anomalies and curiosities of medicine-第62部分

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Cases　of　living　cyclopia；　or　individuals　with　one　eye　in　the　center　of　the　forehead　after　the　manner　of　the　mythical　Cyclops；　are　quite　rare。　Vallentini　in　1884　reports　a　case　of　a　male　cyclopic　infant　which　lived　for　seventy…three　hours。　There　were　median　fissures　of　the　upper　lip；　preauricular　appendages；　oral　deformity；　and　absence　of　the　olfactory　proboscis　The　fetus　was　therefore　a　cyclops　arrhynchus；　or　cyclocephalus。　Blok　describes　a　new…born　infant　which　lived　for　six　or　seven　hours；　having　but　one　eye　and　an　extremely　small　mouth。

The　〃Four…eyed　Man　of　Cricklade〃　was　a　celebrated　English　monstrosity　of　whom　little　reliable　information　is　obtainable。　He　was　visited　by　W。　Drury；　who　is　accredited　with　reporting　the　following

〃　'So　wondrous　a　thing；　such　a　lusus　naturae；　such　a　scorn　and　spite　of　nature　I　have　never　seen。　It　was　a　dreadful　and　shocking　sight。'　This　unfortunate　had　four　eyes　placed　in　pairs；　'one　eye　above　the　other　and　all　four　of　a　dull　brown；　encircled　with　red；　the　pupils　enormously　large。'　The　vision　in　each　organ　appeared　to　be　perfect。　'He　could　shut　any　particular　eye；　the　other　three　remaining　open；　or；　indeed；　as　many　as　he　chose；　each　several　eye　seeming　to　be　controlled　by　his　will　and　acting　independently　of　the　remainder。　He　could　also　revolve　each　eye　separately　in　its　orbit；　looking　backward　with　one　and　forward　with　another；　upward　with　one　and　downward　with　another　simultaneously。'　He　was　of　a　savage；　malignant　disposition；　delighting　in　ugly　tricks；　teasing　children；　torturing　helpless　animals；　uttering　profane　and　blasphemous　words；　and　acting　altogether　like　the　monster；　mental　and　physical；　that　he　was。　'He　could　play　the　fiddle；　though　in　a　silly　sort；　having　his　notes　on　the　left　side；　while　closing　the　right　pair　of　eyes。　He　also　sang；　but　in　a　rough；　screeching　voice　not　to　be　listened　to　without　disgust。'〃

There　is　a　recent　report　of　a　child　born　in　Paris　with　its　eyes　in　the　top　of　its　head。　The　infant　seemed　to　be　doing　well　and　crowds　of　people　have　flocked　to　see　it。　Recent　reports　speak　of　a　child　born　in　Portland；　Oregon；　which　had　a　median　rudimentary　eye　between　two　normal　eyes。　Fournier　describes　an　infant　born　with　perfectly　formed　eyes；　but　with　adherent　eyelids　and　closed　ocular　aperture。　Forlenze　has　seen　the　pupils　adherent　to　the　conjunctiva；　and　by　dissection　has　given　sight　to　the　subject。

Dubois　cites　an　instance　of　supernumerary　eyelid。　At　the　external　angle　of　the　eyelid　was　a　fold　of　conjunctiva　which　extended　0。5　cm。　in　front　of　the　conjunctiva；　to　which　it　did　not　adhere；　therefore　constituting　a　fourth　eyelid。　Fano　presents　a　similar　case　in　a　child　of　four　months；　in　whom　no　other　anomaly；　either　of　organs　or　of　vision；　was　observed。　On　the　right　side；　in　front　of　the　external　half　of　the　sclerotic；　was　observed　a　semilunar　fold　with　the　concavity　inward；　and　which　projected　much　more　when　the　lower　lid　was　depressed。　When　the　eyelid　rolled　inward　the　fold　rolled　with　the　globe；　but　never　reached　so　far　as　the　circumference　of　the　cornea　and　did　not　interfere　with　vision。

Total　absence　of　both　irides　has　been　seen　in　a　man　of　eighteen。　Dixon　reports　a　case　of　total　aniridia　with　excellent　sight　in　a　woman　of　thirty…seven。　In　Guy's　Hospital　there　was　seen　a　case　of　complete　congenital　absence　of　the　iris。　Hentzschel　speaks　of　a　man　with　congenital　absence　of　the　iris　who　had　five　children；　three　of　whom　exhibited　the　same　anomaly　while　the　others　were　normal。　Benson；　Burnett；　Demaux；　Lawson；　Morison；　Reuling；　Samelson；　and　others　also　report　congenital　deficiency　of　the　irides　in　both　eyes。

Jeaffreson　describes　a　female　of　thirty；　living　in　India；　who　was　affected　with　complete　ossification　of　the　iris。　It　was　immovable　and　quite　beautiful　when　seen　through　the　transparent　cornea；　the　sight　was　only　slightly　impaired。　No　cause　was　traceable。

Multiple　Pupils。More　than　one　pupil　in　the　eye　has　often　been　noticed；　and　as　many　as　six　have　been　seen。　They　may　be　congenital　or　due　to　some　pathologic　disturbance　after　birth。　Marcellus　Donatus　speaks　of　two　pupils　in　one　eye。　Beer；　Fritsche；　and　Heuermann　are　among　the　older　writers　who　have　noticed　supernumerary　pupils。　Higgens　in　1885　described　a　boy　whose　right　iris　was　perforated　by　four　pupils；one　above；　one　to　the　inner　side；　one　below；　and　a　fourth　to　the　outer　side。　The　first　three　were　slit…shaped；　the　fourth　was　the　largest　and　had　the　appearance　as　of　the　separation　of　the　iris　from　its　insertion。　There　were　two　pupils　in　the　left　eye；　both　to　the　outer　side　of　the　iris；　one　being　slit…like　and　the　other　resembling　the　fourth　pupil　in　the　right　eye。　All　six　pupils　commenced　at　the　periphery；　extended　inward；　and　were　of　different　sizes。　The　fundus　could　be　clearly　seen　through　all　of　the　pupils；　and　there　was　no　posterior　staphyloma　nor　any　choroidal　changes。　There　was　a　rather　high　degree　of　myopia。　This　peculiarity　was　evidently　congenital；　and　no　traces　of　a　central　pupil　nor　marks　of　a　past　iritis　could　be　found。　Clinical　Sketches　a　contains　quite　an　extensive　article　on　and　several　illustrations　of　congenital　anomalies　of　the　iris。

Double　crystalline　lenses　are　sometimes　seen。　Fritsch　and　Valisneri　have　seen　this　anomaly　and　there　are　modern　references　to　it。　Wordsworth　presented　to　the　Medical　Society　of　London　six　members　of　one　family；　all　of　whom　had　congenital　displacement　of　the　crystalline　lens　outward　and　upward。　The　family　consisted　of　a　woman　of　fifty；　two　sons；　thirty…five　and　thirty…seven；　and　three　grandchildrena　girl　of　ten　and　boys　of　five　and　seven。　The　irides　were　tremulous。

Clark　reports　a　case　of　congenital　dislocation　of　both　crystalline　lenses。　The　lenses　moved　freely　through　the　pupil　into　the　anterior　chambers。　The　condition　remained　unchanged　for　four　years；　when　glaucoma　supervened。

Differences　in　Color　of　the　Two　Eyes。It　is　not　uncommon　to　see　people　with　different　colored　eyes。　Anastasius　I　had　one　black　eye　and　the　other　blue；　from　whence　he　derived　his　name　〃Dicore；〃　by　which　this　Emperor　of　the　Orient　was　generally　known。　Two　distinct　colors　have　been　seen　in　an　iris。　Berry　gives　a　colored　illustration　of　such　a　case。

The　varieties　of　strabismus　are　so　common　that　they　will　be　passed　without　mention。　Kuhn　presents　an　exhaustive　analysis　of　73　cases　of　congenital　defects　of　the　movements　of　the　eyes；　considered　clinically　and　didactically。　Some　or　all　of　the　muscles　may　be　absent　or　two　or　more　may　be　amalgamated；　with　anomalies　of　insertion；　false；　double；　or　degenerated；　etc。

The　influence　of　heredity　in　the　causation　of　congenital　defects　of　the　eye　is　strikingly　illustrated　by　De　Beck。　In　three　generations　twelve　members　of　one　family　had　either　coloboma　iridis　or　irideremia。　He　performed　two　operations　for　the　cure　of　cataract　in　two　brothers。　The　operations　were　attended　with　difficulty　in　all　four　eyes　and　followed　by　cyclitis。　The　result　was　good　in　one　eye　of　each　patient；　the　eye　most　recently　blind。　Posey　had　a　case　of　coloboma　in　the　macular　region　in　a　patient　who　had　a　supernumerary　tooth。　He　believes　the　defects　were　inherited；　as　the　patient's　mother　also　had　a　supernumerary　tooth。

Nunnely　reports　cases　of　congenital　malformation　in　three　children　of　one　family。　The　globes　of　two　of　them　（a　boy　and　a　girl）　were　smaller　than　natural；　and　in　the　boy　in　addition　were　flattened　by　the　action　of　the　recti　muscles　and　were　soft；　the　sclera　were　very　vascular　and　the　cornea；　conical；　the　irides　dull；　thin；　and　tremulous；　the　pupils　were　not　in　the　axis　of　vision；　but　were　to　the　nasal　side。　The　elder　sister　had　the　same　congenital　condition；　but　to　a　lesser　degree。　The　other　boy　in　the　family　had　a　total　absence　of　irides；　but　he　could　see　fairly　well　with　the　left　eye。

Anomalies　of　the　Ears。Bilateral　absence　of　the　external　ears　is　quite　rare；　although　there　is　a　species　of　sheep；　native　of　China；　called　the　〃Yungti；〃　in　which　this　anomaly　is　constant。　Bartholinus；　Lycosthenes；　Pare；　Schenck；　and　Oberteuffer　have　remarked　on　deficient　external　ears。　Guys；　the　celebrated　Marseilles　litterateur　of　the　eighteenth　century；　was　born　with　only　one　ear。　Chantreuil　mentions　obliteration　of　the　external　auditory　canal　in　the　new…born。　Bannofont　reports　a　case　of　congenital　imperforation　of　the　left　auditory　canal　existing　near　the　tympanic　membrane　with　total　deafness　in　that　ear。　Lloyd　described　a　fetus　showing　absence　of　the　external　auditory　meatus　on　both　sides。　Munro　reports　a　case　of　congenital　absence　of　the　external　auditory　meatus　of　the　right　ear；　and　Richardson　speaks　of　congenital　malformation　of　the　external　auditory　apparatus　of　the　right　side。　There　is　an　instance　of　absence　of　the　auditory　canal　with　but　partial　loss　of　hearing。　Mussey　reports　several　cases　of　congenitally　deficient　or　absent　aural　appendages。　One　case　was　that　in　which　there　was　congenital　absence　of　the　external　auditory　meatus　of　both　ears　without　much　impairment　of　hearing。　In　neither　ear　of　N。　W。　Goddard；　aged　twenty…seven；　of　Vermont；　reported　in　1834；　was　there　a　vestige　of　an　opening　or　passage　in　the　external　ear；　and　not　even　an　indentation。　The　Eustachian　tube　was　closed。　The　integuments　of　the　face　and　scalp　were　capable　of　receiving　acoustic　impressions　and　of　transmitting　them　to　the　organs　of　hearing。　The　authors　know　of　a　student　of　a　prominent　New　York　University　who　is　congenitally　deficient　in　external　ears；　yet　his　hearing　is　acute。　He　hides　his　deformity　by　wearing　his　hair　long　and　combed　over　his　ears。

The　knowledge　of　anomalous　auricles　is　lost　in　antiquity。　Figure　103　represents　the　head　of　an　aegipan　in　the　British　Museum　showing　a　supernumerary　auricle。　As　a　rule；　supernumerary　auricles　are　preauricular　appendages。　Warner；　in　a　report　of　the　examination　of　50；000　children；　quoted　by　Ballantyne；　describes　33　with　supernumerary　auricles；　represented　by　sessile　or　pedunculated　outgrowths　in　front　of　the　tragus。　They　are　more　commonly　unilateral；　always　congenital；　and　can　be　easily　removed；　giving　rise　to　no　unpleasant　symptoms。　They　have　a　soft　and　elastic　consistency；　and　are　usually　composed　of　a　hyaline　or　reticular　cartilaginous　axis　covered　with　connective　or　adipose　tissue　and　skin　bearing　fine　hairs；　sometimes　both　cartilag