ANOMALIES OF STATURE, SIZE, AND DEVELOPMENT. 3 page

whom 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

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