Perhaps the most unique collection of congenital malformations of the heart from persons who have reached the age of puberty was to be seen in London in 1895. In this collection there was an adult heart in which the foremen ovale remained open until the age of thirty-seven; there were but two pulmonary valves; there was another heart showing a large patent foramen ovale from a man of forty-six; and there was a septum ventriculorum of an adult heart from a woman of sixty-three, who died of carcinoma of the breast, in which the foremen ovale was still open and would admit the fore-finger. This woman had shown no symptoms of the malformation. There were also hearts in which the interventricular septum was deficient, the ductus arteriosus patent, or some valvular malformation present. All these persons had reached puberty. Displacements of the heart are quite numerous. Deschamps of Laval made an autopsy on an old soldier which justified the expression, "He had a heart in his belly." This organ was found in the left lumbar region; it had, with its vessels, traversed an anomalous opening in the diaphragm. Franck observed in the Hospital of Colmar a woman with the heart in the epigastric region. Ramel and Vetter speak of the heart under the diaphragm. Inversion of the heart is quite frequent, and we often find reports of cases of this anomaly. Fournier describes a soldier of thirty years, of middle height, well proportioned and healthy, who was killed in a duel by receiving a wound in the abdomen; postmortem, the heart was found in the position of the right lung; the two lungs were joined and occupied the left chest. The anomalies of the vascular system are so numerous that we shall dismiss them with a slight mention. Malacarne in Torino in 1784 described a double aorta, and Hommelius mentions an analogous case. The following case is quite an interesting anatomic anomaly: A woman since infancy had difficulty in swallowing, which was augmented at the epoch of menstruation and after exercise; bleeding relieved her momentarily, but the difficulty always returned. At last deglutition became impossible and the patient died of malnutrition. A necropsy revealed the presence of the subclavicular artery passing between the tracheal artery and the esophagus, compressing this latter tube and opposing the passage of food. Anomalies of the Breasts.--The first of the anomalies of the generative apparatus to be discussed, although not distinctly belonging under this head, will be those of the mammae. Amazia, or complete absence of the breast, is seldom seen. Pilcher describes an individual who passed for a female, but who was really a male, in whom the breasts were absolutely wanting. Foerster, Froriep, and Ried cite instances associated with thoracic malformation. Greenhow reports a case in which the mammae were absent, although there were depressed rudimentary nipples and areolae. There were no ovaries and the uterus was congenitally imperfect.