MAJOR TERATA.

Monstrosities have attracted notice from the earliest time, and many of

the ancient philosophers made references to them. In mythology we read

of Centaurs, impossible beings who had the body and extremities of a

beast; the Cyclops, possessed of one enormous eye; or their parallels

in Egyptian myths, the men with pectoral eyes,--the creatures "whose

heads do beneath their shoulders grow;" and the Fauns, those sylvan

deities whose lower extremities bore resemblance to those of a goat.

Monsters possessed of two or more heads or double bodies are found in

the legends and fairy tales of every nation. Hippocrates, his

precursors, Empedocles and Democritus, and Pliny, Aristotle, and Galen,

have all described monsters, although in extravagant and ridiculous

language.

Ballantyne remarks that the occasional occurrence of double monsters

was a fact known to the Hippocratic school, and is indicated by a

passage in De morbis muliebribus, in which it is said that labor is

gravely interfered with when the infant is dead or apoplectic or

double. There is also a reference to monochorionic twins (which are by

modern teratologists regarded as monstrosities) in the treatise De

Superfoetatione, in which it is stated that "a woman, pregnant with

twins, gives birth to them both at the same time, just as she has

conceived them; the two infants are in a single chorion."

Ancient Explanations of Monstrosities.--From the time of Galen to the

sixteenth century many incredible reports of monsters are seen in

medical literature, but without a semblance of scientific truth. There

has been little improvement in the mode of explanation of monstrous

births until the present century, while in the Middle Ages the

superstitions were more ludicrous and observers more ignorant than

before the time of Galen. In his able article on the teratologic

records of Chaldea, Ballantyne makes the following trite statements:

"Credulity and superstition have never been the peculiar possession of

the lower types of civilization only, and the special beliefs that have

gathered round the occurrence of teratologic phenomena have been common

to the cultured Greek and Roman of the past, the ignorant peasant of

modern times, and the savage tribes of all ages. Classical writings,

the literature of the Middle Ages, and the popular beliefs of the

present day all contain views concerning teratologic subjects which so

closely resemble those of the Chaldean magi as to be indistinguishable

from them. Indeed, such works as those of Obsequens, Lycosthenes,

Licetus, and Ambroise Pare only repeat, but with less accuracy of

description and with greater freedom of imagination, the beliefs of

ancient Babylon. Even at the present time the most impossible cases of

so-called 'maternal impressions' are widely scattered through medical

literature; and it is not very long since I received a letter from a

distinguished member of the profession asking me whether, in my

opinion, I thought it possible for a woman to give birth to a dog. Of

course, I do not at all mean to infer that teratology has not made

immense advances within recent times, nor do I suggest that on such

subjects the knowledge of the magi can be compared with that of the

average medical student of the present; but what I wish to emphasize is

that, in the literature of ancient Babylonia, there are indications of

an acquaintance with structural defects and malformations of the human

body which will compare favorably with even the writings of the

sixteenth century of the Christian era."

Many reasons were given for the existence of monsters, and in the

Middle Ages these were as faulty as the descriptions themselves. They

were interpreted as divinations, and were cited as forebodings and

examples of wrath, or even as glorifications of the Almighty. The

semi-human creatures were invented or imagined, and cited as the

results of bestiality and allied forms of sexual perversion prevalent

in those times. We find minute descriptions and portraits of these

impossible results of wicked practices in many of the older medical

books. According to Pare there was born in 1493, as the result of

illicit intercourse between a woman and a dog, a creature resembling in

its upper extremities its mother, while its lower extremities were the

exact counterpart of its canine father. This particular case was

believed by Bateman and others to be a precursor to the murders and

wickedness that followed in the time of Pope Alexander I. Volateranus,

Cardani, and many others cite instances of this kind. Lycosthenes says

that in the year 1110, in the bourg of Liege, there was found a

creature with the head, visage, hands, and feet of a man, and the rest

of the body like that of a pig. Pare quotes this case and gives an

illustration. Rhodiginus mentions a shepherd of Cybare by the name of

Cratain, who had connection with a female goat and impregnated her, so

that she brought forth a beast with a head resembling that of the

father, but with the lower extremities of a goat. He says that the

likeness to the father was so marked that the head-goat of the herd

recognized it, and accordingly slew the goatherd who had sinned so

unnaturally.

In the year 1547, at Cracovia, a very strange monster was born, which

lived three days. It had a head shaped like that of a man; a nose long

and hooked like an elephant's trunk; the hands and feet looking like

the web-foot of a goose; and a tail with a hook on it. It was supposed

to be a male, and was looked upon as a result of sodomy. Rueff says

that the procreation of human beings and beasts is brought about--

(1) By the natural appetite;

(2) By the provocation of nature by delight;

(3) By the attractive virtue of the matrix, which in beasts and women

is alike.

Plutarch, in his "Lesser Parallels," says that Aristonymus Ephesius,

son of Demonstratus, being tired of women, had carnal knowledge with an

ass, which in the process of time brought forth a very beautiful child,

who became the maid Onoscelin. He also speaks of the origin of the

maiden Hippona, or as he calls her, Hippo, as being from the connection

of a man with a mare. Aristotle mentions this in his paradoxes, and we

know that the patron of horses was Hippona. In Helvetia was reported

the existence of a colt (whose mother had been covered by a bull) that

was half horse and half bull. One of the kings of France was supposed

to have been presented with a colt with the hinder part of a hart, and

which could outrun any horse in the kingdom. Its mother had been

covered by a hart.

Writing in 1557, Lycosthenes reports the mythical birth of a serpent by

a woman. It is quite possible that some known and classified type of

monstrosity was indicated here in vague terms. In 1726 Mary Toft, of

Godalming, in Surrey, England, achieved considerable notoriety

throughout Surrey, and even over all England, by her extensively

circulated statements that she bore rabbits. Even at so late a day as

this the credulity of the people was so great that many persons

believed in her. The woman was closely watched, and being detected in

her maneuvers confessed her fraud. To show the extent of discussion

this case called forth, there are no less than nine pamphlets and books

in the Surgeon-General's library at Washington devoted exclusively to

this case of pretended rabbit-breeding. Hamilton in 1848, and Hard in

1884, both report the births in this country of fetal monstrosities

with heads which showed marked resemblance to those of dogs. Doubtless

many of the older cases of the supposed results of bestiality, if seen

to-day, could be readily classified among some of our known forms of

monsters. Modern investigation has shown us the sterile results of the

connections between man and beast or between beasts of different

species, and we can only wonder at the simple credulity and the

imaginative minds of our ancestors. At one period certain phenomena of

nature, such as an eclipse or comet, were thought to exercise their

influence on monstrous births. Rueff mentions that in Sicily there

happened a great eclipse of the sun, and that women immediately began

to bring forth deformed and double-headed children.

Before ending these preliminary remarks, there might be mentioned the

marine monsters, such as mermaids, sea-serpents, and the like, which

from time to time have been reported; even at the present day there are

people who devoutly believe that they have seen horrible and impossible

demons in the sea. Pare describes and pictures a monster, at Rome, on

November 3, 1520, with the upper portion of a child apparently about

five or six years old, and the lower part and ears of a fish-like

animal. He also pictures a sea-devil in the same chapter, together with

other gruesome examples of the power of imagination.

Early Teratology.--Besides such cases as the foregoing, we find the

medieval writers report likely instances of terata, as, for instance,

Rhodiginus, who speaks of a monster in Italy with two heads and two

bodies; Lycosthenes saw a double monster, both components of which

slept at the same time; he also says this creature took its food and

drink simultaneously in its two mouths. Even Saint Augustine says that

he knew of a child born in the Orient who, from the belly up, was in

all parts double.

The first evidences of a step toward classification and definite

reasoning in regard to the causation of monstrosities were evinced by

Ambroise Pare in the sixteenth century, and though his ideas are crude

and some of his phenomena impossible, yet many of his facts and

arguments are worthy of consideration. Pare attributed the cause of

anomalies of excess to an excessive quantity of semen, and anomalies of

default to deficiency of the same fluid. He has collected many

instances of double terata from reliable sources, but has interspersed

his collection with accounts of some hideous and impossible creatures,

such as are illustrated in the accompanying figure, which shows a

creature that was born shortly after a battle of Louis XII, in 1512; it

had the wings, crest, and lower extremity of a bird and a human head

and trunk; besides, it was an hermaphrodite, and had an extra eye in

the knee. Another illustration represents a monstrous head found in an

egg, said to have been sent for examination to King Charles at Metz in

1569. It represented the face and visage of a man, with small living

serpents taking the place of beard and hair. So credulous were people

at this time that even a man so well informed as Pare believed in the

possibility of these last two, or at least represented them as facts.

At this time were also reported double hermaphroditic terata, seemingly

without latter-day analogues. Rhodiginus speaks of a two-headed monster

born in Ferrari, Italy, in 1540, well formed, and with two sets of

genitals, one male and the other female. Pare gives a picture of twins,

born near Heidelberg in 1486, which had double bodies joined back to

back; one of the twins had the aspect of a female and the other of a

male, though both had two sets of genitals.

Scientific Teratology.--About the first half of the eighteenth century

what might be called the positive period of teratology begins.

Following the advent of this era come Mery, Duverney, Winslow, Lemery,

and Littre. In their works true and concise descriptions are given and

violent attacks are made against the ancient beliefs and prejudices.

From the beginning of the second half of the last century to the

present time may be termed the scientific epoch of teratology. We can

almost with a certainty start this era with the names of Haller,

Morgagni, Geoffroy-Saint-Hilaire, and Meckel, who adduced the

explanations asked for by Harvey and Wolff. From the appearance of the

treatise by Geoffroy-Saint-Hilaire, teratology has made enormous

strides, and is to-day well on the road to becoming a science. Hand in

hand with embryology it has been the subject of much investigation in

this century, and to enumerate the workers of the present day who have

helped to bring about scientific progress would be a task of many

pages. Even in the artificial production of monsters much has been

done, and a glance at the work of Dareste well repays the trouble.

Essays on teratogenesis, with reference to batrachians, have been

offered by Lombardini; and by Lereboullet and Knoch with reference to

fishes. Foll and Warynski have reported their success in obtaining

visceral inversion, and even this branch of the subject promises to

become scientific.

Terata are seen in the lower animals and always excite interest. Pare

gives the history of a sheep with three heads, born in 1577; the

central head was larger than the other two, as shown in the

accompanying illustration. Many of the Museums of Natural History

contain evidences of animal terata. At Hallae is a two-headed mouse;

the Conant Museum in Maine contains the skeleton of an adult sheep with

two heads; there was an account of a two-headed pigeon published in

France in 1734; Leidy found a two-headed snake in a field near

Philadelphia; Geoffroy Saint-Hilaire and Conant both found similar

creatures, and there is one in the Museum at Harvard; Wyman saw a

living double-headed snake in the Jardin des Plantes in Paris in 1853,

and many parallel instances are on record.

Classification.--We shall attempt no scientific discussion of the

causation or embryologic derivation of the monster, contenting

ourselves with simple history and description, adding any associate

facts of interest that may be suggested. For further information, the

reader is referred to the authors cited or to any of the standard

treatises on teratology.

Many classifications of terata have been offered, and each possesses

some advantage. The modern reader is referred to the modification of

the grouping of Geoffroy-Saint-Hilaire given by Hirst and Piersol, or

those of Blanc and Guinard. For convenience, we have adopted the

following classification, which will include only those monsters that

have LIVED AFTER BIRTH, and who have attracted general notice or

attained some fame in their time, as attested by accounts in

contemporary literature.

CLASS 1.--Union of several fetuses. CLASS 2.--Union of two distinct

fetuses by a connecting band. CLASS 3.--Union of two distinct fetuses

by an osseous junction of the cranial bones. CLASS 4.--Union of two

distinct fetuses in which one or more parts are eliminated by the

junction. CLASS 5.--Fusion of two fetuses by a bony union of the

ischii. CLASS 6.--Fusion of two fetuses below the umbilicus into a

common lower extremity. CLASS 7.--Bicephalic monsters. CLASS

8.--Parasitic monsters. CLASS 9.--Monsters with a single body and

double lower extremities. CLASS 10.--Diphallic terata. CLASS

11.--Fetus in fetu, and dermoid cysts. CLASS 12.--Hermaphrodites.

CLASS I.--Triple Monsters.--Haller and Meckel were of the opinion that

no cases of triple monsters worthy of credence are on record, and since

their time this has been the popular opinion. Surely none have ever

lived. Licetus describes a human monster with two feet and seven heads

and as many arms. Bartholinus speaks of a three-headed monster who

after birth gave vent to horrible cries and expired. Borellus speaks of

a three-headed dog, a veritable Cerberus. Blasius published an essay on

triple monsters in 1677. Bordenave is quoted as mentioning a human

monster formed of three fetuses, but his description proves clearly

that it was only the union of two. Probably the best example of this

anomaly that we have was described by Galvagni at Cattania in 1834.

This monster had two necks, on one of which was a single head normal in

dimensions. On the other neck were two heads, as seen in the

accompanying illustration. Geoffroy-Saint-Hilaire mentions several

cases, and Martin de Pedro publishes a description of a case in Madrid

in 1879. There are also on record some cases of triple monster by

inclusion which will be spoken of later. Instances in the lower animals

have been seen, the three-headed sheep of Pare, already spoken of,

being one.

CLASS II.--Double Monsters.--A curious mode of junction, probably the

most interesting, as it admits of longer life in these monstrosities,

is that of a simple cartilaginous band extending between two absolutely

distinct and different individuals. The band is generally in the

sternal region. In 1752 there was described a remarkable monstrosity

which consisted of conjoined twins, a perfect and an imperfect child,

connected at their ensiform cartilages by a band 4 inches in

circumference. The Hindoo sisters, described by Dr. Andrew Berry, lived

to be seven years old; they stood face to face, with their chests 6 1/2

inches and their pubes 8 1/2 inches apart. Mitchell describes the

full-grown female twins, born at Newport, Ky., called the Newport

twins. The woman who gave birth to them became impregnated, it is said,

immediately after seeing the famous Siamese twins, and the products of

this pregnancy took the conformation of those celebrated exhibitionists.

Perhaps the best known of all double monsters were the Siamese twins.

They were exhibited all over the globe and had the additional benefit

and advertisement of a much mooted discussion as to the advisability of

their severance, in which opinions of the leading medical men of all

nations were advanced. The literature on these famous brothers is

simply stupendous. The amount of material in the Surgeon General's

library at Washington would surprise an investigator. A curious volume

in this library is a book containing clippings, advertisements, and

divers portraits of the twins. It will be impossible to speak at all

fully on this subject, but a short history and running review of their

lives will be given: Eng and Chang were born in Siam about May, 1811.

Their father was of Chinese extraction and had gone to Siam and there

married a woman whose father was also a Chinaman. Hence, for the most

part, they were of Chinese blood, which probably accounted for their

dark color and Chinese features. Their mother was about thirty-five

years old at the time of their birth and had borne 4 female children

prior to Chang and Eng. She afterward had twins several times, having

eventually 14 children in all. She gave no history of special

significance of the pregnancy, although she averred that the head of

one and the feet of the other were born at the same time. The twins

were both feeble at birth, and Eng continued delicate, while Chang

thrived. It was only with difficulty that their lives were saved, as

Chowpahyi, the reigning king, had a superstition that such freaks of

nature always presaged evil to the country. They were really discovered

by Robert Hunter, a British merchant at Bangkok, who in 1824 saw them

boating and stripped to the waist. He prevailed on the parents and King

Chowpahyi to allow them to go away for exhibition. They were first

taken out of the country by a certain Captain Coffin. The first

scientific description of them was given by Professor J. C. Warren, who

examined them in Boston, at the Harvard University, in 1829. At that

time Eng was 5 feet 2 inches and Chang 5 feet 1 1/2 inches in height.

They presented all the characteristics of Chinamen and wore long black

queues coiled thrice around their heads, as shown by the accompanying

illustration. After an eight-weeks' tour over the Eastern States they

went to London, arriving at that port November 20, 1829. Their tour in

France was forbidden on the same grounds as the objection to the

exhibition of Ritta-Christina, namely, the possibility of causing the

production of monsters by maternal impressions in pregnant women. After

their European tour they returned to the United States and settled down

as farmers in North Carolina, adopting the name of Bunker. When

forty-four years of age they married two sisters, English women,

twenty-six and twenty-eight years of age, respectively. Domestic

infelicity soon compelled them to keep the wives at different houses,

and they alternated weeks in visiting each wife. Chang had six children

and Eng five, all healthy and strong. In 1869 they made another trip to

Europe, ostensibly to consult the most celebrated surgeons of Great

Britain and France on the advisability of being separated. It was

stated that a feeling of antagonistic hatred after a quarrel prompted

them to seek "surgical separation," but the real cause was most likely

to replenish their depleted exchequer by renewed exhibition and

advertisement.

A most pathetic characteristic of these illustrious brothers was the

affection and forbearance they showed for each other until shortly

before their death. They bore each other's trials and petty maladies

with the greatest sympathy, and in this manner rendered their lives far

more agreeable than a casual observer would suppose possible. They both

became Christians and members or attendants of the Baptist Church.

Figure 31 is a representation of the Siamese twins in old age. On each

side of them is a son. The original photograph is in the Mutter Museum,

College of Physicians, Philadelphia.

The feasibility of the operation of separating them was discussed by

many of the leading men of America, and Thompson, Fergusson, Syme, Sir

J. Y. Simpson, Nelaton, and many others in Europe, with various reports

and opinions after examination. These opinions can be seen in full in

nearly any large medical library. At this time they had diseased and

atheromatous arteries, and Chang, who was quite intemperate, had marked

spinal curvature, and shortly afterward became hemiplegic. They were

both partially blind in their two anterior eyes, possibly from looking

outward and obliquely. The point of junction was about the

sterno-siphoid angle, a cartilaginous band extending from sternum to

sternum. In 1869 Simpson measured this band and made the distance on

the superior aspect from sternum to sternum 4 1/2 inches, though it is

most likely that during the early period of exhibition it was not over

3 inches. The illustration shows very well the position of the joining

band.

The twins died on January 17, 1874, and a committee of surgeons from

the College of Physicians of Philadelphia, consisting of Doctors

Andrews, Allen, and Pancoast, went to North Carolina to perform an

autopsy on the body, and, if possible, to secure it. They made a long

and most interesting report on the results of their trip to the

College. The arteries, as was anticipated, were found to have undergone

calcareous degeneration. There was an hepatic connection through the

band, and also some interlacing diaphragmatic fibers therein. There was

slight vascular intercommunication of the livers and independence of

the two peritoneal cavities and the intestines. The band itself was

chiefly a coalescence of the xyphoid cartilages, surrounded by areolar

tissue and skin.

The "Orissa sisters," or Radica-Doddica, shown in Europe in 1893, were

similar to the Siamese twins in conformation. They were born in Orissa,

India, September, 1889, and were the result of the sixth pregnancy, the

other five being normal. They were healthy girls, four years of age,

and apparently perfect in every respect, except that, from the ensiform

cartilage to the umbilicus, they were united by a band 4 inches long

and 2 inches wide. The children when facing each other could draw their

chests three or four inches apart, and the band was so flexible that

they could sit on either side of the body. Up to the date mentioned it

was not known whether the connecting band contained viscera. A portrait

of these twins was shown at the World's Fair in Chicago.

In the village of Arasoor, district of Bhavany, there was reported a

monstrosity in the form of two female children, one 34 inches and the

other 33 3/4 inches high, connected by the sternum. They were said to

have had small-pox and to have recovered. They seemed to have had

individual nervous systems, as when one was pinched the other did not

feel it, and while one slept the other was awake. There must have been

some vascular connection, as medicine given to one affected both.

Fig. 36 shows a mode of cartilaginous junction by which each component

of a double monster may be virtually independent.

Operations on Conjoined Twins.--Swingler speaks of two girls joined at

the xiphoid cartilage and the umbilicus, the band of union being 1 1/2

inches thick, and running below the middle of it was the umbilical

cord, common to both. They first ligated the cord, which fell off in

nine days, and then separated the twins with the bistoury. They each

made early recovery and lived.

In the Ephemerides of 1690 Konig gives a description of two Swiss

sisters born in 1689 and united belly to belly, who were separated by

means of a ligature and the operation afterward completed by an

instrument. The constricting band was formed by a coalition of the

xiphoid cartilages and the umbilical vessels, surrounded by areolar

tissue and covered with skin. Le Beau says that under the Roman reign,

A. D. 945, two male children were brought from Armenia to

Constantinople for exhibition. They were well formed in every respect

and united by their abdomens. After they had been for some time an

object of great curiosity, they were removed by governmental order,

being considered a presage of evil. They returned, however, at the

commencement of the reign of Constantine VII, when one of them took

sick and died. The surgeons undertook to preserve the other by

separating him from the corpse of his brother, but he died on the third

day after the operation.

In 1866 Boehm gives an account of Guzenhausen's case of twins who were

united sternum to sternum. An operation for separation was performed

without accident, but one of the children, already very feeble, died

three days after; the other survived. The last attempt at an operation

like this was in 1881, when Biaudet and Buginon attempted to separate

conjoined sisters (Marie-Adele) born in Switzerland on June 26th.

Unhappily, they were very feeble and life was despaired of when the

operation was performed, on October 29th. Adele died six hours

afterward, and Marie died of peritonitis on the next day.

CLASS III.--Those monsters joined by a fusion of some of the cranial

bones are sometimes called craniopagi. A very ancient observation of

this kind is cited by Geoffroy-Saint-Hilaire. These two girls were

born in 1495, and lived to be ten years old. They were normal in every

respect, except that they were joined at the forehead, causing them to

stand face to face and belly to belly. When one walked forward, the

other was compelled to walk backward; their noses almost touched, and

their eyes were directed laterally. At the death of one an attempt to

separate the other from the cadaver was made, but it was unsuccessful,

the second soon dying; the operation necessitated opening the cranium

and parting the meninges. Bateman said that in 1501 there was living an

instance of double female twins, joined at the forehead. This case was

said to have been caused in the following manner: Two women, one of

whom was pregnant with the twins at the time, were engaged in an

earnest conversation, when a third, coming up behind them, knocked

their heads together with a sharp blow. Bateman describes the death of

one of the twins and its excision from the other, who died

subsequently, evidently of septic infection. There is a possibility

that this is merely a duplication of the account of the preceding case

with a slight anachronism as to the time of death.

At a foundling hospital in St. Petersburg there were born two living

girls, in good health, joined by the heads. They were so united that

the nose of one, if prolonged, would strike the ear of the other; they

had perfectly independent existences, but their vascular systems had

evident connection.

Through extra mobility of their necks they could really lie in a

straight line, one sleeping on the side and the other on the back.

There is a report a of two girls joined at their vertices, who survived

their birth. With the exception of this junction they were well formed

and independent in existence. There was no communication of the cranial

cavities, but simply fusion of the cranial bones covered by superficial

fascia and skin. Daubenton has seen a case of union at the occiput, but

further details are not quoted.

CLASS IV.--The next class to be considered is that in which the

individuals are separate and well formed, except that the point of

fusion is a common part, eliminating their individual components in

this location. The pygopagous twins belong in this section. According

to Bateman, twins were born in 1493 at Rome joined back to back, and

survived their birth. The same authority speaks of a female child who

was born with "2 bellies, 4 arms, 4 legs, 2 heads, and 2 sets of

privates, and was exhibited throughout Italy for gain's sake." The

"Biddenden Maids" were born in Biddenden, Kent, in 1100. Their names

were Mary and Eliza Chulkhurst, and their parents were fairly

well-to-do people. They were supposed to have been united at the hips

and the shoulders, and lived until 1134. At the death of one it was

proposed to separate them, but the remaining sister refused, saying,

"As we came together, we will also go together," and, after about six

hours of this Mezentian existence, they died. They bequeathed to the

church-wardens of the parish and their successors land to the extent of

20 acres, at the present time bringing a rental of about $155.00

annually, with the instructions that the money was to be spent in the

distribution of cakes (bearing the impression of their images, to be

given away on each Easter Sunday to all strangers in Biddenden) and

also 270 quartern loaves, with cheese in proportion, to all the poor in

said parish. Ballantyne has accompanied his description of these

sisters by illustrations, one of which shows the cake. Heaton gives a

very good description of these maids; and a writer in "Notes and

Queries" of March 27, 1875, gives the following information relative to

the bequest:--

"On Easter Monday, at Biddenden, near Staplehurst, Kent, there is a

distribution, according to ancient custom, of 'Biddenden Maids' cakes,'

with bread and cheese, the cost of which is defrayed from the proceeds

of some 20 acres of land, now yielding L35 per annum. and known as the

'Bread and Cheese Lands.' About the year 1100 there lived Eliza and

Mary Chulkhurst, who were joined together after the manner of the

Siamese twins, and who lived for thirty-four years, one dying, and then

being followed by her sister within six hours. They left by their will

the lands above alluded to and their memory is perpetuated by

imprinting on the cakes their effigies 'in their habit as they lived.'

The cakes, which are simple flour and water, are four inches long by

two inches wide, and are much sought after as curiosities. These, which

are given away, are distributed at the discretion of the

church-wardens, and are nearly 300 in number. The bread and cheese

amounts to 540 quartern loaves and 470 pounds of cheese. The

distribution is made on land belonging to the charity, known as the Old

Poorhouse. Formerly it used to take place in the Church, immediately

after the service in the afternoon, but in consequence of the unseemly

disturbance which used to ensue the practice was discontinued. The

Church used to be filled with a congregation whose conduct was

occasionally so reprehensible that sometimes the church-wardens had to

use their wands for other purposes than symbols of office. The

impressions of the maids 'on the cakes are of a primitive character,

and are made by boxwood dies cut in 1814. They bear the date 1100, when

Eliza and Mary Chulkhurst are supposed to have been born, and also

their age at death, thirty-four years."

Ballantyne has summed up about all there is to be said on this national

monstrosity, and his discussion of the case from its historic as well

as teratologic standpoint is so excellent that his conclusions will be

quoted--

"It may be urged that the date fixed for the birth of the Biddenden

Maids is so remote as to throw grave doubt upon the reality of the

occurrence. The year 1100 was, it will be remembered, that in which

William Rufus was found dead in the New Forest, 'with the arrow either

of a hunter or an assassin in his breast.' According to the Anglo-Saxon

Chronicle, several 'prodigies' preceded the death of this profligate

and extravagant monarch. Thus it is recorded that 'at Pentecost blood

was observed gushing from the earth at a certain town of Berkshire,

even as many asserted who declared that they had seen it. And after

this, on the morning after Lammas Day, King William was shot.' Now, it

is just possible that the birth of the Biddenden Maids may have

occurred later, but have been antedated by the popular tradition to the

year above mentioned. For such a birth would, in the opinion of the

times, be regarded undoubtedly as a most evident prodigy or omen of

evil. Still, even admitting that the date 1100 must be allowed to

stand, its remoteness from the present time is not a convincing

argument against a belief in the real occurrence of the phenomenon; for

of the dicephalic Scottish brothers, who lived in 1490, we have

credible historic evidence. Further, Lycosthenes, in his "Chronicon

Prodigiorum atque Ostentorum", published in 1557, states, upon what

authority I know not, that in the year 1112 joined twins resembling the

Biddenden phenomenon in all points save in sex were born in England.

The passage is as follows: 'In Anglia natus est puer geminus a clune ad

superiores partes ita divisus, ut duo haberet capita, duo corpora

integra ad renes cum suis brachiis, qui baptizatus triduo supervixit.'

It is just possible that in some way or other this case has been

confounded with the story of Biddenden; at any rate, the occurrence of

such a statement in Lycosthenes' work is of more than passing interest.

Had there been no bequest of land in connection with the case of the

Kentish Maids, the whole affair would probably soon have been forgotten.

"There is, however, one real difficulty in accepting the story handed

down to us as authentic,--the nature of the teratologic phenomenon

itself. All the records agree in stating that the Maids were joined

together at the shoulders and hips, and the impression on the cakes and

the pictures on the 'broadsides' show this peculiar mode of union, and

represent the bodies as quite separate in the space between the

above-named points. The Maids are shown with four feet and two arms,

the right and left respectively, whilst the other arms (left and right)

are fused together at the shoulder according to one illustration, and a

little above the elbow according to another. Now, although it is not

safe to say that such an anomaly is impossible, I do not know of any

case of this peculiar mode of union; but it may be that, as Prof. A. R.

Simpson has suggested, the Maids had four separate arms, and were in

the habit of going about with their contiguous arms round each other's

necks, and that this gave rise to the notion that these limbs were

united. If this be so, then the teratologic difficulty is removed, for

the case becomes perfectly comparable with the well-known but rare type

of double terata known as the pygopagous twins, which is placed by

Taruffi with that of the ischiopagous twins in the group dicephalus

lecanopagus. Similar instances, which are well known to students of

teratology, are the Hungarian sisters (Helen and Judith), the North

Carolina twins (Millie and Christine), and the Bohemian twins (Rosalie

and Josepha Blazek). The interspace between the thoraces may, however,

have simply been the addition of the first artist who portrayed the

Maids (from imagination?); then it may be surmised that they were

ectopagous twins.

"Pygopagous twins are fetuses united together in the region of the

nates and having each its own pelvis. In the recorded cases the union

has been usually between the sacra and coccyges, and has been either

osseous or (more rarely) ligamentous. Sometimes the point of junction

was the middle line posteriorly, at other times it was rather a

posterolateral union; and it is probable that in the Biddenden Maids it

was of the latter kind; and it is likely, from the proposal made to

separate the sisters after the death of one, that it was ligamentous in

nature.

"If it be granted that the Biddenden Maids were pygopagous twins, a

study of the histories of other recorded cases of this monstrosity

serves to demonstrate many common characters. Thus, of the 8 cases

which Taruffi has collected, in 7 the twins were female; and if to

these we add the sisters Rosalie and Josepha Blazek and the Maids, we

have 10 cases, of which 9 were girls. Again, several of the pygopagous

twins, of whom there are scientific records, survived birth and lived

for a number of years, and thus resembled the Biddenden terata. Helen

and Judith, for instance, were twenty-three years old at death; and the

North Carolina twins, although born in 1851, are still alive. There is,

therefore, nothing inherently improbable in the statement that the

Biddenden Maids lived for thirty-four years. With regard also to the

truth of the record that the one Maid survived her sister for six

hours, there is confirmatory evidence from scientifically observed

instances, for Joly and Peyrat (Bull. de l'Acad. Med., iii., pp. 51 and

383, 1874) state that in the case seen by them the one infant lived ten

hours after the death of the other. It is impossible to make any

statement with regard to the internal structure of the Maids or to the

characters of their genital organs, for there is absolutely no

information forthcoming upon these points. It may simply be said, in

conclusion, that the phenomenon of Biddenden is interesting not only on

account of the curious bequest which arose out of it, but also because

it was an instance of a very rare teratologic type, occurring at a very

early period in our national history."

Possibly the most famous example of twins of this type were Helen and

Judith, the Hungarian sisters, born in 1701 at Szony, in Hungary. They

were the objects of great curiosity, and were shown successively in

Holland, Germany, Italy, France, England, and Poland. At the age of

nine they were placed in a convent, where they died almost

simultaneously in their twenty-second year. During their travels all

over Europe they were examined by many prominent physiologists,

psychologists, and naturalists; Pope and several minor poets have

celebrated their existence in verse; Buffon speaks of them in his

"Natural History," and all the works on teratology for a century or

more have mentioned them. A description of them can be best given by a

quaint translation by Fisher of the Latin lines composed by a Hungarian

physician and inscribed on a bronze statuette of them:--

Two sisters wonderful to behold, who have thus grown as one, That

naught their bodies can divide, no power beneath the sun. The town of

Szoenii gave them birth, hard by far-famed Komorn, Which noble fort may

all the arts of Turkish sultans scorn. Lucina, woman's gentle friend,

did Helen first receive; And Judith, when three hours had passed, her

mother's womb did leave. One urine passage serves for both;--one anus,

so they tell; The other parts their numbers keep, and serve their

owners well. Their parents poor did send them forth, the world to

travel through, That this great wonder of the age should not be hid

from view. The inner parts concealed do lie hid from our eyes, alas!

But all the body here you view erect in solid brass.

They were joined back to back in the lumbar region, and had all their

parts separate except the anus between the right thigh of Helen and the

left of Judith and a single vulva. Helen was the larger, better

looking, the more active, and the more intelligent. Judith at the age

of six became hemiplegic, and afterward was rather delicate and

depressed. They menstruated at sixteen and continued with regularity,

although one began before the other. They had a mutual affection, and

did all in their power to alleviate the circumstances of their sad

position. Judith died of cerebral and pulmonary affections, and Helen,

who previously enjoyed good health, soon after her sister's first

indisposition suddenly sank into a state of collapse, although

preserving her mental faculties, and expired almost immediately after

her sister. They had measles and small-pox simultaneously, but were

affected in different degree by the maladies. The emotions,

inclinations, and appetites were not simultaneous. Eccardus, in a very

interesting paper, discusses the physical, moral, and religious

questions in reference to these wonderful sisters, such as the

advisability of separation, the admissibility of matrimony, and,

finally, whether on the last day they would rise as joined in life, or

separated.

There is an account of two united females, similar in conjunction to

the "Hungarian sisters," who were born in Italy in 1700. They were

killed at the age of four months by an attempt of a surgeon to separate

them.

In 1856 there was reported to have been born in Texas, twins after the

manner of Helen and Judith, united back to back, who lived and attained

some age. They were said to have been of different natures and

dispositions, and inclined to quarrel very often.

Pancoast gives an extensive report of Millie-Christine, who had been

extensively exhibited in Europe and the United States. They were born

of slave parents in Columbus County, N.C., July 11, 1851; the mother,

who had borne 8 children before, was a stout negress of thirty-two,

with a large pelvis. The presentation was first by the stomach and

afterward by the breech. These twins were united at the sacra by a

cartilaginous or possibly osseous union. They were exhibited in Paris

in 1873, and provoked as much discussion there as in the United States.

Physically, Millie was the weaker, but had the stronger will and the

dominating spirit. They menstruated regularly from the age of

thirteen. One from long habit yielded instinctively to the other's

movements, thus preserving the necessary harmony. They ate separately,

had distinct thoughts, and carried on distinct conversations at the

same time. They experienced hunger and thirst generally simultaneously,

and defecated and urinated nearly at the same times. One, in tranquil

sleep, would be wakened by a call of nature of the other. Common

sensibility was experienced near the location of union. They were

intelligent and agreeable and of pleasant appearance, although slightly

under size; they sang duets with pleasant voices and accompanied

themselves with a guitar; they walked, ran, and danced with apparent

ease and grace. Christine could bend over and lift Millie up by the

bond of union.

A recent example of the pygopagus type was Rosa-Josepha Blazek, born in

Skerychov, in Bohemia, January 20, 1878. These twins had a broad bony

union in the lower part of the lumbar region, the pelvis being

obviously completely fused. They had a common urethral and anal

aperture, but a double vaginal orifice, with a very apparent septum.

The sensation was distinct in each, except where the pelves joined.

They were exhibited in Paris in 1891, being then on an exhibition tour

around the world. Rosa was the stronger, and when she walked or ran

forward she drew her sister with her, who must naturally have reversed

her steps. They had independent thoughts and separate minds; one could

sleep while the other was awake. Many of their appetites were

different, one preferring beer, the other wine; one relished salad, the

other detested it, etc. Thirst and hunger were not simultaneous.

Baudoin describes their anatomic construction, their mode of life, and

their mannerisms and tastes in a quite recent article. Fig. 42 is a

reproduction of an early photograph of the twins, and Fig. 43

represents a recent photograph of these "Bohemian twins," as they are

now called.

The latest record we have of this type of monstrosity is that given by

Tynberg to the County Medical Society of New York, May 27, 1895. The

mother was present with the remarkable twins in her arms, crying at the

top of their voices. These two children were born at midnight on April

15th. Tynberg remarked that he believed them to be distinct and

separate children, and not dependent on a common arterial system; he

also expressed his intention of separating them, but did not believe

the operation could be performed with safety before another year.

Jacobi describes in full Tynberg's instance of pygopagus. He says the

confinement was easy; the head of one was born first, soon followed by

the feet and the rest of the twins. The placenta was single and the

cord consisted of two branches. The twins were united below the third

sacral vertebrae in such a manner that they could lie alongside of each

other. They were females, and had two vaginae, two urethrae four labia

minora, and two labia majora, one anus, but a double rectum divided by

a septum. They micturated independently but defecated simultaneously.

They virtually lived separate lives, as one might be asleep while the

other cried, etc.

CLASS V.--While instances of ischiopagi are quite numerous, few have

attained any age, and, necessarily, little notoriety. Pare speaks of

twins united at the pelves, who were born in Paris July 20, 1570. They

were baptized, and named Louis and Louise. Their parents were well

known in the rue des Gravelliers. According to Bateman, and also Rueff,

in the year 1552 there were born, not far from Oxford, female twins,

who, from the description given, were doubtless of the ischiopagus

type. They seldom wept, and one was of a cheerful disposition, while

the other was heavy and drowsy, sleeping continually. They only lived a

short time, one expiring a day before the other. Licetus speaks of Mrs.

John Waterman, a resident of Fishertown, near Salisbury, England, who

gave birth to a double female monster on October 26, 1664, which

evidently from the description was joined by the ischii. It did not

nurse, but took food by both the mouths; all its actions were done in

concert; it was possessed of one set of genitourinary organs; it only

lived a short while. Many people in the region flocked to see the

wonderful child, whom Licetus called "Monstrum Anglicum." It is said

that at the same accouchement the birth of this monster was followed by

the birth of a well-formed female child, who survived.

Geoffroy-Saint-Hilaire quotes a description of twins who were born in

France on October 7, 1838, symmetrically formed and united at their

ischii. One was christened Marie-Louise, and the other

Hortense-Honorine. Their avaricious parents took the children to Paris

for exhibition, the exposures of which soon sacrificed their lives. In

the year 1841 there was born in the island of Ceylon, of native

parents, a monstrous child that was soon brought to Columbo, where it

lived only two months. It had two heads and seemed to have duplication

in all its parts except the anus and male generative organs.

Montgomery speaks of a double child born in County Roscommon, Ireland,

on the 24th of July, 1827. It had two heads, two chests with arms

complete, two abdominal and pelvic cavities united end to end, and four

legs, placed two on either side. It had only one anus, which was

situated between the thighs. One of the twins was dark haired and was

baptized Mary, while the other was a blonde and was named Catherine.

These twins felt and acted independently of each other; they each in

succession sucked from the breast or took milk from the spoon, and used

their limbs vigorously. One vomited without affecting the other, but

the feces were discharged through a common opening.

Goodell speaks of Minna and Minnie Finley, who were born in Ohio and

examined by him. They were fused together in a common longitudinal

axis, having one pelvis, two heads, four legs, and four arms. One was

weak and puny and the other robust and active; it is probable that they

had but one rectum and one bladder. Goodell accompanies his

description by the mention of several analogous cases. Ellis speaks of

female twins, born in Millville, Tenn., and exhibited in New York in

1868, who were joined at the pelves in a longitudinal axis. Between the

limbs on either side were to be seen well-developed female genitals,

and the sisters had been known to urinate from both sides, beginning

and ending at the same time.

Huff details a description of the "Jones twins," born on June 24, 1889,

in Tipton County, Indiana, whose spinal columns were in apposition at

the lower end. The labor, of less than two hours' duration, was

completed before the arrival of the physician. Lying on their mother's

back, they could both nurse at the same time. Both sets of genitals and

ani were on the same side of the line of union, but occupied normal

positions with reference to the legs on either side. Their weight at

birth was 12 pounds and their length 22 inches. Their mother was a

medium-sized brunette of 19, and had one previous child then living at

the age of two; their father was a finely formed man 5 feet 10 inches

in height. The twins differed in complexion and color of the eyes and

hair. They were publicly exhibited for some time, and died February 19

and 20, 1891, at St. John's Hotel, Buffalo, N.Y. Figure 45 shows their

appearance several months after birth.

CLASS VI.--In our sixth class, the first record we have is from the

Commentaries of Sigbert, which contains a description of a monstrosity

born in the reign of the Emperor Theodosius, who had two heads, two

chests with four arms attached, but a single lower extremity. The

emotions, affections, and appetites were different. One head might be

crying while the other laughed, or one feeding while the other was

sleeping. At times they quarreled and occasionally came to blows. This

monster is said to have lived two years, one part dying four days

before the other, which evinced symptoms of decay like its inseparable

neighbor.

Roger of Wendover says that in Lesser Brittany and Normandy, in 1062,

there was seen a female monster, consisting of two women joined about

the umbilicus and fused into a single lower extremity. They took their

food by two mouths but expelled it at a single orifice. At one time,

one of the women laughed, feasted, and talked, while the other wept,

fasted, and kept a religious silence. The account relates how one of

them died, and the survivor bore her dead sister about for three years

before she was overcome by the oppression and stench of the cadaver.

Batemen describes the birth of a boy in 1529, who had two heads, four

ears, four arms, but only two thighs and two legs. Buchanan speaks at

length of the famous "Scottish Brothers," who were the cynosure of the

eyes of the Court of James III of Scotland. This monster consisted of

two men, ordinary in appearance in the superior extremities, whose

trunks fused into a single lower extremity. The King took diligent care

of their education, and they became proficient in music, languages, and

other court accomplishments. Between them they would carry on animated

conversations, sometimes merging into curious debates, followed by

blows. Above the point of union they had no synchronous sensations,

while below, sensation was common to both. This monster lived

twenty-eight years, surviving the royal patron, who died June, 1488.

One of the brothers died some days before the other, and the survivor,

after carrying about his dead brother, succumbed to "infection from

putrescence." There was reported to have been born in Switzerland a

double headed male monster, who in 1538, at the age of thirty, was

possessed of a beard on each face, the two bodies fused at the

umbilicus into a single lower extremity. These two twins resembled one

another in contour and countenance. They were so joined that at rest

they looked upon one another. They had a single wife, with whom they

were said to have lived in harmony. In the Gentleman's Magazine about

one hundred and fifty years since there was given the portrait and

description of a double woman, who was exhibited all over the large

cities of Europe. Little can be ascertained anatomically of her

construction, with the exception that it was stated that she had two

heads, two necks, four arms, two legs, one pelvis, and one set of

pelvic organs.

The most celebrated monster of this type was Ritta-Christina, who was

born in Sassari, in Sardinia, March 23, 1829. These twins were the

result of the ninth confinement of their mother, a woman of thirty-two.

Their superior extremities were double, but they joined in a common

trunk at a point a little below the mammae. Below this point they had

a common trunk and single lower extremities. The right one, christened

Ritta, was feeble and of a sad and melancholy countenance; the left,

Christina, was vigorous and of a gay and happy aspect. They suckled at

different times, and sensations in the upper extremities were distinct.

They expelled urine and feces simultaneously, and had the indications

in common. Their parents, who were very poor, brought them to Paris for

the purpose of public exhibition, which at first was accomplished

clandestinely, but finally interdicted by the public authorities, who

feared that it would open a door for psychologic discussion and

speculation. This failure of the parents to secure public patronage

increased their poverty and hastened the death of the children by

unavoidable exposure in a cold room. The nervous system of the twins

had little in common except in the line of union, the anus, and the

sexual organs, and Christina was in good health all through Ritta's

sickness; when Ritta died, her sister, who was suckling at the mother's

breast, suddenly relaxed hold and expired with a sigh. At the

postmortem, which was secured with some difficulty on account of the

authorities ordering the bodies to be burned, the pericardium was found

single, covering both hearts. The digestive organs were double and

separate as far as the lower third of the ilium, and the cecum was on

the left side and single, in common with the lower bowel. The livers

were fused and the uterus was double. The vertebral columns, which were

entirely separate above, were joined below by a rudimentary os

innorminatum. There was a junction between the manubrium of each. Sir

Astley Cooper saw a monster in Paris in 1792 which, by his description,

must have been very similar to Ritta-Christina.

The Tocci brothers were born in 1877 in the province of Turin, Italy.

They each had a well-formed head, perfect arms, and a perfect thorax to

the sixth rib; they had a common abdomen, a single anus, two legs, two

sacra, two vertebral columns, one penis, but three buttocks, the

central one containing a rudimentary anus. The right boy was christened

Giovanni-Batista, and the left Giacomo. Each individual had power over

the corresponding leg on his side, but not over the other one. Walking

was therefore impossible. All their sensations and emotions were

distinctly individual and independent. At the time of the report, in

1882, they were in good health and showed every indication of attaining

adult age. Figure 48 represents these twins as they were exhibited

several years ago in Germany.

McCallum saw two female children in Montreal in 1878 named Marie-Rosa

Drouin. They formed a right angle with their single trunk, which

commenced at the lower part of the thorax of each. They had a single

genital fissure and the external organs of generation of a female. A

little over three inches from the anus was a rudimentary limb with a

movable articulation; it measured five inches in length and tapered to

a fine point, being furnished with a distinct nail, and it contracted

strongly to irritation. Marie, the left child, was of fair complexion

and more strongly developed than Rosa. The sensations of hunger and

thirst were not experienced at the same time, and one might be asleep

while the other was crying. The pulsations and the respiratory

movements were not synchronous. They were the products of the second

gestation of a mother aged twenty-six, whose abdomen was of such

preternatural size during pregnancy that she was ashamed to appear in

public. The order of birth was as follows: one head and body, the lower

extremity, and the second body and head.

CLASS VII.--There are many instances of bicephalic monsters on record.

Pare mentions and gives an illustration of a female apparently single

in conformation, with the exception of having two heads and two necks.

The Ephemerides, Haller, Schenck, and Archenholz cite examples, and

th

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