tomy, excision of the spleen, has been performed a number of
times, with varying results, but is more successful when performed for
injury than when for disease. Ashhurst has tabulated a total of 109
operations, 27 having been for traumatic causes, and all but five
having terminated successfully; of 82 operations for disease, only 32
recovered. Vulpius has collected 117 cases of splenectomy, with a
death-rate of 50 per cent. If, however, from these cases we deduct
those suffering with leukocythemia and lardaceous spleen, in which the
operation should not be performed, the mortality in the remaining 85
cases is reduced to 33 per cent. Terrier speaks of splenectomy for
torsion or twisting of the pedicle, and such is mentioned by Sir Astley
Cooper, who has found records of only four such cases. Conklin reports
a successful case of splenectomy for malarial spleen, and in reviewing
the subject he says that the records of the past decade in operations
for simple hypertrophy, including malaria, show 20 recoveries and eight
deaths. He also adds that extirpation in cases of floating or displaced
spleen was attended with brilliant results. Zuccarelli is accredited
with reporting two cases of splenectomy for malarial spleen, both of
which recovered early. He gives a table of splenectomies performed in
Italy, in which there were nine cases of movable spleen, with two
deaths; eight cases of simple hypertrophy, with three deaths; 12 cases
of malarial spleen, with three deaths; four cases of leukemia and
pseudoleukemia, with two deaths. In his experiments on rabbits it was
proved by Tizzoni, and in his experiments on dogs, by Crede, that an
individual could live without a spleen; but these observations were
only confirmatory of what had long been known, for, in 1867, Pean
successfully removed a spleen from a woman of twenty. Tricomi reports
eight cases in which he had extirpated the spleen for various morbid
conditions, with a fortunate issue in all but one. In one case he
ligated the splenic artery. In The Lancet there is an account of three
recent excisions of the spleen for injury at St. Thomas Hospital in
London, and it is added that they are among the first of this kind in
Great Britain.

Abnormalities of Size of the Spleen.--The spleen may be extremely
small. Storck mentions a spleen that barely weighed an ounce; Schenck
speaks of one in the last century that weighed as much as 20 pounds.
Frank describes a spleen that weighed 1