Congenital Anomalies of the Heart 29 



divides into aorta and pulmonary artery as in Clark's (1885) 

 case. Rokitansky reported a somewhat more interesting case in 

 which, in addition to the above condition, a remnant of aortic 

 septum was present in the common trunk. Defects of the septum 

 spoken of as communication between the aorta and pulmonary 

 artery no doubt represent minor disturbances in the develop- 

 mental process. 



Persistent truncus communis is always associated with defect- 

 ive development of the ventricular septum and in 70 per cent, 

 there is also defective atrial septum. There are no characteristic 

 clinical symptoms belonging to the condition. While the anomaly 

 adds to the embarrassment of the circulation, it is difficult to say 

 how much since there are so many other factors to consider. In 

 cases occurring in single ventricled hearts the average age was 

 slightly more than two months, while in the cases associated with 

 simply defective ventricular septum the average was slightly 

 more than three years ; in the first group the maximum age was 

 ten months, in the latter nineteen years. Cyanosis was present 

 to a greater or less degree in over one third of the cases. The 

 following list shows the condition present in 4.8 per cent, of all 

 hearts studied. 



Wilson (1798), Standert (1805), Farre (1814), Meckel (1815), Laurence 

 (1837), Stoltz (1841), Foster (1846-8), Ramsbotham (1846), Clark (1848), 

 Toynbee (1849), Hyernaux (1851), Vernon (1856), Clar (1858), Bernard 

 (i860), Hervieux (1861, Buchanan (1864), Bradley (1873), Pott (1879) 

 2 cases, Ribinson (1881), Barand, Barry et Rachet (1884), Barbillon 

 (1886), Clark (1884), Muhr (1889), Preisz (1890), Charrin et LeNoir 

 (1891), Bellot (1895), Gallois (1896), Cade (1897), Martin (1897), Pet- 

 schel (1897), Civatte (1900), Cautley (190-2), Spalverini et Barbieri 

 (1902), Wright & Drake (1903), Rispal & Bay (1904), Elsbergen (1905), 

 Krausse (1905), Hand (1908), Wenner (1909) 2 cases, Knope (1912), 

 Dickson (1913). 



B. Defect of the Aortic Septum 



These cases are characterized by a communication between the 

 aorta and pulmonary artery above the semilunar valves. In 

 almost half of the cases there are other defects of the heart. 

 The average age is 3 years i month, the maximum age 25 years. 

 The lesion produces no symptoms (Livingston 1883), and is with- 



