaks of bloody sweat occurring
periodically in a woman of twenty-seven; the intervals, however,
were occasionally but a week or a fortnight, and the exudation
was not confined to any one locality. Van Swieten quotes the
history of a case of suppression of the menstrual function in
which there were convulsive contractions of the body, followed by
paralysis of the right arm. Later on, the patient received a blow
on the left eye causing amaurosis; swelling of this organ
followed, and one month later blood issued from it, and
subsequently blood oozed from the skin of the nose, and ran in
jets from the skin of the fingers and from the nails.

D'Andrade cites an account of a healthy Parsee lady, eighteen
years of age, who menstruated regularly from thirteen to fifteen
and a half years; the catamenia then became irregular and she
suffered occasional hemorrhages from the gums and nose, together
with attacks of hematemesis. The menstruation returned, but she
never became pregnant, and, later, blood issued from the healthy
skin of the left breast and right forearm, recurring every month
or two, and finally additional dermal hemorrhage developed on the
forehead. Microscopic examination of the exuded blood showed
usual constituents present. There are two somewhat similar cases
spoken of in French literature. The first was that of a young
lady, who, after ten years' suppression of the menstrual
discharge, exhibited the flow from a vesicular eruption on the
finger. The other case was quite peculiar, the woman being a
prostitute, who menstruated from time to time through spots, the
size of a five-franc piece, developing on the breasts, buttocks,
back, axilla, and epigastrium. Barham records a case similar to
the foregoing, in which the menstruation assumed the character of
periodic purpura. Duchesne mentions an instance of complete
amenorrhea, in which the ordinary flow was replaced by periodic
sweats.

Parrot speaks of a woman who, when seven months old, suffered
from strumous ulcers, which left cicatrices on the right hand,
from whence, at the age of six years, issued a sanguineous
discharge with associate convulsions. One day, while in violent
grief, she shed bloody tears. She menstruated at the age of
eleven, and was temporarily improved in her condition; but after
any strong emotion the hemorrhages returned. The subsidence of
the bleeding followed her first pregnancy, but subsequently on
one occasion, when the menses were a few days in arrears, she
exhibited a blood-like exudation from the forehead, eyelids, and
scalp. As in the case under D'Andrade's observation, the
exudation was found by microscopic examination to consist of the
true constituents of blood. An additional element of complication
in this case was the occurrence of occasional attacks of
hematemesis.

Menstruation from the Breasts.--Being in close sympathy with the
generative function, we would naturally expect to find the female
mammae involved in cases of anomalous menstruation, and the truth
of this supposition is substantiated in the abundance of such
cases on record. Schenck reports instances of menstruation from
the nipple; and Richter, de Fontechia, Laurentius, Marcellus
Donatus, Amatus Lusitanus, and Bierling are some of the older
writers who have observed this anomaly. Pare says the wife of
Pierre de Feure, an iron merchant, living at Chasteaudun,
menstruated such quantities from the breasts each month that
several serviettes were necessary to receive the discharge.
Cazenave details the history of a case in which the mammary
menstruation was associated with a similar exudation from the
face, and Wolff saw an example associated with hemorrhage from
the fauces. In the Lancet (1840-1841) is an instance of monthly
discharge from beneath the left mamma. Finley also writes of an
example of mammary hemorrhage simulating menstruation. Barnes saw
a case in St. George's Hospital, London, 1876, in which the young
girl menstruated vicariously from the nipple and stomach. In a
London discussion there was mentioned the case of a healthy woman
of fifty who never was pregnant, and whose menstruation had
ceased two years previously, but who for twelve months had
menstruated regularly from the nipples, the hemorrhage being so
profuse as to require constant change of napkins. The mammae were
large and painful, and the accompanying symptoms were those of
ordinary menstruation. Boulger mentions an instance of periodic
menstrual discharge from beneath the left mamma. Jacobson speaks
of habitual menstruation by both breasts. Rouxeau describes
amenorrhea in a girl of seventeen, who menstruated from the
breast; and Teufard reports a case in which there was
reestablishment of menstruation by the mammae at the age of
fifty-six. Baker details in full the description of a case of
vicarious menstruation from an ulcer on the right mamma of a
woman of twenty. At the time he was called to see her she was
suffering with what was called "green-sickness." The girl had
never menstruated regularly or freely. The right mamma was quite
well developed, flaccid, the nipple prominent, and the
superficial veins larger and more tortuous than usual. The
patient stated that the right mamma had always been larger than
the left. The areola was large and well marked, and 1/4 inch from
its outer edge, immediately under the nipple, there was an ulcer
with slightly elevated edges measuring about 1 1/4 inches across
the base, and having an opening in its center 1/4 inch in
diameter, covered with a thin scab. By removing the scab and
making pressure at the base of the ulcer, drops of thick,
mucopurulent matter were made to exude. This discharge, however,
was not offensive to the smell. On March 17, 1846, the breast
became much enlarged and congested, as portrayed in Plate 1. The
ulcer was much inflamed and painful, the veins corded and deep
colored, and there was a free discharge of sanguineous yellowish
matter. When the girl's general health improved and menstruation
became more natural, the vicarious discharge diminished in
proportion, and the ulcer healed shortly afterward. Every month
this breast had enlarged, the ulcer became inflamed and
discharged vicariously, continuing in this manner for a few days,
with all the accompanying menstrual symptoms, and then dried up
gradually. It was stated that the ulcer was the result of the
girl's stooping over some bushes to take an egg from a hen's
nest, when the point of a palmetto stuck in her breast and broke
off. The ulcer subsequently formed, and ultimately discharged a
piece of palmetto. This happened just at the time of the
beginning of the menstrual epoch. The accompanying figures, Plate
1, show the breast in the ordinary state and at the time of the
anomalous discharge.