Physiologic and Functional Anomalies : The Semen

Anomalies and Curiosities of Medicine
by George M. Gould, M.D., Walter L. Pyle, M.D.

(Page 11 of 50)

Purdon describes an Irish married woman of forty, the subject of rheumatic fever, who occasionally had a blue serous discharge or perspiration that literally flowed from her legs and body, and accompanied by a miliary eruption. It was on the posterior portions, and twelve hours previous was usually preceded by a moldy smell and a prickly sensation. On the abdomen and the back of the neck there was a yellowish secretion. In place of catamenia there was a discharge reddish-green in color. The patient denied having taken any coloring matter or chemicals to influence the color of her perspiration, and no remedy relieved her cardiac or rheumatic symptoms.

The first English case of chromidrosis, or colored sweat, was published by Yonge of Plymouth in 1709. In this affection the colored sweating appears symmetrically in various parts of the body, the parts commonly affected being the cheeks, forehead, side of the nose, whole face, chest, abdomen, backs of the hands, finger-tips, and the flexors, flexures at the axillae, groins, and popliteal spaces. Although the color is generally black, nearly every color has been recorded. Colcott Fox reported a genuine case, and Crocker speaks of a case at Shadwell in a woman of forty-seven of naturally dark complexion. The bowels were habitually sluggish, going three or four days at least without action, and latterly the woman had suffered from articular pains. The discolored sweat came out gradually, beginning at the sides of the face, then spreading to the cheeks and forehead. When seen, the upper half of the forehead, the temporal regions, and the skin between the ear and malar eminence were of a blackish-brown color, with slight hyperemia of the adjacent parts; the woman said the color had been almost black, but she had cleaned her face some. There was evidently much fat in the secretion; there was also seborrhea of the scalp. Washing with soap and water had very little effect upon it; but it was removed with ether, the skin still looking darker and redder than normal. After a week's treatment with saline purgatives the discoloration was much less, but the patient still had articular pains, for which alkalies were prescribed; she did not again attend. Crocker also quotes the case of a girl of twenty, originally under Mackay of Brighton. Her affection had lasted a year and was limited to the left cheek and eyebrow. Six months before the patch appeared she had a superficial burn which did not leave a distinct scar, but the surface was slightly granular. The deposit was distinctly fatty, evidently seborrheic and of a sepia-tint. The girl suffered from obstinate constipation, the bowels acting only once a week. The left side flushed more than the right In connection with this case may be mentioned one by White of Harvard, a case of unilateral yellow chromidrosis in a man. Demons gives the history of a case of yellow sweat in a patient with three intestinal calculi.

Wilson says that cases of green, yellow, and blue perspiration have been seen, and Hebra, Rayer, and Fuchs mention instances. Conradi records a case of blue perspiration on one-half the scrotum. Chojnowski records a case in which the perspiration resembled milk.

Hyperidrosis occurs as a symptom in many nervous diseases, organic and functional, and its presence is often difficult of explanation. The following are recent examples: Kustermann reports a case of acute myelitis in which there was profuse perspiration above the level of the girdle-sensation and none at all below. Sharkey reports a case of tumor of the pons varolii and left crus cerebri, in which for months there was excessive generalized perspiration; it finally disappeared without treatment. Hutchinson describes the case of a woman of sixty-four who for four years had been troubled by excessive sweating on the right side of the face and scalp. At times she was also troubled by an excessive flow of saliva, but she could not say if it was unilateral. There was great irritation of the right side of the tongue, and for two years taste was totally abolished. It was normal at the time of examination. The author offered no explanation of this case, but the patient gave a decidedly neurotic history, and the symptoms seem to point with some degree of probability to hysteria. Pope reports a peculiar case in which there were daily attacks of neuralgia preceded by sweating confined to a bald spot on the head. Rockwell reports a case of unilateral hyperidrosis in a feeble old man which he thought due to organic affection of the cervical sympathetic.

Dupont has published an account of a curious case of chronic general hyperidrosis or profuse sweating which lasted upward of six years. The woman thus affected became pregnant during this time and was happily delivered of an infant, which she nursed herself. According to Dupont, this hyperidrosis was independent of any other affection, and after having been combated fruitlessly by various remedies, yielded at last to fluid extract of aconitin.

Myrtle relates the case of a man of seventy-seven, who, after some flying pains and fever, began to sweat profusely and continued to do so until he died from exhaustion at the end of three months from the onset of the sweating. Richardson records another case of the same kind. Crocker quotes the case of a tailor of sixty-five in whom hyperidrosis had existed for thirty-five years. It was usually confined to the hands and feet, but when worst affected the whole body. It was absent as long as he preserved the horizontal posture, but came on directly when he rose; it was always increased in the summer months. At the height of the attack the man lost appetite and spirit, had a pricking sensation, and sometimes minute red papules appeared all over the hand. He had tried almost every variety of treatment, but sulphur did the most good, as it had kept the disease under for twelve months. Latterly, even that failed.

Bachman reports the history of a case of hyperidrosis cured by hypnotism.

Unilateral and localized sweating accompanies some forms of nervous disturbance. Mickle has discussed unilateral sweating in the general paralysis of the insane. Ramskill reports a case of sweating on one side of the face in a patient who was subject to epileptic convulsions. Takacs describes a case of unilateral sweating with proportionate nervous prostration. Bartholow and Bryan report unilateral sweating of the head. Cason speaks of unilateral sweating of the head, face, and neck. Elliotson mentions sweat from the left half of the body and the left extremities only. Lewis reports a case of unilateral perspiration with an excess of temperature of 3.5 degrees F. in the axilla of the perspiring side. Mills, White, Dow, and Duncan also cite instances of unilateral perspiration. Boquis describes a case of unilateral perspiration of the skin of the head and face, and instances of complete unilateral perspiration have been frequently recorded by the older writers, - Tebure, Marcellus Donatus, Paullini, and Hartmann discussing it. Hyperidrosis confined to the hands and feet is quite common.