anomalies and curiosities of medicine-第179部分

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d；　and　immediately　inquired　what　she　had　done　with　the　baby。　She　replied　that　it　was　in　a　box　on　top　of　the　cab。　When　the　box　was　opened　the　child　was　found　alive。　The　Lancet　comments　on　the　remarkable　fact　that；　shortly　after　confinement；　a　woman　can　travel　six　or　seven　hours　in　a　railroad　train；　and　her　newly…born　babe　conveyed　the　same　distance　in　a　portmanteau；　without　apparent　injury；　and　without　attracting　attention。

Booth　reports　a　remarkable　case　of　vitality　of　a　newly…born　child　which　came　under　his　observation　in　October；　1894。　An　illegitimate　child；　abandoned　by　its　mother；　was　left　at　the　bottom　of　a　cesspool　vault；　she　claimed　that　ten　hours　before　Booth's　visit　it　had　been　accidentally　dropped　during　an　attempt　to　micturate。　The　infant　lived　despite　the　following　facts：　Its　delivery　from　an　ignorant；　inexperienced；　unattended　negress；　its　cord　not　tied；　its　fall　of　12　feet　down　the　pit；　its　ten　hours'　exposure　in　the　cesspool；　its　smothering　by　foul　air；　also　by　a　heavy　covering　of　rags；　paper；　and　straw；　its　pounding　by　three　bricks　which　fell　in　directly　from　eight　feet　above　（some　loose　bricks　were　accidentally　dislodged　from　the　sides　of　the　vault；　in　the　maneuvers　to　extricate　the　infant）；　its　lowered　temperature　previous　to　the　application　of　hot　bottles；　blankets；　and　the　administration　of　cardiac　stimulants。　Booth　adds　that　the　morning　after　its　discovery　the　child　appeared　perfectly　well；　and　some　two　months　afterward　was　brought　into　court　as　evidence　in　the　case。　A　remarkable　case　of　infant　vitality　is　given　on　page　117。

Operations　in　the　Young　and　Old。It　might　be　of　interest　to　mention　that　such　a　major　operation　as　ovariotomy　has　been　successfully　performed　in　an　infant。　In　a　paper　on　infant　ovariotomy　d　several　instances　of　this　nature　are　mentioned。　Roemer　successfully　performed　ovariotomy　on　a　child　one　year　and　eight　months　old；　Swartz；　on　a　child　of　four；　Barker；　on　a　child　of　four；　Knowsley　Thornton；　on　a　child　of　seven；　and　Spencer　Wells　Cupples；　and　Chenoweth；　on　children　of　eight。　Rein　performed　ovariotomy　on　a　girl　of　six；　suffering　from　a　multilocular　cyst　of　the　left　ovary。　He　expresses　his　belief　that　childhood　and　infancy　are　favorable　to　laparotomy。

Kidd　removed　a　dermoid　from　a　child　of　two　years　and　eleven　months；　Hooks　performed　the　same　operation　on　a　child　of　thirty　months。　Chiene　extirpated　an　ovary　from　a　child　of　three；　Neville　duplicated　this　operation　in　a　child　one　month　younger；　and　Alcock　performed　ovariotomy　on　a　child　of　three。

Successful　ovariotomies　are　infrequent　in　the　extremely　aged。　Bennett　mentions　an　instance　in　a　woman　of　seventy…five；　and　Davies　records　a　similar　instance。　Borsini　and　Terrier　cite　instances　of　successful　ovariotomy　in　patients　of　seventy…seven。　Carmichael　performed　the　operation　at　seventy…four。　Owens　mentions　it　at　eighty；　and　Homans　at　eighty…two　years　and　four　months。　Dewees　records　a　successful　case　of　ovariotomy　in　a　woman　over　sixty…seven；　McNutt　reports　a　successful　instance　in　a　patient　of　sixty…seven　years　and　six　months；　the　tumor　weighed　60　pounds；　and　there　were　extensive　adhesions。　Maury　removed　a　monocystic　ovarian　tumor　from　a　woman　of　seventy…four；　his　patient　recovering。　Pippingskold　mentions　an　ovariotomy　at　eighty。　Terrier　describes　double　ovariotomy　for　fibromata　in　a　woman　of　seventy…seven。　Aron　speaks　of　an　operation　for　pilous　dermoid　of　the　ovary　in　a　woman　of　seventy…five。　Shepherd　reports　a　case　of　recurrent　proliferous　cyst　in　a　woman　of　sixty…three；　on　whom　successful　ovariotomy　was　performed　twice　within　nine　months。　Wells　mentions　an　ovarian　cyst　in　a　woman　of　sixty…five；　from　which　72　pints　of　fluid　were　removed。

Hawkins　describes　the　case　of　a　musician；　M。　Rochard；　who　at　the　age　of　one　hundred　and　seven　was　successfully　operated　on　for　strangulated　hernia　of　upward　of　thirty　hours'　duration。　The　wound　healed　by　first　intention；　and　the　man　was　well　in　two　weeks。　Fowler　operated　successfully　for　strangulated　umbilical　hernia　on　a　patient　of　sixty…eight。

Repeated　Operations。Franzolini　speaks　of　a　woman　of　fifty　on　whom　he　performed　six　celiotomies　between　June；　1879；　and　April；　1887。　The　first　operation　was　for　fibrocystic　disease　of　the　uterus。　Since　the　last　operation　the　woman　had　had　remarkably　good　health；　and　there　was　every　indication　that　well…merited　recovery　had　been　effected。　The　Ephemerides　contains　an　account　of　a　case　in　which　cystotomy　was　repeated　four　times；　and　there　is　another　record　of　this　operation　having　been　done　five　times　on　a　man。　Instances　of　repeated　Cesarean　section　are　mentioned　on　page　130。

Before　leaving　this　subject；　we　mention　a　marvelous　operation　performed　by　Billroth　on　a　married　woman　of　twenty…nine；　after　her　sixth　pregnancy。　This　noted　operator　performed；　synchronously；　double　ovariotomy　and　resections　of　portions　of　the　bladder　and　ileum；　for　a　large　medullary　carcinomatous　growth　of　the　ovary；　with　surrounding　involvement。　Menstruation　returned　three　months　after　the　operation；　and　in　fifteen　months　the　patient　was　in　good　health　in　every　way；　with　no　apparent　danger　of　recurrence　of　the　disease。

Self…performed　Surgical　Operations。There　have　been　instances　in　which　surgeons　and　even　laymen　have　performed　considerable　operations　upon　themselves。　On　the　battlefield　men　have　amputated

one　of　their　own　limbs　that　had　been　shattered。　In　such　cases　there　would　be　little　pain；　and　premeditation　would　not　be　brought　into　play　in　the　same　degree　as　in　the　case　of　M。　Clever　de　Maldigny；　a　surgeon　in　the　Royal　Guards　of　France；　who　successfully　performed　a　lithotomy　on　himself　before　a　mirror。　He　says　that　after　the　operation　was　completed　the　urine　flowed　in　abundance；　he　dressed　the　wound　with　lint　dipped　in　an　emollient　solution；　and；　being　perfectly　relieved　from　pain；　fell　into　a　sound　sleep。　On　the　following　day；　M。　Maldigny　says；　he　was　as　tranquil　and　cheerful　as　if　he　had　never　been　a　sufferer。　A　Dutch　blacksmith　and　a　German　cooper　each　performed　lithotomy　on　themselves　for　the　intense　pain　caused　by　a　stone　in　the　bladder。　Tulpius；　Walther；　and　the　Ephemerides　each　report　an　instance　of　self…performed　cystotomy。

The　following　case　is　probably　the　only　instance　in　which　the　patient；　suffering　from　vesical　calculus；　tried　to　crush　and　break　the　stone　himself。　J。　B。；　a　retired　draper；　born　in　1828；　while　a　youth　of　seventeen；　sustained　a　fracture　of　the　leg；　rupture　of　the　urethra；　and　laceration　of　the　perineum；　by　a　fall　down　a　well；　landing　astride　an　iron　bar。　A　permanent　perineal　fistula　was　established；　but　the　patient　was　averse　to　any　operative　remedial　measure。　In　the　year　1852　he　became　aware　of　the　presence　of　a　calculus；　but　not　until　1872　did　he　ask　for　medical　assistance。　He　explained　that　he　had　introduced　a　chisel　through　his　perineal　fistula　to　the　stone；　and　attempted　to　comminute　it　himself　and　thus　remove　it；　and　by　so　doing　had　removed　about　an　ounce　of　the　calculus。　The　physician　started　home　for　his　forceps；　but　during　the　interval；　while　walking　about　in　great　pain；　the　man　was　relieved　by　the　stone　bursting　through　the　perineum；　falling　to　the　floor；　and　breaking　in　two。　Including　the　ounce　already　chiselled　off；　the　stone　weighed　14　1/2　ounces；　and　was　10　5/8　inches　in　its　long　circumference。　B。　recovered　and　lived　to　December；　1883；　still　believing　that　he　had　another　piece　of　stone　in　his　bladder。

In　Holden's　〃Landmarks〃　we　are　told　that　the　operation　of　dividing　the　Achilles　tendon　was　first　performed　by　an　unfortunate　upon　himself；　by　means　of　a　razor。　According　to　Patterson；　the　late　Mr。　Symes　told　of　a　patient　in　North　Scotland　who；　for　incipient　hip…disease；　had　the　cautery　applied　at　the　Edinburgh　Infirmary　with　resultant　great　relief。　After　returning　home　to　the　country　he　experienced　considerable　pain；　and　despite　his　vigorous　efforts　he　was　unable　to　induce　any　of　the　men　to　use　the　cautery　upon　him；　they　termed　it　〃barbarous　treatment。〃　In　desperation　and　fully　believing　in　the　efficacy　of　this　treatment　as　the　best　means　of　permanently　alleviating　his　pain；　the　crippled　Scotchman　heated　a　poker　and　applied　the　cautery　himself。

We　have　already　mentioned　the　marvelous　instances　of　Cesarean　sections　self…performed；　and　in　the　literature　of　obstetric　operations　many　of　the　minor　type　have　been　done　by　the　patient　herself。　In　the　foregoing　cases　it　is　to　be　understood　that　the　operations　have　been　performed　solely　from　the　inability　to　secure　surgical　assistance　or　from　the　incapacity　to　endure　the　pain　any　longer。　These　operations　were　not　the　self…mutilations　of　maniacs；　but　were　performed　by　rational　persons；　driven　to　desperation　by　pain。

Possibly　the　most　remarkable　instances　of　extensive　loss　of　blood；　with　recoveries；　are　to　be　found　in　the　older　records　of　venesection。　The　chronicles　of　excessive　bleeding　in　the　olden　days　are　well　known　to　everybody。　Perhaps　no　similar　practice　was　so　universally　indulged　in。　Both　in　sickness　and　in　health；　depletion　was　indicated；　and　it　is　no　exaggeration　to　say　that　about　the　hospital　rooms　at　times　the　floors　were　covered　with　blood。　The　reckless　way　in　which　venesection　was　resorted　to；　led　to　its　disuse；　until　to…day　it　has　so　vanished　from　medical　practice　that　even　its　benefits　are　overlooked；　and　depletion　is　brought　about　in　some　other　manner。　Turning　to　the　older　writers；　we　find　Burton　describing　a　patient　from　whom　he　took　122　ounces　of　blood　in　four　days。　Dover　speaks　of　the　removal　of　111　and　190　ounces；　Galen；　of　six　pounds；　and　Haen；　of　114　ounces。　Taylor　relates　the　history　of　a　case　of　asphyxia　in　which　he　produced　a　successful　issue　by　extracting　one　gallon　of　blood　from　his　patient　during　twelve　hours。　Lucas　speaks　of　50　venesections　being　practiced　during　one　pregnancy。　Van　der　Wiel　performed　venesection　49　times　during　a　single　pregnancy。　Balmes　mentions　a　case　in　which　500　venesections　were　performed　in　twenty…five　years。　Laugier　mentions　300　venesections　in　twenty…six　months。　Osiander　speaks　of　8000　ounces　of　blood　being　taken　away　in　thirty…five　years。　Pechlin　reports　155　venesections　in　one　person　in　sixteen　years；　and　there　is　a　record　of　1020　repeated　venesections。　

The　loss　of　blood　through　spontaneous　hemorrhage　is　sometimes　remarkable。　Fabric