anomalies and curiosities of medicine-第91部分

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。　A　case　of　this　kind　was　seen　in　1895　at　the　Jefferson　Medical　College　Hospital；　Philadelphia；　in　which　the　chyluria　was　due　to　a　communication　between　the　bladder　and　the　thoracic　duct。

Ackerman　has　spoken　of　metastasis　of　the　tears；　and　Dixon　gives　an　instance　in　which　crying　was　not　attended　by　the　visible　shedding　of　tears。　Salomon　reports　a　case　of　congenital　deficiency　of　tears。　Blood…stained　tears　were　frequently　mentioned　by　the　older　writers。　Recently　Cross　has　written　an　article　on　this　subject；　and　its　analogy　is　seen　in　the　next　chapter　under　hemorrhages　from　the　eyes　through　the　lacrimal　duct。

The　Semen。The　older　writers　spoke　of　metastasis　of　the　seminal　flow；　the　issue　being　by　the　skin　（perspiration）　and　other　routes。　This　was　especially　supposed　to　be　the　case　in　satyriasis；　in　which　the　preternatural　exit　was　due　to　superabundance　of　semen；　which　could　be　recognized　by　its　odor。　There　is　no　doubt　that　some　people　have　a　distinct　seminal　odor；　a　fact　that　will　be　considered　in　the　section　on　〃Human　Odors。〃

The　Ephemerides；　Schurig；　and　Hoffman　report　instances　of　what　they　call　fetid　semen　（possibly　a　complication　of　urethral　disease）。　Paaw　speaks　of　black　semen　in　a　negro；　and　the　Ephemerides　and　Schurig　mention　instances　of　dark　semen。　Blancard　records　an　instance　of　preternatural　exit　of　semen　by　the　bowel。　Heers　mentions　a　similar　case　caused　by　urethral　fistula。　Ingham　mentions　the　escape　of　semen　through　the　testicle　by　means　of　a　fistula。　Demarquay　is　the　authority　on　bloody　semen。

Andouard　mentions　an　instance　of　blue　bile　in　a　woman；　blue　flakes　being　found　in　her　vomit。　There　was　no　trace　of　copper　to　be　found　in　this　case。　Andouard　says　that　the　older　physicians　frequently　spoke　of　this　occurrence。

Rhodius　speaks　of　the　sweat　being　sweet　after　eating　honey；　the　Ephemerides　and　Paullini　also　mention　it。　Chromidrosis；　or　colored　sweat；　is　an　interesting　anomaly　exemplified　in　numerous　reports。　Black　sweat　has　been　mentioned　by　Bartholinus；　who　remarked　that　the　secretion　resembled　ink；　in　other　cases　Galeazzi　and　Zacutus　Lusitanus　said　the　perspiration　resembled　sooty　water。　Phosphorescent　sweat　has　been　recorded。　Paullini　and　the　Ephemerides　mention　perspiration　which　was　of　a　leek…green　color；　and　Borellus　has　observed　deep　green　perspiration。　Marcard　mentions　green　perspiration　of　the　feet；　possibly　due　to　stains　from　colored　foot…gear。　The　Ephemerides　and　Paullini　speak　of　violet　perspiration；　and　Bartholinus　has　described　perspiration　which　in　taste　resembled　wine。

Sir　Benjamin　Brodie　has　communicated　the　history　of　a　case　of　a　young　girl　of　fifteen　on　whose　face　was　a　black　secretion。　On　attempting　to　remove　it　by　washing；　much　pain　was　caused。　The　quantity　removed　by　soap　and　water　at　one　time　was　sufficient　to　make　four　basins　of　water　as　black　as　if　with　India　ink。　It　seemed　to　be　physiologically　analogous　to　melanosis。　The　cessation　of　the　secretion　on　the　forehead　was　followed　by　the　ejection　of　a　similar　substance　from　the　bowel；　stomach；　and　kidney。　The　secretion　was　more　abundant　during　the　night；　and　at　one　time　in　its　course　an　erysipelas…eruption　made　its　appearance。　A　complete　cure　ultimately　followed。

Purdon　describes　an　Irish　married　woman　of　forty；　the　subject　of　rheumatic　fever；　who　occasionally　had　a　blue　serous　discharge　or　perspiration　that　literally　flowed　from　her　legs　and　body；　and　accompanied　by　a　miliary　eruption。　It　was　on　the　posterior　portions；　and　twelve　hours　previous　was　usually　preceded　by　a　moldy　smell　and　a　prickly　sensation。　On　the　abdomen　and　the　back　of　the　neck　there　was　a　yellowish　secretion。　In　place　of　catamenia　there　was　a　discharge　reddish…green　in　color。　The　patient　denied　having　taken　any　coloring　matter　or　chemicals　to　influence　the　color　of　her　perspiration；　and　no　remedy　relieved　her　cardiac　or　rheumatic　symptoms。

The　first　English　case　of　chromidrosis；　or　colored　sweat；　was　published　by　Yonge　of　Plymouth　in　1709。　In　this　affection　the　colored　sweating　appears　symmetrically　in　various　parts　of　the　body；　the　parts　commonly　affected　being　the　cheeks；　forehead；　side　of　the　nose；　whole　face；　chest；　abdomen；　backs　of　the　hands；　finger…tips；　and　the　flexors；　flexures　at　the　axillae；　groins；　and　popliteal　spaces。　Although　the　color　is　generally　black；　nearly　every　color　has　been　recorded。　Colcott　Fox　reported　a　genuine　case；　and　Crocker　speaks　of　a　case　at　Shadwell　in　a　woman　of　forty…seven　of　naturally　dark　complexion。　The　bowels　were　habitually　sluggish；　going　three　or　four　days　at　least　without　action；　and　latterly　the　woman　had　suffered　from　articular　pains。　The　discolored　sweat　came　out　gradually；　beginning　at　the　sides　of　the　face；　then　spreading　to　the　cheeks　and　forehead。　When　seen；　the　upper　half　of　the　forehead；　the　temporal　regions；　and　the　skin　between　the　ear　and　malar　eminence　were　of　a　blackish…brown　color；　with　slight　hyperemia　of　the　adjacent　parts；　the　woman　said　the　color　had　been　almost　black；　but　she　had　cleaned　her　face　some。　There　was　evidently　much　fat　in　the　secretion；　there　was　also　seborrhea　of　the　scalp。　Washing　with　soap　and　water　had　very　little　effect　upon　it；　but　it　was　removed　with　ether；　the　skin　still　looking　darker　and　redder　than　normal。　After　a　week's　treatment　with　saline　purgatives　the　discoloration　was　much　less；　but　the　patient　still　had　articular　pains；　for　which　alkalies　were　prescribed；　she　did　not　again　attend。　Crocker　also　quotes　the　case　of　a　girl　of　twenty；　originally　under　Mackay　of　Brighton。　Her　affection　had　lasted　a　year　and　was　limited　to　the　left　cheek　and　eyebrow。　Six　months　before　the　patch　appeared　she　had　a　superficial　burn　which　did　not　leave　a　distinct　scar；　but　the　surface　was　slightly　granular。　The　deposit　was　distinctly　fatty；　evidently　seborrheic　and　of　a　sepia…tint。　The　girl　suffered　from　obstinate　constipation；　the　bowels　acting　only　once　a　week。　The　left　side　flushed　more　than　the　right　In　connection　with　this　case　may　be　mentioned　one　by　White　of　Harvard；　a　case　of　unilateral　yellow　chromidrosis　in　a　man。　Demons　gives　the　history　of　a　case　of　yellow　sweat　in　a　patient　with　three　intestinal　calculi。

Wilson　says　that　cases　of　green；　yellow；　and　blue　perspiration　have　been　seen；　and　Hebra；　Rayer；　and　Fuchs　mention　instances。　Conradi　records　a　case　of　blue　perspiration　on　one…half　the　scrotum。　Chojnowski　records　a　case　in　which　the　perspiration　resembled　milk。

Hyperidrosis　occurs　as　a　symptom　in　many　nervous　diseases；　organic　and　functional；　and　its　presence　is　often　difficult　of　explanation。　The　following　are　recent　examples：　Kustermann　reports　a　case　of　acute　myelitis　in　which　there　was　profuse　perspiration　above　the　level　of　the　girdle…sensation　and　none　at　all　below。　Sharkey　reports　a　case　of　tumor　of　the　pons　varolii　and　left　crus　cerebri；　in　which　for　months　there　was　excessive　generalized　perspiration；　it　finally　disappeared　without　treatment。　Hutchinson　describes　the　case　of　a　woman　of　sixty…four　who　for　four　years　had　been　troubled　by　excessive　sweating　on　the　right　side　of　the　face　and　scalp。　At　times　she　was　also　troubled　by　an　excessive　flow　of　saliva；　but　she　could　not　say　if　it　was　unilateral。　There　was　great　irritation　of　the　right　side　of　the　tongue；　and　for　two　years　taste　was　totally　abolished。　It　was　normal　at　the　time　of　examination。　The　author　offered　no　explanation　of　this　case；　but　the　patient　gave　a　decidedly　neurotic　history；　and　the　symptoms　seem　to　point　with　some　degree　of　probability　to　hysteria。　Pope　reports　a　peculiar　case　in　which　there　were　daily　attacks　of　neuralgia　preceded　by　sweating　confined　to　a　bald　spot　on　the　head。　Rockwell　reports　a　case　of　unilateral　hyperidrosis　in　a　feeble　old　man　which　he　thought　due　to　organic　affection　of　the　cervical　sympathetic。

Dupont　has　published　an　account　of　a　curious　case　of　chronic　general　hyperidrosis　or　profuse　sweating　which　lasted　upward　of　six　years。　The　woman　thus　affected　became　pregnant　during　this　time　and　was　happily　delivered　of　an　infant；　which　she　nursed　herself。　According　to　Dupont；　this　hyperidrosis　was　independent　of　any　other　affection；　and　after　having　been　combated　fruitlessly　by　various　remedies；　yielded　at　last　to　fluid　extract　of　aconitin。

Myrtle　relates　the　case　of　a　man　of　seventy…seven；　who；　after　some　flying　pains　and　fever；　began　to　sweat　profusely　and　continued　to　do　so　until　he　died　from　exhaustion　at　the　end　of　three　months　from　the　onset　of　the　sweating。　Richardson　records　another　case　of　the　same　kind。　Crocker　quotes　the　case　of　a　tailor　of　sixty…five　in　whom　hyperidrosis　had　existed　for　thirty…five　years。　It　was　usually　confined　to　the　hands　and　feet；　but　when　worst　affected　the　whole　body。　It　was　absent　as　long　as　he　preserved　the　horizontal　posture；　but　came　on　directly　when　he　rose；　it　was　always　increased　in　the　summer　months。　At　the　height　of　the　attack　the　man　lost　appetite　and　spirit；　had　a　pricking　sensation；　and　sometimes　minute　red　papules　appeared　all　over　the　hand。　He　had　tried　almost　every　variety　of　treatment；　but　sulphur　did　the　most　good；　as　it　had　kept　the　disease　under　for　twelve　months。　Latterly；　even　that　failed。

Bachman　reports　the　history　of　a　case　of　hyperidrosis　cured　by　hypnotism。

Unilateral　and　localized　sweating　accompanies　some　forms　of　nervous　disturbance。　Mickle　has　discussed　unilateral　sweating　in　the　general　paralysis　of　the　insane。　Ramskill　reports　a　case　of　sweating　on　one　side　of　the　face　in　a　patient　who　was　subject　to　epileptic　convulsions。　Takacs　describes　a　case　of　unilateral　sweating　with　proportionate　nervous　prostration。　Bartholow　and　Bryan　report　unilateral　sweating　of　the　head。　Cason　speaks　of　unilateral　sweating　of　the　head；　face；　and　neck。　Elliotson　mentions　sweat　from　the　left　half　of　the　body　and　the　left　extremities　only。　Lewis　reports　a　case　of　unilateral　perspiration　with　an　excess　of　temperature　of　3。5　degrees　F。　in　the　axilla　of　the　perspiring　side。　Mills；　White；　Dow；　and　Duncan　also　cite　instances　of　unilateral　perspiration。　Boquis　describes　a　case　of　unilateral　perspiration　of　the　skin　of　the　head　and　face；　and　instances　of　complete　unilateral　perspiration　have　been　frequently　recorded　by　the　older　writers；Tebure；　Marcellus　Donatus；　Paullini；　and　Hartmann　discussing　it。　Hyperidrosis　confined　to　the　hands　a