TAtNCE IN THE CLINICAL EXAMINATION

The interesting points.of this case were the facts: 1. That the aneurysm must have been one occurring in thc superior mesenteric artery in its course behind the pancreas,. remnants of the arterial wall being found lying fiat on tlle posterior wall of the cavity. 2. That the gradual dilatation of the large aneurysmal cavity lhad exercised a tractioii on the aorta itself, so that a falsiform aneurysm was formed. 3. That there was a rotation of the aorta, in that the opening of the coeliac axis artery and what must have been the opening of the snperior mesenteric artery originially, were found on the right side of the aortic anetirySD1. 4. Tlj0lat there must hlave been a radlual and persistent dissection in the upward direction to the lower s.krface of .the liver wlhere the rupture eventually took place, as is evi(enced by the thickening and induration of the walls. For permission to publislh this case I am indebted to the Bledical Superintendent of Addington Hospital.