anomalies and curiosities of medicine-第163部分

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Intestinal　anastomosis；　whereby　two　portions　of　a　severed　or　resected　bowel　can　be　intimately　joined；　excluding　from　fecal　circulation　the　portion　of　bowel　which　has　become　obstructed；　was　originally　suggested　by　Maisonneuve；　and　was　studied　experimentally　by　von　Hacken。　Billroth　resorted　to　it；　and　Senn　modified　it　by　substituting　decalcified　bone…plates　for　sutures。　Since　that　time；　Abbe；　Matas；　Davis；　Brokaw；　Robinson；　Stamm；　Baracz；　and　Dawburn；　have　modified　the　material　of　the　plates　used；　substituting　catgut　rings；　untanned　leather；　cartilage；　raw　turnips；　potatoes；　etc。　Recently　Murphy　of　Chicago　has　invented　a　button；　which　has　been　extensively　used　all　over　the　world；　in　place　of　sutures　and　rings；　as　a　means　of　anastomosis。　Hardly　any　subject　has　had　more　discussion　in　recent　literature　than　the　merits　of　this　ingenious　contrivance。

Foreign　Bodies　in　the　Rectum。Probably　the　most　celebrated　case　of　foreign　body　introduced　into　the　rectum　is　the　classic　one　mentioned　by　Hevin。　Some　students　introduced　the　frozen　tail　of　a　pig　in　the　anus　of　a　French　prostitute。　The　bristles　were　cut　short；　and　having　prepared　the　passage　with　oil；　they　introduced　the　tail　with　great　force　into　the　rectum；　allowing　a　portion　to　protrude。　Great　pain　and　violent　symptoms　followed；　there　was　distressing　vomiting；　obstinate　constipation；　and　fever。　Despite　the　efforts　to　withdraw　the　tail；　the　arrangement　of　the　bristles　which　allowed　entrance；　prevented　removal。　On　the　sixth　day；　in　great　agony；　the　woman　applied　to　Marchettis；　who　ingeniously　adopted　the　simple　procedure　of　taking　a　long　hollow　reed；　and　preparing　one　of　its　extremities　so　that　it　could　be　introduced　into　the　rectum；　he　was　enabled　to　pass　the　reed　entirely　around　the　tail　and　to　withdraw　both。　Relief　was　prompt；　and　the　removal　of　the　foreign　body　was　followed　by　the　issue　of　stercoraceous　matter　which　had　accumulated　the　six　days　it　had　remained　in　situ。

Tuffet　is　quoted　as　mentioning　a　farmer　of　forty…six　who；　in　masturbation；　introduced　a　barley…head　into　his　urethra。　It　was　found　necessary　to　cut　the　foreign　body　out　of　the　side　of　the　glans。　A　year　later　he　put　in　his　anus　a　cylindric　snuff…box　of　large　size；　and　this　had　to　be　removed　by　surgical　methods。　Finally；　a　drinking　goblet　was　used；　but　this　resulted　in　death；　after　much　suffering　and　lay　treatment。　In　his　memoirs　of　the　old　Academy　of　Surgery　in　Paris；　Morand　speaks　of　a　monk　who；　to　cure　a　violent　colic；　introduced　into　his　fundament　a　bottle　of　l'eau　de　la　reine　de　Hongrie；　with　a　small　opening　in　its　mouth；　by　which　the　contents；　drop　by　drop；　could　enter　the　intestine。　He　found　he　could　not　remove　the　bottle；　and　violent　inflammation　ensued。　It　was　at　last　necessary　to　secure　a　boy　with　a　small　hand　to　extract　the　bottle。　There　is　a　record　of　a　case　in　which　a　tin　cup　or　tumbler　was　pushed　up　the　rectum　and　then　passed　into　the　colon　where　it　caused　gangrene　and　death。　It　was　found　to　measure　3　1/2　by　3　1/2　by　two　inches。　There　is　a　French　case　in　which　a　preserve…pot　three　inches　in　diameter　was　introduced　into　the　rectum；　and　had　to　be　broken　and　extracted　piece　by　piece。

Cloquet　had　a　patient　who　put　into　his　rectum　a　beer　glass　and　a　preserving　pot。　Montanari　removed　from　the　rectum　of　a　man　a　mortar　pestle　30　cm。　long；　and　Poulet　mentions　a　pederast　who　accidentally　killed　himself　by　introducing　a　similar　instrument；　55　cm。　long；　which　perforated　his　intestine。　Studsgaard　mentions　that　in　the　pathologic　collection　at　Copenhagen　there　is　a　long；　smooth　stone；　17　cm。　long；　weighing　900　gm。；　which　a　peasant　had　introduced　into　his　rectum　to　relieve　prolapsus。　The　stone　was　extracted　in　1756　by　a　surgeon　named　Frantz　Dyhr。　Jeffreys　speaks　of　a　person　who；　to　stop　diarrhea；　introduced　into　his　rectum　a　piece　of　wood　measuring　seven　inches。

There　is　a　remarkable　case　recorded　of　a　stick　in　the　anus　of　a　man　of　sixty；　the　superior　extremity　in　the　right　hypochondrium；　the　inferior　in　the　concavity　of　the　sacrum。　The　stick　measured　32　cm。　in　length；　the　man　recovered。　It　is　impossible　to　comprehend　this　extent　of　straightening　of　the　intestine　without　great　twisting　of　the　mesocolon。　Tompsett　mentions　that　he　was　called　to　see　a　workman　of　sixty…five；　suffering　from　extreme　rectal　hemorrhage。　He　found　the　man　very　feeble；　without　pulse；　pale；　and　livid。　By　digital　examination　he　found　a　hard　body　in　the　rectum；　which　he　was　sure　was　not　feces。　This　body　he　removed　with　a　polyp…forceps；　and　found　it　to　be　a　cylindric　candle…box；　which　measured　six　inches　in　circumference；　2　1/2　in　length；　and　1　1/2　in　diameter。　The　removal　was　followed　by　a　veritable　flood　of　fecal　material；　and　the　man　recovered。　Lane　reports　perforation　of　the　rectum　by　the　introduction　of　two　large　pieces　of　soap；　there　was　coincident　strangulated　hernia。

Hunter　mentions　a　native　Indian；　a　resident　of　Coorla；　who　had　introduced　a　bullock's　horn　high　up　into　his　abdomen；　which　neither　he　nor　his　friends　could　extract。　He　was　chloroformed　and　placed　in　the　lithotomy　position；　his　buttocks　brought　to　the　edge　of　the　bed；　and　after　dilatation　of　the　sphincter；　by　traction　with　the　fingers　and　tooth…forceps；　the　horn　was　extracted。　It　measured　11　inches　long。　The　young　imbecile　had　picked　it　up　on　the　road；　where　it　had　been　rendered　extremely　rough　by　exposure；　and　this　caused　the　difficulty　in　extraction。

In　Nelson's　Northern　Lancet；　1852；　there　is　the　record　of　a　case　of　a　man　at　stool；　who　slipped　on　a　cow's　horn；　which　entered　the　rectum　and　lodged　beyond　the　sphincter。　It　was　only　removed　with　great　difficulty。

A　convict　at　Brest　put　up　his　rectum　a　box　of　tools。　Symptoms　of　vomiting；　meteorism；　etc。；　began；　and　became　more　violent　until　the　seventh　day；　when　he　died。　After　death；　there　was　found　in　the　transverse　colon；　a　cylindric　or　conic　box；　made　of　sheet　iron；　covered　with　skin　to　protect　the　rectum　and；　doubtless；　to　aid　expulsion。　It　was　six　inches　long　and　five　inches　broad　and　weighed　22　ounces。　It　contained　a　piece　of　gunbarrel　four　inches　long；　a　mother…screw　steel；　a　screw…driver；　a　saw　of　steel　for　cutting　wood　four　inches　long；　another　saw　for　cutting　metal；　a　boring　syringe；　a　prismatic　file；　a　half…franc　piece　and　four　one…franc　pieces　tied　together　with　thread；　a　piece　of　thread；　and　a　piece　of　tallow；　the　latter　presumably　for　greasing　the　instruments。　On　investigation　it　was　found　that　these　conic　cases　were　of　common　use；　and　were　always　thrust　up　the　rectum　base　first。　In　excitement　this　prisoner　had　pushed　the　conic　end　up　first；　thus　rendering　expulsion　almost　impossible。　Ogle　gives　an　interesting　case　of　foreign　body　in　the　rectum　of　a　boy　of　seventeen。　The　boy　was　supposed　to　be　suffering　with　an　abdominal　tumor　about　the　size　of　a　pigeon's　egg　under　the　right　cartilages；　it　had　been　noticed　four　months　before。　On　admission　to　the　hospital　the　lad　was　suffering　with　pain　and　jaundice；　sixteen　days　later　he　passed　a　stick　ten　inches　long；　which　he　reluctantly　confessed　that　he　had　introduced　into　the　anus。　During　all　his　treatment　he　was　conscious　of　the　nature　of　his　trouble；　but　he　suffered　rather　than　confess。　Studsgaard　mentions　a　man　of　thirty…five　who；　for　the　purpose　of　stopping　diarrhea；　introduced　into　his　rectum　a　preserve…bottle　nearly　seven　inches　long　with　the　open　end　uppermost。　The　next　morning　he　had　violent　pain　in　the　abdomen；　and　the　bottle　could　be　felt　through　the　abdominal　wall。　It　was　necessary　to　perform　abdominal　section　through　the　linea　alba；　divide　the　sigmoid　flexure；　and　thus　remove　the　bottle。　The　intestine　was　sutured　and　the　patient　recovered。　The　bottle　measured　17　cm。　long；　five　cm。　in　diameter　at　its　lower　end；　and　three　cm。　at　its　upper　end。

Briggs　reports　a　case　in　which　a　wine　glass　was　introduced　into　the　rectum；　and　although　removed　twenty…four　hours　afterward；　death　ensued。　Hockenhull　extracted　402　stones　from　the　rectum　of　a　boy　of　seven。　Landerer　speaks　of　a　curious　case　in　which　the　absorptive　power　of　the　rectum　was　utilized　in　the　murder　of　a　boy　of　fifteen。　In　order　to　come　into　the　possession　of　a　large　inheritance　the　murderess　poisoned　the　boy　by　introducing　the　ends　of　some　phosphorous　matches　into　his　rectum；　causing　death　that　night；　there　was　intense　inflammation　of　the　rectum。　The　woman　was　speedily　apprehended；　and　committed　suicide　when　her　crime　was　known。

Complete　transfixion　of　the　abdomen　does　not　always　have　a　fatal　issue。　In　fact；　two　older　writers；　Wisemann　and　Muys；　testify　that　it　is　quite　possible　for　a　person　to　be　transfixed　without　having　any　portion　of　the　intestines　or　viscera　wounded。　In　some　nations　in　olden　times；　the　extremest　degree　of　punishment　was　transfixion　by　a　stake。　In　his　voyages　and　travels；　in　describing　the　death　of　the　King　of　Demaa　at　the　hands　of　his　page；　Mendez　Pinto　says　that　instead　of　being　reserved　for　torture；　as　were　his　successors　Ravaillac；　and　Gerard；　the　slayer　of　William　the　Silent；　the　assassin　was　impaled　alive　with　a　long　stake　which　was　thrust　in　at　his　fundament　and　came　out　at　the　nape　of　his　neck。　There　is　a　record　of　a　man　of　twenty…five；　a　soldier　in　the　Chinese　war　of　1860；　who；　in　falling　from　his　horse；　was　accidentally　transfixed　by　a　bayonet。　The　steel　entered　his　back　two　inches　to　the　left　of　the　last　dorsal　vertebra；　and　reappeared　two　inches　to　the　left　and　below　the　umbilicus；　as　there　was　no　symptom　of　visceral　wound　there　were　apparently　no　injuries　except　perforation　of　the　parietes　and　the　peritoneum。　The　man　recovered　promptly。

Ross　reports　a　case　of　transfixion　in　a　young　male　aborigine；　a　native　of　New　South　Wales；　who　had　received　a　spear…wound　in　the　epigastrium　during　a　quarrel；　extraction　was　impossible　because　of　the　sharp…pointed　barbs；　the　spear　was；　therefore；　sawed　off；　and　was　removed　posteriorly　by　means　of　a　small　incision。　The　edges　of　the　wound　were　cleansed；　stitched；　and　a　compress　and　bandage　applied。　During　the　night　the　patient　escaped　and　joined　his　comrades　in　the　camp；　and　on　the　second　day　was　suffering　with　radiating　pains　and　distention。　The　following　day　it　was　found　that　the　stitches　and　plaster　had　been　removed；　and　the　anterior　wound　was　gaping　and　contained　an　ichorous　discharge。　The　patient　was　bathing　the　wound　with　a　decoction　of　t