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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: 818
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