1909 Journal of the American Medical Association  
hemorrhage was treated promptly with calcium sulphid and bydrastis. The hemorrhages disappeared. Occasionally during the spring of 1907 there was a slight hemorrhage, which received the treatment mentioned, and yielded as stated. After the spring of 1907 there was no recurrence, and the patient presented tne normal appearance of a healthy boy. CONCLUSIONS 1. The condition was clearly not hemophilic. 2. The condition perhaps might be called a constitutional scurvy, as opposed to a dietetic
more » ... to a dietetic scurvy; but if so, it was without the epiphyseal and other scorbutic characters. 3. It seemed certain that there were no rheumatic factors. 4. The absence of blood examination was a serious omission. 5. The unsolved question is: Was the disorder fundamentally due to hemic abnormality, vascular abnormality, or both? fi. Calcium sulphid and bydrastis apparently influenced the condition favorably. It has been my intention for years to report this case of an evident atavistic tendency as it is unique in character. Now that it reappears in the fifth successive generation it would seem to be proper that it be reported in order that it may go on record as an evident "freak" in Nature's law of hereditary descent. Generation 1.\p=m-\Thismalformation manifested itself in a single male, in a supernumerary thumb on the right hand and an additional finger on the outer side of the little finger of the left hand. This man lived to be 92 years of age and never married. He had evident pride in his multiplicity of members and bore the inconveniences with a commendable patience. Generation 2.\p=m-\Hisniece had a supernumerary finger on her left hand. She had it removed when a child. Generation 3.\p=m-\The grandnieces had each an additional finger on the left hand, but the parents had them removed when the children were infants. Generation If.-Of eight children in three families this peculiarity is present in only one, a girl, who had a supernumerary toe on the outer side of the little toe of the right foot, which I removed when she was six months old. Generation 5.-In this generation, so far, there are three children, all in one family; in one only, a boy, is this hereditary peculiarity present; he has a superfluous toe. In my opinion the woman of the second generation believed that her child or children would have this malformation, and the daughters both manifested it. The two sons did not, nor did their children after them. Of the five children of the older of the two grandnieces but one, a girl, showed the family characteristic. She had never married. Her older sister married and only one of her three children, a boy, showed polydactylism. The fear of this peculiarity runs through all the female members of each succeeding generation and a lively interest is manifested in each new comer. As a matter of fact, it has never shown itself outside of the females in any generation but the first and the fifth. Is it the result of a strong maternal impression or a mere coincidence, or does it bear out the principle of atavism ? The device here described consists of a pear-shaped dilatable rubber bag perforated along the long axis of its fundus by forty small holes, and tapering at its neck so as to act under the influence of the downward pressure of the water in the vagina as a plug for the vulvar orifice. Its elasticity renders it adaptable to practically any size or shape of orifice, while its extreme flexibility prevents any harmful degree of pressure in the vagina. Being made from the finest rubber it is readily dilatable to more than twice its natural size. It serves as a simple attachment to any syringe being placed on the adult rectal nozzle, or may be at-Fig. 1.-The dilatable rubber bag. Fig. 2.-.Diagrammatic representation of douche in use. tached to a bulbar nozzle of similar caliber, being secured by a piece of silk or soft string. These points are plainly shown in the illustrations. The amount of expansion of the douche bag is controlled entirely by the elevation of the reservoir. For a common douche, unless otherwise ordered, it is from three to four feet. The douche bag may be made by traction to fit the vaginal outlet perfectly, or, as in the case of a long douche, may lie loosely, allowing water to flow in and out. A two-quart syringe bag is usually used, and at the end of the douche this is lowered, and the s.^iall bag collapses and falls out.
doi:10.1001/jama.1909.25420440031003c fatcat:tskpsigqa5f6blbqvfujopf6yi