MINOR TERATA. 1 page

Ancient Ideas Relative to Minor Terata.--The ancients viewed with great

interest the minor structural anomalies of man, and held them to be

divine signs or warnings in much the same manner as they considered

more pronounced monstrosities. In a most interesting and instructive

article, Ballantyne quotes Ragozin in saying that the

Chaldeo-Babylonians, in addition to their other numerous subdivisions

of divination, drew presages and omens for good or evil from the

appearance of the liver, bowels, and viscera of animals offered for

sacrifice and opened for inspection, and from the natural defects or

monstrosities of babies or the young of animals. Ballantyne names this

latter subdivision of divination fetomancy or teratoscopy, and thus

renders a special chapter as to omens derived from monstrous births,

given by Lenormant:--

"The prognostics which the Chaldeans claimed to draw from monstrous

births in man and the animals are worthy of forming a class by

themselves, insomuch the more as it is the part of their divinatory

science with which, up to the present time, we are best acquainted. The

development that their astrology had given to 'genethliaque,' or the

art of horoscopes of births, had led them early to attribute great

importance to all the teratologic facts which were there produced. They

claimed that an experience of 470,000 years of observations, all

concordant, fully justified their system, and that in nothing was the

influence of the stars marked in a more indubitable manner than in the

fatal law which determined the destiny of each individual according to

the state of the sky at the moment when he came into the world. Cicero,

by the very terms which he uses to refute the Chaldeans, shows that the

result of these ideas was to consider all infirmities and monstrosities

that new-born infants exhibited as the inevitable and irremediable

consequence of the action of these astral positions. This being

granted, the observation of similar monstrosities gave, as it were, a

reflection of the state of the sky; on which depended all terrestrial

things; consequently, one might read in them the future with as much

certainty as in the stars themselves. For this reason the greatest

possible importance was attached to the teratologic auguries which

occupy so much space in the fragments of the great treatise on

terrestrial presages which have up to the present time been published."

The rendering into English of the account of 62 teratologic cases in

the human subject with the prophetic meanings attached to them by

Chaldean diviners, after the translation of Opport, is given as follows

by Ballantyne, some of the words being untranslatable:--

"When a woman gives birth to an infant--

(1) that has the ears of a lion, there will be a powerful king in the

country;

(2) that wants the right ear, the days of the master (king) will be

prolonged (reach old age);

(3) that wants both ears, there will be mourning in the country, and

the country will be lessened (diminished);

(4) whose right ear is small, the house of the man (in whose house the

birth took place) will be destroyed;

(5) whose ears are both small, the house of the man will be built of

bricks;

(6) whose right ear is mudissu tehaat (monstrous), there will be an

androgyne in the house of the new-born

(7) whose ears are both mudissu (deformed), the country will perish and

the enemy rejoice;

(8) whose right ear is round, there will be an androgyne in the house

of the new-born;

(9) whose right ear has a wound below, and tur re ut of the man, the

house will be estroyed;

(10) that has two ears on the right side and none on the left, the gods

will bring about a stable reign, the country will flourish, and it will

be a land of repose;

(11) whose ears are both closed, sa a au;

(12) that has a bird's beak, the country will be peaceful;

(13) that has no mouth, the mistress of the house will die;

(14) that has no right nostril, the people of the world will be injured;

(15) whose nostrils are absent, the country will be in affliction, and

the house of the man will be ruined;

(16) whose jaws are absent, the days of the master (king) will be

prolonged, but the house (where the infant is born) will be ruined.

When a woman gives birth to an infant--

(17) that has no lower jaw, mut ta at mat, the name will not be effaced;

(20) that has no nose, affliction will seize upon the country, and the

master of the house will die;

(21) that has neither nose nor virile member (penis), the army of the

king will be strong, peace will be in the land, the men of the king

will be sheltered from evil influences, and Lilit (a female demon)

shall not have power over them;

(22) whose upper lip overrides the lower, the people of the world will

rejoice (or good augury for the troops);

(23) that has no lips, affliction will seize upon the land, and the

house of the man will be destroyed;

(24) whose tongue is kuri aat, the man will be spared (?);

(25) that has no right hand, the country will be convulsed by an

earthquake;

(26) that has no fingers, the town will have no births, the bar shall

be lost;

(27) that has no fingers on the right side, the master (king) will not

pardon his adversary (or shall be humiliated by his enemies);

(28) that has six fingers on the right side, the man will take the

lukunu of the house;

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

lukunu;

(30) that has six toes on each foot, the people of the world will be

injured (calamity to the troops);

(31) that has the heart open and that has no skin, the country will

suffer from calamities;

(32) that has no penis, the master of the house will be enriched by the

harvest of his field;

(33) that wants the penis and the umbilicus, there will be ill-will in

the house, the woman (wife) will have an overbearing eye (be haughty);

but the male descent of the palace will be more extended.

When a woman gives birth to an infant--

(34) that has no well-marked sex, calamity and affliction will seize

upon the land; the master of the house shall have no happiness;

(35) whose anus is closed, the country will suffer from want of

nourishment;

(36) whose right testicle (?) is absent, the country of the master

(king) will perish;

(37) whose right foot is absent, his house will be ruined and there

will be abundance in that of the neighbor;

(38) that has no feet, the canals of the country will be cut

(intercepted) and the house ruined;

(39) that has the right foot in the form of a fish's tail, the booty of

the country of the humble will not be imas sa bir;

(40) whose hands and feet are like four fishes' tails (fins), the

master (king) shall perish (?) and his country shall be consumed;

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

shall be destroyed;

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

prosperity in the land;

(43) that has three feet, two in their normal position (attached to the

body) and the third between them, there will be great prosperity in the

land;

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

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

be destroyed.

When a woman gives birth to an infant--

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

be prolonged;

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

the house will be destroyed;

(48) that has much pinde on the head, joy shall go to meet the house

(that has a head on the head, the good augury shall enter at its aspect

into the house);

(49) that has the head full of hali, there will be ill-will toward him

and the master (king) of the town shall die;

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

masters;

(51) that has some pieces of flesh (skin) hanging on the head, there

shall be ill-will;

(52) that has some branches (?) (excrescences) of flesh (skin) hanging

on the head, there shall be ill-will, the house will perish;

(53) that has some formed fingers (horns?) on the head, the days of the

king will be less and the years lengthened (in the duration of his old

age);

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

(55) that has a ---- of a bird on the head, the master of the house

shall not prosper;

(56) that has some teeth already through (cut), the days of the king

will arrive at old age, the country will show itself powerful over

(against) strange (feeble) lands, but the house where the infant is

born will be ruined;

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

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

(reinforced);

(59) that has on the head the mouth of an old man and that foams

(slabbers), there will be great prosperity in the land, the god Bin

will give a magnificent harvest (inundate the land with fertility), and

abundance shall be in the land;

(60) that has on one side of the head a thickened ear, the first-born

of the men shall live a long time (?);

(61) that has on the head two long and thick ears, there will be

tranquility and the pacification of litigation (contests);

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

As ancient and as obscure as are these records, Ballantyne has

carefully gone over each, and gives the following lucid explanatory

comments:--

"What 'ears like a lion' (No. 1) may have been it is difficult to

determine; but doubtless the direction and shape of the auricles were

so altered as to give them an animal appearance, and possibly the

deformity was that called 'orechio ad ansa' by Lombroso. The absence of

one or both ears (Nos. 2 and 3) has been noted in recent times by

Virchow (Archiv fur path. Anat. xxx., p. 221), Gradenigo (Taruffi's

'Storia della Teratologia,' vi., p. 552), and others. Generally some

cartilaginous remnant is found, but on this point the Chaldean record

is silent. Variations in the size of the ears (Nos. 4 and 5) are well

known at the present time, and have been discussed at length by Binder

(Archiv fur Psychiatrie und Nervenkrankheiten, xx., 1887) and others.

The exact malformation indicated in Nos. 6 and 7 is, of course, not to

be determined, although further researches in Assyriology may clear up

this point. The 'round ear' (No. 8) is one of Binder's types, and that

with a 'wound below' (No. 9) probably refers to a case of fistula auris

congenita (Toynbee, 'Diseases of the Ear,' 1860). The instance of an

infant born with two ears on the right side (No. 10) was doubtless one

of cervical auricle or preauricular appendage, whilst closure of the

external auditory meatus (No. 11) is a well-known deformity.

"The next thirteen cases (Nos. 12-24) were instances of anomalies of

the mouth and nose. The 'bird's beak' (No. 12) may have been a markedly

aquiline nose; No. 13 was a case of astoma; and Nos. 14 and 15 were

instances of stenosis or atresia of the anterior nares. Fetuses with

absence of the maxillae (Nos. 16 and 17) are in modern terminology

called agnathous. Deformities like that existing in Nos. 20 and 21 have

been observed in paracephalic and cyclopic fetuses. The coincident

absence of nose and penis (No. 21) is interesting, especially when

taken in conjunction with the popular belief that the size of the

former organ varies with that of the latter. Enlargement of the upper

lip (No. 22), called epimacrochelia by Taruffi, and absence of the lips

(No. 23), known now under the name of brachychelia, have been not

unfrequently noticed in recent times. The next six cases (Nos. 25-30)

were instances of malformations of the upper limb: Nos. 25, 26. and 27

were probably instances of the so-called spontaneous or intrauterine

amputation; and Nos. 28, 29, and 30 were examples of the comparatively

common deformity known as polydactyly. No. 31 was probably a case of

ectopia cordis.

"Then follow five instances of genital abnormalities (Nos. 32-36),

consisting of absence of the penis (epispadias?), absence of penis and

umbilicus (epispadias and exomphalos?), hermaphroditism, imperforate

anus, and nondescent of one testicle. The nine following cases (Nos.

37-45) were anomalies of the lower limbs: Nos. 37, 38, and 42 may have

been spontaneous amputations; Nos. 39 and 40 were doubtless instances

of webbed toes (syndactyly), and the deformity indicated in No. 45 was

presumably talipes equinus. The infant born with three feet (No. 43)

was possibly a case of parasitic monstrosity, several of which have

been reported in recent teratologic literature; but what is meant by

the statement concerning 'male and female legs' it is not easy to

determine.

"Certain of the ten following prodigies (Nos. 46-55) cannot in the

present state of our knowledge be identified. The presence of

congenital patches of white or gray hair on the scalp, as recorded in

No. 46, is not an unknown occurrence at the present time; but what the

Chaldeans meant by ipga, pinde, hali riksi, and kali on the head of the

new-born infant it is impossible to tell. The guess may be hazarded

that cephalhematoma, hydrocephalus, meningocele, nevi, or an excessive

amount of vernix caseosa were the conditions indicated, but a wider

acquaintance with the meaning of the cuneiform characters is necessary

before any certain identification is possible. The 'pieces of skin

hanging from the head' (No. 51) may have been fragments of the

membranes; but there is nothing in the accompanying prediction to help

us to trace the origin of the popular belief in the good luck following

the baby born with a caul. If No. 53 was a case of congenital horns on

the head, it must be regarded as a unique example, unless, indeed, a

form of fetal ichthyosis be indicated.

"The remaining observations (No. 56-62) refer to cases of congenital

teeth (No. 56) to deformity of the ears (Nos. 60 and 61), and a horn

(No. 62)."

From these early times almost to the present day similar significance

has been attached to minor structural anomalies. In the following pages

the individual anomalies will be discussed separately and the most

interesting examples of each will be cited. It is manifestly evident

that the object of this chapter is to mention the most striking

instances of abnormism and to give accompanying descriptions of

associate points of interest, rather than to offer a scientific

exposition of teratology, for which the reader is referred elsewhere.

Congenital defect of the epidermis and true skin is a rarity in

pathology. Pastorello speaks of a child which lived for two and a half

hours whose hands and feet were entirely destitute of epidermis; the

true skin of those parts looked like that of a dead and already

putrefying child. Hanks cites the history of a case of antepartum

desquamation of the skin in a living fetus. Hochstetter describes a

full-term, living male fetus with cutaneous defect on both sides of the

abdomen a little above the umbilicus. The placenta and membranes were

normal, a fact indicating that the defect was not due to amniotic

adhesions; the child had a club-foot on the left side. The mother had a

fall three weeks before labor.

Abnormal Elasticity of the Skin.--In some instances the skin is affixed

so loosely to the underlying tissues and is possessed of so great

elasticity that it can be stretched almost to the same extent as India

rubber. There have been individuals who could take the skin of the

forehead and pull it down over the nose, or raise the skin of the neck

over the mouth. They also occasionally have an associate muscular

development in the subcutaneous tissues similar to the panniculus

adiposus of quadrupeds, giving them preternatural motile power over the

skin. The man recently exhibited under the title of the "Elastic-Skin

Man" was an example of this anomaly. The first of this class of

exhibitionists was seen in Buda-Pesth some years since and possessed

great elasticity in the skin of his whole body; even his nose could be

stretched. Figure 70 represents a photograph of an exhibitionist named

Felix Wehrle, who besides having the power to stretch his skin could

readily bend his fingers backward and forward. The photograph was taken

in January, 1888.

In these congenital cases there is loose attachment of the skin without

hypertrophy, to which the term dermatolysis is restricted by Crocker.

Job van Meekren, the celebrated Dutch physician of the seventeenth

century, states that in 1657 a Spaniard, Georgius Albes, is reported to

have been able to draw the skin of the left pectoral region to the left

ear, or the skin under the face over the chin to the vertex. The skin

over the knee could be extended half a yard, and when it retracted to

its normal position it was not in folds. Seiffert examined a case of

this nature in a young man of nineteen, and, contrary to Kopp's

supposition, found that in some skin from over the left second rib the

elastic fibers were quite normal, but there was transformation of the

connective tissue of the dermis into an unformed tissue like a myxoma,

with total disappearance of the connective-tissue bundles. Laxity of

the skin after distention is often seen in multipara, both in the

breasts and in the abdominal walls, and also from obesity, but in all

such cases the skin falls in folds, and does not have a normal

appearance like that of the true "elastic-skin man."

Occasionally abnormal development of the scalp is noticed. McDowall of

twenty-two. On each side of the median line of the head there were five

deep furrows, more curved and shorter as the distance from the median

line increased. In the illustration the hair in the furrows is left

longer than that on the rest of the head. The patient was distinctly

microcephalic and the right side of the body was markedly wasted. The

folds were due to hypertrophy of the muscles and scalp, and the same

sort of furrowing is noticed when a dog "pricks his ears." This case

may possibly be considered as an example of reversion to inferior

types. Cowan records two cases of the foregoing nature in idiots. The

first case was a paralytic idiot of thirty-nine, whose cranial

development was small in proportion to the size of the face and body;

the cranium was oxycephalic; the scalp was lax and redundant and the

hair thin; there were 13 furrows, five on each side running

anteroposteriorly, and three in the occipital region running

transversely. The occipitofrontalis muscle had no action on them. The

second case was that of an idiot of forty-four of a more degraded type

than the previous one. The cranium was round and bullet-shaped and the

hair generally thick. The scalp was not so lax as in the other case,

but the furrows were more crooked. By tickling the scalp over the back

of the neck the two median furrows involuntarily deepened.

Impervious Skin.--There have been individuals who claimed that their

skin was impervious to ordinary puncture, and from time to time these

individuals have appeared in some of the larger medical clinics of the

world for inspection. According to a recent number of the London

Graphic, there is in Berlin a Singhalese who baffles all investigations

by physicians by the impenetrability of his skin. The bronzed

Easterner, a Hercules in shape, claims to have found an elixir which

will render the human skin impervious to any metal point or sharpened

edge of a knife or dagger, and calls himself the "Man with Iron Skin."

He is now exhibiting himself, and his greatest feat is to pass with his

entire body through a hoop the inside of which is hardly big enough to

admit his body and is closely set with sharp knife-points, daggers,

nails, and similar things. Through this hoop he squeezes his body with

absolute impunity. The physicians do not agree as to his immunity, and

some of them think that Rhannin, which is his name, is a fakir who has

by long practice succeeded in hardening himself against the impressions

of metal upon his skin. The professors of the Berlin clinic, however,

considered it worth while to lecture about the man's skin, pronouncing

it an inexplicable matter. This individual performed at the London

Alhambra in the latter part of 1895. Besides climbing with bare feet a

ladder whose rungs were sharp-edged swords, and lying on a bed of nail

points with four men seated upon him, he curled himself up in a barrel,

through whose inner edges nails projected, and was rolled about the

stage at a rapid rate. Emerging from thence uninjured, he gracefully

bows himself off the stage.

Some individuals claim immunity from burns and show many interesting

feats in handling fire. As they are nothing but skilful "fire jugglers"

they deserve no mention here. The immunity of the participants in the

savage fire ceremonies will be discussed in Chapter IX.

Albinism is characterized by the absolute or relative absence of

pigment of the skin, due to an arrest, insufficiency, or retardation of

this pigment. Following Trelat and Guinard, we may divide albinism into

two classes,--general and partial.

As to the etiology of albinism, there is no known cause of the complete

form. Heredity plays no part in the number of cases investigated by the

authors. D'Aube, by his observations on white rabbits, believes that

the influence of consanguinity is a marked factor in the production of

albinism; there are, however, many instances of heredity in this

anomaly on record, and this idea is possibly in harmony with the

majority of observers. Geoffroy-Saint-Hilaire has noted that albinism

can also be a consequence of a pathologic condition having its origin

in adverse surroundings, the circumstances of the parents, such as the

want of exercise, nourishment, light, etc.

Lesser knew a family in which six out of seven were albinos, and in

some tropical countries, such as Loango, Lower Guinea, it is said to be

endemic. It is exceptional for the parents to be affected; but in a

case of Schlegel, quoted by Crocker, the grandfather was an albino, and

Marey describes the case of the Cape May albinos, in which the mother

and father were "fair emblems of the African race," and of their

children three were black and three were white, born in the following

order: two consecutive black boys, two consecutive white girls, one

black girl, one white boy. Sym of Edinburgh relates the history of a

family of seven children, who were alternately white and black. All

but the seventh were living and in good health and mentally without

defect. The parents and other relatives were dark. Figure 73 portrays

an albino family by the name of Cavalier who exhibited in Minneapolis

in 1887.

Examples of the total absence of pigment occur in all races, but

particularly is it interesting when seen in negroes who are found

absolutely white but preserving all the characteristics of their race,

as, for instance, the kinky, woolly hair, flattened nose, thick lips,

etc. Rene Claille, in his "Voyage a Tombouctou," says that he saw a

white infant, the offspring of a negro and negress. Its hair was

white, its eyes blue, and its lashes flaxen. Its pupils were of a

reddish color, and its physiognomy that of a Mandingo. He says such

cases are not at all uncommon; they are really negro albinos. Thomas

Jefferson, in his "History of Virginia," has an excellent description

of these negroes, with their tremulous and weak eyes; he remarks that

they freckle easily. Buffon speaks of Ethiops with white twins, and

says that albinos are quite common in Africa, being generally of

delicate constitution, twinkling eyes, and of a low degree of

intelligence; they are despised and ill-treated by the other negroes.

Prichard, quoted by Sedgwick, speaks of a case of atavic transmission

of albinism through the male line of the negro race. The grandfather

and the grandchild were albinos, the father being black. There is a

case of a brother and sister who were albinos, the parents being of

ordinary color but the grandfather an albino. Coinde, quoted by

Sedgwick, speaks of a man who, by two different wives, had three albino

children.

A description of the ordinary type of albino would be as follows: The

skin and hair are deprived of pigment; the eyebrows and eyelashes are

of a brilliant white or are yellowish; the iris and the choroid are

nearly or entirely deprived of coloring material, and in looking at the

eye we see a roseate zone and the ordinary pink pupil; from absence of

pigment they necessarily keep their eyes three-quarters closed, being

photophobic to a high degree. They are amblyopic, and this is due

partially to a high degree of ametropia (caused by crushing of the

eyeball in the endeavor to shut out light) and from retinal exhaustion

and nystagmus. Many authors have claimed that they have little

intelligence, but this opinion is not true. Ordinarily the reproductive

functions are normal, and if we exclude the results of the union of two

albinos we may say that these individuals are fecund.

Partial albinism is seen. The parts most often affected are the

genitals, the hair, the face, the top of the trunk, the nipple, the

back of the hands and fingers. Folker reports the history of a case of

an albino girl having pink eyes and red hair, the rest of the family

having pink eyes and white hair. Partial albinism, necessarily

congenital, presenting a piebald appearance, must not be confounded

with leukoderma, which is rarely seen in the young and which will be

described later.

Date: 2014-12-29; view: 737