THIS is an effort to induce British clinicians to abandon certain terminologies which are inaccurate, misleading, and not sufficiently comprehensive, and to substitute for them a nomenclature or classification which has, a t any rate, the virtue of being in accord with embryological facts and possibilities. The hoary legends of our youth still linger in corners of test-books of deservedly high reputation, but the pathetic interest with which we see them ought not to keep us from admitting the possibility of improving on them.The particular conditions about which I an1 concerned at present are those which are lumped together under the distinguishing term ' branchial 'or 'branchiogenetic'. These terms have been in use unrvorthily for many years past. 'Branchial cyst' is a common expression in the niouth of the student, and some say that ' branchial carcinonia ' is not excessively rare in the neck of patient. It must be stated here a t once that the question whether such a growth or such a cyst exists or does not exist is not of any importance a t all from the present point of view: we are not concerned with that, but only with the provision of a better class-name under which, if it occurs, it would fit naturally, and which it would not require if it does not occur. As a matter of fact, certain developmental vestiges in the neck undoubtedly give rise at times to certain pathological formations; so the necessity exists for an accurate and comprehensive nomenclature. The objection to the use of the word 'branchial' in this connection lies in the fact that these things are not branchial in the strict sense, have nothing to do with branchiz, and in many cases are outside the region which might be honiologized with the pharyngeal arches that carry gills in the lowest vertebrates. Thus, even if the word be extended to take in the gill-bearing regions, it would still be inadequate and erroneous.A better conception of the several conditions of this kind that may occur in the neck might surely be obtained by a terminology that puts them in a class with all other diseased vestigial structures in the body. and allows of necessary subdivision and sub-classification, enabling it to include all the possible pathological variations of these structures, in any part.It is common knowledge that the pharynx of the human embryo possesses in its floor a series of visceral arches, with intervening risceyal grooves--not clefts, as is often wrongly stated. Now these arches do not correspond to the branchial arches in fishes : the third viscerul arch can be homologized with the first branchid, but the two visceral arches in front of this are not properly branchial. Many of the ' branchiogenetic' formations occur in front of the
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