Melanism is an anomaly, the exact contrary of the preceding. It is characterized by the presence in the tissues and skin of an excessive amount of pigment. True total melanism is unknown in man, in whom is only observed partial melanism, characterized simply by a pronounced coloration of part of the integument.
Some curious instances have been related of an infant with a two-colored face, and of others with one side of the face white and the other black; whether they were cases of partial albinism or partial melanism cannot be ascertained from the descriptions.
Such epidermic anomalies as ichthyosis, scleroderma, and molluscum simplex, sometimes appearing shortly after birth, but generally seen later in life, will be spoken of in the chapter on Anomalous Skin Diseases.
Human horns are anomalous outgrowths from the skin and are far more frequent than ordinarily supposed. Nearly all the older writers cite examples. Aldrovandus, Amatus Lusitanus, Boerhaave, Dupre, Schenck, Riverius, Vallisneri, and many others mention horns on the head. In the ancient times horns were symbolic of wisdom and power. Michael Angelo in his famous sculpture of Moses has given the patriarch a pair of horns. Rhodius observed a Benedictine monk who had a pair of horns and who was addicted to rumination. Fabricius saw a man with horns on his head, whose son ruminated; the son considered that by virtue of his ruminating characteristics his father had transmitted to him the peculiar anomaly of the family. Fabricius Hildanus saw a patient with horns all over the body and another with horns on the forehead. Gastaher speaks of a horn from the left temple; Zacutus Lusitanus saw a horn from the heel; Wroe, one of considerable length from the scapula; Cosnard, one from the bregma; the Ephemerides, from the foot; Borellus, from the face and foot, and Ash, horns all over the body. Home, Cooper, and Treves have collected examples of horns, and there is one 11 inches long and 2 1/2 in circumference in a London museum. Lozes collected reports of 71 cases of horns,—37 in females, 31 in males, and three in infants. Of this number, 15 were on the head, eight on the face, 18 on the lower extremities, eight on the trunk, and three on the glans penis. Wilson collected reports of 90 cases,—44 females, 39 males, the sex not being mentioned in the remainder. Of these 48 were on the head, four on the face, four on the nose, 11 on the thigh, three on the leg and foot, six on the back, five on the glans penis, and nine on the trunk. Lebert's collection numbered 109 cases of cutaneous horns. The greater frequency among females is admitted by all authors. Old age is a predisposing cause. Several patients over seventy have been seen and one of ninety-seven.
Instances of cutaneous horns, when seen and reported by the laity, give rise to most amusing exaggerations and descriptions. The following account is given in New South Wales, obviously embellished with apocryphal details by some facetious journalist: The child, five weeks old, was born with hair two inches long all over the body; his features were fiendish and his eyes shone like beads beneath his shaggy brows. He had a tail 18 inches long, horns from the skull, a full set of teeth, and claw-like hands; he snapped like a dog and crawled on all fours, and refused the natural sustenance of a normal child. The mother almost became an imbecile after the birth of the monster. The country people about Bomballa considered this devil-child a punishment for a rebuff that the mother gave to a Jewish peddler selling Crucifixion-pictures. Vexed by his persistence, she said she would sooner have a devil in her house than his picture.
Lamprey has made a minute examination of the much-spoken-of "Horned Men of Africa." He found that this anomaly was caused by a congenital malformation and remarkable development of the infraorbital ridge of the maxillary bone. He described several cases, and through an interpreter found that they were congenital, followed no history of traumatism, caused little inconvenience, and were unassociated with disturbance of the sense of smell. He also learned that the deformity was quite rare in the Cape Coast region, and received no information tending to prove the conjecture that the tribes in West Africa used artificial means to produce the anomaly, although such custom is prevalent among many aborigines.
Probably the most remarkable case of a horn was that of Paul Rodrigues, a Mexican porter, who, from the upper and lateral part of his head, had a horn 14 inches in circumference and divided into three shafts, which he concealed by constantly wearing a peculiarly shaped red cap. There is in Paris a wax model of a horn, eight or nine inches in length, removed from an old woman by the celebrated Souberbielle. Figure 75 is from a wax model supposed to have been taken from life, showing an enormous grayish-black horn proceeding from the forehead. Warren mentions a case under the care of Dubois, in a woman from whose forehead grew a horn six inches in diameter and six inches in height. It was hard at the summit and had a fetid odor. In 1696 there was an old woman in France who constantly shed long horns from her forehead, one of which was presented to the King. Bartholinus mentions a horn 12 inches long. Voigte cites the case of an old woman who had a horn branching into three portions, coming from her forehead. Sands speaks of a woman who had a horn 6 3/4 inches long, growing from her head. There is an account of the extirpation of a horn nearly ten inches in length from the forehead of a woman of eighty-two. Bejau describes a woman of forty from whom he excised an excrescence resembling a ram's horn, growing from the left parietal region. It curved forward and nearly reached the corresponding tuberosity. It was eight cm. long, two cm. broad at the base, and 1 1/2 cm. at the apex, and was quite mobile. It began to grow at the age of eleven and had constantly increased. Vidal presented before the Academie de Medecine in 1886 a twisted horn from the head of a woman. This excrescence was ten inches long, and at the time of presentation reproduction of it was taking place in the woman. Figure 76 shows a case of ichthyosis cornea pictured in the Lancet, 1850.
There was a woman of seventy-five, living near York, who had a horny growth from the face which she broke off and which began to reproduce, the illustration representing the growth during twelve months. Lall mentions a horn from the cheek; Gregory reports one that measured 7 1/2 inches long that was removed from the temple of a woman in Edinburgh; Chariere of Barnstaple saw a horn that measured seven inches growing from the nape of a woman's neck; Kameya Iwa speaks of a dermal horn of the auricle; Saxton of New York has excised several horns from the tympanic membrane of the ear; Noyes speaks of one from the eyelid; Bigelow mentions one from the chin; Minot speaks of a horn from the lower lip, and Doran of one from the neck.
Gould cites the instance of a horn growing from an epitheliomatous penis. The patient was fifty-two years of age and the victim of congenital phimosis. He was circumcised four years previously, and shortly after the wound healed there appeared a small wart, followed by a horn about the size of a marble. Jewett speaks of a penile horn 3 1/2 inches long and 3 3/4 inches in diameter; Pick mentions one 2 1/2 inches long. There is an account of a Russian peasant boy who had a horn on his penis from his earliest childhood. Johnson mentions a case of a horn from the scrotum, which was of sebaceous origin and was subsequently supplanted by an epithelioma.
Ash reported the case of a girl named Annie Jackson, living in Waterford, Ireland, who had horny excrescences from her joints, arms, axillae, nipples, ears, and forehead. Locke speaks of a boy at the Hopital de la Charite in Paris, who had horny excrescences four inches long and 11 inches in circumference growing from his fingers and toes.