, 1874-02-21
CHANG AND ENG,
Result Of the Anatomical IlVestiga-
ton by the Philadelphia
Doctors.
Report to the College Of Physicians
Of That City.
The Surgical Aspect Of the Case Chiefly
DWeIt Upon.

Special Dispatch to Tie CHICAGO Tribune
PHILADELPHIA, Feb. 20.-Below is given an
extract from the scientific report Of Dn5. Pan
coast and AIisn on tie Slamese TWINS before
strictly secret session Of the College Of
Physiciaps OF Philadelphia. Tho bodies of the
6amese Twins being upon the table. the meeting
proceeded to hear the report of Drs. Pancoast
and Alien, on behalf of tho Commission:
DR. PAScoAsr
stated that the dissection not having been en-
tirc1y completed, their report would be verbal
one, to be follow ed at some later date by 4 me-
mo:r upon the subject. He further remarked
that it had been agreed that lie should consider
chiefly the surgical aspect OF the matter in hand,
while to his colleague had been assigned the
demonstration Of the anatomical pecularities.
TILE FEATuRE OF GREATEST INTEREST
is conn ecied with this band, about inches long
and 8 inches in circumference. In addition to
1his, til ere are other points OF Importance in
teratology. in regard to the fultillment of the
Law Of homolagous union, in relation to tla
lunctu1e Of the rccti muscles, and the fascim Of
the obliQuus and transyerealls ut their point OF
meeting in the centre Of the band.
In regard to the position OF the hearts, VIC
think their apiccs present toward each other,
but We havo not yet opened the thorax. The
iyers we have found to approximate to each
other. and to push through tho respective peri
toneal openings into the band. We extended our
tncisions to the margin Of the band i'll front. By
placing my hand in the peritoneal cavity of Eng.
and my colleague placing his hand IN the peri
toneal cavity Of Chang, We pushed before us
processes Of peritoneum which ran on to the
mcdian line OF the baud, aud we could feel our
fingers in tho lower portion Of the band behind
the median liuc with distinct layer of perl
toneum between them. demonstrating ut once
tho
pao1oSaAT1oN OF THE pER1roSEUM INTO THE
BAND,
and the complete separation OF one peritonea1
cavity from the other at this median line. Above
tila1 NO felt some traces Of vascular connection,
apparently running from one liver to the other, !
but this Te will examine into when We lnge q
better opportunity Of carefully dissecting and !
examining what vascular structures may exist. |
We also noticed that, in turning OF the flaps, !
consisting OF tue anterior walls OF the abdomen,
the hypogaEtric arteries, as illustrated by the |
diagram on the blackboard, ran upward in each |
body into tho band. We lost them in this way, |
as We think, toward the common umblicus in !
the anterior interior sutfacs Of the middle OF |
the band. 1t is probable that the two hypogas- !
tric arteries Oh each side passed through this /
umbHcus. Whether or not there We're tTo
USBLlCAL VEINS,
VIC have nos yet been able to decide, nor to an !
swer the question whether the u1nbl1cal cord |
was double or single and composed Of the four !
hypogastric arteries and two umbihcal veins, Or
whether the p1acen:a was single, double, or |
twin. We also recognize that
TILE ESs1FoRM APPENDIX
II each side was prolonged and united in the !
middle nne-
Ou our later examin alton. we find that there |
q complete continuity of structure of the carti
t;3cs hut true joint ut the middle line, al |
;hough it is possible there may be some synovial
,acs further up. The motion is mainly due, as T I
aero demonstrate to you by moving these bodies |
acc:cd ensiform appendices aud intervening /
:Gbre carriages.
In regard to the vascular I
CoENEcT1oS OF TIE BAND, ]
20 have not yet been able to mako go thorough |
md careful an examination at ne wished. But |
still, in throwing colored plaster into tho portal |
circulation of Chang, it has been found to flow
through the vessels Of the upper part of the |
band into the portal vessel Of Eng, 30 that the |
surgicul anatomy Of tho baud consists in the I
Bkin AMI fascla which cover it, the
sNo separate peritonecal pouches which
meet in tie middle the 1arge peritoueal pouch,
the vascular counectlon-to whatever extent
that may e1ist-bctwccu the two portal circula-
teries in the lower portion Of the baud. Thus
the main difficulty III any operation for section
OF the band would seem to be in regard to the
peritoneal processes and the portal circuIations.
The anaEtonosis, which may exist between the
internal maumary arteries and the lutercosta1s
in the intesument in the upper portion of the
baud Of course would present no difficulty.
OPERATIONS ON TIE PEn1ToSEuM
may not be considered 80 hazardous in this daY
when ovariotomy, gastronomy. and even cnsar-
ean section, arc 80 often performed. The peri
toneum pouches themselves would not present
so great q difficulty as might be anticipated I'LL
der pressure, By which the senstiycneas Of tho
structure might be 80 altered as to permit Of
section.
1 vas informed at Mount Airy that in Paris
surgeon had made the experiment Of applying
pressure upon the band. and it WAS reported tho
twins had fnintcd in consequence. could not
however, whether this WAS from de-
sign or actual pain.
PECULIARITIEs OF TIE TWINS.
As Dr.. Hollingsworth is present it may be
proper for mo to mention fact which
hat gentleman can corloco:ate, that Egg
Sns the stronger physically, and Chang was the
stronger mentally. The same difference was |
observable in their characters Chang was more |
irritable than Eng, especially since an attack Of
}araly5s With which he lad been afflicted, this I
icing in the eido next to Eng. Tho Inter had
lot only to bear with the rritability OF weight
!1nong other poculiaritics Chang would some
ines break useful articles or throw them in the |
ire.
In conclusion, let ne say that when l turned
p the skin and superficial fascia Of the incision
q tho poEterior part Of the bRnd+ WAS struck |
nth the development and the strength Of the
bdomina1 aponeuroses. Tho fbrcs archcd. in-
erlaced, and developed into strong fbrous
and about quarter Of an inch wide, running
round the median line, although there WAS no
ctuI joint in the cartilage.