APPENDIX. 411 



M. Alfred Duvaucel, M. Dussumier, M. Ehrenberg, M. Tilesius, M. 

 M. Langsdorf, Temminck, Risso, Bonnelle, Savigny, Biberon, 

 Leach, De Rignyj Bailie, Polydoie Roux, D'Orbigny, Garnot, Bail- 

 Ion ; and several other gentlemen are mentioned, who assisted in px'o- 

 curing the author many specimens (a). 



O:^ (a) As a preat many new principles have been disclosed by comparative 

 anatomy, which apply to the illustration of the anatomy of man, we feel it to be only 

 our duty to give the latest of the very curious and important facts, ascertained re- 

 specting the relations of the peculiar structure of fishes, to that of man. The fol- 

 lowing statement is taken from the work of a Berlin medical gentleman, only recently 

 published in that city ; and it is upon the subject of the branchial openings of the 

 human foetus, as a cause of malformation. 



On the Branchial or GiU-like OpcnirKjs in the Neck of the Human Foetus, as a caiise of 

 certain Malfoymations. — M. Ascherson, the'aiithor of this memoir, lately published 

 in Latin at Berlin, has called the attention of his medical brethren to a curious con- 

 genital anomaly, or "vitium formationis," which he has obsei-ved in several persons. 

 The number of cases altogether amounts to eleven ; and most of them occurred in 

 female children, of a scrofulous, or at least of a lymphatic constitution. The authen- 

 ticity of most is guaranteed by the testimony of that able physiologist Rudolphi. 

 The following may be given as a brief description of the disease : — On the anterior 

 and lateral part of the neck there is observed a fistulous opening, which is situated 

 generally in that triangular hollow between the clavicle and the two points of inser- 

 tion of the sternomastoideus ; but sometimes it is at the inner edge of this muscle. 

 It is much more frequently found on the right than on the left side ; and if there 

 should happen to be one on either side, that on the right is always larger and placed 

 somewhat higher up than the other one. The aperture is invariably very narrow ; 

 occasionally scarcely visible, but at other times it is surrounded with a red circle, or 

 it may project like a papilla. It generally follows the movements of the pharynx in 

 deglutition, and when this is the case, we observe a transverse furrow, at the bottom 

 of which is situated the fistulous opening. If a probe be introduced, it may perhaps 

 be pushed forwards a little way, but in most of the cases it is stopped very soon, in 

 consequence of the sinuosity of the canal. In one case, fluid, injected at the outer 

 opening, passed into the pharynx, and the patient was sensible of its taste ; and in 

 another, the attempts made to cure the fistula in this way were followed by disagree- 

 able consequences, such as swelling of the neck, smarting pain, and the sensation as 

 if a foreign body was sticking in the pharynx. On no occasion was any air ever ob- 

 served to escape from the opening, even whenthe effort of respiration was strong, 

 while the mouth and nostrils were kept closed. The discharge from the fistula was 

 sometimes viscid and clear, and at other times, more of a purulent appearance ; and 

 it was remarked that in the latter case, the quantity of the discharge was always 

 more profuse. Although this disease be congenital, it may increase after birth be- 

 yond its original extent. Eight of the cases seen by Dr. Ascherson, occurred in fe- 

 males, and three in males. These fistulie now described have some analogy with the 

 tracheal fistulae recently discovered and explained by M. Dzondi ; but the origin and 

 the anatomical characters of the two are very different. In order that we may com- 

 pare them, we have extracted the following remarks from Dzondi's narrative: 



"At the anterior part of the neck, about the middle of the concave edge of the 

 thyroid cartilage, there is found a small round opening, of about a line in diameter ; 

 its edges are neither red, tumefied, nor surrounded with any fleshy rim. It is not 

 painful on being touched ; and when firmly compressed, several drops of a puriform 

 fluid may be made to flow out. A probe cannot be pushed very deep, in consequence 

 of the winding track of the fistula, and on no occasion can it be introduced into the 

 trachea, although a few bubbles of air almost always escape upon any forcible srepi- 

 ration." 



These tracheal fistulse may be associated, or occur in connexion with other congeni- 

 tal anomalies or irregularities of formation ; especially with those which arc denomi- 

 nated " monstrosities from asyraphysis," that is, from an incomplete junction of the 

 two lateral halves of the body. We cannot, however, take the same view of those 



