340 



times very doubtful, being either above or below the 24th or being 

 double. There is little or no remnant of a disc below the 24th. The 

 free portion of the 24th is generally a part of a good ultimate, and 

 the 23d generally a good penultimate. 



IV. When the 24th is the ful oralis, certainly or probably, 

 there is often a secondary promontory below it. The 23d may be a 

 good ultimate or a penultimate, or it may present features of both. 

 Thus the transverse processes may be thick and broad at the root^ 

 like those of a 5th lumbar, and toward the tips they may become 

 light by the rising of the lower border, as in the 4th lumbar. The 

 22d is never a typical penultimate. That of spine 478 is the nearest 

 approach I have seen. Perhaps the 1st coccygeal is more likely to 

 be fused to the sacrum if the 24th be the fulcralis or be much 

 sacralized, but I have great doubts whether its condition is of any 

 value. 



In brief it appears that the spine adapts itself much more easily 

 to an additional praesacral vertebra than to the loss of one. In the 

 former case, assuming that the addition is in the thorax, the 24th 

 vertebra is or may be a very good penultimate lumbar, while in the 

 opposite case it is not. Rosenberg alludes to a case of Tenchini, 

 as possibly presenting this condition. I have not had access to it. 

 In my series there is no perfect case. Both 478 and 267 approach 

 the condition, and present lumbar regions which on the whole are not 

 far from typical, but the more normal condition of spine 764, io which 

 the 26th is the fulcralis, is evident. 



The variations of the 19th and20th vertebrae are so 

 famihar to all that it is enough to say that they are absolutely un- 

 stable. It would be impossible to place an isolated one. A 19th may 

 be a typical lumbar, and a 20th a typical thoracic, 



I do not remember to have seen mentioned the fact that when 

 the last ribs are very small or rudimentary, the pair above them is 

 much longer than a penultimate usually is. This is true whether the 

 last pair be on the I9th or the 20th vertebra. 



Cervical, rudimentary 1st Thoracic, Bicipital and 

 Tricipital Ribs. The anomalies of the region at the top of the 

 thorax are both more interesting and more difficult than those at the 

 bottom. There we have just seen that one vertebra may perfectly 

 resemble another of a ditierent numerical position ; here it is more 

 doubtful. From the study of these spines and the writings of others, 

 it appears that there it at least one type of a rib which is seen only 



