can hardly be seriously interfered with by pressure without disturbing the other.

Now I do not suppose pressure was directly made on the locus niger or the origins of the sixth, hypoglossal, or glosso-pharyngeal, though it may have been direct on the origin of the fourth, portio dura, optic thalami, and striated bodies, for these, as we know, are parts lying next to and forming the walls of the lateral, third, and fourth ventricles of the brain; and in this case there can be but little doubt that the wound penetrated the right lateral ventricle, and it is possible blood passed from this into the third, thence into the fourth ventricle.

Admitting, then, that blood occupied these ventricles and pressed upon the origins of the third, motor fifth, sixth portio dura, glosso-pharyngeal, and hypoglossal, I do not quite understand why it should press more on the right than the left, or the reverse, but it seems to me, so far as pressure on these centres is concerned, it must have been equal on the right and the left.

It is as certain that destruction of the locus niger will cause paralysis of the third nerve, as it is that breaking up any part of the spinal cord will paralyze the parts supplied therefrom. If the spinal cord be severed, all parts supplied by nerves coming off from its ganglionic centres below the point of injury are paralyzed, yet the reflex power of these ganglia remains.

May it not be true that cutting the connection between the organ of the will and the origin of the third or any ather of the cranial nerves will cause paralysis of that nerve? Are we therefore forced to the conclusion that in the case related pressure was either directly or indirectly made on the ganglia giving origin to any of the cranial nerves involved, any more than we are that pressure was made on any part of one half of the spinal cord? I think not. Then why lay so much stress on the particular spots with which individual nerves are connected? Are these ganglia in any case anything more than switches on the

railroad track of the nervous system, by which the will power, or its correlative force, is directed to one part or another as may be necessary to the life and health of the individual?

I take the position, then, that blood did not pass into the third and fourth ventricles and press upon the ganglia of the third, sixth portio dura, hypoglossal, and glossopharyngeal nerves, for if the paralysis were due to pressure, then it would have been as much on one as the other side.

And if we have paralysis of the parts supplied by nerves arising in the ganglia of the spinal cord dependent on pressure or other disturbance of ganglia situated within the cranium, and connected by commissures with the spinal centres, we may also have nerves of the cranial group arising in separate ganglia paralyzed by injury of the great centres of volition, or the commissures connecting these with the origins of the cranial nerves.

AUGUST, 1868.

A CASE OF DOUBLE-HEADED MONSTER.

Reported by L. CH. BOISLINIERE, M.D., of St. Louis.

Through the courtesy of Dr. E. FEEHAN, of this city, I was furnished with this interesting case of human monstrosity. The day before he had safely delivered the mother by the forceps and version, causing the body and second head to perform what accoucheurs have described under the name of spontaneous evolution, or rather, spontaneous version, as Prof. HODGE properly calls this process. The heads were those of children at full term, with perfect, and even handsome, features, and the body that of a large male child. A necroscopic examination of this very rare pièce anatomique was made a few hours afterwards by Prof. A. HAMMER; and Prof. A. J. STEELE, of this city, who assisted at the examination, kindly furnished me with the following notes taken at the time.

There were present two vertebral columns, entire and separate; pelvis single; two sacra, separated by a rudimentary mass of bone; two inferior extremities; two heads; three arms; one bifurcated sternum, and ribs of opposite sides articulating with it; posterior ribs fused, making a ridge in the median line, which, when viewed cursorily, resembled a third vertebral column; four clavicles; four scapula, the two median being confluent at their angles; the third, or middle arm, contained one humerus which was double-headed, with two articular facets at its superior extremity; one ulna; two radii; two hands, with the little fingers merged into one, thus making nine fingers for the two palms, thumbs turned outwards; two stomachs, normal; intestinal tracts double for their superior twothirds, being merged and single for their remainder or lower portion; one rectum; one anus; the liver formed of two right lobes fused and contained in a common investment; two gall bladders, the right being rudimentary; two spleens, found in the thoracic cavity, one to the right, anterior, the other to the left, posterior, had escaped from the abdomen through an opening one inch and a half in diameter, which existed in the left leaflet of the diaphragm; two kidneys; one bladder; one penis; two pairs of lungs; two hearts-the lungs and hearts being normal.

The examination was not as complete as desirable, having been somewhat hurried through on account of the great heat. But the specimen having been kept in alcohol,

as soon as practicable, I hope to be able to furnish a more thorough description, especially of the bony structure of this monster. I present here a cut (Fig. 15) from a photograph taken at the time.

In the classification as adopted by FISHER, of New York, who has devoted much study to this subject, and whose nomenclature is very simple, this monster would be described under the head of Diploteratography, Order 1, Catadidyma; Genus I, Dicephalus: Species 4, Dicephalus tribachius dipus. (Synonyms,-Dérodyme, Derodymus, F. LAUTH, and GEOFF. St. HILAIRE; Omodyme, Omodymus, LAUTH; Tetrachirus choristocephalus, GURLT [on Animals]).

I will add that in the various writers on this subject I can find only one case of malformation exactly similar to the one above described.*

The mother made a perfect recovery, and can not trace this anomaly to any maternal impression or injury received during pregnancy.

AUGUST, 1868.

*The author very probably refers to the case reported by BARKOW (Monstra animalium duplicia per anatomen indagata, Tom. 1, p. 17), figured and described in FOERSTER'S Missbildungen des Menschen, Jena, 1861, plate i, figure 2. The differences between this case and that of Dr. BOISLINIERE are very slight: there were but two scapula and two clavicles; the little fingers were entirely separate, the third arm bearing ten fingers; there was but one gall-bladder and but one spleen.—FOERSTER, however, mentions that he has noted 25 cases of Dicephalus tribachius, one other of which he figures, plate vi, fig. 4 (from ZIMMER). In this case, however, the left individual is affected with hemicrania and complete spina bifida. Otherwise, the conformation of the skeleton is still more nearly alike to that in Dr. BOISLINIERE's case than in the one above quoted.—ED.

Reviews and Bibliographical Notices.

THE INDIGESTIONS; or Diseases of the Digestive Organs functionally treated. BY THOMAS KING CHAMBERS, Honorary Physician to H. R. H. the Prince of Wales, Consulting Physician and Lecturer on the Practice of Medicine at St. Mary's Hospital, etc., etc. 2d Amer.. from the 2d revised London edition. Philadelphia: Henry C. Lea. 1868. Svo., pp. 319. Price, $3 00.

[For sale by the St. Louis Book and News Co.]

An unusually agreeable task has been imposed upon us: we have read Dr. CHAMBERS' Indigestions" with satisfaction and pleasure rising with every new chapter, and we sit down to an analysis of its contents with the comfortable feeling that criticism is out of place, and nothing but a review is required to express our favorable opinion of the book. Dr. CHAMBERS' manner of treating his subject is not the only good way, nor his point of view the only one from which a successful exposition of the derangements of the digestive functions is to be expected ;-but, for one, it is excellent, and we may not too highly recommend it.

In order to convey a general idea of the plan and spirit of the book, we can not do better than introduce a few extracts from the introduction. It is well known that Dr. CHAMBERS holds very definite fundamental doctrines in pathology, not so much peculiar to himself as rather presented (elsewhere) with peculiar force and originality. Here is a small specimen in point:

Indigestion is a chronic disease. By that I mean that its natural path is straight on from bad to worse, unless from the interposition of some extraneous circumstances of accidental or designed origin foreign to the phenomena of the disease itself. Hence it is not difficult to test upon it the action of a remedy. A cautious observer may from a moderate number of well-considered cases come to a rational conclusion as to its value. On the other hand, the tendency of acute disease, as I understand it, is to progress in a circle toward the recovery of health; each process, however dangerous and abnormal it may be, being a step toward the final arrival at that result, if only the patient's strength hold out. Art, therefore, modifies it much less glaringly; a small experience is sure to lead to fallacies, and it is only in the numerical comparison of a large number of unprejudged cases that an opinion can be formed.