PHYSIOLOGIC AND FUNCTIONAL ANOMALIES. 11 page

Even those muscles ordinarily involuntary he could exercise at will. He

could produce such rigidity of stature that a blow by a hammer on his

body fell as though on a block of stone. By his power over his

abdominal muscles he could give himself different shapes, from the

portly alderman to the lean and haggard student, and he was even

accredited with assuming the shape of a "living skeleton." Quatrefages,

the celebrated French scientist, examined him, and said that he could

shut off the blood from the right side and then from the left side of

the body, which feat he ascribed to unilateral muscular action.

In 1893 there appeared in Washington, giving exhibitions at the

colleges there and at the Emergency Hospital, a man named Fitzgerald,

claiming to reside in Harrisburg, Pa., who made his living by

exhibiting at medical colleges over the country. He simulated all the

dislocations, claiming that they were complete, using manual force to

produce and reduce them. He exhibited a thorough knowledge of the

pathology of dislocations and of the anatomy of the articulations. He

produced the different forms of talipes, as well as all the major

hip-dislocations. When interrogated as to the cause of his enormous

saphenous veins, which stood out like huge twisted cords under the skin

and were associated with venous varicosity on the leg, he said he

presumed they were caused by his constantly compressing the saphenous

vein at the hip in giving his exhibitions, which in some large cities

were repeated several times a day.

Endurance of Pain.--The question of the endurance of pain is,

necessarily, one of comparison. There is little doubt that in the lower

classes the sensation of pain is felt in a much less degree than in

those of a highly intellectual and nervous temperament. If we

eliminate the element of fear, which always predominates in the lower

classes, the result of general hospital observation will show this

distinction. There are many circumstances which have a marked influence

on pain. Patriotism, enthusiasm, and general excitement, together with

pride and natural obstinacy, prove the power of the mind over the body.

The tortures endured by prisoners of war, religious martyrs and

victims, exemplify the power of a strong will excited by deep emotion

over the sensation of pain. The flagellants, persons who expiated their

sins by voluntarily flaying themselves to the point of exhaustion, are

modern examples of persons who in religious enthusiasm inflict pain on

themselves. In the ancient times in India the frenzied zealots

struggled for positions from which they could throw themselves under

the car of the Juggernaut, and their intense emotions turned the pains

of their wounds into a pleasure. According to the reports of her

Majesty's surgeons, there are at the present time in India native

Brahmins who hang themselves on sharp hooks placed in the flesh between

the scapulae, and remain in this position without the least visible

show of pain. In a similar manner they pierce the lips and cheeks with

long pins and bore the tongue with a hot iron. From a reliable source

the authors have an account of a man in Northern India who as a means

of self-inflicted penance held his arm aloft for the greater part of

each day, bending the fingers tightly on the palms. After a

considerable time the nails had grown or been forced through the palms

of the hands, making their exit on the dorsal surfaces. There are many

savage rites and ceremonies calling for the severe infliction of pain

on the participants which have been described from time to time by

travelers. The Aztecs willingly sacrificed even their lives in the

worship of their Sun-god.

By means of singing and dancing the Aissaoui, in the Algerian town of

Constantine, throw themselves into an ecstatic state in which their

bodies seem to be insensible even to severe wounds. Hellwald says they

run sharp-pointed irons into their heads, eyes, necks, and breasts

without apparent pain or injury to themselves. Some observers claim

they are rendered insensible to pain by self-induced hypnotism.

An account by Carpenter of the Algerian Aissaoui contained the

following lucid description of the performances of these people:--

"The center of the court was given up to the Aissaoui. These were 12

hollow-checked men, some old and some young, who sat cross-legged in an

irregular semicircle on the floor. Six of them had immense flat drums

or tambours, which they presently began to beat noisily. In front of

them a charcoal fire burned in a brazier, and into it one of them from

time to time threw bits of some sort of incense, which gradually filled

the place with a thin smoke and a mildly pungent odor.

"For a long time--it seemed a long time--this went on with nothing to

break the silence but the rhythmical beat of the drums. Gradually,

however, this had become quicker, and now grew wild and almost

deafening, and the men began a monotonous chant which soon was

increased to shouting. Suddenly one of the men threw himself with a

howl to the ground, when he was seized by another, who stripped him of

part of his garments and led him in front of the fire. Here, while the

pounding of the drums and the shouts of the men became more and more

frantic, he stood swaying his body backward and forward, almost

touching the ground in his fearful contortions, and wagging his head

until it seemed as if he must dislocate it from his shoulders. All at

once he drew from the fire a red-hot bar of iron, and with a yell of

horror, which sent a shiver down one's back, held it up before his

eyes. More violently than ever he swayed his body and wagged his head,

until he had worked himself up to a climax of excitement, when he

passed the glowing iron several times over the palm of each hand and

then licked it repeatedly with his tongue. He next took a burning coal

from the fire, and, placing it between his teeth, fanned it by his

breath into a white heat. He ended his part of the performance by

treading on red-hot coals scattered on the floor after which he resumed

his place with the rest. Then the next performer with a yell as before,

suddenly sprang to his feet and began again the same frantic

contortions, in the midst of which he snatched from the fire an iron

rod with a ball on one end, and after winding one of his eyelids around

it until the eyeball was completely exposed, he thrust its point in

behind the eye, which was forced far out on his cheek. It was held

there for a moment when it was withdrawn, the eye released, and then

rubbed vigorously a few times with the balled end of the rod.

"The drums all the time had been beaten lustily, and the men had kept

up their chant, which still went unceasingly on. Again a man sprang to

his feet and went through the same horrid motions. This time the

performer took from the fire a sharp nail and, with a piece of the

sandy limestone common to this region, proceeded with a series of

blood-curdling howls to hammer it down into the top of his head, where

it presently stuck upright, while he tottered dizzily around until it

was pulled out with apparent effort and with a hollow snap by one of

the other men.

"The performance had now fairly begun, and, with short intervals and

always in the same manner, the frenzied contortions first, another ate

up a glass lamp-chimney, which he first broke in pieces in his hands

and then crunched loudly with his teeth. He then produced from a tin

box a live scorpion, which ran across the floor with tail erect, and

was then allowed to attach itself to the back of his hand and his face,

and was finally taken into his mouth, where it hung suspended from the

inside of his cheek and was finally chewed and swallowed. A sword was

next produced, and after the usual preliminaries it was drawn by the

same man who had just given the scorpion such unusual opportunities

several times back and forth across his throat and neck, apparently

deeply imbedded in the flesh. Not content with this, he bared his body

at his waist, and while one man held the sword, edge upward, by the

hilt and another by the point, about which a turban had been wrapped,

he first stood upon it with his bare feet and then balanced himself

across it on his naked stomach, while still another of the performers

stood upon his back, whither he had sprung without any attempt to

mollify the violence of the action. With more yells and genuflections,

another now drew from the fire several iron skewers, some of which he

thrust into the inner side of his cheeks and others into his throat at

the larynx, where they were left for a while to hang.

"The last of the actors in this singular entertainment was a stout man

with a careworn face, who apparently regarded his share as a melancholy

duty which he was bound to perform, and the last part of it, I have no

doubt, was particularly painful. He first took a handful of hay, and,

having bared the whole upper part of his body, lighted the wisp at the

brazier and then passed the blazing mass across his chest and body and

over his arms and face. This was but a preliminary, and presently he

began to sway backward and forward until one grew dazed with watching

him. The drums grew noisier and noisier and the chant louder and

wilder. The man himself had become maudlin, his tongue hung from his

mouth, and now and then he ejaculated a sound like the inarticulate cry

of an animal. He could only totter to the fire, out of which he

snatched the balled instrument already described, which he thereupon

thrust with a vicious stab into the pit of his stomach, where it was

left to hang. A moment after he pulled it out again, and, picking up

the piece of stone used before, he drove it with a series of resounding

blows into a new place, where it hung, drawing the skin downward with

its weight, until a companion pulled it out and the man fell in a heap

on the floor."

To-day it is only through the intervention of the United States troops

that some of the barbarous ceremonies of the North American Indians are

suppressed. The episode of the "Ghost-dance" is fresh in every mind.

Instances of self-mutilation, although illustrating this subject, will

be discussed at length in Chapter XIV.

Malingerers often endure without flinching the most arduous tests.

Supraorbital pressure is generally of little avail, and pinching,

pricking, and even incision are useless with these hospital impostors.

It is reported that in the City Hospital of St. Louis a negro submitted

to the ammonia-test, inhaling this vapor for several hours without

showing any signs of sensibility, and made his escape the moment his

guard was absent. A contemporary journal says:--

"The obstinacy of resolute impostors seems, indeed, capable of

emulating the torture-proof perseverance of religious enthusiasts and

such martyrs of patriotism as Mueius Scaevola or Grand Master Ruediger

of the Teutonic Knights, who refused to reveal the hiding place of his

companion even when his captors belabored him with red-hot irons.

"One Basil Rohatzek, suspected of fraudulent enlistment

(bounty-jumping, as our volunteers called it), pretended to have been

thrown by his horse and to have been permanently disabled by a

paralysis of the lower extremities. He dragged himself along in a

pitiful manner, and his knees looked somewhat bruised, but he was known

to have boasted his ability to procure his discharge somehow or other.

One of his tent mates had also seen him fling himself violently and

repeatedly on his knees (to procure those questionable bruises), and on

the whole there seemed little doubt that the fellow was shamming. All

the surgeons who had examined him concurred in that view, and the case

was finally referred to his commanding officer, General Colloredo. The

impostor was carried to a field hospital in a little Bohemian border

town and watched for a couple of weeks, during which he had been twice

seen moving his feet in his sleep. Still, the witnesses were not

prepared to swear that those changes of position might not have been

effected by a movement of the whole body. The suspect stuck to his

assertion, and Colloredo, in a fit of irritation, finally summoned a

surgeon, who actually placed the feet of the professed paralytic in

"aqua fortis," but even this rigorous method availed the cruel surgeon

nothing, and he was compelled to advise dismissal from the service.

"The martyrdom of Rohatzek, however, was a mere trifle compared with

the ordeal by which the tribunal of Paris tried in vain to extort a

confession of the would-be regicide, Damiens. Robert Damiens, a native

of Arras, had been exiled as an habitual criminal, and returning in

disguise made an attempt upon the life of Louis XV, January 5, 1757.

His dagger pierced the mantle of the King, but merely grazed his neck.

Damiens, who had stumbled, was instantly seized and dragged to prison,

where a convocation of expert torturers exhausted their ingenuity in

the attempt to extort a confession implicating the Jesuits, a

conspiracy of Huguenots, etc. But Damiens refused to speak. He could

have pleaded his inability to name accomplices who did not exist, but

he stuck to his resolution of absolute silence. They singed off his

skin by shreds, they wrenched out his teeth and finger-joints, they

dragged him about at the end of a rope hitched to a team of stout

horses, they sprinkled him from head to foot with acids and seething

oil, but Damiens never uttered a sound till his dying groan announced

the conclusion of the tragedy."

The apparent indifference to the pain of a major operation is sometimes

marvelous, and there are many interesting instances on record. When at

the battle of Dresden in 1813 Moreau, seated beside the Emperor

Alexander, had both limbs shattered by a French cannon-ball, he did not

utter a groan, but asked for a cigar and smoked leisurely while a

surgeon amputated one of his members. In a short time his medical

attendants expressed the danger and questionability of saving his other

limb, and consulted him. In the calmest way the heroic General

instructed them to amputate it, again remaining unmoved throughout the

operation.

Crompton records a case in which during an amputation of the leg not a

sound escaped from the patient's lips, and in three weeks, when it was

found necessary to amputate the other leg, the patient endured the

operation without an anesthetic, making no show of pain, and only

remarking that he thought the saw did not cut well. Crompton quotes

another case, in which the patient held a candle with one hand while

the operator amputated his other arm at the shoulder-joint. Several

instances of self-performed major operations are mentioned in Chapter

XIV.

Supersensitiveness to Pain.--Quite opposite to the foregoing instances

are those cases in which such influences as expectation, naturally

inherited nervousness, and genuine supersensitiveness make the

slightest pain almost unendurable. In many of these instances the state

of the mind and occasionally the time of day have a marked influence.

Men noted for their sagacity and courage have been prostrated by fear

of pain. Sir Robert Peel, a man of acknowledged superior physical and

intellectual power, could not even bear the touch of Brodie's finger to

his fractured clavicle. The authors know of an instance of a pugilist

who had elicited admiration by his ability to stand punishment and his

indomitable courage in his combats, but who fainted from the puncture

of a small boil on his neck.

The relation of pain to shock has been noticed by many writers. Before

the days of anesthesia, such cases as the following, reported by Sir

Astley Cooper, seem to have been not unusual: A brewer's servant, a man

of middle age and robust frame, suffered much agony for several days

from a thecal abscess, occasioned by a splinter of wood beneath the

thumb. A few seconds after the matter was discharged by an incision,

the man raised himself by a convulsive effort from his bed and

instantly expired.

It is a well-known fact that powerful nerve-irritation, such as

produces shock, is painless, and this accounts for the fact that wounds

received during battle are not painful.

Leyden of Berlin showed to his class at the Charite Hospital a number

of hysteric women with a morbid desire for operation without an

anesthetic. Such persons do not seem to experience pain, and, on the

contrary, appear to have genuine pleasure in pain. In illustration,

Leyden showed a young lady who during a hysteric paroxysm had suffered

a serious fracture of the jaw, injuring the facial artery, and

necessitating quite an extensive operation. The facial and carotid

arteries had to be ligated and part of the inferior maxilla removed,

but the patient insisted upon having the operations performed without

an anesthetic, and afterward informed the operator that she had

experienced great pleasure throughout the whole procedure.

Pain as a Means of Sexual Enjoyment.--There is a form of sexual

perversion in which the pervert takes delight in being subjected to

degrading, humiliating, and cruel acts on the part of his or her

associate. It was named masochism from Sacher-Masoch, an Austrian

novelist, whose works describe this form of perversion. The victims

are said to experience peculiar pleasure at the sight of a rival who

has obtained the favor of their mistress, and will even receive blows

and lashes from the rival with a voluptuous mixture of pain and

pleasure. Masochism corresponds to the passivism of Stefanowski, and is

the opposite of sadism, in which the pleasure is derived from

inflicting pain on the object of affection. Krafft-Ebing cites several

instances of masochism.

Although the enjoyment and frenzy of flagellation are well known, its

pleasures are not derived from the pain but by the undoubted

stimulation offered to the sexual centers by the castigation. The

delight of the heroines of flagellation, Maria Magdalena of Pazzi and

Elizabeth of Genton, in being whipped on the naked loins, and thus

calling up sensual and lascivious fancies, clearly shows the

significance of flagellation as a sexual excitant. It is said that when

Elizabeth of Genton was being whipped she believed herself united with

her ideal and would cry out in the loudest tones of the joys of love.

There is undoubtedly a sympathetic communication between the ramifying

nerves of the skin of the loins and the lower portion of the spinal

cord which contains the sexual centers. Recently, in cases of

dysmenorrhea, amenorrhea dysmenorrhagia, and like sexual disorders,

massage or gentle flagellation of the parts contiguous with the

genitalia and pelvic viscera has been recommended. Taxil is the

authority for the statement that just before the sexual act rakes

sometimes have themselves flagellated or pricked until the blood flows

in order to stimulate their diminished sexual power. Rhodiginus,

Bartholinus, and other older physicians mention individuals in whom

severe castigation was a prerequisite of copulation. As a ritual custom

flagellation is preserved to the present day by some sects.

Before leaving the subject of flagellation it should be stated that

among the serious after-results of this practice as a disciplinary

means, fatal emphysema, severe hemorrhage, and shock have been noticed.

There are many cases of death from corporal punishment by flogging.

Ballingal records the death of a soldier from flogging; Davidson has

reported a similar case, and there is a death from the same cause cited

in the Edinburgh Medical and Surgical Journal for 1846.

Idiosyncrasy is a peculiarity of constitution whereby an individual is

affected by external agents in a different manner from others. Begin

defines idiosyncrasy as the predominance of an organ, of a viscus, or a

system of organs. This definition does not entirely grasp the subject.

An idiosyncrasy is something inherent in the organization of the

individual, of which we only see the manifestation when proper causes

are set in action. We do not attempt to explain the susceptibility of

certain persons to certain foods and certain exposures. We know that

such is the fact. According to Begin's idea, there is scarcely any

separation between idiosyncrasy and temperament, whereas from what

would appear to be sound reasoning, based on the physiology of the

subject, a very material difference exists.

Idiosyncrasies may be congenital, hereditary, or acquired, and, if

acquired, may be only temporary. Some, purely of mental origin, are

often readily cured. One individual may synchronously possess an

idiosyncrasy of the digestive, circulatory, and nervous systems.

Striking examples of transitory or temporary idiosyncrasies are seen in

pregnant women.

There are certain so-called antipathies that in reality are

idiosyncrasies, and which are due to peculiarities of the ideal and

emotional centers. The organ of sense in question and the center that

takes cognizance of the image brought to it are in no way disordered.

In some cases the antipathy or the idiosyncrasy develops to such an

extent as to be in itself a species of monomania. The fear-maladies, or

"phobias," as they are called, are examples of this class, and,

belonging properly under temporary mental derangements, the same as

hallucinations or delusions, will be spoken of in another chapter.

Possibly the most satisfactory divisions under which to group the

material on this subject collected from literature are into examples of

idiosyncrasies in which, although the effect is a mystery, the sense is

perceptible and the cause distinctly defined and known, and those in

which sensibility is latent. The former class includes all the peculiar

antipathies which are brought about through the special senses, while

the latter groups all those strange instances in which, without the

slightest antipathy on the part of the subject, a certain food or drug,

after ingestion, produces an untoward effect.

The first examples of idiosyncrasies to be noticed will be those

manifested through the sense of smell. On the authority of Spigelius,

whose name still survives in the nomenclature of the anatomy of the

liver, Mackeuzie quotes an extraordinary case in a Roman Cardinal,

Oliver Caraffa, who could not endure the smell of a rose. This is

confirmed from personal observation by another writer, Pierius, who

adds that the Cardinal was obliged every year to shut himself up during

the rose season, and guards were stationed at the gates of his palace

to stop any visitors who might be wearing the dreadful flower. It is,

of course, possible that in this case the rose may not have caused the

disturbance, and as it is distinctly stated that it was the smell to

which the Cardinal objected, we may fairly conclude that what annoyed

him was simply a manifestation of rose-fever excited by the pollen.

There is also an instance of a noble Venetian who was always confined

to his palace during the rose season. However, in this connection Sir

Kenelm Digby relates that so obnoxious was a rose to Lady Heneage, that

she blistered her cheek while accidentally lying on one while she

slept. Ledelius records the description of a woman who fainted before a

red rose, although she was accustomed to wear white ones in her hair.

Cremer describes a Bishop who died of the smell of a rose from what

might be called "aromatic pain."

The organ of smell is in intimate relation with the brain and the

organs of taste and sight; and its action may thus disturb that of the

esophagus, the stomach, the diaphragm, the intestines, the organs of

generation, etc. Odorous substances have occasioned syncope, stupor,

nausea, vomiting, and sometimes death. It is said that the Hindoos, and

some classes who eat nothing but vegetables, are intensely nauseated by

the odors of European tables, and for this reason they are incapable of

serving as dining-room servants.

Fabricius Hildanus mentions a person who fainted from the odor of

vinegar. The Ephemerides contains an instance of a soldier who fell

insensible from the odor of a peony. Wagner knew a man who was made ill

by the odor of bouillon of crabs. The odors of blood, meat, and fat are

repugnant to herbivorous animals. It is a well-known fact that horses

detest the odor of blood.

Schneider, the father of rhinology, mentions a woman in whom the odor

of orange-flowers produced syncope. Odier has known a woman who was

affected with aphonia whenever exposed to the odor of musk, but who

immediately recovered after taking a cold bath. Dejean has mentioned a

man who could not tolerate an atmosphere of cherries. Highmore knew a

man in whom the slightest smell of musk caused headache followed by

epistaxis. Lanzonius gives an account of a valiant soldier who could

neither bear the sight nor smell of an ordinary pink. There is an

instance on record in which the odor coming from a walnut tree excited

epilepsy. It is said that one of the secretaries of Francis I was

forced to stop his nostrils with bread if apples were on the table. He

would faint if one was held near his nose Schenck says that the noble

family of Fystates in Aquitaine had a similar peculiarity--an innate

hatred of apples. Bruyerinus knew a girl of sixteen who could not bear

the smell of bread, the slightest particle of which she would detect by

its odor. She lived almost entirely on milk. Bierling mentions an

antipathy to the smell of musk, and there is a case on record in which

it caused convulsions. Boerhaave bears witness that the odor of cheese

caused nasal hemorrhage. Whytt mentions an instance in which tobacco

became repugnant to a woman each time she conceived, but after delivery

this aversion changed to almost an appetite for tobacco fumes.

Panaroli mentions an instance of sickness caused by the smell of

sassafras, and there is also a record of a person who fell helpless at

the smell of cinnamon. Wagner had a patient who detested the odor of

citron. Ignorant of this repugnance, he prescribed a potion in which

there was water of balm-mint, of an odor resembling citron. As soon as

the patient took the first dose he became greatly agitated and much

nauseated, and this did not cease until Wagner repressed the balm-mint.

There is reported the case of a young woman, rather robust, otherwise

normal, who always experienced a desire to go to stool after being

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