 | ANOMALIES AND
CURIOSITIES OF MEDICINE.
CHAPTER I.
GENETIC ANOMALIES. Anomalies and Curiosities of Medicine |  |
1. ANOMALIES AND
CURIOSITIES OF MEDICINE.
CHAPTER I.
GENETIC ANOMALIES.
Menstruation has always been of interest, not only to the student of medicine, but to the lay-observer as well. In olden times there were many opinions concerning its causation, all of which, until the era of physiologic investigation, were of superstitious derivation. Believing menstruation to be the natural means of exit of the feminine bodily impurities, the ancients always thought a menstruating woman was to be shunned; her very presence was deleterious to the whole animal economy, as, for instance, among the older writers we find that Pliny [1.1] remarks: "On the approach of a woman in this state, must will become sour, seeds which are touched by her become sterile, grass withers away, garden plants are parched up, and the fruit will fall from the tree beneath which she sits.'' He also says that the menstruating women in Cappadocia were perambulated about the fields to preserve the vegetation from worms and caterpillars. According to Flemming, [1.2] menstrual blood was believed to be so powerful that the mere touch of a menstruating woman would render vines and all kinds of fruit-trees sterile. Among the indigenous Australians, menstrual superstition was so intense that one of the native blacks, who discovered his wife lying on his blanket during her menstrual period, killed her, and died of terror himself in a fortnight. Hence, Australian women during this season are forbidden to touch anything that men use. [1.3] Aristotle said that the very look of a menstruating woman would take the polish out of a mirror, and the next person looking in it would be bewitched. Frommann [1.4] mentions a man who said he saw a tree in Goa which withered because a catamenial napkin was hung on it. Bourke remarks that the dread felt by the American Indians in this respect corresponds with the particulars recited by Pliny. Squaws at the time of menstrual purgation are obliged to seclude themselves, and in most instances to occupy isolated lodges, and in all tribes are forbidden to
Empiricism had doubtless taught the ancient husbands the dangers of sexual intercourse during this period, and the after-results of many such connections were looked upon as manifestations of the contagiousness of the evil excretions issuing at this period. Hence at one time menstruation was held in much awe and abhorrence.
On the other hand, in some of the eastern countries menstruation was regarded as sacred, and the first menstrual discharge was considered so valuable that premenstrual marriages were inaugurated in order that the first ovum might not be wasted, but fertilized, because it was supposed to be the purest and best for the purpose. Such customs are extant at the present day in some parts of India, despite the efforts of the British Government to suppress them, and descriptions of child-marriages and their evil results have often been given by missionaries.
As the advances of physiology enlightened the mind as to the true nature of the menstrual period, and the age of superstition gradually disappeared, the intense interest in menstruation vanished, and now, rather than being held in fear and awe, the physicians of to-day constantly see the results of copulation during this period. The uncontrollable desire of the husband and the mercenary aims of the prostitute furnish examples of modern disregard.
The anomalies of menstruation must naturally have attracted much attention, and we find medical literature of all times replete with examples. While some are simply examples of vicarious or compensatorymenstruation, and were so explained even by the older writers, there are many that are physiologic curiosities of considerable interest. Lhéritier *[485] furnishes the oft-quoted history of the case of a young girl who suffered from suppression of menses, which, instead of flowing through the natural channels, issued periodically from vesicles on the leg for a period of six months, when the seat of the discharge changed to an eruption on the left arm, and continued in this location for one year; then the discharge shifted to a sore on the thumb, and at the end of another six months again changed, the next location being on the upper eyelid; here it continued for a period of two years. Brierre de Boismont and Meisner describe a case apparently identical with the foregoing, though not quoting the source.
Haller, *[400] in a collection of physiologic curiosities covering a period of a century and a half, cites 18 instances of menstruation from the skin. Parrot has also mentioned several cases of this nature. Chambers [1.5] speaks
D'Andradé [1.6] cites an account of a healthy Parsee lady, eighteen years of age, who menstruated regularly from thirteen to fifteen and a half years; the catamenia then became irregular and she suffered occasional hemorrhages from the gums and nose, together with attacks of hematemesis. The menstruation returned, but she never became pregnant, and, later, blood issued from the healthy skin of the left breast and right forearm, recurring every month or two, and finally additional dermal hemorrhage developed on the forehead. Microscopic examination of the exuded blood showed usual constituents present. There are two somewhat similar cases spoken of in French literature. [1.7] The first was that of a young lady, who, after ten years' suppression of the menstrual discharge, exhibited the flow from a vesicular eruption on the finger. The other case was quite peculiar, the woman being a prostitute, who menstruated from time to time through spots, the size of a five-franc piece, developing on the breasts, buttocks, back, axilla, and epigastrium. Barham [1.8] records a case similar to the foregoing, in which the menstruation assumed the character of periodic purpura. Duchesne [1.9] mentions an instance of complete amenorrhea, in which the ordinary flow was replaced by periodic sweats.
Parrot speaks of a woman who, when seven months old, suffered from strumous ulcers, which left cicatrices on the right hand, from whence, at the age of six years, issued a sanguineous discharge with associate convulsions. One day, while in violent grief, she shed bloody tears. She menstruated at the age of eleven, and was temporarily improved in her condition; but after any strong emotion the hemorrhages returned. The subsidence of the bleeding followed her first pregnancy, but subsequently on one occasion, when the menses were a few days in arrears, she exhibited a blood-like exudation from the forehead, eyelids, and scalp. As in the case under D'Andradé's observation, the exudation was found by microscopic examination to consist of the true constituents of blood. An additional element of complication in this case was the occurrence of occasional attacks of hematemesis.
Menstruation from the Breasts.—Being in close sympathy with the generative function, we would naturally expect to find the female mammæ
Hancock [1.24] relates an instance of menstruation from the left breast in a large, otherwise healthy, Englishwoman of thirty-one, who one and a half years after the birth of the youngest child (now ten years old) commenced to have a discharge of fluid from the left breast three days before the time of the regular period. As the fluid escaped from the nipple it became changed in character, passing from a whitish to a bloody and to a yellowish color respectively, and suddenly terminating at the beginning of the real flow from the uterus, to reappear again at the breast at the close of the flow, and then lasting two or three days longer. Some pain of a lancinating type occurred in the breast at this time. The patient first discovered her peculiar condition by a stain of blood upon the night-gown on awakening in the morning, and this she traced to the breast. From an examination it appeared that a neglected lacerated cervix during the birth of the last child had given rise to endometritis, and for a year the patient had suffered from severe menorrhagia, for which she was subsequently treated. At this time the menses became scanty, and then supervened the discharge of bloody fluid from the left breast, as heretofore mentioned. The right breast remained always entirely passive. A remarkable feature of the case was that some escape of fluid occurred from the left breast during coitus. As a possible means of throwing light on this subject it may be added that the patient was unusually vigorous, and during the nursing of her two children she had more than the ordinary amount of milk (galactorrhea), which poured from the breast constantly. Since this time the breasts had been quite normal, except for the tendency manifested in the left one under the conditions given.
Cases of menstruation through the eyes are frequently mentioned by the older writers. Bellini, [1.25] Hellwig, [414] and Dodonæus all speak of menstruation
Relative to menstruation from the ear, Spindler, [1.30] Paullini, [1.31] and Alibert [1.32] furnish examples. In Paullini's case the discharge is spoken of as very foul, which makes it quite possible that this was a case of middle-ear disease associated with some menstrual disturbance, and not one of true vicarious menstruation. Alibert's case was consequent upon suppression of the menses. Law [1.33] cites an instance in a woman of twenty-three, in whom the menstrual discharge was suspended several months. She experienced fulness of the head and bleeding (largely from the ears), which subsequently occurred periodically, being preceded by much throbbing; but the patient finally made a good recovery. Barnes, [1.34] Stepanoff, [1.35] and Field [1.36] adduce examples of this anomaly. Jouilleton [1.37] relates an instance of menstruation from the right ear for five years, following a miscarriage.
Hemorrhage from the mouth of a vicarious nature has been frequently observed associated with menstrual disorders. The Ephemerides, *[104] Meibomius, *[561] and Rhodius mention instances. The case of Meibomius was that of an infant, and the case mentioned by Rhodius was associated with hemorrhages from the lungs, umbilicus, thigh, and tooth-cavity. Allport [1.38] reports the history of a case in which there was recession of the gingival margins and alveolar processes, the consequence of amenorrhea. Caso [1.39] has an instance
Descriptions of menstruation from the extremities are quite numerous. Pechlin [1.41] offers an example from the foot; Boerhaave from the skin of the hand; Ephemerides [104] from the knee; Albertus from the foot; Zacutus Lusitanus [1.42] from the left thumb; Bartholinus [1.43] a curious instance from the hand; and the Ephemerides [1.44] another during pregnancy from the ankle.
Post [1.45] speaks of a very peculiar case of edema of the arm alternating with the menstrual discharge. Sennert writes of menstruation from the groin associated with hemorrhage from the umbilicus and gums. Moses [1.46] offers an example of hemorrhage from the umbilicus, doubtless vicarious. Verduc details the history of two cases from the top of the head, and Kerokring [1.47] cites three similar instances, one of which was associated with hemorrhage from the hand.
A peculiar mode is vicarious menstrual hemorrhage through old ulcers, wounds, or cicatrices, and many examples are on record, a few of which will be described. Calder [1.48] gives an excellent account of menstruation at an ankle-ulcer, and Brincken [1.49] says he has seen periodical bleeding from the cicatrix of a leprous ulcer. In the Lancet [1.50] is an account of a case in the Vienna Hospital of simulated stigmata; the scar opened each month and a menstrual flow proceeded therefrom; but by placing a plaster-of-Paris bandage about the wound, sealing it so that tampering with the wound could be easily detected, healing soon ensued, and the imposture was thus exposed. Such would likely be the result of the investigation of most cases of "bleeding wounds'' which are exhibited to the ignorant and superstitious for religious purposes.
Hogg [1.51] publishes a report describing a young lady who injured her leg with the broken steel of her crinoline. The wound healed nicely, but always burst out afresh the day preceding the regular period. Forster [1.52] speaks of a menstrual ulcer of the face, and Moses [1.53] two of the head. White, quoted by Barnes, cites an instance of vicarious hemorrhage from five deep fissures
Knaggs [1.54] relates an interesting account of a sequel to an operation for ovarian disease. Following the operation, there was a regular, painless menstruation every month, at which time the lower part of the wound reopened, and blood issued forth during the three days of the catamenia. McGraw [1.55] illustrates vicarious menstruation by an example, the discharge issuing from an ovariotomy-scar, and Hooper [1.56] cites an instance in which the vicarious function was performed by a sloughing ulcer. Buchanan [1.57] and Simpson [1.58] describe "amenorrheal ulcers.'' Dupuytren [1.59] speaks of denudation of the skin from a burn, with the subsequent development of vicarious catamenia from the seat of the injury.
There are cases on record in which the menstruation occurs by the rectum or the urinary tract. Barbee [1.60] illustrates this by a case in which cholera morbus occurred monthly in lieu of the regular menstrual discharge. Barrett [1.61] speaks of a case of vicarious menstruation by the rectum. Ast- bury *[318] says he has seen a case of menstruation by the hemorrhoidal vessels, and instances of relief from plethora by vicarious menstruation in this manner are quite common. Rosenbladt *[691] cites an instance of menstruation by the bladder, and Salmuth [1.62] speaks of a pregnant woman who had her monthly flow by the urinary tract. Ford [1.63] illustrates this anomaly by the case of a woman of thirty-two, who began normal menstruation at fourteen; for quite a period she had vicarious menstruation from the urinary tract, which ceased after the birth of her last child. The coexistence of a floating kidney in this case may have been responsible for this hemorrhage, and in reading reports of so-called menstruation due consideration must be given to the existence of any other than menstrual derangement before we can accept the cases as true vicarious hemorrhage. Tarnier cites an instance of a girl without a uterus, in whom menstruation proceeded from the vagina. Zacutus Lusitanus [1.64] relates the history of a case of uterine occlusion, with the flow from the lips of the cervix. There is mentioned an instance of menstruation from the labia.
The occurrence of menstruation after removal of the uterus or ovaries is frequently reported. Storer, [1.65] Clay, [1.66] Tait, [1.67] and the British and Foreign Medico-Chirurgical Review [1.68] report cases in which menstruation took place with neither uterus nor ovary. Doubtless many authentic instances like the preceding could be found to-day. Menstruation after
Hematemesis is a means of anomalous menstruation, and several instances are recorded. Marcellus Donatus [1.69] and Benivenius *[197] exemplify this with cases. Instances of vicarious and compensatory epistaxis and hemoptysis are so common that any examples would be superfluous. There is recorded [1.70] an inexplicable case of menstruation from the region of the sternum, and among the curious anomalies of menstruation must be mentioned that reported by Parvin [1.71] seen in a woman, who, at the menstrual epoch, suffered hemoptysis and oozing of blood from the lips and tongue. Occasionally there was a substitution of a great swelling of the tongue, rendering mastication and articulation very difficult for four or five days. Parvin gives portraits showing the venous congestion and discoloration of the lips.
Instances of migratory menstruation, the flow moving periodically from the ordinary passage to the breasts and mammæ, are found in the older writers. [1.72] Salmuth speaks of a woman [1.73] on whose hands appeared spots immediately before the establishment of the menses. Cases of semimonthly menstruation *[104] and many similar anomalies of periodicity are spoken of.
The Ephemerides contains [1.74] an instance of the simulation of menstruation after death, and Testa [1.75] speaks of menstruation lasting through a long sleep. Instances of black menstruation are to be found, described in full, in the Ephemerides, by Paullini [1.76] and by Schurig, [1.77] and in some of the later works; it is possible that an excess of iron, administered for some menstrual disorder, may cause such an alteration in the color of the menstrual fluid.
Suppression of menstruation is brought about in many peculiar ways, and sometimes by the slightest of causes, some authentic instances being so strange as to seem mythical. Through the Ephemerides *[104] we constantly read of such causes as contact with a corpse, the sight of a serpent or mouse, the sight of monsters, etc. Lightning stroke and curious neuroses have been reported as causes. Many of the older books on obstetric subjects are full of such instances, and modern illustrations are constantly reported.
Menstruation in Man.—Periodic discharges of blood in man, constituting what is called "male menstruation,'' have been frequently noticed and are particularly interesting when the discharge is from the penis or urethra, furnishing a striking analogy to the female function of menstruation. The older authors quoted several such instances, and Mehliss says that in the ancient days certain writers remarked that catamenial lustration from the penis was inflicted on the Jews as a divine punishment. Bartholinus [1.78]
Vicarious Menstruation in the Male.—This simulation of menstruation by the male assumes a vicarious nature as well as in the female. Van Swieten, [1.86] quoting from Benivenius, relates a case of a man who once a month sweated great quantities of blood from his right flank. Pinel mentions a case of a captain in the army (M. Regis), who was wounded by a bullet in the body and who afterward had a monthly discharge from the urethra. Pinel calls attention particularly to the analogy in this case by mentioning that if the captain were exposed to fatigue, privation, cold, etc., he exhibited the ordinary symptoms of amenorrhea or suppression. Fournier [1.87] speaks of a man over thirty years old, who had been the subject of a menstrual evacuation since puberty, or shortly after his first sexual intercourse. He would experience pains of the premenstrual type, about twenty-four hours before the appearance of the flow, which subsided when the menstruation began. He was of an intensely voluptuous nature, and constantly gave himself up to sexual excesses. The flow was abundant on the first day, diminished on the second, and ceased on the third. Halliburton, [1.88] Jouilleton, and Rayman also record male menstruation.
Cases of menstruation during pregnancy and lactation are not rare.
There are some cases on record of child-bearing after the menopause, as, for instance, that of Pearson, [1.93] of a woman who had given birth to nine children up to September, 1836; after this the menses appeared only slightly until July, 1838, when they ceased entirely. A year and a half after this she was delivered of her tenth child. Other cases, somewhat similar, will be found under the discussion of late conception.
Precocious menstruation is seen from birth to nine or ten years. Of course, menstruation before the third or fourth year is extremely rare, most of the cases reported before this age being merely accidental sanguineous discharges from the genitals, not regularly periodical, and not true catamenia. However, there are many authentic cases of infantile menstruation on record, which were generally associated with precocious development in other parts as well. Billard says that the source of infantile menstruation is the lining membrane of the uterus; but Camerer explains it as due to ligature of the umbilical cord before the circulation in the pulmonary vessels is thoroughly established. In the consideration of this subject, we must bear in mind the influence of climate and locality on the time of the appearance of menstruation. In the southern countries, girls arrive at maturity at an earlier age than their sisters of the north. Medical reports from India show early puberty of the females of that country. Campbell remarks that girls attain the age of puberty at twelve in Siam, while, on the contrary, some observers report the fact that menstruation does not appear in the Esquimaux women until the age of twenty-three, and then is very scanty, and is only present in the summer months.
Cases of menstruation commencing within a few days after birth and exhibiting periodical recurrence are spoken of by Penada, [1.94] Neues Hannoverisehes
Cecil [1.101] relates an instance of menstruation on the sixth day, continuing for five days, in which six or eight drams of blood were lost. Peeples [1.102] cites an instance in Texas in an infant at the age of five days, which was associated with a remarkable development of the genital organs and breasts. Van Swieten offers an example at the first month; the British Medical Journal [1.103] at the second month; Conarmond at the third month. Ysabel, a young slave girl belonging to Don Carlos Pedro of Havana, [1.104] began to menstruate soon after birth, and at the first year was regular in this function. At birth her mamma were well developed and her axillæ were slightly covered with hair. At the age of thirty-two months she was three feet ten inches tall, and her genitals and mammæ resembled those of a girl of thirteen. Her voice was grave and sonorous; her moral inclinations were not known. Deever *[358] records an instance of a child two years and seven months old who, with the exception of three months only, had menstruated regularly since the fourth month. Harle [1.105] speaks of a child, the youngest of three girls, who had a bloody discharge at the age of five months which lasted three days and recurred every month until the child was weaned at the tenth month. At the eleventh month it returned and continued periodically until death, occasioned by diarrhea at the fourteenth month. The necropsy showed a uterus 1 5/8 inches long, the lips of which were congested; the left ovary was twice the size of the right, but displayed nothing strikingly abnormal. Baillot and the British Medical Journal [1.106] cite instances of menstruation at the fourth month. A case is on record [1.107] of an infant who menstruated at the age of six months, and whose menses returned on the twenty-eighth day exactly. Clark, Wall, and the Lancet [1.108] give descriptions of cases at the ninth month. Naegele has seen a case at the eighteenth month, and Schmidt and Colly [1.109] in the second year. Another case [1.110] is that of a child, nineteen months old, whose breasts and external genitals were fully developed, although the child had shown no sexual desire, and did not exceed other children of the same age in intellectual development. This prodigy was symmetrically formed and of pleasant appearance. Warner [1.111] speaks of Sophie Gantz, of Jewish parentage, born in Cincinnati, July 27, 1865, whose menses began at the twenty-third month and had continued regularly up to the time of reporting. At the age of three years and six months she was 38 inches tall, 38 pounds in weight, and her girth at the hip was 33 1/2 inches. The pelvis was broad and well shaped, and measured 10 1/2
| 28 at 50 years of age, | 3 at 57 years of age, | |
| 18 " 51 " " " | 3 " 58 " " " | |
| 18 " 52 " " " | 1 " 59 " " " | |
| 11 " 53 " " " | 4 " 60 " " " | |
| 13 " 54 " " " | 4 " 62 " " " | |
| 5 " 55 " " " | 3 " 63 " " " | |
| 4 " 56 " " " |
These statistics were from examination of 6000 cases of menstruating women. The last seven were found to be in women in the highest class of society.
Mehliss has made the following collection of statistics of a somewhat similar nature—
| Late | Dentition. | Late | Late | |
| Male. | Female. | Lactation. | Menstruation. | |
| Between 40 and 50 | 0 | 4 | 0 | 0 |
| '' 50 '' 60 | 1 | 4 | 2 | 1 |
| '' 60 '' 70 | 3 | 2 | 1 | 0 |
| '' 70 '' 80 | 3 | 2 | 0 | 7 |
| '' 80 '' 90 | 6 | 2 | 0 | 0 |
| '' 90 '' 100 | 1 | 1 | 0 | 1 |
| Above 100 | 6 | 1 | 0 | 1 |
| — | — | — | — | |
| 20 | 16 | 3 | 10 |
These statistics seem to have been made with the idea of illustrating the marvelous rather than to give the usual prolongation of these functions. It hardly seems possible that ordinary investigation would show no cases of menstruation between sixty and seventy, and seven cases between seventy and eighty; however, in searching literature for such a collection, we must bear in mind that the more extraordinary the instance, the more likely it is that it would be spoken of, as the natural tendency of medical men is to overlook the important ordinary and report the nonimportant extraordinary. Dewees mentions an example of menstruation at sixty-five, and others at fifty-four and fifty-five years. Motte speaks of a case at sixty-one; Ryan and others, at fifty-five, sixty, and sixty-five; Parry, from sixty-six to seventy seven; Desormeux, from sixty to seventy-five; Semple, at seventy and eighty seven; Higgins, [1.119] [a] at seventy-six; Whitehead, [1.120] [b] at seventy-seven; Bernstein, at seventy-eight; Beyrat, [1.121] [c] at eighty-seven; Haller, at one hundred; and highest of all is Blancardi's case, in which menstruation was present at one hundred and six years. In the London Medical and Surgical Journal, 1831, are reported cases at eighty and ninety-five years. In Good's System of Nosology
Strasberger of Beeskow describes a woman who ceased menstruating at forty-two, who remained in good health up to eighty, suffering slight attacks of rheumatism only, and at this late age was seized with abdominal pains, followed by menstruation, which continued for three years; the woman died the next year. This late menstruation had all the sensible characters of the early one. Kennard [1.124] mentions a negress, aged ninety-one, who menstruated at fourteen, ceased at forty-nine, and at eighty-two commenced again, and was regular for four years, but had had no return since. On the return of her menstruation, believing that her procreative powers were returning, she married a vigorous negro of thirty-five and experienced little difficulty in satisfying his desires. Du Peyrou de Cheyssiole and Bonhoure [1.125] speak of an aged peasant woman, past ninety-one years of age, who menstruated regularly.
Petersen [1.126] describes a woman of seventy-nine, who on March 26th was seized with uterine pains lasting a few days and terminating with hemorrhagic discharge. On April 23d she was seized again, and a discharge commenced on the 25th, continuing four days. Up to the time of the report, one year after, this menstruation had been regular. There is an instance on record of a female who menstruated every three months during the period from her fiftieth to her seventy-fourth year, the discharge, however, being very slight. Thomas [1.127] cites an instance of a woman of sixty-nine who had had no menstruation since her forty-ninth year, but who commenced again the year he saw her. Her mother and sister were similarly affected at the age of sixty, in the first case attributable to grief over the death of a son, in the second ascribed to fright. It seemed to be a peculiar family idiosyncrasy. Velasquez of Tarentum [1.128] says that the Abbess of Monvicaro at the very advanced age of one hundred had a recurrence of catamenia after a severe illness, and subsequently a new set of teeth and a new growth of hair.
Late Establishment of Menstruation.—In some cases menstruation never appears until late in life, presenting the same phenomena as normal menstruation. Perfect [1.129] relates the history of a woman who had been married many years, and whose menstruation did not appear until her forty-seventh year. She was a widow at the time, and had never been pregnant. Up to the time of her death, which was occasioned by a convulsive colic, in her fifty-seventh year, she had the usual prodromes of menstruation followed by the usual discharge. Rodsewitch [1.130] speaks of a widow of a peasant who
The medical literature relative to precocious impregnation is full of marvelous instances. Individually, many of the cases would be beyond credibility, but when instance after instance is reported by reliable authorities we must accept the possibility of their occurrence, even if we doubt the statements of some of the authorities. No less a medical celebrity than the illustrious Sir Astley Cooper remarks that on one occasion he saw a girl in Scotland, seven years old, whose pelvis was so fully developed that he was sure she could easily give birth to a child; and Warner's case of the Jewish girl three and a half years old, with a pelvis of normal width, more than substantiates this supposition. Similar examples of precocious pelvic and sexual development are on record in abundance, and nearly every medical man of experience has seen cases of infantile masturbation.
The ordinary period of female maturity is astonishingly late when compared with the lower animals of the same size, particularly when viewed with cases of animal precocity on record. Berthold [1.135] speaks of a kid fourteen days old which was impregnated by an adult goat, and at the usual period of gestation bore a kid, which was mature but weak, to which it gave milk in abundance, and both the mother and kid grew up strong. Compared with the above, child-bearing by women of eight is not extraordinary.
The earliest case of conception that has come to the authors' notice is a quotation in one of the last century books from von Mandelslo [1.136] of impregnation at six; but a careful search in the British Museum failed to confirm this statement, and, for the present, we must accept the statement as hearsay and without authority available for reference-purposes.
Molitor [1.137] gives an instance of precocious pregnancy in a child of eight. It was probably the same case spoken of by Lefebvre [1.138] and reported to the Belgium Academy: A girl, born in Luxemborg, well developed sexually, having hair on the pubis at birth, who menstruated at four, and at the age of eight was impregnated by a cousin of thirty-seven, who was sentenced to five years' imprisonment for seduction. The pregnancy terminated by the expulsion of a mole containing a well-characterized human embryo. Schmidt's case in 1779 [1.139] was in a child who had menstruated at two, and bore a dead fetus when she was but eight years and ten months old. She had all the appearance and development of a girl of seventeen. Kussmaul gives an example of conception at eight. Dodd [1.140] speaks of a child who menstruated early and continued up to the time of impregnation. She was a hard worker and did all her mother's washing. Her labor pains did not continue over six hours, from first to the last. The child was a large one, weighing 7 pounds, and afterward died in convulsions. The infant's left foot had but 3 toes. The young mother at the time of delivery was only nine years and eight months old, and consequently must have been impregnated before the age of nine. Meyer gives an astonishing instance of birth in a Swiss girl at nine. Carn describes a case of a child who menstruated at two, became pregnant at eight, and lived to an advanced age. Ruttel reports conception in a girl of nine, and as far north as St. Petersburg a girl has become a mother before nine years. The Journal de Sçavans, 1684, *[470] contains the report of the case of a boy, who survived, being born to a mother of nine years.
Beck has reported an instance of delivery in a girl a little over ten years of age. There are instances of fecundity at nine years recorded by Ephemerides, Wolffius, [1.141] Savonarola, [1.142] and others. [1.143] Gleaves [1.144] reports from Wytheville, Va., the history of what he calls the case of the youngest mother in Virginia —Annie H.—who was born in Bland County, July 15, 1885, and, on September 10, 1895, was delivered of a well-formed child weighing 5 pounds. The girl had not the development of a woman, although she had menstruated regularly since her fifth year. The labor was short and uneventful, and, two hours afterward, the child-mother wanted to arise and dress and would have done so had she been permitted. There were no developments of the mammæ nor secretion of milk. The baby was nourished through its short
The instance in the Journal deçavans is reiterated in 1775, [1.145] which is but such a repetition as is found all through medical literature—"new friends with old faces,'' as it were. Haller observed a case of impregnation in a girl of nine, who had menstruated several years, and others who had become pregnant at nine, ten, and twelve years respectively. Rowlett, [1.146] whose case is mentioned by Harris, saw a child who had menstruated the first year and regularly thereafter, and gave birth to a child weighing 7 3/4 pounds when she was only ten years and thirteen days old. At the time of delivery she measured 4 feet 7 inches in height and weighed 100 pounds. Curtis, [1.147] who is also quoted by Harris, relates the history of Elizabeth Drayton, who became pregnant before she was ten, and was delivered of a full-grown, living male child weighing 8 pounds. She had menstruated once or twice before conception, was fairly healthy during gestation, and had a rather lingering but natural labor. To complete the story, the father of this child was a boy of fifteen. One of the faculty of Montpellier [1.148] has reported an instance at New Orleans of a young girl of eleven, who became impregnated by a youth who was not yet sixteen. Maygrier [1.149] says that he knew a girl of twelve, living in the Faubourg Saint-Germain, who was confined.
Harris [1.150] relates the particulars of the case of a white girl who began to menstruate at eleven years and four months, and who gave birth to an oversized male child on January 21, 1872, when she was twelve years and nine months old. She had an abundance of milk and nursed the child; the labor was of about eighteen hours' duration, and laceration was avoided. He also speaks of a mulatto girl, born in 1848, who began to menstruate at eleven
The following are some Indian statistics: [1.151] 1 pregnancy at ten, 6 at eleven, 2 at eighteen, 1 at nineteen. [1.152] Chevers *[266] speaks of a mother at ten and others at eleven and twelve; and Green, at Dacca, performed craniotomy upon the fetus of a girl of twelve. Wilson [1.153] gives an account of a girl thirteen years old, who gave birth to a full-grown female child after three hours' labor. She made a speedy convalescence, but the child died four weeks afterward from bad nursing. The lad who acknowledged paternity was nineteen years old. King [1.154] reports a well-verified case of confinement in a girl of eleven. Both the mother and child did well.
Robertson of Manchester describes a girl, working in a cotton factory, who was a mother at twelve; de La Motte *[474] mentions pregnancy before twelve; Kilpatrick [1.155] in a negress, at eleven years and six months; Fox, [1.156] at twelve; Hall, [1.157] at twelve; Kinney, [1.158] at twelve years, ten months, and sixteen days; Herrick, [1.159] at thirteen years and nine months; Murillo, [1.160] at thirteen years; Philippart, [1.161] at fourteen years; Stallcup, at eleven years and nine months; Stoakley, [1.162] at thirteen years; Walker, [1.163] at the age of twelve years and eight months; another case, [1.164] at twelve years and six months; and Williams, [1.165] at eleven.
In 1816 some girls were admitted to the Paris Maternité as young as thirteen, and during the Revolution several at eleven, and even younger. Smith [1.166] speaks of a legal case in which a girl, eleven years old, being safely delivered of a living child, charged her uncle with rape. Allen [1.167] speaks of a girl who became pregnant at twelve years and nine months, and was delivered of a healthy, 9-pound boy before the physician's arrival; the placenta came away afterward, and the mother made a speedy recovery. She was thought to have had "dropsy of the abdomen,'' as the parents had lost a girl of about the same age who was tapped for ascites. The father of the child was a boy only fourteen years of age.
Marvelous to relate, there are on record several cases of twinsbeing born to a child mother. Kay reports a case of twins in a girl of thirteen; Montgomery, at fourteen; and Meigs reports the case of a young girl, of Spanish blood, at Maracaibo, who gave birth to a child before she was twelve and to twins before reaching fourteen years.
In the older works, the following authors have reported cases of pregnancy before the appearance of menstruation: Ballonius, Vogel, Morgagni, the anatomist of the kidney, Schenck, Bartholinus, Bierling, Zacchias, Charleton, Mauriceau, Ephemerides, and Fabricius Hildanus.
In some cases this precocity seems to be hereditary, being transmitted from mother to daughter, bringing about an almost incredible state of affairs, in which a girl is a grandmother about the ordinary age of maternity. Kay says that he had reported to him, on "pretty good'' authority, an instance of a Damascus Jewess who became a grandmother at twenty-one years. In France [1.168] they record a young grandmother of twenty-eight. Ketchum [1.169] speaks of a negress, aged thirteen, who gave birth to a well-developed child which began to menstruate at ten years and nine months and at thirteen became pregnant; hence the negress was a grandmother at twenty-five years and nine months. She had a second child before she was sixteen, who began to menstruate at seven years and six months, thus proving the inheritance of this precocity, and leaving us at sea to figure what degree of grandmother she may be if she lives to an advanced age. Another interesting case of this nature is that of Mrs. C., [1.170] born 1854, married in 1867, and who had a daughter ten months after. This daughter married in 1882, and in March, 1883, gave birth to a 9-pound boy. The youthful grandmother, not twenty-nine, was present at the birth. This case was remarkable, as the children were both legitimate.
Fecundity in the old seems to have attracted fully as much attention among the older observers as precocity. Pliny [636] speaks of Cornelia, of the family of Serpios, who bore a son at sixty, who was named Volusius Saturnius; and Marsa, a physician of Venice, was deceived in a pregnancy
Kennedy [1.179] reports a delivery at sixty-two years, and the Cincinnati Enquirer, January, 1863, says: "Dr. W. McCarthy was in attendance on a lady of sixty-nine years, on Thursday night last, who gave birth to a fine boy. The father of the child is seventy-four years old, and the mother and child are doing well.'' Quite recently there died in Great Britain a Mrs. Henry of Gortree at the age of one hundred and twelve, leaving a daughter of nine years.
Mayham [1.180] saw a woman seventy-three years old who recovered after delivery of a child. A most peculiar case is that of a widow, seventy years old, a native of Garches. [1.181] She had been in the habit of indulging freely in wine, and, during the last six months, to decided excess. After an unusually prolonged libation she found herself unable to walk home; she sat down by the roadside waiting until she could proceed, and was so found by a young man who knew her and who proposed helping her home. By the time her
Multiple births in the aged have been reported from authentic sources. The Lancet [1.182] quotes a rather fabulous account of a lady over sixty-two years of age who gave birth to triplets, making her total number of children 13. Montgomery, Colomb, and Knehel, each, have recorded the birth of twins in women beyond the usual age of the menopause, and there is a case [1.183] recorded of a woman of fifty-two who was delivered of twins.
Impregnation without completion of the copulative act by reason of some malformation, such as occlusion of the vagina or uterus, fibrous and unruptured hymen, etc., has been a subject of discussion in the works of medical jurisprudence of all ages; and cases of conception without entrance of the penis are found in abundance throughout medical literature, and may have an important medicolegal bearing. There is little doubt of the possibility of spermatozoa deposited on the genitalia making progress to the seat of fertilization, as their power of motility and tenacity of life have been well demonstrated. Percy [1.184] reports an instance in which semen was found issuing from the os uteri eight and one-half days after the last intercourse; and a microscopic examination of this semen revealed the presence of living as well as dead spermatozoa. We have occasional instances of impregnation by rectal coitus, the semen finding its way into an occluded vaginal canal by a fistulous communication.
Guillemeau, [1.185] the surgeon of the French king, tells of a girl of eighteen, who was brought before the French officials in Paris, in 1607, on the citation of her husband of her inability to allow him completion of the marital function. He alleged that he had made several unsuccessful attempts to enter her, and in doing so had caused paraphimosis. On examination by the surgeons she was found to have a dense membrane, of a fibrous nature, entirely occluding the vagina, which they incised. Immediately afterward the woman exhibited morning sickness and the usual signs of pregnancy, and was delivered in four months of a full-term child, the results of an impregnation occasioned by one of the unsuccessful attempts at entrance. Such instances are numerous in the older literature, and a mere citation of a few is considered sufficient here. Zacchias, [1.186] Amand, Fabricius Hildanus, Graaf, the discoverer of the follicles that bear his name, Borellus, Blegny, Blanchard, [1.187] Diemerbroeck, [1.188] Duddell, Mauriceau, a Reyes, Riolan, [1.189] Harvey, the discoverer of the circulation of the blood, [1.190] Wolfius, Walther, Rongier, [1.191] Ruysch, Forestus, Ephemerides, [1.192] and Schurig all mention cases of conception with intact
Gilbert [1.194] gives an account of a case of pregnancy in an unmarried woman, who successfully resisted an attempt at criminal connection and yet became impregnated and gave birth to a perfectly formed female child. The hymen was not ruptured, and the impregnation could not have preceded the birth more than thirty-six weeks. Unfortunately, this poor woman was infected with gonorrhea after the attempted assault. Simmons of St. Louis [1.195] gives a curious peculiarity of conception, in which there was complete closure of the vagina, subsequent conception, and delivery at term. He made the patient's acquaintance from her application to him in regard to a malcondition of her sexual apparatus, causing much domestic infelicity.
Lawson [1.196] speaks of a woman of thirty-five, who had been married ten months, and whose husband could never effect an entrance; yet she became pregnant and had a normal labor, despite the fact that, in addition to a tough and unruptured hymen, she had an occluding vaginal cyst. Hickinbotham of Birmingham [1.197] reports the history of two cases of labor at term in females whose hymens were immensely thickened. H. Grey Edwards has seen a case of imperforate hymen which had to be torn through in labor; yet one single act of copulation, even with this obstacle to entrance, sufficed to impregnate. Champion speaks of a woman who became pregnant although her hymen was intact. She had been in the habit of having coitus by the urethra, and all through her pregnancy continued this practice.
Houghton [1.198] speaks of a girl of twenty-five into whose vagina it was impossible to pass the tip of the first finger on account of the dense cicatricial membrane in the orifice, but who gave birth, with comparative ease, to a child at full term, the only interference necessary being a few slight incisions to permit the passage of the head. Tweedie [1.199] saw an Irish girl of twenty-three, with an imperforate os uteri, who had menstruated only scantily since fourteen and not since her marriage. She became pregnant and went to term, and required some operative interference. He incised at the point of usual location of the os, and one of his incisions was followed by the flow of liquor amnii, and the head fell upon the artificial opening, the diameter of which proved to be one and a half or two inches; the birth then progressed promptly, the child being born alive.
Guerard [1.200] notes an instance in which the opening barely admitted a hair; yet the patient reached the third month of pregnancy, at which time she induced abortion in a manner that could not be ascertained. Roe gives a
Instances in which the presence of an unruptured hymen has complicated or retarded actual labor are quite common, and until the membrane is ruptured by external means the labor is often effectually obstructed. Among others reporting cases of this nature are Beale, [1.212] Carey, [1.213] Davis, Emond, [1.214] Fetherston, Leisenring, [1.215] Mackinlay, [1.216] Martinelli, Palmer, [1.217] Rousseau, Ware, and Yale. [1.218]
There are many cases of stricture or complete occlusion of the vagina, congenital or acquired from cicatricial contraction, obstructing delivery, and in some the impregnation seems more marvelous than cases in which the obstruction is only a thin membranous hymen. Often the obstruction is so dense as to require a large bistoury to divide it, and even that is not always sufficient, and the Cesarean operation only can terminate the obstructed delivery; we cannot surmise how conception could have been possible. Staples [1.219] records a case of pregnancy and parturition with congenital stricture of the vagina. Maisonneuve [1.220] mentions the successful practice of a Cesarean operation in a case of congenital occlusion of the vagina forming a complete obstruction to delivery. Verdile [1.221] records an instance of imperforate vagina in which rectovaginal wall was divided and the delivery effected through the rectum and anus. Lombard [1.222] mentions an observation of complete occlusion of the vagina in a woman, the mother of 4 living children and pregnant for the fifth time. Thus, almost incredible to relate, it is possible for a woman to become a mother of a living child and yet preserve all the vaginal evidences of virginity. Cole [1.223] describes a woman of twenty-four who was delivered without the rupture of the hymen, and Meek [1.224] remarks on a similar case. We can readily see that, in a case like that of Verdile, in which rectal delivery is effected, the hymen could be left intact and the product of conception be born alive.
A natural sequence to the subject of impregnation without entrance is that of artificial impregnation. From being a matter of wonder and
There have been rumors from the beginning of the century of women being impregnated in a bath, from contact with cloths containing semen, etc., and some authorities in medical jurisprudence have accepted the possibility of such an occurrence. It is not in the province of this work to speculate on what may be, but to give authoritative facts, from which the reader may draw his own deductions. Fertilization of plants has been thought to have been known in the oldest times, and there are some who believe that the library at Alexandria must have contained some information relative to it. The first authentic account that we have of artificial impregnation is that of Schwammerdam, who in 1680 attempted it without success by the fecundation of the eggs of fish. Roesel, his scholar, made an attempt in 1690, but also failed; and to Jacobi, in 1700, belongs the honor of success. In 1780, Abbe Spallanzani, following up the success of Jacobi, artificially impregnated a bitch, who brought forth in sixty-two days 3 puppies, all resembling the male. The illustrious John Hunter advised a man afflicted with hypospadias to impregnate his wife by vaginal injections of semen in water with an ordinary syringe, and, in spite of the simplicity of this method, the attempt was followed by a successful issue. Since this time, Nicholas of Nancy and Lesueur have practised the simple vaginal method; while Gigon, d'Angoulême (14 cases), Girault (10 cases), Marion Sims, Thomas, Salmon, Pajot, Gallard, Courty, Roubaud, Dehaut, and others have used the more modern uterine method with success.
A dog-breeder, [1.225] by syringing the uterus of a bitch, has succeeded in impregnating her. Those who are desirous of full information on this subject, as regards the modus operandi, etc., are referred to Girault; [1.226] this author reports in full several examples. One case was that of a woman, aged twenty-five, afflicted with blenorrhea, who, chagrined at not having issue, made repeated forcible injections of semen in water for two months, and finally succeeded in impregnating herself, and was delivered of a living child. Another case was that of a female, aged twenty-three, who had an extra long vaginal canal, probably accounting for the absence of pregnancy. She made injections of semen, and was finally delivered of a child. He also reports the case of a distinguished musician who, by reason of hypospadias, had never
The fundamental condition of fecundity being the union of a spermatozoid and an ovum, the object of artificial impregnation is to further this union by introducing semen directly to the fundus of the uterus. The operation is quite simple and as follows: The husband, having been found perfectly healthy, is directed to cohabit with his wife, using a condom. The semen ejaculated is sucked up by an intrauterine syringe (Fig. 1) which has been properly disinfected and kept warm. The os uteri is now exposed and wiped off with some cotton which has been dipped in an antiseptic fluid; introduced to the fundus of the uterus, and some drops of the fluid slowly expressed into the uterus. The woman is then kept in bed on her back. This operation is best carried out immediately before or immediately after the menstrual epoch, and if not successful at the first attempt should be repeated for several months. At the present day artificial impregnation in pisciculture is extensively used with great success. [1.228]
There is a record of a case [1.231] of a young girl of great moral purity who became pregnant without the slightest knowledge of the source; although, it might be remarked, such cases must be taken "cum grano salis.'' Cases of conception without the slightest sexual desire or pleasure, either from fright, as in rape, or naturally deficient constitution, have been recorded; as well as conception during intoxication and in a hypnotic trance, which latter has recently assumed a much mooted legal aspect. As far back as 1680, *[215] Duverney speaks of conception without the slightest sense of desire or pleasure on the part of the female.
Conception with Deficient Organs.—Having spoken of conception with some obstructive interference, conception with some natural or acquired deficiency of the functional, organic, or genital apparatus must be considered. It is a well-known fact that women exhibiting rudimentary development of the uterus or vagina are still liable to become pregnant, and many such cases have been recorded; but the most peculiar cases are those in which pregnancy has appeared after removal of some of the sexual apparatus.
Pregnancy going to term with a successful delivery frequently follows the performance of ovariotomy with astonishing rapidity. Olier [1.232] cites an
Conception Soon After a Preceding Pregnancy.—Conception sometimes follows birth (or abortion) with astonishing rapidity, and some women seem for a period of their lives either always pregnant or with infants at their breasts. This prolificity is often alluded to, and is not confined to the lower classes, as often stated, but is common even among the nobility. Illustrative of this, we have examples in some of the reigning families in Europe to-day. A peculiar instance is given by Sparkman [1.242] in which a woman conceived just forty hours after abortion. Rice [1.243] mentions the case of a woman who was confined with her first child, a boy, on July 31, 1870, and was again delivered of another child on June 4, 1871. She had become pregnant twenty-eight days after delivery. He also mentions another case of a Mrs. C., who, at the age of twenty-three, gave birth to a child on September 13, 1880, and bore a second child on July 2, 1881. She must have become pregnant twenty-one days after the delivery of her first child.
Superfetation has been known for many centuries; the Romans had laws prescribing the laws of succession in such cases, and many medical writers have mentioned it. Hippocrates and Aristotle wrote of it, the former at some length. Pliny speaks of a slave who bore two infants, one resembling the master, the other a man with whom she had intercourse, and cites the case as one of superfetation. Schenck [1.244] relates instances, and Zacchias, Velchius, and Sinibaldus mention eases. Paré seemed to be well conversant with the possibility as well as the actuality of superfetation; and Harvey [1.245] reports that a certain
Marcellus Donatus, Goret, Schacher, *[717] and Mauriceau [1.246] mention superfetation. In the Académie des Sciences, at Paris, in 1702, there was mentioned the case of a woman who was delivered of a boy; in the placenta was discovered a sort of bladder which was found to contain a female fetus of the age of from four to five months; and in 1729, before the same society, there was an instance in which two fetuses were born a day apart, one aged forty days and the other at full term. From the description, it does not seem possible that either of these were blighted twin pregnancies. Ruysch [1.247] gives an account of a surgeon's wife at Amsterdam, in 1686, who was delivered of a strong child which survived, and, six hours after, of a small embryo, the funis of which was full of hydatids and the placenta as large and thick as one of three months. Ruysch accompanies his description with an illustrative figure. At Lyons, in 1782, Benoite Franquet was unexpectedly delivered of a child seven months old; three weeks later she experienced symptoms indicative of the existence of another fetus, and after five months and sixteen days she was delivered of a remarkably strong and healthy child.
Baudeloque [1.248] speaks of a case of superfetation observed by Desgranges in Lyons in 1780. After the birth of the first infant the lochia failed to flow, no milk appeared in the breasts, and the belly remained large. In about three weeks after the accouchement she had connection with her husband, and in a few days felt fetal movements. A second child was born at term, sixty-eight days after the first; and in 1782 both children were living. A woman of Arles [1.249] was delivered on November 11, 1796, of a child at term; she had connection with her husband four days after; the lochia stopped, and the milk did not flow after this intercourse. About one and a half months after this she felt quickening again, and naturally supposed that she had become impregnated by the first intercourse after confinement; but five months after the first accouchement she was delivered of another child at term, the result of a superfetation. Milk in abundance made its appearance, and she was amply able to nourish both children from the breasts. Lachausse [1.250] speaks of a woman of thirty who bore one child on April 30, 1748, and another on September 16th in the same year. Her breasts were full enough to nourish both of the children. It might be remarked in comment on this case that, according to a French authority, the woman died in 1755, and on dissection was found to have had a double uterus.
A peculiar instance of superfetation was reported by Langmore [1.251] in which there was an abortion of a fetus between the third and fourth months, apparently dead some time, and thirteen hours later a second fetus; an ovum of about four weeks and of perfect formation was found adherent near the fundus. Tyler Smith [1.252] mentions a lady pregnant for the first time who miscarried at five months and some time afterward discharged a small clot containing a perfectly fresh and healthy ovum of about four weeks' formation. There was no sign of a double uterus, and the patient menstruated regularly during pregnancy, being unwell three weeks before the abortion. Harley and Tanner [1.253] speak of a woman of thirty-eight who never had borne twins, and who aborted a fetus of four months' gestation; serious hemorrhage accompanied the removal of the placenta, and on placing the hand in the uterine cavity an embryo of five or six weeks was found inclosed in a sac and floating in clear liquor amnii. The patient was the mother of nine children, the youngest of which was three years old.
Young [1.254] speaks of a woman who three months previously had aborted a three months' fetus, but a tumor still remained in the abdomen, the auscultation of which gave evidence of a fetal heart-beat. Vaginal examination revealed a dilatation of the os uteri of at least one inch and a fetal head pressing out; subsequently a living fetus of about six months of age was delivered. Severe hemorrhage complicated the case, but was controlled, and convalescence speedily ensued. Huse [1.255] cites an instance of a mother bearing a boy on November 4, 1834, and a girl on August 3, 1835. At birth the boy looked premature, about seven months old, which being the case, the girl must have been either a superfetation or a seven months' child also. Van Bibber of Baltimore says he met a young lady who was born five months after her sister, and who was still living.
The most curious and convincing examples of superfetation are those in which children of different colors, either twins or near the same age, are born to the same woman,—similar to that exemplified in the case of the mare who was covered first by a stallion and a quarter of an hour later by an ass, and gave birth at one parturition to a horse and a mule. [1.256] Parsons [1.257] speaks of a case at Charleston, S. C., in 1714, of a white woman who gave birth to twins, one a mulatto and the other white. She confessed that after her husband left her a negro servant came to her and forced her to comply with his wishes by threatening her life. Smellie mentions the case of a black woman who had twins, one child black and the other almost white. She confessed having had intercourse with a white overseer immediately after her husband left her bed. Dewees [1.258] reports a similar case. Newlin of Nashville [1.259] speaks of a negress who bore twins, one distinctly black with the
Archer [1.260] gives facts illustrating and observations showing: "that a white woman, by intercourse with a white man and negro, may conceive twins, one of which shall be white and the other a mulatto; and that, vice versa, a black woman, by intercourse with a negro and a white man, may conceive twins, one of which shall be a negro and the other a mulatto.'' Wight [1.261] narrates that he was called to see a woman, the wife of an East Indian laborer on the Isle of Trinidad, who had been delivered of a fetus 6 inches long, about four months old, and having a cord of about 18 inches in length. He removed the placenta, and in about half an hour the woman was delivered of a full-term white female child. The first child was dark, like the mother and father, and the mother denied any possibility of its being a white man's child; but this was only natural on her part, as East Indian husbands are so intensely jealous that they would even kill an unfaithful wife. Both the mother and the mysterious white baby are doing well. Bouillon [1.262] speaks of a negress in Guadeloupe who bore twins, one a negro and the other a mulatto. She had sexual congress with both a negro and a white man.
Delmas, [1.263] a surgeon of Rouen, tells of a woman of thirty-six who was delivered in the hospital of his city on February 26, 1806, of two children, one black and the other a mulatto. She had been pregnant eight months, and had had intercourse with a negro twice about her fourth month of pregnancy, though living with the white man who first impregnated her. Two placentæ were expelled some time after the twins, and showed a membranous junction. The children died shortly after birth.
Pregnancy often takes place in a unicorn or bicorn uterus, leading to similar anomalous conditions. Galle, Hoffman, Massen, and Sanger give interesting accounts of this occurrence, and Ross [1.264] relates an instance of triple pregnancy in a double uterus. Cleveland [1.265] describes a discharge of an anomalous deciduous membrane during pregnancy which was probably from the unimpregnated half of a double uterus.
An editorial article in the Indian Medical Gazette of Sept., 1890, says:—
"The appearance of menstruation is held by the great majority of natives of India to be evidence and proof of marriageability, but among the Hindu community it is considered disgraceful that a girl should remain unmarried until this function is established. The consequence is that girls are married at the age of nine or ten years, but it is understood or professed that the consummation of the marriage is delayed until after the first menstrual period. There is, however, too much reason to believe that the earlier ceremony is very frequently, perhaps commonly, taken to warrant resort to sexual intercourse before the menstrual flux has occurred: it may be accepted as true that premenstrual copulation is largely practised under the cover of marriage in this country.
"From this practice it results that girls become mothers at the earliest possible period of their lives. A native medical witness testified that in about 20 per cent. of marriages children were born by wives of from twelve to thirteen years of age. Cases of death caused by the first act of sexual intercourse are by no means rare. They are naturally concealed, but ever and anon they come to light. Dr. Chevers mentioned some 14 cases of this sort in the last edition of his `Handbook of Medical Jurisprudence for India,' and Dr. Harvey found 5 in the medicolegal returns submitted by the Civil Surgeons of the Bengal Presidency daring the years 1870-71-72.
"Reform must come from conviction and effort, as in every other case, but meantime the strong arm of the law should be put forth for the protection of female children from the degradation and hurt entailed by premature sexual intercourse. This can easily be done by raising the age of punishable intercourse, which is now fixed at the absurd limit of ten years. Menstruation very seldom appears in native girls before the completed age of twelve years, and if the `age of consent' were raised to that limit, it would not interfere with the prejudices and customs which insist on marriage before menstruation.''
The following extraordinary incident of accidental impregnation, quoted from the American Medical Weekly [1.228a] by the Lancet, [1.228b] is given in brief, not because it bears any semblance of possibility, but as a curious example from the realms of imagination in medicine.
L. G. Capers of Vicksburg, Miss., relates an incident during the late Civil War, as follows: A matron and her two daughters, aged fifteen and seventeen years, filled with the enthusiasm of patriotism, stood ready to minister to the wounds of their countrymen in their fine residence near the scene of the battle of R—, May 12, 1863, between a portion of Grant's army and some Confederates. During the fray a gallant and noble young friend of the narrator staggered and fell to the earth; at the same time a piercing cry was heard in the house near by. Examination of the wounded soldier showed that a bullet had passed through the scrotum and carried away the left testicle. The same bullet had apparently penetrated the left side of the abdomen of the elder young lady, midway between the umbilicus and the anterior superior spinous process of the ilium, and had become lost in the abdomen. This daughter suffered an attack of peritonitis, but recovered in two mouths under the treatment administered.
Marvelous to relate, just two hundred and seventy-eight days after the reception of the minie-ball, she was delivered of a fine boy, weighing 8 pounds, to the surprise of herself and the mortification of her parents and friends. The hymen was intact, and the young mother strenuously insisted on her virginity and innocence. About three weeks after this remarkable birth Dr. Capers was called to see the infant, and the grandmother insisted that there was something wrong with the child's genitals. Examination showed a rough, swollen, and sensitive scrotum, containing some hard substance. He operated, and extracted a smashed and battered minieball. The doctor, after some meditation, theorized in this manner: He concluded that this was the same ball that had carried away the testicle of his young friend, that had penetrated the ovary of the young lady, and, with some spermatozoa upon it, had impregnated her. With this conviction he approached the young man and told him the circumstances; the soldier appeared skeptical at first, but consented to visit the young mother; a friendship ensued which soon ripened into a happy marriage, and the pair had three children, none resembling, in the same degree as the first, the heroic pater familias.
| ANOMALIES AND
CURIOSITIES OF MEDICINE.
CHAPTER I.
GENETIC ANOMALIES. Anomalies and Curiosities of Medicine | |