1658 :<:<■ (■^'/h •Wife':--->;■•:■ ffito?!li';.|:.>!i i««#fe-!;':< Pfe#!;fei>;i;N<;.;: if;! il« i!Rli;i<;;;{;!i;;--:::!: ippfei; SJi 73 DUE n»' m LAST DATE DEC 271965 t h i; M 0 -A- f \^l *» Co ■■)■. 0;-) /XrNrfC'- \ .fe^ IjUfe lij w>: :-'T: :\RIi.XEK /f;,\ ^-fe^'%1 ~^?^l;% CATALOGUE SURGICAL AND PATHOLOGICAL MUSEUM VALENTINE MOTT, MJ), LLJ), EMERITUS PROFESSOR OF SURGERY IN THE UNIVERSITY OF THE CITY OF NEW YORK, ETC, AND OF HIS SON, ALEXANDER B. MOTT, M.D., in BUBGBON OF ST. YIXCEXT'S AND THE JEWS* HOSPITALS. s^trd c^oy^u.\' <&e**>**. though with little tenderness. Pulse about 130, small and soft. In this state, I thought she would not bear any further depletion. Our only hope, and it was a very slender one, was to affect her gums as quickly as possible with mercury. For this object, she took a pill of three grains of calomel, with half a grain of opium, every two hours, which was soon in- creased to five of calomel and then ten, with such corresponding increase of the opium as her nervous system would bear. Extensive frictions of mercurial ointment were also made to the arms and thighs, and, in addi- tion, the blistered surfaces upon the abdomen were dressed with it, and then covered with an emollient poultice. After two or three days, a slight appearance of mercurial action took place in the gums, with some alleviation of the hiccough and tympany. It was, however, for but a few hours. Our efforts to increase the action of the mercury on her system were further continued, but were fruitless. For nearly a week she lingered in this way, with an endurance and tenacity of life, which are rarely seen, at times reviving, and then sinking, as if she would expire. At length, however, poor nature was exhausted, and she expired. The post mortem made about twelve hours after her death, by Dr. A. B. Mott, revealed the whole story, and confirmed my diagnosis, that there was superadded to the inflammation either an invagination, or a kink or twisi. of some portion of small intestine, by which complete obstruction was produced. A more extensive inflammation of the peritoneum is seldom seen. It involved the body of the uterus, the peritoneal covering of aUthe pelvic viscera, and the intestinal peritoneum of the large and small intestines;—being m.>st violent, however, on the latter. The parietes of the abdomen were also affected, though much less. The small intestines throughout were closely glued together by fibrinous exudations. Above the duplication or kink they were also greatly distended with flatus. Below this, in the large intes- tines, there was no flatus nor any foecal matter. Thero was a smaU quan- tity of brownish serum in the posterior part of the abdomen. In reflecting upon this ctfse, I have sometimes regretted that I did not give her the argeutum vivum, in two ounce doses, until a pound or more had been swallowed. From the nature of the twist of the ilium, it strikes me that it migiit have forced it straight, but then again,, as I have slid, the inflammation had already become so extensive, that I fear it would have destroyed her. In one case, I gave more than two pounds, but it did not overcome the difficulty. 22 COMPARTMENT XVII. 927 Tumor, with the appearance of scirrhus, from the breast of Miss —. 409 Mesenteric Gland, enlarged. From a female child, aged 6 years, who died of tabes mesenterica. 909 FungOIlS Testis, with an enormous sac. 444 Male Organs of an adult. Wax model of congenital malformation of them. The scrotum is divided in the mesial fine, each side containing a testicle. At first o-lance, these appear like the labia majora of the female. Within the upper angles of these labia is an opening large enough to adm.t the little finger, which is the urethra^ and leads to the bladder. Above this opening is an apology for a penis. 902 Congenital Fracture of the tibia, ends ununited. From a girl 11 years of age. The ends of the bone were brought together with silver-wire, but unsuccessfully. 802 Spontaneous Gangrene of the lower extremity. 803 Gangrene of the Hand. From a boy, who injured his elbow-joint severely by a fall from a tree. The limb became gangrenous, probably from obliteration of the main-arterial trunk by the injury. It was amputated near the shoulder-joint. 971 Fibrous Tumor, congenital. From the side of a child about 16 months old. It was on the right side, about on a level with the nipplo and midwaybe- tween it and the spine. It had grown from a small point—beginning hard, and, to a slight degree, moveable, and was not accompanied with any pain to the touch. From its situation, I believed it was bound down by the muscles, and, on dividing the skin, it was found to be covered by a portion of the pectoralis major and a large part of the latissimus dorsi. After separating it from its connections, a portion of the serratus magnus anticus was exposed. As the tumor lay upon the ribs, one extremity seemed to bo particularly ad- herent. At this point a ligamentous band was found to pass in between the ribs. "When this was divided, the tumor became detached. This band was the size of a large goose quill, and appeared to originate from the peri- osteum of the upper border of a rib. On laying open the tumor, it was found of great firmness throughout, and to the eye distinctly fibrous. The microscope also revealed the fact that it consisted only of yellowish fibres. The child was from Newark. Chloroform was administered. No unpleasant symptoms followed, and the child recovered. 987 Pachydermatocele, or congenital cutaneous tumor. From a little girl, about 8 years of age, in all other respects in excellent health. This tumor resembles several others preserved in the Museum, to all of which I, have assigned this name. The tumor appeared at birth, and increased with her age. It never was painful, being only an inconvenience, from involving the upper eye-lid and falling over the eye; thus impeding sight. It was situated on the left side of the os frontis, spreading not only over the superciliary ridge and upper eye-fid, but also upward, so as to cover about half of the lateral part of the scalp. It had an elastic, but firm feel like "brawn"—and was not in the slightest degree painful. The quantity of blood lost in this operation was very considerable; not from COMPARTMENT XVII. 23 any remarkable vascularity of the tumor itself, but from the great number of vessels going into its substance, and their extraordinary size. There was nothing, however, of the character of erectile tissue about it. AU the cases of this kind had the same peculiarity in the size and number of ar- teries going to the morbid mass. She recovered. See drawing in my portfolio. 974 Glandular Tumor, lymphatic. From the neck of a lady in Twenty- sixth Street. This tumor was of a dense unyielding feel, and not tender to the touch, had been forming for several years, and now impeded both respiration and deg- lutition. In fairly denuding it of its investments—a point of great surgical importance everywhere in the removal of tumors, and in no other part so necessary as in the neck—a large vein, running over the tumor and close upon it, was cut into. No blood was in it when cut, and it was only found to bo a large vein by tracing it upward and downward after it was filled with blood. At first, I thought it was the facial, where that vessel terminates in the deep jugular, at which point it, the facial, is very often large. Upon closer in- spection, however, it proved to be the tr#k of the deep jugular, near this point. Two ligatures were immediately passed under the vein, one above and the other below the wound, and tied. The subsequent separation of the tumor showed that it was fairly behind the deep jugular, and only in certain positions of the head did it allow any blood to pass through that vessel. This is the third instance in which I have tied the deep jugular, where the patients have subsequently recovered. In the fourth case, while extirpating a largo tumor in the neck, I was com- pelled to pass a ligature around the deep jugular, less than an inch distant from the base of the skull. No marked effect followed the ligature. The wound suppurated, and the ligature came off in duo course. The patient sunk, however, on the third week from hectic irritation, though the wound was still suppurating kindly. 545 Osteo-ccplialoma of the Humerus, occurring in a child 9 years of age, the daughter of J. C. M., of Vesey Street. The disease commenced in the periosteum, under the middle of the deltoid muscle, constituting the "periosteal exostosis" of Sir Astely Cooper. It was unaccompanied by pain. Amputation at the shoulder-joint was proposed, but the parents would not consent. Ulceration took place in the tumor; hectic supervened and death resulted. After death the limb was ampu- tated, and the shoulder-joint found perfectly healthy. The ulcer in the tumor threw out a fungus, which did not readily bleed, but was attended by the usual fetid ichorous discharge. 980 Breast of Mrs. W., of Edinburgh. Scirrhus, with encephaloid disease beginning in another part. About one year previous she was operated upon by Dr. John Pattison, in , London, with caustics. She was under his treatment for eight months, and suffered the most cruel torture. From her account, I think her case had boon greatly aggravated by the diseased mass not being entirely removed. The cicatrix was hard and irregular, and as it was indispensable for the pro- per treatment of the case, to remove the whole of this, the edges of the in- cision came together with a little tension. They were well retained, how- ever, by stitches and plaster, and the wound did well. This operation was performed in 1850. 984 Necrosis Of the Femur of Col. B., of Georgia. Amputation of the thigh, by the double-flap operation, was performed by me hi 1850. He recovered. 24 COMPARTMENT XVII. 993 Bone Aneurism of the Os Caleis of Mr. R., of Green Street. He was about 35 vears of age, and of a flabby, vitiated habit. Some two vears before, he 'had had a hemiphlegic seizure of that side The tumor was on the inside of the os caleis; about the size of a black walnut, and had a distinct aneurismal pulsation. When he came to me, it was a viti- ated ulcer—a surgeon having made an incision into it, from which, he said, a profuse hemorrhage had followed. His history and appearance led to the belief that it was the beginning of malignant disease, and I did not hesitate to tell him so, and that he must not expect much, if any, benefit from treatment. I directed, however, an alterative course of the bichloride and sarsaparilla, with yellow-wash and oil-silk to the part. At the end of three weeks, no material change for the better having taken place, I directed the empl. lytharg. comp. to be applied over the tumor and ulcer. This I did to gaiu time in order to have its nature more fully de- veloped. When he next called, two or three weeks after, on raising the plaster, to my surprise, I found the ulcer perfectly healed. There was now but little enlargement, yet it had a decided aneurismal pulsation. Being convinced that it'Jtis osteo-aneurism, I proposed that he should lose his foot. This not being consented to, the femoral artery was tied in Scarpa's space. No defect of circulation to the limb followed, and the liga- ture came away spontaneously at about the usual period. Very little change took place in the tumor after the operation, except the loss of its pulsation, which did not subsequently return. After the ligature came away, the wound in the thigh, from being nearly healed, began to assume an ill-conditioned appearance, with a small and frequent pulse, loss of appetite, coma and delirium, and brown sordes upon his tongue. These symptoms continued to increase until he sank into a state of profound typhus. A short time before his death, the tumor ulcerated and discharged a brown offensive material, like that from the ulceration in the wound of the thigh. A day or two before death, there was also a small discharge of grumous blood from the thigh. The post mortem was obtained with great difficulty. It was made by Dr. A. B. Mott. The osteo-aneurism proved to be confined to the os caleis. There was extensive phlebitis and arteritis above and below the wound in the thigh, and an ulcerated opening into the femoral vein opposite the place of ligature of the artery. 986 Aneurisms in an old man. A very rare specimen. This is the most remarkable case for extent and number of aneurisms I have ever met with. They are found in the asconding aorta—in the innominata —in the right subclavian, without the scaleni muscles, and in the descend- ing aorta, within the thorax. This latter occasioned extensive caries of several of the ribs. It ultimately burst and proved fatal. The inner coat of the arteries is a most beautiful illustration of degeneration. 985 Anchylosis of the Elbow-joint. In this case carcinomatous ulceration of the integuments about the joint tdok place, which led to amputation of the arm. The patient recovered. The preparation was sent to me from South Carolina. Dr. S—dt was the operator. 9S2 Amputation at the Shoulder joint of Mrs.-----, from Elizabeth Port, New Jersey. A malignant tumor, of the encephaloid character, had been previously taken from the arm. At that time the surrounding tissues all appeared to be sound, and the wound healed. In less than a year, however, the disease returned in the arm, and spread rapidly upward and downward. The arm COMPARTMENT XVIII. 25 was now amputated at the shoulder, and she recovered without anv un- pleasant symptoms. Six months afterward she exhibited symptoms of disorganization of the lum- bar spinal marrow, and these increased, until paralysis of motion and sen- sation was fully established, and after several months of suffering she died. No inspection was permitted. I have no doubt, however, that the same malignant disease existed in the spinal marrow. French Preparation, showing the nerves of the eye, the different ramifications of the fifth pair, and some of the branches of the portio dura. Hair from a case of plica Polonica. Cranium, from Huaco, South America. Cranium. Cranium, from Quilca, South America. Cranium of a female Choctaw. Skull without right temporal bone. Compartment XVII. (Below). CASTS OF VARIOUS DEFORMITIES. COMPARTMENT XVIII. 507 Knee-joint of a negro, ulceration of the cartilages. In consequence of strumous synovitis. Amputation. 421 Section Of the Kliec-joint. Amputation for white swelling; showing deposit of tuberculous matter in the cancellated structure—tuber- cular disease of the bones. 422 Duplicate of 421. G03 it 604 Spina Venlosa of the lower part of the femur. Case of Mr. J. P----. The diseaso was originally attributed to a fall, and was one year in attaining its present size. It was unattended by pain, and was not sensitive to the touch. Its bony shell could be readily indented by pressure with the finger, but would afterward resume its rounded form. It gave rise to no constitutional symptoms, and recovery after amputation was rapid and perfect. The operation was performed in 1S34. lie died in in 1847, from hydro thorax. 760 Encephaloid Tumor of the Thigh. Case of Kev. Mr. Prince. Dupli- cate. The other half in Compartment VI. 850 Necrosis of the Cricoid Cartilage, in a young man of 21, giving rise to symptoms of chronic laryngitis ; fatal This is a specimen of that form of disease which, according to Porter of Dub- lin, is the true phtfiisis laryngea, and for which the only palliative remedy is earlv tracheotomy, by which the parts are set at rest and the only chance of relief secured. In this case, the prominent symptoms were agonizing difficulty in inspiration, attended with a marked and well expressed sense of obstruction in the larynx. Laryngotomy was performed during one of the paroxysms. The S96 355 117 121 125 146 343 26 COMPARTMENT XVIII. relief was only partial, and death followed within forty-eight hours. After death it was found that the opening in the cricothyroid membrane was too near the seat of the obstruction to afford full relief, and that tracheotomy would probably have been followed by a better result. 705 Portion Of the Larynx of Mrs. S., upon whom the operation of laryn- gotomy was performed, on the spur of the moment, by means of a lancet and quill. She had laryngitis. The operation caused temporary relief, but she finally died. 898 Laryngitis, with an abscess behind the posterior walls of the larynx, produced by caries of the cricoid cartilage. This,specimen is from Miss B. Three days prior to death laryngotomy was performed. The post mortem was made by Dr. V. Mott, Jr. This is the disease described by Porter of Dublin. 426 Absence of Epiglottis, discovered by accident after death. The absence of the cartilage is complete, and, as there is no cicatrix visible, it is probable that the defect is congenital. There was no suspicion of its existence before death. Presented by Dr. D----, of Staten Island. 456 Foreign Body in the Trachea. Tamarind stone in a boy, aged 10 years. Death took place before aid could be procured. Tracheotomy would probably have saved life. 534 Nutshells in the Bronchii of a boy 4 years of age. In this case it was concluded, from the character of the respiration, that the foreign bodies were in the bronchial tubes, too low down to be reached by tracheotomy. The dyspnoea was constant and unaccompanied by stridor. The operation, however, was undertaken by Dr. S., without success, and death followed. When the foreign body is in the larynx or trachea, the dyspnoea is paroxys- mal and stridulous. 822 Fibrinous Exudation, passed at stool by a iwoman laboring under enteritis. 651 Fibrinous Exudation on the internal surface of the larynx, and cover- ing the chordae vocales. From a fatal case of croup. 905 Pharynx, affected with malignant disease. 449 Osteo Sarcoma of Inferior Maxilla, removed by operation at the articu- lation. Case of Judge J., of S. C, a gentleman TO years of age, in feeble health, and somewhat cachetic. To increase his strength, he had been sent into the country for some weeks previous to the operation; he improved very slowly, however, and became exceedingly impatient for the operation, which was accordingly performed, and in a manner wholly satisfactory to the operator. Although no ligature was put upon the carotid before the operation, the hemorrhage was moder- ate and easily commanded. The patient, however, insisted upon sitting, during and after the operation; and before the wound was dressed, without any straggle other than a slight rattling in the throat, suddenly died. His death was apparently caused by the shock to the nervous system. There was some slight convulsive action of the muscles of the throat, but none sufficient to warrant the opinion that suffocation followed the contraction of the muscles attached to the os hyoides, by which the tongue is retracted—an accident which is said to have resulted from their detachment from the symphysis menti (Warren on Tumors, p. 115). COMPARTMENT XVIII. 27 The chain saw was used in this operation, and acted admirably well bee Hay's Journal, Jan., 1846, p. 128. Y Portion Of the Lower Jaw, diseased at the angle. From Dr. Cook's patient at Hoboken. Osteo Sarcoma. Inferior maxilla of Baker. Removed successfully at the articulation. A young gentleman of New York, aged 25, of sanguine temperament robust form and strictly regular habits. About eight months previously he was attacked with a swelling in the middle part of the lower jaw, attended with occasional slight pain. About four monthe afterward, when he applied to me, 1 found the tumor possessing a degree of hardness, with that kind of elasticity or pressure so peculiar to osteo-sarcomatous growths. Upon in- spection it was found to extend from the cuspid tooth, in front .backward along the bone and up the ramus as far as could be felt, and circumstances led to the belief that it quite reached the articulation. At this, the first interview, I apprized him of its nature, and of the ultimate necessity of a surgical operation for its removal. To try what benefit might possibly be derived from medical treatment, I directed several leeches to bo applied once a week within the month and an alterative course of iodide of potassium and syrup of sarsaparilla, with decoction of our indig- enous yellow dock root and mild light diet, but the disease instead of diminishing continued steadily to augment. Nov. 23, 184jL I performed the operation. Being satisfied that it would be necessary to remove the jaw at the articulation, the primitive carotid was tied as a preparatory measure. An incision was then made from a point a little in front of the meatus auditorius downward behind the posterior angle of the jaw and along the lower front of the tumor, thence upward upon the chin to a point three quarters of an inch from the border of the lip opposite the second incisor—effocting an opening into the mouth. To de- termine that the bono was sound, the soft parts were detached a short dis- tance on the chin. The second incisor was then extracted and a small opening made through the soft parts opposite with a sharp pointed e uved bistoury, through which a chain saw was conveyed by means of an eyed probe, and the bone then sawed through from below upward. The flap of integuments was next dissected upward and backward from the tumor and the divided extremities of the bono seized with forceps and care- fully dissected from the subjacent parts, sometimes cutting from above and sometimes from below, in order that the vessels when cut should bo acces- sible to the ligature. The lower part of the masseter was found so thick- ened and degenerated that it was necessary to divide it very high up. Another external incision was then made over the condyle through the parotid downward to the first, and the parotid with a portion of the mas- seter was detached from the condyle, so as to expose the coronoid process, which latter was followed up and the temporal muscle completely detached. The diseased mags, now much more mobile, was then relloeted toward the ear, the articulation opened, and the condyloid extremity separated, cutting close to it to avoid the internal maxillary artery. All the arteries cut, bled with a continuous stream. When secured, the flap was turned down, and a cloth, wet with warm water, applied to invite bleeding from any that might have been overlooked. After waiting an hour, the wound was dressed with sutures, plasters, lint, and a compress and bandage. fhe patient bore the operation remarkably well, reaction soon came on, the edges of the wound agglutinated by the first intention, and the ligatures came away without secondary hemorrhage. Osteo Cephaloma of superior maxilla. Removed in 1843, with three of the incisor teeth, from the daughter of Mr. 28 COMPARTMENT XVIII. F of Bond Street, aged 4 years. The wound healed kindly with very little deformity, and the child remains still in good health, 1S40. 945 Portion of Inferior Maxilla, affected wh:i a form of fungoid disease. Removed from Miss M., aged 19, Horn Pennsylvania. 62fO Osteo Sarcoma of the upper jaw. Removed. Successful result. 647 Osteo Sarcoma of the lower jaw. Removed by operation. 487 Osteo Cephaloma of the inferior maxilla. Removed by operation with a portion of the body o\the bono The wound healed kindly, and success was apparently perfect. Nothing has since been heard from the patient. 882 Necrosis of the left ramus and a portion of the body of the inferior maxilla of a child, involving the articulation. It proceeded from tooth-ache. The bone became detached, and was removed within the mouth, by Dr. V. Mott, Jr., without any incision externally. 571 Fungus Hffimatodw of posterior angle of_the right side of the lower jaw. Extirpated. Before removing this enormous mass, the right carotid artery was tied. After the operation the wound healed to a great extent, and. looked kindly, but pulmonary disease supervened about four months afterward, and he died hectic. The head was injected, and a dry preparation made, which shows the collateral circulation. » McGanigle's case. See Hospital Register, vol 2, and Velpeau, Oper. burg., " also drawing of the tumor in my portfolio, and Specimen 177. 738 All Epulis of the gum. 754 Osteo Sarcoma of the body of the lower jaw, involving the alveolar processes only, and extending from the second incisor to second molar of the left side. Removed from Mrs. V----, Jan., 184G—a rim of healthy bone being left at the lower edge of the jaw, as first recommended by Delpech .and Barton. 542 Osteo Sarcoma of the upper jaw. Removed by operation. 688 Osteo Sarcoma of the upper jaw. Removed from Miss -----, of Rhode Island. She recovered permanently, and is still living— the mother of a family. 694 Upper Jaw, a diseased portion of it. Removed by operation. 624 Osteo Sarcoma of the upper jaw. 501 Osteo Sarcoma of the inferior maxilla, removed by operation, Nov. 19, 1821, from Catharine Buckliew, aged 17. This was my first case of exsection of a portion of the lower jaw. It is the case on which are based those claims for priority in the operation for osteo sarcoma, which are conceded by Listen in his Pract. Surg., London, 1846, p. 319. The tumor commenced with pain and swelling behind the angle of the jaw, which continued for three or four weeks, and then left, but without reso- lution. During its progress most of the teeth of that side fell out, though previously she had never had a decayed tooth. When she came under my care, the tumor extended from the root of the coronoid process to the bi- cuspid, rose nearly an inch above the level of the other teeth, spreading considerably wider than the alveola, and was smooth, firm, and somewhat elastic. An incision on each side of it with a scalpel readily enabled me to remove it to the level of the jaw-bone. The removed portion contained many spicuke, osseous, and cartilaginous, and also imbedded in its sub- COMPARTMENT XVIII. 29 stance one of the molar teeth perfectly sound. About three weeks after another small portion, about the size of a nutmeg which wal ZtSj^oZ 2 rSe™rmtitn?e theD ^ to th° M>'> ^ —in^Sn- N^vnlve/Jl0tt!1' th°^mo1r ^/eappeared and grown to such extent as to involve all the right side of the inferior maxillary bone, and was rapidlv mcreasmg The teeth of the upper-jaw formed an abrasion and fuiow in it, attended with constant discharge, which, though offensive, did not ap- pear to be acrid. Outward it produced great convexity of the cheek • up- ward it reached to the os make; downward it came nearly in contact with the thyroid cartilage, and inward it extended beyond the mesial line, push- ing the tongue and uvula to the loft side and having the velum of the right side attached to it in its whole course. Deglutition was very difficult, and speech considerably interfered with, but there was no pain in any part of the tumor. J * The steps in the operation were essentially the same as have been recounted m 449 and 725. The common carotid was tied as a preparatory measure the day previous. I had intended to complete the operation at this time, but she was so overcome by the nervous shock of this part of it, that I deemed it expedient to defer the exsection. The next day at the same hour she had sufficiently recovered, and the bone was laid bare, and di- vided between the second incisor and cuspidatus below, and through the coronoid and condyloid processes above. Recovery was perfect, and in 1830 she was in good health. The curvilinear incision in the operation on the lower-jaw, to which my dis- tinguished friend, Prof. Velpeau, justly attaches so much importance, was used in this case, and I have invariably used it in all my operations since. Its claims are coeval with those of the operation itself. See Velpeau, Oper. Surg., Vol. II., p. 904, also N. Y. Medical and Pins. Journal, Vol. II., and Preparation, No. 488. 685 Osteo Sarcoma of the Lower Jaw. Removed by operation at its arti- culation. From a man about 00 years of age, who came to the city from a distance. The cheek was extensively ulcerated externally. Some time after the operation he died hectic. 541 Encephaloid Disease from antrum maxillare. 713 Osteo Sarcoma of the lower jaw, removed at the articulation. Prince's case. See Am. Journ. Med. Science. 559 Tumor, lying over the lower jaw, and extending upon the face and neck. Removed by operation from a man from Rhode Island. It was malignant. 313 Cyst, accidentally discovered in the antrum Highmorianum of a subject. 167 rtt'i'US, containing foetus at full terra—injected ; showing placenta previa, with cord-presenting. 597 Fascia Of the Pelvis. A splendid preparation, showing the facia iliaca passing to the side of the bladder, making a complete septum between the perineum and cavity of the pelvis. Pre- pared by my pupil, Dr. Vache, when my demonstrator. 71 Malignant Disease, involving the posterior part of the tongue, and the fauces, tonsils, and pharynx. Fatal; disease' removed after death. Case of Mr. H., Broadway. 30 COMPARTMENT XVIII. 923 Encephaloid Disease of the Femur, in which amputation was performed, near the lesser trochanter. Disease returned, I think, in the lungs, and proved fatal in less than a year. Mrs. H's case. 511 Osteo Cephaloma. Removed by operation. 839 Portion Of an Arm, from which Dr. R. S. Kissam had removed a malignant tumor some months previously. The disease had returned with emaciation and hectic. Dr. K. amputated near the shoulder. The wound healed, and the patient went home in improved health No return of the disease for five years. 496 Cerebellum, lacerated, from a fall. All the usual symptoms of com- pression of the brain, from extravasation of blood within the cranium, were present. 914 Cerebellum, lacerated. 406 Injury Of the Head. A coagulum of blood on the surface of the an- terior lobe of the brain. In consequence of a fall. No opera- tion performed. Fatal. 538 Osteo Cephaloma of the upper jaw. Removed by operation. The incision was commenced below the eye and carried through the upper lip, just within the angle. 477 Osteo Sarcoma of the inferior maxilla, removed by section of the body and ramus of the bone. From a lady, 25 years of age, who was nursing at the time. She is now living (1846), and has had no return of the disease. 620 Osteo Sarcoma of the upper jaw. Removed with successful result 721 Stricture of the Esophagus, communicating by a fistulous opening with the right bronchus. A gentleman, from Lima. The disease was originally attributed to the lodge- ment of a Cayenne pepper-pod in the oesophagus. A bougie, armed with caustic, was passed frequently for some weeks, by a surgeon of this city, and with some benefit. "When first seen by me, swallowing was fouowed by severe laryngeal irrita- tion, and return of the matter swaUowed through the trachea. A bougie frequently attempted. No benefit was derived from treatment. Hectic supervened, with extreme emaciation, and nnaUy deatu. 637 Fibrinous Deposit on the mucous membrane of the larynx, from croup. 983 Oedcema Glottidis. This occurred in a patient during convalescence from typhus fever. It was fatal in a few hours. 559^ Disease of the lower Jaw. Removed at the articulation. 142 Cranium, from South America. 339 Skull, exceedingly attenuated and irregular. 113 Cranium. 106 Craninm. m Cranium. COMPARTMENT XIX. 31 COMPARTMENT XIX. 499 Adipose Sarcoma. Removed from the back by operation 737 Adipose Sarcoma. Removed from the anterior, lower and outer part ot the arm. r The radial nerve passed over it, and was closely incorporated with it Mr. 403 Adipose Sarcoma, from the top of the shoulder of a female " ta b5h °sexes."h0Ulder * hj fa the m°8t COmmon situation of these *™" 438 Adipose Sarcoma. 719 Adipose Sarcoma, from the upper part of the arm. Removed at clinique. 720 Adipose Sarcoma, from the scrotum of a boy aged 2| years. (Han- cock, from Ncwbern, N. C.) The tumor involved the penis, pubes, and perinamm, and its removal required tedious and delicate dissection. The child returned home perfectly welL I o me this case is unique. See drawing in my portfolio. 569 Thymus Gland, enlarged and tuberculated. 790 illalignant Tumor. Removed from the neck. 855 Degenerated Lymphatic Glands of the neck. Removed, with a portion of the deep jugular vein, from a boy 4£ years of age, in Perry Street, April, 1848. In this operation, the patient was kept under the full influence of chloroform one hour and twenty-five minutes. The primitive carotid artery was also laid bare throughout the greater part of its course, as portions of the tumor passed behind it. The disease returned. 607 Malignant Disease of sub-maxillary gland. Removed by operation from a man from Albany. The wound healed rapidly. .No return of the disease reported to me. 508 Sarcomatous Tumor enclosing a cyst. Removed from the neck by cpcrr.licr.. S13 Lymtihstic G^ndyls* Tun,or. Remov^ ^™™ w*« a » v™™ inrW 18 years of age. It was situated in the neck, beneath the sterno mastoid muscle, and upon the' transverse processes of the vertebra?—extending from the ramus of the jaw almost to the clavicle, and posteriority, behind the ear, beneath the trape- zius muscle to the back of the neck. In front it obliterated the cavity of of the pharynx, and pushed out of place the great vessels and larynx, causing, of course, great difficulty in deglutition and breathing. Before commencing its extirpation, the common carotid was tied. An in- cision was then made, extending from the mastoid process to the sternum, including the incision for the ligature of the carotid. The tumor was now carefully laid bare, and dissected from the sheath of the great vessels, and from the pharynx. While doing this, it was found necessary, in order to prevent the retrograde hemorrhage, to tie the external carotid artery. In raising the tumor from under the parotid, the portio dura was necessarily dividod near the foramen stylo-mastoideum—a circumstance which has per- manently paralyzed the face. 32 COMPARTMENT XIX. The operation was borne with female fortitude. Recovery was perfect, and the lady is now the mother of a fine family; but to this day the body of the jaw retains the arched form caused by the pressure oi the tumor before Wlnte the°patient was recovering, it was ascertained from her father that Dr. W of Boston, and Dr.,P. of Philadelphia, had been previously consulted and had refused to operate. When Dr. P. was told that the tumor had been removed, he said that " Nobody but such a mad-cap as Mott would have attempted it." 779 Encephaloid Cancer of the pyloric and cardiac orifices of the stomach. Mr. McC, of Hudson Street. 537 Lymphatic Glandular Tumor. A species of tumor which is often mis- taken for disease of the parotid itself. Removed by operation from over the parotid gland. 427 Encephaloid Tumor, from the neck of a young woman, aged 20, from Paterson, N. J. Removed by operation. No return of the disease. 509 Lymphatic Glands, with encephaloid degeneration. Removed by operation. 655 Adipose Sarcoma, from the neck and shoulders of a young woman. 749 Tumor. Removed from the neck of a patient at the clinique. 856 Tumor of similar character to No. 855. From a female child, 8| years of age, from New England. Removed at corner of Amity and Mercer streets. She recovered, and re- turned home. Chloroform was used in this case, with the fullest success. 857 Tumor of same nature as No. 856, and of even greater extent. Re- moved from a delicate boy, 4 years of age, in Thirty-third Street. A part of the tumor surrounded the arteria innominata. which during the operation was fully in view. This' portion was left behind. The boy died at eleven o'clock the same evening, exhausted, though the loss of blood was not greater than in either of the two previous cases. Chloroform was used. The three tumors above referred to appear to be malignant, and to have the characteristic structure of cells and cellules. 756 Malignant Disease, involving the thyroid body. Removed from Mre. ----, Franklin House. It consists partly of encephaloid matter. The lady was attacked by tetanus on the seventh day, from which she re- covered under the alcoholic treatment, carried to the extent of two quart bottles of brandy per day, and as much Madeira wine as could be swallowed —which quantity was continued for more than a month. 605 Bronchocele or goitre of immense size—weighing four pounds. Re- moved by operation, from a man from Dutchess County, aged about 30. It had been growing many years, and had resisted all remedies—except iodine, which was not at that time in use. Some months previously the two su- perior thyroid arteries had been tied but without any visible effect. He bore the operation well. During it the hemorrhage was excessive— principally from the veins, which were enormously enlarged. But I retrret to add he died the same evening of hemorrhage from the slipping of the ligature of the right inferior thyroid artery, which had been tied by Dr. H----. Among the many arteries and veins tied in this formidable operation, I re- COMPARTMENT XIX. 33 member to have asked the assistant, when the ligature was applied to this large artery (for it was huge indeed), if he was sure it was firmly tied. 913 Enlargement of Thyroid Body and vicinity. 729 Tumor from over the thyroid gland of Miss-----. It had been regarded as bronchocele, and treated as such for twenty years. It occupied the situation of the thyroid gland, was closely adherent to it, and by its pressure had caused the absorption of a great portion of that organ. 930 Polypus .\nsi. 780 Hydrocele of the tunica vaginalis. Removed from a subject—un- opened. 4;36 Sac of Hydrocele of tunica vaginalis, with testicle of the same side in a perfectly sound state. Together they constituted a tumor, which was removed by operation, under the impression that it was " sarcocele" of the testicle. This was done too with the advice of my excellent friend, Dr. W. P. The patient recovered entirely, and left the city for his home, South America. before the " tumor" was examined, and the mistake discovered. The error in diagnosis occurred in consequence of an unusual deposit of fat in the subcutaneous tissue of the scrotum, which masked the character of the disease. Being at first in doubt about the case, a small exploring incision was made, less than an inch in length and continued through adipose tissue to the depth of half an inch, at least. But as this added to the mystery of the case, the advice of Dr. P. was requested, who pronounced it a sarcocele, and advised extirpation. # 512 Tunica Vaginalis Testis, indurated and thickened. Removed after death from a case of hydrocele. It was in a post mortem. 715 Head of FcctllS, exhibiting double harelip and hydrocephalus. 732 Hydro Sckroccle, with much thickening of the tunica vaginalis. Removed from a negro, July, 1843. 770 Testicle. 441 Gun-shot Wound of the Liver, showing the point of entrance and exit of a pistol ball which passed through the left lobe. ----Sykes, of New York. The ball afterward passed through the stomach, and was found, after death, lying loosely on the diaphragm. There was no febrile reaction. Death took place on the third day. The pistol was accidentally discharged by Mr. L-----. 1028 Lipoma, from the back. 1029 Violent Inflammation of the Chest, and very thick fibrinous deposit upon the pleura. The liver is also extensively adherent to the diaphragm. 148 Cranium, from Quilca, South America. 130 Caries of the os frontis. 132 Cranium, showing consequences of syphilitic periostitis. 135 Cranium, showing caries and exfoliation of the frontal and parietal bones. 124 Cranium. 34 COMPARTMENT XX. COMPARTMENT XX. The specimens in the upper portion of this compartment belong to my son, Dr. Alexander B. Mott, who performed the operations and furnished the descriptions. 1005 Scirrhus of Mamma. Removed by operation. 1006 ScirrllUS Of Mamma, very large. Removed by operation.^ 1012 Scirrhous Mamma, with axillary glands, showing retraction of the nipple. Removed by operation. 1013 Scirrhous Mamma. Removed by operation. , 1014 Scirrhous Mamma, very large, with retracted nipple. Removed by operation. 1015 Carcinoma of Mamma, with axillary glands. Removed by operation. 1007 Malignant Sarcoma, from the side of Wm. Keating, Jan., 1854. 1008 " " " " " " May 20> 1854- 1009 " " " " " " Oct. 25, 1854. 1010 " " " " " " Jan. 30, 1855. 1011 " " " " " " Mar. 9, 1855. The constitution and general health of this poor man were excellent. Most of the operations were very extensive and extremely painful. At no time in any of them was there tl*3 least morbid portion left, and the wounds invariably healed in the most kind and rapid manner. The intervals between the operations became shorter and shorter, and after the last operation which furnished this specimen, the disease returned very quickly. Escharotics, as kali purum, and chloride of zinc were ap- plied, but they failed to repress its growth. Vide Specimen, No. 103G, removed by caustic, in June, 1855. Prom this period it assumed more the character of fungus hsematodes than that of encephaloid disease, growing so rapidly that in a short time it exceeded the size of his head, and being so offensive that he could not be kept in his own apartments. Notwithstanding cleanliness and disinfectants, it became loaded with macrorots. and he died a most loathsome object in Bellevue Hospital, in the fall of 1855. On two of the latter oocaoious, before operating, an attempt was mado to administer chloroform and'ether, but it congested the brain to so great a degree, with a threatening of convulsions, that it was deemed advisable to discontinue it. As poor Keating's case was very remarkable, at our request he furnished us a record of the different operations upon him, and by whom performed. From his own manuscript it is as follows: In Ireland, June, 1832, by Dr. Horphlin. " " May, 183*7, " Dr. Herbert Orpoen. " Aug., 1840, " " " " " April, 1841, " " " In New York, June, 1843, " Dr. Mott. ' " " June, 1847, " " " " May, 1851, " " " " Jan., 1853, " " " " Aug., 1853, " " " " Jan., 1854, " Dr. A. B. Mott. COMPART MENTXX. 35 In New York, May, 26, 1854, by Dr. A. B. Mott Oct., 25, 1854, " " » Jan., 30, 1855, " " " Mar., 9, 1855, " " June, 1855, " " » 1036 Malignant Sarcoma, from Wm. Keating. Removed in the summer • 1855' by CaUstlC aPPlications around its base 1037 Spina Bifida. Removed by operation from over the lumbar verte- brae of a child 9 months old. A mvSic^n^"11 aPpUe- ar°Und it8 base Previous to its coming under my notice and was causmg great irritation. At the urgent request of the parens the operation was performed, though no encouSmmt could be given as to a successful result. The wcLd^e^broSS Sri theblhtuZTTf mt*TT>healed k^y, bureffusfon&pllce, and the child died about a month after, of hydrocephalus 1034 Spina Venlosa of the metacarpal bone. Removed with rin- fW Recovery with perfect use of the hand 1035 Necrosis of the Lower Jaw. Removed from the inside of the mouth of a girl 7 years old. A S^llf™^9 t!ir°U/h the gum' and> ™th g™tl° traction, this .cCerWX?agpi%.ang ^ ™ "^ ^ ^ ^ 1038 Portion of the Humerus, necrosed. This specimen is from a female child, 8 years old, of scrofulous habit The disease had invaded the bone for over a year. It finally became de- tached by using gentle traction on it from time to time. During this process it was replaced by a new bony formation, and the arm is at present as strong as the other. 1039 Necrosis of the Lower Jaw. This case was of three years' standing, and arose-from carious teeth, whi.h were removed before the disease was fully developed. Having rented all treatment, and rapidly advancing so as to cause serious constitutional disturbance, the operation of removing the jaw at the temporo maxillan- articulation was concluded upon—the disease having alreadv reached that pomt. . J The subject of this operation, Sister G----, was apparently very healthy and was at the tune devoting herself to tne care of tne sick at St V m- cnt.'s Hospital. Provi™* to the operation, durm* *h" +>>™« TOq^ several pieces of bone had from time to time been removed. It was tbl- lowed by a happy result. 1040 Ebumoid Exostosis. Removed from the orbit and nasal cavity. The operation was performed in April, 1854, and in less than three montlis' after, perfect vision was restored to the eye, which had been pressed out of its socket, and its utility destroyed for several years. No return of the disease. Case reported in the American Journal of Medical Sciences, Philadelphia, Vol. XXXIII., January, 1857. 1041 Necrosis Of the Lower Jaw, successfully removed at the temporo maxillary articulation, from a young girl, 17 years of age. 1042 Ulcer of the Stomach. Presented by a pupil, Dr. J. H. noyt, of Greenwich,' Conn. 942 Portion Of Little Finger, amputated at the first joint. Some brother of the craft had taken it off previously through the second 36 COMPART MENTXX. phalanx, by sawing. The bone protruded, and required the present operation. 960 Carcinomatous Ulceration, affecting the middle finger. Amputation. The disease returned about one year after in the hand and fore-arim Con- stitutional treatment was used, but to no avail. The patient being un- willing to submit to another amputation, the disease spread gradually and destroyed him. It is unusual to see this formidable disease affecting the fingers and hand. Every other mode of treatment was resorted to before this operation was performed. 1000 Polypus from the Nose, with a portion of the superior turbinated bone. Removed by operation. Generally there is no return, when, as in this case, the portion of the bone to which the polypus is attached is broken off. 1001 Scirrhous Tumor, situated below the fold of the pectoralis major muscle on the right side. From Mrs. McB----, Fifth Avenue. This lady had had the mamma of that side removed twenty-three years be- fore by Dr. B----, of this city. As no return of the disease had taken place during that lapse of time, and she had enjoyed excellent health, it is reasonable to suppose that her life was prolonged by the first opera- tion. The second, thus far, has been equally successful. Removed in 1855. 1002 Carcinoma of the Breast, of Mrs. K----, of Newbem, N. C, to which place I went and operated. Chloroform was administered in this case, for the first time in that town, in the presence of a number of medical gentlemen. Operation successful. 1003 Osteo Sarcoma Of the Upper Jaw. Successfully removed from a pri vate patient, a young man, aged 24, at St. Vincent's Hospital. 1004 Paronychia Of the Thumb. Formidable effects from neglect ir making early incisions. Removed by operation. 941 Tumor Of the Breast, of a young married woman about 25 years old. Removed by operation. It was fibrous in character, had been twelve months growing, and was hard and completely insulated from the mammary gland. It grew gradually without pain. These tumors are seen in young women, both married and single. They generally increase gradually, and are not attended with much pain. In some instances I have found them so connected with the gland of the breast, as to be obliged to cut through a part of the gland to remove them thoroughly. They are usually as hard as schirrua, and for the most part completely surrounded by fatty tissue. From my experience, no local or general treatment will remove them. They ought to be taken out with the knife. They are generally caned hard knots in the adipose tissue, and are fibrous in their organization. 947 Strumous Testis. Extirpated in 1852. Disease cured. 946 Finger, amputated for compound fracture. 849 Paronychia, neglected. Extensive destruction of the thumb. Re- moved by amputation. 9991 Osteo Steatoma. Successfully removed from the nates of a young man. It had been growing from early infancy; weight 6 lbs. 1853. COMPARTMENT XXI. 37 999i Cast of the same. 1119 Anchylosis of the Knee-joint, with caries of bone and ulceration of cartilages. 1120 Bones of the Leg, showing absorption of the ends after amputation, and partial anchylosis of knee-joint. 1118 Rachitis of bones of lower extremity and pelvis. From a young negro subject. Compartment XX. (Below). 264 Tibia, picked up in the citadel of Antwerp, Aug., 1835. 305 Radius, with ulna necrosed. 328 Calvarium, remarkably thin. 169 Calvarium, very thick. 161 Calvarium. 318 Calvarium, of remarkably irregular thickness. 60 Portion of Fibula, diseased. 284 Calcaria and Os Mala;. 460 Two Lower Cervical Vertebrae, fractured. 317 Half Calvarium, with temporal artery injected. 84 Portion of Inferior Maxilla, necrosed in consequence of fracture from a blow with a brickbat. ^89 Fragments of Cranium from Delphi, Greece. COMPARTMENT XXI. The specimens in the upper portion of this compartment belong to my son, Dr. Alexander B. Mott, who performed the operations and furnished the descriptions. 1043 Scirrhus of .Mamma. Removed by operation. 1044 Scirrhous Mamma. Removed by operation. 1045 Carcinoma of Female Breast. Removed by operation. 1046 Scirrhus Of Mamma. Removed by operation. 1047 Scirrhus Of Breast. Removed by operation. 1048 Scirrhous Tumor. Removed by operation. 1049 Lipoma, from the arm of a lady. Situated over the deltoid muscle. Removed by operation. 1050 Supernumerary Thumb. Removed by operation. 1051 Fibrous Tumor. Removed from the cheek of a boy 11 years old. 1052 Adipose Tumor. Removed from the cheek. 1053 Hydro Sarcocele of Pott, or hydro sclerocele of Ramsden. Removed by operation. 38 COMPARTMENT XXI. 1056 Compound Comminuted Fracture of fore-arm, with laceration of arteries, etc. Amputation. 1057 Cancer of the Lower Lip. Successfully removed. No return of disease. 1058 Malignant Disease of the Eye-ball. From Mr. M-----, of Canada. His sio-ht had been destroyed before the disease made its appearance in the organ. The tumor had been growing for several months and gave much pain, and its removal was deemed necessary in order to relieve him of the intense suffering. A smaller tumor of similar character, situated a little below the inner canthus, was removed at the same time. The wound healed kindly, and the patient returned home. By recent accounts, the disease has returned in the socket, and will prob- ably prove fatal. At the time, I recommended a practice which had proved successful in previous cases of a similar character, that is, ap- plying a ligature to the common carotid of the same side, but his friends urged him to try the extirpation, which was performed in January, 1856. 1059 Carcinoma, from the neck of a man, 60 years of age. It was situated over the sternal insertion of the sterno cleido mastoid muscle. It had bled freely from time to time, and was exhausting the patient very much. The wound healed, and there has been no return of disease to date. 1060 Carcinoma. Removed from the axilla of a female. 1061 Pedunculated Lipoma. Removed from the neck. 1062 Hydro Sarcocele of Testis. Removed from a patient at Jews' Hospital. 1063 Nasal Polypi. Removed by operation. 1064 Portion of Lower Jaw-bone. From a boy 6 years old, I. W., of Bank Street. At the time of the operation there was attached to the bone a large fungous mass, which has since been destroyed by maceration. It is a rare dis- ease 'in a child of that age, and requires early removal, as its growth is very rapid. This operation was successful, the wound healing rapidly, and firm union taking place between the ends of the bone, with no re- turn of the disease. 1129 Case containing Calculi, as follows: No. 1. Two calculi from the bladder of a boy 2^ years old, residing in "Wil- liamsburg. Removed in 1851. No. 2. Calculus from the bladder of a boy 7 years and 5 months old, resid- ing in New York. Removed in 1852. No. 3. Calculus from the bladder of a boy 4 years old, residing in New York. Removed in 1854. No. 4. Calculus from the bladder of a boy 5 years old, residing in Jersey City. Removed in 1857. No. 5. Calculus from the bladder of a boy 7 years old, residing in 'Williams- burg. Removed in 1857. 1065 A Shot from an Air Gun. Removed from the posterior portion of the eye-ball of a boy 12 years old, six days after the accident. The lad was passing through the street near a target, at which some person was firing. He could give no account of the injury to the eye, and it was only after probing the wound, through the opening in the cornea, that a foreign substance was felt. The wound healed, but vision was entirely destroyed. Removed at the Jews' Hospital. COMPARTMENT XXI. 39 1006 Prepuce with Venereal Warts. This case is interesting from the fact that it had been treated previous to coming under my notice, as gonorrhoea, there being a slight discharge through a small opening in the prepuce. The glans penis could be felt through the foreskin, and was apparently very large and knobbed. Con- fident that this discharge, which did not appear to be gonorrhoea!, was produced by some unseen cause, I concluded to lay open the foreskin, and in doing so, found not only the inner surface of it, as seen by speci- men, covered with warty excrescences, but also the glans entirely en- veloped with the same disease. The removal of the prepuce, and the free cauterization of the growth on the glans effected a perfect cure. See drawing. 1067 Carcinoma Of Lower Lip. Removed by operation. No return of disease. 961 Fungus of Testis, from a man 23 years of age. No known cause for it. His constitution was decidedly strumous. The size of the fungus is such that the whole of the tubular part of the testis seems involved in the disorganized mass. On laying open the tumor and balance of the testis, the whole of the struc- ture remaining in the tunica albuginea was found in the form of layers of tuberculous matter of a white and yellow appearance, very beauti- fully arranged. The wound healed rapidly, and the patient improved in health after the operation. 1068 FungllS luTOiatodes of right eye-ball. The diseased mass was very formidable, and was exhausting the patient, a female cliild, about 7 years old, by frequent hemorrhages. In this case a ligature was applied to the common oarotid artery about ten minutes previous to extirpating. Having on previous occasions witnessed, in the practice of other professional men in this city, as well as my own, the failure of these operations, by the immediate return of the disease, when the eye only is extirpated, I have concluded to adopt this plan whenever opportunities offer, believing it to be the best calculated to postpone and sometimes prevent the return of the disease. In this case no return had taken place when I last saw her, two years after the operation, which was performed April 10, 1854. 1069 Lymphatic Glandular Tumors, from the neck of a young lady 16 years of age. They were situated on the left side, and occupied the entire space, from the base of the jaw and behind the ear, down to the clavicle. The most of the mass was covered by the sterno cleido mastoid muscle, and lay in close contact with the carotid artery and deep jugular vein, from which it had to be carefully dissected. The tumors had been gradually increas- ing in size, and resisted all local and constitutional treatment, though faithfully persevered in for over a year. An incision was made of a little more than the full length of the tumor, from near the lobe of the ear to the clavicle, in the direction of the fibres of the mastoid muscle; then a transverse one, beginning from the center of this wound, was carried back between two and three inches on the neck. Before the tumor was laid bare, the platysma myoides muscle, the external jugular vein, and the sterno cleido mastoid muscle, were completely divided—the flaps thus made were next dissected up, and the ' mass removed, after slow and careful dissection. Each tumor composing it required to be detached from firm bands of cellular tissue which con- fined and encircled it. The loss of blood was trifling for so extensive an incision; the vessels being tied as soon as cut. The wound was brought together with interrupted sutures, and the usual dressing applied, and it healed in the course of three or four weeks. The patient soon recover, d, 40 COMPARTMENT XXI. and now enjoys excellent health, there having been no return of the As hShasefdlen to my lot to perform several similar ^^^ I can add my testimony to others, that from the situations of^the, tunor which almost invariably are beneath the muscles and upon deep vessels of the neck, they require the utmost care in raising them from off the deep jugular vein, lest from the intimate connection it bo either torn or cut. This operation was performed in 18o4. 1070 Osteo Sarcoma of the Upper jaw, from a man 29 years of age. This disease had invaded the antrum, and from its size, gave a great amount of uain. The mode adopted for its removal was by making an incision from a point below, and on a line with the inner canthus of the left eye —carrying it downward, parallel with the nose, through the upper lip ; next dissecting the integuments and soft parts off close to the bone; then at the upper edge of the tumor, forcing-a drill through into the mouth; through which opening (after enlarging it with different sized instruments), a long narrow flexible saw was introduced, and the mass removed by saw- ing toward the teeth. The external wound was brought together by sutures, and the cavity filled in with lint, and healed without any un- toward circumstance. No return of the disease. 1071 Malignant Tumor, from the right side of the neck of Miss B. Q., aged 24, residing in Thirty-first Street. The first operation performed on this patient was in December, 1854, when I removed a large mass from her neck; at which time the hemorrhage was very great, but all went on well, and the wound healed kindly. A few months after, the disease was returning very rapidly. As she was still anxious for its removal, I again operated upon her, and, at this time, found a large sac containing fluid, with a fungous mass growing from the bottom of it. This lay immediately upon the deep jugular vein and carotid artery, with which latter it was incorporated. Finding it impossible to detach it without injury to the artery, I concluded to apply a ligature to the common carotid ; which was done low down, and the tumor was then extirpated. This ligature came away on the seventeenth day, and the wound healed rapidly. No return of the disease has taken place, and the patient enjoys excellent health. 1072 Strumous Disease of the Tarsus. Amputation. This disease was of long standing, and the exhaustion produced by the irri- tation and profuse discharge, required amputation to be resorted to above the ankle joint. The patient recovered. 1073 Malignant Disease of the Leg. Amputation. Mrs. "W----, over 50 years of age, was the subject of this operation. The disease returned in the groin about a year after. 944 Steatoma, from over the parotid gland. This tumor, from its position, had been looked upon and treated as disease of the gland; but the feel was enough to indicate its character. After an incision was made down to it, it was easily enucleated, and the wound healed kindly in a few days. The patient had suffered great pain, and that side of the face was left somewhat paralyzed. 854 Lipoma, from the shoulder of a young lady. Removed, Nov., 1848. 994 Strumous Disease of the Tarsus, extensive. Leg amputated in St. Vincent's Hospital, 1857. The patient recovered. 1074 Tuberculous Disease of the Kidney. Not known to exist until post mortem examination. COMPARTMENT XXI. 41 The history of this case was furnished me by Dr. Carroh, who obtained it from the attending physician, and was kind enough to present me with this very interesting specimen. About four years previous to her death, Mrs 0----, a young and interest- ing lady, applied to several eminent professional gentlemen for advice; consultations were held, but the symptoms not being sufficiently weli marked to establish the nature of fcer disease, she had little or no treat- ment. One of the physicians, who at the time was attending her, sus- pected some renal difficulty, but the rest being opposed to him, she passed from his hands to the care of another. About a year previous to her demise, a tumor made its appearance in the right side, which was regarded by some as hepatic, and by others as ovarian enlargement. Various means were tried, but without success, and the patient died in the early part of the year 1857. Post mortem examination revealed extensive tuberculosis of the kidney, the texture of which was completely effaced. It contained nearly a quart of pus. The most curious circumstance connected with this case is, that during the whole course of the disease, the only symptom which led to a suspicion of the true state of affairs, was a slightly increased quantity of urine. Microscopic examinations of the urine were made on several occasions, but nothing was found to direct the attention to disease of the kidney. 1102 Ulceration of the Prepuce, venereal. It had resisted all ordinary treatment in the hands of several physicians of this city for about a year, and was finally cured by removal. The heal- ing process was very slow, the wound threatening to assume the vene- real character from time to time. 1103 Cancer of the Uvula. This is a rare disease, but from minute examination, there is no doubt as to its character! It was cured by removal. 1109 Fibrous Tumor. Removed by operation. 1110 Fractured Os Froiltis, with extravasation of blood. The man from whom this specimen is taken, fell about twenty feet, and • struck upon his forehead, making a small wound of the scalp. He was carried into the house, and recovered from the concussion in a short time. The doctor who saw him, examined the wound carefully, but could de- tect no depression or fracture. He had no bad symptoms until the ninth day, when suddenly he became comatose, and died in a few hours. No fracture or depression could be felt. From the nature of this injury, which was a fissure of the os frontis, down through the orbital plate, no operation would have been justifiable, with- out very urgent symptoms denoting compression of the brain, from ex- travasated blood. Even then it would probably not have been foUowed by a favorable result Taken by me from a cadaver. 1131 Insect Removed from an Abscess, which had formed over the eye- brow of a young man who had lived in Panama. He was stung in the place where the abscess formed, some months previous, and at that time the ovum was probably deposited. The insect was living when removed. Compartment XXI. (Below). 325 Calvarium, remarkably thick in the occipital region. 164 Calvarium of a hydrocephalic subject. 1 Cuticle, from the human foot—enormously thickened. 42 COMPARTMENT XXII. 275 Metatarsal Bones of foot and toe ; from Waterloo. 276 Os \aviculare, from Waterloo. 277 A Cervical Vertebra, from Waterloo. 339 Skull, exceedingly thin and irregular. 320 Tarietal Bones—two; one with fracture. 451 Model Of the Right Arm of a little girl 9 years old, showing dislo- cation of the upper extremity of the radius, toward the inner condyle of the os brachii. Complete pronation of tho hand attends it. COMPARTMENT XXII. The specimens in the upper portion of this compartment belong to my son, Dr. Alexander B. Mott, who performed the operations and furnished the descriptions. 848 Scrofulous Caries, of proximal phalanx of middle finger, with se- questrum. Removed by amputation. 1075 Strumous Disease of Finger. Amputation. 1076 Strumous Disease of Finger, destroying articulation. Amputated. 1032 Lipoma, from the arm—situated over the biceps muscle. Removed by operation. 1033 FfletllS of about five months. 1077 Steatoma. Removed from the scalp. 1078 Steatoma. . Removed from the scalp. 1079 Scirrhous Tumor. Removed by operation. 1080 Ulcerated Carcinoma. Successfully removed from the groin. 1081 Scirrhous Tumor. Removed from the breast. 1082 Fibrous and Adipose Tumors. Removed from the hip, thigh, and arm of Mrs. K-----, of Peekskill. 1083 Adipose Sarcoma. Removed from the neck. 1084 Scirrhous Tumor. Removed by operation. 1085 Encysted Tumor. Removed from the back of the neck. 1086 Scirrhous Tumor. Removed from the axilla. 1087 Portion of Liver, ulcerated. 1088 Gun-shot Wound of Finger. Amputated. 967 Finger. Removed by operation. 968 Supernumerary Thumb, from a cadaver. Presented by Dr. Darling. 1089 Ununited Fracture of the Humerus—operation. This portion of bone was removed bypassing a chain saw above and below the fracture, and the ends were brought together by means of iron wire .—the arm was well secured by splints, and the wire came away in eight weeks. Union had then taken place. 1090 Nasal Polypi. Removed by operation. COMPARTMENT XXII. 43 1091 Scirrhous Disease Of Skin. Returned disease from carcinoma of the breast. Removed by operation. 1092 Portion Of Os (aids, carious, from a girl 7 years old. The disease was of long standing, and was perfectly cured by the exsection. 1093 Glandular Tumors, removed from the neck of a young lady. 1094 Scirrhous Tumor, removed from the axilla. 1095 Osteo Sarcoma of the Upper Jaw. From Mr. S-----, of Wisconsin. The patient, a young man about 24 years of age, had enjoyed exceUent health until within a year previous to the removal of this tumor. The enlargement commenced shortly after having one of the molar teeth ex- tracted, and increased rapidly. He suffered severe pain, and the tumor had encroached so much on the roof of his mouth, that it had become difficult for him to swallow. An incision being made from a point below the inner canthus, down through the lip, and the integuments dissected off; the entire upper jaw of that side was removed by a flexible saw, passed through an opening made at the upper edge of the diseased mass, into the roof of the mouth, and carried downward toward the teeth. The external wounds, being brought together by interrupted sutures, healed kindly, the'eavity within the mouth soon filled up, and ho went home perfectly well There has been no return of the disease. 1096 Cancer, from the forehead of Mrs.-----, aged 52. The wound healed perfectly, with no return after its removal, 1853. 1097 Steatoma, on the point of ulceration. Removed by operation. 1098 Malignant Tumor, from the left side of the neck and shoulder; weight 3L lbs. This case had been operated upon previously, and a tumor half the size of this specimen removed. The disease had returned, and from its size and position (pressing upon the trachea), caused much difficulty in breathing. Under these circumstances, at the urgent solicitation of the patient, Amelia Ger3cheidt, a German girl, 17 years of age, of very healthy appearance, the tumor was removed. The wound healed kindly, but, as was anticipated, the disease returned in the course of a few months, and made such rapid progress, that further interference was considered unjustifiable. A fungus mass soon made its appearance, which, when last seen, was increasing very rapidly. This tumor is of the same character as the numerous specimens taken from Win. Keating, whose caso is recorded under number 1011. 1099 Compound Fracture of the hand and fore arm, occasioned by being caught in a steam saw mill. Amputation. lioo Compound Comminuted Fracture of fore-arm, with laceration of arte- ries, etc. A railroad car passed over it. Amputation. 1101 Portion Of Femur, removed from a compound comminuted fracture of the thigh. The accident occurred seven months previous to my taking charge of the patient, and, although union had taken place between the ends of the bone, he was unable to walk on account of the irritation produced by the presenco of this detached portion of bono. A large sinus led to it, and a very offensive and profuse discharge was gradually exhausting him. An incision, about seven inches in length,,was made on the inside of the thigh, immediately over the dead bone, and it was removed. Tl»e cavity gradually filled up, and recovery followed. 44 COMPARTMENT XXII. 964 Lymphatic Glandular Tumor. Removed by operation from below the base of the lower jaw, in a young woman about 20 years It was^e of the lymphatic glands under the deep ^rvical foscia and, from its proximity to the submaxillary gland, had very much atrophied it. 943 Pedunculated Lipoma, similar to No. 939. Removed from the back of the neck of Mrs. G. 1104 Wound Of Femoral Vein and ulceration of the artery. This preparation is one of great interest, being a specimen of arteritis and phlebitis. The cause of it is as follows: The patient, a middle.aged man, was subjected to the operation of ligature of the femoral artery for aneurism. The hook, while being passed under the artery was forced through the femoral vein. Some hemorrhage took place at the time, but the operator, considering it from a small vein which frequently passes under the artery, after the ligature was tied and the hemorrhage ceased, closed the wound. .,,.,, „t t,- i. The small piece of bougie is passed through the point of the artery which had been separated by the ligature, into the opening of the vein the wound did not heal as well as usual, but discharged an offensive bloody matter, and never took on a healthy appearance. His death occurred some days after the ligature came away. Post mortem made by me. 1105 Scirrhous Tumor, from under the parotid gland. The patient was a young woman about 20 years of age, enjoying excellent health, but suffering great pain from the position of the tumor. The wound healed kindly by first intention, and she returned to her occu- pation in about ten days after its removal. 1106 Scirrhous Disease of the Skin. Case of Mrs. H. Operation. This is the most frequent form in which the disease returns in and about the cicatrix, after the removal of the female breast for scirrhus. 1121 Cterus, with ulceration of the neck. From a cadaver. 1122 Uterus, with carcinomatous ulceration of the neck. From a cadaver. 1123 Heart, Ilypertrophy and carditis. 1124 Uterus, with placenta attached. The subject from which this was taken died after twelve hours of violent convulsions, at the eighth month of pregnancy. She was unconscious from the time she was first taken until death. The post mortem revealed some slight congestion about the brain and a fatty kidney. There being no signs of labor, no attempt was made to produce premature birth 1125 Fatty Kidney, from the same subject as 1124. 1126 FungUS Of the Upper Jaw. Removed by operation from a young lady. It foUowed the extraction of a tooth; had been growing for several months; was removed by means of a strong pair of bone forceps, and has not returned 1127 Vesico Vaginal Fistula, following the use of forceps in a case of pro- tracted labor. Operation and restoration. The patient had miscarried several times since the accident at about the fifth month; but has since the operation given birth to a living child at full period. I operated on her with the clamp and wire suture, as I have COMPARTMENT XXII. 45 on three other cases, each of which I have succeeded in curino- bv a sinele operation. ° J ""'s10 In one of these cases the opening into the bladder was large enough to admit the index finger, and was so high up near the neck of the uterus that I was obliged to enclose the mouth of the womb within the bladder- it healed perfectly, however, and the patient now has the menstrual dis- charge pass through the urethra. 1128 Scirrhus of Female Breast, slightly ulcerated and containing a cyst, which was filled with a thick dark bloody fluid. Removed by operation. 1107 Scirrhous Tumor, from the breast of Mrs. I., Thirty-sixth Street. In this case, as wiU be seen by the specimen, the mammary gland was in no degree affected The tumor was perfectly distinct, and the removal of some of the surrounding fatty tissues with it, gives every reason to suppose that it will not return. The wound healed very kindly. 1108 Skin and Cicatrix, with scirrhous disease, which had returned one year after the mamma had been removed. Vide Specimen No. 1111. 1111 ScirrllUS of Mamma, from same patient as Specimen No. 1108— Mrs. E. Removed by operation. 1030 Encysted Tumor of the neck. Removed by operation. 1112 Fracture of the Humerus, from gun-shot wound. 1113 Dry Pelvis of Infant, showing the separate bones forming the ace- tabulum. 1114 Bones of the Thumb, necrosed. Removed by operation. 1115 Inferior Maxilla of an old man, with total absorption of the alveo- lar process. 1116 Portion Of Tibia, removed from a young woman. Necrosis, the effects of syphilis. 1117 Vertebra? of Child. Prepared by me. 1130 Inferior Maxilla, necrosed portion of it. From a female child 5 years old. An extensive ulceration of the cheek took place after scarlet fever, and destroyed the bone. The ulcer healed per- fectly after its removal. Compartment XXII. (Below). 327 Calvarium, with one foramen, like 326. 323 Cranium, superior portion of, with sutures ossified. 445 Half of the Head. A cast showing a good display of arteries of the face and scalp. On the inside are to be seen the tongue, septum narium, and falx cerebri, with a lateral ventricle and some portions of the cerebrum! 266 Tibia, from the battlo-field of Waterloo. 260 Amputation at the shoulder-joint. 450 Artificial Anus. A wax model. 46 COMPARTMENTS XXIII., XXIV. 97 Penis, injected, in which the glans was diseased. 98 Penis, injected, with the exception of the glans. 274 Os Frontis, from Waterloo. 452 Fractures of Femur and Humerus—an extraordinary case. It occurred in an English gentleman, who was attended by Dr. R., of Lon- don. The femur is fractured just below the neck into three pieces, in- volving the trochanters. The os bracchii is fractured near the neck of the bone, one portion of the fracture extending into the head of it. He suffered very little from this extensive and frightful injury. At the end of the third week, contrary to remonstrances, he arose from his bed and indulged too freely, which brought on a fever that in a few days proved fatal. COMPARTMENT XXIII. 1054 OsteomatOUS Growths, from the fore-arm and hand. Removed by operation at the same time. 747 Piece of Glass, removed from the fore-arm of a patient at clinique. 873 Arch Of the Aorta, punctured. It occurred by accident in a news- boy while at play. 435 Hydro sclerocele of Ramsden. The tunica vaginalis is distended by a collection of fluid, and there is also morbid enlargement of the testicle—probably sypliilitic. See Ramsden on Testicle and Aneurism, London, 1811. 452 SteatomatOUS Cyst containing the matter. Removed by operation from over the external carotid artery. No return of disease. 565 Cyst Of a Steatoma, removed from the neck. 480 Cyst Of a SteatomatOUS Tumor, removed from a patient in hospital. 464 Aneurism by Anastomosis, in a state of ulceration. Removed by the knife from over the brachial artery, in an infant. 144 African Skull, from the Gold Coast. Presented by Captain Shilletoe. 174 Indian Cranium. Of a woman from the Rocky Mountains. Pre- sented by Mr. Cobb. 151 Greek Cranium, from the Acropolis at Atheus. Collected by me. COMPARTMENT XXIV. 609 Melanosis of the Eye-ball, removed by operation. The disease re- turned in the orbit. 610 Melanosis of the Eye-ball. Portion of No. 539. 693 Melanosis Of the Eye-ball, removed by operation. 401 Melanosis of the Parotid Gland. Extirpated July 13th, 1831. A young West Indian. He first observed it about six months previous, after a severe attack of fever. The tumor was now hard (apparently scirrhus), and about the size of the fist As his only.chance for recovery, with his free consent, I resolved on its extirpation. COMPARTMENT XXIV. 47 The first step m the operation was to tie the external carotid, immediatelv *nT p« J' gftStnv mU9cle' b? moans of an indsioQ from the posterior angle of the jaw, about three inches in length, downward and inward A second incision was commenced above the jugum and carried in a curved direction downward and backward upon the occiput, and the first incision I so extended as to intersect it. ■ On detaching the two flaps, the black appearance of the gland fuUy demon- - stratoi i melanosis. Continuing the operation, the inner edge of the masseter j was exposed, and aftor introducing the finger into the mouth to prevent , accidental perforation into this cavity, the tumor was dissected from the masseter and buccal membrane and then from the jugum, to which bone it adhered so closely as to have rendered it carious by its pressure. it was next dissected below from the mastoid and digastric muscles, but the patient complained of so much pain when the tumor was raised, that I con- cluded the detachment by again cutting from above. A few rapid strokes of the knife separated it from the capsular ligament of the jaw, and aUowed the removal of the bulk of the disease. A portion between the styloid and mastoid processes was then removed with the handle of the scalpel, and the portio dura divided, which division gave him much pain and paralyzed instantly the muscles of that side of the face. During the operation several arteries were tied, among which was the tem- poral for a retrograde hemorrhage. The operation lasted about an hour, and he lost, perhaps, a pint of blood. He did not seem much exhausted! and in the course of another hour the wound was dressed with lint, adhe- sive strips, compress, and a roller. During the first week the pulse scarcely exceeded 100, and at the end of two weeks the constitutional effects of the operation had entirely subsided, but I was sorry to notice unmistakable indications of a return of the disease, especially at a point unhealed opposite the ear, which rapidly became mel- anoid fungus. This was followed by pain and swelling of one knee, tumors on the scalp, and a yellow skin, running" into confirmed hectic, of which he died about seven weeks after the operation. No post mortem could be obtained, not even the privilege of plunging a lancet into one of the tumors on the scalp, but I have no doubt they wero melan- otic. The contents of the tumor were of the color and consistence of tar. Description of the case, and operation published, with plates, iu the Amer. Journal of Medical Sciences, for May, 1832, page 17. 638 Onychia Maligna of a toe. 621 An Eye of Captain K. 895 Fungus lurmatodes of the Eye. Mr. G., aged 18 years. Developed by a blow from the tail of a cow. It was removed in 1819, but the disease returned in the orbit, and he died nine months afterward. Vide No. 896. 896 Fuwn'.s Ihcmatodes of the Orbit. Return of disease. Mr. G's. case. Vide No. 895. Post mortem examination made by Drs. V. Mott, jr., and xV. B. Mott. 413 Cancer Of the Eye. From Mr. S., of Georgia. Extirpated. Carcinomatous ulceration of the eye-lids-extonded to the ball of the eye. The wound had very nearly healed, when the disease returned at the bottom of the sockot. Death took place more than a year after the operation. 528 Invagination Of the Ileum in an infant, who died in consequence of it. 503 Melanotic Tumors of the' Scalp. Removed by operation from a lady 50 years of age, from Massachusetts. The wound healed thoroughly, and the disease is not known to have re- turned. 48 COMPARTMENT XXIV. 635 Vascular Sarcoma of the Scalp. It occurred in a boy 12 years of age, of strumous diathesis ^totjd tabit One or two tumors appeared at first, seeming to involve all the tissues ol the scalp, and to fluctuate from contained blood (not «t™,yasated). Ihey were removed ten or twelve times, but when removed othei tumors made their appearance, increasing rapidly, but_ causing no pain until at length the bone became involved by the extension of the disease. Death finally occurred from hectic. . . I have never met with a similar case, nor mdeed heard ot one. 555 Carcinoma, ulcerated. From a negress. It originated in an axillary gland, which became diseased after the removal of the mamma of the same side for malignant disease. 583 Hypertrophy of labium pudendi. Removed by operation. 956 Malignant Sarcoma, from the left side of William Keating (May, 1851). A healthy young Irishman, about 35 years of age, a carpenter by occupation He attributes this terrible form of disease to the pressure of his side against the work-bench. He has been four times operated upon in Dublin, and now four times by me, in New York, and all these operations have been per- formed within the last fourteen years. Each time the wound has readily healed, leaving a most beautiful and healthy cicatrix, and has remained healed from one to two years, without the least appearance of any return. When it once reappears, however, it increases very rapidly. It commences in one tumor or knob, which soon multiplies into several, rom the size of a hen's egg to the fist. In the beginning there is no disclora- tion of the skin, but after awhile they assume a bluish appearance. Al- ways from the early to the last stage, they have that soft, spongy, de- ceptive feel of fluctuation, so peculiarly characteristic of malignant disease, and at no time are they attended with much pain. In none of the opera- tions upon him have they been found attached morbidly to any of the muscles. They have involved, however, aU the dermoid, as well as the subjacent adipose and cellular tissues, quite to the muscular structure be- neath. The latter, however, has always been found normal. This operation is by far the most extensive that has been performed. The pectoralis major, latissimus dorsi, serratus magnus anticus, and origin of the rectus abdominis were extensively laid bare, but the tumors were not found morbidly adherent to them at any part. The cicatrix from the last opera- tion was sound and beautiful at the time throughout, but the tumors were ' so situated on each side of it, as to require, the whole to be removed. As yet no ulceration has taken place in any of these tumors. When cut into, they are found soft and spongy, and have the organization of encephaloid disease. They have not yet affected his health. They become inconvenient from their size, and are occasionally painful from pressure against the work- bench. He is a man of fine general health, light hair and florid com- plexion, all indicative of exemption from malignant disease. The chasm left by this operation was very great, from the necessity of re- moving integuments to such an extent. See No. 965, and Compartment XX., No. 1007. 965 Malignant Tumor, from Mr. Keating, being the ninth time an opera- tion was performed. 825 Malignant Tumor. 539 Melanosis of the Eye-hall. The eye was extirpated, and the disease returned in the orbit. See No. 652. 652 Melanosis, attacking the orbit after removal of the eye, affected with the same disease. COMPARTMENT XXV. 49 622 Melanosis of the Eye. Portion of No. 5.39, removed after death, the disease having returned after removal by operation. 806 Malignant Tumor. 533 Procidentia Recti. Removed after death. 510 Encephaloid Tumor. Removed by operation. 114 Cranium, of unusual thickness. 229 Skull of Gibbs the pirate. A cast. 120 Cranium. COMPARTMENT XXV. 866 Tumor. 150 Tumor of scirrhous hardness, situated over the parotid of Mrs. -----, of Fulton Street, Sept., 1848. 863 Steatoma. 867 Tumor. 940 Fibrous Tumor, from the cheek. Taken out from the inside of the mouth. 853 Lipoma. 910 Fibrous Tumor, from one side of the scrotum. It had the appear- ance of a third testicle. 789 Tumor. Removed by surgical operation. 698 Tumor, from Dr. V. 721 Lymphatic Glandular Tumor, removed July, 1844, from the upper and inner part of the thigh of Mr. F----, of Ohio. This tumor extended from above Poupart's ligament into the scrotum, and was adherent to the periosteum on the spine of the pubes. It was also quite adherent to the other neighboring parts, and very vascular. The wound healed readily by granulation. 674 Lymphatic Glanular Tumor. Removed from over the parotid. See drawing of the negro in my portfolio. 804 Tumor, of fibrous or chondromatous nature, involving the first and second phalanges of the index finder. A man, from Orange County, otherwise healthy. It had been growing fifteen years, and had caused no pain. It seemed to have originated within the cavity of the phalanx, as there were detached laminaj of bone on the sur- face of the tumor. The smaller of the two tumors was decidedly of carti- lage, whieh at some points seemed almost converted into bone. 570 Tumnr, from posterior lobe of the cerebrum. 403 Tumor, from Mrs. C. Presented by Mr. E. 808 Tumors of a peculiar form. Eiloides in character. 846 Tubercular Deposit in Epididymis, accompanied by ulceration and sinuses. Removed by operation, from a young man, 19 years of age. 4 50 COMPARTMENT XXV. .662 Strangulated Umbilical nernia, from a fatal case in a female. The strangulation was caused by an adventitious formation at the inner aper- ture. It seemed thorougldy reduced by taxis, the external tumor disap- pearing, but the symptoms continued, and death foUowed. 481 Hernia of the indirect inguinal variety. The intestine is strangulated at the internal ring, by an adventitious band of fibrine. The patient had been subjected to an operation, and the stric- ture apparently relieved, and the intestine was supposed to be returned en- tirely into the abdomen. The symptoms, however, returned, and he died. 714 Tumor (osteo chondroma), consisting of bone and cartilage, appar- ently of a benign character. Removed by the saw from the sternum and ribs of a man from Georgia, ageo1 30. It had been growing for sixteen years. The wound healed kinp- posite side—its point being arrested by the sternum. The wound was re- ceived in the street (Broadway), and was instantly fatal. See trial. 885 Punctured Wound of the Heart of J. Keily, a soldier belonging to Co. F., N. Y. Volunteers. Received during the Mexican war, at Puebla, Mexico, July, 1847, from a sword-thrust made by Lieut. Mayne Reid, while the soldier was disobey- ing orders and attempting to make his escape from imprisonment in the guard-house. He survived the wound 4^ hours. 560 Wound of the Superior Longitudinal Sinus, from a spicula of bone driven in by the blow of an ax. Inflicted by Dr.----, upon constable Disbrow as the constable was ascend- ing a staircase leading to the doctor's apartment for the purpose of arrest- ing him for debt. The ax passed through the os frontis, and penetrated fully an inch into the left hemisphere of the brain. Twenty-four hours after the wound was received I saw Disbrow. He was laboring under the usual symptoms of compression. A considerable portion of the os frontie was found depressed, several small fragments being driven into the brain. Hey's saw was used with much advantage in removing the sunken portions, but there was no return of consciousness after their removal, and death followed in a few days. The hemorrhage from the wound of the longitudinal sinus was readily controlled by lint and slight pressure. 561 Osteo Sarcoma of the clavicle. Removed by operation, June 17th, 1828. Case of Mr. Yates, of Charleston, S. C. This is the most difficult and dangerous operation I have ever performed. The patient, aged 19, was from "Charlestown, S. C. About four months ■ previous he discovered a tumor about as large as a pigeon's egg on the left clavicle. It was pronounced steatomatous, and treated with blisters. poultices, escharoties, and a seton, but without checking its growth. On examination I found the tumor about four inches in diameter, of-incompres- sible hardness, firmly adherent to the clavicle ; the top of it covered with luxuriant granulations, the result of the above treatment, and withal rapidly increasing in size. _ He was informed of the unprecedented nature of the operation required, of its complicated character, of its immediate danger, and of its ultimate uncer- tainty; yet rather than perish with the disease, with a composure am' 54 COMPARTMENT XXVIII. fortitude that is rarely equalled, he chose the doubtful remedy, and the operation was accordingly performed. An incision was commenced at the sterno-clavicular articulation and carried below the tumor, and as close as the fungus would aUow, to tho top of the shoulder near the acromion; exposing the fibres of the pectoralis major. The fibres of this muscle were then divided as near as possible to the tumor, during which incision arteries sprung in every direction and were tied Some veins also required ligature. A small portion of the deltoid was then detached from the clavicle, and the cephalic vein where it passes between the two muscles drawn outward and upward toward the shoulder. On attempting to pass the finger below this vein and the deltoid, it was discovered that the tumor reached quite to the coracoid pzocess, rendering it impossible to get beneath the clavicle from that direction. A second incision was then made from the outer edge of the external jugular vein, over the tumor, to the top of the shoulder, dividing the platysma myoides and a portion of the trapezius muscle and layingjjare the jplaviol* at a -sound point ifea'refthe acromion. A steel director, very much curved, was now passed under the bone from above, taking great care to keep it in contact with the under surface-*-' Through this opening, by means of an eyed probe, bent to the same curve, a chain saw was passed, and the bone readily divided. In carrying the further dissection along under the surface of the tumor, toward the sternum, behind the pectoralis .major, a number of very large arteries and veins required tying. The first rib being exposed, the costo clavicular ligament was divided, and the joint at the sternum opened from below; giving so much mobility to the diseased mass, as to allow slight elevation of the sawed end of the bone, by means of the double hook, elevator, and broad spatulas. At this stage of the operation I had depended on the sub- clavius muscle as a guide, to avoid wounding the trunk of the subclavian vein, but on reaching it, it was found obliterated in the tumor. Continuing the removal at the upper and outer part, the oma hyoid musele was exposed, from the mastoid muscle almost to the scapula. On dividing the ceUular and fatty structure, between the omo hyoid and the subclavian vessels, a number of large arteries were divided and secured. A third incision was now made, from the sternal end of the clavicle, over the tumor, to the commencement of the second incision at the external jugular vein. On dividing the platysma myoid this vein was exposed, and was isolated for a little distance, and then tied, with two fine ligatures, and divided between. Continuing the incision, the sterno-cleido-mastoid was divided, about three inches from the clavicle, and very cautiously separated from the fascia beneath, untd the anterior scalenus was exposed. Prom this latter muscle to the coracoid process the subclavian vein was found so firmly adherent to the tumor, that further progress in the operation was at one time deemed impossible. But by cautious use of the handle, as well as the edge of the scalpel, the vein was at length detached without injury. This part of the operation was peculiarly difficult, as at every step large vessels were divided, which deluged the parts with blood before secured. Among these the external jugular was again tied, with two ligatures, and divided between. . Turning down the cut portion of the mastoid, and keeping close to the fascia profunda, the tumor was detached from the situation of the thoracic duct and junction of the jugular and subclavian veins, without the least injury to these vessels—thus freeing the mass from its most important attachment. Rut the tumor extended so far down on the outside of the thorax, that it was necessary to make a fourth incision, over the fourth rib, again dividing the pectoralis major, but finally separating the whole mass. The removed portion was of the size of two fists, and the patient lost by estimation from 15 to 20 ounces of blood. As all parts of the wound appeared healthy, the ligatures (about 40) were divided near the knots, the cavity filled with lint, and the edges approxi- COMPARTMENT XXVIII. 55 mated with long adhesive strips. Over these was placed a light compress, loosely^ secured by a single roller around the chest and shoulders. This formidable and intricate operation was borne by the patient with a com- posure and fortitude truly heroic, and I can conceive of no reason, why the gentle resignation and overcoming resolution, shown in such cases on the operating table, should not challenge our admiration, equaUy with the hot- headed exploits of valor on the field of battle. On the fourth day after the operation the pulse had risen to 130, hard and full, with considerable hemorrhage from the wound. During the next week it gradually subsided to less than 100, with return of appetite, soft moist skin, and refreshing sleep. At the end of a month the ligatures had all come away, and the wound was mostly healed. A little exuberance of the granulations was repressed by pressure. The arm wu% suspended in a Bling, and an apparatus adapted to support the shoulder. At the-end of the second month he went to Saratoga, and about the end of the third month returned in better health than he had ever enjoyed. By means of an adventitious clavicle, contrived by Mr. James Kent, full motion of the arm was restored. Reported at length in the Amer. Jour. Med. Science, 1828, Vol. III., p. 100. See also Velpeau's Oper. Surg., Vol. II., p. 894. 630 Guil-sllOt Wound Of the Hand, involving the carpus. Primary amputa- tion of the fore-arm by the circular method. A hospital case. 586 Punctured Wound of the Vena Porta;, from a stab. Fatal. r>88 Heart, showing numerous wounds by small shot; wounds also-in the aorta. From a boy of 15. The consequence of accidental discharge of a fowling- piece on board of a boat. Death was instantaneous. 646. Indelible Marks on the skin of a sailor. 889 Ovarian Dropsy, the sac firmly attached to the peritoneum through- out its entire surface. 933 Sac from an Enormous Encysted Tumor on the upper and inner part of the thigh of Mr.----, of Newburgh. It had the deceptive feel of malignancy. His physician had explored it (un- satisfactorily), after which it was left to increase for a year longer. "When the patient applied to me, it was again explored, and we drew off eight pints of blood}- albuminous serum. A few days after we removed the whole sac, which was filling again with yellowish serum. Vide No. 932. As this occupied almost the wholo thigh from the tuber ischii to the knee, entangling deeply the muscles in the posterior part of the thigh, the opera- tion was difficult and bloody. At the first sight of this tumor, my impression was in favor of its malignant character. Its huge size and freedom from pain led to this opinion, and I advised it to be explored, but the search did not reach the fluid. Nothing unpleasant occurred after the operation. About eight years have elapsed since it was performed, and the patient is now living. 932 Serum, from the above encysted tumor. Drawn off previous to removing the sac, which was situated on the superior and internal part of the thigh. Vide No. 933. 770 Testicle, injected with quicksilver. 411 Fibrinous Adhesions of long standing, between the peritoneal coat of the liver and the diaphragm—the result of inflammation. 182 Part Of the Head. Injected preparation. 179 Half Of the Head. Injected preparation. 56 COMPARTMENT XXIX. ISO Half Of the Head. Injected preparation. 235 Head of a Clu'pptwa Indian (female). 128 Cranium. 110 Cranium. COMPARTMENT XXIX. 919 Steatoma from the scalp. 695 Fungous Bleeding Tumor of the scalp—peculiar. May be called hsem^toma. Removed by the knife. 907 Steatoma of the scalp. 608 Steatoma from the scalp. 636 Diseased Peritonaeum. 702 Gall Stone, in a sac. 556 Miliary Tuberculization of the peritoneal coat of the jejunum. 590 Tubercular Disease of the Peritonceum, covering a portion of the ileum and mesentery. Scrofulous. 828 Stricture Of the Colon at its sigmoid flexure. Case of Mrs. B. Death from ulceration and extravasation into the peritoneal cavity. 579 Ulceration of the Colon. Situated in the descending portion. The result of enteritis. Effusion took place, followed by peritonitis and death. Vide No. 523. 948 Portion of Colon, ulcerated. 506 Stomach of a Horse. A portion, with a number of botts adhering to it. 743 Nasal Polypus./ McBurth's case. For report, with description of the " nasal operation," see Phil. Jour. Med. Science. 691 Aneurism by Anastomosis. Removed from the neck of an infant. 746 Ganglion, connected with the tendou of the semi-tendinosus muscle. 709 Calcareous Degeneration of dermoid tissue of the scrotum. Removed by operation with perfect success, and no subsequent return of the disease. (Curling on Testis). See published case; New York Hospital Register, etc. 408 Hypertrophy Of Labia Majora. Removed by surgical operation. 851 Polypus Uteri (simple), protruding into the vagina. Removed from the mistress of Mr.-----. 816 Polypus of the Uterus. 835 Polypus from the nose. 523 Ulceration of the Colon. The patient died with all the symptoms of inflammation of the mucous lining of the large intestines, terminating in ulceration and perforation. Also a duplicate of the rectum, under the same number. 701 Polypus from the nose. r ^4 The Head, entire. An injected preparation. COMPARTMENT XXX. 57 i 2 9 Hydrocephalic Cranium of a child. i;>- Cranium. 116 Cranium. 119 Cranium. 186 Nerves of the Face and Neck. A magnificent preparation, made by my late pupil, Mr. Starr. 439 Heart and Lungs of a small subject, with the trunks of the arteries and veins injected as far as the clavicle, showing their normal situation. A beautiful preparation. COMPARTMENT XXX. 703 Moveable Cartilages, from the bursa over the olecranon. Discharged by incision. 631 Fungus Haematodes of palm of the hand of a weaver in Carmine Street. This occurred 25 years ago. The disease was not painful, but the discharge exceedingly offensive. Amputation of the fore-arm was performed during hectic fever, yet the man recovered, and is now living in good health. 824 Granular Bodies, from a ganglion, in the palm of the hand and also extending above the annular ligament, in a child. 483 Osteo cephaloma of first phalanx of middle finger. Removed by amputation. No known return of the disease. 482 Supernumerary Finger, hypeitrophied. Removed by amputation from an infant. 815 Spina VeiltOSa of first phalanx of index finger in a young girl. Am- v putated. 522 NEVUS MaterilUS. Removed by operation from the side of a lady, aged 38. This singular tumor seems to involve the dermoid adipose and ceUular tissues only, and has very little vascularity. It was not attached to the ribs, and at the time of its removal was growing quite rapidly. She called It a "veal cutlet," which it very much resembled, and said that her mother when pregnant with her longed for a veal cutlet, and when she found it could not be obtained, put her hand to her side and was very much affected. 829 Pachydermatocele of the Face and Head. Case of Rich's son, 41 MeDougal Street. The disease was removed by oper- ation at two different times, but both times returned. See drawings. 897 Pachydermatocele Of the Scalp. Disposition to return prevented by compressing with dry sponge. 959 Cutaneous Carcinoma of the Face of a man 35 years old, in all other respects healthy. Plastic operation. The disease commenced as a small pimple, with a scurfy surface, which was pronoVmced cancer by an empiric, and treated by caustic applications until it assumed a carcinomatous aspect. The edges were raised, everted, and irregular, with a thin, vitiated, and irritating discharge, and a burning sen- 58 COMPARTMENT XXX. Bation at times in the whole ulcer. It had destroyed the greater part of the left cheek; the entire lower lid; and the side of the nose, abovo the inner canthus of the eye; and a fungous mass was extending along the course of the lower orbital ridge. The left angle of the mouth was nearly invaded. After trying medical treatment for somo time with liq. Donovan and dress- ings of oxide of zinc ointment, at his urgent request the operation was per- formed. Exsecting as completely as possible the ulcer at every part, by a plastic operation, the whole space was covered with two flaps of skin. The one from the neck, and over the parotid gland, and the side of the ear- Where the tongue of the flap was formed—covered the entire cheek and side of the nose. The other from the forehead—beginning beyond the mesial line of the eye-brows, and taking the tongue of it from the temple, on a line a little above the external canthus of the orbit-rrcovered the. margin • < • of 4he orbit:—a point-of• this flap reaching aSove the inner canthus upon the os frontis and along the junction of the ossa nasi. These flaps were secured to each other and to the surrounding pacts with interrupted sutures. He was under the influence of chloroform during the operation. Slight fever followed, but yielded to treatment, and union by adhesion took place per- fectly. The only point where suppuration followed was at the anterior edge of the masseter where the parotid duct was unavoidably cut. This dis- charged saliva very freely during mastication. Pressure, with bandage and compress, however, soon arrested the discharge. Two and a half months after the operation, when all seemed sound and healthy, a fungous growth showed itself from the periosteum along the bony margin of the orbit, under the integument, involving the conjunctiva of the eye. No further operation could be performed. 445 Ulceration Of the Liver, attended by ascites. 894 Cirrhosis, or hob-nail disease of the liver. 626 Ulcerated Carcinoma of the stomach. The disease caused much pain. Death was the result of inanition. The omentum was adherent to the stomach, preventing effusion,from the ulceration which perforated the organ. 419 Wound of the Spleen—laceration. From a man who was run over by a cart, and died a few hours afterward, with all the symptoms of extensive injury of an abdominal viscus. 492 Spleen, containing numerous scrofulous tubercles. Taken from a scrofulous male subject, 9 years of age, who died of tabes mesenterica—the mesenteric glands being of course involved in the tubercular degeneration. 700 Ulcer of the Rectum, from Dr. Pitney. 753 Hypospadias, taken from a subject by Dr. V. B. 584 Stricture of the Urethra, of the annular variety, 11 inches from the orifice. 587 Wound Of Small Intestine, from a jack-knife. In a colored boy. Death followed in a few hours from the shock. 524 Stricture Of the Urethra, in the form of a pack-thread, stretched across the canal. 531 Stricture of the Urethra, near its orifice. 704 Ulcer of the Rectum, suspected to be carcinomatous^ It was ex- sected, and a permanent cure followed. 1055 Elephantiasis of the leg—ulcerated. Amputation. COMPARTMENTS XXXI., XXXII. 59 180 naif of the Head—arteries injected. 185 Whole Head, injected. 143 Cranium. 141 Cranium. 119 Cranium. COMPARTMENT XXXI. 879 Horny Growth, from' beneath the nail of the great toe. Removed at clinique. ...... ,..-«■ 823 Horny Growth, removed from lower lip. 619 Polypi, removecHronrtbe noise? 099 Polypi, from the nose. 654 Skeleton of a Mole. 836 Tonsil, very large. Removed from a child, 6 years old. 861 Polypus of the Nose, with a portion of the turbinated bone attached. Removed by force. 925 Encysted Tumor, its cheesy contents formed into granular shapes. 930 Polypus Nasi. 404 Sipllilitic Caries of the upper-jaw and nasal bones. 456 Skull of a strong warrior, from Minnesota. COMPARTMENT XXXII. 540 Tumor. 877 NffiVUS MaternilS, ulcerated. From the thigh of a boy 18 years old. 817 Encephaloid Tumor, small, simulating polypus and hoemorrhoid. Removed from the verge of the anus of Miss G. She afterward died of cancer of the rectum. 745 Tumor, removed from the lower part of the abdomen of Mrs. M-----, of New burgh. It was closely adherent to the fascia transversalis. 645 Encephaloid Tumor in a state of ulceration. Portion of it. 460 Tumor, probably cerebriform. Removed by operation. 407 Ovarian Tumor, of small size, attached to the body of the uterus. In the same case there was another enormous sarcomatous tumor, attached to the fundus of the uterus, which weighed over 100 lbs. Vide No. 425. Case published, with plate, in Francis Denman's Midwifery, p. 125 (note), X. Y., 1821. 519 Fibrous Tumor. Removed from amongst the muscles on the back part of the thigh, above the popliteal space, in a youug lady, aged 29 years. It had been growing for several years, and was not painful. She recovered entirely. < 78 Encysted Tumor. 60 COMPARTMENT XXXIII. 727 . Cerebriform Tumor. Removed from the mons veneris of a healthy girl, aged 15 (1844, at Rahway, X. J.) The wound healed well, and the disease has not returned. 504 Encephaloid Tumor, with several of the inguinal glands. Removed from the upper part of the thigh, over the femoral vein, in a middle aged man of vitiated habit. The wound healed. Nothing further is known of the case. 884 Encysted Tumor of the Scalp, containing calcareous depositions. Ex- tirpated at clinique. 904 Adipose Tumor. 423 Scirrhus of Mamma, Removed by operation. 765 Encephaloid Tumor. 865 Carcinomatous Ulcer. Removed from the back of the hand of a fisherman, from "Ward's Island. The wound healed kindly. 883 Encysted Tumor, situated within the superior and posterior border of the parotid gland. Extirpated by Dr. V. Mott, Jr. It was in an old man from Tioga County, N. Y., and was complicated with encephaloid disease. It extended back, and seemed to be attached to the base of the cranium, in tbe region of the foramen lacerum posterius, near the internal jugular vein, by a long pedicle, around which a ligature was passed, and its body removed by the knife. A portion of the parotid was extirpated with the tumor. No return of the disease. 909 Fungus Hffimatodes, from the right thigh of a young man, aged 18, from N. J. Operation successful. 744 Tumor. 173 Cranium of Fay-me-Wau-O, a Ponco Indian woman, Missouri. She died in 1835. Presented by Mr. Cobb, June, 1842. 154 Cranium, from the battle-ground of Waterloo. Collected by me, August, 1835. 131 Cranium. 360 Male Organs Of Generation, including the penis, testes, vasa deferentia, vesicular seminales, and bladder in situ. A beautifully injected preparation. COMPARTMENT XXXIII. 574 Urinary Bladder, ruptured, by a fall upon the abdomen. This unfortunate man, a stranger in the city, had put up for the night at a boarding-house in Wall Street. Having an urgent desire to urinate during the night, and finding no convenience in the room, he made his way down stairs in the dark, opened the back door, and thinking he was on a level with the entry, stepped out, and fell forward down five or six steps upon the pavement, striking on his belly. His moans awakened the family, and he was taken up and brought into the house. I saw him shortly after- ward. He was in a state of general collapse, vomiting, and suffering in- tense pain in the abdomen, which was much distended. On hearing tlie account of the case, I introduced a catheter, and a few drops of urine passed, but no relief was afforded. Sinapisms and friction were used externally, and stimulants given, but no re- COMPARTMENT XXXIII. 61 lief was obtained, and death followed in twenty-four hours—without reac- tion. On opening the peritoneal sac, a large quantity of urine was found extravasated. 774 Urinary Bladder, with enlarged prostate gland, exhibiting the pro- jection of the " pathological lobe" of Velpeau. Removed from Alderman M----, of Thirteenth Street. At the time of death, the bladder contained a calculus of considerable size—as large as a hen's egg- 553 Encephaloid Tumor, (portion of an enormous), involving the arm and thorax, which proved fatal. Removed after death. 752 Encysted Tumor, enclosed in left lobe of the thyroid body. Cyst fibrous and bony; contents resembling softened cortical portion of kid- ney. There was no isthmus connecting the lobes. Taken from a male subject, Feb., 1846. 782 Encysted Tumor, removed from the fold of the groin, in a young un- married woman. It had been mistaken for a femoral hernia. 461 Tumor, from the inside of the cheek of Colonel L-----. It was in an ulcerated condition, and refused to heal; its hardness was incon- siderable, and the discharge from it fetid. It was entirely removed, and did not return. 446 MUCOUS Coat of the Bladder* chronic ulceration, with laminae of cal- careous matter deposited in spots. Accompanied by some en- largement of the prostate gland. 488 " Solid Sarcomatous Tumor," with a slight trace of bone at one point. The reproduced disease in the case of Catherine Buckliew, from whom, twelve years before, was removed an osteo-sarcoma of the inferior maxilla. A portion of the condyloid and coronoid process was then left, being appar- ently perfectly sound, and from these points this tumor grew. It was re- moved from within the mouth without external incision. For original dis- ease, see No. 501, and plates, also Velpeau's Oper. Surg., Vol. II., p. 904. 785 Neuromatous Tumor, removed from the popliteal nerve. This man came to me from the country. I diagnosed the tumor a neuroma,* and recommended its removal. It was exquisitely painful to the touch— sensitiveness truly neuralgic. The specimen was sent to me. 671 Tumor. 962 Portion Of One Side Of the Nates. Disease of the integuments and subcutaneous tissues of Dr. M., of this city. The affection was of about seven years' duration, having begun in a small, hard, and painful point in the integuments. After a while this suppurated imperfectly, induration remaining, and another of the same form and cha- racter appeared. In this way it continued, with occasional ill conditioned suppuralions and hardness at new points, until it became very extensive and loathsome to him. To the feel and in appearance it had very much the character of carcinoma, and such we considered it; but on microscopic examination, by an expe- rienced eye, no cells whatever were discovered, wliich obliges me to say that it was benign. The operation was extensive, exposing completely the largest part of the gluteus maximus, and reaching up to the perinseum of that side. The ex- tensive chasm was drawn a little together by long strips of plaster, and 62 COMPARTMENT XXXIV. then filled with lint, and a roller firmly applied to arrest the blood which was oozing, even though a large number of ligatures had beon applied. There foUowed considerable constitutional irritative fever, which continued tour or five days, until suppuration was established by emollient poultices, lho discharge at first was acrid, irritating, and offensive, and the granulation- looked far from healthy. The whole surface was dressed with Balsam Peru, and over this a yeast poultice. After a few days, the appearance became healthy, and it began to contract and heal. This healthy process continued, and it gradually and kindly healed up, with great improvement of his general health. 444 Adipose Tumor, surrounding the neck of the bladder and extending into its cavity. 575 lymphatic Glandular Tumor, situated over the parotid, and simulating disease of that gland. Removed by operation. 847 Cerehriform Tumor, removed from the thigh of a healthy boy, from New Jersey. The wound healed well, but the disease afterward returned in the groin. 500 Encysted Tumor, removed by operation, from the spermatic cord. This tumor extended from the testicle to the external abdominal ring, and,- with the exception of fluctuation, was very obscure in character. It might have been very readily confounded with an encysted hydrocele of the cord, from which it is difficult to imagine any clear diagnostic marks. The patient recovered entirely. 787 Tumor, anomalous. 479 Encephaloid Disease. 641 Mortification of Toe. Amputation. 581 Circular Callous Ulcer, peculiar to the bottom of the foot. A very obstinate disease. All the cases I have seen have been in hard work- ing men. Excision of the ulcer, and the actual cautery, as well as escha- rotics, pulv. cantharid, sulph. cupri, etc., have all been tried without success. In this case the third, fourth, and fifth metatarsal bones# were disarticulated at the tarso metatarsal articulation. See Hospital Register and Velpeau's Oper. Surg. 536 Circular Callous Ulcer, of the bottom of the foot. Very intractable. Removed by operation. See description of the disease in the N. Y. Hospital F.e<™?ter yob TI. 96 JlPfivtj injected, showing venae cava?, vena azygos. thoracic duct, etc., made when a student of Sir Astley Cooper, at St. Thomas's Hospital, London, 1807. 126 Cranium. 455 Indian Skull, from Texas. From E. Kyle. 127 Cranium of Choctaw Woman, from near Natchez. From Dr. Cornell. 134- Cranium, from Delphi, Greece. COMPARTMENT XXXIV. 437 Urethra, membranous portion, ruptured, with false passage into the bladder. from the imprudent use of the catheter to relieve retention of urine. Death COMPARTMENT XXXIV. 63 took place in three or four days from irritative fever—the result of the urinary infiltration. I was afterward called to see the patient, and suc- ceeded in passing the catheter. 557 Rectum terminating in the bladder. Taken from an infant, who died in consequence of the deformity soon after birth. 598 Bladder, diseased, with enlarged prostate. 684 Bladder of an old man, 70 yearp of age. Calculi. Ho had long labored under vesical disease. The prostrate gland is very much enlarged, especially the third lobe. Eleven calculi were found in the blad- der, also phlebolites in the vesical plexus of veins. 589 Coagulum of Blood from the bladder of an old man. Removed after death. He labored under severe irritation of the bladder simulating stone. The coagulum had existed for some time. 633 Bladder of an old man, who died of chronic catarrh of the organ. 408 Bladder, lacerated wound of. The case of" an old man, with enlarged prostate gland in which an abscess had formed, which, pressing upon the prostatic portion of the urethra, pre- vented the bladder from emptying itself The bladder was torn by impru- dent force used in introducing the catheter to relieve this condition. This is a case in which the suggestion of Colles, of Dublin, to discharge the abscess by means of a trocar introduced from the rectum, would have been applicable, if the prostatic abscess had been diagnosticated. 518 Bladder and enlarged prostate gland. This bladder shows evidences of chronic catarrh. Its coats are very much thickened, and there is calculous deposit on the mucous membrane. 769 Tumor. 563 Fatty Tumor, removed from the upper part of the female breast. 794 Fatty Tumor, removed from the neck. 767 Fatty Tumor, situated in the perinaeum, and extending up to the external abdominal ring. Removed from a man. from Long Island. 661 Adipose Sarcoma, from the thigh. AQ4 Wiwtn Tnmni. nr\^e>-rc\A Kir lrit/iornTnaTi+t! 1l>* UU.fKOV iu^.u., —• -■■■---~j----o~------- PnmAT./.fi v,tt Q*>nro+>r>ri frvvrj tiio gi.de °f the p External Iliac Artery, tied for a gun-shot wound. Death in a few days. Anderson's case -of Halifax. See Anderson's Surgical Anatomy. 667 Artery, showing points of calcareous degeneration. 585 Heart, with morbid adhesion of the pericardium. These adhesions cause terrible pulsations in epigastrio. This specimen, from a young man of 28, is the result of rheumatic pericarditis. He was ex- ceedingly distressed by the throbbing, and died of anasarca. In strength and extent of pulsation the case simulated hypertrophy. 869 Aneurism of the Abrta.' 596 Sac of a Popliteal Aneurism—large. 644 Inner Coat of the Aorta, diseased. 420 Arch of the Aorta, anomalous disposition of arterial branches arising from it. The carotids arise from a common trunk in place of the innominata, and then the left subclavian, and lastly the right subclavian from the same trunk. The right subclavian arises on the extreme left, and passes behind the trachea and oesophagus, between the latter and the bodies of the vertebra, to the right shoulder. 582- Eoagula from an Aneurismal Sac, showing layers, etc COMPARTMENT XXXVIII. 69 801 Encephaloid Tumor in the walls of the left auricle of the heart. Mrf,«^k?UIBt'8 °T; -Shehad her thiSh amputated near the lesser tro- aXthe oLTS11 *%£ dfaeMe (See 8pedmea>' and lied^about one y^r alter the operation. There was no return of disease in the stump 520 Hypertrophy of right ventricle, with tumor of the right auricle 786 TWO Lumbrici, strangulated in the rings of an ordinary dress-hook. Passed by a child. A new vermifuge. 523 • Ulceration of the Rectum. 446 Artificial Anus, from a sphacelated portion of intestinum ileum. 17 7 Head of McGarrigle, showing collateral circulation. A successful injection and careful dissection of a case in which the right car- otid had been tied five months previous. The circulation of the right side of the head, face, and neck is beautifully shown. A unique preparation. 105 Cranium, showing results of siphilitic periostitis. 108 Cranium, with a bullet-hole through the parietal bone. COMPARTMENT XXXVIII. 462 Portion Of Carotid Artery to which a ligature was applied less than twenty-four hours before death. It contained a non-adherent clot. See No. 469. 459 Ovum, of about ten weeks. 458 Heart Of a Foetus, showing the foramen ovale and ductus arteriosus pervious. 428 Femoral Vein and Artery from an aneurism. It occurred in a colored man about 39 years of age, who was received into the N. Y. Hospital with diffused true popliteal aneurism, by which his whole limb was enormously distended to the very ends of the toes, and to at least four times its natural size. There was also a circumscribed true aneurism of the femoral artery, about the size of a hen's egg, just above where the vessel perforates the abductor magnus muscle. See No. 505. There was such extraordinary irritability of the nervous system, that he screamed whenever a fly lit upon his legs. In consultation, it was deter- mined to tie the femoral artery at the usual place for ligature, just above the lower part of the upper third of its course, and this was done by me. On the third day sphacelation took place in the toes and foot, and as it was rapidly advancing, we resolved to give him another chance for his life by amputation at the thigh at the point where the ligature had been ap- plied to the artery. During this operation there was a little hemorrhage (though the artery was not re-divided above the ligature), and to arrest it as soon as possible the femoral vein was also tied. The poor man died in le. any dis- turbance, kindly separated in a reasonable time. I have operated successfully in several cases of spontaneous mortification, but have also failed. My experience is in favor of amputation through the thigh, even though the toes only should be involved in the mortification. The greater the distance from the seat of the disease, the more probability is there of the arteries being in a normal state. This old gentleman re- covered a fine state of health after the operation. 342 Skull, minus the right temporal bone. 89 Foetal Skull. 236 Indian Head, of a male Chippewa. 150 Cranium, from Turkey. COMPARTMENT XXXIX. 409 Cast of the Elbow, showing beautifully the superficial veins. Made by Dr. Isaacs. 91 IleO-CflPCal Valve. A portion of colon and ileum, with ccecum. 359 Irregular Origin of the Right Subclavian Artery. It arises from the left of the arch of the aorta, and passes behind the oeso- phagus. The heart and other great vessels are injected There is no innominata. A rare and beautiful preparation. 191 Arterial Preparation of a child. 71 Valvule Conilivcntes, shown in a portion of small intestine. 72 Another Specimen of the same kind. 88 Ossa Parietalia of a foetus. 75 Bifurcation of the Trachea into right and left bronchus. 371 Prepared Skull. A vertical section showing the processes of the dura matter, and the compartments of the nares. 308 Portion Of Fibula attached to a part of the tibia. 373 Depression of the External Table of the Cranium from a blow, leaving the internal intact. 372 Adult Hydrocephalic Head, with enormous thickening of the cranial bones. 159 Cranium, so sawed as to display the reflections of the dura matter. 215 Aneurism of the Arteria Innominata. 421 Jejunum, arterial injection of it. 420 Intestinum Ileum, fine arterial injection of it. 63 Larynx. 218 Aneurism of the Aorta—injected. 369 Arm, showing arteries, veins, and nerves. A beautiful preparation. 3 Head of a Humerus. 82 Cutis Vera, showing its vascularity. Fine injection. COMPARTMENT XL. 73 368 Natural Skeleton Of a Child, beautifully prepared. There is extensive caries of the bodies of several of the dorsal vertebrae, ac- companied with less projection of the spinous processes than usual. 214 Aneurism of the Aorta. 261 Tibia and Fibula, compound comminuted fracture in the middle third of them. 370 Fracture of the Femur, low down, sawed through to show the old and the new bone. 362 Portion Of the Tibia and Fjbula, showing the appearance long after amputation had been performed. 399 Spine and Ribs curiously deformed, from caries of the former. Some appearance of anchylosis. 52 Lumbar Vertebra;. Caries of the bodies of all of them. 66 Coagulum of Blood between the dura mater and the squamous por- tion of the temporal bones. It is situated over the course of the middle meningeal artery, and was the consequence of rupture of that artery from a blow on the head, causing fracture of the skull. 45 Fracture of Cervical Vertebra;. The spinous processes and lamina? of the third and fourth. 87 Portion of Fractured Tibia. 84 Portion of Inferior Maxilla, necrosed in consequence of fracture from a blow with a brickbat. From skull, No. 139. 463 Small Intestine. A portion of it, injected 63 Larynx. 419 Aneurism of the Aorta. The ascending trunk and arch. A good specimen of enlargements of the artery on all sides, from disease of its coats, and also a rare specimen of true anourism. 422 Mesentery and Intestinum Ileum. Injection of arteries and veins. 418 FflBtal Bladder with penis attached, showing the hypogastic arteries running upon the bladder to the umbilicus. 70 CflDeum and Colon with the vessels injected, showing ileo-ccecal valve and appendix vermiformis. 417 Foetal Sternum with cartilages of ribs. 319 Calvarium of remarkable thickness. COMPARTMENT XL. 257 Distorted Femur, from the Catacombs of Paris. 265 Bones of the Foot of a Cock. 258 Skull of Frederick Greenhouse. Ho was struck with a slung-shot, and from the effects upon his mind was supposed to be insane, and was consequently put in the lunatic asylum, where he died. A post mortem revealed the depression of bone produced by the blow. 74 COMPARTMENTXL. 283 Portion of Parietal Bone. 289 Fragments of Cranium, from Delphi, Greece. 280 TWO Humeri, from Waterloo. 270 Two Scapula;. , . i . c 358 Skull of the celebrated Davy Crocket, from an undoubted source. Sent me, by a professional friend, from Alamo, Texas. 403 Head of a New Zealander. 181 Half of the Head. An injected preparation. 274 Two Portions of Frontal Bone from two skulls, from Waterloo. 255 Fractured Femur, from the Catacombs of Paris. 238 Portion of Frontal Bone of enormous thickness, and also presenting evidences of disease external and internal. 387 Portions of Cranium of extraordinary thickness. 38 Spina Ventosa of head of tibia. 241 Three Fractured Clavicles. 46 Portion of the Sternum and costal cartilages. 219 The Cerebral Ganglionic Nerves. A preparation. 152 Greek Cranium, from the Acropolis at Athens. Collected on the spot. 8 Lower Extremity of a rachitic subject. Curvature of the femur, an- chylosis of the knee-joint, and disease of the tibia. 9 Os Innominatum and part of the femur, from a fatal case of coxalgia. 167 Portion of Fractured SkuU, to which the trephine had been applied during life. 168 Another Specimen of the same kind. 171 Trephined Cranium, comprising a portion of the bones. 394 Arch of the Aorta, with an innominata enormously long. 320 Parietal Bones, with fracture on the right side. 243 Three Metacarpal Bones, fractured. 256 Femur, from the Catacombs of Paris. 112 Cranium of a Peruvian Inca. Procured from one of their places of burial, in the cleft of a rock, on the coast, by my pupil, Dr. Hatfield Smith, while on a voyage of pleasure in the U. S. ship Franklin, Commodore Stewart. 354 Indian Skull, from an individual of the Potawattomy tribe. 374 Caries of the Spine. Anchylosis of the three last dorsal and all the lumbar vertebrae—the sacrum also fastened to the left innominata. 393 Second Dentition, just commencing. French. 267 Os Innominatum, right. From the battle-field of Waterloo. 282 Five Spinal Vertebra;. 147 Cranium of a Flat-head Indian, from Columbia River. Obtained for me by Sir George Simpson. COMPARTMENT XL. 75 385 Arch of Cranium. Extraordinary indentations are shown in the course of the longitudinal sinus, from abnormal size of the glandulae pacchionL 436 Cranium of Witrlieta Chief. From Fort Belknap, Texas. 437 Cranium of the same Chiefs Wife. 438 Cranium of his Son. 157 Cranium, from the Catacombs of Paris. Presented by Dr. St. Antoine. 447 Osteoma from the tibia. 448 Mesenteric Glands affected with ossific degeneration. 268 Sacrum, from the battle-field of Waterloo. 269| Femur, from the same locality. 288 Temporal Bones, two. From Cheronjea, Greece. 271 Two Scapula;. From battle-field of Waterloo. 287 Superior Maxilla, from the same locality. 285 Astragalus, from the same locality. 238 Portion of Frontal Bone, of enormous thickness, and presenting evi- dence of disease, external and internal. 274 Os Frontis, from the battle-field of Waterloo. 307 Exostosis of the Tibia. MISCELLANEOUS, 220 Spontaneous Mortification of the toes and foot, (dry gangrene). Case of Mr. XL, of Westchester. The disease had advanced half way up the leg, when the limb was amputated. I operated during its progress, yet the patient recovered. Specimen in Compartment X. 997 Venereal Disease, exhibiting the frightful and fatal effects of chancre in a young woman. Chancres will occasionally assume this condition in vitiated constitutions, and badly ventilated apartments, but such extensive ulceration of aU the external organs as this specimen exhibits, is very seldom met with. I have known a bubo to destroy not only the femoral vein, but also the artery, so that the patient was* lost from hemorrhage during the night time. In the female, I have seen general destruction of the external organs by phagedenic ulceration, and the rectum so invaded, that it has communicated with the vagina. Persistence in the use of mercury, under circumstances of a high degree of inflammation, or when there is great debility, is apt to produce disas- trous effects. The prepuce of the penis, when highly inflamed, is fre- quently made to sphacelate from its injudicious use; or, when this is not the case, the eating ulceration will destroy quite to the glans, and a num- ber of times I have seen the whole member swept away to the pubes, by this gnawing and frightful process. 1132 Head Of Osceola, the great Seminole chief (undoubted). Presented by Dr. Whitehurst, of St. Augustine. 1132 Phymosis, congenital. Fatal termination. Presented by Dr. Waterbury. From a child about one year of age. The prepuce is enormously elongated, and formed during fife all of the penis anterior to the walls of the ab- domen, being over two inches in length. The glans penis and the erec- tile portion of the organ show no tegumentary covering, as the penis proper was too short to protrude beyond the teguments of the pubes. Three or four successive attacks of erysipelas occurred, involving the right leg, and increasing in severity until the last one proved fatal. Specimen in Compartment XXXVI. 1133 Comutcd Growth from the scalp—extraordinary. Removed by my old friend, Dr. Souberbielle, of Paris. 1134 Carcinoma of the Eye-ball, in a woman about 60 years of. age. An accurate wax model. 290 Skull of an Armadillo. 291 Foot and Leg of the Cock, preserved. 292 Claws of a Testndo Coriacea. 293 Portion of the Jaw of a Shark. 453 Whole Subject Injected—arteries, veins, and heart, in situ. 454 Whole Subject Injected—arteries, veins and heart. 329 Heads of Dogs—three. 1140-41 Skeletons of Domestic Cock and Turkey. Over Compartment XIII. PAINTINGS AND CASTS. ---- Thirty Chinese Drawings of tumors, malignant and benign, on the walls around the Museum. 1135 Paintings of Pachydermatocele, a peculiar tumor of the skin. There are five of them. 344 The Liver, Gall-bladder, Stomach, etc. 345 Internal Parts of the Ear in the human subject. 346 Map of Mensuration of the human body. 348 Map of the Muscles. 349 Map of the Muscles, in the attitude of declamation. 350 Map of Two Skeletons, in the attitude of exciting conversation. 351 Map of a Group of Skeletons, also sections of various bones of the system. 352 Pregnant Females—painting of portions of their bodies, representing dissection. 230 Cast of a Tumor. 231 Dislocations of the Ilip-joint. Sir Astley Cooper's Plate. 232 Plate of the Muscles. (Three figures). 233 Plate of the Muscles. (Two figures). 353 Injected Lungs and Heart, painted, in situ. 223 A Bust. 224 Hydrocephalic Head. A cast from a patient. 225 Bust of Gibbs the pirate. 226 Cast ,of Head, with tumor, for which the primitive carotid was tied. 227 The Same, colored. 228 Duplicate of No. 225. 103 Monstrosity. A wax model. 330 Potts' Disease of the Spine. Kinne's second plaster of Paris cast of A. B., after 3 months' treatment. 335 The Same. Kinne's third cast, after 4i months' treatment. 331 Lateral Curvature of the Spine. Kinne's first plaster of Paris cast of Mary B. B., after 4£ months' treatment. 333 Plaster Of Paris Cast of case 33. Kinne's second. 333 Lateral Curvature. Kinne's first cast of Miss M. P. 334 The Same. Kinne's second cast, after 9 months' treatment. 78 PAINTINGS AND OASTS. 336 Lateral Curvature. First cast of Miss M. V. S. 337 The Same. Second cast. 1139 Malignant Tumor of the thigh and pelvis. Cast from a patient in Williamsburg. Over Compartment XV. 1142 Malignant Tumor of the shoulder. Cast from a patient who died at N. Y. Hospital, 1855. Over Compartment X. 1151 A Bust. 1152 Another Bust. 1143-6 Stomachs of Inebriates. Four paintings over Compartment V. 1147-50 Stomachs of Inebriates. Four paintings over Compartment XVIII. The whole set was presented by Dr. Sewall. AWARDS OF THE MOTT MEDALS, Institute in 1856, AND MADE ANNUALLY FOR THE BEST DISSECTIONS AND CLINICAL EEPORTS IN THE UNIVERSITY OP THE CITY OP NEW YORK. AWARDS IN 1857. Gold Medal, to Robt. F. Carli*, of New York City, for the best Injected Preparation—a Superior Extremity. Session 1856-7. Vide No- 1136, Compartment XV. Silver Medal, to Wm. H. Wilson, of Westchester, N. Y, for the second best Injected Preparation—a Half Head. Session 1856-7 Vide No. 1137, Compartment XV. Bronze Medal, to George S. Hardaway, of Georgia, for the best Report of Cases at a Surgical Clinique. 1856. Vide No. 1138 Com- partment XV Gold Medal, to Clarence Cameron, of Staten Island, X. Y, for the best Injected Preparation—the Head, Neck, and Shoulders. Vide No. 1133, Compartment XV. Silver Medal, to Abbot Hodgman, Mass., for the second best Injected Preparation—the Pelvis and Lower Extremity. Vide No. 1134 Compartment XV. NLM032783553