r^%. 
 
 IMAGE EVALUATION 
 TEST TARGET (MT-3) 
 
 2^ 
 
 ^ 
 
 
 /. 
 
 K, 
 
 y. 
 
 1.0 
 
 I.I 
 
 1.25 
 
 ld£|2.( 
 1^ . 
 
 |||2.5 
 
 1^ li^ 
 
 1^ 
 
 t m 
 
 
 IIJ£ 
 
 
 
 
 11^ 
 
 1.4 
 
 ill— 
 
 <p 
 
 ^ 
 
 p> 
 
 
 
 
 Photographic 
 
 Sciences 
 Corporation 
 
 23 WEST MAIN STREET 
 
 WEBSTER, N.Y. 14S80 
 
 (716) 872-4503 
 
 
CIHM/ICMH 
 
 Microfiche 
 
 Series. 
 
 CIHIVI/ICIVIH 
 Collection de 
 microfiches. 
 
 Canadian Institute for Historical Microreproductions / Institut Canadian de microreproductlons historlques 
 
Technical and Bibliographic Notas/Notaa tachniquM at bibliographiquas 
 
 The Institute has attempted to obtain the best 
 original copy available for filming. Features of this 
 copy which may be bibliographically unique, 
 which may alter any of the images in the 
 reproduction, or which may significantly change 
 the usual method of filming, are checked below. 
 
 □ Coloured covers/ 
 Couvertura de coLiour 
 
 pn Covers damaged/ 
 
 D 
 
 Couverture endommagAe 
 
 Covers restored and/or laminated/ 
 Couverture restaur^ et/ou pelliculAe 
 
 I I Cover title missing/ 
 
 D 
 D 
 D 
 D 
 D 
 
 D 
 
 □ 
 
 Le titre de couverture manque 
 
 Coloured maps/ 
 
 Cartes giographiques en couieur 
 
 Coloured ink (i.e. other than blue or black)/ 
 Encre de couieur (i.e. autre que bieue ou noire) 
 
 Coloured plates and/or illustrations/ 
 Planches et/ou illustrations en couieur 
 
 Bound with other material/ 
 Relii avec d'autres documents 
 
 Tight binding may cause shadows or distortion 
 along interior margin/ 
 
 La re Mure serr^e peut causer de I'ombre ou de la 
 distorsion le long de la marge int6rieure 
 
 Blank leaves added during restoration may 
 appear within the text. Whenever possible, these 
 have been omitted from filming/ 
 II se peut que certaines pages blanches ajouties 
 lors d'une restauration apparaissent dans le texte. 
 mais. lorsque cela itait possible, ces pages n'ont 
 pas it6 filmies. 
 
 Additional comments:/ 
 Commentaires supplimentaires: 
 
 L'institut a microfilm^ le meilleur exemplaire 
 qu'il lui a iti possible de se procurer. Les details 
 de cet exemplaire qui sont peut-Atre uniques du 
 point de vue bibliographique, qui peuvent modifier 
 une image reproduite, ou qui peuvent exiger une 
 modification dans la m^thode normale de filmage 
 sont indiquis ci-dessous. 
 
 I I Coloured pages/ 
 
 v/ 
 
 D 
 
 Pages de couieur 
 
 Pages damaged/ 
 Pages endommagies 
 
 T 
 t( 
 
 □ Pages restored and/or laminated/ 
 Pages restauries et/ou pelliculies 
 
 Pages discoloured, stained or foxed/ 
 Pages dicolories, tachetdes ou piquies 
 
 [~n Pages detached/ 
 
 Pages d^tachies 
 
 Showthrough/ 
 Transparence 
 
 Quality of prir 
 
 Qualiti inigale de I'impression 
 
 Includes supplementary materit 
 Comprend du matdriel supplimentaire 
 
 Only edition available/ 
 Seule Edition disponible 
 
 r~l Showthrough/ 
 
 I I Quality of print varies/ 
 
 nn Includes supplementary material/ 
 
 r~~| Only edition available/ 
 
 T 
 
 P 
 
 o 
 fl 
 
 C 
 b 
 ti 
 
 s 
 o 
 fl 
 • 
 o 
 
 T 
 s 
 T 
 v« 
 
 IV 
 dl 
 ei 
 b( 
 ri< 
 r« 
 m 
 
 Pages wholly or partially obscured by errata 
 slips, tissues, etc., have been refilmed to 
 ensure the best possible image/ 
 Les pages totalement ou partieliement 
 obscurcies par un feuillet d'errata, une pelure, 
 etc., ont 6t6 film6es d nouveau de facon d 
 obtenir la meilleure image possible. 
 
 This item is filmed at the reduction ratio checked below/ 
 
 Ce document est filmi au taux de reduction indiqui ci-dessous. 
 
 10X 
 
 
 
 
 14X 
 
 
 
 
 18X 
 
 
 
 
 22X 
 
 
 
 
 26X 
 
 
 
 
 30X 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 J 
 
 
 
 
 
 
 
 
 
 
 
 
 
 12X 
 
 
 
 
 16X 
 
 
 
 
 20X 
 
 
 
 
 24X 
 
 
 
 
 28X 
 
 
 
 
 32X 
 
 
Th« copy film«d h«r« has b—n raproducMl thanks 
 to tho Qonorotity of: 
 
 Medical Library 
 IMcGIII Univeraity 
 IMontreal 
 
 Tho imagM appaaring hara mn tha baat quality 
 posaibia cunsidaring tha condition and lagibility 
 of tha original copy and in Icaaping with tha 
 filming contract spacifications. 
 
 Original copiaa in printad papar eovara ara fiimad 
 baginning with tha front eovar and andikig on 
 tha laat paga with a printad or iiiuatratad impraa- 
 •ion, or tha bacic covar whan appropriate. Ail 
 othar original copiaa ara fiimad baginning on tha 
 firat paga with a printad or iiiuatratad impraa- 
 •ion, and anding on tha laat paga with a printad 
 or iiiuatratad impraaaion. 
 
 Tha laat racordad frama on aach microficha 
 shall contain tha symbol — ^ (moaning "CON- 
 TINUED"), or tha symbol V (moaning "END"), 
 whichavar appiiaa. 
 
 L'axampiaira film* fut raproduit grica k la 
 g^nArositA da: 
 
 Medical Library 
 McGill University 
 Montreal 
 
 Laa imagaa suivantaa ont *t* raproduitaa avac la 
 plua grand soin, compta tanu da la condition at 
 da la nattat* d* Taxampiaira film*, at an 
 conformitA avac ias conditions du contrat da 
 fiimaga. 
 
 Laa axamplairaa originaux dont la couvartura an 
 papiar aat imprimAa sont fiimAs an commandant 
 par la pramiar plat at an tarminant soit par la 
 darnlAra paga qui comporta una amprainta 
 d'impraasion ou d'iliustration, soit par la sacond 
 plat, salon la eaa. Tous laa autraa axamplairaa 
 originaux sont filmAs an commandant par la 
 pramlAra paga qui comporta una amprainta 
 d'impraaaion ou d'iliustration at an tarminant par 
 la darniAra paga qui comporta una taila 
 amprainta. 
 
 Un daa symbolaa suivanta apparattra sur la 
 darnlAra imaga da chaqua microficha. salon la 
 caa: la symbola — »> signifia "A SUIVRE". la 
 aymbola V signifia "FIN". 
 
 Mapa. platas. charta. ate. may ba fiimad at 
 diffarant raduction ratios. Thosa too larga to ba 
 antiraly includad in ona axpoaura ara fiimad 
 baginning in tha uppar laft hand cornar. laft to 
 right and top to bottom, aa many framas aa 
 raquirad. Tha following diagrama lliuatrata tha 
 mathod: 
 
 Laa cartaa. pianchas. tablaaux, ate. pauvant Atra 
 filmAa A daa taux da rAduction diff Arants. 
 Lorsqua la documant aat trop grand pour Atra 
 raproduit an un saul clichA. il aat filmA A partir 
 da i'angia aupAriaur gaucha. da gaucha A droita. 
 at da haut an baa. an pranant la nombra 
 d'imagas nAcaaaaira. lias diagrammas suivants 
 illuatrant la mAthoda. 
 
 1 2 3 
 
 1 
 
 2 
 
 3 
 
 4 
 
 5 
 
 6 
 

 OU-tnt'-i.^L^ 
 
 z/. -y. 
 
 Reprinted from the Montreal Medical Journal, Decnnber, 1895. 
 
 UPON BIFURCATION OF THE RIBS AND COSTAL 
 
 CARTILAGES. 
 
 By Ji^G.'XDAMT, M.A., M.D. 
 Professor of Pathology, McGill University, Montreal. 
 Dr. J. G. AdaMI stated that while bifurcation of the ribs was an 
 abnormality apparently of no very great rarity, and while most 
 museums contain one or more examples of the condition, it was 
 remarkable that most of the larger English text-books of anatomy, 
 which devote attention to the abnormalities of various organs, pass 
 over the subject in complete silence.' He exhibited three specimens 
 illustrative of the condition. The first of these was a preparation 
 presented to the museum by Dr. Shepherd, consisting of the 2nd to 
 the 6th ribs of the right side, with their cartilages and part of the 
 sternum. The specimen showed that the outer end of the 4th rib was 
 much wider than any of the others, the breadth of the 3rd being 12 
 mm. at its articulation, of the 5th 11 mm., while that of the 4th was 
 18 mm. The cartilage of the rib consisted of two processes starting 
 from the widened end of the rib and fusing into one before joining 
 the sternum, thus leaving an oval space 10 mm. long by 6 mm. in a 
 vertical direction. 
 
 The next two specimens had been obtained in the post-mortem 
 room at the Royal Victoria Hospital during the last twelve months. 
 Of these, one was from the body of an aged habitant, who had died of 
 phlegmonous erysipelas. The specimen consisted of the end of the 
 3rd and 4th ribs of the left side, with their cartilages and a portion of the 
 sternum. In this specimen the condition was a little more pronounced, 
 the anterior end of the rib was relatively enormously broadened, being 
 29 mm. across, as compared with 11 mm., the breadth of the articular 
 end of the 3rd rib. The rib presented a short upper process 8 mm 
 broad at its articulation and scarcely projecting from the main mass 
 of bone, and a lower process 9 mm. broad and 10 mm. long. From 
 each of these processes there passed a separate cartilage, and these, as 
 in the last case, fused together before the attachment to the sternum, 
 leaving a space 17 mm. in depth by 20 mm. in a horizontal direction. 
 
 The third specimen showed still further exaggeration of the condi- 
 tion. This was taken from the body of an Irishman 78 years of age, 
 
 1 Of the German text-books ttoth Henle aixd the etCRlier Meckel devote a few lines 
 to the condition. Of the English, Morris sHqi\e has a i>aa9ifl^4«<^eace to it, 
 
 ' -u'.v/iL ftp I J-,. 
 
 -T^T^r 
 
 IT 
 
 -4^ 
 
2 
 
 who had died of cardiac disease. The specimen consisted also of tha 
 4th and 5th ribs, but in this case of the right side. 
 
 In this patient there had been a particularly wide space noted 
 between the 5th and 6th ribs on the left side, and on the right side 
 the bifurcation of the rib was very noticeable upon removing the 
 pectoral muscles. Here the upper process was 20 mm. long tufid con- 
 tinued I'oughly the general course of the rib, while the lower process, 
 25 mm. long, was given off from the main body at an angle of about 
 30°. Careful counting of the ribs in this case showed that only 
 eleven pairs were present, the last of the series having all the charac- 
 ters of the ordinary floating twelfth rib. Unfortunately the exigencies 
 of time prevented in this case the removal of more than the outer 
 portion of the ribs, and the vertebrae were not carefully examined 
 The post-mortem notes contained an entry to the effect that eleven 
 pairs of ribs were present in the second case also. With regard. to 
 this he could not speak so positively, but he believed the statement to 
 be correct. If so, these cases presented examples of a condition not 
 hitherto recorded. Addition,^ to the series of ribs both above in the 
 cervical region and below in the lumbar region were not infrequent. 
 There was one case at least on record of almost complete absence of 
 the 1st rib and several instances of complete absence of the 12th; but 
 diminution in number by fusion of mid-dorsal segments and their ribs 
 was a condition of which he could find no mention. At the same 
 time, when the variation in the number of lumbar saci'al and even 
 cervical vertebrae was taken into account, there was undoubtedly an 
 inherent probability that such fusion or dropping out of a somite of 
 the body could occur in the mid-dorsal region. The fullest description 
 that he had come across of cases of bifurcation of the ribs and their 
 cartilages was given by Professor Struthers in the 9th volume of the 
 JouTtial of Anatomy and Physiology. This observer, in describing 
 a collection of specimens exhibiting variations of the vertebrae and 
 ribs in man which he had accumulated during many years, gives notes 
 upon five cases, two of bifurcation, two resembling the first case men- 
 tioned of ribs broad at the sternal end with bifurcated cartilage, and 
 one in which the cartilage alone was bifurcated. It was interesting 
 to notice that in three of these ca£3s the variety was ascertained to be 
 of the 4th rib — in one it was probably of the 4th, in the other two 
 piobable of the 4th or 5th. Evidently, therefore, taking the cases 
 here described also into consideration, there was a special tendency for 
 this variation to affect either the 4th or the 5th dorsal segment. In 
 one of his cases Struthers stated, and in a second implied, that <ihe 
 number of ribs was normal. 
 
 ' >' 
 
 i 
 
3 
 
 That the ribs should divide at their outer extremity was but in 
 keeping with the general law of variation that re -duplication of parts 
 shows itself most often in the distal portion of an organ, and agree- 
 able to this same law it might be stated that bifurcation of the costal 
 cartilages is more frequent than the well marked bifurcf 'lion of the 
 ribs themselves. As Professor Struthers pointed out, the condition 
 has a clinical interest, as it might well give rise to a mistake in indi- 
 cating the position of a chest symptom or of a fracture. 
 
 ' >' 
 
 I 
 
 l^at^h::