anomalies and curiosities of medicine-第171部分

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of　perivesical　abscess　were　present；　and　seventeen　days　after　the　operation；　and　fifty　days　after　the　introduction　of　the　pencil；　the　patient　died。　Caudmont　mentions　a　man　of　twenty…six　who　introduced　a　pencil…case　into　his　urethra；　from　whence　it　passed　into　his　bladder。　It　rested　about　four　years　in　this　organ　before　violent　symptoms　developed。　Perforation　of　the　bladder　took　place；　and　the　patient　died。　Poulet　mentions　the　case　of　a　man　of　seventy…eight；　in　whose　bladder　a　metallic　sound　was　broken　off。　The　fractured　piece　of　sound；　which　measured　17　cm。　in　length；　made　its　exit　from　the　anus；　and　the　patient　recovered。　Wheeler　reports　the　case　of　a　man　of　twenty…one　who　passed　a　button…hook　into　his　anus；　from　whence　it　escaped　into　his　bladder。　The　hook；　which　was　subsequently　spontaneously　passed；　measured　2　1/2　inches　in　length　and　1/2　inch　in　diameter。

Among　females；　whose　urethrae　are　short　and　dilatable；　foreign　bodies　are　often　found　in　the　bladder；　and　it　is　quite　common　for　smaller　articles　of　the　toilet；　such　as　hair…pins；　to　be　introduced　into　the　bladder；　and　there　form　calculi。　Whiteside　describes　a　case　in　which　a　foreign　body　introduced　into　the　bladder　was　mistaken　for　pregnancy；　and　giving　rise　to　corresponding　symptoms。　The　patient　was　a　young　girl　of　seventeen　who　had　several　times　missed　her　menstruation；　and　who　was　considered　pregnant。　The　abdomen　was　more　developed　than　usual　in　a　young　woman。　The　breasts　were　voluminous；　and　the　nipples　surrounded　by　a　somber　areola。　At　certain　periods　after　the　cessation　of　menstruation；　she　had　incontinence　of　urine；　and　had　also　repeatedly　vomited。　The　urine　was　of　high　specific　gravity；　albuminous；　alkaline；　and　exhaled　a　disagreeable　odor。　In　spite　of　the　signs　of　pregnancy　already　noted；　palpitation　and　percussion　did　not　show　any　augmentation　in　the　size　of　the　uterus；　but　the　introduction　of　a　catheter　into　the　bladder　showed　the　existence　of　a　large　calculus。　Under　chloroform　the　calculus　and　its　nucleus　were　disengaged；　and　proved　to　be　the　handle　of　a　tooth…brush；　the　exact　size　of　which　is　represented　in　the　accompanying　illustration。　The　handle　was　covered　with　calcareous　deposits；　and　was　tightly　fixed　in　the　bladder。　At　first　the　young　woman　would　give　no　explanation　for　its　presence；　but　afterward　explained　that　she　had　several　times　used　this　instrument　for　relief　in　retention　of　urine；　and　one　day　it　had　fallen　into　the　bladder。　A　short　time　after　the　operation　menstruation　returned　for　the　first　time　in　seven　months；　and　was　afterward　normal。　Bigelow　reports　the　case　of　a　woman　who　habitually　introduced　hair…pins　and　common　pins　into　her　bladder。　She　acquired　this　mania　after　an　attempt　at　dilatation　of　the　urethra　in　the　relief　of　an　obstinate　case　of　strangury。　Rode　reports　the　case　of　a　woman　who　had　introduced　a　hog's　penis　into　her　urethra。　It　was　removed　by　an　incision　into　this　canal；　but　the　patient　died　in　five　days　of　septicemia。　There　is　a　curious　case　quoted　of　a　young　domestic　of　fourteen　who　was　first　seen　suffering　with　pain　in　the　sides　of　the　genital　organs；　retention　of　urine；　and　violent　tenesmus。　She　was　examined　by　a　midwife　who　found　nothing；　but　on　the　following　day　the　patient　felt　it　necessary　to　go　to　bed。　Her　general　symptoms　persisted；　and　meanwhile　the　bladder　became　much　distended。　The　patient　had　made　allusion　to　the　loss　of　a　hair…pin；　a　circumstance　which　corresponded　with　the　beginning　of　her　trouble。　Examination　showed　the　orifice　of　the　urethra　to　be　swollen　and　painful　to　the　touch；　and　from　its　canal　a　hair…pin　6。5　cm。　long　was　extracted。　The　patient　was　unable　to　urinate；　and　it　was　necessary　to　resort　to　catheterization。　By　evening　the　general　symptoms　had　disappeared；　and　the　next　day　the　patient　urinated　as　usual。

There　are　peculiar　cases　of　hair　in　the　bladder；　in　which　all　history　as　to　the　method　of　entrance　is　denied；　and　which　leave　as　the　only　explanation　the　possibility　that　the　bladder　was　in　communication　with　some　dermoid　cyst。　Hamelin　mentions　a　case　of　this　nature。　It　is　said　that　all　his　life　Sir　William　Elliot　was　annoyed　by　passing　hairs　in　urination。　They　would　lodge　in　the　urethra　and　cause　constant　irritation。　At　his　death　a　stone　was　taken　from　the　bladder；　covered　with　scurf　and　hair。　Hall　relates　the　case　of　a　woman　of　sixty；　from　whose　bladder；　by　dilatation　of　the　urethra；　was　removed　a　bundle　of　hairs　two　inches　long；　which；　Hall　says；　without　a　doubt　had　grown　from　the　vesical　walls。

Retention　of　Foreign　Bodies　in　the　Pelvis。It　is　a　peculiar　fact　that　foreign　bodies　which　once　gain　entrance　to　the　pelvis　may　be　tolerated　in　this　location　for　many　years。　Baxter　describes　a　man　who　suffered　an　injury　from　a　piece　of　white　board　which　entered　his　pelvis；　and　remained　in　position　for　sixteen　and　a　half　years；　at　this　time　a　piece　of　wood　7　1/2　inches　long　was　discharged　at　stool；　and　the　patient　recovered。　Jones　speaks　of　a　case　in　which　splinters　of　wood　were　retained　in　the　neighborhood　of　the　rectum　and　vagina　for　sixteen　years；　and　spontaneously　discharged。　Barwell　mentions　a　case　in　which　a　gum　elastic　catheter　that　had　been　passed　into　the　vagina　for　the　purpose　of　producing　abortion　became　impacted　in　the　pelvis　for　twenty　months；　and　was　then　removed。

Rupture　of　the　Male　Urethra。The　male　urethra　is　occasionally　ruptured　in　violent　coitus。　Frank　and　the　Philosophical　Transactions　are　among　the　older　authorities　mentioning　this　accident。　In　Frank's　case　there　was　hemorrhage　from　the　penis　to　the　extent　of　five　pounds。　Colles　mentions　a　man　of　thirty…eight；　prone　to　obesity；　and　who　had　been　married　two　months；　who　said　that　in　sexual　congress　he　had　hurt　himself　by　pushing　his　penis　against　the　pubic　bone；　and　added　that　he　had　a　pain　that　felt　as　though　something　had　broken　in　his　organ。　The　integuments　of　the　penis　became　livid　and　swollen　and　were　extremely　painful。　His　urine　had　to　be　drawn　by　a　catheter；　and　by　the　fifth　day　his　condition　was　so　bad　that　an　incision　was　made　into　the　tumor；　and　pus；　blood；　urine；　and　air　issued。　The　patient　suffered　intense　rigors；　his　abdomen　became　tympanitic；　and　he　died。　Postmortem　examination　revealed　the　presence　of　a　ruptured　urethra。

Watson　relates　an　instance　of　coitus　performed　en　postillon　by　a　man　while　drunk；　with　rupture　of　the　urethra　and　fracture　of　the　corpus　spongiosum　only。　Loughlin　mentions　a　rupture　of　the　corpus　spongiosum　during　coitus。　Frank　cites　a　curious　case　of　hemorrhage　from　a　fall　while　the　penis　was　erect。　It　is　not　unusual　to　find　ruptured　urethrae　following　traumatism；　and　various　explanations　are　given　for　it　in　the　standard　works　on　surgery。

Fracture　of　the　Penis。A　peculiar　accident　to　the　penis　is　fracture；　which　sometimes　occurs　in　coitus。　This　accident　consists　in　the　laceration　of　the　corpora　cavernosa；　followed　by　extensive　extravasation　of　blood　into　the　erectile　tissue。　It　has　also　occurred　from　injury　inflicted　accidentally　or　maliciously；　but　always　happening　when　the　organ　was　erect。　An　annoying　sequel　following　this　accident　is　the　tendency　to　curvature　in　erection；　which　is　sometimes　so　marked　as　to　interfere　with　coitus；　and　even　render　the　patient　permanently　impotent。

There　is　an　account　of　a　laborer　of　twenty…seven　who；　in　attempting　to　micturate　with　his　penis　erect；　pressed　it　downward　with　considerable　force　and　fractured　the　corpora　cavernosa。　Veazie　relates　a　case　of　fracture　of　the　corpora　cavernosa　occurring　in　coitus。　During　the　act　the　female　suddenly　withdrew；　and　the　male；　following；　violently　struck　the　pubes；　with　the　resultant　injury。　Recovery　ensued。　M'Clellan　speaks　of　removing　the　cavernous　septum　from　a　man　of　fifty…two；　in　whom　this　part　had　become　infiltrated　with　lime…salts　and　resembled　a　long；　narrow　bone。　When　the　penis　was　erect　it　was　bent　in　the　form　of　a　semicircular　bow。

The　Transactions　of　the　South　Carolina　Medical　Association　contain　an　account　of　a　negro　of　sixty　who　had　urethral　stricture　from　gonorrhea　and　who　had　been　treated　for　fifteen　years　by　caustics。　The　penis　was　seven　inches　in　circumference　around　the　glans；　and　but　little　less　near　the　scrotum。　The　glans　was　riddled　with　holes；　and　numerous　fistulae　existed　on　the　inferior　surface　of　the　urethra；　the　meatus　being　impermeable。　So　great　was　the　weight　and　hypertrophy　that　amputation　was　necessary。　John　Hunter　speaks　of　six　strictures　existing　in　one　urethra　at　one　time；　Lallemand　of　seven；　Bolot　of　eight；　Ducamp　of　five；　Boyer　thought　three　could　never　exist　together；　Leroy　D'Etoilles　found　11；　and　Rokitansky　met　with　four。

Sundry　Injuries　to　the　Penis。Fabricius　Hildanus　mentions　a　curious　case　of　paraphimosis　caused　by　violent　coitus　with　a　virgin　who　had　an　extremely　narrow　vagina。　Joyce　relates　a　history　of　a　stout　man　who　awoke　with　a　vigorous　erection；　and　feeling　much　irritation；　he　scratched　himself　violently。　He　soon　bled　copiously；　his　shirt　and　underlying　sheets　and　blankets　being　soaked　through。　On　examination　the　penis　was　found　swollen；　and　on　drawing　back　the　foreskin　a　small　jet　of　blood　spurted　from　a　small　rupture　in　the　frenum。　The　authors　have　knowledge　of　a　case　in　which　hemorrhage　from　the　frenum　proved　fatal。　The　patient；　in　a　drunken　wager；　attempted　to　circumcise　himself　with　a　piece　of　tin；　and　bled　to　death　before　medical　aid　could　be　summoned。　It　sometimes　happens　that　the　virile　member　is　amputated　by　an　animal　bite。　Paullini　and　Celliez　mention　amputation　of　the　penis　by　a　dog…bite。　Morgan　describes　a　boy　of　thirteen　who　was　feeding　a　donkey　which　suddenly　made　a　snap　at　him；　unfortunately　catching　him　by　the　trousers　and　including　the　penis　in　one　of　the　folds。　By　the　violence　of　the　bite　the　boy　was　thrown　to　the　ground；　and　his　entire　prepuce　was　stripped　off　to　the　root　as　if　it　had　been　done　by　a　knife。　There　was　little　hemorrhage；　and　the　prepuce　was　found　in　the　trousers；　looking　exactly　like　the　finger　of　a　glove。　Morgan　stated　that　this　was　the　third　case　of　the　kind　of　which　he　had　knowledge。　Bookey　records　a　case　in　which　an　artilleryman　was　seized　by　the　penis　by　an　infuriated　horse；　and　the　two　crura　were　pulled　out　entire。

Amputation　of　the　penis　is　not　always　followed　by　loss　of　the　sexual　power　and　instinct；　but　sometimes　has　the　mental　ef