work of the evil spirit. The laws of ancient Greece and Rome required them to be put to death; even as late as the seventeenth century, they were either killed or secluded from sight, and in this century, in some countries, they were confined in certain limits. Happily for this unfortunate class of beings, with the light of science— the guiding and unerring star of hope-a brighter day dawned. In this enlightened century, they are by the general public, gazed upon only as curiosities; pandering to a morbid taste to see the irremediable deformities of a fellow-being. To the lover of medical science, whose mission now is: First, to acquaint himself with the structure of the human body and the sciences based thereon; next, to know when to interfere with and when to let nature have her course; they present a study of peculiar interest in the departments of anatomy, physiology, pathology, obstetrics and surgery.

Three theories have been advanced to account for the cause of double monster, which Vorlick states as follows:* First. The double monster is supposed to have proceeded from two distinct embryos, which have become united in the course of development.

Second. It has been thought to originate in a single germ, which has become double, or has become subdivided.

Third. The germ has been regarded as abnormally compound from the beginning, implying that the organs and parts composing the double monster are at once produced from this germ, without either separation or coalition of its parts, other than belongs to the natural process of development.

Of these theories, it would appear to the writer, that the third is the most natural and rational-that double

*Obstetrical Transactions, Vol. II.

monsters are ab ovo-developed from an original double germ. The first is discarded from the fact that doubleyolked eggs, when brought to incubation, as was done by Prof. Allan Thompson, M.D., never produced joined twins. Nor would this mode of production account for ore or more of the vital organs being common to the two, while all the other organs are duplicated. The second theory predicated on the division of a single germ, appears untenable, although Prof. Thompson demonstrated such a division in the egg of a goose after five days' incubation, which condition, if developed, would produce two united living creatures; but we have no record to show that any segmentary division of a primitive single germ ever matured. The law might apply to some of the lower orders of animal life in which, if a part be removed from a matured body, an exact analogue will be reproduced.

This segregation does not pertain to mammals; it is true, the latter are, the viscera excepted, originally developed in two lateral symmetrical halves, which ultimately unite to form the perfect being, but it seems entirely incredible, that the lateral halves of an originally single germ should, by mere excessive growth, develop two perfect individuals, joined only by some part of the osseous structure or soft tissue, when there is no power to reproduce a limb or an organ that has been removed by accident or disease. A legitimate reasoning from this hypothesis would lead us to expect ordinary, separate, perfectly formed twins, from a primary division of the nascent germ; for if the division could produce two united, there is no reason why an entire separation would not develop two separate foetuses, whether there existed either one or two umbilical cords. Were such a division the result merely of accident or excess of growth, we would, out of the great family of mammals, see more

frequent departures from nature's common laws, whereas this compound class or type are exceedingly rare in comparison with the aggregate number of births.

The limits of this article will not permit a relation of the minute classifications of monstrosities. It will be sufficient for our purpose to state, that the following case belongs to that tribe of compound monsters, which Geoffroy St. Hilaire calls autositaires-two individuals equally developed and having life in common. This tribe represents two varieties, first, where the umbilicus is double; the union being effected at any portion of the trunk or head. To this class belong the black twin sisters of North Carolina, now living; the celebrated Hungarian sisters, who died at the age of twenty-two, and a few similar pairs; each pair being united by a lower part of the spine or sacrum.

The second variety, representing those having one single or common umbilicus, are united by the soft parts of some portion of the abdominal or thoracic walls, or both.

This latter mode of union is by far the most frequent and hence of greater professional interest, which is my apology for adding one more to the list already recorded

For the privilege of presenting to the profession this interesting case of joined twins, I am indebted to my friend, Dr. E. C. Bright, of Eminence, Ky., who was kind enough to present them to me in the spring of 1865. The Doctor informs me he was called to see the mother, a mulatto, aged twenty-eight years, in this, her third confinement, March 29th, 1865. The labor commenced about 7 o'clock P. M., and terminated about 12 o'clock, midnight; the entire labor embracing 'but five hours. The mother had no unusual symptoms, and was not unnaturally large during the pregnancy. The children were living when labor commenced, but died before

delivery was accomplished. He first saw the patient about 8 o'clock P. M.; the head of the presenting fœtus occupied the first position, and was, in a few minutes, delivered; it respired two or three times, when life ceased. No further progress being made, as is usual, at this stage, he made a thorough examination, and detected the presence of twins. Still failing to effect further delivery, he called Dr. D. N. Porter, of Eminence, in council. By this time the uterine contractions had forced down the head and shoulders, sufficient to detect, by a digital examination, the existence of a connecting band. Traction, with forceps, was then made on the head of the present ing fœtus, which force, with other manipulations, brought down the nates and feet; the time occupied about one hour. The second foetus, head also presenting in the first position, was delivered soon after without any manual aid. The single placenta, larger than common and having but a single umbilical cord, was removed at the usual time, and the mother rapidly convalesced without any after treatment. I have been unable to ascertain whether the mother has borne any children since. Dr. B. injected them, through the common carotid arteries, with a solution of the chloride of zinc and had a photograph taken, of which, plate No. 1, is an exact copy. Since they came in my possession, I have kept them in a solution of the same material. At present they are well preserved, without offensive odor, and all the tissues, organs and muscles are dissected with facility. Previous to making any dissections, a solid injection was thrown into the vessels through the common umbilical vein and common carotid arteries by Geo. J. Cook, M.D.

The twins were born at full time, sex male, general physique, except at the bond of union, perfect, height of each nineteen inches; conjoined weight, 48 hours after

birth, 13 pounds.* The connecting band extends from the

zyphoid cartilages downwards

to a point where the natural umbilicus should be; the skin. is continuous on each surface with the corresponding abdominal walls, natural in appearance and without any trace of a median line or raphe between them. The band measures in its vertical diameter 4 inches; transverse at the sternal border 1 inches, at the umbilical border 2 inches; thickness through the lower half of an inch, upper half 1 inch. There is but one common umbilical cord,

*PLATE NO.1.-Anterior view which enters at the centre of from a photograph, as they ap

peared after birth. R and L. the inferior border of the band, Right and left foetus. a, con

necting band. b, superior or thus forming one single umsternal margin. I, inferior or bilicus for two beings; it is na

umbilical cord, entering the cen- tural in size and appearance, tre of the lower margin at the common umbilicus C. and is composed of one common umbilical vein and four hypogastric arteries with the usual envelopes.

Dissection. A vertical incision was made in the mesian plane of the band, and transverse incisons at each border, dividing the skin and superficial fascia. The flaps being reflected, the zyphoid cartilages were found to connect in the centre, forming a section of an inverted arch between the twins, one half an inch in width and one line in thickness. A common linea alba, formed by the tendons right and left alternately of the broad abdominal muscles, extended from the junction of the cartilages down to the point at which the umbilical cord entered; here it bifurcated, one branch extending to the