The Heart.—Absence of the heart has never been recorded in human beings except in the case of monsters, as, for example, the omphalosites, although there was a case reported and firmly believed by the ancient authors,—a Roman soldier in whom Telasius said he could discover no vestige of a heart.
The absence of one ventricle has been recorded. Schenck has seen the left ventricle deficient, and the Ephemerides, Behr, and Kerckring speak of a single ventricle only in the heart. Riolan mentions a heart in which both ventricles were absent. Jurgens reported in Berlin, February 1, 1882, an autopsy on a child who had lived some days after birth, in which the left ventricle of the heart was found completely absent. Playfair showed the heart of a child which had lived nine months in which one ventricle was absent. In King's College Hospital in London there is a heart of a boy of thirteen in which the cavities consist of a single ventricle and a single auricle.
Duplication of the heart, notwithstanding the number of cases reported, has been admitted with the greatest reserve by Geoffroy-Saint-Hilaire and by a number of authors. Among the celebrated anatomists who describe duplex heart are Littre, Meckel, Collomb, Panum, Behr, Paullini, Rhodins, Winslow, and Zacutus Lusitanus.
The Ephemerides cites an instance of triple heart, and Johnston has seen a triple heart in a goose.
The phenomenon of "blue-disease," or congenital cyanosis, is due to the patency of the foremen ovale, which, instead of closing at birth, persists sometimes to adult life.
Perhaps the most unique collection of congenital malformations of the heart from persons who have reached the age of puberty was to be seen in London in 1895. In this collection there was an adult heart in which the foremen ovale remained open until the age of thirty-seven; there were but two pulmonary valves; there was another heart showing a large patent foramen ovale from a man of forty-six; and there was a septum ventriculorum of an adult heart from a woman of sixty-three, who died of carcinoma of the breast, in which the foremen ovale was still open and would admit the fore-finger. This woman had shown no symptoms of the malformation. There were also hearts in which the interventricular septum was deficient, the ductus arteriosus patent, or some valvular malformation present. All these persons had reached puberty.
Displacements of the heart are quite numerous. Deschamps of Laval made an autopsy on an old soldier which justified the expression, "He had a heart in his belly." This organ was found in the left lumbar region; it had, with its vessels, traversed an anomalous opening in the diaphragm. Franck observed in the Hospital of Colmar a woman with the heart in the epigastric region. Ramel and Vetter speak of the heart under the diaphragm.
Inversion of the heart is quite frequent, and we often find reports of cases of this anomaly. Fournier describes a soldier of thirty years, of middle height, well proportioned and healthy, who was killed in a duel by receiving a wound in the abdomen; postmortem, the heart was found in the position of the right lung; the two lungs were joined and occupied the left chest.
The anomalies of the vascular system are so numerous that we shall dismiss them with a slight mention. Malacarne in Torino in 1784 described a double aorta, and Hommelius mentions an analogous case. The following case is quite an interesting anatomic anomaly: A woman since infancy had difficulty in swallowing, which was augmented at the epoch of menstruation and after exercise; bleeding relieved her momentarily, but the difficulty always returned. At last deglutition became impossible and the patient died of malnutrition. A necropsy revealed the presence of the subclavicular artery passing between the tracheal artery and the esophagus, compressing this latter tube and opposing the passage of food.
Anomalies of the Breasts.—The first of the anomalies of the generative apparatus to be discussed, although not distinctly belonging under this head, will be those of the mammae.
Amazia, or complete absence of the breast, is seldom seen. Pilcher describes an individual who passed for a female, but who was really a male, in whom the breasts were absolutely wanting. Foerster, Froriep, and Ried cite instances associated with thoracic malformation. Greenhow reports a case in which the mammae were absent, although there were depressed rudimentary nipples and areolae. There were no ovaries and the uterus was congenitally imperfect.
There was a negress spoken of in 1842 in whom the right breast was missing, and there are cases of but one breast, mentioned by King, Paull, and others. Scanzoni has observed absence of the left mamma with absence of the left ovary.
Micromazia is not so rare, and is generally seen in females with associate genital troubles. Excessive development of the mammae, generally being a pathologic phenomenon, will be mentioned in another chapter. However, among some of the indigenous negroes the female breasts are naturally very large and pendulous. This is well shown in Figure 144, which represents a woman of the Bushman tribe nursing an infant. The breasts are sufficiently pendulous and loose to be easily thrown over the shoulder.
Polymazia is of much more frequent occurrence than is supposed. Julia, the mother of Alexander Severus, was surnamed "Mammea" because she had supernumerary breasts. Anne Boleyn, the unfortunate wife of Henry VIII of England, was reputed to have had six toes, six fingers, and three breasts. Lynceus says that in his time there existed a Roman woman with four mammae, very beautiful in contour, arranged in two lines, regularly, one above the other, and all giving milk in abundance. Rubens has pictured a woman with four breasts; the painting may be seen in the Louvre in Paris.
There was a young and wealthy heiress who addressed herself to the ancient faculty at Tubingen, asking, as she displayed four mammary, whether, should she marry, she would have three or four children at a birth. This was a belief with which some of her elder matron friends had inspired her, and which she held as a hindrance to marriage.
Leichtenstern, who has collected 70 cases of polymazia in females and 22 in males, thinks that accessory breasts or nipples are due to atavism, and that our most remote inferiorly organized ancestors had many breasts, but that by constantly bearing but one child, from being polymastic, females have gradually become bimastic. Some of the older philosophers contended that by the presence of two breasts woman was originally intended to bear two children.
Hirst says: "Supernumerary breasts and nipples are more common than is generally supposed. Bruce found 60 instances in 3956 persons examined (1.56 per cent). Leichtenstern places the frequency at one in 500. Both observers declare that men present the anomaly about twice as frequently as women. It is impossible to account for the accessory glands on the theory of reversion, as they occur with no regularity in situation, but may develop at odd places on the body. The most frequent position is on the pectoral surface below the true mammae and somewhat nearer the middle line, but an accessory gland has been observed on the left shoulder over the prominence of the deltoid, on the abdominal surface below the costal cartilages, above the umbilicus, in the axilla, in the groin, on the dorsal surface, on the labium majus, and on the outer aspect of the left thigh. Ahlfeld explains the presence of mammae on odd parts of the body by the theory that portions of the embryonal material entering into the composition of the mammary gland are carried to and implanted upon any portion of the exterior of the body by means of the amnion."
Possibly the greatest number of accessory mammae reported is that of Neugebauer in 1886, who found ten in one person. Peuch in 1876 collected 77 cases, and since then Hamy, Quinqusud, Whiteford, Engstrom, and Mitchell Bruce have collected cases. Polymazia must have been known in the olden times, and we still have before us the old images of Diana, in which this goddess is portrayed with numerous breasts, indicating her ability to look after the growing child. Figure 145 shows an ancient Oriental statue of Artemisia or Diana now at Naples.
Bartholinus has observed a Danish woman with three mammae, two ordinarily formed and a third forming a triangle with the others and resembling the breasts of a fat man. In the village of Phullendorf in Germany early in this century there was an old woman who sought alms from place to place, exhibiting to the curious four symmetrical breasts, arranged parallel. She was extremely ugly, and when on all fours, with her breasts pendulous, she resembled a beast. The authors have seen a man with six distinct nipples, arranged as regularly as those of a bitch or sow. The two lower were quite small. This man's body was covered with heavy, long hair, making him a very conspicuous object when seen naked during bathing. The hair was absent for a space of nearly an inch about the nipples. Borellus speaks of a woman with three mammae, two as ordinarily, the third to the left side, which gave milk, but not the same quantity as the others. Gardiner describes a mulatto woman who had four mammae, two of which were near the axillae, about four inches in circumference, with proportionate sized nipples. She became a mother at fourteen, and gave milk from all her breasts. In his "Dictionnaire Philosophique" Voltaire gives the history of a woman with four well-formed and symmetrically arranged breasts; she also exhibited an excrescence, covered with a nap-like hair, looking like a cow-tail. Percy thought the excrescence a prolongation of the coccyx, and said that similar instances were seen in savage men of Borneo.
Percy says that among some prisoners taken in Austria was found a woman of Valachia, near Roumania, exceedingly fatigued, and suffering intensely from the cold. It was January, and the ground was covered with three feet of snow. She had been exposed with her two infants, who had been born twenty days, to this freezing temperature, and died on the next day. An examination of her body revealed five mammae, of which four projected as ordinarily, while the fifth was about the size of that of a girl at puberty.
They all had an intense dark ring about them; the fifth was situated about five inches above the umbilicus. Percy injected the subject and dissected and described the mammary blood-supply. Hirst mentions a negress of nineteen who had nine mammae, all told, and as many nipples. The two normal glands were very large. Two accessory glands and nipples below them were small and did not excrete milk. All the other glands and nipples gave milk in large quantities. There were five nipples on the left and four on the right side. The patient's mother had an accessory mamma on the abdomen that secreted milk during the period of lactation.
Charpentier has observed in his clinic a woman with two supplementary axillary mammae with nipples. They gave milk as the ordinary mammae. Robert saw a woman who nourished an infant by a mamma on the thigh. Until the time of pregnancy this mamma was taken for an ordinary nevus, but with pregnancy it began to develop and acquired the size of a citron. Figure 147 is from an old wood-cut showing a child suckling at a supernumerary mamma on its mother's thigh while its brother is at the natural breast. Jenner speaks of a breast on the outer side of the thigh four inches below the great trochanter. Hare describes a woman of thirty-seven who secreted normal milk from her axillae. Lee mentions a woman of thirty-five with four mammae and four nipples; she suckled with the pectoral and not the axillary breasts. McGillicudy describes a pair of rudimentary abdominal mammae, and there is another similar case recorded. Hartung mentions a woman of thirty who while suckling had a mamma on the left labium majus. It was excised, and microscopic examination showed its structure to be that of a rudimentary nipple and mammary gland. Leichtenstern cites a case of a mamma on the left shoulder nearly under the insertion of the deltoid, and Klob speaks of an acromial accessory mamma situated on the shoulder over the greatest prominence of the deltoid. Hall reports the case of a functionally active supernumerary mamma over the costal cartilage of the 8th rib. Jussieu speaks of a woman who had three breasts, one of which was situated on the groin and with which she occasionally suckled; her mother had three breasts, but they were all situated on the chest. Saunois details an account of a female who had two supernumerary breasts on the back. Bartholinus (quoted by Meckel) and Manget also mention mammae on the back, but Geoffroy-Saint-Hilaire questions their existence. Martin gives a very clear illustration of a woman with a supernumerary breast below the natural organ. Sneddon, who has collected quite a number of cases of polymazia, quotes the case of a woman who had two swellings in each axilla in which gland-structure was made out, but with no external openings, and which had no anatomic connection with the mammary glands proper. Shortly after birth they varied in size and proportion, as the breasts were full or empty, and in five weeks all traces of them were lost. Her only married sister had similar enlargements at her third confinement.
Polymazia sometimes seems to be hereditary. Robert saw a daughter whose mother was polymastic, and Woodman saw a mother and eldest daughter who each had three nipples. Lousier mentions a woman wanting a mamma who transmitted this vice of conformation to her daughter. Handyside says he knew two brothers in both of whom breasts were wanting.
Supernumerary nipples alone are also seen, as many as five having been found on the same breast. Neugebauer reports eight supernumerary nipples in one case. Hollerus has seen a woman who had two nipples on the same breast which gave milk with the same regularity and the same abundance as the single nipple. The Ephemerides contains a description of a triple nipple. Barth describes "mamma erratica" on the face in front of the right ear which enlarged during menstruation.
Cases of deficiency of the nipples have been reported by the Ephemerides, Lentilius, Severinus, and Werckardus.
Cases of functional male mammae will be discussed in Chapter IX.
Complete absence of the hymen is very rare, if we may accept the statements of Devilliers, Tardieu, and Brouardel, as they have never seen an example in the numerous young girls they have examined from a medico-legal point of view.
Duplication or biperforation of the hymen is also a very rare anomaly of this membrane. In this instance the hymen generally presents two lateral orifices, more or less irregular and separated by a membranous band, which gives the appearance of duplicity. Roze reported from Strasburg in 1866 a case of this kind, and Delens has observed two examples of biperforate hymen, which show very well that this disposition of the membrane is due to a vice of conformation. The first was in a girl of eleven, in which the membrane was of the usual size and thickness, but was duplicated on either side. In her sister of nine the hymen was normally conformed. The second case was in a girl under treatment by Cornil in 1876 for vaginitis. Her brother had accused a young man of eighteen of having violated her, and on examination the hymen showed a biperforate conformation; there were two oval orifices, their greatest diameter being in the vertical plane; the openings were situated on each side of the median line, about five mm. apart; the dividing band did not appear to be cicatricial, but presented the same roseate coloration as the rest of the hymen. Since this report quite a number of cases have been recorded.
The different varieties of the hymen will be left to the works on obstetrics. As has already been observed, labor is frequently seriously complicated by a persistent and tough hymen.
Deficient vulva may be caused by the persistence of a thick hymen, by congenital occlusion, or by absolute absence in vulvar structure. Bartholinus, Borellus, Ephemerides, Julius, Vallisneri, and Baux are among the older writers who mention this anomaly, but as it is generally associated with congenital occlusion, or complete absence of the vagina, the two will be considered together.
Complete absence of the vagina is quite rare. Baux a reports a case of a girl of fourteen in whom "there was no trace of fundament or of genital organs." Oberteuffer speaks of a case of absent vagina. Vicq d'Azir is accredited with having seen two females who, not having a vagina, copulated all through life by the urethra, and Fournier sagely remarks that the extra large urethra may have been a special dispensation of nature. Bosquet describes a young girl of twenty with a triple vice of conformation—an obliterated vulva, closure of the vagina, and absence of the uterus. Menstrual hemorrhage took place from the gums. Clarke has studied a similar case which was authenticated by an autopsy.
O'Ferral of Dublin, Gooch, Davies, Boyd, Tyler Smith, Hancock, Coste, Klayskens, Debrou, Braid, Watson, and others are quoted by Churchill as having mentioned the absence of the vagina. Amussat observed a German girl who did not have a trace of a vagina and who menstruated regularly. Griffith describes a specimen in the Museum of St. Bartholomew's Hospital, London, in which the ovaries lay on the surface of the pelvic peritoneum and there was neither uterus nor vagina; the pelvis had some of the characteristics of the male type. Matthews Duncan has observed a somewhat similar case, the vagina not measuring more than an inch in length. Ferguson describes a prostitute of eighteen who had never menstruated. The labia were found well developed, but there was no vagina, uterus, or ovaries. Coitus had been through the urethra, which was considerably distended, though not causing incontinence of urine. Hulke reports a case of congenital atresia of the vagina in a brunette of twenty, menstruation occurring through the urethra. He also mentions the instance of congenital atresia of the vagina with hernia of both ovaries into the left groin in a servant of twenty, and the case of an imperforate vagina in a girl of nineteen with an undeveloped uterus.
Brodhurst reports an instance of absence of the vagina and uterus in a girl of sixteen who at four years of age showed signs of approaching puberty. At this early age the mons was covered with hair, and at ten the clitoris was three inches long and two inches in circumference. The mammae were well developed. The labia descended laterally and expanded into folds, resembling the scrotum.
Azema reports an instance of complete absence of the vagina and impermeability and probable absence of the col uterinus. The deficiencies were remedied by operation. Berard mentions a similar deformity and operation in a girl of eighteen. Gooding cites an instance of absent vagina in a married woman, the uterus discharging the functions. Gosselin reports a case in which a voluminous tumor was formed by the retained menstrual fluid in a woman without a vagina. An artificial vagina was created, but the patient died from extravasation of blood into the peritoneal cavity. Carter, Polaillon, Martin, Curtis, Worthington, Hall, Hicks, Moliere, Patry, Dolbeau, Desormeaux, and Gratigny also record instances of absence of the vagina.
There are some cases reported in extramedical literature which might be cited. Bussy Rabutin in his Memoires in 1639 speaks of an instance. The celebrated Madame Recamier was called by the younger Dumas an involuntary virgin; and in this connection could be cited the malicious and piquant sonnet—
Chateaubriand et Madame Recamier.
"Juliette et Rene s'aimaient d'amour si tendre Que Dien, sans les punir, a pu leur pardonner: Il n'avait pas voulu que l'une put donner Ce que l'autre ne pouvait prendre."
Duplex vagina has been observed by Bartholinus, Malacarne, Asch, Meckel, Osiander, Purcell, and other older writers. In more modern times reports of this anomaly are quite frequent. Hunter reports a case of labor at the seventh month in a woman with a double vagina, and delivery through the rectum. Atthill and Watts speak of double vagina with single uterus.
Robb of Johns Hopkins Hospital reports a case of double vagina in a patient of twenty suffering from dyspareunia. The vaginal orifice was contracted; the urethra was dilated and had evidently been used for coitus. A membrane divided the vagina into two canals, the cervix lying in the right half; the septum was also divided. Both the thumbs of the patient were so short that their tips could scarcely meet those of the little fingers. Double vagina is also reported by Anway, Moulton, Freeman, Frazer, Haynes, Lemaistre, Boardman, Dickson, Dunoyer, and Rossignol. This anomaly is usually associated with bipartite or double uterus. Wilcox mentions a primipara, three months pregnant, with a double vagina and a bicornate uterus, who was safely delivered of several children. Haller and Borellus have seen double vagina, double uterus, and double ovarian supply; in the latter case there was also a double vulva. Sanger speaks of a supernumerary vagina connecting with the other vagina by a fistulous opening, and remarks that this was not a case of patent Gartner's duct.
Cullingworth cites two cases in which there were transverse septa of the vagina. Stone reports five cases of transverse septa of the vagina. Three of the patients were young women who had never borne children or suffered injury. Pregnancy existed in each case. In the first the septum was about two inches from the introitus, and contained an opening about 1/2 inch in diameter which admitted the tip of the finger. The membrane was elastic and thin and showed no signs of inflammation. Menstruation had always been regular up to the time of pregnancy. The second was a duplicate of the first, excepting that a few bands extended from the cervix to the membranous septum. In the third the lumen of the vagina, about two inches from the introitus, was distinctly narrowed by a ridge of tissue. There was uterine displacement and some endocervicitis, but no history of injury or operation and no tendency to contraction. The two remaining cases occurred in patients seen by Dr. J. F. Scott. In one the septum was about 1 3/4 inches from the entrance to the vagina and contained an orifice large enough to admit a uterine probe. During labor the septum resisted the advance of the head for several hours, until it was slit in several directions. In the other, menstruation had always been irregular, intermissions being followed by a profuse flow of black and tarry blood, which lasted sometimes for fifteen days and was accompanied by severe pain. The septum was 1 1/2 inches from the vaginal orifice and contained an opening which admitted a uterine sound. It was very dense and tight and fully 1/8 inch in thickness.
Mordie reported a case of congenital deficiency of the rectovaginal septum which was successfully remedied by operation.
Anomalous Openings of the Vagina.—The vagina occasionally opens abnormally into the rectum, into the bladder, the urethra, or upon the abdominal parietes. Rossi reports from a hospital in Turin the case of a Piedmontese girl in whom there was an enormous tumor corresponding to the opening of the vaginal orifice; no traces of a vagina could be found. The tumor was incised and proved to be a living infant. The husband of the woman said that he had coitus without difficulty by the rectum, and examination showed that the vagina opened into the rectum, by which means impregnation had been accomplished. Bonnain and Payne have observed analogous cases of this abnormality of the vaginal opening and subsequent accouchement by the anus. Payne's case was of a woman of thirty-five, well formed, who had been in labor thirty-six hours, when the physician examined and looked in vain for a vaginal opening; the finger, gliding along the perineum, came in contact with the distended anus, in which was recognized the head of the fetus. The woman from prolongation of labor was in a complete state of prostration, which caused uterine inertia. Payne anesthetized the patient, applied the forceps, and extracted the fetus without further accident. The vulva of this woman five months afterward displayed all the characteristics of virginity, the vagina opened into the rectum, and menstruation had always been regular. This woman, as well as her husband, averred that they had no suspicion of the anomaly and that coitus (by the anus) had always been satisfactory.
Opening of the vagina upon the parietes, of which Le Fort has collected a number of cases, has never been observed in connection with a viable fetus.
Absence of the labia majora has been observed, especially by Pozzi, to the exclusion of all other anomalies. It is the rule in exstrophy of the bladder.
Absence of the nymphae has also been observed, particularly by Auvard and by Perchaux, and is generally associated with imperfect development of the clitoris. Constantinedes reports absence of the external organs of generation, probably also of the uterus and its appendages, in a young lady. Van Haartman, LeFort, Magee, and Ogle cite cases of absence of the external female organs. Riolan in the early part of the seventeenth century reported a case of defective nymphae; Neubauer in 1774 offers a contrast to this case in an instance of triple nymphae.
The nymphae are sometimes enormously enlarged by hypertrophy, by varicocele, or by elephantiasis, of which latter type Rigal de Gaillac has observed a most curious case. There is also a variety of enlargement of the clitoris which seems to be constant in some races; it may be a natural hypertrophy, or perhaps produced by artificial manipulation.
The peculiar conditions under which the Chinese women are obliged to live, particularly their mode of sitting, is said to have the effect of causing unusual development of the mons veneris and the labia majora. On the other hand, some of the lower African races have been distinguished by the deficiency in development of the labia majora, mons veneris, and genital hair. In this respect they present an approximation to the genitals of the anthropoid apes, among whom the orang-outang alone shows any tendency to formation of the labia majora.
The labial appendages of the Hottentot female have been celebrated for many years. Blumenbach and others of the earlier travelers found that the apron-like appearance of the genitals of the Hottentot women was due to abnormal hypertrophy of the labia and nymphae. According to John Knott, the French traveler, Le Vaillant, said that the more coquettish among the Hottentot girls are excited by extreme vanity to practice artificial elongation of the nympha and labia. They are said to pull and rub these parts, and even to stretch them by hanging weights to them. Some of them are said to spend several hours a day at this process, which is considered one of the important parts of the toilet of the Hottentot belle, this malformation being an attraction for the male members of the race. Merensky says that in Basutoland the elder women begin to practice labial manipulation on their female children shortly after infancy, and Adams has found this custom to prevail in Dahomey; he says that the King's seraglio includes 3000 members, the elect of his female subjects, all of whom have labia up to the standard of recognized length. Cameron found an analogous practice among the women of the shores of Lake Tanganyika. The females of this nation manipulated the skin of the lower part of the abdomens of the female children from infancy, and at puberty these women exhibit a cutaneous curtain over the genitals which reaches half-way down the thighs.
A corresponding development of the preputian clitorides, attaining the length of 18 mm. or even more, has been observed among the females of Bechuanaland. The greatest elongation measured by Barrow was five inches, but it is quite probable that it was not possible for him to examine the longest, as the females so gifted generally occupied very high social positions.
Morgagni describes a supernumerary left nympha, and Petit is accredited with seeing a case which exhibited neither nymphae, clitoris, nor urinary meatus. Mauriceau performed nymphotomy on a woman whose nymphae were so long as to render coitus difficult. Morand quotes a case of congenital malformation of the nymphae, to which he attributed impotency.
There is sometimes coalition of the labia and nymphae, which may be so firm and extensive as to obliterate the vulva. Debout has reported a case of absence of the vulva in a woman of twenty upon whom he operated, which was the result of the fusion of the labia minora, and this with an enlarged clitoris gave the external appearance of an hermaphrodite.
The absence of the clitoris coincides with epispadias in the male, and in atrophy of the vulva it is common to find the clitoris rudimentary; but a more frequent anomaly is hypertrophy of the clitoris.
Among the older authorities quoting instances of enlarged clitorides are Bartholinus, Schenck, Hellwig, Rhodius, Riolanus, and Zacchias. Albucasis describes an operation for enlarged clitoris, Chabert ligated one, and Riedlin gives an instance of an enlarged clitoris, in which there appeared a tumor synchronous with the menstrual epoch.
We learn from the classics that there were certain females inhabiting the borders of the Aegean Sea who had a sentimental attachment for one another which was called "Lesbian love," and which carried them to the highest degree of frenzy. The immortal effusions of Sappho contain references to this passion. The solution of this peculiar ardor is found in the fact that some of the females had enlarged clitorides, strong voices, robust figures, and imitated men. Their manner was imperative and authoritative to their sex, who worshiped them with perverted devotion. We find in Martial mention of this perverted love, and in the time of the dissolute Greeks and Romans ridiculous jealousies for unfaithfulness between these women prevailed. Aetius said that the Egyptians practiced amputation of the clitoris, so that enlargement of this organ must have been a common vice of conformation along the Nile. It was also said that the Egyptian women practiced circumcision on their females at the age of seven or eight, the time chosen being when the Nile was in flood. Bertherand cites examples of enlarged clitorides in Arab women; Bruce testifies to this circumstance in Abyssinia, and Mungo Park has observed it in the Mandingos and the Ibbos.
Sonnini says that the women of Egypt had a natural excrescence, fleshy in consistency, quite thick and pendulous, coming from the skin of the mons veneris. Sonnini says that in a girl of eight he saw one of these caruncles which was 1/2 inch long, and another on a woman of twenty which was four inches long, and remarks that they seem peculiar only to women of distinct Egyptian origin.
Duhouset says that in circumcision the Egyptian women not only remove a great part of the body of the clitoris with the prepuce, but also adjacent portions of the nymphae; Gallieni found a similar operation customary on the upper banks of the Niger.
Otto at Breslau in 1824 reports seeing a negress with a clitoris 4 1/2 inches long and 1 1/2 inches in the transverse diameter; it projected from the vulva and when supine formed a complete covering for the vaginal orifice. The clitoris may at times become so large as to prevent coitus, and in France has constituted a legitimate cause for divorce. This organ is very sensitive, and it is said that in cases of supposed catalepsy a woman cannot bear titillation of the clitoris without some visible movement.
Columbus cites an example of a clitoris as long as a little finger; Haller mentions one which measured seven inches, and there is a record of an enlarged clitoris which resembled the neck of a goose and which was 12 inches long. Bainbridge reports a case of enlarged clitoris in a woman of thirty-two who was confined with her first child. This organ was five inches in length and of about the diameter of a quiescent penis. Figure 149 shows a well-marked case of hypertrophy of the clitoris. Rogers describes a woman of twenty-five in a reduced state of health with an enormous clitoris and warts about the anus; there were also manifestations of tuberculosis. On questioning her, it was found that she had formerly masturbated; later she had sexual intercourse several times with a young man, but after his death she commenced self-abuse again, which brought on the present enlargement. The clitoris was ligated and came away without leaving disfigurement. Cassano and Pedretti of Naples reported an instance of monstrous clitoris in 1860 before the Academy of Medicine.
In some cases ossification of the clitoris is observed Fournier speaks of a public woman in Venice who had an osseous clitoris; it was said that men having connection with her invariably suffered great pain, followed by inflammation of the penis.
There are a few instances recorded of bifid clitoris, and Arnaud cites the history of a woman who had a double clitoris. Secretain speaks of a clitoris which was in a permanent state of erection.
Complete absence of the ovaries is seldom seen, but there are instances in which one of the ovaries is missing. Hunter, Vidal, and Chaussier report in full cases of the absence of the ovaries, and Thudicum has collected 21 cases of this nature. Morgagni, Pears, and Cripps have published observations in which both ovaries were said to have been absent. Cripps speaks of a young girl of eighteen who had an infantile uterus and no ovaries; she neither menstruated nor had any signs of puberty. Lauth cites the case of a woman whose ovaries and uterus were rudimentary, and who exhibited none of the principal physiologic characteristics of her sex; on the other hand, Ruband describes a woman with only rudimentary ovaries who was very passionate and quite feminine in her aspect.
At one time the existence of genuine supernumerary ovaries was vigorously disputed, and the older records contain no instances, but since the researches of Beigel, Puech, Thudicum, Winckler, de Sinety, and Paladino the presence of multiple ovaries is an incontestable fact. It was originally thought that supernumerary ovaries as well as supernumerary kidneys were simply segmentations of the normal organs and connected to them by portions of the proper substance; now, however, by the recent reports we are warranted in admitting these anomalous structures as distinct organs. It has even been suggested that it is the persistence of these ovaries that causes the menstruation of which we sometimes hear as taking place after ovariotomy. Sippel records an instance of third ovary; Mangiagalli has found a supernumerary ovary in the body of a still-born child, situated to the inner side of the normal organ. Winckel discovered a large supernumerary ovary connected to the uterus by its own ovarian ligament. Klebs found two ovaries on one side, both consisting of true ovarian tissue, and connected by a band 3/5 inch long.
Doran divides supernumerary ovaries into three classes:—
(1) The ovarium succentauriatum of Beigel.
(2) Those cases in which two masses of ovarian tissue are separated by ligamentous bands.
(3) Entirely separate organs, as in Winckel's case.
Prolapsus or displacement of the ovaries into the culdesac of Douglas, the vaginal wall, or into the rectum can be readily ascertained by the resulting sense of nausea, particularly in defecation or in coitus. Munde, Barnes, Lentz, Madden, and Heywood Smith report instances, and Cloquet describes an instance of inguinal hernia of the ovary in which the uterus as well as the Fallopian tube were found in the inguinal canal. Debierre mentions that Puech has gathered 88 instances of inguinal hernia of the ovary and 14 of the crural type, and also adds that Otte cites the only instance in which crural ovarian hernia has been found on both sides. Such a condition with other associate malformations of the genitalia might easily be mistaken for an instance of hermaphroditic testicles.
The Fallopian tubes are rarely absent on either side, although Blasius reports an instance of deficient oviducts. Blot reports a case of atrophy, or rather rudimentary state of one of the ovaries, with absence of the tube on that side, in a woman of forty.
Doran has an instance of multiple Fallopian tubes, and Richard, in 1861, says several varieties are noticed. These tubes are often found fused or adherent to the ovary or to the uterus; but Fabricius describes the symphysis of the Fallopian tube with the rectum.
Absence of the uterus is frequently reported. Lieutaud and Richerand are each said to have dissected female subjects in whom neither the uterus nor its annexed organs were found. Many authors are accredited with mentioning instances of defective or deficient uteri, among them Bosquet, Boyer, Walther, Le Fort, Calori, Pozzi, Munde, and Strauch. Balade has reported a curious absence of the uterus and vagina in a girl of eighteen. Azem, Bastien, Bibb, Bovel, Warren, Ward, and many others report similar instances, and in several cases all the adnexa as well as the uterus and vagina were absent, and even the kidney and bladder malformed.
Phillips speaks of two sisters, both married, with congenital absence of the uterus. In his masterly article on "Heredity," Sedgwick quotes an instance of total absence of the uterus in three out of five daughters of the same family; two of the three were twice married.
Double uterus is so frequently reported that an enumeration of the cases would occupy several pages. Bicorn, bipartite, duplex, and double uteruses are so called according to the extent of the duplication. The varieties range all the way from slight increase to two distinct uteruses, with separate appendages and two vaginae. Meckel, Boehmer, and Callisen are among the older writers who have observed double uterus with associate double vagina. Figure 150 represents a transverse section of a bipartite uterus with a double vagina. The so-called uterus didelphus is really a duplex uterus, or a veritable double uterus, each segment having the appearance of a complete unicorn uterus more or less joined to its neighbor. Vallisneri relates the history of a woman who was poisoned by cantharides who had two uteruses, one opening into the vagina, the other into the rectum. Morand, Bartholinus, Tiedemann, Ollivier, Blundell, and many others relate instances of double uterus in which impregnation had occurred, the fetus being retained until the full term.
Purcell of Dublin says that in the summer of 1773 he opened the body of a woman who died in the ninth month of pregnancy. He found a uterus of ordinary size and form as is usual at this period of gestation, which contained a full-grown fetus, but only one ovary attached to a single Fallopian tube. On the left side he found a second uterus, unimpregnated and of usual size, to which another ovary and tube were attached. Both of these uteruses were distinct and almost entirely separate.
Pregnancy with Double Uterus.—Hollander describes the following anomaly of the uterus which he encountered during the performance of a celiotomy:—
"There were found two uteruses, the posterior one being a normal organ with its adnexa; connected with this uterus was another one, anterior to it. The two uteruses had a common cervix; the anterior of the two organs had no adnexa, though there were lateral peritoneal ligaments; it had become pregnant." Hollander explains the anomaly by stating that probably the Mullerian ducts or one of them had grown excessively, leading to a folding off of a portion which developed into the anterior uterus.
Other cases of double uterus with pregnancy are mentioned on page 49.
When there is simultaneous pregnancy in each portion of a double uterus a complication of circumstances arises. Debierre quotes an instance of a woman who bore one child on July 16, 1870, and another on October 31st of the same year, and both at full term. She had only had three menstrual periods between the confinements. The question as to whether a case like this would be one of superfetation in a normal uterus, or whether the uterus was double, would immediately arise. There would also be the possibility that one of the children was of protracted gestation or that the other was of premature birth. Article 312 of the Civil Code of France accords a minimum of one hundred and eighty and a maximum of three hundred days for the gestation of a viable child. (See Protracted Gestation.)
Voight is accredited with having seen a triple uterus, and there are several older parallels on record. Thilow mentions a uterus which was divided into three small portions.
Of the different anomalous positions of the uterus, most of which are acquired, the only one that will be mentioned is that of complete prolapse of the uterus. In this instance the organ may hang entirely out of the body and even forbid locomotion.
Of 19 cases of hernia of the uterus quoted by Debierre 13 have been observed in the inguinal region, five on the right and seven on the left side. In the case of Roux in 1891 the hernia existed on both sides. The uterus has been found twice only in crural hernia and three times in umbilical hernia. There is one case recorded, according to Debierre, in which the uterus was one of the constituents of an obturator hernia. Sometimes its appendages are found with it. Doring, Ledesma, Rektorzick, and Scazoni have found the uterus in the sac of an inguinal hernia; Leotaud, Murray, and Hagner in an umbilical hernia. The accompanying illustration represents a hernia of the gravid womb through the linea alba.
Absence of the penis is an extremely rare anomaly, although it has been noted by Schenck, Borellus, Bouteiller, Nelaton, and others. Fortunatus Fidelis and Revolat describe a newly born child with absence of external genitals, with spina bifida and umbilical hernia. Nelaton describes a child of two entirely without a penis, but both testicles were found in the scrotum; the boy urinated by the rectum. Ashby and Wright mention complete absence of the penis, the urethra opening at the margin of the anus outside the external sphincter; the scrotum and testicles were well developed. Murphy gives the description of a well-formed infant apparently without a penis; the child passed urine through an opening in the lower part of the abdomen just above the ordinary location of the penis; the scrotum was present. Incisions were made into a small swelling just below the urinary opening in the abdomen which brought into view the penis, the glans being normal but the body very small. The treatment consisted of pressing out the glans daily until the wound healed; the penis receded spontaneously. It is stated that the organ would doubtless be equal to any requirements demanded of it. Demarquay quotes a somewhat similar case in an infant, but it had no urinary opening until after operation.
Among the older writers speaking of deficient or absent penis are Bartholinus, Bauhinus, Cattierus, the Ephemerides, Frank, Panaroli, van der Wiel, and others. Renauldin describes a man with a small penis and enormous mammae. Goschler, quoted by Jacobson, speaks of a well-developed man of twenty-two, with abundant hair on his chin and suprapubic region and the scrotum apparently perfect, with median rapine; a careful search failed to show any trace of a penis; on the anterior wall of the rectum four lines above the anus was an orifice which gave vent to urine; the right testicle and cord were normal, but there was an acute orchitis in the left. Starting from just in front of the anal orifice was a fold of skin 1 1/2 inches long and 3/4 inch high continuous with the rapine, which seemed to be formed of erectile tissue and which swelled under excitement, the enlargement lasting several minutes with usually an emission from the rectum. It was possible to pass a sound through the opening in the rectum to the bladder through a urethra 1 1/2 inches wide; the patient had control of the bladder and urinated from every three to five hours.
Many instances of rudimentary development of the penis have been recorded, most of them complicated with cryptorchism or other abnormality of the sexual organs. In other instances the organ is present, but the infantile type is present all through life; sometimes the subjects are weak in intellect and in a condition similar to cretinism. Kaufmann quotes a case in a weakly boy of twelve whose penis was but 3/4 inch long, about as thick as a goose-quill, and feeling as limp as a mere tube of skin; the corpora cavernosa were not entirely absent, but ran only from the ischium to the junction of the fixed portion of the penis, suddenly terminating at this point. Nothing indicative of a prostate could be found. The testicles were at the entrance of the inguinal canal and the glans was only slightly developed.
Binet speaks of a man of fifty-three whose external genitalia were of the size of those of a boy of nine. The penis was of about the size of the little finger, and contained on each side testicles not larger than a pea. There was no hair on the pubes or the face, giving the man the aspect of an old woman. The prostate was almost exterminated and the seminal vesicles were very primitive in conformation. Wilson was consulted by a gentleman of twenty-six as to his ability to perform the marital function. In size his penis and testicles hardly exceeded those of a boy of eight. He had never felt desire for sexual intercourse until he became acquainted with his intended wife, since when he had erections and nocturnal emissions. The patient married and became the father of a family; those parts which at twenty-six were so much smaller than usual had increased at twenty-eight to normal adult size. There are three cases on record in the older literature of penises extremely primitive in development. They are quoted by the Ephemerides, Plater, Schenck, and Zacchias. The result in these cases was impotency.
In the Army and Medical Museum at Washington are two injected specimens of the male organ divested of skin. From the meatus to the pubis they measure 6 1/2 and 5 1/2 inches; from the extremity to the termination of either crus 9 3/4 and 8 3/4 inches, and the circumferences are 4 3/4 and 4 1/4 inches. Between these two we can strike an average of the size of the normal penis.
In some instances the penis is so large as to forbid coitus and even inconvenience its possessor, measuring as much as ten or even more inches in length. Extraordinary cases of large penis are reported by Albinus (who mentions it as a cause for sterility), Bartholinus, Fabricius Hildanus, Paullini, Peyer, Plater, Schurig, Sinibaldus, and Zacchias. Several cases of enormous penises in the new-born have been observed by Wolff and others.
The penis palme, or suture de la verge of the French, is the name given to those examples of single cutaneous envelope for both the testicles and penis; the penis is adherent to the scrotum by its inferior face; the glans only is free and erection is impossible. Chretien cites an instance in a man of twenty-five, and Schrumpf of Wesserling describes an example of this rare anomaly. The penis and testes were inclosed in a common sac, a slight projection not over 1/4 inch long being seen from the upper part of this curious scrotum. When the child was a year old a plastic operation was performed on this anomalous member with a very satisfactory result. Petit describes an instance in which the penis was slightly fused with the scrotum.
There are many varieties of torsion of the penis. The glans itself may be inclined laterally, the curvature may be total, or there may be a veritable rotation, bringing the inferior face above and the superior face below. Gay describes a child with epispadias whose penis had undergone such torsion on its axis that its inferior surface looked upward to the left, and the child passed urine toward the left shoulder. Follin mentions a similar instance in a boy of twelve with complete epispadias, and Verneuil and Guerlin also record cases, both complicated with associate maldevelopment. Caddy mentions a youth of eighteen who had congenital torsion of the penis with out hypospadias or epispadias. There was a complete half-turn to the left, so that the slit-like urinary meatus was reversed and the frenum was above. Among the older writers who describe incurvation or torsion of the penis are Arantius, the Ephemerides, Haenel, Petit, Schurig, Tulpius, and Zacchias.
Zacutus Lusitans speaks of torsion of the penis from freezing. Paullini mentions a case the result of masturbation, and Hunter speaks of torsion of the penis associated with arthritis.
Ossification of the Penis.—MacClellann speaks of a man of fifty-two whose penis was curved and distorted in such a manner that urine could not be passed without pain and coitus was impossible. A bony mass was discovered in the septum between the corpora cavernosa; this was dissected out with much hemorrhage and the upward curvature was removed, but there resulted a slight inclination in the opposite direction. The formation of bone and cartilage in the penis is quite rare. Velpeau, Kauffmann, Lenhoseck, and Duploy are quoted by Jacobson as having seen this anomaly. There is an excellent preparation in Vienna figured by Demarquay, but no description is given. The Ephemerides and Paullini describe osseous penises.
The complete absence of the frenum and prepuce has been observed in animals but is very rare in man. The incomplete or irregular development is more frequent, but most common is excessive development of the prepuce, constituting phimosis, when there is abnormal adherence with the glans. Instances of phimosis, being quite common, will be passed without special mention. Deficient or absent prepuce has been observed by Blasius, Marcellus Donatus, and Gilibert. Partial deficiency is described by Petit Severinus, and others.
There may be imperforation or congenital occlusion of some portion of the urethra, causing enormous accumulation of urine in the bladder, but fortunately there is generally in such cases some anomalous opening of the urethra giving vent to the excretions. Tulpius mentions a case of deficient urethra. In the Ephemerides there is an account of a man who had a constant flow of semen from an abnormal opening in the abdomen. La Peyroma describes a case of impotence due to ejaculation of the spermatic ducts into the bladder instead of into the urethra, but remarks that there was a cicatrix of a wound of the neighboring parts. There are a number of instances in which the urethra has terminated in the rectum. Congenital dilatation of the urethral canal is very rare, and generally accompanied by other malformation.
Duplication of the urethra or the existence of two permeable canals is not accepted by all the authors, some of whom contend that one of the canals either terminates in a culdesac or is not separate in itself. Verneuil has published an article clearly exposing a number of cases, showing that it is possible for the urethra to have two or more canals which are distinct and have separate functions. Fabricius Hildanus speaks of a double aperture to the urethra; Marcellus Donatus describes duplicity of the urethra, one of the apertures being in the testicle; and there is another case on record in which there was a urethral aperture in the groin. A case of double urethra in a man of twenty-five living in Styria who was under treatment for gonorrhea is described, the supernumerary urethra opening above the natural one and receiving a sound to the depth of 17 cm. There was purulent gonorrhea in both urethrae. Vesalius has an account of a double urethral aperture, one of which was supposed to give spermatic fluid and the other urine. Borellus, Testa, and Cruveilhier have reported similar instances. Instances of double penis have been discussed under the head of diphallic terata, page 194.
Hypospadias and epispadias are names given to malformations of the urethra in which the wall of the canal is deficient either above or below. These anomalies are particularly interesting, as they are nearly always found in male hermaphrodites, the fissure giving the appearance of a vulva, as the scrotum is sometimes included, and even the perineum may be fissured in continuity with the other parts, thus exaggerating the deception. There seems to be an element of heredity in this malformation, and this allegation is exemplified by Sedgwick, who quotes a case from Heuremann in which a family of females had for generations given birth to males with hypospadias. Belloc mentions a man whose urethra terminated at the base of the frenum who had four sons with the same deformity. Picardat mentions a father and son, both of whom had double urethral orifices, one above the other, from one of which issued urine and from the other semen—a fact that shows the possibility of inheritance of this malformation. Patients in whom the urethra opens at the root of the penis, the meatus being imperforate, are not necessarily impotent; as, for instance, Fournier knew of a man whose urethra opened posteriorly who was the father of four children. Fournier supposed that the semen ejaculated vigorously and followed the fissure on the back of the penis to the uterus, the membrane of the vagina supplanting the deficient wall of the urethra. The penis was short, but about as thick as ordinary.
Gray mentions a curious case in a man afflicted with hypospadias who, suffering with delusions, was confined in the insane asylum at Utica. When he determined to get married, fully appreciating his physical defect, he resolved to imitate nature, and being of a very ingenious turn of mind, he busied himself with the construction of an artificial penis. While so engaged he had seized every opportunity to study the conformation of this organ, and finally prepared a body formed of cotton, six inches in length, and shaped like a penis, minus a prepuce. He sheathed it in pig's gut and gave it a slight vermilion hue. To the touch it felt elastic, and its shape was maintained by a piece of gutta-percha tubing, around which the cotton was firmly wound. It was fastened to the waist-band by means of straps, a central and an upper one being so arranged that the penis could be thrown into an erect position and so maintained. He had constructed a flesh-colored covering which completely concealed the straps. With this artificial member he was enabled to deceive his wife for fifteen months, and was only discovered when; she undressed him while he was in a state of intoxication. To further the deception he had told his wife immediately after their marriage that it was quite indecent for a husband to undress in the presence of his wife, and therefore she had always retired first and turned out the light. Partly from fear that his virile power would be questioned and partly from ignorance, the duration of actual coitus would approach an hour. When the discovery was made, his wife hid the instrument with which he had perpetrated a most successful fraud upon her, and the patient subsequently attempted coitus by contact with unsuccessful results, although both parties had incomplete orgasms. Shortly afterward evidences of mental derangement appeared and the man became the subject of exalted delusions. His wife, at the time of report, had filed application for divorce. Haslam reports a case in which loss of the penis was compensated for by the use of an ivory succedaneum. Parallel instances of this kind have been recorded by Ammann and Jonston.
Entire absence of the male sexual apparatus is extremely rare, but Blondin and Velpeau have reported cases.
Complete absence of the testicles, or anorchism, is a comparatively rare anomaly, and it is very difficult to distinguish between anorchism and arrest of development, or simple atrophy, which is much more common. Fisher of Boston describes the case of a man of forty-five, who died of pneumonia. From the age of puberty to twenty-five, and even to the day of death, his voice had never changed and his manners were decidedly effeminate. He always sang soprano in concert with females. After the age of twenty-five, however, his voice became more grave and he could not accompany females with such ease. He had no beard, had never shaved, and had never exhibited amorous propensities or desire for female society. When about twenty-one he became associated with a gay company of men and was addicted to the cup, but would never visit houses of ill-fame. On dissection no trace of testicles could be found; the scrotum was soft and flabby. The cerebellum was the exact size of that of a female child.
Individuals with one testicle are called monorchids, and may be divided into three varieties:—
(1) A solitary testicle divided in the middle by a deep fissure, the two lobes being each provided with a spermatic cord on the same side as the lobe.
(2) Testicles of the same origin, but with coalescence more general.
(3) A single testicle and two cords.
Gruber of St. Petersburg held a postmortem on a man in January, 1867, in whom the right half of the scrotum, the right testicle, epididymis, and the scrotal and inguinal parts of the right vas deferens were absent. Gruber examined the literature for thirty years up to the time of his report, and found 30 recorded postmortem examinations in which there was absence of the testicle, and in eight of these both testicles were missing. As a rule, natural eunuchs have feeble bodies, are mentally dull, and live only a short time. The penis is ordinarily defective and there is sometimes another associate malformation. They are not always disinclined toward the opposite sex.
Polyorchids are persons who have more than two testicles. For a long time the abnormality was not believed to exist, and some of the observers denied the proof by postmortem examination of any of the cases so diagnosed, but there is at present no doubt of the fact,—three, four, and five testicles having been found at autopsies. Russell, one of the older writers on the testicle, mentions a monk who was a triorchid, and was so salacious that his indomitable passion prevented him from keeping his vows of chastity. The amorous propensities and generative faculties of polyorchids have always been supposed greater than ordinary. Russell reports another case of a man with a similar peculiarity, who was prescribed a concubine as a reasonable allowance to a man thus endowed.
Morgagni and Meckel say that they never discovered a third testicle in dissections of reputed triorchids, and though Haller has collected records of a great number of triorchids, he has never been able to verify the presence of the third testicle on dissection. Some authors, including Haller, have demonstrated heredity in examples of polyorchism. There is an old instance in which two testicles, one above the other, were found on the right side and one on the left. Macann describes a recruit of twenty, whose scrotum seemed to be much larger on the right than on the left side, although it was not pendulous. On dissection a right and left testicle were found in their normal positions, but situated on the right side between the groin and the normal testicle was a supernumerary organ, not in contact, and having a separate and short cord. Prankard also describes a man with three testicles. Three cases of triorchidism were found in recruits in the British Army. Lane reports a supernumerary testis found in the right half of the scrotum of a boy of fifteen. In a necropsy held on a man killed in battle, Hohlberg discovered three fully developed testicles, two on the right side placed one above the other. The London Medical Record of 1884 quotes Jdanoff of St. Petersburg in mentioning a soldier of twenty-one who had a supernumerary testicle erroneously diagnosed as inguinal hernia. Quoted by the same reference, Bulatoff mentions a soldier who had a third testicle, which diagnosis was confirmed by several of his confreres. They recommended dismissal of the man from the service, as the third testicle, usually resting in some portion of the inguinal canal, caused extra exposure to traumatic influence.
Venette gives an instance of four testicles, and Scharff, in the Ephemerides, mentions five; Blasius mentions more than three testicles, and, without citing proof, Buffon admits the possibility of such occurrence and adds that such men are generally more vigorous.
Russell mentions four, five, and even six testicles in one individual; all were not verified on dissection. He cites an instance of six testicles four of which were of usual size and two smaller than ordinary.
Baillie, the Ephemerides, and Schurig mention fusion of the testicles, or synorchidism, somewhat after the manner of the normal disposition of the batrachians and also the kangaroos, in the former of which the fusion is abdominal and in the latter scrotal. Kerckring has a description of an individual in whom the scrotum was absent.
In those cases in which the testicles are still in the abdominal cavity the individuals are termed cryptorchids. Johnson has collected the results of postmortem examinations of 89 supposed cryptorchids. In eight of this number no testicles were found postmortem, the number found in the abdomen was uncertain, but in 18 instances both testicles were found in the inguinal canal, and in eight only one was found in the inguinal canal, the other not appearing. The number in which the semen was examined microscopically was 16, and in three spermatozoa were found in the semen; one case was dubious, spermatozoa being found two weeks afterward on a boy's shirt. The number having children was ten. In one case a monorchid generated a cryptorchid child. Some of the cryptorchids were effeminate, although others were manly with good evidences of a beard. The morbid, hypochondriac, the voluptuous, and the imbecile all found a place in Johnson's statistics; and although there are evidences of the possession of the generative function, still, we are compelled to say that the chances are against fecundity of human cryptorchids. In this connection might be quoted the curious case mentioned by Geoffroy-Saint-Hilaire, of a soldier who was hung for rape. It was alleged that no traces of testicles were found externally or internally yet semen containing spermatozoa was found in the seminal vesicles. Spermatozoa have been found days and weeks after castration, and the individuals during this period were capable of impregnation, but in these cases the reservoirs were not empty, although the spring had ceased to flow. Beigel, in Virchow's Archives, mentions a cryptorchid of twenty-two who had nocturnal emissions containing spermatozoa and who indulged in sexual congress. Partridge describes a man of twenty-four who, notwithstanding his condition, gave evidences of virile seminal flow.
In some cases there is anomalous position of the testicle. Hough mentions an instance in which, from the great pain and sudden appearance, a small tumor lying against the right pubic bone was supposed to be a strangulated hernia. There were two well-developed testicles in the scrotum, and the hernia proved to be a third. McElmail describes a soldier of twenty-nine, who two or three months before examination felt a pricking and slight burning pain near the internal aperture of the internal inguinal canal, succeeded by a swelling until the tumor passed into the scrotum. It was found in the upper part of the scrotum above the original testicle, but not in contact, and was about half the size of the normal testicle; its cord and epididymis could be distinctly felt and caused the same sensation as pressure on the other testicle did.
Marshall mentions a boy of sixteen in whom the right half of the scrotum was empty, although the left was of normal size and contained a testicle. On close examination another testicle was found in the perineum; the boy said that while running he fell down, four years before, and on getting up suffered great pain in the groin, and this pain recurred after exertion. This testicle was removed successfully to the scrotum. Horsley collected 20 instances of operators who made a similar attempt, Annandale being the first one; his success was likely due to antisepsis, as previously the testicles had always sloughed. There is a record of a dog remarkable for its salacity who had two testicles in the scrotum and one in the abdomen; some of the older authors often indulged in playful humor on this subject.
Brown describes a child with a swelling in the perineum both painful and elastic to the touch. The child cried if pressure was applied to the tumor and there was every evidence that the tumor was a testicle. Hutcheson, quoted by Russell, has given a curious case in an English seaman who, as was the custom at that time, was impressed into service by H.M.S. Druid in 1807 from a trading ship off the coast of Africa. The man said he had been examined by dozens of ship-surgeons, but was invariably rejected on account of rupture in both groins. The scrotum was found to be an empty bag, and close examination showed that the testicles occupied the seats of the supposed rupture. As soon as the discovery was made the man became unnerved and agitated, and on re-examining the parts the testicles were found in the scrotum. When he found that there was no chance for escape he acknowledged that he was an impostor and gave an exhibition in which, with incredible facility, he pulled both testes up from the bottom of the scrotum to the external abdominal ring. At the word of command he could pull up one testicle, then another, and let them drop simultaneously; he performed other like feats so rapidly that the movements could not be distinguished.
In this connection Russell speaks of a man whose testicle was elevated every time the east wind blew, which caused him a sense of languor and relaxation; the same author describes a man whose testicles ascended into the inguinal canal every time he was in the company of women.
Inversion of the testicle is of several varieties and quite rare, it has been recognized by Sir Astley Cooper, Boyer, Maisonneuve, Royet, and other writers.
The anomalies of the vas deferens and seminal vesicles are of little interest and will be passed with mention of the case of Weber, who found the seminal vesicles double; a similar conformation has been seen in hermaphrodites.
ANOMALIES OF STATURE, SIZE, AND DEVELOPMENT.
Giants.—The fables of mythology contain accounts of horrible monsters, terrible in ferocity, whose mission was the destruction of the life of the individuals unfortunate enough to come into their domains. The ogres known as the Cyclops, and the fierce anthropophages, called Lestrygons, of Sicily, who were neighbors of the Cyclops, are pictured in detail in the "Odyssey" of Homer. Nearly all the nations of the earth have their fairy tales or superstitions of monstrous beings inhabiting some forest, mountain, or cave; and pages have been written in the heroic poems of all languages describing battles between these monsters and men with superhuman courage, in which the giant finally succumbs.
The word giant is derived indirectly from the old English word "geant," which in its turn came from the French of the conquering Normans. It is of Greek derivation, "gigas", or the Latin, "gigas." The Hebrew parallel is "nophel," or plural, "nephilim."
Ancient Giants.—We are told in the Bible a that the bedstead of Og, King of Basham, was 9 cubits long, which in English measure is 16 1/2 feet. Goliath of Gath, who was slain by David, stood 6 cubits and a span tall—about 11 feet. The body of Orestes, according to the Greeks, was 11 1/2 feet long. The mythical Titans, 45 in number, were a race of Giants who warred against the Gods, and their descendants were the Gigantes. The height attributed to these creatures was fabulous, and they were supposed to heap up mountains to scale the sky and to help them to wage their battles. Hercules, a man of incredible strength, but who is said to have been not over 7 feet high, was dispatched against the Gigantes.
Pliny describes Gabbaras, who was brought to Rome by Claudius Caesar from Arabia and was between 9 and 10 feet in height, and adds that the remains of Posio and Secundilla, found in the reign of Augustus Caesar in the Sallustian Gardens, of which they were supposed to be the guardians, measured 10 feet 3 inches each. In common with Augustine, Pliny believed that the stature of man has degenerated, but from the remains of the ancients so far discovered it would appear that the modern stature is about the same as the ancient. The beautiful alabaster sarcophagus discovered near Thebes in 1817 and now in Sir John Soane's Museum in Lincoln's Inn Fields in London measures 9 feet 4 inches long. This unique example, the finest extant, is well worth inspection by visitors in London.
Herodotus says the shoes of Perseus measured an equivalent of about 3 feet, English standard. Josephus tells of Eleazar, a Jew, among the hostages sent by the King of Persia to Rome, who was nearly 11 feet high. Saxo, the grammarian, mentions a giant 13 1/2 feet high and says he had 12 companions who were double his height. Ferragus, the monster supposed to have been slain by Roland, the nephew of Charlemagne, was said to have been nearly 11 feet high. It was said that there was a giant living in the twelfth century under the rule of King Eugene II of Scotland who was 11 1/2 feet high.
There are fabulous stories told of the Emperor Maximilian. Some accounts say that he was between 8 1/2 and 9 feet high, and used his wife's bracelet for a finger-ring, and that he ate 40 pounds of flesh a day and drank six gallons of wine. He was also accredited with being a great runner, and in his earlier days was said to have conquered single-handed eight soldiers. The Emperors Charlemagne and Jovianus were also accredited with great height and strength.
In the olden times there were extraordinary stories of the giants who lived in Patagonia. Some say that Magellan gave the name to this country because its inhabitants measured 5 cubits. The naturalist Turner says that on the river Plata near the Brazilian coast he saw naked savages 12 feet high; and in his description of America, Thevenot confirms this by saying that on the coast of Africa he saw on a boat the skeleton of an American giant who had died in 1559, and who was 11 feet 5 inches in height. He claims to have measured the bones himself. He says that the bones of the leg measured 3 feet 4 inches, and the skull was 3 feet and 1 inch, just about the size of the skull of Borghini, who, however, was only of ordinary height. In his account of a voyage to the Straits of Magellan, Jacob Lemaire says that on December 17, 1615, he found at Port Desire several graves covered with stones, and beneath the stones were skeletons of men which measured between 10 and 11 feet. The ancient idea of the Spaniards was that the men of Patagonia were so tall that the Spanish soldiers could pass under their arms held out straight; yet we know that the Patagonians exhibit no exaggeration of height—in fact, some of the inhabitants about Terra del Fuego are rather diminutive. This superstition of the voyagers was not limited to America; there were accounts of men in the neighborhood of the Peak of Teneriffe who had 80 teeth in their head and bodies 15 feet in height.
Discoveries of "Giants' Bones."—Riolan, the celebrated anatomist, says that there was to be seen at one time in the suburbs of Saint Germain the tomb of the giant Isoret, who was reputed to be 20 feet tall; and that in 1509, in digging ditches at Rouen, near the Dominicans, they found a stone tomb containing a monstrous skeleton, the skull of which would hold a bushel of corn; the shin-bone measured about 4 feet, which, taken as a guide, would make his height over 17 feet. On the tomb was a copper plate which said that the tomb contained the remains of "the noble and puissant lord, the Chevalier Ricon de Vallemont." Plater, the famous physician, declares that he saw at Lucerne the true human bones of a subject that must have been at least 19 feet high.
Valence in Dauphine boasted of possessing the bones of the giant Bucart, the tyrant of the Vivarias, who was slain by his vassal, Count de Cabillon. The Dominicans had the shin-bone and part of the knee-articulation, which, substantiated by the frescoes and inscriptions in their possession, showed him to be 22 1/2 feet high. They claimed to have an os frontis in the medical school of Leyden measuring 9.1 X 12.2 X .5 inches, which they deduce must have belonged to a man 11 or 12 feet high.
It is said that while digging in France in 1613 there was disinterred the body of a giant bearing the title "Theutobochus Rex," and that the skeleton measured 25 feet long, 10 feet across the shoulders, and 5 feet from breast to back. The shin-bone was about 4 feet long, and the teeth as large as those of oxen. This is likely another version of the finding of the remains of Bucart.
Near Mezarino in Sicily in 1516 there was found the skeleton of a giant whose height was at least 30 feet; his head was the size of a hogshead, and each tooth weighed 5 ounces; and in 1548 and in 1550 there were others found of the height of 30 feet. The Athenians found near their city skeletons measuring 34 and 36 feet in height. In Bohemia in 758 it is recorded that there was found a human skeleton 26 feet tall, and the leg-bones are still kept in a medieval castle in that country. In September, 1691, there was the skull of a giant found in Macedonia which held 210 pounds of corn.
General Opinions.—All the accounts of giants originating in the finding of monstrous bones must of course be discredited, as the remains were likely those of some animal. Comparative anatomy has only lately obtained a hold in the public mind, and in the Middle Ages little was known of it. The pretended giants' remains have been those of mastodons, elephants, and other animals. From Suetonius we learn that Augustus Caesar pleased himself by adorning his palaces with so-called giants' bones of incredible size, preferring these to pictures or images. From their enormous size we must believe they were mastodon bones, as no contemporary animals show such measurements. Bartholinus describes a large tooth for many years exhibited as the canine of a giant which proved to be nothing but a tooth of a spermaceti whale (Cetus dentatus), quite a common fish. Hand described an alleged giant's skeleton shown in London early in the eighteenth century, and which was composed of the bones of the fore-fin of a small whale or of a porpoise.
The celebrated Sir Hans Sloane, who treated this subject very learnedly, arrived at the conclusion that while in most instances the bones found were those of mastodons, elephants, whales, etc., in some instances accounts were given by connoisseurs who could not readily be deceived. However, modern scientists will be loath to believe that any men ever existed who measured over 9 feet; in fact, such cases with authentic references are extremely rare Quetelet considers that the tallest man whose stature is authentically recorded was the "Scottish Giant" of Frederick the Great's regiment of giants. This person was not quite 8 feet 3 inches tall. Buffon, ordinarily a reliable authority, comes to a loose conclusion that there is no doubt that men have lived who were 10, 12, and even 15 feet tall; but modern statisticians cannot accept this deduction from the references offered.
From the original estimation of the height of Adam (Henrion once calculated that Adam's height was 123 feet and that of Eve 118) we gradually come to 10 feet, which seemed to be about the favorite height for giants in the Middle Ages. Approaching this century, we still have stories of men from 9 to 10 feet high, but no authentic cases. It was only in the latter part of the last century that we began to have absolutely authentic heights of giants, and to-day the men showing through the country as measuring 8 feet generally exaggerate their height several inches, and exact measurement would show that but few men commonly called giants are over 7 1/2 feet or weigh over 350 pounds. Dana says that the number of giants figuring as public characters since 1700 is not more than 100, and of these about 20 were advertised to be over 8 feet. If we confine ourselves to those accurately and scientifically measured the list is surprisingly small. Topinard measured the tallest man in the Austrian army and found that he was 8 feet 4 1/2 inches. The giant Winckelmeyer measured 8 feet 6 inches in height. Ranke measured Marianne Wehde, who was born in Germany in the present century, and found that she measured 8 feet 4 1/4 inches when only sixteen and a half years old.
In giants, as a rule, the great stature is due to excessive growth of the lower extremities, the size of the head and that of the trunk being nearly the same as those of a man or boy of the same age. On the other hand, in a natural dwarf the proportions are fairly uniform, the head, however, being always larger in proportion to the body, just as we find in infants. Indeed, the proportions of "General Tom Thumb" were those of an ordinary infant of from thirteen to fifteen months old.
Figure 156 shows a portrait of two well-known exhibitionists of about the same age, and illustrates the possible extremes of anomalies in stature.
Recently, the association of acromegaly with gigantism has been noticed, and in these instances there seems to be an acquired uniform enlargement of all the bones of the body. Brissaud and Meige describe the case of a male of forty-seven who presented nothing unusual before the age of sixteen, when he began to grow larger, until, having reached his majority, he measured 7 feet 2 inches in height and weighed about 340 pounds. He remained well and very strong until the age of thirty-seven, when he overlifted, and following this he developed an extreme deformity of the spine and trunk, the latter "telescoping into itself" until the nipples were on a level with the anterior superior spines of the ilium. For two years he suffered with debility, fatigue, bronchitis, night-sweats, headache, and great thirst. Mentally he was dull; the bones of the face and extremities showed the hypertrophies characteristic of acromegaly, the soft parts not being involved. The circumference of the trunk at the nipples was 62 inches, and over the most prominent portion of the kyphosis and pigeon-breast, 74 inches. The authors agree with Dana and others that there is an intimate relation between acromegaly and gigantism, but they go further and compare both to the growth of the body. They call attention to the striking resemblance to acromegaly of the disproportionate growth of the boy at adolescence, which corresponds so well to Marie's terse description of this disease: "The disease manifests itself by preference in the bones of the extremities and in the extremities of the bones," and conclude with this rather striking and aphoristic proposition: "Acromegaly is gigantism of the adult; gigantism is acromegaly of adolescence."
The many theories of the cause of gigantism will not be discussed here, the reader being referred to volumes exclusively devoted to this subject.
Celebrated Giants.—Mention of some of the most famous giants will be made, together with any associate points of interest.
Becanus, physician to Charles V, says that he saw a youth 9 feet high and a man and a woman almost 10 feet. Ainsworth says that in 1553 the Tower of London was guarded by three brothers claiming direct descent from Henry VIII, and surnamed Og, Gog, and Magog, all of whom were over 8 feet in height. In his "Chronicles of Holland" in 1557 Hadrianus Barlandus said that in the time of John, Earl of Holland, the giant Nicholas was so large that men could stand under his arms, and his shoe held 3 ordinary feet. Among the yeoman of the guard of John Frederick, Duke of Hanover, there was one Christopher Munster, 8 1/2 feet high, who died in 1676 in his forty-fifth year. The giant porter of the Duke of Wurtemberg was 7 1/2 feet high. "Big Sam," the porter at Carleton Palace, when George IV was Prince of Wales, was 8 feet high. The porter of Queen Elizabeth, of whom there is a picture in Hampton Court, painted by Zucchero, was 7 1/2 feet high; and Walter Parson, porter to James I, was about the same height. William Evans, who served Charles I, was nearly 8 feet; he carried a dwarf in his pocket.
In the seventeenth century, in order to gratify the Empress of Austria, Guy-Patin made a congress of all the giants and dwarfs in the Germanic Empire. A peculiarity of this congress was that the giants complained to the authorities that the dwarfs teased them in such a manner as to make their lives miserable.
Plater speaks of a girl in Basle, Switzerland, five years old, whose body was as large as that of a full-grown woman and who weighed when a year old as much as a bushel of wheat. He also mentions a man living in 1613, 9 feet high, whose hand was 1 foot 6 inches long. Peter van den Broecke speaks of a Congo negro in 1640 who was 8 feet high. Daniel, the porter of Cromwell, was 7 feet 6 inches high; he became a lunatic.
Frazier speaks of Chilian giants 9 feet tall. There is a chronicle which says one of the Kings of Norway was 8 feet high. Merula says that in 1538 he saw in France a Flemish man over 9 feet. Keysler mentions seeing Hans Brau in Tyrol in 1550, and says that he was nearly 12 feet high.
Jonston mentions a lad in Holland who was 8 feet tall. Pasumot mentions a giant of 8 feet.
Edmund Mallone was said to have measured 7 feet 7 inches. Wierski, a Polander, presented to Maximilian II, was 8 feet high. At the age of thirty-two there died in 1798 a clerk of the Bank of England who was said to have been nearly 7 1/2 feet high. The Daily Advertiser for February 23, 1745, says that there was a young colossus exhibited opposite the Mansion House in London who was 7 feet high, although but fifteen years old. In the same paper on January 31, 1753, is an account of MacGrath, whose skeleton is still preserved in Dublin. In the reign of George I, during the time of the Bartholomew Fair at Smithfield, there was exhibited an English man seventeen years old who was 8 feet tall.
Nicephorus tells of Antonius of Syria, in the reign of Theodosius, who died at the age of twenty-five with a height of 7 feet 7 inches. Artacaecas, in great favor with Xerxes, was the tallest Persian and measured 7 feet. John Middleton, born in 1752 at Hale, Lancashire, humorously called the "Child of Hale," and whose portrait is in Brasenose College, Oxford, measured 9 feet 3 inches tall. In his "History of Ripton," in Devonshire, 1854, Bigsby gives an account of a discovery in 1687 of a skeleton 9 feet long. In 1712 in a village in Holland there died a fisherman named Gerrit Bastiaansen who was 8 feet high and weighed 500 pounds. During Queen Anne's reign there was shown in London and other parts of England a most peculiar anomaly—a German giantess without hands or feet who threaded a needle, cut gloves, etc. About 1821 there was issued an engraving of Miss Angelina Melius, nineteen years of age and 7 feet high, attended by her page, Senor Don Santiago de los Santos, from the Island of Manilla, thirty-live years old and 2 feet 2 inches high. "The Annual Register" records the death of Peter Tuchan at Posen on June 18, 1825, of dropsy of the chest. He was twenty-nine years old and 8 feet 7 inches in height; he began to grow at the age of seven. This monster had no beard; his voice was soft; he was a moderate eater. There was a giant exhibited in St. Petersburg, June, 1829, 8 feet 8 inches in height, who was very thin and emaciated.
Dr. Adam Clarke, who died in 1832, measured a man 8 feet 6 inches tall. Frank Buckland, in his "Curiosities of Natural History," says that Brice, the French giant, was 7 feet 7 inches. Early in 1837 there was exhibited at Parma a young man formerly in the service of the King of the Netherlands who was 8 feet 10 inches high and weighed 401 pounds. Robert Hale, the "Norfolk Giant," who died in Yarmouth in 1843 at the age of forty-three, was 7 feet 6 inches high and weighed 452 pounds. The skeleton of Cornelius McGrath, now preserved in the Trinity College Museum, Dublin, is a striking example of gigantism. At sixteen years he measured 7 feet 10 inches.
O'Brien or Byrne, the Irish giant, was supposed to be 8 feet 4 inches in height at the time of his death in 1783 at the age of twenty-two. The story of his connection with the illustrious John Hunter is quite interesting. Hunter had vowed that he would have the skeleton of O'Brien, and O'Brien was equally averse to being boiled in the distinguished scientist's kettle. The giant was tormented all his life by the constant assertions of Hunter and by his persistence in locating him. Finally, when, following the usual early decline of his class of anomalies, O'Brien came to his death-bed, he bribed some fishermen to take his body after his death to the middle of the Irish Channel and sink it with leaden weights. Hunter, it is alleged, was informed of this and overbribed the prospective undertakers and thus secured the body. It has been estimated that it cost Hunter nearly 500 pounds sterling to gain possession of the skeleton of the "Irish Giant." The kettle in which the body was boiled, together with some interesting literature relative to the circumstances, are preserved in the Museum of the Royal College of Surgeons in London, and were exhibited at the meeting of the British Medical Association in 1895 with other Hunterian relics. The skeleton, which is now one of the features of the Museum, is reported to measure 92 3/4 inches in height, and is mounted alongside that of Caroline Crachami, the Sicilian dwarf, who was exhibited as an Italian princess in London in 1824. She did not grow after birth and died at the age of nine.
Patrick Cotter, the successor of O'Brien, and who for awhile exhibited under this name, claiming that he was a lineal descendant of the famous Irish King, Brian Boru, who he declared was 9 feet in height, was born in 1761, and died in 1806 at the age of forty-five. His shoe was 17 inches long, and he was 8 feet 4 inches tall at his death.
In the Museum of Madame Tussaud in London there is a wax figure of Loushkin, said to be the tallest man of his time. It measures 8 feet 5 inches, and is dressed in the military uniform of a drum-major of the Imperial Preobrajensky Regiment of Guards. To magnify his height there is a figure of the celebrated dwarf, "General Tom Thumb," in the palm of his hand. Figure 158 represents a well-known American giant, Ben Hicks who was called "the Denver Steeple."
Buffon refers to a Swedish giantess who he affirms was 8 feet 6 inches tall. Chang, the "Chinese Giant," whose smiling face is familiar to nearly all the modern world, was said to be 8 feet tall. In 1865, at the age of nineteen, he measured 7 feet 8 inches. At Hawick, Scotland, in 1870, there was an Irishman 7 feet 8 inches in height, 52 inches around the chest, and who weighed 22 stone. Figure 159 shows an American giantess known as "Leah, the Giantess." At the age of nineteen she was 7 feet 2 inches tall and weighed 165 pounds.
On June 17, 1871, there were married at Saint-Martins-in-the-Field in London Captain Martin Van Buren Bates of Kentucky and Miss Anna Swann of Nova Scotia, two celebrated exhibitionists, both of whom were over 7 feet. Captain Bates, familiarly known as the "Kentucky Giant," years ago was a familiar figure in many Northern cities, where he exhibited himself in company with his wife, the combined height of the two being greater than that of any couple known to history. Captain Bates was born in Whitesburg, Letcher County, Ky., on November 9, 1845. He enlisted in the Southern army in 1861, and though only sixteen years old was admitted to the service because of his size. At the close of the war Captain Bates had attained his great height of 7 feet 2 1/2 inches. His body was well proportioned and his weight increased until it reached 450 pounds. He traveled as a curiosity from 1866 to 1880, being connected with various amusement organizations. He visited nearly all the large cities and towns in the United States, Canada, Great Britain, France, Spain, Germany, Switzerland, Austria, and Russia. While in England in 1871 the Captain met Miss Anna H. Swann, known as the "Nova Scotia Giantess," who was two years the junior of her giant lover. Miss Swann was justly proud of her height, 7 feet 5 1/2 inches. The two were married soon afterward. Their combined height of 14 feet 8 inches marked them as the tallest married couple known to mankind.
Captain Bates' parents were of medium size. His father, a native of Virginia, was 5 feet 10 inches high and weighed 160 pounds. His mother was 5 feet 3 inches tall and weighed 125 pounds. The height of the father of Mrs. Anna Swann Bates was 6 feet and her mother was 5 feet and 2 inches high, weighing but 100 pounds.
A recent newspaper dispatch says: "Captain M. V. Bates, whose remarkable height at one time attracted the attention of the world, has recently retired from his conspicuous position and lives in comparative obscurity on his farm in Guilford, Medina County, O., half a mile east of Seville."
In 1845 there was shown in Paris Joachim Eleiceigui, the Spanish giant, who weighed 195 kilograms (429 pounds) and whose hands were 42 cm. (16 1/2 inches) long and of great beauty. In 1882 at the Alhambra in London there was a giantess by the name of Miss Marian, called the "Queen of the Amazons," aged eighteen years, who measured 2.45 meters (96 1/2 inches). William Campbell, a Scotchman, died at Newcastle in May 1878. He was so large that the window of the room in which the deceased lay and the brick-work to the level of the floor had to be taken out, in order that the coffin might be lowered with block and tackle three stories to the ground. On January 27, 1887, a Greek, although a Turkish subject, recently died of phthisis in Simferopol. He was 7 feet 8 inches in height and slept on three beds laid close together.
Giants of History.—A number of persons of great height, particularly sovereigns and warriors, are well-known characters of history, viz., William of Scotland, Edward III, Godefroy of Bouillon, Philip the Long, Fairfax, Moncey, Mortier, Kleber; there are others celebrated in modern times. Rochester, the favorite of Charles II; Pothier, the jurist; Bank, the English naturalist; Gall, Billat-Savarin, Benjamin Constant, the painter David, Bellart, the geographer Delamarche, and Care, the founder of the Gentleman's Magazine, were all men of extraordinary stature.
Dwarfs.—The word "dwarf" is of Saxon origin (dwerg, dweorg) and corresponds to the "pumilio" or "nanus" of the Romans. The Greeks believed in the pygmy people of Thrace and Pliny speaks of the Spithamiens. In the "Iliad" Homer writes of the pygmies and Juvenal also describes them; but the fantasies of these poets have given these creatures such diminutive stature that they have deprived the traditions of credence. Herodotus relates that in the deserts of Lybia there were people of extreme shortness of stature. The Bible mentions that no dwarf can officiate at the altar. Aristotle and Philostratus speak of pygmy people descended from Pygmaeus, son of Dorus. In the seventeenth century van Helmont supposed that there were pygmies in the Canary Islands, and Abyssinia, Brazil, and Japan in the older times were repeatedly said to contain pygmy races. Relics of what must have been a pygmy race have been found in the Hebrides, and in this country in Kentucky and Tennessee.
Dr. Schweinfurth, the distinguished African traveler, confirms the statements of Homer, Herodotus, and Aristotle that there was a race of pygmies near the source of the Nile. Schweinfurth says that they live south of the country occupied by the Niam-Niam, and that their stature varies from 4 feet to 4 feet 10 inches. These people are called the Akkas, and wonderful tales are told of their agility and cunning, characteristics that seem to compensate for their small stature.
In 1860 Paul DuChaillu speaks of the existence of an African people called the Obongos, inhabiting the country of the Ashangos, a little to the south of the equator, who were about 1.4 meters in height. There have been people found in the Esquimaux region of very diminutive stature. Battel discovered another pygmy people near the Obongo who are called the Dongos. Kolle describes the Kenkobs, who are but 3 to 4 feet high, and another tribe called the Reebas, who vary from 3 to 5 feet in height. The Portuguese speak of a race of dwarfs whom they call the Bakka-bakka, and of the Yogas, who inhabit territory as far as the Loango. Nubia has a tribe of dwarfs called the Sukus, but little is known of them. Throughout India there are stories of dwarf tribes descended from the monkey-God, or Hoonuman of the mythologic poems.
In the works of Humboldt and Burgoa there is allusion to the tradition of a race of pygmies in the unexplored region of Chiapas near the Isthmus of Tehuantepec in Central America. There is an expedition of anthropologists now on the way to discover this people. Professor Starr of Chicago on his return from this region reported many colonies of undersized people, but did not discover any pygmy tribes answering to the older legendary descriptions. Figure 160 represents two dwarf Cottas measuring 3 feet 6 inches in height.