502 PEOFESSOK BERTRAM C. A. WINDLE 



IV. Head and Neck. 



Haxsemann (xxxii.) gives a description of two sisters of 2h and Ih 

 years old respectively, affected with microcephaly. The skulls were 

 very small, but the condition was not one of nanocephaly but of 

 extraordinary smallness of the brain chamber, the brain itself being 

 also clearly microcephalous. There was a reduction in the convolu- 

 tions and a quite re i arkable deficiency in development of the so- 

 called association centres, whilst the so-called projection centres were 

 fairly well developed. The insula was not exposed. There was also 

 an extraordinaiy amount of rachitis present, with many periosteal new 

 formations affecting the skull as well as other parts of the skeleton. 

 The question is raised as to the relationship between the two con- 

 ditions. The microcephaly is the result of an intra-uterine disturbance, 

 though a late one, Avhilst rickets affecting the skull has never yet 

 been described as a congenital disease. The author thinks that the 

 two conditions are quite independent of one another in the case in 

 question. Onodi (xxxiii.) describes a case of anencephalus in which 

 the child lived for sixty-one hours. The medulla and pons were present, 

 but not the cerebrum or cerebellum. Several members of the mother's 

 family had borne anencephalous monsters. Caeacachb (xxxiv.) 

 records a case of anencephaly in which there was no spinal fissure. 

 The face was, however, cleft down to and through the ujjper lip and the 

 roof of the mouth. In a case of twins, one of which was normal, 

 Fleischer (xxxv.) found the other to be a7ie7ice23halov>i or pseuden- 

 cephalous, and there was a connection between the membrane covering 

 the top of the head and the amnion. The left nostril was normal, 

 but the right was replaced by a cleft which passed upwards towards 

 the inner can thus of the eye. Mouchotte (xxxvi.) gives an account 

 of a case in which there was congenital miion hehceen the atlas and 

 the occiput. This was clearly not a late union, for the connection 

 between the two was by a true dentate suture. A similar condition 

 has been described in three cases by Eegnault (xxxvii.). In the 

 first, the left half of the anterior arch was alone united to the skull ; 

 in the second, the anterior and posterior arches were united, but only 

 on the right side. In the third case the anterior and posterior arches 

 were united to the occiput on the left side, and the outer part of the 

 ap.terior portion of the right arch was also joined to the same bone. 

 Marion (xxxviii.) describes a case of absence of the left half of the 

 squamous 'part of the occipital bone in a man aged 18i. It was 

 congenital in its nature, and the impulse of the brain could be felt at 

 the spot at each beat of the heart. Schmidt (xxxix.), in a paper on 

 rare clefts in the region of the face, gives the following instances : — 1, 

 A congenital mucoid cyst of the root of the nose with pug-nose; 2, 

 a true median fissure of the upper lip; 3, a case of arhinencephaly ; 

 4, a gliomatous tumour of the back of the nose. Apeijt (xl.) records 

 a case of bifid uvula, where there was also double hare-lip but no 

 alveolar or palatine cleft, in a male aged 36. There Avere also dental 



