most of one’s time—in boxes. . . which you call “buildings”
6. The scrotum may be normal or split; the testicles, commonly two in number, may be normal or atrophic, descended or undescended; the prostate may be normal or imperfectly developed, as may also the vasa deferentia and vesiculae seminales.
7. The commonly associated defects are: More or less completely septate bladder, atresia ani, or more rarely double anus, double urethra, increased breadth of the bony pelvis with defect of the symphysis pubis, and possibly duplication of the lower end of the spine, and hernia of some of the abdominal contents into a perineal pouch. Much more rarely, duplication of the heart, lungs, stomach, and kidneys has been noted, and the lower limbs may be shorter than normal.
CLASS XI.--Cases of fetus in fetu, those strange instances in which one might almost say that a man may be pregnant with his brother or sister, or in which an infant may carry its twin without the fact being apparent, will next be discussed. The older cases were cited as being only a repetition of the process by which Eve was born of Adam. Figure 63 represents an old engraving showing the birth of Eve. Bartholinus, the Ephemerides, Otto, Paullini, Schurig, and Plot speak of instances of fetus in fetu. Ruysch describes a tumor contained in the abdomen of a man which was composed of hair, molar teeth, and other evidences of a fetus. Huxham reported to the Royal Society in 1748 the history of a child which was born with a tumor near the anus larger than the whole body of the child; this tumor contained rudiments of an embryo. Young speaks of a fetus which lay encysted between the laminae of the transverse mesocolon, and Highmore published a report of a fetus in a cyst communicating with the duodenum. Dupuytren gives an example in a boy of thirteen, in whom was found a fetus. Gaetano-Nocito, cited by Philipeaux, has the history of a taken with a great pain in the right hypochondrium, and from which issued subsequently fetal bones and a mass of macerated embryo. His mother had had several double pregnancies, and from the length of the respective tibiae one of the fetuses seemed to be of two months' and the other of three months' intrauterine life. The man died five years after the abscess had burst spontaneously.
Brodie speaks of a case in which fetal remains were taken from the abdomen of a girl of two and one-half years. Gaither describes a child of two years and nine months, supposed to be affected with ascites, who died three hours after the physician's arrival. In its abdomen was found a fetus weighing almost two pounds and connected to the child by a cord resembling an umbilical cord. This child was healthy for about nine months, and had a precocious longing for ardent spirits, and drank freely an hour before its death.
Blundell says that he knew "a boy who was literally and without evasion with child, for the fetus was contained in a sac communicating with the abdomen and was connected to the side of the cyst by a short umbilical cord; nor did the fetus make its appearance until the boy was eight or ten years old, when after much enlargement of pregnancy and subsequent flooding the boy died." The fetus, removed after death, on the whole not very imperfectly formed, was of the size of about six or seven months' gestation. Bury cites an account of a child that had a second imperfectly developed fetus in its face and scalp. There was a boy by the name of Bissieu who from the earliest age had a pain in one of his left ribs; this rib was larger than the rest and seemed to have a tumor under it. He died of phthisis at fourteen, and after death there was found in a pocket lying against the transverse colon and communicating with it all the evidences of a fetus.
At the Hopital de la Charite in Paris, Velpeau startled an audience of 500 students and many physicians by saying that he expected to find a rudimentary fetus in a scrotal tumor placed in his hands for operation. His diagnosis proved correct, and brought him resounding praise, and all wondered as to his reasons for expecting a fetal tumor. It appears that he had read with care a report by Fatti of an operation on the scrotum of a child which had increased in size as the child grew, and was found to contain the ribs, the vertebral column, the lower extremities as far as the knees, and the two orbits of a fetus; and also an account of a similar operation performed by Wendt of Breslau on a Silesian boy of seven. The left testicle in this case was so swollen that it hung almost to the knee, and the fetal remains removed weighed seven ounces.
Sulikowski relates an instance of congenital fetation in the umbilicus of a girl of fourteen, who recovered after the removal of the anomaly. Aretaeos described to the members of the medical fraternity in Athens the case of a woman of twenty-two, who bore two children after a seven months' pregnancy. One was very rudimentary and only 21 inches long, and the other had an enormous head resembling a case of hydrocephalus. On opening the head of the second fetus, another, three inches long, was found in the medulla oblongata, and in the cranial cavity with it were two additional fetuses, neither of which was perfectly formed.
Broca speaks of a fetal cyst being passed in the urine of a man of sixty- one; the cyst contained remnants of hair, bone, and cartilage. Atlee submits quite a remarkable case of congenital ventral gestation, the subject being a girl of six, who recovered after the discharge of the fetal mass from the abdomen. McIntyre speaks of a child of eleven, playing about and feeling well, but whose abdomen progressively increased in size 1 1/2 inches each day. After ten days there was a large fluctuating mass on the right side; the abdomen was opened and the mass enucleated; it was found to contain a fetal mass weighing nearly five pounds, and in addition ten pounds of fluid were removed. The child made an early recovery. Rogers mentions a fetus that was found in a man's bladder. Bouchacourt reports the successful extirpation of the remains of a fetus from the rectum of a child of six. Miner describes a successful excision of a congenital gestation.
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