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ANOMALIES OF STATURE, SIZE, AND DEVELOPMENT. 3 pagewhom died at five with the signs of premature senility; at one year he had shown signs of enlargement of the sexual organs. There was another who at three was 3 feet 6 3/4 inches high, weighed 50 pounds, and had seminal discharges. One of the cases was a child who at birth resembled an ordinary infant of five months. From four to fifteen months his penis enlarged, until at the age of three it measured when erect 3 inches. At this age he was 3 feet 7 inches high and weighed 64 pounds. The last case mentioned was an infant who experienced a change of voice at twelve months and showed hair on the pubes. At three years he was 3 feet 4 1/2 inches tall and weighed 51 1/4 pounds. Smith, in Brewster's Journal, 1829, records the case of a boy who at the age of four was well developed; at the age of six he was 4 feet 2 inches tall and weighed 74 pounds; his lower extremities were extremely short proportionally and his genitals were as well developed as those of an adult. He had a short, dark moustache but no hair on his chin, although his pubic hair was thick, black, and curly. Ruelle describes a child of three and a quarter years who was as strong and muscular as one at eight. He had full-sized male organs and long black hair on the pubes. Under excitement he discharged semen four or five times a day; he had a deep male voice, and dark, short hair on the cheek and upper lip.
Stone gives an account of a boy of four who looked like a child of ten and exhibited the sexual organs of a man with a luxuriant growth of hair on the pubes. This child was said to have been of great beauty and a miniature model of an athlete. His height was 4 feet 1/4 inch and weight 70 pounds; the penis when semiflaccid was 4 1/4 inches long; he was intelligent and lively, and his back was covered with the acne of puberty. A peculiar fact as regards this case was the statement of the father that he himself had had sexual indulgence at eight. Stone parallels this case by several others that he has collected from medical literature. Breschet in 1821 reported the case of a boy born October 20, 1817, who at three years and one month was 3 feet 6 3/4 inches tall; his penis when flaccid measured 4 inches and when erect 5 1/4 inches, but the testicles were not developed in proportion. Lopez describes a mulatto boy of three years ten and a half months whose height was 4 feet 1/2 inch and weight 82 pounds; he measured about the chest 27 1/2 inches and about the waist 27 inches; his penis at rest was 4 inches long and had a circumference of 3 1/2 inches, although the testes were not descended. He had evidences of a beard and his axillae were very hairy; it is said he could with ease lift a man weighing 140 pounds. His body was covered with acne simplex and had a strong spermatic odor, but it was not known whether he had any venereal appetite.
Johnson mentions a boy of seven with severe gonorrhea complicated with buboes which he had contracted from a servant girl with whom he slept. At the Hopital des Enfans Malades children at the breast have been observed to masturbate. Fournier and others assert having seen infantile masturbators, and cite a case of a girl of four who was habitually addicted to masturbation from her infancy but was not detected until her fourth year; she died shortly afterward in a frightful state of marasmus. Vogel alludes to a girl of three in whom repeated attacks of epilepsy occurred after six months' onanism. Van Bambeke mentions three children from ten to twenty months old, two of them females, who masturbated.
Bidwell describes a boy of five years and two months who during the year previous had erections and seminal emissions. His voice had changed and he had a downy moustache on his upper lip and hair on the pubes; his height was 4 feet 3 1/2 inches and his weight was 82 1/2 pounds. His penis and testicles were as well developed as those of a boy of seventeen or eighteen, but from his facial aspect one would take him to be thirteen. He avoided the company of women and would not let his sisters nurse him when he was sick.
Pryor speaks of a boy of three and a half who masturbated and who at five and a half had a penis of adult size, hair on the pubes, and was known to have had seminal emissions. Woods describes a boy of six years and seven months who had the appearance of a youth of eighteen. He was 4 feet 9 inches tall and was quite muscular. He first exhibited signs of precocious growth at the beginning of his second year and when three years old he had hair on the pubes. There is an instance in which a boy of thirteen had intercourse with a young woman at least a dozen times and succeeded in impregnating her. The same journal mentions an instance in which a boy of fourteen succeeded in impregnating a girl of the same age. Chevers speaks of a young boy in India who was sentenced to one year's imprisonment for raping a girl of three.
Douglass describes a boy of four years and three months who was 3 feet 10 1/2 inches tall and weighed 54 pounds; his features were large and coarse, and his penis and testes were of the size of those of an adult. He was unusually dull, mentally, quite obstinate, and self-willed. It is said that he masturbated on all opportunities and had vigorous erections, although no spermatozoa were found in the semen issued. He showed no fondness for the opposite sex. The history of this rapid growth says that he was not unlike other children until the third year, when after wading in a small stream several hours he was taken with a violent chill, after which his voice began to change and his sexual organs to develop.
Blanc quotes the case described by Cozanet in 1875 of Louis Beran, who was born on September 29, 1869, at Saint-Gervais, of normal size. At the age of six months his dimensions and weight increased in an extraordinary fashion. At the age of six years he was 1.28 meters high (4 feet 2 1/3 inches) and weighed 80 pounds. His puberty was completely manifested in every way; he eschewed the society of children and helped his parents in their labors. Campbell showed a lad of fourteen who had been under his observation for ten years. When fifteen months old this prodigy had hair on his pubes and his external genitals were abnormally larger end at the age of two years they were fully developed and had not materially changed in the following years. At times he manifested great sexual excitement. Between four and seven years he had seminal discharges, but it was not determined whether the semen contained spermatozoa. He had the muscular development of a man of twenty-five. He had shaved several years. The boy's education was defective from his failure to attend school.
The accompanying illustration represents a boy of five years and three months of age whose height at this time was 4 feet and his physical development far beyond that usual at this age, his external genitals resembling those of a man of twenty. His upper lip was covered by a mustache, and the hirsute growth elsewhere was similarly precocious.
The inscription on the tombstone of James Weir in the Parish of Carluke, Scotland, says that when only thirteen months old he measured 3 feet 4 inches in height and weighed 5 stone. He was pronounced by the faculty of Edinburgh and Glasgow to be the most extraordinary child of his age. Linnaeus saw a boy at the Amsterdam Fair who at the age of three weighed 98 pounds. In Paris, about 1822, there was shown an infant Hercules of seven who was more remarkable for obesity than general development. He was 3 feet 4 inches high, 4 feet 5 inches in circumference, and weighed 220 pounds. He had prominent eyebrows, black eyes, and his complexion resembled that of a fat cook in the heat. Borellus details a description of a giant child. There is quoted from Boston a the report of a boy of fifteen months weighing 92 pounds who died at Coney Island. He was said to have been of phenomenal size from infancy and was exhibited in several museums during his life.
Desbois of Paris mentions an extraordinary instance of rapid growth in a boy of eleven who grew 6 inches in fifteen days.
Large and Small New-born Infants.--There are many accounts of new-born infants who were characterized by their diminutive size. On page 66 we have mentioned Usher's instance of twins born at the one hundred and thirty-ninth day weighing each less than 11 ounces; Barker's case of a female child at the one hundred and fifty-eighth day weighing 1 pound; Newinton's case of twins at the fifth month, one weighing 1 pound and the other 1 pound 3 1/2 ounces; and on page 67 is an account of Eikam's five-months' child, weighing 8 ounces. Of full-term children Sir Everard Home, in his Croonian Oration in 1824, speaks of one borne by a woman who was traveling with the baggage of the Duke of Wellington's army. At her fourth month of pregnancy this woman was attacked and bitten by a monkey, but she went to term, and a living child was delivered which weighed but a pound and was between 7 and 8 inches long. It was brought to England and died at the age of nine, when 22 inches high. Baker mentions a child fifty days' old that weighed 1 pound 13 ounces and was 14 inches long. Mursick describes a living child who at birth weighed but 1 3/4 pounds. In June, 1896, a baby weighing 1 3/4 pounds was born at the Samaritan Hospital, Philadelphia.
Scott has recorded the birth of a child weighing 2 1/2 pounds, and another 3 1/4 pounds. In the Chicago Inter-Ocean there is a letter dated June 20, 1874, which says that Mrs. J. B. McCrum of Kalamazoo, Michigan, gave birth to a boy and girl that could be held in the palm of the hand of the nurse. Their aggregate weight was 3 pounds 4 ounces, one weighing 1 pound 8 ounces, the other 1 pound 12 ounces. They were less than 8 inches long and perfectly formed; they were not only alive but extremely vivacious.
There is an account of female twins born in 1858 before term. One weighed 22 1/2 ounces, and over its arm, forearm, and hand one could easily pass a wedding-ring. The other weighed 24 ounces. They both lived to adult life; the larger married and was the mother of two children, which she bore easily. The other did not marry, and although not a dwarf, was under-sized; she had her catamenia every third week. Post describes a 2-pound child.
On the other hand, there have been infants characterized by their enormous size at birth. Among the older writers, Cranz describes an infant which at birth weighed 23 pounds; Fern mentions a fetus of 18 pounds; and Mittehauser speaks of a new-born child weighing 24 pounds. Von Siebold in his "Lucina" has recorded a fetus which weighed 22 1/2 pounds. It is worthy of comment that so great is the rarity of these instances that in 3600 cases, in the Rotunda Hospital, Dublin, only one child reached 11 pounds.
There was a child born in Sussex in 1869 which weighed 13 1/2 pounds and measured 26 1/2 inches. Warren delivered a woman in Derbyshire of male twins, one weighing 17 pounds 8 ounces and the other 18 pounds. The placenta weighed 4 pounds, and there was an ordinary pailful of liquor amnii. Both the twins were muscular and well formed; the parents were of ordinary stature, and at last reports the mother was rapidly convalescing. Burgess mentions an 18-pound new-born child; end Meadows has seen a similar instance. Eddowes speaks of the birth of a child at Crewe, a male, which weighed 20 pounds 2 ounces and was 23 inches long. It was 14 1/2 inches about the chest, symmetrically developed, and likely to live. The mother, who was a schoolmistress of thirty-three, had borne two previous children, both of large size. In this instance the gestation had not been prolonged, the delivery was spontaneous, and there was no laceration of the parts.
Chubb says that on Christmas Day, 1852, there was a child delivered weighing 21 pounds. The labor was not severe and the other children of the family were exceptionally large. Dickinson describes a woman, a tertipara, who had a most difficult labor and bore an extremely large child. She had been thirty-six hours in parturition, and by evisceration and craniotomy was delivered of a child weighing 16 pounds. Her first child weighed 9 pounds, her second 20, and her third, the one described, cost her her life soon after delivery.
There is a history of a Swedish woman in Boston who was delivered by the forceps of her first child, which weighed 19 3/4 pounds and which was 25 3/4 inches long. The circumference of the head was 16 3/4 inches, of the neck 9 3/4, and of the thigh 10 3/4 inches.
Rice speaks of a child weighing 20 1/4 pounds at birth. Johnston describes a male infant who was born on November 26, 1848, weighing 20 pounds, and Smith another of the same weight. Baldwin quotes the case of a woman who after having three miscarriages at last had a child that weighed 23 pounds. In the delivery there was extensive laceration of the anterior wall of the vagina; the cervix and perineum, together with an inch of the rectum, were completely destroyed.
Beach describes a birth of a young giant weighing 23 3/4 pounds. Its mother was Mrs. Bates, formerly Anna Swann, the giantess who married Captain Bates. Labor was rather slow, but she was successfully delivered of a healthy child weighing 23 3/4 pounds and 30 inches long. The secundines weighed ten pounds and there were nine quarts of amniotic fluid.
There is a recent record of a Cesarian section performed on a woman of forty in her twelfth pregnancy and one month beyond term. The fetus, which was almost exsanguinated by amputation, weighed 22 1/2 pounds. Bumm speaks of the birth of a premature male infant weighing 4320 gm. (9 1/2 pounds) and measuring 54 cm. long. Artificial labor had been induced at the thirty-fifth week in the hope of delivering a living child, the three preceding infants having all been still-born on account of their large size. Although the mother's pelvis was wide, the disposition to bear huge infants was so great as to render the woman virtually barren.
Congenital asymmetry and hemihypertrophy of the body are most peculiar anomalies and must not be confounded with acromegaly or myxedema, in both of which there is similar lack of symmetric development. There seems to be no satisfactory clue to the causation of these abnormalisms. Most frequently the left side is the least developed, and there is a decided difference in the size of the extremities.
Finlayson reports a case of a child affected with congenital unilateral hypertrophy associated with patches of cutaneous congestion. Logan mentions hypertrophy in the right half of the body in a child of four, first noticed shortly after birth; Langlet also speaks of a case of congenital hypertrophy of the right side. Broca and Trelat were among the first observers to discuss this anomaly.
Tilanus of Munich in 1893 reported a case of hemihypertrophy in a girl of ten. The whole right half of the body was much smaller and better developed than the left, resulting in a limping gait. The electric reaction and the reflexes showed no abnormality. The asymmetry was first observed when the child was three. Mobius and Demme report similar cases.
Adams reports an unusual case of hemihypertrophy in a boy of ten. There was nothing noteworthy in the family history, and the patient had suffered from none of the diseases of childhood. Deformity was noticeable at birth, but not to such a degree relatively as at a later period. The increased growth affected the entire right half of the body, including the face, but was most noticeable in the leg, thigh, and buttock. Numerous telangiectatic spots were scattered irregularly over the body, but most thickly on the right side, especially on the outer surface of the leg. The accompanying illustration represents the child's appearance at the time of report.
Jacobson reports the history of a female child of three years with nearly universal giant growth (Riesenwuchs). At first this case was erroneously diagnosed as acromegaly. The hypertrophy affected the face, the genitals, the left side of the trunk, and all the limbs.
Milne records a case of hemihypertrophy in a female child of one year. The only deviation from uniform excess of size of the right side was shown in the forefinger and thumb, which were of the same size as on the other hand; and the left side showed no overgrowth in any of its members except a little enlargement of the second toe. While hypertrophy of one side is the usual description of such cases, the author suggests that there may be a condition of defect upon the other side, and he is inclined to think that in this case the limb, hand, and foot of the left side seemed rather below the average of the child's age. In this case, as in others previously reported, there were numerous telangiectatic spots of congestion scattered irregularly over the body. Milne also reported later to the Sheffield Medico-Chirurgical Society an instance of unilateral hypertrophy in a female child of nineteen months. The right side was involved and the anomaly was believed to be due to a deficiency of growth of the left side as well as over-development of the right. There were six teeth on the right side and one on the left.
Obesity.--The abnormality of the adipose system, causing in consequence an augmentation of the natural volume of the subject, should be described with other anomalies of size and stature. Obesity may be partial, as seen in the mammae or in the abdomen of both women and men, or it may be general; and it is of general obesity that we shall chiefly deal. Lipomata, being distinctly pathologic formations, will be left for another chapter.
The cases of obesity in infancy and childhood are of considerable interest, and we sometimes see cases that have been termed examples of "congenital corpulency." Figure 167 represents a baby of thirteen months that weighed 75 pounds. Figure 168 shows another example of infantile obesity, known as "Baby Chambers." Elliotson describes a female infant not a year old which weighed 60 pounds. There is an instance on record of a girl of four who weighed 256 pounds Tulpius mentions a girl of five who weighed 150 pounds and had the strength of a man. He says that the acquisition of fat did not commence until some time after birth. Ebstein reports an instance given to him by Fisher of Moscow of a child in Pomerania who at the age of six weighed 137 pounds and was 46 inches tall; her girth was 46 inches and the circumference of her head was 24 inches. She was the offspring of ordinary-sized parents, and lived in narrow and sometimes needy circumstances. The child was intelligent and had an animated expression of countenance.
Bartholinus mentions a girl of eleven who weighed over 200 pounds. There is an instance recorded of a young girl in Russia who weighed nearly 200 pounds when but twelve. Wulf, quoted by Ebstein, describes a child which died at birth weighing 295 ounces. It was well proportioned and looked like a child three months old, except that it had an enormous development of fatty tissue. The parents were not excessively large, and the mother stated that she had had children before of the same proportions. Grisolles mentions a child who was so fat at twelve months that there was constant danger of suffocation; but, marvelous to relate, it lost all its obesity when two and a half, and later was remarkable for its slender figure. Figure 169 shows a girl born in Carbon County, Pa., who weighed 201 pounds when nine years old. McNaughton describes Susanna Tripp, who at six years of age weighed 203 pounds and was 3 feet 6 inches tall and measured 4 feet 2 inches around the waist. Her younger sister, Deborah, weighed 119 pounds; neither of the two weighed over 7 pounds at birth and both began to grow at the fourth month. On October, 1788, there died at an inn in the city of York the surprising "Worcestershire Girl" at the age of five. She had an exceedingly beautiful face and was quite active. She was 4 feet in height and larger around the breast and waist; her thigh measured 18 inches and she weighed nearly 200 pounds. In February, 1814, Mr. S. Pauton was married to the only daughter of Thomas Allanty of Yorkshire; although she was but thirteen she was 13 stone weight (182 pounds). At seven years she had weighed 7 stone (98 pounds). Williams mentions several instances of fat children. The first was a German girl who at birth weighed 13 pounds; at six months, 42 pounds; at four years, 150 pounds; and at twenty years, 450 pounds. Isaac Butterfield, born near Leeds in 1781, weighed 100 pounds in 1782 and was 3 feet 13 inches tall. There was a child named Everitt, exhibited in London in 1780, who at eleven months was 3 feet 9 inches tall and measured around the loins over 3 feet. William Abernethy at the age of thirteen weighed 22 stone (308 pounds) and measured 57 inches around the waist. He was 5 feet 6 inches tall. There was a girl of ten who was 1.45 meters (4 feet 9 inches) high and weighed 175 pounds. Her manners were infantile and her intellectual development was much retarded. She spoke with difficulty in a deep voice; she had a most voracious appetite.
At a meeting of the Physical Society of Vienna on December 4, 1894, there was shown a girl of five and a half who weighed 250 pounds. She was just shedding her first teeth; owing to the excess of fat on her short limbs she toddled like an infant. There was no tendency to obesity in her family. Up to the eleventh month she was nursed by her mother, and subsequently fed on cabbage, milk, and vegetable soup. This child, who was of Russian descent, was said never to perspire.
Cameron describes a child who at birth weighed 14 pounds, at twelve months she weighed 69 pounds, and at seventeen months 98 pounds. She was not weaned until two years old and she then commenced to walk. The parents were not remarkably large. There is an instance of a boy of thirteen and a half who weighed 214 pounds. Kaestner speaks of a child of four who weighed 82 pounds, and Benzenberg noted a child of the same age who weighed 137. Hildman, quoted by Picat, speaks of an infant three years and ten months old who had a girth of 30 inches. Hillairet knew of a child of five which weighed 125 pounds. Botta cites several instances of preternaturally stout children. One child died at the age of three weighing 90 pounds, another at the age of five weighed 100 pounds, and a third at the age of two weighed 75 pounds.
Figure 170 represents Miss "Millie Josephine" of Chicago, a recent exhibitionist, who at the reputed age of thirteen was 5 feet 6 inches tall and weighed 422 pounds.
General Remarks.--It has been chiefly in Great Britain and in Holland that the most remarkable instances of obesity have been seen, especially in the former country colossal weights have been recorded. In some countries corpulency has been considered an adornment of the female sex. Hesse-Wartegg refers to the Jewesses of Tunis, who when scarcely ten years old are subjected to systematic treatment by confinement in narrow, dark rooms, where they are fed on farinaceous foods and the flesh of young puppies until they are almost a shapeless mass of fat. According to Ebstein, the Moorish women reach with astonishing rapidity the desired embonpoint on a diet of dates and a peculiar kind of meal.
In some nations and families obesity is hereditary, and generations come and go without a change in the ordinary conformation of the representatives. In other people slenderness is equally persistent, and efforts to overcome this peculiarity of nature are without avail.
Treatment of Obesity.--Many persons, the most famous of whom was Banting, have advanced theories to reduce corpulency and to improve slenderness; but they have been uniformly unreliable, and the whole subject of stature-development presents an almost unexplored field for investigation. Recently, Leichtenstein, observing in a case of myxedema treated with the thyroid gland that the subcutaneous fat disappeared with the continuance of the treatment, was led to adopt this treatment for obesity itself and reports striking results. The diet of the patient remained the same, and as the appetite was not diminished by the treatment the loss of weight was evidently due to other causes than altered alimentation. He holds that the observations in myxedema, in obesity, and psoriasis warrant the belief that the thyroid gland eliminates a material having a regulating influence upon the constitution of the panniculus adiposus and upon the nutrition of the skin in general. There were 25 patients in all; in 22 the effect was entirely satisfactory, the loss of weight amounting to as much as 9.5 kilos (21 pounds). Of the three cases in which the result was not satisfactory, one had nephritis with severe Graves' disease, and the third psoriasis. Charrin has used the injections of thyroid extract with decided benefit. So soon as the administration of the remedy was stopped the loss of weight ceased, but with the renewal of the remedy the loss of weight again ensued to a certain point, beyond which the extract seemed powerless to act. Ewald also reports good results from this treatment of obesity.
Remarkable Instances of Obesity.--From time immemorial fat men and women have been the object of curiosity and the number who have exhibited themselves is incalculable. Nearly every circus and dime museum has its example, and some of the most famous have in this way been able to accumulate fortunes.
Athenaeus has written quite a long discourse on persons of note who in the olden times were distinguished for their obesity. He quotes a description of Denys, the tyrant of Heraclea, who was so enormous that he was in constant danger of suffocation; most of the time he was in a stupor or asleep, a peculiarity of very fat people. His doctors had needles put in the back of his chairs to keep him from falling asleep when sitting up and thus incurring the danger of suffocation. In the same work Athenaeus speaks of several sovereigns noted for their obesity; among others he says that Ptolemy VII, son of Alexander, was so fat that, according to Posidonius, when he walked he had to be supported on both sides. Nevertheless, when he was excited at a Date: 2014-12-29; view: 817
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