anomalies and curiosities of medicine-第174部分

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patient　stated　that　since　the　removal　of　the　second　gland　he　had　regular　sexual　desire　and　coitus；　apparently　not　differing　from　that　in　which　he　indulged　before　castration。　For　a　few　months　previous　to　the　time　of　report　the　cord　on　the　left　side；　which　had　not　been　completely　extirpated；　became　extremely　painful　and　was　also　removed。

Atrophy　of　the　testicle　may　follow　venereal　excess；　and　according　to　Larrey；　deep　wounds　of　the　neck　may　produce　the　same　result；　with　the　loss　of　the　features　of　virility。　Guthrie　mentions　a　case　of　spontaneous　absorption　of　the　testicle。　According　to　Larrey；　on　the　return　of　the　French　Army　from　the　Egyptian　expedition　the　soldiers　complained　of　atrophy　and　disappearance　of　the　testicle；　without　any　venereal　affection。　The　testicle　would　lose　its　sensibility；　become　soft；　and　gradually　diminish　in　size。　One　testicle　at　a　time　was　attacked；　and　when　both　were　involved　the　patient　was　deprived　of　the　power　of　procreation；　of　which　he　was　apprised　by　the　lack　of　desire　and　laxity　of　the　penis。　In　this　peculiar　condition　the　general　health　seemed　to　fail；　and　the　subjects　occasionally　became　mentally　deranged。　Atrophy　of　the　testicles　has　been　known　to　follow　an　attack　of　mumps。

In　his　description　of　the　diseases　of　Barbadoes　Hendy　mentions　several　peculiar　cases　under　his　observation　in　which　the　scrotum　sloughed；　leaving　the　testicles　denuded。　Alix　and　Richter　mention　a　singular　modification　of　rheumatic　inflammation　of　the　testicle；　in　which　the　affection　flitted　from　one　testicle　to　the　other；　and　alternated　with　rheumatic　pains　elsewhere。

There　is　a　case　of　retraction　of　the　testicle　reported　in　a　young　soldier　of　twenty…one　who；　when　first　seen；　complained　of　a　swelling　in　the　right　groin。　He　stated　that　while　riding　bareback　his　horse　suddenly　plunged　and　threw　him　on　the　withers。　He　at　once　felt　a　sickening　pain　in　the　groin　and　became　so　ill　that　he　had　to　dismount。　On　inspection　an　oval　tumor　was　seen　in　the　groin；　tender　to　the　touch　and　showing　no　impulse　on　coughing。　The　left　testicle　was　in　its　usual　position；　but　the　right　was　absent。　The　patient　stated　positively　that　both　testicles　were　in　situ　before　the　accident。　An　attempt　at　reduction　was　made；　but　the　pain　was　so　severe　that　manipulation　could　not　be　endured。　A　warm　bath　and　laudanum　were　ordered；　but　unfortunately；　as　the　patient　at　stool　gave　a　sudden　bend　to　the　left；　his　testicle　slipped　up　into　the　abdomen　and　was　completely　lost　to　palpation。　Orchitis　threatened；　but　the　symptoms　subsided；　the　patient　was　kept　under　observation　for　some　weeks；　and　then　as　a　tentative　measure；　discharged　to　duty。　Shortly　afterward　he　returned；　saying　that　he　was　ill；　and　that　while　lifting　a　sack　of　corn　his　testicle　came　partly　down；　causing　him　great　pain。　At　the　time　of　report　his　left　testicle　was　in　position；　but　the　right　could　not　be　felt。　The　scrotum　on　that　side　had　retracted　until　it　had　almost　disappeared；　the　right　external　ring　was　very　patent；　and　the　finger　could　be　passed　up　in　the　inguinal　canal；　there　was　no　impulse　on　coughing　and　no　tendency　to　hernia。

A　unique　case　of　ectopia　of　the　testicle　in　a　man　of　twenty…four　is　given　by　Popoff。　The　scrotum　was　normally　developed；　and　the　right　testicle　in　situ。　The　left　half　of　the　scrotum　was　empty；　and　at　the　root　of　the　penis　there　was　a　swelling　the　size　of　a　walnut；　covered　with　normal　skin；　and　containing　an　oval　body　about　four…fifths　the　size　of　the　testicle；　but　softer　in　constituency。　The　patient　claimed　that　this　swelling　had　been　present　since　childhood。　His　sexual　power　had　been　normal；　but　for　the　past　six　months　he　had　been　impotent。　In　childhood　the　patient　had　a　small　inguinal　hernia；　and　Popoff　thought　this　caused　the　displacement　of　the　testicle。

A　somewhat　similar　case　occurred　in　the　Hotel…Dieu；　Paris。　Through　the　agency　of　compression　one　of　the　testes　was　forced　along　the　corpus　cavernosum　under　the　skin　as　far　as　the　glans　penis。　It　was　easily　reduced；　and　at　a　subsequent　autopsy　it　was　found　that　it　had　not　been　separated　from　the　cord。　Gluiteras　a　cites　a　parallel　case　of　dislocation　of　the　testicle　into　the　penis。　It　was　the　result　of　traumatisma　fall　upon　the　wheel　of　a　cart。　It　was　reduced　under　anesthesia；　after　two　incisions　had　been　made；　the　adhesions　broken　up；　and　the　shrunken　sac　enlarged　by　stretching。

Rupture　of　the　spermatic　arteries　and　veins　has　caused　sudden　death。　Schleiser　is　accredited　with　describing　an　instance　in　which　a　healthy　man　was　engaged　in　a　fray　in　the　dark；　and；　suddenly　crying　out；　fell　into　convulsions　and　died　in　five　minutes。　On　examination　the　only　injury　found　was　the　rupture　of　both　spermatic　arteries　at　the　internal　ring；　produced　by　a　violent　pull　on　the　scrotum　and　testicles　by　one　of　his　antagonists。　Shock　was　evidently　a　strong　factor　in　this　case。　Fabricius　Hildanus　gives　a　case　of　impotency　due　to　lesions　of　the　spermatic　vessels　following　a　burn。　There　is　an　old　record　of　an　aged　man　who；　on　marrying；　found　that　he　had　erections　but　no　ejaculations。　He　died　of　ague；　and　at　the　autopsy　it　was　found　that　the　verumontanum　was　hard　and　of　the　size　of　a　walnut　and　that　the　ejaculatory　ducts　contained　calculi　about　the　size　and　shape　of　peas。

Hydrocele　is　a　condition　in　which　there　is　an　abnormal　quantity　of　fluid　in　the　tunica　vaginalis。　It　is　generally　caused　by　traumatism；　violent　muscular　efforts；　or　straining；　and　is　much　more　frequent　in　tropic　countries　than　elsewhere。　It　sometimes　attains　an　enormous　size。　Leigh　mentions　a　hydrocele　weighing　120　pounds；　and　there　are　records　of　hydroceles　weighing　40　and　60　pounds。　Larrey　speaks　of　a　sarcocele　in　the　coverings　of　the　testicle　which　weighed　100　pounds。　Mursinna　describes　a　hydrocele　which　measured　27　inches　in　its　longest　and　17　in　its　transverse　axis。

Tedford　gives　a　curious　case　of　separation　of　the　ovary　in　a　woman　of　twenty…eight。　After　suffering　from　invagination　of　the　bowel　and　inflammation　of　the　ovarian　tissue；　an　ovary　was　discharged　through　an　opening　in　the　sigmoid　flexure；　and　thence　expelled　from　the　anus。

In　discussing　injuries　of　the　vagina；　the　first　to　be　mentioned　will　be　a　remarkable　case　reported　by　Curran。　The　subject　was　an　Irish　girl　of　twenty。　While　carrying　a　bundle　of　clothes　that　prevented　her　from　seeing　objects　in　front　of　her；　she　started　to　pass　over　a　stile；　just　opposite　to　which　a　goat　was　lying。　The　woman　wore　no　underclothing；　and　in　the　ascent　her　body　was　partially　exposed；　and；　while　in　this　enforced　attitude；　the　goat；　frightened　by　her　approach；　suddenly　started　up；　and　in　so　doing　thrust　his　horn　forcibly　into　her　anus　and　about　two　or　three　inches　up　her　rectum。　The　horn　then　passed　through　the　bowel　and　its　coverings；　just　above　the　hymen；　and　was　then　withdrawn　as　she　flinched　and　fell　back。　The　resultant　wound　included　the　lower　part　of　the　vagina　and　rectum；　the　sphincter　and；　the　fourchet；　and　perineum。　Hemorrhage　was　profuse；　and　the　wound　caused　excruciating　pain。　The　subject　fainted　on　the　spot　from　hemorrhage　and　shock。　Her　modesty　forbade　her　summoning　medical　aid　for　three　days；　during　which　time　the　wound　was　undergoing　most　primitive　treatment。　After　suturing；　cicatrization　followed　without　delay。

Trompert　mentions　a　case　of　rupture　of　the　vagina　by　the　horn　of　a　bull。　There　is　a　case　recorded　in　the　Pennsylvania　Hospital　Reports　of　a　girl　of　nineteen　who　jumped　out　of　a　second…story　window。　On　reaching　the　ground；　her　foot　turned　under　her　as　she　fell。　The　high　heel　of　a　French　boot　was　driven　through　the　perineum　one　inch　from　the　median　line；　midway　between　the　anus　and　the　posterior　commissure　of　the　labia　majora。　The　wound　extended　into　the　vagina　above　the　external　opening；　in　which　the　heel；　now　separated　from　the　boot；　projected；　and　whence　it　was　removed　without　difficulty。　This　wound　was　the　only　injury　sustained　by　the　fall。

Beckett　records　a　case　of　impalement　in　a　woman　of　forty…five　who；　while　attempting　to　obtain　water　from　a　hogshead；　fell　with　one　limb　inside　the　cistern；　striking　a　projecting　stave　three　inches　wide　and　1/2　inch　thick。　The　external　labia　were　divided；　the　left　crus　of　the　clitoris　separated；　the　nymphae　lacerated；　and　the　vaginal　wall　penetrated　to　the　extent　of　five　inches；　the　patient　recovered　by　the　fourth　week。

Homans　reports　recovery　from　extensive　wounds　acquired　by　a　negress　who　fell　from　a　roof；　striking　astride　an　upright　barrel。　There　was　a　wound　of　the　perineum；　and　penetration　of　the　posterior　wall　of　the　vagina；　with　complete　separation　of　the　soft　parts　from　the　symphysis　pubis；　and　extrusion　of　the　bladder。

Howe　reports　a　case　of　impalement　with　recovery　in　a　girl　of　fifteen　who　slid　down　a　hay…stack；　striking　a　hay…hook　which　penetrated　her　perineum　and　passed　into　her　body；　emerging　two　inches　below　the　umbilicus　and　one　inch　to　the　right　of　the　median　line。

Injuries　of　the　vagina　may　be　so　extensive　as　to　allow　protrusion　of　the　intestines；　and　some　horrible　cases　of　this　nature　are　recorded。　In　The　Lancet　for　1873　there　is　reported　a　murder　or　suicide　of　this　description。　The　woman　was　found　with　a　wound　in　the　vagina；　through　which　the　intestines；　with　clean…cut　ends；　protruded。　Over　7　1/2　feet　of　the　intestines　had　been　cut　off　in　three　pieces。　The　cuts　were　all　clean　and　carefully　separated　from　the　mesentery。　The　woman　survived　her　injuries　a　whole　week；　finally　succumbing　to　loss　of　blood　and　peritonitis。　Her　husband　was　tried　for　murder；　but　was　acquitted　by　a　Glasgow　jury。　Taylor　mentions　similar　cases　of　two　women　murdered　in　Edinburgh　some　years　since；　the　wounds　having　been　produced　by　razor　slashes　in　the　vagina。　Taylor　remarks　that　this　crime　seems　to　be　quite　common　in　Scotland。　Starkey　reports　an　instance　in　which　the　body　of　an　old　colored　woman　was　found；　with　evidences　of　vomiting；　and　her　clothing　stained　with　blood　that　had　evidently　come　from　her　vagina。　A　postmortem　showed　the　abdominal　cavity　to　be　full　of　blood；　at　Douglas'　culdesac　there　was　a　tear　large　enough　to　admit　a　man's　hand；　through　which　protruded　a　portion　of　the　omentum；　this　was　at　first　taken　for　the　membranes　of　an　abortion。　There　were　distinct　signs　of　acute　peritonitis。　After　investigation　it　was　proved　that　a　drunken　glass…blow