PHYSIOLOGIC AND FUNCTIONAL ANOMALIES. 2 page

There is the history of a woman who suffered from metastasis of milk to

the stomach, and who, with convulsive action of the chest and abdomen,

vomited it daily. A peculiar instance of milk in a tumor is that of a

Mrs. Reed, who, when pregnant with twins, developed an abdominal tumor

from which 25 pounds of milk was drawn off.

There is a French report of secretion of milk in the scrotum of a man

of twenty-one. The scrotum was tumefied, and to the touch gave the

sensation of a human breast, and the parts were pigmented similar to an

engorged breast. Analysis showed the secretion to have been true human

milk.

Cases of lactation in the new-born are not infrequent. Bartholinus,

Baricelli, Muraltus, Deusingius, Rhodius, Schenck, and Schurig mention

instances of it. Cardanus describes an infant of one month whose

breasts were swollen and gave milk copiously. Battersby cites a

description of a male child three weeks old whose breasts were full of

a fluid, analysis proving it to have been human milk; Darby, in the

same journal, mentions a child of eight days whose breasts were so

engorged that the nurse had to milk it. Faye gives an interesting paper

in which he has collected many instances of milk in the breasts of the

new-born. Jonston details a description of lactation in an infant.

Variot mentions milk-secretion in the new-born and says that it

generally takes place from the eighth to the fifteenth day and not in

the first week. He also adds that probably mammary abscesses in the

new-born could be avoided if the milk were squeezed out of the breasts

in the first days. Variot says that out of 32 children of both sexes,

aged from six to nine months, all but six showed the presence of milk

in the breasts. Gibb mentions copious milk-secretion in an infant, and

Sworder and Menard have seen young babes with abundant milk-secretion.

Precocious Lactation.--Bochut says that he saw a child whose breasts

were large and completely developed, offering a striking contrast to

the slight development of the thorax. They were as large as a stout

man's fist, pear-shaped, with a rosy areola, in the center of which was

a nipple. These precocious breasts increased in size at the beginning

of the menstrual epoch (which was also present) and remained enlarged

while the menses lasted. The vulva was covered with thick hair and the

external genitalia were well developed. The child was reticent, and

with a doll was inclined to play the role of mother.

Baudelocque mentions a girl of eight who suckled her brother with her

extraordinarily developed breasts. In 1783 this child milked her

breasts in the presence of the Royal Academy at Paris. Belloc spoke of

a similar case. There is another of a young negress who was able to

nourish an infant; and among the older writers we read accounts of

young virgins who induced lactation by applying infants to their

breasts. Bartholinus, Benedictus, Hippocrates, Lentilius, Salmuth, and

Schenck mention lactation in virgins.

De la Coide describes a case in which lactation was present, though

menstruation had always been deficient. Dix, at the Derby Infirmary,

has observed two females in whom there was continued lactation,

although they had never been pregnant. The first was a chaste female of

twenty-five, who for two years had abundant and spontaneous discharge

of milk that wetted the linen; and the other was in a prostitute of

twenty, who had never been pregnant, but who had, nevertheless, for

several months an abundant secretion of healthy milk. Zoologists know

that a nonpregnant bitch may secrete milk in abundance. Delafond and de

Sinnety have cited instances.

Lactation in the aged has been frequently noticed. Amatus Lusitanus and

Schenck have observed lactation in old women; in recent years Dunglison

has collected some instances. Semple relates the history of an elderly

woman who took charge of an infant the mother of which had died of

puerperal infection. As a means of soothing the child she allowed it to

take the nipple, and, strange to say, in thirty-six hours milk appeared

in her breasts, and soon she had a flow as copious as she had ever had

in her early married life. The child thrived on this production of a

sympathetic and spontaneous lactation. Sir Hans Sloane mentions a lady

of sixty-eight who though not having borne a child for twenty years,

nursed her grandchildren one after another.

Montegre describes a woman in the Department of Charente who bore two

male children in 1810. Not having enough milk for both, and being too

poor to secure the assistance of a midwife, in her desperation she

sought an old woman named Laverge, a widow of sixty-five, whose husband

had been dead twenty-nine years. This old woman gave the breast to one

of the children, and in a few days an abundant flow of milk was

present. For twenty-two months she nursed the infant, and it thrived as

well as its brother, who was nursed by their common mother--in fact, it

was even the stronger of the two.

Dargan tells of a case of remarkable rejuvenated lactation in a woman

of sixty, who, in play, placed the child to her breast, and to her

surprise after three weeks' nursing of this kind there appeared an

abundant supply of milk, even exceeding in amount that of the young

mother.

Blanchard mentions milk in the breasts of a woman of sixty, and Krane

cites a similar instance. In the Philosophical Transactions there is an

instance of a woman of sixty-eight having abundant lactation.

Warren, Boring, Buzzi, Stack, Durston, Egan, Scalzi, Fitzpatrick, and

Gillespie mention rejuvenation and renewed lactation in aged women.

Ford has collected several cases in which lactation was artificially

induced by women who, though for some time not having been pregnant

themselves, nursed for others.

Prolonged lactation and galactorrhea may extend through several

pregnancies. Green reports the case of a woman of forty-seven, the

mother of four children, who after each weaning had so much milk

constantly in her breasts that it had to be drawn until the next birth.

At the time of report the milk was still secreting in abundance. A

similar and oft-quoted case was that of Gomez Pamo, who described a

woman in whom lactation seemed indefinitely prolonged; she married at

sixteen, two years after the establishment of menstruation. She became

pregnant shortly after marriage, and after delivery had continued

lactation for a year without any sign of returning menstruation. Again

becoming pregnant, she weaned her first child and nursed the other

without delay or complication. This occurrence took place fourteen

times. She nursed all 14 of her children up to the time that she found

herself pregnant again, and during the pregnancies after the first the

flow of milk never entirely ceased; always after the birth of an infant

she was able to nurse it. The milk was of good quality and always

abundant, and during the period between her first pregnancy to seven

years after the birth of her last child the menses had never

reappeared. She weaned her last child five years before the time of

report, and since then the milk had still persisted in spite of all

treatment. It was sometimes so abundant as to necessitate drawing it

from the breast to relieve painful tension.

Kennedy describes a woman of eighty-one who persistently menstruated

through lactation, and for forty-seven years had uninterruptedly nursed

many children, some of which were not her own. Three years of this time

she was a widow. At the last reports she had a moderate but regular

secretion of milk in her eighty-first year.

In regard to profuse lacteal flow, Remy is quoted as having seen a

young woman in Japan from whom was taken 12 1/2 pints of milk each day,

which is possibly one of the most extreme instance of continued

galactorrhea on record.

Galen refers to gynecomastia or gynecomazia; Aristotle says he has seen

men with mammae a which were as well developed as those of a woman, and

Paulus aegineta recognized the fact in the ancient Greeks. Subsequently

Albucasis discusses it in his writings. Bartholinus, Behr, Benedictus,

Borellus, Bonet, the Ephemerides, Marcellus Donatus, Schenck, Vesalius,

Schacher, Martineau, and Buffon all discuss the anomalous presence of

milk in the male breast. Puech says that this condition is found in one

out of 13,000 conscripts.

To Bedor, a marine surgeon, we owe the first scientific exposition of

this subject, and a little later Villeneuve published his article in

the French dictionary. Since then many observations have been made on

this subject, and quite recently Laurent has published a most

exhaustive treatise upon it.

Robert describes an old man who suckled a child, and Meyer discusses

the case of a castrated man who was said to suckle children. It is said

that a Bishop of Cork, who gave one-half crown to an old Frenchman of

seventy, was rewarded by an exhibition of his breasts, which were

larger than the Bishop had ever seen in a woman. Petrequin speaks of a

male breast 18 inches long which he amputated, and Laurent gives the

photograph of a man whose breasts measured 30 cm. in circumference at

the base, and hung like those of a nursing woman.

In some instances whole families with supernumerary breasts are seen.

Handyside gives two instances of quadruple breasts in brothers.

Blanchard speaks of a father who had a supernumerary nipple on each

breast and his seven sons had the same deformities; it was not noticed

in the daughters. The youngest son transmitted this anomaly to his four

sons. Petrequin describes a man with three mammae, two on the left

side, the third being beneath the others. He had three sons with

accessory mammae on the right side and two daughters with the same

anomaly on the left side. Savitzky reports a case of gynecomazia in a

peasant of twenty-one whose father, elder brother, and a cousin were

similarly endowed. The patient's breasts were 33 cm. in circumference

and 15 cm. from the nipple to the base of the gland; they resembled

normal female mammae in all respects. The penis and the other genitalia

were normal, but the man had a female voice and absence of facial hair.

There was an abundance of subcutaneous fat and a rather broad pelvis.

Wiltshire said that he knew a gynecomast in the person of a

distinguished naturalist who since the age of puberty observed activity

in his breasts, accompanied with secretion of milky fluid which lasted

for a period of six weeks and occurred every spring. This authority

also mentions that the French call husbands who have well-developed

mammae "la couvade;" the Germans call male supernumerary breasts

"bauchwarze," or ventral nipples. Hutchinson describes several cases

of gynecomazia, in which the external genital organs decreased in

proportion to the size of the breast and the manners became effeminate.

Cameron, quoted by Snedden, speaks of a fellow-student who had a

supernumerary nipple, and also says he saw a case in a little boy who

had an extra pair of nipples much wider than the ordinary ones.

Ansiaux, surgeon of Liege, saw a conscript of thirteen whose left mamma

was well developed like that of a woman, and whose nipple was

surrounded by a large areola. He said that this breast had always been

larger than the other, but since puberty had grown greatly; the genital

organs were well formed. Morgan examined a seaman of twenty-one,

admitted to the Royal Naval Hospital at Hong Kong, whose right mamma,

in size and conformation, had the appearance of the well developed

breast of a full-grown woman. It was lobulated and had a large,

brown-colored areola; the nipple, however, was of the same size as that

on the left breast. The man stated that he first observed the breast to

enlarge at sixteen and a half years; since that time it had steadily

increased, but there was no milk at any time from the nipple; the

external genital organs were well and fully developed. He complained of

no pain or uneasiness except when in drilling aloft his breast came in

contact with the ropes.

Gruger of St. Petersburg divides gynecomazia into three classes:--

(1) That in which the male generative organs are normal;

(2) In which they are deformed;

(3) In which the anomaly is spurious, the breast being a mass of fat or

a new growth.

The same journal quotes an instance (possibly Morgan's case) in a young

man of twenty-one with a deep voice, excellent health, and genitals

well developed, and who cohabited with his wife regularly. When sixteen

his right breast began to enlarge, a fact that he attributed to the

pressure of a rope. Glandular substance could be distinctly felt, but

there was no milk-secretion. The left breast was normal. Schuchardt has

collected 272 cases of gynecomazia.

Instances of Men Suckling Infants.--These instances of gynecomazia are

particularly interesting when the individuals display ability to suckle

infants. Hunter refers to a man of fifty who shared equally with his

wife the suckling of their children. There is an instance of a sailor

who, having lost his wife, took his son to his own breast to quiet him,

and after three or four days was able to nourish him. Humboldt

describes a South American peasant of thirty-two who, when his wife

fell sick immediately after delivery, sustained the child with his own

milk, which came soon after the application to the breast; for five

months the child took no other nourishment. In Franklin's "Voyages to

the Polar Seas" he quotes the instance of an old Chippewa who, on

losing his wife in childbirth, had put his infant to his breast and

earnestly prayed that milk might flow; he was fortunate enough to

eventually produce enough milk to rear the child. The left breast, with

which he nursed, afterward retained its unusual size. According to

Mehliss some missionaries in Brazil in the sixteenth century asserted

that there was a whole Indian nation whose women had small and withered

breasts, and whose children owed their nourishment entirely to the

males. Hall exhibited to his class in Baltimore a negro of fifty-five

who had suckled all his mistress' family. Dunglison reports this case

in 1837, and says that the mammae projected seven inches from the

chest, and that the external genital organs were well developed.

Paullini and Schenck cite cases of men suckling infants, and Blumenbach

has described a male-goat which, on account of the engorgement of the

mammae, it was necessary to milk every other day of the year.

Ford mentions the case of a captain who in order to soothe a child's

cries put it to his breast, and who subsequently developed a full

supply of milk. He also quotes an instance of a man suckling his own

children, and mentions a negro boy of fourteen who secreted milk in one

breast. Hornor and Pulido y Fernandez also mention similar instances of

gynecomazia.

Human Odors.--Curious as it may seem, each individual as well as each

species is in life enveloped with an odor peculiarly its own, due to

its exhaled breath, its excretions, and principally to its insensible

perspiration. The faculty of recognizing an odor in different

individuals, although more developed in savage tribes, is by no means

unknown in civilized society. Fournier quotes the instance of a young

man who, like a dog, could smell the enemy by scent, and who by smell

alone recognized his own wife from other persons.

Fournier also mentions a French woman, an inhabitant of Naples, who had

an extreme supersensitiveness of smell. The slightest odor was to her

intolerable; sometimes she could not tolerate the presence of certain

individuals. She could tell in a numerous circle which women were

menstruating. This woman could not sleep in a bed which any one else

had made, and for this reason discharged her maid, preparing her own

toilet and her sleeping apartments. Cadet de Gassieourt witnessed this

peculiar instance, and in consultation with several of the physicians

of Paris attributed this excessive sensitiveness to the climate. There

is a tale told of a Hungarian monk who affirmed that he was able to

decide the chastity of females by the sense of smell alone. It is well

known that some savage tribes with their large, open nostrils not only

recognize their enemies but also track game the same as hounds.

Individual Odors.--Many individuals are said to have exhaled

particularly strong odors, and history is full of such instances. We

are told by Plutarch that Alexander the Great exhaled an odor similar

to that of violet flowers, and his undergarments always smelled of this

natural perfume. It is said that Cujas offered a particular analogy to

this. On the contrary, there are certain persons spoken of who exhaled

a sulphurous odor. Martial said that Thais was an example of the class

of people whose odor was insupportable. Schmidt has inserted in the

Ephemerides an account of a journeyman saddler, twenty-three years of

age, of rather robust constitution, whose hands exhaled a smell of

sulphur so powerful and penetrating as to rapidly fill any room in

which he happened to be. Rayer was once consulted by a valet-de-chambre

who could never keep a place in consequence of the odor he left behind

him in the rooms in which he worked.

Hammond is quoted with saying that when the blessed Venturni of

Bergamons officiated at the altar people struggled to come near him in

order to enjoy the odor he exhaled. It was said that St. Francis de

Paul, after he had subjected himself to frequent disciplinary

inflictions, including a fast of thirty-eight to forty days, exhaled a

most sensible and delicious odor. Hammond attributes the peculiar odors

of the saints of earlier days to neglect of washing and, in a measure,

to affections of the nervous system. It may be added that these odors

were augmented by aromatics, incense, etc., artificially applied. In

more modern times Malherbe and Haller were said to diffuse from their

bodies the agreeable odor of musk. These "human flowers," to use

Goethe's expression, are more highly perfumed in Southern latitudes.

Modifying Causes.--According to Brieude, sex, age, climate, habits,

ailments, the passions, the emotions, and the occupations modify the

difference in the humors exhaled, resulting in necessarily different

odors. Nursing infants have a peculiar sourish smell, caused by the

butyric acid of the milk, while bottle-fed children smell like strong

butter. After being weaned the odors of the babies become less decided.

Boys when they reach puberty exhibit peculiar odors which are similar

to those of animals when in heat. These odors are leading symptoms of

what Borden calls "seminal fever" and are more strongly marked in those

of a voluptuous nature. They are said to be caused by the absorption of

spermatic fluid into the circulation and its subsequent elimination by

the skin. This peculiar circumstance, however, is not seen in girls, in

whom menstruation is sometimes to be distinguished by an odor somewhat

similar to that of leather. Old age produces an odor similar to that of

dry leaves, and there have been persons who declared that they could

tell approximately the age of individuals by the sense of smell.

Certain tribes and races of people have characteristic odors. Negroes

have a rank ammoniacal odor, unmitigated by cleanliness; according to

Pruner-Bey it is due to a volatile oil set free by the sebaceous

follicles. The Esquimaux and Greenlanders have the odors of their

greasy and oily foods, and it is said that the Cossacks, who live much

with their horses, and who are principally vegetarians, will leave the

atmosphere charged with odors several hours after their passage in

numbers through a neighborhood. The lower race of Chinamen are

distinguished by a peculiar musty odor, which may be noticed in the

laundry shops of this country. Some people, such as the low grade of

Indians, have odors, not distinctive, and solely due to the filth of

their persons. Food and drink, as have been mentioned, markedly

influence the odor of an individual, and those perpetually addicted to

a special diet or drink have a particular odor.

Odor after Coitus.--Preismann in 1877 makes the statement that for six

hours after coitus there is a peculiar odor noticeable in the breath,

owing to a peculiar secretion of the buccal glands. He says that this

odor is most perceptible in men of about thirty-five, and can be

discerned at a distance of from four to six feet. He also adds that

this fact would be of great medicolegal value in the early arrest of

those charged with rape. In this connection the analogy of the breath

immediately after coitus to the odor of chloroform has been mentioned.

The same article states that after coitus naturally foul breath becomes

sweet.

The emotions are said to have a decided influence on the odor of an

individual. Gambrini, quoted by Monin, mentions a young man,

unfortunate in love and violently jealous, whose whole body exhaled a

sickening, pernicious, and fetid odor. Orteschi met a young lady who,

without any possibility of fraud, exhaled the strong odor of vanilla

from the commissures of her fingers.

Rayer speaks of a woman under his care at the Hopital de la Charite

affected with chronic peritonitis, who some time before her death

exhaled a very decided odor of musk. The smell had been noticed several

days, but was thought to be due to a bag of musk put purposely into the

bed to overpower other bad smells. The woman, however, gave full

assurance that she had no kind of perfume about her and that her

clothes had been frequently changed. The odor of musk in this case was

very perceptible on the arms and other portions of the body, but did

not become more powerful by friction. After continuing for about eight

days it grew fainter and nearly vanished before the patient's death.

Speranza relates a similar case.

Complexion.--Pare states that persons of red hair and freckled

complexion have a noxious exhalation; the odor of prussic acid is said

to come from dark individuals, while blondes exhale a secretion

resembling musk. Fat persons frequently have an oleaginous smell.

The disorders of the nervous system are said to be associated with

peculiar odors. Fevre says the odor of the sweat of lunatics resembles

that of yellow deer or mice, and Knight remarks that the absence of

this symptom would enable him to tell whether insanity was feigned or

not. Burrows declares that in the absence of further evidence he would

not hesitate to pronounce a person insane if he could perceive certain

associate odors. Sir William Gull and others are credited with

asserting that they could detect syphilis by smell. Weir Mitchell has

observed that in lesions of nerves the corresponding cutaneous area

exhaled the odor of stagnant water. Hammond refers to three cases under

his notice in which specific odors were the results of affections of

the nervous system. One of these cases was a young woman of hysterical

tendencies who exhaled the odor of violets, which pervaded her

apartments. This odor was given off the left half of the chest only and

could be obtained concentrated by collecting the perspiration on a

handkerchief, heating it with four ounces of spirit, and distilling the

remaining mixture. The administration of the salicylate of soda

modified in degree this violaceous odor. Hammond also speaks of a young

lady subject to chorea whose insensible perspiration had an odor of

pineapples; a hypochondriac gentleman under his care smelled of

violets. In this connection he mentions a young woman who, when

suffering from intense sick headache, exhaled an odor resembling that

of Limburger cheese.

Barbier met a case of disordered innervation in a captain of infantry,

the upper half of whose body was subject to such offensive perspiration

that despite all treatment he had to finally resign his commission.

In lethargy and catalepsy the perspiration very often has a cadaverous

odor, which has probably occasionally led to a mistaken diagnosis of

death. Schaper and de Meara speak of persons having a cadaveric odor

during their entire life.

Various ingesta readily give evidence of themselves by their influence

upon the breath. It has been remarked that the breath of individuals

who have recently performed a prolonged necropsy smells for some hours

of the odor of the cadaver. Such things as copaiba, cubebs, sandalwood,

alcohol, coffee, etc., have their recognizable fragrance. There is an

instance of a young woman taking Fowler's solution who had periodic

offensive axillary sweats that ceased when the medicine was

discontinued.

Henry of Navarre was a victim of bromidrosis; proximity to him was

insufferable to his courtiers and mistresses, who said that his odor

was like that of carrion. Tallemant says that when his wife, Marie de

Medicis, approached the bridal night with him she perfumed her

apartments and her person with the essences of the flowers of her

country in order that she might be spared the disgusting odor of her

spouse. Some persons are afflicted with an excessive perspiration of

the feet which often takes a disgusting odor. The inguinoscrotal and

inguinovulvar perspirations have an aromatic odor like that of the

genitals of either sex.

During menstruation, hyperidrosis of the axillae diffuses an aromatic

odor similar to that of acids or chloroform, and in suppression of

menses, according to the Ephemerides, the odor is as of hops.

Odors of Disease.--The various diseases have their own peculiar odors.

The "hospital odor," so well known, is essentially variable in

character and chiefly due to an aggregation of cutaneous exhalations.

The wards containing women and children are perfumed with butyric acid,

while those containing men are influenced by the presence of alkalies

like ammonia.

Gout, icterus, and even cholera (Drasch and Porker) have their own

odors. Older observers, confirmed by Doppner, say that all the

plague-patients at Vetlianka diffused an odor of honey. In diabetes

there is a marked odor of apples. The sweat in dysentery unmistakably

bears the odor of the dejecta. Behier calls the odor of typhoid that of

the blood, and Berard says that it attracts flies even before death.

Typhus has a mouse-like odor, and the following diseases have at

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