MINOR TERATA. 6 page

trunk were the same as in any other child of like age. He was 22 1/2

inches high, had no spinal curvature, but was absolutely devoid of

lower extremities. The right arm was two inches long and the left 2

1/4. Each contained the head and a small adjoining portion of the

humerus. The legs were represented by masses of cellular tissue and fat

covered by skin which projected about an inch. He was intelligent, had

a good memory, and exhibited considerable activity. He seemed to have

had more than usual mobility and power of flexion of the lower lumbar

region. When on his back he was unable to rise up, but resting on the

lower part of the pelvis he was able to maintain himself erect. He

usually picked up objects with his teeth, and could hold a coin in the

axilla as he rolled from place to place. His rolling was accomplished

by a peculiar twisting of the thorax and bending of the pelvis. There

was no history of maternal impression during pregnancy, no injury, and

no hereditary disposition to anomalous members. Figure 112 represents a

boy with congenital deficiency of the lower extremities who was

exhibited a few years ago in Philadelphia. In Figure 113, which

represents a similar case in a girl whose photograph is deposited in

the Mutter Museum of the College of Physicians, Philadelphia, we see

how cleverly the congenital defect may be remedied by mechanical

contrivance. With her crutches and artificial legs this girl was said

to have moved about easily.

Parvin describes a "turtle-man" as an ectromelian, almost entering the

class of phocomelians or seal-like monsters; the former term signifies

abortive or imperfect formation of the members. The hands and feet were

normally developed, but the arms, forearms, and legs are much shortened.

The "turtle-woman" of Demerara was so called because her mother when

pregnant was frightened by a turtle, and also from the child's fancied

resemblance to a turtle. The femur was six inches long, the woman had a

foot of six bones, four being toes, viz., the first and second

phalanges of the first and second toes. She had an acetabulum, capsule,

and ligamentum teres, but no tibia or fibula; she also had a defective

right forearm. She was never the victim of rachitis or like disease,

but died of syphilis in the Colonial Hospital. In her twenty-second

year she was delivered of a full-grown child free of deformity.

There was a woman living in Bavaria, under the observation of Buhl, who

had congenital absence of both femurs and both fibulas. Almost all the

muscles of the thigh existed, and the main attachment to the pelvis was

by a large capsular articulation. Charpentier gives the portrait of a

woman in whom there was a uniform diminution in the size of the limbs.

Debout portrays a young man with almost complete absence of the thigh

and leg, from whose right hip there depended a foot. Accrell describes

a peasant of twenty-six, born without a hip, thigh, or leg on the right

side. The external genital organs were in their usual place, but there

was only one testicle in the scrotum. The man was virile. The rectum

instead of opening outward and underneath was deflected to the right.

Supernumerary Limbs.--Haller reports several cases of supernumerary

extremities. Plancus speaks of an infant with a complete third leg, and

Dumeril cites a similar instance. Geoffroy-Saint-Hilaire presented to

the Academie des Sciences in 1830 a child with four legs and feet who

was in good health. Amman saw a girl with a large thigh attached to

her nates. Below the thigh was a single leg made by the fusion of two

legs. No patella was found and the knee was anchylosed. One of the feet

of the supernumerary limb had six toes, while the other, which was

merely an outgrowth, had two toes on it.

According to Jules Guerin, the child named Gustav Evrard was born with

a thigh ending in two legs and two imperfect feet depending from the

left nates.

Tucker describes a baby born in the Sloane Maternity in New York,

October 1, 1894, who had a third leg hanging from a bony and fleshy

union attached to the dorsal spine. The supernumerary leg was well

formed and had a left foot attached to it. Larkin and Jones mention the

removal of a meningocele and a supernumerary limb from an infant of

four months. This limb contained three fingers only, one of which did

not have a bony skeleton.

Pare says that on the day the Venetians and the Genevois made peace a

monster was born in Italy which had four legs of equal proportions, and

besides had two supernumerary arms from the elbows of the normal limbs.

This creature lived and was baptized.

Anomalies of the Feet.--Hatte has seen a woman who bore a child that

had three feet. Bull gives a description of a female infant with the

left foot double or cloven. There was only one heel, but the anterior

portion consisted of an anterior and a posterior part. The anterior

foot presented a great toe and four smaller ones, but deformed like an

example of talipes equinovarus. Continuous with the outer edge of the

anterior part and curving beneath it was a posterior part, looking not

unlike a second foot, containing six well-formed toes situated directly

beneath the other five. The eleven toes were all perfect and none of

them were webbed.

There is a class of monsters called "Sirens" on account of their

resemblance to the fabulous creatures of mythology of that name. Under

the influence of compression exercised in the uterus during the early

period of gestation fusion of the inferior extremities is effected. The

accompanying illustration shows the appearance of these monsters, which

are thought to resemble the enchantresses celebrated by Homer.

Anomalies of the Hand.--Blumenbach speaks of an officer who, having

lost his right hand, was subsequently presented by his wife with

infants of both sexes showing the same deformity. Murray cites the

instance of a woman of thirty-eight, well developed, healthy, and the

mother of normal children, who had a double hand. The left arm was

abnormal, the flexion of the elbow imperfect, and the forearm

terminated in a double hand with only rudimentary thumbs. In working as

a charwoman she leaned on the back of the flexed carpus. The double

hand could grasp firmly, though the maximum power was not so great as

that of the right hand. Sensation was equally acute in all three of the

hands. The middle and ring fingers of the supernumerary hand were

webbed as far as the proximal joints, and the movements of this hand

were stiff and imperfect. No single finger of the two hands could be

extended while the other seven were flexed. Giraldes saw an infant in

1864 with somewhat the same deformity, but in which the disposition of

the muscles and tendons permitted the ordinary movements.

Absence of Digits.--Maygrier describes a woman of twenty-four who

instead of having a hand on each arm had only one finger, and each foot

had but two toes. She was delivered of two female children in 1827 and

one in 1829, each having exactly the same deformities. Her mother was

perfectly formed, but the father had but one toe on his foot and one

finger on his left hand.

Kohler gives photographs of quite a remarkable case of suppression and

deformity of the digits of both the fingers and toes.

Figure 123 shows a man who was recently exhibited in Philadelphia. He

had but two fingers on each hand and two toes on each foot, and

resembles Kohler's case in the anomalous digital conformation.

Figure 124 represents an exhibitionist with congenital suppression of

four digits on each hand.

Tubby has seen a boy of three in whom the first, second, and third toes

of each foot were suppressed, the great toe and the little toe being so

overgrown that they could be opposed. In this family for four

generations 15 individuals out of 22 presented this defect of the lower

extremity. The patient's brothers and a sister had exactly the same

deformity, which has been called "lobster-claw foot."

Falla of Jedburgh speaks of an infant who was born without forearms or

hands; at the elbow there was a single finger attached by a thin string

of tissue. This was the sixth child, and it presented no other

deformity. Falla also says that instances of intrauterine digital

amputation are occasionally seen.

According to Annandale, supernumerary digits may be classified as

follows:--

(1) A deficient organ, loosely attached by a narrow pedicle to the hand

or foot (or to another digit).

(2) A more or less developed organ, free at its extremity, and

articulating with the head or sides of a metacarpal, metatarsal, or

phalangeal bone.

(3) A fully developed separate digit.

(4) A digit intimately united along its whole length with another

digit, and having either an additional metacarpal or metatarsal bone of

its own, or articulating with the head of one which is common to it and

another digit.

Superstitions relative to supernumerary fingers have long been

prevalent. In the days of the ancient Chaldeans it was for those of

royal birth especially that divinations relative to extra digits were

cast. Among the ancients we also occasionally see illustrations

emblematic of wisdom in an individual with many fingers, or rather

double hands, on each arm.

Hutchinson, in his comments on a short-limbed, polydactylous dwarf

which was dissected by Ruysch, the celebrated Amsterdam anatomist,

writes as follows.--

"This quaint figure is copied from Theodore Kerckring's 'Spicilegium

Anatomicum,' published in Amsterdam in 1670. The description states

that the body was that of an infant found drowned in the river on

October 16, 1668. It was dissected by the renowned Ruysch. A detailed

description of the skeleton is given. My reason for now reproducing

the plate is that it offers an important item of evidence in reference

to the development of short-limbed dwarfs. Although we must not place

too much reliance on the accuracy of the draughtsman, since he has

figured some superfluous lumbar vertebrae, yet there can be no doubt

that the limbs are much too short for the trunk and head. This remark

especially applies to the lower limbs and pelvis. These are exactly

like those of the Norwich dwarf and of the skeleton in the Heidelberg

Museum which I described in a recent number of the 'Archives.' The

point of extreme interest in the present case is that this dwarfing of

the limbs is associated with polydactylism. Both the hands have seven

digits. The right foot has eight and the left nine. The conditions are

not exactly symmetrical, since in some instances a metacarpal or

metatarsal bone is wanting; or, to put it otherwise, two are welded

together. It will be seen that the upper extremities are so short that

the tips of the digits will only just touch the iliac crests.

"This occurrence of short limbs with polydactylism seems to prove

conclusively that the condition may be due to a modification of

development of a totally different nature from rickets. It is probable

that the infant was not at full term. Among the points which the author

has noticed in his description are that the fontanelle was double its

usual size; that the orbits were somewhat deformed; that the two halves

of the lower jaw were already united; and that the ribs were short and

badly formed. He also, of course, draws attention to the shortness of

the limbs, the stoutness of the long bones, and the supernumerary

digits. I find no statement that the skeleton was deposited in any

museum, but it is very possible that it is still in existence in

Amsterdam, and if so it is very desirable that it should be more

exactly described."

In Figure 126, A represents division of thumb after Guyot-Daubes, shows

a typical case of supernumerary fingers, and C pictures Morand's case

of duplication of several toes.

Forster gives a sketch of a hand with nine fingers and a foot with nine

toes. Voight records an instance of 13 fingers on each hand and 12 toes

on each foot. Saviard saw an infant at the Hotel-Dieu in Paris in 1687

which had 40 digits, ten on each member. Annandale relates the history

of a woman who had six fingers and two thumbs on each hand, and another

who had eight toes on one foot.

Meckel tells of a case in which a man had 12 fingers and 12 toes, all

well formed, and whose children and grandchildren inherited the

deformity. Mason has seen nine toes on the left foot. There is recorded

the account of a child who had 12 toes and six fingers on each hand,

one fractured. Braid describes talipes varus in a child of a few months

who had ten toes. There is also on record a collection of cases of from

seven to ten fingers on each hand and from seven to ten toes on each

foot. Scherer gives an illustration of a female infant, otherwise

normally formed, with seven fingers on each hand, all united and

bearing claw-like nails. On each foot there was a double halux and five

other digits, some of which were webbed.

The influence of heredity on this anomaly is well demonstrated.

Reaumur was one of the first to prove this, as shown by the Kelleia

family of Malta, and there have been many corroboratory instances

reported; it is shown to last for three, four, and even five

generations; intermarriage with normal persons finally eradicates it.

It is particularly in places where consanguineous marriages are

prevalent that supernumerary digits persist in a family. The family of

Foldi in the tribe of Hyabites living in Arabia are very numerous and

confine their marriages to their tribe. They all have 24 digits, and

infants born with the normal number are sacrificed as being the

offspring of adultery. The inhabitants of the village of Eycaux in

France, at the end of the last century, had nearly all supernumerary

digits either on the hands or feet. Being isolated in an inaccessible

and mountainous region, they had for many years intermarried and thus

perpetuated the anomaly. Communication being opened, they emigrated or

married strangers and the sexdigitism vanished. Maupertuis recalls the

history of a family living in Berlin whose members had 24 digits for

many generations. One of them being presented with a normal infant

refused to acknowledge it. There is an instance in the Western United

States in which supernumerary digits have lasted through five

generations. Cameron speaks of two children in the same family who were

polydactylic, though not having the same number of supernumerary

fingers.

Smith and Norwell report the case of a boy of fifteen both of whose

hands showed webbing of the middle and ring fingers and accessory

nodules of bone between the metacarpals, and six toes on each foot. The

boy's father showed similar malformations, and in five generations 21

out of 28 individuals were thus malformed, ten females and 11 males.

The deformity was especially transmitted in the female line.

Instances of supernumerary thumbs are cited by Panaroli, Ephemerides,

Munconys, as well as in numerous journals since. This anomaly is not

confined to man alone; apes, dogs, and other lower animals possess it.

Bucephalus, the celebrated horse of Alexander, and the horse of Caesar

were said to have been cloven-hoofed.

Hypertrophy of the digits is the result of many different processes,

and true hypertrophy or gigantism must be differentiated from

acromegaly, elephantiasis, leontiasis, and arthritis deformans, for

which distinction the reader is referred to an article by Park. Park

also calls attention to the difference between acquired gigantism,

particularly of the finger and toes, and another condition of

congenital gigantism, in which either after or before birth there is a

relatively disproportionate, sometimes enormous, overgrowth of perhaps

one finger or two, perhaps of a limited portion of a hand or foot, or

possibly of a part of one of the limbs. The best collection of this

kind of specimens is in the College of Surgeons in London.

Curling quotes a most peculiar instance of hypertrophy of the fingers

in a sickly girl. The middle and ring fingers of the right hand were of

unusual size, the middle finger measuring 5 1/2 inches in length four

inches in circumference. On the left hand the thumb and middle fingers

were hypertrophied and the index finger was as long as the middle one

of the right hand. The middle finger had a lateral curvature outward,

due to a displacement of the extensor tendon. This affection resembled

acromegaly. Curling cites similar cases, one in a Spanish gentleman,

Governor of Luzon, in the Philippine Islands, in 1850, who had an

extraordinary middle finger, which he concealed by carrying it in the

breast of his coat.

Hutchinson exhibited a photograph showing the absence of the radius and

thumb, with shortening of the forearm. Conditions more or less

approaching this had occurred in several members of the same family. In

some they were associated with defects of development in the lower

extremities also.

The varieties of club-foot--talipes varus, valgus, equinus,

equino-varus, etc.--are so well known that they will be passed with

mention only of a few persons who have been noted for their activity

despite their deformity. Tyrtee, Parini, Byron, and Scott are among the

poets who were club-footed; some writers say that Shakespeare suffered

in a slight degree from this deformity. Agesilas, Genserie, Robert II,

Duke of Normandy, Henry II, Emperor of the West, Otto II, Duke of

Brunswick, Charles II, King of Naples, and Tamerlane were victims of

deformed feet. Mlle. Valliere, the mistress of Louis XIV, was supposed

to have both club-foot and hip-disease. Genu valgum and genu varum are

ordinary deformities and quite common in all classes.

Transpositions of the character of the vertebrae are sometimes seen. In

man the lumbar vertebrae have sometimes assumed the character of the

sacral vertebrae, the sacral vertebrae presenting the aspect of lumbar

vertebrae, etc. It is quite common to see the first lumbar vertebra

presenting certain characteristics of the dorsal.

Numerical anomalies of the vertebrae are quite common, generally in the

lumbar and dorsal regions, being quite rare in the cervical, although

there have been instances of six or eight cervical vertebrae. In the

lower animals the vertebrae are prolonged into a tail, which, however,

is sometimes absent, particularly when hereditary influence exists. It

has been noticed in the class of dogs whose tails are habitually

amputated to improve their appearance that the tail gradually decreases

in length. Some breeders deny this fact.

Human Tails.--The prolongation of the coccyx sometimes takes the shape

of a caudal extremity in man. Broca and others claim that the sacrum

and the coccyx represent the normal tail of man, but examples are not

infrequent in which there has been a fleshy or bony tail appended to

the coccygeal region. Traditions of tailed men are old and widespread,

and tailed races were supposed to reside in almost every country. There

was at one time an ancient belief that all Cornishmen had tails, and

certain men of Kent were said to have been afflicted with tails in

retribution for their insults to Thomas a Becket. Struys, a Dutch

traveler in Formosa in the seventeenth century, describes a wild man

caught and tied for execution who had a tail more than a foot long,

which was covered with red hair like that of a cow.

The Niam Niams of Central Africa are reported to have tails smooth and

hairy and from two to ten inches long. Hubsch of Constantinople remarks

that both men and women of this tribe have tails. Carpus, or

Berengarius Carpensis, as he is called, in one of his Commentaries said

that there were some people in Hibernia with long tails, but whether

they were fleshy or cartilaginous could not be known, as the people

could not be approached. Certain supposed tailed races which have been

described by sea-captains and voyagers are really only examples of

people who wear artificial appendages about the waists, such as

palm-leaves and hair. A certain Wesleyan missionary, George Brown, in

1876 spoke of a formal breeding of a tailed race in Kali, off the coast

of New Britain. Tailless children were slain at once, as they would be

exposed to public ridicule. The tailed men of Borneo are people

afflicted with hereditary malformation analogous to sexdigitism. A

tailed race of princes have ruled Rajoopootana, and are fond of their

ancestral mark. There are fabulous stories told of canoes in the East

Indies which have holes in their benches made for the tails of the

rowers. At one time in the East the presence of tails was taken as a

sign of brute force.

There was reported from Caracas the discovery of a tribe of Indians in

Paraguay who were provided with tails. The narrative reads somewhat

after this manner: One day a number of workmen belonging to Tacura Tuyn

while engaged in cutting grass had their mules attacked by some

Guayacuyan Indians. The workmen pursued the Indians but only succeeded

in capturing a boy of eight. He was taken to the house of Senor

Francisco Galeochoa at Posedas, and was there discovered to have a tail

ten inches long. On interrogation the boy stated that he had a brother

who had a tail as long as his own, and that all the tribe had tails.

Aetius, Bartholinus, Falk, Harvey, Kolping, Hesse, Paulinus, Strauss,

and Wolff give descriptions of tails. Blanchard says he saw a tail

fully a span in length: and there is a description in 1690 of a man by

the name of Emanuel Konig, a son of a doctor of laws who had a tail

half a span long, which grew directly downward from the coccyx and was

coiled on the perineum, causing much discomfort. Jacob describes a

pouch of skin resembling a tail which hung from the tip of the coccyx

to the length of six inches. It was removed and was found to be thicker

than the thumb, consisted of distinctly jointed portions with synovial

capsules. Gosselin saw at his clinic a caudal appendix in an infant

which measured about ten cm. Lissner says that in 1872 he assisted in

the delivery of a young girl who had a tail consisting of a coccyx

prolonged and covered with skin, and in 1884 he saw the same girl, at

this time the tail measuring nearly 13 cm.

Virchow received for examination a tail three inches long amputated

from a boy of eight weeks. Ornstein, chief physician of the Greek army,

describes a Greek of twenty-six who had a hairless, conical tail, free

only at the tip, two inches long and containing three vertebrae. He

also remarks that other instances have been observed in recruits. Thirk

of Broussa in 1820 described the tail of a Kurd of twenty-two which

contained four vertebrae. Belinovski gives an account of a hip-joint

amputation and extirpation of a fatty caudal extremity, the only one he

had ever observed.

Before the Berlin Anthropological Society there were presented two

adult male Papuans, in good health and spirits, who had been brought

from New Guinea; their coccygeal bones projected 1 1/2 inches. Oliver

Wendell Holmes in the Atlantic Monthly, June, 1890, says that he saw in

London a photograph of a boy with a considerable tail. The "Moi Boy"

was a lad of twelve, who was found in Cochin China, with a tail a foot

long which was simply a mass of flesh. Miller tells of a West Point

student who had an elongation of the coccyx, forming a protuberance

which bulged very visibly under the skin. Exercise at the riding school

always gave him great distress, and the protuberance would often chafe

until the skin was broken, the blood trickling into his boots.

Bartels presents a very complete article in which he describes 21

persons born with tails, most of the tails being merely fleshy

protuberances. Darwin speaks of a person with a fleshy tail and refers

to a French article on human tails.

Science contains a description of a negro child born near Louisville,

eight weeks old, with a pedunculated tail 2 1/2 inches long, with a

base 1 1/4 inches in circumference. The tail resembled in shape a pig's

tail and had grown 1/4 inch since birth. It showed no signs of

cartilage or bone, and had its origin from a point slightly to the left

of the median line and about an inch above the end of the spinal column.

Dickinson recently reported the birth of a child with a tail. It was a

well-developed female between 5 1/2 and six pounds in weight. The

coccyx was covered with the skin on both the anterior and posterior

surfaces. It thus formed a tail of the size of the nail of the little

finger, with a length of nearly 3/16 inch on the inner surface and 3/8

inch on the rear surface. This little tip could be raised from the body

and it slowly sank back.

In addition to the familiar caudal projection of the human fetus,

Dickinson mentions a group of other vestigial remains of a former state

of things. Briefly these are:--

(1) The plica semilunaris as a vestige of the nictitating membrane of

certain birds.

(2) The pointed ear, or the turned-down tip of the ears of many men.

(3) The atrophied muscles, such as those that move the ear, that are

well developed in certain people, or that shift the scalp, resembling

the action of a horse in ridding itself of flies.

(4) The supracondyloid foremen of the humerus.

(5) The vermiform appendix.

(6) The location and direction of the hair on the trunk and limbs.

(7) The dwindling wisdom-teeth.

(8) The feet of the fetus strongly deflected inward, as in the apes,

and persisting in the early months of life, together with great

mobility and a distinct projection of the great toe at an angle from

the side of the foot.

(9) The remarkable grasping power of the hand at birth and for a few

weeks thereafter, that permits young babies to suspend their whole

weight on a cane for a period varying from half a minute to two minutes.

Horrocks ascribes to these anal tags a pathologic importance. He claims

that they may be productive of fistula in ano, superficial ulcerations,

fecal concretions, fissure in ano, and that they may hypertrophy and

set up tenesmus and other troubles. The presence of human tails has

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