A patient was admitted to an army hospital on March 4, 1942 with a history of a self-inflicted wound to remove his "voice box." When admitted he had a transverse incision at the level of the hyoid bone from one sternomastoid muscle to the other, and he was cyanotic from hemorrhage and clots in his neck. In a paper bag, brought in by the ambulance attendant, was the specimen shown in figures 1 and 2. An incision was immediately made in the midline down to the junction of the trachea, which had been cut off. After the clots over the tracheal opening had been cleaned out the patient's cyanosis was relieved.
It was found that the patient had removed his hyoid bone, larynx, thyroid gland (including three parathyroids), trachea down to about the third ring, about 2 inches of the anterior part of the esophagus, and about ½ inch of