anomalies and curiosities of medicine-第212部分

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tches　coalesced。　At　the　time　of　report　the　lumbar　region　was　the　seat　of　the　disease；　the　affection　here　presenting　a　most　peculiar　appearance；　looking　as　if　an　enormous　butterfly　had　alighted　on　the　patient's　back；　with　its　dark　blue　wings　covered　with　silvery　scales；　widely　expanded。　The　patient　was　not　anemic　and　appeared　to　be　in　the　best　of　health。　None　of　the　glands　were　affected。　According　to　Thomson　there　is　little　doubt　that　this　disease　is　caused　by　non…pyogenic　bacteria　gaining　access　to　the　sweat…glands。　The　irritation　produced　by　their　presence　gives　rise　to　proliferation　of　the　connective…tissue　corpuscles。

Jamieson　reports　a　case　of　mycosis　in　a　native　of　Aberdeenshire　aged　thirty…eight。　There　was　no　history　of　any　previous　illness。　The　disease　began　three　years　previous　to　his　application　for　treatment；　as　a　red；　itching；　small　spot　on　the　cheek。　Two　years　later　lumps　presented　themselves；　at　first　upon　his　shoulders。　The　first　thing　to　strike　an　observer　was　the　offensive　odor　about　the　patient。　In　the　hospital　wards　it　made　all　the　occupants　sick。　The　various　stages　of　the　disease　were　marked　upon　the　different　parts　of　the　body。　On　the　chest　and　abdomen　it　resembled　an　eczema；　on　the　shoulders　there　were　brown；　pinkish…red　areas。　On　the　scalp　the　hair　was　scanty；　the　eye…brows　denuded；　and　the　eyelashes　absent。　The　forehead　was　leonine　in　aspect。　From　between　the　various　nodosities　a　continual　discharge　exuded；　the　nodosities　being　markedly　irregular　over　the　limbs。　The　backs　of　the　hands；　the　dorsums　of　the　feet；　the　wrists　and　ankles；　had　closely　approximating　growths　upon　them；　while　under　the　thick　epidermis　of　the　palms　of　the　hands　were　blisters。　Itching　was　intense。　The　patient　became　emaciated　and　died　thirteen　days　after　his　admission　into　the　hospital。　A　histologic　examination　showed　the　sarcomatous　nature　of　the　various　growths。　The　disease　differed　from　〃button…scurvy。〃　Mycosis　fungoides　approximates；　clinically　and　histologically；　granulomata　and　sarcomata。

Morris　described　an　interesting　case　of　universal　dermatitis；　probably　a　rare　variety　of　mycosis　fungoides。　The　patient　had　for　many　years　a　disease　which　had　first　appeared　on　the　arms　and　legs；　and　which　was　usually　regarded　by　the　physicians　who　saw　the　case　as　eczema。　At　times　the　disease　would　entirely　disappear；　but　it　relapsed；　especially　during　visits　to　India。　At　the　time　the　patient　came　under　the　care　of　Morris；　his　general　health　seemed　unaffected。　The　skin　of　the　whole　body；　except　the　face；　the　scalp；　and　the　front　of　the　chest；　was　of　a　mahogany　color。　The　skin　of　the　lips　was　so　thickened　that　it　could　not　be　pinched　into　folds；　and　was　of　a　mottled　appearance；　due　to　hemorrhagic　spots。　All　over　the　thickened　and　reddened　surface　were　scattered　crops　of　vesicles　and　boils。　The　nails　were　deformed；　and　the　toes　beyond　the　nails　were　tense　with　a　serous　accumulation。　The　glands　in　the　right　axilla　and　the　groin　were　much　enlarged。　The　hair　on　the　pubes　had　disappeared。　The　abdomen　was　in　a　condition　similar　to　that　upon　the　limbs；　but　less　in　degree。　The　front　of　the　chest　below　the　nipples　was　covered　with　dark　papules　the　size　of　a　pin's　head。　The　back；　the　buttocks；　the　face；　and　the　scalp　presented　similar　lesions。　The　most　striking　lesions　were　three　ulcersone　on　the　back　of　the　right　hand；　one　on　the　right　temple；　and　the　other　on　the　left　cheek。　The　largest　was　the　size　of　a　florin；　and　had　elevated　borders；　somewhat　infiltrated；　they　were　covered　with　a　brown；　dry　scab。　The　patient　suffered　from　itching　at　night　so　that　he　could　not　sleep。　He　was　kept　under　observation；　and　in　spite　of　treatment　the　malady　advanced　in　a　periodic　manner；　each　exacerbation　being　preceded　by　a　feeling　of　tension　in　the　parts；　after　which　a　crop　of　vesicles　would　appear。　Sometimes；　especially　on　the　feet；　bullae　formed。　The　patient　finally　left　the　hospital　and　died　of　an　intercurrent　attack　of　pneumonia。　A　microscopic　examination　revealed　a　condition　which　might　be　found　with　a　number　of　the　chronic　affections　of　the　skin；　but；　in　addition；　there　were　certain　cell…inclusions　which　were　thought　to　represent　psorosperms。　Morris　thought　this　case　corresponded　more　to　mycosis　fungoides　than　any　other　malady。



CHAPTER　XVII。

ANOMALOUS　NERVOUS　AND　MENTAL　DISEASES。

Epilepsy　has　been　professionally　recognized　as　a　distinct　type　of　disease　since　the　time　of　Hippocrates；　but　in　earlier　times；　and　popularly　throughout　later　times；　it　was　illy　defined。　The　knowledge　of　the　clinical　symptoms　has　become　definite　only　since　the　era　of　cerebral　local　anatomy　and　localization。　Examination　of　the　older　records　of　epilepsy　shows　curious　forms　recorded。　The　Ephemerides　speaks　of　epilepsy　manifested　only　on　the　birthday。　Testa　mentions　epilepsy　recurring　at　the　festival　of　St。　John；　and　Bartholinus　reports　a　case　in　which　the　convulsions　corresponded　with　the　moon's　phases。　Paullini　describes　epilepsy　which　occurred　during　the　blowing　of　wind　from　the　south；　and　also　speaks　of　epilepsy　during　the　paroxysms　of　which　the　individual　barked。　Fabricius　and　the　Ephemerides　record　dancing　epilepsy。　Bartholinus　and　Hagendorn　mention　cases　during　which　various　splendors　appeared　before　the　eyes　during　the　paroxysm。　Godart　Portius；　and　Salmuth　speak　of　visions　occurring　before　and　after　epileptic　paroxysms。　The　Ephemerides　contains　records　of　epilepsy　in　which　blindness　preceded　the　paroxysm；　in　which　there　was　singing　during　it；　and　a　case　in　which　the　paroxysm　was　attended　with　singultus。　Various　older　writers　mention　cases　of　epilepsy　in　which　curious　spots　appeared　on　the　face；　and　the　kinds　of　aura　mentioned　are　too　numerous　to　transcribe。

Baly　mentions　a　case　of　epilepsy　occasioned　by　irritation　in　the　socket　of　a　tooth。　Webber　reports　a　case　of　epilepsy　due　to　phimosis　and　to　irritation　from　a　tooth。　Beardsley　speaks　of　an　attempt　at　strangulation　that　produced　epilepsy。　Brown…Sequard　records　an　instance　produced　by　injury　to　the　sciatic　nerve。　Doyle　gives　an　account　of　the　production　of　epilepsy　from　protracted　bathing　in　a　pond。　Duncan　cites　an　instance　of　epilepsy　connected　with　vesical　calculus　that　was　cured　by　lithotomy。　Museroft　mentions　an　analogous　case。　Greenhow　speaks　of　epilepsy　arising　from　an　injury　to　the　thumb。　Garmannus；　early　in　the　eighteenth　century；　describes　epilepsy　arising　from　fright　and　terror。　Bristowe　in　1880；　and　Farre　speak　of　similar　instances。　In　Farre's　case　the　disease　was　temporarily　cured　by　an　attack　of　acute　rheumatism。　Thorington　of　Philadelphia　has　seen　a　paroxysm　of　epilepsy　induced　by　the　instillation　of　atropia　in　the　eye　of　a　child　nearly　cured　of　the　malady。　It　was　supposed　that　the　child　was　terrified　on　awakening　and　finding　its　vision　suddenly　diminished；　and　that　the　convulsions　were　directly　due　to　the　emotional　disturbance。　Orwin　describes　epilepsy　from　prolonged　lactation；　and　instances　of　ovarian　and　uterine　epilepsy　are　quite　common。

There　is　a　peculiar　case　of　running　epilepsy　recorded。　The　patient　was　a　workman　who　would　be　suddenly　seized　with　a　paroxysm；　and　unconsciously　run　some　distance　at　full　speed。　On　one　occasion　he　ran　from　Peterborough　to　Whittlesey；　where　he　was　stopped　and　brought　back。　Once　he　ran　into　a　pit　containing　six　feet　of　water；　from　which　he　was　rescued。　Yeo　says　that　sexual　intercourse　occasionally　induces　epilepsy；　and　relates　a　case　in　which　a　severe　epileptic　fit　terminated　fatally　three　days　after　the　seizure；　which　occurred　on　the　nuptial　night。

Drake　reports　the　case　of　a　man　who　was　wounded　in　the　War　of　1812；　near　Baltimore；　the　ball　passing　along　the　left　ear　and　temple　so　close　as　to　graze　the　skin。　Eighteen　years　after　the　accident　he　suffered　with　pain　in　the　left　ear　and　temple；　accompanied　by　epileptic　fits　and　partial　amnesia；　together　with　an　entire　loss　of　power　of　remembering　proper　names　and　applying　them　to　the　objects　to　which　they　belonged。　He　would；　for　instance；　invariably　write　Kentucky　for　Louisville。　Beirne　records　the　case　of　a　dangerous　lunatic；　an　epileptic；　who　was　attacked　by　a　fellow…inmate　and　sustained　an　extensive　fracture　of　the　right　parietal　bone；　with　great　hemorrhage；　followed　by　coma。　Strange　to　say；　after　the　accident　he　recovered　his　intellect；　and　was　cured　of　his　epileptic　attacks；　but　for　six　years　he　was　a　paralytic　from　the　hips　down。

The　Dancing　Mania。Chorea　has　appeared　in　various　epidemic　forms　under　the　names　of　St。　Vitus's　dance；　St。　Guy's　dance；　St。　Anthony's　dance；　choromania；　tanzplage；　orchestromania；　dance　of　St。　Modesti　or　St。　John；　the　dancing　mania；　etc。；　although　these　various　functional　phenomena　of　the　nervous　system　have　been　called　chorea；　they　bear　very　little　resemblance　to　what；　at　the　present　day；　is　called　by　this　name。　The　epidemic　form　appeared　about　1374；　although　Hecker　claims　that；　at　that　time；　it　was　no　new　thing。　Assemblages　of　men　and　women　were　seen　at　Aix…la…Chapelle　who；　impelled　by　a　common　delusion；　would　form　circles；　hand　in　hand；　and　dance　in　wild　delirium　until　they　fell　to　the　ground　exhausted；　somewhat　after　the　manner　of　the　Ghost…Dance　or　Messiah…Dance　of　our　North　American　Indians。　In　their　Bacchantic　leaps　they　were　apparently　haunted　by　visions　and　hallucinations；　the　fancy　conjuring　up　spirits　whose　names　they　shrieked　out。　Some　of　them　afterward　stated　that　they　appeared　to　be　immersed　in　a　stream　of　blood　which　obliged　them　to　leap　so　high。　Others　saw　the　heavens　open　and　disclose　the　Saviour　enthroned　with　the　Virgin　Mary。　The　participants　seemed　to　suffer　greatly　from　tympanites　which　was　generally　relieved　by　compression　or　thumping　on　the　abdomen。　A　few　months　after　this　dancing　malady　had　made　its　appearance　at　Aix…la…Chapelle　it　broke　out　at　Cologne；　and　about　the　same　time　at　Metz；　the　streets　of　which　were　said　to　have　been　filled　with　1100　dancers。　This　rich　city　became　the　scene　of　the　most　ruinous　disorder。　Peasants　left　their　plows；　mechanics　their　shops；　servants　their　masters；　children　their　homes；　and　beggars　and　idle　vagabonds；　who　understood　how　to　imitate　the　convulsions；　roved　from　place　to　place；　inducing　all　sorts　of　crime　and　vice　among　the　afflicted。　Strasburg　was　visited　by　the　dancing　plague　in　1418；　and　it　was　here　that　the　plague　assumed　the　name