Anomalies And Curiosities Of Medicine Part 31

There is the history of a woman who suffered from metastasis of milk to the stomach, and who, with convulsive action of the chest and abdomen, vomited it daily. A peculiar instance of milk in a tumor is that of a Mrs. Reed, who, when pregnant with twins, developed an abdominal tumor from which 25 pounds of milk was drawn off.

There is a French report of secretion of milk in the s.c.r.o.t.u.m of a man of twenty-one. The s.c.r.o.t.u.m was tumefied, and to the touch gave the sensation of a human breast, and the parts were pigmented similar to an engorged breast. a.n.a.lysis showed the secretion to have been true human milk.

Cases of lactation in the new-born are not infrequent. Bartholinus, Baricelli, Muraltus, Deusingius, Rhodius, Schenck, and Schurig mention instances of it. Carda.n.u.s describes an infant of one month whose b.r.e.a.s.t.s were swollen and gave milk copiously. Battersby cites a description of a male child three weeks old whose b.r.e.a.s.t.s were full of a fluid, a.n.a.lysis proving it to have been human milk; Darby, in the same journal, mentions a child of eight days whose b.r.e.a.s.t.s were so engorged that the nurse had to milk it. Faye gives an interesting paper in which he has collected many instances of milk in the b.r.e.a.s.t.s of the new-born. Jonston details a description of lactation in an infant.

Variot mentions milk-secretion in the new-born and says that it generally takes place from the eighth to the fifteenth day and not in the first week. He also adds that probably mammary abscesses in the new-born could be avoided if the milk were squeezed out of the b.r.e.a.s.t.s in the first days. Variot says that out of 32 children of both s.e.xes, aged from six to nine months, all but six showed the presence of milk in the b.r.e.a.s.t.s. Gibb mentions copious milk-secretion in an infant, and Sworder and Menard have seen young babes with abundant milk-secretion.

Precocious Lactation.--Bochut says that he saw a child whose b.r.e.a.s.t.s were large and completely developed, offering a striking contrast to the slight development of the thorax. They were as large as a stout man's fist, pear-shaped, with a rosy areola, in the center of which was a nipple. These precocious b.r.e.a.s.t.s increased in size at the beginning of the menstrual epoch (which was also present) and remained enlarged while the menses lasted. The v.u.l.v.a was covered with thick hair and the external genitalia were well developed. The child was reticent, and with a doll was inclined to play the role of mother.

Baudelocque mentions a girl of eight who suckled her brother with her extraordinarily developed b.r.e.a.s.t.s. In 1783 this child milked her b.r.e.a.s.t.s in the presence of the Royal Academy at Paris. Belloc spoke of a similar case. There is another of a young negress who was able to nourish an infant; and among the older writers we read accounts of young virgins who induced lactation by applying infants to their b.r.e.a.s.t.s. Bartholinus, Benedictus, Hippocrates, Lentilius, Salmuth, and Schenck mention lactation in virgins.

De la Coide describes a case in which lactation was present, though menstruation had always been deficient. Dix, at the Derby Infirmary, has observed two females in whom there was continued lactation, although they had never been pregnant. The first was a chaste female of twenty-five, who for two years had abundant and spontaneous discharge of milk that wetted the linen; and the other was in a prost.i.tute of twenty, who had never been pregnant, but who had, nevertheless, for several months an abundant secretion of healthy milk. Zoologists know that a nonpregnant b.i.t.c.h may secrete milk in abundance. Delafond and de Sinnety have cited instances.

Lactation in the aged has been frequently noticed. Amatus Lusita.n.u.s and Schenck have observed lactation in old women; in recent years Dunglison has collected some instances. Semple relates the history of an elderly woman who took charge of an infant the mother of which had died of puerperal infection. As a means of soothing the child she allowed it to take the nipple, and, strange to say, in thirty-six hours milk appeared in her b.r.e.a.s.t.s, and soon she had a flow as copious as she had ever had in her early married life. The child thrived on this production of a sympathetic and spontaneous lactation. Sir Hans Sloane mentions a lady of sixty-eight who though not having borne a child for twenty years, nursed her grandchildren one after another.

Montegre describes a woman in the Department of Charente who bore two male children in 1810. Not having enough milk for both, and being too poor to secure the a.s.sistance of a midwife, in her desperation she sought an old woman named Laverge, a widow of sixty-five, whose husband had been dead twenty-nine years. This old woman gave the breast to one of the children, and in a few days an abundant flow of milk was present. For twenty-two months she nursed the infant, and it thrived as well as its brother, who was nursed by their common mother--in fact, it was even the stronger of the two.

Dargan tells of a case of remarkable rejuvenated lactation in a woman of sixty, who, in play, placed the child to her breast, and to her surprise after three weeks' nursing of this kind there appeared an abundant supply of milk, even exceeding in amount that of the young mother.

Blanchard mentions milk in the b.r.e.a.s.t.s of a woman of sixty, and Krane cites a similar instance. In the Philosophical Transactions there is an instance of a woman of sixty-eight having abundant lactation.

Warren, Boring, Buzzi, Stack, Durston, Egan, Scalzi, Fitzpatrick, and Gillespie mention rejuvenation and renewed lactation in aged women.

Ford has collected several cases in which lactation was artificially induced by women who, though for some time not having been pregnant themselves, nursed for others.

Prolonged lactation and galactorrhea may extend through several pregnancies. Green reports the case of a woman of forty-seven, the mother of four children, who after each weaning had so much milk constantly in her b.r.e.a.s.t.s that it had to be drawn until the next birth.

At the time of report the milk was still secreting in abundance. A similar and oft-quoted case was that of Gomez Pamo, who described a woman in whom lactation seemed indefinitely prolonged; she married at sixteen, two years after the establishment of menstruation. She became pregnant shortly after marriage, and after delivery had continued lactation for a year without any sign of returning menstruation. Again becoming pregnant, she weaned her first child and nursed the other without delay or complication. This occurrence took place fourteen times. She nursed all 14 of her children up to the time that she found herself pregnant again, and during the pregnancies after the first the flow of milk never entirely ceased; always after the birth of an infant she was able to nurse it. The milk was of good quality and always abundant, and during the period between her first pregnancy to seven years after the birth of her last child the menses had never reappeared. She weaned her last child five years before the time of report, and since then the milk had still persisted in spite of all treatment. It was sometimes so abundant as to necessitate drawing it from the breast to relieve painful tension.

Kennedy describes a woman of eighty-one who persistently menstruated through lactation, and for forty-seven years had uninterruptedly nursed many children, some of which were not her own. Three years of this time she was a widow. At the last reports she had a moderate but regular secretion of milk in her eighty-first year.

In regard to profuse lacteal flow, Remy is quoted as having seen a young woman in j.a.pan from whom was taken 12 1/2 pints of milk each day, which is possibly one of the most extreme instance of continued galactorrhea on record.

Galen refers to gynecomastia or gynecomazia; Aristotle says he has seen men with mammae a which were as well developed as those of a woman, and Paulus aegineta recognized the fact in the ancient Greeks. Subsequently Albucasis discusses it in his writings. Bartholinus, Behr, Benedictus, Borellus, Bonet, the Ephemerides, Marcellus Donatus, Schenck, Vesalius, Schacher, Martineau, and Buffon all discuss the anomalous presence of milk in the male breast. Puech says that this condition is found in one out of 13,000 conscripts.

To Bedor, a marine surgeon, we owe the first scientific exposition of this subject, and a little later Villeneuve published his article in the French dictionary. Since then many observations have been made on this subject, and quite recently Laurent has published a most exhaustive treatise upon it.

Robert describes an old man who suckled a child, and Meyer discusses the case of a castrated man who was said to suckle children. It is said that a Bishop of Cork, who gave one-half crown to an old Frenchman of seventy, was rewarded by an exhibition of his b.r.e.a.s.t.s, which were larger than the Bishop had ever seen in a woman. Petrequin speaks of a male breast 18 inches long which he amputated, and Laurent gives the photograph of a man whose b.r.e.a.s.t.s measured 30 cm. in circ.u.mference at the base, and hung like those of a nursing woman.

In some instances whole families with supernumerary b.r.e.a.s.t.s are seen.

Handyside gives two instances of quadruple b.r.e.a.s.t.s in brothers.

Blanchard speaks of a father who had a supernumerary nipple on each breast and his seven sons had the same deformities; it was not noticed in the daughters. The youngest son transmitted this anomaly to his four sons. Petrequin describes a man with three mammae, two on the left side, the third being beneath the others. He had three sons with accessory mammae on the right side and two daughters with the same anomaly on the left side. Savitzky reports a case of gynecomazia in a peasant of twenty-one whose father, elder brother, and a cousin were similarly endowed. The patient's b.r.e.a.s.t.s were 33 cm. in circ.u.mference and 15 cm. from the nipple to the base of the gland; they resembled normal female mammae in all respects. The p.e.n.i.s and the other genitalia were normal, but the man had a female voice and absence of facial hair.

There was an abundance of subcutaneous fat and a rather broad pelvis.

Wiltshire said that he knew a gynecomast in the person of a distinguished naturalist who since the age of p.u.b.erty observed activity in his b.r.e.a.s.t.s, accompanied with secretion of milky fluid which lasted for a period of six weeks and occurred every spring. This authority also mentions that the French call husbands who have well-developed mammae "la couvade;" the Germans call male supernumerary b.r.e.a.s.t.s "bauchwarze," or ventral nipples. Hutchinson describes several cases of gynecomazia, in which the external genital organs decreased in proportion to the size of the breast and the manners became effeminate.

Cameron, quoted by Snedden, speaks of a fellow-student who had a supernumerary nipple, and also says he saw a case in a little boy who had an extra pair of nipples much wider than the ordinary ones.

Ansiaux, surgeon of Liege, saw a conscript of thirteen whose left mamma was well developed like that of a woman, and whose nipple was surrounded by a large areola. He said that this breast had always been larger than the other, but since p.u.b.erty had grown greatly; the genital organs were well formed. Morgan examined a seaman of twenty-one, admitted to the Royal Naval Hospital at Hong Kong, whose right mamma, in size and conformation, had the appearance of the well developed breast of a full-grown woman. It was lobulated and had a large, brown-colored areola; the nipple, however, was of the same size as that on the left breast. The man stated that he first observed the breast to enlarge at sixteen and a half years; since that time it had steadily increased, but there was no milk at any time from the nipple; the external genital organs were well and fully developed. He complained of no pain or uneasiness except when in drilling aloft his breast came in contact with the ropes.

Gruger of St. Petersburg divides gynecomazia into three cla.s.ses:--

(1) That in which the male generative organs are normal;

(2) In which they are deformed;

(3) In which the anomaly is spurious, the breast being a ma.s.s of fat or a new growth.

The same journal quotes an instance (possibly Morgan's case) in a young man of twenty-one with a deep voice, excellent health, and genitals well developed, and who cohabited with his wife regularly. When sixteen his right breast began to enlarge, a fact that he attributed to the pressure of a rope. Glandular substance could be distinctly felt, but there was no milk-secretion. The left breast was normal. Schuchardt has collected 272 cases of gynecomazia.

Instances of Men Suckling Infants.--These instances of gynecomazia are particularly interesting when the individuals display ability to suckle infants. Hunter refers to a man of fifty who shared equally with his wife the suckling of their children. There is an instance of a sailor who, having lost his wife, took his son to his own breast to quiet him, and after three or four days was able to nourish him. Humboldt describes a South American peasant of thirty-two who, when his wife fell sick immediately after delivery, sustained the child with his own milk, which came soon after the application to the breast; for five months the child took no other nourishment. In Franklin's "Voyages to the Polar Seas" he quotes the instance of an old Chippewa who, on losing his wife in childbirth, had put his infant to his breast and earnestly prayed that milk might flow; he was fortunate enough to eventually produce enough milk to rear the child. The left breast, with which he nursed, afterward retained its unusual size. According to Mehliss some missionaries in Brazil in the sixteenth century a.s.serted that there was a whole Indian nation whose women had small and withered b.r.e.a.s.t.s, and whose children owed their nourishment entirely to the males. Hall exhibited to his cla.s.s in Baltimore a negro of fifty-five who had suckled all his mistress' family. Dunglison reports this case in 1837, and says that the mammae projected seven inches from the chest, and that the external genital organs were well developed.

Paullini and Schenck cite cases of men suckling infants, and Blumenbach has described a male-goat which, on account of the engorgement of the mammae, it was necessary to milk every other day of the year.

Ford mentions the case of a captain who in order to soothe a child's cries put it to his breast, and who subsequently developed a full supply of milk. He also quotes an instance of a man suckling his own children, and mentions a negro boy of fourteen who secreted milk in one breast. Hornor and Pulido y Fernandez also mention similar instances of gynecomazia.

Human Odors.--Curious as it may seem, each individual as well as each species is in life enveloped with an odor peculiarly its own, due to its exhaled breath, its excretions, and princ.i.p.ally to its insensible perspiration. The faculty of recognizing an odor in different individuals, although more developed in savage tribes, is by no means unknown in civilized society. Fournier quotes the instance of a young man who, like a dog, could smell the enemy by scent, and who by smell alone recognized his own wife from other persons.

Fournier also mentions a French woman, an inhabitant of Naples, who had an extreme supersensitiveness of smell. The slightest odor was to her intolerable; sometimes she could not tolerate the presence of certain individuals. She could tell in a numerous circle which women were menstruating. This woman could not sleep in a bed which any one else had made, and for this reason discharged her maid, preparing her own toilet and her sleeping apartments. Cadet de Ga.s.sieourt witnessed this peculiar instance, and in consultation with several of the physicians of Paris attributed this excessive sensitiveness to the climate. There is a tale told of a Hungarian monk who affirmed that he was able to decide the chast.i.ty of females by the sense of smell alone. It is well known that some savage tribes with their large, open nostrils not only recognize their enemies but also track game the same as hounds.

Individual Odors.--Many individuals are said to have exhaled particularly strong odors, and history is full of such instances. We are told by Plutarch that Alexander the Great exhaled an odor similar to that of violet flowers, and his undergarments always smelled of this natural perfume. It is said that Cujas offered a particular a.n.a.logy to this. On the contrary, there are certain persons spoken of who exhaled a sulphurous odor. Martial said that Thais was an example of the cla.s.s of people whose odor was insupportable. Schmidt has inserted in the Ephemerides an account of a journeyman saddler, twenty-three years of age, of rather robust const.i.tution, whose hands exhaled a smell of sulphur so powerful and penetrating as to rapidly fill any room in which he happened to be. Rayer was once consulted by a valet-de-chambre who could never keep a place in consequence of the odor he left behind him in the rooms in which he worked.

Hammond is quoted with saying that when the blessed Venturni of Bergamons officiated at the altar people struggled to come near him in order to enjoy the odor he exhaled. It was said that St. Francis de Paul, after he had subjected himself to frequent disciplinary inflictions, including a fast of thirty-eight to forty days, exhaled a most sensible and delicious odor. Hammond attributes the peculiar odors of the saints of earlier days to neglect of washing and, in a measure, to affections of the nervous system. It may be added that these odors were augmented by aromatics, incense, etc., artificially applied. In more modern times Malherbe and Haller were said to diffuse from their bodies the agreeable odor of musk. These "human flowers," to use Goethe's expression, are more highly perfumed in Southern lat.i.tudes.

Modifying Causes.--According to Brieude, s.e.x, age, climate, habits, ailments, the pa.s.sions, the emotions, and the occupations modify the difference in the humors exhaled, resulting in necessarily different odors. Nursing infants have a peculiar sourish smell, caused by the butyric acid of the milk, while bottle-fed children smell like strong b.u.t.ter. After being weaned the odors of the babies become less decided.

Boys when they reach p.u.b.erty exhibit peculiar odors which are similar to those of animals when in heat. These odors are leading symptoms of what Borden calls "seminal fever" and are more strongly marked in those of a voluptuous nature. They are said to be caused by the absorption of spermatic fluid into the circulation and its subsequent elimination by the skin. This peculiar circ.u.mstance, however, is not seen in girls, in whom menstruation is sometimes to be distinguished by an odor somewhat similar to that of leather. Old age produces an odor similar to that of dry leaves, and there have been persons who declared that they could tell approximately the age of individuals by the sense of smell.

Certain tribes and races of people have characteristic odors. Negroes have a rank ammoniacal odor, unmitigated by cleanliness; according to Pruner-Bey it is due to a volatile oil set free by the sebaceous follicles. The Esquimaux and Greenlanders have the odors of their greasy and oily foods, and it is said that the Cossacks, who live much with their horses, and who are princ.i.p.ally vegetarians, will leave the atmosphere charged with odors several hours after their pa.s.sage in numbers through a neighborhood. The lower race of Chinamen are distinguished by a peculiar musty odor, which may be noticed in the laundry shops of this country. Some people, such as the low grade of Indians, have odors, not distinctive, and solely due to the filth of their persons. Food and drink, as have been mentioned, markedly influence the odor of an individual, and those perpetually addicted to a special diet or drink have a particular odor.

Odor after Coitus.--Preismann in 1877 makes the statement that for six hours after coitus there is a peculiar odor noticeable in the breath, owing to a peculiar secretion of the buccal glands. He says that this odor is most perceptible in men of about thirty-five, and can be discerned at a distance of from four to six feet. He also adds that this fact would be of great medicolegal value in the early arrest of those charged with rape. In this connection the a.n.a.logy of the breath immediately after coitus to the odor of chloroform has been mentioned.

The same article states that after coitus naturally foul breath becomes sweet.

The emotions are said to have a decided influence on the odor of an individual. Gambrini, quoted by Monin, mentions a young man, unfortunate in love and violently jealous, whose whole body exhaled a sickening, pernicious, and fetid odor. Orteschi met a young lady who, without any possibility of fraud, exhaled the strong odor of vanilla from the commissures of her fingers.

Rayer speaks of a woman under his care at the Hopital de la Charite affected with chronic peritonitis, who some time before her death exhaled a very decided odor of musk. The smell had been noticed several days, but was thought to be due to a bag of musk put purposely into the bed to overpower other bad smells. The woman, however, gave full a.s.surance that she had no kind of perfume about her and that her clothes had been frequently changed. The odor of musk in this case was very perceptible on the arms and other portions of the body, but did not become more powerful by friction. After continuing for about eight days it grew fainter and nearly vanished before the patient's death.

Speranza relates a similar case.

Complexion.--Pare states that persons of red hair and freckled complexion have a noxious exhalation; the odor of prussic acid is said to come from dark individuals, while blondes exhale a secretion resembling musk. Fat persons frequently have an oleaginous smell.

The disorders of the nervous system are said to be a.s.sociated with peculiar odors. Fevre says the odor of the sweat of lunatics resembles that of yellow deer or mice, and Knight remarks that the absence of this symptom would enable him to tell whether insanity was feigned or not. Burrows declares that in the absence of further evidence he would not hesitate to p.r.o.nounce a person insane if he could perceive certain a.s.sociate odors. Sir William Gull and others are credited with a.s.serting that they could detect syphilis by smell. Weir Mitch.e.l.l has observed that in lesions of nerves the corresponding cutaneous area exhaled the odor of stagnant water. Hammond refers to three cases under his notice in which specific odors were the results of affections of the nervous system. One of these cases was a young woman of hysterical tendencies who exhaled the odor of violets, which pervaded her apartments. This odor was given off the left half of the chest only and could be obtained concentrated by collecting the perspiration on a handkerchief, heating it with four ounces of spirit, and distilling the remaining mixture. The administration of the salicylate of soda modified in degree this violaceous odor. Hammond also speaks of a young lady subject to ch.o.r.ea whose insensible perspiration had an odor of pineapples; a hypochondriac gentleman under his care smelled of violets. In this connection he mentions a young woman who, when suffering from intense sick headache, exhaled an odor resembling that of Limburger cheese.

Barbier met a case of disordered innervation in a captain of infantry, the upper half of whose body was subject to such offensive perspiration that despite all treatment he had to finally resign his commission.

In lethargy and catalepsy the perspiration very often has a cadaverous odor, which has probably occasionally led to a mistaken diagnosis of death. Schaper and de Meara speak of persons having a cadaveric odor during their entire life.

Various ingesta readily give evidence of themselves by their influence upon the breath. It has been remarked that the breath of individuals who have recently performed a prolonged necropsy smells for some hours of the odor of the cadaver. Such things as copaiba, cubebs, sandalwood, alcohol, coffee, etc., have their recognizable fragrance. There is an instance of a young woman taking Fowler's solution who had periodic offensive axillary sweats that ceased when the medicine was discontinued.

Henry of Navarre was a victim of bromidrosis; proximity to him was insufferable to his courtiers and mistresses, who said that his odor was like that of carrion. Tallemant says that when his wife, Marie de Medicis, approached the bridal night with him she perfumed her apartments and her person with the essences of the flowers of her country in order that she might be spared the disgusting odor of her spouse. Some persons are afflicted with an excessive perspiration of the feet which often takes a disgusting odor. The inguinoscrotal and inguinov.u.l.v.ar perspirations have an aromatic odor like that of the genitals of either s.e.x.

During menstruation, hyperidrosis of the axillae diffuses an aromatic odor similar to that of acids or chloroform, and in suppression of menses, according to the Ephemerides, the odor is as of hops.

Odors of Disease.--The various diseases have their own peculiar odors.

The "hospital odor," so well known, is essentially variable in character and chiefly due to an aggregation of cutaneous exhalations.

The wards containing women and children are perfumed with butyric acid, while those containing men are influenced by the presence of alkalies like ammonia.