anomalies and curiosities of medicine-第31部分

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The　Ephemerides　gives　examples　of　the　child　hiccoughing　in　the　uterus。　Cases　of　crying　before　delivery；　some　in　the　vagina；　some　just　before　the　complete　expulsion　of　the　head　from　the　os　uteri；　are　very　numerous　in　the　older　writers；　and　it　is　quite　possible　that　on　auscultation　of　the　pregnant　abdomen　fetal　sounds　may　have　been　exaggerated　into　cries。　Bartholinus；　Borellus；　Boyle；　Buchner；　Paullini；　Mezger；　Riolanus；　Lentillus；　Marcellus　Donatus；　and　Wolff　all　speak　of　children　crying　before　delivery；　and　Mazinus　relates　the　instance　of　a　puppy　whose　feeble　cries　could　be　heard　before　expulsion　from　the　bitch。　Osiander　fully　discusses　the　subject　of　infants　crying　during　parturition。

McLean　describes　a　case　in　which　he　positively　states　that　a　child　cried　lustily　in　utero　during　application　of　the　forceps。　He　compared　the　sound　as　though　from　a　voice　in　the　cellar。　This　child　was　in　the　uterus；　not　in　the　vagina；　and　continued　the　crying　during　the　whole　of　the　five　minutes　occupied　by　delivery。

Cesarean　Section。Although　the　legendary　history　of　Cesarean　section　is　quite　copious；　it　is　very　seldom　that　we　find　authentic　records　in　the　writings　of　the　older　medical　observers。　The　works　of　Hippocrates；　Aretxeus；　Galen；　Celsus；　and　Aetius　contain　nothing　relative　to　records　of　successful　Cesarean　sections。　However；　Pliny　says　that　Scipio　Africanus　was　the　first　and　Manlius　the　second　of　the　Romans　who　owed　their　lives　to　the　operation　of　Cesarean　section；　in　his　seventh　book　he　says　that　Julius　Caesar　was　born　in　this　way；　the　fact　giving　origin　to　his　name。　Others　deny　this　and　say　that　his　name　came　from　the　thick　head　of　hair　which　he　possessed。　It　is　a　frequent　subject　in　old　Roman　sculpture；　and　there　are　many　delineations　of　the　birth　of　Bacchus　by　Cesarean　section　from　the　corpse　of　Semele。　Greek　mythology　tells　us　of　the　birth　of　Bacchus　in　the　following　manner：　After　Zeus　burnt　the　house　of　Semele；　daughter　of　Cadmus；　he　sent　Hermes　in　great　haste　with　directions　to　take　from　the　burnt　body　of　the　mother　the　fruit　of　seven　months。　This　child；　as　we　know；　was　Bacchus。　Aesculapius；　according　to　the　legend　of　the　Romans；　had　been　excised　from　the　belly　of　his　dead　mother；　Corinis；　who　was　already　on　the　funeral　pile；　by　his　benefactor；　Apollo；　and　from　this　legend　all　products　of　Cesarean　sections　were　regarded　as　sacred　to　Apollo；　and　were　thought　to　have　been　endowed　with　sagacity　and　bravery。

Old　records　tell　us　that　one　of　the　kings　of　Navarre　was　delivered　in　this　way；　and　we　also　have　records　of　the　birth　of　the　celebrated　Doge；　Andreas　Doria；　by　this　method。　Jane　Seymour　was　supposed　to　have　been　delivered　of　Edward　VI　by　Cesarean　section；　the　father；　after　the　consultation　of　the　physicians　was　announced　to　him；　replying：　〃Save　the　child　by　all　means；　for　I　shall　be　able　to　get　mothers　enough。〃　Robert　II　of　Scotland　was　supposed　to　have　been　delivered　in　this　way　after　the　death　of　his　mother；　Margery　Bruce；　who　was　killed　by　being　thrown　from　a　horse。　Shakespere's　immortal　citation　of　Macduff；　〃who　was　from　his　mother's　womb　untimely　ripped；〃　must　have　been　such　a　case；　possibly　crudely　done；　perchance　by　cattle…horn。　Pope　Gregory　XIV　was　said　to　have　been　taken　from　his　mother's　belly　after　her　death。　The　Philosophical　Transactions；　in　the　last　century　contain　accounts　of　Cesarean　section　performed　by　an　ignorant　butcher　and　also　by　a　midwife；　and　there　are　many　records　of　the　celebrated　case　performed　by　Jacob　Nufer；　a　cattle　gelder；　at　the　beginning　of　the　sixteenth　century。

By　the　advent　of　antisepsis　and　the　improvements　of　Porro　and　others；　Cesarean　section　has　come　to　be　a　quite　frequent　event；　and　a　record　of　the　successful　cases　would　hardly　be　considered　a　matter　of　extraordinary　interest；　and　would　be　out　of　the　province　of　this　work；　but　a　citation　of　anomalous　cases　will　be　given。　Baldwin　reports　a　case　of　Cesarean　section　on　a　typical　rachitic　dwarf　of　twenty…four；　who　weighed　100　pounds　and　was　only　47　1/2　inches　tall。　It　was　the　ninth　American　case；　according　to　the　calculation　of　Harris；　only　the　third　successful　one；　and　the　first　successful　one　in　Ohio。　The　woman　had　a　uniformly　contracted　pelvis　whose　anteroposterior　diameter　was　about　1　1/4　inches。　The　hygienic　surroundings　for　the　operation　were　not　of　the　best；　as　the　woman　lived　in　a　cellar。　Tait's　method　of　performing　the　operation　was　determined　upon　and　successfully　performed。　Convalescence　was　prompt；　and　in　three　weeks　the　case　was　dismissed。　The　child　was　a　female　of　7　1/2　pounds　which　inherited　the　deformities　of　its　mother。　It　thrived　for　nine　and　a　half　months；　when　it　died　of　angina　Ludovici。　Figure　15　represents　the　mother　and　child。

Harris　gives　an　account　of　an　operation　upon　a　rachitic　dwarf　who　was　impregnated　by　a　large　man；　a　baby　weighing　14　pounds　and　measuring　20　inches　being　delivered　by　the　knife。　St。　Braun　gives　the　account　of　a　Porro…Cesarean　operation　in　the　case　of　a　rachitic　dwarf　3　feet　10　inches　tall；　in　which　both　the　mother　and　child　recovered。　Munde　speaks　of　twins　being　delivered　by　Cesarean　section。　Franklin　gives　the　instance　of　a　woman　delivered　at　full　term　of　a　living　child　by　this　means；　in　whom　was　also　found　a　dead　fetus。　It　lay　behind　the　stump　of　the　amputated　cervix；　in　the　culdesac　of　Douglas。　The　patient　died　of　hemorrhage。

Croston　reports　a　case　of　Cesarean　section　on　a　primipara　of　twenty…four　at　full　term；　with　the　delivery　of　a　double　female　monster　weighing　12　1/2　pounds。　This　monster　consisted　of　two　females　of　about　the　same　size；　united　from　the　sternal　notch　to　the　navel；　having　one　cord　and　one　placenta。　It　was　stillborn。　The　diagnosis　was　made　before　operation　by　vaginal　examination。　In　a　communication　to　Croston；　Harris　remarked　that　this　was　the　first　successful　Cesarean　section　for　double　monstrous　conception　in　America；　and　added　that　in　1881　Collins　and　Leidy　performed　the　same　operation　without　success。

Instances　of　repeated　Cesarean　section　were　quite　numerous；　and　the　pride　of　the　operators　noteworthy；　before　the　uterus　was　removed　at　the　first　operation；　as　is　now　generally　done。　Bacque　reports　two　sections　in　the　same　woman；　and　Bertrandi　speaks　of　a　case　in　which　the　operation　was　successfully　executed　many　times　in　the　same　woman。　Rosenberg　reports　three　cases　repeated　successfully　by　Leopold　of　Dresden。　Skutsch　reports　a　case　in　which　it　was　twice　performed　on　a　woman　with　a　rachitic　pelvis；　and　who　the　second　time　was　pregnant　with　twins；　the　children　and　mother　recovered。　Zweifel　cites　an　instance　in　which　two　Cesarean　sections　were　performed　on　a　patient；　both　of　the　children　delivered　being　in　vigorous　health。　Stolz　relates　a　similar　case。　Beck　gives　an　account　of　a　Cesarean　operation　twice　on　the　same　woman；　in　the　first　the　child　perished；　but　in　the　second　it　survived。　Merinar　cites　an　instance　of　a　woman　thrice　opened。　Parravini　gives　a　similar　instance。　Charlton　gives　an　account　of　the　performance　carried　out　successfully　four　times　in　the　same　woman；　Chisholm　mentions　a　case　in　which　it　was　twice　performed。　Michaelis　of　Kiel　gives　an　instance　in　which　he　performed　the　same　operation　on　a　woman　four　times；　with　successful　issues　to　both　mother　and　children；　despite　the　presence　of　peritonitis　the　last　time。　He　had　operated　in　1826；　1830；　1832；　and　1836。　Coe　and　Gueniot　both　mention　cases　in　which　Cesarean　section　had　been　twice　performed　with　successful　terminations　as　regards　both　mothers　and　children。　Rosenberg　tabulates　a　number　of　similar　cases　from　medical　literature。

Cases　of　Cesarean　section　by　the　patient　herself　are　most　curious；　but　may　be　readily　believed　if　there　is　any　truth　in　the　reports　of　the　operation　being　done　in　savage　tribes。　Felkin　gives　an　account　of　a　successful　case　performed　in　his　presence；　with　preservation　of　the　lives　of　both　mother　and　child；　by　a　native　African　in　Kahura；　Uganda　Country。　The　young　girl　was　operated　on　in　the　crudest　manner；　the　hemorrhage　being　checked　by　a　hot　iron。　The　sutures　were　made　by　means　of　seven　thin；　hot　iron　spikes；　resembling　acupressure…needles；　closing　the　peritoneum　and　skin。　The　wound　healed　in　eleven　days；　and　the　mother　made　a　complete　recovery。　Thomas　Cowley　describes　the　case　of　a　negro　woman　who；　being　unable　to　bear　the　pains　of　labor　any　longer；　took　a　sharp　knife　and　made　a　deep　incision　in　her　bellydeep　enough　to　wound　the　buttocks　of　her　child；　and　extracted　the　child；　placenta　and　all。　A　negro　horse…doctor　was　called；　who　sewed　the　wound　up　in　a　manner　similar　to　the　way　dead　bodies　are　closed　at　the　present　time。

Barker　gives　the　instance　of　a　woman　who；　on　being　abused　by　her　husband　after　a　previous　tedious　labor；　resolved　to　free　herself　of　the　child；　and　slyly　made　an　incision　five　inches　long　on　the　left　side　of　the　abdomen　with　a　weaver's　knife。　When　Barker　arrived　the　patient　was　literally　drenched　with　blood　and　to　all　appearance　dead。　He　extracted　a　dead　child　from　the　abdomen　and　bandaged　the　mother；　who　lived　only　forty　hours。　In　his　discourses　on　Tropical　Diseases　Moseley　speaks　of　a　young　negress　in　Jamaica　who　opened　her　uterus　and　extracted　therefrom　a　child　which　lived　six　days；　the　woman　recovered。　Barker　relates　another　case　in　Rensselaer　County；　N。Y。；　in　which　the　incision　was　made　with　the　razor；　the　woman　likewise　recovering。　There　is　an　interesting　account　of　a　poor　woman　at　Prischtina；　near　the　Servian　frontier；　who；　suffering　greatly　from　the　pains　of　labor；　resolved　to　open　her　abdomen　and　uterus。　She　summoned　a　neighbor　to　sew　up　the　incision　after　she　had　extracted　the　child；　and　at　the　time　of　report；　several　months　later；　both　the　mother　and　child　were　doing　well。

Madigan　cites　the　case　of　a　woman　of　thirty…four；　in　her　seventh　confinement；　who；　while　temporarily　insane；　laid　open　her　abdomen　with　a　razor；　incised　the　uterus；　and　brought　out　a　male　child。　The　abdominal　wound　was　five　inches　long；　and　extended　from　one　inch　above　the　umbilicus　straight　downward。　There　was　little　or　no　bleeding　and　the　uterus　was　firmly　contracted。　She　did　not　see　a　physician　for　three　hours。　The　child　was　found　dead　and；　with　the　placenta；　was　lying　by　her　side。　The　neighbors　were　so　frightened　by　the　awful　sight　that　they　ran　away；　or　possibly　the　child　mi