anomalies and curiosities of medicine-第75部分

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of　heredity　in　this　malformation；　and　this　allegation　is　exemplified　by　Sedgwick；　who　quotes　a　case　from　Heuremann　in　which　a　family　of　females　had　for　generations　given　birth　to　males　with　hypospadias。　Belloc　mentions　a　man　whose　urethra　terminated　at　the　base　of　the　frenum　who　had　four　sons　with　the　same　deformity。　Picardat　mentions　a　father　and　son；　both　of　whom　had　double　urethral　orifices；　one　above　the　other；　from　one　of　which　issued　urine　and　from　the　other　semena　fact　that　shows　the　possibility　of　inheritance　of　this　malformation。　Patients　in　whom　the　urethra　opens　at　the　root　of　the　penis；　the　meatus　being　imperforate；　are　not　necessarily　impotent；　as；　for　instance；　Fournier　knew　of　a　man　whose　urethra　opened　posteriorly　who　was　the　father　of　four　children。　Fournier　supposed　that　the　semen　ejaculated　vigorously　and　followed　the　fissure　on　the　back　of　the　penis　to　the　uterus；　the　membrane　of　the　vagina　supplanting　the　deficient　wall　of　the　urethra。　The　penis　was　short；　but　about　as　thick　as　ordinary。

Gray　mentions　a　curious　case　in　a　man　afflicted　with　hypospadias　who；　suffering　with　delusions；　was　confined　in　the　insane　asylum　at　Utica。　When　he　determined　to　get　married；　fully　appreciating　his　physical　defect；　he　resolved　to　imitate　nature；　and　being　of　a　very　ingenious　turn　of　mind；　he　busied　himself　with　the　construction　of　an　artificial　penis。　While　so　engaged　he　had　seized　every　opportunity　to　study　the　conformation　of　this　organ；　and　finally　prepared　a　body　formed　of　cotton；　six　inches　in　length；　and　shaped　like　a　penis；　minus　a　prepuce。　He　sheathed　it　in　pig's　gut　and　gave　it　a　slight　vermilion　hue。　To　the　touch　it　felt　elastic；　and　its　shape　was　maintained　by　a　piece　of　gutta…percha　tubing；　around　which　the　cotton　was　firmly　wound。　It　was　fastened　to　the　waist…band　by　means　of　straps；　a　central　and　an　upper　one　being　so　arranged　that　the　penis　could　be　thrown　into　an　erect　position　and　so　maintained。　He　had　constructed　a　flesh…colored　covering　which　completely　concealed　the　straps。　With　this　artificial　member　he　was　enabled　to　deceive　his　wife　for　fifteen　months；　and　was　only　discovered　when；　she　undressed　him　while　he　was　in　a　state　of　intoxication。　To　further　the　deception　he　had　told　his　wife　immediately　after　their　marriage　that　it　was　quite　indecent　for　a　husband　to　undress　in　the　presence　of　his　wife；　and　therefore　she　had　always　retired　first　and　turned　out　the　light。　Partly　from　fear　that　his　virile　power　would　be　questioned　and　partly　from　ignorance；　the　duration　of　actual　coitus　would　approach　an　hour。　When　the　discovery　was　made；　his　wife　hid　the　instrument　with　which　he　had　perpetrated　a　most　successful　fraud　upon　her；　and　the　patient　subsequently　attempted　coitus　by　contact　with　unsuccessful　results；　although　both　parties　had　incomplete　orgasms。　Shortly　afterward　evidences　of　mental　derangement　appeared　and　the　man　became　the　subject　of　exalted　delusions。　His　wife；　at　the　time　of　report；　had　filed　application　for　divorce。　Haslam　reports　a　case　in　which　loss　of　the　penis　was　compensated　for　by　the　use　of　an　ivory　succedaneum。　Parallel　instances　of　this　kind　have　been　recorded　by　Ammann　and　Jonston。　

Entire　absence　of　the　male　sexual　apparatus　is　extremely　rare；　but　Blondin　and　Velpeau　have　reported　cases。

Complete　absence　of　the　testicles；　or　anorchism；　is　a　comparatively　rare　anomaly；　and　it　is　very　difficult　to　distinguish　between　anorchism　and　arrest　of　development；　or　simple　atrophy；　which　is　much　more　common。　Fisher　of　Boston　describes　the　case　of　a　man　of　forty…five；　who　died　of　pneumonia。　From　the　age　of　puberty　to　twenty…five；　and　even　to　the　day　of　death；　his　voice　had　never　changed　and　his　manners　were　decidedly　effeminate。　He　always　sang　soprano　in　concert　with　females。　After　the　age　of　twenty…five；　however；　his　voice　became　more　grave　and　he　could　not　accompany　females　with　such　ease。　He　had　no　beard；　had　never　shaved；　and　had　never　exhibited　amorous　propensities　or　desire　for　female　society。　When　about　twenty…one　he　became　associated　with　a　gay　company　of　men　and　was　addicted　to　the　cup；　but　would　never　visit　houses　of　ill…fame。　On　dissection　no　trace　of　testicles　could　be　found；　the　scrotum　was　soft　and　flabby。　The　cerebellum　was　the　exact　size　of　that　of　a　female　child。

Individuals　with　one　testicle　are　called　monorchids；　and　may　be　divided　into　three　varieties：

（1）　A　solitary　testicle　divided　in　the　middle　by　a　deep　fissure；　the　two　lobes　being　each　provided　with　a　spermatic　cord　on　the　same　side　as　the　lobe。

（2）　Testicles　of　the　same　origin；　but　with　coalescence　more　general。

（3）　A　single　testicle　and　two　cords。

Gruber　of　St。　Petersburg　held　a　postmortem　on　a　man　in　January；　1867；　in　whom　the　right　half　of　the　scrotum；　the　right　testicle；　epididymis；　and　the　scrotal　and　inguinal　parts　of　the　right　vas　deferens　were　absent。　Gruber　examined　the　literature　for　thirty　years　up　to　the　time　of　his　report；　and　found　30　recorded　postmortem　examinations　in　which　there　was　absence　of　the　testicle；　and　in　eight　of　these　both　testicles　were　missing。　As　a　rule；　natural　eunuchs　have　feeble　bodies；　are　mentally　dull；　and　live　only　a　short　time。　The　penis　is　ordinarily　defective　and　there　is　sometimes　another　associate　malformation。　They　are　not　always　disinclined　toward　the　opposite　sex。

Polyorchids　are　persons　who　have　more　than　two　testicles。　For　a　long　time　the　abnormality　was　not　believed　to　exist；　and　some　of　the　observers　denied　the　proof　by　postmortem　examination　of　any　of　the　cases　so　diagnosed；　but　there　is　at　present　no　doubt　of　the　fact；three；　four；　and　five　testicles　having　been　found　at　autopsies。　Russell；　one　of　the　older　writers　on　the　testicle；　mentions　a　monk　who　was　a　triorchid；　and　was　so　salacious　that　his　indomitable　passion　prevented　him　from　keeping　his　vows　of　chastity。　The　amorous　propensities　and　generative　faculties　of　polyorchids　have　always　been　supposed　greater　than　ordinary。　Russell　reports　another　case　of　a　man　with　a　similar　peculiarity；　who　was　prescribed　a　concubine　as　a　reasonable　allowance　to　a　man　thus　endowed。

Morgagni　and　Meckel　say　that　they　never　discovered　a　third　testicle　in　dissections　of　reputed　triorchids；　and　though　Haller　has　collected　records　of　a　great　number　of　triorchids；　he　has　never　been　able　to　verify　the　presence　of　the　third　testicle　on　dissection。　Some　authors；　including　Haller；　have　demonstrated　heredity　in　examples　of　polyorchism。　There　is　an　old　instance　in　which　two　testicles；　one　above　the　other；　were　found　on　the　right　side　and　one　on　the　left。　Macann　describes　a　recruit　of　twenty；　whose　scrotum　seemed　to　be　much　larger　on　the　right　than　on　the　left　side；　although　it　was　not　pendulous。　On　dissection　a　right　and　left　testicle　were　found　in　their　normal　positions；　but　situated　on　the　right　side　between　the　groin　and　the　normal　testicle　was　a　supernumerary　organ；　not　in　contact；　and　having　a　separate　and　short　cord。　Prankard　also　describes　a　man　with　three　testicles。　Three　cases　of　triorchidism　were　found　in　recruits　in　the　British　Army。　Lane　reports　a　supernumerary　testis　found　in　the　right　half　of　the　scrotum　of　a　boy　of　fifteen。　In　a　necropsy　held　on　a　man　killed　in　battle；　Hohlberg　discovered　three　fully　developed　testicles；　two　on　the　right　side　placed　one　above　the　other。　The　London　Medical　Record　of　1884　quotes　Jdanoff　of　St。　Petersburg　in　mentioning　a　soldier　of　twenty…one　who　had　a　supernumerary　testicle　erroneously　diagnosed　as　inguinal　hernia。　Quoted　by　the　same　reference；　Bulatoff　mentions　a　soldier　who　had　a　third　testicle；　which　diagnosis　was　confirmed　by　several　of　his　confreres。　They　recommended　dismissal　of　the　man　from　the　service；　as　the　third　testicle；　usually　resting　in　some　portion　of　the　inguinal　canal；　caused　extra　exposure　to　traumatic　influence。

Venette　gives　an　instance　of　four　testicles；　and　Scharff；　in　the　Ephemerides；　mentions　five；　Blasius　mentions　more　than　three　testicles；　and；　without　citing　proof；　Buffon　admits　the　possibility　of　such　occurrence　and　adds　that　such　men　are　generally　more　vigorous。

Russell　mentions　four；　five；　and　even　six　testicles　in　one　individual；　all　were　not　verified　on　dissection。　He　cites　an　instance　of　six　testicles　four　of　which　were　of　usual　size　and　two　smaller　than　ordinary。

Baillie；　the　Ephemerides；　and　Schurig　mention　fusion　of　the　testicles；　or　synorchidism；　somewhat　after　the　manner　of　the　normal　disposition　of　the　batrachians　and　also　the　kangaroos；　in　the　former　of　which　the　fusion　is　abdominal　and　in　the　latter　scrotal。　Kerckring　has　a　description　of　an　individual　in　whom　the　scrotum　was　absent。

In　those　cases　in　which　the　testicles　are　still　in　the　abdominal　cavity　the　individuals　are　termed　cryptorchids。　Johnson　has　collected　the　results　of　postmortem　examinations　of　89　supposed　cryptorchids。　In　eight　of　this　number　no　testicles　were　found　postmortem；　the　number　found　in　the　abdomen　was　uncertain；　but　in　18　instances　both　testicles　were　found　in　the　inguinal　canal；　and　in　eight　only　one　was　found　in　the　inguinal　canal；　the　other　not　appearing。　The　number　in　which　the　semen　was　examined　microscopically　was　16；　and　in　three　spermatozoa　were　found　in　the　semen；　one　case　was　dubious；　spermatozoa　being　found　two　weeks　afterward　on　a　boy's　shirt。　The　number　having　children　was　ten。　In　one　case　a　monorchid　generated　a　cryptorchid　child。　Some　of　the　cryptorchids　were　effeminate；　although　others　were　manly　with　good　evidences　of　a　beard。　The　morbid；　hypochondriac；　the　voluptuous；　and　the　imbecile　all　found　a　place　in　Johnson's　statistics；　and　although　there　are　evidences　of　the　possession　of　the　generative　function；　still；　we　are　compelled　to　say　that　the　chances　are　against　fecundity　of　human　cryptorchids。　In　this　connection　might　be　quoted　the　curious　case　mentioned　by　Geoffroy…Saint…Hilaire；　of　a　soldier　who　was　hung　for　rape。　It　was　alleged　that　no　traces　of　testicles　were　found　externally　or　internally　yet　semen　containing　spermatozoa　was　found　in　the　seminal　vesicles。　Spermatozoa　have　been　found　days　and　weeks　after　castration；　and　the　individuals　during　this　period　were　capable　of　impregnation；　but　in　these　cases　the　reservoirs　were　not　empty；　although　the　spring　had　ceased　to　flow。　Beigel；　in　Virchow's　Archives；　mentions　a　cryptorchid　of　twe