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Eve was made from the thirteenth rib of the right side…. She was not drawn out by the head lest she should be vain; nor by the eyes, lest she should be wanton; nor from the mouth, lest she should be given to garrulity; nor by the ears, lest she should be an eavesdropper; nor by the hands, lest she should be intermeddling; nor by the feet, lest she be a gadder; nor by the heart, for fear she should be jealous; but she was taken out from the side. Yet in spite of all these precautions she had all the faults so carefully provided against. (Quoted from Rabbi Jonathan’s Targum, by G. W. Niven, Brit. M. J. 2: 1732, 1898.)

Thirty-eight operations were performed on thirty-six patients for the resection of localized pulmonary metastatic disease secondary to lesions arising in the head, trunk, or extremities. The primary lesions were largely sarcomatous. The pulmonary resections were limited in extent, consistent with the size and location of the metastatic lesion, and there was no operative mortality. The one, three, and five-year survival rates were 69, 21, and 23 per cent, respectively. The prognosis did not appear to be related to the specific type of lesion, the size of the lesion, the presence of clinical signs of pulmonary involvement, or the length of time since the primary operation. Multicentricity of the metastatic lesions was associated with lower survival rates. The prognosis in these patients does not appear to be quite so good as in those with localized pulmonary metastasis from visceral organs, but the results indicate that resection is justified and worth while in properly selected cases.

Massive fragmentation of a neoplasm with embolic spread to the brain causing vascular obstruction and infarction is a rarely reported phenomenon. The most frequent site of such obstruction in the cerebral circulation is in the middle cerebral artery or one of its branches. Only one reported case1of neoplastic occlusion of the basilar artery by embolism was found in the world literature. Recently we observed a second case; because of the rarity of this condition, we wish to report it and to review the pertinent literature. Report of Case A 64-year-old housewife was referred to the Mayo Clinic on April 19, 1960, for evaluation of a mass in the lung, and for hemoptysis. The patient gave a history of having had intermittent cough with blood-streaked sputum for 6 months and of general malaise and anorexia with loss of 10 pounds in the last 2 months. She denied smoking cigarettes.

Mammary Paget's disease appears to be invariably associated with intraductal or parenchymal carcinoma of the breast; however, the nature of the extramammary form of the disease is still controversial.In a review of 145 patients with mammary Paget's disease and 10 patients with extramammary involvement, the authors found that (1) the average survival of patients in both groups was roughly equivalent; (2) regional or widespread metastatic involvement from underlying apocrine or regional carcinoma frequently occurs in extramammary Paget's disease; (3) metastatic lymphadenopathy reduces the survival rate by at least 50 per cent; (4) local recurrences seem the rule in extramammary involvement but are rare in mammary disease; and (5) metastatic carcinoma was the predominant cause of death in both groups of patients.

(1947). Spontaneous Rupture of the Esophagus. Postgraduate Medicine: Vol. 2, No. 6, pp. 417-421.

Until we encountered the first of the two cases to be discussed in this paper, we had not thought of pulmonary histoplasmosis as a surgical condition. Because of the tendency of this disease to disseminate, one could anticipate that only rarely would the process be sufficiently well localized in the lungs to make surgical removal advisable. Because our unusual experience with these two patients seemed to present a new aspect of the disease, we thought it should be recorded together with a review of the reports of cases of pulmonary histoplasmosis published in medical literature. SUMMARY OF DATA ON REPORTED CASES OF HISTOPLASMOSIS We have reviewed the reports of all the cases of histoplasmosis, regardless of the organs involved, which are recorded in the literature up to Jan. 1, 1950. In a previously published paper,1we reviewed the reports of the cases recorded prior to January 1949. We