1*7 



MON8TKK. 



MONSTER. 



nil, of th<x> imliv iduaU in whom thin transposition of organs lias been 

 ..Wrve.1, Uie existence of tho anomaly has not even been inspected 

 .luring life, which, as in the celebrated case communicated by Mi'ry 

 to the Academy of Science* (of an invalid loUier, aged 72), may be 

 prolonged to iU ordinary term. The causes of this malformation are 

 exceedingly obscure, but it seems probable that general change of 

 position of all the viscera depends on some original alteration in the 

 situation of one important organ, as the heart or liver; for we know 

 that many organs are connected by their functions, or by the medium 

 of large bloodvessels, in such a manner as to acquire a certain relative 

 situation to each other, which also becomes necessary to preserve the 

 general shape of the animal. Accordingly we find that when any 

 important viscus is changed in its situation other viscera are affected 

 in a similar manner. In the earlier periods of the evolution of the 

 foetus, several of those organs which afterwards incline to one side are 

 naturally placed in the centre of the body, or in the median line : this 

 is the case with both the heart and the liver. The knowledge of this 

 fact enables us to understand more readily how these parti may at a 

 subsequent perio.l incline to the opposite side to that on which they 

 are ususlly found ; though we are unable to explain the mode in 

 which they change the direction of all the other abdominal and 

 thoracic viscera. 



Together with the alterations of connection, we must place those 

 cases in which, from arrest of development, different organs, naturally 

 entire, are apparently divided into two or more portions, as in HABK- 

 1.11- and spins bifida. The latter of these malformations consists in 

 a division or fissure of the posterior part of the rings of the vertebra, 

 i-ither in one region of the back (as is most common) or throughout 

 the whole spine. The mode in which the production of these and 

 many other anomalies of the same nature can be explained by arrest 

 of development, is by a knowledge of the method by which parts are 

 formed. It has been observed in some organs (and the same thing is 

 supposed by analogy to take place in almost all), that the growth goes 

 on from the circumference towards the centre, and that the lateral 

 parts of any single organ are developed before the central parts, and 

 tlui', at an early period of foetal life, hare-lip and spinal fissure are 

 natural conditions of the embryo. If the process of development 

 becomes arrested by any accidental cause these states will become 

 permanent, and the child will be malformed. 



We have shown that arrest of development may produce unnatural 

 separation of parts, and it may also occasion the closure r connection 

 of ports naturally open or separate. Thus we frequently meet with 

 deficiency of one or more of the orifices which open on the surface 

 of the body, and particularly of the anus. In this case the intestinal 

 canal may be perfect, and its orifice only closed by a membranous 

 fold, or it may be very incomplete, and terminate in a cul-de-sac at a 

 greater or less distance from the situation of its natural outlet This 

 anomaly is easily explained by the mode of formation of the 

 alimentary canal, which is originally a prolongation of the intestinal 

 vesicle, which gives rise in one direction to the stomach and upper 

 part of the digestive tube, ami in the opposite direction to the infe- 

 rior or descending part of the intestines. The formation of either of 

 them portions may be arrested in any part of its course (the canal 

 terminating in a blind extremity), though the large intestines, as the 

 colon or rectum, are most commonly the seat of this anomaly, which, 

 on account of the serious interference which it occasions in the func- 

 tions of nutrition, speedily destroys the life of the child, unless it can 

 be removed by surgical art. 



Monsters sometimes present irregularities in the number of parts 

 which they possess, being either furnished with supernumerary organs 

 or exhibiting some deficiency. An order of monsters thus composed 

 of deviations from the natural number of parts seems to be clearly 

 distinguished from all others ; but if we carefully examine the dif- 

 ferent cases which it comprises, we shall find that a great many of 

 them may be arranged together with cases belonging to other orders 

 of monstrosity, being in fact referrible to some alterations of volume 

 or change of connection in the affected parts. Thus when an organ 

 is apparently deficient, it is often possible to detect the rudiments of 

 it by a careful dissection, and therefore, though much diminished in 

 ' still exiaU. In the same manner when supernumerary ports 

 are added to any organ, anatomical examination will sometimes show 

 that there is no real formation of new parts, but only an increased 

 development of those structures which commonly remain in a rudi- 

 mentary state. In many cases also the deficiency or addition of organs, 

 as supernumerary fingers or toes, and vice versA, may be explained 

 by the complete division of one part into two, or the intimate union 

 of two or more parts. 



The development of supernumerary mammic is one of the most 

 frequent anomalies of thin kind which occur in the human subject. 

 Then is commonly only the addition of one extra gland in these 

 cases, making three breasts, but both four and five have been occasion- 

 ally seen. When four exist they are generally arranged symmetrically 

 two on each aide of the chest. When three or five are present, the 

 o.l.l one may be placed laterally beneath one of the others or in the 

 median line : when in the latter situation, it has been remarked that 

 it is generally small and rudimentary, which may be owing to the 

 mode of distribution of tho mammary arteries which run parallel 

 down the ti.lcs of the chest. A very remarkable but rare anomaly in 



man is the existence of a mamma in the inguinal region ; one or two 

 authi-utio cases of this kind are recorded. (' Journal Gen. de Modo'- 

 cine,' torn, c., p. 57.) The only theory which explains these 

 anomalies is that which Geoffrey St. Hilaire has denominated the 

 " law of unity of organic composition." This naturalist supposes that 

 the whole animal kingdom is formed upon a common type, the organs 

 of ililli-rvut animals in tho earliest states of the embryo being all 

 similar, but during their development assuming different forms ill 

 different animals ; some ports being highly developed in one species, 

 and remaining in a rudimentary state in others. Almost all the 

 Mammalia have several mammary gland* disposed in two parallel 

 series ; and though two are only naturally developed in man, yet wo 

 may suppose that the elements of others have existed at an early 

 period, which become developed in these anomalous cases by excel* 

 or irregularity of the formative process. The bones, muscles, vessels, 

 viscera, and other organs, have all been frequently observed to present 

 alterations in the number of their parts. Many cases are related by 

 authors of an increase or diminution in the uumber of the cavities of 

 the heart ; three ventricles have been met with (Chemineau, ' Hist, de 

 1'Acad. des Sciences,' 1699) ; absence of both the auricles has been 

 observed (Turner, ' Journal Gen. de Jlodociue,' torn. xcvi.); and many 

 anatomist) have described hearts which were furnished with only a 

 single auricle and ventricle, as in fishes : cases are even related in 

 which two distinct hearts have been found in the same individual, but 

 their authenticity must bo doubted. Au unnatural number of teeth 

 bos often been observed. Arnold (' Obs. Physic. Medic.,' p. 69) mentions 

 a case in which there existed 8 incisor, 4 canine, and 24 molar teeth 

 in each jaw making together 72. The truth of this case may well 

 be suspected, though many instances of the presence of several super- 

 numerary teeth have been recorded by other authors. 



The second class of simple monsters, comprising the various forms 

 of extensive malformation, contains an immense number of dill, nut 

 cases. Some monsters, though greatly altered both in form ami 

 structure, are yet capable of living for a considerable time after birth ; 

 others, on the contrary, are entirely destitute of the power of support- 

 ing an independent vitality, and may be so imperfectly formed that 

 the symmetry of the body is lost, and nothing remains but an irregular 

 shapeless mass. Malformation often affects only one region of tho 

 body in monsters, the other ports remaining comparatively natural : 

 thus the limbs ore frequently very much altered in structure and 

 appearance, and may be even entirely deficient, in cases where the 

 head and trunk preserve almost their regular form. Monsters have 

 been seen in whom the hands or feet were alone developed and inserted 

 immediately upon the trunk. From a fancied resemblance between 

 the state of the limbs in these monsters and their natural state 

 in the Seal and other amphibious animals, the name PhocomtUt 

 has been applied to them. M. UumoVil (' Bull de la Soc. Philoma- 

 thique,' torn. iiL, art. xi.) has described a man who was 'affected 

 with this anomaly, and who died in Paris about the year 1800, at 

 the age of 62. HU body was carefully examined after death, when 

 all four limbs were found alike deficient : the two clavicles were very 

 short and thick ; thu humeri and bones of the fore arm did not exist 

 at all, but the hands were articulated by the bones of the wrist imme- 

 diately to the scapula. In the abdominal limbs the head of the femur 

 and the trochaute.ro were found on both sides, and a rudimentary tibia 

 existed which was articulated with the foot, but had no connection 

 with the short thigh-bone. The hand.* and feet have sometimes been 

 found wanting in cases where the whole or part of the arms and legs 

 were developed, which terminated in a rounded extremity or stump ; 

 and lastly, one or more of the limbs in man and different animals 

 have been found entirely deficient. In another family of monsters, 

 denominated Symtla, or Sirens, tho two thoracic or abdominal limbs 

 are fused together into a niugle member : thus the two legs have been 

 seeu united into one, and furnished with either a double or single foot, 

 or terminating in a point or stump. These monsters are generally 

 malformed in some other respects, and mostly die soon after birth. 



The trunk may be the principal seat of malformation, while the 

 head and limbs only slightly participate in it In monsters of this 

 kind eventration has generally been found, accompanied with other 

 anomalies. Eveutratiou consists in imperfect development of tho 

 walls of the abdomen, and consequently protrusion of the gr.-:id r 

 part of the viscera, which form a largo tumour in front of the abdo- 

 men, which is only covered by a thin and delicate membrane, 

 consisting of the dilated base of the umbilical cord. This anomaly 

 may be solely confined to the abdomen, or it may also implicate thu 

 thoracic viscera : thus if the eventration occupies the upper part of 

 the abdomen, tho sternum may be divided by a fissure, or may even 

 be completely wonting, so that heruial displacement of the heart will 

 take place. Where the sternum and chest are implicated, the dia- 

 phragm is also imperfect, being partly wanting or divided. (I. Geoff. 

 St Hilaire, 'Hist des Anom.,' t XL, p. 283.) When the eventratiou 

 occupies the inferior regions of the abdomen, the urinary and genital 

 organs are often imperfectly developed, as well as in some cases one 

 or both of the abdominal limbs. 



Extroversion of the bladder is one of the best known anomalies of 

 this class. In this malformation there is both displacement and 

 imperfect development of the bladder itself, as well as of part of the 

 wiills of the abdomen, the front wall of the bladder in deficient, and 



