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anomalies and curiosities of medicine-第87章

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bishop Sancroft; in his journal; written in the seventeenth century; says that he was born with two tongues and passed through life so; one; however; gradually atrophying。 In the polyclinic of Schnitzer in Vienna in 1892 Hajek observed in a lad of twelve an accessory tongue 2。4 cm。 in length and eight mm。 in breadth; forming a tumor at the base of the normal tongue。 It was removed by scissors; and on histologic examination proved to be a true tongue with the typical tissues and constituents。 Borellus; Ephemerides; Eschenbach; Mortimer; Penada; and Schenck speak of double tongues; and Avicenna and Schenck have seen fissured tongues。 Dolaeus records an instance of double tongue in a paper entitled 〃De puella bilingui;〃 and Beaudry and Brothers speak of cleft tongue。 Braine records a case in which there was a large hypertrophied fold of membrane coming from each side of the upper lip。

In some cases there is marked augmentation of the volume of the tongue。 Fournier has seen a juggler with a tongue so long that he could extrude it six inches from his mouth。 He also refers to a woman in Berlin with a long tongue; but it was thinner than that of a cat。 When she laughed it hung over her teeth like a curtain; and was always extremely cold to the touch。 In the same article there is a description of a man with a very long neck who could touch his tongue to his chest without reclining his head。 Congenital and acquired hypertrophy of the tongue will be discussed later。

Amatus Lusitanus and Portal refer to the presence of hair on the tongue; and later there was an account of a medical student who complained of dyspepsia and a sticky sensation in the mouth。 On examination a considerable growth of hair was found on the surface of the tongue。 The hairs would be detached in vomiting but would grow again; and when he was last seen they were one inch long。 Such are possibly nevoid in formation。

The ordinary anomalies of the palate are the fissures; unilateral; bilateral; median; etc。: they are generally associated with hare…lip。 The median fissure commencing between the middle incisors is quite rare。

Many curious forms of obturator or artificial palate are employed to remedy congenital defects。 Sercombe mentions a case in which destruction of the entire palate was successfully relieved by mechanical means。 In some instances among the lower classes these obturators are simple pieces of wood; so fashioned as to fit into the palatine cleft; and not infrequently the obturator has been swallowed; causing obstruction of the air…passages or occluding the esophagus。

Abnormalism of the Uvula。Examples of double uvula are found in the older writers; and Hagendorn speaks of a man who was born without a uvula。 The Ephemerides and Salmuth describe uvulae so defective as to be hardly noticeable。 Bolster; Delius; Hodges; Mackenzie of Baltimore; Orr; Riedel; Schufeldt; and Tidyman are among observers reporting bifurcated and double uvula; and they are quite common。 Ogle records instances of congenital absence of the uvula。

Anomalies of the Epiglottis。Morgagni mentions a man without an epiglottis who ate and spoke without difficulty。 He thought the arytenoids were so strongly developed that they replaced the functions of the missing organ。 Enos of Brooklyn in 1854 reported absence of the epiglottis without interference with deglutition。 Manifold speaks of a case of bifurcated epiglottis。 Debloisi records an instance of congenital web of the vocal bands。 Mackenzie removed a congenital papillomatous web which had united the vocal cords until the age of twenty…three; thus establishing the voice。 Poore also recorded a case of congenital web in the larynx。 Elsberg and Scheff mention occlusion of the rima glottidis by a membrane。

Instances of duplication of the epiglottis attended with a species of double voice possess great interest。 French described a man of thirty; by occupation a singer and contortionist; who became possessed of an extra voice when he was sixteen。 In high and falsetto tones he could run the scale from A to F in an upper and lower range。 The compass of the low voice was so small that he could not reach the high notes of any song with it; and in singing he only used it to break in on the falsetto and produce a sensation。 He was supposed to possess a double epiglottis。 

Roe describes a young lady who could whistle at will with the lower part of her throat and without the aid of her lips。 Laryngeal examination showed that the fundamental tones were produced by vibrations of the edges of the vocal cords; and the modifications were effected by a minute adjustment of the ventricular bands; which regulated the laryngeal opening above the cord; and pressing firmly down closed the ventricle and acted as a damper preventing the vibrations of the cords except in their middle third。 Morgan in the same journal mentions the case of a boy of nineteen; who seemed to be affected with laryngeal catarrh; and who exhibited distinct diphthongia。 He was seen to have two glottic orifices with associate bands。 The treatment was directed to the catarrh and consequent paresis of the posterior bands; and he soon lost his evidences of double voice。 

{footnote} The following is a description of the laryngeal formation of a singer who has recently acquired considerable notice by her ability to sing notes of the highest tones and to display the greatest compass of voice。 It is extracted from a Cleveland; Ohio; newspaper: 〃She has unusual development of the larynx; which enables her to throw into vibration and with different degrees of rapidity the entire length of the vocal cords or only a part thereof。 But of greatest interest is her remarkable control over the muscles which regulate the division and modification of the resonant cavities; the laryngeal; pharyngeal; oral; and nasal; and upon this depends the quality of her voice。 The uvula is bifurcated; and the two divisions sometimes act independently。 The epiglottis during the production of the highest notes rises upward and backward against the posterior pharyngeal wall in such a way as almost entirely to separate the pharyngeal cavities; at the same time that it gives an unusual conformation to those resonant chambers。〃


Complete absence of the eyes is a very rare anomaly。 Wordsworth describes a baby of seven weeks; otherwise well formed and healthy; which had congenital absence of both eyes。 The parents of this child were in every respect healthy。 There are some cases of monstrosities with closed; adherent eyelids and absence of eyes。 Holmes reports a case of congenital absence of both eyes; the child otherwise being strong and perfect。 The child died of cholera infantum。 He also reports a case very similar in a female child of American parents。 In a girl of eight; of German parents; he reports deficiency of the external walls of each orbit; in addition to great deformity of the side of the head。 He also gives an instance of congenital paralysis of the levator palpebrae muscles in a child whose vision was perfect and who was otherwise perfect。 Holmes also reports a case of enormous congenital exophthalmos; in which the right eye protruded from the orbit and was no longer covered by the cornea。 Kinn
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