Report of an autopsy on the bodies of Chang and Eng Bunker, commonly known as the Siamese twinsAllen, Harrison
History
Report of an autopsy on the bodies of Chang and Eng Bunker, commonly known as the Siamese twins
Allen, Harrison
Conjoined twins
This statement appears pertinent, at this stage of the autopsy, in order
to explain—
V. Interior of Band.
We here describe (1) _the hepatic pouches_; (2) _the umbilical pouches_;
(3) _the vascular structures of the band_; (4) _the diaphragms_; (5)
_the ensiform cartilages_.
1. _The hepatic pouches._—The photograph (Fig. 2) indicates the position
of the right lobe of Eng’s liver in the right hypochondriac region. The
right lobe of Chang is of course not seen in the figure, since it lies
on the side of the body which is not in the field of vision. It must
follow from the rights and lefts of the two individuals being opposites
that, in drawing a line between the livers (which, as already seen,
occupy normal positions as to right and left) across the band, such a
line will be diagonal to the axes of the ensiform cartilages; Chang’s
half of the band having the line enter the band from his “right,” Eng
from his “left.” It will also follow that any pouches of peritoneum
which might accompany this line will pursue a similar direction—be on
the same plane—be right or left with respect to the axis of that plane.
Now it was actually demonstrated that such a line did extend between the
livers, and was accompanied by such peritoneal pouches. These pouches
were termed the hepatic pouches, and may be described as follows:—
Chang.—The subject lying on the table with rights and lefts determined
as in the acquired position, the finger could be inserted behind the
suspensory ligament (Fig. 7) in a pouch lying directly beneath the
ensiform cartilages, into which passed an extension of liver-like
tissue.
Eng.—This fact could not be well demonstrated in Eng in this position,
but is well seen in Fig. 8.
It follows that the two hepatic pouches are on nearly the same plane,
and that each approaches the central point of the band diagonally from
the right side of the subject with whose abdominal cavity it is
continuous.
2. _The umbilical pouches._—Beneath the hepatic pouches, and between
them and the inferior border of the band, were two pouches which, from
their association with the round ligament, have been termed _the
umbilical pouches_.
When the finger was passed toward the band from the abdomen of Chang,
and following the peritoneum of the anterior wall of the abdomen, it
passed into a pouch of the band directly over the skin covering, across
the band, over the umbilicus, and was received within the folds of the
suspensory ligament of the liver of Eng. This pouch was so superficial
that while the finger was in the pouch any motion of the finger was
readily followed by the observer.
In the same way as above, if the finger was introduced _behind_ the
suspensory ligament of Eng, it slipped into a pouch which passed across
the median line of the band, and was received within the folds of the
suspensory ligament of the liver of Chang.
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