T H E BRITISH JOURNAL O F SURGERYwith a pair of forceps and pulled forwards. It was found to be at.tached hp a pedicle t o the extreme base of the tongue. The pedicle was immediately transfixed and the accessory tonguc removed. It is clear that a t the time of the first examination this accessory tongue had fallen back into the larynx and was missed by the examining finger.On examination its appearance was found to resemble exactly a tongue, with a well-marked median raphh. On section it was seen t o be covered with squamous epithelium, possessing a core of connective and muscular tissue. The muscular tissue was striped and was found to run in two planes. Its structure was quite simple and closely resembled that of a fmtal tongue. The general appearance and microscopic structure indicated that it was a congenital anomaly rather than any form of benign new growth.ONE night in April, 1929, a woman of 69 retired to bed feeling perfectly well and contented after a dinner composed largely of lobster. She was awakened about 4 a.m. with violent pain which was felt mainly in the left upper quadrant of the abdomen.Thinking that the lobster was to blame she took a vegetable laxative pill, but no action of the bowels could be obtained even after four attempts, although the desire was still present. The pain continued and the vomiting became incessant. I was asked to see her about 9 a.m., when she looked in danger of iimminent death. The temperature was 97", and a pulse of 120 was hardly perceptible a t the wrist. The shock, the character of the pain, the inability to pass either faxes or flatus, and the persistent and progressive nature of the vomiting pointed to a diagnosis of acute intestinal obstruction.On following my invariable practice of examining all acute abdominal cases with a stethoscope, I heard in the left hypochondrium, and only there, a sound which could have been nothing else than the bruit of an aneurysm. A careful examination showed that the thoracic aorta was free from blame. On leaving the patient's room I asked the practitioner to listen to the upper abdomen, being careful t o give him no hint of what I wished him to hear, When he rejoined me he asked, '' What can it be ? " I replied that it must be an aneurysm of the splenic artery which had ruptured.Operation was decided upon and t gr. of morphia was administered hypodermically. Within a few minutes the patient was free from pain and was pink and warm ; the vomiting ceased a t once, and the pulse was 90 and of good volume. This reaction to the drug seemed so like that of a case of acute obstruction that I wavered in sticking to what appeared such an outrageous diagnosis. I ordered an enema, and since there was no result I finally ASSISTANT SURGEON .4T THE ROYAL INPIR>IABY. SHEFFIELD.She vomited and felt an intense desire to deffecate.
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