CHAPTER IX.

PHYSIOLOGIC AND FUNCTIONAL ANOMALIES.

In considering the anomalies of the secretions, it must be remembered

that the ingestion of certain kinds of food and the administration of

peculiar drugs in medicine have a marked influence in coloring

secretions. Probably the most interesting of all these anomalies is the

class in which, by a compensatory process, metastasis of the secretions

is noticed.

Colored Saliva.--Among the older writers the Ephemerides contains an

account of blue saliva; Huxham speaks of green saliva; Marcellus

Donatus of yellow, and Peterman relates the history of a case of yellow

saliva. Dickinson describes a woman of sixty whose saliva was blue;

besides this nothing was definitely the matter with her. It seemed

however, that the color was due to some chemic-pencil poisoning rather

than to a pathologic process. A piece of this aniline pencil was

caught in the false teeth. Paget cites an instance of blue saliva due

to staining the tongue in the same manner. Most cases of anomalous

coloring of this kind can be subsequently traced to artificial

substances unconsciously introduced. Crocker mentions a woman who on

washing her hands constantly found that the water was stained blue, but

this was subsequently traced to the accidental introduction of an

orchid leaf. In another instance there was a woman whose linen was at

every change stained brown; this, however, was found to be due to a

hair-wash that she was in the habit of using.

Among the older writers who have mentioned abnormal modes of exit of

the urine is Baux, who mentions urine from the nipples; Paullini and

the Ephemerides describe instances of urination from the eyes.

Blancard, the Ephemerides, Sorbalt, and Vallisneri speak of urination

by the mouth. Arnold relates the history of a case of dysuria in which

urine was discharged from the nose, breasts, ears, and umbilicus; the

woman was twenty-seven years old, and the dysuria was caused by a

prolapsed uterus. There was an instance of anomalous discharge of urine

from the body reported in Philadelphia many years ago which led to

animated discussion. A case of dysuria in which the patient discharged

urine from the stomach was reported early in this century from Germany.

The patient could feel the accumulation of urine by burning pain in the

epigastrium. Suddenly the pain would move to the soles of the feet, she

would become nauseated, and large quantities of urine would soon be

vomited. There was reported the case of an hysterical female who had

convulsions and mania, alternating with anuria of a peculiar nature and

lasting seven days. There was not a drop of urine passed during this

time, but there were discharges through the mouth of alkaline waters

with a strong ammoniacal odor.

Senter reports in a young woman a singular case of ischuria which

continued for more than three years; during this time if her urine was

not drawn off with the catheter she frequently voided it by vomiting;

for the last twenty months she passed much gravel by the catheter; when

the use of the instrument was omitted or unsuccessfully applied the

vomitus contained gravel. Carlisle mentions a case in which there was

vomiting of a fluid containing urea and having the sensible properties

of urine. Curious to relate, a cure was effected after ligature of the

superior thyroid arteries and sloughing of the thyroid gland. Vomiting

of urine is also mentioned by Coley, Domine, Liron, Malago, Zeviani,

and Yeats. Marsden reports a case in which, following secondary papular

syphilis and profuse spontaneous ptyalism, there was vicarious

secretion of the urinary constituents from the skin.

Instances of the anomalous exit of urine caused by congenital

malformation or fistulous connections are mentioned in another chapter.

Black urine is generally caused by the ingestion of pigmented food or

drugs, such as carbolic acid and the anilines. Amatus Lusitanus,

Bartholinus, and the Ephemerides speak of black urine after eating

grapes or damson plums. The Ephemerides speaks of black urine being a

precursor of death, but Piso, Rhodius, and Schenck say it is anomalous

and seldom a sign of death. White urine, commonly known as chyluria, is

frequently seen, and sometimes results from purulent cystitis. Though

containing sediment, the urine looks as if full of milk. 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 and feet is quite

common.

Instances of bloody sweat and "stigmata" have been known through the

ages and are most interesting anomalies. In the olden times there were

people who represented that in their own persons they realized at

certain periods the agonies of Gethsemane, as portrayed in medieval

art, e.g., by pictures of Christ wearing the crown of thorns in

Pilate's judgment hall. Some of these instances were, perhaps, of the

nature of compensatory hemorrhage, substituting the menses or periodic

hemorrhoids, hemoptysis, epistaxis, etc., or possibly purpura. Extreme

religious frenzy or deep emotions might have been the indirect cause of

a number of these bleeding zealots. There are instances on record in

which fear and other similar emotions have caused a sweating of blood,

the expression "sweating blood" being not uncommon.

Among the older writers, Ballonius, Marcolini, and Riedlin mention

bloody sweat. The Ephemerides speaks of it in front of the

hypochondrium. Paullini observed a sailor of thirty, who, falling

speechless and faint during a storm on the deck of his ship, sweated a

red perspiration from his entire body and which stained his clothes. He

also mentions bloody sweat following coitus. Aristotle speaks of bloody

sweat, and Pellison describes a scar which periodically opened and

sweated blood. There were many cases like this, the scars being usually

in the location of Christ's wounds.

De Thou mentions an Italian officer who in 1552, during the war between

Henry II of France and Emperor Charles V, was threatened with public

execution; he became so agitated that he sweated blood from every

portion of the body. A young Florentine about to be put to death by an

order of Pope Sixtus V was so overcome with grief that he shed bloody

tears and sweated blood. The Ephemerides contains many instances of

bloody tears and sweat occasioned by extreme fear, more especially fear

of death. Mezeray mentions that the detestable Charles IX of France,

being under constant agitation and emotion, sank under a disorder which

was accompanied by an exudation of blood from every pore of his body.

This was taken as an attempt of nature to cure by bleeding according to

the theory of the venesectionists. Fabricius Hildanus mentions a child

who, as a rule, never drank anything but water, but once, contrary to

her habit, drank freely of white wine, and this was soon followed by

hemorrhage from the gums, nose, and skin.

There is a case also related of a woman of forty-five who had lost her

only son. One day she fancied she beheld him beseeching her to release

his soul from purgatory by prayers and fasting every Friday. The

following Friday, which was in the month of August, and for five

succeeding Fridays she had a profuse bloody perspiration, the disorder

disappearing on Friday, March 8th, of the following year. Pooley says

that Maldonato, in his "Commentaries of Four Gospels," mentions a

healthy and robust man who on hearing of his sentence of death sweated

blood, and Zacchias noted a similar phenomenon in a young man condemned

to the flames. Allusion may also be made to St. Luke, who said of

Christ that in agony He prayed more earnestly, "and His sweat was, as

it were, great drops of blood falling down to the ground."

Pooley quotes the case of a young woman of indolent habit who in a

religious fanatical trance sweated blood. The stigmatists were often

imposters who artificially opened their scars, and set the example for

the really peculiar cases of bloody sweat, which among ignorant people

was considered evidence of sympathy with the agony of the Cross.

Probably the best studied case on record is that of Louise Lateau of

Bois d'Haine, which, according to Gray, occurred in 1869 in a village

of Belgium when the girl was at the age of twenty-three; her previous

life had offered nothing remarkable. The account is as follows: "One

Friday Louise Lateau noticed that blood was flowing from one side of

her chest, and this recurred every Friday. On each Thursday morning an

oval surface about one inch in length on the back of each hand became

pink in color and smooth, whilst a similar oval surface on the palm of

each hand became of the same hue, and on the upper surface of each foot

a pinkish-white square appeared. Examined under a magnifying glass, the

epidermis appeared at first without solution of continuity and

delicate. About noon on Thursday a vesicle formed on the pink surfaces

containing clear serum. In the night between Thursday and Friday,

usually between midnight and one o'clock, the flow of blood began, the

vesicle first rupturing. The amount of blood lost during the so called

stigmata varied, and some observers estimated it at about one and

three-quarter pints. The blood itself was of a reddish color, inclining

to violet, about the hue therefore, of capillary blood, coagulating in

the usual way, and the white and red corpuscles being normal in

character and relative proportion. The flow ceased on Saturdays. During

the flow of the blood the patient was in a rapt, ecstatic condition.

The facial expression was one of absorption and far-off contemplation,

changing often to melancholy, terror, to an attitude of prayer or

contrition. The patient herself stated that at the beginning of the

ecstasy she imagined herself surrounded by a brilliant light; figures

then passed before her, and the successive scenes of the crucifixion

were panoramically progressive. She saw Christ in person--His clothing,

His wounds, His crown of thorns, His cross--as well as the Apostles,

the holy women, and the assembled Jews. During the ecstasy the

circulation of the skin and heart was regular, although at times a

sudden flash or pallor overspread the face, according with the play of

the expression. From midday of Thursdays, when she took a frugal meal,

until eight o'clock on Saturday mornings the girl took no nourishment,

not even water, because it was said that she did not feel the want of

it and could not retain anything upon her stomach. During this time the

ordinary secretions were suspended."

Fournier mentions a statesman of forty-five who, following great

Cabinet labors during several years and after some worriment, found

that the day after indulging in sexual indiscretions he would be in a

febrile condition, with pains in the thighs, groins, legs, and penis.

The veins of these parts became engorged, and subsequently blood oozed

from them, the flow lasting several days. The penis was the part most

affected. He was under observation for twenty months and presented the

same phenomena periodically, except that during the last few months

they were diminished in every respect. Fournier also mentions a curious

case of diapedesis in a woman injured by a cow. The animal struck her

in the epigastric region, she fell unconscious, and soon after vomited

great quantities of blood, and continued with convulsive efforts of

expulsion to eject blood periodically from every eight to fifteen days,

losing possibly a pound at each paroxysm. There was no alteration of

her menses. A physician gave her astringents, which partly suppressed

the vomiting, but the hemorrhage changed to the skin, and every day she

sweated blood from the chest, back of the thighs, feet, and the

extremities of the fingers. When the blood ceased to flow from her skin

she lost her appetite, became oppressed, and was confined to her bed

for some days. Itching always preceded the appearance of a new flow.

There was no dermal change that could be noticed.

Fullerton mentions a girl of thirteen who had occasional oozing of

blood from her brow, face, and the skin under the eyes. Sometimes a

pound of clots was found about her face and pillow. The blood first

appeared in a single clot, and, strange to say, lumps of fleshy

substance and minute pieces of bone were discharged all day. This

latter discharge became more infrequent, the bone being replaced by

cartilaginous substance. There was no pain, discoloration, swelling, or

soreness, and after this strange anomaly disappeared menstruation

regularly commenced. Van Swieten mentions a young lady who from her

twelfth year at her menstrual periods had hemorrhages from pustules in

the skin, the pustules disappearing in the interval.

Schmidt's Jahrbucher for 1836 gives an account of a woman who had

diseased ovaries and a rectovesicovaginal fistula, and though sometimes

catamenia appeared at the proper place it was generally arrested and

hemorrhage appeared on the face. Chambers mentions a woman of

twenty-seven who suffered from bloody sweat after the manner of the

stigmatists, and Petrone mentions a young man of healthy antecedents,

the sweat from whose axillae and pubes was red and very pungent.

Petrone believes it was due to a chromogenic micrococcus, and relieved

the patient by the use of a five per cent solution of caustic potash.

Chloroform, ether, and phenol had been tried without success. Hebra

mentions a young man in whom the blood spurted from the hand in a

spiral jet corresponding to the direction of the duct of the

sweat-gland. Wilson refers to five cases of bloody sweat.

There is a record of a patient who once or twice a day was attacked

with swelling of the scrotum, which at length acquired a deep red color

and a stony hardness, at which time the blood would spring from a

hundred points and flow in the finest streams until the scrotum was

again empty.

Hill describes a boy of four who during the sweating stage of malaria

sweated blood from the head and neck. Two months later the

skin-hemorrhages ceased and the boy died, vomiting blood and with

bloody stools.

Postmortem sweating is described in the Ephemerides and reported by

Hasenest and Schneider. Bartholinus speaks of bloody sweat in a cadaver.

In considering the anomalies of lactation we shall first discuss those

of color and then the extraordinary places of secretion. Black milk is

spoken of by the Ephemerides and Paullini. Red milk has been observed

by Cramer and Viger. Green milk has been observed by Lanzonius,

Riverius, and Paullini. The Ephemerides also contains an account of

green milk. Yellow milk has been mentioned in the Ephemerides and its

cause ascribed to eating rhubarb.

It is a well-known fact that some cathartics administered to nursing

mothers are taken from the breast by their infants, who,

notwithstanding its indirect mode of administration, exhibit the

effects of the original drug. The same is the case with some poisons,

and instances of lead-poisoning and arsenic-poisoning have been seen in

children who have obtained the toxic substance in the mother's milk.

There is one singular case on record in which a child has been poisoned

from the milk of its mother after she had been bitten by a serpent.

Paullini and the Ephemerides give instances of milk appearing in the

perspiration, and there are numerous varieties of milk-metastasis

recorded Dolaeus and Nuck mention the appearance of milk in the saliva.

Autenreith mentions metastasis of milk through an abdominal abscess to

the thigh, and Balthazaar also mentions excretion of milk from the

thigh. Bourdon mentions milk from the thigh, labia, and vulva. Klein

speaks of the metastasis of the milk to the lochia. Gardane speaks of

metastasis to the lungs, and there is another case on record in which

this phenomenon caused asphyxia. Schenck describes excretion of milk

from the bladder and uterus. Jaeger in 1770 at Tubingen describes the

metastasis of milk to the umbilicus, Haen to the back, and Schurig to a

wound in the foot. Knackstedt has seen an abscess of the thigh which

contained eight pounds of milk. Hauser gives the history of a case in

which the kidneys secreted milk vicariously.

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 scrotum of a man

of twenty-one. The scrotum was tumefied, and to the touch gave the

sensation of a human breast, and the parts were pigmented similar to an

engorged breast. Analysis 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. Cardanus describes an infant of one month whose

breasts were swollen and gave milk copiously. Battersby cites a

description of a male child three weeks old whose breasts were full of

a fluid, analysis proving it to have been human milk; Darby, in the

same journal, mentions a child of eight days whose breasts 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 breasts 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 breasts

in the first days. Variot says that out of 32 children of both sexes,

aged from six to nine months, all but six showed the presence of milk

in the breasts. 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 breasts

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 breasts increased in size at the beginning

of the menstrual epoch (which was also present) and remained enlarged

while the menses lasted. The vulva 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 breasts. In 1783 this child milked her

breasts 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

breasts. 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 prostitute 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 bitch may secrete milk in abundance. Delafond and de

Sinnety have cited instances.

Lactation in the aged has been frequently noticed. Amatus Lusitanus 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 breasts, 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 assistance 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 breasts 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 breasts 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 Japan 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 breasts, 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 breasts measured 30 cm. in circumference at

the base, and hung like those of a nursing woman.

In some instances whole families with supernumerary breasts are seen.

Handyside gives two instances of quadruple breasts 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 breasts were 33 cm. in circumference

and 15 cm. from the nipple to the base of the gland; they resembled

normal female mammae in all respects. The penis 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 puberty observed activity

in his breasts, 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 breasts

"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 puberty 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 classes:--

(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 mass 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 asserted

that there was a whole Indian nation whose women had small and withered

breasts, and whose children owed their nourishment entirely to the

males. Hall exhibited to his class 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 principally 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 Gassieourt 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 chastity 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 analogy 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 class

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 constitution, 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 latitudes.

Modifying Causes.--According to Brieude, sex, age, climate, habits,

ailments, the passions, 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

butter. After being weaned the odors of the babies become less decided.

Boys when they reach puberty 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 circumstance, 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 principally vegetarians, will leave the

atmosphere charged with odors several hours after their passage 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 analogy 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

assurance 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 associated 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 pronounce a person insane if he could perceive certain

associate odors. Sir William Gull and others are credited with

asserting that they could detect syphilis by smell. Weir Mitchell 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 chorea 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

inguinovulvar perspirations have an aromatic odor like that of the

genitals of either sex.

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.

Gout, icterus, and even cholera (Drasch and Porker) have their own

odors. Older observers, confirmed by Doppner, say that all the

plague-patients at Vetlianka diffused an odor of honey. In diabetes

there is a marked odor of apples. The sweat in dysentery unmistakably

bears the odor of the dejecta. Behier calls the odor of typhoid that of

the blood, and Berard says that it attracts flies even before death.

Typhus has a mouse-like odor, and the following diseases have at

different times been described as having peculiar odors,--measles, the

smell of freshly plucked feathers; scarlatina, of bread hot from the

oven; eczema and impetigo, the smell of mold; and rupia, a decidedly

offensive odor.

The hair has peculiar odors, differing in individuals. The hair of the

Chinese is known to have the odor of musk, which cannot be washed away

by the strongest of chemicals. Often the distinctive odor of a female

is really due to the odor of great masses of hair. It is said that

wig-makers simply by the sense of smell can tell whether hair has been

cut from the living head or from combings, as hair loses its odor when

it falls out. In the paroxysms of hysteroepilepsy the hair sometimes

has a specific odor of ozone. Taenia favosa gives to the scalp an odor

resembling that of cat's urine.

Sexual Influence of Odors.--In this connection it may be mentioned that

there is a peculiar form of sexual perversion, called by Binet

"fetichism," in which the subject displays a perverted taste for the

odors of handkerchiefs, shoes, underclothing, and other articles of

raiment worn by the opposite sex. Binet maintains that these articles

play the part of the "fetich" in early theology. It is said that the

favors given by the ladies to the knights in the Middle Ages were not

only tokens of remembrance and appreciation, but sexual excitants as

well. In his remarkable "Osphresiologie," Cloquet calls attention to

the sexual pleasure excited by the odors of flowers, and tells how

Richelieu excited his sexual functions by living in an atmosphere

loaded with these perfumes. In the Orient the harems are perfumed with

intense extracts and flowers, in accordance with the strong belief in

the aphrodisiac effect of odors.

Krafft-Ebing quotes several interesting cases in which the connection

between the olfactory and sexual functions is strikingly verified.

"The case of Henry III shows that contact with a person's perspiration

may be the exciting cause of passionate love. At the betrothal feast of

the King of Navarre and Margaret of Valois he accidentally dried his

face with a garment of Maria of Cleves which was moist with her

perspiration. Although she was the bride of the Prince of Conde, Henry

immediately conceived such a passion for her that he could not resist

it, and, as history shows, made her very unhappy. An analogous instance

is related of Henry IV, whose passion for the beautiful Gabrielle is

said to have originated at the instant when, at a ball, he wiped his

brow with her handkerchief."

Krafft-Ebing also says that "one learns from reading the work of Ploss

('Das Weib') that attempts to attract a person of the opposite sex by

means of the perspiration may be discerned in many forms in popular

psychology. In reference to this a custom is remarkable which holds

among the natives of the Philippine Islands when they become engaged.

When it becomes necessary for the engaged pair to separate they

exchange articles of wearing apparel, by means of which each becomes

assured of faithfulness. These objects are carefully preserved,

covered with kisses, and smelled."

The love of perfumes by libertines and prostitutes, as well as sensual

women of the higher classes, is quite marked. Heschl reported a case of

a man of forty-five in whom absence of the olfactory sense was

associated with imperfect development of the genitals; it is also well

known that olfactory hallucinations are frequently associated with

psychoses of an erotic type.

Garnier has recently collected a number of observations of fetichism,

in which he mentions individuals who have taken sexual satisfaction

from the odors of shoes, night-dresses, bonnets, drawers, menstrual

napkins, and other objects of the female toilet. He also mentions

creatures who have gloated over the odors of the blood and excretions

from the bodies of women, and gives instances of fetichism of persons

who have been arrested in the streets of Paris for clipping the long

hair from young girls. There are also on record instances of

homosexual fetichism, a type of disgusting inversion of the sexual

instinct, which, however, it is not in the province of this work to

discuss.

Among animals the influence of the olfactory perceptions on the sexual

sense is unmistakable. According to Krafft Ebing, Althaus shows that

animals of opposite sexes are drawn to each other by means of olfactory

perceptions, and that almost all animals at the time of rutting emit a

very strong odor from their genitals. It is said that the dog is

attracted in this way to the bitch several miles away. An experiment by

Schiff is confirmatory. He extirpated the olfactory nerves of puppies,

and found that as they grew the male was unable to distinguish the

female. Certain animals, such as the musk-ox, civet-cat, and beaver,

possess glands on their sexual organs that secrete materials having a

very strong odor. Musk, a substance possessing the most penetrating

odor and used in therapeutics, is obtained from the preputial follicles

of the musk-deer of Thibet; and castor, a substance less penetrating,

is obtained from the preputial sacs of the beaver. Virgin moths

(Bombyx) carried in boxes in the pockets of entomologists will on wide

commons cause the appearance of males of the same species.

Bulimia is excessive morbid hunger, also called canine appetite. While

sometimes present in healthy people, it is most often seen in idiots

and the insane, and is a symptom of diabetes mellitus. Mortimer

mentions a boy of twelve who, while laboring under this affliction, in

six days devoured food to the extent of 384 pounds and two ounces. He

constantly vomited, but his craving for food was so insatiable that if

not satisfied he would devour the flesh off his own bones. Martyn,

Professor of Botany at Cambridge in the early part of the last century,

tells of a boy ten years old whose appetite was enormous. He consumed

in one week 373 pounds of food and drink. His urine and stools were

voided in normal quantities, the excess being vomited. A pig was fed on

what he vomited, and was sold in the market. The boy continued in this

condition for a year, and at last reports was fast failing. Burroughs

mentions a laborer at Stanton, near Bury, who ate an ordinary leg of

veal at a meal, and fed at this extravagant rate for many days

together. He would eat thistles and other similar herbs greedily. At

times he would void worms as large as the shank of a clay-pipe, and

then for a short period the bulimia would disappear.

Johnston mentions a case of bulimia in a man who devoured large

quantities of raw flesh. There is an instance on record of a case of

canine appetite in which nearly 400 pounds of solid and fluid elements

were taken into the body in six days and again ejected. A recovery was

effected by giving very concentrated food, frequently repeated in small

quantities. Mason mentions a woman in St. Bartholomew's Hospital in

London in the early part of this century who was wretched unless she

was always eating. Each day she consumed three quartern-loaves, three

pounds of beef-steak, in addition to large quantities of vegetables,

meal, etc., and water. Smith describes a boy of fourteen who ate

continuously fifteen hours out of the twenty-four, and who had eight

bowel movements each day. One year previous his weight was 105 pounds,

but when last seen he weighed 284 pounds and was increasing a half

pound daily. Despite his continuous eating, this boy constantly

complained of hunger.

Polydipsia is an abnormal thirst; it may be seen in persons otherwise

normal, or it may be associated with diseases--such as diabetes

mellitus or diabetes insipidus. Mackenzie quotes a case from Trousseau,

in which an individual afflicted with diabetes insipidus passed 32

liters of urine daily and drank enormous quantities of water. This

patient subjected himself to severe regimen for eight months,--although

one day, in his agonies, he seized the chamber-pot and drank its

contents at once. Mackenzie also mentions an infant of three who had

polydipsia from birth and drank daily nearly two pailfuls of water. At

the age of twenty-two she married a cobbler, unaware of her propensity,

who found that his earnings did not suffice to keep her in water alone,

and he was compelled to melt ice and snow for her. She drank four

pailfuls a day, the price being 12 sous; water in the community was

scarce and had to be bought. This woman bore 11 children. At the age of

forty she appeared before a scientific commission and drank in their

presence 14 quarts of water in ten hours and passed ten quarts of

almost colorless urine. Dickinson mentions that he has had patients in

his own practice who drank their own urine. Mackenzie also quotes

Trousseau's history of a man who drank a liter of strong French brandy

in two hours, and habitually drank the same quantity daily. He stated

that he was free from the effects of alcohol; on several occasions on a

wager he took 20 liters of wine, gaining his wager without visibly

affecting his nervous system.

There is an instance of a man of fifty-eight who could not live through

the night without a pail of water, although his health was otherwise

good. Atkinson in 1856 reported a young man who in childhood was a

dirt-eater, though at that time complaining of nothing but excessive

thirst. He was active, industrious, enjoyed good health, and was not

addicted to alcoholics. His daily ration of water was from eight to

twelve gallons. He always placed a tub of water by his bed at night,

but this sometimes proved insufficient. He had frequently driven hogs

from mudholes to slake his thirst with the water. He married in 1829

and moved into Western Tennessee, and in 1854 he was still drinking the

accustomed amount; and at this time he had grown-up children. Ware

mentions a young man of twenty who drank six gallons of water daily. He

was tormented with thirst, and if he abstained he became weak, sick,

and dizzy. Throughout a long life he continued his habit, sometimes

drinking a gallon at one draught; he never used spirits. There are

three cases of polydipsia reported from London in 1792.

Field describes a boy with bilious remittent fever who would drink

until his stomach was completely distended and then call for more.

Emesis was followed by cries for more water. Becoming frantic, he would

jump from his bed and struggle for the water bucket; failing in this,

he ran to the kitchen and drank soapsuds, dish-water, and any other

liquid he could find. He had swallowed a mass of mackerel which he had

not properly masticated, a fact proved later by ejection of the whole

mass. There is a case on record a in which there was intolerable

thirst after retiring, lasting for a year. There was apparently no

polydipsia during the daytime.

The amount of water drunk by glass-blowers in a day is almost

incredible. McElroy has made observations in the glass-factories in his

neighborhood, and estimates that in the nine working hours of each day

a glass-blower drinks from 50 to 60 pints of water. In addition to

this many are addicted to the use of beer and spirits after working

hours and at lunch-time. The excreta and urine never seem to be

perceptibly increased. When not working these men do not drink more

than three or four pints of water. Occasionally a man becomes what is

termed "blown-up with water;" that is, the perspiration ceases, the man

becomes utterly helpless, has to be carried out, and is disabled until

the sweating process is restored by vigorously applied friction. There

is little deleterious change noticed in these men; in fact, they are

rarely invalids.

Hydroadipsia is a lack of thirst or absence of the normal desire for

water. In some of these cases there is a central lesion which accounts

for the symptoms. McElroy, among other cases, speaks of one in a

patient who was continually dull and listless, eating little, and

complaining of much pain after the least food. This, too, will be

mentioned under abstinence.

Perverted appetites are of great variety and present many interesting

as well as disgusting examples of anomalies. In some cases the tastes

of people differ so that an article considered by one race as

disgusting would be held as a delicacy by another class. The ancients

used asafetida as a seasoning, and what we have called "stercus

diaboli," the Asiatics have named the "food of the gods." The

inhabitants of Greenland drink the oil of the whale with as much

avidity as we would a delicate wine, and they eat blubber the mere

smell of which nauseates an European. In some nations of the lower

grade, insects, worms, serpents, etc., are considered edible. The

inhabitants of the interior of Africa are said to relish the flesh of

serpents and eat grubs and worms. The very earliest accounts of the

Indians of Florida and Texas show that "for food, they dug roots, and

that they ate spiders, ants' eggs, worms, lizards, salamanders, snakes,

earth, wood, the dung of deer, and many other things." Gomara, in his

"Historia de les Indias," says this loathsome diet was particular to

one tribe, the Yagusces of Florida. It is said that a Russian peasant

prefers a rotten egg to a fresh one; and there are persons who prefer

game partly spoiled.

Bourke recalls that the drinking of human urine has often been a

religious rite, and describes the urine-dance of the Zunis of New

Mexico, in which the participants drink freely of their urine; he draws

an analogy to the Feast of the Fools, a religious custom of Pagan

origin which did not disappear in Europe until the time of the

Reformation. It is still a practice in some parts of the United States

to give children fresh urine for certain diseases. It is said that the

ordure of the Grand Lama of Thibet was at one time so venerated that it

was collected and worn as amulets.

The disgusting habit of eating human excrement is mentioned by Schurig,

who gives numerous examples in epileptics, maniacs, chlorotic young

women, pregnant women, children who have soiled their beds and,

dreading detection, have swallowed their ejecta, and finally among men

and women with abnormal appetites. The Indians of North America

consider a broth made from the dung of the hare and caribou a dainty

dish, and according to Abbe Domenech, as a means of imparting a flavor,

the bands near Lake Superior mix their rice with the excrement of

rabbits. De Bry mentions that the negroes of Guinea ate filthy,

stinking elephant-meat and buffalo-flesh infested with thousands of

maggots, and says that they ravenously devoured dogs' guts raw.

Spencer, in his "Descriptive Sociology," describes a "Snake savage" of

Australia who devoured the contents of entrails of an animal. Some

authors have said that within the last century the Hottentots devoured

the flesh and the entrails of wild beasts, uncleansed of their filth

and excrement, and whether sound or rotten. In a personal letter to

Captain Bourke, the Reverend J. Owen Dorsey reports that while among

the Ponkas he saw a woman and child devour the entrails of a beef with

their contents. Bourke also cites instances in which human ordure was

eaten by East Indian fanatics. Numerous authorities are quoted by

Bourke to prove the alleged use of ordure in food by the ancient

Israelites. Pages of such reference are to be found in the works on

Scatology, and for further reference the reader is referred to books on

this subject, of which prominent in English literature is that of

Bourke.

Probably the most revolting of all the perverted tastes is that for

human flesh. This is called anthropophagy or cannibalism, and is a

time-honored custom among some of the tribes of Africa. This custom is

often practised more in the spirit of vengeance than of real desire for

food. Prisoners of war were killed and eaten, sometimes cooked, and

among some tribes raw. In their religious frenzy the Aztecs ate the

remains of the human beings who were sacrificed to their idols. At

other times cannibalism has been a necessity. In a famine in Egypt, as

pictured by the Arab Abdullatif, the putrefying debris of animals, as

well as their excrement, was used as food, and finally the human dead

were used; then infants were killed and devoured, so great was the

distress. In many sieges, shipwrecks, etc., cannibalism has been

practiced as a last resort for sustaining life. When supplies have

given out several Arctic explorers have had to resort to eating the

bodies of their comrades. In the famous Wiertz Museum in Brussels is a

painting by this eccentric artist in which he has graphically portrayed

a woman driven to insanity by hunger, who has actually destroyed her

child with a view to cannibalism. At the siege of Rochelle it is

related that, urged by starvation, a father and mother dug up the

scarcely cold body of their daughter and ate it. At the siege of Paris

by Henry IV the cemeteries furnished food for the starving. One mother

in imitation of what occurred at the siege of Jerusalem roasted the

limbs of her dead child and died of grief under this revolting

nourishment.

St. Jerome states that he saw Scotchmen in the Roman armies in Gaul

whose regular diet was human flesh, and who had "double teeth all

around."

Cannibalism, according to a prominent New York journal, has been

recently made a special study by the Bureau of Ethnology at Washington,

D.C. Data on the subject have been gathered from all parts of the

world, which are particularly interesting in view of discoveries

pointing to the conclusion that this horrible practice is far more

widespread than was imagined. Stanley claims that 30,000,000 cannibals

dwell in the basin of the Congo to-day--people who relish human flesh

above all other meat. Perah, the most peculiar form of cannibalism, is

found in certain mountainous districts of northeast Burmah, where there

are tribes that follow a life in all important respects like that of

wild beasts. These people eat the congealed blood of their enemies.

The blood is poured into bamboo reeds, and in the course of time, being

corked up, it hardens. The filled reeds are hung under the roofs of the

huts, and when a person desires to treat his friends very hospitably

the reeds are broken and the contents devoured.

"The black natives of Australia are all professed cannibals. Dr. Carl

Lumholtz, a Norwegian scientist, spent many months in studying them in

the wilds of the interior. He was alone among these savages, who are

extremely treacherous. Wearing no clothing whatever, and living in

nearly every respect as monkeys do, they know no such thing as

gratitude, and have no feeling that can be properly termed human. Only

fear of the traveler's weapons prevented them from slaying him, and

more than once he had a narrow escape. One of the first of them whom he

employed looked more like a brute than a man. 'When he talked,' says

the doctor, 'he rubbed his belly with complacency, as if the sight of

me made his mouth water.' This individual was regarded with much

respect by his fellows because of his success in procuring human flesh

to eat. These aborigines say that the white man's flesh is salt and

occasions nausea. A Chinaman they consider as good for eating as a

black man, his food being chiefly vegetable.

"The most horrible development of cannibalism among the Australian

blacks is the eating of defunct relatives. When a person dies there

follows an elaborate ceremony, which terminates with the lowering of

the corpse into the grave. In the grave is a man not related to the

deceased, who proceeds to cut off the fat adhering to the muscles of

the face, thighs, arms, and stomach, and passes it around to be

swallowed by some of the near relatives. All those who have eaten of

the cadaver have a black ring of charcoal powder and fat drawn around

the mouth. The order in which the mourners partake of their dead

relatives is duly prescribed. The mother eats of her children and the

children of their mother. A man eats of his sister's husband and of his

brother's wife. Mothers' brothers, mothers' sisters, sisters' children,

mothers' parents, and daughters' children are also eaten by those to

whom the deceased person stands in such relation. But the father does

not eat of his children, nor the children of their sire.

"The New Zealanders, up to very recent times, were probably the most

anthropophagous race that ever existed. As many as 1000 prisoners have

been slaughtered by them at one time after a successful battle, the

bodies being baked in ovens underground. If the individual consumed

had been a redoubtable enemy they dried his head as a trophy and made

flutes of his thigh bones.

"Among the Monbuttos of Africa human fat is commonly employed for a

variety of purposes. The explorer Schweinfurth speaks of writing out in

the evenings his memoranda respecting these people by the light of a

little oil-lamp contrived by himself, which was supplied with some

questionable-looking grease furnished by the natives. The smell of this

grease, he says, could not fail to arouse one's worst suspicions

against the negroes. According to his account the Monbuttos are the

most confirmed cannibals in Africa. Surrounded as they are by a number

of peoples who are blacker than themselves, and who, being inferior to

them in culture, are held in contempt, they carry on expeditions of war

and plunder which result in the acquisition of a booty especially

coveted by them--namely, human flesh. The bodies of all foes who fall

in battle are distributed on the field among the victors, and are

prepared by drying for transportation. The savages drive their

prisoners before them, and these are reserved for killing at a later

time. During Schweinfurth's residence at the Court of Munza it was

generally understood that nearly every day a little child was

sacrificed to supply a meal for the ogre potentate. For centuries past

the slave trade in the Congo Basin has been conducted largely for the

purpose of furnishing human flesh to consumers. Slaves are sold and

bought in great numbers for market, and are fattened for slaughter.

"The Mundurucus of the Upper Amazon, who are exceedingly ferocious,

have been accused of cannibalism. It is they who preserve human heads

in such a remarkable way. When one of their warriors has killed an

enemy he cuts off the head with his bamboo knife, removes the brain,

soaks the head in a vegetable oil, takes out bones of the skull, and

dries the remaining parts by putting hot pebbles inside of it. At the

same time care is taken to preserve all the features and the hair

intact. By repeating the process with the hot pebbles many times the

head finally becomes shrunken to that of a small doll, though still

retaining its human aspect, so that the effect produced is very weird

and uncanny. Lastly, the head is decorated with brilliant feathers, and

the lips are fastened together with a string, by which the head is

suspended from the rafters of the council-house."

Ancient Customs.--According to Herodotus the ancient Lydians and Medes,

and according to Plato the islanders in the Atlantic, cemented

friendship by drinking human blood. Tacitus speaks of Asian princes

swearing allegiance with their own blood, which they drank. Juvenal

says that the Scythians drank the blood of their enemies to quench

their thirst.

Occasionally a religious ceremony has given sanction to cannibalism. It

is said that in the Island of Chios there was a rite by way of

sacrifice to Dionysius in which a man was torn limb from limb, and

Faber tells us that the Cretans had an annual festival in which they

tore a living bull with their teeth. Spencer quotes that among the

Bacchic orgies of many of the tribes of North America, at the

inauguration of one of the Clallum chiefs on the northwest coast of

British America, the chief seized a small dog and began to devour it

alive, and also bit the shoulders of bystanders. In speaking of these

ceremonies, Boas, quoted by Bourke, says that members of the tribes

practicing Hamatsa ceremonies show remarkable scars produced by biting,

and at certain festivals ritualistic cannibalism is practiced, it being

the duty of the Hamatsa to bite portions of flesh out of the arms,

legs, or breast of a man.

Another cause of cannibalism, and the one which deserves discussion

here, is genuine perversion or depravity of the appetite for human

flesh among civilized persons,--the desire sometimes being so strong as

to lead to actual murder. Several examples of this anomaly are on

record. Gruner of Jena speaks of a man by the name of Goldschmidt, in

the environs of Weimar, who developed a depraved appetite for human

flesh. He was married at twenty-seven, and for twenty-eight years

exercised his calling as a cow-herd. Nothing extraordinary was noticed

in him, except his rudeness of manner and his choleric and gross

disposition. In 1771, at the age of fifty-five, he met a young traveler

in the woods, and accused him of frightening his cows; a discussion

arose, and subsequently a quarrel, in which Goldschmidt killed his

antagonist by a blow with a stick which he used. To avoid detection he

dragged the body to the bushes, cut it up, and took it home in

sections. He then washed, boiled, and ate each piece. Subsequently, he

developed a further taste for human flesh, and was finally detected in

eating a child which he had enticed into his house and killed. He

acknowledged his appetite before his trial.

Hector Boetius says that a Scotch brigand and his wife and children

were condemned to death on proof that they killed and ate their

prisoners. The extreme youth of one of the girls excused her from

capital punishment; but at twelve years she was found guilty of the

same crime as her father and suffered capital punishment. This child

had been brought up in good surroundings, yet her inherited appetite

developed. Gall tells of an individual who, instigated by an

irresistible desire to eat human flesh, assassinated many persons; and

his daughter, though educated away from him, yielded to the same

graving.

At Bicetre there was an individual who had a horribly depraved appetite

for decaying human flesh. He would haunt the graveyards and eat the

putrefying remains of the recently buried, preferring the intestines.

Having regaled himself in a midnight prowl, he would fill his pockets

for future use. When interrogated on the subject of his depravity he

said it had existed since childhood. He acknowledged the greatest

desire to devour children he would meet playing; but he did not possess

the courage to kill them.

Prochaska quotes the case of a woman of Milan who attracted children to

her home in order that she might slay, salt, and eat them. About 1600,

there is the record of a boy named Jean Granier, who had repeatedly

killed and devoured several young children before he was discovered.

Rodericus a Castro tells of a pregnant woman who so strongly desired to

eat the shoulder of a baker that she killed him, salted his body, and

devoured it at intervals.

There is a record of a woman who in July, 1817, was discovered in

cooking an amputated leg of her little child. Gorget in 1827 reported

the celebrated case of Leger the vine dresser, who at the age of

twenty-four wandered about a forest for eight days during an attack of

depression. Coming across a girl of twelve, he violated her, and then

mutilated her genitals, and tore out her heart, eating of it, and

drinking the blood. He finally confessed his crime with calm

indifference. After Leger's execution Esquirol found morbid adhesions

between the brain and the cerebral membranes. Mascha relates a similar

instance in a man of fifty-five who violated and killed a young girl,

eating of her genitals and mammae. At the trial he begged for

execution, saying that the inner impulse that led him to his crime

constantly persecuted him.

A modern example of lust-murder and anthropophagy is that of Menesclou,

who was examined by Brouardel, Motet, and others, and declared to be

mentally sound; he was convicted. This miscreant was arrested with the

forearm of a missing child in his pocket, and in his stove were found

the head and entrails in a half-burnt condition. Parts of the body were

found in the water-closet, but the genitals were missing; he was

executed, although he made no confession, saying the deed was an

accident. Morbid changes were found in his brain. Krafft-Ebing cites

the case of Alton, a clerk in England, who lured a child into a

thicket, and after a time returned to his office, where he made an

entry in his note-book: "Killed to-day a young girl; it was fine and

hot." The child was missed, searched for, and found cut into pieces.

Many parts, and among them the genitals, could not be found. Alton did

not show the slightest trace of emotion, and gave no explanation of the

motive or circumstances of his horrible deed; he was executed.

D'Amador tells of persons who went into slaughter-houses and

waste-places to dispute with wolves for the most revolting carrion. It

is also mentioned that patients in hospitals have been detected in

drinking the blood of patients after venesections, and in other

instances frequenting dead-houses and sucking the blood of the recently

deceased. Du Saulle quotes the case of a chlorotic girl of fourteen who

eagerly drank human blood. She preferred that flowing fresh from a

recent wound.

Further Examples of Depraved Appetites.--Bijoux speaks of a porter or

garcon at the Jardin des Plantes in Paris who was a prodigious glutton.

He had eaten the body of a lion that had died of disease at the

menagerie. He ate with avidity the most disgusting things to satiate

his depraved appetite. He showed further signs of a perverted mind by

classifying the animals of the menagerie according to the form of their

excrement, of which he had a collection. He died of indigestion

following a meal of eight pounds of hot bread.

Percy saw the famous Tarrare, who died at Versailles, at about

twenty-six years of age. At seventeen he weighed 100 pounds. He ate a

quarter of beef in twenty-four hours. He was fond of the most revolting

things. He particularly relished the flesh of serpents and would

quickly devour the largest. In the presence of Lorenze he seized a live

cat with his teeth, eventrated it, sucked its blood, and ate it,

leaving the bare skeleton only. In about thirty minutes he rejected the

hairs in the manner of birds of prey and carnivorous animals. He also

ate dogs in the same manner. On one occasion it was said that he

swallowed a living eel without chewing it; but he had first bitten off

its head. He ate almost instantly a dinner that had been prepared for

15 vigorous workmen and drank the accompanying water and took their

aggregate allowance of salt at the same time. After this meal his

abdomen was so swollen that it resembled a balloon. He was seen by

Courville, a surgeon-major in a military hospital, where he had

swallowed a wooden box wrapped in plain white paper. This he passed the

next day with the paper intact. The General-in-chief had seen him

devour thirty pounds of raw liver and lungs. Nothing seemed to diminish

his appetite. He waited around butcher-shops to eat what was discarded

for the dogs. He drank the bleedings of the hospital and ate the dead

from the dead-houses. He was suspected of eating a child of fourteen

months, but no proof could be produced of this. He was of middle height

and was always heated and sweating. He died of a purulent diarrhea, all

his intestines and peritoneum being in a suppurating condition.

Fulton mentions a girl of six who exhibited a marked taste for feeding

on slugs, beetles, cockroaches, spiders, and repulsive insects. This

child had been carefully brought up and was one of 13 children, none of

whom displayed any similar depravity of appetite. The child was of good

disposition and slightly below the normal mental standard for her age.

At the age of fourteen her appetite became normal.

In the older writings many curious instances of abnormal appetite are

seen. Borellus speaks of individuals swallowing stones, horns,

serpents, and toads. Plater mentions snail-eating and eel-eating, two

customs still extant. Rhodius is accredited with seeing persons who

swallowed spiders and scorpions. Jonston says that Avicenna, Rufus, and

Gentilis relate instances of young girls who acquired a taste for

poisonous animals and substances, who could ingest them with impunity.

Colonia Agrippina was supposed to have eaten spiders with impunity. Van

Woensel is said to have seen persons who devoured live eels.

The habit of dirt eating or clay-eating, called pica, is well

authenticated in many countries. The Ephemerides contains mention of

it; Hunter speaks of the blacks who eat potters' clay; Bartholinus

describes dirt-eating as does also a Castro. Properly speaking,

dirt-eating should be called geophagism; it is common in the Antilles

and South America, among the low classes, and is seen in the negroes

and poorest classes of some portions of the Southern United States. It

has also been reported from Java, China, Japan, and is said to have

been seen in Spain and Portugal. Peat-eating or bog-eating is still

seen in some parts of Ireland.

There were a number of people in the sixteenth and seventeenth

centuries who had formed the habit of eating small pebbles after each

meal. They formed the habit from seeing birds swallowing gravel after

eating. A number of such cases are on record.

There is on record the account of a man living in Wurtemberg who with

much voracity had eaten a suckling pig, and sometimes devoured an

entire sheep. He swallowed dirt, clay, pebbles, and glass, and was

addicted to intoxication by brandy. He lived sixty years in this manner

and then he became abstemious; he died at seventy-nine. His omentum was

very lean, but the liver covered all his abdominal viscera. His stomach

was very large and thick, but the intestines were very narrow.

Ely had a patient who was addicted to chalk-eating; this ha said

invariably relieved his gastric irritation. In the twenty-five years of

the habit he had used over 1/2 ton of chalk; but notwithstanding this

he always enjoyed good health. The Ephemerides contains a similar

instance, and Verzascha mentions a lime-eater. Adams mentions a child

of three who had an instinctive desire to eat mortar. This baby was

rickety and had carious teeth. It would pick its preferred diet out of

the wall, and if prevented would cry loudly. When deprived of the

mortar it would vomit its food until this substance was given to it

again. At the time of report part of the routine duties of the sisters

of this boy was to supply him with mortar containing a little sand.

Lime-water was substituted, but he insisted so vigorously on the solid

form of food that it had to be replaced in his diet. He suffered from

small-pox; on waking up in the night with a fever, he always cried for

a piece of mortar. The quantity consumed in twenty-four hours was about

1/2 teacupful. The child had never been weaned.

Arsenic Eaters.--It has been frequently stated that the peasants of

Styria are in the habit of taking from two to five grains of arsenious

acid daily for the purpose of improving the health, avoiding infection,

and raising the whole tone of the body. It is a well-substantiated fact

that the quantities taken habitually are quite sufficient to produce

immediate death ordinarily. But the same might be easily said of those

addicted to opium and chloral, a subject that will be considered later.

Perverted appetites during pregnancy have been discussed on pages 80

and 81.

Glass-eaters, penknife-swallowers, and sword-swallowers, being

exhibitionists and jugglers, and not individuals with perverted

appetites, will be considered in Chapter XII.

Fasting.--The length of time which a person can live with complete

abstinence from food is quite variable. Hippocrates admits the

possibility of fasting more than six days without a fatal issue; but

Pliny and others allow a much longer time, and both the ancient and

modern literature of medicine are replete with examples of abstinence

to almost incredible lengths of time. Formerly, and particularly in

the Middle Ages when religious frenzy was at its highest pitch,

prolonged abstinence was prompted by a desire to do penance and to gain

the approbation of Heaven.

In many religions fasting has become a part of worship or religions

ceremony, and from the earliest times certain sects have carried this

custom to extremes. It is well known that some of the priests and

anchorites of the East now subsist on the minimum amount of food, and

from the earliest times before the advent of Christianity we find

instances of prolonged fasting associated with religious worship. The

Assyrians, the Hebrews, the Egyptians, and other Eastern nations, and

also the Greeks and Romans, as well as feasting days, had their times

of fasting, and some of these were quite prolonged.

At the present day religious fervor accounts for but few of our

remarkable instances of abstinence, most of them being due to some form

of nervous disorder, varying from hysteria and melancholia to absolute

insanity. The ability seen in the Middle Ages to live on the Holy

Sacrament and to resist starvation may possibly have its analogy in

some of the fasting girls of the present day. In the older times these

persons were said to have been nourished by angels or devils; but

according to Hammond many cases both of diabolical abstinence from food

and of holy fasting exhibited manifest signs of hysteric symptoms.

Hammond, in his exhaustive treatise on the subject of "Fasting Girls,"

also remarks that some of the chronicles detail the exact symptoms of

hysteria and without hesitation ascribe them to a devilish agency. For

instance, he speaks of a young girl in the valley of Calepino who had

all her limbs twisted and contracted and had a sensation in her

esophagus as if a ball was sometimes rising in her throat or falling

into the stomach--a rather lay description of the characteristic

hysteric "lump in the throat," a frequent sign of nervous abstinence.

Abstinence, or rather anorexia, is naturally associated with numerous

diseases, particularly of the febrile type; but in all of these the

patient is maintained by the use of nutrient enemata or by other means,

and the abstinence is never complete.

A peculiar type of anorexia is that striking and remarkable digestive

disturbance of hysteria which Sir William Gull has called anorexia

nervosa. In this malady there is such annihilation of the appetite that

in some cases it seems impossible ever to eat again. Out of it grows an

antagonism to food which results at last, and in its worst forms, in

spasm on the approach of food, and this in its turn gives rise to some

of those remarkable cases of survival for long periods without food.

As this goes on there may be an extreme degree of muscular

restlessness, so that the patients wander about until exhausted.

According to Osler, who reports a fatal case in a girl who, at her

death, only weighed 49 pounds, nothing more pitiable is to be seen in

medical practice than an advanced case of this malady. The emaciation

and exhaustion are extreme, and the patient is as miserable as one with

carcinoma of the esophagus, food either not being taken at all or only

upon urgent compulsion.

Gull mentions a girl of fourteen, of healthy, plump appearance, who in

the beginning of February, 1887, without apparent cause evinced a great

repugnance to food and soon afterward declined to take anything but a

half cup of tea or coffee. Gull saw her in April, when she was much

emaciated; she persisted in walking through the streets, where she was

the object of remark of passers-by. At this time her height was five

feet four inches, her weight 63 pounds, her temperature 97 degrees F.,

her pulse 46, and her respiration from 12 to 14. She had a persistent

wish to be moving all the time, despite her emaciation and the

exhaustion of the nutritive functions.

There is another class of abstainers from food exemplified in the

exhibitionists who either for notoriety or for wages demonstrate their

ability to forego eating, and sometimes drinking, for long periods.

Some have been clever frauds, who by means of artifices have carried on

skilful deceptions; others have been really interesting physiologic

anomalies.

Older Instances.--Democritus in 323 B.C. is said to have lived forty

days by simply smelling honey and hot bread. Hippocrates remarks that

most of those who endeavored to abstain five days died within that

period, and even if they were prevailed upon to eat and drink before

the termination of their fast they still perished. There is a

possibility that some of these cases of Hippocrates were instances of

pyloric carcinoma or of stenosis of the pylorus. In the older writings

there are instances reported in which the period of abstinence has

varied from a short time to endurance beyond the bounds of credulity.

Hufeland mentions total abstinence from food for seventeen days, and

there is a contemporary case of abstinence for forty days in a maniac

who subsisted solely on water and tobacco. Bolsot speaks of abstinence

for fourteen months, and Consbruch mentions a girl who fasted eighteen

months. Muller mentions an old man of forty-five who lived six weeks on

cold water. There is an instance of a person living in a cave

twenty-four days without food or drink, and another of a man who

survived five weeks' burial under ruins. Ramazzini speaks of fasting

sixty-six days; Willian, sixty days (resulting in death); von Wocher,

thirty-seven days (associated with tetanus); Lantana, sixty days;

Hobbes, forty days; Marcardier, six months; Cruikshank, two months; the

Ephemerides, thirteen months; Gerard, sixty-nine days (resulting in

death); and in 1722 there was recorded an instance of abstinence

lasting twenty-five months.

Desbarreaux-Bernard says that Guillaume Granie died in the prison of

Toulouse in 1831, after a voluntary suicidal abstinence of sixty-three

days.

Haller cites a number of examples of long abstinence, but most

extraordinary was that of a girl of Confolens, described by Citois of

Poitiers, who published a history of the case in the beginning of the

seventeenth century. This girl is said to have passed three entire

years, from eleven to fourteen, without taking any kind of aliment. In

the "Harleian Miscellanies" is a copy of a paper humbly offered to the

Royal Society by John Reynolds, containing a discourse upon prodigious

abstinence, occasioned by the twelve months' fasting of a woman named

Martha Taylor, a damsel of Derbyshire. Plot gives a great variety of

curious anecdotes of prolonged abstinence. Ames refers to "the true and

admirable history of the maiden of Confolens," mentioned by Haller. In

the Annual Register, vol. i., is an account of three persons who were

buried five weeks in the snow; and in the same journal, in 1762, is the

history of a girl who is said to have subsisted nearly four years on

water. In 1684 four miners were buried in a coal-pit in Horstel, a half

mile from Liege, Belgium, and lived twenty-four days without food,

eventually making good recoveries. An analysis of the water used during

their confinement showed an almost total absence of organic matter and

only a slight residue of calcium salts.

Joanna Crippen lay six days in the snow without nutriment, being

overcome by the cold while on the way to her house; she recovered

despite her exposure. Somis, physician to the King of Sardinia, gives

an account of three women of Piedmont, Italy, who were saved from the

ruins of a stable where they had been buried by an avalanche of snow,

March 19, 1765. thirty-seven days before. Thirty houses and 22

inhabitants were buried in this catastrophe, and these three women,

together with a child of two, were sheltered in a stable over which the

snow lodged 42 feet deep. They were in a manger 20 inches broad and

upheld by a strong arch. Their enforced position was with their backs

to the wall and their knees to their faces. One woman had 15 chestnuts,

and, fortunately, there were two goats near by, and within reach some

hay, sufficient to feed them for a short time. By milking one of the

goats which had a kid, they obtained about two pints daily, upon which

they subsisted for a time. They quenched their thirst with melted snow

liquefied by the heat of their hands. Their sufferings were greatly

increased by the filth, extreme cold, and their uncomfortable

positions; their clothes had rotted. When they were taken out their

eyes were unable to endure the light and their stomachs at first

rejected all food.

While returning from Cambridge, February 2, 1799, Elizabeth Woodcock

dismounted from her horse, which ran away, leaving her in a violent

snowstorm. She was soon overwhelmed by an enormous drift six feet high.

The sensation of hunger ceased after the first day and that of thirst

predominated, which she quenched by sucking snow. She was discovered on

the 10th of February, and although suffering from extensive gangrene of

the toes, she recovered. Hamilton says that at a barracks near Oppido,

celebrated for its earthquakes, there were rescued two girls, one

sixteen and the other eleven; the former had remained under the ruins

without food for eleven days. This poor creature had counted the days

by a light coming through a small opening. The other girl remained six

days under the ruin in a confined and distressing posture, her hands

pressing her cheek until they had almost made a hole in it. Two persons

were buried under earthquake ruins at Messina for twenty-three and

twenty-two days each.

Thomas Creaser gives the history of Joseph Lockier of Bath, who, while

going through a woods between 6 and 7 P.M., on the 18th of August, was

struck insensible by a violent thunderbolt. His senses gradually

returned and he felt excessively cold. His clothes were wet, and his

feet so swollen that the power of the lower extremities was totally

gone and that of the arms was much impaired. For a long time he was

unable to articulate or to summon assistance. Early in September he

heard some persons in the wood and, having managed to summon them in a

feeble voice, told them his story. They declared him to be an impostor

and left him. On the evening of the same day his late master came to

his assistance and removed him to Swan Inn. He affirmed that during his

exposure in the woods he had nothing to eat; though distressing at

first, hunger soon subsided and yielded to thirst, which he appeased by

chewing grass having beads of water thereon. He slept during the

warmth of the day, but the cold kept him awake at night. During his

sleep he dreamt of eating and drinking. On November 17, 1806, several

surgeons of Bath made an affidavit, in which they stated that this man

was admitted to the Bath City Dispensary on September 15th, almost a

month after his reputed stroke, in an extremely emaciated condition,

with his legs and thighs shriveled as well as motionless. There were

several livid spots on his legs and one toe was gangrenous. After some

time they amputated the toe. The power in the lower extremities soon

returned.

In relating his travels in the Levant, Hasselquist mentions 1000

Abyssinians who became destitute of provisions while en route to Cairo,

and who lived two months on gum arabic alone, arriving at their

destination without any unusual sickness or mortality. Dr. Franklin

lived on bread and water for a fortnight, at the rate of ten pounds per

week, and maintained himself stout and healthy. Sir John Pringle knew

a lady of ninety who lived on pure fat meat. Glower of Chelmsford had a

patient who lived ten years on a pint of tea daily, only now or then

chewing a half dozen raisins or almonds, but not swallowing them. Once

in long intervals she took a little bread.

Brassavolus describes a younger daughter of Frederick King of Naples

who lived entirely without meat, and could not endure even the taste of

it, as often as she put any in her mouth she fell fainting. The monks

of Monte Santo (Mount Athos) never touched animal food, but lived on

vegetables, olives, end cheese. In 1806 one of them at the age of one

hundred and twenty was healthy.

Sometimes in the older writings we find records of incredible

abstinence. Jonston speaks of a man in 1460 who, after an unfortunate

matrimonial experience, lived alone for fifteen years, taking neither

food nor drink. Petrus Aponensis cites the instance of a girl fasting

for eight years. According to Jonston, Hermolus lived forty years on

air alone. This same author has also collected cases of abstinence

lasting eleven, twenty-two, and thirty years and cites Aristotle as an

authority in substantiating his instances of fasting girls.