FROM PHOTOGRAPHS.

[Fig. 1]. Twins in acquired position (E. R., C. L.). Taken in St. Petersburg, 1870. [Page 3]. [Fig. 2]. Twins in acquired position (E. R., C. L.). Taken after death at Philadelphia. [Page 8].

FROM SKETCHES.

[Fig. 3]. The surface, C. R., E. L., exposed by removal of skin and superficial fascia to display the tendons of the external oblique muscles and adjacent parts. [Page 12]. A. The superficial fascia—lost over the position of Chang’s umbilical pouch. B, C. Supplemental layers of fibrous tissue of Eng not seen in Chang; B is a continuation toward Eng of aponeurotic fibres having a source from the linea alba of Chang;
C is independent of the former, and is continuous with the deep pectoral fascia. D. The interlacing of fibres on tendon of external oblique muscle of Chang. E. The linea alba of Chang, beginning at C. R. F. Its continuation to E. L., and insertion upon the ensiform cartilage. [Fig. 4]. The umbilical ligament in Eng. [Page 15]. A. The umbilical ligament. B. The lobule of fat at position of normal umbilicus. [Fig. 5]. The umbilical ligament in Chang. [Page 16].
The letters as in Fig. 4. [Fig. 6]. The abdominal organs of Eng—the small intestines removed. [Page 17]. A. Left lobe of liver. B. Right lobe of liver. C. Gall-bladder. D. Suspensory ligament. E. Lobules of fat in the position of the termination of the umbilical ligament. [Fig. 7]. The abdominal organs in Chang—the small intestines removed. [Page 19].
The letters as in Fig. 6. [Fig. 8]. The surface, C. R., E. L., showing the interior of band by free division of the aponeuroses seen in Fig. 7, and their underlying peritoneal attachments. [Page 24]. A. The orifice of umbilical pouch of Eng. B. The orifice of umbilical pouch of Chang, showing connection with suspensory ligament of Eng. C. The fenestrated umbilical pouch of Eng passing between the folds of the suspensory ligament of Chang. D. Suspensory ligament of liver of Eng. E. Hepatic tract. F. Hepatic pouch of Eng. G. The septum. [Fig. 9]. The septum viewed from Chang’s side. [Page 25]. A. The orifice of umbilical pouch of Chang. B. The orifice of hepatic pouch of Chang. C. Suspensory ligament of Chang, containing umbilical pouch of Eng. [Fig. 10]. The septum viewed from Eng’s side. [Page 26]. A. The orifice of umbilical pouch of Eng. B. The orifice of hepatic pouch of Eng. C. Suspensory ligament of Eng, containing umbilical pouch of Chang. [Fig. 11]. The surface, C. R., E. L., with pouches removed to display the hepatic tract. [Page 27]. A. Liver of Chang. B. Liver of Eng. C. Portal vessel of Chang. D, D. Minute branches of hepatic artery. E. Subcutaneous fat of surface, E. R., C. L. [Fig. 12]. The surface, C. R., E. L., with pouches, hepatic tract, and peritoneal attachments removed to display the diaphragms. [Page 28]. A. Subcutaneous fat of surface, E. R., C. L. B, C. Symmetrical muscular fasciculi. D. Fasciculi of Eng, crossing median line of band. [Fig. 13]. The peritoneal linings of the anterior walls of both abdominal cavities. [Page 29]. A, A. The summits of the bladders. B, B. The umbilical ligaments. C, C. The nodules of fat at the parietal scar. D, D. The isolated lobules of fat. [Fig. 14]. A section of both ensiform cartilages, C. R., E. L. [Page 31]. A. Chang’s cartilage. B. Eng’s cartilage. C. The synchondrosis. D. The bursa-like sac covering the same. E. An opening into the sac. F. Transversalis muscle of Eng. G. Transversalis muscle of Chang. [Fig. 15]. Upper surface of ensiform cartilages. [Page 32]. A. The upper ligament uniting the cartilages. [Fig. 16]. The livers. [Page 34]. A. Right lobe of Eng. B. Left lobe of same. C. Right lobe of Chang. D. Left lobe of same. E. Hepatic tract. F. Round ligament of Eng. G. Round ligament of Chang. H. Accessory suspensory ligament of Eng, with termination of the right mammary artery. I. Fundus of gall-bladder of Chang. J. Fundus of gall-bladder of Eng. [Fig. 17]. Kidneys of Eng. [Page 35]. A. Left kidney. B. Right kidney. C. Left renal vein. D. Left supra-renal vein. E. Left spermatic vein. F. Descending vena cava not distended with clot. G. Right renal vein. H. Aorta distended with plaster. I. Primitive iliac arteries. [Fig. 18]. Kidneys of Chang. [Page 37]. A. Left kidney. B. Right kidney. C. Left renal vein. D. Right renal vein. E. Left spermatic vein. F. Aorta filled with plaster. G. Primitive iliac veins. H. Descending cava distended with clot. I. Left supra-renal vein. [Fig. 19]. Foreshortened view of the trunks, showing in the acquired position the band from above, and the contours of its lateral surfaces. [Page 42].

Footnotes

[1]. For this statement see an article in Lippincott’s Magazine, March, 1874.

[2]. The folds of peritoneum containing remains of the hypogastric arteries will be called throughout by the name of the umbilical ligaments.

[3]. The presence of a great amount of adipose tissue throughout, in Eng, was very noticeable as contrasted with the emaciated appearance of the tissues in Chang.

[4]. Before the septum was known to exist, the band was opened from behind in the presence of the Fellows of the College (Feb. 18th, 1874). The exact relations of the septum could not at that time be determined. Figs. [8], [9], and [10] are taken from studies of the parts made the day after the meeting.