EXCISION OF THE RIBS 
595 
aware that it has been performed by any other British veterina¬ 
rian. These c^ses will occupy a few pages ; but after the reader 
has perused them he will be in possession of all he wishes to 
know respecting the excision of the ribs.—Y.] 
The following is the account of Sign. Cittadini’s operations on 
the human subject, as extracted from .4////. Univ. di Mediciua. 
“ The first case is that of a female, who had for a long time been 
affected with fistulous ulcers, caused by improper treatment of 
an absess on the left breast. Several methods of treatment, the 
actual and potential cautery, &c. had been tried, but without any 
effect; and when M. Cittadini first examined the fistulous canals 
he found a portion of the sternum, and the cartilages of the 
sixth and seventh rib, denuded. These parts were laid open by 
an incision, and it was found that the sternum was carious to the 
extent of more than an inch, and that the cartilages were consi¬ 
derably swelled, and in some cases perforated. In order to pro¬ 
duce exfoliation of the bone the actual cautery was employed, 
which caused a violent indammation of the pleura, but failed in 
its main object. Six months after this period a large quantity 
of matter had gradually collected in the pleura; the patient was 
affected with constant pain and dyspnoea, and was much ema¬ 
ciated. M. Cittadini having laid bare the bone a second time, 
found a fistulous passage between the sixth and seventh rib, lead¬ 
ing into the cavity of the chest. He divided the muscles, tied 
the intercostal arteries by means of a curved and blunt-pointed 
needle, and removed those parts of the two ribs which were com¬ 
prised between the ligature and the sternum. A large trephine 
was now applied to the diseased part of the sternum, and all the 
isolated parts, by means of a spatula, removed from the pleura, 
which, although diseased to a great extent, could not be removed 
on account of the great proximity of the internal mammary 
artery. The operation lasted a considerable time; and on the 
introduction of air into the thoracic cavity a violent attack of suffo¬ 
cation took place, from which the patient was recovered by fric¬ 
tions, and the insufflation of air into the lungs. The wound was 
quickly covered with dossils of lint, which were kept in their 
place by an elastic bandage. During two months the patient 
laboured under dyspnoea: the wound having, however, cicatrized, 
this symptom gradually disappeared, and she was finally cured.” 
The second case was that of a young man who had, for a con¬ 
siderable time, a fungous tumour on the cartilages of the sixth, 
seventh, and eighth ribs, about an inch from the xyphoi'd car¬ 
tilage. Repeated cauterization and excision having been per- 
