216 Appendix. — Account of the Siamese Twin Brothers. 



Anotlier question which has presented itself in relation to them, is, 

 whether it would be possible to separate them from each other witli 

 safety. There seems to me nothing in the connecting medium, 

 which would render such an operation necessarily fatal. It is not 

 improbable that the peritoneum is continuous from the abdomen of 

 one to that of the other. The division of this membrane would in- 

 volve some danger, though not very considerable. The attempt to 

 separate them, does not, however, appear to me to be authorized un- 

 der existing circumstances. Surgeons are justified in putting the life 

 of an individual at risk, when it becomes necessary in order to re- 

 lieve him of a menacing disease ; but it would not be proper to haz- 

 ard life, in order to procure some convenience, however desirable 

 this might be. When the minds of these boys have been sufficiently 

 ^jultivated to enable them to understand the nature and dangers of an 

 operation ; and the advantages they would derive from it, the sub- 

 ject might be presented to them ; and if, with a full knowledge of the 

 consequences, they desired and demanded tlie separation to be ef- 

 fected, it might be proper to undertake it. Should one die before 

 the other, they should be cut apart immediately. The success of 

 the operation would, of course, be affected by the nature of the mor- 

 tal disease, and its influence on the constitution of the survivor. 



A union of the bodies of twins by various parts, is not an unusual 

 occurrence. The collections of anatomists present many such ob- 

 jects. Ambrose Pare has depicted for the entertainment of his rea- 

 ders, instances of union by the back,- belly, and forehead. The last 

 occurred in two girls, who lived to the age of ten years, when one of 

 them dying, a separation was made ; the wound of the living girl as- 

 sumed a bad character, and soon proved fatal. The Hungarian sis- 

 ters, who lived about a century since, were united by the back ; had 

 one passage from the Intestines, and one from the urinary organs. 

 They died when they were twenty two years of age. In the Philo- 

 sophical Transactions and various other works, a multitude of similar 

 monstrosities are recorded ; most of them born dead, or dying soon 

 after birth. 



The Siamese boys, present, I believe, the most remarkable case 

 of this lusus natura, which has yet been known, taking into view the 

 perfection and disdnctness of their organization, and the length of 

 time they have lived. Their health Is at present good ; but it is pro- 

 bable that the change of dieir simple habits of living, for the luxuries 

 they now obtain, together with the confinement their situation neces- 

 sarily involves, will bring their lives to a close within a few years. 



