anomalies and curiosities of medicine-第43部分

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　notion　that　these　limbs　were　united。　If　this　be　so；　then　the　teratologic　difficulty　is　removed；　for　the　case　becomes　perfectly　comparable　with　the　well…known　but　rare　type　of　double　terata　known　as　the　pygopagous　twins；　which　is　placed　by　Taruffi　with　that　of　the　ischiopagous　twins　in　the　group　dicephalus　lecanopagus。　Similar　instances；　which　are　well　known　to　students　of　teratology；　are　the　Hungarian　sisters　（Helen　and　Judith）；　the　North　Carolina　twins　（Millie　and　Christine）；　and　the　Bohemian　twins　（Rosalie　and　Josepha　Blazek）。　The　interspace　between　the　thoraces　may；　however；　have　simply　been　the　addition　of　the　first　artist　who　portrayed　the　Maids　（from　imagination？）；　then　it　may　be　surmised　that　they　were　ectopagous　twins。

〃Pygopagous　twins　are　fetuses　united　together　in　the　region　of　the　nates　and　having　each　its　own　pelvis。　In　the　recorded　cases　the　union　has　been　usually　between　the　sacra　and　coccyges；　and　has　been　either　osseous　or　（more　rarely）　ligamentous。　Sometimes　the　point　of　junction　was　the　middle　line　posteriorly；　at　other　times　it　was　rather　a　posterolateral　union；　and　it　is　probable　that　in　the　Biddenden　Maids　it　was　of　the　latter　kind；　and　it　is　likely；　from　the　proposal　made　to　separate　the　sisters　after　the　death　of　one；　that　it　was　ligamentous　in　nature。

〃If　it　be　granted　that　the　Biddenden　Maids　were　pygopagous　twins；　a　study　of　the　histories　of　other　recorded　cases　of　this　monstrosity　serves　to　demonstrate　many　common　characters。　Thus；　of　the　8　cases　which　Taruffi　has　collected；　in　7　the　twins　were　female；　and　if　to　these　we　add　the　sisters　Rosalie　and　Josepha　Blazek　and　the　Maids；　we　have　10　cases；　of　which　9　were　girls。　Again；　several　of　the　pygopagous　twins；　of　whom　there　are　scientific　records；　survived　birth　and　lived　for　a　number　of　years；　and　thus　resembled　the　Biddenden　terata。　Helen　and　Judith；　for　instance；　were　twenty…three　years　old　at　death；　and　the　North　Carolina　twins；　although　born　in　1851；　are　still　alive。　There　is；　therefore；　nothing　inherently　improbable　in　the　statement　that　the　Biddenden　Maids　lived　for　thirty…four　years。　With　regard　also　to　the　truth　of　the　record　that　the　one　Maid　survived　her　sister　for　six　hours；　there　is　confirmatory　evidence　from　scientifically　observed　instances；　for　Joly　and　Peyrat　（Bull。　de　l'Acad。　Med。；　iii。；　pp。　51　and　383；　1874）　state　that　in　the　case　seen　by　them　the　one　infant　lived　ten　hours　after　the　death　of　the　other。　It　is　impossible　to　make　any　statement　with　regard　to　the　internal　structure　of　the　Maids　or　to　the　characters　of　their　genital　organs；　for　there　is　absolutely　no　information　forthcoming　upon　these　points。　It　may　simply　be　said；　in　conclusion；　that　the　phenomenon　of　Biddenden　is　interesting　not　only　on　account　of　the　curious　bequest　which　arose　out　of　it；　but　also　because　it　was　an　instance　of　a　very　rare　teratologic　type；　occurring　at　a　very　early　period　in　our　national　history。〃

Possibly　the　most　famous　example　of　twins　of　this　type　were　Helen　and　Judith；　the　Hungarian　sisters；　born　in　1701　at　Szony；　in　Hungary。　They　were　the　objects　of　great　curiosity；　and　were　shown　successively　in　Holland；　Germany；　Italy；　France；　England；　and　Poland。　At　the　age　of　nine　they　were　placed　in　a　convent；　where　they　died　almost　simultaneously　in　their　twenty…second　year。　During　their　travels　all　over　Europe　they　were　examined　by　many　prominent　physiologists；　psychologists；　and　naturalists；　Pope　and　several　minor　poets　have　celebrated　their　existence　in　verse；　Buffon　speaks　of　them　in　his　〃Natural　History；〃　and　all　the　works　on　teratology　for　a　century　or　more　have　mentioned　them。　A　description　of　them　can　be　best　given　by　a　quaint　translation　by　Fisher　of　the　Latin　lines　composed　by　a　Hungarian　physician　and　inscribed　on　a　bronze　statuette　of　them：　

Two　sisters　wonderful　to　behold；　who　have　thus　grown　as　one；　　That　naught　their　bodies　can　divide；　no　power　beneath　the　sun。　The　town　of　Szoenii　gave　them　birth；　hard　by　far…famed　Komorn；　　Which　noble　fort　may　all　the　arts　of　Turkish　sultans　scorn。　　Lucina；　woman's　gentle　friend；　did　Helen　first　receive；　　And　Judith；　when　three　hours　had　passed；　her　mother's　womb　did　leave。　　　One　urine　passage　serves　for　both；one　anus；　so　they　tell；　　The　other　parts　their　numbers　keep；　and　serve　their　owners　well。　　Their　parents　poor　did　send　them　forth；　the　world　to　travel　through；　　　That　this　great　wonder　of　the　age　should　not　be　hid　from　view。　　The　inner　parts　concealed　do　lie　hid　from　our　eyes；　alas！　　　But　all　the　body　here　you　view　erect　in　solid　brass。


They　were　joined　back　to　back　in　the　lumbar　region；　and　had　all　their　parts　separate　except　the　anus　between　the　right　thigh　of　Helen　and　the　left　of　Judith　and　a　single　vulva。　Helen　was　the　larger；　better　looking；　the　more　active；　and　the　more　intelligent。　Judith　at　the　age　of　six　became　hemiplegic；　and　afterward　was　rather　delicate　and　depressed。　They　menstruated　at　sixteen　and　continued　with　regularity；　although　one　began　before　the　other。　They　had　a　mutual　affection；　and　did　all　in　their　power　to　alleviate　the　circumstances　of　their　sad　position。　Judith　died　of　cerebral　and　pulmonary　affections；　and　Helen；　who　previously　enjoyed　good　health；　soon　after　her　sister's　first　indisposition　suddenly　sank　into　a　state　of　collapse；　although　preserving　her　mental　faculties；　and　expired　almost　immediately　after　her　sister。　They　had　measles　and　small…pox　simultaneously；　but　were　affected　in　different　degree　by　the　maladies。　The　emotions；　inclinations；　and　appetites　were　not　simultaneous。　Eccardus；　in　a　very　interesting　paper；　discusses　the　physical；　moral；　and　religious　questions　in　reference　to　these　wonderful　sisters；　such　as　the　advisability　of　separation；　the　admissibility　of　matrimony；　and；　finally；　whether　on　the　last　day　they　would　rise　as　joined　in　life；　or　separated。

There　is　an　account　of　two　united　females；　similar　in　conjunction　to　the　〃Hungarian　sisters；〃　who　were　born　in　Italy　in　1700。　They　were　killed　at　the　age　of　four　months　by　an　attempt　of　a　surgeon　to　separate　them。

In　1856　there　was　reported　to　have　been　born　in　Texas；　twins　after　the　manner　of　Helen　and　Judith；　united　back　to　back；　who　lived　and　attained　some　age。　They　were　said　to　have　been　of　different　natures　and　dispositions；　and　inclined　to　quarrel　very　often。

Pancoast　gives　an　extensive　report　of　Millie…Christine；　who　had　been　extensively　exhibited　in　Europe　and　the　United　States。　They　were　born　of　slave　parents　in　Columbus　County；　N。C。；　July　11；　1851；　the　mother；　who　had　borne　8　children　before；　was　a　stout　negress　of　thirty…two；　with　a　large　pelvis。　The　presentation　was　first　by　the　stomach　and　afterward　by　the　breech。　These　twins　were　united　at　the　sacra　by　a　cartilaginous　or　possibly　osseous　union。　They　were　exhibited　in　Paris　in　1873；　and　provoked　as　much　discussion　there　as　in　the　United　States。　Physically；　Millie　was　the　weaker；　but　had　the　stronger　will　and　the　dominating　spirit。　They　menstruated　regularly　from　the　age　of　thirteen。　One　from　long　habit　yielded　instinctively　to　the　other's　movements；　thus　preserving　the　necessary　harmony。　They　ate　separately；　had　distinct　thoughts；　and　carried　on　distinct　conversations　at　the　same　time。　They　experienced　hunger　and　thirst　generally　simultaneously；　and　defecated　and　urinated　nearly　at　the　same　times。　One；　in　tranquil　sleep；　would　be　wakened　by　a　call　of　nature　of　the　other。　Common　sensibility　was　experienced　near　the　location　of　union。　They　were　intelligent　and　agreeable　and　of　pleasant　appearance；　although　slightly　under　size；　they　sang　duets　with　pleasant　voices　and　accompanied　themselves　with　a　guitar；　they　walked；　ran；　and　danced　with　apparent　ease　and　grace。　Christine　could　bend　over　and　lift　Millie　up　by　the　bond　of　union。

A　recent　example　of　the　pygopagus　type　was　Rosa…Josepha　Blazek；　born　in　Skerychov；　in　Bohemia；　January　20；　1878。　These　twins　had　a　broad　bony　union　in　the　lower　part　of　the　lumbar　region；　the　pelvis　being　obviously　completely　fused。　They　had　a　common　urethral　and　anal　aperture；　but　a　double　vaginal　orifice；　with　a　very　apparent　septum。　The　sensation　was　distinct　in　each；　except　where　the　pelves　joined。　They　were　exhibited　in　Paris　in　1891；　being　then　on　an　exhibition　tour　around　the　world。　Rosa　was　the　stronger；　and　when　she　walked　or　ran　forward　she　drew　her　sister　with　her；　who　must　naturally　have　reversed　her　steps。　They　had　independent　thoughts　and　separate　minds；　one　could　sleep　while　the　other　was　awake。　Many　of　their　appetites　were　different；　one　preferring　beer；　the　other　wine；　one　relished　salad；　the　other　detested　it；　etc。　Thirst　and　hunger　were　not　simultaneous。　Baudoin　describes　their　anatomic　construction；　their　mode　of　life；　and　their　mannerisms　and　tastes　in　a　quite　recent　article。　Fig。　42　is　a　reproduction　of　an　early　photograph　of　the　twins；　and　Fig。　43　represents　a　recent　photograph　of　these　〃Bohemian　twins；〃　as　they　are　now　called。

The　latest　record　we　have　of　this　type　of　monstrosity　is　that　given　by　Tynberg　to　the　County　Medical　Society　of　New　York；　May　27；　1895。　The　mother　was　present　with　the　remarkable　twins　in　her　arms；　crying　at　the　top　of　their　voices。　These　two　children　were　born　at　midnight　on　April　15th。　Tynberg　remarked　that　he　believed　them　to　be　distinct　and　separate　children；　and　not　dependent　on　a　common　arterial　system；　he　also　expressed　his　intention　of　separating　them；　but　did　not　believe　the　operation　could　be　performed　with　safety　before　another　year。　Jacobi　describes　in　full　Tynberg's　instance　of　pygopagus。　He　says　the　confinement　was　easy；　the　head　of　one　was　born　first；　soon　followed　by　the　feet　and　the　rest　of　the　twins。　The　placenta　was　single　and　the　cord　consisted　of　two　branches。　The　twins　were　united　below　the　third　sacral　vertebrae　in　such　a　manner　that　they　could　lie　alongside　of　each　other。　They　were　females；　and　had　two　vaginae；　two　urethrae　four　labia　minora；　and　two　labia　majora；　one　anus；　but　a　double　rectum　divided　by　a　septum。　They　micturated　independently　but　defecated　simultaneously。　They　virtually　lived　separate　lives；　as　one　might　be　asleep　while　the　other　cried；　etc。

CLASS　V。While　instances　of　ischiopagi　are　quite　numerous；　few　have　attained　any　age；　and；　necessarily；　little　notoriety。　Pare　speaks　of　twins　united　at　the　pelves；　who　were　bo