Epigastric-heteropagus Twins Recorded in Madras Presidency in 1789

Twinning is rare in humans, and conjoined twins are rarer. One type of conjoined twins is 'parasitic twins', also referred to as 'heteropagus twins'. This kind of birth anomaly presents asymmetrically joined twins, one of which will usually be intensely deformed and depend parasitically on the other, the near-normal one. We present here the report 'An account of a monster of the human species' written from Fort St. George, Madras and published in the Philosophical Transactions of the Royal Society of London in 1789. This report consists of two letters: one from Baron Reichel to Sir Joseph Banks and the other from James Anderson to Baron Reichel. The Reichel and Anderson letters impress as the earliest formal record of heteropagus twins in India. The morphogenesis of heteropagus twinning is still unclear. The origin of heteropagus twins is explained as monozygotic by some obstetricians and as dizygotic by others. Until the mid-20th century, medical parlance referred to these humans as monsters and their deformities as monstrosities, which was unfortunate.