anomalies and curiosities of medicine-第3部分

按键盘上方向键 ← 或 → 可快速上下翻页，按键盘上的 Enter 键可回到本书目录页，按键盘上方向键 ↑ 可回到本页顶部！
————未阅读完？加入书签已便下次继续阅读！



Haller；　in　a　collection　of　physiologic　curiosities　covering　a　period　of　a　century　and　a　half；　cites　18　instances　of　menstruation　from　the　skin。　Parrot　has　also　mentioned　several　cases　of　this　nature。　Chambers　speaks　of　bloody　sweat　occurring　periodically　in　a　woman　of　twenty…seven；　the　intervals；　however；　were　occasionally　but　a　week　or　a　fortnight；　and　the　exudation　was　not　confined　to　any　one　locality。　Van　Swieten　quotes　the　history　of　a　case　of　suppression　of　the　menstrual　function　in　which　there　were　convulsive　contractions　of　the　body；　followed　by　paralysis　of　the　right　arm。　Later　on；　the　patient　received　a　blow　on　the　left　eye　causing　amaurosis；　swelling　of　this　organ　followed；　and　one　month　later　blood　issued　from　it；　and　subsequently　blood　oozed　from　the　skin　of　the　nose；　and　ran　in　jets　from　the　skin　of　the　fingers　and　from　the　nails。

D'Andrade　cites　an　account　of　a　healthy　Parsee　lady；　eighteen　years　of　age；　who　menstruated　regularly　from　thirteen　to　fifteen　and　a　half　years；　the　catamenia　then　became　irregular　and　she　suffered　occasional　hemorrhages　from　the　gums　and　nose；　together　with　attacks　of　hematemesis。　The　menstruation　returned；　but　she　never　became　pregnant；　and；　later；　blood　issued　from　the　healthy　skin　of　the　left　breast　and　right　forearm；　recurring　every　month　or　two；　and　finally　additional　dermal　hemorrhage　developed　on　the　forehead。　Microscopic　examination　of　the　exuded　blood　showed　usual　constituents　present。　There　are　two　somewhat　similar　cases　spoken　of　in　French　literature。　The　first　was　that　of　a　young　lady；　who；　after　ten　years'　suppression　of　the　menstrual　discharge；　exhibited　the　flow　from　a　vesicular　eruption　on　the　finger。　The　other　case　was　quite　peculiar；　the　woman　being　a　prostitute；　who　menstruated　from　time　to　time　through　spots；　the　size　of　a　five…franc　piece；　developing　on　the　breasts；　buttocks；　back；　axilla；　and　epigastrium。　Barham　records　a　case　similar　to　the　foregoing；　in　which　the　menstruation　assumed　the　character　of　periodic　purpura。　Duchesne　mentions　an　instance　of　complete　amenorrhea；　in　which　the　ordinary　flow　was　replaced　by　periodic　sweats。

Parrot　speaks　of　a　woman　who；　when　seven　months　old；　suffered　from　strumous　ulcers；　which　left　cicatrices　on　the　right　hand；　from　whence；　at　the　age　of　six　years；　issued　a　sanguineous　discharge　with　associate　convulsions。　One　day；　while　in　violent　grief；　she　shed　bloody　tears。　She　menstruated　at　the　age　of　eleven；　and　was　temporarily　improved　in　her　condition；　but　after　any　strong　emotion　the　hemorrhages　returned。　The　subsidence　of　the　bleeding　followed　her　first　pregnancy；　but　subsequently　on　one　occasion；　when　the　menses　were　a　few　days　in　arrears；　she　exhibited　a　blood…like　exudation　from　the　forehead；　eyelids；　and　scalp。　As　in　the　case　under　D'Andrade's　observation；　the　exudation　was　found　by　microscopic　examination　to　consist　of　the　true　constituents　of　blood。　An　additional　element　of　complication　in　this　case　was　the　occurrence　of　occasional　attacks　of　hematemesis。

Menstruation　from　the　Breasts。Being　in　close　sympathy　with　the　generative　function；　we　would　naturally　expect　to　find　the　female　mammae　involved　in　cases　of　anomalous　menstruation；　and　the　truth　of　this　supposition　is　substantiated　in　the　abundance　of　such　cases　on　record。　Schenck　reports　instances　of　menstruation　from　the　nipple；　and　Richter；　de　Fontechia；　Laurentius；　Marcellus　Donatus；　Amatus　Lusitanus；　and　Bierling　are　some　of　the　older　writers　who　have　observed　this　anomaly。　Pare　says　the　wife　of　Pierre　de　Feure；　an　iron　merchant；　living　at　Chasteaudun；　menstruated　such　quantities　from　the　breasts　each　month　that　several　serviettes　were　necessary　to　receive　the　discharge。　Cazenave　details　the　history　of　a　case　in　which　the　mammary　menstruation　was　associated　with　a　similar　exudation　from　the　face；　and　Wolff　saw　an　example　associated　with　hemorrhage　from　the　fauces。　In　the　Lancet　（1840…1841）　is　an　instance　of　monthly　discharge　from　beneath　the　left　mamma。　Finley　also　writes　of　an　example　of　mammary　hemorrhage　simulating　menstruation。　Barnes　saw　a　case　in　St。　George's　Hospital；　London；　1876；　in　which　the　young　girl　menstruated　vicariously　from　the　nipple　and　stomach。　In　a　London　discussion　there　was　mentioned　the　case　of　a　healthy　woman　of　fifty　who　never　was　pregnant；　and　whose　menstruation　had　ceased　two　years　previously；　but　who　for　twelve　months　had　menstruated　regularly　from　the　nipples；　the　hemorrhage　being　so　profuse　as　to　require　constant　change　of　napkins。　The　mammae　were　large　and　painful；　and　the　accompanying　symptoms　were　those　of　ordinary　menstruation。　Boulger　mentions　an　instance　of　periodic　menstrual　discharge　from　beneath　the　left　mamma。　Jacobson　speaks　of　habitual　menstruation　by　both　breasts。　Rouxeau　describes　amenorrhea　in　a　girl　of　seventeen；　who　menstruated　from　the　breast；　and　Teufard　reports　a　case　in　which　there　was　reestablishment　of　menstruation　by　the　mammae　at　the　age　of　fifty…six。　Baker　details　in　full　the　description　of　a　case　of　vicarious　menstruation　from　an　ulcer　on　the　right　mamma　of　a　woman　of　twenty。　At　the　time　he　was　called　to　see　her　she　was　suffering　with　what　was　called　〃green…sickness。〃　The　girl　had　never　menstruated　regularly　or　freely。　The　right　mamma　was　quite　well　developed；　flaccid；　the　nipple　prominent；　and　the　superficial　veins　larger　and　more　tortuous　than　usual。　The　patient　stated　that　the　right　mamma　had　always　been　larger　than　the　left。　The　areola　was　large　and　well　marked；　and　1/4　inch　from　its　outer　edge；　immediately　under　the　nipple；　there　was　an　ulcer　with　slightly　elevated　edges　measuring　about　1　1/4　inches　across　the　base；　and　having　an　opening　in　its　center　1/4　inch　in　diameter；　covered　with　a　thin　scab。　By　removing　the　scab　and　making　pressure　at　the　base　of　the　ulcer；　drops　of　thick；　mucopurulent　matter　were　made　to　exude。　This　discharge；　however；　was　not　offensive　to　the　smell。　On　March　17；　1846；　the　breast　became　much　enlarged　and　congested；　as　portrayed　in　Plate　1。　The　ulcer　was　much　inflamed　and　painful；　the　veins　corded　and　deep　colored；　and　there　was　a　free　discharge　of　sanguineous　yellowish　matter。　When　the　girl's　general　health　improved　and　menstruation　became　more　natural；　the　vicarious　discharge　diminished　in　proportion；　and　the　ulcer　healed　shortly　afterward。　Every　month　this　breast　had　enlarged；　the　ulcer　became　inflamed　and　discharged　vicariously；　continuing　in　this　manner　for　a　few　days；　with　all　the　accompanying　menstrual　symptoms；　and　then　dried　up　gradually。　It　was　stated　that　the　ulcer　was　the　result　of　the　girl's　stooping　over　some　bushes　to　take　an　egg　from　a　hen's　nest；　when　the　point　of　a　palmetto　stuck　in　her　breast　and　broke　off。　The　ulcer　subsequently　formed；　and　ultimately　discharged　a　piece　of　palmetto。　This　happened　just　at　the　time　of　the　beginning　of　the　menstrual　epoch。　The　accompanying　figures；　Plate　1；　show　the　breast　in　the　ordinary　state　and　at　the　time　of　the　anomalous　discharge。

Hancock　relates　an　instance　of　menstruation　from　the　left　breast　in　a　large；　otherwise　healthy；　Englishwoman　of　thirty…one；　who　one　and　a　half　years　after　the　birth　of　the　youngest　child　（now　ten　years　old）　commenced　to　have　a　discharge　of　fluid　from　the　left　breast　three　days　before　the　time　of　the　regular　period。　As　the　fluid　escaped　from　the　nipple　it　became　changed　in　character；　passing　from　a　whitish　to　a　bloody　and　to　a　yellowish　color　respectively；　and　suddenly　terminating　at　the　beginning　of　the　real　flow　from　the　uterus；　to　reappear　again　at　the　breast　at　the　close　of　the　flow；　and　then　lasting　two　or　three　days　longer。　Some　pain　of　a　lancinating　type　occurred　in　the　breast　at　this　time。　The　patient　first　discovered　her　peculiar　condition　by　a　stain　of　blood　upon　the　night…gown　on　awakening　in　the　morning；　and　this　she　traced　to　the　breast。　From　an　examination　it　appeared　that　a　neglected　lacerated　cervix　during　the　birth　of　the　last　child　had　given　rise　to　endometritis；　and　for　a　year　the　patient　had　suffered　from　severe　menorrhagia；　for　which　she　was　subsequently　treated。　At　this　time　the　menses　became　scanty；　and　then　supervened　the　discharge　of　bloody　fluid　from　the　left　breast；　as　heretofore　mentioned。　The　right　breast　remained　always　entirely　passive。　A　remarkable　feature　of　the　case　was　that　some　escape　of　fluid　occurred　from　the　left　breast　during　coitus。　As　a　possible　means　of　throwing　light　on　this　subject　it　may　be　added　that　the　patient　was　unusually　vigorous；　and　during　the　nursing　of　her　two　children　she　had　more　than　the　ordinary　amount　of　milk　（galactorrhea）；　which　poured　from　the　breast　constantly。　Since　this　time　the　breasts　had　been　quite　normal；　except　for　the　tendency　manifested　in　the　left　one　under　the　conditions　given。

Cases　of　menstruation　through　the　eyes　are　frequently　mentioned　by　the　older　writers。　Bellini；　Hellwig；　and　Dodonaeus　all　speak　of　menstruation　from　the　eye。　Jonston　quotes　an　example　of　ocular　menstruation　in　a　young　Saxon　girl；　and　Bartholinus　an　instance　associated　with　bloody　discharge　of　the　foot。　Guepin　has　an　example　in　a　case　of　a　girl　of　eighteen；　who　commenced　to　menstruate　when　three　years　old。　The　menstruation　was　tolerably　regular；　occurring　every　thirty…two　or　thirty…three　days；　and　lasting　from　one　to　six　days。　At　the　cessation　of　the　menstrual　flow；　she　generally　had　a　supplementary　epistaxis；　and　on　one　occasion；　when　this　was　omitted；　she　suffered　a　sudden　effusion　into　the　anterior　chamber　of　the　eye。　The　discharge　had　only　lasted　two　hours　on　this　occasion。　He　also　relates　an　example　of　hemorrhage　into　the　vitreous　humor　in　a　case　of　amenorrhea。　Conjunctival　hemorrhage　has　been　noticed　as　a　manifestation　of　vicarious　menstruation　by　several　American　observers。　Liebreich　found　examples　of　retinal　hemorrhage　in　suppressed　menstruation；　and　Sir　James　Paget　says　that　he　has　seen　a　young　girl　at　Moorfields　who　had　a　small　effusion　of　blood　into　the　anterior　chamber　of　the　eye　at　the　menstrual　period；　which　became　absorbed　during　the　intervals　of　menstruation。　Blair　relates　the　history　of　a　case　of　vicarious　menstruation　attended　with　conjunctivitis　and　opacity　of　the　cornea。　Law　speaks　of　a　plethoric　woman　of　thirty　who　bled　freely　from　the　eyes；　though　menstruating　regularly。

Relative　to　menstruation　from　the　ear；　Spindler；　Paulli