PHYSIOLOGIC AND FUNCTIONAL ANOMALIES.
In considering the anomalies of the secretions, it must be remembered that the ingestion of certain kinds of food and the administration of peculiar drugs in medicine have a marked influence in coloring secretions. Probably the most interesting of all these anomalies is the class in which, by a compensatory process, metastasis of the secretions is noticed.
Colored Saliva.--Among the older writers the Ephemerides contains an account of blue saliva; Huxham speaks of green saliva;Marcellus Donatus of yellow, and Peterman relates the history of a case of yellow saliva. Dickinson describes a woman of sixty whose saliva was blue; besides this nothing was definitely the matter with her. It seemed however, that the color was due to some chemic-pencil poisoning rather than to a pathologic process.
A piece of this aniline pencil was caught in the false teeth.
Paget cites an instance of blue saliva due to staining the tongue in the same manner. Most cases of anomalous coloring of this kind can be subsequently traced to artificial substances unconsciously introduced. Crocker mentions a woman who on washing her hands constantly found that the water was stained blue, but this was subsequently traced to the accidental introduction of an orchid leaf. In another instance there was a woman whose linen was at every change stained brown; this, however, was found to be due to a hair-wash that she was in the habit of using.
Among the older writers who have mentioned abnormal modes of exit of the urine is Baux, who mentions urine from the nipples;Paullini and the Ephemerides describe instances of urination from the eyes. Blancard, the Ephemerides, Sorbalt, and Vallisneri speak of urination by the mouth. Arnold relates the history of a case of dysuria in which urine was discharged from the nose, breasts, ears, and umbilicus; the woman was twenty-seven years old, and the dysuria was caused by a prolapsed uterus. There was an instance of anomalous discharge of urine from the body reported in Philadelphia many years ago which led to animated discussion. A case of dysuria in which the patient discharged urine from the stomach was reported early in this century from Germany. The patient could feel the accumulation of urine by burning pain in the epigastrium. Suddenly the pain would move to the soles of the feet, she would become nauseated, and large quantities of urine would soon be vomited. There was reported the case of an hysterical female who had convulsions and mania, alternating with anuria of a peculiar nature and lasting seven days. There was not a drop of urine passed during this time, but there were discharges through the mouth of alkaline waters with a strong ammoniacal odor.
Senter reports in a young woman a singular case of ischuria which continued for more than three years; during this time if her urine was not drawn off with the catheter she frequently voided it by vomiting; for the last twenty months she passed much gravel by the catheter; when the use of the instrument was omitted or unsuccessfully applied the vomitus contained gravel. Carlisle mentions a case in which there was vomiting of a fluid containing urea and having the sensible properties of urine. Curious to relate, a cure was effected after ligature of the superior thyroid arteries and sloughing of the thyroid gland. Vomiting of urine is also mentioned by Coley, Domine, Liron, Malago, Zeviani, and Yeats. Marsden reports a case in which, following secondary papular syphilis and profuse spontaneous ptyalism, there was vicarious secretion of the urinary constituents from the skin.
Instances of the anomalous exit of urine caused by congenital malformation or fistulous connections are mentioned in another chapter. Black urine is generally caused by the ingestion of pigmented food or drugs, such as carbolic acid and the anilines.
Amatus Lusitanus, Bartholinus, and the Ephemerides speak of black urine after eating grapes or damson plums. The Ephemerides speaks of black urine being a precursor of death, but Piso, Rhodius, and Schenck say it is anomalous and seldom a sign of death. White urine, commonly known as chyluria, is frequently seen, and sometimes results from purulent cystitis. Though containing sediment, the urine looks as if full of milk. A case of this kind was seen in 1895 at the Jefferson Medical College Hospital, Philadelphia, in which the chyluria was due to a communication between the bladder and the thoracic duct.
Ackerman has spoken of metastasis of the tears, and Dixon gives an instance in which crying was not attended by the visible shedding of tears. Salomon reports a case of congenital deficiency of tears. Blood-stained tears were frequently mentioned by the older writers. Recently Cross has written an article on this subject, and its analogy is seen in the next chapter under hemorrhages from the eyes through the lacrimal duct.
The Semen.--The older writers spoke of metastasis of the seminal flow, the issue being by the skin (perspiration) and other routes. This was especially supposed to be the case in satyriasis, in which the preternatural exit was due to superabundance of semen, which could be recognized by its odor.
There is no doubt that some people have a distinct seminal odor, a fact that will be considered in the section on "Human Odors."The Ephemerides, Schurig, and Hoffman report instances of what they call fetid semen (possibly a complication of urethral disease). Paaw speaks of black semen in a negro, and the Ephemerides and Schurig mention instances of dark semen. Blancard records an instance of preternatural exit of semen by the bowel.
Heers mentions a similar case caused by urethral fistula. Ingham mentions the escape of semen through the testicle by means of a fistula. Demarquay is the authority on bloody semen.