44 C. W. M. Poynter 



man (1869); and Crocker (1879) the homologous condition in 

 situs viscerum transversus. 



Duchek (1862) reported a very interesting condition in which 

 the right pulmonary veins opened into the right ventricle. 



B. Systemic Veins. — Occasionally two superior venae cavse are 

 encountered. In these cases the right opens into the right atrium 

 in the normal way, while the left enters the right atrium through 

 the coronary sinus. This is a case of persistence of the left duct 

 of Cuvier and part of the anterior cardinal vein ; cases are not 

 infrequent. 



Longhurst ( 1874) reported the inferior vena cava entering the 

 left atrium and Crocker (1879) and Miura (1889) observed the 

 superior vena cava entering the same chamber. Cases in which 

 both superior and inferior vense cavse entered the left atrium 

 were reported by Jacoby (1884) and Lucien & Harter (1907). 

 Barbo (1900) saw the superior and inferior vense cavse open into 

 the right atrium in a case of situs viscerum transversus. 



§ XVII. . 



CLINICAL CLASSIFICATION 



In discussing the difficulties of classification I have already 

 pointed out that to properly understand the congenital heart 

 anomalies it is necessary to study each lesion independently of all 

 others which may be present. The first section of this study has 

 been taken up with the examination of each anomaly which this 

 collection of hearts has furnished, and considering each without 

 regard to any other irregularity which may be, occasionally or 

 frequently, found in association with it. 



In this section the cases are regrouped according to the differ- 

 ent lesion complexes which they present. I have used the defects 

 of the cardiac septa as the leading lesions simply because they 

 are of frequent occurrence, any other scheme would lead to the 

 same results. Many simple conditions which have been fully 

 treated in the first part are omitted here to avoid repetition. The 

 more exact distinctions in lesions, as the position of a defect of 

 the interventricular septum or of pulmonary stenosis are not at- 



