MONSTER 763 like the redundancy, it is apt to repeat itself in the same family. Meckel saw a girl who had an extra digit on each extremity, while a sister wanted four of the fingers of one hand. Where the supernumerary digits are more than one on each extremity, the whole set are apt to be rudimentary or stunted ; they look as if two or more of the embryonic buds had been subject to cleavage down the middle, and to arrest of longitudinal growth. There are two or three authentic instances of a whole lower limb ap pearing at birth as two withered halves, as if from embry onic cleavage. 1 Other redundancies of the skeleton are extra vertebrae (sometimes the coccygeal, giving the ap pearance of a rudimentary tail), or an extra rib. A double row of teeth is occasionally met with ; the most interesting case of this anomaly is that in which the rudiments of a double row exist from the first, but the phenomenon is sometimes produced by the milk teeth persisting along with the second set. One or more extra teeth are occasionally met with in line with the rest. Among redundancies of the soft parts, by far the most frequent is an extra nipple, or pair of nipples. It is only the nipple, or the most external mechanical adjunct of the mammary apparatus, that is repeated, and very seldom, if ever, the breast structure itself. The nipple, although it is the latest addition to the mechanism of lactation, is in the individual mammal developed on the skin before the gland is formed underneath ; and that facility, which applies to the development of external characters generally, appears to be the reason why there may be one or more extra nipples but no redundant gland. In the same connexion, it is interesting to observe that the supernumerary nipple has been shown by statistics on a large scale to be twice as common in men as in women, although in the male the mammary function never comes to maturity, and even the structure retrogrades after puberty. Traces of an additional nipple, or pair of them, in more or less symmetrical position below the normal ones, are not very uncommon when care fully looked for. Among the sense organs there is a remarkable instance recorded of doubling of the appendages of the left eye, but not of the eyeball itself ; the left half of the frontal bone is double, making two eye-sockets on that side, and the extra orbit has an eyebrow and eyelid. 2 The external ear (pinna) has also been found double on one side. Doubling of any of the internal organs is extremely rare, and is probably always traceable to a more or less complete fissuring or lobation. The ducts or vessels con nected with organs, and playing a purely mechanical part, are not unfrequently doubled ; thus each kidney may have two ureters, and a similar variation may occur in veins and arteries. Monstrosities from Defective Closure in the Middle Line. Under this head come some of the commonest congenital malformations, including slight deficiencies such as harelip, and serious defects such as a gap in the crown of the head with absence of the brain. The embryo is originally a circular flattened disc spread out on one pole of the yolk, and it is formed into a cylindrical body (with four appendages) by the free margins of the disc, or rather its ventral laminae, folding inwards to meet in the middle line and so close in the pelvic, abdominal, thoracic, pharyngeal, and oral cavities. Meanwhile, and indeed rather earlier, two longitudinal parallel ridges on the top or along the back of the disc have grown up and united in the middle line to form the second barrel of the body the neural canal of small and uniform width in the lower three-fourths or spinal region, but expanding into a wide chamber for the brain. This division into neural (dorsal) and haemal (ventral) canals 1 See Forster s Atlas, Taf. viii. , figs. 13 and 14. 2 See preparation in the Wiirzburg Museum, figured by Forster, Taf. viii., figs. 9-12. underlies all vertebrate development. Imperfect closure along either of those embryonic lines of junction may pro duce various degrees of monstrosity. The simplest and commonest form, hardly to be reckoned in the present cate gory, is harelip with or without cleft palate, which results from defective closure of the ventral laminae at their extreme upper end. Another simple form, but of much more serious import, is a gap left in the neural canal at its lower end ; usually the arches of the lumbar vertebrae are deficient, and the fluid that surrounds the spinal cord bulges out in its membranes, producing a soft tumour under the skin at the lower part of the back. This is the condition known as hydrorkacJiis, depending on the osseous defect known as spina bijida. Children born with this defect are difficult to rear, and are very likely to die in a few days or weeks. More rarely the gap in the arches of the vertebrae is in the region of the neck. If it extend all along the back, it will probably involve the skull also. Deficiency of the crown of the head, and in the spine as well, may be not always traceable to want of formative power to close the canal in the middle line ; an over-distended condition of the central water-canal and water-spaces of the cord and brain may prevent the closure of the bones, and ultimately lead to the disruption of the nervous organs themselves ; and injuries to the mother, with inflammation set up in the foetus and its appendages, may be the more remote cause. But it is by defect in the middle line that the mischief manifests itself, and it is in that anatomical category that the malformations are included. The osseous deficiency at the crown of the head is usually accompanied by want of the scalp, as well as of the brain and membranes. The bones of the face may be well developed and the features regular, except that the eyeballs bulge forward under the closed lids ; but there is an abrupt horizontal line above the orbits where the bones cease, the skin of the brow joining on to a spongy kind of tissue that occupies the sides and floor of the cranium. This is the commonest form of an anencephalous or brainless monster. There are generally mere traces of the brain, although, in some rare and curious instances, the hemispheres are developed in an exposed position on the back of the neck. The cranial nerves are usually perfect, with the exception sometimes of the optic (and retina). Vegetative existence is not im possible, and a brainless monster has been known to survive sixty-five days. The child is usually a very large one. Closely allied, as we have seen, to the anencephalous condition is the condition of congenital liydroceplicdus. The nervous system at its beginning is a neural canal, not only as regards its bony covering, but in its interior ; a wide space lined by ciliated epithelium and filled with water extends along the axis of the spinal cord, and expands into a series of water-chambers in the brain. As development proceeds, the walls thicken at the expense of the internal water-spaces, the original tubular or chambered plan of the central nervous system is departed from, and those organs assume the practically solid form in which we familiarly know them. If, however, the water-spaces persist in their embryonic proportions notwithstanding the thickening of the nervous substance forming their walls, there results an enormous brain which is more than half occupied inside with water, contained in spaces that correspond on the whole to the ventricles of the brain as normally bounded. A hydrocephalic fcetus may sur vive its birth, and will be more apt to be affected in its nutrition than in its intelligence. In many cases the hydrocephalic condition does not come on till after the child is born. The microcephalous condition, where it is not a part of cretinism, is not usually a congenital defect
in the strict sense, but more often a consequence of the