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ere vomiting of stercoraceous matter； the pains then ceased and she cleansed her mouth with aromatic washes； remaining well until the following third day。 Some of the urine was evacuated by the mammae。 The examiners displayed much desire to see her after puberty to note the disposition of the menstrual flow； but no further observation of her case can be found。
Fournier narrates that he was called by three students； who had been trying to deliver a woman for five days。 He found a well…constituted woman of twenty…two in horrible agony； who they said had not had a passage of the bowels for eight days； so he prescribed an enema。 The student who was directed to give the enema found to his surprise that there was no anus； but by putting his finger in the vagina he could discern the floating end of the rectum； which was full of feces。 There was an opening in this suspended rectum about the size of an undistended anus。 Lavage was practiced by a cannula introduced through the opening； and a great number of cherry stones agglutinated with feces followed the water； and labor was soon terminated。 The woman afterward confessed that she was perfectly aware of her deformity； but was ashamed to disclose it before。 There was an analogue of this case found by Mercurialis in a child of a Jew called Teutonicus。
Gerster reports a rare form of imperforate anus； with malposition of the left ureter； obliteration of the ostia of both ureters； with consequent hydronephrosis of a confluent kidney。 There was a minute opening into the bladder； which allowed the passage of meconium through the urethra。 Burge mentions the case of what he calls 〃sexless child；〃 in which there was an imperforate anus and no pubic arch； the ureters discharged upon a tumor the size of a teacup extending from the umbilicus to the pubes。 A postmortem examination confirmed the diagnosis of sexless child。
The Liver。The Ephemerides； Frankenau； von Home； Molinetti； Schenok； and others speak of deficient or absent liver。 Zacutus Lusitanus says that he once found a mass of flesh in place of the liver。 Lieutaud is quoted as describing a postmortem examination of an adult who had died of hydropsy； in whom the liver and spleen were entirely missing。 The portal vein discharged immediately into the vena cava； this case is probably unique； as no authentic parallel could be found。
Laget reports an instance of supernumerary lobe in the liver。 Van Buren describes a supernumerary liver。 Sometimes there is rotation； real or apparent； caused by transposition of the characteristics of the liver。 Handy mentions such a case。 Kirmisson reports a singular anomaly of the liver which he calls double displacement by interversion and rotation on the vertical axis。 Actual displacements of the liver as well as what is known as wandering liver are not uncommon。 The operation for floating liver will be spoken of later。
Hawkins reports a case of congenital obliteration of the ductus communis choledochus in a male infant which died at the age of four and a half months。 Jaundice appeared on the eighth day and lasted through the short life。 The hepatic and cystic ducts were pervious and the hepatic duct obliterated。 There were signs of hepatic cirrhosis and in addition an inguinal hernia
The Gall…Bladder。Harle mentions the case of a man of fifty； in whom he could find no gall…bladder； Patterson has seen a similar instance in a men of twenty…five。 Purser describes a double gall…bladder。
The spleen has been found deficient or wanting by Lebby； Ramsay； and others； but more frequently it is seen doubled。 Cabrolius； Morgagni； and others have found two spleens in one subject； Cheselden and Fallopius report three； Fantoni mentions four found in one subject； Guy…Patin has seen five； none as large as the ordinary organ； Hollerius； Kerckringius； and others have remarked on multiple spleens。 There is a possibility that in some of the cases of multiple spleens reported the organ is really single but divided into several lobes。 Albrecht mentions a case shown at a meeting of the Vienna Medical Society of a very large number of spleens found in the mesogastrium； peritoneum； on the mesentery and transverse mesocolon； in Douglas' pouch； etc。 There was a spleen 〃the size of a walnut〃 in the usual position； with the splenic artery and vein in their normal position。 Every one of these spleens had a capsule； was covered by peritoneum； and exhibited the histologic appearance of splenic tissue。 According to the review of this article； Toldt explains the case by assuming that other parts of the celomic epithelium； besides that of the mesogastrium； are capable of forming splenic tissue。 Jameson reports a case of double spleen and kidneys。 Bainbrigge mentions a case of supernumerary spleen causing death from the patient being placed in the supine position in consequence of fracture of the thigh。 Peevor mentions an instance of second spleen。 Beclard and Guy…Patin have seen the spleen congenitally misplaced on the right side and the liver on the left； Borellus and Bartholinus with others have observed misplacement of the spleen。
The Pancreas。Lieutaud has seen the pancreas missing and speaks of a double pancreatic duct that he found in a man who died from starvation； Bonet speaks of a case similar to this last。
There are several cases of complete transposition of the viscera on record。 This bizarre anomaly was probably observed first in 1650 by Riolanus； but the most celebrated case was that of Morand in 1660； and Mery described the instance later which was the subject of the following quatrain：
〃La nature； peu sage et sans douse en debauche Placa le foie au cote gauche； Et de meme； vice versa Le coeur a le droite placa。〃
Young cites an example in a woman of eighty…five who died at Hammersmith； London。 She was found dead in bed； and in a postmortem examination； ordered to discover if possible the cause of death； there was seen complete transposition of the viscera。 The heart lay with its base toward the left； its apex toward the right； reaching the lower border of the 4th rib； under the right mamma。 The vena cava was on the left side and passed into the pulmonary cavity of the heart； which was also on the left side； the aorta and systemic ventricle being on the right。 The left splenic vein was lying on the superior vena cava； the liver under the left ribs； and the spleen on the right side underneath the heart。 The esophagus was on the right of the aorta； and the location of the two ends of the stomach was reversed； the sigmoid flexure was on the right side。 Davis describes a similar instance in a man。
Herrick mentions transposition of viscera in a man of twenty…five。 Barbieux cites a case of transposition of viscera in a man who was wounded in a duel。 The liver was to the left and the spleen and heart to the right etc。 Albers； Baron； Beclard； Boyer； Bull； Mackensie； Hutchinson； Hunt； Murray； Dareste； Curran； Duchesne； Musser； Sabatier； Shrady； Vulpian； Wilson； and Wehn are among others reporting instances of transposition and inversion of the viscera。
Congenital extroversion or eventration is the result of some congenital deficiency in the abdominal wall； instances are not uncommon； and some patients live as