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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