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Full text of "The anatomy of the arteries of the human body : and its application to pathology and operative surgery, with a series of lithographic drawings"

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THE LIBRARY 

OF 

THE UNIVERSITY 
OF CALIFORNIA 



PRESENTED BY 

PROF. CHARLES A. KOFOID AND 
MRS. PRUDENCE W. KOFOID 





THE 



ANATOMY OF THE ARTERIES 



THE HUMAN BODY. 



1 



THE 



ANATOMY OF THE ARTERIES 



THE HUMAN BODY 



AND ITS APPLICATIONS TO PATHOLOGY AND OPERATIVE 
SURGERY 



A SERIES OF LITHOGRAPHIC DRAWINGS 



RICHARD QUAIN, F.R.S. 

PROFESSOR OF ANATOMY IN UNIVERSITY COLLEGE AND SURGEON TO UNIVERSITY COLLEGE 

HOSPITAL 



THE DRAWINGS FROM NATURE AND ON STONE 

BY JOSEPH MACLISE, ESQ. SURGEON. 



LONDON 
PRINTED FOR TAYLOR AND WALTON 

BOOKSELLERS AND PUBLISHERS TO UNIVERSITY COLLEGE 

UPPER GOWER STREET 

MDCCCXL1V 



PREFACE. 



SEVERAL years have elapsed since I became impressed with 
the belief that the difficulties which have often occurred in the 
performance of those surgical operations in which the larger 
arteries are concerned, have arisen in great part from want 
6f sufficient acquaintance with the differences in anatomical 
disposition to which these vessels are subject not merely 
the deviations in the origin of large branches, which are 
usually named varieties, but other peculiarities of various 
kinds which are liable to occur, such as those which affect 
the length, position, or direction of the vessels. Under that 
impression I was led to observe these circumstances more 
closely, and finally determined to obtain a record of the con- 
dition, whatever it might be, of the more important vessels 
in a considerable number of cases. 

With this view, I examined with more or less attention the 
bodies which were received during a series of years for the 
study of anatomy into the School of Medicine in University 
College. These bodies, to the number of 1040, were, with rare 
exceptions, so inspected with reference to the subject of my 
inquiries, that anything very unusual could not escape notice ; 
and, in order to insure accuracy, when other occupations 
allowed, the arteries were carefully examined and their con- 
dition noted at the time, attention being always particularly 
directed to those vessels and to the points in their history 
which seemed to be of importance in the practice of surgery. 

This detailed investigation was continued until the number 
of cases observed appeared such as would afford grounds for 
fixing what should be considered the most frequent or stan- 
dard conformation of the vessels, and for forming at the same 



MS70530 



vi PREFACE. 

time reasonable conclusions both as to the limits of the 
deviations from that standard and the relative frequency of 
their occurrence. 

While the observations thus made were written down, 
drawings were obtained of all the important peculiarities 
which presented themselves, and when it was practicable the 
preparations were preserved. 

The varieties in the arrangement of the blood-vessels thus 
noted grew, as may be supposed, to be very numerous ; but 
instead of difficulties multiplying with the number of observa- 
tions, it was usually found that as the facts accumulated, the 
transition from one state to a very different one ceased to be 
abrupt or without method, for others from time to time inter- 
posed which served to link them together. 

Originally these observations were intended exclusively for 
the benefit of my class ; but as their number and connexion 
seemed likely to render them more extensively useful, I 
resolved to publish them. On examining with a view to pub- 
lication the materials which I had collected, it became obvious 
that their utility would be very limited, unless as a part of a 
full history of the arteries with adequate delineations. In 
consequence, a series of drawings, showing the arteries accord- 
ing to their usual arrangement, has been prepared, and to 
these are appended the observations previously alluded to. 
The work has thus grown under my hands, and has gradually 
assumed its present form. 

To carry out my views as to the delineations, I obtained 
the assistance of my friend and former pupil, Mr. Joseph 
Maclise. In reference to that gentleman's labours, it may 
be allowed me to say, that while I have had the co-operation 
of an anatomist and surgeon, obviously a great advantage, 
the drawings will, I believe, be found not to have lost in spirit 
or effect. It affords me much gratification to render my 
acknowledgments to Mr. Maclise, for the readiness with 
which he acceded to my wishes, and undertook so arduous a 
task, and the zeal with which he has devoted himself to it in 
the intervals of application to the duties of his profession. 

Before I explain the plan pursued in this publication, it 
may be permitted me to advert shortly to the distinguishing 



PREFACE. vii 

features of the principal works' 'hitherto published on the 
Arteries, because it will thus be apparent in what respects 
this publication differs from others. 

The work of Haller *, the first in point of time which 
deserves notice, and still in many respects the best on the 
Anatomy of the Arterial System, is characterised by vast 
learning, by candour in the appreciation of the labours of 
others, and accurate observation in short, by those high 
qualities which distinguish all the writings of that illustrious 
author. The written descriptions, especially those of the 
branches, have perhaps never been equalled for copiousness 
and accuracy. But the drawings were in many instances taken 
from the bodies of very young children; and the treatise alto- 
gether is deficient in systematic arrangement and continuity, 
probably in consequence of the desultory manner of its pre- 
paration, and the length of time which intervened between 
the publication of its parts. On the whole, though not suited 
to general use, the " Icones Anatomicse " are, and will con- 
tinue to be, to the diligent inquirer a most valuable contribution 
to the history of the arteries. 

The representations of the arteries contained in Scarpa's 
work on Aneurism f, like all the delineations published by 
the same author, are most carefully and beautifully executed. 
They comprehend, however, but a small portion of the 
arterial system, and have obviously been intended to show 
not so much the position and connexions of the arteries, as 
the branches by which the circulation was likely to be carried 
on after an operation for aneurism an object which the 
results since obtained in the treatment of aneurism have 
fully demonstrated to be unnecessary. 

TiedemannJ has given, in the "Tabulae Arteriarum," 
systematic and clear delineations of the arteries, with many 
of their so-named varieties. To this valuable work the 
modern student of anatomy is almost exclusively indebted for 
representations of the arterial system. In it, however, as in 

* Icones Anatomicae, quibus prsecipuse aliquse partes Corporis human! delineates 
proponuntur et Arteriarum potissimum historia continetur. Gottingse 1804. 

f Sull' Anetirisma-Riflessioni ed Osservazioni Anatomico-chirurgiche. Pavia 1756. 
J Tabulae Arteriarum Corporis Humani. Carlsruhse 1822. 



Tiii PREFACE. 

the other treatises referred to, the veins and nerves are not 
shown in connexion with the arteries, and those modifications 
or peculiarities of the vessels alluded to at the commence- 
ment of these observations are not taken into account. 

In the present work the arteries are represented 

1st. According to their most frequent arrangement, 
without the accompanying veins. 

2ndly. They are shown in connexion with the larger veins 
and the nerves. 

Srdly. The deviations from that which has been taken as 
the standard because the most frequent condition of the 
arteries, are illustrated in a series of sketches. 

4thly. Such peculiarities of the veins, and occasionally of 
the nerves and muscles, as appeared likely to be of import- 
ance in surgical operations, are represented on a reduced 
scale. 

The letter-press, besides an explanation of the drawings 
and remarks on them, contains 

A series of Tables, showing, in a considerable number of 
cases, the condition of the arteries as to some of the points 
of most importance in their anatomy ; 

A connected view of their anatomical history, the details 
being arranged in systematic order ; 

And Practical Commentaries : which consist, for the most 
part, of inferences from the facts previously set forth, and 
their application in performing surgical operations. 

R. Q. 



REFERENCE TO THE PLATES AND 
EXPLANATION. 



PLATE I. PAGE 

The large Arteries of the Thorax and the Neck, viz. : the Arch and 
the Thoracic part of the Aorta, the Innominate, Left Carotid, Left 
Subclavian, together with the Left Axillary, Bronchial, yEsophageal, 
and the origin of the Coronary arteries 9 

PLATE II. 

The Heart, and the large Arteries of the Thorax and the Neck, with the 
accompanying Veins and Nerves. 

ARTERIES. The Arch of the Aorta, the Innominate, Right Carotid, 
Right Subclavian, Left Carotid, Left Subclavian. 

VEINS. The Jugular, Subclavian, Innominate, Superior Vena Cava. 
NERVES. The Pneumo-Gastric, Phrenic, Brachial plexus. 

PLATE III. 

The more superficial Arteries of the Neck on the right side, viz. : the 
end of the Common Carotid, the beginning of the External and of 
the Internal Carotid, the Subclavian beyond the anterior scalenus 
muscle 12 

PLATE IV. 

FIG. 1. The end of the Left Common Carotid, in connexion with the i 

Fascia, and the Veins and Nerves. 
FIGS. 2 & 3. Peculiarities of the Veins in connexion with the Common ) 18 

Carotid arteries. 
FIG. 4. A peculiarity of the Vagus Nerve. 



I 



PLATE V. 

Peculiarities of the commencement of the Aorta affecting its position, 

direction, and shape . . . . . . . .15 

PLATES VI. AND VII. 

Peculiarities of the large branches, taking origin from the Arch of the 

Aorta 41 

PLATE VIII. 

The External Carotid artery, and its branches 87 

PLATE IX. 

The Internal Maxillary artery 88 



x REFERENCE TO THE PLATES AND EXPLANATION. 

PLATE X. PAGE 

The Lingual, the Pharyngeal, and the Internal Carotid arteries . . 89 

PLATE XI. 

The External Carotid artery of the right side, with the accompanying Veins 

and Nerves 91 

PLATE XII. 

Peculiarities of the Common Carotid arteries, of the External Carotid, 

and of the branches of the latter 92 

PLATES XIII., XIV., XV. 

Peculiarities of the branches of the External Carotid arteries . . 96 

PLATE XVI. 

The Right Common Carotid artery; the Right Subclavian, and its branches 131 

PLATE XVII. 

FIG. 1. The commencement of the Right Subclavian artery, with its'] 

accompanying Veins and Nerves. >133 

FIG. 2. The end of the Right Subclavian artery, with its accompanying 
Veins and Nerves. 

PLATE XVIII. 

FIG. 1. The Superior Intercostal artery, and the Deep Cervical (ar. prof. T 

cerv.) of the left side. I 133 

FIG. 2. The Vertebral artery of the right side its cervical part. J 

PLATE XIX. 

The Arteries of the side and the back part of the Head, with those of the 
back part of the Neck and the Shoulder, viz. : the Superficial 
Temporal, Posterior Auricular, Occipital, Supra-Scapular, Posterior 
Scapular, Dorsal Scapular, &c. . . . . . . .135 

PLATE xx. 
Peculiarities of the Subclavian arteries affecting the trunk . .136 

PLATE XXI. 

Peculiarities of the Subclavian arteries affecting the trunk and the 

origin of the branches 139 

PLATE XXII. 

Peculiarities of the Vertebral arteries 141 

PLATE XXIII. 

Peculiarities of the Thyroid arteries 143 

PLATE XXIV. 

Peculiarities of the Internal Mammary, and of some other branches of 

the Subclavian arteries .145 

PLATE xxv. 

Peculiarities of the Deep Cervical arteries. Peculiarities of the Nerves, 
the Veins, the Muscles and the Bones, in connexion with the 
Subclavian arteries .... 147 



REFERENCE TO THE PLATES AND EXPLANATION. xi 

PLATE XX7I. PAGB 

The Axillary and the Brachial arteries, with their branches . .211 

PLATE XXVII. 

The Axillary and the Brachial arteries, with the accompanying Veins 

and Nerves 212 

PLATE XXVIII. 

The Axilla seen from below showing the Arteries, the Veins, the Nerves, 

and the Lymphatic glands 213 

PLATE XXIX. 

FIG. 1. The Posterior Circumflex artery. The dorsal branch of the~j 

Subscapular. >213 

FIG. 2. The Anterior Circumflex, and the arteries on the ventral surface I 
of the Scapula. 

PLATE XXX. 

Peculiarities of the Axillary artery, and of its branches . . .214 

PLATE XXXI. 

Peculiarities of the Radial artery affecting the position of its origin . 216 

PLATE XXXII. 

Peculiarities of the Ulnar artery affecting the position of its origin, and 

its course . 217 

PLATE XXXIII. 

Peculiarities of the Interosseous artery affecting the position of its origin 218 

PLATE xxxiv. 
The Axillary, and the Brachial arteries, divided into two branches, which 

re-unite or communicate one with the other at the bend of the elbow 220 

PLATE xxxv. 
Various examples of " Vasa Aberrantia," extending from the Axillary, or 

Brachial arteries, to those of the fore-arm 221 

PLATE XXXVI. 

FIGS. 1 & 2. Rare deviations of the Uluar artery. 1 
FIGS. 3 & 4. Peculiarities of the Brachial artery. / 

PLATE XXXVII. 

FIGS. 1 & 2. Deviations of one of the two arteries representing the Brachial. 
All the figm'es illustrate peculiarities of the Muscles in the neigh- 
bourhood of the same artery 224 

PLATE XXXVIII. 

Views of the anterior Arteries of the fore-arm and hand : their usual 

arrangement 305 

PLATE xxxix. 
The deep Arteries on the anterior surface of the fore-arm and hand : 

their usual conformation 306 



xii REFERENCE TO THE PLATES AND EXPLANATION. 

PLATE XL. PACK 

FIG. 1. The Arteries on the back part of the fore-arm and hand. 
FIG. 2. The Superficial Veins and Nerves in front of the elbow joint, and f 30 ? 
a small part of the Deep vessels and nerves. 

PLATE XLI. 
Views of the Superficial Veins in front of the elbow joint, in connexion 

with several variations of the arteries 308 

PLATE XLII. 

FIGS. 1 & 2. The Arterial Branches anastomosing about the elbow joint. 
FIGS. 3, 4, & 5. Peculiarities of the Radial artery .... 309 

PLATE XLIII. 

Peculiar forms of the Radial, Ulnar, and 'Interosseous arteries in the fore- 
arm and hand 311 

PLATE XLIV. 
The Interosseous joins in different cases with the other two arteries of the 

fore-arm, and compensates for their small size . . . .312 



PLATE XLV. 

FIG. 1. A rare form of Median artery. 

FIG. 2. A peculiar muscle connected with the Ulnar artery. 

FIGS. 3 to 6. Various states of the Superficial Volar and Palmar arteries. 



ies. J 



PLATE XLVI. 

Various conditions of the Arteries of the hand . . . . .315 

PLATE XLVII. 

The Thoracic Aorta and the Intercostal arteries, with the Intercostal 
Veins, Vena Azygos, the Thoracic duct, &c., seen in connexion 
with the parietes of the thorax .338 

PLATE XLVIII. 
The entire of the Aorta, with the branches springing from it. The 

Heart and the Vessels connected with it. The Coronary arteries . 339 

PLATE XL1X. 

The Abdomen opened, and the Cseliac axis with its branches, viz., 

Coronary (of Stomach), Hepatic, and Splenic ... . 340 

PLATE L. 

FIG. 1. The branches of the Cseliac axis more fully displayed. -i 

FIGS. 2 & 3. Some branches of the Superior and the Inferior Mesenteric 1 341 
arteries : to show their arrangement as they approach the intestine J 

PLATE LT. 

The Superior Mesenteric artery and its branches 343 

PLATE LII. 
The Inferior Mesenteric artery and its branches . . . . .343 



REFERENCE TO THE PLATES AND EXPLANATION. xiii 

PLATE L1II. PAGE 

The Abdominal Aorta and the branches arising in its course. The Iliac 

arteries 344 

PLATE LIV. 

The Abdominal Aorta. Some of its branches more fully displayed than 

in the preceding plate 345 

PLATE LV. 

The Iliac arteries in connexion with the Veins . . . ... 346 

PLATE LVI. 

Peculiarities of the Abdominal Aorta, and of some of its branches . 365 

PLATE LVI I. 

Peculiarities of some of the branches of the Abdominal Aorta, and of the 

Iliac arteries 366 

PLATE LVIII. 

FIG. 1. Unusual conformation of the Iliac arteries. -> 

FIGS. 2 to 10. Examples of peculiar dispositions of the large Veins of the Ls69 
Abdomen and Thorax. J 

PLATE LIX. 

The Arteries distributed to the female Pelvic organs .... 372 

PLATE LX. 
The Arteries of the Pelvis of the male 373 

PLATE LXI. 

A view of the Arteries and other structures displayed in a superficial 

dissection of the Perineum ... . . . . 393 

PLATE LX1I. 

A deeper dissection of the Perineum. The Pudic artery and the artery 

of the Bulb are shown 393 

PLATE LXIII. 

FIG. 1. The Uterine and Ovarian branches. -\ 

H 



FIG. 2. The Pudic artery, and the branches of the Pelvic Viscera of the I 394 

male fully dissected out. 
FIGS. 3, 4, & 5. Peculiar forms of the Pudic branches. J 



PLATE LXIV. 
Various forms of the Pudic branches seen in the Perineum . . . 397 

PLATE LXV. 

FIG. 1. A peculiarity of one of the Pudic branches. 

FIGS. 2 & 3. Enlarged Veins of the Prostate Gland and Urinary Bladder. I 3Q9 
FIGS. 4 to 7. Variations of the branches taking rise from the External J 
Iliac and Internal Iliac arteries. 

PLATE LXVI. 

FIGS. 1 , 2, and 3. Various conditions of the Obturator artery. "1 

Fio. 4. The Epigastric in connexion with a Hernia. J 



xiv REFERENCE TO THE PLATES AND EXPLANATION. 

PLATE LXVII. PAGE 

The position of the Epigastric artery with reference to different kinds of 

Hernia illustrated 402 

PLATE LXVIII. 

The various relations of the Obturator artery to different kinds of Hernia 403 

PLATE LXIX. 

The Femoral artery, and its branches .463 

PLATE LXX. 

A view of the Femoral artery, with the Veins, Nerves, and Fascia . 463 

PLATE LXXI. 

FIG. 1. The Femoral artery, with Nerves and Veins more fully shown. 1 
FIG. 2. Double Femoral artery. 



3. 1 & 2 are supplemental to a former Plate, giving additional illus--^ 
tration of the peculiarities of the Epigastric artery, and of the I 
position of the Obturator in reference to Crural Hernia. 
FIGS. 3 to 6. Various forms of the Deep Femoral artery. 

PLATE LXXIII. 
Peculiarities of the branches of the Deep Femoral, especially the 

External Circumflex 466 

PLATE LXXIV. 
The branches of the Deep Femoral further illustrated, and especially the 

Internal Circumflex 468 

PLATE LXXV. 
Various forms of the Veins connected with the Femoral artery , . . 469 

PLATE LXXVI. 

The Arteries on the posterior surface of the Pelvis , . . .471 

PLATE LXXVII. 

The Arteries on the Pelvis more completely exposed than in the foregoing 
plate ; together with the termination of the Internal Circumflex and 
perforating branches. The Popliteal artery its upper part . . 472 

PLATE LXXVI1I. 

FIG. 1. The Artery, with the Veins and Nerves of the Popliteal space. -j 
FIGS. 2 & 3. Different views of the Popliteal artery in its whole 1-472 
length, and of the branches. J 

PLATE LXXIX. 
The Popliteal artery, and its peculiarities : 473 

PLATE LXXX. 

Various arrangements of the Veins and the Muscles connected with the 

Popliteal artery 474 



REFERENCE TO THE PLATES AND EXPLANATION. xv 

PLATE LXXXI. PAGE 

Views of the Arteries on the back part of the Leg : Popliteal, Posterior 

Tibial and Peroneal 500 

PLATE LXXXII. 

The Anterior Tibial artery .... ... 

PLATE LXXXIII. 

FIG. 1. Part of the Posterior Tibial, with the Veins, Nerve, and Fascia-- 
exposed without removing any muscle. 1.501 
FIG. 2. The Peroneal artery. 
FIG. 3. The Dorsal artery of the foot. 

PLATE LXXXIV. 

The Dorsal Artery of the Foot, and some peculiarities of the Posterior 

Tibial, and Peroneal ... 503 



PLATE LXXXV. 

FIG. 1 . Unusual conformation of a Muscle over the Posterior Tibial. 
FIGS. 2 to 5. Different forms of the Anterior Tibial and Dorsal Artery of J-504 
the foot. 



of I; 



PLATE LXXXVI. 

The Plantar arteries : their usual arrangement and some deviations 

from it 506 

PLATE LXXXVII. 

The ordinary disposition of the Cerebral and Spinal arteries, and some 

peculiarities of the former 507 



EXPLANATION OF PLATES. 



EXPLANATION OF PLATE I. 



THE body of which this plate is a representation was placed 
in the sitting posture, the head thrown back and inclined to 
the right side, the left arm raised and supported. 

The anterior wall of the chest was removed to a greater 
extent on the left than the right side, the heart and the 
lungs taken out, some of the muscles of the neck were cut 
away, viz. the sterno-hyoid, sterno-thyroid, and greater part 
of the sterno-mastoid. The pectoral muscles are seen to have 
been divided and their external attachments turned aside. 
By these means the arch of the aorta, its continuation in the 
thorax, and its large branches, were exposed. 



a Lower maxillary bone. 

b Submaxillary gland. 

c Digastric muscle. 

d Mylo-hyoid, the muscles of oppo- 
site sides are seen to join ; a 
lymphatic gland * has been acci- 
dentally allowed to remain. 

e Os hyoides. 

e l Hyoglossus muscle. 

/ Thyroid cartilage. 

/ Thyro-hyoid muscle. 

g Thyroid body. 

h Cricoid cartilage, from it are seen 
diverging upwards to the thyroid 
cartilage, the crico-thyroid mus- 
cles. 

i Trachea. 



j Pleura. 

k Clavicle. 

/ Sterno-mastoid muscle. 

m Anterior scalenus. 

n Posterior scalenus. 

o Greater pectoral. 

p Smaller pectoral. 

q Biceps brachialis with coraco-bra- 

chialis to its inner side. 

r Subscapular. 

s Tendon of latissimus dorsi. 

s 1 Teres major. 

t Serratus magnus. 

v Bronchus of left side. 

w (Esophagus. 

x Sternum. 



10 



EXPLANATION OF THE SECOND PLATE. 



ARTERIES. 



J. Aorta. 

2. Coronary. 

3. Innominate. 

4. Carotid. 

5. Subclavian. 

6. Beginning of axillary. 

7. Internal mammary. 
7*. Vertebral. 

8. Thyroid axis. 

9. Supra-scapular. 

10. Superficialis colli. 
10*. Posterior scapular. 

11. Ascending cervical. 

12. The largest of three thoracic 
branches. 

13. Subscapular : from this artery 
branches are given to each side ; 
the largest, which is directed 
backwards, is the dorsal artery 
of the scapula. 



14. The origin of the posterior cir- 
cumflex. 

15. Superior-thyroid : from it the la- 
ryngeal is directed in wards beneath 
the thyro-hyoid muscle, and a su- 
perficial branch outwards over the 
carotid artery. 

16. Lingual. 

17. Facial : this artery, after emerg- 
ing from the submaxillary gland, 
is seen to give its submental 
branch, and then to turn over the 
maxillary bone. 

17*. Occipital. 

18. Internal carotid. 

1 9. Left bronchial. 

20. (Esophageal : below this is an- 
other, which is also an oesophageal 
branch ; it passed behind the oeso- 
phagus, and ramified in its sub- 
stance. 



EXPLANATION OF PLATE II. 



THE body from which this drawing was taken was placed 
on a chair in the sitting posture ; the left fore-arm happened 
to rest on the arm of the chair. 

The plate shows that a considerable part of the anterior 
wall of the chest has been removed, and the pericardium laid 
open to expose the heart and the great vessels. The large 
branches of these are shown in the neck by the removal of a 
part of the muscles attached to the sternum and clavicle. 



a Thyroid cartilage. 

b Sterno-hyoid muscle. 

c Sterno-thyroid. 

d Omo-hyoid. 

e Sterno-mastoid. 

/ Scalenus anticus. 

g Thyroid body. 



1. Aorta. 

2. Right coronary. 

2 1 . Branch of left coronary. 

3. Innominate. 



h Trachea. 

i Trapezius muscle. 

k Clavicle. 

/ Greater pectoral muscle. 

m Pleura. 

n Pericardium. 



ARTERIES. 

4. Common carotid. 

5. Subclavian. 

6. Internal mammary. The artery of 

left side rests on a portion of 



EXPLANATION OF THE SECOND PLATE. 



11 



pleura, and is cut short. That of 
the right side has behind it the 
pleura, from which it is separated 
at the lower part of the thorax by 
some fibres of the triangularis 
sterni. From its outer side are given 
anterior intercostal branches : in- 
wards are sent two mediastinal 
arteries ; over the lowest exposed 



. rib is seen a perforating branch. 
The mammary artery is accom- 
panied below by two veins, by the 
junction of which is formed the 
single internal mammary vein. 

Supra-scapular. 

Transversalis colli. 

Pulmonary artery. 



VEINS. 



10. External jugular of right side. 
It is joined near the clavicle by 
the supra-scapular and by the 
anterior jugular, part of which 
remains. 

11. The anterior jugular, cut. This 
vein descended superficially to the 
sterno-hyoid and sterno-thyroid 
muscles, and crossing outwards 
beneath the sterno-mastoid, ended 
with the external jugular in the 
subclavian. 

12. Internal jugular. The vein of the 
right side receives internally a 
middle thyroid vein, which is fre- 
quently present, though perhaps 
not usually so ; from without it 
receives a transverse vein, which 
comes from beneath the trapezius 
muscle, and usually ends in the 
external jugular ; this branch may 
be regarded as corresponding to 
the transversalis colli ar.tery. The 
internal jugular vein of the left 
side (12) is held aside to expose 
arterial branches which arise be- 
hind it. 

13. The subclavian veins seen to 
join with the internal jugular and 



form the innominate veins (14) 
on each side. The innominate 
veins are unequal in length, and 
different in direction ; each of 
these veins receives from above at 
its commencement the vertebral 
vein, which is seen to cross the 
subclavian artery after coming 
from behind the vagus nerve ; on 
the right side the vertebral vein 
escapes from behind, also a portion 
of the fascia or sheath, which sepa- 
rates the large cervical vessels 
from the spine. The innominate 
vein of the right side receives the 
internal mammary of the same 
side close to its end ; that of the 
left side receives from the thyroid 
body two branches (inferior thy- 
roid), and from below two veins, 
which are represented cut ; of the 
latter, the branch next to the 
junction of the subclavian and in- 
ternal jugular veins, is the left 
internal mammary ; that which is 
nearer to the vena cava, and rests 
against the origin of the innomi- 
nate artery, is a mediastinal vein. 
15. Vena cava. 



NERVES. 



16. Vagus. The nerve of the right 
side sends its recurrent laryngeal 
branch behind the commencement 
of the subclavian artery. On the 
left side the vagus is seen to be 
directed down over the arch of 
the aorta, and below this to give 
two branches. Of these, one 
(the recurrent laryngeal) turns 
inwards against the ligamentum 
arteriosum, which, in consequence 
of the deep shadow in which the 
part lay, is indistinctly seen. The 



lower and smaller branch of the 
nerve is the anterior pulmonary ; 
the vagus itself is directed back- 
wards. 

17. Phrenic. The nerve of the left 
side, after entering the chest, lies 
at a considerably greater depth 
than the internal mammary 
artery ; lower down it is seen 
between the pleura and pericar- 
dium, and turning round the 
point of the heart. 

1 8. The nerves of the brachial plexus. 



12 



EXPLANATION OF THE THIRD PLATE. 



EXPLANATION OF PLATE III. 



THE integuments have been turned aside ; the platysma- 
myoides and cervical fascia, with the veins and the nerves, 
except those of the brachial plexus, are removed from the side 
of the neck. 



a The masseter muscle, covering the 
inferior maxillary bone; on it a 
branch of the facial artery is seen 
to ramify. 

b Parotid gland. 

c Digastric muscle. 

d Stylo-hyoid muscle. 

e Submaxillary gland. 

/ Mylo-hyoid muscle : it is seen to 
join with the muscle of the oppo- 
site side above g. 

/* Hyoglossus muscle. 

g Hyoid bone. 

h Thyroid cartilage. * 

Omo-hyoid muscle : in this case 



the tendinous part of the muscle 
is very small, and is seen only at 
the upper margin of the muscle, 
immediately behind the sterno- 
mastoid. 

j Sterno-hyoid muscle. 

k Sterno-thyroid muscle. 

I Sterno-mastoid muscle. 

m Anterior scalenus muscle. 

n Posterior scalenus muscle. 

o Levator anguli scapulae. 

p Trapezius muscle. 

q Clavicle. 

r Larger pectoral muscle. 

s Deltoid muscle. 



ARTERIES. 



1. Common carotid. 

2. External carotid. 

3. Internal carotid. 

4. Superior thyroid ; its hyoid branch 
is seen to ramify in the muscles 
attached to the hyoid bone. 

5. Lingual : this artery usually makes 
the curve represented here, before 
it becomes covered by the hyo- 
glossus muscle. 

6. Facial : a branch (lower masse- 
teric) is shown on the masseter 
muscle ; the end of its submental 



branch is seen on the mylo-hyoid 
muscle, emerging from under the 
anterior belly of the digastric. 

7. Occipital : a small artery (sterno- 
mastoid) given off with the occi- 
pital, is directed back to the 
sterno-mastoid muscle. 

8. Subclavian. 

9. Supra-scapular : a branch of this 
artery supplies the muscles above 
the inner end of the clavicle. 

10. Superficialis colli. 

1 1 . Posterior scapular. 



NERVES. 

12. Brachial plexus. 



The common carotid artery, which in the lower part of the 
neck is covered by the omo-hyoid, sterno-thyroid, sterno-hyoid, 
and sterno-cleido mastoid, is at its upper part exposed, by 



EXPLANATION OF THE FOURTH PLATE. 13 

reason of the divergence of the muscles towards their superior 
attachment. The vessel just named, with the two into which 
it divides, (external carotid and internal carotid,) with the 
commencement of some of the branches of the former (superior 
thyroid, lingual, facial, and occipital), are seen to lie in a 
triangular space, the sides of which are formed by the sterno- 
mastoid, the omo-hyoid, and digastric muscles. This triangle 
and those elsewhere noticed, are apparent only in the dissected 
neck, and they are referred to in this work not because of any 
real or practical importance attached to such modes of descrip- 
tion, but in deference to the practice of writers of anatomical 
works. At the lower part of the neck is another triangular 
space, bounded by the clavicle, the omo-hyoid muscle, and the 
sterno-mastoid or anterior scalenus. In this, the subclavian 
artery is seen to lie with the anterior scalenus muscle 
to its inner side, and the brachial plexus of nerves to its 
outer side. 

The arteries which cross the neck between the trapezius 
and sterno-mastoid muscles have important relation to 
operations performed on the subclavian artery, and will be 
again referred to in treating of that artery and its branches. 



EXPLANATION OF PLATE IV. 



NEARLY the same view of the carotid artery and its branches 
is given in this plate as in the preceding ; but here it is seen 
in relation with the veins, the nerves, and the fascia of the 
neck. 



a Masseter muscle, at the anterior 
margin of which the facial artery 
is seen after escaping from under 
the submaxillary gland, to wind 
upwards over the lower maxillary 
bone. 

b Parotid gland, partly covered by cer- 
vical fascia. 

d Digastric muscle. 



e Submaxillary gland. 
/ Cervical fascia. 
g Sheath of the vessels. 
h Sterno-mastoid muscle. 



i Thyroid cartilage. 
j Omo-hyoid muscle. 
k Sterno-hyoid muscle. 
I Sterno-thyroid muscle. 



14 EXPLANATION OF THE FOURTH PLATE. 



1 . Common carotid artery. 

2. Internal carotid. 

3. External carotid. 

4. Internal jugular vein. 

5. Vagus nerve. 

6. 9th or hypoglossal nerve. 

7. Junction of the descending branch 

of 9th or hypoglossal nerve (n. 
descendens noni.) with a branch 
from the cervical nerves. The 



form of the union between these 
nerves varies in different bodies. 
In that of which this plate is a 
representation, two cervical nerves 
united into a single branch, which 
is seen to turn round the internal 
jugular vein, and join with the 
branch descending over the carotid 
artery from the ninth. 



FIG. 1. 

On turning aside the integuments and the platysma-myoides, 
a portion of which (latter) remains upon the inferior maxilla 
and below that bone, the cervical fascia is seen to cover the 
sterno-hyoid, sterno-thyroid, and omo-hyoid muscles, and to 
encase the lower part of the sterno-mastoid. The same 
membrane binds into its place the parotid gland, on which a 
portion has been left. 

The " sheath of the vessels " covers the artery, vein, vagus 
nerve, and in this case also the branch descending from the 
ninth nerve, together with that which joins it from the 
cervical nerves. 

The smaller veins and arteries, which branch out over the 
upper part of the common carotid, are a source of difficulty 
in the operation for placing a ligature on that vessel in this 
situation. In some cases the number of veins is greater than 
here represented, so as occasionally to amount even to the 
condition of a plexus ; and the difficulty from this cause is 
proportionably increased. 

FIGS. 2 AND 3. 

The second and third drawings show peculiarities of the 
veins ; in the former, the internal jugular covers the common 
carotid artery to such an extent that the vein must, in such a 
case, have been turned aside, in order to expose the artery. 
In the latter, the large vein covers the common carotid at its 
bifurcation, and an additional vein of smaller size (anterior 
jugular) is seen to the inner side of the artery. The 
anterior jugular vein, which is frequently found, is sometimes 
close to the middle line, and is occasionally joined to the 



EXPLANATION OF THE FIFTH PLATE. 15 

external jugular by transverse .communicating branches. 
After turning outwards at the lower part of the neck between 
the sterno-mastoid and the muscles beneath it, the anterior 
jugular ends in the subclavian vein, or in the external 
jugular. (See plate 2). 

FIG. 4. 

In this sketch the vagus nerve lies over the carotid artery. 
The caution suggested to the surgeon by this position of the 
nerve is obvious. 



EXPLANATION OF PLATE V. 

ARCH OF THE AORTA. 

THE same parts are marked with the same letters or 
numerals in all the figures of this plate. 



a The heart. 
b Trachea. 



c Bronchus. 

d (Esophagus. 



ARTERIES. 



1. Arch of Aorta. 

2. The descending part of Aorta. 

3. Innominate. 

4. Right carotid. 
4 1 . Left carotid. 

5. Right subclavian. 



9. Innominate of right side. 
9 1 . Innominate of left side. 
10. V. Azygos. 



5 l . Left subclavian. 

6. Right external carotid. 
6 1 . Left external carotid. 

7. Right internal carotid. 
7 1 . Left internal carotid. 

8. Pulmonary. 



VEINS. 



11. V. Cava superior. 

12. Hepatic veins. 



Some of the peculiarities of the arch of the aorta are illus- 
trated in this plate. 

POSITION OF THE ARCH. 

The most frequent changes of the arch, independently of slight 
varieties of shape, take place in its position with reference to 
the upper part of the walls of the chest. Its top or highest 
part is usually somewhat less than an inch from the upper 
margin of the sternum. 



16 



ARCH OF THE AORTA POSITION. 



Figure 1 is taken from a body in which the arch was exactly 
opposite the interval between the first and second dorsal ver- 
tebrae, and but a little below the level of the top of the sternum. 
In Figure 2 the arch is seen to be deeply placed in the chest ; 
its upper margin being as low as the middle of the 
fourth vertebra. In the first case the innominate artery rose 
high into the neck. In the second, that artery divided within 
the chest, and the subclavian artery too, lay within that 
cavity, from which it ascended perpendicularly and close to 
the carotid. The cases delineated may be considered as oppo- 
site extremes, between which there are many intermediate 
degrees. (See table.) The influence of the position of the 
arch of the aorta here referred to on the accessibility of the 
innominate artery in a surgical operation, and on the size 
which aneurism of the aorta directed upwards would attain 
before making its appearance at the bottom of the neck, is 
so obvious as not to require comment. 

In the notes taken of the condition of the arch of the aorta it 
is stated in many cases that its position is higher and in others 
that it is lower than usual. The exact distance was ascertained 
in but a few cases, which are here subjoined 





Distance in inches between the 




Distance in inches between the 


No. 


highest part of the arch and the 
top of the sternum. 


No. 


highest part of the arch and the 
top of the sternum. 


53 


1| 


96 


i 


58 




98 




59 


1* 


117 


H 


67 


1 


121 





73 


u 


142 


nearly 3. 


74 


f 


249 


( nearly on a level with 


80 


4 




I sternum. 


89 


$ nearly on a level with 
\ top of sternum. 


250 


^ arch opposite middle 
I of 4th dorsal vertebra. 


90 





262 


H 


91 


1 


272 


H 


92 


3 


289 




94 


f 







ABSTRACT OF THE TABLE. 

Cases, in which the highest part of the arch was distant less than 1 inch 

from the upper margin of the sternum . . . .11 

1 inch, not exceeding 1 9 

more than l 2 



RELATION TO THE STERNUM UNUSUAL DIRECTION. 17 



RELATION OF THE ARCH TO THE POSTERIOR SURFACE OF THE 

STERNUM. 

The ascending part or right side of the arch, it is well 
known, is separated by only a small interval from the sternum. 
The following fact may be mentioned as illustrative of this 
point : In some bodies in which the arteries had been injected 
from the abdominal aorta, the ascending part of the arch was 
found to be slightly flattened in nearly its whole length, 
doubtless in consequence of pressure against the sternum, 
while the injection became solid. The artery did not appear 
to be unusually distended, though it must have been so in 
some degree, and there was not any perceptible change of the 
shape of the arch. 

UNUSUAL DIRECTION OF THE ARCH. 

Figure 3 is drawn from a preparation in the Museum of 
University College, taken from the body of a person who was 
condemned to death for arson. It shows the arch of the 
aorta and the large veins in the state which accompanies 
transposition of the viscera. The aorta curves to the right 
side, turning over the root of the right instead of that of the 
left lung, at the same time that the vena azygos has suffered 
a similar change from the right, its usual course, to the left 
side*. 

In Figure 4, taken from a preparation in the Museum of St. 
Bartholomew's Hospital ( ; the aorta corresponds in its dispo- 
sition to the preceding case, but the vena azygos, instead of 
being of the usual size, is here continued from the inferior 
cava. A full description of this case has been published by 
Mr. McWhinnieJ, who says of the veins "A remarkable 

* Cases of this kind are not very uncommon. This, however, is the only one 
observed in University College amongst 930 bodies. For a drawing of another case, 
which occurred in the "Westminster Hospital, I am indebted to my friend Mr. 
Thurnam. 

t The permission to have this and some other draAvings made from preparations in 
the same museum, I owe to the kindness of Mr. Paget. 

A case of transposition of the thoracic and abdominal viscera, accompanied 
with an unusual variety in the venous svstem. London Medical Gazette, 27th March 
1840. 



18 ARCH OF THE AORTA 

feature in the case is the disposition of the vena cava inferior, 
which after being formed by the union of the common iliac 
veins (in this instance as high as the first lumbar vertebrae), 
and receiving the lumbar, renal, spermatic, and phrenic veins, 
entered the chest through the diaphragm, close to the left of 
the aortic opening. From this point it continued to ascend 
parallel with and to the left of the aorta, and arriving on a 
level with the arch of this vessel, curved forward over the left 
pulmonary vessels to join the vena cava superior. 1 " 

" The vense cavse hepaticse united to form a trunk, which 
entering the chest through the left of the tendinous centre of 
the diaphragm, terminated separately in the reversed right 
auricle." 

FIG. 5. 

Cases are recorded by Abernethy*, Fiorati*)*, Sandifort^ 
Cailliot, J. F. Meokel||, BernhardU, Otto**, and others, 
in which the aorta arched over the right bronchus with the 
vena azygos, (see fig. 5, and plate 7, fig. 1 & 3,) and after- 
wards resumed its usual situation on the vertebrae. This con- 
dition contrasts with that illustrated in the two preceding 
figures, in this respect, that the aorta and vena azygos are 
here side by side, whereas in the cases alluded to in the 
preceding sections these vessels are transposed or change 
places one with the other. 

The aorta, in some of the cases above referred to, after 
turning over the bronchus speedily inclined to its usual situa- 
tion on the bodies of the vertebrseff, in others the inclina- 

* Account of two instances of uncommon formation in the viscera of the human 
body. Philosophical Transactions, 1793, p. 59. 

"I" Osservazione Anatomica del Signer Girolamo Fiorati. Tnsolita posizione dell' 
Aorta e Stravagante origine de' suoi primi rami in Saggi scientific! e letterari dell' 
Acad. diPadova,1786. 

J Museum Anatom. torn. 1, partes molles morbosse, p. 79. 

Extrait de trois Observations, &c. in Bulletin de la Faculte de Medecine de 
Paris, torn. i. 1812. 

[| Handbuch der Pathologischen Anatomic, zweiter Band, erste Abtheilung, s. 97, 
Leipzig 1816. 

^| De Arteriarum e Corde prodeuntium aberrationibus. Berolini, 1818. 

** Seltene Beobachtungen. Th. 2, s. 61. 

"f"f After describing the curve of the arch over the right bronchus, Mr. Abernethy 
continues, " The aorta afterwards pursued its ordinary course." In the account of one 
of Cailliot's cases it is said, " L'aorte embrassait dans sacourbure la bronche droite et 
passait derriere 1'extremite inferieure de la trachee artere, pour aller gagner le cote 
gauche de la colonne vertdbrale." 



UNUSUAL DIRECTION. 19 

tion to the left side occurred considerably lower down*, but 
in every instance the vessel appears to have gained its ordinary 
position before reaching the abdomen. 

It is mentioned by Otto, a learned anatomist and acute 
observer, in his statement of the examination of the body 
before referred to, that on directing attention to the vertebral 
column at the upper part of its dorsal division, he found the 
convexity of the slight lateral curve which exists in that situa- 
tion directed to the right side, i. e. towards the point at which 
the arch of the aorta was applied to the vertebrae. This fact 
militates against the opinion that the inclination of the spine 
is referable to the action of the heart and the contact of the 
large artery, and affords an argument scarcely perhaps needed, 
in favour of the influence of muscular action, as the cause of 
the deviation in question, a view which gains further support 
from the additional observation that the right arm was more 
muscular than the left. 

In Mr. Abernethy's case, which was that of a foetus at 
the usual period of birth, the condition of the vena azygos 
requires notice. In the figure (No. 5) which has been 
sketched from the preparation preserved in St. Bartholomew's 
Hospital, the vena azygos is seen to be of unusual size : it 
continued from the vena cava inferior as in the case delineated 
in fig. 4, from which, however, it differs in its relation to the 
aorta and to the bronchus. In his account of the case, 
Mr. Abernethy says, " The situation of the heart was reversed, 
the basis of that organ was placed a little to the left of the 
sternum, whilst its apex extended considerably to the right, 
and pointed against the space between the sixth and seventh 

* Bernhard follows up his account of the course of the arch over the right branch 
of the trachea thus : " Turn pone dextrutn ramum arterise asperse in latere dextro ver- 
tebrarum corporum descendit, quo in situ vena quoque azyga, ut solet, huic ad dextrum 
posita erat et oesophagus ad sinistrum latus, ita tamen, ut ilia simul ante earn positus 
esset. Denique in regione septimce vel octaves dorsi vertebras sinistrorsum inclinata 
in decursu solito per hiatum aorticum in cavum abdominis descendit, in quo a normali 
positura haud amplius recessit." Lib. cit. 7. 

Aorta jam inde a basi cordis egressa, solitumque emensa spatiura, versus dextras in 
arcum sese flectens progrediebatur, ita ut truncus ejus descendens latus fere dextrum 
vertebrarum legeret, usque dum, e diaphragmate in abdomen emergens, sinisterius, 
quemadmodum assolet, se converteret. Aglietti in Sandifort loco citato. 

Of the same caseFiorati says, " Cosi seguia suo cammino, che non mi parve importante 
di far desegnare,./mo all 'ultima vertebra del dorsonel qual sito inclinandosi a sinistra 
prendeva il suo posto ordinario," &c. 

In Otto's case the artery did not incline to the left side till it approached the 
Diaphragm. 

c 2 



20 ARCH OF THE AORTA 

ribs. The cavities usually called the right auricle and ventricle 
were consequently inclined to the left side of the body. The 
inferior vena cava passed as usual through a tendinous ring in 
the right side of the centre of the diaphragm, it afterwards 
pursued the course of the vena azygos, the place of which 

it supplied, &c. The veins returning the blood from the 

liver united into one trunk which passed through a tendinous 
aperture' in the left of the centre of the diaphragm, and 
terminated immediately in the anterior auricle." 



UNUSUAL CONFORMATION OF THE COMMENCEMENT OF 
THE AORTA. 

FlGS. 6 AND 7. 

The arrangement of the great artery represented in these 
drawings has been very rarely met with in man, though it 
corresponds to that which is usual in many mammalia. The 
case here delineated was observed by Klinz * in the body of 
a young soldier, Paul Markow, who appears to have been 
healthy up to the period of being attacked with an acute 
inflammatory disease of the chest, which caused his death. 

In Figure 6, the aorta, without forming an arch, divides 
into an ascending and a descending branch. The former was 
directed vertically upwards to the length of four inches, and 
then divided in form of a cross into three principal branches. 
The right horizontal branch is the innominate, and from it arose 
the right carotid artery. The perpendicular branch became the 
left carotid, and the left horizontal one is the left subclavian. 

J. F. Meckel, in noticing the case, remarks on the vertical 
direction of the heart, seeming to consider this circumstance 
as an additional approximation to the state of the organs in 
lower animals *f. This fact may, however, be reasonably 
attributed to the accumulation of fluid found in the left cavity 
of the chest, which is stated in the report to have been so great 
as to have forced the mediastinum towards the right side. In 
the same manner may the condition of the left pulmonary 

* In Abhandlungcn der Josephinischen Med.-Chirurg. Acad. zu Wien. Band 1, S. 
271, 1787. 

f Merkwtirdig ist dabei, dass auch das Herz, wiebei den meisten Thieren, senlcrecht 
stand. Handbuch der Pathol. Anat. Band 2, S. 94. 



UNUSUAL CONFORMATION. 21 

artery be accounted for. That branch is not delineated in the 
plate (Fig. 7), and it is said to have been absent, as well as 
all trace of the lung and the bronchus. But it is highly pro- 
bable that these parts were merely so compressed and altered 
by the disease, (pleurisy) as not to have been recognised. 

An example of similar conformation of the aorta was found 
by M. Troussieres in the body of a child aged five years. The 
account given of the appearances sets forth that the vessels 
were in their usual situation, except that the aorta did not 
form an arch, but divided into two large branches at three 
fingers 1 breadth from the origin *. 

In dismissing this curious disposition of the aorta, it may 
be observed that the contemplation of it is calculated to recall 
to mind the origin of the terms " ascending" and " descend- 
ing" aorta. These words were introduced into anatomical 
language at a time when the systemic artery was supposed to 
divide, as shown in Fig. 6, into two parts, which took opposite 
directions, and were properly named ascending and descend- 
ing. The idea of the form of the aorta was then taken, as is 
generally known, from its state in quadrupeds ; but the terms 
were retained even when the error as to the fact had been 
removed. As an evidence of the late origin of correct 
anatomical knowledge, it is worthy of remark to how advanced 
a period of the history of mankind the error alluded to con- 
tinued. Even the great leader in the regeneration of 
anatomy, who observed so much and so well, and removed so 
many errors, delineated and described the aorta as dividing 
into two parts f. The modern understanding of the words 
applied to the right and left sides of the aortic arch is well 
stated by Ruysch J ; but the real condition of the artery in the 
human body had been known before that distinguished 
anatomist wrote. 



* The examination of the body was made *' par M. Troussieres maistrc chirurgien, 
en presence de Messieurs Gamier et Spon, Docteurs en Medecine." Extrait d'line 
lettre ecrite de Lyon, 4 Nov. 1667, in Le Journal des Sgavans, 1668. Nouv. Edit. 
a Paris, 1729. 

f" Postquam vero magna arteria coronales deprompsit, k cordis basis centro sursum 
quodauimodo sub venae arterialis caudice conscendit : ac cordis involucrum perforans, 
bipartite scinditur, &c. Andrese Vesalii Opera oin. Anat. et Chirurg. cap. xii. 

J Ita ut Aorta proprie; in duos truncos k natura haud sit divisa, unus idemque 
truucus ascendens et descendens : siquis tamen hanc aortam, quatenus ascendit, ascen- 
dentem, et quatenus descendit, descendentcm nominare velit, nonrenuam. Rcsponsio 
ad eruditum Dnum Johannem Gaubium 1695. 



22 ARCH OF THE AORTA 

FIG. 8. 

Hommel, who had been the assistant of Haller *, described 
the very remarkable preparation represented in this figure, 
and gave a delineation, from which this is copied, with the 
omission of the heart and right lung, which are shown in the 
original drawing. " The aorta," says the author, " divided 
at the beginning of the arch (at the beginning of that which 
is called the transverse part of the arch ?), and was again 
united at its end. Through the sort of island constructed by 
the bifurcation pass the trachea and oesophagus ; a disposition, 
he correctly adds, perhaps never previously observed *f*. 

FIGS. 9 AND 10. 

These are taken from drawings given by Malacarne J, of 
a variety found in the body of an old man, and of which he 
has published a detailed account. The aorta arose by a 
single trunk, which was of large size, and contained five valves. 
At the distance of three lines and a third from the base of the 
heart, and after having given off the coronary arteries, it 
divided into two unequal parts, by the reunion of which the 
descending aorta was formed . From the two lateral vessels arose 
the cervical arteries, which presented the remarkable pecu- 
liarity that, instead of an innominate, and a common carotid 
artery, the external and internal carotids of both sides were 
given separately from the aorta. On each side three branches 
are seen, of which the first is the subclavian, the second the 
external, and the third the internal carotid artery. The 
course of the two carotid arteries in this case will be reverted 
to when the vessels of that name are specially under con- 
sideration. 



Deviations from the usual conformation of important parts 
of the circulating system, so remarkable as those represented 
in the several figures which have here been passed in review, 
are calculated to suggest to every inquiring mind the question 
in what manner is their occurrence to be accounted for ? 
or how are they produced ? 

* Optimus Hummel meus olim Bernse incisor. Haller Elem. Physiol. t. 2, p. Ifi2. 
f Comnaercium literarium. Hebdom 21. Norimbergse 1737. 
J Delle osservazioni in chirurgia &c,, parte 2, 119. 



UNUSUAL CONFORMATION. 23 

The investigations of anatomists have shown that the 
vessels, after their first appearance in the embryo, undergo a 
series of changes which lead to that which is considered their 
ordinary or natural condition, and that the variations from 
that condition are for the most part referable to an arrest or 
deviation in the process of change. To demonstrate this by a 
series of instances, or rather to trace the changes which take 
place in the various phases of development, and to connect these 
with such aberrations as those referred to in the foregoing pages, 
would be an object of the highest interest. It is, however, 
one which would require much research, and would perhaps 
properly form matter for separate investigation. It is, 
moreover, altogether beyond the limits of practical utility, 
within which it is proposed to circumscribe this work. A 
few remarks may, however, be made on the subject as regards 
some of the peculiarities of the aorta and great vein, seen in 
the figures of plate 5. 

As regards the aorta at an early period of existence 
branches are given to each side from the parent vessel, which 
after embracing the trachea and oasophagus, meet at the 
vertebrae and constitute a single vessel, being analogous at 
this period to the permanent condition in fishes and reptiles. 
In the usual course of development one of these vascular 
arches on the left side forms the aorta, the others, with the 
exception of that connected to the pulmonary artery, being 
wholly or partially obliterated. To the persistence of a 
branch on both sides may the arrangement of the great artery 
in figures 8 and 9 be referred. 

The state represented in figure 5, in which the aorta turns 
to the right side, may be conceived to result from the con- 
tinuance of a branch on that, the right side, the usual one on 
the left being removed. It may be observed that the direction 
of the aorta over the right bronchus is that usual in birds. 

Lastly, in the great size of the vena azygos, as seen in 
figures 4 and 5, may be recognised the continuance of that 
which, in the first periods of development, is the chief vein of 
the trunk. 



24 



EXPLANATION IN REFERENCE TO THE TABULAR VIEWS OF 
THE ARTERIES. 

The number in the first column marks the same body in all the tables ; so 
that the condition of all the arteries of any body, at least of all those noted, may 
be ascertained by reference to its number in the different tables. 

The name, age, and sex, are not included except in the first table that of the 
arch of the aorta but by means of the number and a reference to that table 
these particulars may be ascertained for any other artery. 

In every instance in which the condition of the vessel has happened not to be 
noted, the number of the body is omitted, except in the case of the arch of the 
aorta, in which the number is retained because of its connexion with the name, 
age, and sex, in that table. 



EXPLANATION CONCERNING THE TABLE OF THE BRANCHES 
OF THE ARCH OF THE AORTA. 

By the statement that the branches presented the usual arrangement, is im- 
plied that they were three in number : viz. Innominate, Left Carotid, and Left 
Subclavian ; that these arose from the middle or highest part of the arch or 
nearly so ; that the Left Carotid was somewhat closer to the Innominate than to 
the Left Subclavian. 

Slight deviations from the disposition here described have not been considered 
sufficient to justify any special notice. 

The foregoing condition of the branches, for shortness' sake, is generally 
indicated by the word " usual. 1 ' 

The following are some of the abbreviations made use of : 

Br. Branch ; R. Right ; L. Left ; fr. from ; trans, transverse. 

The names of the vessels are for the most part shortened by the omission of 
some of the last letters, thus : Car. stands for Carotid ; Vert, for Vertebral \ 
and so in other cases. 



ARCH OF THE AORTA. 

BRANCHES. 



No. 


Name. 


d 

GO 


Age. 


Number and Arrangement of 
the Branches. 


No. 


Name 


1 


Age. 


Number and Arrangement of 
the Branches. 


1 


M G 


f. 


41 


J" 2 Brs. (L. Car. fr. lower 
\end of Innom.) 


16 


PO 


m. 


40 


Usual. 












17 


A M 


m. 


59 




2 


JC 


m. 


63 


f 2 Brs. , same arrange- 
\ ment as No. 1 . 


18 


SH 


f. 


81 


Usual. 


3 


PP 


m. 


61 


Usual arrangement of Brs. 


19 


JK 


m. 


72 


Usual. 


4 


ER 


f. 


84 


Usual. 


20 


WH 


m. 


47 


Usual. 


5 


JL 


m. 


72 


Usual. 


21 


A B 


f. 


85 


4 Brs. (L. Vert. fr. arch.) 


6 


M N 


f. 


52 


Usual. 


22 


MW 


f. 


54 




7 


S T 


f. 


60 


Usual. 


23 


EO 


f. 


92 




8 


M A 


f. 


40 


Usual. 


24 


M M 


f. 


23 


Usual. 


9 


SS 


m. 


45 


J2 Brs. (L. Car. fr. 
glower end of Innom.) 


25 


MP 


f. 


75 


Usual. 












26 


MH 


f. 


75 


Usual. 










f~'2 Brs. close together 












10 


EC 


f. 


73 


I and given fr. : R. end 
| of trans, part of Arch 


27 


M B 


f. 


40 


Usual. 










l^(L. Car. fr. Innom.) 


28 


CH 


f. 


adult 












[firs, arise fr. R. curve 


29 


CB 


f. 


83 


Usual. 


11 


AC 


f. 


64 


< of arch, and lower than 




















[ usual. 










("Brs. take origin fr. R. 












30 


HW 


f. 


60 


< end of trans, part of arch, 


12 


CB 


f. 


80 


Usual. 










|_and lower than usual. 


13 


MR 


f. 


50 


Usual. 


31 


AW 


u. 


18 




14 


JH 


m. 


60 


Usual. 


32 


MM 


f. 


78 


Usual. 


15 


JG 


111. 


50 


{Brs. spring fr. R. curve 
of arch, and lower than 


33 


EH 


f. 


30 


Usual. 










usual. 


34 


MF 


f. 


50 


J L. Car. at origin very 
\ close to Innom. 



ARCH OF THE AORTABRANCHES. 



No. 


Name. 


1 


Age. 


Number and Arrangement of 
the Branches. 


No. 


Name. 


I 


Age. 


Number and Arrangement of 
the Branches. 


35 


M S 


f. 


68 




59 


WL 


m. 


77 


Usual arrangement of Brs. 


36 


WL 


in. 


69 


Usual arrangement of Brs. 


60 


DF 


m. 


40 


Usual. 


37 


M K 


f. 


66 


Usual. 


61 


N A 


m. 


50 


Usual. 


38 


W L 


in. 


53 


Usual. 


62 


JS 


m. 


51 




39 


RK 


m. 


45 


Usual. 










{Brs. spring from R. end 












63 


ww 


m. 


60 


of trans, part of arch 


40 


C H 


m. 


26 


Usual. 










and close together. 


















about 












{3 Brs. unusually arrang- 


64 




m. 


50 


Usual. 


41 


CC 


f. 


50 


ed (1st. Coin, trunk of 
Carotids. 2nd. L. Sub- 
clav. 3rd. R. Subclav.) 


65 


SB 


f. 


35 


T2 Brs. (L. Car. from 
\ beginning of Innom.) 


42 


EC 


f. 


58 


{3 Brs. unusually arrang- 
ed (1st. Com. trunk of 
Carotids. 2nd. L. Sub- 


66 


M N 


f. 


57 


J" Brs. arise fr. R. end of 
\ trans, part of Arch. 










clav. 3rd. R. subclav.) 


67 


M A 


f. 


18 


2 Brs. (L. Car. fr. Innom.) 


43 


J M 


ru. 


81 


Usual. 


68 


J K 


m. 


62 




44 


MP 


f. 


25 


2 Brs. (L. Car. fr. Innom.) 










T4 Brs. (L. Vert. fr. 












69 


JM 


m. 


22 


< arch and runs superf. 


45 


J J 


in. 


20 


2 Brs. (L. Car. fr. Innom.) 










|_to the Infer. Thyroid.) 


46 


SE 


ID. 


56 


Usual. 


70 


TC 


m. 


70 




47 


WD 


111. 


43 


Usual. 


71 


we 


111. 


52 




48 


A J 


f. 


18 


Usual. 










/Brs. arise fr. R. end of 




















J trans, part of arch and 


49 


J T 


m. 


20 




72 


A H 


f. 


66 


< close one to the other. 




















I Left Innom. vein crosses 










/Brs. given from R. end 










V. them higher than usual . 


50 




in. 


adult 


1 of the trans, part of arch 
I and close as possible. L. 


73 


WW 


m. 


70 


Usual. 










V.Subclav. very oblique. 












51 


SB 


f. 


65 


Usual. 


74 


C B 


f. 


60 


J" L. Car. very close to 
\ Innom. at origin. 


52 


ES 


f. 




f L. Car. at origin is very 
|_close to Innom. 


75 


A T 


in. 


60 


Same as No. 74. 












76 


EM 


f. 


47 


Usual. 


53 


T D 


in. 




Usual. 






















77 


A A 


f. 


52 


Usual. 


54 


VVR 


in. 


66 


Usual. 






















78 


D C 


in. 


46 


Usual. 


55 


G S 


in. 


30 


Usual. 






















79 


JH 


in. 


65 




56 


MR 


f. 


76 
























80 


CN 


in. 


27 


Brs. equidistant at origin. 


57 


M C 


f. 


85 


4 Brs. (L. Vert. fr. arch.) 






















81 


ET 


f. 


76 


Usual. 


58 


M K 


f. 


31 


Usual. 













ARCH OF THE AORTA: BRANCHES. 



27 



No. 


Name. 


3 ^ 


Number and Arrangement of 
the Branches. 


No. 


Name. 


1 


Age. 


Number and Arrangement of 
the Branches. 


82 


JN 


m. 


72 


f L Car. touches Innom. 
\at origin. 


104 


GL 


m. 


50 


Usual. 












105 


E W 


m. 


19 


2 Brs. (L. Car. fr. Innom.) 










{2 Bra. (L. Car. fr. In- 












83 


EP 


in. 


60 


noui.) given fr. R. end 


106 


JD 


f. 


80 


Usual. 










of trans, part of arch. 






















107 


C M 


f. 


75 




84 


MR 


f. 


36 


J2 Brs. (L. Car. fr. 
\beginning of Innom.) 


108 


GP 


m. 


adult 




85 


W F 


ra. 


63 




109 


JL 


ru. 


adult 




86 


M B 


t 


48 


{2 Brs. (L. Car. fr. In- 
nom.) given fr. beginning 
of trans, part of arch. 


110 


EF 


f. 


70 


J L. Car. very close to 
\ Innom. at origin. 












111 


EH 


f. 


58 


Usual. 


87 


EC 


f. 


40 














88 


E R 


f. 


68 


Usual. 


112 


MS< 


f. 


83 


f L. Car. very close to 
\ Innom. at origin. 


89 


T 


f. 


40 


f L. Car. joined to Innom. 
\at origin. 


113 


J W 


m. 


48 


Usual. 












114 


H M 


m. 


30 


Usual. 










fBrs. take origin to R. 












90 


JR 


m. 


85 


) of usual situation and 
j below the highest pail 


115 


J A 


in. 


18 


Usual. 










i^of arch. 


116 


P R 


m. 


67 


Usual. 


91 


SB 


m. 


45 




117 


JS 


m. 


30 


Usual. 










fBrs. very close, and 


118 


PL 


m. 


29 


Usual. 


92 


E T 


f. 


81 


< their origin is to R. of 




















[usual position. 


119 


E Y 


f. 


49 












("Brs. arise to R. of usual 


120 


SC 


f. 


45 


Usual. 


93 


MM 


f. 


42 


< position, and lower on 




















L the arch than ordinary. 


121 


ss 


f. 


32 


Usual. 


94 


J K 


m. 


55 


Usual. 


122 


WR 


ni. 


66 


Usual. 


95 


MH 


f. 


28 




123 


WM 


in. 


68 




96 


H V 


f. 


60 


Usual. 


124 


CR 


f. 


76 


Usual. 


97 


ES 


m. 


27 


Usual. 


125 


J W 


in. 


57 




98 


M B 


f. 


76 




126 


J W 


m. 


48 




99 


AF 


f. 


85 


Usual. 


127 


CH 


f. 


35 


Usual. 


100 


CB 


m. 


26 


Usual. 


128 


H C 


in. 


44 




101 


M G 





79 


Usual. 










{Brs. are given from R. 




















end of the trans, part 


102 


WJ 


m. 


75 




129 


EH 


f. 


64 


of arch, and the origins 
of Innom. and L. Car. 


103 


AW 


f. 


45 


f L. Car. joined to Innom. 
\ at origin. 










are lower than usual 
and close together. 



28 



ARCH OF THE AORTA BRANCHES. 



No. 


Name 


B 

V) 


Age. 


Number and Arrangement of 
the Branches. 


No. 


Name. 


1 


Age. 


Number and Arrangement of 
the Branches. 


130 


J D 


m 


61 


Usual. 










fBrs. given fr. R. end 


131 


RC 


m 


51 


f L. Car. very close to 
\Innom. at origin. 


151 


JT 


m. 


69 


J of trans, part. L. Car. 
1 and Innom. joined at 
{_ origin. 


132 


J T 


w 


82 




152 


SH 


m. 


38 


Usual. 


133 


RH 


m 


30 




153 


J A 


m. 


70 




134 


EC 


m 


66 


Usual. 


154 


MM 


f. 


adult 




135 


AC 


f. 


89 


Usual. 


155 


DC 


m. 


70 


f L. Car. and Innom. 
(_ joined at origin. 


136 


W J 


in. 


40 


Usual. 






















156 


ET 


f. 


35 


Usual. 










(4 Brs. the Carotids 




















I and Stibclavians arise 


157 


C D 


m. 


38 




137 


JN 


f. 


56 


{ separately from arch 




















j R. Subclav. given from 










(3 Brs. unusually arrang- 










^descending part of aorta. 


158 


AF 


f. 


56 


1 ed (1st. Com. trunk of 
\ Carotids. 2nd. L. Sub- 


138 


M B 


m. 


75 


Usual. 










V clav. 3rd. R. Subclav.) 










TBrs. arise close together 


159 


M L 


f. 


60 


2 Brs. (L. Car. fr. Innom.) 


139 


A C 


f. 


63 


J fr. right end of trans. 
j part, and lower than 










{L. Vert, and L. Sub- 










^ usual on arch. 


160 




m. 


adult 


clav. rise in conjunction 




















fr. arch. 


140 


M L 


f. 


68 
























161 


H H 


f. 


73 




141 


W B 


m. 


66 


r 












142 


SM 


f. 


81 


Usual. 


162 


CS 


f. 


22 


f L. Car. very close to 
\ Innom. at origin. 


143 


TG 


m. 


72 




163 


M S 


f. 


70 


J Brs. derived fr. R. end 
\ of trans, part of arch. 










;Brs. arise fr. R. end of 












144 


MC 


f. 


80 


trans, part of arch. 
\Innom. and L. Car. 


164 


M N 


f. 


adult 












joined at origin. 


165 


SL 


f. 


93 


Usual. 










I" Brs. very close and arise 


166 


E W 


f. 


91 


Usual. 


145 


WN 


U1. 


59 


1 fr. R. end of the trans. 












146 




m. 


55 


[part of arch. 


167 


JL 


f. 


50 


f Brs. fr. R. -end of trans. 
\ part of arch . 












168 


AF 


f. 


30 












(" Considerable and equal 












147 


M J 


f. 


19 


< spaces between Brs. at 


169 


EC 


f. 


63 


Usual. 










(_ their origin. 






















170 


AC 


f. 


34 




148 


EC 


f. 


60 














149 


MB 


f. 


adult 




171 


A R 


f. 


54 


f Brs. arise fr. R. end of 
\ trans, part of arch. 










{Brs. spring fr. R. end of 










fBrs. close and given fr. 


150 


SF 


f. 


54 


the trans, part of arch, 


172 


SD 


f. 


31 


< beginning of trans, part 










and very close together. 










[of arch. 



ARCH OF THE AORTA BRANCHES. 



29 



No. 


Name. 


1 


Age. 


Number and Arrangement of 
the Branches. 


No. 


Name. 


1 


Age. 


Number and Arrangement of 
the Branches. 


173 


JS 


n. 


56 


{Brs. close, and given fr. 
beginning of trans, part 


195 


D D 


m. 


41 


2 Brs. (L.Car. fr. Innom.) 










of arch. 


196 


F W 


in. 


adult 


Usual. 


174 


ww 


n. 


65 


{Brs. arise fr. beginning 
of trans, part of arch. 


197 


T P 


m. 


20 




175 


MW 


n. 


36 




198 


RN 


m. 


41 


{L. Car. close to Innom. 
at origin. 


176 


AS 


f. 


38 


Usual arrangement of Brs. 


199 


J B 


in. 


61 


Usual. 


177 


w c 


D. 


30 


J 4 Brs. equidistant at 
\ origin (L.Vert. fr. arch.) 


200 


JD 


m. 


43 


Usual. 












201 


MH 


f. 


40 


Usual. 


178 


MW 


f. 


33 


2 Brs. (L. Car. fr. Innom.) 






















202 


WO 


m. 


32 


Usual. 










/'Arch broad, trans, part 












179 


HG 


f. 


33 


j long and straight L. 
| Car. very close to Tn- 


203 


SB 


f. 


69 


{2 Brs. given fr. R. end 
of trans, part of arch 










V^nom. at origin. 










(L. Car. fr. Innom.) 


180 


M R 


f. 


52 


f Brs. given fr. R. end of 
\ trans, part of arch. 


204 


JC 


m. 


60 


Usual. 












205 


SE 


f. 


65 


Usual. 










[" Brs. fr. R. end of trans. 












181 


J B 


rn. 


55 


< part. Much of arch to 


206 


MM 


f. 


60 


Usual. 










[left of L. Subclav. 






















207 


JH 


m. 


68 


Usual. 


182 


J J 


in. 


50 


Usual arrangement of Brs. 






















208 


SR 


f. 


68 


Usual. 


183 


CF 


f. 


52 


Usual. 






























/'Brs. take origin fr. R. 


184 


WH 


m. 


54 


Usual. 


209 


EM 


f. 


80 


I end of trans, part of 
\ arch much of it to their 


185 


JB 


f. 


18 


fL. Car. at origin very 
\ close to Innom. 










(jeft. 












210 


M F 


f. 


29 




186 


EH 


f. 


18 


L. Car. close to Innom. 






















211 


EH 


f. 


45 


Usual. 


187 


E N 


f. 


73 


f Brs. arise fr. R. end of 
\ trans, part of arch. 


212 


JE 


in. 


59 




188 


M C 


f. 


55 












Innom. takes origin 




















much lower than usual, 


189 


TS 


m. 


adult 












and at nearly 1 inch 


190 


M D 


f. 


60, 




213 


JE 


m. 


adult 


dist. from L. Car. The 
latter and L. Subclav. 




















rise close together fr. 


191 


RK 


m. 


68 


{2 Brs. given fr. R. end 
of trans, part of arch. 










middle of trans, part of 
arch. 










(L. Car. fr. Innom.) 






















214 


AH 


f. 


51 


Usual. 


192 


S W 


f. 


46 


Usual. 






















215 


T T 


tn. 


18 


Usual. 


193 


ES 


f. 


37 


Usual. 






















216 


MB 


f. 


81 


Usual. 


194 


JC 


m. 


46 


Usual. 













30 



ARCH OF THE AORTABRANCHES. 



No. 


Name 


I 


Age. 


Number and Arrangement of 
the Branches. 


No. 


Name 


I 


Age. 


Number and Arrangement of 
the Branches. 










("L. Car. at origin close 


242 


TB 


m. 


55 


Usual. 


217 


TH 


m 


60 


< to Innom., widely sepa- 




















[ rated fr. L. Subclav. 










("Brs. arise fr. R. curve 












243 


JC 


m. 


58 


< of arch, and lower than 


218 


SS 


f. 


50 


Usual. 










|_ usual. 


219 


J W 


m. 


29 


Usual. 


244 


J L 


m. 


64 




220 


J C 


m. 


70 


I* Brs. given fr. mid. of a 
\long trans, part of arch. 


245 


WF 


m. 


60 














246 


S W 


f. 


37 




221 


JF 


m. 


2 


2 Brs. L. Car. fr. Innom. 






















247 


S W 


f. 


adult 


Usual. 


222 


SS 


f. 


18 


Usual. 






















248 


EW 


m. 


35 


Usual. 


223 


MU 


m. 


28 


Jsual. 






















249 


M M 


f. 


40 


Usual. 


224 


WG 


m. 


25 
























250 


J H 


m. 


60 


2 Brs. (L. Car. fr. Innom/ 


225 


H K 


f. 


20 


Brs. equidistant at origin. 












226 


EB 


m. 


70 




251 


AL 


f. 


64 


f L. Car. slightly joined 
\ to Innom. at origin. 


227 


M T 


f. 


80 




252 


JB 


f. 


24 


Usual. 


228 


EK 


f. 


59 


Usual. 


253 


WH 


m. 


71 


Usual. 


229 


AD 


f. 


50 




254 


TL 


m. 


75 


Usual. 


230 


J L 


m. 


57 


Brs. equidistant at origin. 


255 


M J 


f. 


71 


f Brs. arise fr. R. end of 
L trans, part of arch. 


231 


TB 


n. 


adult 


Usual. 






















256 


M H 


f. 


6 


Usual. 


232 


JB 


in. 


48 
























257 


T M 


m. 


adult 


Usual. 


233 


EB 


f. 


60 


Brs. equidistant at origin. 












234 


ER 


f. 


50 


("& Brs. unusually arrang- 
J ed (1st. Com. trunk of 
\ Carotids. 2nd. L. Sub- 


258 
259 


MK 
HC 


f. 

f. 


70 
64 


/ Brs. fr. R. curve of arch, 
\and lower than usual. 

Usual. 










l^clav. 3rd. R. Subclav.) 






















260 


SB 


f. 


75 


Usual. 


235 


W J 


m. 


19 


2 Brs. (L. Car. fr. Innom.) 






















261 


R W 


m. 


38 


Usual . 


23G 


AK 


f. 


45 


JBrs. close together at 
\origin, and equally so. 


262 


M S 


f. 


60 


Usual. 


237 


ET 


f. 


70 


Usual. 


263 


P M 


n. 


65 




238 


AM 


f. 


80 


J Brs. given from R. end 
\ of trans, part of arch. 


264 


MR 


n. 


54 














265 


JC 


n. 


52 


2 Brs. (L. Car. fr. Innom.) 


239 


R W 


m. 


14 
























266 


HC 


f. 


19 




240 


SP 


f. 


27 


Usual. 






















267 


M H 


f. 


33 


Usual. 


241 


JH 


n. 


69 
























268 


JC 


n. 


57 


2 Brs. (L. Car. fr. Innom.) 



ARCH OF THE AORTA BRANCHES. 



31 



No. 


Name. 


3 


Age. 


Number and Arrangement of 
the Branches. 


No. 


Name. 


I 


Age. 


Number and Arrangement of 
the Branches. 


269 


J M 


m. 


84 




279 


J W 


f. 


29 


Usual. 










{2 Brs. Innom. & L. Car. 


280 


JR 


m. 


65 




270 


UF 


f. 


42 


joined at origin, and 
form one thick trunk. 


281 


D D 


m 


35 












(2 Brs. Innom. arises 


282 


C F 


f. 


72 












fr. mid. of trans, part, 












271 


E A 


f. 


22 


and gives L. Car. L. 


283 


MM 


f. 


70 












Subclav. given fr. left 




















curve of arch. 


284 


R M 


m. 


68 












{Brs. arise fr. R. curve 


285 


E W 


m. 


30 




272 


S A 


in. 


adult 


of arch. Origin of In- 




















nom. lower than usual. 


286 


S D 


f. 


adult 




273 


M R 


f. 


45 




287 


ED 


f. 


45 




274 


MP 


f. 


72 




288 


E F 


f. 


75 




275 


JC 


f. 


25 


Usual. 


289 


A J 


f. 


23 


Usual. 


276 


WO 


m. 


20 




290 


FH 


f. 


28 


2 Brs. (L. Car. fr. Innom.) 


277 


EG 


f. 


52 




291 


M H 


f 


28 


Usual. 










fL. Car. at origin close 












278 


SC 


f. 


86 


J to Innom., and at a 
| greater dist. than usual 




















[_fr. L. Snbclav. 













32 



ARCH OF THE AORTA BRANCHES 

ABSTRACT OF THE FOREGOING TABLE. 



Cases in which the branches arose to the right of the usual situation, see 

plate 6, fig. 1 and 2 35 

Left Carotid more than usually close to Innominate, plate 6, fig. 5 15 
Left Carotid joined with Innominate, plate 6, fig. 6 ... 7 
Left Carotid given from Innominate or both vessels united so as 

to form one large trunk, plate 6, fig. 7 .... 25 

Left Vertebral given from the Arch of Aorta .... 5* 
3 brs. unusually arranged. 1st. Common trunk of both common 
Carotid arteries. 2nd. Left Subclavian. 3rd. Right Sub- 

clavian . . . 3 

The Carotid and the Subclavian arteries spring separately from 

the arch , 1 

The usual arrangement of the branches ..... 121 
There did not occur any more remarkable deviation from the usual arrange- 
ment of the branches in 930 bodies except that represented in plate 7, fig. 2. 

* Judging by the preparations in my collection and the general impression on my 
mind, I should be disposed to regard this as an under-statement of the frequency of 
the occurrence of this variety. And though there is no doubt of the accuracy of the 
table, I should not be surprised to find the Vertebral artery given from the Aorta in a 
larger proportion of another series of cases. 



INNOMINATE OR BRACHIO-CEPHALIC ARTERY. 



IN the following table the word " usual" is sometimes applied to the length of the 
artery and to the place of division in the former case, it implies that the vessel, which 
was not measured, appeared to be from one and a half to two inches in length ; when 
applied to the place of division, it is to be understood that this was situated behind the 
inner end of the Clavicle, or nearly on a level with its upper margin. 

The abbreviations are similar to those explained at the beginning of the preceding 
table. 





Length 








Length 


| 


No. 


in 


Place of Division. 


Peculiarities. 


No. 


in 


Place of Division. 


Peculiarities. 




Inches. 








Inches. 






1 


1* 




("gives L. Ca- 
< rotid close to 
[ origin. 


16 




f opposite up- 
< per margin of 
[ Clavicle. 




2 


H 




/ gives L. Ca- 
\ rotid as No. 1 . 


18 


k 


J 1 inch above 
\ Clavicle. 


/gives a Thy- 
\roid branch. 


3 


H 






19 


2i 


f not above Cla- 
|_ vicle. 








(""opposite upper 












4 


?f 


J margin of the 
| sternal end of 




20 




/not above Cla- 
\ vicle. 








[_ Clavicle. 












5 


H 






22 




/opposite Cla- 
\ vicle. 




6 


2 






23 




same. 




7 


2 






24 


li 










Tabove the up- 




25 


li 






8 


1* 


J per margin ol 
| the sternal end 
L of Clavicle. 




26 


usual. 


f opposite Cla- 
\ vicle. 




9 


H 




gives L. Carotid. 


27 


usual. 


same. 




10 






gives L. Carotid. 


28 


usual. 


same. 




11 






fgives a small 
J branch which 
| descends on 
L Trachea. 


29 
30 


usual. 

longer 
than 


same.. 

/not above Cla- 
\ vicle. 














usual. 






12 




f opposite up- 
tper margin o1 




31 




/opposite Cla- 
\ vicle. 








Clavicle. 




















30 




f behind Cla- 






greater 


f below Sterno- 




o 




\ vicle. 




15 


than 


< clavicular Ar- 














usual. 


Lticulation. 




35 




same. 


' 



34 



INNOMINATE OR BRACHIO-CEPHALIC ARTERY. 





Length 








Length 






No 


in 


Place of Division 


Peculiarities. 


N 


in 


Place of Division. 


Peculiarities. 




Inches. 








Inches 






3( 






f gives a Thy 
\ roid branch . 


6 


14 


usual. 












6 


2 


usual. 




38 


usual. 


usual. 




















6 


2 


usual. 


gives L. Carotic 


3 


usual. 


usual. 
























("opposite uppe 




4C 


usual. 


usual. 




6 


2 


I margin of th 
j sternal end o 




41 






;no Innomin 
ata. See th 






[.Clavicle. 




4 J 






1 arch of th 








f gives L. Car. 


42 






[_ Aorta, 
same as No. 41 


6 


If 




1 close to origin, 
< and a Thyroic 
1 branch at bi- 
















i^furcation. 


43 


usual. 


usual. 




















6 


H 


usual. 




44 


usual. 


usual. 


gives L. Carotic 
























{left Innom. 


45 


usual. 


usual. 


gives L. Carotic 








vein crosses 










7 


if 


usual. 


the artery 


46 


usual. 


usual. 










higher than 










7 


2 




usual. 


47 


usual. 


usual. 


























|"L. Carotid is 


48 


usual. 


usual. 




74 


2 i 


usual. 


I close to it .at 
















[origin. 






f considerably 












49 




< above Clavi- 




75 


2 


sual. 








Ida. 




















76 


2 


sual. 




50 


usual. 


sual. 




















77 


2 


sual. 








f not above Cla- 












5] 


f 


[ vicle. 




78 


usual. 


sual. 




52 


2 


sual. 


f L. Car. very 
t close at origin. 


80 


2 














81 


H 






53 


2 


sual. 












54 


If 


sual. 




82 


H 


sual. 


PL. Carotid 
1 touches it at 
[origin. 


55 


ji 


sual. 
















"opposite upper 




83 


if 




r gives L. Car. 
close to origin. 


57 


If 


margin of the 
sternal end of 










Tgives L. Car. 






^Clavicle. 




84 


H 




J at lower end, 
] or both united 


58 


li 


sual. 










[_ at their origin. 


59 


If 


sual 










("gives L. Car., 
















J which takes 


60 


i| 


sual. 




86 


2 




| its rise higher 
















(^than usual. 


61 


2 


sual. 













INNOMINATE OR BRACHIO-CEPHALIC ARTERY. 



35 



No. 


Length 
in 


Place of Division. 


Peculiarities. 


No. 


' Length 
in 


Place of Division. 


Peculiarities. 




Inches. 


- 






Inches. 






88 


f 










(""opposite upper 




89 


u 




("joined at ori- 
\ gin to L. Car. 


121 


* 


I margin of the 
| sternal end of 
[Clavicle. 




90 


2 






122 


H 


usual. 




91 


2 






124 


11 


usual. 




92 


If 


usual. 




127 


if 


usual. 




93 


2 


usual. 


(" rises low down 
I on the arch of 


129 


11 


usual. 


f L. Car. close 
\ to its origin. 








L Aorta. 


















130 


H 


usual. 




94 


ji 


usual. 




















131 


|i 


usual. 




96 


]_1 


usual. 




















134 


2 


usual . 




97 


2 


usual. 




















135 


usual. 


usual. 




98 


21 


usual. 




















136 


2 


usual. 




99 


24 


usual. 


























(R. Car. and 


100 


2 












R. Subclavian 


101 


11 


usual. 




137 






1 arise separate- 
| ly fr. Aorta. 
















(See the Arch 


103 


If 


usual. 


("joined at ori- 
\ gin by L. Car. 








I of Aorta.) 














("opposite lower 




104 


2 


usual. 




138 


2* 


J margin of the 
] sternal end of 




105 


2? 




lives L. Carotid. 






[Clavicle. 




106 


11 


usual. 




139 


2* 




/joined to L. 
\ Car. at origin. 


110 


If 


usual. 


/ close to L. 
l_ Car. at origin. 






f considerably 












142 


2 


< below the top 




111 


1 


usual. 








Lof sternum. 




112 


2 


usual. 




144 


If 


usual. 


/joined at ori- 
\ gin to L. Car. 


113 


11 






















145 


If 


within Thorax. 




114 


ftjk 


usual. 




















147 


ordiny. 


usual. 




115 


H 


usual. 




















150 


],i 






116 


2 














117 


1* 


usual. 




151 


4 




("joined to L. 
\ Car. at origin 


118 


H 


usual. 




152 


H 






120 


il 


usual. 




155 


a 


usual. 





36 



INNOMINATE OR BRACHIO-CEPHALIC ARTERY. 





Length 








Length 






No. 


in 


Place of Division. 


Peculiarities. 


No. 


in 


Place of Division. 


Peculiarities. 




Inches. 








Inches. 






156 


li 


usual. 










|"L. Car. close 










179 


f 


low in chest. 


< to Innom. at 








instead of an 








{_ origin. 








Innom., the 
















first branch of 






(""opposite upper 




158 






the trans, pt. 
< of the Arch 


180 


H 


J margin of the 
"^ inner end of 










of Aorta is a 






[Clavicle. 










short trunk 
















com. to both 


181 


*i 


usual. 










Carotids. 










159 






jives L. Carotid. 


182 


if 


f notabove Cla- 
(^ vicle. 




160 


usual. 


usual. 




183 


H 






162 


usual. 


usual. 


( L. Car. very 
\closeatorigin. 


184 


if 


usual. 










Abe Innoin. 


185 


ii 




f L. Car. close 
[at origin. 








1 and Subclav. 










163 


2i 


{higher than 
usual. 


J arch upwards 
j considerably 


186 


li 












1 above first rib 


187 


if 












l^and Clavicle. 
























Ogives L. Car. 


165 


!J 


usual. 










j near origin, 










191 


*i 


not above Clav. 


I and a Thyrou 


166 


2 


usual. 










j br. near bi- 
















V. furcation. 


167 


H 


usual. 




















192 


if 






169 


2 








8 














193 


H 






171 


usual. 


usual. 




















194 


if 






172 


usual. 


usual. 


























Ogives L. Car. 


173 


2 


usual. 










at lower enc 
















andaThyroid, 


174 


2 


f not above Cla- 
\ vide . 


("rises lower 
J than usual on 
] the Arch of 


195 


11 




J which sup- 
\ plies place o 
the R. infer. 








L Aorta. 








Thyroid, near 
















^bifurcation. 


176 


H 


usual. 




















196 


if 


usual. 




177 


i 


J not above Cla- 
\vicle. 




198 


ordiny. 


usual. 










'gives L. Car. 


199 


H 










/ in the chest 


From the L. 














1 some distance 


Car. to its bi- 


200 


if 






178 


i 


I below the up- 
| per part of its 


furcation the 
Innom. mea- 


201 


2 


usual. 








j osseous boun- 


sures three- 














V.daries. 


quarters of an 
inch. 


202 


2 




f L. Car. close 
|_ at origin. 



INNOMINATE OR BRACHIO-CEPHALIC ARTERY. 



37 



No. 


Length 
in 


Place of Division. 


Peculiarities. 


No. 


lAngth 
in 


Place of Division. 


Peculiarities. 




Inches. 








Inches. 












f gives L, Car. 


223 


H 


usual. 




203 


If 




<( a little above 
















V.ovigin. 


225 


ii 


usual. 




204 


*l 






228 


H 


usual. 




205 


usual. 


usual. 




230 


2| 


C above sternal 
t end of Clav. 




206 


If 


usual. 




















231 


H 






207 


i* 


usual. 


























gives at the 


208 


1* 












distance of | 
















inch from its 


209 


1 












bifurcation a 
















small branch, 


210 


usual. 


usual . 




233 


2 




t which runs up- 
















wards under 


211 


li 












the muscles, 
















and does not 








'the origin is 








reach theThy- 








considerably 








joid body. 








lower than 
















usual fr. the 








fno Innom. 








end of the as- 








I in place of it 








cending part 


234 






< is a trunk 


213 


If 




of the arch 
and at dis- 








I common to 
V both Carotids. 








tance of half 
















an inch from 


235 


H 


usual. 


gives L. Carotid. 








origin of L. 
















Car., which 


236 


If 


usual. 










is close to L. 
















^Subclav. 


237 


H 


usual. 




214 


If 


usual. 




238 


H 


usual. 




215 


1* 






240 


4 


usual. 




216 


2 






242 


if 






217 


1ft 




f L. Car. close 
\at origin. 


243 


2 




$ joined to L. 
Car. at origin. 


218 


i 


fin chest, near- 
J ly opposite 
| lower margin 




247 


2 




/'gives a Thy- 
< roid br. near 
^bifurcation. 






Lof Clavicle. 




















248 


H 


usual. 




219 


H 


same as 218 












220 


if 






249 


II 


fa little above 
< the margin of 
l^Clav. 




221 




. 


(gives L. Car. 
at origin. 






^low in thorax 




222 


if 






250 


I* 


) oppos. mid. 
j of 2nd. dors. 


$ joined to L. 
i Car. at origin. 














^ vcrteb. 





38 



INNOMINATE OR BRACHIO-CEPHALIC ARTERY. 



No. 


Length 
in 
Inches. 


Place of Division. 


Peculiarities. 


No. 


Length 
in 
Inches. 


Place of Division. 


Peculiarities. 


251 


If 


usual. 


(joined to L. 
( Car. at origin. 


267 


H 


usual. 


















{gives L. Car. 


252 


H 












from this 










268 


If 




to bifurcation 


253 


If 












of Innom. 1 
















inch. 


254 


usual. 


usual. 


























f Innom. and 


255 


If 






270 


li 




( L. Car. united 
















\^at origin. 








Ogives a Thy- 










256 


i 




J roid branch at 
j junction with 


271 


If 




gives L. Car. 


258 


H 


usual. 


V^the com. Car. 


272 


2i 


5 \ inch above 
I Clavicle. 


Arises low on 
\ the Arch of 
^ Aorta. 


259 


if 


usual. 




275 


usual. 


usual. 




260 


11 


usual. 




070 


2 1 




S close to L. 










A 1 O 






I Car. at origin. 


261 


II 




(joined to L. 
| Car. at origin. 


279 


2 






262 


if 






288 


Ii 


below Clavicle. 










(gives L. Car., 


289 


H 


usual. 










above which 










265 


2 




it measures 


290 


H 


usual. 


gives L. Carotid. 








to bifurcation 
















1^ inch. 


291 


H 


isual. 




266 

















39 



INNOMINATE, OR BRACHIO-CEPHALIC ARTERY. 

ABSTRACT OF THE TABLE. 



Number of Cases in which the Artery measured 1 inch and under . . 8 

Above 1, not exceeding 11 81 

Half of those marked usual . . * . . . .24 

. 105 

Above 1, not exceeding 2 . . . . . 66 

Half of those marked usual 24 

90 

Above 2 . . . .-.'... . . . 16 

PLACE OF DIVISION. 

Number in which the bifurcation of the Artery took place considerably 

above the Clavicle ........ 7 

At some distance below that bone .9 

Behind the Sterno Clavicular-joint, on a level with the upper 

margin of the Clavicle, or nearly so 121 



Innominate gave L. Carotid, or both vessels united into one large trunk . 25 

A Thyroid branch . 7 

A small Artery which ramified downwards over the Trachea . . 2 



ARCH OF THE AORTA. 

BRANCHES. 



EXPLANATION OF PLATE VI. 

THE parts bear the same marks wherever they occur in the 
same plate. 

a Larynx. | b Trachea. 

d (Esophagus. 

ARTERIES. 



1 . The commencement of the arch of 

the aorta. 

2. The descending aorta. 

3. Innominate. 

4. hight carotid. 



4 1 . Left carotid. 

5. Right subclavian. 
5 ! . Left subclavian. 

6. Vertebral. 



a Heart. 

ft Trachea. 
li } Larynx. 



EXPLANATION OF PLATE VII. 



c Bronchus. 

d (Esophagus. 

e The thyroid body. 



ARTERIES. 

1. The arch of the aorta. I 6. Left vertebral. 

2. The descending aorta. G 1 . Right vertebral. 
+ A pouch projecting from the ! 7. Thyroid. 

aorta. 8. Internal mammary of the right 

I). Innominate. side. 



4. Right carotid. 
4 l . Lett carotid. 

5. Right subclavian. 
o ' . Left subclavian. 

E 



9. Pulmonary. 

10. Ligarnentumarteriosum, or Duc- 
tus arteriosus. 



42 ARCH OF THE AORTA BRANCHES. 

VEINS. 
11. V. cava superior. | 12. V. azygos. 

NERVES. 
13. N. vagus of the right side. | 13 l . N. vagus of the left side. 



THE BRANCHES GIVEN FROM THE ARCH. 

The deviations from the ordinary disposition of the arch of 
the aorta referred to in the preceding pages, and represented 
in the majority of the figures in the fifth plate, are of very 
rare occurrence, insomuch, that in the number of bodies 
(nearly a thousand) over which my observation has extended 
with a special view to the subject, no important changes were 
found in the arch, with the exception of those which occur in 
its position or height within the chest, and the single case of 
transposed aorta accompanying transposition of the viscera 
(ante #, pages 15 and 16, and plate 5, figures 1, 2, and 3). 

But the variations in the large branches given upwards 
from the arch are not unfrequent, as will be apparent on 
reference to the table, page 15 et seq., or to the abstract of 
it at page 32. The repeated statement of Haller *, that 

* After enumerating some of the previously recorded variations in the arch of the 
aorta and its branches, he remarks 

" Natura hanc principem arteriarum originem fahricata est, adeo tamen hasc rara 
sunt, ut in quadringentorum cadaverum incisione nihil ejusmodi viderim, neque ante 
me, Celebris olim ex manus medicantis et dissecantis solertia, Gulielmus Cheselden." 
Elem. Physiol. t. ii. p. 162. 

The statement of Cheselden runs thus : " By some authors these vessels have been 
described in a different manner ; but I believe these descriptions were, for want of 
human bodies, taken from brutes ; for I have never yet seen any variety in these 
vessels in humane bodies, though I have in the veins nearer the heart." The Anatomy 
of the Human Body, 4th ed. 1730, chap. viii. p. 175. 

On the same subject Haller elsewhere writes thus : " Nullum in eo arcu unquam 
varietatis, genus reperi, nisi quod earn saepe varietatem vidi quam," &c. &c. ; referring 
to several papers containing accounts of the origin of the vertebral artery from the 
aorta. He continues thus: " Satis nempe frequenter vertebralem arteriam ex arcus 
parte sinistra inter subclaviam et carotidcm prodiisse vidi." And after alluding to the 
descriptions of several varieties contained in various works, he adds, " Rara vero hsec 
omnia esse si dixero, cum quadringenta nunc cadavera humana dissecuerim, fidem forte 
invcniam. Iconum Anatom. fascic. vi. p. 1." 

It is worthy of remark, that the learned Dr. Barclay committed the oversight of 
mistaking the word quadringenta for quadraginta. In reference to the last-cited 
passage, he says, " Haller, remarking that all such cases are extremely rare, expresses a 
hope that after dissecting forty (ought to be four hundred) bodies, he may be allowed to 
obtain some credit for his assertion." A Description of the Arteries of the Human 
Body, p. 9, note. Edinburgh, 1820. 



THEIR VARIATIONS. 43 

notwithstanding his large experience, he had witnessed no 
other arrangement of the arch and its branches than the 
ordinary one, with the exception of the left vertebral artery 
arising from the aorta, is to be attributed partly to the cir- 
cumstance of his not having directed attention to some 
changes recorded in this work ; partly, also, to the vague- 
ness and want of accuracy which are inseparable from a 
reliance on general impressions only, where facts are con- 
cerned. 

Before entering on the consideration of the variations 
which take place in the branches of the arch of the aorta, it 
is necessary in the first place to state, that the coronary and 
bronchial arteries will not be referred to under this head ; 
secondly, it is necessary to determine that standard condition 
from which others are said to vary, viz. the most frequent, and 
therefore the usual condition of the vessels. It is universally 
and correctly stated by anatomists, that the most frequent 
arrangement is that in which the innominate, the left carotid, 
and the left subclavian arteries are derived from the middle 
or the top of the arch ; the left carotid being somewhat 
nearer to the common trunk of the arteries of the right side, 
than to the vessel destined to its own side. 



CLASSIFICATION OF THE VARIATIONS IN THE 
BRANCHES. 

So numerous are the forms of deviation from the standard 
condition, that some arrangement or classification is indis- 
pensably necessary. They admit at the outset of being 
separated into two classes : 

1 . The first, to comprise the cases in which the primary 
branches, viz. the carotid and subclavian arteries, or the 
innominate, the common trunk of two of these, are concerned. 

2. The second to include those in which one or more 
secondary branches, usually given from the subclavian, take 
origin directly from the aorta. 

E 2 



44 ARCH OF THE AORTA BRANCHES. 

CLASS I. 

The variations included in the first class, namely those in 
which the primary branches are concerned, affect 

a The situation which the vessels occupy on the arch. 

b The contiguity of the branches one to another ; (in both 
of tfoese cases the vessels retain the order in which they 
usually take their origin). 

c Their number, relative position, and arrangement. 

a VARIATIONS IN THE SITUATION WHICH THE VESSELS 
OCCUPY ON THE ARCH. 

PLATE 6 FIGURES 1 AND 2 *. 

Instead of being given from the middle or highest part of 
the arch, the branches frequently are moved towards the 
right side, taking rise from the right end of the transverse part 
of the arch, or the curve on that side. When such a change 
occurs, their origin is, in consequence of the arched shape of 
the great parent vessel, almost necessarily lower than ordi- 
nary, and that of the innominate must obviously be lower 
than either of the other arteries. It is apparent that the 
length of the last-named vessel, which would be requisite to 
reach above the clavicle, and cause it to be accessible in the 
neck when it takes origin in the usual situation, would be 
insufficient to extend to the same point under the circum- 
stances here alluded to. 

When the arteries arise, as indicated, on the right of their 
usual situation, they are generally close one to the other, and 
appear as it were crowded together on the aorta (fig. 1). 
Occasionally, however, they are not so, as is exemplified in 
fig. 2, which shows the innominate removed from the other 
arteries, the left carotid being closer to the left subclavian 
than to it. 



b VARIATIONS IN THE CONTIGUITY OF THE PRIMARY BRANCHES 
ONE TO THE OTHER. 

The branches sometimes take their rise at equal distances 
one from the other (fig. 3) ; and the distance between them 

* Taken from preparations 253 a & b in my collection. 



THEIR VARIATIONS SIXTH PLATE. 45 

is occasionally, but rarely, much greater than in this figure, 
or than is usual. 

The change most frequently observed in the position of the 
branches, results from the tendency which it may be said the 
left carotid has to approach, and even to join the innominate. 
In figures 3, 4, 5, 6*, that vessel undergoes a gradual transi- 
tion towards the innominate, until, in figure 7 * } it arises from 
that artery. 

c. VARIATIONS IN THE NUMBER, THE RELATIVE POSITION, AND 
ARRANGEMENT OF THE PRIMARY BRANCHES. 

The primary branches may be decreased from their usual 
number to two, or augmented to four. There is no example with 
which I am acquainted of a greater extent of departure from 
the usual number than those here stated, with the exception of 
two cases f, in which it was increased to six. An additional 
source of variation in the primary branches arises from a 
difference in their arrangement, the number being unchanged 
from that which is usual. 

Reduction of the number of the primary branches. Of this 
variety three examples are given in figures 7, 8, and 9. 

In figure 7 ? the left carotid is derived from the innominate. 
The observations recorded above show this to be by much the 
most frequent change which occurs in the number of the 
branches. This statement is not in accordance with that 
usually made by anatomical writers, who are almost unanimous 
in regarding the increase of the number by the origin of the 
left vertebral artery from the arch as the most frequent source 
of change in the branches f. 

Figure 8 is sketched from the work of Tiedemann, (plate 4, 

* Drawn from preparations 127 and 129 a b c in my collection. 

f Malacarne's case, plate^5, fig. 9, and another which will be referred to under the 
head of the Carotid Arteries. 

J Haller, in a passage of the Icon. Anatom. previously cited. 

J. F. Meckel observes " Haufiger vermehrt sich die Zahl der Stamme, als dass sie 
sich verminderte. Am gewohnlichsten iibersteigt die Zahl der Stamme die regelmassige 
nur um eine, so dass sich vier finden. Dies geschieht nicht immer auf dieselbe Weise. 
Meinen Erfahrungen nach wird es am haufigsten dadurch bewirkt dass die linke 
Wirbelpulsader, der Regel nach ein Ast der Schliisselpulsader^unmittelbar ausder Aorte 
entsteht." Handbuch der menschlichen Anatomic, Band 3 Halle und Berlin, 1817. 

Professor Harrison says, " Exceptions to this (the usual) order frequently occur : 
the most common one is that of four arteries arising from the middle of the arch, the 
additional branch being generally the left vertebral," &c. The Surgical Anatomy of 
the Arteries, vol. i., p. 11. 



46 ARCH OF THE AORTA BRANCHES. 

fig. 8,) in which it is stated of the case merely that it was 
observed by Zagorsky. Now, on reference to the essay of the 
Russian anatomist, I find that he has not illustrated the 
description by a drawing : the representation given by Tiede- 
mann is, in consequence, to be regarded as a plan made in 
conformity with the description in the original paper. 

It must further be remarked, that the account of the pre- 
paration published by Zagorsky is defective, inasmuch as it 
contains no allusion to the state of the aorta*. This omis- 
sion diminishes considerably the value of the case ; for with 
such an arrangement of the branches, our experience would 
lead us to expect that the arch should be directed to the right 
side, seeing that the tendency of the branches is to approach 
and to join one to another towards the beginning of the aorta, 
for such the right side may be considered when the great 
vessel has its usual course. In the absence, therefore, of in- 
formation as to the aortic arch, the case in question will be 
regarded as of doubtful value. 

Figure 9 is also taken from Tiedemann. He observed 
an example of this arrangement of the vessels in the Museum 
of Berlin. Similar cases had been previously described but 
not figured by Malacarnef and BiumiJ. 

Increase of the number of the primary branches. This variety 
may be said to arise from the decomposition or division of the 
innominate trunk ; the right carotid and subclavian taking 
their rise directly from the arch of the aorta. 

The figures 10, 11, 12 and 13, show the two carotid and the 
left subclavian arteries arising from the arch in the usual 
order. But the right subclavian artery undergoes a gradual 
transition from the right to the left side ; thus in figure 10 
the right subclavian and carotid have the relation, which may 

* After describing the arrangement most usual when two branches arise from the 
aorta, the author continues in these words " In nostro autem subjecto vice versa 
res se habebat ; truncus enim dexter pergebat, pectore egressus, ad solam extremitatem 
dextram, sinister vero spargebat utramque arteriam carotidem et subclaviam sinistram." 
Meui. de I'Acad. Imperiale de St. Petersbourg, torn, i., St. Petersbourg, 1809. 

f " Ho pero negli anni seguenti veduto in due cadaveri umani dall' arco dell' aorta a 
nascere le due sole succlavie, e da caduna di questa una carotide." Osservazioni in 
Chirurgia, parte ii., p. 128, Torino 1784. 

J " Subclavia sinistra orta est singulari plane exemplo ex carotide sinistra. Itaque 
duae tantum arterise ex arcu prodibant. Nil tale unquam vidi." Francisci Biumi, 
Philosophi et Medici, Observat. Anatom. ; tomus primus, observat. 10. 



THEIR VARIATIONS SEVENTH PLATE. 47 

be supposed to result from a simple division of the innominate ; 
in the eleventh figure the subclavian is seen to have passed 
to the left of one carotid ; figure 12 shows it beyond the other 
carotid, and in figure 13 it has proceeded beyond, or to the 
left side of the left subclavian artery. 

It is remarkable that when the four primary branches are 
given separately from the arch of the aorta, the arrangement 
which apparently deviates most from the usual disposition, 
that, namely, in which the right subclavian arises from the 
left side of the aorta, is of much the most frequent occurrence. 
That vessel, when it does not spring from the innominate, is 
usually given at the point indicated. 

Some instances are published of the arrangement repre- 
sented in figure 10 *, but of the variations shown in figures 
11-f- and 12^ I have not seen an account of any other 
examples than those from which were taken the original 
representations here copied. 

In plate 7, figures 1 and I 1 , is represented an arrangement 
of the vessels the reverse of that in the last figure of the 
preceding plate. The left carotid is the first branch, the 
carotid of the right side the second, the right subclavian 
follows emanating from the highest part of the arch ; lastly, 

* " When there are four, the two middle branches are termed Arteriae Carotides ; the 
other two Subclavise ; and both are distinguished into right and left." An anatomical 
exposition of the structure of the human body by James Benignus Winslow, transl. 
by G. Douglas, M.D. Vol. 2, p. 3. London, 1776. 

" Weniger vom Normal abweichend ist die Spaltung der aus dem Aortenbogen 
entspringenden Starame, wo alle an ihrer normalen Stelle bleiben, die rechte Schliissel- 
pulsader also zuerst entsteht. Diese beobachteten * * * und ich in zwei Fallen." 
J. F. Meckel Handbuch der Pathol. Anatom. band, 2, 8. 107. 

f The figure has been slightly modified from that published by Httber. Of the 
case he observes "Nulluin exhibebat cadaverculum puellse in partu extinctae innomi- 
natam arteriam. * * Seorsim enim e central! quasi arcus parte prodibat arteria Sub- 
clavia dextra, latens primo intuitu, et pone Carotidem sui lateris incedens, suara versus 
claviculam mox obliquato incessu tendebat, in consuetos ibidem ramos divisa. Sola 
nempe exibat ex arcu Carotis dextra, recta adscendens, ortu suo prima, s. dextima." 
Acta Helvetica, &c. vol. viii. observat. iv. p. 74. Basilese 1777. 

J This representation is copied from one of several published with the descriptions 
of the cases by Walter in the Nouveaux Memoires de 1' Acad. des Sciences & Belles 
Lettres, Berlin, 1785. 

Of the case represented in these figures Fiorati and Sandifort published repre- 
sentations at different times, the preparation having been taken from Italy to Leyden 
and presented to Sandifort by Aglietti, who had been a pupil of the Italian professor. 
The former figure is taken from Fiorati without other alteration than the omission of 
the larynx, and a little addition made to the distinctness of some of the parts. The 
latter sketch is copied from one of those contained in the valuable work of Sandifort. 
See ante a, page 18. 



48 ARCH OF THE AORTA BRANCHES. 

the left subclavian is connected to the descending aorta, or 
the end of the arch. This alteration of the origin in the 
branches accompanies the reversed course of the arch of the 
aorta, which was directed over the right bronchus. The case 
also presents an example of a remarkable peculiarity in the 
mode of origin of one of the branches, namely the left sub- 
clavian artery, which is here the last branch. That vessel 
does not take its rise immediately from the aorta, but from 
a projection from it or pouch (f ), which at nearly the same 
point receives the attachment of the ligamentum arteriosum 
(10) and gives origin to the subclavian artery (5 1 ). In figure 
1. b. the pouch is more clearly marked than in the larger 
drawing. Though it is not distinctly stated in the account 
published of the preparation by Fiorati, or in that by Sandi- 
fort, there is little doubt that the trachea and oesophagus 
were anterior to the pouch, between it and the aortic arch. 

The recurrent laryngeal nerves are singularly disposed in 
this case. The nerve of the right side is seen to turn round 
the aorta in the same manner that it does on the opposite 
side when the great vessel arches in the usual direction ; on 
the left side the nerve winds round the ligamentum arteriosum. 

The preparation (No. 72 in my collection) represented in 
figure 2 was found in the body of a male idiot of about 20 
years of age. The arrangement of the branches at their 
origin may be said to be very irregular. Thus the left carotid 
arising as the first branch crosses by the two arteries of the 
right side, and the right subclavian, from the position at 
which it arises from the aorta, is directed behind the carotid 
to its usual position under the clavicle. In this case, as in 
that represented in the preceding figures, the left subclavian 
takes its origin at a considerable distance beyond the other 
arteries from a pouch : this is more clearly seen in the profile 
view of it, figure 2. b., which is taken from the same prepa- 
ration. The carotid arteries in figure 2 are of very unequal 
size, that of the right side is much smaller than usual. From 
the examination, not a very careful one, which was made of 
the artery in the neck the skull was not permitted to be 
opened it was concluded that there was no internal carotid 
artery; but it was not ascertained how the deficiency was 



THEIR VARIATIONS SEVENTH PLATE. 49 

supplied. It will, however, be noticed that the internal 
carotid of the opposite side is unusually large, and the size of 
this artery suggests- the probability that it compensated for 
the absence of the vessel of the right side. 

The number of the branches the same as usual, but their 
arrangement is altered. The third source of variation in the 
primary branches arises from a difference in their arrangement, 
the number continuing three, the usual one. Different forms 
of the condition are represented in figures 3, 4, 5, and 6. 

The three branches given from the aorta in figure 3* are 
obviously the reverse of the usual arrangement, consequent on 
the altered direction of the arch of the aorta, which is curved 
to the right side. Other examples of the same arrangement 
of the branches and the arch of the aorta are contained in the 
fifth plate, figures 3, 4, and 5. In the case before us, the 
ductus arteriosus, which was pervious, is seen to end in a very 
unusual manner, inasmuch as it joins the left subclavian artery 
a little beyond the innominate, without forming any connexion 
with the aorta. The recurrent laryngeal nerve at the left 
side is directed behind the ductus arteriosus, and it is probable 
that the nerve of the opposite side turned round the arch 
of the aorta ; but the written description contains no allusion 
to the nerves. 

The interesting facts in reference to the origin of the left 
subclavian artery and its connexion with the pulmonary 
artery, illustrated in this and the preceding figures of the same 
plate, will come under consideration when the anatomy* of the 
subclavian arteries is being discussed. 

The conditions of the large branches represented in figures 
4f and 5 J, have some analogy one to the other. In both the 

* Copied from Bernhard's drawing (loco citat.), the lungs and the trunk of the body, 
which are represented in the original, heing omitted. 

It is necessary to observe that the description given of this case hy Tiedemann is cor- 
rect so far as it goes, but the drawing (Tab. iv. Fig. 9) differs from the desciiption, and 
does not correspond with Bernhard's original figure. 

~\" Of the figure given in his third plate, from which this has been taken, Tiedemann 
observes, " Proponit rarissimam varietatem, quse mihi in dissecando cadavere juvenis 
viginti duorum annorum occurreb.it." 

Portal met with a case of the same kind, which he thus refers to, " J'ai vu les 
deux carotides reunies en un seul tronc dans un sujet chez lequel les deux sous- 
davieres aboutissoient imme'diatement et separe'uient dans la cavite' de 1'aorte." Cours 
d'Anatomie Medicale, t. iii. p. 155. 

1 From a preparation (No. 401) in my collection. 



50 ARCH OF THE AORTA BRANCHES. 

carotid arteries are joined, and the right subclavian arises 
separately ; but in the one that vessel issues from the com- 
mencement of the transverse part of the arch before the other 
branches ; in the other, it is given from the end of the same 
part, and beyond the left subclavian. 

Figure 6*, which also represents an example of three primary 
branches, the unusual circumstance of the junction of the left 
carotid and the subclavian of the same side is to be noticed. 
A junction of the same kind is exemplified in plate 6, figure 9. 
Considering, however, that when the aorta arches over the 
root of the right lung, the carotid and subclavian arteries are 
usually joined on the left side (see pi. 5, figs. 3, 4, 5, and pi. 7, 
fig. 3), it would be more correct to say, in reference to the 
disposition of the vessels represented in the figure under obser- 
vation, that it exemplified the unusual circumstance of a 
junction between the carotid and subclavian arteries, which 
arise most remotely from the origin of the aorta. 



CLASS II. 

CASES IN WHICH ONE OR MORE SECONDARY BRANCHES USUALLY 
GIVEN FROM THE SUBCLAVIAN ARTERY TAKE ORIGIN 
DIRECTLY FROM THE AORTA. 

In Figures 7, 8, and 9, the origin of a secondary branch 
from the aortic arch coincides with the ordinary disposition 
of the primary branches. 

The origin of a secondary branch from the arch accom- 
panying a diminution in the number of the primary branches 
is illustrated in figure 10. 

In figure 11, it is seen to coexist with an increase in 
the number of the larger branches. 

The instances recorded of two secondary branches arising 
directly from the aorta are very few. The figure 12 shows 
two such vessels, the internal mammary of the right side, and 
the vertebral of the left, in conjunction with the usual primary 
branches. 

* The variety represented in this figure was observed by Tiedemann in the body of 
an eight months' foetus which had hare-lip. 



THEIR VARIATIONSSEVENTH PLATE. 51 

In figure 13, two secondary branches, the right and the left 
vertebral, are seen, with the four primary branches, to occupy 
the upper part of the arch. 

The descent to the aorta so to express the fact of their 
connexion with it of the smaller arteries represented in the 
figures which have here been reviewed, is of very rare occur- 
rence, with the exception of the left vertebral, as represented 
in figures 7 and 10. 

The origin of the left vertebral from the aorta, in com- 
bination with the arrangement of the primary branches seen 
in the figures just referred to, is so often met with that, 
as has been previously stated, it is commonly considered 
to constitute the most frequent source of alteration from 
the usual arrangement of the branches of the arch, and 
when it takes its rise from the aorta, it is almost invariably 
placed between the carotid and subclavian of the left side. 

In figure 8, the origin of the left vertebral artery occupies 
a very rare position *. 

Figure 1 1 f. The combination of a left vertebral with the 
four primary branches is not of very rare occurrence. I have 
seen two preparations in which the arrangement was the same 
as that presented in the figure before us. Koberwein J 
describes a case which differs from that here represented in 
the circumstance of the right subclavian taking origin from 
the right side of the arch before the other branches. 



* A preparation in which the left vertebral arose from the aorta in this very unusual 
situation, is mentioned by Walter : " Arcus arterise aortse, cera flava impletus, ex 
quo tres prodeunttrunci ; primus, arteriam carotidem sinistram, dextram et subclaviam 
dextram, edit. Secundus est ipsa subclavia sinistra ; tertius, vertebralis sinistra. Ex 
adulto." Museum Anatomicum, p. 237. Berolini, 1805. 

J. F. Meckel remarks, " Unter den vielen Fallen, die ich sahe, fand ich nur in einem 
einzigen die linke W irbelarterie mehr nach aussen liegend, uls die Schliisselpulsader." 
Pathol. Anat. band ii. s. 109. 

Tiedemann, from whose figure ours is copied, states that he observed the anomaly in 
the body of a man thirty years of age. 

f This figure is taken from a drawing made of a preparation which is in the 
Museum of the Royal College of Surgeons in Ireland, by Mr. Kirwau, under the 
direction of my friend Professor Hart. It affords me much pleasure to acknowledge 
the great kindness with which Dr. Hart has consented to aid me by the inspection of 
the museums in Dublin, and the superintendence of any drawing which may be 
required. 

" Surgunt in nostro, ex arcu aortae justo minori, carolis dextra solum et carotis 
sinistra, ex descendente dein ante vertebram dorsi secundam, vertebralis sinistra, infra 
hanc, subclavia sinistra, ante cartilaginem tandem vertebris tertiae et quartae interme- 
diam, subclavia dextra." De Vasorum decursu abnormi, &c. 



52 ARCH OF THE AORTABRANCHES. 

Otto has given the description of a case previously referred 
to, in which the branches presented an arrangement that may 
be regarded as the reverse of that delineated in figure 1 1 . The 
aorta arched to the right side ; the primary branches arose 
separately, the left carotid being given first, and the left 
subclavian the last. The vertebral artery took its rise 
between the carotid and subclavian of the right side, and was 
distributed to that the right side. 

Figure 9. The origin of a thyroid artery from the aorta 
is of very rare occurrence * ; the only case which has fallen 
under my observation is represented in this figure. 

In most of the examples recorded of this variety, the 
unusual artery was seen, as in the figure before us, to arise 
between the innominate and the left carotid. It was so 
placed in Neubauer's preparation, which is described and 
figured in the inaugural dissertation of his pupil Erdmann f . 
Nicolai saw the artery given from the aortic arch between 
the carotid and subclavian of the left side }, in the situation 
in which the vertebral takes its rise when derived from the 
aorta. 

* It is difficult to account for the statement made in Bichat's Anatomy, that the 
thyroid artery arises from the aorta more frequently than the left vertebral does ; the 
words are " Quelquefois on a vu la vertebrale gauche naitre immediatement de 
1'aorte et former un quatrithne tronc primitif. Plus souvent on trouve une petite 
artre nee de 1'aorte entre 1'innominee et la carotide gauche, et remontant verti- 
calement stir la trachee pour aller se rendre k la glande thyroide." Anatomic Descrip- 
tive de Xavier Bichat, torn. iv. p. 147 ; nouv. edit. Paris, 1829. 

The error contained in this passage, for such it must be considered,. is remarked on 
by Meckel (Handbuch der menschlich. Anatom,, b. 3, s. 80). 

The distinguished writer last referred to, has, in his admirable work on Pathological 
Anatomy, fallen into the mistake of assigning six examples of the variety to the obser- 
vation of one anatomist ; " Hiiber sahe sie sechsmal unmittelbar aus dem Bogen der 
Aorta entstehen." On consulting Hiiber's Essay, I find that he does not make any 
mention of a thyroid artery arising from the aorta, but that in the page referred to by 
Meckel, he describes it as given from the innominate. "Singularem plane arteriam, 
altius paulum, quam dicta mox thymica, exire vidi ex innomiuata ; incurvato, pro 
indole harum arteriarum, reptatu adscendentem et brevi itinere glandulse thyroidis 
partem infimam adeuntem. In aliis cadaveribus (pluries enim illam observuvi, bis in 
Goettengensi et quater Cassellano theatre Anatomico) &c. &c." Observationes aliquot 
&c. in the Acta Helvet. vol. viii p. 83. 

Tiedemann also, apparently following Meckel, gives the same reference to HUber in 
his account of the variety now under observation. 

f Descriptio Anatomica Arterise innominate et Thyroideae imse. Jense 1772. 

J Preterita tamen hyeme in theatre nostro anatomico, quatuor observavi ramos. 
Horum tres majores eo, ut descripsi, i. e. ordinario modo collocabantur, quartus vero 
diametri longe angustioris, inter carotidem et subclaviam sinistram ex ipso arcu 
emergent, ad glandulae thyroidese partem infimam flexuoso decnrsu properabat, &c. 
De directione vasorum, &c. H. A. Nicolai, Argentorati 17'-25, in HaUer Dissertat. 
Anatom. Select, vol. ii., p. 497. 



THEIR VARIATIONS SEVENTH PLATE. 53 

The figure 12 is copied from that published by Boehmer *, 
of a case observed and prepared by Cassebohm. 

One additional example of two secondary branches in 
conjunction with the ordinary condition of the larger arteries 
may be cited. Meckel gives an account of a preparation, 
which differed from that delineated by Boehmer only in the 
circumstance of the right vertebral artery being given instead 
of the internal mammary "f". 

The 13th figure shows a most unusual condition of the 
vessels. Meckel and Tiedemann have each recorded a single 
instance of this variety. The figure is taken from that given 
in the " Tabulae Arteriarum." 

It may be said that this case is remarkable by several cir- 
cumstances : 

1st. The primary branches arise separately. 

2ndly. The right subclavian is given on the right side ; 
when freed from the innominate that vessel is usually derived 
from the left side of the aorta. 

3rdly. The left vertebral is conjoined to the unusual 
arrangement of the primary branches. 

Lastly. The right vertebral, which arises from the aorta 
with extreme rarity, is here added to the list of deviations 
from the usual arrangement of the branches, furnished from 
the arch of the aorta. 

* Observations binas anatom. &c. in Haller Dissertat. Anatom. vol. ii. p. 451. 

f- " In eiuem Falle den ich vor mir habe, entspringen beide Vertebralarterien mit 
Ubrigens norrnaler Vertheilung der grossen Aeste aus dem Bogen, die rechte zwischen 
dem ungenanntcn Stamme und der linken Carotis, die linke zwischen dieser und der 
linken Schllisselbeinarterie." Ueber die Bildungsfehler des Herzens, Meckel in Reil's 
Arcliiv. fur die Physiologic, band 6, p. 571. Halle, 1805. 



THE CAROTID ARTERIES. 



THE following are a few of the abbreviations used in this table in addition to those 
previously explained i 

Th. or Thyr, for Thyroid ; H. for Hyoid ; Cart, for Cartilage. 

The word "usual" implies that, on examination, the vessels seemed not to depart 
from the usual disposition to such an extent as to require comment. 



COMMON CAROTID. 


EXTERNAL CAROTID BRANCHES. 


*> 


Side 
of the 
Body. 


Length 
in 
Inches. 


Place of Division. 


Peculiarities. 




R 




r opposite the 
upper margin 




- 








"] of the Thy- 












[_roid Cartilage. 








L 




Th. Cart. 


f rises from In- 
L nominate. 




2 


L 




Th. Cart. 


J rises from In- 
|_ nominate. 










["opposite mid- 






3 


R 


H 


< die of Thyroid 
|_ Cartilage. 








L 


4 


J opposite Cri- 
\ coid Cart. 






4 


R 


4 


Th. Cart. 








L 


5 


Th. Cart. 






4a 


R 




Th. Cart. 






6 


R 




Th. Cart. 








L 


5 


Th. Cart. 






7 


R 


3* 


Th. Cart. 








L 


5 


Th. Cart. 






8 


R 


3 


Th. Cart. 








L 


<i 


Th. Cart. 






9 


R 




Th. Cart. 


J rises from 
\ Innominate. 





56 



THE CAROTID ARTERIES. 



COMMON CAROTID. 


EXTERNAL CAROTID BRANCHES. 


No. 


Side 
of the 
Body 


Length 
Inches. 


' Place of Division. 


Peculiarities. 




L 




Th. Out. 






9a 


R 




Th. Cart. 








L 




Th. Cart. 






9b 


R 




f above Os Hy- 

\ oides. 




f Lingl. and Facl. arise by a common 
\ trunk. 




L 




OsH. 






9c 


R 




Th. Cart. 




usual. 




L 




Th. Cart. 




usual. 


10 


R 




Th. Cart. 


/gives Super. 
\ Thyroid. 




12 


L 
R 




Th. Cart. 
Th. Cart. 


f arises from 
\ Innominate. 






L 




f ^ inch above 
LOsH. 




Ahe ext. Carotid is directed almost 
j horizontally backwards to behim 
< the angle of the lower Maxilla, at 
j which point all the Branches arc 
^given off together. 


13 


L 




above Os H. 


J gives Super. 
\ Thyroid. 




13a 


R 




Th. Cart. 




I" the Branches examined and presente( 
\ nothing worthy of note. 




L 




Th. Cart. 




usual arrangement of the Brs. 


13b 


L 




mid. Th. Cart. 




theLaryngl. aseparatebr. fr. Ext. Car. 


16 


R 




OsH. 


(a, long, slend. 
j artery (from 
j Sup. Thyr. ?) 
\ and a vein 
I course down 
1 over the caro- 
(tid. 




18 


R 




OsH. 




f Lingl. and Facl. rise by a common 
\ trunk. Other Brs. usual. 


19 


R 




mid. Th. Cart. 




usual. 


19a 


R 




Th. Cart. 








L 




Th. Cart. 







THE CAROTID ARTERIES. 



57 



COMMON CAROTID. 


EXTERNAL CAROTID BRANCHES. 


No. 
19b 


Side 
of the 
Body. 


Length 
in 
Inches. 


Place of Division. 


Peculiarities. 


R 




mid. Th. Cart. 






22 


R 




TL. Cart. 






23 


R 




Th. Cart. 








L 




Th. Cart. 






23a 


R 








f Super. Thyr. sends a large br. over 
< the Crico-thyroid membrane other 
|_ Brs. usual. 


26 


R 




Th. Cart. 








L 




Th. Cart. 




f Super. Thyr. deficient ; in its stead 
j two small Brs., of which one is the 
< Laryngl. br., the other is given to 
1 Sterno-Mast. muscle. The other 
^Brs. present nothing remarkable. 


28 


R 




Th. Cart. 




usual. 


29 


R 




Th. Curt. 




usual. 




I, 




Th. Cart. 




usual. 


30 


R 




Th. Cart. 




JLingl. and Facl. arise by one trunk. 
(_Other Brs. usual. 


31 


R 




Th. Cart. 








L 




Th. Cart. 






31a 


R 




mid. Th. Cart. 




{Laryngl. br. given separately fr. Ext. 
Car. Lingl. and Facl. arise by one 
trunk. Infer. Palat. and Tonsil.. 












brs. fr. Ext. Car. and joined at 
origin. The other Brs. usual. 


Sib 


R 




mid. Th. Cart. 




f Laryngl. a separate br. of Ext. Car. 
\ The other Brs. usual. 


31 c 


R 




{TJ inch abovi 
Os H. 






31d 


R 




Th. Cart. 






31 e 


R 




\ higher than 
\ usual. 








L 




J higher than 
\ usual. 






32 


L 




\ 1 inch abovi 
\OsH. 




J Laryngl. a separate br. of Ext. Car. 
\The other Brs. usual. 



58 



THE CAROTID ARTERIES. 



COMMON CAROTID. 


EXTERNAL CAROTID BRANCHES. 


No. 


Side 
of the 
Body. 


Length 
in 
Inches. 


Place of Division. 


Peculiarities. 


33 


R 




Th. Cart. 














{arises unusu- 












ally close to 




34 


L 




above Os H. 


Innominate, 












andgives Sup. 












Thyr. 




34 a 


L 




f 1 inch above 
\OsH. 






34b 


L 




mid. Th. Cart. 






38 


R 




Th. Cart. 




J~ Lingl. and Facl. arise by one trunk. 
\ The other Brs. usual. 




L 




Th. Cart. 




f Lingl. and Facl, by one trunk. The 
\ other Brs. usual. 


38 a 


R 




OsH. 




f Super. Thyr. gives a br. of consider- 
\ able size over sheath of Com. Car. 


38b 


R 




Th. Cart. 




usual disposition of Brs. 




L 




Th. Cart. 




usual. 


39 


L 




Th. Cart. 




("Laryngl. given from Ext. Car. 
\Other Brs. usual. 










f arises in com- 












mon with the 




40 


R 




Th. Cart. 


Left Carotid : 
< is crossed by 
Thyr. veins 


J" Lingl. and Facl. fr. one trunk. 
\ Other Brs. usual. 










opp. mid. o1 












VTh. Cart. 












[" arises in com- 


{Ext. Car. divides into a lash of brs. 


41 


L 




Th. Cart. 


< mon with R. 
[ Carotid. 


opp. the angle of the lower Maxilla. 
Brs. in other respects usual. 










f arises in com- 












I mon with left 




42 


R 




above Th. Cart. 


J Carotid: gives 
j the Infer, and 


4 










the Super. Th. 












V arteries. 












r arises in corn- 












I mon with R. 






L 






1 Cak>tid. See 












1 the Arch of 












V. Aorta. 




43 


R 




Th. Cart. 







THE CAROTID ARTERIES. 



59 



COMMON CAROTID. 


EXTERNAL CAROTID BRANCHES. 


No. 


Side 
of the 
Body. 


Length 
in 
Inches. 


Place of Division. 


Peculiarities. 


44 


R 




Os H. 




J" Thyr., Lingl. and Faol. arise by a 
\ common trunk. The other Brs. usual. 




L 






fr. Innom. 




45 


R 




Th. Cart. 








L 






fr. Innom. 












/"crossed at the 




46 


R 




/lower margin 
\ of Th. Cart. 


I end or divi- 
| sion by Omo- 
(_hyoid muscle. 




47 


R 




f below upper 
< margin of Th. 
I Cart. 








L 




above Th. Cart. 






47a 


L 




Th. Cart. 






50 


R 




OsH. 




{Lingl. and Facl. fr. a com. trunk. 
Infer. Palat. given from Ext. Car. 
Other Brs usual. 


51 


R 




Th. Cart. 




usual. 




L 




Th. Cart. 




usual. 










'Anter.jugular 












vein commu- 




52 


R 




Th. Cart. 


nicates over 
< St. Mast.mns- 
cle with Ext. 
jugular, which 
is small. 


["Thyr. and Lingl. united into one 
< trunk at their origin. Other Brs. 
(_ usual. 




L 




Th. Cart. 


fvcry close to 
< Innom. at 


usual. 










[origin. 




53 


R 




Th. Cart. 




usual. 




L 




Th. Cart. 




usual. 


54 


R 


H 


Th. Cart. 








L 


5i 


Th. Cart. 




usual. 


55 


R 


3J 


Th. Cart. 


f Anter. Jugr. 
\ vein large. 


usual. 




L 




Th. Cart. 




usual. 



60 



THE CAROTID ARTERIES. 



COMMON CAROTID. 


EXTERNAL CAROTIDBRANCHES. 


No. 


Side 
of the 
Body. 


Length 
Inches. 


Place of Division. 


Peculiarities. 


57 


R 


si 


above Th. Cart. 




I" Occipl. gives the only Sterno-Mastoid 
\br. Brs. usual. 




L 




Th. Cart. 






58 


R 





above Th. Cart. 




fLaryngl. abr. of Ext. Car. : greatest 
I part of Occipl. runs superficially to 
j the upper end of the St.-Mastoid 
[_ muscle. Other Brs. usual. 




L 


41 


Th. Cart. 




usual. 


59 


R 




Os H. 




usual. 




L 


5 


Os II. 




usual. 


60 


R 




Th. Cart. 




["Facl. gives Sublingl. wh. follows 
I Submaxilly. duct to the Sublingl. 
[gland. The other Brs. usual. 


61 


R 




Th. Cart. 




Lingl. and Facl. arise by a com. trunk. 




L 


H 


Th. Cart. 




usual. 


63 


R 


4| 


OsH. 




usual. 




L 


6 


OsH. 




usual. 


64 


R 


31 


mid. Th. Cart. 




{Lingl. and Facl. arise by a single 
trunk. Other Brs. usual. 


65 


R 


4 


Th. Cart. 




{A long interval betw. Thyr. and 
Lingl. Brs. usual. 




L 






fr. Innom. 




66 


R 


4 


above Th. Cart. 




{Laryngl. br. enters Larynx betw. 
Thyr. and Cric. cartilages. The 
Super. Lar. nerve enters in the usual 
situation. Sublingl. is a br. of 
Facl. The other Brs. usual. 




L 




Th. Cart. 






67 


L 






fr. Innom. 




68 


L 




Th. Cart. 






69 


L 




above Th. Cart. 




f Th. Lingl. and Facl. arise very close 
< one to the other fr. the beginning of 
[ Ext. Car. The other Brs. usual. 


71 


R 




OsH. 




TLingl. and Facl. arise by a single 
I trunk. Thyr. rises higher than usual 
] and descends to its destination. The 












Bother Brs. usual. 



THE CAROTID ARTERIES. 



61 



COMMON CAROTID. 


EXTERNAL CAROTID BRANCHES. 


No. 


Side 
of the 
Body. 


Length 
in 
Inches. 


Place of Division. 


Peculiarities. 


72 


R 


4 


Th. Cart. 




( Lingl. and Facl. by a com. origin. 
\ Other Brs. usual. 












["Lingl. and Facl. by a com. origin. 




L 


4 






< Trans. Facl., Int. Maxil., and Temp. 












(_ arise together. Other Brs. usual. 












f Facl. arises above the angle of lower 


73 


R 


H 


Os H. 




< Maxilla and descends to usual position. 












I The other Brs. usual. 












TFacl. arises opposite the middle of 




L 


6 


Os H. 




I the Ramus Maxillae Infer., and de- 
1 cends below its angle to usual situ- 












^ation. The other Brs. as usual. 










f Anter. jugu- 




74 


R 






< lar vein pre- 












[sent. 






L 


5f 


[ below upper 
\ margin of Th. 
[ Cart. 


!very close to 
Innom. at ori- 
gin : Anter. 
Jugular vein 
present. 


CA separate br. of Ext. Car. gives 
I Infer. Palat. and Tonsill. The only 
| Sterno-Mastoid br. fr. Occipl. Other 
[_Brs. usual. 


75 


R 


4 


Th. Cart. 




usual. 










("very close to 






L 


51 


Th. Cart. 


< Innom. at 


usual. 










|_ origin. 




76 


R 




Os H. 




usual. 




L 




OsH. 


f gives Super. 
\Thyr. 


J Lingl. and Facl. by a com. origin. 
\ Other Brs. usual. 


77 


R 


a* 


J Lower part of 
\ Th. Cart. 




usual. 








(~ below upper 








L 


5 


< margin of Th. 




usual. 








[Cart. 






78 


R 


5 


Os H. 














C Large Super- 






L 


H 


Th. Cart. 


J ficial veins 
] (Ant. & Ext. 
L Jugular.) 


{Laryngl. given fr. Ext. Car. Other 
Brs. usual. 












fThyr., Lingl., FacL, Pharyngl. and 












J Occipl. arise very close together fr. 


81 


R 


** 


Os H. 




( beginning of Ext. Car. The only 








^ - 




J Sterno - Mastoid br. is fr. Occipl. 












(^Other Brs, usual. 



62 



THE CAROTID ARTERIES. 



COMMON CAROTID. 


EXTERNAL CAROTID BRANCHES. 


No. 


Side 
of the 
Body. 


Length 
in 
Inches. 


Place of Division. 


Peculiarities. 




L 






the Super. Thyr. 


JPharyngl, gives Palat. Other Brs. 
\ usual. 


82 


R 


k 


OsH. 




("Large Sterno-Mastoid br. Other 
[Brs. usual. 




L 


6 


J a little above 
\0s H. 


fits origin 
< touches that 
(_of Innom. 


f Occipl. arises 1 inch, above Facl., 
< and gives Poster. Auricr. Other 
(_ Brs. usual. 


83 


R 


H 


Th. Cart. 




f Lingl. and Facl. arise by a com. 
\ trunk. Other Brs. usual. 












f Liugl. and Facl. fr. a com. origin. 




L 


** 


OsH. 


fr. Innom. 


< Poster. Auricr. fr. Occipl. Other 












[_Brs. usual. 


84 


R 


4 


Th. Cart. 




f Super. Thyr. and Lingl. arise by a 
\ com. trunk. Other Brs. usual. 












TLaryngl. is given as a separate br. of 




L 


6 


OsH. 


fr. Innom. 


\ Ext. Car. The origin of Post. 
| Auricr. much higher than ordinary. 












LThe other Brs. usual. 


86 


R 


8* 


{below upper 
margin of Th. 
Cart. 




J" Three small separate brs. instead of 
\ Super. Thyr. Other Brs. usual. 












!Thyr. of large size. Lingl. and 








{a little below 




Facl. given fr. a com. origin. La- 




L 


*i 


upper margin 


fr. Innom. 


ryngl. and Palat. are given each 








of Th. Cart. 




separately from Ext. Car. Other 












Brs. usual. 












TLingl. and Facl. by common origin. 


88 


R 


4 


f a little above 
\ Th. Cart. 




J Laryngl. arises separately from Ext. 
j Car. The only Sterno-Mastoid from 












[Occipl. Other Brs. usual. 












rSterno-Mastoid br. from Ext. Car., 










f gives Super. 


j and has 9th nerve winding round it. 




L 


H 


OsH. 


{ Thyr. at bi- 


< 2 small Phatyngl. brs., one fr. Ext. 










[_ furcation. 


I Car., the other fr. Occipl. Other 












^Brs. usual. 










{fr. Innom. 




89 


R 


3 


mid. Th. Cart, 


gives Super. 












Thyr. 












fh&s close be- 






L 


41 


Th. Cart. 


1 hind it the 
< Left Vert., 
j which is 4 


f The only Sterno-Mastoid br. is fr. 
\Occipl. Other Brs. usual. 










finches long. 





THE CAROTID ARTERIES. 



COMMON CAROTID. 


EXTERNAL CAROTID-BRANCHES. 


No. 


Side 
f the 
Body. 


Length 
in 
Inches. 


Place of Division. 


Peculiarities. 


90 


R 


4 


OsH. 




usual. 




L 


6 


Os H. 




Lingl. and Facl. by a com. origin. 


91 


R 


4 


above Th. Cart. 




usual. 




L 


4* 


Th. Cart. 




f Lingl. and Facl. fr. a com. trunk of 
\ origin. 












["distance between Super. Thyr. and 


92 


R 


3 


Th. Cart. 




I the next brs. 1 inch. Lingl. and 
1 Facl. close at their origin. Other 












[_Brs. usual. 




L 


5 


OsH. 


f Super. Thyr. 
<. given at the 
I bifurcation. 


{space between Brs. as on R. side. 
Lingl., Facl. and Occipl. close together 
at their origin. Other Brs. usual. 


93 


R 




Th. Cart. 


("Super. Thyr. 
< given at the 
|_ bifurcation. 


Lingl. and Facl. arise by a com. origin. 








(" a little below 






94 


R 


3* 


< upper margin 




Laryngl. a separate br. of Ext. Car. 








1 of Th. Cart. 








L 




Th. Cart. 




usual. 


96 


R 

% 


<* 


Th. Cart. 




usual. 




L 


4i 






nearly usual. 












/'Laryngl. a separate br. of Ext. Car. 












Lingl. and Facl. by a common 


97 


R 


Si 


1" below upper 
< margin of Th. 
[Cart. 




origin rather the former given from 
1 the latter. A small artery given fr. 
| Ext. Car., in the usual position o1 
the Lingual, ramifies over the Mylo- 












hyoid muscle (it corresponds to 












^Hyoid br. of Lingl. ?) 




L 




f below upper 
4 margin of Th. 
[ Cart. 


f gives Super 
\Thyr. 


f Laryngl. a separate br. of Ext. Car. 
\ Other Brs. usual. 


98 


R 


4f 


above Os H. 


("gives Pharyn- 
< gl. in the bi 
[ furcation. 


["the Brs. given close to origin of Ext. 
I Car. Super. Thyr. and Lingl. 
j descend to their destination. Brs. 
I |Jn other respects usual. 




L 


6ft 


above Os H. 


("gives Pharyn 
< gl. in the bi 
(_ furcation. 


f arrangement of Brs. same as on the 
Bright side. 



THE CAROTID ARTERIES. 



COMMON CAROTID. 


EXTERNAL CAROTID BRANCHES. 


No. 


Side 
of the 
Body. 


Length 
in 
Inches. 


Place of Division. 


Peculiarities. 


99 


R 


3f 


OsH. 




fRegular intervals between the Brs. 
J at their origin, but considerable ppace 
j between the terminal Brs. and those 












[_below : in other respects usual. 




L 


5 




the Super. -Thyr. 


usual. 


100 


R 


H 






Usual. 




L 


5 


Th. Cart. 




nearly usual. 


101 


R 


4 




the Super. Thyr. 


usual. 




L 


5 


Os H. 


Tgives a small 
I Super. Thyr. 
| and a separate 
[_Laryngl. br. 


usual. 


103 


R 


Si 


Th. Cart. 




{Pharyngl. and the only Sterno- 
-j Mastoid br. fr. Occipl. Other Brs. 
( usual. 










{"joined to In- 
nom . at its 






L 




Th. Cart. 


origin. Pha- 
ryngl. fr. the 
bifurcation. 




104 


R 


3* 


above Th. Cart. 




C Lingl. and Facl. by a com. origin. 
I Other Brs. usual. 




L 


5* 






( Lingl. and Facl. arise by a com. trunk. 
| Other Brs. usual. 


105 


L 


5| 




f given from 
I Innom. 


usual. 


106 


R 


4 


Th. Cart. 




( St.-Mastoid a separate br. of Ext. 
< Car. Post. Auvicr. arises close to the 












C terminal brs. Other Brs. usual. 




L 




Th. Cart. 




usual. 


107 


R 




Th. Cart. 




nearly usual. 




L 






the Super. Thyr. 


( Laryngl. given separately from Ext. 
( Car. Other Brs. usual. 


110 


R 


4 


Th. Cart. 




(Thyr. very small. Facl. gives a 
large Palat. br., which supplies de- 
ficiency of a small Pharyngl. Oc- 
cipl. continued from the " cervicalis 
ascendens " (br. of the Infer. Thyr.) 
Other Brs. nearly usual. 



THE CAROTID ARTERIES. 



65 



f*- 
COMMON CAROTID. 


EXTERNAL CAROTID BRANCHES. 


No. 


Side 
of the 
Body. 


Length 
Inches. 


Place of Division. 


Peculiarities. 










< very close to 






L 






^ Innom. at ori- 












Igin. 














( The Brs. arise at regular intervals. 


Ill 


R 


4 


Th. Cart. 




-< and are nearly as usual in their dis- 












( tributions. 












/^5 Brs., viz. Lingl., Facl., Pharyngl., 












Sterno-Mast., and Occipl., arise 












close to origin of Ext. Car. A 




L 


5 


OsH. 


the Super. Thyr. 


\ second Sterno-Mast. br. fr. Occipl. 












Palat. br. of Facl. large, and does 












not pass between the Stylo-Gloss, and 












\^Stylo-Pharyng. muscles. 












f Thyr., Lingl., Facl. and Occipl. arise 












j close to beginning of Ext. Cart. 


112 


R 


4| 


OsH. 




< Post. Auricr. arises in mid. of interval 












j between the preceding and the two 












^terminal brs. 










( very close to 






L 






< Innom. atori- 




113 


R 


4* 


Th. Cart. 




/Lingl. and Facl. by a com. origin. 
\ Other Brs. nearly usual. 




L 


5 






{Lingl. and Facl. by one origin. 
Other Brs. nearly usual. 


114 


R 








f The only St.-Mastoid br. is given 
\fr. Occipl. Other Brs. usual, 












{Thyr. unusually small. Lingl. and 






K 


C a little above 




Facl. by one origin. Only St.-Mas- 






O 


1 Th. Cart. 




toid br. is fr. Occipl. Pharyngl. fr. 












Intern. Carotid. 












(The Brs., except the Post. Auricr. 












and the terminal ones, arise close to 


115 


R 


4 






the beginning of Ext. Car. Lingl. 












and Facl. fr. a com. origin. St.- 












Mastoid a separate br. of Ext. Car. 


116 


R 


H 


f below upper 
< margin of Th. 




f Occipl. and Pharyngl. arise consider- 
< ably higher than usual j the former 








CCart. 




C gives P. Auricr. 




L 


4* 


Th. Cart. 




same arrangement as on the right side. 


117 


R 


4| 


Os H. 


- 


} Occipl. gives Pharyngl. Other Brs. 












^ usual. 



66 



THE CAROTID ARTERIES. 



COMMON CAROTID. 


EXTERNAL CAROTID BRANCHES. 


No. 


Side 
of the 
Body. 


Length 
Inches. 


Place of Division. 


Peculiarities. 




L 


5 




("gives Pharyn- 
< gl. from bifur- 
1 catioD. 


fLaryngl. a separate br. of Ext. Car. 
J Occipl. arises fr. beginning of Ext. 
j Car. and gives P. Auricr. In other 












[_ respects the Brs. usual. 


118 


R 




Th. Cart. 




usual. 




L 




Th. Cart. 




^ Lingl. and Facl. by one origin. 
1 Other Brs. nearly usual. 












("Occipl. and Pharyngl. by a com. 


120 


R 


4 






4 trunk fr. Intern. Carotid. Other 












[_Brs. usual. 


121 


R 


4* 


















C'2 Super. Thyroid brs. of equal size 


122 


R 


3| 






J arise close one to the other, and both 
j arch downwards in the same way as 












[ the single Br. usually does. 




L 




mid. Th. Cart. 




nearly usual. 


123 


L 


5 


















TThyr. very small. 2 small unusual 


124 


L 








J Brs. arise close to it, (their destina- 
j tion is not noted). Other Brs. 












(^ usual. 


127 


R 




Os H. 
















fOccipl. arises much higher than usual 




L 






the Super. Thyr. 


I and gives Post. Auricr. Other Brs., 
| except the terminal, arise close to the 












[_beginning of Ext. Car. 


129 


R 


4 


Th. Cart. 




nearly usual. 










(rises lower 












than usual on 


fThyr. given immediately at the origin 




L 


** 


Th. Cart. 


the Arch of 
Aorta, and 


J of Ext. Car. Lingl., Facl. and Oc- 
] cipl. 1 inch higher. Pharyngl. fr. 










close to the 


L Occipl. 










Innom. 




131 


R 


3 


} opposite the 
I Cricoid Cart. 




i Thyr. arises one inch above Com. 
< Car. The other Brs. are given in 
^ succession at considerable intervals. 




L 


4 


( opposite the 
I Cricoid Cart. 


[" the origin is 
< very close to 
L that of Innom. 


{ Brs. arise at a considerable distance 
\ fr. the beginning of Ext. Car. 



THE CAROTID ARTERIES. 



COMMON CAROTID. 


EXTERNAL CAROTID BRANCHES. 


No. 

135 


Side 
f the 
Body. 

R 


Length 
Inches. 


Place of Division. 


Peculiarities. 




above Th. Cart. 




Sterno-Mastoid br. given separately 
fr. Ext. Car. Sublingl. br. arises 
fr. Facl., and perforates the Mylo- 
Hyoid muscle. Occipl. superficial 
to Trachelo-Mastoid muscle, and per- 
forates the Splenius and Sterno- 
Mastoid near their inner or posterior 
^margins. Other Brs. usual. 




L 




OsH. 


the Super. Thyr. 




136 


R 


*i 




Th. Cart. 


usual. 




L 


6 




above Th. Cart. 


(Ext. Car. passes between Digastric 
and Stylo-Hyoid muscles covered 
by former, superficial to the latter. 
The Brs. arise at considerable in- 












tervals one from the other ; in other 












respects they are nearly as usual. 


137 


R 






("given fr. the 
[Arch of Aorta. 






L 


<i 


OsH. 
















f Sterno-Mastoid br. fr. Ext. Car. 


138 


R 


4 






< Occipl. rises near the upper end ol 
( Ext. Car. Other Brs. usual. 


139 


R 




Th. Cart. 








L 






f joined to In- 
^nom. at origin. 


C Occipl. rises much higher than usual, 
< close to Post. Auricr. Other Brs. 
( usual. 


140 


R 








J Occipl. gives Pharyngl. and Post. 
]_ Auricr. Other Brs. usual. 










Ilip inch in 




142 


R 


*f 




length of the 
artery is con- 
tained within 


(" Pharyngl. given fr. Intern. Car. In- 
< tern. Maxilly, under Ext. Pterygoid 
L muscle. Other Brs. usual. 










the Thorax. 




144 


R 


4 


Th. Cart. 




usual. 










{joined to In- 
nom. at origin, 
which is lower 






L 






than usual on 












the Arch o: 












the Aorta. 




145 


R 


4 




fthe origin is 
< situated with- 
[ in the Thorax. 


("Pharyngl. given fr. Intern. Car. 
< Intern. Maxilly. nnder the Ext. 
[Pterygoid muscle. Other Brs. usual. 



68 



THE CAROTID ARTERIES. 



COMMON CAROTID. 






Side 


Length 






EXTERNAL CAROTID BRANCHES. 


No. 


of th 


in 


Place of Division. 


Peculiarities. 






Body 


Inches. 










L 


~~5f~ 


















fLingl., Facl., Occipl. and Pharyngl. 












I arise at a considerable distance above 


146 


R 




Th. Cart. 




| the Super. Thyr. The Brs. in other 












(^respects usual. 




L 




Th. Cart. 




Brs. as on the right side. 


147 


R 




Th. Cart. 




usual. 




L 




Th. Cart. 




usual. 


149 


L 








usual. 












!Thyr. arises at beginning of Ext. 












Car. as usual. Lingl., Facl., Oc- 


150 


R 




Th. Cart. 




cipl. and Pharyngl. are given close 












together, 1 inch higher. Post. Auricr. 












and terminal Brs. usual. 










("the origin is 






L 




Th. Cart. 


I very close to 
| Innom. & to 


nearly usual. 










[^L. Subclav. 




151 


R 


3* 


Th. Cart. 




usual. 




L 


5 


Th. Cart. 


/origin is joined 
j_ to Innom. 














[~ Occipl. arises higher than usual 


152 


R 


4 


Th. Cart. 




< and gives Post. Auricr. Other Brs. 












[ usual. 












fSublingl. fr. Facl. Pharyngl. arises 













I above Occipl., and at distance of 1^ 




L 








| inch from the Com. Car. Other 












[_Brs. usual. 












("Instead of a Post. Auricr. br. a small 


153 


L 








I artery is given, wh. enters the Stylo- 
] Mastoid foramen. Pharyngl. arises 












(^fr. Occipl. Other B.IS. usual. 


154 


L 


H 


above Os H. 




/no Pharyngl. artery. Other Brs. 
\ usual. 


155 


R 




Th. Cart. 




usual. 




L 






/joined to In- 












\nom.atorigin. 




156 


R 




Th. Cart. 




usual. 



THE CAROTID ARTERIES. 



69 



COMMON CAROTID. 


EXTERNAL CAROTID BRANCHES. 


No. 


Side 
of the 
Body. 


Length 
in 
Inches. 


Place of Division. 


Peculiarities. 










/'both arise by 






R) 






| a common ori- 




158 


& [ 






^ gin from the 






L) 






1 Arch of the 












^ Aorta. 












'arises from 












Innom. & at 
the distance of 


(Tlnyr., Lingl., Facl., Occipl. and 
j Pharyngl. arise fr. the commence- 


159 


L 






< a third of its 


<( ment of Ext. Car. Post. Auricr. 










length fr. the 


j midway to its end. In other respects 










beginning of 


V^Brs. usual. 


160 


L 


6 


Os H. 




J nearly equidistant in their origin. In 
L other respects nearly usual . 


162 


R 




Th. Cart. 








L 


5 


Th. Cart. 


J" close to In- 
|_nom. at origin. 


J Thyr. unusually small ; so is the 
\ Thyr. body. Other Brs. usual. 


163 


R 


* 


Th, Curt. 


("given from a 
(_ long Innom. 






L 


5 ? 


Th. Cart. 






169 


R 




Th. Cart. 




f Lingl. and Facl. by a com. origin. 
\ Other Brs. usual. 


171 


L 




Os H. 


the Super. Thyr. 


usual except absence of Super. Thyr. 










'Corn. Car. is 












covered by in- 












tern, jugular 












vein, except a 




I71a 








small portion 




'fern. 


L 




Th. Cart. 


< of its up. end. 


Brs. nearly usual. 


adt.) 








The Omohy- 












oid muscle 












is membra- 












nous in itsan- 












^terior half. 




172 


R 


4 


Th. Cart. 














{the origin is 
close to In- 


rOccipl. rises near beginning of Ext. 
j Car. and gives Post. Auricr. Con- 




L 


6 


Th. Cart. 


nom. and to 


< siderable intervals between the origins 










the L. Sub- 


1 of Thyr., Lingl. and Facl. The 










clav. 


V,Brs. in other respects usual. 


173 


R 


H 


Os H. 






173n 


R 


^ 


Th. Cart. 




[ Lingl. and Facl. are very close at 
|_ their origin. Other Brs. usual. 



70 



THE CAROTID ARTERIES. 



COMMON CAROTID. 


EXTERNAL CAROTID BRANCHES. 


No. 


Side 
of th 
Body 


Length 
in 
Inches. 


Place of Division. 


Peculiarities/ 










fthe> origin is 






L 






J close to In- 












| nom. and to 












[_the L. Suhcl. 




174 


R 


3f 


Th. Cart. 




f Lingl. and Facl. very close at their 
\origin. Brs. usual. 




L 


4 


Th. Cart. 




nearly usual. 


176 


R 


3 


Th. Cart. 




f Infer. Palat. a separate br. of Ext. 
L Car. Other Brs. nearly usual. 




L 




Th. Cart. 


f gives Pharyn. 
\atbifurcation. 


( Lingl. and Facl. by one trunk o 
< origin, which is close to Thyr. am 
( Pharyngl. Other Brs. usual. 


177 


L 


ft 




/gives Pharyn. 
\ at bifurcation. 


usual. 












{Ext. Car. measures 3 inches. Lingl. 












and Facl. by a com. origin, which, 


178 


R 


2f 


flower part of 
\ Th. Cart. 




with Pharyngl. and Occipl., arise 
close together at ^ inch from begin- 












ning of Ext. Car. Brs. in other 












respects usual. 












C Ext. Car. measures 3 inches ; at 1 










fjoined to In- 


I inch from its commencement arise the 




L 


41 


J~ lower part of 
\ Th. Cart. " 


J nom. or given 
1 fr. it; gives 


J Lingl. and Facl., (by a com. trunk^ 
| with the Occipl., Palat., Pharyngl., 










l_Super. Thyr. 


1 and a Muscular br., all close to- 












Vgether. Post. Auricr. fr. Occipl. 












fExt. Car. 2f inches in length. 












I Thyr., Lingl., Facl., Occipl. and 


179 


R 


3f 


Th. Cart. 




< Post. Auricr. arise at nearly equal 












1 distances one fr. the other. Pharyngl. 












(jr. Occipl. 










( very close to 


-. 




L 






-c Innom. at ori- 












(gin. 














/'Ext. Car. 2| inches long. Thyr. 












given at beginning of Ext. Car. as 












usual. Lingl., Facl., Occipl. and 


180 


R 




Th. Cart. 




Pharyngl. arise all together 1 inch 
higher up. Stylo-Mastoid br. of 












Post. Auricr. larger than the con- 












tinued vessel. 2 Pharyngl. brs., 












^the second given by Occipl. 












TExt. Car. 2^ inches in length. Brs. 




L 








J same as on opposite side, except that 












1 Occipl. does not give a Pharyngl. br. 












[_and Post. Auricr. is disposed as usual. 



THE CAROTID ARTERIES. 



71 



COMMON CAROTID. 


EXTERNAL CAROTID BRANCHES. 


No. 


Side 
of the 
Body. 


Length 
in 

Inches. 


Place of Division. 


Peculiarities. 












{Ext. and Int. Carotids very tortuous. 












Ext. Car. 2 inches long. Lingl., 


181 


R 


51 




the Super.Thyr. 


Facl. (given fr. a com. origin), Palat. 
and 2 Pharyngl. brs. arise fr. begin- 












ning of Ext. Car. Post. Auricr. fr. 












the beginning of Occipl. 












TExt. Car. measures 2^- inches, and 












j is superficial to Stylo-Hyoid muscle. 




L 








< Thyr., Lingl., Facl. and Occipl. given 












j close to origin of Ext. Car. Brs. in 












Bother respects usual. 












f Ext. Car. 2^ inches long. It gives 












j Thyr., Lingl., Facl., Pharyngl. and 


182 


R 


5 


Os H. 




<( Occipl. in succession within f- inch 












j of origin. The other Brs. and the 












^distribution usual. 










'inclines from 












Innom., near 












wh. it arises, 












towards L. 












Subclav., and 






L 




Th. Cart. 


< is unusually 


usual. 










close to that 












artery as far 












as the upper 












margin of the 












^ Thorax. 














f Ext. Car. 2 inches long. Thyr., 












1 Lingl., Facl., Occipl. and Pharyngl. 


183 


R 




Os H. 




t arise all within % inch fr. beginning 












j of Ext. Car. Post. Auricr. midway 












^higher up. 












| Brs. very nearly as on the right side 




L 




Os H. 




< 2 Palat. brs., one from Facl., as 












(usual, the other fr. Lingl. 












{Ext. Car. 3 inches long. Thyr., 












Lingl., Facl. and Occipl. arise within 


184 


R 








1 inch fr. beginning of Ext. Car. 












Pharyngl. given fr. Int. Car. Other 












Brs. usual. 












f the Brs., except the Post. Auricr. and 




L 








< the terminal ones, arise fr. Ext. Car. 












(within % inch of its origin. 












^Ext. Cart. 2 inches long. It gives 












2 Super. Thyr., a separate Laryngl., 












Lingl., Facl., Occipl. and Pharyngl., 












all within | inch of its origin. Post. 


185 


R 


3 s 


Th. Cart. 




I Auricr. rises beyond the preceding 






* 






| brs., midway to end of Ex. Car. 












The Thyr. brs. are of nearly equal 












size, and both arch downwards and 












supply the Thyroid body ; the lower 












Vone furnishes brs. to the muscles. 



72 



THE CAROTID ARTERIES. 



COMMON CAROTID. 


EXTERNAL CAROTID BRANCHES. 


No. 


Side 
of the 
Body. 


Length 
Inches. 


Place of Division. 


Peculiarities. 




L 




Th. Cart. 


r rises vcryclose 
J tolnnom. and 
| gives Super. 
[Th. 


TLingl., Facl., Occipl. and Pharyngl. 
J arise together at f inch from 
1 origin of Ext. Car. P. Auricr. as 
[_ usual. 


186 


R 




Os H. 




(Ext. Car. 2f inches long. Thyr., 
j Lingl., Facl., Occipl. and Pharyngl. 
< arise at intervals within 1^ inch fr 












1 commencement of Ext. Car. Post. 












V. Auricr. fr. Occipl. 




L 


' 


Th. Cart. 




fExt. Car. 2f inches long. The Brs., 
1 except the terminal ones, given at 
^ intervals within 1 inch of the origin 
j of the Ext. Car. Thyr. and Lingl. 
^arise by a common origin. 










'very close to 
R. Subclav. 












for some dis- 




187 


R 






tance from 
< origin ; gives 
Super. Thyr. ; 
all the arte- 


| Ext. Car. 2 inches long. Lingl. 
< and Facl. by a com. origin. Other 
(firs, usual. 










ries are much 












^curved. 






L 






the Super. Thyr. 


f Ext. Car. 2 inches in length. Lingl., 
J Facl., Occipl. and Pharyngl. given 
| very close one to the other. Brs. in 
Bother respects usual. 


188 


R 








!Ext. Car. 2 inches long. Thyr., 
Lingl., Facl., Occipl. and Pharyngl. 
arise within -^ an inch fr. origin of 
Ext. Car. In other respects the Brs; 
are usual. 




L 








(Ext. Car. 2 inches long-. Thyr., 
Lingl., Facl., Occipl. and Pharyngl. 
arise within ^ inch of beginning 
of Ext. Car. P. Auricr. 1 inch 












h'gher. 


191 


R 






the Super. Thyr. 


/'Ext. Car. 3^- inches in length. 
Lingl., Facl., Occipl. and Pharyngl. 
given together at 1 inch fr. origin 
< of Ext. Car. Lingl. and Facl. by 
a com. origin. Palatine is a sepa- 
rate br of Ext. Car. In other respects 
V^Brs. usual. 




L 






| arises fr. In- 
< nom ; gives 
(Super. Thyr. 


t Ext. Car. 3^ inches long. Lingl. 
< nnd Facl. arise by a com. trunk. 
(Other Brs. usual. 



THE CAROTID ARTERIES. 



73 



COMMON CAROTID. 


* 








EXTERNAL CAROTID BRANCHES. 




Side Length 






No. 


of the 


in 


Place of Division. 


Peculiarities. 






Body. 


Inches. 














Ext. Car. 2 inches long and divides 












lower than usual. Thyr. small. 












Lingl., Facl., Pharyngl. and Oc- 












cipl. arise close one to the other, 












at 1 inch distance fr. beginning of 






! 




Ext. Car. Post. Auricr. arises with 


192 


R 








i the terminal brs. Trans. Facl., ol 












large size, springs from the Temporal 












1 inch above the Intern. Maxillary, 










. 


and inclines downwards and inwards 




j 







over the Masseter muscle to supply 












the upper lip and side of the nose. 












Facl. ends in the lower lip. 




1 


















Ej^^Car. 2^ inches long. Lingl., 












OcapT; and Pharyngl. arise at the 












distance of inch above the Coin. 










("gives Super. 


Car. Facl. at 1 inch. Post. Auricr. 




L 




0H. 


1 Thyr. and 
j Laryngl. se- 


arises still higher, as usual. Trans. 
Facl. is given at the end of the Ext. 










(^parately. 


Car., and, as on the right side, sup- 












plies the upper lip and the nose 












instead of the Facl., which does not 












ascend so far. 












'Ext. Car. 2 inches long. The 


193 


R 






(the Carotid 
partly covers 
the R. Subcl. 
near the ori- 


Branches arise at considerable in- 
tervals one from the ether ; may be 
, said to be diffused over the parent 
vessel. The origin of the Facl. is 
higher than usual, and close to the 










gin. 


Post. Auricr. Brs. in other respects 












usual. 




L 




J 


[" Pharyngl. is 
< given fr. the 
\_ hi furcation. 


{Thyr., Laryngl., Lingl. and Occipl. 
are given close together fr. the origin 
of Ext. Car. In other respects 
Brs. usual. 












TExt. Car. 2^ inches in length; tor- 












j tuous. Thyr. and Occipl. arise at 


194 


R 


H 


Th. Cart. 




J distance of ^ inch above Com. Car. 
j Lingl. and Facl. by a com. trunk 












1 above preceding. Pharyngl. is given 












\^fr. Occipl. Other Brs. usual. 












'Ext. Car. gives no brs. except at its 












upper and lower ends. Thyr., Lingl., 












Facl. and Occipl. arise close to the 




j 








Com. Car. Lingl. and Facl. are 










given fr. acorn, trunk, to the begin- 










ning of wh. the Thyr. is joined. 










Ext. Car. divides into Post. Auricr. 










Tempi, and Int. Maxillary. 



74 



THE CAROTID ARTERIES. 



COMMON CAROTID. 


EXTERNAL CAROTID BRANCHES. 


No. 


Sid 
of th 
Bodj 


Length 
e in 

r. Inches. 


Place of Division 


Peculiarities. 












(Ext. Car. 2| inches long. Thyr. is 




' - 1 




larger than usual, and sends a thic 


195 


j 

R 




Th. Cart. 


Ahe artery \ 
j an inch fro 
1 its origin c 


br. , which crosses obliquely over the 
Crico-Thyr. membrane to the o 
< posite side of the Thyr. body. Ling 










1 vers, or Ij 
J anteriorto,th 


Facl., Occipl. and Pharyngl. are 
inch distant from Com. -Car. in their 










VR. Subclav. 


origins, which are all close together. 












^Post. Auricr. usual. 










f rises from In 


("Facl., though of good size, is ex- 




L 




Th. Cart. 


< nom. & gives 


< pended chiefly below the Inferior 










(.Super. Thyr. 


L Maxilla. Other Brs. nearly usual. 












(Ext. Car. 2^- inches in length. Ling] 


196 


L 






the Super. Thyr. 


Facl. and Occipl. arise close together 
at distance of % inch fr. Com. Car. 












P. Auricr. higher in origin, as usual. 












Brs. in other respects usual. 












(Ext. Car. measures 2 inches. The 












j Branches are given at considerable 


197 


L 




Th. Cart. 




^ intervals one after the other, am 












j present the usual disposition in their 












^distribution. 


198 


R 




Os H. 


("gives Super. 
Thyr. at junc- 
tion with Ext. 


f Ext. Car. 2 inches in length. Brs. 
\ usual. 










^.Car. 












"at its origin is 




198 a 


L 






closer to L. 
Subclav. than 


/Intern. Maxillary arises by a com. 
\ trunk with Facl. Other Brs. usual. 










_to Innom. 




199 


R 






'almost com- 
pletely covers 
the R. Subcl. 


f Ext. Car. 2f . Lingl. gives Palat. 
| artery. 2 Pharyngl. (one is given 
fr. bifurcation of Com. Car., the 










for some dis- 
tance above 


other ^ inch higher up). Other Brs. 










Jnnom. 


i^ usual. 












fExt. Car. 2^ long. Lingl., Facl., 












Occipl. and Phar. arise close one to 




L 








the other at the distance of $ inch fr. 












Com. Car., close to wh. is the origin 












^ of Thyr., as usual. Post. Auricr. usual. 












'Ext. Car. measures 3 inches. Thyr. 












very small. Lingl. and Facl. by a 












com. origin. The foregoing, with 


200 


R 








Pharyngl. and a muscular br., arise 












within the space of ^ inch fr. Com. 












Car. Occipl. at 2 inches fr. same, 












and gives Post. Auricr. 



THE CAROTID ARTERIES. 



75 



COMMON CAROTID. 


EXTERNAL CAROTID BRANCHES. 


Side 
No. of the 
! Body. 


Length 
in 
Inches. 


Place of Division. 


Peculiarities. 












Tthe Brs. arise at considerable in- 


201 


R 




Th. Cart. 




J tervals one fr. the other. The origin 
| of Thyr. higher than usual. Brs. 












(jn other respects usual. 




L 




Th. Cart. 




Brs. nearly usual. 


202 


R 




Th. Cart. 
















I" Ext. Car. 2 inches long. 2 small 




L 




Th. Cart. 




I Pharyngl. brs. Thyr., Lingl., Facl. 












[and Post. Auricr. usual.j 










'the com. Car. 












is altogether 












covered in the 












neck by the 




202 a 








Intern, jug. 




(male 






Os H. 


- vein; and the 




adt.) 








Vagus also lies 












on or anterior 












to it for the 












greater part of 












its extent. 












"covers origin 












of R. Subcl. 












and is crossed 


f Ext. Car. 2| inches in length. Thyr. 


203 


R 






by a br. from 
< infer. Thyr., 


j and Lingl. usual former is small. 
< Facl., Occipl. and Pharyngl. are 










wh. also gives 


j given at distance of 1 inch fr. Com. 










the usual Th. 


V^Car. P. Auricr. usuaL. 










artery behind 












the Com ..Car. 






L 




Th. Cart. 


jrises fr. Innom. 




204 


R 






("partly covers 
< the beginning 
[ofR.Subclav. 


TExt. Car. 2 inches long. Thyr.. 
J Lingl., &Post. Auricr. usual ; Facl., 
\Oceipl., and Pharyngl. arise together 
at ^ inch distance from Com. Car. 




L 




Th. Curt. 




; Ext. Car. measures 2f inches in length 
Thyr., Lingl., Facl. and Post. Auricr. 
\usual. Occipl. arises in bifurcation 












of the Com. Car. and gives Pharyngl. 


205 


R 




Th. Cart. 




3rs. usual. 




L 




Th. Cart. 




rhyr. very small. Other Brs. usual. 












fExt. Car. 2 inches long. Thyr., 


206 


R 




Th. Cart. 




J Lingl. and Post. Auricr. usual. Facl., 
j Occipl. and Pharyngl. arise inch 
l^above Com. Car. 



7 



THE CAROTID ARTERIES. 









81* R 



ltaerfl 



* 



{itCtat 



Ik Cart. 



Ik Cart. 



Ik A 



ffcuCart, 



TluCart. 



2f iadkcsmlcagtk. 



Est. Car. 




tatSaaCT.TjE. 



r 



Gnu. 



Car. 



iada aWre CM. Car. (tw 
by a caau traak). Past. Anier. 



Oar. 



FaeL, 



f Elt. Car. seance k* tka 2 



Fad. oA as lafoal aaaL Tk 
af OeriaL k k%kcr tkaa 



Car. fa&m. 



fr. Est. 
Mia bfc 



Oat ^ iadcs laag. Ifcyr. 
L Lia^., Fad. aad OcoaL 

"^" """ 



vUdkigpicaithen 

2 sanQ Pknp^L IOL fr. Ext. Car. 



.Car. 
FaA, OedaL 



bL Car. 
F_E-.. Car, 



-^ 



Fad. fr. ca4 f 



THE CAROTID ARTERIES. 



COMMON CAROTID. 


EXTERNAL CAROTID BRANCHES. 


Side 
No. of the 
Bod jr. 


Lenjrth 
in Place of Division. 
Inches. 


Peculiarities. 








fExt. Car. 2f inches long. Brs. 


212 


R 


Th. Cart. 




I usual, except Pharv ngl., which arises 
1 at a distance of 1 inch fr. Com. 












[_Car. 




L 




Th. Cart. 




JExt. Car. 2f inches long. Bre. 
\ usual. 










f arises close to 












JL. Subclav. 


* 


213 


L 






< and at distance 










I of 1 inch fr. 










^Innom. 




214 


R 


Th. Cart. 




f Ext. Car. 3 inches long. The Brs. 
< separated by large intervals at their 










[ origin. 




L 






the Super. Thyr. 


{Lingl. and Facl. arise above Occipl., 
at the distance of 1 J and 1^ inches fr. 
Com. Car. 


215 








I" Ext. Car. 2| inches in length. Thyr., 
< Lingl. and Facl. arise immediately 










[fr. beginning of Ext. Car. 












{Ext. Car. 3A inches long. Thyr., 
Lingl. and Facl. usual. Occipl. 


216 J* 




Th. Cart. 




gives Pharyngl. Post, Auricr. arises 












within inch of upper end of Ext 










Car., and approaches Occipl. on the 










Scull. 






' 




fall except Post. Auricr. and the ter- 












minal brs. arise fr. the beginning of 












Ext. Car. Lingl. and Facl. by one 




L 


usual. 




< trunk. 3 small Pharyngl., one of 










which is given at bifurcation of Com. 










Car. Occipl. is superficial to the 













^Trachelo-Mastoid muscle. 












f Ext. Car. has the Stylo-Hyoid muscle 












I under it. The Brs. arise close to the 


217 


R 




0* H. 


the Super. Thyr. 


< origin of the parent vessel, except 












1 the Post. Auricr. and the terminal 










ihe origin is 










close to In- 










uom., and at 




L 




4 greater dis- 








tance than 








usual from L. 








^Subclav. 





THE CAROTID ARTERIES. 



COMMON CAROTID. 


EXTERNAL CAROTID BRANCHES. 


No 


Side 
of the 
Body. 


Length 
in 
Inches. 


Place of Division. 


Peculiarities. 


218 


R 




Th. Cart. 


Ogives Super. 
Thyr.,of wh. 
a large br. is 
{ directed to the 
opp. side over 
the Crico-Tb. 
^membrane. 


{Lingl. and Facl. are given fr. a com. 
origin. Laryngl. is a separate br. of 
Ext. Car. Facl. gives an unusually 
large Infer. Labial br. Temporal 
furnishes a large br. over the orbit. 
In otber respects Brs. usual. 












fThyr., Lingl., Facl. and Occipl. are 


219 


R 




usual. 




I given immediately at origin of Ext. 
J Car. Three first nearly joined toge- 












l_ther. Other Brs. usual. 




L 




f higher than 
\ usual. 




/ Ext. Car. 2 inches in length. Brs. 
\ usual. 


220 


R 




usual. 


f gives Super. 
\fiijr. 


[ Ext. Car. 3 inches long. Brs. usual, 
l_ except absence of Thyr. 












{Ext. Car. 2f inches long. Lingl. 












and Facl. arise close together at dis- 




L 




usual. 




tance of 1 inch above Com. Car. 












Occipl. and Phar. at -J inch distance 












fr. same. Other Brs. usual. 


221 


L 






fr. innom. 














f Ext. Car. 2| inches long. Thyr. is 












very small. Laryngl. arises sepa- 












rately fr. Ext. Car. above preceding. 


222 


L 




usual. 




J Lingl. and Facl. given fr. a com. 
J trunk, which, with Occipl., Pharyngl. 












and a Hyoid br., arise close together 












at 1 inch distance above Com. Car. 












l^Post. Auricr. usual. 












fThyr. and P. Auricr. usual. Lingl. 


223 


R 




usual. 




1 J and Facl. arise by a com. trunk. 
| Occipl. gives Pharyngl. Palat. is a 













(_ separate br. of Ext. Car. 












fThyr. small (the Infer, is larger than 












j usual). Lingl. and Facl. are close 




L 


4* 


J above Thyr. 
t Cart. 




J in their origin. Laryngl. is given 
j separately fr. Ext. Car. Intern. 












j Maxillary under the Ext. Pterygoid 












(^muscle. 


225 


R 




usual. 


f gives Super. 
\Thyr. 


("Ext. Car. 2 inches long. Lingl. 
< and Facl. given by a com. origin. 
(_ Other Brs. nearly usual. 












fExt. Car. 2f inches long. The Brs. 




L 








J arise at considerable intervals, and in 












| other respects present the usual ar- 












l_rangement. 



THE CAROTID ARTERIES. 



7'J 



T^ 

COMMON CAROTID. 


EXTERNAL CAROTID BRANCHES. 


No. 


Side 
>f the 
Body. 


Length 
Inches. 


P)ae of Division. 


Peculiarities. 












1" Ext. Car. 2- inches long. Sterno- 


226 


R 


41 


OsH. 




< Mastoid br. given fr. Ext. Cat. 












|_ The Brs. usual. 












fLingl. and Facl. rise higher than 












usual and descend to their destination. 












Occipl. is directed backwards beneath 


227 


R 




Os H. 




1 the trans, process of the first Cervical 
Vertebra. Intern. Maxillary is under 












Ext. Pterygoid muscle, close to 












Infer. Maxillary division of the 5th 












V^nerve. 












f On this side the Intern. Maxillary is 












L superficial to Ext. Pterygoid muscle. 


228 


R 








f Facl. supplies the Sublingl. gland. 
\ Other Brs. usual. 












{Ext. Car. measures 2^ inches. La- 












ryngl. arises fr. Ext. Car. above 


230 


R 


3f 


J above the Th. 
\ Cart. 





Thyr.; Occipl. gives Pharyngl. In- 
tern. Maxilly. under Extern. Ptery- 












goid muscle. In other respects the 












Brs. are as usual. 












ff hyr. smaller and its deficiency sup- 


233 


R 








J plied by the Infer. Thyr. Laryngl. 
] arises fir. Ext. Car. Pharyngl. fr. 












[_ Occipl. 












f~2 Thyroid brs., which are smaller 




L 




close to Os H. 




J than the Inferior. Laryngl. is a 
| separate br. of Ext. Car. Occipl. 












(^gives Pharyngl. 


234 


R 




above Th. Cart. 


{rises in com- 
mon with L. 
Car. 


{Lingl. and Facl. given fr. a com. 
origin. Occipl. is continued from 
the ascending cervical br. of the Infer. 












Thyroid. 










! rises by 11 












trunk com- 


Tint. Maxillary under Ext. Pterygoid 








Os II. 


mon to it, 


J muscle : on the right side it is over 










and R. Car. ; 


j or superficial to that muscle. Other 










gives Super. 


[_Brs. usual. 










Thjr. 
























!Lingl. and Facl. fr. a com. trunk,, the 












former ends at the side of the nose. 


235 


R 




above Th. Cart. 




Pharyngl. and Infer. Palat. arise as 
separate brs. of Ext. Car. at the 












distance of 1 inch fr. the Com. Car. 












Other Brs. usual. 



THE CAROTID ARTERIES. 



COMMON CAROTID. 


EXTERNAL CAROTID BRANCHES. 


No. 


Side 
of th 
Body 


LenKth 
Inche.. 


Place of Division. 


Peculiarities. 




L 






fr. Tnnom. 




236 


L 




Th. Cart. 


Tclose to In- 
J nom. and to 
| L. Subclav. at 
(^origin. 


{Ext. Car. 2| inches long. Laryngl. 
is very small and rises fr. Ext. Car. 
Occipl. and Pharyngl. are slightly 
joined at their origin. Other Brs. 
usual. 


237 


R 




Th. Cart, 


f gives Pharyn. 
< in the bifur- 
(_ cation. 


J" Occipl. rises higher than usual am 
\ give Post. Auricr. Other Brs. usual. 












fThyr. very small. Facl. ends at the 


238 


R 




0H. 




I side of the nose, and is assisted by 
| the Intern. Maxillary. In other 












(^respects the Brs. usual". 


240 










f Occipl. gives Pharyngl. The other 
(_ Brs. usual. 


241 


R 




above Th. Cart. 


J arises within 
\ the cheat. 


Brs. usual. 


242 


R 




Th. Cart. 




/ Ext. Car. 3^ inches long. Pharyngl. 
\fr. Occipl. Other Brs. usual. 








{opposite the 






244 


R 




Cricoid carti- 












lage. 












f opposite the 








L 




< Cricoid carti - 












|>ge. 
















f Occipl. arises fr. Intern. Carotid and 


245 


R 




usual. 




s gives Pharyngl. Brs. nearly usual 













L in other respects. 













f Facl. is smaller than ordinary. Infer. 


246 


R 




usual. 




< Palat. is given fr. Ext. Car. Other 












[Bra. usual. 




L 




usual. 




I" Thyr. very small. Lingl. and Facl. 
< by a single trunk of origin. Palat. 
[ arises separately fr. Ext. Car. 


247 


R 


8* 


I" below upper 
< margiu of Th. 
[Cart. 


r covers or lies 
anterior to R. 
^ Subclav. after 
[_ origin. 


fExt. Car. 2 inches long. Pharyngl. 
1 absent. Palat. a separate br. and 
runs between the Stylo-Glossus and 
^Stylo-Pharyngeus muscles. 




L 




su al. 




sual. 



THE CAROTID ARTERIES. 



COMMON CAROTID. 


EXTERNAL CAROTID BRANCHES. 


No. 


Side 
of the 
Body. 


Length 
in 
Inches. 


Place of Division. 


Peculiarities. 












(Ext. Car. 2 inches long. Lingl. 












and Facl. arise by a com. trunk. 












Thyr., Pharyngl., Occipl. and Post. 












Auricr. usual. Intern. Maxilly. is 


248 


R 


3* 


Th. Cart. 




for a short space beyond the condyle 
\ of the lower Maxilla, covered by the 












Ext. Pterygoid, the middle of which 












it perforates from within outwards, 












and then inclining forward over or 












superficially to the muscle, is disposec 












V^as usual. 










'the Ant. Jug. 












vein is very 












large, & com- 












municates 


g 










with the Int. 












Jugular over 


1- 




L 






the External 


| 
I 1 










and Internal 












Carotid arte- 












ries. The Int. 












Jugular vein 












covers the 












Com. Car. for 












some space. 




249 


R 


H 


Th. Cart. 




Brs. usual. 












{Lingl. and Facl. from a com. trunk. 




L 


l 


above Th. Cart. 




Occipl. is unusually high in its origin. 
Pharyngl. fr. Intern. Car. 


250 


R 


31 


J middle of Th. 




JBrs. of Ext. Car. usual. Intern. 






8 


\ Cart. 




\ Carotid measures 3^- inches. 








("middle of Th. 












\ Cart. 
















/'Occipl. arises opposite Thyr. Pha- 












ryngl. given by Intern. Car. Intern. 












Maxillary passes under Ext. Pterv- 










("covered at its 


goid muscle and between the Gus- 


251 


R 




usual. 


J upper part by 
| the Ant. Jug. 
[^ vein. 


1 tatory and Dental bis. of the 5th 
j nerve, which are connected by a 
transverse Branch below the vessel. 












At the anterior part of the muscle. 












the artery is seen to curve forwards 












^and inwards, as usual. 










(gives Super. 
Thyroid and 


[" Sterno-Mast. and Palat. are separate 




L 




usual. 


Pharyn. ; the 


j brs. of Ext. Car. Post. Auricr. fr. 










latter in the 


[ Occipl. Other Brs. nearly usual. 










bifurcation, j 



r,2 



THE CAROTID ARTERIES. 



COMMON CAROTID. 


EXTERNAL CAROTID BRANCHES. 


No. 


Side 
of th 
Body 


Length 
Inches. 


Place of Division. 


Peculiarities. 












fExt. Car. 2| inches long. Pharyngl. 


252 


R 


H 




/ middle of Th. 
I Cart. 


1 is given fr. Occipl., and crosses over 
| the Intern. Car. in its course in- 












[_ wards. 


253 


R 




usual. 








L 




usual. 




Thyr. of small size. Other Brs. usual. 












( Lateral nasal br. is given from the 












Ophthalmic artery. Infer. Palat. 












arises separately fr. Ext. Car. In- 












tern. Maxillary is at first under Ext. 












Pterygoid ; it perforates the middle 












of the muscle, and after coursing 












forward or superficially to it, enters 


254 


R 


3f 


above Th. Cart 




1 the Spheno-Maxillary fossa in the 
\ usual way, while, concealed by the 












Pterygoid muscle, the artery is ex- 












ternal (superficial) to the Infer. Max- 












illary division of the 5th nerve, and 












is crossed by a Branch which com- 












municates between the Temporo- 












Auricr.and the Dental nerves. Other 












vBrs. usual. 












( Lingl. and Pharyngl. joined at their 












(origin. Intern. Maxillary is under 




L 




usual. 


he Super. Thyr. 


Extern. Pterygoid muscle, and runs 
| through the brs. of the Infer. Max- 












1 illary division of the 5th nerve. 












Bother Brs. usual. 


256 


R 








J Lingl. and Facl. fr, a com., origin. 
\ Other Brs. usual. 










fa Thyr. br. 












(the 5th in 






L 




isual. 


1 this case) ari- 
j sesatthejunc- 


J Lingl. and Facl. by a com. origin. 
\ Other Brs. usual. 










1 tion of L. Car. 












^and Innoin. 














f Intern. Maxillary lies under cover of 
the Extern. Pterygoid muscle ; it 


257 


R 




usual. 




curves in a small space outwards, and 
| then forwards and inwards to the 












Spheno-Maxillary fossa, more dis- 












( tinctly than usual. 












["Intern. Maxillary on this side is Ex- 




L 




siial. 




ternal or superficial to the Extern. 
Pterygoid muscle. Pharyngl. arises 












Jr. Occipl. 



THE CAROTID ARTERIES. 



83 



COMMON CAROTID. 


EXTERNAL CAROTID BRANCHES. 


No. 


Side 
of the 
Body. 


Length 
in 
Inches. 


Place of Division. 


Peculiarities. 










Tgives Super. 


fExt. Car. gives a br., -which ramifies 


258 


R 




Th. Cart. 


1 Thyr. at the 
j point of bifur- 
l^cation. 


J in the Stylo-Glossus and Stylo-Pha- 
j ryngeus muscles. Thyr. small. Other 
(_Brs. usual. 




L 




usual. 




C Thyr. small. Lingl. and Facl. by a 










fc. 


( com. origin. 


259 


R 




usual. 






260 


R 




usual. 




j Thyr. a small br. Lingl. and Facl. 
1 by a com. origin. Other Brs. usual. 












fPalat. given separately fr. Ext. Car. 












Intern. Maxillary under the Ext. 












Pterygoid muscle which it perforates 




L 






the Super. Thyr. 


< exactly at the middle, and then, after 












coursing forwards and inwards over 












the muscle, ie disposed in the usual 












V^way. Other Brs. usual. 


261 


R 




usual. 




Fhyr. a large br. Other Brs. usual. 




L 




above Th. Cart. 


the Super. Thyr. 


Brs. usual. 


262 


R 




Os H. 


{gives Super. 
Thyr. and one 
of two Pha- 


("2 Pharyngl. brs. in this case. The 
J smaller is given in the bifurcation of 
| Com. Car. The larger arises fr. 






t 




ryngl. brs. 


[^Ext. Car. 1 inch above the Com. Car. 


264 


R 




Os H. 


f gives Super; 
< Thyr. at point 
[of bifurcation. 


TLingl. and Facl. fr. a com. origin. 
I Pharyngl. fr. Oceipl., which arises 
| below preceding br. Other Brs. 
(^usual. 












/'Thyr. small. Lingl. and Facl. by a 












com. origin ; fir. Facl. are given two 












brs., one very small, after passing 












betw. the Stylo-Gloss, and Stylo - 


265 


L 


'*l 




fr. Innom. 


( Pharyngl. is soon lost in the muscles; 












the second larger, runs anteriorly to 












the first named muscle and ramifies 












in the Intern. Pterygoid. Other 












^Brs. usual. 












{Lingl. gives the Submental, which 


- 










pierces the Mylo-Hyoid muscle fr. 


269 


R 




usual. 




within outwards. Pharyngl. arises 
fr. Occipl., and is large at the same 












time that the Infer. Palat. is a small 












br. Other Brs. usual. 


270 


R 








f Thyr. larger than usual. Other Brs. 
\ usual. 



THE CAROTID ARTERIES. 



COMMON CAROTID. 


EXTERNAL CAROTID-BRANCHES. 


No. 


Side 
of th 
Body 


Length 
in 
Inches. 


Place of Division. 


Peculiarities. 












fThyr. large and gives a considerable 
I br., which crosses to the opposite side 












] over the Crico-Thyroid membrane. 












^Other Brs. nearly as usual. 












["The Brs., except Post. Auricr.and the 


271 


R 







the Super. Thyr 


I terminal, arise close to the beginning 
| of Ext. Car. Lingl. and Facl. given 












|^fr. a com. origin. Other. Brs. usual. 












f Several Brs. arise from the beginning 












of the Ext. Car. The Soft Palate is 












supplied fr. the Pharyngl. Facl. 




L 




OsH. 


the Super. Thyr 


I gives brs. to Intern. Pterygoid 
1 muscle in the place of Palat. Sub- 












inaxillary gland receives a br. fr. 












the Lingl. as well as brs. from the 












^Facl. Other Bra. usual. 












/'Palat. br. of Facl. ends on the Tonsil. 












I Pharyngl. larger, and supplies the 


272 


R 








< Soft Palate. Intern. Maxillary under 












I Extern. Pterygoid muscle. Other 












l^Brs. usual. 












r Laryngl. and Palat. are separate brs. 


273 


R 




isual. 




1 of Ext. Car. Pharyngl. arises fr. 
| Occipl. ; does not supply the Soft 












(_ Palate. 












f Laryngl. and Palat. each separately 




L 






he Super. Thyr. 


1 fr. Ext. Car. Pharyngl. fr. Occipl. 
j Intern Maxillary under the Extern. 












(^ Pterygoid muscle. 












("Lingl. and Facl. fr. a com. origin. 


274 


R 




feal. 


- 


< Intern. Maxillary under Extern. 












[_ Pterygoid muscle. Other Brs. usual. 


275 


R 






("gives Super. 
I Thyroid anc 
| Laryngl. sepa- 


f Palat. a separate br. of Ext. Car. 
]_ Other Brs. nearly usual. 










(j-atcly. 














f" Palat. a separate br. of Ext. Car. 




L 








< Tonsil receives a distinct Br. fr. 












[Facl. Other Brs. nearly usual. 


276 


L 








TLingl. and Facl. by a com." origin. 
I A distinct Br. is given to the Tonsil. 












1 Intern. Maxillary under Extern. 












[_ Pterygoid muscle. 


277 


R 








f The Facl. arises above the Digastric 












\ muscle. 



THE CAROTID ARTERIES. 



COMMON CAROTID. f + 


EXTERNAL CAROTID BRANCHES. 


No. 


Side 
of the 
Body. 


Length 
in 
Inches. 


Place of Division. 


Peculiarities. 












'Lingl. and Facl. by a com. origin ; 












the latter gives besides the Palat. a 












distinct br. to the Tonsil. Pharyngl. 


278 


R 




U3lial. 




< arises fr. the origin of the Linguo- 












Facl. trunk, and does not send any 












br. to the Soft Palate. Other Brs. 












usual. 












("Facl. gives Palat. and Tonsil, brs., 


281 


R 








I which supply respectively the Soft 












| Palate and the Tonsil. Pharyngl. 












[does not supply the Palate. 


290 


L 




usual. 




/Left Palat. (fr. Facl.) supplies the 
\ Soft Palate. ' Other Brs. usual. . 












f Thyr. sends a large br. over the 


291 


R 




usual. 




< Crico-Thyr. membrane to the opposite 
[side. Other Brs. usual. 



Bti 



COMMON CAROTID ARTERIES. 



ABSTRACT OF THE TABLE. 

Right side. . NUMBER 

less than 3 inches ...... ... 2 

3 inches, not exceeding 3 . . ..... 21 

more than 3, not exceeding 4 ...... 24 

more than 4, not exceeding 4| ....... 15 

more than 4^, not exceeding 5 ...... 5 

more than 5, not exceeding o ....... 1 

Left side. 

less than 4 inches . . . . . * . .0 

4 inches, not exceeding 4^ . ...... 11 

more than 4-|, not exceeding 5 . . . . * . .18 

more than 5, not exceeding 5 ...... 9 

more than 5, not exceeding 6 ........ 9 

more than 6, not exceeding 6 ..... . .2 



PLACE OF DIVISION. 

Opposite the Cricoid Cartilage R ..... 2 

L ...... 3 

Below upper margin of the Thyroid Cartilage R. 17 

L. . . . 9 

-- 26 

Opposite upper margin of the Thy. Cartilage R. . .105 

L. . . . 79 

-- 104 
Above Thyr. Cartilage R. . ..... 15 

L ........ 8 

-- 23 
Opposite Os Hyoides R ........ 29 

L ......... 18 

-- 47 
Above Os Hyoides R ........ 3 

L. . . . . ... 7 

-- 10 

EXTERNAL CAROTID ARTERIES BRANCHES. 

The facts contained in the part of the table which refers to the External 
Carotid Arteries and their Branches, will be made use of in the observations on 
those vessels. 



17 



EXPLANATION OF PLATE VIII. 



THIS plate shows the arteries at the upper part of the neck, 
and the side of the face and head. 



The tendinous fibres in which the 
occipital part of the occipito- 
frontal muscle ends ; in front this 
tendon is continued by a mem- 
branous structure to the fibres of 

. the frontal part of the same mus- 
cle, arid at the side it receives the 
attachment of the upper muscle 
of the pinna of the ear. 

Frontal part of the occipito-frontal 
muscle. 

The superior muscle of the ear ; 
below it are a few muscular fibres 
the anterior muscle of the same 
part ; and both are connected by 
a membranous, or, as it appeared, 
a musculo-membranous structure, 
to the outer margin of the muscle 
marked b. 

Orbicularis palpebrarum ; from it 
a few pale fibres descend to the 
lip in connexion with its Levator. 

Levator Labii superioris. 



/ Levator anguli oris. 

g Zygomaticus. 

h Orbicularis oris. 

i Depressor labii inferioris. 

k Depressor anguli oris. 

/ A portion of the Platysma myoides. 

m Buccinator. 

n Masseter. 

o A little of the parotid gland and 

the duct. 

p Digastric. 

q Stylo-hyoid. 

r Mylo-hyoid. 

s Hyo-glossus. 

t Os Hyoides. 

u Thyroid cartilage. 

v Sterno-hyoid. 

w Omo-hyoid. 

x Sterno-thyroid. 

a? 1 Thyro-hyoid. 

y Sterno-cleido-mastoid. 

z Thyroid body. 



ARTERIES. 



1. Common cai'otid. 

2. External carotid. 

3. Internal carotid. 

4. Superior thyroid. From this 
artery a branch is given back- 
wards to the sterno-mastoid, and 
the lymphatic glands beneath it ; 
another, the laryngeal, is directed 
under the thyro-hyoid ; the hyoid 
branch ramifies over the os hyoi- 
des, supplying the muscles at- 
tached to that bone and the in- 
teguments over them. The rest 
of the artery is distributed to the 
muscles and the thyroid body. 

5. Lingual. It usually curves up- 
wards and inwards as seen here, 



before entering under cover of the 
hyoglossus and mylo-hyoid muscle, 
and sometimes gives a hyoid 
branch to the muscles in the 
neighbourhood. 

6. Facial exposed beneath the max- 
illa by the removal of the sub- 
maxillary gland. 

7. A sterno-mastoid branch given 
frequently as here from the ex- 
ternal carotid. 

8. Occipital. 

9. Posterior auricular. 

10. Beginning of internal maxillary. 

11. Temporal giving forward a small 
branch, superior masseteric, to 
the masseter muscle ; and back- 



EXPLANATION OF THE TENTH PLATE. 



wards another, the anterior au- 
ricular. 

12; Transverse facial, usually derived 
from the temporal. 

12'. Middle temporal. 

13. Submental. 

14. Inferior labial. 

1 5. Inferior coronary. 

16. Superior coronary. 

17. Lateral nasal. 

18. A branch of the ophthalmic artery 
escaping from the inner side of 
the orbit, and freely communi- 



cating with the end of the facial 
artery. 

19. A branch of the same artery 
frontal which also ascends from 
the orbit over the frontalis mus.- 
cle, and anastomoses with the 
anterior temporal. 

20. Anterior temporal, from which 
some branches extend forward 
towards the orbit, and others at 
small intervals are directed in a 
.peculiar manner backwards, and 
to the opposite side. 



22. Internal jugular. 



VEINS. 

| 23. Facial. 



EXPLANATION OF PLATE IX. 



THIS plate is intended to show the internal maxillary artery. 
The masseter muscle was removed, except a small part of its 
lower end. The zygoma is seen to have been divided and a 
portion taken away ; the condyle, neck, and part of the ramus 
of the lower maxilla remain in their natural position ; the 
coronoid process and a considerable portion of the ramus are 
turned up on the temple with the temporal muscle. 



Temporal muscle. 
b External pterygoid. 
c. Internal pterygoid. 
d Buccinator, into which the duct of 
the parotid gland enters. 



e A small part of the masseter. 

/ Digastric. 

g Sterno-cleido mastoid. 

h Zygoma. 

i Lower maxillary bone. 



ARTERIES. 



Common carotid. 
External carotid. 
Internal carotid. 
Occipital. 

Posterior auricular. 
Temporal. 
Internal maxillary. 
Inferior dental. 



9. Middle meningeal sinking beneath 
the external pterygoid muscle. 

10. Deep temporal anterior branch. 
10'. Deep temporal posterior 

branch *. 

11. Buccal. 

12. Superior maxillary alveolar or 
dental branch. 



* In the third figure of his seventh plate, Tiedemann places the deep temporal 
arteries over or superficially to the temporal muscle. 



EXPLANATION OF THE TENTH PLATE. 89 

NERVES. 

The nerves here seen are all branches of the third or 
inferior maxillary division of the fifth nerve. 

13. Inferior dental. I 15. Masseteric. 

14. Lingual or gustatory. ) 16. Buccal. 

The temporal nerve is directed upwards near the posterior 
deep temporal artery, and there exists in this case another 
branch situated farther forward, and furnished by the buccal 
nerve. The second temporal nerve, though not constant, is 
not unfrequently met with. 



EXPLANATION OF PLATE X. 

VIEW OF PHARYNGEAL AND LINGUAL ARTERIES. 



THE lower maxillary bone was divided near its middle, and 
its left side removed as well as the muscles connected to it, 
with the exception of those attached to the bone near its 
symphysis. The temporal muscle was divided above the 
zygoma, and cleared from under it in order to show the process 
more fully. The buccinator muscle was cut away, and with 
the intention of displaying the pharynx more clearly, it was 
distended and the os hyoides hooked forward. 



a External pterygoid process of the 

sphenoid bone. 
I Tensor v. circumflexus palati 

muscle. 

c Levator palati. 

d Superior constrictor of the pharynx. 
d 1 Tonsil. 

e Middle constrictor of the pharynx. 
/ Inferior constrictor. 
y Hyoglossus. 



k Mylo-hyoid, turned down after 
separation from the lower maxilla. 

/ Digastric. The attachment to the 
maxillary bone is left, the greater 
part of the muscle is turned to the 
back part of the neck. 

m Styloid process of the temporal bone. 

n Stylo-glossus muscle. 

o Stylo -pharyngeus. 

p Os hyoides. 



h Genio-hyoglossus. I q Thyroid cartilage. 

7i> Sublingual gland ; on which lies a j r Sterno-hyoid muscle. 



part of the duct of the submax- 
illary gland. 
Genio-hyoid. 



Omo-hyoid. 
Sterno-thyroid. 
Thyro-hyoid. 
Sterno-cleido-mastoid. 



5'U 



EXPLANATION OF THE TENTH PLATE. 



ARTERIES. 



1. Common carotid. 

2. External carotid. 

3. Internal carotid. 

4. Superior thyroid, giving among 
others the 

4 1 . Laryngeal. 

5. Lingual. The peculiar curve of 
this artery is removed by the 
traction on the os hyoides, and 
the distension of the pharynx. It 
is seen to give, behind the hyo- 
glossus muscle, a small artery 
directed downwards to the muscles 
connected to the hyoid bone 
(hyoid branch) and upwards an- 
other (arter. dorsalis linguae). 
Anteriorly to the hyoglossus 
muscle, the sublingual branch is 
seen to ramify on the gland ; the 
Ranine artery is directed on- 
wards to the end of the tongue, 
decreasing in size ; and, in this 
case, several of the muscular 
branches emanate from a common 
trunk, which is seen below the 
artery last named. 



6. Facial. Its palatine branch was, 
in the body from which the draw- 
ing was taken, very small, and 
ended in the tonsil. 

7. Pharyngeal. Here of large size, 
and its upper part giving a con- 
siderable branch, which arches 
downwards and is directed to the 
soft palate over the margin of the 
superior constrictor of the pharynx, 
and in company with the tensor 
and the levator palati. 

8. Occipital. 

9. The end of the internal maxillary 
in the spheno-palatine fossa. 

10. The middle meningeal branch of 
the preceding ; from it is given 
forwards a small artery, which 
ramifies over the large plexus of 
veins found in this situation, 
after having furnished a menin- 
geal branch through the foramen 
ovale of the sphenoid bone (art. 
meningia parva) ; this is seen beside 
the inferior maxillary nerve. 

11. Temporal. 



NERVES. 



12. Inferior maxillary division of the 

fifth. 

12 1 . Lingual or gustatory branch of 
preceding. 

13. Hypoglossal, or 9th ; the two 



last have a branch of communi- 
cation extending between them. 

14. Pneumogastric or N. vagus. 
14 1 . Its superior laryngeal branch. 

15. Glosso-pharyngeal. 



EXPLANATION OF PLATE XL 



THE integuments, platysma myoides, and cervical fascia, 
were removed from the upper part of the neck of the body of 
which this drawing is a representation. The parotid gland 
was also taken from the fossa behind the branch of the lower 
maxillary bone and the greater part cut away. 



a Masseter muscle. 

I Digastric. 

c Duct of parotid gland. 

c 1 Sub-maxillary gland. 

d Thyroid cartilage. 

e Sterno-hyoid muscle. 

f Omo-hyoid. 



g Sterno-thyroid. 

g^ Thyro-hyoid. 

h Sterno-cleido-mastoid. 

h l Part of the same muscle turned 

back. 
* * Lymphatic glands. 



ARTERIES. 



1. Common carotid. 

2. External carotid. 

3. Internal carotid. 

4. Superior thyroid. This vessel 
gives the following offsets : viz. 
a laryngeal branch which is seen 
to sink under the thyro-hyoid 
muscle (#') ; a small hyoid (?) 
branch over that muscle; an artery 
which, after crossing over the large 
vessels, is distributed to the lym- 
phatic glands and the sterno- 
mastoid muscle. The remaining 
division of the thyroid artery 
ramifies in the thyroid body and 
the muscles which cover it. 



5. Lingual. The hyoid branch of 
this artery is here very distinct. 

6. Facial : as it emerges from the 
sub-maxillary gland, this artery 
seuds off the inferior masseteric 
branch which is directed upwards 
on the muscle, and farther forward 
the submental artery which 
supplies the lymphatic glands and 
the contiguous muscles. 

7. Temporal ; from which near its 
origin are derived two branches, 
viz. superior masseteric and 
transverse facial. 

8. Internal maxillary. 



VEINS. 



9. Temporo-maxillary vein, result- 
ing from the union of the temporal 
and the internal maxillary, and 
ending as external jugular. 
Internal jugular. It receives on 
its inner side two, which may be 
called thyroid veins, and above 
these the facial (12). 
External jugular, descending over 
the sterno-mastoid muscle to ter- 
minate in the subclavian vein. 
There is a branch of communica- 
tion between the external and the 
internal jugular veins opposite the 
angle of the maxilla . The branch 
in this case joins the facial as that 



10. 



11 



12. 



vein is about to enter in the inter- 
nal jugular. 

Facial. This vein receives the 
submental from below the base of 
the maxillary bone ; and where it 
crosses the external carotid artery 
another vein is seen to enter it from 
above. The vessel last referred to 
results from the junction of two 
small veins (one of them is ob- 
servable in the drawing above the 
digastric muscle, the other lay 
concealed by the artery) which 
accompany the carotid in the 
manner of venae comites. 



EXPLANATION OF THE TWELFTH PLATE. 



NERVES. 



13. Pneumogastric or n. vagus. 

14. Portio dura of seventh ; the 
branches have been cut and re- 
moved. 

15. Descending branch of the ninth 
(n. descendens noni), forming 
with a branch derived from the 



cervical nerves, a loop from which 
filaments are given to the muscles, 

16. Auricular, from the cervical 
plexus, seen to communicate with 
the portio dura. 

17. Spinal accessory. 



EXPLANATION OF PLATE XII. 



a Thyroid cartilage. 

b Trachea. 

d Thyroid body. 



e Masseter muscle . 
/ Digastric. 
g (Esophagus. 



1. Aorta its ascending part. 

2. Aorta its descending part. 

3. Innominate. 

4. Right common carotid. 
4 1 . Left common carotid. 

5. Right subclavian. 
5 ' . Left subclavian. 

6. Right external carotid. 
6 l . Left external carotid. 

7. Right internal carotid. 
7 1 . Left internal carotid. 



ARTERIES. 

8. Superior thyroid. 
8 1 . Laryngeal. 

9. Lingual. 

10. Facial. 

10'. Ascending palatine. 

11. Occipital. 
II 1 . Pharyngeal. 

12. Posterior auricular. 

13. Thyroid axis. 
13 l . Inferior thyroid . 



14. Pneumogastric or n. vagus. 



NERVES. 

| 14 1 . Inferior laryrigeal. 






The plate is intended to show some of the variations of 
the common carotid and the external carotid arteries. Those 
which occur in the origin of the former, are illustrated in the 
plates in which the arch of the aorta and its branches are 
represented. 

In Figure 1, the common carotid of the right side is seen 
to extend much higher than usual considerably above the 
hyoid bone. 

In Figure 2, the external and internal carotid arteries are 
seen to separate from the common carotid, opposite the 
cricoid cartilage. 



EXPLANATION OF THE TWELFTH PLATE. 93 

The common carotid is altogether wanting on the right 
side in figure 3 ; and the external and internal carotid are 
seen to take origin directly from the aorta. 

Figure 4. The common carotid gives the superior and the 
inferior thyroid arteries. The branch directed inwards under 
the carotid from the thyroid axis was distributed to the oeso- 
phagus and the trachea. In the preparation from which the 
sketch has been taken*, both carotid arteries are derived 
from the aorta by a short common trunk, and the right 
subclavian, taking its rise to the left of the other branches 
crosses to the first rib immediately in front of the vertebral 
column. The inferior laryngeal nerve, instead of turning 
upwards behind the subclavian artery, branches from the 
pneumogastric opposite the lower end of the larynx. These 
facts will be further noticed under the head of the subclavian 
artery. 

In Figure 5, the external carotid of the right side is placed 
between the digastric and the stylo-hyoid muscles, instead of 
being covered by both. 

Figures 6, 7, and 8, are intended to illustrate peculiarities 
often noticed in the place of origin of the branches of the 
external carotid. In the first of the sketches, the branches 
are seen to be given off only at the lower and the upper ends 
of the main vessel ; in the second, they arise close together 
below its middle ; and in the third case they are given in 
succession at nearly regular intervals. 

Figure 9. The superior thyroid artery is derived from 
the common carotid at a considerable distance from its division, 
and the laryngeal is a distinct branch of the carotid. 

* No. 239, in my collection. 



i 2 



94 EXPLANATION OF THE THIRTEENTH PLATE. 



EXPLANATION OF PLATE XIII. 



Temporal muscle. 
External pterygoid. 
Internal pterygoid. 



1. Common carotid. 

2. External carotid. 

3. Internal carotid. 

4. Superior thyroid. 
4 1 . Laryngeal. 

5- Lingual. 

6. Facial. 

7. Occipital. 

8. Temporal. 

9. Internal maxillary. 

9 1 . Middle meningeal (fig. 7). 

10. Posterior auricular. 

1 1 . Pharyngeal. 

12. Middle meningeal(fig. 8). 



d Styloid process of the temporal 
bone. 



ARTERIES. 



13. A branch of the internal maxil- 
lary which enters the skull through 
the foramen ovale, and joins that 
marked 15. 

14. Infra-orbital. 

15. A branch of the internal maxil- 
lary, entering the cranium through 
the foramen rotundum, and join- 
ing the vessel marked 13, to form a 
considerable trunk, which gives the 
ophthalmic and a cerebral artery. 

16. Ophthalmic. 
17- Inferior dental. 



18. Optic nerve. 



Figure 1 shows the superior thyroid and lingual arteries 
united at their origin ; and there are two pharyngeal 
branches. 

In Figure 2, the superior thyroid is joined to the common 
trunk of the lingual and facial. 

In Figure 3, two superior thyroid arteries and the laryn- 
geal are seen to arise separately from the external carotid ; 
the occipital and pharyngeal branches take origin above their 
most frequent position. 

The lingual and facial arise by a common trunk in figure 4. 

The facial (in figure 5) is given off considerably higher 
than usual, and descends behind the angle of the lower 
maxilla to gain its ordinary situation. 

Figure 6. The facial and internal maxillary arise by one 
trunk in the usual position of the former, so that it may be 
said the internal maxillary is derived from the facial. 

In Figure 7, the internal maxillary is covered by the 
external pterygoid muscle. 



EXPLANATION OF THE FOURTEENTH PLATE. 95 

Figure 8. In the preparation here represented*, the 
internal carotid artery and the carotid canal of the temporal 
bone are absent. The place of the carotid artery is supplied 
by two branches of the internal maxillary which enter the 
cavity of the cranium through the foramen rotundum and the 
foramen ovale. The vessel constructed by the junction of the 
two branches indicated, are seen in the preparation to lie to the 
inner side of the nervus trigeminus; and it may be added, that 
the unusual arteries are more tortuous than they are repre- 
sented in the drawing. The internal carotid artery of the 
right side is larger than usual, and doubtless compensated for 
the small size of the cerebral artery shown on the left side. 



EXPLANATION OF PLATE XIV. 



ARTERIES. 



Common carotid. 
External carotid. 
Internal carotid. 
Superior thyroid. 
Lingual. 
Facial. 
Occipital. 

A large branch of the occipital 
taking an unusual course over the 
sterno-mastoid muscle. 
Temporal. 

A large branch of the preceding 
directed over the orbit. 
Internal maxillary. 



10. Transverse facial. 

11. A large branch of the internal 
maxillary. 

12. Infra-orbital branch of the inter- 
nal maxillary. 

13. Supra-orbital branch of the 
ophthalmic, giving upwards a 
considerable frontal artery, and 
downwards another branch which 
ramifies on the nose. 

14. Pharyngeal. 

15. External jugular vein. 

16. Pneumogastric nerve orn. vagus. 



This plate illustrates some of the variations of the facial, 
the temporal, and the occipital arteries. 

The facial artery is shown in figure 1 to end in the inferior 
masseteric and the submental branches. Its place is taken on 
the face by branches of the internal maxillary (11 and 12), 
and by the inferior coronary of the left side. 

Figure 2 shows the deficiency of the facial supplied by the 
transverse facial (10). 

In Figure 3, the transverse facial artery (10) and a branch 
of the ophthalmic are seen to compensate for the small size of 
the facial. 

No. 357. 



96 



EXPLANATION OF THE FIFTEENTH PLATE. 



Figure 4 is a representation of a large branch of the tem- 
poral artery directed along the upper margin of the orbit, 
where it joins with a small branch of the ophthalmic, and 
furnishes the frontal arteries. 

Figure 5. The greater part of the occipital artery is seen 
in this figure to be directed to the occiput over all the muscles, 
while but a small branch follows the usual course of that vessel. 

The occipital is shown in figure 6 taking origin from the 
internal carotid artery. 



EXPLANATION OF PLATE XV. 



Temporal muscle. 

Pterygoid process of the sphenoid 

bone. 
Circumflexus, or tensor palati 

muscle. 
Levator palati. 

Superior constrictor of the pharynx. 
Middle constrictor. 
Hyo-glossus. 
Genio-hyoglossus. 
Genio-hyoid. 
Mylo-hyoid. 
Sublingual gland. 



m Hyoid bone. 

n Thyroid cartilage. 

o Styloid process of the temporal 

bone. 

p Stylo-glossus muscle. 

q Stylo-pharyngeus. 

r Stylo-hyoid. 

5 Digastric. 

t Sterno-cleido-mastoid. 

v Transverse process of the atlas. 

w Duct of parotid gland. 

x M. rectus anticus capitis major. 

y Submaxillary gland. 



ARTERIES. 



1. 

2. 

;-5. 

4. 
5. 
(>. 
6. 
7. 
B. 


Common carotid. 
External carotid. 
Internal carotid. 
Superior thyroid. 
Lingual. 
Facial. 
Inferior palatine. 
Occipital. 
Temporal. 


9. 
9 1 . 

& 

10. 
11. 
12. 

13. 


Internal maxillary. 
Middle tneningeal. 
Small meningeal. 
Posterior auricular. 
Pharyngeal. 
Vertebral. 

Inferior maxillary division of the 
fifth nerve. 



The fifteenth plate is intended chiefly to show some of 
various conditions of the pharyngeal artery. 

Figure 1. The arrangement of the pharyngeal and the 
inferior palatine arteries in this figure contrasts with that 
represented in the ninth plate. Here the pharyngeal ends in 
three branches, one of which continues close by the internal 
carotid artery and enters the cranium ; the two others arch 



COMMON CAROTID ARTERIES. 97 

down to the pharynx on which they are distributed. The 
inferior palatine, after furnishing many branches to the 
pharynx, in front 6*f the pharyngeal, and to the tonsil, arches 
over the superior constrictor to the soft palate, in which it 
ramifies. 

The lingual artery (5) in this plate preserves its usual curve 
towards the hyoid bone. The sublingual branch- is small, but 
on the lower part of the gland is seen part of another artery, 
which was probably derived from the facial, and penetrated 
the mylo-hyoid muscle. The peculiar mode of ramification of 
the artery, and its gradual decrease in size, are well shown in 
front of the hyoglossus muscle. 

The internal maxillary artery (9) in this case was covered 
by the external pterygoid muscle as in plate 13, figure 7, and 
in consequence of the removal of the muscle, that part of the 
internal maxillary which had been covered by it, and the 
branches given from the artery in this situation, are exposed. 

In Figure 2, the pharyngeal is represented arising from the 
occipital artery. 

Figure 3, shows it taking origin from the internal carotid 
artery. 

Figure 4. The occipital artery springs from the internal 
carotid and gives the pharyngeal. 

THE COMMON CAROTID ARTERIES. 

Inasmuch as the arteries of both sides differ one from the 
other in their origin and length, they will be treated of sepa- 
rately in reference to these points. 

The origin of the right common carotid was found to be in 
common with that of the subclavian, from the innominate, in 
all the cases observed (930) with the exception of five*. In 
two of these it was given separately from the arch of the 
aorta -f- ; and in the others it was conjoined with the left 
carotid, both vessels arising from a short common trunk j. 
When not united with the subclavian, the vessel under con- 

* See abstract of the table, ante p. 32. 

-f- Plate 7, figure 2. The other case differed from that represented in plate 6, 
figure 13, only in the right vertebral having its usual origin. 
Plate 7, figures 4. See also same plate, fig. 5. 



98 COMMON CAROTID ARTERIES. 

sideration is usually the first branch of the aortic arch* ; it 
is however occasionally preceded by the right subclavianf, 
and very rarely by the left carotid J. 

The usual situation of the commencement of the right carotid 

/ O 

artery, when derived from the innominate, is behind the inner 
end of the clavicle, or on a level with the upper margin of that 
bone or nearly so ; but the origin is not unfrequently found 
to be higher or lower than the point indicated. The place 
of division of the innominate, which obviously is coincident 
with the beginning of the carotid, was noted in 137 bodies ; 
in 7 of these the carotid separated from the innominate in 
the neck considerably above the clavicle ; in 9 it arose below 
that bone; and in 121 the origin of the artery occupied the 
usual situation. The deviations, therefore, in this respect 
were about 1 in 87, and they were more frequently above 
than below the ordinary position. 

The length of the common carotid of the right side was 
noted in 68 bodies. For the details of these cases, reference 
may be made to the table, ante p. 55 et seq., or to the ab- 
stract p. 86. From the latter it appears that in 60 cases the 
length varied between 3 and 4-J inches ; 2 measured less than 
3 inches ; and the remaining 6 varied between 4-J- and 5 inches. 
The average length may be stated to be from 3^- to 4 inches. 

The origin of the left common carotid deviates from the usual 
position much more frequently than that of the artery of the 
right side. In 25 out of 219 instances in which the exami- 
nation was made, the left carotid was derived from the 
innominate, or was joined with that vessel so as to form with 
it one large trunk . The proportion, therefore, of variations 
from the usual origin, dependent on this source, was nearly 1 in 
8^. It is to be observed, however, that the left carotid not only 
takes its origin in common with both the vessels of the oppo- 
site side, but that in the greater number of cases in which the 
right subclavian is a distinct branch of the aorta it arises in 



* Plate 5, fig. 8; plate 6, figs. 11, 12, and 13; plate 7, figs. 5, 6, and 11. 

f Plate 6, fig. 10 ; plate 7, figs. 4 and 13 ; and to these may be added the remark- 
able cases represented in plate 5, fig. 9, and plate 12, fig. 3. 

* Ante p. 48, and plate 7, fig. 2 ; and a nearly similar case described and delineated 
by Walter in Nouv. Mem. cle 1'Acad. dcs Sciences, &c. Berlin, 1/85. 

Ante p. 45, and plate 6, fig. 7. 



COMMON CAROTID ARTERIES. 99 

conjunction with the carotid of the right side (PL 7, figs. 
4 and 5). In the foregoing the artery is seen tending towards 
the vessels of the right side ; and in two cases its origin was 
placed even to the right of both of them*. It is remarkable 
that the instances which are recorded of a junction between 
this vessel and the subclavian at its own side are very few. 
Only three cases are referred to in which the carotid and sub- 
clavian arteries were derived from a common or innominate 
trunk on the left as well as on the right side*f- ; and one 
is recorded in which the only innominate existed on the left 
sidej. 

The foregoing remarks on the origin of the common carotid 
arteries apply to those vessels when the arch of the aorta has 
the usual course to the left side ; when the great artery 
arches to the right side the branches must be considered as 
reversed || . 

Place of division of the common carotid arteries. Under 
this head the vessels of both sides will be treated of together. 
The bifurcation of the arteries was noted in 295 cases ; in 
184 it was situated opposite the upper margin of the thyroid 
cartilage which is therefore considered the usual position 
and in the remaining 111 cases the division occurred at 
different and more or less distant points. The deviations 
from the usual place of division, were consequently as 1 in 
about 2-J. 

The cases of deviation, 111 in number, were distributed as 
follows : 

A Those in which the bifurcation occurred above the usual 
position. 

Above the thyroid cartilage, or opposite the hyoid 

bone 60 about 1 in 5 

Above the hyoid bone, considerably higher than 

usual 10 1 in 29- 

Total above the ordinary place of division . . 70 about 1 in 4 

* Ante p. 48, and plate 7, fig. 2 ; and a nearly similar case described and delineated 
by Walter in Nouv. Mem. de 1'Acad. des Sciences, &c. Berlin, 1785. 
f- Ante p. 46, and plate 6, fig. 9. 
t Plate 7, fig. 6. 
|| Plate 5, figs. 3, 4, and 5 ; and plate 7, fig. 3. 



100 COMMON CAROTID ARTERIES. 

B Cases in which the division was situated below the 
usual position. 

Beneath the upper margin or opposite the middle 

of the thyroid cartilage .... 26 about 1 in 11 
Opposite the cricoid cartilage . . . . 5 1 in 59 

Total below the usual place of division . .31 about 1 in 9^ 

No example has occurred in my experience of a higher 
division of the common carotid than that delineated in the 
first figure of the twelfth plate, in which the thyroid, lingual 
and facial arteries are seen to descend from the external 
carotid to their destinations, instead of being directed imme- 
diately inwards, as is usual when the common carotid divides 
opposite the thyroid cartilage. Allan Burns describes an 
instance in which the common carotid appears to have ex- 
tended still nearer to the base of the skull, but several of the 
branches ordinarily furnished by the external carotid, were 
given by the common carotid in its ascent*. 

The case last referred to, may be regarded in some degree 
as a transition to the entire absence of a division of the 
common carotid into two large vessels the internal carotid 
being altogether wanting. The carotid artery is seen in one 
preparation in my possession (see plate 13, fig. 8), to furnish, 
as it ascends along the neck, the usual branches of the external 
carotid, and to divide into the temporal and internal maxil- 
lary arteries. In the place of an internal carotid, of which 
there is no trace, two tortuous branches derived from the 
internal maxillary join within the skull and form a single 
vessel ; this had been distributed to the brain and orbit. The 
artery so constructed being however smaller than the usual 
size of the internal carotid, the deficiency is compensated for 
by the artery of the opposite side, which is of large size. 
A case is described by Todef, in which the right internal 
carotid was absent, and the carotid canal was very small 
sufficient only to allow the passage of a bristle. 

* " In a preparation which was in my possession, the common carotid, instead of 
dividing in the neck, sends off lateral branches, till it reaches considerably beyond tho 
angle of the jaw. Opposite to the root of the styloid process it divided into two branches, 
one formed the internal carotid, the other was the conjoined trunk of the temporal 
and internal maxillary arteries." Loco citato, p. 125. 

f Mcdicinisch-chirurgischc Dibliothck, B. 10. S. 408, Kopenhagen, 1787. 



COMMON CAROTID ARTERIES. 101 

Instances are on record in which the carotid divided lower 
down than any referred to above. An example is described by 
Morgagni, in which the left common carotid was but one inch 
and a half in length *. It may be inferred that the external and 
internal carotids must in this case have been given off at the 
bottom of the neck ; and most probably the common trunk 
would not have been accessible above the clavicle. Reference 
is made by Allan Burns to an instance of division of the 
artery opposite the sixth cervical vertebra ; but the length 
of the vessel, or the side of the body on which it occurred, is 
not stated f. 

Absence of the common carotid. The . early division of this 
artery conducts to that condition in which the external and 
internal carotids, instead of being derived from a common 
trunk, arise separately from the aorta. This variety was 
observed by Dr. Power, of Dublin, who states that, "on 
examining the subject" (one brought for anatomical purposes 
into the dissecting-room), " I found that the arch of the 
aorta had ascended unusually high towards the summit of the 
thorax ; there was no arteria innominata, but in the situation 
usually occupied by this vessel the two vessels we have here 
delineated arose : the cerebral carotid lying internally but 
closely related to the external carotid artery, to the outer 
side of which next arose the right subclavian.f See the 
sketch, plate 12, figure 3. 

* " Nam preeter coronariam illam de qua dictum est, cum arterias carotides inter 
se compararem, evidenter major latitudo occurrebat sinistrae, quam dextrsc. Cumque 
ilia, vix sesquipollicis ab origine spatio emenso, in duos, insolito exemplo, dividiretur 
ramos," &c. The observation was made in the body of an aged female, " Paupercula, 
rusticana fcsmina, annorum ut \idebatur circiter quinquaginta," &c. De Sedibus et 
Causis Morb. per Anatomen indagatis. Epist. 29, art. 20. 

f " In one of our subjects the common carotid separated into two trunks low in the 
neck. The division took place opposite the upper margin of the sixth cervical vertebra 
and about three inches Jbelow the angle of the jaw. The two vessels mounted along 
the side of the larynx parallel to each other, and enveloped in the same sheath with 
the internal jugular vein and nervus vagus." 

Observations on the surgical anatomy of the head and neck, p. 124, 2nd Edit, by 
G. S. Pattison, Glasgow, 1824 ; also in Observations on some of the Diseases of the 
Heart, &c. by the same author. Edinburgh, 1809, p. 285. 

$ Extract from remarks on the preparation, very obligingly communicated by Dr. 
Power, lecturer on Anatomy and Physiology in the school of Medicine, Richmond 
Hospital, Dublin. The drawing was taken by Mr. Kirwan, from the preparation in 
the Museum of the hospital, and has been furnished to me through the good offices of 
Professor Hart. The preparation had been inadvertently removed from the body with- 
out Dr. Power's knowledge, and the connexion with the aorta severed. The larynx, 
trachea, and part of the rosophagus, are however preserved in connexion with the two 



102 COMMON CAROTID ARTERIES. 

In Malacarne's case, which has been previously referred to 
for a remarkable peculiarity of the aorta*, the external and 
internal carotid arteries of both sides took origin separately 
from the divisions of the double aorta, and are described as 
ascending parallel one to the other close to the trachea to the 
level of the cricoid cartilage. In this situation the external 
carotid inclined forward, and curving over the internal carotid 
approached the larynx f. It is to be inferred that the internal 
carotid lay next the trachea in this as in the case just referred 
to. Both cases appear to correspond also in the inclination 
of the external carotid inwards over the other vessel. They 
differ in the disposition of the aorta, and in the circumstance 
that in the one case the unusual state of the vessels existed at 
both sides ; while in the other it is seen only on the right side. 

Tortuous state of the Arteries. The carotid like some other 
arteries, instead of having the usual straight direction, are 
occasionally found to be much curved ; and my observation 
inclines me to state that, of the carotid arteries, the internal 
is the most frequently affected in this way. ' The vessels thus 
changed are usually, if not exclusively, met with in the bodies 
of persons of advanced age. An example of the condition 
alluded to, which was observed by Morgagni in the body of 
an old man, is worthy of particular notice. The common 
carotids, though quite straight in other parts, were at the 
middle coiled up in the manner of a spiral shell, and when the 
vessels were artificially untwisted, they immediately resumed 
the curved state on the removal of the extending force J. 

unusual vessels. It must be added that in the sketch (plate 12, fig. 3) made from the 
original drawing, the liberty, I hope not altogether an unwarrantable one, has been 
taken to represent the larynx with more distinctness than it is seen in the preparation, 
and to add or restore in outline the aorta and the subclavian arteries. By the difference 
in drawing it may be at once discerned how much belongs to the preparation. 

* Ante p. 22, and pi. 5, figs. 9 and 10. 

f After describing the peculiarities of the aorta and the origin of subclavian arteries, 
the author proceeds : " I second! tronchi che formavano le sole carotidi esterne e gli 
ultimi piu alti e posteriori, che constituivano le sole carotidi interne salivano paralelli 
ai lati della trachea prendendosi in mezzo le jugulari interne fino all' altczza della 
cartilagine cricoidea. La i tronchi delle carotidi esterne portandosi piu iunanzi con le 
jugulari, s' iucrocicchiavano con le carotidi interne per avvicinarsi maggiormente alia 
laringe," &c. &c. Osservazioni in chirurgia, p. 2, 119. 

J Nee singulare quoddam carotidum vitiumest rcticendum : quse cum ad suaslongi- 
tudinis medium ascendissent,ibi seintorqnebant cochleae instar,statimque ad rectitudinctn 
redibant ; eratque ille flexus adeo pertinax ut si in rectum artcrias extenderes, mox 
amota manu, in eandem se ctmtorsionem restitucrent. De Sedibus et Causis Morbor. 
&c. Epist. 49, Art. 18. 



COMMON CAROTID ARTERIES. 103 

Veins and Nerves. The position which the anterior and 
the internal jugular veins occasionally bear with reference to 
the carotid arteries, has been mentioned and illustrated in a 
former part of this work ; and a variety in the position of the 
nervus vagus is shown in the same place *. It will here only 
be added, that I have frequently seen the internal jugular 
vein cover the carotid artery : and in two bodies the vein and 
nerve lay distinctly over it. The unusual situation of the vein 
occurs much more frequently and to the greatest extent on the 
left side ; this fact may, perhaps, be owing to the inclination 
the veins have towards the right side of the heart. 

Branches are very unfrequently given in the course of the 
common carotid arteries, except near the bifurcation, where 
the superior-thyroid is frequently seen to arise. That vessel was 
derived from the common carotid in 41 of the cases noted in 
the table, giving a proportion of 1 in 7i- The laryngeal 
artery was also a distinct branch of the same trunk in three 
instances, and in but two of all the cases (930) was the com- 
mon carotid observed to give an offset in any other situation. In 
both the instances last referred to, an inferior or an additional 
thyroid was the unusual branch : one is represented in plate 

12, figure 4, in the other the branch was given from the com- 
mon carotid near its origin. Examples of the thyroid arising 
from the lower part of the carotid are noticed by several 
observers; e. g. Nicolaif, ErdmannJ, Haller, and Huber||. 

The vertebral artery has been seen to take origin from the 
common carotid. This rare variety is shown in plate 6, fig. 

13, which is taken from a preparation in the Museum of 
St. Bartholomew's Hospital. Other examples are described 
by Murray and Green ^f. In these cases the variety occurred 
on the right side of the body, and the right subclavian artery 
arose from the left side of the aorta. 

* Page 14, and plate 4. 

f De direct. Vasor. 1725, in Haller Disp. Anatom. Select, vol. ii. p. 499. 

J Descript. Anatom. Art. innom. et thyroideae imso, p. 31. Jense 1772. This Essay 
contains the observations of Neubauer, whose pupil the author was. 

Elem. Physiol. vol. Hi. p. 404. 

|| Acta. Helvet. t. 8. p. 84. 

^[ Der. K. Schwedischen Acad. der Wissenschaften Abhandl. aus dem Schwedis- 
chen ubersetzt von A. G. Kastner, b. 30. s. 92. 

" All the vessels arise from the left side of the arch. First, the right carotid, which 
crosses the lower part of the trachea, giving off the right vertebral," &c. An Account 
of the Varieties in the Arterial System of the Human Body, p. 7. Dublin, 1830, 



104 EXTERNAL CAROTID ARTERIES. 



EXTERNAL CAROTID ARTERIES. 

But few peculiarities requiring notice occur in the anatomy 
of the external carotid independently of the branches. In 
reference to its connexions, it requires only to be stated that 
the artery is sometimes directed upwards between the stylo- 
hyoid and digastric (plate 12, fig. 5), instead of being as usual 
covered by both these muscles. 

The Lenyth. On referring to the table it is found that the 
length was noted in 61 cases, which may be set down under 
the three following heads, viz. : 

From 2 to 2f inches, inclusive . . . . . .44 

From 3 to 3, inclusive 12 

Below those contained in the first division, and not less than 

2 inches . 5 

61 

The branches of the external carotid vary to a great extent 
in the position at which they are given off, and in their 
number. 

Origin of the branches. The variations which take place 
in the origin of the branches will be noticed as each comes 
under consideration ; the observations to be made on the 
subject in this place will therefore have reference only to pecu- 
liarities observed in the position of the branches generally or 
taken together. In some cases recorded above, the origins of 
several branches were crowded together at the beginning of 
the parent vessel (plate 12, fig. 6 *) ; in other cases the 
arteries were seen to arise close together at some distance 
higher up (plate 12, fig. 7) ; lastly, they were sometimes 
observed, as shown in fig. 8 of the same plate, to take origin 
at nearly regular intervals. 

Number of the branches. Independently of several small 
vessels furnished to the parotid gland, &c., the usual number 
of the branches derived from the external carotid, and to 
which names are assigned, may be stated to be eight, viz. 
the superior thyroid, lingual, facial, occipital, posterior auri- 
cular, internal maxillary, temporal, and pharyngeal. I am 

* " In a preparation of the vessels of the head and neck which is in my possession," 
says Allan Burns, " the external carotid is a short thick stump, resembling the axis 
arterise caliaca?, and like it, from the top of this, the large branches take their 
origin." Observations on the Surg. Anat. of the Head and Neck, p. 125. 



SUPERIOR THYROID ARTERY. 105 

under the impression that most frequently there is no separate 
sterno-mastoid branch. The number stated may be diminished 
or increased, or by the coincidence of a source of diminution 
with one of increase, may continue unaltered though the 
branches of which it is made up are in some respects dif- 
ferent. 

The following are the sources of decrease of the number of 
branches : 

Absence of the superior thyroid artery, which is often 
derived from the common carotid ; the union of the same 
artery with the lingual or with the common trunk of the lin- 
gual and facial. 

Union of the lingual and facial. 

Absence of the occipital ; this artery being in some cases 
given from the internal carotid, and occasionally from the 
subclavian. 

The origin of the posterior auricular from the occipital. 

The junction of the internal maxillary to the facial. 

The origin of the pharyngeal from the occipital or from 
the internal carotid ; or its entire absence. 

The increase of the number is owing either to the fact that 
arteries usually given from another source are supplied 
directly by the external carotid, or to the existence of an 
additional artery. The branches mentioned in the table as 
thus changed in their origin, are : the laryngeal, ascending 
palatine, and transverse facial. The unusual or additional 
branches to which an increase of the number is occasionally 
owing, are : the sterno-mastoid, a second superior thyroid, 
a second or even a third pharyngeal. 



SUPERIOR THYROID ARTERY. 

The condition of the superior thyroid artery was noted in 
292 cases ; in the computation the vessels of the right and the 
left side have been added together. 

Independently of variations in size, the examples of which 
were very numerous, the most remarkable peculiarities met 
with are as follows : 



106 LINGUAL ARTERY. 

In several cases the artery supplied the thyroid body on the 
opposite side ; the branch following this unusual course 
was observed to be of large size, and to cross the crico- 

thyroid membrane in 5 

The super, thyroid was derived from the common carotid in 41 1 in 7 
The origin was joined to that of the lingual artery in . 2 
to the common trunk of the lingual 
and facial in . . . . 1 

There were two thyroid arteries (the laryngeal being a 
separate branch in 2 of these) in .... 3 

The hyoid branch is often very small, or even wanted altogether. 
The laryngeal artery arose separately from the exter- 
nal carotid in ...... 24 

from the common carotid in 2 , about 
26 }lin H 

Some other peculiarities of the last named branch will be 
noticed when the superior and inferior thyroid arteries are 
under consideration. 

The thyroid did not supply the thyroid body ; the small 
artery occupying its situation, ended in branches to the 
sterno-mastoid muscle and the larynx, in ... 3 



LINGUAL ARTERY. 

Origin. The lingual artery frequently takes rise not singly 
or directly from the external carotid, but through the medium 
of a trunk common to it and the facial. This mode of origin 
was found in 61 of 302 cases noted in the table or about 1 in 
5. In two cases it was joined with the thyroid, pi. 1 3, fig. 1 . 

Branches. The hyoid branch is not unfrequently deficient ; 
and it appears to me that in general when a hyoid artery of 
good size is given from the lingual, the thyroid supplies none, 
or a very small one, and the converse. See plates 3, 8, 10 
and 11, in which different conditions of the hyoid branches are 
illustrated. 

The sublingual, ordinarily a branch of the lingual artery, is 
occasionally derived from the facial. When it has this unusual 
origin, its course to the gland is either through the mylo- 
hyoid muscle, or with the duct of the submaxillary gland 
behind and beneath the muscle. The sublingual gland was 
seen in one case to be furnished from both the lingual and 
the facial arteries. The lingual artery has been observed to 
furnish the submental artery and the ascending palatine. 



FACIAL ARTERY. 107 



FACIAL OR LABIAL ARTERY*. 

The most frequent change in the origin of the artery is its 
junction with the lingual (see the observations on the origin 
of that artery and of the superior thyroid). Occasionally it 
takes its rise above the usual position, even as high as the 
middle of the ramus of the lower maxilla, and thence descends 
beneath the angle of this bone to assume the usual course 
(pi. 13, fig. 5). 

In size this artery is very variable also in the extent to 
which it reaches. In the case delineated in plate 14, fig. 1, 
the vessel is expended almost altogether beneath the maxilla, 
ending as the submental ; figs. 2 and 3 show it reaching to 
the lower lip and the side of the mouth. The sketches just 
referred to serve to illustrate the various means by which the 
deficiency alluded to is supplied. The vessels which take 
the place of the facial when deficient are derived either from 
the ophthalmic, the transverse facial, or the internal maxillary ; 
the first mentioned is that most frequently thus supplemental, 
and it generally descends to the nose from the inner side of 
the orbit, and not, as represented in the third figure of the 
plate, in common with the frontal artery. 

Brandies. Ascending palatine artery (. This vessel was 
found, instead of being a branch of the facial, to be derived 
from the external carotid in 21 of the cases detailed in 
the table, or about 1 in 14. Its size varies considerably 
the variations in this respect being dependent on the extent 
to which it reaches and the parts which it supplies ; thus, in 
some cases it supplies the soft palate, in others, on the con- 
trary, it is expended on the pharynx and tonsil, and in one 
case a considerable branch was given to the tongue. It may 
be asked, why is the artery named palatine when it does not 
extend beyond the tonsil ? We can only say, that the shorter 

* Labialem arteriaru voco, quam vulgo vel maxillarem externam vocant, vel max- 
illarem, vel denique ob supremos ramos, angularem. Maxillaris enim noinen mihi 
ambiguum videtur, angularis plerumque non verum ; labia vero vix unquam non adit. 
Haller. Icon. Ana torn. Fascic. 3, n. 10. 

f Palatinam adscendentem vocavi, vix descriptam hactenus, ut a palatina descen- 
dente separarem, quaj ramus est maxillaris internse. Icon. Anatom. fascic. 3, n. 11. 



108 OCCIPITAL ARTERY. 

vessel occupies the position between the muscles of the styloid 
process, and has the direction which belongs to the artery 
when it reaches the palate. 

A special tonsillar branch of the facial is often found, but 
is still more frequently absent. Further observations on the 
palatine and tonsillar branches are placed under the head of 
the pharyngeal artery. A branch of the facial is occasionally 
given to the sublingual gland, and this unusual vessel either 
follows the duct of the submaxillary gland inwards, or per- 
forates the mylo-hyoid muscle this variety was noted in five 
cases. On the other hand, the lingual occasionally sends 
branches to some of the parts, which ordinarily derive their 
supply from the facial. Thus the submental was seen in one 
case to be derived from the lingual ; a supplemental palatine 
artery and a branch to the submaxillary gland were observed 
in two other cases to be derived from the same source. 



THE OCCIPITAL ARTERY. 

The origin of the artery is usually opposite the facial, at 
the distance of about an inch from the division of the common 
carotid, but several cases are mentioned in the table in which 
it was higher or lower than this point. In plate 13, figures 
3 and 6, the occipital artery is seen to arise above the 
ordinary situation, while in plate 15, fig. 2, it is given off from 
the bifurcation of the common carotid. The occipital is occa- 
sionally derived from the internal carotid (plate 14, fig. 6, and 
plate 15, fig. 4), and a few cases have occurred in which it 
continued from the ascending cervical branch of the inferior 
thyroid, and was thus derived from the subclavian artery (see 
the plates illustrative of the peculiarities of that artery). 

The sterno-mastoid, splenius, and trachelo-mastoid muscles, 
cover the occipital artery in the course backwards to the occi- 
put ; it is, however, sometimes superficial to the last-named 
muscle, and in one or two cases it perforated the two first 
muscles, near their inner or posterior margins (table No. 
135 R). A very rare variety is represented in plate 14, fig. 
5, in which the chief branch of the occipital is superficial 
to the sterno-mastoid muscle, and but a very small artery is 



TEMPORAL AND INTERNAL MAXILLARY ARTERIES. 109 

deeply placed in the usual situation. The artery in a few 
cases turned backwards beneath the transverse process of the 
atlas, above which it usually lies. 

Branches. The variations of most importance to be noticed 
under this head, are the occasional origin of the posterior 
auricular and the pharyngeal from the occipital artery. 



POSTERIOR AURICULAR ARTERY. 

This artery is frequently very small in size, and I have 
seen it end as the stylo-mastoid branch. It is often a branch 
of the occipital. 

TEMPORAL ARTERY. 

The temporal artery is frequently tortuous ; always so, to a 
certain extent, in aged persons. But few observations have 
been made on peculiarities of this vessel. The branches vary 
in size, and occasionally a very large one is directed forward 
above the zygoma to the upper part of the 'orbit. This un- 
usual artery is seen in plate 14, fig. 4, to join with a small 
branch of the ophthalmic, aud furnish large frontal branches. 

INTERNAL MAXILLARY ARTERY. 

This artery and the preceding are very constant in their 
origin. It was observed in two instances to take origin from 
the facial, from which it coursed upwards to pass beneath the 
ramus of the maxillary bone in the usual situation. 

The internal maxillary artery is very frequently covered by 
the external pterygoid in the manner delineated in plate 
13, fig. 7, instead of lying superficially to that muscle as 
shown in the ninth plate. In a few cases e. g. 248, 254, 
260, in the table the vessel was seen to perforate the muscle 
exactly at the middle, after having been for a very short 
space covered by it, and then to incline forwards on the 
outer surface to enter the spheno- maxillary fossa in the usual 
way. It may be added, that I have seen the artery lodged in 
a notch which is often observable on the margin of the exter- 
nal pterygoid process of the sphenoid bone, and bound into it 
by a little fibrous structure. 



110 PHARYNGEAL ARTERY. 

Branches. The only reference which is necessary to be 
made in this work to the branches is to their state in the 
remarkable case represented in plate 13, fig. 8. Two tortuous 
branches of the internal maxillary are there seen to enter the 
skull through the foramen rotundum and foramen ovale, and 
form an artery in the place of the internal carotid, which 
is altogether wanting ; the internal carotid of the opposite 
side is considerably larger than usual. 

PHARYNGEAL ARTERY. 

The origin of this vessel was noted in 144 cases, which 
admit of being classified as follows : 

Cases in which the Artery arose from the bifurcation of Common Carotid 6 

Within an inch above this point 20 

At ^ an inch 27 

Above ^ an inch, not exceeding 1 inch 50 

Above I inch (extreme height 2 inches) .... 9 

112 

Cases in which the Artery was given from an unusual source. 

From the Occipital . . 19 

From the Internal Carotid 9 

From a Linguo- facial branch 1 

29 

Cases in which there were more than one Pharyngeal branch 

Two brs. from Ext. Carotid ....... 4 

Three brs. from Ext. Carotid 2 

Two brs., one from Occipital, 2nd from Ext. Carotid . . 2 

_. 8 

Absence of the Pharyngeal Artery 

This variety was observed in 1 

The pharyngeal artery and the inferior palatine branch of 
the facial co-operate in supplying the upper part of the 
pharynx, and sometimes the one, sometimes the other, is dis- 
tributed to the soft palate. When the pharyngeal artery 
supplies the palate, the branch given from the facial in the 
usual situation of the palatine ends in the tonsil and in the 
neighbouring muscular structure. The tonsil is, according to 
the observations I have made, more frequently supplied by 
the inferior palatine or the artery in its situation, than by a 
separate offset of the facial. 

The distribution of the pharyngeal artery to the soft palate, 
and the small size of the ascending palatine, are illustrated in 



PHAilYNGEAL AND ASCENDING PALATINE ARTERIES. Ill 

plate 10. In that figure the vessel is seen to divide into 
two branches immediately above the styloglossus muscle. 
The anterior and deeper branch was found on examination to 
ramify in the rectus major muscle and other structures in 
front of the vertebral column. The other branch, the larger 
of the two, subdivides into two parts, having different direc- 
tions, the one vertical, the other horizontal ; the former 
ascends to the cranial bones, the latter, which in the draw- 
ing arches inwards above the margin of the superior con- 
strictor of the pharynx, supplied the soft palate, the 
Eustachian tube, and the tonsil. To these parts the horizontal 
branch was, on prosecuting the dissection, found to be dis- 
tributed thus : The higher division separated into two 
branches, which ramified under the mucous membrane of the 
fore part of the soft palate, in the glandular and muscular 
structure ; the lower division in like manner furnished branches 
to the soft palate under the mucous membrane of its posterior 
surface, and also supplied the Eustachian tube and the tonsil. 
The branch of the facial, which occupies the position of the 
inferior palatine, ended in the tonsil, as shown in the plate. 

In plate 15, fig. 1, that which may be considered the oppo- 
site arrangement of the vessels is seen, for the inferior palatine 
extends to the soft palate, while the branches drooping inwards 
from the pharyngeal end on the side of the pharynx. 

To afford an opportunity of repeatedly observing the distri- 
bution of the arteries in question, several careful dissections 
were made at different times ; and from the notes of them 
taken at the moment, the following extracts are made. 

(1.) The pharyngeal arises from the external carotid artery, 
and ascends vertically to the base of the skull, close to the 
internal carotid ; in this course two branches are given inwards 
to the pharynx, and one to the rectus and longus colli 
muscles; at about the distance of an inch from the skull, 
the artery subdivides into three slender vessels. Of these 
one inclines back to the bone which it penetrates, the others 
arch down to the side of the pharynx. 

The inferior palatine artery ascends from the beginning of 
the facial, between the stylo-glossus and the stylo-pharyngeus 
muscles, and soon divides into two parts : the anterior of 



112 PHARYNGEAL AND ASCENDING PALATINE ARTERIES. 

these spreads out in branches on the tonsil ; the posterior, the 
larger of the two, arches over the superior constrictor of the 
pharynx to the soft palate. From the curve formed by the 
latter branch where it enters the pharynx a small artery is 
directed upwards to the Eustachian tube in which it ramifies 
together with an offset from the pharyngeal. 

(2.) The pharyngeal of large size divides into two branches, 
one of which ascends behind the internal carotid artery to the 
bones of the skull, distributing branches to the nerves in its 
course upwards; the other branch, situated to the inner side 
of the internal carotid, supplies the side of the pharynx and 
enters to the soft palate above the superior constrictor. 

A branch of the facial, the only one given in this situation, 
is directed upwards between the stylo-glossus and the stylo- 
pharyngeus muscles, and ends in the tonsil. This is the 
representative of the inferior palatine. 

(3.) The arteries have the same disposition as in case 1, 
except that a separate branch is given from the facial to the 
tonsiL 

(4.) The arrangement is the same as in the second case, 
with the exception that the facial artery distributes a small 
additional branch to the tonsil, so that here the gland receives 
two separate branches of the facial, viz. that which occupies 
the place of the ascending palatine, and that usually called 
tonsillar. 

All the cases observed were either the same as the foregoing 
those corresponding to the two first being the most frequent 
or, as they presented but slight modifications, were easily 
referred to one or other of those conditions. The modifica- 
tions of most frequency were those affecting the places of 
origin of the pharyngeal and the inferior palatine arteries, 
points previously referred to. It may be added, that the 
last-named artery was occasionally seen behind and under the 
two muscles of the styloid process, and not as usual between 
them. 

Lastly, the disposition of the vessels was in some cases found 
to be exactly the same on both sides of the body, while others 
presented examples of the opposite arrangements on the two 
sides. 



SUBCLAVIAN ARTERIES AND THEIR BRANCHES. 



THE abbreviations which occur in the following table consist, as in the foregoing, in 
the omission of the last letters of the word: e. g. P. Scap. stands for Posterior Scapular ; 
S. Scap. for Supra Scapular ; Tr. Col. for Transversalis Colli ; seal, for scalenus ; m. 
for muscle, &c. 

The word "usual," applied to the branches which arise to the inner side of the 
Scalenus muscle, implies that the Vertebral, Mammary, and Thyroid arteries were 
given off in that situation. In reference to the branches given under the muscle on the 
right side, it denotes that the Intercostal took origin there. 



No. 


Side 
of the 
Body. 

L 


Brs. internal to 
the anterior Sca- 
lenus muscle. 


Brs. under the 
anterior Scalenus 
muscle. 


Brs. beyond the 
anterior Scalenus 
muscle. 


Peculiarities. 


la 


J~ usual ex- 
\ cept Vert. 






Vert, arises from the Aorta. 


2a 


L 


usual. 






Mam. from Th. axis. 


3a 


R 


f usual ex- 
Lcept Th. 






Infer. Th. absent. 




L 


J" usual ex- 
\ cept Th. 






Infer. Th. absent. 


11 


R 


usual. 


usual. 


P. Scap. 




13a 


R 






P. Scap. 


Subclav. ascends 11 inch above clav. 


13b 


R 








Vert, enters third cerv. verteb. 


15 


R 


usual. 


usual. 


none. 




15a 


R 








f Subclav. is not higher than clav. ; it 
< is covered in its whole length by st. 
I mast, muscle. 


16 


R 


usual. 


usual. 


a branch. 


Subclav. not above clav. 


19 




usual. 


usual. 


P. Scap. 


Subclav. little above clav. 


19a 


R 


usual. 


usual. 


none. 


Subclav. not above clav. 


19b 


L 


usual. 


tntercost. 


none. 


f Subclav. not above clav. St. mast. 
< muscle unusually thick at lower end, 
[_ and broad at upper. 


21 


R 


usual. 


usual. 


none. 


{Infer. Th. very large (Super. Th. 
small). 




L 


/ usual ex- 
\ cept Vert. 


[ntercost. 


none. 


f Infer. Th. small (Super. Th. large) : 
\ Vert, from Aorta. 


26 


L 


usual. 


[ntercost. 


none. 


Infer. Th. large. (See Table, p. 57). 



114 



SUBCLAVIAN ARTERIES AND THEIR BRANCHES. 



No. 


Side 
of the 
Body. 


Brs. internal to 
the anterior Sca- 
lenus muscle. 


Brs. under the 
anterior Scalenus 
muscle. 


Brs. beyond the 
anterior Scalenus 
muscle. 


Peculiarities. 


28 


R 


usual. 


usual. 


none. 


Subclav. ascends 1 inch above clav. 


29 a 


R 








Th. large. Thyroid body enlarged. 




L 








J" Th. absent, but a br. is given, 
\ instead, from Innom. 


30 a 


R 


usual. 


usual. 


none. 


Cerv. ascend, becomes Occipl. 


33 


R 








Scap. brs. are not given from Th. 


41 


R 


J" usual ex- 
\ cept Th. 






rSubclav. given from descending 
j Aorta, and crosses behind the 
1 cesoph. and the Com. Car. Th. 
\ is from Com. Car. ; the br. in 
j usual situation of Th., ramifies on 












V^trachea and oesophagus. 


42 


R 








f Subclav. fr. descending Aorta and 
j crosses behind cesoph. and Com. 
I Car. ; no Infer. Th. (Super. Th. 
1 large). Infer, lar. nerve not re- 
^ current, and not behind Subclav. 




L 


usual. 






Infer. Th. small. 


45 


R 


usual. 


usual. 


large P. Scap. 




47 a 




usual. 


usual. 




J St. mast, muscle 3 inches broad at 
\ lower end. 


48 


R 


usual. 


usual. 


JS. Scap. & 
\P. Scap. 


f S. Scap. and P. Scap. arise by a 
< com. trunk on outer margin of 1st 
[rib. 




L 


usual. 


Intercost. 


P. Scap. 


Mam. from Th. 


50 


L 








("Subclav. given from left side of 
< Aortic arch, and directed very ob- 
|_liquely across to 1st rib. 


51 


R 


usual. 


usual. 


none. 




52 


R 


usual. 


usual . 


P. Scap. 


P. Scap. gives Prof. 




L 






/large P. 
\Scap. 


P. Scap. gives Prof. 


53 


R 


usual. 


usual. 


none. 






L 






a large br. 




54 


R 


usual. 


usiial. 


P. Scap. 






L 






none. 


f Vert, rises at dist. of inch fr. 
\ origin of Subclav. 


55 


R 




P. Sc. & Prof. 


none. 


Vert, small. Intercost. absent. 



SUBCLAVIAN ARTERIES AND THEIR BRANCHES. 



115 



No. 


Side 
of the 
Body. 


Brs. internal to 
he anterior Sea- 
lenus muscle. 


Bra. under the 

anterior Scalenus 
muscle. 


Bra. leyond the 
.interior Scalenus 
muscle. 


Peculiarities 


57 


R 




usual. 


a small br. 


I" Subclav. does not ascend above 
i clav. ; S. Scap. and Tr. Col. by 
L one trunk close to Th. 


58 


R 






none. 


Subclav. does not ascend above clav. 




L 


usual. 


!ntercost. 


none. 




59 


R 


usual. 


usual. 


none. 


Subclav. ascends 1 inch above clav. 




L 


usual. 


[ntercost. 


none. 




60 


R 






none. 


Subclav. ascends 1 inch above clav. 


61 


R 


usual. 


usual. 


a large br. 






L 






a large br. 




63 


R 


usual. 


usual. 


loue. 






L 


("usual and 
\ Intercost. 


P. Scap. 


none. 




64 


R 






Tr. Col. 




65 


R 






none. 


Subclav. ascends a little above clav. 


66 


R 




J usual and 
\ P. Scap. 




fSubclav. arches 1-J inch above 
J clav. ; Tr. Col. by two brs. Su- 
] perfic. Cer. with P. Scap. by one 
L trunk close to Th. 


67 


R 


|~ usual, with 
I S.Scap. and 
LSuperf.Cer. 


J usual and 
IP. Scap. 




J* Vert, large. S. Scap. and Superf. 
\Cerv. by a com. trunk. 




L 


["usual, with 
J Intercost., 
1 S. Scap., & 
LSuperf.Cer. 


P. Scap. 




f Vert, small. S. Scap. and Superf. 
\ Cerv. by a com. trunk. 


68 


R 


usual. 


usual. 


none. 






L 


usual. 


Intercost. 


none. 




69 


R 




f usual and 
\P. Scap. 


none. 


Subclav. ascends a little above clav. 




L 




J Intercost. & 
\P. Scap. 


none. 


J" Subclav. ascends a little above clav. 
\ Vert, very small,andgivenfromTh. 


70 


R 


usual. 


usual. 


P. Scap. 






L 


usual. 


Intercost. 


P, Scap. 




72 


R 


{usual an dS 
Scap. 


usual. 


J P. Scap. and 
\ another br. 


[" Tr. Col. in two parts ; Superfic. 
< Cer. from Th. S. Scap. from Sub- 
[ clav. near Th. 



L 2 



116 



SUBCLAVIAN ARTERIES AND THEIR BRANCHES. 



No. 


Side 
of the 
Body. 


Brs. internal to 
the anterior Sca- 
lenus muscle. 


Brs. under the 
anterior Scalenus 
muscle. 


Brs. beyond the 
anterior Scalenus 
muscle. 


Peculiarities. 




L 


/ usual and 
\ Intercost. 


f Tr. Col. 
\andS.Scap. 




/ No Scap. br. from Th. ; 3 small 
\ separate brs. instead of Prof. 






r usual and 








74 


L 


\ Intercost. 


none. 


none. 


Intercost. close to Vert. 












I" Subclav. ascends little above clav. ; 


75 


R 


usual. 


usual. 


none. 


< Vert, from lower aspect of Subclav., 












(_ and turns up behind it. 




L 


/ usual and 
\ S. Scap. 


Intercost. 


P. Scap. 


[" Vert, as at R. ; S. Scap. and 
1 Superfic. Cer. fr. Subclav. by a 
|_com. trunk which is close to Th. 


76 


L 


usual. 


Intercost. 


none. 




77 


R 






fboth Scap. 
< by common 
[ trunk. 


fSubclav. ascends little above clav. ; 
J it perforates scal.m. ; 2 small brs. 
j fr. Th. in place of Scap. brs. ; S. 
[_Scap. under ligt. of scap. 




L 


all brs. 


none. 


none. 


Intercost. intern, to seal. m. 


78 


R 


{usual ex- 
cept Scap. 
brs. 


usual. 


fTr. Col. & 
I S. Scap. by 
| a common 
Ltrimk. 


{Subclav. ascends little above clav. ; 
Scap. brs. directly from Subclav. 
Vert, rises close to Innom. 






r USUtll CX- 




{S. Scap. & 






L 


< cept Scap. 
[bra. 


Intercost. 


Tr. Col. by 
a common 
trunk. 


/ Scap. arteries arise directly from 
\Subclav. 


80 


R 


all brs. 


none. 


none. 


/ Tr. Col. separ. br. intern, to seal. 
\ m. ; Intercost. intern, to same. 




L 


fall except 
1 Tr. Col. 


Tr. Col. 


none. 


Tr. Col. separ. br. 










fP. Scap. & 




82 


R 






< Prof, by a 












{_ com. trunk. 














("Subclav. perforates seal. m. Mam. 




L 








< gives a br. across the lower part of 












[ the neck. 


83 


R 


usual. 


/ usual and 
\P. Scap. 


none. 


Subclav. arches little above clav. 






/ usual and 










L 


\ Intercost. 


Tr. Col. 


none. 




84 


R 


usual. 


/ usual and 
\ Tr. Col. 


none. 


Prof, ascends from beneath the 1st rib. 




L 






/Tr. Col. & 


f No. Scap. br. from Th. ; Prof. 










\ S. Scap. 


\ascends from beneath the 1st rib. 


86 


R 


("usual and 
\ Intercost. 


none. 


P. Scap. 


Vert, arises near the origin of Subclav. 



SUBCLAVIAN ARTERIES AND THEIR BRANCHES. 



117 



No. 


Side 
of the 
Body. 


Brs. internal to 
the anterior Sca- 
lenus muscle. 


Brs. under the 
anterior Scalenus 
muscle. 


Brs. beyotft the 
anterior Scalenus 

muscle. 


Peculiarities. 


88 


L 
R 


usual. 

f usual and 
\ Intercost. 


Intercost. 
P. Scap. 


none, 
none. 


J Th. small and gives no br. to thy- 
\roidbody. 




L 


f usual and 
\ Intercost. 


P. Scap. 


none. 




89 


R 


usual . 


usual. ' 


none. 






L 


f usual ex- 
l cept Vert. 


f Intercost.& 
\P. Scap. 




I ' 
Vert, from Aorta. 


90 


R 


usual. 


f usual and 
\Tr. Col. 


none. 






L 


usual. 


[ntercost. 


none. 




91 


R 


usual. 


fTr.Col.and 
\ usual. 


none. 


f Subclav. ascends little above clav. ; 
\ Intercost. and Prof, are separ. brs. 




L 


J" all except 
\ Tr\ Col. 


Tr. Col. 


none. 




93 


R 


usual. 


f P. Scap. and 
\ usual. 


none. 




94 


R 


all. 


none. 


none. 


{Tr. Col. a separ. br. of Subclav. ; 
Prof, is directed backwards between 
6th and 7th vertebrae. 




L 


/ all except 
t Tr. Col. 


Tr. Col. 


none. 




96 


R 


usual. 


f P. Scap. and 
\ usual. 


none. 


Cerv. ascend, from Superf. Cerv. 




L 


all. 


none. 


none. 




97 


R 


usual. 


usual. 


none. 


Mam. from Th. axis. 


99 


R 


J* usual except 
\ S. Scap. 


usual. 


none. 


S. Scap. rises from the Axillary artery. 


100 


R 


J~ usual and 
1_ Scap. brs. 


usual. 


none. 


f Tr. Col. and S. Scap. arise fr. 
< Subclav. by a com. trunk which 
[gives Cerv. ascend. 




L 


I" usual and 
\ Intercost. 


P. Scap. 


none. 




101 


R 


f usual with 
\Scap. brs. 


usual. 


none. 


fTr. Col. and S. Scap. arise fr. 
I Subclav. by a com. trunk ; Prof. 
J continued from Ascend, cerv. and 
| directed backwards betw. 4th and 
1 5th vertebrse ; Intercost. gives no 
l^Prof. br. 



118 



SUBCLAVIAN ARTERIES AND THEIR BRANCHES. 



No. 


Side 
of the 
Body. 


Brs. internal to 
the anterior Sca- 
lenus muscle. 


Brs. under the 
anterior Scalenus 
muscle. 


Brs. beyond the 
anterior Scalenus 
muscle. 


Peculiarities. 


101 


L 


all. 


none. 


none. 


Mam. arises from Th. axis. 


103 


R 




Tr. Col. 


none. 


( Vert, arises close to origin of Sub- 
] clav. ; Th. gives Intercost. but not 
) the Scap. brs., or Cerv. ascend., 
\ which (latter) is from Tr. Col. S. 
1 Scap. arises fr. Axillary and passes 
Bunder lig. of scap. 


104 


R 


f usual and 
\ Intercost, 


("none but 
J small brs. 
] tointervert. 
[_foram. 


f a branch, 
t (P. Scap.?) 






L 


f usual and 
\ Intercost. 


P. Scap. 


none. 




105 


R 


usual. 


usual. 


none. 




106 


R 


usual. 


usual. 


P. Scap. 


f Subclav. arches ! inch above 
\ clav. ; Cerv. ascend, from Tr. Col. 




L 


usual. 


tntercost. 


P. Scap. 


P. Scap. rises on the 1st rib. 


110 


R 


J" usual and 
\ Intercost. 


none. 


none. 


("The brs. are given at the distance 
J of 1 inch fr. origin of Subclav. ; 
| Cerv. ascend, becomes Occipl. ; 
(^ Intercost. gives a br. to trachea. 




L 


all. 


none. 


none. 


Cerv. ascend, becomes the Occipl. 


111 


R 


J" usual and 
\ Intercost. 


{small brs. 
tointervert. 
foram. 


P. Scap. 


Cerv. ascend, fr. S. Scap. 




L 


J usual and 
\ Intercost. 


none. 


P. Scap. 


Main, arises from Th. axis. 


112 


R 


usual. 


usual. 


P. Scap. 




113 


R 


usual. 


usual. 


P. Scap. 






L 


usual. 


Intercost. 


P. Scap. 




114 


R 


f usual and 
\ Scap. brs. 


usual. 


none. 


f Vert, gives Th. ; Tr. Col. and P. 
< Scap. arise from Subclav. by a com. 
|_ trunk. 




L 








f Th. is a separ. br. ; Mam., Tr. Col., 
< S. Scap. and Cerv. ascend, are 
[ given fr. one trunk. 


116 


R 


f" usual with 
< Intercost. 
[ and Prof. 


none. 


P. Scap. 


(" Intercost. and Prof, are separ. brs. 
< latter passes between 6th and 
|_ 7th vert. 




L 


usual. 


Intercost. 


P. Scap. 





SUBCLAVIAN ARTERIES AND THEIR BRANCHES. 



No. 


Side 
of the 
Body 


Brs. internal to 
the anterior Sca- 
lenus muscle. 


Brs. under the 
anterior Scalenu? 
muscle. 


Brs. beyond^the 
anterior SdUenus 
muscle. 


Peculiarities. 


117 


R 


f usual and 
\ Intercost. 


none. 


f a br. to 
\ muscles. 


f Intercost. from Vert, and gives Prof. 
{_ as usual. 




L 


("usual with 
< Intercost. 
[and Prof. 


none. 


P. Scap. 


f Prof, a separ.br. and passes between 
\ 6th and 7th vert. 


119 


L 






S. Scap. 


S. Scap. rises fr. Subclav. on 1st rib. 


120 


R 


usual. 


usual. 


none. 


S. Scap. from Axillary. 


121 


R 


usual. 


usual. 


none. 


f Prof, from Ascend, cerv. br. of Th. 
\ and passes between 4th and 5th vert. 




L 


usual. 


Intercost. 


none. 


Prof, same as on the right side. 


122 


R 


usual. 


usual. 


P. Scap. 


Prof, between 6th and 7th vert. 


123 


L 


usual. 


Intercost. 


none. 


f Prof, small deficiency compen- 
\ sated for by Cerv. ascend. 


124 


L 


usual. 


Intercost. 


none. 




127 


R 


\ usual and 
1 S. Scap. 


usual . 


P. Scap. 


S. Scap. a separ. br. (fr. Subclav.) 




L 


usual. 


Intercost. 


none. 




129 


R 


usual. 


usual. 


P. Scap. 






L 


usual. 


Intercost. 


P. Scap. 




130 


R 








Mam. from Th. axis. 








[Prof., In- 






J31 


R 


usual. 


< tercost. and 
[ P. Scap. 


none. 


Intercost. and Prof, are separate brs. 


134 


R 


isual. 


usual. 


P. Scap. 






L 


usual. 


fntercost. 


P. Scap. 




135 


R 


f usual and 
\ Intercost. 


P. Scap. 


none. 






L 


isual. 


[ntercost. 


none. 


{S. Scap. by a com. trunk with Tr. 
Col. (from Th.) and crosses the 
neck higher than usual. 


136 


R 


usual. 


usual. 


none. 


Prof, small. 




L 


/ usual and 
\ Intercost. 


none. 


P. Scap. 


f Th. gives Mam. and a br. to trachea 
\ and oesophagus within the chest. 


137 


R 


J~ usual and 
\ Intercost. 


none. 


P. Scap. 


f Subclav. from descending Aorta 
< and crosses behind oesophagus; 
[Mam. from Th. 



120 



SUBCLAVIAN ARTERIES AND THEIR BRANCHES. 



No. 


Side 
of the 
Body. 


Brs. internal to 
the anterior Sca- 
lenus muscle. 


Brs. under the 
anterior Scalenus 
muscle. 


Brs. beyond the 
anterior Scalenus 
muscle. 


Peculiarities. 


138 


R 


("usual with 
I S. Scap. 
| and Cerv. 
(^ascend. 


usual. 


Tr. Col. 


f Vert, rises near origin of Subclav. ; 
< S. Scap. and Cerv. ascend, are 
[separ. brs. of Subclav. 


139 


L 


usual. 


Intercost. 


none. 


Vert, small. 


140 


R 


usual. 


usual. 


none. 




142 


R 


usual. 


usual. 


P. Scap. 


Origin of Subclav. is low inthe thorax. 


145 


R 


f usual and 
\ Intercost. 


none. 


P. Scap. 




145 


L 


usual. 


Intercost. 


P. Scap. 




146 


R 


J usual and 
\ S. Scap. 


usual. 


none. . 


S. Scap. a separ. br. of Subclav. 


147 


L 


Vert. 


Intercost. 


Th. and Mam. 


|~ Th. axis and Mam. are directed 
4 inwards over the anterior scalenus 
|_ muscle. 


149 


L 


J usual and 
\ Intercost. 


none. 


none. 




150 


R 


usual. 


usual. 


P. Scap. 




151 


R 


usual. 


usual. 


a large br. 




153 


R 


f" usual, with 
< Intercost. 
|_andS. Scap. 


none. 


P. Scap. 


f Th. is a separ. br. ; Marn. and S. 
\ Scap. arise by a com. trunk. 


155 


R 


usual. 


usual. 


P. Scap. 




160 


L 


f usual, with 
j Intercost. & 
4 3 small brs. 
j tointervert. 
^foram. 


none. 


P. Scap. 


J" Vert, from near origin of Subclav. 
\ and enters 3rd vert. 


167 


R 


usual. 


usual. 


P. Scap. 






L 


usual. 


Intercost. 


P. Scap. 




169 


R 


usual. 


usual. 


P. Scap. 




170 


R 


usual. 


usual. 


P. Scap. 


Subclav. arches 1 inch above clav. 




L 


f usual and 
\ Intercost. 


none. 


none. 


Vert, from near origin of Subclav. 


173 


R 


usual. 


usual. 


none. 




173a 


R 


J usual and 
\ Intercost. 


none. 


P. Scap. 





SUBCLAVIAN ARTERIES AND THEIR BRANCHES. 



121 



No. 


Side 
of the 
Body. 


Brs. internal to 
the anterior Sca- 
lenus muscle. 


Brs. under the 
anterior Scalenus 
muscle. 


Brs. beyond the 
anterior Scalenus 
muscle. 


Peculiarities. 


174 


L 


usual. 


flntercost. 
J and a br. to 
| intervert. 
l^foram. 


none. 




176 


R 


usual. 


f usual and 2 
\ small brs. 


R Scap. 


Distance to origin of brs. -| inch. 




L 


f usual and 
\ Intercost. 


f 1 br. of Tr. 

I Col. (Su- 
[perf. Cerv.) 


fa f2nd br. 
4 of Tr. Col. 
L (P. Scap.?) 


Prof, ascends from below 1 st rib. 


177 


R 


usual. 


f usual and 
IP. Scap. 


none* 


J Th . divides into 2 brs. before crossing 
\ beneath the Com. Car. 




L 


fMam., Th. 
< and Inter - 
L coat. 


f 1 br/of Tr. 

1 Col. ' (Su- 
|_perf. Cerv.) 


J2nd br. of 
\ Tr. Col. 


Vert, from Aorta. 


178 


R 


usual . 


f usual and 
\ P. Scap. 




Distance to origin of brs. inch. 




L 


J~ usual and 
\ Intercost. 


P. Scap. 


none. 




179 


R 


usual. 


J~ Intercost. & 
\P. Scap. 




("Sterno-mastoid m. is 3 inches broad 
J at lower end and extends outside 
j Subclav. artery. Distance to origin 
l^of brs. -^ inch 


180 


R 


usual. 


usual. 


P. Scap. 


f Distance to origin of brs. f inch. 
< Intercost. ascends from beneath 1st 




L 


f usual and 
\ Intercost. 


P. Scap. 


none. 


P. Scap. perforates post, scalen. m. 


181 


R 


f usual and 
\ Intercost. 


f small brs. 
< to intervert. 
[foram. 


P. Scap. 


Distance to origin of brs. 1 inch. 


182 


R 


usual. 


usual. 


P. Scap. 


Distance to origin of brs. 1 inch. 




L 


usual. 


Intercost. 


P. Scap. 




183 


R 


usual. 


usual. 


P. Scap. 


/'Subclav. perforates the anterior 
j scalenus. Omo-hyoid m. arises 
<{ from middle of clav. Distance to 
j origin of brs. 1 inch. Superficial 
^Cerv. from S. Scap. 




L 


/ usual and 
\ Intercost. 


P. Scap. 


none. 


Superficial Cerv. from S. Scap. 


184 


R 


usual. 


J Intercost. & 
\ P. Scap. 


none. 


Distance to origin of brs. f inch. 



122 



SUBCLAVIAN ARTERIES AND THEIR BRANCHES. 



No. 


Side 
of th 
Body 

L 


Brs. internal to 
the anterior Sea 
lenus muscle- 


Brs. under the 
anterior Scalenu 
muscle. 


Brs. beyond the 
anterior Scalenu 
muscle. 


Peculiarities. 


J" usual and 
\ Intercost. 


none. 


none. 


("Common trunk of Scnpular arteries 
J and the Mammary arise from Th. 
j axis which is much dilated; Th. 












(^artery crosses behind Vert. 


185 


R 


usual. 


usual. 


P. Scap. 


Distance to origin of brs. ^ inch. 




L 


f usual anc 
|_ Intercost. 


P. Scap. 


none. 


{Prof, is at first placed between the 
neck of 1st rib and tras. process of 
1st dorsal vertebra. 


186 


R 


usual. 


Prof. 


P. Scap. 


f Distance to origin of brs. % inch. 
1 Intercost. given from Vert., descends 
I through foramen in tras. process ol 
j 7th cerv. vert, and between necks 
1 of 3 ribs and tras. processes of 3 
^dorsal vertebrae. 




L 


J usual and 
\ Intercost. 


P. Scap. 




rVert. through foramen of 7th cerv. 
J vert. ; Intercost. between the necks 
^ of 2 ribs and tras. processes of dor- 
[_sal vertebrae. 


187 


R 


usual. 


usual. 


none. 


f S. Scap. very small : its place on 
< scapula is supplied by dorsal br. of 
L Sub. Scap. 




L 


("usual and 
\ Intercost. 


none. 


P. Scap. 


J" Th. very small not supplying Th. 
\ body ; S. Scap. not given from Th. 


188 


R 


f usual and 
< com. trunk 
[ of Scap. brs. 


f usual and 2 
J small brs., 
< which enter 
| intervert. 
^foramina. 


none. 


f Scap. brs. by a common trunk 
\ which is joined to Mam. 




L 


usual. 


ntercost. 


none. 


Mam. united to Th. axis. 


191 


R 


usual. 


usual. 


P. Scap. 


Distance to Istbr. (Mam.) \ inch. 




L 


isual. 


flntercost.& 
\sj. large br. 


none. 


JThe br. under seal. m. supplies 
\ muscles and gives the Prof. 


192 


R 


usual. 


usual. 


P. Scap. 


I" Distance to 1st br. (Vert.) | inch : 
< to others 1 inch. S. Scap. from 
[Mam. 




L 


isual. 


J Intercost. & 
\ P. Scap. 


lone. 


f Th. crosses behind Vert. ; S. Scap. 
\ from Mam. 


193 


R 


usual. 


usual. , 


T a br. on 
< 1st rib to 

[muscles. 






L 


/ usual and 
\ Intercost. 


/ br. to inter- 
\vert.foram. 




Vlam. joined to Th. axis at origin. 



SUBCLAVIAN ARTERIES AND THEIR BRANCHES. 



123 



No. 


Side 
of the 
Body. 


Brs. internal to 
the anterior Sca- 
lenus muscle. 


Brs. under the 
anterior Scalenus 
muscle- 


Brs. beyond the 
anterior Scalenus 
muscle. 


Peculiarities. 


194 


R 


usual. 


USUal. 


P. Scap. 


fBrs. internal to seal. m. arise at 
J nearly regular intervals ; Prof. 
| double, one above, the other below 
List rib. 




L 


usual. 


{a large br. 
(P. Scap.?) 


none. 




195 


R 








f Subclav. is covered by Carotid for 
< 1 inch of its length ; Th. absent 
|_(a br. from Innom. instead). 




L 


usual. 






Prof, ascends from beneath 1st rib. 


196 


R 


J~ usual and 
\ Prof. 


Intercost. 


none. 


f Mam. gives a br. directed trans- 
\ versely behind clav. 




L 


J" usual and 
\ Prof. 


{a large br. 
(P. Scap.?) 


none. 


J The br. under seal. m. gives In- 
\ tercost. and P. Scap. 


198 


L 


f usual, In- 
< tercost. and 
[P. Scap. 


none. 


none. 




199 


R 


usual. 


usual. 


none. 


Th. axis much enlarged. 




L 


f usual and 
\ Intercost. 


/ a large br. 
t (P. Scap.?) 






200 


R 


usual. 


usual. 


P. Scap. 


Distance to origin of brs. inch. 


201 


R 


usual. 


usual. 


P. Scap. 






L 


usual. 


Intercost. 


none. 




202 


L 


J usual and 
\ Intercost. 


none. 


none. 


TTh. small and does not supply th. 
J body, which receives a br. from 
| Innom. (Superior and Inferior Th. 
(^arteries on right side are of full size). 


203 


R 


usual. 


usual. 


P. Scap. 


TDistanre to origin of brs. nearly 1 
I inch ; besides the usual br. Th. axis 
| gives another br. to th. body over 
[_Com. Carotid. 


204 


R 
L 


usual. 

["usual \vith 
< Intercost. & 
(_ Scap. brs. 


usual, 
none. 


fa large br. 
\ (P. Scap.?) 

none. 


J" Scap brs. arise by a com. trunk 
\ from Subclav. 


205 


L 


f usual and 
\ Intercost. 


none. 


none. 




206 


R 


usual. 


usual. 


none. 


Distance to origin of t.rs. inch. 




L 


usual. 


Intercost. 


P. Scap. 





124 



SUBCLAVIAN ARTERIES AND THEIR BRANCHES. 



No. 


Side 
of the 
Body 


Brs. internal to 
the anterior Sca- 
lenus muscle. 


Brs. under the 
anterior Scalenus 
muscle. 


Brs. beyond the 
anterior Scalenus 
. muscle. 


Peculiarities. 


207 


R 


usual. 


usual. 


none. 


Distance to origin of brs. 1| inch. 




L 


J~ usual and 
\ Intercost. 


none. 


none. 


J Intercost. arises from Subclav. 
\ before the other brs. 


208 


R 


usual. 


/ usual anc 
\ Tr. Col. 


none. 


/"Distance to origin of brs. l inch. 
I Intercost. gives an unusual br., 
< which runs along the oesophag. am 
I trachea. Mam. furnishes a large 
^Bronchial artery. 


209 


R 


J" usual and 
\ Intercost. 


none. 


P. Scap. 


Distance to origin of brs. 1^ inch. 


210 


R 


usual. 


usual. 


P. Scap. 


TDistance to origin of brs. -|- inch. 
I Intercost. supplies one intercost. 
| space. Prof, ascends from beneath 
List rib. 




L 


usual. 


J" Intercost. & 
\P. Scap. 


none. 


f Intercost. very small; Prof.ascends 
\from beneath 1st rib. 


211 


R 


usual. 


usual. 


none. 


Distance to origin of brs. % inch. 




L 


f usual and 
\ Intercost. 


none. 


P. Scap. 




213 


R 


usual. 


usual. 


P. Scap. 


TDistance to origin of brs. -| inch ; 
I a small separate br. to trachea ; 
| Mam. from Th. axis ; Intercost. 
Land Prof, separate brs. 




L 


f usual and 
\ lutercost. 


none. 


none. 




214 


R 


usual. 


usual. 


P. Scap. 


Distance to origin of brs. f inch. 




L 


/ usual and 
\ Intercost. 


none. 


P. Scap. 




215 


R 


usual. 


usual. 


P. Scap. 


I" Distance to origin of brs. 1 inch ; 
< two brs. for Prof. 1 st from Inter- 
(_cost., 2nd from Cerv. ascend. 




L 


usual. 


fntercost. 


none. 


f Th. gives a br. turning inwards to 
\ oesophag. 


216 


R 
L 


usual. 

f usual and 
\ Intercost. 


usual. 
none. 


P. Scap. 
P. Scap. 


f Th. arises separately at beginning 
\ of Subclav. 


217 


R 


J usual and 
\ Intercost. 


none. 


none. 


Vtam. from Th. axis. 


218 


R 


/ usual and 
\ Intercost. 


none. 


none. 


f Distance to origin of 1st br. (Vert.) 
liinch. 



SUBCLAVIAN ARTERIES AND THEIR BRANCHES. 



125 



No. 


Side 
of the 
Body. 


Brs. internal to 
the anterior Sca- 
lenus muscle. 


Brs. under the 
anterior Scalenus 
muscle. 


Brs. beyond the 
anterior Scalenus 
muscle. 


Peculiarities. 


219 


R 


usual. 


usual. 


P. Scap. 


("Distance to origin of brs. inch ; 
J Th. a separate br. ; Mam. joined 
] to Scap. brs. ; Intercost. and Prof. 
(_ separate brs. 




L 


f usual and 
\ Intercost. 


none. 


P. Scap. 


f Th. a separate br. Soap. brs. by 
\a com. trunk. 


220 


R 


usual. 


usual. 


P. Scap. 






L 


f usual and 
\ Intercost. 


P. Scap. 


none. 




221 


R 


usual. 


usual. 


P. Scap. 


Distance to origin of brs. f inch. 


222 


R 


usual. 


two brs. 


J P. Scap. & 
\S. Scap. 


f S. Scap. on 1st rib and passes under 
\ ligament of scapula. 


223 


R 


usual. 


usual. 


P. Scap. 


Distance to origin of brs. % inch. 




L 


usual. 


Intercost. 


none. 


Mam. from Th. axis. 


225 


R 


usual. 


usual. 


none. 


{Distance to 1st br. ^ inch ; a 
separate br. from Subclav. to tra- 
chea ; Prof, ascends from beneath 
1st rib ; S. Scap. given from Sub- 
Scap. 


226 


R 


usual. 


usual. 


P. Scap. 


Distance to origin of brs. 1-f inch. 


228 


R 


usual. 


usual. 


none. 


Distance to origin of brs. % inch. 


229 


R 








f Omo-hyoid m. arises from clavicle 
< and covers the Subclav. artery 
(_ beyond the scalenus m. 


230 


R 


/usual and 
\ Intercost. 


none. 


P. Scap. 


Distance to origin of brs. f inch. 




L 


usual. 


Intercost. 


none. 




231 


R 


usual. 


usual. 


P. Scap. 


Distance to origin of brs. 1-J- inch. 


233 


R 


f usual and 
\ Intercost. 






Distance to origin of brs. % inch. 




L 


usual. 


Intercost. 






234 


R 


J" usual and 
\ Intercost. 






f Subclav. arises to left of other brs. 
< and crosses behind cesopbag. ; 
L Cerv. ascend, becomes Occipl. 




L 


J usual and 
\ Intercost. 


none. 


P. Scap. 


[" Cerv. ascend, becomes Occipl. ; 
< and on both sides it turns back 
[beneath transverse process of atlas. 


235 


R 


usual. 


usual. 





J Distance to origin of brs. l inch ; 
\ Prof, ascends from beneath 1st rib. 



126 



SUBCLAVIAN ARTERIES AND THEIR BRANCHES. 



No. 


Side 
of the 
Body. 


Brs. internal to 
he anterior Sca- 
lenus muscle. 


Brs. under the 
nterior Scalenus 
muscle. 


Brs. beyond the 
anterior Scalenus 
muscle. 


Peculiarities. 


236 


R 


f usual and 
\ Intercost. 


none. 


none. 


TDistance to origin of 1st br. f 
I inch ; two brs. from Th. axis to 
j tb. body one under, the other 
[^over, Com. Carotid. 




L 


j" usual and 
\ Intercost. 


none. 


none. 




237 


R 


usual. 


usual. 


a small br. 


C Distance to origin of brs. 1 inch ; 
j Prof, as two brs. one from In- 
\ tercost., the other from Th. (the 
j latter is close at first to Cerv. 
V^ascend.) 


238 


R 


usual. 


usual. 


usual. 


Distance to origin of brs. 1^ inch. 




L 


usual. 


Intercost. 


none. 


{Prof, passes between transverse 
process of 1st dorsal verteb. and 
1st rib. 


240 


R 


usual. 


usual. 


none. 


Distance to origin of brs. ^ inch. 


242 


R 


f usual and 
\ Intercost. 


P. Scap. 


none. 


f Distance to origin of brs. -^ inch ; 
< Tntercost. arises with the first brs. ; 
|_P. Scap. through p. seal. m. 


243 


R 
L 


usual. 

J" usual and 
\ Intercost. 


J usual and 
IP. Scap. 

none. 


S. Scap. 
P. Scap. 


[" Distance to origin of brs. 1 inch ; 
< S. Scap. on 1st rib and passes 
[_ under lig. of scapula. 

Mam. from Th. axis. 


246 


R 


usual. 


usual. 


none. 


Distance to origin of brs. ^ inch. 




L 


f usual and 
\ Intercost. 


none. 


P. Scap. 




247 


R 


usual. 


usual. 


P. Scap. 


Distance to origin of brs. |- inch. 




L 


f usual and 
\ Intercost. 


none. 


P. Scap. 




248 


R 


usual. 


usual. 


none. 


[" Distance to origin of brs. 1 inch ; 
< the Scap. brs. scarcely joined to 
[Th. 




L 


f usual and 
I Intercost. 


none. 


none. 


Scap. and Th. arteries arise separately. 


249 


R 


usual. 


usual. 


none. 


Distance to origin of brs. -g- inch. 




L 


f usual and 
\ Intercost. 


none. 


P. Scap. 




250 


R 


usual. 


usual. 




fSubclav. arises low in chest and 
< ascends close to Com. Car. ; dis- 
[_ tance to origin of brs. 1| inch. 



SUBCLAVIAN ARTERIES AND THEIR BRANCHES. 



127 



No. 


Side 
of the 
Body. 


Brs. internal to 
the anterior Sca- 
lenus muscle. 


Brs. under the 
anterior Scalenus 
muscle. 


Brs. beyond the 
anterior Scalenus 
muscle. 


Peculiarities. 


251 


L 


J usual and 
\ Intercost. 


none. 


none. 




252 


R 


usual. 


J~ usual and 
\P. Scap. 


none. 


("Distance to origin of brs. | inch ; 
J Prof, as two brs. one from In. 
| tercost., the other from the begin- 
l_ning of P. Scap. 


253 


R 


usual. 


usual. 


none. 






L 


f usual and 
\ Intercost. 


none. 


none. 




24 


L 


f usual and 
\ Intercost. 


P. Scap. 


none. 


JProf. ascends from beneath 1st 
\ rib. 


255 


R 


usual. 


usual. 


P. Scap. 


[" Distance to origin of brs. ]|- inch ; 
< Th. a separate br. ; S. Scap. and 
" |_ Superficial cerv. by a com . trunk. 


256 


R 


usual. 


usual. 


P. Scap. 


r Th. a separate br. from beginning oi 
< Subclav. ; a. second Th. from Com. 
I Carotid near origin. 




L 


usual. 


Intercost. 


P. Scap. 




257 


R 


usual. 


usual. 




(" Distance to origin of brs. 1 inch ; 
< Prof, as two brs. one above, the 
Bother below the 1st rib. 




L 


usual. 


J" Intercost. & 
\ Prof. 


none. 


Intercost. and Prof, separate brs. 


258 


R 


usual. 


usual. 


Tr. Col. 


Distance to origin of brs. 1 inch. 




L 


usual. 


Intercost. 


P. Scap. 


("Inferior Th. on both sides large, 
< supplying the deficiency of Superior 
[Th. 


260 


R 


usual. 


usual. 


none. 


Distance to origin of brs. 1^- inch. 




L 


usual. 


J" Intercost. 
\ and Prof. 


none. 


1" Intercost. and Prof, merely joined 
< at oiigin ; Cerv. ascend, given 
[ from Tr. Col. 


261 


R 


usual. 


usual. 


none. 


J Distance to origin of brs. % inch. 
\ Vert, small. 


262 


L 


usual. 


Intercost. 


none. 




264 


R 


usual. 


/ Intorcost. & 
1 P. Scap. 




f Distance to origin of brs. % inch ; 
j Prof, as two brs. one from In- 
( tercost. (small), the other (large) 
j from Cerv. ascend. : latter turns 
V^back below 3rd vert. 


265 


R 


usual. 


usual. 


none. 


f Distance to origin of brs. 1 inch ; 
\ Intercost. supplies three spaces. 



128 



SUBCLAVIAN ARTERIES AND THEIR BRANCHES. 



No. 


Side 
of the 
Body. 


Brs. internal to ', 
the anterior Sea- 
lemis muscle. 


I Brs. under the 
anterior Scalenus 
muscle. 


Brs. beyond the 
anterior Scalenus 
muscle. 


Peculiarities. 


265 


L 


r usual with 
1 Intercost.& 
[ Prof. 


none. 


P. Scap. 


/ Intercost. and Prof, joined at origin 
(_ former supplies one space. 












( Distance to origin of hrs. 1^- inch ; 












j S. Scap. from Mam., which gives 


268 


R 


usual. 


usual. 


none. 


< another branch ramifying on tra- 












1 chea and bronchial glands ; Inter - 












V^cost. ramifies in three spaces. 












(" Mam. gives a br. into chest as on 




L 


usual. 


[ntercost. 


P. Scap. 


< right side. Prof, ascends from 












[_ beneath 1st rib. 












/"Distance to origin of brs. 1 inch ; 








[" Intercost. & 




j Intercost. supplies a branch wh. 


269 


R 


usual. 


< a branch to 


none. 


{ runs on the trachea to become a 








L muscles. 




j bronchial artery ; Prof, ascends 












^ from beneath 1 st rib. 


270 


R 


usual. 


J" usual and 
1 P. Scap. 


none. 


Distance to origin of brs. 1 inch. 




L 


I" usual and 
\ Intercost. 


none. 


S. Scap. 


J" A br. arches beneath Th. artery to 
\ oesophagus. 






r usual and 








271 


L 


\Intercost. 


P. Scap. 


none. 


Prof, ascends from beneath 1st rib. 


272 


R 


usual. 


usual. 


none. 


("Intercost. gives a br. to oesophag. 
\ and trachea. 












r Distance to origin of 1st br. (Th.) 


273 


R 


usual. 


usual. 


none. 


J 3 inch ; Prof, as two brs. one 
j from Tntercost. (small), the other 












(^from Cerv. ascend. 












f Th. gives no Scap. br. ; S. Scap. 




L 


("usual ex- 
< cept Scap. 
[_ arteries. 


small Prof. 


P. Scap. 


1 from Axillary ; Prof, as two brs. 
1 one from Subclav. (small), the other 
j from Cerv. ascend. : latter turns 
I back below 3rd cerv. vert. these 












V^brs. anastomose together. 


275 


R 


Th. and Vert. 


usual. 


J P. Scap. & 
\Marn. 


("Distance to origin of brs. ^ inch. 
< P. Scap. is close to seal. m. Mam. 
(_ one inch beyond it on 1 st rib. 




L 


J usual exc. 
\Marn. 


[ntercost. 


fa small P. 
< Scap. and 
|_Mam. 


("P. Scap. touches outer margin of 
J scalen. m. ; Mam. arises from end 
] of Subclav. and turns inwards under 
[_clav. and subclavius in. 


276 


L 


usual. 


Intercost. 


none. 














f Vert, very close to Innom. at origin 


277 


R 


usual. 


usual. 


P. Scap. 


< and it enters 4th vert. ; Th. crosses 












[ behind it. 



SUBCLAVIAN ARTERIES AND THEIR BRANCHES. 



129 



No. 


Side 
of the 
'Body. 


Brs. internal to 
the anterior Sca- 
lenus muscle. 


Brs. under the 
anterior Scalenus 
muscle. 


Brs. beyond the 
anterior Scalenus 
muscle. 


Peculiarities. 


278 


R 


usual. 


usual. 


P. Scap. 


f Distance to- origin of brs. 1 inch ; 
< Subclav. at first covered by Com. 
I Carotid. 


279 


R 


J" usual exc. 
\Marn. 


f usual and 
\P. Scap. 


Mam. 


f Distance to origin of brs. If inch ; 
< Subclav. behind Com. Carotid at 
[ origin ; Vert, arises close to Innom. 


288 


R 


usual. 


usual. 


none. 


f Distance to origin of 1st br. (Vert.) 
< 1^- inch , Subclav. at origin covered 
[ by Com. Carotid. 


289 


R 


usual. 


usual. 


none. 


Distance to origin of brs. f inch. 


291 


R 


usual. 


J usual and 
\ P. Scap. 


none. 


Distance to origin of brs. inch. 


292 


L 


/ Vert, and 
\ Intercost. 


none. 


f P. Scap., 




293 


L 


JVert.&abr. 
\ to cesophag. 


Intercost. 


TScap. brs., 
J Cerv. as- 
1 cend. and 


[" Th. art. absent, deficiency is com- 
< pensated for by Super. Th. and a 
[ br. from Innom. 








{Intercost. 




TVert. from Aorta and in front of 


294 


L 


Th. 


with Mam., 
S. Scap. & 
Tr. Col. 




J Th. ; Scap. brs. and Mam. arise 
| from a short trunk which perforates 
(jcal. muscle. Th. a separ. br. 


295 
296 










Tin both these bodies the phrenic 
J nerve, instead of being between the 
| Subclav. artery and vein, is placed 
[^in front of the latter vessel. 



ABSTRACT of die foregoing table, so Cur as regards the branches which 
derived from die Subclarian artery, where it is covered by die Scalenus, 
where it is beyond or external to that muscle. 



BRANCHES 


UNDER SCALENUS 


MUSCLE. 


"-ST* 


16 
3450 . * . 


about lin. 5i 


O" ^ 


112 
68180 . . . 


,. lin. H 


* I2T 


21 
9 30 . 


. lin. 8f 


"HS* 


3 
1 4 


lm-66 




264 




BRANCHES BEYOND SCALENUS 


MUSCLE. 


None \ j"jT 


76 
66142 . . 


about lin. If 


-1ST 


72 
40112 . . . 


, 1 in. 2 


*-J2T 


4 
37 . 


n lin. 37^ 


*~ J2f 



2 2 . 


lin. 131 




oco 





The observations contained in die table on die origin, die position, and course 
of die Snbdavian arteries, as well as on die peculiarities of die branches, are 
uDUi tbej are severally under 



131 



EXPLANATION OF PLATE XVI. 



THE preparation to show the parts as they are represented 
in this plate consisted in the removal of the platjsma myoides, 
the cervical fascia, with part of the sterno-cleido-mastoid, 
sterno-hyoid, omo-hyoid, and sterno-thyroid muscles. At 
the same time, the clavicular attachment of the trapezras was 
divided and the muscle turned back ; a portion of the clavicle, 
after separation from the larger pectoral muscle, was removed, 
and, in consequence, the subclavius muscle lay exposed. The 
first rib was brought into view by detaching from it the inner 
end of the last-named muscle. 



6 Parotidgland. 

c Digastric mud 

d Stylo-hyoid. 

e Sterno-dado-fl 



/ Sub-maxillary gland. 

g Mylo-hyoid muscle. 

A Hyoidbone. 

i Thyroid cartilage. 

k Sterno-hyoid musde. 

I Omo-hyoid. 

Sterao-thyroid. 

-Crico-thyroid. 

Thyroid body. 




ARTERIES. 



1. Innominate. 

2. Common carotid. 

3. Snbdarian. 

4. External carotid. 

5. Internal carotid. 

6. Superior thyroid, 
of the artery reprea 



Tr.e 



:..: :.v;:.. :,:;:_-;:.--- 
orer the muscles below the hyoid 
bone; the laryngeal, which is 
concealed except at its origin by 
the thyro-hyoid musde ; a 
lar bianch 

the omo-hyoid muscle; 
continuation of the artery which 
the thyroid body and the 
constrictor muscle of the 




Another 

tike crico-thyroid mem- 
md one given from the 



inferior thyroid _ 

from under the thyroid body to 

_" J m-t _- *m_ , _.*.' ?,-_ .! 

UO CDC ; >*|PTI MH LDTTOM1 ID SapptT- 

ing the anterior surtace of that 



7. LingnaL 

8. FaciaL 

9. OcdpitaL 

10. Temporal 

11. TertebraL In front of the artery 
is a portion of the accompanying 



12. 
12*. 



Thyroid axis. 

Inferior thyroid artery. 

:: 




132 



EXPLANATION OF THE SEVENTEENTH PLATE. 



13. 
13'. 

14. 
15. 



Internal mammary. 

One of the perforating branches 
of the last-named artery. 

Ascending cervical. 

Supra-scapular. The branch 
which turns inwards from this 
artery over the sternal end of the 
clavicle is generally, if not con- 



stantly, found and is distributed 
to the muscles in this situation. 
I5 1 . A branch (acromial) of the pre- 
ceding : it crosses the supra-spi- 
natus muscle (w.) and ramifies 
about the acromion. 

16. A. Superficialis colli. 

17. Posterior scapular. 



VEINS. 

18. Subclavian. | 19. Internal jugular. 

20. External j ug ular. 



NERVES, 



21. Pneumogastric or n. vagus. 

22. Phrenic. 

23. Cervical part of those which 
formed the cervical plexus. 

34. Anterior branches of the lower 
cervical and first dorsal, directed 



outwards to form the brachial 
plexus. 

25. A small branch which supplies 
the subclavius muscle, and give* 
a slender offset to join the phrenic 
nerve within the thorax. 



EXPLANATION OF PLATE XVII. 



THE figure marked No. I is intended to show the innomi- 
nate artery at its bifurcation, and the common carotid and 
subclavian arteries immediately after their origin, together 
with the veins and nerves which are in connexion with them 
above the sternum and the inner end of the clavicle. The 
sterno-cleido-mastoid muscle has been divided, one part is 
reflected upwards on the neck, and the lower end being turned 
down the sternal and clavicular attachments of the muscle, fall 
separately on the thorax. By the removal of a portion of the 
sterno-hyoid and of the sterno-thyroid muscle, the deep layer 
of the cervical fascia, which descends behind the sternum after 
covering the trachea and the large vessels, is exposed, and, by 
the excision of a portion of it, the vessels and nerves have been 
brought into view. The disposition of the more superficial 
part of the fascia on the muscles is also displayed. 

In the figure No. 2, the third part of the subclavian artery 
is represented in connexion with the veins and nerves which 
are found in its neighbourhood. 

The common integument together with a part of the 



EXPLANATION OF THE EIGHTEENTH PLATE. 



133 



platysma myoides and the cervical fascia being removed, the 
supra-clavicular triangular space of anatomical writers is 
displayed ; the sides of it are formed by the clavicle, the 
omo-hyoid muscle, and the sterno-cleido-mastoid or anterior 
scalenus. 



a The cervical fascia. 

b Sterno-cleido-mastoid muscle. 

b ' Sterno-cleido-mastoid muscle of the 

left side. 
c Sterno-thyroid. 



d Sterno-hyoid. 

d l Left sterno-hyoid. 

e Omo-hyoid. 

/ Anterior scalenus. 

g Trapezius. 



ARTERIES. 



1. Innominate. 

2. Common carotid. 

3. Subclavian. 



VEINS. 



6. Internal jugular. 

7. Anterior jugular. 

8. The preceding vein terminating 
with the external jugular in the 
subclavian : the last-named vein is 
seen to a small extent above the 
clavicle. 

9. Vertebral. 

10. External jugular slightly drawn 
backwards to expose the subcla- 
vian artery : it receives, from 
under the trapezius muscle, the 
veins which correspond to the 
supra scapular and the transverse 
cervical (transversalis colli) arte- 



11 



Supra-scapular. 

A. Transversalis colli. 



ries, and ends in the subclavian 
vein close to or in connexion with 
the anterior jugular (see also plate 
2). 

A small vein which lies close 
to the subclavian artery, is in this 
case, joined to the external jugu- 
lar ; it is often present, but seldom 
of so large size as is here repre- 
sented. 

Supra-scapular ; it follows the 
course of the artery of that name. 

The vein which accompanies the 
transverse cervical (transversalis 
colli) artery. 



NERVES. 



1'2. Pneumo-gastricor n. vagus; a car- 
diac nerve is seen to descend from 
it along the innominate artery. 

13. Small branches of the sympa- 
thetic nerve. 

14. The common trunk of some of 



the superficial branches of the 

cervical plexus. 
15. The nerves descending to form 

the brachial plexus, 
f. Lymphatic glands. 



EXPLANATION OF PLATE XVIII. 



a Masseter muscle. 

b Digastric. 

c Superior oblique (m. obliquus 
capitis superior). 

d Inferior oblique (m. obi. cap. in- 
ferior). 

e M. rectus cap. poslicus major. 

/ Sterno-cleido-mastoid muscle. 



Anterior scalenus. 

Posterior scalenus. 

M. semi-spinalis colli. 

A small part of the trapezius. 

Clavicle. 

Acromion (process of the scapula), 

Part of the omo-hyoid muscle. 

M. longus colli. 



134 



EXPLANATION OF THE EIGHTEENTH PLATE. 



ARTERIES. 



1. Arch of the aorta. 

2. Innominate. 

3. Right common carotid* 
3 l . Left common carotid. 

4. Right subclavian. 
4 l . Left subclavian. 

5. Right vertebral. 
51. Left vertebral. 

5f. Branch of the vertebral inoscu- 
lating with the " Profunda cer- 
vicis." 

5J. A cervical branch of the same 
artery, of larger size than usual. 

6. Internal mammary. 

7. Thyroid axis. 
7 1 . Supra- scapular. 

8. Superior intercostal of the right 
side. 

81. Ditto of the left side. 
8f. Posterior branch of the pre- 
ceding. 



9. " Profunda cervicis" of the right 

side. 
9 1 . Ditto of the left side. 

10. Posterior scapular of the right 
side. 

10 1 . Ditto of the left side. 

11. A small artery which distributes 
branches to the muscles, and 
along the nerves to the inter- 
vertebral foramina. 

12. External carotid. 

13. Internal carotid. 

14. Facial. 

15. Occipital. 

15f. A branch of the preceding, with 
anastomoses with the vertebral 
and the " Profunda cervicis." 

16. Posterior auricular. 



17. 



NERVES. 

One of the lower cervical placed between the anterior and posterior 

scalenus muscle. 
18. Pneumogastric or n. vagus. 



Figure 1. During the delineation of this figure, the body 
was viewed from above. The appearance of the clavicle and 
scapula contrasts with that of the same parts in the succeed- 
ing plate where the delineation was made from a subject 
which had been raised more nearly to the level of the eye. 

The deep artery of the neck (Ar. Profunda cervicis) of the 
left side is represented together with its inosculations with the 
vertebral and occipital arteries. To expose the vessel, the 
trapezius, the upper part of the sterno-cleido-mastoid, together 
with the splenius, the complexus, the trachelo-mastoid, and 
a portion of the lower end of the posterior scalenus muscles, 
were removed. The subclavian artery crosses over the first 
rib and under the clavicle. The intercostal artery takes 
origin from the subclavian behind the anterior scalenus 
muscle, and arches downwards into the thorax, after giving 
near its origin the " Profunda cervicis." The latter, being in 
this body at the origin of somewhat more than the usual size, 
inclines backwards between the neck of the first rib and the 



EXPLANATION OF THE NINETEENTH PLATE. 



135 



transverse process of the seventh cervical vertebra, and is 
directed upwards on the semispinalis colli, distributing branches 
on each side, and approaching the spinous processes of the ver- 
tebrae. The veins which accompanied the artery, and the 
nerves (posterior branches of the cervical) which crossed it, 
were removed in the dissection. 

Figure 2. In this figure the cervical part of the right 
vertebral artery is shown, together with the small branches 
given from it in this situation -exclusively of those which 
enter the spinal canal. 

On the left side, a portion of the rectus capitis anticus 
major (muscle) having been unintentionally left in connexion 
with the longus colli, the upper part of this muscle has the 
appearance of reaching to the base of the cranium. In con- 
sequence of this circumstance, that small part of the figure is 
in the state which Haller would have called " minus nitida." 



EXPLANATION OF PLATE XIX. 



Superior muscle of the ear. 

Posterior. 

Occipital part of the occipito- 

frontal muscle. 

Tendinous expansion, in which the 

fibres of the preceding end. 

Sterno-cleido-mastoid. 

M. splenius capitis. 

Splenius colli. 

Trachelo-mastoid. 

M. obliquus capitis superior. 

Complexus. 



i Levator anguli scapulae. 
k Serratus posticus superior. 
/ Rhomboid. 
m Omohyoid. 

Spine of the scapula. 

Deltoid muscle. 

M. infra-spinatus. 

Long head of the m. triceps ex- 
tensor brachii. 

M. teres major. 

Latissimus dorsi. 

Trapezius. 



ARTERIES. 



1. Temporal. 

2. Posterior auricular. 

3. Occipital. 

3 1 . Cervical branch of the preceding ; 
this artery descends along the 
trachelo-mastoid muscle under 
the splenius, and ramifies in the 
muscles near the transverse pro- 
cesses of the vertebrae. 

3f. An offset from the last .branch, 
which, after penetrating in the 
angular space bounded by the 
trachelo-mastoid, superior oblique, 
and complexus muscles (f, g, h), 



6. 



anastomoses with the vertebral 
artery and the t( profunda cervi- 
cis," see plate 18, fig. 1. 
Supra- scapular, exposed by the 
removal of the trapezius and the 
supra-spinatus muscles. 
Superficialis colli, distributed be- 
neath the trapezius. 
A branch of the last-named artery 
ramifying under the integument. 
Posterior scapular, which, in this 
case, divides into three branches 
under the levator anguli scapulae 
muscle (6', 6f, 6J). 



136 



EXPLANATION OF THE TWENTIETH PLATE. 



This is the proper posterior sca- 
pular artery. It usually becomes 
concealed, as is represented in 
this plate, by the scapula, and 
ends beneath it in the serratus 
magnus muscle. Where it returns 
to view from under the scapula, 
the artery has been accidentally 
marked thus 6 nl . 
" Dorsalis scapulae " division of 
the subscapular artery. 



7'. Another dorsal branch of the 
same. 

7f. A small artery which communi- 
cates between the subscapular and 
the supra-scapular arteries in 
front of the spine of the scapula. 

8. The three lowest vessels th-.s 
marked are the posterior branches 
of intercostal arteries ; the highest 
is derived from the " Profunda 
cervicis.'' 



9. " N. occipitalis major " cut., 
being the large occipital branch of 
the first proper cervical. 



NERVES. 

10. The nerves which form the bra- 



chial plexus. 
11. Supra-scapular. 



By the separation of the integument from the greater part 
of the left side of the head, the superficial temporal, posterior 
auricular arteries, and a considerable part of the occipital have 
been exposed. The last-named artery is shown to a further 
extent by the excision of a small part of the sterno-cleido- 
mastoid and of the splenius muscles. It must be stated that the 
communicating branches between the arteries behind the ear 
are larger in this representation than they usually occur. The 
trapezius being divided close to its attachment to the clavicle 
and the spine of the scapula (to which bones a small portion 
of the muscle remains connected), and being then reflected 
towards the spine, the superficialis colli (5), with a larger 
transverse artery 6f, and the posterior branches of some of 
the intercostals,came into view. Finally, the scapular arteries 
namely, the posterior scapular, the suprascapular, and the 
dorsal branch of the subscapular have been shown by the 
removal to a greater or less extent of the rhomboid for the 
first-named, the supra-spinatus for the second, and the infra- 
spinatus and teres minor muscles for the third. 



EXPLANATION OF PLATE XX. 



a Thyroid cartilage. 
b Trachea. 
c Bronchus in some cases the root 
of the lung. 
d (Esophagus. 


e Anterior scalenus muscle. . 
/ Clavicle of the right side. 
/ l Clavicle of the left side. 
g Sterno-cleido-mastoid muscle. 
h Heart. 



EXPLANATION OF THE TWENTIETH PLATE. 



ARTERIES 

Arch of the aorta its ascending 
part 



1. 

2. Descending part of the aorta, 

3. Innominate. 

4. Right carotid. 
4 1 . Left carotid. 

5. Right subclavian. 
5 1 . Left subclavian. 

6. Vertebral. 

7. Thyroid. 

7*f. Ascending cervical branch of 
thyroid. 

8. Internal mammary. 

9. Supra-scapular. 
10. Posterior scapular. 

Hi. 2 Intercostal branches of the left 



VEINS. 

15. V. cava superior. 

16. Right subclavian. 

) 7. End of the internal jugular. Near 



12. 

12 1 . 

13. 

13 1 . 

13f. 

14. 

14f. 

14k 



side, given from the right sub- 
clavian. 

Right intercostal branches of 
the aorta. 

Left intercostal branches of the 
aorta. 

Pulmonary. 

Left pulmonary. 

Right pulmonary. 

Canalis V. Ductus arteriosus. 

Ligamentum arteriosum. 

A pouch, which ends in the left 
subclavian artery, and receives the 
attachment of the ligamentum 
arteriosum . 



to this is the vertebral vein, which, 
in this case, has an unusual course 
behind the subclavian artery. 



NERVES. 



18. Pneumo-gastric, or n. vagus. 
18t- Inferior laryngeal branch of the 
preceding. 



19. 
20. 



Phrenic . 

The branches which form 
brachial plexus. 



the 



The figures of this plate illustrate some peculiarities of the 
innominate and the subclavian arteries. 

Figure 1. The left carotid is joined to a very short inno- 
minate artery. 

Figure 2. The innominate is not seen in the neck, and the 
right subclavian is but very slightly above the clavicle. 

Figure 8. The innominate and the right subclavian arteries 
contrast strongly with those in the figure immediately preceding. 

Figure 4. The right subclavian is covered at and imme- 
diately after its origin by the carotid. 

Figure 5. The right subclavian artery arises to the left 
of the other branches, and crosses obliquely to the first rib, 
immediately in front of the vertebral column, behind the 
oesophagus. The inferior laryngeal nerve has its usual course 
on the left side : it is seen to be directed transversely inwards 
to the larynx on the right side. The common carotid arteries 
take origin from a common trunk. 

Figure 6 is taken from an essay by Adolphus Murray *. 

* Anatomische Bemerkungen bey einer sonderbaren Stellung einiger grb'ssern Puls- 
adernstamme unweit des Herzens, wie man solche in einem Leichname gefunden hat. 
In " Der K. Schwed. Acad. der Wissenschaften Abhandl. iibersetzt von A. G. 
Kastner," B. 30. 

* N 



138 EXPLANATION OF THE TWENTIETH PLATE. 

It shows the right subclavian artery arising lower down than 
in the preceding figure, and two intercostal branches of the 
left side (1 1 ! ) given from it. The other intercostal arteries 
(12 and 12 1 ) are branches of the aorta. In the original 
drawing, the internal mammary artery of the right side is 
delineated, and, in the accompanying essay, is described as 
arising from the axillary (end of the subclavian ?) artery, at the 
same time that the right vertebral is derived from the com- 
mon carotid. It has not been considered necessary to extend 
the delineation so as to include the origin of the vessels 
referred to, inasmuch as facts of the same kind are shown in 
other plates. 

The representation of the heart being unnecessary for our 
purpose, that organ has been omitted, and the appearance of 
the trachea, which in the original is so unlike that structure 
as to require comment by the author *, has been altered. 

In Figure 7, the right subclavian artery passes from the 
left side of the aorta, between the trachea and oesophagus, to 
its usual position on the first rib. It is copied from one of 
those given of a remarkable case reported by Dr. Bayford^. 

Figures 8 and 9 are introduced to illustrate a 3 ery unusual 
mode of origin of the left subclavian artery. They have been 
drawn from a preparation in the museum of Guy's Hospital j . 

Figures 10 and 11, which also have reference to the origin 
of the left subclavian artery, are taken from an essay by 
Klinkosch. 

All the figures of this plate will be farther described, and 
the objects of their introduction will be more fully stated, 
in the observations on the innominate and the subclavian 
arteries. 

* " Besonders erinnere ich dass in der Abzeichnung der Theile die Luftrohre und 
der Larynx, weil der Zeichner solche Theile zu betrachten weniger gewohnt war, 
anders sind vorgestellt worden, als die Natur sie zeigt ; welches ich doch habe dabey 
bewenden lassen, weil meine Anmerkungen diese Theile nicht betreffen." 

f "An account of a singular case of obstructed deglutition" in " Memoirs of the 
Medical Society of London," vol. ii. p. 275. London, 1794. 

% The preparation has been with much liberality placed at my disposal by direction 
of the Treasurer, Mr. Harrison. 

<e Anatom. Partus Capite Monstroso," in " Dissertationes Medicse Selectiores 
Pragenses," vol. i., p. 201. Pragje et Dresdse, 1775. 



EXPLANATION OF PLATE XXI. 



a Thyroid cartilage. 

b Trachea. 

6 1 Thyroid body. 



Anterior scalenus muscle. 
Posterior scalenus. 



ARTERIES. 



1. Ascending part of the arch of the 

aorta. 

2. Descending part of the arch. 

3. Innominate. 

4. Right carotid. 
4 l . Left carotid. 

5. Right subclavian. 
5 1 . Left subclavian. 

6. Vertebral. 

7. Inferior thyroid. In figure 7 this 
mark is on the small artery, which 
arises in the situation of the thyroid, 
and in figures 1 and 10, on the 
thyroid axis. 



8. Internal mammary. 

9. Supra-scapular. 

10. Posterior scapular in some, ar. 

trans, colli. 

10f. Superficial cervical (ar. cervic. 
super f.) 

11. Ascending cervical (ar. cervic. 

ascend.) 

12. Two muscular branches. 

13. Superior intercostal. 

14. Thyroid branch of the innomi- 

nate (ar. thyroidea ima). 



NERVES. 



15. 



Those which form the brachial 
plexus. 



16. 

17. 



Pneumo-gastric (nerv. vagus). 
Phrenic. 



The three first figures of this plate show the manner in 
which the subclavian arteries occasionally lie with respect to 
the anterior scalenus muscle. 

The remaining figures illustrate some peculiarities in the 
position which the branches have at their origin. 

Figure 1. The right subclavian perforates the anterior 
scalenus muscle. Nearly an equal portion of the muscle was 
interposed on the one side between the artery and the nerves, 
on the other between it and the vein. 

Figure 2. The left subclavian artery has the same position 
in the scalenus muscle as in the preceding figure, and is accom- 
panied by one of the large nerves which go to form the 
brachial plexus. 

Figure 3*. The left subclavian artery is in front of the 
muscle, and it lay in contact with the subclavian vein. The 
nerves which had been in their usual position between the two 
scaleni muscles, were removed from the preparation. 

1 * Drawn from a preparation in the museum of St. Bartholomew's Hospital. 

O 



140 EXPLANATION OF THE TWENTY-FIRST PLATE. 

Figure 4. The drawing is intended to show the distance 
at which the branches sometimes arise, from the commence- 
ment of the right subclavian artery. The superior intercostal 
artery here occupies an unusual position, being given from the 
subclavian to the inner side of the scalenus. 

Figure 5. This is an example of a very rare condition of 
the branches. The number is greater than usual, and they 
are diffused over the first part of the trunk. The thyroid 
axis has been subjected to a sort of decomposition, and its 
constituents the ascending cervical, thyroid, and scapular 
branches arise separately from the subclavian artery. 

Figure 6. The chief peculiarity here represented is the 
passage outwards so to express the fact of their origin being 
external to its usual position of some of the branches. The 
internal mammary, the transverse cervical, and the supra- 
scapular branches, are given from a common trunk which 
perforates the anterior scalenus muscle. The left vertebral 
being at the same time given from the aorta, no branch arises 
from the subclavian internally to the scalenus muscle, with the 
exception of the inferior thyroid. 

Figures 7 and 8. The branches are moved still farther out 
than in the preceding figure. 

In the seventh drawing considerable branches arise at 
three different points in the space between the scalenus 
muscle and the outer margin of the first rib ; the first is a 
trunk common to the scapular and the ascending cervical 
arteries : the second is the internal mammary : lastly, two 
muscular branches arise close together. Other peculiarities of 
the sketch require notice, namely, those of the thyroid artery, 
and of the phrenic nerve. The branch given from the sub- 
clavian in the position usually occupied by the thyroid, is 
very small, and does not reach the thyroid body, which 
receives, instead, a branch from the innominate. The phrenic 
nerve turns round the large branch external to the scalenus. 
In the eighth figure the vessels given beyond the scalenus 
muscle are two in number, and of unequal size. The first is 
the larger, and furnishes the inferior thyroid, ascending 
cervical, internal mammary, and transverse cervical branches. 
The second is the posterior scapular. 



EXPLANATION OF THE TWENTY-SECOND PLATE. 



141 



Figures 9 and 10 have been .introduced as examples of the 
origin, from the commencement of the subclavian artery, of 
branches which ordinarily take their rise close to the scalenus 
muscle. 

In the ninth figure, the inferior thyroid artery, being as it 
were set free from the common trunk of the scapular and 
ascending cervical branches, has taken the unusual position. 

The vertebral artery is the branch given near the origin of 
the subclavian in the tenth figure, and in it also the internal 
mammary takes rise on the first rib. 



EXPLANATION OF PLATE XXII. 



a Thyroid cartilage. 
b Trachea. 



6 1 Thyroid body. 

c Anterior scalenus muscle. 



ARTERIES. 



2. 

3. 

4. 

4i. 

5. 

S 1 . 

6. 

6 1 . 

6f. 



6*. 



Right side of the arch of the 

aorta. 

Left side of the arch of the aorta. 
Innominate. 
Right carotid. 
Left carotid. 
Right subclavian. 
Left subclavian. 
Right vertebral. 
Left vertebral. 
A second left vertebral arising 

from the subclavian. 
Left vertebral arising from the 

aorta. 

Small branches given from the 
left subclavian in positions which 
the origin of the vertebral artery 



sometimes occupies ; they entered 
the intervertebral foramina. 
7. Thyroid axis. 
7f. Inferior thyroid taking origin 

from the vertebral. 
Internal mammary. 
Transverse cervical (ar. transv. 

colli.) 

Supra-scapular. 
Ascending cervical (ar. cervic. 

ascend.) 

Right superior intercostal. 
Left superior intercostal. 



8. 
9. 

10. 
11. 

12. 

12', 

12f. First aortic intercostal. 
13. Deep cervical (ar. profunda 
cervicis.) 



Various conditions of the vertebral arteries are illustrated 
in this plate. 

Figure 1. The difference of size, which sometimes exists 
between the arteries of the opposite sides, is shown. 

Figures 2, 3, and 4 are introduced to point out the gradual 
descent of the left vertebral from the usual position of its origin 
the angle formed on the left subclavian artery to the aorta. 

o 2 



142 EXPLANATION OF THE TWENTY-SECOND PLATE. 

Figure 5. The left vertebral enters the last cervical ver- 
tebra. On the right side the superior intercostal artery is 
derived from the vertebral, and passes downwards into the 
thorax through the foramen in the transverse process of the 
seventh cervical vertebra, and afterwards between the necks of 
the ribs and the corresponding transverse processes of the 
dorsal vertebrae. It will be observed that the superior inter- 
costal of the other side descends also between the ribs and the 
processes of the vertebrae ; and that the first aortic intercostal 
branch occupies a similar position in reference to the bones. 

Figure 6. The inferior thyroid artery of the left side arises 
from the vertebral which is given directly from the aorta. 

In figures 7, 8, and 9, and figure 2 of plate 24, the vertebral 
artery is constituted by the union of two branches in one 
case, three branches, which arise in different positions and 
unite into a single vessel at various points. 

Figure 7*. One of the two arteries arises from the sub- 
clavian in the position usually occupied by the origin of the 
vertebral, the other is given from the aorta, and the union 
between them took place before either had entered the fora- 
mina in the vertebrae. 

Figure 8. The roots so to call them of the artery take 
origin as in the preceding representation ; but the union 
occurs after one has passed through the foramen of a vertebra. 

Figure 9f. Both roots spring from the subclavian and unite 
after one has ascended through two vertebral foramina. 

Figure 10 has been added with a view to explain the con- 
jecture which may reasonably be formed as to the mode of 
formation of the variations in the vertebral and other arteries. 
The left vertebral is given from the aorta, and two small arteries 
are derived from the subclavian, in situations in which the 
origin of that vessel is often placed. 

In the cases represented in the preceding figures, the 
double origin of the vertebral artery occurs on the left side. 
In plate 24, figure 2, the vessel is seen to result from the union 
of three arteries and on the right side. 

* Taken from a drawing of Huber's in the " Acta Helvet." loc. cit. Part of the 
original has not been included in this sketch. 

f Drawn with the kind permission of the owner, from a preparation in the possession 
of Dr. Catley, of Delaware, Ohio, during his temporary residence in London. 



143 



EXPLANATION OF PLATE XXIII. 



a Thyroid cartilage. 

of Hyoid bone. 

a\ Epiglottis. 

b Trachea. 

b l Thyroid body. 



1. 



Anterior scalenus muscle of the 

right side. 
Anterior scalenus muscle of the 

left side. 



ARTERIES. 



Ascending part of the arch of 
the aorta. 

2. Descending part of the arch of 

the aorta. 

3. Innominate. 

4. Right carotid. 
4 1 . Left carotid. 

5. Right subclavian. 
5 1 . Left subclavian. 

6. Right superior thyroid. 
6'. Left superior thyroid. 

6 J. Branch on the crico-thyroid mem- 
brane. 

7. Right inferior thyroid. 
7'. Left inferior thyroid. 

7f- An additional inferior thyroid, 
given from the subclavian. 



7+. Thyroid artery derived from the 
innominate (ar. thyroidea ima). 
In figure 10, the artery arises 
from the lower part of the right 
carotid. 

8. & 8 1 . Superior laryngeal. 

9. Right vertebral. 
9u Left vertebral. 

10. Right internal mammary. 
10i. Left internal mammary. 

11. Right ascending cervical. 
11 '. Left ascending cervical. 

12. Supra scapular. 

13. Transverse cervical (ar. trans- 
versalis colli). In the first figure 
this mark is placed on the poste- 
rior scapular. 



NERVES. 



14. Pneumo-gastric. N. vagus. 

15. The lower cervical nerves and 



the first dorsal which form the 
brachial plexus. 



It has been accidentally omitted to mark the superior laryngeal nerve in 
figure 5. 



Different conditions of the thyroid arteries are represented 
in this plate ; variations of the origin of these vessels have 
been illustrated in the plates of the external carotid and the 
subclavian arteries. 

Figure 1. The thyroid artery of the right side gives a 
large branch, which crosses to the left side of the thyroid body, 
and in its course lies on the crico-thyroid ligament. 

Figure 2. Both superior arteries are very defective, and 
the inferior distribute considerable branches to the anterior 
surface of the thyroid body to supply the defect. The vicarious 
branch thus to term it on the right side emerges from 
beneath the upper part of the body and descends in front of 
it : that on the left side is directed from below upwards. 



144 EXPLANATION OF THE TWENTY-THIRD PLATE. 

Figure 3. The reverse of the arrangement of figure 2 is 
exhibited in the arteries of this drawing. The left inferior 
thyroid is wanting, and its place is taken, at the posterior sur- 
face of the thyroid body, by a large branch of the superior 
the course being shown by the dotted line. 

Figure 4. The laryngeal branch of the left superior thy- 
roid takes an unusual course through the thyroid cartilage. 

Figure 5. The laryngeal artery reaches the interior of the 
larynx at the outer margin of the crico-thyroid ligament. 

Figure 6 *. In this figure the thyroid body is larger than 
usual. The laryngeal artery is of very unusual size. It runs 
along the inner side of the thyroid cartilage and, escaping by 
the side of the crico-thyroid ligament, ends in the thyroid 
body. 

The remaining figures of this plate, and the first figure of 
plate 24, are examples of unusual inferior thyroid arteries. 
They arise in various situations and differ very much in their 
size, and to some extent in the manner of their distribution. 

In figure 7, the unusual artery takes the place chiefly of the 
left inferior thyroid, which may be considered to be absent : 
for the small artery in its situation is distributed only to the 
oesophagus, and the muscles in front of the spinal column. 

Figure 8. The peculiarities in the arteries are these : 
The inferior thyroid, of the right side is altogether wanting, 
and the defect is supplied by a branch given from the inno- 
minate. The right superior thyroid gives a large branch, 
which crosses over the crico-thyroid ligament and joins the 
artery on the opposite side. 

Figure 9. The thyroid body was very large, and, to a con- 
siderable extent, ossified. Both the superior arteries are very 
small; and on the right side there is no inferior thyroid in the 
usual situation. A branch of unusually large size, furnished 
by the innominate, ramifies on each side over the thyroid 
body, to make up for the insufficiency of the arteries 
which usually ramify over its anterior surface. A branch 
is also seen to pass behind the left side of the thyroid body, 

" Taken from one of two figures of the same preparation, published by Professor 
Arnold, in his " Beraerkungen Uber den Bau des Hirns und Riickenmarks, &c. mit 
Abbildungen." Zurich, 1838. 



EXPLANATION OF THE TWENTY-FOURTH PLATE. 



145 



where it takes the place of the vessel that is ordinarily in this 
situation. 

Figure 10. There are here five thyroid arteries. The 
additional branch is derived from the lower end of the right 
common carotid. 

Figure 11. In this figure also there is a fifth thyroid 
artery, which arises from the right subclavian and crosses over 
the common carotid, at the same time that the usual inferior 
thyroid artery occupies its accustomed place behind that vessel. 

In the first figure of plate 24, the right inferior thyroid 
artery is seen to be given from the common carotid at some 
distance from the origin of the latter. 



EXPLANATION OF PLATE XXIV. 



a End of the transverse process of 

the atlas. 

4 Trapezius muscle. 

c Splenius. 

d Complexus. 

e Trachelo-mastoid. 

f Levator anguli scapulae. 

g Anterior scalenus. 

</f Posterior scalenus. 

h Digastric. 

i Submaxillary gland. 

k Mylo-hyoid muscle. 

/ Hyoid bone. 

m Thyroid cartilage. 

n Thyroid body. 

o Trachea. 

p Clavicle. 



q Subclavius muscle. 

r The first rib of the right side. 

r l The first rib of the left side. 

s Scapula. 

5 f The glenoid cavity of the scapula. 

t The coracoid process of the same 

bone. 

Omo-hyoid muscle. 
v Subscapular. 

w Tendon of the latissimus dorsi. 
x Biceps. 

y Coraco-brachialis. 
z The head of the humerus covered 

by the capsular ligament, 
f The long head of the triceps muscle. 
J The tendon of the larger pectoral. 



ARTERIES. 



1. Ascending part of the arch of i 

the aorta. 

2. Descending part of the arch. 

3. Innominate. 

4. Right carotid. 
4'. Left carotid. 

5. Right subclavian. 
5'. Left subclavian. 

6. Right vertebral. 
6 1 . Lett vertebral. 

6 a . 6 b . 6 C . Three branches which 
unite to form the vertebral artery 
in figure 2. 



7 . Right inferior thyroid. It is placed 
on the thyroid axis in figure 3. 

7 1 . Left inferior thyroid. 

7f. Ascending cervical (Ar. cerv. 
ascendens). In fig. 3 it arises 
with the transverse cervical by a 
common trunk and turns back- 
wards below the transverse pro- 
cess of the atlas to become the 
occipital. 

7J. Right inferior thyroid derived 
from the common carotid. 

8. Right internal mammary. 



146 



EXPLANATION OF THE TWENTY-FOURTH PLATE. 



8 1 . Left internal mammary. 

8f. Bronchial derived from the 

internal mammary. 
9. Supra-scapular. 
10. Superior intercostal. 
10f. A branch of the last named 
artery ; it arches inwards to the 
side of the oesophagus on which 
it ramifies within the thorax. 



11. & II 1 . Posterior scapular in 
figure 3 this mark is placed on 
the transverse cervical. 

12. External carotid. 

13. Internal carotid. 

14. Superior thyroid. 

15. Axillary. 

16. Sub-scapular. 5 



NERVES. 

17. Those which form the brachial j 18. Supra-scapular, 
plexus. 



Figure 1 is supplemental to those contained in plate 23. 
The right inferior thyroid artery arises from the common 
carotid, instead of taking its origin from the subclavian. 

Figure 2 *. In this figure is represented a very unusual 
arrangement of the right vertebral artery which results from 
the union of three branches. 

Figure 3. The ascending cervical is much enlarged, and 
takes the place of the occipital artery. It arises with the trans- 
verse cervical instead of being given from the inferior thyroid 
artery, and is directed backwards to the occiput below the 
transverse process of the atlas the usual course of the occipital 
being above that bone. 

Figure 4. The internal mammary arteries take origin at both 
sides beyond the scalenus, but at different distances from that 
muscle. On the right side the origin of the vessel is on the 
inner margin of the first rib : on the left, it is beyond the 
outer margin of the same bone, and on this side the clavicle 
has been slightly raised to expose the artery. 

Figure 5. Two unusual arteries are seen in this drawing 
to descend into the thorax. One, arising from the internal 
mammary, is a bronchial artery. The other is derived from 
the commencement of the superior intercostal, and ramifies on 
the oesophagus, and in front of the vertebral column. 

Figure 6. The supra-scapular artery is given from the 
internal mammary. 

Figure 7. The supra-scapular is a branch of the axillary 
artery. 

- * Copied from a drawing which accompanies a paper by A. Meckel. It is entitled 
"Anatomische Bemerkungen," and is contained in J. E. Meckel's "Archiv. fur Anatom. 
uud Physiologie." 1828. 



147 



EXPLANATION OF PLATE XXV. 



a Digastric muscle. 

b Hyoid bone. 

c Thyroid cartilage. 

cf Thyroid body. 

d Trachea. 

e Sterno-hyoid muscle. 

ef Omo-hyoid. 

/ Sterno-cleido-mastoid. 

g Trapezius. 

#t A muscular slip originating from 

the trapezius, and joining the 

under surface of the sterno-cleido- 

mastoid. 

h Anterior scalenus. 
Af Posterior scalenus. 
* Levator anguli scapulae. 
k Clavicle. 
/ Deltoid muscle. 
m Larger pectoral. 
n Coracoid process of the scapula. 
n*f Coracoid ligament (Lig. propr. 

posticum scapulae). 



Subscapular muscle. 

Head of the humerus covered by the 
capsular ligament of the shoulder 
joint. 

Tendon, the latissimus dorsi 
(muscle). 

Teres-major. 

Biceps. 

Coraco-brachialis. 

Tendon of the larger pectoral. 

Triceps. 

First rib of the right side. 

First rib of the left side. 

" Cervical rib" of the right side con- 
nected at the outer end to a 
projection on the first rib. 

A rudimentary cervical rib on the 
left side. 

Last cervical vertebra. 

First dorsal vertebra. 



ARTERIES. 



1. Ascending part of the arch of the 

aorta. 

2. Descending part of the arch of 

the aorta. 

3. Innominate. 

4. Right carotid. 
4. Left carotid. 

5. Right subclavian. 
5 1 . Left subclavian. 

6. Right vertebral. 

6f- Left vertebral given from the 
aorta. 

7. Inferior thyroid. 

8. Internal mammary. 

9. Supra- scapular. 

10. Transverse cervical (Ar 
colli.) 



18. Right internal jugular. 
18 1 . Left internal jugular. 

19. Right external jugular. 
19 1 . Left external jugular. 

20. Right subclavian. 



11. Ascending cervical (Ar. cervi- 

calis ascendens). 

llf. A branch of the preceding di- 
rected behind the transverse 
process of the vertebrae, to take 
the place of the deep artery (ar. 
profunda cerv.) at the upper part 
of the neck. 

12. Superior intercostal. 

12f. Deep cervical (ar. profunda cerv.) 

13. External carotid. 

14. Internal carotid. 

15. A branch of the superior thyroid 
descending to the sternal end of 
the clavicle. 



r. trans. 


16. 


Axillary. 




17. 


Subscapular. 


VEINS. 






20 1 . 


Left subclavian. 




21. 


Right innominate. 




21 1 . 


Left innominate. 




22. 


V. Cava superior. 




23. 


Cephalic. 



Figure 1. The Supra scapular artery of whose origin 
some variations are represented in plate 24 is here seen to 



148 EXPLANATION OF THE TWENTY-FIFTH PLATE. 

be derived from the subscapular branch of the axillary, and 
to pass beneath the posterior proper ligament of the scapula. 

Figures 2 and 3 are illustrations of some of the peculiarities 
of the deep artery of the neck (ar. profunda cerv.). In the 
former, the artery ascends on the right side from beneath the 
transverse process of the first, and on the left side from 
beneath that of the second dorsal vertebra. It was on both 
sides as usual a branch of the superior intercostal, but each 
took origin opposite the point at which it becomes apparent 
behind. 

In the latter figure (3), the deep cervical passes backwards 
in the most frequent position, but it is of much less than the 
ordinary size, and the defect is supplied by a considerable 
off-set from the ascending cervical branch of the inferior 
thyroid. Several instances of this arrangement are recorded 
in the table. 

The small artery which arises from the superior intercostal, 
close to the deep cervical, was distributed to the spinal canal. 

The remaining figures of this plate have been drawn on a 
reduced scale. 

Figures 4 and 5 have reference to the veins. In one, the 
external jugular descends over the clavicle, and in the prepa- 
ration it was seen to join the subclavian after turning round 
that bone, between it and the subclavius muscle. In the other 
sketch the cephalic vein crosses the clavicle, and terminates 
in the external jugular. 

Figure 6. This is a representation of one of two cases in 
which the phrenic nerve, instead of lying between the sub- 
clavian artery and vein, was placed in front of the vein. 

Figure 7. This drawing has been taken from a body in 
which there was no interval between the trapezius and the 
sterno cleido mastoid muscles. 

Figure 8. Other peculiarities of the muscles, in connexion 
with the subclavian artery, are delineated in this sketch. 
The omohyoid arises from the clavicle, and nearly covers the 
large artery an arrangement of the muscle not of unfrequent 
occurrence. A small muscular slip is also seen to extend 
from the trapezius and join the under surface of the sterno- 



SUBCLAVIAN ARTERIES. 149 

cleido-raastoid near the clavicle. I have seen this unusual 
band of fibres perforate the omohyoid muscle. 

Figure 9 has been taken from a preparation in the Anato- 
mical Museum of the University of Cambridge *. It is intro- 
duced to illustrate the probable position of a " cervical rib," 
with respect to the subclavian artery. The vertebrae repre- 
sented, are the seventh cervical and the first dorsal. With 
the former there is connected on each side a slightly move- 
able process. That of the left side is short ; the process of 
the right side reaches to a considerable distance, and is united 
to a tuberosity raised from about the middle of the first 
ordinary rib. These cervical ribs as they are termed are 
obviously an extension of the piece which usually forms the 
anterior boundary of the foramen in the transverse process of 
the vertebra. As the piece referred to is developed from a 
separate osseous centre, and is therefore always distinct at an 
early period of life, the condition of the bones represented in 
the drawing is to be regarded as the persistence of an original 
state with an increased growth of the part. 



THE SUBCLAVIAN ARTERIES. 

The observations on the subclavian arteries and their 
branches will be arranged under the following heads : 

A. The origin and course of the artery of the right side 
when derived from the innominate. 

B. The origin and course of the same artery when it arises 
as a separate offset of the aorta. 

C. Peculiarities in the origin and course of the left 
subclavian. 

D. The position of the origin of the branches generally. 

E. Peculiarities of the branches individually. 

F. Some peculiarities of the veins, nerves, and muscles in 
connexion with the subclavian arteries. 

* Professor Clark not only gave me, in the examination of the museum, the advan- 
tage of his personal acquaintance with the objects in it, but even took the trouble to 
make drawings of this and other preparations for the purposes of this work. I am 
deeply sensible of his great courtesy and kindness. 



150 THE RIGHT SUBCLAVIAN ARTERY 

A. The origin and course of the right subclavian artery r , when 
derived from the innominate. The position of the commence- 
ment of the artery necessarily varies as has been stated of the 
common carotid, and for the same reason with the situation 
in which the innominate bifurcates ; and is, therefore, in the 
great majority of cases situated on a level with the upper margin 
of the clavicle, at its sternal end or near that point (see 
abstract of the table, ante page 39, and pi. 16) The vessel, 
however, takes its rise in some instances within the thorax ; 
this is recorded in the table of nine cases, and it is illustrated 
in plate 5, fig. 2, and plate 20, fig. 2. In a few cases, on the 
contrary seven are recorded in the table, in consequence of 
the innominate extending higher than usual, the subclavian 
arose at some distance upwards in the neck (plate 20, fig. 3). 

In most cases the subclavian and carotid arteries of the 
right side lie at their origin on the same plane and equally 
near to the integuments : not unfrequently, however, the 
origin of the subclavian is covered to a greater or less 
extent in some cases partially, in a few completely by the 
common carotid. My attention was first drawn to this fact 
by the preparation from which the fig. 4, plate 20 has been 
taken ; in it, the commencement of the subclavian is not only 
behind but even somewhat to the inner or tracheal side of the 
carotid. When the arteries have the relative position here 
pointed out, they are separated by a process of the cervical 
fascia the general investing membrane of the vessels and 
other structures of the neck so that, after the carotid has 
been turned aside, this membrane must be divided before the 
subclavian is brought into view. 

The extent to which the subclavian artery arches into the 
neck, has so direct an influence on the accessibility of the vessel 
during a surgical operation, especially when the clavicle is 
elevated, as it usually is in cases of aneurism in the axilla, that 
the height becomes an important consideration in its anato- 
mical history. It is obvious that in the case represented in 
plate 20, fig. 3, no degree of elevation of the clavicle that could 
have occurred, in consequence of the presence of a tumor in the 
axilla, would have caused the bone to be raised above the 
artery. On the contrary, the artery and the bone lie so 



ITS ORIGIN AND COURSE. 151 

nearly on a level, in the second figure of the same plate, that 
if the shoulder were slightly raised the former would be 
deeply placed and difficult of access ; and its depth, and 
the difficulty to be encountered in the operation for carrying 
a ligature round it, would increase in direct proportion to the 
elevation of the clavicle. 

In a few cases twenty-five the relative position of the 
artery and the clavicle was noted, and gave the following 
result : 

The artery was not higher than the clavicle in . . _ ./ ,* . 6 

was slightly higher in . . . . . . . 11 

was inch, and not exceeding 1 inch higher in 4 

more than 1 inch, not exceeding 1^ inch in . . . 4 

25 

The size of the muscles and the quantity of subcutaneous fat 
have also, as in other parts of the body, their influence on 
the depth of this artery ; and I am disposed to adopt the 
statement of Dupuytren as to the effect of the direction of 
the shoulders likewise. " The third part of the subclavian 
artery," says that celebrated surgeon, " lies near the skin in 
those who are thin and have slender and long necks with 
lean and pendent shoulders ; it is, on the contrary, deeply 
hidden in persons who have short, thick necks and muscular 
shoulders," &c. * It should, however, be understood that my 
opinion as to the correctness of this statement is founded on 
the observation, with special reference to this point, of only 
a few cases, and on the general impression existing on my mind, 
and that it is not an inference from such a number of carefully 
examined bodies as would warrant entire reliance on its 
accuracy. There is no evidence that Dupuytren's statement 
has any better foundation. 

In a few cases and with the same frequency on both sides 
of the body the subclavian artery perforated the anterior 
scalenus muscle ; it was, therefore, separated by a smaller 
interval than usual from the subclavian vein, and probably 
the margin of the muscle would not have been a guide to the 
position of the vessel. See plate 21, fig. 1. A case is repre- 
sented, in the second figure of the same plate, in which the 
artery when placed in this unusual position in the substance 

* Leons Orales, par M. le Baron Dupuytren, tome iv., p. 528. 



152 THE RIGHT SUBCL AVIAN ARTERY 

of the scalenus muscle was accompanied by one of the large 
nerves which form the brachial plexus. A still further depar- 
ture of the artery from its ordinary position is, where it lies 
altogether anterior to the muscle close to the subclavian 
vein and the phrenic nerve. The disposition last mentioned 
has not been present in any of the bodies which I have 
observed : the illustration given of it plate 21, fig. 3, has 
been taken from a preparation in the museum of St. Bartho- 
lomew's Hospital. In this case the artery lay in contact with 
the vein, and the lower cervical nerves were in the usual 
situation, behind the anterior scalenus muscle. Manec * and 
Velpeau f mention similar cases. 

B. The origin and course of the right subclavian artery 
when it arises directly from the aorta. In the observations 
made on the large branches given from the arch of the 
aorta, it has been shown that the innominate artery is 
sometimes altogether wanting, and that the subclavian 
is, in such cases, a separate offset of the aorta. When 
given thus, as an independent branch, the subclavian varies 
as to the position in which it takes its origin with reference 
to the other branches sometimes preceding them occasion- 
ally, but rarely, occurring as the second or the third of 
four (ante page 47 and plate 6, figs. 10, 11, and 12) but 
most frequently being the last of the branches. These 
unusual cases severally require examination in respect to 
their course and connexions. 

1. When the subclavian is the first branch of the arch it 
occupies the position of the innominate, and may be supposed 
to lie with regard to neighbouring parts as that artery usually 
does. 

2. In the instance probably the only one hitherto observed 
in which the subclavian followed immediately after the right 
carotid, it was found to proceed to its destination behind that 
vessel J. 

3. In one of two cases in which the subclavian arose after 
both carotid arteries, the position with respect to the right 

* Traite Theorique et Pratique de la Ligature des Arteres. Planche 3. Paris, 
1832. 

f Traite Complet d' Anatomic Chirurgicale, &c. Edit. 2. Tome i., p. 494. 
Paris, 1833. 

+ " Pone Carotidem sui lateris incedens." Huber. loco cit. et ante p. 47 note. 



ITS ORIGIN AND COURSE. 153 

carotid was the same as in that laset referred to see plate 7, 
fig. 2 ; in the other, on the contrary, it is stated by the 
observer (Walter) to have been directed to the right side, 
in front of the other branches and of the trachea. 

4. The position which the artery under consideration 
occupies on the aorta when it springs on the left side, 
beyond all the other branches, is not constant. Thus, in 
some cases, it is seen to take rise from the upper part of the 
arch as in plate 7, figs. 5 and II, and plate 20, fig. 5 ; in 
others it is derived from the posterior aspect of the arch 
plate 6, fig. 13, and plate 20, fig. 7; lastly, the origin may 
be found much lower down, even from the descending aorta, 
as shown in a case represented at plate 20, fig. 6, which pro- 
bably stands alone both in respect to the depth at which the 
subclavian artery arises and to the circumstance of two inter- 
costal arteries being given from it near the origin. 

The course of the subclavian artery from the left side of the 
aorta to its destination is, in a great majority of cases, oblique, 
in front of the vertebral column, between this and the 
oesophagus *. Inasmuch as examples of this disposition of the 
vessel are to be found in most museums of anatomy, and the 
instances recorded by writers are so numerous, that a special 
reference to them would be tedious and useless, I will only 
add, in reference to the frequency with which it is likely to 
occur, that in the bodies which have come under my notice 

* It is remarkable that Walter, in describing one of his figures, in which the right 
subclavian arises beyond the other branches, as shown in plate 7, fig. 5, erroneously, 
in my opinion, speaks of that vessel as crossing in front of the trachea. " Cette 
souclaviere droite est precisement tres-remarquable et le plus souvent tres-dangereuse : 
car comme il va du cote gauche du cou au cote droit, et par consequent d'une manure 
tout-a-fait transversale devant 1'artere aspera, elle pourroit exposer au plus grand 
peril celui auquel on feroit reparation de labronchotomie.'' He then adds that " a 
distinguished professor being engaged in performing the operation mentioned (bron- 
chotomy) on the child of another equally distinguished professor," the patient died in his 
hands, without the operator being able to assign any cause for the unfortunate result ; 
and he implies that the artery must have been wounded. There is little doubt, 
however, that if this had occurred, the surgeon would not have had any doubt as to 
the cause of death. Nouv. M6m. de 1'Acad. des Sciences, Berlin, 1785. 

Bourgery gives in his large woik a plate showing some of the variations of the 
brandies of the arch of the aorta, and he states that they have been borrowed (em- 
piuntees) from Tiedemami. It is necessary to remark that all the arteries have been 
altered in shape, and that the trachea has been added in a great number, though not 
represented in the work from which they are said to be taken ; and the direction, 
given to the carotid, and especially the subclavian artery, with respect to the air-tube, 
is in many cases incorrect. Trait 6 de 1' Anatomic de 1'Homme, &c., tome 4, pi. 33. 



154 THE RIGHT SUBCLAVIAN ARTERY- 

DOW nearly a thousand in number four cases have been 
found ; giving a proportion of 1 in about 250. 

The passage of the artery between the trachea and the 
oesophagus is of extremely rare occurrence. It is often 
mentioned in treatises of anatomy generally, however, with- 
out reference to particular cases. Meckel describes one *, 
and others are assigned to the observation of Dr. Monro f 
and ZagorskyJ. But on examining the dissertation of the 
former , and the essay of the latter ||, it does not in either 
case appear clearly from the written description, or the 
figure, what the position of the vessel was with regard to the 
ceso'phagus. The most remarkable example of this rare course 
of the artery is that described by Dr. Bayford IT, from one of 
whose drawings figure 7, in plate 20, has been taken. This 
case is especially worthy of notice, because the person in 
whose body the peculiar disposition of the vessel was found, 
had been affected, during a long series of years, with symptoms 
which probably resulted from the contact of the artery with 
the oesophagus. 

A female was from the earliest age occasionally subject to 
difficulty of swallowing : her sufferings were increased at the 
period of puberty, and afterwards became periodically once 
or twice a month so much aggravated as to require the loss 
of blood ; the abstraction of which always afforded relief. 
The menstrual function was habitually defective. During the 
course of a life, extended to about sixty-two years, this most 
distressing complaint was liable to increase on taking exercise, 
or under the influence of any cause tending to accelerate the 
circulation. The pain and the seat of the obstruction were 
referred by the patient to the upper part of the sternum. " As 
her complaints," says Dr. Bayford, " were continually aggra- 
vated rather than diminished by time, she became at length 

* " Dem normaleu naher 1st der Weg zwischen der Luft und Speiserohre, welchen 
diese Arterie bisweile nimmt. Dies fand in dem dritten der von mir beobachteten 
Falle ** Statt," &c. Handbuch derpathol. Anatomic, Band 2, S. 100. 

f By Allan Burns op. cit. and by others. 

J By Otto in " A Compendium of Human and Comparative Pathological Ana- 
tomy " translated, with additional notes, &c., by J. F. South, London. 1831. 

De Dysphagia. Edinb. 1797. 

II "Mem. de 1'Acad. Imp. des Sciences de St. Petersbourg" torn. 2, p. 3-18. 
1810. 

T " Memoirs of the Medical Society of London" vol. 2, p. 275. 1793. 



ITS ORIGIN AND COURSE. 155 

unable to struggle ; and being worn out by fatigue and famine 
(for it is asserted that she scarcely swallowed a single morsel 
for the last three weeks of her life), she sank into her 
grave." 

On examination of the body after death, nothing was detected, 
to which the difficulty of deglutition could be assigned, except 
the position of the artery between the trachea and oesophagus. 
From the obvious connexion between the state of the circula- 
tion and the symptoms, it was reasonably concluded that the 
vessel was the source of these; and, under the guidance 
of an opinion then generally entertained, that deviations 
from the usual arrangement or position of organs were so 
many " lusus naturae," Dr. Bay ford gave the name " dysphagia 
lusoria " to a disease which he was the first to describe. As 
there is not, so far as 1 have been able to learn, any case on 
record in which an exactly similar state of the vessels was 
ascertained to exist, with or without symptoms of a like kind, 
it cannot be said that the inference drawn from that now 
detailed has been confirmed, or the contrary. It is, I believe, 
at present an isolated observation. 

The other cases, in which the existence of a subclavian 
artery, directed transversely from the left side of the aorta, 
has been associated with an account of the state of deglutition, 
differ from that above referred to in the important circum- 
stance that the artery was found in each behind the oesophagus, 
not between that tube and the trachea ; and they for the 
most part happily go to prove that the vessel may be so 
placed without exercising any injurious influence. Two cases, 
which appeared to the authors to have the opposite tendency, 
are reported in a very elaborate and lengthened paper by 
Autenrieth and Pfleiderer*. Of one of these the only one 
which appears to bear pointedly on the subject a few par- 
ticulars may be stated. 

On the examination of the body of a female who died at an 
advanced age, the right subclavian artery was found to arise 
from the left side of the arch of the aorta, and to cross behind 
the oesophagus to its usual position on the first rib. It was 

* Dissertatio inaugurate. De dysphagia lusoria, 1806, in Reil, and Autenrieth's 
Archi. fur die Physiologic," Band 7. 1807. 

P 



156 THE LEFT SUBCLAVIAN ARTERY 

ascertained that the person had been, for some time before 
death, subject to pain in the stomach and difficult deglutition ; 
and those symptoms were augmented towards the close of life 
to such an extent that she refused to take any food except 
fluids, declaring her inability to swallow. The symptoms 
do not appear, from the report of this case, to have been 
so continuous and urgent during the whole of life, as they 
would probably have been if produced by the position of the 
artery ; and the details are insufficient to prove that the diffi- 
culty of deglutition was not attributable to some other cause. 

Finally, it should be stated, that while the general absence 
of allusion to impediment of deglutition in those persons in 
whose bodies the unusual artery was discovered, may be taken 
as presumptive evidence that it had not existed, some observa- 
tions, carefully made, afford positive testimony to the same 
effect. One example may be shortly cited. 

The subclavian artery was found in the unusual position 
between the oasophagus and the spinal column, in the body 
of a young man. Professor Otto, who gives the history of 
the case *, states that he had observed the person closely for 
a considerable time previously to his death, and that there was 
not the slightest difficulty in swallowing. 

C. Peculiarities in the origin and course of the left subclavian 
artery. This artery is not unfrequently altered in position 
together with the other large branches towards the right 
side of the arch ; and when the situation of its origin is thus 
changed, the direction of the vessel is necessarily more oblique 
than usual towards the point of emergence from the thorax. 

It has little tendency to combine, or arise in common with 
the other branches of the aorta ; there are, however, a few, 
and only a few, examples of its junction with the left carotid. 
Ante page 46, and plate 6, figs. 8 and 9. 

The statement as to the infrequency with which this sub- 
clavian artery joins the carotid does not apply to the cases 

* " Das Subject war ein Scirifferknecht von etlichen 20 Jahren. * * * Da ich ihn 
hier mehrere Monate zu beobachten und zu behandeln Gelegenheit hatte, und ihn oft 
trinken und essen gesehen hatte, ohne dass die geringsten Beschwerden beim Schlucken 
entstanden waren, so ist dieser Fall ein neuer Beweis, dass die so genannte dysphagia 
lusoria nicht immer Folge dieser Arterien varietal ist, &c." Seltene Beobachtunzen, 
Th. 1, S. 100. 



ITS ORIGIN AND COURSE. 157 

in which the aorta arches to the right instead of the left side, 
for in them the innominate if it' exists is as usual the first 
branch, but the position being changed with that of the aorta, 
it divides into the left carotid and subclavian, as is seen in 
plate 5, figures 3, 4, and 5. 

It is interesting to observe that when the aorta has the 
direction last referred to namely, when it turns over the 
right instead of the left bronchus a subclavian artery may be 
found to arise from the descending part of the arch and take, 
to a certain extent, the course across the vertebral column, 
which has been described in the preceding pages ; but here 
the vessel has the opposite direction from the right to the 
left side and is the left in place of the right subclavian 
artery. 

One case in which this disposition appears to have existed 
without any other remarkable peculiarity, is mentioned by 
Otto *. Descriptions and delineations have been separately 
and independently published by Fiorati and Sandifort of a 
preparation previously referred to, as showing peculiarities 
of the arch of the aorta and its branches } in which the left 
subclavian had apparently the origin and course above pointed 
out, but in reality the artery was derived from a conical 
dilatation. This peculiar structure was connected by its base 
to the aorta, and narrowing at the other end, at the same 
time gave origin to the subclavian artery, and received the 
attachment of the ligamentum arteriosum. On examination 
of a case lately described by Mr. Ewen J, I have found that it 
corresponds with the preceding, both as to the existence of the 
dilatation and the arrangement of the vessels. See plate 20, 

* "Die Arterienaste, welche aus dem Aortenbogen entsprangen, waren, von links 
nach rechts gezahlt, folgende. 1. die A. carotis sinistra ; 2. diecarot. dextra;3. die art. 
vertebralis dextra ; 4. die subclavia dextra, und; 5.,ganzen hinten,nach dem Ruck- 
grathe zu, und viel weiter unten und fast schon aus der Aorta descendens, die subclavia 
sinistra ; welche zwischen der Wirbelsaule und dem Sclunde zum linken Arme 
hinuber lief." Seltene Beobacht. Th. 2. S. 61. 

It is to be regretted that the paper contains no account of the pulmonary artery, or 
of the ligamentum arteriosum. 

f Ante pages 18 and 47, and Plate 7, figs. 1 and Ib. 

J Case of transposition of the aorta, trachea, and oesophagus; tuberculated liver, &c., 
with a plate. Guy's Hospital Reports, vol. 5, p. 283. In Mr. Ewen's description of 
the preparation is contained the following reference to the left subclavian and pulmonary 
arteries : " The impervious canalis arteriosus passed from the root of the left sub- 
clavian, before the lower end of the trachea and commencement of the left bronchus, 
to reach the pulmonary artery." 



158 THE LEFT SUBCLAVIAN ARTERY 

figs. 8 and 9, and compare these with figs. 1 and 1 Z>, of plate 7. 
The foregoing are not the only examples of the vessels given 
from the aorta having dilatations connected with their origin. 
Hommel mentions one found in connexion with the subclavian 
artery of the right side, and another is described by Walter 
at the origin of the vessel of the left side. A case similar 
to that described and delineated by the last-named observer, is 
represented in figs. 2 and 2, plate 6, from a preparation in 
my collection. In these three instances the arch of the aorta 
had its accustomed course to the left side. 

With respect to the nature of the enlargement or dilata- 
tion existing in these different cases, the observers referred to 
scarcely offer a conjecture, and I have not succeeded in obtain- 
ing any information on the subject from works of anatomy. 
The remarks made concerning it in the papers quoted, are 
confined to the description of the appearance and connexions, 
without allusion to the manner of its production. Thus, 
Sandifort * speaks of it as a purse or protuberance into which 
the aorta was expanded below its arch. Fiorati mentions it 
nearly in the same way. Hommel f states, of his case, that the 
artery arose by a large orifice as if from a kind of sac. 
Walter { alone gives an opinion as to its nature, describing it 
as an aneurism. 

In order to explain the conclusion I have arrived at, as to 
the nature of the pouch for such it may be named for 
sake of convenience it will be necessary to give a statement 
of the facts which have led to the conclusion. These may be 

* " Quod yero attentionem maxinie ad se convertit, bursa fuit seu protuberantia 
conoidea ferme, in quam truncus ipse aortae descendentis statim infra arcum sese 
explicabat, quas protuberantia, a dextris ad sinistras procedens, sensim contrahebatur ut 
in truncum sinistrse subclavise desineret. Inter apicem hujus conoideae protuberantias 
et radicem subclaviae quaeex ipsosurgebat, inserebatur canalis arteriosus, jam ligamentum 
factus, &c.' Mus. Anatom. torn. 1, p. 273. 

-j- " Alterum exeinplum, quod laudatus D. auctor observavit, nionstrat arcum aortas, 
ex quo ambse carotides ex communi ductu brevissimo ad latus dextrum exsurgunt j 
Bubclavia vero utraque peculiar! trunco oritur ita quidem, ut sinistra in medio sit, 
dextra autem in sinistro latere amplo orificio, quasi ex sacco quodain, proveniat." 
Commerc. Lit. Norric. t. 2, p. 318. 

$ " En tant done qu'on rencontre ici quatre arteres, c'est une observation rare ; mais 
si nous faisons attention a la maniere dont 1'artere souclavidre gauche, d6s son origine 
de Tare de 1'aorte, a form4 un grand sac qui Ta rendu anevrismatique, alors cette 
observation offre un cas egalement rare et dangereux. Ce n'est pas un simple jeu de 
la nature ; c'est la cause d'une des maladies du coeur." Nouv. Mem. de 1'Acad. Royale 
des Sciences, &c., p. 16, 14, Berlin 1785. 



PECULIARITIES OF ITS ORIGIN. 159 

arranged into two sets : according to the position which the 
pulmonary artery and the ligamentura arteriosum or canalis 
arteriosus bear with reference to the arch of the aorta, 

a. The vessels having their usual course and position : a 
small nipple-shaped dilatation is not unfrequently observable 
on the concave side of the arch towards the left side, pro- 
jecting at the point at which the ligamentum arteriosum is 
united to the aorta. The connexion of this dilatation, with 
the ligament just named , suggests that it is an unobliterated 
part of the canalis arteriosus. But the dilatation from which 
the subclavian artery has been found to arise, is of consider- 
ably larger size than those now noticed, (see plate 7, fig. 2 b). 
In accounting for this fact it will be assumed for the present 
that the subclavian artery may arise from the canalis arteriosus 
near its end. Now, supposing this to be the case, it is 
manifest that, blood being transmitted from the aorta into the 
subclavian artery through the end of the canalis arteriosus, 
the obliteration of the upper part of this tube must, as a 
necessary consequence, be prevented. The greater size of the 
pouch in this case is, then, according to the view here taken 
of the subject, owing to the origin of the large artery from it. 

It may here be added that should the aorta be directed to 
the right side, the change of its course being accompanied by 
the general transposition of the viscera, the pulmonary artery 
undergoes a corresponding alteration of its position ; it is 
placed on the right side, and the ligamentum arteriosum joins 
the concavity of the arch in the usual way, (plate 5, figure 4). 
And, moreover, when the aorta has the unusual direction at 
the same time that the viscera retain their ordinary position, 
the course of the pulmonary artery and the ligamentum 
arteriosum, or canalis arteriosus, may be but, as will presently 
appear, is not always the same as that just indicated. This 
fact is illustrated in the body of a foetus described by Mr. 
Abernethy, and noticed in a former part of this work, page 18, 
and plate 5, fig. 5 *. From the circumstances before stated, it 

* Having by the favour of Mr. Stanley and Mr. Paget, made a careful examination 
of this preparation in the museum of St. Bartholomew's Hospital, I found the 
pulmonary artery on the right side of the aorta, and the canalis arteriosus joining the 
descending part of the arch, as occurs when the vessels have their accustomed course. 



160 THE LEFT SUBCLAVIAN ARTERY 

is apparent that, as the canalis arteriosus joins the arch of the 
aorta in the ordinary way in these various cases, a dilatation, 
if any existed, would probably be the same as those already 
described. 

b. A very different disposition from the preceding exists 
in the two preparations, represented in plate 7, fig. 1, 
and plate 20, figs. 8 and 9 : for while the aorta arches to the 
right side, the pulmonary artery retains its usual position 
on the left, and the ligamentum arteriosum joins a pouch pro- 
jecting from the aorta. Now, an inspection of the figure 
(8) will show that the canalis arteriosus, in order to join the 
aorta at the end of its arch, must, in such a case as this, neces- 
sarily pursue a circuitous course, and cross the trachea, and 
oesophagus. If it had the transverse course behind these tubes, 
if also the subclavian artery arose from it, the appearance of 
the vessels would be easily explained, for the pouch would be 
in these, as in the former instances, the end of the arterial 
canal, unobliterated, because of the transmission of blood 
through it from the aorta. 

In order to complete the view here presented of the nature of 
the dilatations or pouches under discussion, it is necessary to 
show the left subclavian artery arising from the canalis arteri- 
osus in the foetal state before any part of this canal has been 
changed into a ligament. Cases in which the subclavian artery 
and the "arterial canal" had this disposition are recorded 
by Klinkosch *, and Meckelt, and two figures contained in the 
essay of the former are copied in plate 20, figs. 10 and* 11. 
In one of the figures the heart and large vessels are viewed 

* After mentioning the course of the aorta to the right side, the author continues : 
" Ductus arteriosus, ut altera aortas radix, flexione obtusa facta et oblique deorsum 
et dextrorsum descendens, cum columna posteriore arcus aortae seque oblique posita, in 
distantia quatuor circiter linearum sub origine arteries subclaviae dextrae, confluxit 
in regione quintae vertebrae dorsi in unam aortain descendentem, insulamque cum arcu 
aortas effecit, quae et arteriam asperam et cesophagum transraisit. Ductus mine arterio- 
sus, truncum arteriae pulmonalis inter et aortum communicans in ^ longitudinis suae 
distantia ab aorta, emisit arteriam subclariam sinistram. Quae oblique antrorsum se 
conferens solitos dedit ramos. Hinc arteria subclavia sinistra soboles erat canalis 
arteriosi et non aortae," &c. " Anatome partus capite monstroso" in the "Dissert. 
medicaR selectiores Pragenses," vol. i. p. 201. Pragae et Dresdae, 1775. 

f "Bisweilen aber ist auch die linke Schliisselpulsader ein Product dcr rechten 
Aorta. So entsprang sie in dem einen der von mir angefuhrten Falle nicht aus dcr 
Aorta, sondern aus dem arteriosen Gange," &c. " Handbuch der Pathol . Anat." B. 2, 
S. 105. 



PECULIARITIES OF ITS ORIGIN. 161 

from before: in the other, the parts are seen on their 
posterior aspect. The aorta and pulmonary artery have, 
as they arise from the base of the heart, their ordinary 
relative position (see fig. 10) : the former is directed to 
the right, and the latter to the left side of the trachea 
and oesophagus. On an inspection of the eleventh figure 
the vessels being viewed from behind the canalis 
arteriosus (14) is seen to have a transverse course behind 
the oesophagus and the trachea (d and 2>), and to join the 
aorta; and the left subclavian artery (5 ') is derived from it 
at some distance from the aorta. 

In conclusion : supposing the case last mentioned to undergo 
the usual changes which occur after birth, a doubt cannot be 
entertained that it would be brought into the exact condition 
of those referred to immediately before ; for the canalis 
arterjosus would be partly reduced to the state of a cord or 
ligament, but this alteration would not extend beyond the 
point at which the subclavian artery takes its origin ; and 
the remainder, transmitting blood from the aorta into the 
artery just named, and being larger than the vessel given from 
it, would constitute a pouch. 

Before parting from the cases which have been last under 
observation, the position of the trachea and the oesophagus 
with respect to the arteries, requires notice. They are seen 
in plate 20, figures 10 and 11, to be surrounded by the blood- 
vessels ; for, the aorta is in front of them and at the right side, 
the pulmonary artery on the left, and behind is placed the 
canalis arteriosus. And in the modification of this condition 
which exists in the adult, the arrangement is the same, except 
that a portion of the " canalis " has become impervious see 
the figures immediately preceding those last referred to. This 
position of the air-tube and oesophagus recalls to mind a case 
described in a former part of this work, in which they passed 
through a division of the aorta *. 

* Page 22 and plate 5, figure 8. Since the reference to this case was written, I have 
met with the account of another similar to it nearly in all respects. It was 
found in the body of an adult male. The aorta divided, and the parts after embracing 
the trachea again speedily united ; but the ossophagus is not mentioned as being placed 
in the sort of ring formed by the vessel, and it is to be inferred from the statement of 
the observer that the oesophagus was not so placed ; for, the divisions of the aorta are 



162 THE LEFT SUBCLAVIAN ARTERY 

Connexion of the" Canalis arteriosus" with the left subclavian 
artery. In the foregoing observations the left subclavian artery 
has been seen to take rise from the canalis arteriosus ; another 
class of cases showing a different connexion between these vessels 
will now be shortly adverted to. In these cases the " arterial 
canal " unites with the left subclavian, and has no connexion 
with the aorta. A figure which, in so far as the arteries are 
concerned, may serve as a type of this arrangement, has been 
copied from an essay by Bernhard, see plate 7, fig. 3. The 
body was that of an infant, who died immediately after birth, 
this having occurred at the usual period. The aorta arches 
to the right side, and to the left of it lies the pulmonary artery 
in the ordinary position. The right pulmonary artery is 
directed transversely as usual, and, in addition to its ordinary 
connexions, crosses in front of the descending aorta : and the 
artery of the left side enters immediately into the lung. The 
canalis arteriosus, still unobliterated, having its accustomed 
origin from the beginning of the left pulmonary artery, joins 
the left subclavian immediately beyond the innominate, which 
in this case is on the left side. 

Cases are recorded by Reinmann *, Obet f , Cail- 

said to have been fitted to the trachea, the anterior division of the vessel being adapted 
to the rounded shape of the front and sides of the air-tube, and the posterior to its 
flattened back part. After describing the arrangement of the aorta, the author con- 
tinues, " Et, quod raagis mirum est, per hiatum ilium prseter naturam formatum, pars 
inferior tracheae migrabat, eoque superato, in bronchia sueto ordine dividebatur. Forma 
hiatus hujus, qui tracheam arete amplectebatur undique, erat irregularis, et ipsius 
tracheae formse perfecte accommodabatur, sic, ut margine, posticitus recto, responderet 
planitiei partis posterioris musculoso-membranacese, anticitus vero et lateraliter margine 
excavato adaptaretur convexitati externse segmentorum cartilagineorum fistulae spira- 
tilis." Zagorsky, loc. citat. tome 9, p. 387. The detail of this case would have been 
more satisfactory if the situation of the oesophagus had been stated. 

* " In cadavere mendici cujusdam, catarrho suffocativo in via extincti et pro 
instituenda publica sectione in theatrum anatomicum delati, deprehendi canalem 
arteriosum ab arteria pulmonali sursum ascendisse, atque arteriae subclaviae sinistrse 
fnisse insertum, quam plane singularem structaram et connexionem, nondum hactenus 
ullibi notatam animadvertere mini licuit." Nova Acta Phys. Med. Acad. Caesar. 
Leopold, et Carol. Naturae Curiosorum exhibentia Ephemerides torn. 1, observat. 
74_Norimbergse, 1757. 

t "Le sujet de cette observation est n a Brest, le 31, Decer. 1800, et est mort 
le 10 Deer. 1813. 

L'Artere pulmonaire dont le calibre etoit trop petit pour permettre 1'iutroduc tion 
d'une sonde a poitrine, et dont les parois dtoient tres minces, naissoit de la pa rtie 
supeVieure du ventricule droit, un peu en avant de la cloison qui ordinairement separe 
les deux ventricules " (the septum is stated at another place to have been defective at 
the upper part of the ventricle) ; " elle se bifurquoit comme dans I'e'tat naturel et 
fournissoit, avant sa division, le canal arteriel, dont le calibre e*toit assez petit, mais 
qui n'etoit cependant pas oblitere ; ce canal alloit s'ouvrir& 1'origine de 1'artere 



ITS CONNEXION WITH THE << CANALIS ARTERIOSUS." 163 

Hot *, Jackson -f, and others, in wliich the canalis arteriosus 
and the left subclavian are described as being connected in 
the manner here stated. It should be observed that the 
accounts of the cases are generally defective as far as regards 
the course of the aorta ; but it is to be inferred from the 
direction of the innominate artery to the left side in some of 
them, that, in these at least, the aorta arched to the right side, 
as in the example recorded by Bernhard. 

It is an important feature of these cases that the curious 
disposition of the vessels was found to be accompanied with 
malformation of the heart the right and left cavities com- 
municating one with the pther ; such, at least, was found to 
be the fact in the instances in which that organ was 
examined. 

Although it will not be strictly in place under the head of 
the left subclavian artery, allusion may here be made to a case 
in which there existed two arterial canals, or branches of com- 
munication between the pulmonary and the systemic arteries. 

sousclaviere gauche. * * La crosse de Taorte etoit d'un volume un peu plus 
qu'ordinaire ; mais le depart des troncs prindpaux qui constituent 1'aorte ascendante 
offroit des particularites tres remarquables : la carotide et la sousclaviere gauche en 
partoient les premieres et naissoient d'un tronc commun, et c'est k la naissance de cette 
derniere, placee la plus gauche, que venoit aboutir le canal arteriel," &c. &c. 

The child had been for some time after birth in good health ; in a couple of months 
it became affected with difficulty of breathing; and, towards the close of life, the skin, 
which up to that period was natural in its colour, assumed a dark or bronze hue. 
*' Bulletin des Sciences Medicales, public par la Societe M^dicale d'Ernulation de Paris " 
torn. 2, p. 65. Paris, 1809. 

* "L'orifice de 1'artere pulmonaire tres-etroit, ne presentait que deux valvules 
sigmoides. Cette artere, plus rtrecie encore au-dessus de son origine, augmentait 
ensuite de diam^tre en s'eloignant du creur, &c. * * Le canal arteriel complete- 
ment oblitere, se rendait dans la sousclaviere gauche : "celle-ci donnait naissance & la 
carotide du mme c6te, tandisque la sous-claviere et la carotide droites naissaient par 
deux troncs separes." 

Two cases are detailed by the same physician. In both, the arrangement of the vessels 
was probably the same ; and the right and left cavities of the heart communicated, the 
partitions both of the auricles and the ventricles being incomplete. One of the 
children, that whose case is detailed, was eleven years of age : the other three years. 

Bulletin de la Facultede MeU de Paris tome 1 1812. 

f Case of a female child who died at the age of three years. Respiration had been 
habitually hurried, especially on taking exercise, but the skin had always the natural 
appearance. After stating that the septum of the auricles and that of the ventricles 
were defective, the reporter continues : " The great arteries were considerably different 
from what is common. The pulmonary artery was by much the largest and most 
prominent. It formed a small arch, which made it appear like the aorta. It divided 
into two branches immediately as it began to descend after having made its curvature. 
Of these branches that to the left side was the largest. They went to the lungs as 
usual ; but from the left branch went off a small vessel to the left subclavian." " Case 
of inflammation of the mucous membrane of the alimentary canal, and of malformation 
of the heart," in the " London Mcd. and Phys. Journal," vol. 34 1815. 



164 THE SUBCLAVIAN ARTERIES 

One joined the aorta in the usual way ; the other arose from 
the right pulmonary artery close to the lung, and terminated 
in the innominate very near the origin of the right subclavian. 
The latter was much longer and more slender than the 
former *. 

D. The position of the origin of the branches, generally. The 
situation in which the branches arise from any large artery is 
an important consideration in its history, because of the 
influence which their presence has on the result of an operation 
for the cure of aneurism. And, considering the shortness 
of the trunk, the size of the offsets, and the manner of their 
arrangement on the parent vessel, it may be confidently 
stated that there is no artery in which the influence alluded to 
is more considerable than in the subclavian. 
. Each subclavian artery is almost universally considered to 
be divisible into three parts, marked by the anterior scalenus 
muscle the first part being to the inner side of the muscle : 
the second beneath it : and the third, the portion extending 
from the scalenus to the outer margin of the first rib. The 
circumstances of the vessel are so different in these three 
situations, in respect to the connexions and the branches given 
in each of them, that the division is a very convenient one, 
and it will be followed here. 

The branches which arise from the first part of the subclavian 
arteries are usually the vertebral, the internal mammary, and 
the thyroid axis the last-named being a trunk common to the 
inferior thyroid, the supra-scapular, and transverse cervical 
branches. To these three branches must be added, for the 
left side, the superior intercostal, which on that side takes its 
rise somewhat more frequently to the internally to the scalenus 
muscle than beneath it. The instances of a departure from this 
arrangement, of material or practical importance, are not 
numerous; those most worthy of notice are cases of rare 
occurrence, in which several of the branches are transferred 
from the first to the second or the third division of the artery ; 
they will be again referred to. The position which the 

* Case of a malformed male infant aged six weeks, in a paper by Brcschct, con- 
tained in the " Repert. generale d'Anatomie et de Physiologic pathologiques, &c." 
Tome 2, p. 10. Paris, 1826. 



THEIR BRANCHES, GENERALLY. 165 

branches occupy on the first part of the arteries requires 
separate consideration on each side. 

The left subclavian being nearly vertical in direction from 
the arch of the aorta to the scalenus muscle, only a small 
part can be said to be placed to the inner side of the 
scalenus after its emergence from the thorax ; and the entire 
of the artery from the aorta to the muscle is so deeply placed , 
and, at the same time, covered by such important parts, which 
do not admit of being moved aside namely, the pleura and the 
lung with the internal jugular and innominate veins that no 
operation has been hitherto undertaken on this division of 
the vessel ; and indeed an effort to expose it in a surgical 
operation does not seem admissible. It is, therefore, un- 
necessary to comment on the position of the branches in this 
place, further than to say that they generally are given off 
close to the scalenus muscle, and that they are at their 
origin covered by the internal jugular vein see plates 1 
and 2. 

The distance from the commencement of the right subcla- 
vian artery to the origin of the branches is of importance in a 
surgical point of view, because it may be desired to place a 
ligature on the first part of this artery for the cure of aneu- 
rism. To determine this point, to ascertain the distance in 
several cases, observations were made on sixty-five bodies 
(see the table) ; and they were distributed as follows : 

Length of the right subclavian artery from its origin to the point at which 
branches arise 

^ inch and under . . . ..'.*." 8 

more than inch, and not exceeding 1 inch . . . 33 

more than 1 inch, and not exceeding H inch . . 23 

1-| inch (the extreme length) . ..... 1 

Cases have occasionally come under my observation in which 
one of the branches, instead of arising with the others near 
the scalenus muscle, was found to be given very close to the 
innominate artery. The branches found to occupy this 
unusual position were the vertebral and the inferior thyroid 
see plate 21, figs. 9 and 10. 

I have sometimes seen the branches given off at regular 



166 THE SUBCLAVIAN ARTERIES THEIR BRANCHES. 

intervals one being close to the beginning, another at the 
middle, and a third at the end of the first division of the main 
artery. A still greater departure than this from the ordinary 
arrangement and position of the vessels is that rare condition 
represented in the fifth figure of the twenty-first plate, in 
which the branches are seen to be more numerous than usual, 
and to be diffused over the main artery in such a way that a 
ligature, placed at any point, must have been close to or in 
contact with a branch. 

The branches derived from the second division of the subclavian 
arteries. From the observations which have been made see 
the table, page 113, et eq., and the abstract of it, page 
130 it appears that in two^thirds of the cases noted, one 
branch took its rise in this situation, and that in more than 
half the remainder the artery furnished no offset. Two 
branches occurred in the proportion of 1 in 8f- cases, and 
three branches in the proportion of 1 in 66. In a single 
instance the greater number of the branches of the subclavian 
arose in this part of the artery viz., the internal mammary, 
the scapular, and the superior intercostal see plate 21, fig. 
6. A difference was noticed between the vessels of opposite 
sides, the entire absence of branches having been found more 
frequently on the left side, and the presence of one branch 
more frequently on the right side. 

The branches derived from the third division of the subclavian 
arteries. In the table and abstract already referred to, it is 
seen that in somewhat more than half of all the cases noted 
this division of the arteries was without any offset the 
proportion is 1 in 1| ; and that in less than half, one example 
occurring in 2 it gave origin to a single branch. Two 
branches were occasionally observed the proportion of the 
variation being 1 in 37^- and three occurred in two instances 
out of 263. I have lately seen another instance * of the vari- 
ation last alluded to, and one in which four branches arose 
between the scalenus muscle and the outer part of the first 
rib see plate 21, figs. 7, 8, and 10, and plate 24, fig. 4. 

* This was met with by Mr. R. Quaiu, M.B., while performing surgical operations 
on the dead bodv. 



THE VERTEBRAL. 167 

E. Peculiarities of the branches individually. The obser- 
vations made on the arteries in this work having chiefly 
reference to such points as bear on the operations of surgery, 
the notice of these branches will, as in other cases, be brief, and 
will not include any part of history of small ramifications. 

THE VERTEBRAL ARTERY. 

The origin of this artery was noted in 290 cases. It was 
not found in any instance to be placed beneath or beyond the 
scalenus ; and there is not, that I am acquainted with, any 
example on record of its being so situated. 

The artery of the right side has not been seen either in 
any of the cases noted in the table, or in any of the bodies 
which have come under my observation, to deviate from the 
ordinary place of origin, further than by being given from 
the subclavian artery nearer than usual to the commencement 
of this vessel. Seven examples of deviation to this extent are 
recorded in the table, and I have observed a much greater 
number ; it is exemplified in plate 21, figures 5 and 10. 
Several instances have been described by anatomists of the 
right vertebral being derived from the common carotid ; and 
in all the cases of this variety that I have observed in 
museums, or read of, the subclavian was given as a branch 
of the aorta see plate 5, figure 8, and plate 6, figure 13. It 
is remarkable that in a majority of the specimens showing the 
subclavian artery to arise from the left side of the aorta, 
which are contained in one valuable collection *, the vertebral 
is a branch of the carotid ; and that this did not once occur 
in the cases which fell under my immediate observation. The 
right vertebral artery has in a few cases been found to arise 
directly from the aorta : see ante, page 53, where two examples 
are cited; and to these may be added one in which the 
unusual origin of the vertebral artery accompanied transposi- 
tion of the arch of the aorta, see ante, p. 52. 

The usual place of origin of the left vertebral is the angle 
formed by the subclavian, as this artery inclines outwards in 

* The Macartney collection in the Anatomical Museum of the University of 
Cambridge. 



168 THE SUBCLAVIAN ARTERIES THEIR BRANCHES. 

the neck from the thorax. From that point the vertebral 
ascends vertically, so that it may be said to continue the 
vertical direction of the thoracic part of the subclavian. Not 
imfrequently .the artery of this side is derived from the 
arch of the aorta. In these cases it is usually placed 
between the carotid and subclavian of the left side ; but there 
are a few examples of the vessel having been found to take 
origin from the arch beyond or to the left of all the branches : 
they are referred to in a previous part of this work page 51. 
Between the points of origin stated namely, that from the 
subclavian and that from the aorta there are several inter- 
mediate stages at which the artery under observation occa- 
sionally arises ; so that on the examination of a large number 
of cases, there would be found an easy transition between 
the extremes. Figures 2, 3, and 4, in plate 22, drawn 
from preparations in my possession have been introduced to 
illustrate this fact. 

The vertebral arteries have been found in a few instances 
to result from the union of two or even of three branches, or 
rather roots : and each of these is given off, for the most part, 
in the situations in which the artery when single is, in 
different cases, seen to take origin. Thus, both may spring 
from the subclavian, as shown in plate 22, figure 9 ; or one 
from that vessel and the other from the aorta, as in figures 
7 and 8 in the same plate. All the examples that I am 
acquainted with, in which this artery has more than a 
single origin, occurred on the left side, with the exception of 
one, and in it there were three distinct roots two being 
derived from the subclavian, and one from the thyroid artery 
see plate 24, figure 2. The place of union of the smaller 
vessels into a single artery varies ; being in one case before 
either had entered the canal in the vertebrae : in others, after 
one vessel had passed through a single vertebra, or through 
the foramina of two of these bones. The figures already 
mentioned contain illustrations of these facts. 

To explain the manner of the production of the various 
conditions of the vertebral arteries noticed in the latter part 
of the preceding observations, it may be supposed that in an 
early stage of development a great number of blood-jcanals 



THE VERTEBRAL. 169 

exists, and that the continuance' of one of these, varying in 
its position in different cases, while all the others are 
removed, will account for the existence of a single branch, 
and the variations which occur in its position. Further, the 
persistence of two or three of the original canals would explain 
the double or threefold origin found in some cases. The 
preparation represented in plate 22, figure 10, may be men- 
tioned in corroboration of this view ; in it there are three 
branches each occupying a position in which the single verte- 
bral artery is occasionally found. It is obvious that the 
increase in size of either of the two upper branches, which 
are here in a rudimentary state, would the others being 
removed constitute one of the conditions of the vertebral 
artery represented in figures 1 and 2 ; and that a modification 
of the size, and the junction of two of them, would give rise 
to the double origin shown in the other figures. 

The vertebral arteries of opposite sides often differ in size. 
An example of this difference to an unusual extent is given in 
the first figure of the plate above referred to. 

They usually enter the canal in the spinal column at the 
sixth vertebra; but one is not unfrequently found to rise 
higher before perforating a transverse process. No example 
has occurred under my observation of the vessel entering in 
the first instance a vertebra higher than the third ; there 
are, however, some mentioned by anatomists, in which the 
second or the first vertebra was that which first received the 
artery. 

Branches. The branches given from the vertebral arteries 
are chiefly distributed to the spinal cord and the encephalon, 
and will be shown in a future part of this work. Independently 
of these and of some small offsets to the muscles of the neck, 
shown in plate 18, fig. 2 the vertebral has been occasionally 
found to give origin to some of the branches which are 
usually furnished by the subclavian. In one instance I found 
the inferior thyroid artery, and in two cases the superior 
intercostal, to take origin from it see plate 22, figs. 
5 and 6. 



170 THE SUBCLAVIAN ARTERIES THEIR BRANCHES. 



THE THYROID AXIS. 

The Origin. The thyriod axis was found to take origin 
from the subclavian, internally to the scalenus muscle, in 271 
of the cases noted in the table. In two it arose beyond the 
muscle, and both occurred on the left side. The artery was 
in several cases so connected to other vessels at its origin, that 
it might be said to give rise to them. In fifteen instances it 
gave origin to the internal mammary ; and the vertebral, the 
superior intercostal and the " profunda cervicis," were found 
to be derived from the thyroid, each in a single instance. 

Branches. The usual branches of the thyroid axis are the 
inferior thyroid, the supra -scapular, and the transverse cer- 
vical. The branches deviate from this arrangement and from 
their usual distribution so frequently that they require to be 
separately commented on. 

THE INFERIOR THYROID ARTERY. 

This artery arose as an independent branch in twenty- nine 
of the cases recorded in the table. In one of these it arose 
from the common carotid plate 12, fig. 4 ; in another, from 
the vertebral plate 22, fig, 6; and in the remainder it was 
derived from the subclavian, in the manner illustrated in plate 
21, figs. 5, 6, and 9. Two other examples of the inferior thyroid 
being given from the common carotid, are delineated in plate 
23, fig. 10, and plate 24, fig. 1. The inferior thyroid 
is often mentioned in my notes as being smaller in size 
than usual, and in six cases it was altogether wanting see 
plate 23, figures 3, 7, and 8. The manner in which the absence 
is compensated for in various cases will be shown in the next 
paragraph. On the other hand, instead of a single inferior 
thyroid artery, two of these vessels are occasionally found to 
exist, as exemplified in the eleventh figure of the same 
plate ; in this case, one of the branches has the usual position 
with reference to the common carotid artery : the other 
crosses in front of that vessel. This is a rare variety. 

The superior and the inferior thyroid arteries are so in- 
timately associated in their distribution, and they are so 



THE THYROID ARTERIES. 171 

often found to take the place, 'one of the other, that it is 
necessary to review them in connexion. Some other branches 
which assist these vessels, or supply their places in certain 
cases, will at the same time be noticed. 



THE SUPERIOR AND INFERIOR THYROID ARTERIES. 

The arteries distributed to the thyroid body are usually 
four in number on each side, two one being superior, the 
other inferior. The former is derived from the external 
carotid, and ramifies on the anterior surface of the thyroid 
body ; the latter takes origin, as shown above, from the thyroid 
axis, and supplies the posterior surface of the same structure. 

The number of these arteries is not unfrequently altered ; it 
may be diminished to three or two, or increased to five'or more. 
The diminution of the number to two may arise from the 
absence of the two arteries from above, or of those from below. 
In such cases the defect is supplied by the vessels present, 
which are then of increased size. Thus in the second 
figure of the twenty-third plate, both the superior arteries may 
be said to be wanting, and their place is taken on the anterior 
surface of the thyroid body, by branches from the inferior 
arteries. In the following figure of the same plate the 
contrary occurs, for the usual branch is not given from the 
subclavian ; and instead of it, one from the superior thyroid 
sinks to the posterior surface of the thyroid body. If one of 
these sources of diminution of the number should be present 
on one side, at the same time that the usual disposition of the 
vessels exists on the other side, the number of thyroid 
arteries would obviously be three. Other arrangements of the 
thyroid arteries producing modifications of their number will 
be found in the twenty-third plate. 

The thyroid body sometimes receives an artery from a dif- 
ferent source, e. g. the innominate, the common carotid, sub- 
clavian (a second branch), or the aorta. The thyroid 
branches derived from these arteries are rarely met with, 
except that from the innominate, and this alone requires de- 
scription here, the others having been already sufficiently 
referred to ante, pages 52 and 170. 



172 THE SUBCLAVIAN ARTERIES -THEIR BRANCHES. 

The thyroid branch of the innominate artery is chiefly 
important from the position it has with respect to the trachea, 
and the consequent bearing on the operation of tracheotomy. 
It was named the " lowest thyroid artery," (arteria thyroidea 
ima) by Neubauer and Erdmann*, who have given a very 
accurate and elaborate description of it, in an essay quoted 
in other parts of this work. 

This artery is, in some cases, a fifth or an additional 
branch of supply to the thyroid body ; in others it is found 
to take the place of one or more of the ordinary branches. 
Thus, in figure 7 of the plate referred to, it is distributed in 
place of the left inferior thyroid artery : in figure 8, in place 
of the right inferior : in figure 9, it compensates at the same 
time for the defect of the two superior, and of the left inferior 
branches. And the tenth figure affords an example of five 
arteries distributed to the thyroid body the branch of the 
innominate being the fifth or additional branch. 

The size of the lowest thyroid artery varies very much. In 
reference to this point, it may be said that the artery is 
generally of moderate dimensions not unfrequently very 
slender and occasionally of considerable thickness. See figs. 
7, 8, 10, and 9, of plate 23. 



THE LARYNGEAL BRANCH OF THE SUPERIOR THYROID 
ARTERY. 

In the observations on this artery contained in page 106, 
some facts were reserved for this place, in order that they 
should more nearly accompany the illustrations in plate 23. 
The laryngeal artery is sometimes seen to perforate the 

* "At ab interne, sen sinistro arterise anonymse latere, ejusque parte media vel 
paullulum superiore, ramus interdum provenit, qui super asperam arteriam sursum 
proserpens, pluribus ramulis suis inferiori glandulae thyroidese parti prospicit. Arte- 
riam thyroideam imam ilium denominabo." 

The authors of this paper give also descriptions of the thyroid branch which occa- 
sionally arises from the lower part of the common carotid, and of that so rarely derived 
from the arch of the aorta ; and they apply to them the same name, distinguishing 
each by the addition of the name of the trunk from which it emanates. Thus, three 
chapters containing an account of the arteries are headed as follows : 

" vi. De art. thyr. ima, rariore arteriae innominatoe ramo." " vii. Art. thyr. 
ima, ex carotidum trunco dextro nata." " viii. Art. thyr. ima, ex. arcu aortse 
producta." 

" Descript. Anatora. Arterise innominatae et thyroidese imse. Cum tab. seneis. 
Jenae 1772." 



THE SUPRA-SCAPULAR. THE TRANSVERSE CERVICAL. 173 

thyroid cartilage, instead of passing inwards through the 
thyro-hyoid membrane ; and I have found it to pass to 
the interior of the larynx below that cartilage, immediately 
to the outer side of the crico- thyroid membrane see plate 
23, figures 4 and 5. A laryngeal artery of unusually 
large size has in one case plate 23, figure 6 been seen to 
course downward on the inner side of the thyroid cartilage, 
and to end in the thyroid body after having escaped from 
within, by the side of the crico-thyroid membrane. 

SUPRA-SCAPULAR ARTERY. 

Among the cases recorded in the table, the origin of the 
supra-scapular artery was placed 

Internally to the anterior scalenus muscle in . . . . 169 

under the muscle in 3 

beyond it in *...... 14 

The artery is usually derived from the thyroid axis, but, 
not unfrequently, has a different mode of origin. It was 
observed to arise directly from the subclavian, or in connexion 
with some other branch than the thyroid e. g. the transverse 
cervical in thirty-two instances. These include four cases 
in which it was derived from the internal mammary plate 24?, 
figure 6. The supra-scapular was found to arise from the 
axillary artery in three of the bodies registered in the table- 
plate 24, fig. 7 ; and one example occurred of its origin from 
the sub-scapular branch of that artery plate 25, fig. 1. I 
have observed the variations here referred to in several other 
cases not included in the table. 



THE TRANSVERSE CERVICAL, THE SUPERFICIAL CERVICAL, 
AND THE POSTERIOR SCAPULAR ARTERIES. 

A comparison of the best treatises on Anatomy will show 
considerable discrepancies as to the nomenclature and the 
description of the arteries known under these names. These 
discrepancies are attributable to the fact that the arrangement 
of the vessels varies considerably, and probably, also, to the 
neglect of the writings of their predecessors, on the part of 
the authors of some anatomical works. 



174 THE SUBCLAVIAN ARTERIES -THEIR BRANCHES. 

The names assigned to the branches in the table and in the 
following observations have been made to correspond with 
those used in the anatomical treatises in general use in this 
country. The remarks contained in the note * will show how 

* Haller ("Icon. f Anatom." fascic. 2, p. 17 and 19) describes two arteries. According 
to his description one arises from the thyroid axis, and, after crossing the neck, ramifies 
in the muscles ; this is named " ramus transversus colli." The other artery which 
arises from the subclavian artery externally to the anterior scalenus muscle and passes 
through the nerves of the brachial plexus to be distributed, &c. is designated ' cervi- 
calis superficialis." Was this name (as M. Cruveilhier conjectures) applied in conse- 
quence of the comparatively superficial origin of the artery ? 

Murray (" Descript. Arter. Corp. Hum. in tab. redact." Ed. altera p. 49,) describes 
likewise two separate arteries, and uses the same nomenclature. He thus speaks of the 
" cervicalis superficialis." " Uncise dimidise a scaleno primo distantia ex superiore atque 
anteriore arterise facie enascitur, tumque statim inter nervos brachiales se abscondit," &c. 

Scemmering appears to recognise two distinct branches, and speaks of that given from 
the third part of the subclavian artery under the name *' cervicalis superior sive super- 
ficialis." " De Corp. Hum. Fabrica," t. 5, p. 183. 

J. Bell follows the same arrangement of the arteries as the preceding writers. 
He describes " the transverse artery of the neck, or transversalis colli," as a branch of 
the inferior thyroid; and remarks, under the head " arteria cervicalis superficialis," 
" The subclavian artery has got from under the muscle, and has passed the splenii a 
little way before it gives off this superficial cervical." " The Anat. of the Human 
Body," by J. and C. Bell, 7th ed. vol. 2, p. 163. 

Bichat mentions but one artery, which he names " artere scapulaire posterieure," and 
describes it as arising frequently from the inferior thyroid, and occasionally from the 
axillary (the subclavian externally to the scalenus muscle). " Anat. Descript. t. 4, 
p. 222 nouv. edit." 

Boyer describes but a single branch, naming it " artere cervicale transverse." 
He speaks of the origin in the same manner as Bichat, and, in treating of the branches 
given at the side of the neck, says " Parmi ces rameaux, il y en a ordinairement un 
plus considerable, auquel on pourroit donner le nom d'artere cervicale superficielle, 
parce qu'il se perd dans le tissu cellulaire et dans la peau de la partie inferieure et 
late'rale du cou." " Traitd Complet d'Anat." t. 3, p. 76, Edit. 4. 

J. F. Meckel applies the designation " Oberflachliche oder quere Nackenpulsader " 
to the single vessel which he describes thus making the names superficial cervical and 
transverse cervical synonymous. " Handbuch der Mcnschlich. Anat." B. 3, S. 148. 

Tiedemann and Weber describe two separate branches corresponding in distribution 
to the third mode of arrangement mentioned in the text. In the works of these 
anatomists, the small branch given from the thyroid is named " arteria cervicalis 
superficialis ". and the larger branch which arises directly from the subclavian is 
denominated " arteria trans versa colli, seu, dorsalis scapulae." 

" Icones Arler." tab. 6 and 10, and " F. Hildebrandt's Handbuch der Anat. des 
Menschen, besorgt von E. H. Weber." Edit. 4. 

H. Cloquet, like Bichat and Boyer, mentions one artery only, and to designate 
it, he combines the names used by them. This anatomist gives the distinctive 
appellation superficial cervical (" artere cervicale superficielle") to one of the branches 
apparently following up the suggestion in the extract from Boyer' s work. " Trait<5 
d'Anat. Descript." t. 2, p. 462, Edit. 5. 

Considering the influence which the treatises of Bichat and Boyer have exercised 
on the modern Anatomical works of this country, it is very probable that the present 
manner of viewing the arteries in question has been derived from them, and that the 
change in the application of the name " superficial colli" is due to one of them. 

Professor Harrison, ("The Surgical Anatomy of the Arteries," &c. vol. 1, p. 
130,) speaks of the "Transversalis Colli" as dividing "into two principal branches, 
viz. the arteria cervicalis superficialis and arteria scapularis posterior ;" and in describ- 
ing the latter, states the fact that it " frequently arises distinctly from the trunk of the 
tubclavian artery external to the scaleni muscles." 



THE TRANSVERSE CERVICAL. THE POSTERIOR SCAPULAR. 175 

far they agree, and in what respect they differ from the no- 
menclature introduced or adopted by some of the ablest 
anatomists. 

The examination of a large number of bodies has shown 
that the arteries under consideration present one of three 
distinct modes of arrangement ; the deviations from these 
are so slight, that every case may be readily assigned to 
one or other of them. 

(1.) A considerable artery (transverse cervical arteria 
transversalis colli) arises from the thyroid axis with the supra- 
scapular, and crosses the side of the neck at some distance 
above the clavicle and the last-named artery, as far as the 
levator anguli scapulae, close to which muscle it divides into 
two principal branches, a. One of these (the superficial cer- 
vical arteria superficial cervicis) runs superficially to the 
muscle just named, and ramifies under the trapezius, distri- 
buting branches to it and the muscles beneath it. b The 
other branch (posterior scapular arteria scapularis poste- 
rior) lies much more deeply than the preceding ; it sinks 
under the levator anguli scapulae, and turns downwards along 
the base of the scapula, beneath the rhomboid muscles. 

This disposition of the arteries existed in the body, of 
which the second plate is a representation. 

(2.) There are two separate arteries of nearly equal size. 
a. One arises as in the preceding case from the thyroid, and 
has the same course across the neck. It ends in branches 
under the trapezius muscles. From the similarity of the 
distribution of this artery to the superficial branch of the 
transverse cervical noticed in the foregoing paragraph, this is 
entitled to the same name (superficial cervical), b. The 
second artery usually arises from the third part of the sub- 
clavian, and, like the deep branch in the former case, is 
directed along the posterior margin of the scapula under 
the same muscles. This must obviously be named the 
posterior scapular artery. 

This mode of arrangement of the vessels is illustrated in 
the first and sixteenth plates. 

(3.) In this as in the second case there are two arteries ; but 
one is much smaller, and the other larger, than those which 



176 THE SUBCLAVIAN ARTERIES THEIR BRANCHES. 

belong to that arrangement, a. The first artery is very 
slender. Arising from the thyroid, it has the usual course of 
the transverse cervical, and is expended in small ramifications 
at the side of the neck between the sterno-cleido-mastoid 
and the trapozius muscles. This might be considered to 
correspond to a part of the superficial cervical, b. An artery 
of considerable size given from the third part of the subclavian 
divides opposite the levator anguli scapulae into two principal 
divisions. One of these supplies the trapezius with the 
muscles which it covers, and may be regarded as correspond- 
ing to the greater part of the superficial cervical of the 
other cases. The other division of the artery has the usual 
course of the posterior scapular. 

The disposition of the arteries here pointed out was present 
in the body from which the third and the nineteenth plates were 
drawn. The size, the division, and the arrangement of the 
vessels are illustrated in the latter plate. 

Transverse cervical artery. This vessel may, according to 
the above statement, be regarded as the common trunk of the 
superficial cervical and the posterior scapular. 

In the bodies registered in the table, it was found to 
arise 

Internally to the anterior scalenus muscle in .... 120 cases 

under that muscle in . . . . . . . . 11 

beyond it in . . . . . . . . . (I 

The artery is generally derived from the thyroid axis, but 
the origin was found 

Connected to other branches than the thyroid usually to the supra- 
scapular alone, occasionally to this branch and the internal 
mammary conjointly in .16 cases 

It arose singly from the subclavian in 14 

Branches. The ascending cervical artery is occasionally a 
branch of the transverse cervical. Four examples are noticed 
in the table. 

Posterior scapular. The origin of this artery as a separate 
branch of the subclavian, is noted in the table as 

Internal to the anterior scalenus muscle in .... 1 instance. 

under it in . . . . . ... 43 

beyond it in .... .... 101 



THE SUPERFICIAL CERVICAL. THE ASCENDING CERVICAL. 177 

It usually extends as far as the lower angle of the scapula. 
I have sometimes seen it end opposite the spine of that bone, 
and in such cases one or two of the posterior branches of 
the intercostal arteries were distributed instead of this 
vessel. 

Branches. Besides those usually derived from it, the 
" profunda cervicis" took origin from the posterior scapular 
in four cases. 

Superficial cervical. The artery, noticed under this name 
in the second and third of the modifications described above, 
has occasionally some peculiarities in its origin. 

In the table it is stated to have arisen 

From the supra-scapular artery in . . . .7 cases 

directly from the subclavian in . . . . . . 2 

" from the thyroid artery in 1 

THE ASCENDING CERVICAL ARTERY. 

The origin. This branch usually arises from the inferior 
thyroid, where that vessel is about to incline inwards behind 
the common carotid artery ; but it is occasionally derived from 
the subclavian artery directly or from one of the branches, e. g. 
the transverse cervical : the supra-scapular : a trunk common 
to these two arteries : and the superficial cervical. Illus- 
trations of these variations in the origin will be found in 
plate 21, figures 5, 7, and 9: plate 23, figures 3, 8, and 10 : 
and plate 24, figures 1 and 6. 

The ascending cervical is sometimes of much larger size 
than usual, and takes the place of the occipital, which is 
ordinarily a branch of the external carotid. Five examples 
of this variation are noted in the table. When the occipital 
has this mode of origin, it generally occupies the usual position 
of that vessel in reference to the muscles and to the bones. 
I have occasionally seen it lie below the transverse process of 
the atlas instead of being above that bone. See plate 24, fig 3. 

Branches. The most remarkable peculiarity in reference 
to the branches is, that one is occasionally found to take the 
place of the "profunda cervicis" at the upper part of the 
neck when that artery is small. This peculiarity is stated in 
the table to have occurred in seven instances, but I have seen 



178 THE SUBCLAVIAN ARTERIES THEIR BRANCHES. 

a greater number. It is represented in the third figure of 
the 25th plate. 

THE INTERNAL MAMMARY ARTERY. 

The condition of this artery was noted in the table in 297 
instances those of the right and of the left side being added 
together. 

The origin was found to be placed 

RIGHT. LEFT. 

Internally to the anterior scalenus muscle in . 290 

Under that muscle in see plate 21, figure 6.01 1 

Beyond itplate 21, figures 7, 8, 10 . . . 2 4 6 

When the origin is placed externally to the scalenus, the 
distance from the muscle varies. In one of the cases above 
referred to, the internal mammary arose beyond the first rib, 
and therefore from the axillary artery (plate 24, figure 4). 

I have not seen any example of this vessel deviating to any 
extent from its usual position in the opposite direction i. e. 
inwards or towards the aorta. Neubauer saw one case in 
which it was derived from the innominate artery, and 
Boehmer* has given the description and a figure of one in 
which it arose from the arch of the aorta. In Neubauer's 
case " the innominate artery, at the distance of three Paris 
lines from its origin, gave off the right internal mammary. 
This branch made immediately a peculiar curve under the 
subclavian vein, and passed forwards and to the right side, 
across the superior vena cava, &c. &e."-f- 

Instead of arising directly from the subclavian artery, the 
internal mammary was found connected at its origin with 
some of the other branches, or derived from them in 20 cases. 

They were disposed as follows : 

RIGHT. LEFT. 

Combined with the thyroid axis or'arising from it . 6 9 1 /> 

" with the common trunk of the supra- 1 

scapular and the transverse cervical in J 3 2 6 

Branches. The internal mammary occasionally gives rise 
to the supra-scapular. This occurred in four of the cases 
noticed in the table, and a representation of it is given in 
the sixth figure of the twenty-fourth plate. A bronchial 
branch of considerable size was observed to arise from this 

* Ante, p. 53, and plate 6, figure 12. f Erdmann, loc. citat. p. 37. 



THE SUPERIOR INTERCOSTAL. 179 

artery in four of the same cases ; an example of such a branch, 
but of more than usual size, is shown in plate 24, fig. 5. 

I have more than once seen a branch descend from the inter- 
nal mammary and run vertically at the side of the thorax, cross- 
ing the internal surface of a few of the ribs about their 
middle. Otto mentions two cases observed by himself in 
which such branches were present, and he adds this comment, 
" that the anomaly may, in penetrating wounds of the chest, 
fractured ribs, &c., give rise to internal hemorrhage."" * 

THE SUPERIOR INTERCOSTAL ARTERY. 

The table contains reference to the state of this artery in 
276 cases, 161 being on the right side, and 115 on the left. 
The origin was found as follows : 

RIGHT. LEFT. 

Internally to the anterior scalenus muscle . . . 24 61 

Under that muscle . . . . . . . 134 54 

Externally to it 

From the vertebral artery 2 

thyroid 1 

From this statement it appears that on the right side the 
artery arose most frequently beneath the scalenus ; and that 
on the left side the origin was placed somewhat more 
frequently to the inner side of the muscle than beneath it. 

The size varies frequently, and with it the extent to which 
the vessel reaches. In general the artery supplies two inter- 
costal spaces, sometimes three or only one ; and in rare casts 
it is altogether wanting. 

I have in a few instances seen the intercostal artery pass 
between the necks of one or two ribs and the transverse pro- 
cesses of the dorsal vertebrae ; and in one instance, after arising 
from the vertebral artery it descended through the foramen 
in the transverse process of the last cervical vertebra, and then 
continued between the bones just named see plate 22, 
figure 5. 

Branches. Besides those to the intercostal spaces, the 
superior intercostal usually furnishes one or two slender offsets 

* Compendium of Human and Compar. Pathol. Anat. transl. by South, p. 302, 
and " Neues Verzeichniss der Anat. Sammlung, &c., 7.11 Breslati." ppn 1927. In 
the preparation mentioned in the latter publication the unusual branch existed on 
both sides. 



180 THE SUBCLAVIAN ARTERIES. 

along the nerves to the spinal canal (plate 25, fig. 3) ; and in 
most cases the deep cervical is a branch of this artery. 



THE DEEP CERVICAL ARTERY. AR. PROFUNDA CERVICIS. 
This artery is represented in the first figure of the eighteenth 
plate. 

The origin. Among 285 cases it arose 

from the suhclavian in . . .14 abt. 1 in 20^ 

from the posterior scapular in . 5 

from the superior intercostal or was con- 
joined with that vessel at its origin . 266 

Of the cases in which the " profunda " was a separate 
branch of the subclavian, it arose 

internally to the anterior scalenus muscle in Right 3 

Left 2 

5 

under it in Right 6 

Left 3 



In consequence of the constancy with which it is derived 
from the superior intercostal, the deep cervical might be 
considered analogous to the posterior branch of the aortic 
intercostal arteries, from which it differs only in being of 
greater size. 

The deep cervical artery is in most cases directed to its 
destination at the back part of the neck between the last 
cervical vertebra and the first rib ; but the deviations from 
this position are not unfrequent. In some instances it 
inclined backwards between the transverse processes of the 
sixth and seventh vertebrae. In seventeen cases it separated 
from the superior intercostal within the chest, and passed 
backwards below the first rib and the transverse process of 
the first dorsal vertebra (in a few instances, between these 
bones) : and it was occasionally placed below even the second 
rib see plate 25, figure 2. 

The " profunda " was not unfrequently of small size, and 
when this occurred, another or supplemental branch was 
found to make up for the defect ; so that in such cases 



THE VEINS. 181 

two deep cervical arteries were present. The additional artery 
took origin in some cases (as well as the ordinary branch) 
from the intercostal one being situated below, the other 
above the first rib ; and it was seen to emanate very rarely, 
however from the posterior scapular and from the inferior 
thyroid. But most frequently the second " profunda " derived 
its origin from the ascending cervical branch of the inferior 
thyroid, and took its course backwards beneath the transverse 
process of the third cervical vertebra ; this occurred in seven 
of the cases recorded in the table, and it is represented in 
plate 25, figure 3. 

Besides the foregoing branches, which are all of consider- 
able size, a very slender artery is frequently given from the 
subclavian, while under cover of the anterior scalenus muscle. 
This little artery has received no name ; it ramifies among the 
nerves of the brachial plexus and in the spinal canal, see plate 
18, figure 2. There are occasionally more small branches 
of this kind than one. 



THE VEINS CONNECTED WITH THE SUBCLAVIAN ARTERIES. 

The ordinary disposition of the veins, which are in the 
immediate neighbourhood of the subclavian arteries, will, in 
the first place, be briefly referred to ; and, secondly, the pecu- 
liarities which occur in these vessels will be noticed. 

a. The subclavian vein lies below the level of the subclavian 
artery, and is almost altogether concealed by the clavicle, 
whereas the artery is, to a greater or less extent, higher than 
that bone ; and the second division of the artery being behind 
the scalenus muscle, at the same time that the vein is in front 
of it, these vessels are here separated one from the other to a 
greater degree than in any other part. The first division of the 
artery is crossed immediately to the inner side of the scalenus 
muscle, by the internal jugular and the vertebral veins plate 
2 and plate 17, figure 1. In the last division of its course, 
the artery is covered more or less completely in different 
cases by the external jugular vein, which receives in this 
situation two other venous branches, namely, the supra- 
scapular and the transverse cervical, those which accompany 

s 2 



182 THE SUBCLAVIAN ARTERIES. 

the arteries thus named. The veins here referred to, and 
their position with respect to the arteries, are shown in the 
second and seventeenth plates, 

Some peculiarities of the Veins. I have not observed any 
instance of change of the position, or other remarkable pecu- 
liarity of the subclavian vein. M. Robert describes a case in 
which the subclavian vein having been, as is stated, higher 
than usual and in front of the artery, was transfixed and 
in part included in a ligature, in an attempt to tie the subcla- 
vian artery.* A case is recorded by M. Blandin in which there 
occurred a more remarkable departure of this vein from its 
usual position. It was placed between the scaleni muscles 
with the artery. -f 1 M. Velpeau J states that he observed an 
example of the vein similarly placed. Morgagni in one 
instance found, on both sides of the same body, two venous 
trunks placed side by side, instead of the usual subclavian 
vein. On the right side, the two parts into which the 
vein was divided, were of equal size, and about five inches 
in length. They began in the axillary vein, and reached 
to the point at which the , internal jugular ends. On the 
left side, the divisions were of unequal size one being 
very slender and as they measured less than two inches in 
length, they included but little of the axillary vein. 

The anterior jugular vein. This vein is not constant, but 

* " Un homrae qui portait une tumeur anevrismatique de 1'artere sous-claviere 
developpee en avant, fut soutnis a la ligature de cette artere a sa sortie des sealeries. 
La tumeur ge"nait beaucoup I'ope'rateur ; cependant une partie que 1'on crut 6tre 
1'artere, car dtaut soulevee les pulsations cesserent dans la tumeur, fut comprise dans la 
ligature. Des accidens graves se manifest^rent ; le malnde succomba. A 1'atitopsie, 
on trouva que les parties embrasse'es dans la ligature etaient un des nerfs du plexus 
brachial, et de plus une partie de la veine sous-clavie're que 1'instrnment et le 111 avaient 
perce"e de part.en part. Ici existait, comme le demontra la dissection, la variete' dont 
je parle, c'est-a-dire que la veine sous-claviere passait tres-haut an devant des sca- 
lenes," &c. Journal des Progrs des Sciences et Institutions Medicales, p. 203, 
vol. 7, 1828. 

f " Mais ce qui est excessivement rare, et ce que j'ai vu une seule fois, c'est le 
passage de la veine axillaire avec 1'artere de ce noui dans Tintervalle des muscles 
scalenes." Traite d' Anatomic Topographique, &c. p. 210. 

J Traite Complet d'Anat. Chirurg, t. 1, p. 494. 

" Subclavia vena dextra ex duabus constabat quse in axillari jam incipientes, 
non ante in unam confluebant quaro ad ostium accessissent Jugularis internse, et 
insula fieret longa digitos transversos quinque. Erant autem duae illse quac insulam 
comprebendebant, venae pari ainbae crassitudinc ; et a sinistris in Axillari vena erat 
insula multo brevior, quippe non longa digitos duos, imparibusque comprehensa venis, 
altera videlicet multo quam altera, tenuiore." De Sedib. et Causis Morborum, &c. 
Epist. 69, art. 2. 



THE NERVES. 183 

its presence is of frequent occurrence. It has been already 
mentioned and delineated in connexion with the common 
carotid artery page 14 and plate 4, figure 3. From the 
neighbourhood of that artery, the vein inclines obliquely out- 
wards, under the sterno-cleido-mastoid muscle, and, after 
crossing the anterior scalenus, ends either in the external 
jugular or directly in the subclavian vein plate 2 and plate 
17, figures 1 and 2. 

The external jugular is, in some cases, double, and in 
others of but very small size. In one instance, this vein 
instead of terminating directly at the root of the neck, 
descended over the clavicle, and, after turning inwards 
between that bone and the subclavius muscle, joined the 
subclavian vein plate 25, figure 4. 

The supra-scapular and the transverse cervical veins, are 
occasionally directed inwards over the anterior scalenus 
muscle to join the internal jugular ; or one of them may 
be found to have this disposition, while the other ends in the 
external jugular as usual. In some instances, these veins 
form a plexus over the third part of the subclavian artery, by 
means of communicating branches, extending from one to the 
other. 

Not unfrequently a small vein courses along the subclavian 
artery, in the manner represented in the second figure of the 
seventeenth plate. 

Cephalic vein. This vein, in almost all cases, ends below 
the clavicle in the axillary vein ; but in one body which came 
under my observation, it extended upwards over the clavicle, 
and terminated with the external jugular in the subclavian 
vein. When the cephalic vein has this disposition, it would 
bear important relation to an operation on the subclavian 
artery see plate 25, figure 5. 



THE NERVES CONNECTED WITH THE SUBCLAVIAN ARTERIES. 

I have noticed but few deviations from the ordinary ar- 
rangement of the nerves, situated in the immmediate neigh- 
bourhood of the subclavian arteries. 

Pneumogastric nerve N. vagus. When the subclavian artery 



184 THE SUBCLAVIAN ARTERIES. 

and the aorta have their usual course, this nerve has not been 
observed so far as I know to present any remarkable de- 
parture from the ordinary disposition ; but some of the vari- 
ations of the vessels are accompanied by changes in the nerves 
which require notice. 

In the cases in which the right subclavian artery arose 
from the left side of the arch of the aorta, the inferior laryn- 
geal nerve was found, in all the instances in which its condi- 
dition was noticed, to arise opposite the lower part of the 
larynx, whence it was directed inwards behind the common 
carotid artery.* The nerve, when so disposed, can scarcely 
be named " recurrent," inasmuch as it has but little of the 
direction which that designation implies. 

Professor Hart, in the paper referred to, which was written 
with the view of accounting for this condition of the laryngeal 
nerve, makes the following observations. 

" In the earlier periods of the existence of the foetus, the 
rudiment of the head appears as a small projection from the 
upper and anterior part of the trunk, the neck not being yet 
developed. The larynx at this time is placed behind the 
ascending portion of the arch of the aorta; while the brain, as 
it then exists, is situated so low, as to rest on the thymus 
gland, and front of that vessel. Hence it is, that the inferior 
laryngeal nerves pass back to the larynx, separated by the 
ascencling aorta, the left going through its arch, while the right 
goes below the arteria innominata. 

" As gestation advances, the head becomes more distinct 
and the neck begins to be formed after the second month, 
which, as it lengthens, has the effect of removing the brain 
upwards to a greater distance, and of drawing out the larynx 
from the chest, in consequence of which, the nerves of the par 
vagum and their recurrents become elongated, and hence the 
circuitous route the latter are found to take afterwards, form- 
ing loops in which the aorta and right subclavian artery are, 
as it were, suspended." 

When the arch of the aorta is directed to the right instead 
of to the left side, the laryngeal nerves probably undergo a cor- 

* Dr. Stcdman, in Edirib. Med. and Surg. Journal, 1823. Dr. Hart, in same 
Journal, 1826. Also plate 12, fig. 4, and plate 20, fig. 5. 



THE NERVES. 185 

responding change the nerve of the right side winding round 
the aorta, and that of the left side ascending from behind the 
subclavian artery. The condition of the nerves is not stated 
in the account of these cases ; but in the delineation given of 
one, they appear to have that disposition. See plate 7, 
figure 3. In the description accompanying his representa- 
tion of the case from which ours is copied Bernhard makes 
no mention of the nerves. 

In one of those singular cases the only one in which the 
arrangement of the nerves has been recorded in which the 
arch being directed over the right bronchus, the left subcla- 
vian artery arises from a pouch,* the laryngeal nerve of 
the right side took its upward course behind the arch of 
the aorta ; and the nerve of the left side was found to turn 
round the ligamentum arteriosum.f Plate 7, figure 1. 

Phrenic nerve. This nerve generally crosses very obliquely 
from the outer to the inner side of the anterior scalenus, and 
is separated from the subclavian artery by a few of the inner- 
most fibres of the muscle ; but occasionally it is in contact 
with the artery. 

I have, in one instance, seen the nerve cross the subclavian 
artery on the outer side of the muscle, over which it was then 
directed obliquely inwards to the thorax. The unusual position 
of the nerve was accompanied by a change in the place of 
origin of the thyroid axis. This artery arose from the third 
division of the subclavian. Now the nerve is often in contact 
with the outer side of the thyroid axis especially on the left 
side, and, as in the case under observation, it has the same 
position, it may be supposed to be, as it were, borne outwards 
by the artery see plate 21, figure 7. 

The phrenic nerve, in two bodies, lay in front of the subcla- 
vian vein, instead of being, as it usually is, behind that vessel.J 

* Ante, page 160. 

f " Non ea quoque praetermittenda, quae ad paris vagi ramorum ad laryngem recur- 
ventium retroflexionem spectabat. Nempe recurrens dexter sub ipso aortse arcu et 
circa eum flectebatur, sursum procedens, sinister vero circa canalem arteriosum, jam in 
ligamentum mutatum, reflexus ad laryngem procedebat." Sandifort, loc. citat. 

ijr Plate 25, figure 6. One of these cases was shown to me by Mr. Listen. 



186 THE SUBCLAVIAN ARTERIES. 

THE MUSCLES IN THE IMMEDIATE NEIGHBOURHOOD 
OF THE SUBCLAVIAN ARTERIES. 

Sterno-cleido-mastoid and trapezius. The interval between 
these muscles is very various in different bodies. The greater 
part of the breadth of the former at its lower end is due to 
the fibres connected to the clavicle. This portion of the 
muscle is, in some instances, very narrow, and does not 
exceed in width the tendon connected to the sternum ; in 
other cases, on the contrary, it reaches as far nearly as the 
middle of the clavicle, and conceals the whole of the subcla- 
vian artery. In one body the sterno-cleido-mastoid and 
trapezius were found actually in contact ; so that there was 
no space between the margins of the muscles, and the upper 
border of the clavicle gave origin to muscular fibres in its 
whole length see plate 25, figure 7. The muscles are seen 
of what may be considered an average size in plate 3 and 
plate 17, figure 2. 

The omohyoid varies considerably in size being in one case 
eo broad as to cover completely the subclavian artery beyond* 
the scalenus, and in another, on the contrary, so slender as 
scarcely to obscure any part of the vessel. It is usually in- 
tersected with tendon, and thus becomes digastric ; but some- 
times there is an interruption of only a portion of the muscu- 
lar fibres, and occasionally there is no trace of tendinous in- 
tersection plate 3 and plate 17, figure 2, illustrate these 
facts. 

This muscle is not unfrequently found to arise from the cla- 
vicle at nearly the middle of the bone, and to cover the sub- 
clavian artery. A case of this kind is represented in plate 25, 
figure 8. In the same figure a slip of muscle is seen to extend 
from the trapezius to the sterno-cleido-mastoid, over the sub- 
clavian artery.* 

Some variations in the disposition of the anterior scalenus 
muscle, with reference to the subclavian artery, have been 
mentioned in the observations upon the vessel ante page 
151, and they are illustrated in figures 1, 2, and 3 of plate 21. 

* In a case brought under my notice by Mr. J. P. Potter, a muscular slip of the same 
kind passed through the omohyoid in the interval between the trapezius and the sterno- 
inastoid. 



THE BONES. 187 

THE BONES IN THE NEIGHBOURHOOD OF THE SUBCLAVIAN 
ARTERIES. 

The only bones which have any bearing on the anatomy of 
the subclavian arteries are the clavicle and the first rib. The 
cervical rib may be alluded to, though it is very rarely met 
with, and still more rarely is it found of such size as to approach 
the artery. 

Reference has been previously made page 151 to the 
influence of the direction of the shoulders on the depth of the 
subclavian arteries. Further observations on the position of 
the clavicle and the first rib appear to me to be required. 

I have met with only one example of a cervical rib in 
connexion with the muscles and vessels. The osseous pro- 
jection was, in that case, close behind the artery : but the 
preparation was unfortunately destroyed, even before a draw- 
ing could be made from it. The representation of an unusu- 
ally good specimen of a prominent cervical rib will be found in 
plate 25, figure 9. The artery in this case lay probably in 
front of the elevated process of the nst dorsal rib to which 
the supplemental rib is connected at its anterior end. 



AXILLARY ARTERIES. 



THE abbreviations in this table are made in the same manner as in the foregoing tables 
namely, by the omission of letters from the end of the word : e. g. " circumfl." stands 
for circumflex ; " dorsal." for dorsalis ; "prof." for profunda ; "scap." for scapula; 
' subscap." for subscapular ; " super." for superior ; thor. 1 ' for thoracic. 

In some cases of prefixed names the initial letter only is retained ; thus " A." before 
circumfl. is used for anterior, and " P." in a like position stands for posterior. The 
letter * m." occasionally supplies the place of muscle, and " n." that of nerve, &c. 



No. 


Side 
of the 
Body. 


Trunk. 


Branches. 


la 


R 


I" is not embraced by 
< the nerves of the 


{P. Circumfl. and Subscap. arise by one trunk J the 
common' trunk is embraced by the nerves of the 






Lbrachial plexus. 


brachial plexus. 






f divides into two 




2a 


L 


J brs.; is not embraced 
1 by the nerves of the 


I" Subscap., P. Circumfl., and both Prof, arise by one 
\ trunk, which is embraced by the nerves. 






j^brachial plexus. 








/"divides into two 




3 


R 


I trunks, of nearly 
< equal size, at lower 
1 margin of subscap. 


/ Subscap., Super, and Infer. Prof., with A. and P. 
\ Circumfl., arise by one trunk. 






[m. 






L 


divides into two brs. 


f Ulnar arises at lower border of subscap. m. Brs. 
\ usual. 


3a 


R 


("divides into two 
< brs ; is not embraced 
|_by the nerves. 


f Super, and Infer. Prof., with A. and P. Circumfl. 
L arise by one trunk, which is embraced by the nerves. 


4b 


R 


usual. 


P. Circumfl. gives Super. Prof. 




L 


usual. 


P. Circumfl. gives Super. Prof. 


5a 


R 


usual. 


P. Circumfl. gives Super. Prof. 


6a 


R 


usual. 


P. Circumfl. ascends from Super. Prof. 




L 


usual. 


P. Circumfl. ascends from Super. Prof. 


7 


R 


usual. 


usual. 




L 


usual. 


usual. 


7a 


R 


usual. 


usual. 




L 


usual. 


usual. 



AXILLARY ARTERIES. 



189 



No. 


Side 
of the 
Body. 


Trunk. 


Branches. 


7b 


R 


usual. 


usual. 




L 


usual. 


usual. 


7c 


R 


usual. 


usual. 




L 


usual. 


usual. 


8 


R 


usual. 


P. Circumfl. ascends from Super. Prof. 




L 


usual. 


usual. .' ;; 


9 


R 


("divides into two 
I brs. ; is not em- 
| braced by the 
[_ nerves. 


f Subscap. with A. and P. Circumfl., and Super, and 
< Infer. Prof, by one trunk, which is embraced by 
|_the nerves. 




L 


usual. 


Supra-scapular is a br. of Axillary. 


9a 


R 


usual. 


usual. 




L 


usual. 


usual. 


9b 


L 


usual. 


P. Circumfl. ascends from Brachial. 


9c 


R 


usual. 


usual. 




L 


usual. 


usual. 


10 


R 


{divides into twobrs.; 
is not embraced by 
the nerves. 


("Several Thoracic brs. arise by one trunk. Subscap. 
I is a small br. Dorsalis Scap. and P. Circumfl., with 
| Super, and Infer. P., arise by one trunk, which is 
(^embraced by the nerves. 




L 


usual. 


usual. 


lOa 


R 


usual. 


Both Circumfl. and both Prof, arise by one trunk. 


10b 


R 


usual. 


usual. 




L 


usual. 


usual. 


11 


R 


usual. 


usual. 




L 


usual. 


usual. 


12 


R 


usual. 


usual. 




L 


usual. 


usual. 


13 


L 


usual. 


Subscap. and P. Circumfl. arise by one trunk. 


13a 


R 


usual. 


usual. 




L 


usual. 


usual. 


14 


R 


usual. 


Subscap. and P. Circumfl. arise by one trunk. 



190 



AXILLARY 'ARTERIES. 



No. 


Side 
of the 
Body. 


Trunk. 


Branches. 


15 


R 


usual. 


usual. 




L 


usual. 


usual. 


15a 


R 


usual. 


Subscap. and P. Circumfl. arise by one trunk. 




L 


j" divides into two 
< brs. at origin o 
{_ Circumfl. br. 


(" The Radial artery arises from inner side of Axillary 
< artery and crosses over it to the outer side. Brs. 
[ usual. 


15b 


R 


usual. 


usual. . 




L 


usual. 


usual. 


16 


R 


usual. 


usual. 




L 


isual. 


usual. 


17 


R 


usual. 


usual. 




L 


usual. 


usual. 


18 


R 


usual. 


Subscap. and P. Circumfl. arise by one trunk. 


19 


R 


usual. 


usual. 




L 


usual. 


usual. 


Ida 


R 


usual . 


usual. 




L 


sual. 


usual. 


19b 


R 


sual. 


usual. 




L 


sual. 


usual. 


19c 


R 


sual. 


usual. 




L 


sual. 


usual. 


19d 


R 


sual. 


sual. 




L 


sual. 


sual. 


20 


L 


sual. 


sual. 


21 


R 


SUctl* 


sual. 




L 


sual. 


sual. 


22 


R 


sual. 


sual. 




L 


sual. 


sual. 


23 


R 


sual. 


sual. 



AXILLARY ARTERIES. 



191 



No. 


Side 
of the 
Body. 


Trunk. 


Branches. 




L 


/'Besides the usiia 
I connexion with (he 
} nerves, it is crosscc 
(by ext. cutan. 
nerve, which is a br 
of the median. 


usual . 


23 a 


R 


usual. 


P. Circumfl. gives the Super. Prof. 




L 


usual. 





24 


R 


usual. 


f a long slender br. (Vas Aberrans) passes down from 
[ Axillary and joins Radial at its origin. 




L 


usual. 


usual. 


25 


R 


divides in to two brs. 


Subscnp., both Circumfl,., and both Prof, by one trunk. 




L 


divides into two brs. 


Subsoap., both Circumfl., and both Prof, by one trunk. 


26 


R 


usual. 


* 

usual. 




L 


usual. 


usual. 


27 


R 


usual. 


isual. 




L 


usual. 


isual. 


27a 


R 


isual. 


P. Circumfl. ascends from Super. Prof. 


28 


R 


usual. 


isual. 




L 


isual. 


isual. 


29 


L 


usual. 


JP. Circumfl. arises below teres maj. and latiss. 
\ dorsi m. 


30 


R 


isual. 


usual. 




L 


usual. 


isual. 


30 a 


R 


usual. 


usual. 




L 


usual. 


isual. 


31 


R 


usual. 


Both Circumfl. are given by one trunk. 




L 


ivides into two brs. 


f The Radial arises from inner side of Axillary, and 
< crosses to outer side over the larger artery. Brs. 
[ usual. 


31* 


R 


isual. 


f Subscap. arising higher than usual, gives a Thoracic 
< br. ; Dorsalis Soap., and A. and P. Circumfl., with 
[part of Prof, arise by one trunk. 




L 


isual. 


("A. and P. Circumfl. arise by one trunk; Super. 
[ Prof, is given from Axillary. 



192 



AXILLARY ARTERIES. 



No. 


Side 
c.f the 
Body. 


Trunk. 


Branches. 


31f 


R 


goal. 


Subscap. and P. Circumfl. arise by one trunk. 


31a 


R 


sual. 


usual. 




L 


sual. 


sual. 


31c 


R 


sual. 


Subscap. and P. Circuinfl. arise by one trunk. 




L 


sual. 


usual. 


3U 


R 


usual. 


f Subscap., both Circumfl. and a Thoracic br. arise 
\ by one trunk. 




L 


usual. 


f Subscap., both Circumfl. and a Thoracic br. arise 
{__ by one trunk. 


31d 


L 


.ivides into two brs. 


f Subscap., both Circumfl. and both Prof, arise by 
\ one trunk. 


32 


R 


usual. 


usual. 


33 


R 


isual. 


usual. 




L 


usual. 


usual. 


34 


L 


usual. 


usual. 


37 


R 


divides into two brs. 


f Subscap., both Circumfl. and both Prof, arise by 
\ one trunk. 


37a 


L 


usual. 


usual. 


33 


R 


divides into two brs. 


{Radial arises at subscap. m., and communicates by 
a cross branch with Brachial at bend of elbow. 
Brs. usual. 


39 


R 


usual. 


P. Circumfl. ascends from Super. Prof. 




L 


usual. 


P. Circumfl. ascends from Super. Prof. 


40 


L 


usual. 


usual. 


40 a 


R 


usual. 


J Subscap. and both Circumfl. arise by one trunk. 
\ Thoracic brs. are given by one trunk. 


41 


R 


usual. 


usual. 


41a 


R 


usual. 


P. Circumfl. ascends from Super. Prof. 


42 


R 


usual. 


usual. 


43 


L 


f divides into tw 
< brs.;isnotembrace( 
[ by the nerves. 


f Subscap., both Circumfl. and Super. Prof, arise by 
\one trunk, which is embraced by the nerves. 


44 


R 


usual. 


usual. 



AXILLARY ARTERIES. 



193 



No. 


Side 
of the 
Body. 


Trunk. 


Branches. 




L 


usual. 


usual. 


45 


R 


{dividesinto two brs.; 
is not embraced by 
the nerves. 


J Subscap., both Circumfl. and both Prof, arise by 
\ one trunk, which is embraced by the nerves. 




L 


usual. 


usual . 


47 


R 


f divides into two brs.; 
< is not embraced by 
[ the nerves. 


/ Subscap., both Circumfl. and both Prof, arise by one 
\ trunk, which is crossed by the nerves. 


48 


R 


usual. 


f S. and P. Scap. arise by one trunk at the junction 
\ of Subclav. and Axillary arteries. 




L 


usual. 


/ Dorsalis Scap. is a separate br. ; A. and P. Cir- 
\ cumfl. arise by one trunk. 


48a 


R 


usual 


usual. 


49a 


R 


usual. 


usual. 




L 


usual. 


usual. 


50 


R 


usual. 


usual. 




L 


{dividesinto two brs.; 
is not embraced by 
the nerves. 


/ Subscap., both Circumfl. and Super. Prof, arise by 
\ one trunk, which is embraced by the nerves. 


51 


R 


usual. 


Subscap. and P. Circumfl. arise by one trunk. 




L 


usual. 


Several Thoracic brs. are given from one trunk. 


52 


R 


usual. 


Subscap. and P. Circumfl. arise by one trunk. 




L 


usual. 


Subscap. and P. Circumfl. arise by one trunk. 


53 


R 


usual. 


P. Circumfl. ascends from Super. Prof. 




L 


usual. 


Subscap. and P. Circumfl. arise by one trunk. 


54 


R 


usual. 


P. Circumfl. ascends from Super. Prof. 




L 


usual. 


P. Circumfl. ascends from Super. Prof. 


56 


R 


["dividesinto two brs.; 
< at lower margin of 
[_subscap. m. 


f Radial arises from Axillary. P. Circumfl. ascends 
\ from Super. Prof. 




L 


usual. 


P. Circumfl. ascends from Super. Prof. 


57 


R 


usual. 


fSubscap. arises in two parts (Dorsalis Scap. being 
1 a distinct br.) ; P. Circumfl. and Super. Prof, arise 
| by one trunk ; the latter descends behind teres maj. 
{^and latissimus dorsi m. 



194 



AXILLARY ARTERIES. 



No. 


Side 
of the 
Body. 


Trunk. 


Branches. 




L 


usual. 


J Subscap. arises in two parts (Dorsalis Scap. being a 
|_ separate br. of Axillary). 


58 


R 


usual. 


P. Circumfl. gives Super. Prof. 




L 


usual. 


P. Circumfl. gives Super. Prof. 


59 


R 


usual. 


usual. 




L 


usual. 


usual. 


60 


R 


usual. 


usual. 




L 


usual. 


P. Circumfl. ascends from Super. Prof. 


61 


R 


usual. 


{Subscap. and Thoracica Longa arise by one trunk. 
Dorsalis Scap. is a separate branch. 




L 


f" divides into two 
< brs.; is not embraced 
|_ by the nerves. 


f Subscap., both Circumfl. and both Prof, arise by 
\ one trunk, which is embraced by the nerves. 


62 


R 


usual. 


f"P. Circumfl. given in two parts, one ascends from 
< Super. Prof. : a second, small one, arises in the 
|_ usual situation. 




L 


usual. 


Subscap., and P. Circumfl. arise by one trunk. 


63 


L 


usual. 


P. Circumfl. ascends from Super. Prof. 


64 


R 


usual. 


("P. Circumfl. gives Super. Prof., and a small br. is 
\also given in the usual situation of the latter. 




L 


usual. 


P. Circnrafl. gives Super. Prof. 


65 


R 


usual. 


("Subscap. and a Thoracic br. arise by one trunk. 
< Dorsalis Scap. nnd both Circumfl. aie also given by 
|_a common trunk. 




L 


usual. 


usual. 


G6 


R 


usual. 


usual. 




L 


usual. 


Subscap. and P. Circumfl. arise by one trunk. 


61 


R 


usual, 


Subscap. and P. Circumfl. arise by one trunk. 




L 


usual. 


Subscap., P. Circumfl. and aThor. br. arise by one trunk. 


6fl 


R 


usual. 


Subscap. and P. Circumfl. arise by one trunk. 




L 


usual. 


usual . 


69 


R 


usual. 


usual. 




L 


divides into two brs. 


f Subcap., both Circumfl. and both Prof, arise by 
\ one trunk. 



AXILLARY ARTERIES. 



195 



No. 


Side 
of the 
Body. 


Trunk. 


Branches. 


70 


R 


usual. 


f Thoracic. Acromial. gives three other brs. Subscap. 
(_ and P. Circumfl. arise by one trunk. 




L 


f divides into two brs. 
< is not embraced by 
[ the nerves. 


f Subscap., both Circumfl. and both Prof, arise by a 
\ common trunk, which is embraced by the nerves. 


71 


R 


usual. 


P. Circnmfl. ascends from Super. Prof. 




L 


usual. 


usual. 


72 


R 


usual. 


Subscap. and P. Circumfl. arise by one trunk. 




L 


usual. 


usual. 


73 


R 


usual. 


P. Circumfl. gives part of Super. Prof. 




L 


usual. 


usual. 


74 


R 


usual. 


usual. 




L 


usual. 


P. Circumfl. gives Dorsalis Scap. 


75 


R 


(" divides into two brs. 
< is not embraced by 
[the nerves. 


("Subscap., Super. Prof, and both Circumfl. arise by 
< one trunk, on which the nerves cross. Prof, passes 
[in front of latissimus dorsi m. 




L 


usual. 


Subscap. and P. Circumfl. arise by one trunk. 


76 


R 


divides into two brs. 


Radial arises from Axillary. Brs. usual. 




L 


usual. 


usual. 


77 


R 


usual. 


f" Subscap. arises 2^ inches higher than usual. A. 
< and P. Circumfl. arise by one trunk. S. Prof, 
[given from Axillary. 




L 


usual. 


/Subscap. 2 A inches higher than usual. A. and P. 
\ Circumfl. arise by one trunk. 


78 


R 


/'Two additional brs. 
1 of nerves cross from 
^ ext. cutan. n. to 
1 median over the 
^artery. 


f Thoracic brs. arise by one trunk. Subscap. arises 
-< 2^ inches above lower margin of subscap. m., and 
[gives P. Circumfl. 




L 


usual. 


Subscap. and P. Circumfl. arise by one trunk. 


79 


R 


usual. 


usual. 


80 


R 


usual. 


?. Circumfl. ascends from Super. Prof. 




L 


usual. 


?. Circumfl. ascends from Super. Prof. 


81 


R 


usual. 


Subscap. and P. Circumfl. arise by one trunk. 




L 


usual. 


Subscap. and P. Circumfl. arise by one trunk. 



196 



AXILLARY ARTERIES. 



No. 


Side 
of the 
Body. 


Trunk. 


Branches. 


82 


R 


usual. 


P. Circumfl. ascends from Super. Prof. 




L 


usual. 


P. Circumfl. ascends from Super. Prof. 


83 


R 


f divides into t wo brs.; 
< is not embraced by 
{_ the nerves. 


|" Subscap., both Prof., both Circumfl. and Ana- 
< stomotic arise by one trunk, which is embraced by 
(_ the nerves. 




L 


[" divides into two brs.; 
< is not embraced by 
[the nerves. 


f" Subscap., both Prof., both Circumfl. and Ana- 
< stamotic arise by one trunk, on which the nerves 
[ cross. 


84 


R 


usual. 


Subscap. and P. Circumfl. arise by one trunk. 




L 


usual. 


P. Circumfl. gives Super. Prof. 


85 


R 


usual. 


usual. 




L 


{divides into two brs. ; 
is not embraced by 
the nerves. 


/ Subscap., both Circumfl. and Super. Prof, arise by 
\one trunk. 


86 


R 


usual. 


usual. 




L 


usual. 


usual. 


88 


R 


usual. 


Subscap. and P. Circumfl. arise by one trunk. 




L 


usual. 


Thoracic brs. and P. Circumfl. arise by one trunk. 


89 


R 


usual. 


Subscap. and P. Circumfl. arise by one trunk. 






{is not crossed by 
median n. the heads 






L 


of which unite at 
the beginning of the 
lower third of the 


Subscap. and a Thoracic br. arise by one trunk. 






arm. 




90 


R 


usual. 


usual. 




L 


usual. 


usual. 


91 


R 


usual. 


usual. 




L 


usual. 


usual. 


92 


R 


usual. 


Subscap. and P. Circumfl. arise by one trunk. 




L 


usual. 


|~A. and P. Circumfl. arise by one trunk. P. Cir- 
< cumfl. gives part of Super. Prof., which lies behind 
[lat. dorsi m. 


93 


R 


usual. 


usual. 




L 


usual. 


usual. 


94 


R 


usual. 


Subscap. and P. Circumfl. arise by one trunk. 



AXILLARY ARTERIES. 



197 



No. 


Side 
of the 
Body. 


Trunk. 


Branches. 




L 


usual. 


Subscap. and P. Circumfl. arise by one trunk. 


95 


L 


usual. 


P. Circumfl. ascends from Super Prof. 


96 


R 


usual. 


Subscap. and P. Circumfl. arise by one trunk. 




L 


usual. 


Subscap. and P. Circumfl. arise by one trunk. 


97 


R 


usual. 


usual. 




L 


usual. 


usual. 


98 


R 


usual. 


Super. Prot is a br. of Axillary. 




L 


divides into two brs. 


J Radial arises immediately below the clavicle. Brs. 
\ usual. 


99 


R 


usual. 


/ S. Scap. is the first br. ; it arises opp. upper part of 
\ coracoid process. 




L 


usual. 


P. Circumfl. ascends from Prof. 


100 


R 


usual. 


P. Circumfl. ascends from Super. Prof. 




L 


usual. 


P. Circumfl. ascends from Super. Prof. 


101 


R 


usual. 


usual. 




L 


usual. 


usual. 


102 


R 


usual. 


Subscap. and P. Circumfl. arise by one trunk. 




L 


(" divides into two brs.; 
< is not embraced by 
[the nerves. 


("Subscap., both Circumfl. and Super. Prof, arise by 
\ one trunk, which is embraced by the nerves. 


103 


R 


("divides into two brs.; 
< is not embraced by 
(_ the nerves. 


^Radial arises opp. lower margin of coracoid process ; 
I nerves cross on the larger and deeper trunk. Sub- 
< scap. arises in two parts. (Dorsal. Scap. is a dis- 
I tinct branch of the Axillary.) Both Circumfl. arise 
l^by one trunk. 




L 


usual. 


Both Circumfl. arise by one trunk. 


104 


R 


usual. 


usual. 




L 


usual. 


usual. 


105 


R 


usual. 


usual. 




L 


usual. 


usual. 


106 


R 


usual. 


J" Subscap. arises in two parts. (Dorsal. Scap. is a 
\ distinct br. of the Axillift-y.) 




L 


usual. 


usual. 



T 2 



198 



AXILLARY ARTERIES. 



No. 


Side 
of the 
Body. 


* Trunk. 


Branches. 


107 


R 


usual. 


usual. 




L 


divides into two brs. 


Radial arises opp. tbe head of humerus. Brs. usual. 


108 


R 


usual. 


Both Circumfl. arise by one trunk. 




L 


usual. 


Subscap. and P. Circumfl. arise by one trunk. 


109 


R 


usual. 


usual. 




L 


usual. 


P. Circumfl. ascends from Super. Prof. 


110 


R 


usual. 


usual. 




L 


usual. 


Both Circumfl. arise by one trunk. 


111 


R 


usual. 


Both Circumfl. arise by one trunk. 




L 


usual. 


/ Subscap. arises in two parts. (Dorsal. Scap. is a 
\ distinct br. of the Axillary.) 


112 


R 


usual. 


usual. 




L 


usual. 


usual. 


113 


R 


usual. 


?. Circumfl. gives Super. Prof. 




L 


usual. 


usual. 


114 


R 


usual. 


Subscap. and P. Circumfl. arise by one trunk. 




L 


divides into two brs. 


Ulnar arises opp. head of humerus. Brs. usual. 


115 


R 


usual. 


Subscap. gives Super. Prof. 




L 


usual. 


Subscap. gives Super. Prof. 


116 


R 


usual. 


usual. 




L 


usual. 


usual. 


117 


R 


usual. 


usual. 




L 


divides into two brs. 


f Ulnar arises one inch above lower margin of 
\Subscap. m. Brs. usual. 


118 


R 


J" divides into two brs. 
\ of nearl y equal size. 


/Subscap., both Circumfl. and both Prof, arise by 
\ one trunk. 




L 


usual. 


Both Circumfl. arise by one trunk. 


119 


R 


usual. 


J Subscap. and a Thoracic br. arise by one trunk. 
\ Both Circumfl. arise by one trunk. 




L 


usual. 


usual. 


120 


R 


usual. 


usual. 



AXILLARY ARTERIES. 



199 



No. 


Side 
of the 
Body. 


Trunk. 


Branches. 




L 


/divides into two br 
\ of nearly equal size 


J" Subscap., 'both Circumfl. and Super. Prof, arise by 
\ one trunk. 


122 


R 


usual. 


Subscap. and P. Circumfl. arise by one trunk. 


123 


L 


usual. 


Subscap. and P. Circumfl. arise by one trunk. 


124 


R 


usual. 


P. Circumfl. ascends from Super Prof. 




L 


usual. 


P. Circumfl. gives Super. Prof. 


125 


R 


usual. 


usual. 




L 


usual. 


usual. 


126 


L 


usual. 


usual. 


127 


R 


usual. 


A. and P. Circumfl. arise by one trunk. 




L 


usual. 


usual. 


128 


R 


usual. 


i*. Circumfl. ascends from Super. Prof. 




L 


usual. 


Subscap. and both Circumfl. arise by one trunk. 


129 


R 


usual. 


P. Circumfl. ascends from Super. Prof. 




L 




TBesides the usual branches a Vas Aberrans is given 
I off, which arises from the Axillary and proceeds 
1 superficially to the Brachial artery to join the 
(^Radial soon after its origin. 


130 


R 


usual. 


usual. 




L 


sual . 


P. Circumfl. ascends from Super. Prof. 


131 


R 


sual. 


Nearly usual. 




L 


sual. 


T Subscap., Thoracica Longa and P. Circumfl. arise 
^ by one trunk. 


132 


R 


sual. 


sual. '-' - 




L 


sual. 


sual. 


133 


R 


sual. 


sual. 




L 


sual. 


oth Circumfl. arise by one trunk. 


134 


R 


sual. 


. Circumfl. ascends from Super. Prof. 




L 


sual. 


i*. Circumfl. ascends from Super. Prof. 


135 


R 


sual. 


sual. 




L 


sual. 


ubscap. and both Circumfl. arise by one trunk. 



200 



AXILLARY ARTERIES. 



No. 


Side 
of the 
Body. 


Trunk. 


Branches. 


136 


R 


usual. 


f Subscap. and a Thoracic br. arise by one trunk. 
\ Dorsalis Scap. a separate br. 




L 


usual. 


f Subscap. and a Thoracic br. arise by one trunk. P. 
\ Circumfl. ascends from Super. Prof. 


137 


R 


usual. 


usual. 




L 


usual. 


usual. 


138 


R 


usual. 


nearly usual. 




L 


usual. 


Subscap. and a Thoracic br. arise by one trunk. 


138" 


R 


usual. 


Both Circumfl. arise by one trunk. 


139 


R 


usual. 


Subscap. and P. Circumfl. arise by one trunk. 




L 


usual. 


Subscap. and P. Circumfl. arise by one trunk. 


140 


R 


usual. 


usual. 




L 


usual. 


usual. 


141 


R 


usual. 


usual. 


145 


R 


usual. 


f Subscap. and a Thoracic br. arise by one trunk. 
\Both Circumfl. arise by one trunk. 




L 


usual. 


usual. 


146 


R 


usual. 


usual. 




L 


usual. 


usual. 


147 


R 


usual. 


usual. 




L 


usual. 


usual. 


148 


R 


usual. 


usual. 


149 


R 


usual. 


usual. 




L 


usual. 


usual. 


150 


R 


usual. 


usual. 




L 


usual. 


Both Circumfl. and Super. Prof, arise by one trunk. 


151 


R 


usual. 


P. Circumfl. ascends from Super. Prof. 




L 


usual. 


Both Circumfl. arise by one trunk. 


152 


R 


usual. 


P. Circumfl. ascends from Super. Prof. 




L 


usual. 


Subscap. and P. Circumfl. arise by one trunk. 



AXILLARY ARTERIES. 



201 



No. 


Side 
of the 
Body. 


Trunk. 


jtt 

Branches. 


153 


R 


usual. 


?. Circumfl. ascends from Super. Prof. 




L 


usual. 


?. Circumfl. ascends from Super. Prof. 


154 


R 


usual. 


usual. 


155 


1 R 


usual. 


usual. 




L 


usual. 


usual. 


156 


R 


usual. 


Both Circumfl. arise by one trunk. 


157 


R 


usual. 


Subscap. and P. Circumfl. arise by one trunk. 


158 


R 


usual. 


P. Circumfl. ascends from Super. Prof. 




L 


usual. 


P. Circumfl. ascends from Super. Prof. 


160 


R 


usual. 


{Subscap. arises in two parts, and gives a Thoracic br. 
P. Circumfl. and Dorsalis Scap. arise by one trunk. 




L' 


usual. 


f Subscap. arises in two parts, and gives a Thoracic br., 
"^P. Circumfl. and Dorsalis Scap. arise by one trunk. 


164 


R 


usual. 


usual. 


165 


R 


usual. 


P. Circumfl. ascends from Super. Prof. 




L 


usual. 


usual. 


168 


R 


usual. 


usual. 




L 


usual. 


usual. 


169 f 


R 


usual. 


{Subscap. in two parts. Dorsalis Scap. and P. 
Circumfl. arise by one trunk. 


169g 


R 


usual. 


f Subscap. in two parts. Dorsalis Scap. and P. 
\ Circumfl. arise by one trunk. 


169o 


R 


f divides into two 
< unequal brs. at 
[ head of humerus. 


f Radial arises opp. head of humerus. The larger br. 
j gives P. Circumfl. and both Prof, by one trunk ; 
< other brs. usual : The two brs. into which the 
1 artery divides are connected by a short br. at the 
^bend of the elbow. 


171 


R 


usual. 


usual. 




L 


usual. 


usual. 


172 


R 


usual. 


usual. 




L 


usual. 


usual. 


174 


R 


usual. 


usual. 




L 


usual. 


usual. 



202 



AXILLARY ARTERIES. 



No. 


Side 
of the 
Body. 


Trunk. 


Branches. 


176 


R 


usual. 


usual. 






/^divides into two 








I unequal trunks opp 








I the head of hume- 


f Radial arises opp. head of humerus. The brs. are 






| rus. The nerves 


\ given from the larger and deeper trunk. 






1 cross on the deepei 
\Jrunk. 




177 


R 


usual. 


Subscap. and P. Circumfl. arise by one trunk. 




L 


usual. 


usual. 


178 


R 


usual. 


usual. 




L 


usual. 


usual. 


179 


R 


usual. 


usual. 




L 


usual. 


I" Subscap. arises in two divisions. Dorsalis Scap. 
\and P. Circumfl. arise by one trunk. 


180 


L 


usual. 


("Subscap. and P. Circumfl. arise by one trunk. 
\ Other brs. nearly usual. 






'is crossed in two dif- 








ferent situations by 








brs. of brachl. plex- 




181 


R 


< us of nerves ; the 


usual. 






additional crossing 








is opp. corac. pro- 








cess of scapula. 








[" Same arrangement 






L 


< of nerves as on right 


usual. 






[side. . 





182 


R 


usual. 


usual. 






!A second br. of 








brachial plexus 






L 


crosses the artery 


tisual. 






opp. coracoid pro- 
cess. 




183 


R 


usual. 


Subscap. and P. Circumfl. arise by one trunk. 


184 


R 


usual. 


Subscap. and P. Circumfl. arise by one trunk. 






1" dividesinto two brs.; 


("Subscap., both Circumfl. and Super. Prof., arise by 




L 


< is not embraced by 


< one trunk, which is crossed by the nerves of brachial 






[ the nerves. 


I plexus. 


185 


R 


usual. 


usual. 




L 


usual. 


Both Circumfl. arise by one trunk. 



AXILLARY ARTERIES. 



203 



No. 


Side 
of the 
Body. 


Trunk. 


Branches. 


186 


R 


("divides into two brs., 
< and is not crossed 
L by nerves as usual. 


pSubscap., both Circumfl. and both Prof, arise by 
J one trunk, which, after giving the brs. named, 
] becomes Interosseous. The nerves embrace this 
L trunk. 




L 


divides into two brs. 


Ulnar is given near the clavicle. 


187 


R 


ps crossed by a second 
I br. of the brachial 
J plexus of nerves, 
J and divides into two 
j brs. opp. lat. dorsi 
l^m. 


("Both Circumfl. arise by one trunk. Other brs. 
\usual. Ulnar rises opp. lat. dorsi m. 

i 




L 


fis crossed by a second 
I br. of the brachial 
! plexus of nerves, 
j and divides into two 
J brs. opp. lat. dorsi 
tm. 


J~ Both Circumfl. arise by one trunk. Other brs. 
L usual. Ulnar rises opp. lat, dorsi ni. 


188 


R 


usual. 


Subscap. and P. Circumfl. arise by one trunk. 


189 


R 


usual. 


Both Circumfl. arise by one trunk. 




L 


usual. 


usual. 


190 


R 


usual. 


usual. 




iL 


usual. 


usual. 


191 


R 


fis crossed by a small 
J additional br. of 
| brachial plexus of 
(^nerves. 


Subscap. and P. Circumfl. arise by one trunk. 




L 


pis crossed by a small 
I additional br. of 
| brachial plexus of 
[_ nerves. 


neatly usual. 


192 


R 


usual. 


f nearly usual. A long muscular br. descends to 
\ outer side of biceps m. 




L 


usual. 


Both Circumfl. arise by one trunk. 


193 


R 


ris crossed by a small 
J additional br. of 
j brachial plexus of 
[_nerves. 


usual. 




L 


usual. 


usual. 


194 


R 


usual. 


usual. 




L 


usual. 


Subscap. and P. Circumfl. by one trunk. 



204 



AXILLARY ARTERIES. 



No. 


Side 
of the 
Body. 


Trunk. 


Branches. 


195 


R 


usual. 


usual. 




L 


usual. 


Both Circumfl. by one trunk. 


196 


R 


usual. 


{Subscap. arises in two parts. P. Circumfl. and 
Dorsalis Scap. by one trunk. 




L 


usual. 


f Subscap. arises in two parts. Both Circumfl. and 
\ Dorsalis Scap. by one trunk. 


197 


L 


usual . 


usual. 


198. 


R 


usual. 


Subscap. and P. Circumfl. arise by one trunk. 


199 


R 


f divides into two brs.; 
< is not crossed by 
[ nerves as usual. 


J Subscap., both Circumfl. and both Prof, arise by 
\ one trunk, which is crossed by the nerves. 




L 


usual. 


Subscap. and P. Circumfl. arise by one trunk. 


200 


R 


usual. 


Subscap. and P. Circumfl. arise by one trunk. 




L 


f divides into two brs.; 
4 is not crossed by 
[nerves as usual. 


J Subscap., both Circumfl. and both Prof, arise by 
\ one trunk, which is crossed by the nerves. 


201 


R 


usual. 


J Subscap. arises in two parts. P. Circumfl. and Dor- 
\ salis Scap. given by one trunk. 




L 


usual. 


usual. 


203 


R 


usual. 


P. Circumfl. ascends from Super. Prof. 




L 


usual. 


Subscap. and P. Circumfl. arise by one trunk. 


204* 


R 


usual. 


usual. 


205 


R 


usual . 


/Both Circumfl. arise by one trunk, which gives 
I Super. Prof. 




L 


usual. 


P. Circumfl. ascends from Super. Prof. 


207 


R 


usual. 


P. Circumfl. ascends from Super. Prof. 


207 a 


R 


usual. 


Subscap. gives a Thoracic br. 




L 


f is crossed by a small 
< br. of median n. 
|_high up. 


f Thoracic brs. arise by one trunk. P. Circumfl. 
\ ascends from Super. Prof. 


207b 


R 


usual. 


usual. 




L 


usual. 


Thoracic brs. arise by one trunk. 


207c 


R 


usual. 


Thoracic brs. arise by one trunk. 




L 


usual. 


Thoracic brs. arise by one trunk. 



AXILLARY ARTERIES. 



205 



No. 


Side 
of the 
Body. 


Trunk. 


Branches. 


209 


R 


usual. 


?. Circumfl. ascends from Super Prof. 


210 


L 


usual. 


Subscap. and P. Circumfl. arise by one trunk. 


211 


L 


usual. 


usual. 


212 


R 


usual. 


?. Circumfl. ascends from Super. Prof. 


213 


R 


usual. 


usual. 




L 


usual. 


usual. 


214 


R 


usual. 


P. Circumfl. ascends from Super. Prof. 


215 


R 


jusual. 


[" P. Circumfl. ascends from Super. Prof. One 
< Thoracic br. from Axillary ; a second from Sub- 
[scap. 


216 


R 


usual. 


usual. 




L 


usual. 


P. Circumfl. ascends from Super. Prof. 


217 


R 


usual. 


P. Circumfl. ascends from Super. Prof. 


218 


R 


usual. 


usual. 




L 


usual. 


Subscap. and P. Circumfl. arise by one trunk. 


219 


R 


usual. 


usual. 




L 


usual. 


usual. 


220 


R 


usual. 


Both Circumfl. and Super. Prof, arise by one trunk. 


221 


R 


1" divides into two brs.; 
< is not crossed by 
[nerves, j 


f Subscap., both Circumfl. and both Prof, arise by 
L one trunk, wbich is crossed by the nerves. 




L 


I" divides into two brs.; 
< is not crossed by 
[nerves. 


J Subscap. both Circumfl. and both Prof, arise by 
\ one trunk, which is crossed by the nerves. 


222 


R 


usual. 


usual. 




L 


usual. 


{A Vas Aberrans arises opp. head of humerus, and 
joins Radial at the bend of the elbow. Other 
brs. usual. 


223 


R 


usual. 


P. Circumfl. ascends from Super Prof. 




L 


usual. 


usual. 


224 


R 


usual. 


P. Circumfl. ascends from Super Prof. 


225 


R 


usual. 


Subscap. gives Supra-Scap. 



20G 



AXILLARY ARTERIES. 



No. 


Side 
of the 
Body. 


Trunk. 


Branches. 


226 


R 


["divides into two brs 
J opp. coracoid pro 
] cess ; is not crossed 
[_by nerves. 


{Subscap. arises in two parts. Dorsalis Scap., 
both Circumfl. and Super. Prof, arise by one trunk, 
on which the nerves cross. 




L 


usual. 


("P. Circumfl. ascends from Super. Prof. A Vas 
< Aberrans given from Axillary joins Radial at the 
(_ middle of the fore-arm. 


227 


R 


usual. 


usual. 




L 


usual. 


usual. 


229 


R 


usual. 


usual. 




- 


f crossed by a secom 
< external origin o 
|_ median nerve. 


usual. 


230 


R 


usual. 


f Both Circumfl. and Super. Prof, arise by one trunk. 
< The latter passes behind lat. dorsi and teres 






- 


|_ major m. 




L 


crossed twice by nerves 


P. Circumfl. and Super. Prof, arise by one trunk. 


231 


R 


usual. 


nearly usual. 




L 


usual. 


usual. 


232 


R 


usual. 


Subscap. and P. Circumfl. arise by one trunk. 




L 


usual. 


Subscap. and P. Circumfl. arise by one trunk. 


233 


R 


usual. 


P. Circumfl. ascends from Super. Prof. 




L 


isual. 


Subscap. and P. Circumfl. arise by one trunk. 


234 


R 


["crossed by the 
I junction of ulnar 
^ n. with inner head 
|^of median n. 


usual. 




L 


usual. 


*. Circumfl. ascends from Super. Prof. 


235 


R 


usual. 


:*. Circumfl. ascends from Super. Prof. 




L 


usual. 


;*. Circumfl. ascends from Super Prof. 


236 


R 


usual. 


f Subscap. and P. Circumfl. arise by one trunk. A 
< Vas Aberrans arises at the tendon of lat. dorsi 
[ m. and joins Radial near the bend of the elbow. 


237 


R 


usual. 


sual. 




L 


usual. 


sual. 


238 


R 


sual. 


sual. 



AXILLARY ARTERIES. 



207 



No. 


Side 
of the 
Body. 


Trunk. 


/* 
Branches. 


239 


L 


usual. 


usual. 


240a 


R 


usual. 


usual. 


241 


L 


usual. 


P. Circumfl. ascends from Super. Prof. 


242 


R 


usual. 


Subscap. and P. Circumfl. arise by one trunk. 


243 


R 


usual. 


Subscap. and P. Circumfl. arise by one trunk. 




L 


usual. 


usual. 


247 


R 


usual. 


usual. 


248 


R 


usual. 


Subscap. and P. Circumfl. arise by one trunk. 


249 


R 


usual. 


f Subscap., a Thoracic br. and P. Circumfl. arise by 
\one trunk. 




L 


usual. 


J~ Subscap., P. Circumfl. and part of Super. Prof. 
\ arise by one trunk. 


250 


R 


usual. 


P. Circumfl. ascends from Super. Prof. 




L 


usual. 


J Subscap. gives a Thoracic br.; P. Circumfl. ascends 
\from Super. Prof. 


251 


R 


usual. 


nearly usual. 




L 


usual. 


Subscap. and P. Circumfl. arise by one trunk. 


252 


R 


ps crossed by an ad- 
j ditionalheadof ine- 
< dian nerve higher 
I than the usual 
^crossing. 


(" Subscap. arises in two parts. Dorsalis Scap. is 
< a separate br. of Axillary. Both Circumfl. arise 
|_ by one trunk. 




L 


f~ divides into two brs. ; 
< is not crossed by 
|_ nerves. 


f Subscap., both Circumfl. and both Prof, arise by 
\ one trunk, which is embraced by the nerves. 


253 


R 


usual. 


Subscap. and P. Circumfl. arise by one trunk. 




L 


usual. 


usual. 


254 


R 


usual. 


nearly usual. 




L 


("is crossed by nerves 
J in usual situation, 
| and again opp. lat. 
[ dorsi m. 


3oth Circumfl. arise by one trunk. 


255 


R 


{is accompanied at 
each side by heads 
of median n., which 
do not unite until 
the artery becomes 
Brachial. 


J" Subscap. and P. Circumfl. arise by one trunk. 
\ Radial is given off at the end of Axillary. 



208 



AXILLARY ARTERIES. 



No. 


Side 
of the 
Body. 


Trunk. 


Branches. 








("Subscap. arises in two parts. Dorsalis Scap. is 




L 


usual. 


I a separate br. of Axillary. There are two A, 
^ Circumfl. brs., one being from P. Circumfl., which 








[_gives also Super. Prof. 


255 a 


R 


usual. 






L 


usual. 


nearly usual. 


256 


L 


usual. 


P. Circumfl. ascends from Super. Prof. 


257 


R 


usual. 


P. Circumfl. ascends from Super. Prof. 




L 


usual. 


P. Circumfl. ascends from Super. Prof. 


258 


L 


usual. 


usual. 


259 


R 


{The nerves cross be- 
hind the Axillary 
artery. 


fSubscap. and both Circumfl. arise by one trunk. 
J Both Prof, and part of Anastomotic are given by 
I one trunk, which arises opp. the upper part of lat. 
[^dorsi m. 


260 


R 


usual. 


J Subscap. and P. Circumfl. arise by one trunk. 
\ Super. Prof, arises opp. upper part of lat. dorsi m. 


261 


L 


f divides into two brs. 
< nearly opp. coracoid 


/gives Radial a little below coracoid process and 
\both Prof. 






[^ process. 




262 


R 


J" is crossed twice by 
L nerves. 


f Subscap. gives a Thoracic br. Both Circumfl. arise 
\by one trunk. 




L 


usual. 


J" Subscap. arises higher than usual, and gives a 
\ Thoracic br. 


264 


R 


usual. 


usual. 


265 


R 


usual. 


J" Subscap. gives P. Circumfl.-,ad, a little lower down, 
\ the Super. Prof. also. 


266 


R 


f is not crossed by 








\ nerves. 




267 


R 


usual. 


P. Circumfl. ascends from Super. Prof. 




L 


usual . 


P. Circumfl. ascends from Super. Prof. 


268 


R 


usual. 


J" Subscap. rises higher than usual, and gives a 
\ Thoracic br. and P. Circumfl. 




L 


usual. 


Subscap. and P. Circumfl. arise by one trunk. 






ps crossed by nerves 








I as usual, and lower 




269 


R 


< down by a br. o! 


P. Circumfl. ascends from Super. Prof. 






1 ext. cutaneous n., 








\ whichjoins median. 





AXILLARY ARTERIES. 



209 



No. 


Side 
of the 
Body. 


Trunk. 


Branches. 




L 


usual. 


usual. 


271 


R 


usual. 


?. Circumfl. ascends from Super. Prof. 




L 


usual. 


P. Circumfl. ascends from Super. Prof. 


272 


L 


usual. 


usual. 


274 


R 


usual. 


|~ Subscap. arises by two separate brs. (Dorsalis 
< Scap. is a distinct br. of Axillary.) Both Circumfl. 
|_ arise by one trunk. 


275 


R 


J"is not crossed by 
\ nerves. 


usual. 




L 


usual. 


usual. 


277 


R 


usual. 


usual. 


278 


R 


usual. 


Subscap. and P. Circumfl. arise by one trunk. 




L 


divides into two brs. 


jives Radial. 


279 


L 


usual. 


usual. 


282 


L 


usual. 


usual. 


283 


R 


usual. 


("Subscap. arises by two distinct brs. (Dorsalis Scap. 
\is a separate br. of Axillary.) 




L 


usual. 


usual. 


284 


R 


usual. 


J~ Subscap. arises higher than usual, and gives P. 
\ Circumfl. 




L 


usual . 


J Subscap. arises higher than usual, and giv^s P. 
\ Circumfl. 


289 


R 


usual. 


usual. 




L 


usual. 


usual. 


290 


R 


T divides into two brs.; 
< is not crossed by 
[ nerves as usual. 


J Subscap., both Circumfl. and both Prof, arise by 
\ one trunk, which is embraced by the nerves. 




L 


divides into two brs. 


J Ulnar arises from Axillary, and is an unusually 
\ slender br. 


292 a 


R 


divides into two brs. 


Radial arises opp. coracoid process of scapula. 


293b 


R 


divides into two brs. 


Radial is given from Axillary. 



210 AXILLARY ARTERIES. 

THE word " usual " in the foregoing table, applied to the trunk of the Axillary 
artery is intended to signify that the vessel was a single trunk, and that it was 
surrounded by the nerves of the brachial plexus one or both the roots of the 
median nerve crossing in front of it. 

Applied to the branches, the same word implies that they were given separately 
from the trunk ; that the Thoracic branches were the first offsets ; that the 
Subscapular arose at the lower margin of the Subscapular muscle, and the two 
Circumflex immediately after. 



ABSTRACT OF THE TABLE, 

SO FAR AS REGARDS THE TRUNK OF THE AXILLARY ARTERY. 

CASES 

The artery had the usual disposition, Right side . . . 239 

Left . . . . 205 

444 

It was not surrounded or crossed by the nerves of the brachial 

plexus, Right side . . . ... . .16 

Left , . . .;? ''. -' . ' ; . : . . 13 

29 

was crossed by branches of the nerves in two places, Right side 8 

Left 9 

17 

" " in three places, Right side 1 

Left 

1 

The artery gave a large unusual branch, or divided into two branches, 

Right side .... 25 

Left 26 

51 

The unusual branch referred to was 

the Radial, Right side . .' 8 
Left ... 7 

15 

the Ulnar, Right side . . 1 
Left . . . 6 

7 

the Interosseous, Right side. . . 1 
Left. . . 

] 

a trunk common to several of the branches 
of the Axillary and the Brachial arteries, 

Right side . .15 
Left. . . . 13 28 

Examples of a " Vas Aberrans " were found, Right side . . 2 

Left . . 4 

6 

Several instances of branches taking origin from the Axillary, which are 
ordinarily derived from other sources, are not included in the abstract of the 
table: e. g. the Supra- Scapular, Dorsalis Scapulae, Superior Profunda, and 
others. These cases will be referred to in the observations on the branches indi- 
vidually. 

The statements contained in the second column of the table, that occupied with 
the branches, will be made use of when these are severally under consideration. 



211 



/ 



EXPLANATION OF PLATE XXVI. 



This plate is intended to show the axillary and the brachial 
arteries of the right side, with their branches. The body 
from which the drawing was taken was placed in the sitting 
posture the arm extended and supported on a table ; and it 
was elevated in such a way, that the part represented was 
nearly on a level with the eye of the observer. 

The dissection consisted in the removal of the integuments, 
the fascia, the veins, and small nerves, from the thorax and 
the arm, together with the excision of a part of the larger 
and the smaller pectoral muscles. 



a Clavicle. 

b Greater pectoral muscle. 

b f Smaller pectoral. 

c Subclavius. 

d Serratus magnus. 

e Latissimus dorsi. 

e f Teres major. 

/ Subscapular. 

g Deltoid. 

h Coraco-brachialis. 



h f Coracoid process of the scapula. 

i Biceps muscle. 

k Triceps. 

/ Brachialis anticus. 

m Intermuscular septum. 

n Internal condyle of the humerus. 

o Tendinous expansion of the biceps 

muscle. 
p Long supinator muscle. 



THE ARTERIES. 



1. Axillary. 

2. Brachial. 

3. Acromial thoracic. From it a 

large branch is directed inwards 
to the side of the thorax (ar. 
thoracicasuprema); and another 
downwards to the shoulder 
between the deltoid and the 
greater pectoral muscles (ar. 
thoracica humeraria). 

4. Two small branches (ar. thora- 

cica alares ? ) 



5. A large branch to the thorax (ar. 

thoracica longa). 

6. Subscapular. 

6f. Dorsal branch of the last-named 
(ar. dorsalis scapulae). 

7. Posterior circumflex. 
7f Anterior circumflex. 

8. Superior profunda. 

9. Inferior profunda (of larger size 

than usual). 

10. Anastomotic (this branch is gene- 
rally of smaller size than here 
represented). 



11. Musculo-cutaneous External 

cutaneous. 

12. Median. 

13. Ulnar. 



NERVES. 
14. 



Musculo-spiral. A considerable 
portion of this nerve was re- 
moved; the lower part is seen 
in company with the " superior 
profunda" artery. 



212 



EXPLANATION OF PLATE XXVII. 



The axillary and brachial divisions of the artery of the 
right upper extremity, are seen in this drawing to the same 
extent as in the preceding, and by a similar mode of dissec- 
tion. But the veins, the lymphatic glands, a portion of the 
fascia, and some additional nerves, have been left in connexion 
with the arteries. While the drawing was being made, the 
body was somewhat lower than that of which the twenty- sixth 
plate is a representation ; and the greater extent to which 
the shoulder is seen here, as well as some other slight differences 
observable in the position of the parts, are owing to this cir- 
cumstance. 



a Clavicle. 

b Greater pectoral muscle. 

c Smallar pectoral. 

d Latissimus dorsi. 

e Coraco-brachialis. 



1. Axillary. 

2. Brachial. 



/ Deltoid. 

g Biceps. 

h Triceps. 

k Fascia. 



ARTERIES. 

I 3. Acromial thoracic. 
I 4. Subscapular. 



5. Axillary. 



VEINS. 

8. Basilic. 



6. " Venae comites " of the brachial 

artery. 

7. Cephalic. 



9. Median basilic. 
10. Median cephalic. 



11. Median. 

12. Musculo-cutaneous External 

cutaneous. 

13. Ulnar. 

14. Internal cutaneous. 



NERVES. 
15. 



Smaller internal cutaneous 
" nerv. cutaneus minor inter- 
nus vel ulnaris " (Wrisberg*). 
f. Lymphatic glands. 



* This nerve is a distinct branch of the brachial plexus. The first clear account of 
it was given by Klint,Wrisberg's pupil, in a dissertation on the nerves of the arm, written 
under the guidance of his master (solertissimus et fidelissimuspraeceptor). Of the nerve 
under observation, he says, " Cum nervo cubitali connexus est, ex eodemque pariter 
originem capit, uti cutaneus secundus seu internus plerorumque autorum, tertius nervus 
cutaneus verus et constans ab aiiis prsetervisus, ab ill. Wrisbergio ' cutaneus minor inter- 
nus vel cubitalis ' dicitur." After mentioning the names of several anatomists who had 
overlooked this nerve, he continues, " Visum nobis interim est, cgregium Vieussenium, 
cujus labor pro ea aetate stupendam industriam et diligentiam prodit, paucis hunc nervum 
tetigisse." 

lac. Jo. Klint u De nervis brachii." Cap. 5, 18. Gottingse 1784. 



213 



/ 



EXPLANATION OF PLATE XXVIII. 

The integuments and the fascia, with some cellular sub- 
stance, and fat being removed, the bloodvessels, the nerves, 
and lymphatic glands of the axilla are seen, together with the 
muscles which bound the axillary space. 



a Greater pectoral muscle. 
b Smaller pectoral. 
c Latissimus dorsi. 



1. Axillary. 

2. Subscapular. 



Serratus magnus. 
Coraco-brachialis. 



ARTERIES. 

3. A large branch of one of the 
thoracic arteries. 



7. 

8. 

9. 

10. 

11. 

12. 



VEINS. 

Axillary. 

A long venous branch extending 

6. 



from the side of the thorax to 
the axillary vein. 
Subscapular. 



NERVES. 



Musculo-cutaneous External 

cutaneous. 
Median. 
Ulnar. 
Musculo-spiral drawn out from 

under the artery. 
Internal cutaneous. 
Smaller internal cutaneous " n. 



cutaneus minor internus vel 
ulnaris" (Wrisberg). 

13. Two Intercosto-humeral, cut. 

1 4. The nerve of the serratus magnus 

muscle posterior thoracic 
" external respiratory" of Bell. 

15. One of the Subscapular nerves 

given to the teres major and the 
latissimus dorsi muscles. 



Three of the middle cutaneous branches of the dorsal nerves are seen directed 
upwards on the serratus magnus and cut. The distribution of these nerves is 
briefly as follows : Each divides into two branches, one of which is inclined 
forwards, and the other in the opposite direction. The anterior branches of 
those which escape by the second and the third intercostal spaces, turn forward* 
over the margin of the pectoral muscle, and the posterior branches are those 
named intercosto-humeral ; the latter are marked (13) in the plate. 



EXPLANATION OF PLATE XXIX. 



The back part of the scapula and of the arm are represented 
in the first figure. The deltoid muscle was partly separated from 
its connexion to the spine of the scapula, in order to expose 
the posterior circumflex artery and the circumflex nerve. 



214 



EXPLANATION OF THE THIRTIETH PLATE. 



The fore arm being supported by a string, was seen and 
has been represented considerably fore-shortened. 

The second figure of the plate shows the arteries, which 
ramify on the ventral surface of the scapula. These small 
vessels are derived from the supra-scapular, the posterior 
scapular, and the sub-scapular arteries. They are much 
smaller than those which ramify on the opposite surface of 
the same bone. See plate 19. 



a Spine of the scapula. 

b Supra spinatus muscle. 

o Infra spinatus. 

d Teres minor. 

e Teres major. 

/ A portion of the latissimus dorsi. 

/t Tendon of the latissimus dorsi. 

g Triceps. 



h Tendon of the subscapular. 

i Long head of the biceps. 

k Head of the humerus. 

/ Deltoid muscle. 

/ f Part of the deltoid cut and turned 
forwards ; the head of the hu- 
merus and the circumflex artery 
and nerve are thereby exposed. 



ARTERIES. 



1. Axillary. 

2. Subscapular. 

2f. The dorsal branch of that artery. 
2J. A branch ramifying in the sub- 
scapular fossa. 

3. Posterior circumflex. 

4. Anterior circumflex. 



5. A branch of the superior profunda. 

6. Supra scapular. 

7. Posterior scapular. Smallbrancb.es 

of this artery are given to the 
dorsal as well as the ventral 
surface of the scapula. 



NERVES. 



8. Circumflex distributing large 
branches to the deltoid muscle ; 
other branches are given to the 



infra spinatus muscle. 
External cutaneous branch 
the musculo-spiral. 



of 



EXPLANATION OF PLATE XXX. 



In this plate are represented some of the peculiarities which 
occur in the branches of the axillary artery. 



Subscapular muscle. 

Part of the latissimus dorsi. 

A small part of the serratus magnus 
on it lies a portion of the 
posterior scapular artery. 

Coracoid process. 

Deltoid muscle. 



/ Biceps muscle. 

<7 Triceps. 

h Coraco-brachialis. 

k The outer end of the greater pectoral. 

&f The outer endof the smaller pectoral. 

I Internal condyle of the humerus. 



EXPLANATION OF THE THIRTIETH PLATE. 215 

ARTERIES. 



1 . Axillary. 

2. Brachial. 

3. Subscapular. 

3f. A trunk which gives origin to the 
sub-scapular,both the circumflex 
and both the profunda arteries. 

4. Anterior circumflex. 

4f . A trunk giving origin to the an- 
terior circumflex, the posterior 



circumflex, and the superior 
profunda branches. 

5. Posterior circumflex. 

6. Superior profunda. 

7. Inferior profunda. 

8. Anastomotic. 

9. Radial. 
10. Ulnar. 



NERVES. 



11. Musculo- cutaneous External 

cutaneous. 

12. Median. 



13. Musculo-spiral. 

14. Ulnar. 



In the first figure, the sub-scapular artery takes origin at 
some distance above its usual position, and gives branches 
which were distributed to the thorax. The anterior and the 
posterior circumflex, with the superior profunda, arise from 
one trunk. 

In the second figure, the axillary artery divides into two 
branches of nearly equal size ; one descends to supply the 
usual branches to the fore-arm, and, in its course, gives very 
few offsets to the upper arm. The other division of the 
artery soon divides into the branches, which are usually given 
singly from the axillary and the brachial trunks namely, the 
subscapular, both the circumflex and both the profunda ; it 
is placed behind the former artery, and the nerves of the 
brachial plexus are arranged closely around it, instead of 
embracing the axillary artery. This disposition of the ar- 
teries is not of unfrequent occurrence. 

Figure 3. In this figure, also, the axillary artery divides 
into two large branches. The deeper one gives, as in the 
preceding case, the principal branches of the shoulder and the 
arm, and is likewise surrounded by the nerves. The arrange- 
ment differs from that represented in the former figure 
chiefly in this respect, viz. that after giving the branches, the, 
artery continues to the fore-arm, becoming the radial. This 
modification is very rarely met with. 



216 



EXPLANATION OF PLATE XXXI. 



Some of the variations which occur in the origin and 
course of the radial artery are represented in this plate . 



a Clavicle. 

b Coracoid process of the scapula. 

c Deltoid muscle. 

d Head of the humerus covered by 

the capsular ligament. 
e Coraco-brachialis muscle. 
/ Latissimus dorsi. 
/f Greater pectoral. 
g Biceps. 
h Triceps. 
t Brachialis-anticus. 
k Inner condyle of the humerus. 



I Pronator teres muscle. 

m Supinator longus. 

n The fibrous expansion from the 
tendon of the biceps muscle. 

o An unusual tendinous cord of con- 
siderable thickness, which was 
connected with the tendon of the 
biceps on the outer side, and with 
the intermuscular septum on the 
inner side of the arm. It lay be- 
neath the fascia, and crossed the 
vessels and nerves. 



1 . Axillary. 

2. Brachial. 

3. Subscapular. 

4. Posterior circumflex. 
4.f Anterior circumflex. 

5. Radial. 



ARTERIES. 

5.f Radial below the bend of the 



elbow. 

Superior profunda. 
Anastomotic. 
Ulnar. 
Radial recurrent. 



NERVES. 



10. Musculo-cutaneous, external- 

cutaneous. 

11. Median. 



12. Circumflex. 

13. Musculo-spiral. 

14. Ulnar. 



Figure 1. In the arm, from which this representation was 
taken, the radial artery arose close to the clavicle, and lay 
nearly over the other larger artery along the arm. 

In the same figure, some peculiarities of the branches are 
shown. Thus, the subscapular takes its origin a considerable 
distance above the usual position ; the posterior circumflex is 
given from the superior profunda, and ascends behind the 
tendon of the latissimus dorsi, to its usual situation ; the 
inferior profunda is wanting, and its place is taken by the 
anastomotic. 

Figure 2. The radial is given from the inner side of the 
brachial, and courses along the arm over that vessel. In the 
upper part of the forearm, it is somewhat further removed 
from the supinator longus muscle than usual. 



EXPLANATION OF THE THIRTY.SECOND PLATE. 



217 



The axillary artery is crossed by a small branch of the 
brachial plexus of nerves, above that which occurs in the usual 
position. The brachial vessels and the biceps muscle, are 
crossed obliquely by a tendinous cord, which extends from the 
long head of the muscle just named, to the intermuscular par- 
tition above the inner condyle of the humerus. The cord 
was rounded and more even than it is represented in the 
drawing. The radial recurrent artery takes origin from the 
larger or ulnar branch, and passes behind the tendon of the 
biceps muscle. 

Figure 3. The radial artery is derived from the outer side 
of the brachial, a couple of inches above the usual situation. 



EXPLANATION OF PLATE XXXII. 



Some of the variations, in the place of origin of the ulnar 
artery, are represented in this plate. 



a Coracoid process of the scapula. 

b Deltoid muscle. 

c Greater pectoral. 

d Latissimus dorsi. 

e Head of the humerus. 

/ Coraco-brachialis muscle. 

g Biceps. 

h Triceps. 



i Brachialis-anticus. 

k Inner condyle of the humerus. 

/ The fibrous expansion from the 

tendon of the biceps muscle. 

m The fascia of the forearm. 

n Flexor- carpi ulnaris muscle. 

o Flexor-carpi radialis. 

p Supinator longus. 



1. Axillary. 

2. Brachial. 

3. Subscapular. 

4. Posterior circumflex. 
4.f Anterior circumflex. 

5. Ulnar. 



10. Median. 

11. Musculo- spiral. 



ARTERIES. 

5.f Ulnar below the bend of the 
elbow. 

6. Superior profunda. 

7. Inferior profunda. 

8. Radial. 

9. Interosseous. 

NERVES. 

12. Ulnar. 



Figure 1. The ulnar artery arises from the upper part of 
the axillary. After lying over the larger artery, as far as the 
middle of the arm, it inclines inwards, and is placed at some 
distance from that vessel, at the bend of the elbow. In the 



218 



EXPLANATION OF THE THIRTY-THIRD PLATE. 



forearm, the ulnar artery is covered immediately by the fascia. 
The other and larger branch (brachial) of the axillary, has the 
nerves disposed on it ; it gives the branches to the upper arm 
and divides a little below the bend of the elbow, into the 
radial and interosseous arteries. 

The subscapular artery is seen in this drawing to arise 
above the usual position, and to give origin to the posterior 
circumflex. 

Figure 2. In this figure, the ulnar is given from the outer 
side of the brachial, and, after crossing obliquely to the inner 
side, it lies in the forearm, between the muscles and the fascia. 

The larger artery (brachial ?) furnishes the branches to the 
arm and to the forearm dividing into the radial and inter- 
osseous. 

Figure 3. The ulnar here is given close to the pronator 
teres muscle. From this situation, it is directed obliquely 
towards the flexor carpi ulnaris, and gains the usual position, 
with reference to that muscle and the ulnar nerve, at the 
distance of about a third from the lower end of the forearm. 



EXPLANATION OF PLATE XXXIII. 



This plate is intended to illustrate the variations in the 
place of origin of the interosseous artery. 



Clavicle. 

Coracoid process^of the scapula. 

Deltoid muscle. 

Head of the humerus covered by 

the capsular ligament of the 

shoulder joint. 
Coraco-brachialis muscle. 
Tendon of the latissimus dorsi. 



/f Humeral end of the greater pec- 



toral, (the cross f appears to have 
been omitted from the first figure.) 

g Biceps. 

h Triceps. 

i Brachialis anticus. 

k Inner condyle of the humerus. 

/ Pronator teres muscle. 

m Supinator longus. 

n Palmaris longus. 



ARTERIES. 



1. Axillary. 

2. Subscapular. 

3. Brachial. 

4. Superior profunda. 

5. Interosseous. 

5.f Interosseous below the elbow. 

6. Inferior profunda. 

7. Anastomotic. 



8. Brachial, the common trunk of 
the radial and ulnar. 

9. Radial. 

9.f Radial recurrent. In figure 2, 
this branch is given from the in- 
terosseous. 
10. Ulnar. 



EXPLANATION OF THE THIRTY-THIRD PLATE. 219 



NERVES 




1 1 . Musculo-cutaneous. External- 




muscle. 


cutaneous. 


12. 


Median. 


ll.f A branch of the musculo-cuta- 


13. 


Musculo-spiral. 


neous, which joins the median 


14. 


Ulnar. 


below the latissimus dorsi 







In figure 1 , the interosseous arises from the axillary artery ; 
but a more detailed description of this figure is necessary. 

The main artery divides a little below the clavicle into two 
large branches. One of these continues in the usual course 
of the brachial, and divides at the bend of the elbow into the 
radial and ulnar arteries. The ulnar was covered by the 
fascia and lay, as represented in the drawing, superficially to 
the muscles of the forearm, with the exception of the palmaris 
longus, which crossed over the vessel. 

The second division of the axillary artery lies deeper than 
the preceding, and is embraced by the nerves of the brachial 
plexus in this case, a second nervous branch crosses the 
vessel below the axilla. This artery gives nearly all the 
branches usually derived from the axillary and the brachial, 
viz. the subscapular, both the circumflex, both the profunda 
and the anastomotic ; and it ends as the interosseous 
furnishing all the recurrent branches except the radial. 

The large branch of the axillary artery supplied, therefore, 
the shoulder (in great part), together with the arm and the 
forearm. 

Figure 2. The interosseous artery here arises from 
the brachial. After descending to the forearm, the interos- 
seous furnished, besides its accustomed branches, the recur- 
rent arteries, usually derived from the radial and ulnar. 
The last-named vessel lay between the fascia and the 
muscles, in its course along the forearm. 

Figure 3. In this figure, the interosseous artery arises near 
the bend of the elbow, and the radial and ulnar take their 
origin at the same point. The first-named vessel was placed 
at its origin, behind the other two ; and it furnished the same 
branches as the corresponding artery represented in the pre- 
ceding figure, with the exception of the radial recurrent, which 
is seen to have its usual origin. 



220 



EXPLANATION OF THE THIRTY-FOURTH PLATE. 



The brachial artery, in this case, divides into three 
large arteries at the same point. In the other arm of the 
same body, the interosseous branch arose nearly in the same 
place, but the radial and ulnar arteries separated one from 
the other, at some distance about two inches farther down. 



EXPLANATION OF PLATE XXXIV. 



In all the figures of this plate the main artery of the upper 
limb divides into two branches above the usual position. The 
branches in one case join again, and in the others they com- 
municate by a short branch at the bend of the elbow. 



Coracoid process of the scapula. 
Deltoid muscle. 
Greater pectoral. 
Latissimus dorsi. 
Head of the humerus. 
Coraco-brachialis muscle. 



g Biceps. 

h Triceps. 

i Brachialis anticus. 

k Inner condyle of the humerus. 

/ Pronator-teres muscle. 

m Supinator longus. 



ARTERIES. 



1 . Axillary. 

2. Brachial. 

2.fl Two brachial arteries which 
2.J J unite at the bend of the elbow. 

3. Subscapular. 

4. Posterior circumflex. 
4.f Anterior circumflex. 

5. Radial. 

S.fRadial below thebend of the elbow. 

6. Superior profunda. 



7. Reunion of the two parts of the 

brachial artery. 
7. 1 A short communicating branch 

between radial and ulnar. 
7.fA branch still longer, uniting the 

same vessels. 
7.JA somewhat similar branch but 

in this case taking a circuitous 

course round the tendon of the 

biceps muscle. 

8. Ulnar. 



9. Musculo-cutaneous. 
10. Median. 



NERVES. 

I 11. Ulnar. 



Figure 1. The axillary artery gives, near the clavicle, a 
long slender branch,* which is joined by a short transverse 
one at the upper part of the forearm. Having thus become 
larger than before, the artery follows the ordinary course of the 



* This vessel was more slender than it is represented in the drawing, 
still observable in the preparation, No. 509. 



This fact is 



EXPLANATION OF THE THIRTY-FIFTH PLATE. 221 

radial. Or it may be said that the radial arises from the axil- 
lary artery, and is reinforced by the communicating artery at 
the elbow. 

Figure 2. Two large branches, into which the brachial 
artery divided, are connected by a short branch at the elbow. 

Figure 3. The brachial artery at its commencement divides 
into two branches. These re-unite and form a single trunk, which 
speedily gives the radial and ulnar branches in the usual way*. 

Figure 4. The two arteries, into which the brachial divides 
(radial and ulnar), are brought into communication by a 
branch which pursues a circuitous course round the tendon of 
the biceps muscle. 



EXPLANATION OF PLATE XXXV. 

Various instances of " vasa aberrantia" are represented in 
this plate. 



a Deltoid muscle. 

b Latissimus dorsi. 

c Greater pectoral. 

d Coraco-brachialis. 

e Biceps. 

/ Triceps. 

g Brachialis anticus. 

h Inner condyle of the humerus. 

i Upper part of the pronator-teres 



muscle. 
i f Lower part of the pronator-teres, 

turned outwards after having been 

divided. 

k Supinator longus. 
/ Flexor profundus digitorum. 
m Flexor carpi ulnaris. 
n Flexor longus pollicis. 



ARTERIES. 



1 . Axillary. 

2. Brachial. 

3. " Vas aberrans." 

4. Radial. 

4,f Radial recurrent. 



5. Ulnar. 

5.f Ulnar below the origin of the 
interosseous, 

6. Interosseous. 

Cf Posterior interosseous. 



NERVES. 

7. Median. I 8. Ulnar. 



Figure 1. The unusual vessel springs from the beginning 
of the brachial artery, and joins the commencement of the 
radial. 

* I have been favoured by Professor Clark with a drawing of a case very similar to 
this. The preparation from which it was taken is in the Macartney collection in the 
anatomical museum of the University of Cambridge. 



222 - EXPLANATION OF THE THIRTY-FIFTH PLATE. 

Figure 2. The " vas aberrans" arises from the brachial, farther 
down than in the preceding case, and joins the recurrent 
radial, which is here derived from the ulnar artery. 

Figure 3. The "vas aberrans" joins the radial. The latter 
has an unusual course behind the tendon of the biceps muscle. 
The arrangement may be stated to be this : namely, that the 
radial artery has a double origin, one (the vas aberrans) from 
the axillary, the other from the brachial. 

Figure 4. The brachial artery here continues undivided 
much lower than usual, and gives, at the same time, the 
radial, the ulnar, and both the interosseous arteries. 

The "vas aberrans" was given by the axillary, and, as seen in 
the drawing, it joined the radial below the middle of the arm. 
It is obvious that in this case, as in the foregoing, the manner 
of considering and describing the artery might be differently 
stated. 

In each of the cases, delineated in the first, the third, and 
the fourth figures, the " vas aberrans" lay in a greater or less 
degree in front of the brachial artery; but in that represented 
in the second figure, it was behind that vessel. 



223 



EXPLANATION OF PLATE XXXVI. 



a Biceps muscle. 

b Triceps. 

c Brachialis anticus. 

cf An osseous projection from the 

humerus. 

d Inner condyle of the humerus. 
e Pronator teres muscle, 
ef Part of the pronator teres turned 



outwards. 
The -superficial prouator and flexor 

muscles cut. 
Flexor carpi ulnaris. 
Flexor digitorum profundus. 
Supinator longus. 
Fascia of the arm and forearoa. 



Arf Fibrous expansion of the biceps. 



1. Brachial. 

2. Dinar arising above the elbow. 
2f. The same artery below the elbow. 

3. Radial-interosseous trunk (Bra- 
chial ?) 



THE ARTERIES. 

3f. Radial. 

3J. Communicating branch between 

the radial and the ulnar. 
4. Interosseous. 



5. Median. 



NERVES. 

| 6. Ulnar. 



Figures 1 and 2. These may be considered supplemental 
to the thirty-second plate, in which peculiarities of the ulnar 
artery are represented. In one of the figures now under 
observation, the ulnar artery, after arising from the brachial, 
is placed over the fascia of the forearm, immediately under 
the common integument. In the other figure, on the contrary, 
the vessel lies under the superficial muscles of the forearm. 
The recurrent ulnar branches were derived in the latter case, 
as well as in the former, from the interosseous artery. 

Figure 3. The brachial artery, instead of being directed 
along the biceps muscle, to its usual position at the bend of 
the elbow, inclines inwards on the intermuscular septum to 
the origin of the pronator teres, and then, taking an opposite 
course (outwards) under the upper margin of that muscle, 
divides about the usual situation. The artery is accompanied in 
this unusual course by the median nerve, and, at the point at 
which the direction is changed, it is seen to turn round a bony 
prominence (cf ). This projects from the humerus by the side 



224 



EXPLANATION OP THE THIRTY-SEVENTH PLATE. 



of the vessel, and gives attachment to a fibrous band, which 
crosses over the artery and the nerve. 

Figure 4. One of two branches into which the brachial 
artery is divided near its beginning, deviates together with 
the median nerve somewhat in the same manner as the single 
vessel in the preceding case. They pass through the inter- 
muscular septum immediately above the margin of the pronator 
teres muscle, and in their course outwards to the middle of 
the bend of the elbow are partially covered by the muscle. 
The two vessels into which the brachial artery divides are 
connected by a thick transverse branch at the upper part 
of the forearm. 

In the cases represented in the last two figures, the pronator 
teres is broader than usual at its origin. 



EXPLANATION OF PLATE XXXVII. 



a Deltoid muscle. 

at Head of the humerus. 

b Greater pectoral muscle. 

c Coraco-brachialis. 

cf Coracoid process of the scapula. 

d Latissimus dorsi (muscle). 

e Biceps. 

e' In figure 5, an unusual bundle 
of muscular fibres extending over 
the brachial artery from the 
biceps muscle to the inter- 
muscular septum. (The dash (') 
appears to have been omitted 
by the printer.) 

e\ Fibrous expansion from the tendon 
of the biceps. 



/ Triceps. 

g Brachialis anticus. 

#f A layer of the brachialis anticus 
covering the larger of two branches 
into which the brachial artery is 
divided, together with the median 
nerve. 

h Inner condyle of the humerus. 

t Supinator longus (muscle). 

k Pronator teres. 

fc^ Pronator teres presenting the pe- 
culiarity of being much broader 
than usual at its upper end. 

/ Superficial flexor muscles cut. 

m Flexor digitorum profundus. 

n Fascia. 



ARTERIES. 



1. Axillary. 

2. Brachial. 

2f. The larger of the two branches 
into which the brachial divides 
the common trunk of the ulnar 



and interosseous. 

3. Ulnar below the origin of the 
interosseous. 

4. Radial. 

5. Interosseous. 



6. Median. 

6f. Roots of the median. 

7. Ulnar. 



NERVES. 

8. Musculo-cutaneous External 
cutaneous. 



AXILLARY ARTERIES. 225 

Figures 1 and 2 contain modifications of that peculiarity of 
the brachial artery of which examples are given in the last 
two figures of the preceding plate. In both the cases here 
represented the smaller division (radial) of the main artery 
follows the usual course of the brachial on the inner side of 
the biceps muscle, while the larger vessel, the common trunk 
of the ulnar and interossoous arteries (brachial ?), together 
with the median nerve, is placed at some distance to the inner 
side, to within a couple of inches of the inner condyle of 
the humerus ; at this point it becomes covered by a broad 
pronator teres, and is directed to the middle of the bend of 
the elbow beneath that muscle. 

The difference between the two cases consists mainly in the 
difference of the place at which the principal artery divides. 

Figures 8, 4, and 5, contain representations of some peculi- 
arities of the muscles connected with the brachial artery. 
In the first two the brachial artery and the median nerve are 
seen to be covered by a thin layer of the brachialis anticus 
muscle, and in each the radial artery occurs in the ordinary 
position of the brachial. Figure 4 is from the arm of a person 
who had suffered amputation some years before death. 

The fifth figure shows the brachial artery concealed for 
a short space by a thick bundle of muscular fibres, which 
extends from the biceps to the intermuscular septum on the 
inner side of the arm. This may be considered to constitute 
a second insertion of the biceps. The same figure affords an 
example of junction of the roots of the median nerve, taking 
place further down than usual. 

THE AXILLARY ARTERIES. 

The ordinary disposition of the axillary artery is repre- 
sented in the twenty-sixth plate, and its connexions with nerves 
and veins are shown in the twenty-seventh and twenty-eighth 
plates. The observations on this artery will, as in the case of 
other arteries, be confined to the deviations from the standard 
or usual condition. 

The arrangement, which will be regarded as the usual one, 
has been already referred to ; see the abstract of the table at 
page 210. The deviation of most practical importance is that 
in which the vessel, instead of continuing as an undivided 

Y 2 



226 AXILLARY ARTERIES. 

trunk, and giving, at intervals, offsets to the parts in its 
neighbourhood, divides into two large branches, or, as it may 
be expressed, sends off* a branch of much larger size than usual. 
The table contains the record of 506 cases, 270 being of 
the right side, and 236 of the left. In 51 the axillary was 
observed to divide into two such branches, giving a proportion 
of about one in ten. 

In a majority (28) of the cases last referred to, the unusual 
or second branch was fully equal in thickness to the continued 
(brachial) trunk, and generally gave origin to the subscapular, 
both the circumflex, and both the profunda branches. (See 
the table, p. 230.) So that the peculiarity consisted in the 
fact of the vessels just named being given from a common 
origin, in place of arising in succession and at greater or less 
intervals from the axillary and brachial divisions of the main 
artery. This condition of the branches is represented in 
plate 30, figure 2. 

In the remainder (23) of the deviations under consideration, 
one of the arteries of the forearm, usually given near the 
elbow, was found to spring from the axillary. These cases 
were distributed as follows : 

The Radial arose from the Axillary in 15 1 in about 33 
Ulnar . . . .in 71 in 72f. 
Interosseous . * . . in I in 506 

Besides the foregoing unusual branches, which are of so 
large size that the main artery may be regarded as dividing 
into two parts where they arise and independently of its 
proper or usual branches to be noticed presently, the axil- 
lary occasionally gives origin to small branches, ordinarily 
found to emanate from other sources. The following have 
been noted in the table : 

A. dorsalis scapulae (usually a branch of the subscapular). Right side 7 

Left 3 

10 

Arteries usually derived from the subclavian found to arise 
from the axillary. 

Internal Mammary see plate 24, figure 4. (Mention of this 

has been accidentally omitted from the table.) .... 1 
Supra-Scapular see plate 24, figure 7 . . . Right . 1 

Left . . 1 

2 
Supra- Scapular and Posterior Scapular by one trunk. Right . 1 



THEIR BRANCHES. 227 

Arteries usually given from the brachial found to arise from 
the axillary. 

Superior Profunda Right side 3 

Left . 1 

^ 

Superior Profunda and Inferior profunda bygone trunk Left . 1 
Both Profunda and Anastomotic by one trunk . . Left . 1 
Examples of " Vasa Aberrantia " occurred in . . . Right . 2 

Left . 4 

6 

To those instances of the presence of unusual branches will 
be added one of the absence from the axillary of a branch 
usually derived from it. 

The Posterior Circumflex did not arise from the Axillary, in f Right . 38 
or from one of its branches. (See remarks on this branch) \ Left . 33 

71 

BRANCHES OF THE AXILLARY ARTERIES. 

The axillary, like other arteries, distribute branches to 
the parts in their immediate neighbourhood. Exclusively of 
several of small size given to the nerves and other structures, 
the branches consist of the external thoracic, the subscapular, 
and two circumflex. 



THE EXTERNAL THORACIC ARTERIES. 

The arteries known under this name differ so much in number 
and size, and so little of practical importance attaches to these 
differences, that I have not thought it necessary to make any 
detailed series of observations on the arrangement which they 
present in various cases. 

Haller described four naming them, thoracica prima v. 
suprema : thoracica altera major sive longior : thoracica acro- 
mialis v. humeraria : alaris (ultima thoracicarum) ; but he 
admits that there is really in nature much variety as to 
these vessels*. Some anatomists have adopted this arrange- 

* " Eadem etiam in sede, secundum infrascapularem eundo, educit quatuor sibi 
vicinas arterias Thoracicas externas, quas sollicite describemus, supremam, et longi- 
orem, Tboracicain humerariam, alarem. Alias tres sunt, et humeralis eumdem 
truncum cum majori tboracica habet. Alias prius quam reliquae Acromialis sivo 
Thoracica humeralis provenit. Alias vidi, Thoracicam primam, acromialem et 
Scapularem inferiorem solas adfuisse, a qua Thoracica longior oriretur, et non rarum 
est, deticere alarem. Alias, et nunc maxime coram, sex omnino arterias dignas vidi, 



228 AXILLARY ARTERIES. 

ment *, while others admit the existence of three f, or but twoj: 
external thoracic branches, as requiring to have names assigned 
to them. A few remarks may be made on each of the branches 
recognised by Haller. 

The first or highest thoracic branch is perhaps as fre- 
quently connected with that next named as it is separate from it. 
It was so disposed in the cases represented in plates 26 and 27. 

The acromial thoracic, or humeral thoracic \\ . The course 
which its principal branches take will sufficiently account for 
the names applied to this artery. It is the most constant of 
the external thoracic arteries, and often gives rise to one or 
more of them, most frequently to the branch placed first in 
the series ; see plates 26 and 27. 

The long thoracic, or external mammary^, is not unfrequently 
derived from the acromial artery, and occasionally arises in 
common with the subscapular, especially when the latter takes 
origin higher than usual. Meckel regards their connexion as 
so much the most frequent condition, that he describes the 

quse Thoracicae externse dicerentur. * * * * Cseterum scriptores omnes, etiam 
miperrimi, a nostris observation ibus in his thoracicis differuut, et oportet maxiraam 
varietatem naturae esse." Icones, &c. Fascic. vi. p. 10. 

" Postquam arteria subclaviain arteriam axillarem transiit, prseter parvos illos ratnulos 
ad nervos brachiales, &c. * * * tres, quatuor vel sex edit arterias thoracicas 
externas." Sceminering. De Corp. h. fabr. t. v. p. 186. 

* In describing these arteries, Soeinmering (loc. citat.) : J. Bell (The Anat. of the 
Human Body, Ed. 7, vol. 2, p. 169): Fyfe (A Compend. of the Anatomy, &c., Ed. 4, 
vol. 3, p. 47) arid Harrison (The Surg. Anat. of the Arteries, vol. 1, p. 145, et seq.) 
appear to adopt the nomenclature and arrangement of Haller. 

t Bichat (Anat. Descript. uouv. ed. t. 4, p. 229) omits the " thoracica alaris," and 
in other respects follows the arrangement just referred to recognising, therefore, three 
thoracic arteries. This modification is adopted by Boyer (Traite Compl. &c. 4 e . Ed. 
t. 3, p. 82). H. Cloquet, (Tr. d'Anat. Descript. 5 e . Ed. t. 2, p. 466), and Hildebrandt 
and Weber (Handbuch der Anat. des Menschen, 4 e Ausgabe, 3. B.,S. 210). 

$ J. F. Meckel (Handbuch der Menschlich. Anat, 3. B., S. 162) omits the alar 
branch, and connects the long thoracic with the subscapular. Thus, independently of 
variations in the thoracic arteries, which, he says, sometimes augment their number to 
four or five, Meckel admits the existence of but two, viz. the " thor. suprerna " and the 
4< thor. acromialis." 

Cruveilhier likewise describes but two thoracic branches. He ouiits the alar 
artery, like the anatomists last referred to, and considers the " thor. suprema " and 
" thor. acromalis " as one branch ; recognising, therefore, it and tlie long thoracic as 
separate offsets of the axillary artery. Anat. Descript. t. 3 e ., p. 160. 

"Thoracica suprema," sive "prima." Haller. " Thor. ext. suprema, sive 
prima, sive minor, s. matnmaria exterua, vulgo prima." Simmering. " Artere 
thoracique externe superieure." Bichat. " Die obere oder erste aussere Brust- 
pulsader," " die kleinere iiussere Brustpulsader." J. F. Meckel. 

|| " Thoracica humeraria quam ab acromio voco Acromialem." &c. Haller. 

^[ " Thoracica altera major, sive longior." " Hanc etiam suspicor csse Heisteri 
niammariam externaiD." Haller. "Artere thoracique externe inferieurc." 
Bichat. 



THEIR BRANCHES. 229 

long thoracic as a branch of the subscapular *. According to 
my observation, the arteries are generally independent one of 
the other. 

The alar thoracic f. This branch, should any such be sepa- 
rately given from the axillary, is destined to the axillary 
glands. Its existence is admitted by those writers who follow 
Haller f in their description of the arteries, and is not allowed 
by others . I believe it to be generally wanting, and that 
the lymphatic glands of the axilla are supplied from several 
sources the thoracic and the subscapular arteries. 

Lastly, the number of the branches that may be considered 
the external thoracic is most commonly two or three, but 
occasionally it is greater, and it is found, rarely however, to be 
even less.' In the table ten cases are mentioned in which 
but one external thoracic artery arose from the axillary, and 
from it branches were given in about the usual number. Four 
of the examples of this diminution of the number occurred on 
the right, and six on the left side. 



OF THE REMAINING BRANCHES, NAMELY, THE SUBSCAPU- 
LAR, THE ANTERIOR CIRCUMFLEX, AND THE POSTERIOR 
CIRCUMFLEX. 

The peculiarities noticed with respect to these arteries have 
been so numerous, that it seems best to place them in a 
tabular form. The condition implied by the term " usual" 
as applied to them will, in the first place, be briefly stated for 
each branch. 

The Subscapular Infrascapular |] . The subscapular artery 
usually arises opposite the lower margin of the subscapular 
muscle, and distributes branches to the muscles in the neigh- 
bourhood, viz. subscapularis, teres major, latissimus dorsi, 

* " Die lange aussere Brustpulsader ist so allgemein ein Zwcig der Unterschulter- 
blattpulsader, das sic gar nicht als eigner Ast bescreiben werden eollte." J. F. Meckel. 
loc. cit. 1407. 

f " Alaris, ultima Thoracicarum." " Ad glandulas caeterum alares numerosos 
ramos dat." Haller. " Arteria thoracica profunda, give quarta, sive alaris, sive axil- 
laris glandulosa." Soemmering. 

J Ante, p. 228, note *. 

Page 228, notes f & J. 

II " Scapulareiu inferiorem aut infrascapularem voco," Haller. " Arteria propria 
subscapularis, sive scapularis inferior, sive infrascapularis," Scemrnering. " Unter- 
echulterblattpulsader, A. scapularis communis," J. F. Meckel. 



230 AXILLARY ARTERIES. 

and serratus magnus, as well as to the lymphatic glands 
of the axilla. It gives several branches, of which two 
especially require notice. These ramify, one on the dorsal, 
the other on the ventral surface of the scapula, between 
the bone and the muscles ; the former is named the 
dorsal branch a. dorsalis scapulae circumflexa scapulae. 
They are of unequal size, the dorsal artery being much the 
larger. The subscapular artery and its connexions and 
branches are represented in plates 19, 26, 28, and 29. Its 
peculiarities will be associated with those of the circumflex 
arteries. 

The anterior circumflex and the posterior circumflex. These 
branches arise close to the subscapular, and often opposite 
one to the other. The posterior is considerably the larger, and 
is accompanied in its distribution by the circumflex nerve ; see 
plates 26 and 29. 

The entire number of the cases noted in the table 

both sides included is ..... 501 



The Branches are marked " usual " in . . . . | J^ 8 ^ e } Jg 

-- 217 
THE PECULIARITIES. 

Subscapular gives Supra-scapular plate 25, figure 1 1 

Subscap. arises in two parts Dorsalis Scapulae being a separate J R. 17 
branch of the Axillary ....... 1 L. 7 

-24 

Subscap. gives a considerable Thoracic branch. (Plate 30, JR. 10 
figure I) .......... \ L. 6 

16 

Subscap. gives a large Thoracic br. and Post. Circumfl., or JR. 2 
they arise by one trunk ....... \ L. 2 

4 

Subscap. and P. Circumfl. arise by one trunk . . . ] L 24 

'-67 



2 
2 

2 

4 



r p j 

Subscap., a Thor. br., and both Circumfl., arise by one trunk < j 
Subscap. and both Circumfl. arise by one trunk . . -"IT 

r ~n 1 

Subscap., P. Circumfl., and Super Prof, arise by one trunk < ^ 

2 
Subscap., both Circumfl., and Super Prof, arise by one trunk -[ ?' 1 

7 
Subscap., P. Circumfl., and both Prof, arise by one trunk -f ?* 

* 1 



THEIR BRANCHES. 231 

Subscap., both Circumfl., and both Prof, arise by one trunk f R. 10 

plate 30, figure 2 \L. 8 

18 

Subscap., both Circumfl., both Prof, and Anastom. arise by one JR. 1 
trunk \L. 1 

2 
Subscap., both Circumfl., both Prof, and Inteross. arise by one f R. 1 

trunk Plate 33, figure 1 : - ^ *; t \1* 

Subscap , both Circumfl., both Prof, and Radial arise by one |"R. 
trunk plate 30, figure 3. This case is not included in the-< L. 

table ,. .. t ; ., .'- ., .. , fc . _ -, /,; . L l 

In the foregoing cases the common trunk of the branches had the usual place 
of origin of the Subscapular artery, which might be considered to have given off 
theothers ; except, however, when a Thoracic artery of considerable size was one 
of the branches : in which case the common trunk was for the most part placed 
above its usual position. 

Post. Circumfl. gave origin to Dorsalis Scap. . . l T/ 3 

* 8 

" to Super. Prof. . . j ?' 

L Lt. o 

14 

to both Prof. - 1 .,' . . .|J- l 

1 

" " to Dorsalis Scap., and both Prof., or ("R. 1 

these brs. arose by a common trunk . . . , .\L. 

1 
Anter Circumfl. and Post. Circumfl. arose from a common JR. 14 

trunk . . w. . . ....'.'!.-. .. . IL. 15 

29 
r "R i 
' Both Circumfl. and Dorsal Scap. from a common trunk . 1 L* 1 



Both Circumfl., Dorsal Scap. and Super. Prof, from a com- f R. 2 

\ 



2 

. 
mon trunk ......... L. 

2 

Both Circumfl. and Super. Prof, from a common trunk plate/ R. 3 
30, figure 1. \L. 2 

5 

r T> n 

Both Circumfl. and both Prof, from a common trunk . . 4 * 

2 
In the cases here referred to, the trunk common to the Posterior Circumflex 

and other branches had the usual position of the Posterior Circumflex when a 
single artery, and it may therefore be said to have given off the branches. 

Post. Circumfl. arose from the Brachial artery *,.... ,. 'JL 2 

2 

" from the Super. Prof., or both emanated ("R. 37 

from a common trunk which had the usual place of origin of < L. 30 
the Super. Prof. ........ [ 67 

In the cases in which the Post. Circumfl. had this unusual origin, it ascended 
to its destination behind the tendons of the latissimus dorsi and teres major 
muscles. 

The Anterior and the Posterior Circumflex arteries were in some instances 
found to be double the latter most frequently so. 



232 AXILLARY ARTERIES. 



THE VEINS, THE NERVES, AND THE MUSCLES IN CONNEXION 
WITH THE AXILLARY ARTERIES. 

The veins. The position which the veins usually have with 
respect to the axillary artery is shown in plates 27 and 28. 

The axillary vein. I have not noticed any peculiarity of 
this vein requiring mention, in consequence of an influence it 
would be likely to exert on the performance of a surgical 
operation. An example of a double axillary and subclavian 
vein, observed by Morgagni, has been referred to in a pre- 
ceding part of this work (page 182). I have repeatedly seen 
the axillary vein perforated by a branch of the internal 
cutaneous nerve. May not the condition of the vein, in this 
case, be regarded as a transition to that noticed by Morgagni ? 

The cephalic vein was found in one instance to cross the 
clavicle, and end in the subclavian instead of the axillary vein. 
This case has likewise been previously noticed, page 183, and 
plate 25, figure 5. 

Reference may here be made to a peculiarity of another 
vein, the external jugular, which in one instance crossed the 
clavicle from above, and had therefore some connexion with 
the commencement of the axillary artery ; see ante, page 183, 
and plate 25, figure 4. 

The nerves. The ordinary disposition of the nerves will be 
found represented in the twenty-sixth and other plates. The 
peculiarities consist chiefly in the number of the branches 
which cross in front of the artery being increased from one to 
two, or to three. Examples of the artery being crossed by 
the nerves (roots of the median) at two points, are noticed in 
the table to have been observed in seventeen cases eight 
being on the right side, and nine on the left; see plate 31, 
figure 2. It was occasionally seen to be crossed successively 
by three such nerves ; only one instance, however, is recorded 
in the table. 

It is remarkable that when the axillary artery gives a large 
muscular trunk, from which several of the branches usually 
given singly from the axillary and the brachial arteries arise, 
the nerves are disposed around this unusual offset instead of 
the main vessel. This is recorded in the table of twenty-eight 



PECULIARITIES OF THE MUSCLES. 233 

cases, fifteen being on the right 'side, thirteen on the left. 
And it is illustrated in plate 33, figure 1, and in plate 30, 
figures 1 and 2. 

The heads of the median nerve are mentioned as having 
crossed the brachial in place of the axillary artery in two cases. 

The muscles. I have in several instances observed the 
lower part of the axilla crossed by a broad band of muscle, 
reaching from the latissimus dorsi, with which its fibres were 
continuous, to the fascia covering the biceps, or to the tendon 
of the larger pectoral muscle. 

I have seen a few examples of a deficiency of the lower part 
of the larger pectoral muscle ; and during the last winter a 
body came under my notice in which the lower half of the 
costal portion of the muscle was wanting, and the smaller 
pectoral lay exposed to a considerable extent after the integu- 
ments had been removed. But the deficiency of muscular 
fibres in these cases not approaching the situation of the 
axillary vessels, did not in any degree alter the accessibility 
of the artery. They are noticed in this place because they 
may be considered as a transition to a remarkable one lately 
observed. 

Of the case last referred to, it is stated that on the left side 
of the body no part of the greater pectoral muscle was present 
except that derived from the clavicle; that the smaller pectoral 
muscle was altogether wanting ; and that there existed but a 
small portion of the serratus magnus those fibres only which 
arise from the first two ribs. The position of the axillary 
vessels with reference to the free margin of the pectoral 
muscle is not mentioned in the report, and they are altogether 
omitted in the sketch accompanying it. It is probable 
that the vessels might have been exposed by turning the 
muscle slightly aside *. 

* The observation was made on the body of a male, *' 1'especting whom no history 
could be obtained ; except that it was remarked he could never draw his left arm across 
the chest ; and that when asked to give his left hand, in order that the pulse might be 
felt by any one standing on his right side, he invariably turned (his body ?) round to 
do so." The body generally " was spare and delicate. The muscles of the right arm 
were much more developed than those of the left," &c. 

" Deficiency of the pectoral muscles reported by Mr. Alfred Poland," in Guy's 
Hospital Reports, No. xii. p. 191 London, 1841. 



BRACHIAL ARTERIES. 



THE abbreviations adopted in the following table have been made in the same manner 
as those in the foregoing tables. 

The Brachial artery is said to be " usual" where it was a single vessel as far as the 
bifurcation at the bend of the elbow : situated along the inner side of the biceps muscle : 
uncovered by muscle : and crossed by the median nerve this being in front of the vessel. 

Where the branches are stated to have been " usual," it is implied that, besides several 
muscular branches directed outwards or backwards, there were three of greater length 
and usually of greater thickness, given from the inner side of the trunk namely, the 
Superior Profunda, the Inferior Profunda, and the Anastomotica magna. That these 
arose in the order they are here named the first being given close to the origin of the 
Brachial artery : the last a little above the inner condyle of the humerus : the third 
branch intervening between the other two, but situated nearer to the former than the 
latter. 

The statement that the trunk was " as two branches " means that the place of the 
usually single Brachial artery was occupied by two vessels into which the Axillary had 
divided. 



No. 


Side 
of the 
Body. 


Trunk. , 


Branches given above the bend of the Elbow. 


1 


B 


usual. 


usual. 




L 


usual. 


usual. 






["divides into two brs. 




1* 


L 


J (one of which is very 
| small) 1 inch from 


usual, and a " Vas Aberrans," which joins Radial. 






(^ beginning. 




2 


R 


usual. 


usual. 




L 


usual. 


usual. 






f divides into two brs. 




2 


R 


< about the middle of 


usual, and also the Radial. 






[_ humerus. 




2a 


R 


usual. 


f Both Prof, arise by one trunk. Anastomotic. 
\ Mag. arises higher than usual. 




L 


usual. 


Both Prof, arise from Axillary. 


2+ 


R 


usual. 


usual. 




L 


usual. 


usual. 


2f 


R 


usual. 


usual. 




L 


usual. 


usual. 


3a 


R 


usual. 


Both Prof, arise from Axillary, 


3b 


R 


f divides into two brs. 
\ about mid. of arm. 


usual, and the Ulnar. 




L 


usual. 


usual. 


3 


R 


fis in front of me- 
\ dian n. 


Prof, and Anastomotic brs. arise from Axillary. 



336 



BRACHIAL ARTERIES. 



No. 


Side 
of the 
Body. 


Trunk. 


Branches given above the bend of the Elbow. 




L 


as two brs. 


usual. 


4 


R 


fat two inches from 
j itsbeginning,divides 
J into two brs., one o 
| which crosses over 
j the other at the 
V^bend of the elbow 


usual, and also the Radial. 




L 


usual. 


usual. 


5 


R 


fas two brs., one of 
J which crosses over 
| the other near the 
l^bend of the elbow. 


Both Prof, arise by one trunk. 




L 


Tdivides, at one inch 
J from its beginning, 
j into two brs., one oi 
l^which is very small. 


usual and a "Vas Aberrans," which joined Radial. 





R 


^divides, high up, 
I into two brs., one oi 
< which crosses over 
I the other at the 
V^bend of elbow. 


usual, and Radial. 




L 


( divides near its be- 
j ginning into two 
j brs., one of which 
j crosses over the 
J other at the bend of 


usual, and Radial. 


5 


R 


usual. 


usual. 




L 


usual. 


usual. 


5* 


R 


usual. 


usual. 




L 


usual. 


usual. 


5a 


R 


isual. 


Super. Prof, arises from Axillary. 




L 


usual. 


usual. 


5b 


R 


until. 


usual. 




L 


usual. 


usual. 


6a 


R 


usual. 


Super. Prof, gives P. Circumfl. 




L 


f divides opp. middle 
< of the arm into two 
[bra. 


usual and Radial. Super. Prof, gives P. Circumfl. 



BRACHIAL ARTERIES. 



337 



No. 


Side 
of the 
Body. 


Trunk. 


Branches given above the bend of the Elbow. 


6 


R 


/divides near its be- 
|_ ginning into two brs. 


usual, and Radial. 




L 


usual. 


usual. 


7 


R 


f divides into two brs. 
L near its beginning. 


usual, and Radial. 




L 


usual. 


usual. 


7a 


R 


usual. 


usual. 




L 


usual. 


usual. 


7b 


R 


usual. 


usual. 




L 


usual. 


usual. 


8 


R 


usual. 


usual. .'-.- 




L 


usual. 


usual. 


9 


R 


usual. 


Both Prof, are given from Axillary. 




L 


usual. 


usual. 


9b 


R 


usual. 


usual and P. Circumfl. 




L 


usual. 


usual. 


9c 


R 


usual. 


usual. 




L 


usual. 


usual. 


10 


R 


usual. 


Both Prof, are given from Axillary. 




L 


usual. 


usual. 


lOa 


R 


f divides at middle of 
\ arm into two brs. 


/ Both Prof, from Axillary. Radial arises from inner 
\ side of the Brachial. 




L 


usual. 


usual. 


lOb 


R 


usual. 


usual. 




L 


usual. 




10 c 


R 


usual. 


usual. 




L 


usual. 


usual. 


11 


R 


usual. 


Both Prof, arise by one trunk. 




L 


usual. 


usual. 


12 


L 


usual. 


Both Prof, arise by one trunk. 



338 



BRACHIAL ARTERIES. 



No. 


Side 
of the 
Body. 


Trunk. 


Branches given above the bend of the Elbow. 


13 


R 


I" perforates median n. 
< at middle of the 


Both Prof, arise by one trunk. 






[arm. 




13a 


R 


usual. 


usual. 




L 


usual. 


usual. 


14 


L 


usual. 


Super Prof, as three small separate brs. 






f"\s crossed at mid. of 








j the arm by a br. of 




15 


R 


< ext. cutan. nerve, 


usual. 






1 which joins the me- 








(^dian n. 








ps crossed at mid. of 
1 the arm by a br. of 






L 


1 ext. cutan. nerve, 


usual. 






I which joins theme- 
l^dian. 




15a 


R 


usual. 


Both Prof, and the Anastomotic arise by one trunk- 




L 


as two brs. 


usual. 


15b 


R 


usual. 


usual. 




L 


usual. 


usual. 


16 


R 


usual. 


usual. 




L 


usual. 


Super. Prof, as three small separate brs. 


18 


R 


("crosses in front of 
\ median nerve. 


Super. Prof, as three small brs. 


19c 


R 


usual. 


usual. 




L 


usual . 


usual. 


20 


R 


usual. 


usual. 




L 


f crosses in front of 
\ median nerve. 


usual. 


21 


R 


usual. 


usual. 




L 


usual. 


usual. 


'23 


R 


usual. 


P. Circumfl. arises from Brachial. 




L 


usual. 


Infer. Prof, is larger than usual. 


23 a 


R 


usual. 


Super. Prof, descends from P. Circumfl. 




L 


usual. 


P. Circumfl. arises from Brachial. 



BRACHIAL ARTERIES. 



239 



No. 


Side 
of the 
Body. 


Trunk. 


Branches given above the bend of the Elbow. 


24 


R 


as two brs. 


usual. 




L 


usual. 


usual. 


26 


R 


usual. 


usual. 




L 


usual. 


usual. 






("divides near its be- 




27 


R 


< ginning into two 
[bra. 


usual and Ulnar. 






f divides above inner 







L 


< condyleof humerus 
L into two brs. 


usual and Ulnar. 


27a 


R 


usual. 


Super. Prof, gives P. Circumfl. 




L 






28 


R 


usual. 


usual. 




L 


usual. 


usual. 


29 


R 


usual. 


P. Circumfl. arises from Brachial. 


30 


R 


usual. 


usual. 




L 


usual. 


usual. 


31 


R 


usual. 


Super. Prof, double. 




L 


as two brs. 


usual. 


sit 


R 


usual. 


f Super. Prof, double, one br. being from a large 
\ Muscular br. of Axillary. 




L 


usual. 


Super. Prof, arises from Axillary. 


31c 


R 


usual. 


Both Prof, arise by one trunk. 






/divides opp. middle 
I of hum er us into two 






L 


1 brs., one of which 
] crosses over tbe 


usual with Radial, and Radial Recurrent. 






1 other at the bend of 








V elbow. 




31: 


R 


usual. 


usual. 




L 


usual. 


usual. 


31d 


R 


usual. 


usual. 




L 


usual. 


Both Prof, from a Muscular br. of Axillary. 


31e 


R 


nearly usual. 


Radial is given at 1^ inch above elbow. 



240 



BRACHIAL ARTERIES. 



No. 


Side 
of the 
Body. 


Trunk. 


Branches given above the bend of the Elbow. 




L 


'divides at middle of 
the arm into two 
brs., one of which 
crosses over the 
other at bend of the 
elbow. Median n. 
is to inner side of 
^both. 


isual and Radial. 


33 


R 


usual. 


Super. Prof, double. 


34 


L 


usual. 


usual. 


37 


R 


usual. 


Both Prof, arise from Axillary. 


37J 


L 


usual. 


usual, with some additional Muscular brs. 


37b 


L 


usual. 


usual. 


38 


R 


as two brs. 


j" A short transverse br. communicates at the bend of 
< the elbow between the two into which the Axillary 
|_ divides. 


39 


R 


usual. 


Super. Prof, gives P. Circumfl. 




L 


usual. 


Super. Prof, gives P. Circumfl. 


40 


L 


usual. 


usual. 


40a 


L 


usual. 


usual. 


40b 


R 


usual. 


usual. 


41 


R 


usual. 


usual. 


41 a 


R 


usual. 


Super. Prof, gives P. Circumfl. 


42 


R 


usual. 


usual. 


43 


L 


usual. 


Super. Prof. fr. a large Muscular br. of Axillary. 


44 


R 


usual. 


usual. 




L 


usual. 


usual. 


45 


R 


usual. 


Both Prof, from a large Muscular br. of Axillary. 


47 


R 


usual. 


Both Prof, from a large Muscular br. of Axillary. 


48 


R 


usual. 


usual. 




L 


usual. 


usual. 


48a 


R 


usual. 


usual. 


49a 


R 


usual. 


usual. 



BRACHIAL ARTERIES. 



241 



No. 


Side 
of the 
Body. 


Trunk. 


Branches given above the bend of the Elbow. 




L 


usual. 


usual. 


50 


R 


usual. 


usual. 




L 


usual. 


Super. Prof. fr. a large Muscular br. of Axillary. 


51 


R 


usual. 


usual. 




L 


usual. 


usual, and Radial Recurrent. 


52 


R 


usual. 


usual. 




L 


usual. 


usual. 


53 


R 


usual. 


Super. Prof, gives P. Circumfl. 




L 


usual. 


usual. 


54 


R 


usual. 


Super. Prof, gives P. Circumfl. 




L 


usual. 


Super. Prof, gives P. Circumfl. Infer. Prof, absent. 


55 


R 


usual. 


usual, and Radial Recurrent. 




L 


usual. 


Super. Prof, as three small brs. 


56 


R 


fas two brs., one of 
J which crosses over 
j the other at bend of 
[_elbow. 


Super. Prof, gives P. Circumfl. 




L 


usual. 


Super. Prof, gives P. Circumfl. 


57 


R 


usual. 


Super. Prof, descends from P. Circumfl. 




L 


usual. 


Anastomotic is absent. Radial Recurrent fr. Brachial. 


58 


R 


usual. 


Super. Prof, gives P. Circumfl. 




L 


usual. 


Super. Prof, gives P. Circumfl. 


59 


R 


usual. 


Infer. Prof, rises as high as Super. Prof. 




L 


usual. 


usual. 


60 


R 


usual. 


usual. 




L 


usual. 


Super. Prof, gives P. Circumfl. 


61 


R 


/crosses in front of 
\median n. 


Both Prof, arise by one trunk. 




L 


usual. 


usual. 


62 


R 


usual. 


usual. 


63 


R 


usual. 


Super. Prof, as three brs. 



7, 2 



242 



BRACHIAL ARTERIES. 



No. 


Side 
of the 
Body. 


Trunk. 


Branches given above the bend of the Elbow. 




L 


usual. 


Super. Prof, gives P. Circumfl. 


64 


R 


usual. 


Super. Prof, descends from P. Circumfl. 




L 


usual. 


Super. Prof, descends from P. Circumfl. 


65 


R 


usual. 


Infer. Prof, is very small. 




L 


usual. 


usual. 


66 


R 


usual. 


/Super. Prof, gives brs. to biceps muscle ; they pass 
\ behind the Brachial artery. 




L 


("divides in to two brs. 
< at one inch from its 
(_ beginning. 


usual, with Radial and Recurrent Radial. 


67 


R 


f crosses in front of 
\ median nerve. 


Anastomotic is absent. 




L 


("divides at its be- 
J ginningintotwo brs. 
| both of which cross 
|^in front of median n. 


usual and Radial. 


68 


R 


TThe division into 
I two brs. occurs a 
| little above the 
j^usual position. 


usual. 




L 


usual. 


usual. 


69 


R 


usual. 


usual. 




L 


usual. 


Both Prof, arise from Axillary. 


70 


R 


usual. 


usual. 




L 


isual. 


J" Both Prof, from a large Muscular br. of Axillary. 
\ 8 Muscular brs. arise from Brachial. 


71 


R 


usual. 


icarly usual. 




L 


usual. 


usual. 


72 


R 


isual. 


J Both Prof, arise by one trunk. Radial Recurrent 
^from Brachial. 




L 


usual. 


nearly usual. 


73 


R 


as two brs. 


f Super. Prof, in two parts, one from Circumfl., 
]_ the other from Brachial. 




L 


f dividesinto two brs. 
[_ at commencement. 


f Both Prof, arise by one trunk. Ulnar from be- 
\ginning of Brachial. 


74 


R 


usual. 


isual. 



BRACHIAL ARTERIES. 



243 



No. 


Side 
of the 
Body. 


Trunk. 


Branches given above the bend of the Elbow. 




L 


usual. 


J Super. Prof, as three brs. Radial Recurrent from 
\ Brachial. 


75 


R 


usual. 


("Super. Prof, arises from a large Muscular br. of 
< Axillary, and passes in front of lat. dors. m. 
L Infer. Prof, absent. 


76 


R 


as two brs. 


fSuper. Prof, as three brs. Infer. Prof, small, and 
J from Super. Prof. The two arteries into which 
j the Axillary divides, communicate by a short trans- 
Averse br. at the bend of the elbow. 




L 


usual. 


usual. 


77 


R 


usual. 


Super. Prof, descends from Circumfl. 




L 


fis in front of median 
j nerve, and divide 
< opp. inner condyle 
1 of bumerus into 
l^two brs. 


/ Super. Prof, from Circumfl. Ulrrar from Brachial 
\a little above the usual position. 


78 


R 


usual. 


usual. 




L 


usual. 


usual. 


79 


R 


usual. 


usual. 




L 


usual. 


isual. 


80 


R 


ml. 


J Super. Prof, gives P. Circumfl. Brachial gives six 
\ Muscular brs. 




L 


sual. 


Super. Prof, gives P. Circumfl. 


81 


L 


sual. 


isual. 


82 


R 


sual. 


Super. Prof, gives P. Circumfl. 




L 


sual. 


Super. Prof, gives P. Circumfl. 


83 


R 


" divides above inner 
condyle of humerus. 


f Both Prof, and Anastomotic from Axillary. Ulnar 
[ from Brachial higher than usual. 




L 


divides above inner 
condyle of humerus. 


r Both Prof, and Anastomotic from Axillary. Uluar 
w from Brachial above usual position. 


84 


R 


sual. 


sual. 




L 


sual. 


' Super. Prof, from P. Circumfl. Brachial gives five 
Muscular brs. and Radial Recurrent. 


85 


R 


sual. 


sual. 




L 


sual. 


'Super. Prof, arises from Axillary, and passes in 
w front of lat. dorsi m. 



244 



BRACHIAL ARTERIES. 



No. 


Side 
of the 
Body. 


Trunk. 


Branches given above the bend of the Elbow. 


86 


R 


usual. 


usual. 




L 


usual. 


usual, with eight Muscular brs. and Radial Recurrent. 


87 


L 


usual. 


usual. 


88 


R 


usual. 


f Super. Prof, as two brs. Anastomotic as two brs. 
I Five Muscular brs. arise from Brachial. 




L 


isual. 


Super. Prof, as two brs. 


89 


R 


usual. 


Anastomotic as two brs. Four Muscular brs. 






is crossed by a 








bundle of muscular 








fibres extending 








above the middle 






L 


of the arm from 
biceps to triceps : 


usual. 






also by a nerve 








reaching from ext. 








cutaneous to me- 








^dian. 




90 


R 


usual. 


usual. 




L 


usual. 


Super. Prof, as two brs. 


91 


R 


usual. 


usual, and eight Muscular brs. 




L 


usual. 


usual. 


92 


R 


{divides into two 
brs., one inch from 
commencement. 


usual : with Ulnar and four Muscular brs. 




L 


usual. 


Super. Prof, as 2 brs.; 6 Muscular brs. 


93 


R 


usual. 


usual. 




L 


usual . 


usual. 


94 


R 


usual. 


usual. 




L 


usual. 


usual. 


95 


L 


usual. 


Super. Prof, gives P. Circumfl. 


96 


R 


usual. 


J Super. Prof, as three brs. ; Recurrent Radial from 
\ Brachial. 




L 


usual. 


nearly usual. 


97 


R 


usual. 


usual. 




L 


usual. 


usual. 



BRACHIAL ARTERIES. 



245 



No. 


Side 
of the 
Body. 


Trunk. 


* 

Branches given above the bend of the Elbow. 


98 


R 


. [" divides into two brs 
< half inch from it 
|_ commencement. 


f Super. Prof, from Axillary ; Radial from beginnin 
\ of Brachial ; others usual. 




L 


as two brs. 


Super. Prof, as four brs. 


99 


R 


usual. 


usual. 




L 


usual. 


Super. Prof, gives P. Circumfl. 


100 


R 


usual. 


/ usual, with eight Muscular brs., and Radial Recur- 
\ rent. Super. Prof, gives P. Circumfl. 




L 


usual. 


J~ usual, and three large Muscular brs. Super. Prof. 
\ gives P. Circumfl. 


101 


R 


usual. 


usual. 




L 


usual. 


usual. 


102 


R 


usual. 


nearly usual. 




L 


usual. 


1" Super. Prof, from a large Muscular br. of Axillary, 
4 and in front of latiss. dorsi m. Radial Recurrent 
(_ from Brachial. 


103 


R 


as two brs. 


usual. 




L 


usual. 


usual. 


104 


R 


isual. 


usual. 




L 


asual. 


usual. 


105 


R 


usual. 


nearly usual. 




L 


usual. 


usual. 


106 


L 


usual. 


3oth Prof, arise by one trunk. 


107 


R 


("divides at its coni- 
< mencement into 
[two brs. 


usual and Radial. 




L 


s two brs. 


[nfer. Prof, is absent. 


108 


R 


sual. 


usual. 




L 


sual. 


Both Prof, arise by one trunk. 


109 


R 


sual. 


usual. 




L 


sual. 


asual, and six Muscular brs. 


110 


R 


sual. 


usual. 




L 


sual. 


usual. 



246 



BRACHIAL ARTERIES. 



No. 


Side 
of the 
Body. 


Trunk. 


Branches given above the bend of the Elbow. 


Ill 


R 


usual. 


Super. Prof, as four brs. Five Muscular brs. 




L 


usual. 


usual, and four Muscular brs. 


112 


R 


usual. 


f usual, and Radial Recurrent, which passes behind 
\tendon of biceps. 




L 


usual. 


usual. 


113 


R 


usual. 


Super. Prof, from P. Circumfl. 




L 


usual. 


usual. 


114 


R 


(" divides at one inch 
< above inner condyle 
[into two brs. 


nearly usual. Ulnar above usual position. 




L 


as two brs. 


nearly usual. 


115 


R 


usual. 


usual. 




L 


usual. 


usual. 


116 


R 


usual. / ' 


f Anastomotic and Radial Recurrent arise from end 
\ of Brachial. 




L 


usual. 


f Super. Prof, as two brs. Brachial gives seven 
\ Muscular brs. and Radial Recurrent. 


117 


R 


usual. 


usual. 




L 


as two brs. 


usual. 


118 


R 


usual. 


f Both Prof, arise from a Muscular br. of Axillary. 
\ Recurrent Radial from end of Brachial. 




L 


usual . 


usual . 


119 


R 


/'divides, one inch 
1 from commence- 
1 incnt, into two brs. 
\ which communicate 
I by transverse br. a1 
Vjhe end of elbow. 


nearly usual. 




L 


usual. 


usual and Radial Recurrent. 


120 


L 


usual. 


f Super. Prof, arises from a large Muscular br. of 
\ Axillary. Infer. Prof, absent. 


121 


R 


f divides into two brs 
< at two inches from 
(_ its commencement. 


usual and Radial. 




L 


usual. 


usual. 



BRACHIAL ARTERIES. 



247 



No. 


Side 
of the 
Body. 


Trunk. 


Branches given above the hend of the Elbow. 


122 


R 


J~ divides one inch 
\ higher than usual. 


isual. 


123 


L 


usual; 


usual. 


124 


R 


usual. 


Super. Prof, gives P. Circumfl. 




L 


usual. 


Super. Prof, gives P. Circumfl. 


125 


R 


usual. 


usual. 




L 


usual. 


usual. 


126 


L 


usual. 


usual. 


127 


R 


{divides at com- 
mencement into 
two brs., which 
communicate by a 
short br. at bend 
of elbow. 


usual and Radial. 




L 


usual. 


usual. 


128 


R 


usual. 


Super. Prof, gives P. Circumfl. 




L 


usual. 


usual. 


129 


R 


f perforates the fi- 
< brous expansion of 
|_ biceps m. 


J~ usual and Recurrent Radial. Super. Prof, gives 
\ P. Circumfl. 




L 


Tas two brs. : one is 
1 very slender and 
<{ perforates the fi- 
1 brous expansion of 
l^biceps m. 


usual. 


130 


R 


usual. 


usual. 




L 


usual. 


f usual and Radial Recurrent. Super. Prof, gives 
\P. Circumfl. 


131 


R 


usual. 


usual. 




L 


usual. 


Two Muscular brs. 


132 


R 


["divides above the 
< margin of pronator 
[ teres m. 


usual. 




L 


usual. 


usual. 


133 


L 


f divides into two 
< brs. at its com- 
[ mencement. 

1 





248 



BRACHIAL ARTERIES. 



No. 


Side 
of the 
Body. 


Trunk. 


Branches given above the bend of the Elbow. 


134 


L 


usual. 


f usual and Radial Recurrent. Super. Prof, gives 
\ P. Circumfl: 


135 


R 


usual. 


usual. 




L 


usual. 


usual. 


136 


j R 


usual. 


usual. 




L 


usual. 


f usual and four Muscular. Super. Prof, gives P. 
"[_ Circumfl. 


137 


R 


f divides into two brs 
\ at its beginning. 


usual and Ulnar. 




L 


usual. 


usual. 


138 


R 


usual. 


usual, and four Muscular. 


139 


R 


usual. 


usual, and seven small Muscular. 




L 


usual. 


usual. 


140 


R 


usual. 


usual, and one Muscular. 




L 


usual. 


usual, and one Muscular. 


141 


R 


usual. 


3oth Prof, arise by one trunk. 


145 


R 


[" divides into two brs. 
< at two inches from 
|_its beginning. 


usual and Radial. 




L 


usual. 


usual. 


146 


R 


usual. 


isual. 




L 


usual. 


isual. 


148 


R 


usual. 


usual. 


149 


R 


usual . 


f usual and Radial Recurrent, which crosses behind 
\ tendon of biceps m. 




L 


usual. 


usual. 


150 


R 


("divides into three 
< brs.aboveinnercon- 
[dyle of humerus. 


/usual, and four Muscular. Radial, Ulnar, and 
\ Inteross. also arise from Brachial. 




L 


I" gives Inteross. a 
< little above inner 
[condyle. 


I" Super. Prof, arises from P. Circumfl. Inteross. 
\ from Brachial. 


151 


R 


f divides into two brs. 
< opp. inner condyle 
[ of humerus. 


[ Four muscular and Ulnar. Super. Prof, gives P. 
\ Circumfl. Infer. Prof, absent. 



BRACHIAL ARTERIES. 



249 



No. 


Side 
of the 
Body. 


Trunk. 


Branches given above the bend of the Elbow. 




L 


usual. 


usual. 


152 


R 


usual. 


J~ Both Prof, arise by one trunk, which gives also P. 
\ Circumfl. There are nine small Muscular brs. 




L 


usual. 


usual. 


153 


R 


usual. 


Super. Prof, gives P. Circumfl. 




L 


usual. 


Super. Prof, gives P. Circumfl. 


154 


R 


usual. 


usual. 




L 


usual. 


usual. 


155 


L 


usual. 


Both Prof, arise by one trunk. 


156 


R 


usual. 


usual, and five Muscular. 




L 


usual. 


usual. 


157 


R 


usual. 


Anastomotic arises from Infer. Prof. 




L 


f divides into two brs 
\ at its middle. 


usual and Radial. 


158 


R 


usual. 


Super. Prof, gives P. Circumfl. 




L 


usual. 


Super. Prof, gives P. Circumfl. 


164 


R 


usual. 


Super. Prof, as three brs. 


168 


R 


usual. 


usual. 




L 


usual. 


usual. 


169 


R 


fas two brs. which 
< communicate by a 
|_ br. at bend of elbow. 


Both Prof, and P. Cii'cumfl. are given by one trunk. 


172 


R 


usual. 


usual, and five Muscular. 




L 


usual. 


usual. 


174 


R 


usual. 


usual. 


176 


R 


("crosses in front of a 
J br. of ext. cutan. 
] nerve, which goes 
[_to median. 


f Infer. Prof, large, supplying a deficiency of Super. 
\ Prof, and Anastomotic. 




L 


as two brs. 


usual. 


177 


R 


usual. 


Super. Prof, as two brs. 




L 


usual. 


usual and Radial Recurrent. Super. Prof, as two brs. 



250 



BRACHIAL ARTERIES. 



No. 


Side 
of the 
Body. 


Trunk. 


Branches given above the bend of the Elbow. 


178 


R 


usual. 


usual and Radial Recurrent. 






("divides into two brs. 






L 


< opp. inner condole 
[ofhumerus. 




179 


R 


usual. 


Infer. Prof, small. Anastomotic large. 




L 


usual. 




180 


L 


usual. 


usual, and seven small Muscular. 


181 


R 


usual. 


Super. Prof, as two brs. 






f~is crossed at two 






L 


I inches from begin- 
| ning by a root of 
[_ median n. 


usual and six Muscular. 


182 


R 


usual. 


Both Prof, arise by one trunk. 




L 


usual. 


f usual, and three Muscular. One of the latter is 
\ very large. 


183 


R 


usual. 


usual, and six Muscular. 


184 


R 


usual . 


usual. 




L 


usual. 


J Super. Prof, arises from a large Muscular br. of 
\ Axillary. 


185a 


R 


(" divides into two brs. 
I at 1 inch from its 
|_ origin. 


/Both Prof, and P. Circumfl. are given by one 
\ trunk close to the origin of the Brachial. 


185 


L 


usual. 


usual. 


186 


R 


is two brs. 


Both Prof, arise by one trunk. 




L 


as two brs. 


usual. 


187 


R 


as two brs. 


isual. 




L 


as two brs. 


usual, and four Muscular. 


188 


R 


/ divides one inch 
\ higher than usual. 


usual, and eight Muscular. 


189 


R 


usual. 


Both Prof, arise by one trunk. 


190 


L 


usual. 


usual. 




L 


usual. 


Super. Prof, as three brs. 






f divides into two brs. 




191 


R 


< at about two inches 
[from its beginning. 


3oth Prof, arise by one trunk. 



BRACHIAL ARTERIES. 



251 



No. 


Side 
of the 
Body. 


Trunk. 


Branches given above the bend of the Elbow. 


L 


f divides into two bre. 
\ at its middle. 


Both Prof, arise by one trunk. 


192 


R 


usual. 


usual, and seven Muscular. 




L 


( divides at its middle 
I into two brs., which 
J at bend of elbow 
\ are close together, 
1 and external to me- 
^dian n. 


Super. Prof, as two brs. Four Muscular. 


193 


R 


usual. 


usual, and six Muscular. 




L 


Tis crossed at bend of 
I elbow by a slender 
< br. of ext. cutan. 
1 n. which joins me- 
\^dian n. 


Super. Prof, as two brs. 


194 


L 


usual. 


usual, and three Muscular. 


195 


R 


usual. 


usual. 




L 


/'is crossed at two 
J inches from its com- 
4 mencement by a n. 
1 reaching from ext. 
\ cutan. to med. n. 


usual, and six Muscular two of which are large. 


199 


R 


usual. 


J" Both Prof, arise from a large Muscular br. of 
\ Axillary. Five Muscular brs. 




L 


usual. 


usual. 


200 


L 


usual. 


Both Prof, arise from a large muscular br. of Axillary. 


203 


R 


usual. 


Super. Prof, gives P. Circumfl. 


204* 


L 


usual. 


usual. 


205 


R 


usual. 


usual. 


207 


L 

R 


/divides one inch 
\ higher than usual. 

usual. 


usual. 

J" usual and Radial Recurrent. Super. Prof, gives 
\ P. Circumfl. 


207a 


R 


ps crossed a little 
I above hend of elbow 
< by a nerve passing 
j from ext. cutan. to 
^median n. 


Both Prof, arise by one trunk. 




L 


usual. 


Super. Prof, gives P. Circumfl. 


207 b 


L 


usual. 


usual. 



252 



BRACHIAL ARTERIES. 



No. 


Side 
of the 
Body. 


Trunk. 


Branches given above, the bend of the Elbow. 


209 


R 


usual. 


Super. Prof, gives P. Circumfl. 


210 


L 


usuaL 


usual and Radial Recurrent. 


211 


L 


usual. 


usual. 


212 


R 


usual. 


Super. Prof, gives P. Circumfl. 


213 


R 


usual. 


usual. 




L 


usual. 


usual. 


214 


R 


usual. 


Super. Prof, gives P. Circumfl. 


215 


R 


usual. 


J usual, and nine Muscular one of which is large. 
\ Super. Prof, gives P. Circumfl. 


216 


R 


usual. 


usual. 




L 


usual. 


{Super. Prof, arises one inch above lower margin of 
lat. dorsi m., and gives P. Circumfl., which turns 
[_ upwards behind that muscle. 






Tis crossed at its 




217 


R 


I middle by a nerve 
| reaching from ext. 
(_cutan. to median n. 


Super. Prof, gives P. Circumfl. 


218 


R 


usual. 


usual. 


219 


R 


usual. 


usual. 


220 


R 


usual. 


J Super. Prof, arises from a large Muscular br. of 
\ Axillary. 




L 


divides into two brs. 


f usual, and a " Vas Aberrans," which joins Radial 
\ Recurrent. 


221 




usual. 


Both Prof, arise from a large Muscular br. of Axillary. 






usual. 


Both Prof, arise from a large Muscular br. of Axillary. 


222 


R 


( divides 1^ inch from 
I beginning into two 
1 brs., the larger of 
| which is covered by 
1 a layer of brachialis 
V^ant. muscle. 


usual and Radial. 




L 


f as two brs., one of 
\ wh. is very slender. 


usual. 


223 


R 


usual. 


/Super. Prof, as two brs., one of which gives P. 
\ Circumfl. 




L 


usual. 


("Super. Prof, as two brs v one of which gives P. 
\ Circumfl. 



BRACHIAL ARTERIES. 



253 



No. 


Side 
of the 
Body. 


Trunk. 


Branches given above the bend of the Elbow. 


224 


R 


usual. 


Super. Prof, gives P. Circumfl. 


225 


R 


usual . 


usual. 






'is separated from 








median n. near the 








bend of elbow, by a 








broad additional ori- 






L 


< gin which pronat. 


usual and Radial Recurrent. 






teres m. has from 








the intermuscular 








septum above inner 








^condyle of humerus. 








^divides at two inches 








j from beginning into 




226 


R 


{ two brs., which are 


usual and Radial. 






I connected by a short 








l^br. at bend of elbow. 








fas two brs., thelar- 






L 


1 ger of which divides 
<{ much lower than 
I usual, into Ulnar, 


("usual : with the Radial Recurrent and the Ulnar 
\ Recurrents. Super. Prof, gives P. Circumfl. 






V^Rad,, and Inteross. 




227 


R 


usual. 


usual. 




L 


usual. 


usual. 






/""crosses in front of 








1 median n., and di- 




229 


R 


< vides immediately 


Anastomotic from Super. Prof. 






1 above pronator teres 




230 


R 


usual. 


Super. Prof, arises from P. Circumfl. 






f" divides into two brs. 






L 


I at 2i inches from 


usual. 






l_its beginning. 




231 


R 


usual. 


/ usual and Radial Recurrent, which crosses behind 
\ tendon of biceps m. 






Tis crossed near its 






L 


I end by a br. of ext. 
| cutan. n. reaching 


usual. 






[_to median. 




232 


R 


usual. 


/usual. Eight Muscular, and Radial Recurrent. 
\ Super. Prof, as two brs. 






val 


("usual and Radial Recurrent. Super. Prof, as 








\ two brs. 



254 



BRACHIAL ARTERIES. 



No. 


Side 
of the 
Body. 


Trunk. 


Branches given abore the bend of the Elbow. 


233 


R 


f'\a crossed by a br. 
1 of ext. cutan. n. 
1 reaching to median ; 
| divides into two brs. 
I at three inches from 
^beginning. 


usual and Radial. Super. Prof, gives P. Circumfl. 




L 


/'divides at 3 inches 
from beginning into 
two brs. These are 
crossed by a tendi- 
nous cord, which 
reaches from outer 
side of biceps m. to 
the intermuscular 
septum above inner 
condyle of humerus. 


f usual and Radial, with six Muscular brs., and Radial 
-< Recurrent. The last-named crosses behind tendon 
{_ of biceps m. 


234 


L 


usual. 


Super. Prof, as two brs. 


235 


R 


usual. 


Super. Prof, gives P. Circumfl. 




L 


usual. 


Super. Prof, gives P. Circumfl. 


236 


R 


fas two brs., one of 
\ wh. is very slender. 


usual. 


237 


R 


f divides into two brs. 
\ above its middle. 


usual and Radial. 




L 


usual. 


usual. 


238 


R 


f divides into two brs. 
\ near its beginning. 


usual, and a Vas Aberrans, which joins Radial. 


240 


R 


usual. 


usual. 


241 


R 


f divides a little 
\ higher than usual. 


Super. Prof, gives P. Circumfl. and Infer. Prof. 


242 


R 


usual. 


usual. 


243 


R 


Cia crossed at its mid- 
\ die by a nerve going 
1 from ext. cutan. to 
l_ median. 


usual and Radial Recurrent. 


247 


R 


usual. 


usual. 


248 


R 


usual. 


usual. 


249 


R 


usual. 


isual. 




L 


usual. 


f Super. Prof, as two brs. ; one descends from P. 
\ Cireumfl. 


250 


R 


usual. 


Super. Prof, gives P. Circumfl. 



BRACHIAL ARTERIES. 



255 



No. 


Side 
of the 
Body. 


Trunk. 


Branches given above the bend of the Elbow. 




L 


usual. 


Super. Prof, gives P. Circumfl. 


251 


R 


usual. 


usual. 




L 


/ divides 1 inch above 
\ usual position. 


usual. 


252 


R 


usual. 


usual. 




L 


usual. 


usual. 


253 


R 


/ divides into two brs. 
\ at its beginning. 


usual and Ulnar. 




L 


usual. 


Both Prof, arise by one trunk. 


254 




usual. 


usual. 




L 


usual. 


Super. Prof, as two brs. 


255 


R 


'as two brs. The 
larger is crossed by 
the heads of median 
n.: and with the 
same nerve deviates 
to the inner side of 
the arm, and is co- 
vered by a layer of 
brachialis ant.mus- 


usual. 




L 


usual. 


Super. Prof, gives P. Circumfl. 


256. 


R 


usual. 


/Super. Prof, gives a small br., which turns upwards 
\ behind teres major m. 


257 


L 


usual. 


Super. Prof, gives P. Circumfl. 




R 


usual. 


Super. Prof, gives P. Circumfl. 




L 


usual. 


Super. Prof, gives P. Circumfl. 


258 


L 


'is crossed by a bun- 
dle of muscular 
fibres, which joins 
biceps m. near its 
< end. Also, at two 
inches from elbow, 
by a br. of nerve 
reaching from ext. 
^cutan, to median n. 




259 


R 


usual. 


/ Both Prof, and Anastomotic arise by a common 
\ trunk from Axillary. 


2GO 


R 


usual. 


Super. Prof, arises opp. upper part of lat. dorsi m. 



256 



BRACHIAL ARTERIES. 



No. 


Side 
of the 
Body. 


Trunk. 


Branches given above the bend of the Elbow. 






fas two brs. The 








larger of these, ac- 








companied by me- 








dian nerve, lies close 








to the intermuscular 








septum above the 




261 


L 


innercondyle of the 
humerus as far as 


Both Prof, from Axillary. 






thepronat. teres,un- 








der the upper mar- 








gin of which mus- 








cle it inclines out- 








wards to its usual 








position at the bend 








of the elbow. 








f divides into two brs. 




262 


R 


< at two inches from 


usual and Intefoss. 






|_its origin. 






L 


f divides into two brs. 
\ at its beginning. 


usual and Radial. 


264 


R 


{divides opp. inner 
condyle of the hu- 


% 






merus. 




265 




usual. 


Super. Prof, arises from Axillary. 


267 


R 


usual. 


Super. Prof, gives P. Circumfl. 




L 


usual. 


Super. Prof, gives P. Circumfl. 






ps crossed at its be- 




269 


R 


j ginning by a large 
-^ br. extending from 


Super. Prof, gives P. Circumfl. 






I ext. cutan. to me- 








l^dian nerve. 




271 


R 


J" is in front of median 
\ nerve. 


{usual and Radial Recurrent. Super. Prof, gives 
P. Circumfl. 




L 


usual. 


Super. Prof, gives P. Circumfl. 


272 


R 


usual. 


usual. 




L 


isual. 


usual. 


274 


R 


usual. 


usual. 




L 


usual. 


usual. 






fis crossed at its be- 




275 


R 


< ginnning by one 


usual. 






I head of median n. 





BRACHIAL ARTERIES. 



257 



No. 


Side 
of the 
Body. 


Trunk. 


Branches given above the bend of the Elbow. 






/^divides at 2 inche 








above inner con 




276 


L 


dyle of humeru 
into two brs.; the 
larger of these i 
1 directed inwards to 
the intermuscula 


usual and Radial. 






septum, in company 
with the median n. 








and is covered by a 
very broad pronato 
^teres muscle. 




277 


R 


usual. 


usual. 


278 


R 


f divides into two brs 
\ at its beginning. 


usual and Interosseous. 




L 


as two brs. 


usual. 


279 


L 


usual. 


usual. 






fis crossed at its mid- 




281 


L 


J die by a br. of ext 
] cutan. nerve going 
[_to median. 




282 


L 


usual. 


usual. 


283 


R 


f divides into two brs. 
\ near its beginning. 


usual and Radial. 


284 


R 


usual. 


usual. 




L' 


usual. 


usual. 


289 


R 


usual . 


usual. 




L 


I" divides into two brs. 
L near its beginning. 


usual and Radial. 


290 


R 


usual. 


Both Prof, arise from a Muscular trunk of Axillary. 




L 


as two brs. 




291 


R 


s two brs. 


usual. 


292 a 


R 


as two brs. 


isual. 






^as two brs., the 








larger of which is 
crossed near bend of 




293b 


R 


elbow by a br. of 
nerve extending 
from ext. cutan. to 


usual. 






median . 





258 BRA CHI AL ARTERIES. 

ABSTRACT OF THE TABLE, 

AS REGARDS THE TRUNK OP THE BRACHIAL ARTERIES. 



CASKS 

The artery had the usual * disposition . . . Right side . 186 

Left . .179 

365 

The artery divided into two branches above the usual 

situation Right side . 32 

Left . . 21 

53 

The division occurred at the distance of one 

inch or less from its beginning . . Right side . 1 1 

Left . . 8 

at more than one inch, and not ex- 
ceeding three inches . . . Right side . 9 

Left . . 2 

at about the middle of the humerus Right side . 4 

Left . . 5 

opposite the inner condyle of the 

humerus, and not more than one inch 
above it . *..-'. !""' Right side . 8 

Left . . 6 

53 

The artery divided considerably below the usual position. Right side . 

Left . . 1 

j 

It divided into three branches a little above the inner 

condyle of humerus ..... Right side . 1 

Left . . 

1 

It was "as two branches " that is to say, two branches 
resulting from the division of the Axillary occupied 
the place of the Brachial . . . Right side . 15 

Left . . 15 

30 

The two arteries resulting from the division of the Axillary, 
or from the premature division of the Brachial, were 
found to communicate by a transverse branch at the 

bend of elbow Right side . 6 

Left 3 



Several facts having reference to the Axillary artery, which are recorded in 
the table and are not included in the above abstract, will be made use of in the 
observations on the artery. 

The statements in the table respecting the branches will be noticed in the 
remarks on the branches. 

* The arrangement considered to be the usual one is described in the remarks 
prefixed to the table. 



259 



BRACHIAL ARTERIES. 

The observations on these arteries will be placed under the 
following heads : 

A. The position they occupy along the arm. 

B. The place of division. 

C. The presence of more than one artery in the position of 
the brachial. 

D. The arrangement of the branches. 

E. The disposition of the veins, the nerves, and the muscles, 
in the immediate neighbourhood of the arteries. 

A. The position occupied by the brachial arteries. Though 
the brachial artery very rarely deviates from its usual position 
along the inner margin of the biceps muscle, yet a few cases 
have fallen under my observation in which the muscle would 
not have been a guide to the situation of the vessel. I was 
first made acquainted with this kind of deviation by the case 
of which a representation is given in the first figure of the 
thirty-seventh plate. In it the division of the main artery 
occurred in the axilla, and while the smaller part (the radial) 
followed the ordinary course of the brachial artery, the larger, 
(ulnar-interosseous, brachial ?), with the median nerve, was se- 
parated by a considerable interval from the biceps muscle. 
From this, and two other nearly similar cases, the inference 
was readily drawn, that the undivided trunk might be found 
in the same unusual course. The correctness of the inference 
was soon confirmed, and I have hitherto examined three 
examples of this remarkable peculiarity*. In each the bra- 
chial artery and the median nerve continued from the axilla 
in a direction towards the internal condyle of the humerus, 
and to within about two inches of that prominence. At this 
point the vessel and nerve became covered by the pronator 

* Mr. Beaumont being engaged in practising the operations for placing ligatures on 
the arteries, was unable to find the brachial artery. On further examination, it turned 
out that the artery was removed from the usual position, in the manner stated in 
the text. The case represented in plate 36, figure 3, which is given in illustration of 
the peculiarity, was met with by Mr. R. Quain, M.B., under similar circumstances, 

B B 



260 BRACHIAL ARTERIES. 

teres muscle which was in every case broader than usual at 
its origin and inclined outwards to the ordinary position at 
the bend of the elbow, still under cover of the muscle. See 
plate 36, figure 3. Two of the three cases referred to pre- 
sented slight peculiarities requiring some notice. In one 
that represented in the figure the vessel turned round a bony 
prominence immediately above the pronator muscle. In the 
second the added muscular fibres were separated by an inter- 
val from those which would constitute the muscle of its usual 
size, and the artery passed through the middle of the acces- 
sory muscle, at its connexion with the humerus. 

B. The division of the artery its usual position. The posi- 
tion at which the brachial artery usually divides into the 
arteries of the fore-arm, is stated by most anatomical writers 
to be opposite the elbow joint. While preparing these 
remarks, I have examined, with reference to this point, 
twenty-two preparations of the arteries of the arm, in which 
the division of the vessels would be said to occur in the 
usual situation. The result of the examination is, that, in 
four of the number, the bifurcation was found to take place 
exactly opposite the point at which the bones of the arm and 
fore-arm come into contact ; and that in the remainder 
(eighteen), it was distinctly below the joint. In the latter 
cases, the point of division varied slightly being in some on 
a level with the head of the radius, and in others opposite 
different parts of the neck of the bone. It may, further, 
be said, that, when the division is situated exactly opposite 
the joint, the brachial artery has the appearance, to the eye of 
the practised observer, of ending somewhat higher than usual. 

The usual place of division will, therefore, be stated to be 
a little below the elbow joint. 

The deviations from the usual place of division come now to 
be considered. In entering on the statement of the facts 
bearing on this point, it is necessary to premise that, in the 
table, the brachial artery is said to have " divided" where 
the radial, the ulnar, or the interosseous, was given from 
it. Moreover, the cases of " vasa aberrantia" a few in 
number are included in the same category. In most in- 
stances, the table contains the name of the vessel by reason 



THEIR DIVISION. 261 

of whose origin the main artery is^said to divide ; and where 
the mere fact of division is expressed, without mention of the 
branches resulting, it is to be 'inferred that there was nothing 
peculiar in this respect. In such cases, the radial will be 
considered to have arisen above the usual position. 

It is remarkable that the deviation from the ordinary posi- 
tion tends constantly towards a higher part of the arm. This, 
if not invariable, is very nearly so *. I have seen but one 
instance of deviation in the opposite direction. In this single 
case of exception, the main artery divided between two and 
three inches below the elbow joint. But it must be mentioned, 
that the inference to be drawn from this preparation is not 
without deduction, inasmuch as the low situation of the 
chief division was accompanied by the existence of a vas 
aberrans, extending from the axillary to the radial artery. 
See plate 35, figure 4. 

The following is an abstract of the information contained 
in the tables, in reference to the point under consideration. 

The entire number of the cases in which the place of f Right side 252 
division of the main artery is recorded in the table < Left 229 
is [ 481 

The division was in the " usual" position in ("Right 199 
the immediate neighbourhood of the elbow < Left 187 
joint in [ 386 

The brachial divided at a point more or less re- /Right 40 
moved from the joint but above it in . \ Left 24 

64 

The last general statement includes various modes of divi- 
sion, occurring with different degrees of frequency, as appears 
from the subjoined analysis. 

f R 29 
The radial arose above the usual position in . -| , 

45 
The ulnar in { L* 4 

12 

r R 2 

The interosseous in .... 

Vasa aberrantia" existed in . . . -"I j ' 



64 

* " Nur sehr selten, vielleicht nie, geschieht diese Theilung bedeutend tiefer, nicht 
selten liohcr als gewohnlich." J. F. Meckel Handb. der Menschlich. Anat. 3. B. 
1416. 

B B 2 



262 BRACHIAL ARTERIES. 

The situation of the early division of the brachial artery 
varies very much in different cases. It may be found at any 
point, from the axilla downwards. The variations in this 
respect are recorded in the table, and the abstract of a con- 
siderable number of cases will be found at page 258. 

C. The presence of more than one artery in the place of the 
brachial. Having found that the axillary artery gives origin 
now to one, now to another of the branches of the fore-arm, 
and that the brachial divides at various points above the 
usual situation, it becomes necessary to review the arteries 
which in such cases occupy the place of the last-named vessel. 
Limiting, for the present, our attention to these arteries 
while in the arm, and in front of the elbow, where they 
represent the brachial, the notice of them in this place will 
have reference to their number and extent ; the frequency 
of their occurrence ; the position they occupy ; their commu- 
nications one with the other; " vasa aberrantia;" and the 
question of the correspondence between both arms, in re- 
spect to such arteries. 

The number. In every example of early division of the 
artery that I have met with, there were two vessels in the arm 
below the point of division, except in a single instance. In 
the case here excepted, the radial, ulnar, and interosseous 
arteries arose together a little above the inner condyle of the 
humerus, so that there were for a short space three arteries 
in place of the brachial. See plate 33, figure 3. An in- 
stance of a similar arrangement of the vessels is described by 
Barclay *. 

The extent to which two arteries exist, must depend on the 
height at which the division of the trunk is placed a subject 
adverted to in a former paragraph and when this occurs in 
the axilla, there will obviously be two arteries in the whole 
length of the brachial portion. 

To estimate the frequency with which two arteries are likely 
to exist in the arm so far as the cases in this work will serve 
that purpose it is necessary to add together the instances of 
early division mentioned in the table of the axillary, and in 

* " In a rare instance, which I have seen, and which is still preserved in my collec- 
tion, the three arteries spring up together at the bend of the arm." Loc. cit. p. 103. 



PRESENCE OF MORE THAN ONE ARTERY. 263 

that of the brachial artery, and to v ascertain the proportion 
these bear to the entire number. This being done, the fol- 
lowing result is obtained. 

The axillary artery divided into two branches, 

continuing along the arm in . . 30 
The brachial divided above the usual position in 64 

94 in 481, or 1 in about 5^. 

The position of the two arteries. They may be said to be 
generally close together, and in the usual situation of the 
brachial artery. But the vessels, to which the high origin 
belongs in different cases, are liable to some peculiarities as 
to position, and these severally require notice. 

The radial artery often arises on the inner side, and after 
lying close to the larger vessel, crosses over it at the bend of 
the elbow *. 

The ulnar has some tendency to incline away from the 
usual position of the brachial artery. This deviation, how- 
ever, occurs only at the lower part of the arm ; and as the 
course taken is inwards, it may be considered an inclination 
towards the ordinary situation of the vessel in the fore- arm. 
The ulnar artery may, by reason of a change of this kind from 
the ordinary course, be placed within a short distance from 
the inner condyle of the humerus ; and to the same vessel 
belongs almost exclusively the position between the integu- 
ments and the fascia, in which it is occasionally found f. 

I have always seen the interosseous artery behind the 
larger trunk J, at the bend of the arm ; but Tiedemann gives 
the representation of a case, in which this artery was placed 
much nearer to the inner condyle of the humerus. 

A most remarkable departure from the course generally 
pursued by the branches, is that in which the larger of the 
two the ulnar-interosseous (brachial ?) instead of following 
the biceps muscle, courses along the intermuscular septum in 
a line towards the inner condyle of the humerus, until it 
reaches the origin of the pronator teres muscle, and thence is 
directed outwards, under cover of that muscle. In all the 

* See plate 30, fig. 3 ; plate 31, fig. 2 ; and plate 41, figure 1. 

f Plate 32, figures 1 and 2 ; plate 36, figure 1 ; and plate 41, figure 3. 

% See plate 33 ; and plate 41, figure 5. 

Op. cit. plate 15, figure 3. 



264 BRACHIAL ARTERIES. 

examples of this class of cases that I have hitherto met with, 
the muscle extended upwards beyond the condyle, to a greater 
distance than usual, and the deviating artery was accompanied 
by the median nerve*. 

In the foregoing observations, the greatest amount of de- 
parture from the usual position has been seen to consist of 
the removal of one of the branches towards the line of the 
inner condyle of the humerus ; and there is not any recorded 
example that I can find of deviation to a greater extent, 
except one mentioned by Heister. Of this case it is stated, 
that the axillary at its termination divided into two branches ; 
that one of these pursued the ordinary course of the brachial ; 
while the other passed over the biceps and, after following 
this muscle on the outer side of the arm as far as the radius, 
took the usual place of the radial artery. The course as- 
signed to the latter of these branches is so extraordinary so 
entirely without a parallel that I insert Heister's account 
of it in his own wordsf . I cannot, at the same time, omit 
to remark on a want of accuracy in the report, which in some 
degree diminishes the value of the observation, in my estima- 
tion. The artery is said to have divided at the lower end of 
the axilla, or rather below this (" ubi axillam deseruerat") 
and the radial is described as commencing its unusual course 
immediately below the shoulder joint (" mox infra articulum 
humeri"). 

Communication between the branches. The arteries resulting 
from the premature division of the trunk, remain in most 
cases distinct and independent, one of the other, to their 
ultimate distribution ; but a communication is occasionally 
found to be established between them. The communications 

* Plate 36, figure 4; and plate 37, figures 1 and 2. 

f* "An. 1729. In cadavere feminine, in quo arterias totius corporis cera rubra 
repleverarn, hoc imprimis riotatu dignum indicavi, quod arteria axillaris dextra, statim 
ubi axillam dcseruerat, atque ad brachiura pervenerat, mox in duos ejusdem magni- 
tudinis insignes ramos bracbiales divisa esset : quorum alter per internum brachii 
latus versus cubituui, uti alias ex consueta naturae lege fieri solet, pergebat, ibique 
postea easdem divisiones, eundemque per cubitum et nianum progressuui ac divisionem, 
ut alias, quando unica tantum arterise brachialis trunctis adest, habebat ; alter vero 
mox infra articulum humeri super musctilum bicipitem transibat, et in externo brachii 
latere, juxta bicipitem usque ad os radii, ac deinde sccundum hujus situm ad carpum 
et pollicem manus descendebat, orteriamque primo illam, quae in carpo apud scgros 
explorari solet a medicis, constituebat." D. Lavrentii Heisteri " Compendium Ana- 
tomicum." Ed. 4, T. 1, Notse (66**) p. 126. 



" VASA ABERRANTIA." 265 

usually occur near the bend of the arm, and they are various 
in their kind. In one case the connexion is effected by a 
short intervening artery ; in another, actual reunion of the 
branches takes place. Only a single example of reunion of 
the branches has come under my immediate observation. In 
it the brachial artery separated near its commencement into 
two parts, which again became united at the lower part of 
the arm into a single trunk, which, after a short course, 
divided in the ordinary manner of the brachial. See plate 34, 
figure 3. This conformation of the vessels was first described 
by Dr. Quain*, from a case which he observed ; and another 
example of it has been referred to in a former part of this 
work f . 

Connexion of the branches by an intervening artery. In 
all the examples of this peculiarity that I have observed, (the 
number of those recorded in the table is nine,) the connecting 
artery extended from the larger (ulnar-interosseous) branch 
to the radial or the radial recurrent. Its form varies being 
in one instance a short, thick, straight branch ; in another, of 
greater length and giving small offsets ; in a third, curved and 
winding round the tendons of the biceps muscle. For illus- 
trations of these varieties of form see plate 34 ; and another 
case, differing from those now referred to, in the circumstance 
of the connexion being established at a lower part of the 
limb and situated behind the superficial flexor muscles, will 
be seen at plate 36, figure 4. 

" Vasa aberrantia." The arteries known under this name are 
very slender in proportion to their length. They arise from 
the axillary or brachial, and instead of being distributed to 
the structures in their neighbourhood, they end by joining 
one of the arteries of the fore-arm, and hence doubtless their 
designation. 

In the cases recorded in the table in number nine the 
vas aberrans in every instance but one ended in the radial. 
In most cases, the radial artery receiving the vas aberrans, 
arose in the usual position near the bend of the arm ; but in 
one preparation in my collection it arose about the middle 

* " Elements of Anatomy," 4th Ed. p. 538. London, 1837. 
t Page 221. 



266 BRACHIAL ARTERIES. 

of the arm * ; and in another it was given off considerably 
below the bend of the arm plate 35, figure 4. The radial 
artery in one instance presented the peculiarity of crossing 
behind the tendon of the biceps before it was joined by the 
" aberrant " vessel. 

The examples of their terminating otherwise than in the 
radial are of rare occurrence. In one of our cases, repre- 
sented in plate 35, figure 2, the " vas aberrans " joined the 
radial recurrent, which in that instance arose from the ulnar. 
And it is described and figured as terminating directly in the 
ulnar artery by Monrof and J. F. MeckelJ. Each of these 
observers had met with a single case. 

What degree of correspondence exists between both arms, in 
reference to the high division of the arteries ? Two celebrated 
anatomists have maintained opposite opinions on this subject. 
Bichat || has stated that the existence of any peculiarity in the 
disposition of the vessels of one side of the body did not gene- 
rally imply its presence on the opposite side. But it is to be 
observed that the facts on which this statement was founded 
are not mentioned. Meckel, on the contrary, in an elaborate 
paper written expressly on the varieties that occur in the 
arteries of the arm, asserts with confidence apparently from 
the observation of eight cases that the high division most 
frequently takes place on both sides at the same time, though 

* For this preparation I am indebted to the kindness of Mr. Perceval Price. 

f " Remarks on the coats of arteries, their diseases, &c.," in Medical Essays and 
Observations, published by a society in % Edinburgh. Vol. 2, Ed. 4, ] 772. 

J " Tab. Anatom. Pathol." fascic. 2, p. 8, and tab. 11. 

|| " Dans les vaisscaux des membres, des varietes continuelles s'observent, et, ce 
qu'il y a de remarquable, c'est que dans les varietes la disposition d'un cote n'entraine 
point celle du c6te oppose?." " Recherches Physiol. sur la Vie et la Mort," p. 1 1 , 
3rd ed. Paris, 1805. 

After reciting the view of Bichat as stated above, he continues " Allein in der 
That scheint gerade das Gegentheil haufiger zu seyn. Die meisten Schriftsteller 
beriihren zwar diesen Punct nicht ; allein meine Erfahrung spricht offenbar fiir diese 
Meinung. Ich habe diese Bildungsabweichung jetzt in achtzehn Fallen vor mir, unter 
welchen ich sie in acht Leichen selbst gefunden habe. Mit Bestimtntheit weiss ich 
hrer, dass sie in demselben Subject unter dieser Anzahl von Fallen siebenmahl auf 
beiden Seiten in denaselben Kbrper gefunden wurde, und nur von einem mit Gewiss- 
heit, dass sie nur auf einer Seite vorkam. * * * 

Ich bin fest iiberzeugt, dass Aufmerksamkeit der Anatomen auf diesen Gegenstand 
die Richtigkeit Meiner meinung bestimmt erweisen wird. Diese Conformitat beider 
Seiten, auch bei Abweichungen, ist desto interessanter, da sie beweist, dass die seit- 
liche Symmetric, unter alien die volkommenste, sich auch bei abweichender Bildung 
erhalt. Uebrigens ist der Grad dieser Abweichung night immer auf beiden seiten 
dcrselbe." " Ueber den regelwidrigen Verlauf der Armpulsadern " in Meckel's 
Deutsches Archiv fur die Physiologic, B. 2, S. 117. 



THEIR BRANCHES. 267 

not necessarily at the same height. And he was so assured 
of correctness as to the fact, that he did not hesitate to 
regard it as a proof that " the lateral symmetry, the most 
powerful of all (kinds of symmetry), is maintained even in 
malformations." 

Now, in order to apply the facts set forth in the table to 
the question under consideration, we extract all the cases 
which have reference to it namely, those in which the con- 
dition of the arteries in both limbs having been noted, one or 
both was found to have divided higher than the usual position 
and the following result is arrived at. 

The entire number of cases is . . . ; . . . . 61 
The high division existed on both sides in the same position in 5 
It occurred on both sides but in different positions in . . 13 



18 

artery on the opposite side 
dividing at the usual situation in 



It occurred on but one side, the artery on the opposite side"! .., 



61 

From this statement the conclusion is obvious if a general 
conclusion may be drawn from such a number of facts that 
most commonly there is not a correspondence between both 
arms with respect to the high division of their arteries. 

D. The arrangement of the branches. The number of the 
branches given by the brachial artery is often considerable, 
but the majority of them are so small that names are 
usually assigned to no more than three, viz. superior pro- 
funda, inferior profunda, anastomotica magna; and some 
anatomists, omitting the second of these, recognise no more 
than two branches as sufficiently large and regular in their 
distribution to require separate description. In conformity with 
the plan of this work ; the notice of the branches in this 
place will be brief, and will consist chiefly of a statement of 
the most important deviations from their ordinary condition. 

Superior profunda. Arteria profunda superior : vel collater- 
als magna. This artery is usually given from the commence- 
ment of the brachial, and winds round the posterior surface of 
thehumerus, in company with the musculo- spiral nerve, distri- 
buting branches to the triceps muscle and in the neighbour- 
hood of the elbow joint. It communicates largely on the 
outer side of the joint with other arteries *. 

* Plate 2G, and plate 42, figures 1 and 2. 



268 BRACHIAL ARTERIES. 

The peculiarities of this artery noticed in the table are the 
following ; the division into parts, each arising separately 
from the parent trunk ; the change in the position of its origin ; 
the connexion with other branches at its origin. We subjoin 
an abstract of the cases recorded in the table, made in refe- 
rence to these points. 

It was found to arise as two distinct branches in Right side 1 

Left . . 11 

21 
as three branches in Right side . 5 

Left . . G 

11 
It gave origin to the inferior profunda in Right side . 22 

Left . . 13 

35 
It gave the posterior circumflex, or both were 

derived from a common trunk, which arose in 
the usual position of the superior profunda in Right side . 39 

Left . . 31 

70 , 

It arose from the axillary artery, either sepa- 
rately or in connexion with other branches in Right side . 34 

Left . . 28 

62 
The last general statement includes 

Separate origin of superior profunda from the axillary . 4 
Its origin from axillary in connexion with the inferior 

profunda only 2 

in connexion with the posterior circumflex only 

Right side . 6 
Left . . 8 

14 

In the remainder of the cases here referred to, the superior 
profunda arose from the axillary artery in connexion with several 
branches, and the names of those branches have been already set 
forth in the observations on the axillary artery, ante, pages 230 
and 231. 

Inferior profunda. Arteria profunda inferior ; v. profunda 
altera : v. collaterals ulnaris prima. This branch arises usually 
at a short distance from the last- described artery, and follows 
the course of the ulnar nerve towards the inner side of the 
elbow joint. In general it is not placed deeply at any part of 
its course, and therefore cannot be regarded as fitly designated 
by the name usually assigned to it, that at the head of the 
paragraph. In some instances, however, it takes the place of 
the anastomotic artery on the posterior surface of the humerus, 



THEIR BRANCHES. 269 

and there lies deeply, being covered by the triceps muscle ; 
see plate 42, figure 2. The inferior profunda is mentioned in 
the table to have been connected with the superior profunda, 
or rather derived from that branch in a considerable number of 
cases. It was given from the axillary, in combination, how- 
ever, with other branches, in 28 cases. Lastly, it occasionally 
occurs that there is no trace of an inferior profunda branch ; 
and to this circumstance, as well as the frequent connexion 
with the superior profunda, must be attributed its omission 
from the list by some anatomical writers. But the peculiari- 
ties with respect to origin and union with other branches 
having been already mentioned in the observations on the 
superior profunda and the axillary artery, do not require 
lengthened notice in this place. 

Anastomotica magna. Arteria anastomotica magna: v. pro- 
funda inferior : v. collateralis ulnaris secunda. This branch, 
after crossing the brachialis anticus muscle, and piercing the 
intermuscular septum, turns backwards between the triceps 
and the lower end of the humerus, and joins a large branch of 
the superior profunda, both forming an arch that extends 
from one side of the bone to the other immediately above the 
olecranon fossa. This arterial arch has been named by Haller 
" arcus dorsalis humeri posticus. r> In some instances the 
anastomotic artery is small, and its place on the humerus 
is taken by the inferior profunda ; see plate 42, figure 2. 

Besides the foregoing branches, the brachial artery furnishes 
to the biceps and brachialis anticus muscles several, which are 
generally smaller, and have much less regularity in the 
position of their origin. These are known as " muscular 
branches." They vary very much in number. In two of the 
cases mentioned in the table there existed, in each, but a single 
branch ; in two more there were as many as nine ; but in the 
majority the number varied between four and six. 

E. The veins, nerves, and muscles in the immediate neighbour- 
hood of the Irachial artery . The veins. The position of the 
veins, with reference to the artery, when the vessels have 
their usual disposition, is represented in plate 27, and plate 
40, figure 2. The most important deviations from the ordi- 
nary relative position of the vessels are referable to the changes 



270 BRACHIAL ARTERIES. 

occurring in the artery, and illustrations of these will be found 
in plate 41. 

The nerves. The median nerve crosses the brachial artery 
from the outer to the inner side, and in most cases over the 
vessel ; but the nerve occasionally crosses under the artery. 
A few other peculiarities in the disposition of nerves may be 
noticed. Instead of joining in the axilla, the heads of the 
median nerve may be found to come together over the brachial 
artery ; and, independently of this larger communication be- 
tween the musculo-cutaneous and the median nerves, a small 
branch reaching from the former to the latter not unfre- 
quently crosses the vessel. Such branches vary in size, but 
they are usually small ; and they occupy different positions. 
I have, in a few instances, seen one close to the bend of the 
arm. 

Muscles. I have, in a few cases, found the brachial artery. 
covered for a small space by muscular fibres, which, in an 
operation for aneurism, must have been divided before the 
artery could be brought into view at these points. The mus- 
cular fibres that I have hitherto seen thus disposed with respect 
to the artery, were connected to the biceps or to the brachialis 
anticus. A thick muscular slip in one body reached from the 
biceps to the intermuscular septum above the inner condyle 
of the humerus, covering the artery for the space of about an 
inch and a half. See plate 37, figure 5. In another case the 
unusual muscular slip reached in the opposite direction from 
the humerus to the biceps at a lower part of the arm. This 
differed from the additional " origin," which the biceps not 
very uncommonly derives from the humerus, in the circum- 
stance that the latter lies outside the artery, while the former 
crossed over the vessel*. 

A thin layer of the brachialis anticus muscle was observed in 
a few instances to be spread over the larger of the two branches 

* The following case may be cited as probably analogous to one of those mentioned 
in the text. " There was a preparation in the museum of Mr. Allan Burns, and 
which, I believe, is at present in the possession of Mr. G. S. Patteson of Baltimore, 
U.S., where a slip of muscle passed across the humeral artery, and impeded its action. 
On inquiry being made, it was found that the subject had been a servant girl ; and, 
though strong and healthy in other respects, she could never, for any length of time, 
pump a well or switch a carpet." Dr. Dunlop in notes to Beck's " Elements of 
Medical Jurisprudence." Ed. 6, p. 5. London, 1838. 



VARIATIONS OF THE MUSCLES. 271 

(ulnar-interosseous) resulting from- the premature division of 
the brachial artery, together with the median nerve. With 
respect to this arrangement of a portion of the brachialis anti- 
cus, I would observe, that the fibres which arise from the 
middle of the humerus, not unfrequently project at the outer 
side of the artery ; that I have noticed some of those fibres 
in other cases to overlap the vessel, and that the muscular 
cover given to the artery by the brachialis anticus, may be 
regarded as the further extension inwards of fibres of the 
same kind from the middle of the muscle. See plate 37, figures 
3 and 4. 

Coinciding with a very rare deviation of the brachial artery 
or of a large branch, the pronator teres was observed to be 
considerably increased in breadth at its origin, and to be placed 
over the artery in a part of its irregular course. This dis- 
position having been already sufficiently noticed, requires only 
to be indicated here. Ante, page 259 ; and plate 36, figures 
3 and 4, and plate 37, figures 1 and 2. 



ARTERIES OF THE FORE-ARM AND HAND. 



The explanations concerning this table will be found at its end. 



No. 


i 

Side 
of the 
Body. 


Radial. 


Ulnar. 


Palmar. 






("is joined near origin by 






1* 


L 


I a " Vas Aberrans" 
|_from Brachial. 


usual. 




2 


R 


isual. 


usual . 






L 


isual. 


usual. 




n 


R 


[" is given from Brachial 
< about the middle of 
[humerus. 


usual. 








'divides into two Brs. 










three inches above the 










wrist. One of these 










has the usual direction 










of the Radial, but it 










enters the palm between 






2 a 


R 


< the second and third 










metacavp. bones. The 










other runs over the 










tendons, and penetrates 










to palmar surface be- 










tween first and second 










metacarp. bones. 






24. 


R 


usual. 


usual. 


f Superf. Volse becomes the 
\ Radial br. of index ringer. 




L 


usual. 


usual . 








"gives a large Metacarp 






2t 


R 


br., which divides into 
two parts. One o 
these enters the palm 
through the carpal end 
of the second interosse- 
ous space, the other 
turns forward to the 


{Inteross. gives a Br. 
which accompanies me- 
dian nerve to the palm 


/'Superf. Volae absent. Me- 
dian br.joins Arch, and sup- 
plies the thumb and index 
< finger. Digital, br. com. 
to index and mid. fingers 
is joined by Metacarp. br. 
from behind. 






palmar surface at the an- 










v terior end of same space. 







274 



ARTERIES OF THE FORE-ARM AND HAND. 





Side 








Na 


of the 


Radial. 


Ulnar. 


Palmar. 




Body 
















/'Superf. Volse absent. Su- 


31 


R 


/'gives Inteross., or both 
1 arise from a com. trunk 
1 Metacarp. br. turns for 
| ward to palmar surface 
1 of band at anterior em 
l^of first inteross. space. 


As given from Brachia 
I about the mid. of upper 
< arm, and lies over the 
I fascia of the fore-arm ; 
l^does not give Inteross. 


perf. Arch and its Digita 
brs. are small ; each of 
latter is joined by a Br. 
< from the Deep Arch, ex- 
cept that com. to index 
and mid. fingers, which is 
joined by Metacarp. br. 










from behind. 




L 


usual. 




usual. 






ps directed to first meta- 


'arises a little above 








carp. space over the 


usual position, and runs 








tendons which usually 


bet ween the muscles anc 


/'Ulnar supplies 2 fingers ; 






cover it; gives Inteross. 


the fascia of fore-arm ; 


1 remaining Digital brs. are 






or both arise from a 


does not give Inteross. 


j given from Superf. Volse 






com. trunk. Superf. 


or Recurrent brs. 


j and the Deep Arch. Me- 






Volse arises at 2 inches 


About two inches from 


1 dian joins a Br. furnishe< 






above carpus. Inteross. 


wrist gives a Br. which 


Vby latter. 






gives Ulnar Recurrent 


accompanies median n. 








brs. 


to the palm. 






L 


("gives Inteross., or both 
I arise from a com. trunk. 
] Inteross. gives Ulnar 
1 Recurrent brs. 


'from Axillary; it passes 
between the muscles 
and the fascia of the 
fore-arm; does not give 
Inteross. or the Recur- 
rent brs. A Br. ac- 
companies median n. 
^to the palm. 


'Superf. Volse supplies outer 
sideof thumb. Median br.is 
given to inner side of same, 
and to neighbouring bor- 
der of index ; next Digita 
br. is from Deep Arch ; 
remainder from Ulnar. 






("arises from Brachial at 






4 


R 


< two inches from its be- 


usual. 








(_ ginning. 








L 


usual. 


usual. 








(" from Axillary, and 






5 


R 


< crosses Ulnar-Inteross. 


usual. 








[ at bend of elbow. 










Auras behind the tendon 








L 


1 of biceps m., and curv- 
< ing forward, is joined 


isual. 








1 by a " Vas Aberrans " 










\^from Brachial. 






5f 


R 


J from Brachial above 
L usual position. 


isual. 






L 


J from Brachial near its 










\ commencement. 






5* 


R 


usual. 


usual. 






L 


usual. 


isual. 





ARTERIES OF THE FORE-ARM AND HAND. 



275 



No. 


Side 
of the 
Body. 

R 


Radial. 


Ulnar. 


Palmar. 


5J 


usual. 


usual. 






L 


usual. 


usual. 










'divides at the wrist into 






5a 


R 


< 


two Brs. of unequal size. 
The larger continues to 
the carpal end of the 
second metacarp. space, 
where it turns forward 
to the palm. The other 
Br. is very small, and 
takes the ordinary 
course of the Radial to 




- 








the first metacarp. 












^ space. 












'divides at the wrist into 












two equal parts : one 
follows the usual course 








L 


- 


in the first metacarp. 
space ; the other runs 
to the second metacarp. 
space, and after giving 
a large Br. between the 
heads of second in- 


usual. 










teross. m., courses for- 












ward to join the Digital 
br. com. to index and 












^rnid. fingers. 






5b 


R 


usual. 


usual. 






L 


usual. 


usual. 




6a 


R 


usual. 


usual. 






L 


J~ from Brachial at mid- 
\ die of the arm. 


usual. 




6 


R 


("from upper part of 
|_ Brachial. 


usual. 






L 


usual. 


usual. 




7 


R 


f from upper part of 
IBraclrial. 


usual. 






L 


J" gives Superf. Volse two 
\ inches above carpus. 


usual. 


/'Ulnar and a large Snperf. 
f Volae supply the fingers 
< equally ; they do not com- 
1 municate directly, and 
^there is no distinct Arch, 


7a 


R 


usual. 


usual. 






L 


usual. 


usual. 





c c 



276 



ARTERIES OP THE FORE- ARM AND HAND. 



No 


Sid 
of th 
Bod 


Radial. 


Ulnar. 


Palmar. 


7 


R 


usual. 


usual. 






L 


usual. 


usual. 




8 


R 


usual. 


usual. 






L 


usual. 


usual, 




y 


R 


usual. 


usual. 






L 


usual. 


usual. 




9b 


R 


usual. 


usual. 






L 


usual. 


usual. 




9o 


R 


usual. 


usual. 






L 


usual. 


usual. 




10 


R 


usual. 


usual. 






L 


usual. 


usual. 












/'Ulnar and a large Superf. 










Volae supply the fingers 


lOa 


R 


/from Brachial at mid- 
[ die of the iirm. 


("gives a Br., which ac- 
< companies median n. 
|_ to the palm. 


equally. The only com- 
, munication between them 
is effected on the end o 
mid. finger and by Median 










br., which joins Superf. 










^Volse in the palm. 










( Superf. Volse is large, anc 










I supplies the thumb andhal 




L 


sual. 


early usual. 


I of index finger ; it has no 
| junction with Ulnar ex- 










1 cept on the last phalanx of 










ijhe index finger. 


lOb 


R 


sual. 


sual. 






L 


sual. 


sual. 




lOc 


R 


sual. 


sual. 






L 


sual. 


sual. 




11 


R 


sual. 


sual. 






L 


sual. 


sual. 




12 


L 


sual. 


sual. 




13 


R 


sual. 


sual. 




13a 


R 


sual. 


sual. 





ARTERIES OF THE FORE-ARM AND HAND. 



277 



No. 


Side 
of th 
Body 


Radial. 


Ulnap. 


Palmar. 




L 


usual. 


usual. 




14 


L 


usual. 


(" gives along slender Br. 
4 which accompanies me 
j_ dian n. to the palm. 


f Superf. Volse absent. Me- 
-< dian br. joins the Radial 
[_ part of Palmar vessels. 


15 


R 


usual. 


usual. 






L 


usual. 


usual. 




15a 


R 


usual. 


usual. 


[" Superf. Volae is very small 
< and is expended in the 
L muscles of the thumb. 




L 


rom Axillary. 


usual. 




15b 


R 


usual. 


usual. 






L 


usual. 


usual. 




16 


R 


usual. 


usual. 






L 


usual. 


usual. 




18 


R 


usual. 


isual. 






L 


usual. 


usual . 




19 


R 


usual. 


usual. 






L 


usual. 


usual. 




20 


R 


usual. 


usual. 






L 


usual. 


usual. 




23 


R 


usual. 


usual. 






L 


usual. 


usual. 




24 


R 


fis joined near origin by 
^ a " Vas Aberrans," 
[ from Axillary. 


usual. 






L 


usual. 


usual. 




26 


R 


usual. 


usual. 






L 


s smaller than usual. 


fgives, close to origin of 
I Inteross., a long and 
< slender Br., which ac- 
1 companies median n. 
V^to the palm. 


rSuperf. Volse absent. Ul- 
\ nar ar. and the Median br. 
| supply the fingers in nearly 
l^equal proportions. 


27 


R 


usual. 


f arises from upper part of 
Brachial, and runs be- 
| tween the muscles and 
(jhefascia of thefore-arm 





c c 2 



278 



ARTERIES OF THE FORE-ARM AND HAND. 



No. 


Side 
of the 
Body. 


Radial. 


Ulnar. 


Palmar. 








(is given from Brachial 










a little higher than 










usual, and immediately 






L 


usual. 


runs between the mus- 










cles and the fascia oi 










fore-arm. 




27a 


R 


usual. 


usual. 


J" Superf. Volse is larger than 
\ usual. 




L 


usual. 


J a long Br. accompanies 
\ median n. to the palm. 


1" Superf. Volse absent. Mc- 
< dian br. joins Ulnar in the 
(_ palm. 










f Ulnar and a large Superf. 


28 


R 


usual. 


usual. 


< Volse supply the fingers in 










[equal proportions. 


29 


R 


usual. 


usual. 


Superf. Volae absent. 


30 


R 


usual. 


usual. 






L 


usual. 


usual. 




31 


R 


larger than usual. 


smaller than usual. 






L 


is given from Axillary. 


nearly usual. 




31a 


R 


usual. 


usual. 






L 


usual. 


usual. 




31c 


R 


usual . 


usual. 








("arises from middle of 








L 


< Brachial ; does not give 


usual. 








|_ a Recurrent br. 






31* 


R 


usual. 


usual. 






L 


usual. 


usual. 




31d 


R 


usual. 


usual. 






L 


nearly usual. 


("nearly usual. Inteross. 
j gives a Br. which ac- 
| companies median n. to 
[_iho palm. 


f" Median br. supplies the 
< index finger and one side 
[ of the middle one. 






("arises from Brachial 1^ 






31e 


R 


< inches above elbow 


usual. 








[joint. 








L 


f is given from middle of 
\ Brachial. 


nearly usual. 




33 


R 


usual. 


usual. 


Superf. Volae absent. 



ARTERIES OF THE FORE-ARM AND HAND. 



279 



No. 


Side 
of the 
Body. 


Radial 


Ulnar. 


Palmar. 


34 


L 


usual. 


usual. 




37 


R 


usual. 


usual. 




37J 


L 


usual. 


fusual. Com. trunk of 
J Inteross. gives a large 
| Br., which accompanies 
[^median n. to the palm. 




37b 


L 


usual. 


usual. 


Superf. Volse absent. 


38 


R 


f arises from Axillary, 
j and communicates with 
J Ulnar-Inteross. (Bra- 
\ chial ?) by a short Br. 
1 at the bend of the 
1, elbow. 


usual. 




39 


R 


usual. 


I" a Br. accompanies me- 
\ dian n. to the palm. 


[" Superf. Arch is joined by 
< Median br. and a large 
[ Superf. Volae. 




L 


usual. 






40 


L 


usual. 


usual. 




40a 


L 


usual. 


usual. 


TSuperf. Arch is very small ; 
J the Digital brs. are rein- 
| forced by Brs. from the 
LDeep Arch. 


40b 


R 


usual. 


usual. 


Superf. Volae absent. 


41 


R 


usual. 


usual. 




41 a 


R 


usual. 


usual. 




42 


R 


usual. 


usual. 


Superf. Volse absent. 


43 


L 


usual. 


usual. 




44 


R 


usual. 


usual. 






L 


usual. 


usual. 




45 


R 


usual. 


usual. 




46 


R 


f arises from Brachial 
\ near its middle, 


usual. 






L 


J" arises from middle ol 
\ Brachial. 


usual. 




47 


R 


usual. 


usual. 




48 


R 


usual. 




Superf. Volse absent. 



280 



ARTERIES OF THE FORE- ARM AND HAND. 



No. 


Side 
of the 
Body 


Radial. 


Ulnar. 


Palmar. 




L 


usual. 




Superf. Volse absent. 


48a 


R 


usual. 


usual. 




49a 


R 


nearly usual. 


small. 


I" Superf. Arch is small. The 
< Digit, arteries are joined by 
[ Brs. from the Deep Arch. 


50 


R 


usual. 


usual. 






L 


usual. 


usual. 




51 


R 


f Recurrent br. arise 
\ from Brachial. 


usual. 


(" Superf. Volse is small, am 
< is expended in the muscles 
L of the thumb. 




L 


usual. 


usual. 




52 


R 


usual. 


usual. 


{Superf. Volse is of large 
size. Superf. Arch sup- 
plies all the Digital brs. 
except that com. to index 
and mid. fingers; this is 
from the Deep Arch. 




L 


usual. 


usual. 


T Superf. Voles is large. It is 
< joined to Superf. Arch,anc 
l_ supplies the thumb. 


53 


R 


usual. 


nearly usual. 






L 


usual. 


usual. 


f Superf. Volse is very small, 
< and is expended in the 
(_ muscles of the thumb. 


54 


R 


usual. 


usual. 






L 


usual. 


usual. 


("Superf. Volse is large. 
< Supei'f. Arch supplies al] 
[the Digital brs. 


55 


R 


/ Recurrent br. is given 
\from Brachial. 


usual. 


f" Superf. Volse is very small, 
< and is lost in the muscles 
L of the thumb. 




L 


J~ Recurrent br. is given 
\from Brachial. 


isual. 




56 


R 


rises from Axillary. 


usual. 


J Superf. Arch furnishes all 
\ the Digital brs. 




L 


usual. 


usual. 




57 


R 


usual. 


ps at a considerable dis- 
J tance from flexor carpi 
| ulnaris m. in the whole 
[_ length of the fore-arm. 





ARTERIES OF THE FORE- ARM AND HAND. 



281 



No. 


Side 
of the 
Body 


Radial. 


Ulnar. 


Palmar. 




L 


f Recurrent br. is given 
\from Brachial. 


usual. 












(" Superf. Volae is small, anc 


58 


R 


usual. 


nearly usual. 


< is expended in the muscles 










|_ of the thumb. 




L 


usual. 


usual. 


Superf. Volae absent. 


59 


R 


usual . 


usual. 


Superf. Volae absent. 




L 


usual, 


nearly usual. 




61 


R 


usual. 


usual. 












'Superf. Volae is of large 










size. It joins the Arch, 










and supplies the thumb and 


62 


R 


usual. 


nearly usual. 


one side of index finger. 
^ The Digital br. com. to 










index and mid. fingers is 










small, and is joined by a 










Br. of Deep Arch. 










'Superf. Volae is of large 










size. It joins the Arch, 










and supplies the thumb and 




L 


usual. 


nearly usual. 


) one side of index finger. 
] The Digital br. com. to 










index and mid. fingers is 










small, and is joined by a 










^Br. of Deep Arch. 










f Superf. Volae supplies the 










(outer side of the thumb 


63 


R 


usual. 


usual. 


without joining the Arch. 
^ The Digital br. com. to 










(index and mid. fingers is 
^from the Deep Arch. 




L 


isual. 


nearly usual. 


Superf. Volae absent. 










f Superf. Volae is small, and 


64 


R 


usual. 


usual. 


< islost in the muscles of the 










j_ thumb. 




L 


usual. 


usual. 


{Superf. Volse is small, and 
is lost in the muscles of the 










thumb. 










/'Superf. Volae is small, and 










1 is lost in the muscles of 


65 


R 


usual. 


usual. 


{ the thumb. Digital arte- 










1 ries are joined by Brs. 










V^from the Deep Arch. 




L 


usual. 


usual. 





282 



ARTERIES OF THE FORE-ARM AND HAND. 



No. 


Side 
f the 
Body. 


Radial. 


I 

Ulnar. 


Palmar. 


66 


R 
L 


isual. 

/'arises from Brachial at 
j 1 inch from its begin- 
1 ning ; is of smaller size 
J than usual. Recurrent 
1 br. is given from Bia- 
l^chial. 


usual, 
usual. 


!" Superf. Volse is small, and 
< is lost in the muscles of 
I the thumb. 

f Superf. Volse is small, and 
< is lost in the muscles of 
[_ the thumb. 


67 


R 


usual. 


usual. 






L 


/arises from commence- 
ment of Brachial. Re- 
"j current br. arises from 
L Brachial. 


learly usual. 




68 


R 


/arises a little higher 
than usual. Recurrent 
^| br. is given from Ulnar- 
l^Inteross. (Brachial?) 


("gives Ant. and Post. 
\ Inteross. separately. 


fSuperf. Volae is large. All 
\ Digital brs. but those ol 
| thumb are given from 
(^Superf. Arch. 




L 


jives two Recurrent brs. 


usual. 


{Superf. Volse joins one of 
the Digital brs. of the 
thumb. Deep Arch gives 
a Digital artery. 


69 


R 


tsual. 


usual. 


Superf. Volse absent. 


70 


R 


usual. 


usual. 


f Supevf. Volse is expended in 
\ the muscles of the thumb. 


71 


R 


usual. 


usual. 


I" Superf. Volse is expended in 
\ the muscles of the thumb. 




L 


usual. 


f A Br. accompanies the 
\ median n. to the palm 


fSuperf. Volse is absent. 
Ulnar supplies 2^ fingers. 
Median gives brs. to the 
others, but they are small, 
and are joined to brs. from 
Radial. 


72 


R 


f Recurrent br. is given 
\ from Brachial. 


usual. 


{Superf. Volse is of gooc 
size, and joins Arch. 




L 


is very slender. 


usual. 


TSup. Volse absent. All 
I the Digital brs. are given 
| from Ulnar. Deep Arch is 
[_very small. 








{"arises at bend of elbow, 










and runs between the 










muscles and fascia o 




73a 


R 


usual. 


1 fore-arm ; does not give 
| Inteross. orRecurrents 


Superf. Vola3 absent. 








Inteross. from Axillary 
and gives Ulnar Recur 










Brents. 





ARTERIES OF THE FORE-ARM AND HAND. 



283 



No. 


de 
the 
dy 


Radial. 


Ulnar. 


Palmar. 








'arises from beginning 






L 


"gives Inteross., or both 
arise from a common 
trunk. Inteross. gives 
Ulnar Recurrent brs. 


of Brachial, and lies rg erf . Vo lse is small, and 
between the muscles I / nded in the mugcles 

and fascia of fore-arm ; ] e ^ +v,,,r 
. . , 1 or the thumb, 
does not give Inteross. * 








or Recurrent brs. 




74 


R 


Recurrent arises from 
end of Brachial. 


ual. Superf. Volae absent. 




L 


ual. 


"A small Br. accompa- 
nies median n. to the < 
l m 


Super. Volse absent. The 
Digital br. com. to index 
and mid. fingers, is from 








[Deep Arch. 


75 


R 


sual. 


J" Superf. Volae is small, and 
8 * Mis lost in muscles of thumb. 






{arises from Axillary. 


^ 




76 


R 


It is joined to the Ul- 
nar-Inteross. (Brachi- 
al?) by a short trans- 
verse br. at bend o 


f Superf. Volse is large, an< 
sual. < supplies the inner side of 
1 |_the thumb. 






elbow. 


. 










fSuperf. Volae large. Digi- 










tal br. com. to 4th and 




L 


sual. 


| 5th fingers is joined by a 








I 


_Br. from the Deep Arch. 










'Superf. Volse absent. Su- 










perf. Arch supplies singly, 








." 


but the Digital br. between 


77 


R 


usual. 


usual. < 


4th and 5th fingers ; a 








.-'' , 


its other Digital brs. are 








. : 


very small ,and are joined 1 










Brs. from the Deep Arc 








^ arises opp. inner con- 


Superf. Volae large. Su- 




- 


("gives Inteross., or bol 
J arise from acorn. trunl 
| Inteross. gives Ulna 
[_ Recurrent brs. 


dyle of humerus, and 
passes immediately be- 
< tween the muscles andL 
the fascia of fore-arm ; 
does not give Inteross. 


perf. Arch is small, and 
supplies independently but 
the inner side of the little 
finger. The other Digital 
brs. are given from the Deep 








l^or the Recurrent brs. 


^Arch. 


78 


R 


usual. 


f gives a large PosteriorL 
i 5, , , Superf. Volse joins the Arch. 






("Recurrent is larger tha 










J usual, and gives a I 








k 


j which takes place 


tlSUB>l* 








^Inteross. Recurrent. 














fSuperf. Volae absent. The 


7f\ 




f Recurrent as four sma 


. 


1 Poster. Metacarp. br. joins 


9 


J 


\brs. 


u^ 


] the Digital br. com. to 








1 


Ijndex and mid. fingers. 



284 



ARTERIES OF THE FORE-ARM AND HAND. 



No. 


Side 
of the 
Body 


Radial. 


Ulnar. 


Palmar. 


80 


R 


J Recurrent as three 
\ small brs. 


f Both Recurrents arise 
\ by one trunk. 


fSuperf. Volae absent. The 
J Digital br. com. to ring 
| and mid. fingers is joined 
Lby a Br. of Deep Arch. 




L 


usual. 


usual . 


fSuperf. Volse absent. The 
J Digital br. com. to index 
| and mid. fingers, is joinec 
l^by a Br. cf Deep Arch. 


81 


L 


usual. 


usual. 


Superf. Volae absent. 


82 


R 


usual. 


usual. 


Superf. Volse absent. 




L 


usual. 


nearly usual. 


Superf. Volae absent. 


83 


R 


{gives Inteross., or both 
arise by a com. trunk. 
Inteross. is of larger 
size than Ulnar or 
Radial, and gives Ulnar 
Recurrent brs. 


^arises above inner con- 
j dyle of humerus, and 
1 runs superficially to the 
j fascia of fore-arm ; does 
j not give Inteross. or 
^Recurrent brs. 


fSuperf. Volse is expended 
in the muscles of the 
thumb. Superf. Arch 
1 supplies the inner side o1 
* the thumb. The Digital 
br. com. to index and mid. 
fingers is joined by a Br. 
v from Deep Arch. 








'arises above inner con- 






L 


("gives Inteross., or both 
J arise from a common 
| trunk. Inteross. gives 
[_ Ulnar Recurrent brs. 


dyle, and passes over 
the fascia for about two 
inches below elbow, 
< after which it is co- 
vered by that mem- 
brane ; does not give 
Inteross. or Recurrent 


{Superf. Volae is large. The 
Arch supplies the inner 
side of the thumb. The 
Digital br. com to index 
and mid. fingers is joined 
by a Br. from Deep Arch. 








brs. 




84 


R 


usual. 


usual. 


rSuperf. Volae absent. Digi- 
1 tal brs. of Superf. Arch 
] are small, and are joined 
i^by Brs. from Deep Arch. 




L 


f Recurrent br. is given 
\ from end of Brachial. 


usual. 


["Digital br. com. to index 
< and mid. fingers is joined 
L by a Br. from Deep Arch . 


85 


R 


isual. 


usual. 


{Superf. Volae absent. Ul- 
nar and Radial join on 
adduct. pollicis m. A Br. 
from Post. Metacarp. joins 
the Digital br. of index 
and mid. fingers. 




L 


usual. 


usual. 


Superf. Volse joins Arch. 


86 


R 


Recurrent as two brs. 


usual. 


Superf. Volae joins Arch. 



ARTERIES OF THE FORE-ARM AND HAND. 



285 



No. 


Side 
of the 
Body. 


Radial. 


Ulnar. 


Palmar. 










f Superf. Volae large. It 






("Recurrent arises from 




j joins Arch, and supplies 




L 


J Brachial, and crosses 
| behind the tendon of 


usual. 


I thumb and index fingers. 
j Post. Metacarp. gives a br. 






^Biceps muscle. 




I to the Digital artery of 










\jndex and mid. fingers. 










f Superf. Volse is small, and 


87 


L 


usual. 


usual. 


< is expended in the muscles 










[ of the thumb. 










(" Superf. Volae becomes 


88 


R 


usual. 


usual. 


< "Radialis Indicis " with- 










L out joining the Arch. 










("Superf. Volae joins the 




L 


usual. 


usual. 


J artery on outer side of 
j the thumb, without being 










[_connected to the Arch. 










'Superf. Volse is very small, 










and joins a br. recurrent 










from the Arch. Median 


89 


R 


usual. 


f A Br. accompanies me- 
\ dian n. to the palm. 


< br. joins the Arch. The 
Digital br. com. to index 










and mid. fingers is joined 










by a Br. from Deep Arch. 










{Superf. Volae is very small, 










and does not join Arch. 




L 


usual. 


f A Br. accompanies me- 
\ dian n. to the palm. 


Median br. reinforced by 
one from Deep Arch, sup- 










plies index and mid. fin- 










gers. 


90 


R 


Recurrent as three brs. 


J A Br. accompanies me- 
\ dian n. to the palm. 


Superf. Volse absent. 




L 


usual. 


usual. 












'Superf. Volse joins Arch by 










a very small br., and runs 


91 


R 


Recurrent as three brs. 


/Ant. and Post. In- 
\ teross. arise separately. 


to outer side of thumb. 
The Digital br. between 
index and mid. fingers is 










joined by a Br. from the 
v Deep Arch. 




L 


usual. 


usual. 












'Superf. Volse is small, and 










does not reach the Arch. 










The Ulnar is very small, 


92 


R 


("gives Inteross. , or both 
J arise from a common 
| trunk ; gives Ulnar 
[_Recurrent brs. 


("arises from beginning 
I of Brachial ; is of small 
"l size, and does not give 
^Recurrent brs. 


and gives but two Digital 
brs. : one of these supplies 
< inner side of little finger, 
the other is joined by a 
Br. from Deep Arch, and 










is com. to the ring and 










little fingers. Other Digi- 










tal brs. are from Deep Arch. 



ARTERIES OF THE FORE-ARM AND HAND. 



No. 


Side 
of the 
Body. 


IRadial. 


.Ulnar. 


Palmar. 




L 


usual. 


usual. 


f Superf. Volae is small, anc 
\ does riot join the Arch. 


93 


R 


usual. 














{Superf. Volas is very small, 










and does not join Arch. 




L 


usual. 


usual. 


Digital br. between index 
and mid. finger is joinec 










by Metacarp. br. from be- 










hind. 


94 


R 


J" gives Superf. Volse two 
\ inches above carpus. 


usual. 


f Superf. Volse joins Arch 
< by a small br., and be- 
|_ comes " Radialis Indicis." 










fSuperf. Volse absent. Di- 




L 


usual. 


usual. 


J gital br. between index 
| and mid. fingers is joined 










[ by a Br. of the Deep Arch. 


95 


L 


is of very small size, 


["is larger than usual. 
< Ant. and Post. luteross. 
I are separate brs. 


f All the Digital brs. are 
\ supplied from Ulnar. 










'Superf. Volse absent. The 










Ulnar supplies singly, but 










the inner side of little 


96 


R 


j" Recurrent is given from 
\ Brachial. 


is smaller than usual. 


finger; its other Digital brs. 
are small, and are joined 
by Brs. from the Deep 










Arch, except that com. to 










index and mid. fingers, 










which is solely from Deep 










_Arch. 










r Superf. Volse absent. The 










Ulnar supplies only inner 










side of little finger. Other 




L 


usual. 


usual. 


Digital brs. are joined by 
Brs. from Deep Arch, ex- 










cept that com. to the ring 










and little fingers, which is 










solely from the Deep Arch. 










f Supert Volte is of large 


97 


R 


usual. 


usual. 


size. All the Digital brs. 
-v are given from the Superf. 










j Arch, except that to the 










pouter side of the thumb. 










( Superf. Volae is large. All 










j Digital brs. are given from 




L 


isual. 


usual. 


J Superf. Arch : that be- 










Itween index and mid. 










fingers is joined by Me- 










tacarp. br. from behind. 



ARTERIES OF THE FORE-ARM AND HAND. 



287 



No. 


Side 
of the 
Body. 


Radial. 


Ulnar. 


Palmar. 


98 


R 


/arises from beginning 
\ of Brachial. 


usual. 


Superf. Volae absent. 




L 


r arises from beginning 
of Axillary ; is very 
slender, and does not 
give Recurrent br. or 
) deep Palmar Arch. It 
| ends between first and 
second metacarp. bones, 
there joining the Deep 
Arch, which is derived 


("gives Radial Recurrent 
< br. and the Deep Palmar 
[Arch. 


(Superf. Vote absent. Ul- 
nar supplies all Digital 
brs. and the Deep Arch. 
This (last) is joined by 
the end of Radial between 
first and second metacarp. 
w bones. 






\from Ulnar. 






99 


L 


/does not give Recur - 
|_ rent br. 


f gives Radial Recurrent 
\ br. close to origin. 


Superf. Volae absent. 


100 


R 


f Recurrent br. is given 
1 from the end of Bra- 
4 chial. Superf. Volae 
1 arises 1 inch above 
V. carpus. 


usual. 


f" Superf. Volae does not join 
< Arch ; it supplies radial 
j_ side of thumb. 




L 


usual. 




("Superf. Volse does not join 
< the Ulnar, but supplies the 
[ thumb and index finger. 


101 


R 


usual. 


usual. 


{Superf. Volae joins the 
Arch, and supplies ulnar 
side of thumb. "Radialis 










Indicis " is given from Su- 
perf. Arch. 




L 


usual. 


usual. 


f Superf. Volae joins br. of 
< Radial between thumb and 










[ index finger. 


102 


R 


/does not give Recur- 
\ rent br. 


f gives _ Radial Recur- 
\ rent br. 


[" Superf. Volae is small, and 
< is lost in the muscles of 
[ the thumb. 




L 


J" Recurrent br. is given 
\ from end of Brachial. 


usual. 


Superf. Volae absent. 


103 


R 


arises from Axillary. 


usual. 


("Superf. Volae absent. Su- 
J perf, Arch supplies four 
j fingers. Radial gives brs. 
[to the thumb only. 




L 


nearly usual. 


nearly usual. 




104 


R 


usual. 


usual. 


f" Superf. Volae is small, and 
< is lost in the muscles of the 










|_ thumb. 




L 


usual. 


usual. 


TSuperf. Volae absent. The 
J Digital br. between index 
| and mid. fingers is joined 
[by a Br. from Deep Arch. 



ARTERIES OF THE FORE-ARM AND HAND. 



No. 


Side 
of the 
Body 


Radial. 


Ulnar. 


Palmar. 


105 


R 


usual. 


usual. 


fSuperf. Volas is small, anc 
I is lost in the muscles of 
| the thumb. Superf. Arch 
(^ supplies four fingers. 




L 


usual. 


is larger than usual. 


! Superf. Volae absent. Su- 
perf. Arch supplies all the 
fingers, but the br. on 
outer side of thumb is 










joined by a small br. of 
Radial. 


106 


L 


("does not give Recur- 
\ rent br. 


f gives Radial Recurrent 
\br. 


rUlnar supplies two and a 
I half fingers. The other 
| fingers receive their Brs. 
l^from Radial. 


107 


R 


["arises from beginning 
J of Brachial; gives Super. 
"} Volse 2ij inches above 
X_carpus. 


usual. 


f Superf. Volae joins Arch, 
< which supplies four fin- 
[gers. 




L 


arises from Axillary. 


usual. 


Superf. Volse joins the Arch. 


108 


R 


usual. 


usual. 


TSuperf. Volae is lost in the 
I muscles of the thumb. 
| Superf. Arch furnishes all 
l^the Digital brs. 










'Superf. Yoke absent. Su- 
perf. Arch gives all the 
Digital brs. ; that on the 
outer side of the thumb 




L 


is smaller than usual. 


usual. 


crosses from the br. on its 
inner side, beneath the 










tendon of flexor long, pol- 
licis : it is protected from 
the tendon by a fibrous 
band. 


109 


R 


usual. 


usual. 






L 


usual. 


usual. 


^Superf. Volse is small, and 
j is expended in the muscles 
1 of the thumb. The Di- 
| gital br. between index 
1 and mid. fingers is rein- 
^ forced from the Deep Arch. 


110 


R 


usual. 


/'Both Recurrent brs arise 
I by one trunk. Inter- 
1 osseous gives a long 
| Br., which accompanies 
I median nerve to the 
Vpalrn. 


'Superf. Volae is small : does 
not reach beyond the mus- 
cles of the thumb. Ulnar 
supplies two and a half 
< fingers. The other Di- 
gital brs. are given from 
the Deep Arch, and they 
are joined by small offsets 
of the Median artery. 






ARTERIES OF THE FORE- ARM AND HAND. 



289 



No. 


Side 
of th 
Body 


Radial. 


Ulnar. 


Palmar. 




L 


Recurrent as three brs. 


usual. 


Superf. Volae absent. 


Ill 


R 


usual. 


f Ant. and Post. Inter 
\ oss. arise separately. 


Superf. Volae absent. 










( Superf. Volss absent. The 


112 


R 


J Recurrent br. is given 
\ from end of Brachial. 


usual. 


I Digital br. between index 
< and mid. fingers is joine( 
I by a Br. from the Dee 










(.Arch. 




L 


usual. 


usual. 


Superf. Volae absent. 


113 


R 


usual. 


usual. 


Superf. Volae absent. 




L 


usual. 


usual . 


Superf. Volse absent. 








^takes origin one incl 










above inner condyle 








("gives Inteross., or both 


and in the fore-arm 




114 


R 


J are given from a com. 
j trunk. Inteross. gives 


lies at first for a shor 
space superficial to the 


Superf. Volae joins the Arch. 






(^ Ulnar Recurrent brs. 


fascia, then between i 










and the muscles. Does 










not give Recurrent brs. 










'rises opp. head of hu- 










merus ; is superficia 










to the fascia for a 










short space at bend of 








f gives Inteross., or both 


elbow, and afterwards 








are given from a com. 


between it and the 








\trunk. Ulnar Recur- 
rents arise fr. Inteross. 


muscles, being first co- 
vered by the fibrous 










expansion from the 










tendon of the biceps m. 










Does not give Recur- 










rent brs. 




115 


R 


usual. 


isual. 






L 


usual. 




f Superf. Volae is small, and 










\ does not reach the Arch. 










f Superf. Volae small, and 


116 


R 


(" Recurrent br. arises 
< from the end of Bra- 
[chial. 


isual. 


1 does not reach the Arch. 
I The Digital br. between 
| index and mid. fingers is 
joined by a Branch from 










l^the Deep Arch. 










( Superf. Volae is very small, 




L 


("Recurrent br. is given 
from the end of Bra- 
[chial. 


sual. 


and does not reach the 
! Arch. The Digital br. 
| between index and mid. 










| fingers is joined by a Br. 










i^from the Deep Arch. 



290 



ARTERIES OF THE FORE-ARM AND HAND. 



No. 


Side 
of the 
Body. 


Radial. 


Ulnar. 


Palmar. 


117 


R 


usual. 


usual. 


f Superf. Volae joins the 
I Arch. The Digital br. 
< between index and mid. 
1 fingers is joined by a Br. 
V^from Deep Arch. 




L 


("gives Inteross., or both 
I arise from a common 
| trunk. Inteross. gave 
(^Ulnar Recurrent brs. 


(" arises from Axillary ; 
< is very slender ; does 
[ not give Recurrent brs. 


fSuperf. Volse absent. The 
Digital br. of Radial is 
joined between thumb and 
index finger by a Br. from 
dorsal surface of hand. 


118 


R 


f Recurrent br. arises fr. 
\ end of Brachial. 


usual. 


{Superf. Vote absent. The 
Digital br. between index 
and mid. fingers is joined 
by a Br. of Deep Arch. 




L 


usual. 


usual. 


{Superf. Volae absent. The 
Digital br. between index 
and mid. fingers is joined 
by a Br. of Deep Arch. 






'arises from upper part 
of Brachial, and com- 
municates at bend of 










elbow with the larger 
trunk, by means of a 
short Br. Instead of a 






119 


R 


4 single Recurrent there 
are four small brs., 


usual . 








which arise from the 










br. of communication 










between the Radial and 










the Ulnar-Interosseous 










k (Brachial ?) 








L 


["Recurrent br. is given 
< from the end of Bra- 
|_ chial. 


usual. 


Superf. Volse absent. 


121 


R 


f fr.Brachial at two inches 
\ from its beginning. 


usual. 






L 


usual. 


usual. 




122 


R 


usual. 


usual. 




124 


R 


usual. 


usual. 


f Superf. Volae large. Deep 
1 Arch reinforces the Digital 
< br. between index and mid. 










I fingers, and supplies the 
Vring and the little fingers. 




L 


usual. 


usual. 


fSuperf. Volse large. All 
J Digital brs. are from the 
| Superf. Arch, except that 
l_to outer side of thumb. 



ARTERIES OF THE FORE-ARM AND HAND. 



291 



No. 


Side 
of the 
Body. 


Radial. 


Ulnar. 


Palmar. 










f Superf. Volse is small, and 


125 


R 


usual. 


usual. 


< is lost in the muscles of 










|_ the thumb. 










I" Superf. Volse is small, and 




L 


usual. 


usual. 


< is lost in the muscles of 










L the thumb. 










f Superf. Volse absent. Ul- 


126 


L 


usual. 


usual. 


< nar and Radial supply 2 










L fingers each. 


127 


R 


/^arises from beginning 
I of Brachial. Recurrent 
1 Radial is given by Ulnar- 
j Inteross. (Brachial?), 
I and crosses behind ten- 
^don of biceps m. 


usual. 


'Superf. Volse is lost in the 
muscles of the thumb. 
The only Digital br. of 
< Superf. Arch is that com. 
to the mid. and ring fingers. 
The others are given from 
the Deep Arch.' 


129 


R 


/ Recurrent br. is given 
\ from end of Brachial. 


usual. 








fA Vas Aberrans " 










I from Axillary perforates 








L 


< fibrous expansion of 


usual. 








I biceps m. and joins 










V Radial close to its origin. 






130 


R 


usual. 


usual. 


Superf. Volse absent. 




L 


f Recurrent br. is given 










\ from end of Brachial. 


usual. 












{Superf. Volse absent. The 










Digital br. between index 


131 


R 


usual. 


usual. 


and mid. fingers if joined 










by Metacarp. br. from 










behind. 






'arises from anterior 










surface of Brachial, but 










in usual situation. 










Along the fore-arm it 








L 


appears closer than usual 
to the fascia, and is 


usual. 


f Superf. Volse is large, and 
(Joins the Arch. 






easily felt in all this 










part of its course, al- 










though the muscles are 










^well developed. 












'arises above pronator 


'Superf. Volse is small, and 








teres m., and passes 


is lost in the muscles of 






Tis behind Ulnar at origin, 
I and gives Inteross., or 


between the muscles 
and the fascia. It is 


the thumb. Ulnar supplies 
all Digital brs., except that 


132 


R 


< both arise from a com. 


< close to flex. carp. rad. 


< to outer side of thumb. 






| trunk ; the com. trunk 


m. as far as the lower 


The Digital br. com. to 






Ijs very short. 


third of fore-arm, where 


index and mid. fingers i^ 








it bends inwards to 


joined by a Br. from the 








^flexor carpi ulnaris. 


^Deep Arch. 



D D 



292 



ARTERIES OF THE FORE-ARM AND HAND. 



No. 


Side 
of the 
Body. 


Radial, 


Ulnar. 


Palmar. 




L 


usual. 


usual. 


Superf. Volae is of large size. 


134 


L 


J~ Recurrent is given from 
\ the end of Brachial. 


usual. 




135 


R 


(is smaller than usual. 
I Recurrent br. is very 
< large, about equal in 
1 size with the cohtinua- 
V.tion of Radial. 


("gives a large Br., which 
< accompanies median u. 
[ to the palm. 


("Superf. Volse is small, and 
I is lost in the muscles of 
j the thumb. The Arch is 
(joined by the Median br. 




L 


s smaller than usual. 


J" gives a large Br. with 
\ median n. 


f The Arch is joined by a 
\ large Median br. 


136 


R 


usual. 


usual. 


Superf. Volse absent. 




L 


usual. 


is smaller than usual. 


T Ulnar supplies 2^ fingers : 
< the others are supplied by 
I the Deep Arch. 


137 


R 


("gives Inteross., or both 
(__ arise from a com. trunk. 


{arises from beginning 
of Brachial, and runs 
between the muscles 
and the fascia of the 
fore-arm. 






L 


usual. 


usual. 




138 


R 


usual. 


usual. 


Superf. Volae absent. 


139 


R 


usual. 


usual. 


Superf. Volse absent. 




L 


usual. 


gives a Br. with median n. 


[" Superf. Volse absent. The 
< Arch is joined by Median 
[br. 


140 


R 


usual. 


usual. 


Superf. Volse absent. 




L 


usual. 


usual. 


|" Superf. Volse is small, and 
< is lost in the muscles of 
(_the thumb. 


141 


R 


f Recurrent br. crosses 
< behind tendon of biceps 
[m. 


usual. 


Superf. Volse absent. 


145 


R 


("arises from Brachial at 
< two inches from its com- 
(_ mencement. 


usual. 


/'Superf. Volse joins the arch. 
j This supplies all the Digital 
brs., except those to ra- 
1 dial side of the thumb and 
^to the index finger. 




L 


usual. 


usual. 




146 


R 


usual. 


usual . 






L 


usual. 


usual. 





ARTERIES OF THE FORE-ARM AND HAND. 



293 



No. 


Side 
f the 
Body. 


Radial. 


Ulnar. 


Palmar. 










("Superf. Volse absent. The 


148 


R 


usual. 


isual. 


I Digital br. com. to index 
| and mid fingers is joined 










[_by a Br. from Deep Arch. 


149 


R 


usual. 


isual. 


Superf. Volae joins the Arch. 




L 


usual. 


isual. 










'arises from Brachial a 










little above inner con- 










dyle of humerus, and 








["arises from Brachial a 


passes between the mus- 
cles and the fascia. 




150 


R 


< little above inner con- 


Does not give Inteross. 








|_ dyle of humerus. 


or the Recurrent brs. 










Inteross. arises froiu 










Brachial a little above 










inner coodyle of hu- 










merus, and gives the 










Ulnar Recurrent brs. 










'rises at upper margin of 










pronator teres m., and 










runs between the mus- 










cles and the fascia of 










fore-arm ; does not give 










Inteross. or the Recur- 






L 


usual. 


rent brs. Inteross. 










arises from Brachial a 










little above inner con- 










dyle of humerus, and 










gives the Ulnar Recur- 










^rent brs. 










'arises opp. the inner 




151 


R 


Tgives Inteross. .or both 
I arise from acorn, trunk. 
| Inteross. gives Ulnar 


condyle of humerus, 
and passes between the 
{ muscles and fascia of 








^Recurrent brs. 


fore-arm ; does not give 
Intcross. or the Recur- 










jent brs. 






L 


usual. 


usual. 


J" Superf. Volae is small, and 
{Joins the Arch. 


152 


L 


usual. 


usual. 


Superf. Volae absent. 


153 


R 


Recurrent as two brs. 


usual. 






L 


usual. 


usual. 


f Superf. Volae is large, and 
\ joins the Arch. 










("Superf. Vote joins the 


154 


R 


usual. 


usual. 


< Arch, and gives the Digital 










\_ brs. of the thumb. 



D D 2 



294 



ARTERIES OF THE FORE-ARM AND HAND. 



No. 


Side 
of the 
Body. 


Radial. 


Ulnar. 


Palmar. 




L 


usual. 


usual. 


f Superf. Volse is large, and 
\ joins the Arch. 


155 


L 


usual. 


usual. 


f Superf. Volae is lost in the 
\ muscles of the thumb. 










T Superf. Volse is small, and 


156 


R 


Recurrent as two brs. 


usual. 


< is lost in the muscles of 










[the thumb. 


157 


R 


usual. 


usual. 


Superf. Volae joins the Arch. 




L 


("arises from middle of 
< Brachial, and does not 
[ give Recurrent br. 


f usual, and gives Radial 
L Recurrent br. 


Superf. Volse absent. 


158 


R 


does not give Recurrent br. 


J usual, and gives Radial 
\ Recurrent br. 




164 


R 


usual. 


usual. 












fSuperf. Volse is Iarg6, and 


168 


L 


usual. 


usual. 


J supplies contiguous sides 
J of the thumb and the index 










(^finger. 








'gives a short Br., which 




169 


R 


farises opp. head of hu- 
J merus, and receives a 
| communicating Br. at 
(^bend of elbow. 


after running under the 
tendon of biceps m.and 
4 sending off Radial Re- 
cur, br., connects the 
Ulnar-lnteross. (Bra- 










,chial ?) with Radial. 












f Superf. Volae small, and not 










1 to Arch. Ulnar supplies 


172 


R 


usual. 


usual. 


1 4th finger, and one 
| side of 3rd, and of 5th. 










I Other fingers are supplied 










^from Deep Arch. 




L 


usual. 


usual. 


f Superf. Volse is lost in the 
\ muscles of thumb. 


174 


R 


usual. 


usual. 


f Superf. Volse is lost in the 
\ muscles of thumb. 


176 


L 


arises from Axillary. 


usual. 












("Superf. Volse absent. Me- 


177 


R 


asual. 


gives a Br. with median n. 


J dian br. joins the Digital 
J artery on inner side of 










[thumb. 




L 


f Rad. Recurr.br. is given 
\ from end of Brachial. 


gives a Br. with median n. 





ARTERIES OP THE FORE-ARM AND HAND. 



295 



No. 


Side 
of the 
Body 


Radial. 


Ulnar. 


Palmar. 


178 


R 


(" Recurrent br. arises 
< from the end of Bra- 
(_ chial. 


usual. 


J Superf. Volae is small, and 
(Joins the Arch. 




L 


fgives Inteross., or both 
J arise from a com. trunk. 
| Inteross. gives Ulnar 
[_ Recurrent brs. 


f arises opp. inner condyle 
of humerus, and runs 
over muscles, except 
< palmaris longus, which 
is in front of it ; does 
not give Inteross. 01 
^Recurrent brs. 


{Superf. Volae is small, and 
joins the Arch. The Di- 
gital br. between index 
and mid. fingers is rein- 
forced from Deep Arch. 


179 


R 


usual. 


usual. 






L 


usual. 


J~ gives a Br. with median 


(Superf. Volse absent. The 
Arch is joined by Median 
br. The Digital artery 
com. to index and mid. 










fingers is joined by a Br. 
of Deep Arch. 


180 


L 


usual. 


usual. 




181 


R 


usual. 


usual. 


Superf. Volae absent. 




L 


Recurrent as three brs. 


usual. 




182 


R 


usual. 


usual. 


f Superf. Volae is small : it 
L joins the Arch. 




L 


usual. 


isual. 


fSuperf. Volae joins arch by 
J a small br., and supplies 
1 contiguous sides of the 
(^ thumb and index finger. 


183 


R 


usual. 


usual. 


/'Superf. Volae is large, and 
joins the Arch. The Di- 
1 git.il br. between index 
j and mid. fingers is joined 
1 by Metacarpal artery from 
l^ dorsal surface. 








fis covered for two inches 




184 


R 


usual. 


J above the pisiform bone 
1 by part of a broad pal- 
{^maris longus muscle. 


Superf. Volae absent. 




L 


usual. 


usual. 


Superf. Volae absent. 


185 a 


R 


usual. 


^arises from Brachial at 
1 1^ inch from its origin, 
-( and runs between the 
j muscles and the fascia 


'Superf. Volse is large, and 
gives a Digital br. to the 
contiguous sides of the 
< the thumb and index finger. 
Inner side of the little 








\^ of fore-arm. 


finger is supplied from the 
Deep Arch. 



296 



ARTERIES OF THE FORE-ARM AND HAND- 



No. 


Side 
f the 
Body. 


Radial. 


Ulnar. 


Palmar. 










! Superf. Volse is large. It 










joins the Arch by a very 


185 


L 


isual. 


asual. 


small br., and gives a Di- 
gital br., which supplies 










the contiguous sides of the 










thumb and index finger. 








rises opp. bend of elbow, 










and is superficial to the 










muscles of fore-arm. 










except palmaris longus, 










under which it crosses; 










does not give Inteross. 




186 


R 


usual. 


or Recurrent brs. In- 
teross. arises from Ax- 


Superf. volse absent. 








illary, being the conti- 










nuation of an artery wh. 










gave several large brs., 










viz. Subscap., CirctimfL, 










and Profund.,and gives 










^Ulnar-Recurrent brs. 










rises from Axillary, and 








'gives Inteross., or both 
arise from a com. trunk. 


runs between the mus- 
cles and the fascia oi 








Anter. Inteross. sends 


fore-arm ; lies about the 






L 


a large Br. with median 
{ n. to the palm, am 
another to join the Ul- 
nar near the carpus. 


middle of the limb, not 
approaching the flexoi 
carpi ulnaris till arrivec 
at carpus; is very slen- 


{Superf. Volse very small. 
Median br. joins arch. 






Post. Inteross. gives a 


der, and is joined neai 








Jarge Metaearp. br. 


the wrist by a br. o: 
Anter. Inteross. ; does 










s not give Recurrent brs 




187 


R 


("gives Inteross., or both 
I arise by a com. trunk. 
| Inteross. gives Ulnar 
(^Recurrent brs. 


^arises from end of Ax- 
I illary,and runs between 
1 the muscles and the 
| fascia of fore-arm ; does 
1 not give Inteross. 01 
^Recurrent brs. 


( Superf. Volae small, and not 
j to Arch. Ulnar small. 
< Digital brs. of 2nd, 3rd, 
1 and 4th fingers reiuforcec 
^from Deep Arch. 








("arises from end of Ax- 


["Superf. Volse absent. The 




L 


usual. 


\ illary, and runsbetween 


\ Digital br. between index 








] the muscles and fascia 


| and mid. fingers is joined 








[_of fore-arm. 


[_by a Br. from Deep Arch. 


188 


R 


("gives Inteross., or both 
I arise by a com. trunk ; 
j does not give Recurrent 


/ gives Radial Recurrent 
\br. 


{Superf. Volse is small, and 
does not join the Arch. 
The Digital br. com. to 
index and mid. fingers is 






Lbr. 




joined by a Br. from Deep 










Arch. 


189 


R 


usual. 


usual. 


f Superf. Volae supplies the 
\ outer side of the thumb. 



ARTERIES OF THE FORE-ARM AND HAND. 



297 



No. 


Side 
of the 
Body 


Radial. 


Ulnar. 


Palmar. 




L 


usual. 


usual. 








f arises from Brachial ai 






191 


R 


< about two inches from 


usual. 








|_its beginning. 












'lies between the mus- 










cles and the fascia oi 










fore-arm ; does not give 






L 


nearly usual. 


I Inteross. or Recurrent 
j brs. Inteross. arises fr. 










middle of Brachial; and 










gives Ulnar Recurrent 




192 


R 


usual. 


["usual. A Br. accom- 
< panics median nerve to 
L the palm. 


rSuperf. Volae is small, and 
1 ends in the muscles of the 
| thumb. Median br. joins 
[_the Arch. 






("arises from middle of 








L 


\ Brachial. 


usual. 




193 


R 


usual. 


J~ Recurrent brs. arise by 
\ one trunk. 


f Superf. Volae is large, and 
\ joins the Arch. 


194 


L 


usual. 


usual. 




195 


R 


Recurrent as two brs. 


usual. 


f Superf. Volae is large, and 










\joins the Arch. 




L 


usual. 


usual. 


/ Superf. Volae is lost in the 










\ muscles of the thumb. 


204* 


L 


f gives Superf. Volae two 
L inches above carpus. 


isual. 


Superf. Volae joins the Arch. 










I" Superf. Volae is small, and 


205 


R 


usual. 


isual. 


< is lost in the muscles of the 










L thumb. 




L 


usual. 


isual. 


f Superf. Volae is small, and 
\ does not reach the Arch. 


207 


R 


J~ Recurrent is given from 
\ the end of Brachial. 


isual. 


f Superf. Volae does not join 
the Arch. The Digital 
J br. between index and mid. 
\ fingers is joined by Meta- 










j carp. br. from dorsal sur- 










face. 










'Superf. Volae is small, and 










does not join Arch. The 










Digital brs. bom. to index 


209 


R 


usual. 


usual. 


< and mid. fingers, and to 










the latter and the ling finger 










are reinforced from Deep 










^Arch. 



298 



ARTERIES OF THE FORE-ARM AND HAND. 



No. 


Side 
of the 
Body. 


Radial. 


Ulnar. 


Palmar. 


210 


L 


Recurrent from Brachial. 


usual. 


f Superf. Volse is very small, 
\ and does not join the Arch. 


211 


L 


usual. 


usual. 




213 


R 


f gives Superf. Volae one 
|_ inch above carpus. 


usual. 


f Superf. Volse supplies the 
j thumb and index finger 
L without joining the Arch. 




L 


isual. 


usual. 




216 


R 


usual. 


usual. 


Superf. Volae absent. 




L 


usual. 


usual. 




218 


R 


usual. 


usual. 


Superf. Volse joins the Arch. 


219 


R 


usual. 


f A Br. accompanies tne- 
\dian n. to the palm. 


[" Superf. Volas absent. The 
< Arch is joined by a Median 
[br. 


220 


R 


isual. 


usual. 


f Superf. Volse is small, and 
\ does not reach the Arch. 




L 


doesnotgive Recurrent br. 


{gives Recurrent Radial, 
which is joined by a 
"Vas aberrans." 




222 


R 


f arises at 1 inch from 
\ beginning of Brachial. 


usual. 


Superf. Volae absent. 




L 


f receives a " Vas Ab- 
\ errans " fr. Axillary. 


usual. 




223 


R 


usual. 


usual. 


f Superf. Volse is large, and 
\ joins the Arch. 




L 


usual. 


usual . 


f Superf. Volse is large, and 
< supplies the thumb and the 
(_ index finger. 


224 


R 


usual. 


usual. 




225 


R 


usual. 


usual. 


Superf. Volse joins the Arch. 




L 


f Recurrent is given from 
[_ the end of Brachial. 


usual. 








/'Radial arises at two 










inches from beginning 
of Brachial. The Re- 






226 


R 


current br. is joined bj 
a branch (of Ulnar) 
< which turns round the 
tendon of the biceps m 
The two principal ar- 
teries are thus made to 


("gives a Br., which turns 
I round the tendon o 
| biceps m., and joins 
[_the Radial Recurrent. 








communicate one wit) 










\ the other. 







ARTERIES OP THE FORE-ARM AND HAND. 



299 



No. 


Side 
of the 
Body. 


Radial. 


Ulnar. 


Palmar. 






/arises from Brachial 










j much lower than usual, 


("arises much lower than 








J and is joined by a " Vas 


J usual. Inteross. and 








| Al.errans" fr. Axillary. 


1 the Recurrent bis. arise 








1 Recurrent br. is given 


l^from Brachial. 








Vby Brachial. 






227 


R 


usual. 


usual. 


f Superf. Volae is large, and 
\ joins the Arch. 






divides into two brs. 










about three inches above 










carpus ; one becomes 










Superf. Volse, the other 








L 


< turns backwards over 


usual. 


Superf. Volse joins the Arch. 






the tendons and then 










takes the course of Ra- 










dial between the first 










^two metacarp. bones. 












farises immediately 










above pronator teresm., 




229 


R 


("gives Inteross., or both 
\ arise by a com. trunk. 


and runs between the 
I muscles and the fascia 
of fore-arm ; does not 


|" Superf. Vote is very small, 
< and is lost in the muscles 
|_of the thumb. 








give Inteross. or Re- 










l^current brs. 












f Superf. Volae is small, ant 


230 


R 


usual. 


usual. 


< is lost in the muscles of 










|_the thumb. 




L 


{arises from Brachial at 
two inches and a half 
from its beginning. 


usual. 


f Superf. Volse is small, am 
< is lost in the muscles o 
[ the thumb. 










f Superf. Volse is small, and 


231 


R 


["Recurrent br. is given 
J from Brachial, and 
| crosses behind the ten- 
[_don of biceps m. 


["gives a Br., which ac- 
< companies median n. 
[ to the palm. 


I is joined by a Br. ascend- 
1 ing from the Arch. The 
j Arch is joined by Median 
1 br., and furnishes all the 










^Digital arteries. 


232 


R 


J Recurrent is given from 
\ the end of Brachial. 


usual. 


f" Superf. Volae is small, and 
|_ does not join the Arch. 




L 


f Recurrent is given from 
\ the end of Brachial. 


usual. 


f Superf. Vola3 is small, and 
{_ does not joiii the Arch. 






j" arises from Brachial at 






233 


R 


< three inches from be- 


usual. 


Superf. Volae joins the Arch. 






|_ ginning. 










'arises from Brachial 










three inches from its 










beginning; is very tor- 








L 


tuous. Recurrent br. 
is given from Radial- 


does not give Inteross. 


Superf. Volse is of good size. 






Inteross. trunk, and 










crosses behind the tend. 










of biceps in. 







300 



ARTERIES OF THE FORE-ARM AND HAND. 



No. 

234 


Side 
of the 
Body. 

R 


Radial. 


Ulnar. 


Palmar. 


Recurrent as two brs. 


usual. 




235 


R 


usual. 


usual. 


f Superf. Volae is small, and 
\ joins the Arch. 




L 


usual. 


usual. 




236 


R 


("is joined at its com- 
J mencement by a " Vas 
| Aberrans " from Axil- 
[lary. 


usual. 


Superf. Volae absent. 


237 


R 


f arises from Brachial 
"|_ above its middle. 


usual. 






L 


usual. 


usual. 


f Superf. Volse is small, and 
\ does not reach the Arch. 


238 


R 


("is joined by a " VasAb- 
\enans" from Brachial. 


usual. 


rSuperf. Volae is small, and 
does not join the Arch. 
TheDigit.br.com. to index 
< and the mid. fingers, and 
to the latter and the ring 
finger, are reinforced from 
\^Deep Arch. 


240 


R . 


usual. 


usual. 


f Superf. Volae is small, and 
\ does not join the Arch. 


241 
242 


R 
R 


/'arises half an inch 
j higher than usual. Re- 
^ currentbr. isgiven from 
1 Ulnar-Inteross. (Bra- 
^chial ?) 

f gives Superf. Volae two 
\ inches above the carpus. 


gives Radial Recurrent br. 

fusual, but is covered 
] near its end by a mus- 
< cular slip, extending 
1 from ulna to the small 
V.muscles of little finger. 


f Superf. Volae is small, and 
\ does not join the Arch. 

{Superf. Volae is large, and 
joins the Arch. All the 
Digital brs., except that to 
outer side of thumb, are 
given from the Superf. 
Arch. 


243 


R 


does not give Recurrent br. 


usual. 


f Superf. Volae is small, and 
\joins the Arch. 


247 


R 


usual. 


usual. 




248 


R 


usual. 


usual. 


1" Superf. Volae is small, and 
< is expended in the mus- 
[ cles of the thumb. 


249 


R 


usual. 


usual. 






L 


usual. 


usual. 




251 


R 


usual. 


usual . 






L 


usual. 


isual. 


f Superf. Volae is small, and 
\does not join the Arch. 



ARTERIES OF THE FORE-ARM AND HAND. 



301 



No. 


Side 
f the 
Body. 


Radial. 


Ulnar. 


Palmar. 


252 




isual. 


isual. 


J" Superf. Volse is large, and 
\ joins the Arch. 








arises from the begin- 










ning of Brachial. Abo YC 










the bend of the elbow 










it lies between the 










fascia and the integu- 




253 


R 


usual. 


ments close to the ba- 
silic vein ; afterwards, 
insinuating itself under 


f Superf. Volae is small, and 
L does not join the Arch. 








the fibrous expansion 










from the biceps m., it 










becomes placed between 










the muscles and the 










/ascia. 






L 


isual. 


usual. 




254 


R 


usual. 


isual. 


Superf. Volee joins the Arch. 




L 


usual. 


usual. 


Superf. Volse joins the Arch. 


255 


R 


arises from Axillary. 


usual. 






L 


J gives Superf. Volse two 
\inches above carpus. 


isual. 


Superf. Volae joins the Arch. 


256 


L 


usual. 


usual. 


J" Superf. Volse is small, anc 
\ does not join the Arch. 


257 


R 


usual. 


usual. 




253 


L 


Recurrent as three brs. 


usual. 


f Superf. Volse is very small, 
\ and does not join the Arch. 


260 


R 


usual. 


usual. 


J Superf. Volse is large, and 
[Joins the Arch. 


261 


L 


arises from Axillary. 


usual. 










'lies between the mus- 










cles and the fascia of 










fore-arm ; does not give 




262 


R 


nearly usual. 


Inteross. or the Re- 
< current brs. Inteross 


Superf. Volae absent. 








arises from Brachial at 










two inches from its be- 










ginning, and gives Ulnar 










^Recurrent brs. 






L 


/from Brachial at its 
\ beginning. 


nearly usual. 




264 


R 


usual. 


usual. 


I" Superf. Volae is small, and 
\does not reach the Arch. 



302 



ARTERIES OF THE FORE-ARM AND HAND. 



No. 


Side 
of th 
Body 


Radial. 


Ulnar. 


Palmar. 


265 


R 


Recurrent as three brs. 






267 


R 


usual. 


usual. 


f Superf. Volae is small, and 
\ does not reach the Arch. 




L 


usual. 


usual. 












TSuperf. Volae is small, and 


271 


R 


usual., 


f A large Br. accompanies 
\ median n. to the palm 


J does not reach the Arch. 
] The Median br. supplies 










Lhalf the fingers. 




L 


usual. 


gives a large Median br. 


f The Median br. supplies 
\ half the fingers. 


272 


R 


usual. 


usual. 






L 


usual. 


usual. 


Superf. Volse is absent. 


274 


L 


usual. 


usual. 


f Superf. Volae is small, and 
[joins the Arch. 






("arises from Brachial at 


{does not approach ulnar 




276 


L 


< two inches above inner 


nerve until it reaches 








[ condyle of humerus. 


the carpus. 




277 


R 


isual. 


usual. 










'runs between the mus- 










cles and the fascia of 










fore-arm; does not give 




278 


R 


nearly usual. 


j Inteross. or Recurrent 
brs. Inteross. arises 










from beginning of Bra- 










chial ; gives Ulnar Re- 










current brs. 








C arises from Axillary, 










j being the continuation 








L 


< of a large trunk which 
1 furnishes the brs. to the 


usual. 








V shoulder and the arm. 






279 


L 


usual. 


usual. 


Superf. Volse is of large size. 


282 


L 


jsual. 


sual. 












f^ Superf. Volse does not join 


283 


R 


("arises from beginning 
\ of Brachial. 


f A large Br. accompanies 
L median n. to the palm. 


J the Arch. The Median 
< ar. supplies the Digital brs. 
I of the thumb and index 










\ finger. 


284 


R 


sual. 


sual. 


Superf. Volse absent. 




L 


sual. 


sual. 


iuperf. Volse absent. 



ARTERIES OF THE FORE-ARM AND HAND. 



303 



No. 


Side 
of the 
Body 


Radial. 


Ulnar. 


Palmar. 


289 


R 


usual. 


usual. 


Superf. Volee absent. 




L 


/ arises from Brachial 
\ near its beginning. 


usual. 




290 


L 


usual. 


{arises from Axillary ; 
is very slender. 










'arises from Axillary ; 










is superficial to the 










fascia for a short space 










above bend of elbow, 










and, below this point, 




291 


R 


usual. 


i passes between the 










membrane and the 










muscles of the fore-arm; 










gives a Br., which ac- 










companies the median 










n. to the palm. 










|~is covered above the 




292a 


R 


arises from Axillary. 


< carpus by a small, un- 










j_ usual muscle. 




293b 


R 


arises from Axillary. 







IN the foregoing table the Radial artery is said to be " usual " when it arose close to the 
elbow joint : gave a Recurrent branch : extended as an undivided trunk along the fore-arm 
close to the supinator longus muscle : turned outwards at the carpus beneath the tendons 
of the extensor muscles of the thumb : was directed forward to the palmar surface of the 
hand between the first two metacarpal bones, and between the heads of the first dorsal 
interosseous muscle : and, lastly, lay in the palm against the carpal end of the metacarpal 
bones and the interosseous muscles, covered by the tendons of the flexor muscles. 

The Ulnar artery is said to be " usual " when it arose in the immediate neighbourhood 
of the elbow joint : gave the Interosseous artery : gave two Recurrent branches, singly 
or by one trunk : was directed inwards to the flexor carpi ulnaris muscle and the 
ulnar nerve, approaching them above the middle of the fore- arm : was covered at first 
by several muscles, afterwards by fascia : entered the palm over the annular ligament of 
the carpus : and lying between the palmar fascia and the tendons of the flexor muscles, 
divided into branches for the supply of the fingers. 



The details of the table do not admit of being arranged in a general abstract of moderate 
size. They will, however, be fully made use of in the observations on the arteries to 
which they refer. 



305 



EXPLANATION OF PLATE XXXVIII. 



The superficial arteries of the front of the fore-arm and 
hand are seen in this plate. 



Biceps (muscle). 
Triceps. 

Brachialis anticus. 
Inner condyle of the humerus. 
Supinator longus (muscle). 
Pronator teres. 
Flexor carpi radialis. 
Palmaris longus. 
Flexor carpi uluaris. 
Pisiform bone. 

Tendon of extensor carpi radialis 
longior (muscle). 



I Extensor ossis metacarpi pollicis.* 
m Flexor digitorum sublimis. 
n Flexor longus pollicis. 
o Pronator quadratus. 
p Palmaris brevis. 
q Muscles of the thumb. 
q\ Adductor pollicis. 
r Abductor digiti minimi. 
* Flexor brevis digiti minimi. 
t Anterior annular ligament of the 
carpus. 



1. Brachial. 

2. Radial. 

2f. Recurrent radial. 

3. Ulnar. 

4. Superficial palmar arch. 



THE ARTERIES. 

5. Branch of ulnar, communicating 
with the deep arch. 

6. Branch of radial, joining the super- 
ficial arch. 

7. Radial branch of index finger 

(from radial artery). 



NERVES. 

8. Median. 

9. Ulnar. 

9f. Branch of ulnar, destined for the 
back of the hand. 



9J. Deep palmar branch of ulnar. 
10. Radial. 



Figure 1. This drawing presents a view of the arteries 
at the lower part of the arm, of those of the fore-arm, and 
to a small extent of those of the hand. The dissection con- 
sisted in the removal of the integuments and the fascia, 
together with the veins and the cutaneous nerves. Thus the 
superficial arteries only, with their accompanying nerves, are 
displayed. But in consequence of the removal of the support 
given by the fascia, the muscles in the neighbourhood of the 
radial artery, especially the supinator longus, have fallen a little 
aside, and the radial artery is at its upper part more completely 
exposed than is natural ; and by drawing aside the flexor carpi 



306 



EXPLANATION OP THE THIRTY-NINTH PLATE. 



ulnaris muscle, the ulnar artery and nerve are shown to a 
greater extent than they would otherwise be seen. 

Figure 2. By the removal of the integuments and the 
fascia, the superficial arteries of the lower part of the fore-arm, 
the superficial palmar arch, and the digital artery, together 
with the nerves distributed with them, have been exposed. 



EXPLANATION OF PLATE XXXIX. 



In this plate the deeper arteries of the fore-arm and hand 
are represented. 



a Biceps (muscle). 

b Triceps. 

c Brachialis anticus. 

d Inner condyle of the humerus. 

e Pronator teres (muscle) divided, 

and the lower end turned outwards. 
/ The superficial pronator and flexor 

muscles divided. 
ff Supinator brevis. 
h Radius. 

Supinator longus (muscle). 
k Flexor carpi ulnaris. 



&f Pisiform bone. 

I Flexor digitorum profundus (mus- 
cle). 

m Flexor longus pollicis. 
n Extensor ossis metacarpi pollicis. 
o Pronator quadratus. 
p Muscles of the thumb. 
q Abductor digiti minimi. 
<?f Flexor brevis digiti minimi. 
r Interosseous muscles. 
s Metacarpal bone of the thumb. 



1. Brachial. 

2. Radial. 

2-K Radial recurrent. 

3. Ulnar. 

3'. Anterior ulnar recurrent. 
3f. Posterior ,, 

4. Anterior interosseous. 

5. Deep palmar arch. 



ARTERIES. 

6. Principal artery of the thumb. 

7. Radial branch of index finger. 

8. Branches of the deep palmar arch. 

9. Branch of ulnar, joining the deep 

palmar arch. 

10. A digital branch of ulnar, given 
from a small remaining part of 
superficial palmar arch. 



NERVES. 



11. Median. 

llf. Lower end of median cut and 
turned downwards. A small 
artery ramifies on it. 
The same mark has been inad- 
vertently placed on the anterior 
interosseous nerve. 



12. Musculo-spiral. 

12f. Radial, after having turned back- 
wards beneath supinator longus 
muscle. 

13. Ulnar. 

13'. Deep palmar branch of ulnar. 



Figure 1. The view of the ulnar arteries given in this 
figure was obtained by the excision of a portion of the super- 
ficial flexor muscles, and turning outwards the pronator teres ; 



EXPLANATION OF THE FORTIETH PLATE. 



307 



and the interosseous artery was exposed by drawing aside the 
deep flexor of the fingers. It may be observed that the 
radial artery happened to be slightly inclined outwards at 
the middle of the fore-arm by throwing the pronator muscle 
in that direction. 

Figure 2. The deep palmar arch is represented in this 
figure, together with the other branches given from the radial 
artery in the same situation. These vessels were exposed by 
dividing the anterior annular ligament of the carpus, and 
removing the tendons of both the common flexor muscles of 
the fingers, as well as the muscles of the ball of the thumb. 
Portions of the tendons of the flexor muscles are turned down 
on the fingers with the ends of two " lumbricales." In the 
hand from which the drawing was taken there existed but one 
flexor tendon for the little finger. 

In both figures the nerves which accompany the arteries 
are shown. 



EXPLANATION OF PLATE XL. 



Biceps (muscle). 
Biceps covered by fascia. 
Triceps. 

Triceps covered by fascia. 
Supinator longus. 
Extensor carpi radialis longior. 
> u brevior. 

Extensor digitorum communis and 

extensor digiti minimi cut. 
Extensor carpi ulnaris cut. 



/ Outer condyle of humerus. 

f^ Inner condyle of humerus. 

g Olecranon process of ulna. 

h Anconeus (muscle). 

t Ulna. 

k Extensor ossis metacarpi pollicis 

(muscle). 

I Extensor primi internodii pollicis. 
m secundi ,, ,, 

n Extensor indicis. 



Branches of superior profunda. 
Posterior interosseous. 
Posterior branch of anterior inter- 
osseous. 



ARTERIES. 

4. Radial. 

5. A large carpal branch. 

6. Metacarpal branches. 

7. Brachial. 



VEINS. 



8. Cephalic. 

9. Median. 
10. Basilic. 



11. Veins accompanying brachial ar- 
tery (" venae couaites"). 



NERVES. 



12. Divisions of internal cutaneous. 

13. External cutaneous. 

14. Median. 



15. Posterior interosseous (from mus- 
culo-spiral). 



E E 



308 EXPLANATION OP THE FORTY-FIRST PLATE. 

Figure 1 exhibits the arteries of the back of the fore- arm 
and hand. After the removal of the integuments and fascia 
with the cutaneous veins and nerves, the superficial extensor 
muscles were divided, and to a considerable extent removed. 
The lower ends of the divided muscles were turned down on the 
annular ligament, and this ligament having been drawn down- 
wards on the inner side, the head of the ulna was exposed. 

Figure 2 is intended to show the superficial veins at the 
bend of the arm, and their position with respect to the brachial 
artery. The nerves are also represented. The dissection 
consisted in turning aside the integument, and, for the purpose 
of exposing the artery, a small portion of the fascia was cut 
through. 



EXPLANATION OF PLATE XLI. 

This plate contains illustrations of the position of the veins 
at the bend of the elbow, with reference to various peculiarities 
of the arteries. 

a Biceps muscle in some cases covered [ b Inner condyle of the humerus. 
by fascia. | c Pronator teres muscle. 

ARTERIES. 



1. Brachial. 

2. Radial. 

2f . Common trunk of radial andinter- 



3. Ulnar. 

3f. The ulnar, not giving interosseous. 

4. . Interosseous. 



VEINS. 



5. Median. 

5f. Median-basilic. 



6. Basilic. 

7. Cephalic. 



8. Median nerve. 



Figure 1. The arteries are in this figure in the condition 
most frequently met with when the division has occurred above 
the bend of the arm. They are close together, and beneath 
the fascia. 

Figure 2. One of the arteries (the ulnar) is moved inwards 
from the usual situation, and lies for some space over the 
fascia, but afterwards sinks beneath the membrane. 



EXPLANATION OF THE FORTY-SECOND PLATE. 



309 



Figure 3. The ulnar artery is placed over the fascia. 

Figure 4. A small artery, which afterwards took the course 
of the radial, here lies immediately under the integuments. 
This variety is of very rare occurrence. 

Figure 5. Three arteries are shown close together, and 
under the fascia. The radial and ulnar separate from a 
common trunk ; the interosseous crosses beneath them. 



EXPLANATION OF PLATE XLIL 



a Humerus. 

af Outer condyle of humerus. 

a+ Inner } , ,, 

b Radius. 

if Interosseous ligament. 

c Ulna. 

cf Olecranon process of ulna. 

d Biceps (muscle). 



rff Tendon of biceps. 
e Brachialis anticus. 
/ Supinator longus. 
g Pronator teres. 

h Extensor ossis metacarpi and ex- 
tensor primi internodii pollicis. 
/if" Extensor secundi internodii pollicis. 
i First dorsal interosseous muscle. 



ARTERIES. 



1. Brachial. 

2. Radial. 

2'. Radial- Recurrent. 
2f. Superficialis volse. 
2J. Lower part of radial taking an un- 
usual course over the tendons. 

3. Ulnar. 

3'. Anterior ulnar recurrent. 



3f. Posterior ulnar recurrent 

4. Common trunk of the interosseous 

arteries. 

4'. Anterior interosseous. 
4"f\ Posterior ,, 

5. Superior profunda. 

6. Inferior 

7. Anastomotica magna. 



8. Median. 



10. 



NERVES. 

| 9. Ulnar. 
Musculo-spiral. 



Figures 1 and 2. The small arteries ramifying about the 
elbow joint are represented in these figures. To display the 
vessels in front of the joint as they are shown in the first 
figure, the muscles were removed, except the brachialis anti- 
cus, and the tendon of the biceps. On the outer side the 
radial recurrent artery is seen to be joined to branches de- 
scending from the superior profunda ; and on the inner side 
the anterior ulnar recurrent ascends to be connected with 
the anastomotica magna, and the inferior profunda. 



310 EXPLANATION OF THE FORTY-SECOND PLATE. 

The second figure is a view of the same preparation from 
behind. The superior profunda, inferior profunda, and ana- 
stomotica magna, communicate by small ramifications with the 
recurrent branches, viz. the posterior ulnar, and the interosseous. 
Across the lower end of the humerus an arch is formed be- 
tween the superior profunda and the inferior profunda ; in 
most cases the inner portion of the arch is given from the 
anastomotic artery. This arrangement of the vessels con- 
stitutes the " arcus dorsalis humeri posticus" of Haller and 
other anatomists. 

Figures 3, 4, and 5, are representations of peculiarities of 
the radial artery, and they may be regarded as differing 
mainly one from the other in degree. The variation from the 
usual disposition in the first case, is the origin of the super- 
ficialis volse above the position at which it commonly arises. 
In the second there is the additional peculiarity, that the 
radial artery, after giving rise to the superficialis volse, is 
directed backwards over the tendons of the extensor muscles 
of the thumb. The radial artery of the last figure divides 
soon after its commencement into two parts. One of these 
continues in the usual situation of the radial as far as the 
carpus, and becomes the superficialis volse ; the other turns 
over the muscles to the outer side of the limb, and after 
coursing superficially along the fore-arm and carpus, takes up 
the position of the radial between the first two metacarpal 
bones ; or, in accordance with the manner of describing the 
vessels in the preceding figure, it may be said of this case, 
that the superficialis volse is given at the upper part of the 
fore-arm, and that the radial artery is directed out of its ordi- 
nary course. 



311 



EXPLANATION OF PLATE XLIII. 



The first figure of this plate continues the subject of the 
last three of the preceding plate. The others are illustrations 
of some of the peculiarities of the interosseous artery. 



a Biceps (muscle). 

af Brachialis anticus. 

b Triceps. 

c Inner condyle of humerus. 

d Superficial muscles cut. 

c?f Pronator teres. 

e Supinator longns. 

f Flexor carpi ulnaris. 

g longus pollicis. 



Flexor digitorum profundus. 

Interosseous ligament. 

Pronator quadratus (muscle). 

Extensor ossis metacarpi and ex- 
tensor primi internodii pollicis. 

Extensorsecundi internodii pollicis. 

Extensores carpi radialis longior 
and brevior. 

First dorsal interosseous. 



1. Brachial. 

2. Radial. 

2"f*. Branch of radial crossing over the 
tendons of the extensor muscles 
of the thumb. 

2. A. branch of radial running be- 
neath the tendons of the ex- 
tensor muscles. 



ARTERIES. 

3f. Ulnar. 



not giving interosseous. 

4. Interosseous. 

4f. Interosseous given from the ax- 
illary. 

5. A large branch of ulnar accom- 

panying the median nerve, and 
joining the palmar arch. 



6. Median. 



NERVES, 

| 7. Ulnar. 



Figure 1. The radial artery divides at the lower part of 
the fore-arm into two parts of equal size. One of these takes 
the course exemplified in the former plate, namely, outwards 
over the tendons, and then forward to the palmar surface 
between the heads of the first dorsal interosseous muscle. 
The other branch turns backwards also, but beneath the ten- 
dons. From each artery a branch is directed over an in- 
terosseous space to the palmar surface ; and the first of these 
joins the artery of the thumb ; the second is connected to the 
digital artery common to the index and middle fingers. 

Figure 2. The superficial pronator and flexor muscles 
having been divided and partly removed, and the deep com- 



312 



EXPLANATION OF THE FORTY-FOURTH PLATE. 



mon flexor muscle of the fingers drawn aside, the distribution 
of an interosseous artery given from the axillary is displayed. 
Figure 3. An example of a branch of the ulnar artery 
accompanying the median nerve, and forming part of the 
palmar arch, is represented in this drawing. The " median" 
artery for so such branches are sometimes named is of 
unusual size, and has the additional peculiarity of perforating 
the median nerve. The ulnar artery was in this case sepa- 
rated from the ulnar nerve by a considerable interval in the 
entire length of the fore-arm. 



EXPLANATION OF PLATE XLIV. 



This plate contains examples of small radial and ulnar 
arteries joined by branches of the anterior interosseous. 



Biceps (muscle). 

Brachialis anticus. 

Outer condyle of the humerus. 

Inner ,, 

Supinator longus (muscle). 

Superficial muscles cut. 
/f Pronator teres (its lower end) turned 

outwards. 

g Flexor longus pollicis. 
h digitorum profundus. 



i Radius. 

k Interosseous ligament. 

/ Pronator quadratus (muscle). 

m Extensor ossis metacarpi, and ex- 
tensor primi internodii pollicis. 

wif Extensor secundiinternodii pollicis. 

n Tendons of extensor muscles cut 
and thrown across the hand. 

wf- Extensor indicis. 

o Dorsal interosseous muscles. 



ARTERIES. 



1. Brachial. 

2. Radial. 

2f. A slender radial given from the 
axillary. 

3. Ulnar. 

3f. A slender ulnar given from the 
axillary. 

4. Interosseous. 

4f. Branch of anterior interosseous 

joining the radial. 
4. Branch of anterior interosseous 



passing between the bone and 
muscles, and joining the ulnar. 

5. Branch of ulnar forming part of 
the palmar arch. It accompa- 
nied the median nerve. 

5f . Branch of interosseous joining the 
palmar arch. It descended with 
the median nerve. 

6 Posterior branch of anterior inter- 
osseous of large size. It gives 
several branches, the largest of 
which reinforces a slender radial. 



7. Ulnar nerve. 



Figure 1. A slender radial artery, given from the Axillary, 
is reinforced at the lower end of the fore-arm by a branch of 



EXPLANATION OF THE FORTY-FIFTH PLATE. 



313 



the anterior interosseous. To bring this unusual offset of the 
interosseous into view, the radius was cleared of the muscles. 
There was also present in this case a considerable " median" 
artery, given from the ulnar. 

Figure 2. A branch of the anterior interosseous, resem- 
bling, " mutatis mutandis," that in the preceding figure, joins 
a slender ulnar artery. Here, too, there is a large " median " 
artery, but it is derived from the anterior interosseous. 

Figure 3 is a view of the back of the hand. To expose the 
vessels more fully, some of the tendons of the extensor muscles 
were divided and turned aside. 

The interosseous, in this instance, compensates for the small 
size of the radial artery in the following manner: The pos- 
terior division of the anterior interosseous divides into branches. 
The largest branch joins the radial, and the artery resulting 
from their union passes forward to the palmar surface at two 
points of the first interosseous space. The other branches of 
the interosseous are distributed over the metacarpus, and 
send perforating arteries between the heads of the interosseous 
muscles to join the deep palmar arch. 



EXPLANATION OF PLATE XLV. 



a Biceps (muscle). 
b Inner condyle of humerus. 
c Supinator longus. 
d Palmaris longus. 
d"f A muscle which may be named 
a second palmaris longus. 



e Flexor carpi ulnaris. 

/ Tendons of the extensor muscles of 

the thumb. 

g Muscles of the ball of the thumb. 
h Anterior annular ligament of the 

carpus. 



1. Brachial. 

2. Radial. 

2f. Superficialis volae. 

2J. A branch of deep arch reinforcing 

the digital artery of the index 

and middle fingers. 



ARTERIES. 

3. Ulnar. 

4. A " vas aberrans," or a " median " 

branch, extending from the bra- 
chial to the palmar arch. 



Figure 1. A slender artery given from the brachial, after 
running for some distance over the muscles, takes, at the lower 



314 EXPLANATION OF THE FORTY-FIFTH PLATE. 

part of the fore-arm, the position of a " median " artery, and 
joins the palmar arch. 

Figure 2. This figure is introduced to show the ulnar artery 
covered by a muscle for several inches above the carpus. 
The muscular fibres arose from a slender tendon, and, after 
spreading inwards over the artery, they divide into two parts. 
One of these, situated close to the tendon of the palmaris 
longus, becomes connected to the annular ligament by ten- 
dinous fibres, and from this point some muscular fibres proceed 
inwards under the ulnar artery to join the muscles of the 
little finger. The other division of the unusual muscle, 
narrowing, extends downward over the muscles of the little 
finger, and becomes blended with them a little above its first 
phalanx. 

In the other figures of this plate some peculiarities of the 
superficial palmar arch, and especially of the " arteria super- 
ficialis volse," are represented. 

Figure 3. The superficial volse is of large size, and forms 
part of the superficial palmar arch. All the digital branches 
are furnished by the arch. 

Figure 4. The superficialis volse is of large size, and is 
distributed to several fingers, without being connected to the 
ulnar artery. 

Figure 5. The superficialis volse becomes the external 
digital artery of the thumb. The end of the ulnar artery is 
joined to the radial on the adductor pollicis muscle a portion 
of the tendon of the long flexor of the thumb was removed to 
show this communication. The digital artery, common to 
the index and the middle fingers, is joined by a considerable 
branch of the deep arch. 

Figure 6. The superficialis volse becomes the radial branch 
of the index finger. 



315 , 



EXPLANATION OF PLATE XLVI. 



This plate contains illustrations of some variations of the 
superficial palmar arch, of the deep palmar arch, and of the 
digital arteries. 



ARTERIES. 



1. Radial. 

If. Superficialis volte. 
1 j. A large branch of the radial artery 
or of the deep palmar arch. 

2. Ulnar. 

3. Median. 

4. Deep palmar arch. 

4f. Digital artery given by the deep 
palmar arch. 

4$. Branch from the deep-arch join- 
ing the ulnar. 



5. Digital artery of the thumb derived 
from the radial when about to 
penetrate the first interosseous 
space. This branch takes its 
course over the dorsal surface 
of the first interosseous muscle, 
to the point at which it becomes 
visible in the drawing. 

5"f~. Digital artery common to the index 
and middle fingers. 



Figure 1. A " median " artery descends beneath the anterior 
annular ligament of the carpus, and gives the digital branches 
to the outer side of the thumb, and to the same side of the 
index finger. 

Figure 2. The ulnar artery supplies but two fingers and 
a half. The digital artery common to the index and the 
middle fingers, is given from the deep arch. The internal 
artery of the thumb arose from the radial (where this vessel 
was about to penetrate between the two first metacarpal 
bones) and descended between the first dorsal interosseous 
muscle and the integument to the point at which it appears in 
the drawing. It gives a branch (6) which crosses between the 
tendon of the long flexor muscle and the bone, to assist the 
artery on the outer side. The little branch is separated from 
the tendon in its transverse course by a fibrous band, which, 
with the bone, forms a distinct canal for it. A " median " 
artery of small size, here fully exposed by removal of the 
anterior annular ligament of the carpus, terminates by joining 
three of the digital arteries. 



F F 



316 EXPLANATION OF THE FORTY-SIXTH PLATE. 

Figure 3. The ulnar artery is of small size, and gives but 
one digital artery, that common to the middle and the ring 
fingers. It is joined to a large branch (1 J) of the radial artery 
at the middle of the-hand, and to three other branches (4t) of 
the same artery. 

The radial artery is of large size. It furnishes all the digital 
arteries, except the single one given from the ulnar. The 
branches come forward from beneath the tendon of the long 
flexor of the thumb and the tendons of the common flexors 
of the fingers ; and one branch (4 J) emerges between the 
muscles of the little finger where the communicating branch 
between the superficial and the deep arches is ordinarily 
placed. 

Figure 4. The superficial palmar arch, formed by the ulnar 
artery and " superficial volse," is very slender. The digital 
branches are, with one exception, derived from the radial, 
and are joined by the little offsets from the superficial arch. 
The ulnar furnishes but a single digital artery that to the 
inner side of the little finger. 

Figure 5. A large metacarpal branch of the radial artery is 
directed forwards over the posterior surface of the second 
interosseous space to the cleft between the index and middle 
fingers, where it becomes the digital artery common to these 
fingers, in the manner shown in the next figure. 

Figure 6 is intended mainly to show the further course of 
the unusual artery represented in the preceding figure. It is 
marked 5-)% and is joined by a small branch of the superficial 
palmar artery. 

Figure 7. The radial furnishes all the digital arteries. 
They are joined by small branches of the superficial arch. To 
expose the vessels as they are represented in this figure, the 
tendons of the common flexor muscles were withdrawn from 
the anterior annular ligament of the carpus, and cut away. 
The ligament remains entire. 

Figure 8. The deep palmar arch has been brought into 
view by preparation similar to that used in the last case, 
except that the annular ligament was cut through. The radial 
artery is here of extremely small size, and the deep arch is 
derived from the ulnar artery. 



317 



RADIAL ARTERY. 

For the purpose of rendering the subsequent observations 
on the peculiarities of the radial artery intelligible, it will be 
sufficient to make, in reference to the c< usual " disposition, 
this brief statement, viz. that the vessel arises opposite, or a 
little below the middle of the elbow joint, and courses beneath 
the fascia along the inner margin of the supinator longus as 
far as the carpus ; that it here turns outwards beneath the 
tendons of the extensor muscles of the thumb, and penetrates 
to the "palmar surface in the first inter osseous space, and 
between the heads of the first dorsal interosseous muscle ; 
that it furnishes the branches named recurrent radial, super- 
ficial volar, carpal (anterior and posterior), besides several 
small muscular branches, given along the fore-arm, and palmar 
and digital arteries. The disposition here described is illus- 
trated in plates 38 and 39. 

The number of cases in which the condition of the radial / Right side 229 

artery is stated in the table, is 1 Left 200 

429 

It had the "usual" disposition above /Right 177 
described in ... \ Left 157 

334 

The vessel presented some considerable deviation J R. 52 
from the ordinary state in . . . \ L. 43 

95 about 1 in 4. 
429 

The further observations on the radial artery will have 
reference, as in other parts of this work, chiefly to the pe- 
culiarities of the vessel. They will be made in the following 
order : 

A. The place of origin. 

B. The course along the fore-arm. 

C. The size of the vessel. 

D. Its entire absence. 

E. Connexion with other arteries. 

F. Disposition of the branches. 

F F 2 



318 RADIAL ARTERIES 

A. The place of origin. The whole of the cases noted J Right 231 
with reference to this point, are in number . . 1 Left 198 

429 

The artery arose in the "usual" situation |~R. 199 
a little below or opposite the elbow < L. 177 

joint* in [ 376 

It arose in some unusual position specified JR. 32 ... 
underneath (see plate 31) . . . \L. 21 

53, or 1 in nearly 8 T * r 
429 



PR 9 
The origin was from the axillary artery in -I { 7 

i 16 

from the Brachial, within two f R. 13 
inches of the beginning of this 4 L. 6 
in . . . . I -19 

from the same artery at its JR. 5 
. \L. ' 



middle . . . . I L. 8 

13 
from the same artery near the 

lower end _ 

5 

37 
53 



e JR. 5 
. |_L. 



B. The course along the fore-arm. The disposition of the 
artery in the arm, when it happens to arise above the ordinary 
situation, having been already referred to (page 263), our 
attention will here be restricted to its course in the fore- 
arm. In the ordinary course briefly described above the 
artery is very constant, the instances of deviation of any 
kind occurring very seldom ; and in this respect the radial 
contrasts with the other principal artery of the fore-arm. 
Examples, however, do occur, though rarely, of deviation to 
a considerable extent, from the general course. Thus the 
radial artery may be found over the fascia, instead of under 
that membrane : on the surface of the supinator longus muscle, 
not along its inner margin : and superficial to the tendons of the 
extensor muscles of the thumb, in place of being beneath them. 

Such peculiarities will be found to be illustated in the cases 
now to be described. 

1. After arising from the brachial about its middle, the 
radial artery was found in a single case to run over the apo- 
neurotic expansion of the biceps muscle and the fascia of the 
fore-arm, and to cross immediately behind the median-basilic 

* See the remarks on the division of the brachial artery at page 260. 



THEIR COURSE. 319 

vein *. At the end of the upper "third of the fore-arm it 
divided into two nearly equal parts ; one of these turned over 
the outer side of the limb, and penetrated to the palmar 
surface in the second interosseous space of the hand ; the 
other lay in the ordinary direction of the radial artery, and 
after crossing over the tendons of the muscles of the thumb, 
passed through the first interosseous space. 

2. Another case-f presented a conformation in some respects 
similar to that just noticed. The radial artery arose in the 
usual position, and separated, a little below the elbow joint, into 
two branches of nearly equal size ; one of which, after running 
in the course of the radial artery in the fore- arm, continued in 
a straight direction to the palmar surface of the hand, over the 
muscles of the thenar eminence, and joined the superficial arch 
in the manner of the superficial volar. The other branch 
inclined outwards over the supinator longus muscle, and ran 
nearly parallel with the former at the distance of about an inch 
from it to penetrate between the first two metacarpal bones. 
One of these divisions of the artery, therefore, occupied the 
position of the radial artery in the fore-arm, while the other 
took its place in the hand J. Now, of this case it might be 
said, that the radial artery turned backwards out of its 
course, and that the superficial volar arose much above 
the ordinary situation ; and this mode of viewing the arteries 

* Plato 41, figure 4. Tiedemann, in speaking of the radial artery, seems to imply 
that it may be over or under the fascia, indifferently. These are his words " Arteria 
radialis vel ab aponeurosi brachii inclusa est, vel fasciam tendineam perforans inter hanc 
et cutem cum vena cephalica decurrit." Explicat. Tab. xiv. p. 169. 

The vein referred to as the " cephalic " in this extract cannot he easily determined, 
because that name is given in the explanation of the second figure of the same plate, to 
a vein which accompanies the radial artery, and runs to the inner side of the biceps 
muscle. Dr. Green says of the radial artery " In some rare instances the vessel 
pierces the brachial aponeurosis, and becomes quite superficial. I have a distinct 
recollection of one such occurrence." Loc. Cit. page 1 9, 

M. Bourgery (Op. Cit. T. iv. pi. 48, fig. 5) gives the representation of a very extra- 
ordinary case. The end of the brachial, and the radial and ulnar arteries, are seen to 
lie over the fascia. The last-named vessel runs over the palmaris brevis muscle also, 
but beneath the palmar fascia. The interosseous artery penetrates the fascia, being given 
from the ulnar, which is on that membrane. It is to be regretted that the figure is not 
accompanied by any detailed description. 

f Plate 42, figure 5. 

J There is in the museum of the College of Surgeons of Edinburgh, a preparation 
showing the same arrangement of the arteries. It is one of the collection of Dr. Barclay. 

"In some subjects," says Allan Burns, ' the radial artery, very soon after its 
origin, gives off the arteria superficialis volse, which is long, small, and, in some cases, 
tortuous, and descends in the situation of the radial artery, which twists to the back of 



320 RADIAL ARTERIES. 

will be strengthened by comparing their arrangement with 
that which is shown in the following case. 

3. In this instance the radial artery, at the distance of about 
three inches from the hand, passed obliquely over the muscles 
of the thumb to enter the palmar surface at the accustomed 
point ; while the superficial volar, of large size, alone occu- 
pied the place of the radial immediately above the carpus *. 
The previous case may obviously be regarded as a farther 
extension of the same arrangement. In both, the radial 
artery was directed out of the general course, and lay nearer 
to the surface than usual ; in both, the superficial volar alone 
existed at the point at which the pulse is commonly felt. 

4. The disposition of the artery to be here referred to, is 
shown in plate 43, figure 1. The radial divides, between two 
and three inches from the lower end of the radius, into two 
parts of equal size, which run parallel, and close one to the 
other, to the carpus. At this point one is directed over the 
small tendons, and dips into the first metacarpal space ; this 
vessel may be regarded as the continuation of the radial 
artery. The other branch crosses under the tendons of the 
extensor muscles of the thumb, together with that of the 
extensor carpi radialis longior, and enters the second inter- 
osseous space. The case described is the only example of 
such an arrangement of the vessels that I have observed. 

C. The size of the radial artery does not often vary to any 
considerable extent. A few instances are mentioned in the 
table of the size being decidedly less than ordinary ; and a few 
others are recorded, in which it exceeded the most frequent 
or standard condition. 

It may here be stated, that every case we examine of 
variation of the size or the arteries of the fore- arm will prove 
that there prevails among them what might be termed a prin- 
ciple of compensation the deficiency of one being compen- 
sated by the increase of the other. Thus the radial artery 
is larger than usual in the case delineated in plate 46, figure 

the radius." He adds that he had seen " several examples" of the "lusus," and that 
Dr. Baird had observed " three instances in the same family," meaning, I apprehend, 
that he had distinguished it by the touch in living persons. "Observ. on the Diseases 
of the Heart," &c., p. 300. 

* Plate 42, figure 4. The same peculiarity has been noticed by Tiedemarin and others. 



THEIR SIZE ABSENCE. 321 

7, and it gives origin to the digital arteries, which are ordi- 
narily supplied by the ulnar. An example of a remarkable 
diminution of size is given in plate 46, figure 8. It will be 
observed that in the latter instance the radial artery, instead 
of giving off certain branches to the hand, ends beneath the 
first metacarpal bone, where it joins the deep palmar arch ; 
and this, together with the other branches usually derived 
from the radial, is furnished by the ulnar artery. 

Again, the small size of the radial artery has been found to 
be compensated for in another and very different manner 
namely, by the junction of a branch from the anterior inter- 
osseous. I have hitherto met with two forms of such rein- 
forcement of the vessel. In one, the slender radial, running 
the ordinary course in front of the fore-arm, was joined at 
the wrist by a considerable branch of the anterior interos- 
seous, and was in consequence augmented to about the ordi- 
nary size plate 44, figure 1. In the other form of the con- 
formation, shown in the third figure of the same plate, the 
reinforcing branch was derived from the posterior division of 
the same artery, and joined the radial behind the carpus. 
See the observations on the interosseous arteries. 

D. Absence of the radial artery. The very reduced size of the 
artery noticed in the last paragraph, prepares us in some degree 
for its entire absence. This peculiarity, however, is of ex- 
treme rarity. I have never seen any example of its occurrence ; 
and the only recorded one that I have met with is mentioned 
by Professor Otto, who gives of it the following account * : 
"The radial artery, in very rare instances, is entirely wanting, 
and there can no pulse be felt on the fore-arm. I have ob- 
served this during life, and after death, on both arms of an 
aged woman; from the radial artery there is merely the 
recurrent and a few little muscular branches ; the descending 
trunk is entirely wanting ; hence the interosseal is larger, and 
gives off the branch to the hand, which is naturally sent from 
the radial )-." It may be noticed, that the absence of the 

* Loc. cit. p. 302. 

f The preparation No. 2047 in the Catalogue of the Anatomical Museum at Breslaw. 
was probably taken from the body of the person here alluded to. It is noticed in M. 
Otto's Catalogue in these words : " Ein linker Arm, an welchem die Arteria radialig 
fehlt, vveshalb im Leben an diesem Arme kein Puls zu fiihlen war." " Neues Ver- 
/eichniss der anatomisch. Sammlung, &c. zu Breslau" 1838. 



322 RADIAL ARTERIES 

radial in the fore-arm was made up for in the way which the 
cases immediately before under observation would lead us to 
expect, namely, by the anterior interosseous. 

E. Connexion with other arteries. Under this head it is 
proposed to include the direct connexion of the trunk of the 
radial with other arteries, without referring to the various 
anastomoses that exist in the hand, between its branches and 
those of the ulnar artery. The connexions in question having 
been already described in detail in preceding parts of this work, 
it will here be sufficient to make reference to them, viz. the 
branches of communication between the radial and ulnar 
arteries occurring opposite the bend of the elbow * : the modes 
of termination of " vasa aberrantiaf : " and the connexion 
with the interosseous artery, pointed out in a recent paragraph. 

F. Disposition of the brandies. When the radial artery arises 
above the bend of the elbow, it gives origin, in the arm, only to 
branches of insignificant size (see plate 31). An exception to 
this statement occurs in a case, the only one of the kind I 
have met with, represented in plate 30, figure 3. The radial 
artery there arises in the axilla, and furnishes the subscapular, 
the circumflex, and profunda branches. 

The branches ordinarily given from the radial artery in the 
fore-arm and hand, are the following : the radial recurrent ; 
superficial volar ; anterior and posterior carpal ; metacarpal ; 
the branches given to the thumb and the index finger ; 
and the deep palmar arch. 

Radial recurrent. This branch usually takes its rise a little 
below the bend of the elbow close to the commencement of 
the radial artery when this ^vessel arises in the ordinary 
situation. It distributes offsets in different directions ; those 
which ascend in the immediate neighbourhood of the musculo- 
spiral nerve communicate with the superior profunda artery ; 
the descending branches are distributed to muscles. See 
plates 38 and 39, and plate 42, figure 1. 

The deviations from the more usual arrangement affect the 
size, the number, the place of origin and course, and the con- 
nexion between this and other arteries. 

The size of the recurrent is occasionally found to be greater 
or less than ordinary. In two instances I observed it of equal 

* Page 264. f Pago 265. 



THEIR BRANCHES. 323 

thickness with the continuation of" the radial artery, and in 
one it furnished the interosseous recurrent, or a branch in the 
place of that which is so named. 

Instead of a single branch distributing offsets in different 
directions, two or more are occasionally met with. Thus, in 
the table, cases are mentioned in which there were two, three, 
or even four branches arising separately from the radial 
artery in the place of the recurrent. 

The origin is transferred not unfrequently to the brachial 
artery, occasionally to the ulnar, and rarely to the inter- 
osseous ; when derived from the brachial artery, it may be 
found to cross behind the tendon of the biceps *. 

Besides the anastomoses of branches about the elbow joint, 
in which the radial recurrent has a share, I have observed a 
few examples of a different kind of connexion with other and 
larger arteries. In one of these, depicted in plate 35, figure 
2, it is joined to a " vas aberrans ; " in another it forms part 
of a communication established between the radial and ulnar 
arteries plate 34, figure 4. 

Arteria superficialis voice. This branch presents several 
peculiarities in size, mode of distribution, and place of origin. 

The number of observations made on its condition and "1 Right side 132 
recorded in the table is ..... /Left 103 

-- 235 

And they were so disposed as to admit of being arranged in 
three classes, as follows : 



1. The artery was of very small size, and was soon"^ 

expended in the muscles of the thumb with- I Right 80 
out joining either the superficial palmar >Left 61 
arch, or any of the digital arteries ; or it j -- 141 

was altogether wanting in . . . ) 
In the remaining cases the superficialis volse is to be under- 
stood to have been of rather considerable size. 

2. It ended by forming part of the superficial "1 Right 40 

palmar arch in . . . . J Left 25 

65 

It joined the superficial arch, and continued"'! 

onward to furnish a digital branch or I Right 2 
branches to the thumb, or the index finger, [Left 2 
or to both of these in . . J -- 4 

69 

3. It furnished one or more digital arteries, but was "1 Right 1 7 

not connected to the superficial arch in . /Left 8 

-- 25 

-- 235 

* Plate 42, figure 1 ; plate 35, figures 4 and 2 ; and plate 33, figure 2. 



324 RADIAL ARTERIES 

With respect to the first two of the preceding classes : 
illustrations of one, the first, are contained in plate 38, 39, 
43, 44, and others ; and the second is exemplified in plate 
42, figure 3 ; plate 45, figure 3 ; and plate 46, figure 4. 

The disposition of the artery in the third series or class, has 
several modifications. Thus, in some instances it is of large 
size, and furnishes the digital arteries of several fingers plate 
45, figure 4. In others it passes directly to one side of the 
thumb, or of the index finger ; or again, it supplies both these 
fingers wholly or in part. Two of these peculiarities are re- 
presented in plate 45, figures 5 and 6 : in the former of these 
figures, the superficial volar ramifies on the outer side of 
the thumb ; in the latter, it is distributed on the same side of 
the index finger, becoming the branch named "radialis indicis." 

The place of origin of the superficial volar has been noted 
only with respect to the cases included in the last two classes 
above referred to those, namely, in which the 'artery was 
of moderate or considerable size. It usually takes its rise 
close to the lower end of the radius, where the radial artery is 
about to turn to the dorsal aspect of the hand ; and the devia- 
tions from this point are not of frequent occurrence. The 
table contains notes of ten instances in which it was given at 
the distance of from one inch and a half to two inches and a 
half above the ordinary position ; and I have met with one 
(not contained in the table) in which the artery may be said 
to have arisen near the commencement of the radial plate 
42, figure 5. 

In most instances of early origin of the superficial volar, 
the radial artery and the branch run close together as far as 
the carpus (plate 42, figure 3), but when the parent vessel 
inclines prematurely to the back of the hand, a course rarely 
met with, the superficial volar alone is in the situation at 
which the pulse is generally felt by the medical practitioner 
to ascertain the state of the circulation *. This fact is shown 
in the fourth and fifth figures of the plates last referred to. 

* It is insinuated by Allan Burns (loc. cit.) that an injurious line of practice had, 
in one case, been pursued by a physician, " a keen Brunonian," in consequence of the 
presence of this conformation of the arteries. The patient died. Burns adds " On 
dissecting him, we found that the physician had never felt the pulsation of the radial 
artery, having all along mistaken the action of the arteria superficialis volee for that of 
the radial artery." 



THEIR BRANCHES. 325 

In the foregoing comments, and the illustrative figures, the 
superficial volar artery has been observed to have very different 
directions and modes of distribution in different cases ; in one 
instance, to the outer side of the thumb ; in another, towards 
the middle of the palm ; in a third, to some intervening point. 
With the view to throw light in some degree on these changes 
of position, I would remark that, in a dissection of the outer 
side of the hand, if made with moderate care, several small 
branches will be found crossing over the small muscles of the 
thumb at short intervals plate 38, figure 2 ; and it may be 
supposed that the enlargement of these now in one line, again 
in another will serve to account for the varieties that occur 
in the course of the branch in question. 

Carpal and metacarpal branches. Two carpal branches are 
recognised by anatomists the anterior and posterior. The 
former is very small, and I have not noticed any peculiarity 
affecting it that requires observation. The posterior carpal is 
often conjoined with the metacarpal branch. This or the 
united trunk, gives several small branches, the most remark- 
able of which (metacarpal branches) descend along the poste- 
rior surface of the dorsal interosseous muscles, and communi- 
cate with the deep palmar arch by means of little arteries that 
penetrate the interosseous spaces between the heads of the 
interosseous muscles. See plate 40, figure 1 ; in which, how- 
ever, the artery is somewhat larger than it is commonly found 
to be. 

The most frequent peculiarity of these arteries, indepen- 
dently of alterations of size, consists in the enlargement of the 
metacarpal branch that lies over the second interosseous space, 
and its distribution to the index and the middle finger, whose 
common digital branch it becomes. This arrangement was 
noted in twelve of the cases recorded in the table, eight oc- 
curring on the right side, and four on the left. It is illustrated 
in plate 46, figures 5 and 6. 

A metacarpal branch was also occasionally observed to take 
a similar course over the interosseous muscle, and to join the 
digital arteries of the thumb. But this branch takes its rise 
directly from the radial, and is to be regarded as nothing 
more than the small artery which usually occurs in the same 



326 ULNAR ARTERIES 

situation, enlarged beyond the size it commonly has plate 46, 
figures 2 and 4, and plate 40, figure 1. 

In a few instances I have seen the posterior division of the 
anterior interosseous artery supply, to a greater or less extent, 
the place of the posterior carpal and metacarpal branches 
one case presenting a very unusual degree of this conformation, 
is figured in plate 44. There the interosseous takes the place 
of the absent branches of the radial, and strengthens the 
main vessel by yielding to it a considerable addition. 

The deep palmar arch, and the arteries of the thumb and 
index finger, will be considered in connexion with the other 
arteries of the hand. 



ULNAR ARTERY. 

The ordinary disposition of this artery is exhibited in plate 
38, figures 1 and 2, and plate 39, figure 1 ; and it may be 
briefly stated as follows. After arising opposite or a little 
below the bend of the elbow*, the artery inclines obliquely 
inwards under cover of the superficial pronator and flexor 
muscles, and having come into contact with the ulnar nerve 
above the middle of the fore-arm, it is then directed vertically 
downwards, in company with the nerve, and by the side of the 
flexor carpi ulnaris muscle, to the palmar surface of the hand. 

The branches given in this course are the anterior and 
posterior recurrent, and the interosseous, with small muscular 
and carpal arteries. The further distribution of the ulnar 
artery will be commented on at the same time with the other 
branches furnished to the hand. 

The prevalence of the conformation above described, and 
the frequency of deviation from it, may be thus stated from 
the table. 

The number of instances in which the condition of the 1 Right side 225 
artery is recorded is . . . . . J Left 197 

- i22 

It had the usual disposition in . { j^Z?;; 

-- 381 
And deviated in some respects from it in . . 41, or 1 in nearly 



* See the observations on the division of the brachial artery in a former page of this 
work 260. 



THEIR PECULIARITIES. 327 

The deviations from the usual disposition will be arranged 
under the following heads : 

A. The origin. 

B. Position and direction. 

C. Size. 

D. The branches. 

E. Peculiarities of the muscles in the immediate neighbour- 
hood of the artery. 



A. The place of origin of the artery was noted in ,-| J^"" side ^ 

422 
It was found to arise in the usnal position in-j j^| ~~ ^gg 

390 

r R 19 

above that point in . { T ' , 
|_L.. It 

31 
below it in . . L. 1 

The origin deviated from the usual position in . . 32 -I a . 'Jaj, 

The following is the analysis of the cases in which the artery 
took its rise above the bend of the elbow. 

f R. 

It was given from the axillary artery in . . } J 

from the brachial near its beginning "j T i 

' _ 6 

r T> -i 

from th same artery at the middle . < y 

1 

{R 11 
L 5 
' 16 
23 
31 

The variations that occur in the point of origin when it is 
higher than the usual position, are illustrated in plate 32 ; 
and the single case in which the vessel was observed to arise 
lower than usual, is represented in plate 35, figure 4. 

B. Position and direction. Where its origin occurs in the 
usual situation, the ulnar artery has little tendency to depart 
from the common course. I have, however, in more than one 
instance, seen it separated from the flexor carpi ulnaris by a 
considerable interval in the whole length of the fore-arm 



328 ULNAR ARTERIES 

arriving at its ordinary position for the first time on the 
carpus plate 43, figure 8. With respect to the case figured 
in the plate, it is to be observed, that a large median artery 
makes a very unusual curve to perforate the median nerve, 
and that there may possibly be some connexion between this 
circumstance and the direction of the ulnar artery. 

When the artery arises higher than usual and the remain- 
ing observations will have reference to it only when such is 
the case it almost invariably deviates largely from the usual 
position in the fore-arm. The peculiarities that occur in the 
upper-arm, having been already noticed under the head of 
the brachial artery (page 263), attention will here be re- 
stricted to the course along the fore- arm. I shall consider the 
variations in position with reference to the muscles and to 
the fascia. 9 

The origin being above the ordinary position the vessel 
is almost invariably situated over the superficial 'muscles of 
the fore-arm. With so much constancy is it thus placed that 
I have never in more than a single example (plate 36, figure 2) 
found the artery covered by the muscles. 

Most commonly the ulnar artery lies beneath the fascia, 
between it and the muscles : as represented in plate 32, figures 
1, 2, and 3. Only three instances have occurred under 
my observation in which it was altogether subcutaneous. 
Two of these are delineated in plate 36, figure 1 : and plate 
41, figure 3. The third was noticed in a living person. 
I have observed some cases in which the position of the vessel, 
with respect to the fascia, partook of the condition of both 
those just mentioned, and was different from either. In this 
class of cases, the vessel lies over the fascia opposite the bend 
of the elbow, and for a small extent of the fore-arm, but is 
covered by the membrane in the rest of its course plate 41, 
figure 2. Five examples of this arrangement are mentioned 
in the table, and I have noticed a greater number. It is a 
condition easily recognised during life. In one arm of a 
young friend of mine, a member of the medical profession, 
the ulnar artery can be readily distinguished immediately 
beneath the skin, at the upper part of the fore-arm ; but after 
the passage of a few inches, it ceases to be distinguishable in 



THEIR COURSE. 329 

the same manner, obviously because of being more firmly 
bound down by sinking beneath the fascia. 

Having so far considered the variations that occur in the 
position of the ulnar artery, with respect to the fascia and to 
the muscles, the line of direction it follows comes next for 
observation. When placed over the muscles, (the deviation 
observed in its direction, when under the muscles, has been 
mentioned at the beginning of this division of the commentary,) 
the ulnar artery varies in the point at which it begins the 
course along the fore-arm. If the origin be immediately 
above the usual position, the artery crosses the pronator teres 
opposite the middle of the bend of the elbow, or nearly so 
plate 32, figure 3, and plate 41, figure 3. On the other hand, 
when the origin is situated at some distance higher in the 
arm, the vessel not unfrequently commences its course in the 
fore-arm considerably nearer to the inner margin of the limb, 
as is shown in plate 32. figures 1 and 2, and in plate 41, 
figure 2. 

In its course downwards, the vessel for the most part 
inclines gradually to the flexor carpi ulnaris and the ulnar 
nerve. But a different disposition occasionally obtains. Thus, 
I have in at least two instances, (a drawing of one of them is 
now before me,) seen it directed nearly midway between both 
sides of the limb, and along the inner margin of the flexor 
carpi radialis to within little more than two inches of the 
wrist. At this point, the artery, changing its course, turned 
transversely inwards to the usual position, and then inclined 
downwards in company with the ulnar nerve, having formed 
two nearly right angles. I once noticed the same disposition 
in a living person an old female, in University College hospital, 
and I observed that in her arm the angles of the artery were 
alternately increased and diminished the vessel being, in 
fact, plainly seen to become alternately more and less straight. 
In the last case, the artery was altogether subcutaneous ; in 
each of the others, it was covered by the fascia. 

Occasionally the artery does not approach the flexor carpi 
ulnaris till it is arrived at the carpus. This fact was well 
illustrated in the arm, of which a representation is given in 
plate 44, figure 2. 



330 ULNAR ARTERIES 

C. The Size. The ulnar artery, when disposed in the usual 
manner, always loses much of its size by giving off the inter- 
osseous. It has the same diminished size from the origin 
when this occurs above the bend of the elbow, or when the 
vessel lies over the muscles of the fore -arm ; for in such cases 
the interosseous is never, as far as I know, a branch of the 
ulnar artery. A similar effect is produced, without any 
change in the place of origin by the transfer of the inter- 
osseous to another artery. But the ulnar, " strictly so called,' 1 
as Dr. Barclay used to name the artery apart from the 
interosseous, is sometimes found to have less or more than 
the ordinary dimensions. Without dwelling on constantly 
occurring minute shades of difference, it may be mentioned 
that the vessel is occasionally found to be so small as to afford 
few or nearly none of the branches ordinarily derived from 
it ; or, on the other hand, it may be so large as to take the 
place of a defective radial artery. A decided decrease of 
size is more frequently met with than the opposite ; and 
when it occurs, the arterial supply is derived from sources 
that vary in different cases. 1. The source from which the 
deficiency is most frequently supplied is the radial artery. 
Illustrations of several forms of branches of this artery sub- 
stituted for the ulnar will be found in the forty- sixth plate, 
and a detailed reference to them is contained in the observa- 
tions on the arteries of the hand. 2. The median artery 
occasionally yields assistance to the ulnar in the hand ; a state- 
ment of the manner in which it is afforded is contained in the 
observations on that vessel, 3. Lastly, I have found a slender 
ulnar artery directly joined by a branch of the anterior inter- 
osseous, and thereby increased to the ordinary dimensions : see 
the notice of the interosseous artery and plate 44, figure 2. 

Rarely does the ulnar exceed the common size, and take 
the place of the radial to any extent deserving notice. A 
well-marked instance is, however, shown in plate 46, figure 8*. 

D. Tlie Branches. The branches to be noticed in this place 
are those given in the fore-arm ; the palmar and digital 
branches will be associated with the other arteries of the hand. 

* The observations made on the connexion between the radial and other arteries 
(p. 322) apply equally to the ulnar artery. 



THEIR BRANCHES. 331 

Anterior recurrent : posterior recurrent. The usual arrange- 
ment of these branches will be found in plate 39, figure 1, and 
plate 42, figures 1 and 2. They sometimes are derived from 
a common trunk, instead of arising singly from the ulnar 
artery ; and when this artery takes origin above the ordinary 
situation, the recurrent branches are given by the interosseous 
plate 33, figure 1 : 43, figure 2, and 44, figure 2. In the single 
example of the arteries of the fore-arm arising below their 
ordinary position, the recurrent branches were derived from 
the brachial artery ; and I have occasionally seen them, or one 
of them, arise above the elbow-joint and descend to be distri- 
buted in the usual manner plate 43, figure 2. 

Interosseous. For the usual arrangement of this artery and 
its branches, see plate 39, figure 1, and plate 40, figure 1. 
There is generally a single vessel, which divdes into the anterior 
and posterior branches as represented in the former of the two 
plates referred to, but occasionally the branches are given 
singly from the ulnar artery. 

The most important deviations from the ordinary disposi- 
tion, are, 1st, those affecting the origin, and in connexion with 
it, the course ; 2ndly, those in which some unusual branches 
are concerned. 

Origin. The most frequent change in the mode of origin 
of the interosseous accompanies the alteration in the point 
at which the ulnar artery arises ; for when this vessel is given 
above the usual position, the interosseous is transferred (so 
to express the fact of their connexion) to the radial artery *. 
But a more extensive alteration of the place of origin remains 
to be noticed. The interosseous is occasionally found to ema- 
nate from the axillary or the brachial artery. Four examples 
of such a change of the origin are mentioned in the table ; the 
interosseous being in one of them derived from the axillary, in 
the others from the brachial artery. I have observed one 
other case in which the interosseous artery was given by the 
axillary, and two in which it proceeded from the brachial 
artery f . 

* Plate 32, figures 1, 2, 3 ; plate 36, figures 1 and 2. 

f Plate 33, figures 1, 2, and 3 ; plate 35, figure 4 ; plate 44, figure 1. The in- 
terosseous artery will be seen to arise from the end of the brachial artery in the last 
three figures. 

G G 



332 ULNAR ARTERIES 

The course the artery follows along the upper arm in the cases 
just noticed, has been referred to in the comments on the 
brachial artery (page 263). It is illustrated in plate S3, 
figures 1, 2, 3 : plate 41, figure 5, and in plate 43, figure 2. 

Branches of the interosseous artery. Few variations requir- 
ing observation in consequence of practical importance occur 
in the ordinary branches, and I have only to observe with 
respect to them that in one instance I saw the place of the 
interosseous recurrent taken by a branch of the radial recur- 
rent, and that the anterior interosseous artery, after reaching 
the back part of the fore-arm, sometimes furnishes the 
branches to the back of the hand. 

I observed that when the interosseous artery was given off 
from the axillary, it furnished the branches of the shoulder and 
the arm ; namely, the subscapular, the circumflex, and the 
profunda arteries plate 33, figure 1 . This occurred in both 
the cases that fell under my observation. 

To another class of branches, occasionally found to arise 
from the interosseous artery, considerable interest attaches. 
Some variety exists in the cases now referred to, but they 
have this in common, that in every instance the unusual 
branch aids the radial or the ulnar artery, compensating for 
the small size of the one or the other of these vessels. The 
branch most frequently met with descends to the hand to join 
the palmar arch, or to take the place of some of the offsets of 
that artery. It will presently be noticed more at length 
under the name " median artery." The other forms of the 
peculiarity now under observation, consist in the anterior 
interosseous giving a branch to join directly a slender radial 
or ulnar artery. In one case, the branch passes from the ante- 
rior interosseous outward, between the pronator quadratus and 
theradius,and joins the radial artery; inanother, the reinforcing 
branch, " mutatis mutandis," has a similar course to the inner 
side of the fore-arm to join the ulnar ; in a third the posterior 
division of the same vessel gives a thick branch to join the 
radial artery on the dorsal surface of the hand. These 
varieties of conformation are represented in the forty-fourth 
plate. I have seen but another example of a similar arrange- 
ment, and it differed in no respect from that delineated in the 



THEIR BRANCHES. 333 

first figure of the plate to which reference has been made. 
Trew* and Dr. Green + have each described the communi- 
cating branch given from the anterior interosseous to the radial 
artery in front of the fore-arm. 

The disposition of the arteries in some of the cases which 
have now been mentioned, may be regarded as a transition 
to an arrangement observed by Otto, and previously noticed 
in this work (page 321) that namely in which the radial 
artery having been altogether wanting, the interosseous, in- 
clining outwards, in front of the lower end of the radius, was 
found to take its place. 

Median artery. The artery thus named, because of its 
course in the middle of the fore- arm with the median nerve J, 
is noted in the table as having been present in twenty-four 
arms. It is derived from the anterior interosseous or the 
ulnar artery most frequently from the former, and, accom- 
panying the median nerve, reaches the hand beneath the 
annular ligament of the carpus . See plate 43, figure 8, plate 
44, figures 1 and 2, and plate 46, figures 1 and 2. In each of 
two instances I found a slender branch given from the brachial ; 
which, from the latter part of its course, might be considered a 
" median " artery. This little vessel, after arising, as stated, 
from the brachial, lay over the muscles of the fore-arm and 
descended to the hand beneath the anterior annular ligament 
of the carpus. One of the examples of this peculiarity oc- 
curred in the body of a very young child ; the other is 
delineated at plate 45, figure 1. 

The median artery varies in its mode of termination. In 

* The radial artery arose high in the arm, and received two communicating branches 
one at the bend of the elbow, from the brachial (ulnar-interosseous), the other near 
the wrist, from the anterior interosseous. The author gives a sketch of the vessels, 
adding, " ut autem et hsec (the high division, &c.) melius intelligi queant, in gratiam 
eorum quorum ea scire interest, similis distributionis, ob varias praterea anastomoses 
inemorabilis, delineationem fieri curavi." " Commerc. litter. Noric." 1737. Hebd. 24. 

f 1 " An Account of the Varieties," &c., page 21, and Tab. 4, figure 6. 

t " Arteria interossea superficial, quse non inepte mediana vocari potest, quia 
nervum medianum comitatur." Tiedemann. " Explicat. Tab. xvi." p. 191. 

The sixteenth plate of Professor Tiedemann's work contains two figures in which 
the median artery >is shown. And in both it is made to cross in front of the 
annular ligament. M. Bourgery (T. iv., fig. 2 and 6) gives two similar figures, which 
have apparently been copied from Tiedemann. 

Now, I have never seen the median artery so placed with reference to the annular 
ligament, and I am inclined to regard the representations referred to as, in that respect, 



334 ARTERIES OF THE HAND 

a great majority (nineteen) of the cases set down in the table, 
it was found to join the superficial palmar arch (plate 43, 
figure 3, and 44, figures 1 and 2). And in the remaining 
number (five) it supplied the fingers, or joined digital branches 
derived from another source plate 46, figures 1 and 2. See 
the remarks on the arteries of the hand. 

E. Peculiarities of muscles in the immediate neighbourhood of 
the artery. I have in a few instances found the ulnar artery 
covered by muscle for some distance above the carpus. The 
extent to which the vessel was thus covered varied from two 
to four inches. The disposition of the unusual muscular fibres 
was not the same in different cases ; but the arrangement I 
most frequently met with (it occurred in three cases) resembled 
that delineated in plate 45, figure 2. The manner in which 
the muscular fibres terminated in this case is mentioned in 
the explanation of the plate (p. 314). I have seen them end 
differently, having been attached in parts to the deep layer of 
fascia that separates the flexor carpi ulnaris from the flexor 
profundus, and partly to the annular ligament and the muscles 
of the little finger. These peculiar muscles might be regarded 
as a modification of the second palmaris longus a slender 
bundle of muscular fibres unconnected with the ulnar artery, 
of which I have repeatedly seen examples. The unusual muscle 
is said in the table (No. 242) to have reached in one in- 
stance from the ulnar to the muscles of the little finger. 

THE ARTERIES OF THE HAND. 

The arteries of the hand which it is proposed to review in 
this place are, the superficial palmar arch, the deep palmar arch 
and the digital branches. The carpal and metacarpal branches 
have already been noticed at sufficient length for the purposes 
of this work. 

The superficial palmar arch or artery crosses the hand from 
the inner towards the outer side, lying beneath the palmar 
fascia, and in front of the tendons of the flexor muscles. It is 
generally formed by the ulnar artery, with a communicating 
branch from the radial. 

There are numerous varieties as to the mode of connexion 
with the radial artery. Thus . the superficial palmar artery, is 



THE SUPERFICIAL PALMAR ARCH. 335 

frequently joined by the superficial. volar (plate 45, figure 3, 
and plate 46, figure 4) ; and this arrangement is described by 
several anatomical writers as that which generally prevails. 
But it has been shown in the account previously given of that 
branch, that the superficial volar is in a majority of bodies a 
very small branch, and is expended in the muscles of the 
thumb ; at least such is the result of the examination of a 
large number. Moreover, when of considerable size, it has 
not invariably a direct connexion with the superficial arch 
(plate 45, figure 4). b. A large branch of the radial is occa- 
sionally found to emerge from between the thumb and the 
index finger, and to form the medium of communication with 
the ulnar artery (plate 46, figure 3). c. But the connexion is 
with most frequency effected by means of a small branch 
directed transversely from among the muscles of the thumb. 
One form of such a branch will be found in plate 38, figure 2. 

Such are the most important of the modes of connexion 
between the radial artery and the superficial branch of the 
ulnar. It must be added that cases sometimes occur in which 
no communication exists between the arteries in this situation. 
The absence of communication is shown in plate 45, figure 4, 
and plate 46, figures 1 and 2. 

When a median artery exists, it perhaps most commonly 
joins the upper part of the superficial arch, in the manner 
shown in plate 45, figure 1 ; but the instances are not of rare 
occurrence in which this artery takes the place of a branch 
from the radial, in completing the superficial arch at the outer 
side. This disposition of the median artery is shown in plate 
43, figure 3, and plate 44, figure 2. 

The size of the superficial arch is very various. In one case 
it is sufficiently large to supply all the digital arteries * ; in 
another, on the contrary, it is so small f as scarcely to furnish 
a digital branch. Between these extremes there are many 
intermediate degrees of size, as will be seen on reference to 
the forty-fifth, the forty-sixth, and other plates. 

Lastly, the arch may in some instances be said to be alto- 
gether wanting. This occurs when the principal arteries 

* Plate 43, figure 2, and plate 44, figures 1 and 2. 
t Plato 46, figure 4. 



336 ARTERIES OF THE HAND 

divide without any approach to a transverse direction, or when 
the branches usually given from the arch emerge at various 
points, and in such a manner, that though the digital branches 
are present in the usual number, an arch cannot be said to exist. 
Cases illustrative of this statement are represented in plate 
45, figure 4, and plate 46, figure 2. 

The deep palmar arch is placed transversely behind the 
tendons of the flexor muscles, and lies higher or nearer to the 
carpus than the superficial arch *. It is derived from the 
radial artery, with very rare exceptions, and is joined on the 
inner side by a branch of the ulnar or perhaps it would be 
more correct to say of many cases, that the deep arch is con- 
tinued into the ulnar artery on the inner side of the hand, 
inasmuch as there is no difference of size or other mark, by 
which to be guided in determining the extent of the arch to be 
assigned to each artery. The communication between the 
deep arch and the ulnar artery is, however, often effected by 
means of a small branch f, and this, according to the usual 
manner, may be said to spring from the last-named vessel. 

The size of the deep arch is occasionally diminished below 
the ordinary condition, but it is more frequently augmented, 
and compensates for deficiency in the superficial arch. An 
example of the latter kind is represented in plate 46, figure 7. 
The radial artery, however, rarely furnishes so many of the 
branches ordinarily given from the ulnar as it is seen to do in 
this drawing. 

I have in a few instances observed the deep palmar arch to 
emanate from the ulnar artery, the radial being of extremely 
small size. This rare peculiarity is exemplified in the eighth 
figure of the plate last referred to. 

The digital arteries. It is with sufficient general correctness 
stated in anatomical works, that the superficial arch furnishes 
the digital arteries to three fingers and a half, reckoning from 
the inner side, and that the radial artery supplies the thumb 
and one side of the index finger J. 

But the deviations from this arrangement are numerous and 
of various kinds. For convenience' sake, they will be arranged 

* Plate 39, figure 2. f Plate 46, figures 1, 3, 4, and 7. 

$ Plate 38, figure 2, and plate 39, figure 2. 



THE DIGITAL ARTERIES. 337 

in two series ; the first to comprise" the peculiarities of the 
branches usually derived from the superficial arch ; the second 
to include the variations of the arteries of the thumb and 
the radial side of the index finger. 

1. The peculiarity most frequently met with in this series is 
the substitution of a branch or branches from the deep arch 
for one or more of those generally given from the superficial 
one. The radial artery, or deep palmar arch, is mentioned in 
the table to have furnished one or more digital arteries in 
fifty-one cases, which were disposed as follows : 

The entire number . . . . .. . { gg* side ** 

51 
r T? i (\ 
One digital artery * was given in . "I T ' iq 

35 

Two in i?" n 

[L,. 

5 

Threef in !?'? 

(_ Lt. o 

8 
Four* in . . . . . . { *; 

3 

51 

The digital arteries are also supplied, but with less frequency, 
from other sources. These may be enumerated as follows : 
the superficial volar ; a metacarpal branch from the back of 
the hand || ; a branch given by the radial artery in the same 
place as the deep arch ^f ; and the median artery as shown (at 
least in part) in the second figure of the forty-sixth plate. 

2. The principal sources from which digital arteries are given 
to the thumb and the outer side of the index finger, in the place 
of those they ordinarily receive, are the following : the super- 
ficial palmar arch, which may be found to supply all the fingers**; 
the superficialis volse, giving now one digital branch, and in 
another case a different oneff ; the median artery JJ ; lastly, a 
metacarpal branch , given on the back of the hand from the 
radial as it is about to pass forward in the first interosseous 
space. 

* Plate 45, figure 5 ; and plate 46, figure 2. f Plate 46, figures 3 and 4. 

J Plate 46, figure 7. Plate 45, figure 4. 

|| Plate 43, figure 1 ; aud plate 46, figures 5 and 6. ^ Plate 46, figure 3. 

** Plate 43, figure 2 ; plate 44, figures 1 and 2 ; and plate 45, figure 1. 
ft Plate 45, figures 5 and 6. J+ Plate 44, figure ]; and plate 46, figure 1. 

Plate 43, figure 1 ; and plate 46, figures 2 and 4. 



338 



EXPLANATION OF PLATE XLVII. 



This plate is intended to exhibit the thoracic or descending 
aorta with the intercostal arteries. The shoulders and arms 
were removed. The walls of the chest and abdomen, including 
the diaphragm, having been divided, the anterior part was 
taken away to a large extent. At the same time, the heart, 
the lungs, part of the oesophagus,, and the viscera of the 
abdomen were removed. Further, the pleura was stripped 
from the ribs and intercostal muscles of the right side, and 
that membrane was dissected for a short space from the same 
parts near their cut margin on the left side. 

The left intercostal arteries were but obscurely seen because 
of the left side of thorax having been in deep shadow, especially 
near the aorta and the vertebral column. 

The body was in the sitting posture while the drawing was 
being made. 

a Sterno-cleido-mastoid muscle of 

the right side, 
af Sterno-cleido-mastoid of the left 

side. 

b Sterno-hyoid of the right side. 
6f Sterno-hyoid of the left side. 
c Thyroid body. 
d Trachea. 
c?f Right bronchus. 
d Left bronchus. 



Anterior scalenus muscle of the 

right side. 

Anterior scalenus of the left side. 
Posterior scalenus. 
(Esophagus. 
Diaphragm. 
Pleura. 
Right kidney. 
Left kidney. 



ARTERIES. 



1. Arch of the aorta. 

2. Descending or thoracic aorta. 

3. Innominate. 
4 Right carotid. 
4f. Left carotid. 

5. Right subclavian. 
5f. Left subclavian. 

6. Thyroid axis. 

7. Internal mammary. 



8. This mark is placed on some of 
the aortic intercostal arteries of 
the right side. 

8f. Superior intercostal of the right 
side. 



9. 
10. 



" Vena azygos." 
Thoracic duct. 



339 



EXPLANATION OF PLATE XLVIII. 



a Right ventricle of the heart, 
af Left ventricle. 



b Right auricle, 
if Left auricle. 



ARTERIES. 



1. 
2. 
2'. 
3'. 

4. 

4f. 
5. 
5'. 
6. 

7. 
8. 

8'. 

9. 
10. 
11. 

12. 



24. 
24'. 
25. 
25'. 
26'. 



Arch of the aorta. 

Descending or thoracic aorta. 

The same viewed from behind. 

Abdominal aorta viewed from be- 
hind. 

Right coronary. 

Left coronary. 

Innominate. 

The same viewed from behind. 

Left carotid. 

Left subclavian. 

First aortic intercostal and last 
lumbar. 

The same viewed from behind. 

Right bronchial. 

CEsophageal. 

Phrenic. 

Coeliac axis. 



13. Coronary. 

14. Hepatic. 

15. Splenic. 

16. Superior mesenteric. 

17. Capsular artery of the supra- 

renal capsule. 

17'. The same seen from behind. 

1 8. Renal. 9 
18'. The same viewed from behind. 

19. Spermatic. 

20. Inferior mesenteric. 

2 1 . Middle sacral. 

21'. The same viewed from behind. 

22. Common iliac. 

23. Pulmonary. 
23f. Right pulmonary. 
23J. Left pulmonary. 



VEINS. 



"Vena cava inferior." 
The same viewed from behind. 
Hepatic. 

The same viewed from behind. 
" Vena azygos " viewed from be- 
hind. 



27. " Vena cava superior." 

27'. The same viewed from behind. 

28. Pulmonary of right side. 
28f. of left side. 



Figure 1 is intended mainly to show the coronary arteries. 
The heart and the large vessels connected with it were viewed 
directly in front during the delineation, and have been repre- 
sented in their natural position. In order to display the left 
coronary artery, the pulmonary artery was divided near its 
origin, and the greater part of it was removed, together with 
the branches. 

Figure 2. In this figure the heart and large vessels are 
viewed from behind. The pulmonary arteries and veins, and 
the " vena azygos," are here seen in addition to the parts re- 
presented in the foregoing figure. 



H H 



340 EXPLANATION OF THE FORTY-NINTH PLATE. 

Figure 3 is a representation of the aorta in its entire length, 
and of the commencement of the branches which take rise 
from it. The aorta having been viewed directly in front, 
and in 'its natural situation on the vertebral column, the 
intercostal arteries of the left side were not seen near their 
origin, owing to the circumstance of their being concealed for 
some space by the great vessel from which they arise. Those 
of the right side on the contrary were prominently in view on 
the bodies of the vertebrae. 

Figure 4. The aorta being removed from its natural con- 
nexions, is here represented on its posterior aspect. And the 
branches, whose origin become visible in such a view, are 
likewise shown ; but a small portion, however, of each being 
included. The branches are the intercostal, the lumbar, r and 
tfte middle sacral, springing from the back part of the great 
artery, with the renal and capsular, taking rise from its lateral 
aspect. 



EXPLANATION OF PLATE XLIX. 



In this plate, the arteries of the stomach and the liver are 
represented without the removal or displacement of any of 
the organs. 

To exhibit the parts as they are here seen, the wall of the 
abdomen was in great part removed, and in order to show 
more fully the viscera at the upper part of the abdominal 
cavity, the entire margin of the chest was cut away. Some 
of the divided ribs and other structures are visible below 
the fore-arm on the right side ; the rest were entirely con- 
cealed by the fore-arms these having been, with that intention, 
held in the position in which they are drawn. The stomach 
and intestines were slightly inflated ; and the liver having 
been held up by means of hooks, dropped into the shape that 
is represented. 

The body was supported in the erect position during the 
preparation of the drawing. 



EXPLANATION OF THE FIFTIETH PLATE. 



341 



a Diaphragm. 

b Liver. 

Iff " Lobulus Spigelii " of the liver. 

c Gall-bladder in this case connected 
to the colon by a fold of peri- 
toneum *. 

d Stomach. 

e Spleen. 



/ Great omentum. " 

/f Great omentum allowing the trans- 
verse colon to be seen behind it. 

g Rectus muscl. 

h Pancreas. 

i A. fold of the peritoneum con- 
necting the gall-bladder to the 
colon*. 



ARTERIES. 



1. Coeliac axis* 

2. Gastric : Coronary of stomach. 

3. Hepatic. 

4. Splenic. 

5. Gastro-duodenal. 



Pyloric branch. 

Cystic. 

Gastro-epiploic of the right side. 

Gastro-epiploic of the left side. 



10. " Vena portae." 



12. Hepatic duct. 

13, Cystic duct. 



VEINS. 

| 11. "Venacava. 5 

BILE DUCTS. 



14. Common bile duct. Ductus com- 
munis choledochus. 



EXPLANATION OF PLATE L. 



a Stomach. 

b Duodenum. 

c Part of the jejunum. 

d Liver. 

rff Gall-bladder. 

e Pancreas. 

/ Spleen. 



g Kidney of the right side. 

g" Kidney of the left side. 

h Portion of the large intestine 
taken from the descending colon 
and the sigmoid flexure of the 
colon. 



ARTERIES. 



1. Aorta. 

2. Gastric : coronary of stomach. 

3. Hepatic. 

4. Gastro-duodenal. 

4f. Gastro-epiploic of the right side. 
4J. Pancreatico-duodenal. 

5. Splenic. 



Gastro-epiploic of the left side. 
" Vasabrevia." 

6. Superior mesenteric. 

7. Inferior mesenteric. 

7f. The part of the inferior mesen- 
teric which descended to the 
pelvis (superior hsemorrhoidal)-. 



* This fold of the peritoneum is often present, and varies somewhat in extent, It is 
distinctly a natural formation not a false membrane. The layers of the serous 
membrane which compose it are continuous with the small omentum, and reach from 
the gall bladder to the colon and its peritoneal support. I have seen the fold fixed 
above to the liver instead of the gall-bladder very close, however, to the latter. 

The arrangement of this process of the peritoneum, its modifications, and the fre- 
quency of its occurrence, will be shown by my colleague, Mr. G. V. Ellis, who is 
engaged in making observations with respect to it. 



342 . EXPLANATION OF THE FIFTIETH PLATE. 



VEINS. 

8. " Vena cava inferior." I 10. Splenic. 

9. Portal : " vena portse." | 11. Superior mesenteric. 



Figure 1 continues the representation of the branches of 
the coeliac artery from the preceding plate. In order to dis- 
play the arteries furnished to the spleen, the pancreas, the 
duodenum, and to the great curvature of the stomach, the last- 
named organ was held upwards from its natural position, and 
is so represented in the drawing. 

Figure 2. In this outline, a part of the jejunum, and the 
arterial branches which supply it, are delineated with the in- 
tention of showing the mode in which the superior mesenteric 
artery branches, previously to entering the substance of the 
intestine, with more distinctness than could be done in the 
plate 51 ; in which the convolutions of the intestines partly 
conceal the small branches of the vessel. 

Figure 3. With a like intention, a portion of the descend- 
ing colon, and of its sigmoid flexure, is shown in connexion 
with the inferior mesenteric artery. 



343 



EXPLANATION OF PLATE LI. 



THE superior mesenteric artery and most of its branches 
are displayed in this plate. To obtain the view of the parts 
as they are represented, after the removal of the greater part 
of the wall of the abdomen in front, the colon was drawn into 
the position in which it is seen by means of strings. Those 
for the transverse colon were passed upwards through the 
fore part of the diaphragm and the parietes of the chest. 
The jejunum and ileon were folded so as to expose but a 
portion of the numerous arteries which supply them. And 
the peritoneum was removed from one side of all the vessels. 

In consequence of the body having been placed in the 
erect position, the duodenum and both ends of the pancreas 
drooped downwards. 



Duodenum. 

Jejunum and ileon. 

Head of the colon : caput caecum 
coli. The vermiform appendage is 
seen to escape from its lower end. 

Right or ascending part of the 
colon. 



cf Transverse part of the colon. 

cj Left or descending part of the 
colon. 

d Pancreas. 

e Transverse meso-colon. One of its 
layers has been removed to ex- 
pose the arterial branches. 



ARTERIES. 



1. Superior mesenteric. The nume- 
rous branches given from its 
left side to the jejunum and 
ileon are not distinguished by 
names. Some of them have 
been folded with the intestine to 
which they are distributed under 
the part which lies exposed. 



2. Ileo-colic branch. 

3. Right colic branch : arteria colica 

dextra. 

4. Middle colic branch : arteria co- 

lica media. 



5. Superior mesenteric vein. 



EXPLANATION OF PLATE LII. 



THE distribution of the inferior mesenteric artery (except 
the pelvic portion) and some branches of the superior mesen- 
teric, are here shown. The small intestines were turned to 
the right side in order to expose the end of the colon, and the 



i i 



344 



EXPLANATION OF THE FIFTY-THIRD PLATE. 



latter was held out as represented, to show the vessels more 
fully. 

The peritoneum was removed from the lower surface of the 
branches of the superior mesenteric artery, and from the aorta 
the vertebral column, and the left lumbar and iliac regions. 
The kidney and ureter, with the psoas muscle of the left side, 
are indistinctly seen through a thick layer of laminated cellular 
membrane. 



Jejunum and ileon turned from the 
natural position on the left side. 

Duodenum drawn with the remain- 
der of the small intestine to the 
right side. 

Right or ascending part of the 
colon. 

Transverse part of the colon. 

Left or descending part of the 
colon. 

Sigmoid flexure of the colon. 

Transverse meso-colon. One of 
the two layers of which it con- 



/t 



sists has been removed to dis- 
play the arteries. 

Divided edge of the dense cellular 
membrane which lies behind 
the peritoneum. It was dis- 
sected from the aorta, to show 
that vessel more clearly. 

Kidney of the left side. It is 
covered by the membrane (e) 
and therefore indistinctly seen. 

Ureter. 

Left psoas muscle, also covered in 
the same way. 



ARTERIES. 



1. 
2. 

2 1 . 



Aorta. 

Superior mesenteric. 

Right colic : arteria colica dextra. 



2f . Middle colic :-arteria colica media. 
3. Inferior mesenteric. 
3 1 . Left colic : arteria colica sinistra. 
3f. Branches to the sigmoid flexure of 

the colon arteriae sigmoideae. 
3J. The continuation of the inferior 

mesenteric into the pelvis for 



4. 

4f. 

5. 

5 l . 

6. 

7. 



the supply of the rectum 
superior hsemorrhoidal. 

Left renal. 

Left spermatic. 

Right common iliac. 

Left common iliac. 

Middle sacral. 

Left epigastric. 



8. Left common iliac vein. 



EXPLANATION OF PLATE LIU. 



IT was desired to show the abdominal aorta and the origin 
of its branches, together with the iliac arteries. With this 
view the viscera of the abdomen were removed, with the 
exception of the kidneys and supra-renal capsules. The 
urinary bladder and the rectum occupy the pelvis. 

The body having been viewed directly in front, the 
diaphragm was seen, as it is represented, to a small extent, 
fore-shortened, and for the most part in deep shadow. 



EXPLANATION OF THE FIFTY-FOURTH PLATE. 



345 



a Diaphragm. 

b End of the oesophagus. 

c Kidney of the right side. 

c l Kidney of the left side. 

erf* Ureter. The ureters are in this 
case seen to be furnished with 
their arteries from the renal and 
the common iliac. 

cj Supra-renal capsule. 

d Right psoas muscle. 

d l Left psoas. 



e Ilfacus muscle of the right side, 

covered by the iliac fascia. 
e l The same on the left side. 
/ Transversalis muscle cut to expose 

a branch of the circumflex-iliac 

artery. 
g Rectus muscle. Its fibres are seen 

below the margin of its sheath. 
h Rectum : intestinum rectum. 
Urinary bladder. 
k Vas deferens of the right side. 
fr Vas deferens of the left side. 



ARTERIES. 



1. Aorta. 

If. Middle sacral. 

2. Right phrenic, or diaphragmatic. 
2 1 . Left phrenic. 

3. Capsular : artery of the supra- 

renal capsule. 

4. Coeliac. 

5. Coronary of the stomach : arteria 

coronaria ventriculi. 

6. Hepatic. 

7. Splenic. 

8. Superior mesenteric. 

9. Right renal. 
9 1 . Left renal. 

10. Right spermatic. 
10'. Left spermatic. 

11 Inferior mesenteric. 

12. Lumbar of the right side, A dash 



(*) has been accidentally and 
erroneously added to the number 
affixed to the first of these 
branches. 
12 l . Lumbar of the left side. 

13. Right common iliac. 
13'. Left common iliac. 

14. Right external iliac. 
14 1 . Left external iliac. 

15. Right internal iliac. 
15 l . Left internal iliac. 

15J.A branch of the ilio -lumbar. 

16. Right epigastric. 
16 1 . Left epigastric, 

17. Obturator of right side. 
17 1 . Obturator of left side. 

18. Branches of circumflex -iliac : 

arteria circumflexa ilii. 



VEINS. 

19. " Vena cava." { 20. Hepatic. 



EXPLANATION OF PLATE LIV. 



IT is introduced to exhibit some of the arteries of the 
abdomen those of the diaphragm and others which could 
not be shown in the last plate. 

The vessels represented here were unusually large. The 
body was that of a very tall man, in whom the arteries were 
naturally of more than ordinary dimensions. It should be 
mentioned, too, that they appeared to be fully distended with 
injection. 

In order that the diaphragm might be drawn upwards and 
its arteries fully displayed, the sternum with the anterior part 
of the ribs was removed. 

i i2 



346 



EXPLANATION OP THE FIFTY-FIFTH PLATE. 



a Diaphragm. 

b End of the oesophagus. 

c Kidney. 

cf Supra-renal capsule. 

cj Ureter. 

d Psoas muscle of the right side. 

d l Psoas muscle of the left side. 

e Quadratus lumborum of the right 

side. 
e l Quadratus lumborum of the left 

side. 
/ One of the layers (the middle one) 

of those named " fascia lumbo- 



rum," continued from the trans- 

versalis abdominis muscle. 
Iliacus muscle of the right side. 
Iliacus muscle of the left side. 
The highest part of the crest of the 

right iliac bone. 
The same on the left side. 
Rectum : intestinum rectum. 
Urinary bladder. 
Rectus abdominis muscle of the 

right side. 
The same muscle on the left side. 



THE ARTERIES. 



5. 
6. 
6 l . 

7. 
8. 
9. 
9f. 



Aorta. 

Right phrenic. 

Left phrenic. 

Cceliac. 

Right capsular : artery of the 

supra-renal capsule. 
Left capsular. 
Superior mesenteric. 
Right renal. 
Left renal. 
Spermatic. 
Inferior mesenteric. 
Lumbar. 
Branch of an intercostal artery. 



10. Right common iliac. 
10 l . Left common iliac. 

11. Middle sacral. 

12. Right external iliac. 
12'. Left external iliac. 

13. Right internal iliac. 
13 1 . Left internal iliac. 

14. llio-lumbar. 

15. Epigastric. 

16. Circumflex-iliac of the right side. 
16'. Circumflex-iliac of the left side. 



17. The vena cava, cut at its passage 
through the diaphragm. 



EXPLANATION OF PLATE LV. 



IN this plate the lower end of the aorta and the iliac arteries 
are shown in connexion with the veins by which they are 
accompanied, and some of the nerves. The intestines were 
removed to a sufficient extent to expose the vessels. 



a Small intestine. 

b Colon. 

c Rectum. 

d Ureter of the right side. 

d [ Ureter of the left side. 

e Urinary bladder. 



Aorta. 

Inferior mesenteric. 
Middle sacral. 
Right common iliac. 
Left common iliac. 
Right external iliac. 
Left external iliac. 
Right internal iliac. 
Left internal iliac. 



/ Vas deferens. 
g Right psoas muscle. 
ff l Left psoas. 
h Iliacus. 

i Highest part of the crest of the left 
iliac bone. 



ARTERIES. 

7. This figure is placed on one of the 

spermatic veins. It was in- 
tended for the spermatic artery, 
which is close on the outer side. 

8. Right epigastric. 
8 l . Left epigastric. 

9. Circumflex-iliac : arteria circum- 

flexa-ilii. 



EXPLANATION OF THE FIFTY-FIFTH PLATE. 347 

VEINS. 

10. " Vena cava." 

The other veins are sufficiently distinguished by the arteries 
they accompany. 

NERVES. 

On the left side two nerves have been left. That which 
crosses the iliacus muscle, near the anterior end of the 
crest of the iliac bone, is the external cutaneous nerve of the 
thigh. On the psoas muscle is placed the genito-crural 
nerve. It divides into branches as it approaches the wall 
of the abdomen near the groin. 



THE ABDOMINAL AORTA. THE COMMON ILIAC 

ARTERIES. 



No. 


THE AOKTA ITS PLACE OF DIVISION, 


COMMON ILIAC. 


on the Lumbar Vertebrae. 


with refer, to the 
highest part of the 
Crest of the Ilium. 


Side 
of the 
iBody. 


Length 
in 
Inches. 


Place of Di vision, &c. 


9 


the lower margin of 4th vert. 










9a 


the upper margin of 4th vert. 










15 


the lower margin of 4th vert. 










19b 


the lower margin of 2nd vert. 


1^ inch above. 


R 


4 




19c 


the mid. of 3rd vert. 










23 a 


between 3rd and 4th vert. 










25 


the lower margin of 4th vert. 










27 


between 3rd and 4th vert. 




R 


ii 




28 


between 4th and 5th vert. 










29 


between 4th and 5th vert. 










30 


between 4th and 5th vert. 










30a 


the mid. of 4th vert. 










31J 


between 4th and 5th vert. 










31a 


between 4th and 5th vert. 










31f 


between 4th and 5th vert. 










31f 


between 4th and 5th vert. 










32 


between 3rd and 4th vert. 










33 


the mid. of 4th vert. 










33a 


between 4th and 5th vert. 


- 









THE ABDOMINAL AORTA. THE COMMON ILIAC ARTERIES. 349 



No. 


THE AORTA ITS PLACE OF DIVISION, 


COMMON ILIAC. 


on the Lumbar Vertebrae. 


with refer, to the 
highest part of th 
Crest of the Ilium 


Side 
of the 
Body 


Lengt 
in 
Inches 


Place of Division, &c. 


34 


between 3rd and 4th vert. 




R 




between 4th and 5th vert. 








L 




between 4th and 5th vert. 


34 a 


the mid. of 4th vert. 










35 


between 4th and 5th vert. 










36 


between 3rd and 4th vert. 




R 




Between 4th and 5th vert. 








L 




between 4th and 5th vert. 


37 


between 4th and 5th vert. 










37 a 


the upper part of 4th vert. 










40b 


between 3rd and 4th vert. 










43 


the mid. of 4th vert. 




R 




below sacro-iliac articulation. 








L 




bel o w sacro-iliac articulation. 


45 


he mid. of 4th vert. 










48 


on the 4th vert. 










48 a 


he mid. of 4th vert. 










49 


on the 4th vert. 










51 


he mid. of 4th vert. 




R 


3 










L 


3 




52 


between 4th and 5th vert, 


opposite. 


R 


H 










L 


2* 




53 


between 3rd and 4th vert. 


inch above. 


R 


3 


opp. the mid. of 5th vert. 








L 


H 


opp. sacro-iliac articulation. 


54 


he lower margin of 4th vert. 




R 


2f 










L 


2* 




55 


he upper margin of 4th vert. 


r inch above. 


R 


3 










L 


% 




56 


he lower margin of 4th vert. 




R 


2f 


letween 5 th vert, and sacrum. 








L 


2 


etween 5th vert, and sacrum. 


57 


etween 3rd and 4th vert. 


inch above. 


R 


2 


>etween 4th and 5th vert. 



350 THE ABDOMINAL AORTA, THE COMMON ILIAC ARTERIES. 



No. 


THE AORTA ITS PLACE OF DIVISION, 


COMMON ILIAC. 


on the Lumbar Vertebrae. 


with refer, to the 
highest part of the 
Crest of the Ilium. 


Side 
of the 
Body. 


..ength 
in 
Inches. 


Pface of Division, &c. 








L 


If 


between 4th and 5th vert. 


58 


he mid. of 4th vert. 




R 


2| 


below the mid. of 5th vert. 








L 


2 




59 


he upper margin of 4th vert. 




R 


3 










L 


2| 




60 


he upper part of 4th vert. 


opposite. 


R 


2* 


f opp. the upper margin of 
\sacruin. 








L 


2f 


near mid. of iliac fossa. 


61 






R 


2| 










L 


2| 




63 


the lower margin of 3rd vert 




R 


2| 










L 


2f 




64 


the upper margin of 4th vert 


| inch above. 


R 


2 


on the mid. of 5th vert. 








L 


2* 


{opp. the lower margin of 
5th vert. 


65 


the lower part of 4th vert. 


~ inch below. 


R 


2J 










L 


2! 




66 


the upper margin of 4th vert 




R 


3i 


f opp. the interval between 
|_ 5th vert, and sacrum. 








L 


31 


opp. sacro-iliac articulation. 


67 






L 


3 




68 


the lower margin of 4th vert 


^ inch below. 


R 


3 










L 


3 




69 


the upper margin of 4th vert 


| inch above. 


R 


21 


opp. the mid. of 5th vert. 








L 


2 


opp. the mid. of 5th vert. 


70 


between 4th and 5th vert. 




R 


2 










L 


2 




72 


the lower margin of 4th vert 


1 inch below. 


R 


2 


f opp. the lower margin of 
\ 5th vert. 








L 


. 2 





THE ABDOMINAL AORTA. THE COMMON ILIAC ARTERIES. 351 



No. 

73 


THE AORTA ITS PLACE OF DIVISION, 


COMMON ILIAC. 


on the Lumbar Vertebrae. 


with refer, to the 
highest part of the 
Crest of the Ilium. 


Side 
f the 
Body. 


Length 
Inches. 


Place of Division, &c. 


between 4th and 5th vert. 


[ inch below. 


R 


n 










L 


2 




74 


the lower part of 4th vert. 


\ inch below. 


R 


3 










L 


2| 




75 


the lower part of 4th vert. 


opposite. 


R 


3 


J" opp. the upper margin of 
\ sacrum. 


76 


the upper part of 4th vert. 


f 1 inch below 
< (a deformed 
[ body). 


L 
R 


3* 


{opp. the upper margin of 
sacrum. 








L 


2 f 




77 


the lower part of 4th vert. 


opposite. 


R 


2| 










L 


2i 




78 






R 


3j 











L 


3 




79 


the upper part of 4th vert. 


I inch above. 


R 


3 










L 


3 




80 


between 4th and 5th vert. 


~ inch below. 


R 


.3 

4 










L 


1 




81 


the lower margin of 4th vert. 


~ inch below. 


R 


H 










L 


i| 




82 


J opp. the upper margin of 
\5thvert. 


If inch below. 


R 


if 










L 


*f 




83 


the mid. of 4th vert. 


j inch helow. 


R 


3 










L 


2| 




84 


the upper part of 4th vert. 


1 inch above. 


R 


3 


the mid. of 5th vert. 








L 


H 


J opp. interval between 5th 
\ vert, and sacrum. 


85 


the lower part of 4th vert. 




R 


2| 










L 


2* 





352 THE ABDOMINAL AORTA. THE COMMON ILIAC ARTERIES. 



No. 


THE AORTA ITS PLACE OF DIVISION, 


COMMON ILIAC. 


on the Lumbar Vertebrae. 


with refer, to the 
lighest part of the 
Crest of the Ilium. 


Side 
f the 
Body. 


Length 
nches. 


Place of Division, &c. 


86 


he upper margin of 5th vert. 


inch below. 


R 


If 










L 


ii 




87 


between 3rd and 4th vert. 


. inch above. 


R 


2* 


the mid. of 5th vert. 








L 


U 




88 


he lower margin of 4th vert. 


a little below. 


R 


2 










L 


2f 


__ 


89 


the mid. of 4th vert. 


\ inch below. 


R 


2* 










L 


2i 




90 


between 4th and 5th vert. 


L inch below. 


R 


11 










L 


2 




91 


;he upper part of 5th vert. 


inch below. 


R 


2 











L 


2| 




92 


the lower part of 4th vert. 




R 


3* 










L 


3 




93 


between 4th and 5th vert. 


1^ inch below. 


R 


3| 










L 


3 




94 


between 4th and 5th vert. 


inch below. 


R 


2| 










L 


2| 




95 


the upper part of 4th vert. 


1^ inch above. 


R 


2| 










L 


3 




96 


the mid. of 4th vert. 


opposite. 


R 


2f 










L 


21 




97 


the lower part of 4th vert. 


opposite. 


R 


3i 










L 


3 




98 


between 3rd and 4th vert. 




R 


2 


f opp. the interval between 
\ 4th and 5th vert. 








L 


2 


opp. the mid. of 5th vert. 


99 


the mid. of 4th vert. 


opposite. 


R 


2 





THE ABDOMINAL AORTA. THE COMMON ILIAC ARTERIES. 353 



No. 


THE AORTA ITS PLACE OF DIVISION, 


COMMON ILIAC. 


on the Lumbar Vertebrae. 


with refer, to the 
highest part of the 
Crest of the Ilium. 


Side 
of the 
Body. 


Length 
in 
Inches. 


Place of Division, &c. 








L 


If 




100 


he mid. of 4th vert. 


opposite. 


R 


1! 










L 


If 




101 


he upper part of 4th vert. 




R 


2* 










L 


2 




102 






R 


2 










L 


2f 




103 


the lower part of 4th vert. 


| inch below. 


R 


If 










L 


If 




104 


between 4th and 5th vert. 


a little below. 


R 


3 




107 






R 


1$ 










L 


1 




108 


the lower part of 4th vert. 




R 


2f 










L 


2| 




109 






R 


1 










L 


2 




111 


between 4th and 5th vert. 


5 inch below. 


R 


84 










L 


2 




112 


the upper part of 5th vert. 


1 inch below. 


R 


If 










L 


If 




113 


between 4th and 5th vert. 


a little below. 


R 


2| 










L 


2$ 




114 


the mid. of 4th vert. 


opposite. 


R 


If 










L 


If 


V.; ' ' - 


115 


the mid. of 4th vert. 


opposite. 


R 


4 










L 


3 




115a 


between 4th and 5th vert. 


| inch below. 


R 


2 










L 


2J 





354 THE ABDOMINAL AORTA. THE COMMON ILIAC ARTERIES. 



No. 


THE AORTA ITS PLACE OF DIVISION, 


COMMON ILIAC. 


on the Lumbar Vertebrae. 


with refer, to the 
highest part of the 
Crest of the Ilium. 


Side 
of the 
Body. 


iLength 
in 
Inches. 


Place of Division, &c. 


116 


between 3rd and 4th vert. 


~ inch below. 


R 


n 










L 


2| 




117 


between 3rd and 4th vert. 




R 


3f 










L 


4 




119 


the lower margin of 3rd vert. 




R 


3| 


below sacro-iliac articulation. 








L 


3"! 


below sacro-iliac articulation. 


120 


the lower margin of 4th vert. 




R 


3| 






' 




L 


H 




121 


the upper margin of 4th vert. 




R 


3| 










L 


3| 




122 


the lower margin of 4th vert. 


^ inch below. 


R 


2 


f opp. the lower part of 
\ 5th vert. 








L 


2 


f opp. the lower part of 5th 
\ vert. 


123 


the lower margin of 4th vert. 


~ inch below. 


R 


1| 










L 


If 




124 


the lower part of 4th vert. 


a little below. 


R 


3 










L 


3 




125 


between 4th and 5th vert. 




R 


1 










L 


H 




127 


the upper part of 4th vert. 




R 


3 


J opp. the interval between 
\ 5th vert, and sacrum. 








L 


3| 


lower than at the opp. side. 


128 


the upper part of 4th vert. 




R 


2 










L 


U 




129 


the upper margin of 5th vert. 


1 inch below. 


R 


If 










L 


1 




130 


the lower margin of 4th vert. 




R 


2| 










L 


2* 




131 


the lower part of 4th vert. 


opposite. 


R 


2| 





THE ABDOMINAL AORTA. THE COMMON ILIAC ARTERIES. 355 



No. 


THE AORTA ITS PLACE OF DIVISION, 


COMMON ILIAC. 


on the Lumbar Vertebrae. 


with refer, to the 
highest part of the 
Crest of the Ilium. 


Side 
of the 
Body. 


Length 
Inches. 


Place of Di vision, &c. 








L 


2J 




133 






R 


2| 










L 


2} 




134 


the upper part of 5th vert. 


1 inch below. 


R 


2 











L 


2* 




135 


the mid. of 4th vert. 




R 


3* 










L 


2f 




136 


the inid. of 4th vert. 


/a very little 
|_ above. 


R 


2| 










L 


2 I 




137 






R 


If 










L 


2J 




138 


the upper part of 4th vert. 




R 


3 










L 


2| 




139 


the lower part of 4th vert. 


1 inch below. 


L 


3 




141 


mid. 4 vert. 


opposite. 


R 


If 










L 


If 




142 






R 


3 










L 


5| 




145 


the upper margin of 4th vert. 


1 inch ahove. 


R 


3 










L 


2f 




147 


the lower margin of 4th vert. 


opposite. 


R 


2J 










L 


H 




149 


the lower part of 4th vert. 


inch below. 


R 


2 










L 


2 




150 


the upper part of 4th vert. 


^ inch above. 


R 


2f 










L 


8* 




151 


between 4th and 5th vert. 


a little below. 


R 


2 





356 THE ABDOMINAL AORTA. THE COMMON ILIAC ARTERIES. 



No. 


THE AORTA ITS PLACE OF DIVISION, 


COMMON ILIAC. 


on the Lumbar Vertebrae. 


with refer, to the 
highest part of the 
Crest of the Ilium. 


Side 
of the 
Body. 


Length 
in 
Inches. 


Place of Division, &c. 








L 


2 




152 


the upper margin of 4th vert. 


TJ inch above. 


L 


3 




153 






R 


1 










L 


If 




154 


the upper part of 4th vert. 


1 inch above. 


R 


H 




155 


the upper part of 5th vert. 


2~ inches below. 


R 


3 










L 


3| 




156 


the mid. of 4th vert. 


opposite. 


R 


If 










L 


2f 




157 


the upper margin of 5th vert. 




R 


2f 










L 


2f 




158 


the mid. of 4th vert. 


a little below. 


R 


2f 










L 


2 




159 


the upper part of 5th vert. 


| inch below. 


R 


If 










L 


2| 




161 


between 4th and 5th vert. 


opposite. 


R 


1| 










L 


I 




162 


on the 5th vert. 




R 


If 










L 


If 




164 


between 4th and 5th vert. 


opposite. 


R 


2| 










L 


If 




165 


the lower part of 4th vert. 




R 


3f 










L 


3 




165* 


between 4th and 5th vert. 


1 inch below. 


R 


If 










L 


2 




166 


the lower part of 4th vert. 




R 


2f 








lg inch below. 


L 


2f 





THE ABDOMINAL AORTA. THE COMMON ILIAC ARTERIES. 357 



No. 


THE AORTA ITS PLACE OF DIVISION, 


COMMON ILIAC. 


on the Lumbar Vertebrae. 


with refer, to the 
highest part of the 
Crest of the Ilium. 


Side 
of the 
Body. 


Length 
in 
Inches. 


Place of Di vision, &c. 












f besides a small br. to the 












\ glands it gives, near the 


168 


the lower part of 4th vert. 


opposite. 


R 


2| 


{ end, a lumbar artery, 












1 which perforates the iliac 












^vein. 








L 


*f 
















169 


the mid. of 4th vert. 




R 


H 










L 


2| 




169 


the upper margin of 3rd vert. 


1 inch above. 


R 


3 










L 


3f 




170 


the upper margin of 4th vert. 




R 


If 










L 


If 




172 


the lower part of 4th vert. 


a little below. 


R 


If 










L 


2* 




173 






R 


2j 










L 


If 




174 


fopp. the lower margin of 
\ 4th vert. 


a little below. 


R 


If 










L 


2 




176 


the upper margin of 5th vert. 


~ inch below. 


R 


2 










L 


2j 




177 


the upper margin of 5th vert. 


i inch below. 


R 


If 










L 


If 




178 


the upper margin of 4th vert. 


~ inch above. 


R 


2f 










L 


3f 




179 






R 


If 


opp. the mid. of 5th vert. 








L 


If 


opp. the mid. of 5th vert. 






(opposite. (In 
this body 


R 


If 


J~ opp. the lower margin of 
\ 4th (last) vert. 


180 


the upper margin of 4th vert. 


there are but 
4 lumbar 
vertebrae). 


L 


" 


J" opp. the lower margin of 
\ 4th (last) vert. 



358 THE ABDOMINAL AORTA. THE COMMON ILIAC ARTERIES. 



No. 

181 


THE AORTA ITS PLACE OF DIVISION, 


COMMON ILIAC. 


on the Lumbar Vertebrae. 


with refer, to the 
highest part of the 
Crest of the Ilium. 


Side 
of the 
Body. 


Length 
in 
Inches. 


Place of Division, &c. 


the mid. of 4th vert. 


nearly opposite. 


R 


2f 










L 


2| 




184 


the lower part of 4th vert. 




R 


2 


J opp. the interval between 
\ 5th vert, and sacrum. 








L 


2* 


J~ opp. the upper margin of 
\sacium. 


185 


the upper part of 4th vert. 


\ inch above. 


R 


2f 


f opp. the lower margin of 
\ 5th vert. 








L 


2* 


f opp. the upper margin of 
\ sacrum . 


186 


the lower margin of 4th vert. 


f inch below. 


R 


11 


the lower margin of 5th vert. 








L 


11 


the upper margin of sacrum. 


187 


the lower margin of 4th vert. 


(opp. the mid. 
of iliac fossa. 
(The pel vis is 
much de- 


R 
L 


2 








formed). 








188 


the mid. of 4th vert. 


a little below. 


R 


2 i 










L 


2 




189 


the mid. of 4th vert. 


a little below. 


R 


2| 


J opp. the lower margin of 
\ 5th vert. 








L 


If 


opp. the mid. of 5th vert. 


190 


the upper margin of 5th vert. 


a little below. 


R 
L 


Sf 

2* 


1" both divide in iliac fossa 
< the Right a little lower 
(_ than the Left. 


191 


the upper margin of 4th vert. 


nearly opposite. 


R 


21 


{opp. the lower margin of 
5th vert. 








L 


2f 


a little lower than the Right. 


192 


the upper part of 5th vert. 




R 


* 


f opp. the lower margin of 
\ 5th vert. 








L 


u 


J" opp. the upper margin of 
\sacrutn. 


195 


the upper part of 4th vert. 




R 


2f 


f opp. the lower margin of 
\ 5th vert. 








L 


3 


{opp. the interval between 
5th vert, and sacrum. 



THE ABDOMINAL AORTA. THE COMMON ILIAC ARTERIES. 359 



No. 


THE AORTA ITS PLACE OF DIVISION, 


COMMON ILIAC. 


on the Lumbar Vertebrae. 


with refer, to the 
highest part of the 
Crest of the Ilium 


Side 
of the 
Body 

R 


Length 
Inches 


Place of Di vision, &c. 


196 


the upper part of 4th vert. 


5 inch above. 


If 


/ opp. the upper part o 
\ 5th vert. 








L 


If 


/opp. the upper part of 
\ 5th vert. 


199 


the lower part of 4th vert. 




R 


2f 


/ opp. the interval between 
\ 5th vert, and sacrum. 








L 


2| 


/ opp. the lower margin of 
\ 5th vert. 


203 


the mid. of 4th vert. 


~ inch below. 


R 


U 


the mid. of 5th vert. 








L 


1* 


;he mid. of 5th vert. 


204 






R 


2 


/ on the upper part of sa- 
\ crum ; is tortuous. 








L 


If 


opp. the upper part of sacrum. 


205 


the mid. of 4th vert. 




R 


2f 


/ opp. the interval between 
\ 5th vert, and sacrum. 


207 


near the lower part of 4th vert. 




R 


21 


/ opp. the interval between 
\ 5th vert, and sacrum. 








L 





/ opp. the upper margin of 
\ sacrum. 


208 


the mid. of 4th vert. 


a little below. 


R 


3 


/ opp. the upper margin of 
\ sacrum. 








L 


2i 


/ opp. the upper margin of 
\ sacrum. 


210 


he upper part of 4th vert. 


a little above. 


R 


2 


opp. the mid. of 5th vert. 








L 


2 




212 


he upper part of 4th vert. 


a little above. 


R 


2| 


on the upper part of 5th vert. 








L 





{on the mid. of 5th vert. 
(Both diverge less than 
usual). 


213 


he upper part of 4th vert. 




R 


H 


/gives a small br. to the 
\psoas muscle. 








L 


34- 


fopp. the upper margin of 
j sacrum gives a lumbar 
< artery near its end, and a 
j small br. to the cellular 
^tissue. 



K K 



360 THE ABDOMINAL AORTA. THE COMMON ILIAC ARTERIES. 



^o. 


THE AORTA ITS PLACE OF DIVISION, 


COMMON ILIAC. 


on the Lumbar Vertebrae. 


with refer, to the 
ghest part of the 
Crest of the Ilium. 


Side 
of the 
Body. 


Length 
in 
nches. 


Place of Division, &c. 


215 


' opp. the interval between 
_ 4th and 5th vert. 


pposite. 


R 


If 


" opp. the mid. of the in- 
terval between 5th vert. 
^ and sacrum . 








L 


If 


[ opp. the mid. of the in- 
terval between 5th vert. 
|_and sacrum. 


216 


ie upper part of 5th vert. 


little below. 


R 


If 


fopp. the mid. of the in- 
terval between 5th vert. 
Land sacrum. 








L 


2J 


("below the upper margin 
L of sacrum. 


217 


be upper part of 4th vert. 


inch above. 


R 


3f 


J" opp. the interval between 
\ 5th vert, and sacrum. 








L 


3| 


J" opp. the interval between 
\ 5th vert, and sacrum. 


219 


he lower part of 4th vert. 




R 


2J 


fopp. the upper margin of 
J sacrum ; gives a lumbar 
\artery 1 inch from begin- 
ning. 








L 


3 


J~ opp. the sacro-iliac articu- 
j_lation. 


221 


the lower part of 4th vert. 


a little above. 


R 




{opp. the lower part of 5th 
vert.; gives a br. to the 
psoas muscle. 








L 




opp. thelowerpartof 5th vert. 


222 


the upper part of 4th vert. 




R 


n 


/ opp. the lower margin of 
\ 5th vert. 








L 


2| 


{opp. the lower margin of 
5th vert. 


223 


the lower part of 4th vert. 


a little above. 


R 


2J 


{opp. the lower margin o 
5th vert. ; gives a lumbar 
artery near its lower end. 


224 


the lower margin of 4th vert 


I inch below. 


R 


1* 


f above the lower margin o 
\ 5th vert. 








L 


If 


f above the lower margin of 
\ 5th vert. 


225 


the upper margin of 4th vert 


1 inch above. 


R 


3 


J~ opp. the interval between 
L5th vert, and sacrum. 



THE ABDOMINAL AORTA. THE COMMON ILIAC ARTERIES. 361 



No. 


THE AORTA ITS PLACE OF DIVISION, 


COMMON ILIAC. 


on the Lumbar Vertebrae. 


with refer, to the 
ighest part of the 
Crest of the Ilium. 


Side 
f the 
Body. 


Length 
in 

nclies. 


Place of Division, &c. 








L 


3| 


J opp. the lower margin of 
\5th vert. 


226 


the lower part of 4th vert. 




R 


2f 


f opp. the lower margin of 
\ 5th vert. 








L 


2* 


f opp. the lower margin of 
1 5th vert. 


230 


the upper margin of 5th vert. 


below. 


R 


2| 


{on the upper margin of 
sacrum. 


233 


f above the lower margin of 
\ 4th vert. 


a little below. 


L 
R 


21 
If 


fopp. the upper margin of 
j sacrum, (diverges more 
^ from the middle line of 
1 the body than the artery 
^ of the other side.) 

opp. the lower part of 5th vert. 








L 


11 


f opp. the lower margin oi 
\ 5th vert. 


234 


the upper part of 4th vert. 


a little below. 


R 


2| 


opp. the mid. of 5th vert. 








L 


2| 




237 


the upper part of 5th vert. 


L j inch below. 


R 


2| 


{opp. the sacro-iliac articu- 
lation. 








L 


2 


f opp. the sacro-iliac articu- 
< lation. Both arteries 
|_ diverge widely. 


238 


the upper part of 4th vert. 


opposite. 


R 


3f 


f opp. the upper margin of 
\ sacrum. 








L 


2| 


(opp. the sacro-iliac articu- 
lation ; is tortuous, am 
when uncoiled measures 
the same as the artery of 
the opp. side. 


240* 


on the 3rd vert. 


2 inches above 


R 


3 


J~ opp. the upper part of 5tl 
^vert. close to its body. 








L 


31 


on the upper part of 5th vert. 


241 


the upper part of 4th vert. 




R 


If 


f on the upper part of 5th 
\ vert, at the middle line. 








L 


3 


I" opp. the upper margin o 
L sacrum ; is tortuous. 



362 THE ABDOMINAL AORTA. THE COMMON ILIAC ARTERIES. 



No. 


THE AORTA ITS PLACE OF DIVISION, 


COMMON ILIAC, 


on the Lumbar Vertebrae. 


with refer, to the 
highest part of th 
Crest of the Ilium 


Side 
of th 
Body 


Lengt 
in 
Inches 


Place of Di vision, &c. 


242 


the mid. of 4th vert. 


opposite. 


R 


2| 


f opp. the lower margin o 
\ 5th vert. 








L 


2f 


f opp. the lower margin of 
\ 5th vert. 


242 


f opp. the interval between 
\ 4th and 5th vert. 




R 


2 










L 


2 




243 


the lower part of 5th vert. 




R 


If 










L 


2 i 


is tortuous. 


246 


the lower part of 4th vert. 




L 





(over the larger sciatic 
notch ; gives, near its 
origin, a br. to the psoas 
muscle, and another near 
its end to the iliacus. 


247 


fa little above the upper 
L margin of 5th vert. 




R 


n 


f opp. the sacro-iliac articu- 
\ lation. 








L 


v 


f opp. the sacro-iliac articu- 
\ lation. 


249 


he upper part of 4th vert. 


1 inch above. 


R 


3* 


f opp. the upper margin of 
\ sacrum. 








L 


2i 


fopp. the lower part of 
\ 5th vert. 


250 


he lower part of 4th vert. 




R 


2 


I" on the lower edge of 5th 
< vert. ; gives a small br. to 
I the psoas muscle. 












fopp. the upper margin o1 








L 


2f 


I sacrum ; is tortuous, and 
< diverges from the middle 
1 line of the body more than 
V the artery of the opp. side. 


251 


tie lower part of 4th vert. 




R 


U 


pp. the mid. of 5th vert. 








L 


i* 


f above the lower part of 
|_ 5th vert. 


252 


tie mid. of 4th vert. 


little below. 


R 


i* 


f opp. the interval between 
I 4th and 5th vert. 








L 


i! 


r opp. the upper margin of 
L 5th vert. 


253 


he upper part of 4th vert. 




R 


2 


n 5th vert. 



THE ABDOMINAL AORTA THE COMMON ILIAC ARTERIES. 363 



No. 


THE AORTA ITS PLACE OF DIVISION, 


COMMON ILIAC. 


on the Lumbar Vertebrae. 


with refer, to the 
highest part of the 
Crest of the Ilium. 


Side 
of the 
Body. 


Length 
Inches. 


Place of Division, &c. 








L 


3i 


J opp. the sacro-iliac articu- 
\ lation. 


256 


the mid. of 4th vert. 


above. 


R 


If 


J~ opp. the interval between 
\ 5th vert, and sacrum. 








L 


If 


J close to the upper margin 
\ of sacrum. 


257 


the upper part of 4th vert. 


a little below. 


R 


4| 


{opp. the upper margin of 
sacrum ; gives a br. to the 
iliac fossa. 








L 


*J 


fat the sacro-iliac articula- 
j tion. Both arteries are 
| tortuous and seem forced 
[_with injection. 


260 
261 


the mid. of 4th vert, 
the mid. of 4th vert. 


a little below, 
below. 


R 


3 


f opp. the upper margin of 
\ sacrum. 


262 


the upper part of 4th vert. 


opposite. 


R 


2i 


the mid. of 5th vert. 








L 


If 


the mid. of 5th vert. 


264 


fopp. the interval between 
\ 4th and 5th vert. 


^ inch below. 


R 


2f 


/below the level of the 
\ upper margin of sacrum. 








L 


2f 


f opp. the upper margin ol 
\ sacrum. 


267 


the mid. of 4th vert. 


opposite. 


R 


4 


I" on the 5th vert, at the 
\ middle line. 








L 


2| 


fopp. lower margin of 
I 5th vert. ; diverges from 
| middle line more than the 
(^artery of opp. side. 


268 


the lower margin of 4th vert. 


1 inch below. 


R 


3 


("divides opp. the posterior 
I margin of psoas muscle ; 
| gives near its origin a br. 
|^to that muscle. 








L 


2f 


^divides opp. posterior 
I margin of psoas muscle ; 
< gives at its middle a br. 
1 to that muscle. Both the 
^arteries are tortuous. 


269 


the upper part of 5th vert. 


i inch below. 


R 


2f 


J" close to the upper margin 
\ of sacrum. 



L L 



364 THE ABDOMINAL AORTA. THE COMMON ILIAC ARTERIES. 



No. 


THE AORTA ITS PLACE OF DIVISION, 


COMMON ILIAC. 


on the Lumbar Vertebrae. 


with refer, to the 
highest part of the 
Crest ot the ilium. 


Side 
of the 
Body. 


Length 
in Place of Division, &e. 
Inches. 








L 


2* 


fopp. the upper margin of 
I sacrum ; diverges more 
j than the artery of the 
[ opp. side. 


271 


the upper margin of 5th vert. 




R 


U 


{on the lower margin of 
5th vert. gives a renal 
artery. 








L 


if 


1" lower than the upper mar- 
< gin of sacrum. gives a 
(_ renal artery. 


271* 


the upper margin of 4lh vert. 


| inch above. 


R 


3| 


f below upper margin of 
\ sacrum. 








L 


3f 


("close to sacro-iliac articu- 
< lation; diverges more than 
[ the artery of the opp. side. 


281 


the upper part of 4th vert. 


opposi te. 


R 


2* 


the raid, of 5th vert. 








L 


2 


above the mid. of 5th vert. 


284 


the mid. of 4th vert. 


a little below. 


R 


H 


f opp. the upper margin of 
\ sacrum. 








L 


3| 


fopp. the upper margin ol 
\ sacrum ; is tortuous. 


287 


the upper part of 5th vert. 


a little below. 


R 


2 










L 


2 




288 


the lower margin of 4th vert. 




R 


1* 


opp. the mid. of 5th vert. 








L 


1 


opp. the mid. of 5th vert. 



Abstracts of the foreyoiny table will be found in the observations on the aorta 
and the iliac arteries. 



365 



EXPLANATION OF PLATE LVI. 



a Diaphragm. 

b Stomach. 

b 1 ^ (Esophagus. 

c An indication of the liver. 



d Kidney. 

e Fifth lumbar vertebra. 

/ Sacrum. 

g Iliac bone. 



ARTERIES. 



1. Aorta. 

2. Right phrenic. 
2 1 . Left phrenic. 

2f . A branch given to the diaphragm 
from the left hepatic. 

3. Ceeliac. 

4. Coronary arteria coronaria ven- 

triculi. 

5. Hepatic. 

5f. Right and left hepatic branches. 



6. Splenic. 

7. Superior mesenteric. 

8. Right renal. 
8'. Left renal. 

9. Right common iliac. 
9 1 . Left common iliac. 

10. External iliac. 

11. Internal iliac, 
f. Ilio-lumbar. 



THE figures marked 1, 2, 3, are intended to illustrate the 
variations that occur in the place of division of the aorta. In 
the other figures some peculiarities of the branches are shown. 

Figures 1, 2, 3. In two of the cases represented in these 
figures (the first and third) the lower end of the aorta lies in 
the middle line of the body ; while in the other (second) it is 
placed considerably to the left of that point. 

The division of the great artery occurs in different positions. 
Thus, in the first figure it divides on the third lumbar verte- 
bra, considerably above the highest part of the iliac bone. In 
the second, the division is on the fourth lumbar vertebra, and 
slightly above the ilium; and in the figure marked 3, it is 
seen to be placed on the fifth vertebra, and below the level 
of the highest part of the ilium. 

Figure 4 is an example of both phrenic arteries given 
from a single trunk, which derived its origin from the aorta 
above the margin of the diaphragm. 

In figure 5, the phrenic artery arises from the renal on each 
side. 

Figure 6. In this case there are several peculiarities of the 
branches. Besides the ordinary phrenic arteries which are 
here derived from the coaliac by a common trunk an addi- 
tional (third) branch is furnished from the left hepatic. In 



366 EXPLANATION OF THE FIFTY-SEVENTH PLATE. 

its course to the diaphragm this unusual branch was found to 
lie in apposition with the liver, immediately in front of the 
lobulus Spigelii. 

The hepatic, instead of being a branch of the coeliac artery, 
is given from the superior mesenteric. 



EXPLANATION OF PLATE LVII. 



a Right kidney. 
a 1 Left kidney, 
af Ureter. 



b Testis. 

c Diaphragm. 

d Lumbar vertebrae. 



Double ureter. 

ARTERIES. 



1. Aorta. 

If. Middle sacral. 

2. Right phrenic. 
2 1 . Left phrenic. 

3. Coronary of the stomach. 

4. Splenic. 

5. Hepatic. 

6. Renal. 



Spermatic. 



8. Common iliac. 

9. External iliac. 
1 0. Internal iliac. 
f. Ilio-lumbar. 

J. A lumbar artery. 



11. " Vena cava inferior." 



IN the first five sketches the illustration of the peculiarities 
which occur in the branches of the abdominal aorta is con- 
tinued from the preceding plate. Some of the variations of 
the iliac arteries are represented in the other figures. 

Figure 1. There are on each side three renal arteries. 
Those on the right side, where they cross the vena cava infe- 
rior, lie at different sides of that vessel one being behind it, 
the other two in front. 

The ureters happened, in the case here represented, to be 
double on both sides, and the two parts joined at unequal 
heights. The junction occurred, as shown, a little below the 
kidney on the right side, but on the left side the two tubes 
remained separate until they came into connexion with the 
bladder. 

Figure 2 *. Five renal arteries occur on the left side. There 
existed but one on the opposite side. 

* This sketch has been taken from a preparation in the museum of St. Bartholo- 
mew's Hospital. 



EXPLANATION OF THE FIFTY-SEVENTH PLATE. 367 

The dilated part of the ureter (pelvis) is observed to lie on 
the anterior surface of the kidney, which in that situation 
presents an irregular depression. 

Figure 3 *. The splenic, hepatic, and coronary arteries, 
instead of arising from a common trunk, are given singly 
from the aorta, and the cceliac axis or artery is therefore 
altogether wanting. 

While the left kidney receives, as is most common, a single 
artery, that of the right side is furnished with four. Two of 
these require especial attention, one being derived from the 
common iliac artery of the right side, above its middle : the 
other from the left common iliac, immediately at its origin 
from the aorta. The renal branch given by the right iliac 
artery crosses behind the kidney and enters the anterior 
surface of the organ, after turning round its outer margin. 

Three of the right renal branches cross the vena cava in 
front, the fourth lies, with reference to the vein, in the position 
which the artery usually has when single, namely, behind it. 

Both the kidneys were longer in proportion to the breadth, 
and were lower in the abdomen than usual. These remarks 
apply particularly to that of the right side, the lower end ot 
which lay over the external iliac artery. It is to be observed 
that the peculiarities in the kidneys were more apparent in 
the recent body than they are shown in the drawing ; for this 
was not made until the parts had shrunk in some degree, in 
consequence of being partially dried. 

The ureter of the right side escaped from an irregular 
depression on the anterior surface of the kidney, somewhat as 
ia the case represented in the preceding figure. 

Figure 4 f . An irregularly-shaped and lobulated right 
kidney is seen to receive three arteries. One arises from the 
side of the aorta, at about the usual place ; the second is 
given from the same vessel in a very unusual position viz. 
from its fore-part and close to its bifurcation; the third 
deviates still further from the accustomed place of origin 
of renal arteries being derived from the lower end of the 
common iliac. 

* Taken from the case marked 271 iu the table. 

f Copied from Tiedemann's " Tabulae Arteriarum," tab. 30. 



368 EXPLANATION OF THE FIFTY-EIGHTH PLATE 

Figure 5. The phrenic arteries arise by a common trunk 
from the aorta. 

There are on one side three spermatic arteries ; two of 
which are given from the aorta, and one from the renal artery. 

Figure 6. Both common iliac arteries have more than the 
usual length. The left is the longer of the two, and it gives 
a lumbar artery from the lower end. 

The internal iliac arteries are short, and from that of the 
right side near its origin the ilio-lumbar branch is given. 

Figure 7. The aorta divides on the middle line of the 
vertebrae. 

The common iliac arteries are short. Their division occurs 
opposite the upper part of the fifth lumbar vertebra. And 
they do not differ, one from the other, in length. 

The internal iliac artery of the left side has more than the 
usual length. It lay for some space parallel with the external 
iliac before dipping into the pelvis. 

Figure 8. The left common iliac artery is very short. The 
internal iliac of the same side is proportionably longer than 
usual. 

Figure 9. The usual relative length of the common iliac 
arteries is reversed, that of the left side being the longer, 
and to a considerable extent. The artery of the right side is 
remarkably short, and the internal iliac which springs from 
it is of much greater length than that vessel is commonly 
found to be. 



EXPLANATION OF PLATE LV1II. 



a Fifth lumbar vertebra. 

b Sacrum. 

c A small portion of the diaphragm. 

d Heart its anterior surface. 



e Kidney. 

e\ Supra-renal capsule. 

/ Trachea seen in front. 

f\- Trachea seen from behind. 



d\- Heart its posterior surface. 

ARTERIES. 
1. Arch of the aorta. . 3f. Internal iliac. 



The descending or thoracic aorta, 
seen from behind. 



3. Abdominal aorta. 
3 1 . Right common iliuc. 



3J. Two circumflex iliac. 
4. Pulmonary. 

4f. Right pulmonary seen from be- 
hind. 



EXPLANATION OP THE FIFTY-EIGHTH PLATE. 369 

VEINS. 



5. Right innominate. 
5 1 . Left innominate. 

5f. Part of left innominate, having a 
very unusual course. It con- 
tinues around the left side of 
the heart to its posterior aspect, 
and enters the right auricle 



in connexion with the coronary 
vein. 

6. "Vena cava superior." 

7. " Vena cava inferior." 

8. Right common iliac. 
8'. Left common iliac. 

9. Left internal iliac. 

10. Pulmonary. 



THE first figure continues the illustration of peculiarities of 
the iliac arteries, from the preceding plate. 

In all the remaining figures, are represented variations of 
the veins from their ordinary disposition. These are drawn 
on a reduced scale, with the exception of the seventh figure. 

Figure 1. The left common iliac artery is unusually long ; 
the internal iliac, on the contrary, is very short. From the 
external iliac two branches arise in the place of the circumflex 
iliac artery. 

Figure 2*. The common iliac veins join on the left side of 
the aorta, and the vena cava inferior continues on the same 
side for some space. After receiving the left renal vein, the 
vena cava crosses obliquely over the aorta, immediately below 
the superior mesenteric artery, to the usual position on the 
right side, and is joined by the right renal vein. Above the 
point at which it is represented in the drawing, the great 
vein was found to pass behind the liver and to perforate the 
diaphragm in the usual manner. 

Figure 3. The vena cava inferior lies altogether to the left 
of the aorta. All the viscera were transposed in the body 
from which the drawing was made, and, the liver being on the 
left side, the hepatic veins joined the vena cava. 

Figure 4. Here the lower part of the aorta is seen to lie 
between two large veins. The following is their arrange- 
ment. The left common iliac vein divides into two parts. 
One of these joins the common iliac of the right side ; the 
other courses upwards on the left side, receives the left renal 
vein, and, after crossing over the aorta, joins the large venous 
trunk of the right side. The vena cava may properly be said 

* Tlie preparation represented in this drawing, was found by Mr. Fearnsidc and 
Mr. diaries Jones iu the hodv of an adult. 



370 EXPLANATION OF THE FIFTY-EIGHTH PLATE. 

to be formed at this point of junction, and it is therefore con- 
siderably shorter than usual. 

Figure 5 is the representation of a case in which the right 
common iliac vein is double. The two parts lie in apposition 
one with the other, and the common iliac artery is partly in 
front of both. 

Figure 6. There are two internal iliac veins on the left 
side, and the artery is placed between them. 

The common iliac has a slight indication of division into 
two parts. 

Figure 7. This plan is taken from one given by Herholdt*. 
the kidney and an outline of the trunk of the body, which arc 
given in the original, being omitted. It represents the dispo- 
sition of the veins in a foetus. The viscera having been 
transposed, the vena cava superior was placed on the left side, 
and the thoracic duct was directed to the right side of the neck. 
The trunk of the hepatic veins perforated the diaphragm on 
the left side, and, without communicating with the vena cava, 
terminated in the right auricle of the heart, as this large 
vessel is wont to do. The enlarged azygos vein, after having 
passed from the abdomen to the thorax in the same opening 
with the aorta, is said to have turned forward at its termi- 
nation above the left bronchus. 

The object proposed in the introduction of this figure, was 
to show the manner in which the inferior vena cava, formed 
on the lumbar vertebrae in the usual way, is occasionally con- 
tinued upwards to join the superior cava through the medium 
of the vena azygos. As the example given from M. Herholdt 
was accompanied by transposition of organs, and the original 
drawing has not been made with as much care as was to be 
desired, I would have preferred to illustrate the point by 
copying one of the sketches given by Dr. Hornerf, of a case 
observed by him, if the iliac veins had not been omitted from 
them. 

* Bcschreibung sechs menschlich : Misgeburten. Kopenhagen, 1830. Not having 
been able to procure the original work, lam indebted for the knowledge of the case, 
and for the figure, to an essay by Stark, entitled " Commentatio anatoraico-physio- 
logica de venae azygos natura, vi atque munero. Scripsit D. C. G. Stark. Lipsiae, &e." 

f- " A case of unusual arrangement of the ascending cava and the external 
jugular veins of the human subject, by Wm. E. Homer, M.D.," in the "Journal of 
the Academy of Natural Sciences of Philadelphia." Vol. i. page 401 , 1817 18. 



EXPLANATION OF THE FIFTY-EIGHTH PLATE. 371 

Figure 8. In the case sketched in this figure, as well as in 
the preceding, the inferior vena cava continued into the 
thorax, as the vena azygos, and the blood from it entered the 
heart through the vena cava superior. The hepatic veins 
opened into the right auricle of the heart in the usual situation 
of the inferior vena cava. 

But there are in this case some remarkable additional 
peculiarities. The iliac veins remain separate, as high as the 
second lumbar vertebra, and they receive the renal veins, of 
which there are two on the right side, and one on the left. 
Moreover, the right iliac vein crosses behind the aorta to join 
the vein of the opposite side. 

The vena cava inferior, resulting from the junction of the 
vessels just referred to, is placed to the left side of the aorta. 
It enters the thorax through the aortic opening, and after 
lying on the same (left) side for some space, crosses to the 
right side, behind the great artery and the thoracic duct, and 
joins the vena cava superior as the vena azygos usually does. 

The intercostal veins were thus disposed: On the right side 
the veins from the upper intercostal spaces formed a small 
common trunk, which joined the enlarged azygos. The lower 
intercostal veins were likewise joined into another small trunk, 
which terminated in the same way (see the figure) ; and it is 
to be inferred from the description, that the veins from the 
middle spaces from the fifth to the eighth opened directly 
into the large vein ; which thus, mediately or immediately, 
received all the veins of the right side. The branches of the 
left side also ended in the same vein, with the exception of 
those belonging to the superior intercostal spaces. 

This case was observed by Professor Otto of Breslau, in the 
body of a full-grown man. The account given of it here, and 
the figure have been taken from an essay by M.Gurlt *, in which 
it was originally described. 

Figures 9 and 10 are a front and back view of a preparation 
illustrating a remarkable peculiarity of the veins through 
which the blood is conveyed from the upper part of the body 

* " De venarum deformitatibus, adncxa venae cavse inferioris aberrationis rarioris 
descriptione &c., auctore E. T. Gurlt. Vratislavise, 1819." A small part of the 
original figure lias been omitted in our sketch. 

M M 



372 EXPLANATION OF THE FIFTY.NINTH PLATE. 

to the heart. It occurred in the body of an adult, and was 
discovered and prepared some years ago by Dr. Sharpey*. 

In this case the innominate veins, instead of joining to form 
a single trunk (vena cava superior), open separately into the 
right auricle of the heart. The vein of the right side follows 
the ordinary course of the vena cava. That of the left side, 
after sending a small transverse branch to the right in the 
course usually followed by the entire vein, descends vertically 
in front of the root of the left lung, and having turned round 
the left side of the heart to its posterior aspect, enters the 
right auricle in connexion with the coronary vein, (5t in 
figures 9 and 10). 



EXPLANATION OF PLATE LIX. 

THE pelvic viscera of the female and their arteries are 
shown in this plate. 

The process of dissection was, in so far as the pelvis was 
concerned, as nearly as possible the same as that described 
for the exhibition of the pelvic organs of the male ; see the 
explanation of the sixtieth plate. But the spine of the 
ischium was drawn down, for the plate before us, and it re- 
mained suspended by the coccygeus muscle and the sacro- 
sciatic ligament. The pudic artery was therefore divided. 

The muscular and membranous structures which, in the 
natural condition, separate the pudic artery from the rectum, 
the vagina and the urethra, were removed in order to show 
those organs more clearly. This circumstance, and the fact 
that the vessel is removed from the organs referred to by an 
interval which gradually diminishes from behind forward 
from the sacrum to the pubes are not to be lost sight of 
when the drawing is under observation. 

In order that the ovary, the Fallopian tube and the arteries, 
might be more fully exposed, the fold of peritoneum named the 
broad ligament of the uterus was cut away. 

It may be observed that when the body was under prepa- 

* The preparation is now in the Museum of Human Anatomy, in University 
College, having been presented to it by Dr. Sharpey. 



EXPLANATION OF THE SIXTIETH PLATE. 



373 



ration, it was not intended to include in the drawing anything 
above the pelvis. To this circumstance must the irregular 
or jagged condition of the muscles of the abdomen be attri- 
buted ; for they were divided carelessly and without any view 
to a representation of them. 

Fallopian tube turned forward on 
the urinary bladder. 

Round ligament of the uterus, cut. 

Uterus. 

Vagina. 

Sphincter vaginse. 

Urinary bladder. 

Crus clitoridis divided. 

Section of the left pubic bone. 

Spine of the left ischium hanging 
down and supported by the 
coccygeus muscle and the shorter 
sacro-sciatic ligament. 



a Left kidney. The kidney of the 
right side also is obscurely seen. 

af Left ureter. 

b Sacrum. 

6f The end of the coccyx. 

c Left psoas muscle cut. 

d Rectum : intestinum rectum. 

d-\ Rectum : below the point at 
which the peritoneum is re- 
flected away from it. 

dl Sphincter ani. 

e Left ovary held up by means of a 
hook. 



THE ARTERIES. 



1 . Aorta. 

2. Ovarian. It runs on the margin 

of the ovary and anastomoses 
with a branch of the uterine 
artery. 

3. Inferior mesenteric. 

4. External iliac cut close to its 

origin. 

5. Internal iliac. 

5f. Hypogastric gradually losingits 
permeability and becoming a 
fibrous cord. 

6. Uterine. 

7. Vaginal. 

8. Pudic. This artery was cut 

across and the greater part of 
it, together with the spine of 



9. 



the ischium. fell considerably 
below the natural level. The 
branches of the pudic artery 
delineated in this drawing are 
the following : viz., the hsemor- 
rhoidal, the superficial perineal, 
with the cavernous and dorsal 
arteries of the clitoris. 

Sciatic. The divided branch 
given from its upper part is a 
portion of the obturator artery. 

Gluteal. 

The lower end of the inferior 
mesenteric superior haemor- 
rhoidal. 



12. Sacral nerves. 



EXPLANATION OF PLATE LX. 



THIS plate contains a representation of the pelvic viscera of 
the male body, and of the arteries distributed to them. 

The view was obtained by the removal of the os innomina- 
tum and the lower limb of the left side. In effecting this, 
the body of the pubes was sawed through, the ilium was sepa- 
rated from the sacrum, and the soft parts were divided in a 
manner which is sufficiently apparent on examining the plate. 

For the purpose of preserving the pudic artery entire, the 
spine of the ischium on the outer side of which it turns 
was sawed off, and the fragment of bone was left connected to 



374 



EXPLANATION OF THE SIXTIETH PLATE. 



the sacrum by means of the coccygeus muscle and the smaller 
sacro-sciatic ligament. And in order to show the branches of 
the same artery in connexion with the parts to which they 
belong, the levator ani muscle, with some fat and membrane, 
was removed from between the vessel on the one hand, and 
the rectum, the prostate gland, and the urethra on the other. 
During the preparation of the drawing, the pudic artery 
was held by means of the hook at about the usual distance 
from the organs last named. But the space which intervenes 
between them, and the difference in its extent behind and in 
front, (caused by the approximation of the vessel to the 
middle line of the body as it approaches the pubes,) cannot 
be sufficiently marked, except in a view taken from the 
perineum ; and for this, reference is to be made to the sixty- 
second plate. 



a Psoas muscle of the left side, cut 
across. 

b Sacrum the articular surface for 
the iliac bone. 

At Coccyx. 

c A small piece of the ischium sawed 
off with the spine of that bone. 
It is connected to the sacrum 
by the coccygeus muscle and 
the short sacro-sciatic ligament, 
and is supported by the pudic 
artery. 

d The upper part of the rectum 
covered by peritoneum. 

rff The lower part of the rectum on 
which the peritoneum does not 
descend. 

e Peritoneum where it is reflected 
from the wall of the abdomen to 
the urinary bladder. The mem- 
brane having been divided, the 



margin of the division is seen on 

the rectum and on the bladder. 
e\ Peritoneum held up to show the 

ureter and the internal iliac 

artery. 

/ Urinary bladder, 
/f Ureter. 
g A section of the pubic bone, made at 

a short distance from the sym- 

physis of the pubes. 
h Vas deferens. 
h^ Spermatic cord. 
A Vesicula seminalis. 
i Prostate gland, 
f Cowper's gland. 
1c The bulb the posterior end of the 

corpus spongiosum urethrse. 
/ Crus penis cut across. 
m Superficial sphincter ani. 
n Rectus muscle of the left side 

divided transversely. 



THE ARTERIES. 



1. Common iliac. 

2. External iliac. 

3. Internal iliac. 
3f. Hypogastric. 

4. Gluteal. 

5. Sciatic. 

6. Pudic. This artery is seen to 

give in succession the following 
branches, viz., two inferior 
hsernorrhoidal : the superficial 
perineal : the artery of " the 
bulb" : that of the corpus caver- 
nosum penis : and the dorsal 
branch of the penis. The 
pudic artery, it is to be re- 
membered, does not, in the 



7. 



natural state of the parts, lie 
in contact with the rectum, 
the prostate or the urethra. 
It is at some distance from those 
organs, and other structures 
are interposed. See above, the 
general remarks on the plate. 

A branch distributed to the 
lower part of the bladder, to the 
vesicula seminalis, the prostate 
gland, and the rectum. 

The end of the inferior mesen- 
teric (superior heemorrhoidal). 



9. Sacral nerves. 



INTERNAL ILIAC AND EXTERNAL ILIAC 
ARTERIES. 



19a 



32b 



,33 



Side 
of the 
Body. 



INTERNAL ILIAC. 



Length Branches before the uh 
Incnes. "me division. 



EXTERNAL ILIAC. 



Length 
Inches 



33 a 


L 








f Epigast. at Poup. lig., and gives Ob- 
< turator. Circumfl. 11. at Poup. lig., and 
[gives Int. Circumfl. 


34 


R 








{Epigast. gives Obturator. Circumfl. 11. 
at Poup. lig., and gives aBr. which takes 
the place of one from Ext. Circumfl. 




L 








Epigast. gives Obturator. 


34 e 


R 




1 




Epigast. gives Obturator. 




L 






| 


Epigast. gives Obturator. 



Place of origin of the principal branches, &c 



f Epigast. a little below Poup. lig. (from 
\ Femoral). 

{Epigast. a little below Poup. lig. (from 
Femoral). 

J Epigast. If inch above Poup. lig., and 
L gives Obturator. 

Epigast. gives Obturator. 

f Epigast. ji inch above Poup. lig., and 
\gives Obturator. Circumfl. II. as two brs. 

Epigast. gives Obturator. 

f Epigast. from commencement of Femoral, 
and gives Obturator. Circumfl. 11 . as two 
brs. ; one of which arises from end ol 
Ext. Iliac, the other from commence- 
ment of Femoral. 

Spigast. under Poup. lig., aiid gives Obturator. 



N N 



376 



INTERNAL ILIAC AND EXTERNAL ILIAC ARTERIES. 



No. 


Side 
of the 
Body. 


INTERNAL ILIAC. 


EXTERNAL ILIAC. 


Length 
nches. 


tranches before the ulti- 
mate division. 


Length 
Inches. 


Place of origin of the principal branches, &c. 


36 


R 






f Epigast. at Poup. lig. Circumfl. 11. from 
\ commencement of Femoral. 




L 








[" Epigast at Poup. lig. Circumfl. 11. from 
< commencement of Femoral, and gives a 
|_ descending Br. to the thigh. 


37 


L 








Epigast. gives Obturator. 


37b 


R 








Spigast. gives Obturator. 


38 


R 




' 




Epigast. gives Obturator. 


38b 


L 








Epigast. at Poup. lig. 


39 


R 








Epigast. gives Obturator. 


41 


L 








Epigast. gives Obturator. 


48 


L 








Epigast. gives Obturator. 


50 


R 








Epigast. at Poup. lig. 




L 








f Epigast. \ inch below Poup. lig. (from 
\ Femoral). 


51 


R 


1 






Gives Obturator at middle. 




L 


1 








52 


R 


2| 










L 


2 




4 




53 


R 


1| 










L 


H 








54 


R 


H 










L 


if 








55 


R 


ft 




4 


Epigast. inch above Poup. lig. 




L 


l* 




4 


Epigast. close to Poup. lig. 


56 


R 


2 




4| 


Epigast. at Poup. lig. 




L 


2 




H 


Epigast. at Poup. lig., and gives Obturator. 


57 


R 


2| 




5 


1" Epigast. inch above Poup. lig. Cir- 
\cumfl. 11. at Poup. lig. 




L 


3 




5 


Epigast. at Poup. lig., and gives Obturator. 



INTERNAL ILIAC AND EXTERNAL ILIAC ARTERIES. 



377 





Side 


INTERNAL ILIAC. 


EXTERNAL ILIAC. 


No. 


of the 
Body. 


Length 
Inches. 


Branches before the ulti- 
mate division. 


Length 
in 
Inches. 


Place of origin of the principal branches, &c. 


58 


R 


If 




4 


Epigast. ^ inch above Poup. lig. 




L 


If 




41 


Epigast. If inch above Poup. lig. 


59 


R 


1 










L 


U 






f Epigast. gives one of two brs., which form 
\the Obturator. 


GO 


R 


i* 










L 


2. 

4, 








63 


R 


H 






J Epigast. a little below Poup. lig. (from 
\ Femoral). 




L 


i 






Epigast. gives Obturator. 


64 


R 








J Epigast. a little below Poup. lig. (from 
\ Femoral. 




L 








Epigast. at Poup. lig. 


65 


R 


ii 




k 


f Epigast. and Circumfl. 11. inch above 
\ Poup. lig. 




L 


u 




3 


Epigast. under Poup. lig. 


66 


R 


2 




3* 


Epigast. and Circumfl. 11. at Poup. lig. 




L 


2 




4 


Epigast. and Circumfl. 11. at Poup. lig. 


67 


L 


f 


f gives Ilio-lurnbar 
\ at middle. 


3 


Epigast. and Circumfl. 11. under Poup. lig. 


68 


R 


* 






J Circumfl. 11. as two brs.: one at Poup. 
\ lig., the other at 1 inch above it. 


69 


R 


2 






Epigast. and Circumfl. 11. close to Poup. lig. 




L 


2 






Epigast. and Circumfl. 11. close to Poup. lig. 












I" Epigast. at Poup. lig. Circumfl. 11. as 


70 


R 


4 




4 


< two brs. : one at Poup. lig., the other at 












1 1 inch above it. 




L 


H 




4 


Epigast. and Circumfl. 11. at Poup. lig. 


71 


R 


if 






f Epigast. and Circumfl. 11. a little below 
I Poup. lig. (from Femoral). 


72 


R 


If 




4 


Epigast. and Circumfl. 11. at Poup. lig. 




L 


if 




H 


Epigast. and Circumfl. 11. at Poup. lig. 



N N 2 



378 



INTERNAL ILIAC AND EXTERNAL ILIAC ARTERIES. 





Side 


INTERNAL ILIAC. 


EXTERNAL ILIAC. 


No. 


of the 
Body. 


Length 
Inches. 


Branches before the .ulti- 
mate division. 


Length 
in 
Inches. 


Place of origin of the principal branches, &c. 


73 


R 


u 






Epigast. and Circumfl. 11. at Poup. lig. 




L 


H 






f Epigast. at Poup. lig. Circumfl. 11. inch 
\ below it (from Femoral). 


74 


R 


1 






Epigast. and Circumfl. 11. at Poup. lig. 




L 


1 






Epigast. and Circumfl. 11. at Poup. lig. 


75 


R 


' 




4* 


/ Epigast. and Circumfl. 11. 1 inch above 
\ Poup. lig. ; former gives Obturator. 




L 


1 




4 


Epigast. and Circumfl. IL under Poup. lig. 


76 


R 


'* 




3 


f Epigast. ^ inch above Poup. lig. Cir- 
\ cumfl. 11. at Poup. lig. 




L 


1 




* 


Epigast. and Circumfl. 11. at Poup. lig. 


77 


R 


2 




4 


Epigast. and Circumfl. 11. at Poup. lig. 




L 


1* 




* 


Epigast. and Circumfl. 11. close to Poup. lig. 


78 


R 


1 




31 


f Epigast. | inch above Poup. lig., and gives 
\ Obturator. Circumfl. 11. at Poup. lig. 




L 


if 




H 


f Epigast. inch above Poup. lig. Cir- 
\ cumfl. 11. at Poup. lig. 


79 


R 


u 


/gives Ilio-lumbar 
{_ near origin. 


3* 


("Epigast. under Poup. lig., and gives Ob- 
\ turator. 




L 


2 




5 


Epigast. and Circumfl. 11. at Poup. ligr. 












fls crossed 1 inch above Poup. lig. by Cir- 


80 


R 


If 




4* 


< cumfl. iliac vein. Epigast. and Circumfl. 












|_I1. from commencement of Femoral. 




L 


if 




4 


|~ Is crossed by a large Circumfl. iliac vein 
< as on R. side. Epigast. and Circumfl. 11. 












[from commencement of Femoral. 


81 


R 


i| 


; 




Epigast. and Circumfl. 11. at Poup. lig. 




L 


14 






f Epigast. and Circumfl. 11. at Poup. lig. ; 






2 






[_ former gives Obturator. 


82 


R 


1 






Epigast. and Circumfl. 11. at Poup. lig. 




L 


H 






{Epigast. and Circumfl. 11. 1 inch above 
Poup. lig. 


83 


R 


i 




3 , 


/Epigast. under Poup. lig. Circumfl. 11. 












\ ac Poup. lig. 



INTERNAL ILIAC AND EXTERNAL ILIAC ARTERIES. 



379 



No. 


Side 
of the 
Body 


INTERNAL ILIAC. 


EXTERNAL ILIAC. 


Length 
Inches 


Branches before the ulti 
mate division. 


Length 
Inches 


Place of origin of the principal branches, &c. 




L 


u 




S 


{Epigast. under Poup. lig. Circumfl. 11 
at Poup. lig. 


84 


R 


2 




4 


/ Epigast. under Poup. lig. Circumfl. 11. 
\ j inch above it. 




L 


2 




4 


Epigast. and Circumfl. 11. under Poup. lig. 


85 


R 


U 




3! 


/ Epigast. and Circumfl. 11. from commence- 
l raent of Femoral. 






1 




_^ 


J" Epigast. and Circumfl. 11. from commence- 






1 




s 


\ ment of Femoral ; former gives Obturator. 


86 


R 


i* 




4* 


f Epigast. j inch above Poup. lig. Cir- 
\cuinfl. 11. at Poup. lig. 




L 


i* 




4 


J Epigast. ^ inch above Poup. lig. Cir- 
\cumfl. 11. close to Poup. lig. 


87 


L 








J Epigast. at Poup. lig. Circumfl. 11. i 
\ inch below Poup. lig. 


88 


R 


H 




4 


("Epigast. 1 inch above Poup. lig. Cir- 
\ cumfl. 11. at Poup. lig. 




L 


H 




4 


f Epigast. ~ inch above Poup. lig. Cir- 
\cumfl. 11. at Poup. lig. 












I" Epigast. inch above Poup. lig., and gives 


89 


R 


11 




4 


< Obturator. Circumfl. 11. ^ inch above 












[ Poup. lig. 




L 


H 




4 


f Epigast. and Circumfl. 11. under Poup. 
\lig. Obturator arises 1^ inch above same. 


90 


R 


j 






f Epigast. ^ inch above Poup. lig. Circumfl. 
\I1. close to same. 






J! 






/"Epigast. a little above Poup. lig. Cir- 






^ 






\cumfl. 11. at Poup. lig. 


Q1 




1 




3 1 


f Epigast. at Poup. lig. Circumfl. 11. from 


y i 




4 




2 


\ commencement of Femoral. 






1 






/Epigast. at Poup. lig. Circumfl. 11. from 






JL 




* 


\ commencement of Femoral. 


92 


R 


1 










L 


H 








93 


R 


i 

4 




3 


Epigast. and Circumfl. 11. at Poup. lig. 




L 


2. 

4 




3 





380 



INTERNAL ILIAC AND EXTERNAL ILIAC ARTERIES. 



No. 


Side 
of the 
Body. 


INTERNAL ILIAC. 


EXTERNAL ILIAC. 


Length 
Inches. 


Branches before the ulti- 
mate division. 


Length 
in 

Inches. 


Place of origin of the principal branches, &c. 


94 


R 


If 




4J 


Epigast. and Circumfl. 11. at Poup. lig. 




L 


If 




4f 


Epigast. and Circumfl. 11. at Poup. lig. 


95 


R 


2 




3| 


Spigast. and Circumfl. 11. under Poup. lig. 




L 


1 




3i 


f Epigast. gives Obturator. Circumfl. 11 . 










2 


\ as two brs. 


96 


R 


If 




4 


{Epigast. and Circumfl. 11. ^ inch above 
Poup. lig. 




L 


2 




4 


J Epigast. and Circumfl. 11. ^ inch above 
\ Poup. lig. 


97 


R 


1 




3f 


Epigast. and Circumfl. 11. at Poup. lig. 




L 


1 




3| 


Epigast. and Circumfl. 11. at Poup. lig. 


9B 


R 


If 




4f 






L 


s 




4f 




99 


R 


If 










L 


If 








100 


R 


2 




4 


J Epigast. and Circumfl. 11. from commence- 
\ ment of Femoral. 




L 


If 




3f 


Epigast. and Circumfl. 11. at Poup. lig. 


101 


R 


1 


J" Ilio-lumbar inch 
\ from origin. 


3| 


{Epigast. at Poup. lig. Circumfl. 11. as 
two brs. one at Poup. lig., the other, 
inch above it. 




L 


1 


J Ilio - lumbar a 
\lower end. 


4 


f Epigast. and Circumfl. 11. inch above 
\ Poup. lig. 


102 


R 


H 




4 


Epigast. and Circumfl. 11. at Poup. lig. 








f gives near begin 








L 


]i 


< ning a Br. which 


4 










[_ perforates the vein 






103 


R 


"i 






("Epigast. 1 inch above Poup. lig., and 
\gives Obturator. 


L 


if 








104 | R 


i 


f Ilio - lumbar a 
\rnid. 


3* 


Epigast. and Circumfl. 11. at Poup. lig. 


107 


R 


2 




5 


1" Epigast. at Poup. lig. Circumfl. 11. from 
\ commencement of Femoral. 



INTERNAL ILIAC AND EXTERNAL ILIAC ARTERIES. 



381 



No. 


Side 
of the 
Body. 


INTERNAL ILIAC. 


EXTERNAL ILIAC. 


Length 
Inches. 


Branches before the ulti- 
mate division. 


Length 
in 
Inches. 


Place of origin of the principal branches, &c. 




L 


If 




4 


/Epigast. Ij inch above Poup. lig. Cir- 
\ cumfl. 11. at Poup. lig. 












("Epigast. a little above Poup. lig., and gives 


108 


R 


1 




a* 


J Obturator. Circumfl. 11. at Poup. lig., 
j and divides immediately into two brs. of 












l_ equal size. 




L 


If 






f Epigast. at Poup. lig. Circumfl. 11. 
\ inch below same. 


109 


R 


3 




U 


/ Epigast. from commencement of Femoral, 
\ and gives Obturator. 










j 


f Epigast. from commencement of Femoral, 






2 




% 


[and gives Obturator. 


110 


L 








Epigast. gives Obturator. 


111 




2 




_ 


f Epigast. and Circumfl. 11. a little above 










4 4 


\ Poup. lig. 




L 


n 


' 


4* 


J Epigast. and Circumfl. 11. under Poup. lig. ; 
\ Epigast. gives Obturator. 












f" Epigast. 1 inch above Poup. lig., and gives 


112 


R 


2 


Ilio-lumbar at mid. 


4- 


< Obturator. Circumfl. 11. 1 inch above 












|_Poup. lig. 












f Epigast. 1 inch above Poup. lig., and gives 




L 


2 


Ilio-lumbar at mid. 


4f 


< Obturator. Circumfl. 11. 1 inch above 












L Poup. lig. 


113 


R 


1 








114 


R 


If 


; 




J Epigast. and Circumfl. 11. at Poup. lig. 
I Former gives Obturator. 












f Epigast. and Circumfl. 11. at Poup. lig. 












\ Former gives Obturator. 


115 


R 


If 


("gives at mid.aBr., 
J which divides into 
| Ilio-lumbar and 


4* 


f Epigast. at Poup. lig. Circumfl. 11. from 
\ commencement of Femoral. 








L Lateral sacral. 








L 


If 




4 


Epigast. and Circumfl. 11. at Poup. lig. 


116 


R 


2 


f Ilio-lumbar close 
\ to lower end. 




Epigast. and Circumfl. 11. at Poup. lig. 




L 


If 


f Ilio-lumbar close 
\ to lower end. 




J" Kpigast. and Circumfl. 11. at Poup. lig. 
\ Former gives Obturator. 


117 


R 


U 


f gives a Br. j inch 
\ from lower end. 





J Epigast. a little below Poup. lig., and gives 
\ Obturator. Circumfl. 11. at Poup. lig. 



382 



INTERNAL ILTAC AND EXTERNAL ILIAC ARTERIES. 



No. 


Side 
f the 
Body. 


INTERNAL ILIAC. 


EXTERNAL ILIAC. 


Length 
in 
nches. 


Branches before the ulti- 
mate division. 


,ength 
in 
Inches. 


Place of origin of the principal branches, &c. 




L 


u 


gives a Br. at mid. 


i 


Epigast. and Circumfl. 11. at Poup. lig. 


118 


L 








Epigast. gives Obturator. 


119 


R 


u 


J" Ilio-lumbar above 
\raid. 


3i 


f Epigast. and Circumfl. 11. ~ inch above 
\ Poup. lig. 




L 


If 


f Ilio-lumbar close 
\ to origin. 





f Epigast. and Circumfl. 11. at Poup. lig. 
< Epigast, gives one of two brs. which form 
(_ Obturator. 








I" Ilio - lumbar at 






120 


R 


1 


< origin, and Late- 


2| 


Spigast. and Circumfl. 11. under Poup. lig. 








(_ral sacral at mid. 












Tllio - lumbar at 












I mid.; and two La- 










- 


) teral sacral brs. 


3 


f Gives Epigast. and Circumfl. 11. under 








\ one at beginning, 
1 the other at lower 
\^end. 




\ Poup. lig. 


121 


R 


H 




3f 


Epigast. at Poup. lig., and gives Obturator. 




L 


i* 


flio-lumbar at mid. 


3f 


Epigast. at Poup. lig., and gives Obturator. 


122 


R 


if 




H 


J Epigast. ^ inch above Poup. lig. Cir- 
\cumfl. 11. at Poup. lig. 




L 


if 








123 


R 


11 


Ilio-lumbar at mid. 




J Epigast. and Circumfl. 11. at Poup. lig. 
\ Epigast. gives Obturator. 




L 


if 


f" Ilio-lumbar and 
< Lateral sacral near 




J Epigast. and Circumfl. 11. at Poup. lig. 
\ Former gives Obturator. 


124 


R 


i| 


Ilio-lumbar at mid. 
















J Epigast. and Circumfl. 11. at Poup. lig. 


125 


L 








\ Former gives Obturator. 


127 


R 


f 


f Ilio-lumbar near 
\lower end. 


34 


Epigast. and Circumfl. 11. at Poup. lig. 




L 


!* 


f Ilio-lumbar near 
\lower end. 


31 


Rpigast. and Circumfl. 11. at Poup. lig. 








J" Ilio-lumbar from 






128 


R 


! l 


"[_ lower end. 












{Ilio-lumbar at j 








L 


2 


inch from lower 












end. 







INTERNAL ILIAC AND EXTERNAL ILIAC ARTERIES. 



883 



No. 


Side 
of the 
Body. 


INTERNAL ILIAC. 


EXTERNAL ILIAC. 


Length 
Inches. 


Branches before the ulti- 
mate division. 


Length 
Inches. 


Place of origin of the principal branches, &c. 












r Epigast. from Femoral \ inch below Poup. 


129 


R 


H 




4 


J lig., and passes inwards and upwards behind 
| the femoral vein. Circumfl. 11. at Poup. 












1% 












fEpigast. and Circumfl. 11. at Poup. lig. 












\ Epigast. passes at first behind the iliac vein. 


130 


R 


i 




k 


Epigast. and Circumfl. 11. at Poup. lig. 




L 


i 




H 


Epigast. and Circumfl. 11. at Poup. lig. 












f Epigast. and Circumfl. 11. at Poup. lig. 


131 










\ Epigast. gives Obturator. 




L 


11 






Epigast. and Circumfl. 11. at Poup. lig. 


132 


R 








{Epigast. at Poup. lig. Circumfl. 11. as 
three brs. ; one of which arises at Poup. 












]ig., another above it, the third below it. 












f Epigast. at Poup. lig. Circumfl. 11. as 




L 








< three brs. ; one of which arises at Poup. 












[lig., another above it, the third below it. 


133 


R 


1 




3 


Epigast. at Poup. lig. Circumfl. 11. under it.' 




L 


i 




3 


f Epigast. a little above Poup. lig. Cir- 
\cumfl. 11. a little below same. 
























fEpigast. from Femoral a little below Poup. 1 


134 


R 


i 


J Ilio-lumbar near 
flower end. 


2f 


I lig., and gives Obturator. Circumfl. 11. 
| as two brs. ; one at Poup. lig., the other' 












j^one inch above it. 




L 


'* 


J Ilio-lumbar from 
\ lower end. 


3 


{Epigast. under Poup. lig., and gives Ob- 
turator. Circumfl. 11. a little below Poup. 
Kg- 


1 *)G 






- 




j" Epigast. and Circumfl. 11. at Poup. lig. 


loo 


i 


.i 






\ Former gives Obturator. 




L 


11 






Epigast. and Circnmfl. 11. at Poup. lig. 


137 


R 


i 


{Ilio - lumbar at 
mid. 








L 


i 








138 


R 


n 






Epig.ist. and Circumfl. 11. at Poup. lig. 




L 


2 






Kpigast. and Circumfl. 11. at Poup. lig. 


139 


L 


L 
i 









384 



INTERNAL ILIAC AND EXTERNAL ILIAC ARTERIES. 



No. 


Side 
of the 
Body. 


INTERNAL ILIAC. 


EXTERNAL ILIAC. 


Length 
in 

Inches. 


{ranches before the ulti- 
mate division. 


Length 
Inches. 


Place of origin, of the principal branches, &c. 


L40 


R 








f Epigast. and Circumfl. 11. 1 inch above 












\ Poup. lig. 












I" Epigast. 1 ~ inch above Poup. lig. Circumfl. 




L 


1 






< 11. as 2 brs., one of which arises at Poup. 












l_lig., the other lj inch above it. 


141 


R 


U 


/ Ilio - lumbar at 
\rnid. 


3J 


Epigast. inch above Poup. lig. 




L 


'* 


{gives a Lumbar 
and Ilio-lumbar 
brs. near mid. 


4 


f Epigast. and Circumfl. 11. at Poup. lig. 
\ Epigast. gives Obturator. 








{Ilio - lumbar % 






142 


R 


11 


inch from lower 


3| 


Epigast. and Circumfl. 11. at Poup. lig. 








end. 








L 


H 


/ Ilio-lumbar near 
|_ upper end. 


2* 


Epigast. and Circumfl. 11. close to Poup. lig. 


145 


R 


H 




4 


Epigast. and Circumfl. 11. at Poup. lig. 




L 


1 


J" Ilio - lumbar at 
\ mid. 


3* 


/Epigast. at Poup. lig., and gives one of 
\ two Obturator brs. 












f Epigast. and Circumfl. 11. at Poup. lig. 


147 


R 








< Obturator from Ext. Iliac, at l^inch above 












|_ Poup. lig. 




L 








/ Epigast. and Circumfl. 11. at Poup. lig. 






'4 






\ Epigast. gives Obturator. 


149 


R 


if 




M 


Epigast. and Circumfl. 11." at Poup. lig. 




L 


U 








150 


R 


i 


f Ilio - lumbar at 
\rnid. 




{Epigast. and Circumfl. 11. | inch above 
Poup. lig. Epigast. gives Obturator. 




L 


j 




3 , 


/ Epigast. and Circumfl. 11. at Poup. lig. 








(" Ilio - lumbar 1 


4 


\ Epigast. gives Obturator. 


151 


R 




< inch from be- 












[ ginning. 












{Ilio - lumbar ~ 








L 


11 


inch from be- 


H 


Epigast. and Circumfl. 11. at Poup. lig. 








ginning. 






152 


R 








/ Epigast. and Circumfl. 11. at Poup. lig. 
\ Epigast. gives Obturator. 




L 


j 






J Epigast. and Circumfl. 11. at Poup. lig. 












\ Epigast. gives Obturator. 



INTERNAL ILIAC AND EXTERNAL ILIAC ARTERIES. 



385 



No. 

154 


Side 

R 


INTERNAL ILIAC. 


EXTERNAL ILIAC. 


Length 
Inches. 


Branches before the ulti- 
mate division. 


Length 
Inches. 


Place of origin of the principal branches, &c. 


1 








155 


R 


1 


I" Ilio - lumbar at 
\mid. 








L 1 








156 


R 


u 




4| 


Epigast. and Circumfl. 11. at Poup. lig. 




L 


4 


j" Ilio - lumbar j 
< inch from be- 
[ ginning. 


^ 


f Epigast. 1| inch above Poup. lig. Cir- 
\cumfl. 11. at Poup. lig. 


157 


R 


ii 


gives Ilio-lumbar. 




f Epigast. and Circumfl. 11. at Poup. lig. 
\ Epigast. gives Obturator. 








f Ilio-lumbar and 








L 


H 


J a Lateral sa- 
] cral 1 inch from 
[origin. 




Epigast. and Circumfl. 11. at Poup. lig. 


158 


R 


1* 


f Ilio-lumbar near 
\ lower end. 




J Epigast. gives a Br., which runs behind the 
\ pubes and is distributed to the clitoris. 




L 


1* 


J Ilio-lumbar near 
\ lower end. 






159 


R 


H 


f a Lumbar br. at 
\ beginning. 








L 


i 








161 


L 


H 


J Ilio-lumbar near 
\ lower end. 


H 




162 


R 






3i 


{Epigast. ^ inch above Poup. lig., and gives 
Obturator. Circumfl. 11. at Poup. lig. 




L 








J Epigast. l inch above Poup. lig., and gives 
\ Obturator. Circumfl. 11. under Poup. lig. 


164 


R 

' 


H 


J~ gives a Br. near 
\ lower end. 








L 


H 


f Ilio-lumbar near 
\ lower end. 






165 


R 1 






Circumfl. 11. as two brs. 




1 
L f 


("gives at beginning 
J Ilio-lumbar, which 
^ perforates the com. 
L iliac vein. 






165* 


R H 






Epigast. and Circumfl. 11. at Poup. lig. 



386 



INTERNAL ILIAC AND EXTERNAL ILIAC ARTERIES. 



No. 


Side 
of the 
Body. 


INTERNAL ILIAC. 


EXTERNAL ILIAC. 


Length 
in 
Inches. 


Branches before the ulti- 
mate division. 


Length 
Inches 


Place of origin of the principal branches, &c. 






11 


/ Ilio - lumbar at 










*f 


\ lower end. 






166 


R 


1 










L 


1 








168 


R 













L 


If 


/ Ilio - lumbar at 
\ mid - 




- 


169 


'R 


H 










L 


H 








170 


R 


2* 


J Ilio-lumbar near 
\ mid. 


4 


Epigast. and Circumfl. 11. at Poup. lig. 






2 


/ Ilio - lumbar at 


3 3 


f Epigast. and Circumfl. 11. at Poup. lig. 








\ mid. 


4 


\ Epigast. gives Obturator. 


172 


R 


3 




| 


f Epigast. 1 inch above Poup. lig. Circumfl. 
\I1. at Poup. lig. 




L 


2* 


f (the main artery is 
\ very tortuous.) 


i 


f Epigast. ~ inch above Poup. lig. Circumfl. 
< 11. at Poup. lig. The main artery is very 
[tortuous. 








[" Ilio - lumbar is 






173 


R 


H 


< given at mid., and 




Epigast. and Circumfl. 11. close to Poup. lig. 








[as two distinct brs. 






173* 


R 


If 




4J 


/Epigast. and Circumfl. 11. at Poup. lig. 
\ Epigast. gives Obturator. 




L 


U 


f Ilio-lumbar near 
\ lower end. 


4 


Epigast. and Circumfl. 11. at Poup. lig. 


174 


L 








Epigast. at Poup. lig., and gives Int. Circumfl. 


176 


R 


i 






Epigast. and Circumfl. 11. at Poup. lig. 




L 


1 






Epigast. and Circumfl. 11. at Poup. lig. 


177 


R 


2 






Epigast. and Circumfl. 11. at Poup. lig. 




L 


2 


{Ilio - lumbar at 
lower end. 




Epigast. and Circumfl. 11. at Poup. lig. 


178 


R 


14 


J Ilio- lumbar at 
\ mid. 


4i 


Epigast. and Circumfl. 11. at Poup. lig. 




L 


'* 


J" Ilio - lumbar at 
\ beginning. 


H 


/Epigast. and Circumfl. 11. ^ inch-%bove 
\ Poup. lig. 



INTERNAL ILIAC AND EXTERNAL ILIAC ARTERIES. 



387 



No. 


Side 
of the 
Body. 


INTERNAL ILIAC. 


EXTERNAL ILIAC. 


Length 
in 

Inches. 


Branches before the ulti- 
mate division. 


Length 
in 

Inches. 


Place of origin of the principal branches, Stc. 


179 


R 


2J 


f Ilio - lumbar at 
|_ lower end. 


5 


f Epigast. inch above Poup. lig. Cir- 
"[_ cumfl. 11. close to Poup. lig. 




L 


2 


f Ilio - lumbar at 
\ lower end. 


$J 


f Epigast. 1 inch above Poup. lig. Cir- 
\ cumfl. 11. at Poup. lig. 


180 


R 


If 




3| 


J Epigast. and Circumfl. II. a little above] 
\ Poup. lig. Epigast. gives Obturator. 




L 


1* 




4 


f Epigast. and Circumfl. 11. a little above 
\ Poup. lig. Epigast. gives Obturator. 


181 


R 


1$ 










L 


1 








185 


R 


1 






{Epigast. and Circumfl. II. at Poup. lig. 
Epigast. gives Obturator. 




L 


ii 






{Epigast. aud Circumfl. 11. at Poup. lig. 
Epigast. gives Obturator. 








{Ilio - lumbar ~ 






186 


R 


4 


inch from lower 


S| 


Epigast. gives Obturator. 








end. 








L 


ii 




3* 


Epigast. at Poup. lig. 


187 


R 








Epigast. and Circumfl. 11. at Poup. lig. 












C Epigast. at Poup. lig., and communicates 












J with Obturator by several small brs. Cir- 












| cumfl. 11. as two brs. ; one at Poup. lig., 












{^the other ^ inch above it. 


188 


R 


ii 






{Epigast. j inch above Poup. lig. Cir- 
cumfl. 11. at Poup. lig. 








fllio-lumbar and 








L 


H 


I another small or. 




Epigast. and Circumfl. 11. at Poup. lig. 








|_at mid. 






isy 


R 


l| 






Epigast. and Circumfl. 11. close to Poup. lig. 




L 


if 


J Ilio - lumbar at 
\rnid. 




Epigast. and Circumfl. 11. close to Poup. lig. 








J" Ilio - lumbar at 






190 


R 


i 


\ lower end. 


H 


Epigast. and Circumfl. 11. at Poup. lig. 




L 


1 




sj 


J Epigast. and Circumfl. 11. at Poup. lig., 
\ and a small Muscular br. at mid. 












TEpigast. and Circumfl. 11. close to Poup. 


1Q1 


R 






3A 


I lig. A small Br. of main artery winds 


L y i A* 






2 


j round the external iliac vein, and passes 










Bunder the psoas muscle. 



388 



INTERNAL ILIAC AND EXTERNAL ILIAC ARTERIES. 



No. 


Side 
of the 
Body. 


INTERNAL ILIAC. 


EXTERNAL ILIAC. 


Length 
Inches. 


Branches before the ulti- 
mate division. 


Length 
in 
Inches 


Place of origin of the principal branches, &c. 




L 






3* 


Epigast. and Circumfl. 11. at Poup. lig. 


192 


R 


2* 


f Ilio-lumbar at 1^ 
< inch from lower 


4 l 


/ Epigast. a little above Poup. lig. Cir- 
tcumfl. 11. a little below it. 








[end. 






195 


R 


1 


f Ilio - lumbar at 
\mid. 












{Ilio-lumbar as 2 












brs. ; one at mid., 








L 


U 


the other at lower 












end. 






196 


R 


2 


/gives a Br. at its 
t mid. 




/Epigast. and Circumfl. 11. a little above 
\ Poup. lig. 




L 


2* 






Epigast. and Circumfl. 11. at Poup. lig. 


199 


R 


n 










L 


M 








202 


R 








/ Epigast. and Circumfl. 11. at Poup. lig. 
t Obturator ^ inch above it. 




L 








/Epigast. and Circumfl. 11. a little above 












t Poup. lig. 


204* 


R 


if 










L 


if 








205 


R 


H 


/ Ilio - lumbar at 




Epigast. and Circumfl. 11. at Poup. lig. 




L 




/Ilio- lumbar at 
\ mid. 






207 


R 


if 






Epigast. and Circumfl. 11. at Poup. lig. 




L 


1* 


/ llicr-lumbar near 
t origin 













f" Lateral sacral 






208 


R 


i 


J at mid., Ilio- 
1 lumbar at lower 




Epigast. and Circumfl. 11. at Poup. lig. 








Lend. 










7 


/ Lateral-sacral at 










t 


tmid. 






210 


R 


2 


/ Ilio - lumbar at 
tmid. 








INTERNAL ILIAC AND EXTERNAL ILIAC ARTERIES. 



389 



No. 


Side 
of the 
Body. 


INTERNAL ILIAC. 


EXTERNAL ILIAC. 


Length 

'nches. 


ranches before the ulti- 
mate division. 


Length 
in 
Inches. 


Place of origin of the principal branches, &c. 




L 


1! 


ives a Br. at mid. 












f~A Lumbar br. (^ 










r* ^ 


J inch from lower 






212 


R 


2 I 


| end) ; and Ilio- 












^ lumbar. 












1" A Lumbar br. at 








L 


2 


4 mid., and Ilio- 
L lumbar at end. 




Spigast. at Poup. lig., and gives Obturator. 


213 


R 


1 


J" Ilio -lumbar at 












\mid. 








L 


1 








215 


R 


- 


("A Lumbar br. at 
< 1 inch from begin- 
Lning. 




fEpigast. close to Poup. lig. Circumfl. 
J 11. as two brs., one of which arises at 1 
| inch above Poup. lig., the other a little 
(^higher up. 




L 


U 






Epigast. from Profunda-femoris. 


216 


R 









{Epigast. 1 inch above Poup. lig. ; Cir- 
cumfl. 11. at Poup. lig.; Obturator, as a dis- 
tinct br., a little higher than Epigast. 




L 


1 


{Ilio- lumbar near 
mid. 






217 


R 


1 










L 


1* 


J Ilio - lumbar at 
\roid. 






219 


R 


If 






Epigast. and Circumfl. 11. close to Poup. lig. 




L 


H 






Epigast. and Circumfl. 11. close to Poup. lig. 








fA Lumbar br. at 






222 


R 


'* 


J mid., and Ilio- 
| lumbar at lower 




J" Epigast. and Circumfl. 11. at Poup. lig. 
\ Epigast. gives Obturator. 


223 


R 


H 


f Ilio -lumbar '-, 
\ inch from lowe 
[end. 




("Epigast. 1 inch above Poup. lig. Cir- 
\ cumfl. 11. j inch above same. 








f Ilio - lumbar j 






224 


R 


I"! 


< inch from lowe 












[end. 








L 


if 


{gives two moderate 
Brs. in its course 







390 



INTERNAL ILIAC AND EXTERNAL ILIAC ARTERIES. 



No. 


Side 
of the 
Body. 

R 


INTERNAL ILIAC. 


EXTERNAL ILIAC. 


Length 
in 
Inches. 


Branches before the ulti- 
mate division. 


Length 
in 
Inches 


Place of origin of the principal branches, &c. 


225 


H 


f A Lumbar br. near 
\ beginning. 




J" Epigast. arises at Poup. lig., and gives Ob- 
|_ turator. Circumfl. 11. as two brs. 




L 




J Ilio - lumbar at 
|_ mid. 




f Epigast. and Circumfl. 11. at Poup. lig. 
[_ Epigast. gives Obturator. 


226 


R 


il 


f A Lumbar br. at 
|_ mid. 




Epigast. at Poup. lig., and gives Obturator. 




L 


2 


f A Lumbar br. at 
]_ mid. 




f Epigast. and Circumfl. 11, at Poup. lig. 
I Epigast. gives Obturator. 


227 


R 








Epigast. and Circumfl. 11. under Poup. lig. 




L 








Epigast. and Circumfl. 11. at Poup. lig. 


230 


R 


2 






J Epigast. inch above Poup. lig. Circumfl. 
\ 11. at Poup. lig. 




L 


U 






I" Epigast. and Circumfl. 11. ~ inch above 
\ Poup. lig. 


233 


R 


If 










L 


If 








234 


R 


H 


j" gives a small Mu s- 
< cular br. near 
(Blower end. 




f Epigast. and Circumfl. 11. at Poup. lig. 
\ Epigast. gives Obturator. 




L 


i 






{Epigast. at Poup. lig., and gives Obturator. 
Circumfl. 11- a little above Poup. lig. 


237 


R 


i 






f Epigast. and Circumfl. 11. inch above 
\ Poup. lig. 




L 


if 






{Epigast. 1| inch above Poup. lig. Cir- 
cumfl. 11. ^ inch above Poup. lig. 


241 


R 


2J 


{gives two Visceral 
brs. before divi- 
sion. 








L 


a* 


("gives two Visceral 
J brs. and Ilio-lum- 
] bar before divi- 




f Epigast. and Circumfl. 11. a little above 
\ Poup. lig. 








[_sion. 






243 


R 


H 






{Epigasf. and Circumfl. 11. at Poup. lig. 
Epigast. gives Obturator. 




L 


i 






/"Epigast. and Circumfl. 11. at Poup. lig. 
L Epigast. gives Obturator. 


246 


L 


i 




2| 





INTERNAL ILIAC AND EXTERNAL ILIAC ARTERIES. 



391 





Side 


INTERNAL ILIAC. 


EXTERNAL ILIAC. 


No. 


of the 
Body. 


Length 
in 
Inches. 


Branches before the ulti- 
mate division. 


Length 
in 
Inches. 


Place of origin of the principal branches, &c. 


247 


R 


1 










L 


1 






f Epigast. and Circumfl. 11. a little above 
\ Poup. lig. Epigast. gives Obturator. 


249 


R 


If 










L 


21 








250 


R 


II 


f A Lumbar br. at 
\rnid. 








L 


1| 








252 


R 


2 




K Epigast. and Circumfl. 11. from a common 
trunk at 1 inch above Poup. lig. 




L 


If 






f Epigast. and Circumfl. 11. near Poup. lig. 
\ Epigast. gives Obturator. 


253 


R 


n 










L 


ij 








254 


R 


2 










L 


2 














Ogives lumbar por- 












j tion of Ilio-lum. 






256 


R 


f 


< bar near beginning. 




Spigast. near Poup. lig., and gives Obturator. 








I and iliac part oi 












V^same near end. 








L 


.3 

4 


{Ilio - lumbar at 
mid. 






257 


R 


i 






Epigast. and Circumfl. 11. at Poup. lig. 




L 


I* 


f gives iliac portion 
< of Ilio -lumbar 




Epigast. and Circumfl. 11. at Poup. lig. 








^near beginning. 






260 


R 


1 








262 


R 


H 




4 


Epigast. and Circumfl, II. close to Poup. lig. 




L 


if 








264 


R 


i 










L 


i 




' 


- 


267 


R 


i 




4 





o o 



392 



INTERNAL ILIAC AND EXTERNAL ILIAC ARTERIES. 



No. 


Side 
of the 
Body 


INTERNAL ILIAC. 


EXTERNAL ILIAC. 


Length 
in 
Inches 


Branches before the ulti 
mate division. 


Length 
in j Place of origin of the principal branches, Sec. 
Inches. 




L 


I* 




H 


iw . 


268 


R 






2f 






L 






2f 




269 


R 


i 


f Ilio-lumbar near 
\ lower end . 




J Epigast. and Circumfl. II. at Poup. lig. 
\ Epigast. gives Obturator. 




L 


u 


f A Lateral-sacral 
\ br. at mid. 




f Epigast. and Circumfl. 11. at Poup. lig. 
\ Epigast. gives Obturator. 


269 


R 


J 
4 










L 


f 














f Lateral-sacral and 






281 


R 


11 


< Ilio-lumbar near 












[mid. 






284 


R 


1 


{Ilio - lumbar at 
mid. 








L 


* 








287 


R 


i 


f Ilio - lumbar at 
\rnid. 








L 


H 


f Ilio - lumbar at 
\rnid. 






288 


R 


4 






Epigast. and Circumfl. 11. at Poup. lig. 




L 


ii 






J Epigast. and Circumfl. 11. at Poup. lig. 
|^ Epigast. gives Obturator. 



Abstracts of the foregoing table will be found in the observations on the internal iliac 
and the external iliac arteries. 



393 



EXPLANATION OF PLATE LXI. 

IN this plate are shown the superficial vessels of the perineum, 
together with the superficial fascia and muscles. To expose 
those parts as they are here represented, the body having 
been fixed in the position which is customary for the operation 
of lithotomy, the integuments were turned aside from the 
perineum, from the fascia lata covering the adductor muscles 
of the thighs, and from the margins of the great gluteal 
muscles. The dissection was completed by removing a portion 
of the superficial fascia. 

The perineal space is seen to be bounded on each side by 
bone (the branches of the ischium and pubes), and behind by 
the gluteus maximus. In its area are contained muscles, 
arteries, and nerves, which are indicated by letters, together 
with the lower extremity of the intestinal canal (anus), and 
two masses of loose fat, which are placed one on each side 
between the rectum and the ischium, filling up deep depressions 
aptly named the ischio-rectal fossae. 

a Superficial fascia. The posterior ' c Erector penis. 

part of this membrane has been ; d Transversus perinei. 

cut away, in order to expose the e Sphincter ani. This muscle is ex - 

muscles with the small arterial posed by the removal only of 

and nervous branches. There- the skin: of which a small 

maining fascia is shown to be ' portion has been allowed to 

connected on each side to the ' remain. 

bone and to be continued for- ' :/ Gluteus maximus. 

ward into the scrotum. 



Accelerator urinae. The letter is 
on tk,e junction between the 
two muscles thus named. 



1. Superficial perineal artery. 

2. Superficial perineal nerve. 



EXPLANATION OF PLATE LXJI. 

PARTS more deeply placed than those in the last plate are 
here shown. The additional dissection consisted in the 
removal of the superficial muscles, viz., the erector penis, the 
transverse perineal, and a part of the accelerator urinae on 



394 



EXPLANATION OF THE SIXTY-THIRD PLATE. 



each side, together with a portion of the superficial perineal 
arteries and nerves, and the mass of fat on each side of the 
rectum. 

The muscles having been removed, the crus penis, the 
" bulb " and " spongy substance " of the urethra, and the 
deep perineal fascia were displayed ; and by cutting away 
a small piece of the last-named structure on the left side, 
the pudic artery, with the artery of the bulb and Cowper's 
gland, was brought into view. Further, the fat on each 
side of the rectum having been dissected out of the deep 
angular depression (the ischio-rectal fossa) in which it was 
lodged, the levatorani, and the inferior hsemorrhoidal arterial, 
and nervous branches lay exposed. 



Superficial fascia. Its posterior 
part has been removed. 

Accelerator urinae. A portion 
of both the muscles has been 
cut away. 

Crus penis. 

Bulb of the urethra. 



e Deep perineal fascia : v. triangu- 
lar ligament of the urethra. 

/ Levator ani muscle. 

g Sphincter ani. 

h Coccyx. 

k Glutens maximus muscle. 

f Cowper's gland. 



1. Pudic. 

2. Superficial perineal. 

3. Inferior hsemorrhoidal. 



ARTERIES. 

I 4. Artery of "the bulb." 



The nerves exposed are the superficial, 
perineal, and the hsemorrhoidal. 



EXPLANATION OF PLATE LXIII. 



Uterus. 
Vagina. 
Inner side of the vagina partially 

turned outwards. 
Fallopian tube. 
Ovary. 

Round ligament of the uterus. 
Rectum : intestinum rectum. 
Urinary bladder. 
Prostate gland. 
Bulb of the urethra. 



k Corpus cavernosum penis. 

I Section of the body or*the pubes. 

m Sacrum. 

wf Coccyx. 

n Vesicula seminalis. 

nf Vas deferens. 

o Ureter. 

p Ischium its tuberosity. 

p-f Ischium its spine, sawed off. 

q Suspensory ligament of the penis. 



1. Aorta. 

2. Common iliac. 

3. Internal iliac. 
3>. Gluteal. 



ARTERIES. 



3J. Sciatic. 

4. External iliac. 

5. Ovarian right and left. 

6. Uterine. 



EXPLANATION OF THE SIXTY-THIRD PLATE. 



395 



7. Vaginal. 

8. Left pudic. 
8. Right pudic. 

8f. An unusual artery (accessory 
pudic), giving origin to both 
the arteries of the corpus caver- 
nosum penis. 

8:J:. Another form of accessory pudic 
artery, giving origin to the 
"cavernous" and the dorsal 
artery of the penis of one side. 

9. Inferior hsemorrhoidal. 

10. Superficial perineal. 

11. Artery of " the bulb." 

12. That of the corpus cavernosum. 

13. Dorsal branch of the penis. 



14. Vesical. 

15. Prostatic and inferior vesical. This 

artery furnishes small branches 
(besides those implied by the 
name) to the rectum and the 
vesicula seminalis. The last- 
named body receives also several 
long and delicate offsets from a 
small branch which arises below 
that marked 15. These little 
arteries were not visible except 
on turning aside the vesicula 
seminalis. They do not, there- 
fore, appear in the drawing. 

16. Superior hsemorrhoidal. 



The figures marked 1 and 2 show respectively the ordinary 
disposition of some of the arteries of the female and male 
genital organs, and the other figures contain illustrations of 
some of the peculiarities of the pudic artery in the male. 

Figure 1. The ovarian and uterine arteries are represented 
in this figure. On the right side the anterior layer of the 
broad ligament of the uterus was raised in order to display 
the blood-vessels of the uterus and its " appendages," viz., the 
ovarium, the Fallopian tube, and the round ligament. 

The uterine artery ascends tortuously from the internal 
iliac by the side of the uterus, and gives to it numerous 
branches. Turning outwards at its upper end, the vessel 
divides into two branches, one of which joins the ovarian 
artery ; the other ramifies on the Fallopian tube. 

The ovarian artery is directed inwards from the side of the 
pelvis on the upper margin of the ovarium, between the layers 
of the serous membrane by which that organ is closely 
invested, and after distributing to it numerous branches, 
joins an offset of the uterine artery. 

Figure 2. The arteries which are furnished to the urinary 
bladder are so numerous, that this outline taken from a 
body, which had been injected with considerable success has 
been introduced because it affords a more ample display of the 
branches than is contained in the more finished drawing, 
plate 60. 

The remarks made with respect to the mode in which the 
pudic artery is shown in that plate (ante, pp. .373-4) are also 



396 EXPLANATION OF THE SIXTY-THIRD PLATE. 

applicable here. The distance between the artery and the 
organs situated to its inner side viz., the rectum and ure- 
thra is in some degree indicated by the shadow of the 
vessel on those organs. 

Among the small arterial branches, those on the prostate 
require especial attention. They will come again under notice 
in a subsequent part of this work namely, in the commen- 
taries on the operations of surgery. 

Figure 3. The pudic artery of the left side ends in " the 
bulb ;" and the u cavernous " and dorsal branches of the 
penis are given from an unusual artery. This, which may be 
named an accessory pudic artery, passes close to the bladder 
and the upper part of the prostate gland, and emerges from 
the pelvis under the arch of the pubes. 

Figure 4. In the case represented in this figure, there 
existed an arrangement of the vessels nearly the same as that 
shown in the preceding figure. The difference consisted in 
the position of the accessory artery with respect to the pro- 
state. Instead of lying on the upper margin of the gland as 
in fig. 4, the vessel was placed along its middle. 

Figure 5. The ordinary pudic arteries of both sides are 
defective, and the deficiency is compensated by an additional 
or accessory artery. 

On the left side, the pudic artery ends in the bulb of the 
urethra. The branch for the corpus cavernosum is derived 
from the third or added vessel ; and the dorsal branch of 
the penis is supplied by the pudic artery of the opposite 
side. 

The pudic artery of the right side, after furnishing a branch 
to " the bulb," is directed forward to the dorsum penis ; and 
here, having more than the accustomed size, it makes up for 
the want of a dorsal branch from the left pudic artery. 

An accessory pudic artery takes its rise from the end of 
the internal iliac of the right side, in connexion with the 
obturator branch, and courses along the side and fore part of 
the bladder and the upper surface of the prostate. After 
escaping from the pelvis under the pubic arch, this artery 
divides into two equal parts, which sink into the penis, becom- 
ing the right and left arteries of the corpus cavernosum. 



EXPLANATION OF THE SIXTY-FOURTH PLATE. 



397 



Some arteries (accessory pudic) which, like those shown in 
the last three figures, pursue an unusual course to the penis, 
will be found represented in the following plate as they appear 
when viewed from the perineum. 



EXPLANATION OF PLATE LXIV. 



a Bulb of the urethra. 

b Crus penis with or without its 
muscular cover (the erector 
penis). 

c Deep perineal fascia : v. Triangu- 
lar ligament of the urethra. 



Part of the "Constrictor of the 
isthmus of the urethra" ex- 
posed by removal of a layer of 
the deep perineal fascia. 

Sphincter ani. 

Gluteus maximus. 



ARTERIES. 



1. Pudic. 

1J. An accessory pudic. It emerges 
from the pelvis beneath the arch 
of the pubes, and furnishes 
branches ordinarily supplied by 
the pudic artery. 

2. Artery of " the bulb." 

2f. A second branch given to the 



same structure, or to the corpus 
spongiosum urethrae. 
2J. Artery of "the bulb" derived 
from the accessory pudic (1+). 

3. Artery of the corpus cavernosum 

penis. 

3J. A " cavernous" branch furnished 
by an accessory pudic (1+). 

4. Dorsal artery of the penis. 



Peculiarities of the arteries of the perineum are contained 
in all the figures of this plate. In the first two, the artery of 
" the bulb " is seen to deviate from its ordinary course. Some 
forms of those unusual arteries, which, in other plates, are 
represented in connexion with the pelvic viscera, are shown 
in the third and fourth figures of that before us, as they 
appear when viewed from the perineum. 

Figure 1 . On both sides, the artery of the bulb, instead of 
being directed horizontally, or nearly so, inwards, leaves the 
pudic artery near the tuberosity of the ischium and ascends 
obliquely to its destination. 

Figure 2. Here, too, the artery of the bulb arises on each 
side farther back than usual ; but this case differs from the 
preceding in some respects, a. In one, the artery is directed 
towards the bulb with a uniform inclination inwards ; in the 
other, its course is at first more transverse, and afterwards 



393 EXPLANATION OF THE SIXTY-FOURTH PLATE. 

approaches more to the vertical direction, b. There are two 
arteries on the right side, in the second figure, c. In that 
figure, also, the vessels enter the erectile tissue, in which they 
ramify, at a greater distance from its posterior end than 
occurs in the first figure or than is usual. 

Figure 3. The ordinary pudic arteries are defective on both 
sides, but in unequal degrees ; and accessory arteries, which 
escape from the pelvis near the arch of the pubes, take their 
place furnishing some branches usually given from the pudic. 

On the left side, the pudic artery ends in " the bulb," and 
the two remaining branches, namely, the " cavernous " and 
" dorsalis penis," are supplied by an accessory pudic artery. 

The pudic artery of the left side, after giving the superficial 
perineal branch, ends in small offsets to the structures situated 
about the middle of the perineum. A supplemental artery 
(accessory pudic) escapes from the pelvis lower, than that 
on the opposite side, and furnishes to the penis its three 
branches *. 

An anastomosis exists on each side, between the proper 
pudic and the accessory one. 

Figure 4. The posterior part of the pelvis was more than 
commonly raised and brought into view while this sketch was 
taken. 

An accessory pudic artery exists on the right side only. 
It is of very small size, and is distributed exclusively to the 
corpus cavernosum, which also receives a branch from the 
proper pudic. 

The accessory pudic arteries represented in the last two 
figures of this plate were derived from the internal iliac or 
one of its divisions. An example of a similar vessel, given 
from a different source, will be found in the first figure of the 
next plate. 

* In a drawing which Mr. Listen has lately shown me, the arteries of the right side 
have very nearly the same arrangement that here occurs on the left. 



399 



EXPLANATION OF PLATE LXV. 



Innominate bone its iliac fossa. j e Crus penis of the left side. 



f Iliac fossa covered by the iliacus 

muscle. 

b Sacrum : os sacrum. 
c Urinary bladder. 
d Corpus cavernosum penis. 



/ Rectum : intestinum rectum. 

g Pubes its symphysis, or a section 

of the body. 
h Part of the lateral muscles of the 



abdomen. 



ARTERIES. 



1. Common iliac. 

2. Internal iliac. 

3. External iliac. 

4. Circumflex iliac. 

5. Epigastric. 

6. Obturator. 

6f. Obturator given from the epigastric. 



7. Pudic. 

8. Artery of " the bulb." 

9. That of the " corpus cavernosum." 
9f. A " cavernous " artery, derived 

from the obturator. 

10. Dorsal branch of the penis. 



VEINS. 

11. Vesical, as they approach the in- I 12. Hsemorrhoidal. 

ternal iliac. , 13. Veins encircling the prostate. 



The first figure of this plate contains the representation of 
a supplemental or accessory pudic artery proceeding from a 
very uncommon source. The next two are introduced to 
illustrate the disposition of the veins about the neck of the 
urinary bladder and the prostate. They are drawn on a reduced 
scale. Some peculiarities of the branches of the external iliac 
artery are shown in the remaining figures. 

Figure 1.* An accessory pudic branch (9 f) given from the 
obturator passes to the perineum beneath the pubic arch, 
and ends in the corpus cavernosum penis. 

The pudic artery gives the accustomed branches that to 
the corpus cavernosum, however, being small, is aided by 
the accessory artery. 

A small branch crosses the pelvis in the ordinary course of 

* The original drawing for this figure has been kindly furnished to me by Professor 
Allen Thomson, under whose observation the case occurred. The objects being repre- 
sented of the natural size, it will be readily inferred that the body was that of a young 
person. 

The pudic artery and the small obturator (6 and 7) are not shown in the original 
drawing , but, with a view to prevent the necessity of an additional sketch, an indication 
of them has been given in dotted lines. The course of these vessels has been supplied 
from a deeper view or plan, with which likewise I have been favoured by Dr. Thomson. 

P P 



400 EXPLANATION OP THE SIXTY-SIXTH PLATE. 

the obturator when derived from the internal iliac, and ends 
in the large obturator, which in this case is given from the 
epigastric. 

Figure 2. Large veins are shown on the urinary bladder. 

Figure 3. The prostate is surrounded by very large veins. 
The preparation sketched in this figure was taken from the 
body of a man in advanced age. 

Figure 4. The epigastric artery arises above the middle of 
the external iliac. 

In figure 5 the branches of the external iliac arise consider- 
ably above the position at which they generally take their 
origin. There are in this case other peculiarities deserving 
of notice : the circumflex iliac takes its origin in two 
separate parts ; and the epigastric gives off the obturator, 
at a greater distance than usual from its origin in other 
words, the common trunk of the epigastric and obturator has 
more than the accustomed length. 

Figure 6. The obturator artery arises separately from the 
external iliac, a little above the epigastric and circumflex 
iliac. 

Figure 7. The origin of the obturator is here, likewise, 
from the external iliac artery, but it is placed considerably 
higher than in figure 6. 



EXPLANATION OF PLATE LXVI. 



a The larger psoas muscle cut across. 

b Iliacus. 

c Transversalis abdominis. 

d Rectus. 



/ Internal oblique. 

g Spermatic cord. 

h Hernia. 

k Femoral ring. 



e External oblique. 

ARTERIES. 

1. External iliac. 3f. Obturator given from the epi- 

2. Epigastric. gastric. 

3. Obturator. 4. Circumflex iliac. 

5. A small portion of the pudic. 

VEINS. 

6. External iliac. | 7. Saphenous. 

8. Obturator nerve. 



EXPLANATION OF THE SIXTY-SIXTH PLATE. 401 

The first three figures of this plate have been introduced 
to illustrate various conditions of the obturator artery. Be- 
sides the blood-vessels, an innominate bone and some muscles 
are represented in each of the figures ; but the obturator 
ligament and the bone in its neighbourhood were laid bare 
in the preparations delineated in the second and third ; those 
parts were still covered by the internal obturator muscle and 
its fascia in the case of which the first is a representation. 

The disposition of the obturator artery in the several 
figures is as follows : Figure 1. That vessel having taken 
origin from the internal iliac, gives, before its exit from the 
pelvis, a considerable branch, which receives a small off-set 
from the epigastric. The communicating branch crosses the 
femoral ring. The obturator artery of the second figure is 
derived from the epigastric, and is joined by a small branch 
from the internal iliac. In its course downwards, the artery 
passes close to the external iliac vein, and is situated to the 
outer side of the femoral ring. Figure 3. Two branches of 
about equal size one given from the internal iliac, the other 
from the epigastric join behind the pubes, and from the 
point of union a single artery passes onwards from the pelvis. 
The part supplied by the epigastric arches inwards at a con- 
siderable distance from the external iliac vein, and curves 
over the anterior and inner side of the femoral ring. 

Figure 4. The position of the epigastric artery, with 
reference to an oblique inguinal hernia, is shown in this figure. 
The external and internal oblique muscles are seen to have 
been divided, in order to expose the artery ; the division of 
the transversalis fascia which likewise is requisite for that 
purpose will be found to be indicated in the first figure of 
the following plate. 



402 



EXPLANATION OF PLATE LXVII. 



a External oblique muscle. 

b Internal oblique. 

c Transversalis. 

cf The same muscle seen from behind, 

and covered by the fascia trans- 

versalis. 
d Rectus. 
df The posterior surface of the same 

muscle. 
e Pyraroidalis. 



/ The larger psoas cut across. The 
tendon of the smaller psoas 
rests on it (figure 3). 

g Iliacus. 

h Hernia. 

&f Opening of the hernial sac seen 
from behind. 

k Spermatic cord. 

/ Testis. 

m Sartorius muscle. 



2. 



External iliac. 
Femoral. 



ARTERIES. 

3. 

4. 



Epigastric. 
Obturator. 



5. External iliac. 



8. Obturator. 



VEINS. 

| 6. Femoral. 
7. Saphenous. 

NERVES. 

| 9. Anterior crural. 



The chief object of this plate is to illustrate the position 
which the epigastric artery bears with respect to some forms 
of hernia. 

Figure 1. The artery, with its companion veins (which are 
partially exposed) lies to the outer side of a direct inguinal 
hernia ; and some of the vessels of the spermatic cord sepa- 
rated one from the other are observable on the posterior 
part of its outer side. 

The epigastric artery was brought into view by dividing 
the external and internal oblique muscles and the transversalis 
fascia. The conjoined tendons of the internal oblique and the 
transversalis muscles in this case arched above the hernia ; 
which was fully distended when the drawing was under pre- 
paration. 

Figure 2. The epigastric artery is moved inwards from 
its usual position by an oblique inguinal hernia, which was 
of long standing, and had increased largely at its upper part. 
In order that the vessels might be more fully displayed, the 



EXPLANATION OF THE SIXTY-EIGHTH PLATE. 



403 



hernia was little distended while the drawing was under pre- 
paration. 

Figure 3 is another and different view of a case of the 
same kind as that delineated in the preceding figure. The 
innominate bone having been removed from the body, a portion 
of the anterior wall of the abdomen is here viewed from 
behind, and the epigastric artery is seen to curve round the 
upper opening or mouth of the sac of a large oblique inguinal 
hernia. 

Figure 4. The epigastric artery and the vessels of the 
spermatic cord are shown in connexion with a femoral hernia. 
The course of the epigastric artery upwards to the rectus 
muscle, was displayed by turning a side apart of the external 
oblique muscle and removing portions of the internal oblique, 
and transversalis muscles, together with a little of the trans- 
versalis fascia. After the removal of the integuments and 
fasciae of the thigh, for a small space, the origin of the same 
vessel was brought under view by drawing inwards the upper 
part of the hernia. 



EXPLANATION OF PLATE LXVIII. 



a External oblique muscle of the ab- 
domen. 

b Internal oblique. 

o Transversalis. 

c-f- The same muscle seen from behind 
and covered with the fascia 
transversalis. 

d Rectus. 

df The posterior surface of the same 
muscle. 

e Spermatic cord. 



ef Vessels of the spermatic cord. 

el Testis. 

/ Poupart's ligament. 

g End of the round ligament of the 

uterus. 
h Hernia. 
i Iliacus muscle. 
k Larger psoas cut across. 
/ Obturator ligament. 
m Sartorius muscle. 



ARTERIES. 



1. External iliac. 

2. Femoral. 



5. External iliac. 

6. Femoral. 



9. Obturator. 



Epigastric. 
Obturator. 



VEINS. 



7. Epigastric. 

8. Saphenous. 



NERVES. 
10. 



Anterior crural. 



404 EXPLANATION OF THE SIXTY-EIGHTH PLATE. 

In this plate examples are given of the different positions 
which the obturator artery, when derived from the epigastric, 
holds with reference to femoral hernia. 

Figures 1 and 2. The obturator is placed to the outer side 
of the hernial sac. In the front view of the parts contained, 
in the first figure, the vessels were exposed at their origin by 
the removal of a portion of the fascia lata, and of the sheath 
of the femoral vessels ; and the epigastric artery, in its fur- 
ther progress upwards to the rectus muscle, was laid bare by 
turning outwards a part of the three lateral muscles of the 
abdomen with the fascia trans versalis. The vessels are shown 
in connexion with the mouth of the hernial sac, in the pos- 
terior view given in the second figure. Both the drawings 
illustrate the close relation of the spermatic cord to the 
hernia. 

Figures 3 and 4 are front and back views of the same pre- 
paration, which was taken from the body of an adult female*. 
The obturator artery curves over the anterior and the inner 
side of the sac of a femoral hernia. 

* The preparation is in the collection of Mr. Listen ; and I am indebted to him for 
the opportunity to place drawings of it in this work. It is necessary to state that the 
bone and muscles to the outer side of the large vessels, which had been removed from 
the preparation in order to diminish its bulk, have, in the drawing, been added or 
restored from a recent dissection. 



OBTURATOR ARTERIES. 



No. 


Side 
of the 
Body. 


Place of Origin and Course. 


No. 


Side 
of the 
Body. 


Place of Origin and Course. 


1 


L 


fr. Epigastric. 






ffr. Epigast., and turns down- 










L { wards at a moderate distance 






ffr. Epigast., and turns down- 






|_from ext. iliac vein. 


2f 


R 


< wards at a moderate distance 












|_ from the ext. iliac vein. 


13b 


R 


fr. Int. Iliac. 






("fr. Epigast., and turns down- 




L 


fr. Int. Iliac. 




L 


< wards close to the ext. iliac 
L vein. 


15 


R 


fr. Int. Iliac. 


4b 


R 


fr. Epigast. 




L 


fr. Int. Iliac. 


5* 


R 


fr. Int. Iliac. 


15a 


R 


ffr. Epigast., and turns down. 
(Awards close to ext. iliac vein. 




L 


r. Int. Iliac. 






ffr. Epigast., and turns down- 








15b 


R 


< wards at a moderate distance 


B* 


R 


fr. Int. Iliac. 






|_from ext. iliac vein. 










L 


fr. Int. Iliac. 


10 


R 


fr. Int. Iliac. 














16 


R 


fr. Int. Iliac. 




L 


fr. Int. Iliac. 
















L 


Fr. Int. Iliac. 


lOa 


R 


ffr. Epigast., and turns down- 
< wards at a moderate distance 






ffr. Epigast., and turns down- 






[from ext iliac vein. 


19 


R 


< wards at a moderate distance 
(_from ext. iliac vein. 




L 


{fr. Epigast., and turns down- 
wards close to ext. Iliac vein. 


19a 


R 


fr. Epigast. 


13 


R 


r. Int. Iliac. 




L 


fr. Epigast. 








27 


R 


fr. Int. Iliac. 




L 


fr. Int. Iliac. 
















L 


[r. Int. Iliac. 


13 a 


R 


{fr. Epigast., and turns down- 
wards at a moderate distance 
from ext. iliac vein. 


28 


L 


J fr. Epigast., and turns down- 
\ wards close to ext. iliac vein. 



406 



OBTURATOR ARTERIES. 



No. 


Side 
of the 
Body. 


Place of Origin and Course. 


No. 


Side 
of the 
Body. 


Place of Origin and Course. 


29 


R 


fr. Epigast. 






ffr. Epigast., and turns down 










L 


< wards at a moderate <iistanc 




L 


fr. Int. Iliac. 






[from ext. iliac vein. 


30 


R 


fr. Int. Iliac. 






ffr. Epigast., and turns down 








34 a 


R 


< wards at a moderate distanc 




L 


fr. Int. Iliac. 






[ from ext. iliac vein. 


31a 


R 


r. Int. Iliac. 




[ J 


J fr. Epigast., and turns down 












\ wards close to ext. iliac vein. 




L 


fr. Int. Iliac. 








31b 


R 


f fr. Epigast., and turns down- 
\ wards close to ext. iliac vein. 


37 


L 


{fr. Epigast., and turns down 
wards close to ext. iliac vein. 








37a 


R 


fr. Int. Iliac. 


3U 


R 


f fr. Epigast., and turns down- 
\ wards close to ext. iliac vein. 




L 


fr. Int. Iliac. 


31f 


R 


fr. Int. Iliac. 






{fr. Epigast., and turns dowi 








37b 


R 


wards at a moderate distanc 




L 


fr. Int. Iliac. 






from ext. iliac vein. 


31 f 


R 


fr. Int. Iliac. 




L 


fr. Int. Iliac. 




L 


Fr. Int. Iliac. 


38 


R 


/fr. Epigast., and turns dowi 












\ wards close to ext. iliac vein. 


32 a 


B 


/"fr. Epigast., and turns down- 












\ ward close to ext. iliac vein. 


38b 


R 


fr. Int. Iliac. 






ffr. Epigast., and turns down- 






("fr. Ext. Iliac above Epigast 




L 


< wards at a moderate distance 




L 


-< and turns downwards close 






[from ext. iliac vein. 






[ext. iliac vein. 


32b 


R 


fr. Int. Iliac. 


39 


R 


ffr. Epigast., and turns dowi 
\ wards close to ext. iliac vein. 




L 


{fr. Epigast., and turns down- 
wards at a moderate distance 




L 


fr. Int. Iliac. 






from ext. iliac vein. 














40 a 


R 


fr. Int. Iliac. 






("fr. Epigast., and turns down- 








33 


R 


< wards at a moderate distance 




L 


fr. Int. Iliac. 






[from ext. iliac vein. 














40b 


R 


fr. Int. Iliac. 






|"fr. Epigast., and turns down- 










L 


< wards at a moderate distance 




L 


fr. Int. Iliac. 






[from ext. iliac vein. 








33a 


R 


fr. Int. Iliac. 


41 


L 


f fr. Epigast., and turns dow 
L wards close to ext. iliac vein. 




L 


ffr. Epigast., and turns down- 


41 a 


R 


fr. Int.- Iliac. 






\ wards close to ext. iliac vein. 















43 


R 


fr. Int. Iliac. 






j"fr. Epigast., and turns down- 








34 


R 


< wards at a moderate distance 




L 


fr. Int. Iliac. 






[from ext. iliac vein. 














45 


R 


fr. Int. Iliac. 



OBTURATOR ARTERIES. 



407 





Side 






Side 




No. 


f the 


Place of Origin and Course. 


No. 


f the 


Place of Origin and Course. 




Body. 






Body. 






L 


r. Int. Iliac. 


58 


R 


r. Int. Iliac. 


46 


R 


r. Int. Iliac. 




L 


r. Int. Iliac. 




L 


r. Int. Iliac. 






f is formed from two brs. : one of 


47* 


R 


r. Int. Iliac. 


59 


L 


< wh. is given from Int. Iliac, 
[ the other from Epigast. 




L 


r. Int. Iliac. 


60 


R 


T. Int. Iliac. 


48 


R 


r. Int. Iliac. 




L 


r. Int. Iliac. 






ffr. Epigast., and turns down- 


61 


R 


r. Int. Iliac. 




L 


< wards at a moderate distance 












[from ext. iliac vein. 




L 


r. Int. Iliac. 


48 a 


R 


r. Int. Iliac. 


63 


R 


r. Int. Iliac. 




L 


r. Int. Iliac. 






ffr. Epigast., and turns down- 


49a 


R 


r. Int. Iliac. 




L 


wards at a moderate distance 
[from ext. iliac vein. 




L 


r. Int. Iliac. 


64 


R 


fr. Int. Iliac. 


50 


R 


r. Int. Iliac. 




L 


r. Int. Iliac. 




L 


r. Int. Iliac. 


65 


R 


r. Int. Iliac. 


51 


R 


r. middle of External Iliac. 




L 


r. Int. Iliac. 


52 


R 


fr. Int. Iliac. 


66 


R 


fr. Int. Iliac. 




L 


fr. Int. Iliac. 




L 


fr. Int. Iliac. 


53 


R 


fr. Int. Iliac. 


67 


L 


fr. Int. Iliac. 




L 


fr. Int. Iliac. 


69 


R 


fr. Int. Iliac. 


54 


R 


fr. Int. Iliac. 




L 


r. Int. Iliac. 




L 


fr. Int. Iliac. 


70 


R 


fr. Int. Iliac. 


55 


R 


fr. Int. Iliac. 




L 


fr. Int. Iliac. 




L 


fr. Int. Iliac. 






ffr. Epigast. a little below Poup. 








n~ 




I lig. In its course upwards and 


56 


R 


fr. Int. Iliac. 






| into the pelvis it lies close to 












j^tlie femoral and the iliac vein. 






ffr. Epigast., and turns down- 










L 


i wards at a moderate distance 




L 


fr. Int. Iliac. 






[fr. ext. iliac vein. 














72 


R 


fr. Int. Iliac. 


57 


R 


fr. Int. Iliac. 
















L 


fr. Int. Iliac. 






ffr. Epigast., and turns down 










L 


< wards at a moderate distance 


73 


R 


fr. Int. Iliac. 






[from ext. iliac vein. 









408 



OBTURATOR ARTERIES. 



No. 


Side 
of the 
Body. 


Place of Origin and Course. 


No. 


Side 
of the 
Body 


Place of Origin and Course. 




L 


fr. Int. Iliac. 


86 


R 


fr. Int. Iliac. 


74 


R 


fr. Int. Iliac. 




L 


fr. Int. Iliac. 




L 


fr. Int. Iliac. 


87 


R 


fr. Int. Iliac. 


yt 




f fr. Epigast., and turns down- 




L 


fr. Int. Iliac. 


/ o 




Awards close to ext. iliac vein. 














88 


R 


fr. Int. Iliac. 




L 


fr. Int. Iliac. 
















L 


fr. Int. Iliac. 


76 


R 


fr. Int. Iliac. 


















("fr. Epigast., and turns down- 




L 


fr. Int. Iliac. 


89 


R 


< wards at a moderate distance 












[from ext. iliac vein. 


77 


R 


fr. Int. Iliac. 










L 


fr. Int. Iliac. 




L 


f fr. Ext. Iliac at 1^ inch above 
\ Poup. lig. 


78 


R 


("fr. Epigast., and turns down- 
wards at a moderate distance 
[from ext. iliac vein. 


90 


R 
L 


fr. Int. Iliac, 
fr. Int. Iliac. 




L 


fr. Int. Iliac. 


91 


R 


fr. Int. Iliac. 


7Q 


R 


("fr. Epigast., and turns down- 




L 


fr. Int. Iliac. 


1 i? 




\ wards close to ext. iliac vein. 














92 


R 


fr. Int. Iliac. 




L 


fr. Int. Iliac. 














93 


R 


fr. Int. Iliac. 


80 


R 


Fr. Int. Iliac. 
















L 


fr. Int. Iliac. 




L 


fr. Int. Iliac. 














94 


R 


fr. Int. Iliac. 


81 


R 


fr. Int. Iliac. 
















L 


fr. Int. Iliac. 




L 


ffr. Epigast., and turns down- 
< wards at a moderate distance 
[ from ext. iliac vein. 


95 


R 


fr. Int. Iliac. 












("fr. Epigast., and turns down- 


82 


R 


fr. Int. Iliac. 




L 


's wards at a moderate distance 












[from ext. iliac vein. 


83 


R 


fr. Int. Iliac. 














97 


R 


fr. Int. Iliac. 




L 


fr. Int. Iliac. 
















L 


fr. Int. Iliac. 


84 


R 


fr. Int. Iliac. 














98 


R 


fr. Int. Iliac. 




L 


fr. Int. Iliac. 












; 1 




L 


fr. Int. Iliac. 


85 


R 


fr. Int. Iliac. 














99 


R 


fr. Int. Iliac. 






fis formed by union of two brs.; 










L 


I one of which is derived from 


100 


R 


fr. Int. Iliac. 






| Int. Iliac, the other fr. Epi- 












Lgast. 




L 


fr. Int. Iliac. 



OBTURATOR ARTERIES. 



409 





Side 






Side 




No. 


f the 


Place of Origin and Course. 


No. 


of the 


Place of Origin and Courw. 




Body. 






Body. 




101 


R 


r. Int. -Iliac. 


113 


R 


fr. Int. Iliac. 




L 


r. Int. Iliac. 




L 


fr. Int. Iliac. 


102 


R 
L 


T. Int. Iliac, 
fr. Int. Iliac. 


114 


R 


{fr. Epigast., and turns down- 
wards close to ext. iliac 
vein. 


103 


R 


ffr. Epigast., and turns down- 
\ wards close to ext. iliac vein. 




L 


[fr. Epigast., and turns down- 
-j wards close to ext. iliac 












[vein. 




L 


fr. Int. Iliac. 














115 


R 


fr. Int. Iliac. 


104 


R 


fr. Int. Iliac. 
















L 


fr, Int. Iliac. 




L 


fr. Int. Iliac. 














115a 


R 


fr. Int. Iliac. 


106 


R 


fr. Int. Iliac. 
















L 


fr. Int. Iliac. 




L 


fr. Int. Iliac. 














116 


R 


fr. Int. Iliac. 


107 


R 


fr. Int. Iliac. 
















L 


ffr. Epigast., and turns down- 




L 


fr. Int. Iliac. 






Awards close to ext. iliac vein. 


108 


R 


ffr. Epigast., and turns down- 
Awards close to ext. iliac vein. 


117 


R 


Jfrom Epigast., and turns down- 
L wards close to ext. iliac vein. 




L 


fr. Int. Iliac. 




L 


fr. Int. Iliac. 


109 


R 


{fr. Epigast., and turns down- 
wards at a moderate distance 


118 


L 


ffr. Epigast., and turns down- 
\ wards close to ext. iliac vein. 






from ext. iliac vein. 














119 


R 


fr. Int. Iliac. 






[fr. Epigast., and turns down- 










L 


< wards at a moderate distance 






{is formed by union of two brs. : 






[from ext. iliac vein. 






one of which is given fr. Int. 










L 


Iliac, the other fr. Epigast. 


110 


R 


fr. Int. Iliac. 






Their union occurs at the ob- 












tur. foramen. 






ffr. Epigast., and turns down- 












\ wards close to ext. iliac vein. 


120 


R 


fr. Int. Iliac. 


111 


R 


fr. Int. Iliac. 




L 


fr. Int. Iliac. 






ffr. Epigast., and turns down- 






f fr. Epigast., and turns down- 




L 


4 wards at a short distance from 


121 


R 


i wards at a moderate distance fr. 






[ ext. iliac vein. 






[ext. iliac vein. 


112 


R 


{fr. Epigast., and turns down- 
wards at a short distance from 
ext. iliac vein. 




L 


[fr. Epigast., and turns down- 
< wards at a moderate distance 
[from ext. iliac vein. 






ffr. Epigast., and turns down- 


122 


R 


fr. Int. Iliac. 




L 


< wards at a considerable distance 












[from ext. iliac vein. 




L 


fr. Int. Iliac. 



410 



OBTURATOR ARTERIES. 



No. 


Side 
of the 
Body. 


Place of Origin and Course. 


No. 


Side 
of the 
Body. 


Place of Origin and Course. 


123 


R 


ffr. Epigast., and turns down- 
< wards at a considerable distance 


141 


L 


ffr. Epigast., and turns down- 
< wards at a short distance from 






[ from ext. iliac vein. 






[ext. iliac vein. 






ffr. Epigast., and turns down- 


142 


R 


fr. Int. Iliac. 




L 


< wards at a considerable distance 












[ from ext. iliac vein. 




L 


fr. Int. Iliac. 


125 


L 


ffr. Epigast., and turns down- 
\ wards close to ext. iliac vein. 


145 


R 


fr. Int. Iliac. 












fi& formed by two brs. : one of 


127 


R 


fr. Int. Iliac. 






I which (the larger) is given by 










, 


j Int. Iliac, the other by Epigast. 




L 


fr. Int. Iliac. 






J The latter turns downwards at 












1 a short distance from ext, iliac 


128 


R 


fr. Int. Iliac. 






(.vein. 


129 


R 


fr. Int. Iliac. 


147 


R 


ffr. Ext. Iliac 1^ inch above 
\ Poup. lig. 




L 


fr. Int. Iliac. 
















L 


ffr. Epigast., and turns down- 


130 


R 


fr. Int. Iliac. 






|_ wards close to ext. iliac vein. 




L 


fr. Int. Iliac. 


149 


R 


fr. Int. Iliac. 


131 


R 


f fr. Epigast., and turns down- 




L 


fr. Int. Iliac. 






\ wards close to ext. iliac vein. 


















ffr. Epigast., and turns down- 




R 


ffr. Epigast., and turns down- 


150 




< wards at a moderate distance 






\ wards close to ext. iliac vein. 






[from ext. iliac vein. 






ffr. Epigast., and turns down- 






ffr. Epigast., and turns down- 


135 


R 


< wards at a short distance from 


150 


L 


< wards at a moderate distance 






[ext. iliac vein. 






[ from ext. iliac vein. 






ffr. Epigast., and turns down- 


151 


L 


fr. Int. Iliac. 






\ wards close to ext. iliac vein. 














152 


R 


ffr. Epigast., and turns down- 


136 


R 


f fr. Epigast., and turns down- 






\ wards close to ext. iliac vein. 






\ wards close to ext. iliac vein. 


















ffr. Epigast., and turns down- 




L 


fr. Int. Iliac. 




L 


< wards at a considerable distance 












[fr. ext. iliac vein. 


138 


R 


fr. Int. Iliac. 














156 


R 


fr. Int. Iliac. 




L 


fr. Int. Iliac. 
















L 


fr. Int. Iliac. 


139 


L 


fr. Int. Iliac. 


















ffr. Epigast., and turns down- 






f fr. Epigast., and turns down- 


157 


R 


< wards at a moderate distance 


140 


R 


< wards at a moderate distance 






\_ from ext. iliac vein. 






[from ext. iliac vein. 
















L 


fr. Int. Iliac. 






ffr. Epigast., and turns down- 










L 


< wards at a moderate distance 






ffr. Epigast., and turns down- 






[ from ext. iliac vein. 


159 


L 


< wards at a moderate distance 












(_from ext. iliac vein. 



OBTURATOR ARTERIES. 



411 





Side 






Side 




No. 


of the 


Place of Origin and Course. 


No. 


of the 


Plaee. of Origin and Course. 




Body. 






Body 




162 


R 


fr. Epigast. 


179 


R 


fr. Int. Iliac. 




L 


fr, Epigfist. 




L 


fr. Int. Iliac. 


164 


R 


fr. Int. Iliac. 






{fr. Epigast., and turns down- 








180 


R 


wards at a short distance from 




L 


r. Int. Iliac. 






ext. iliac vein. 


165 


R 


fr. Int. Iliac. 






{fr. Epigast., and turns down- 










L 


wards at a moderate distance 




L 


f fr. Epigast., and turns down- 






from ext. iliac vein. 






\ wards close to ext. iliac vein. 














181 


R 


fr. Int. Iliac. 


165* 


R 


fr. Int. Iliac. 
















L 


fr. Int. Iliac. 




L 


'r. Int. Iliac. 


















'is formed by two brs. : the larger 


169 


R 


ffr. Epigast., and turns down- 
\ wards close to ext. iliac vein. 






of which is derived fr. Epigast., 
and passes backwards close to 








185 


R 


< the ext. iliac vein : the smaller 




L 


"r. Int. Iliac. 






is given fr. Int. Iliac. The 












union of the two occurs at the 


170 


R 


fr. Int. Iliac. 






^obturator foramen. 






/'fr. Epigast., and turns down- 






ffr. Epigast., and turns down- 






j wards at a moderate distance 




L 


< wards close to the ext. iliac 




L 


) from ext. iliac vein, curving 






[vein. 






Iupon an enlarged lymphatic 
gland, which occupies the crural 






ffr. Epigast., and turns down- 






ring. 


186 


R 


< wards at a considerable distance 












[from ext. iliac vein. 


172 


R 


fr. Int. Iliac. 
















L 


T. Int. Iliac. 






fr. Int. Iliac. 








173 


R 


fr. Int. Iliac. 


187 


R 


ffr. Epigast., and turns down- 
\ wards close to ext. iliac vein. 




L 


fr. Int. Iliac. 
{fr. Epigast., and turns down- 




L 


ffr. Int. Iliac; communicates 
< with Epigast. by several small 
[bra. 


173* 


R 


wards at a very short distance 












from ext, iliac vein. 


188 


R 


T. Int. Iliac. 




L 


fr. Int. Iliac. 




L 


fr. Int. Iliac. 


176 


R 


fr. Int. Iliac. 


189 


R 


fr. Int. Iliac. 




L 


Fr. Int. Iliac. 




L 


fr. Int. Iliac. 


177 


R 


fr. Int. Iliac. 


190 


R 


fr. Int. Iliac. 




L 


fr. Int. Iliac. 




L 


fr. Int. Iliac. 


178 


R 


fr. Int. Iliac. 


191 


R 


fr. Int. Iliac. 




L 


fr. Int. Iliac. 




L 


fr. Int. Iliac. 



412 



OBTURATOR ARTERIES. 



No. 


Side 
of the 
Body. 


Place of Origin and Course. 


No. 


Side 
of the 
Body. 


Place of Origin and Course. 


192 


R 


fr. Int. Iliac. 


223 


R 


fr. Int. Iliac. 


195 


R 


fr. Int. Iliac. 






ffr. Epigast., and turns down- 








225 


R 


< wards at a considei'able distance 




L 


fr. Int. Iliac. 






[from ext. iliac vein. 


196 


R 


fr. Int. Iliac. 






ffr. Epigast., and turns down- 










L 


< wards at a moderate distance 




L 


fr. Int. Iliac. 






[from ext. iliac vein. 


202 


R 


/fr. Ext. Iliac f inch above 
\ Poup. lig. 


226 


R 


{fr. Epigast., and turns down- 
wards at a considerable distance 












from ext. iliac vein. 


204* 


R 


fr. Int. Iliac. 




* 




205 


R 


fr. Int. Iliac. 




L 


("fr. Epigast., and turns down- 
< wards at a considerable distance 
[from ext. iliac vein. 




L 


fr. Int. Iliac. 














230 


R 


fr. Int. Iliac. 


207 


R 


fr. Int. Iliac. 
















L 


fr. Int. Iliac. 




L 


fr. Int. Iliac. 














233 


L 


fr. Int. Iliac. 


208 


R 


fr. Int. Iliac. 


















{fr. Epigast., and turns down- 




L 


fr. Int. Iliac. 


234 


R 


wards at a considerable distance 












from ext. iliac vein. 


212 


R 


fr. Int. Iliac. 


















ffr. Epigast., and descends straight 




L 


("fr. Epigast., and turns down- 
< wards at a moderate distance 




L 


I to obtur. foramen close to ext. 
| iliac vein. It gives a consider- 






[from ext. iliac vein. 






[_able br. over the urinary bladder. 


213 


R 


fr. Int. Iliac. 


237 


R 


fr. Int. Iliac. 


215 


R 


fr. Int. Iliac. 


241 


L 


fr. Int. Iliac. 




L 


fr. Int. Iliac. 






("fr. Epigast., and turns down- 








243 


R 


< wards a short distance from 


216 


R 


/fr. Ext. Iliac l inch above 
\ Poup. lig. 






[ext. iliac vein. 


217 


R 


fr. Int. Iliac. 




L 


{fr. Epigast., and turns down- 
wards at a short distance from 












ext. iliac vein. 


220 


R 


fr. Int. Iliac. 














247 


R 


fr. Int. Iliac. 




L 


fr. Int. Iliac. 












ps formed by two brs., which 




L 


("fr. Epigast., and turns down- 
\ wards close to ext. iliac vein. 






1 unite at the obturator foramen. 








222 


R 


1 The larger " root" arises from 


249 


R 


fr. Int. Iliac. 


mm& 




j Epigast., and turns downwards 












1 close to ext. iliac vein : the 




L 


fr. Int. Iliac. 






^smaller is derived fr. Int. Iliac. 


















ffr. Int. Iliac., and gives the 




L 


fr. Int. Iliac. 


250 


R 


< iliac Branch usually derived fr. 












[ llio-lumbar. 



OBTURATOR ARTERIES. 



413 





Side 






Side 




No. 


of the 


Place of Origin and Course. 


No. 


of the 


Place of Origin and Course. 




Body. 






Body. 




250 


L 


fr. Int. Iliac. 






ffr. Epigast., and turns down- 








269 


R 


< wards at a moderate distance 


251 


L 


fr. Int. Iliac. 






Lfrom ext. iliac vein. 


252 


R 


fr. Int. Iliac. 




L 


{fr. Epigast., and turns down- 
wards at a short distance from 






Jfr. Epigast., and turns down- 






ext. iliac vein. 






\ wards close to ext. iliac vein. 














269* 


R 


fr. Int. Iliac. 


253 


R 


fr. Int. Iliac. 
















L 


fr. Int. Iliac. 




L 


fr. Int. Iliac. 














281 


R 


fr. Int. Iliac. 


254 


L 


/fr. Epigast., and turns down- 
\ wards close to ext. iliac vein. 


284 


R 


fr. Int. Iliac. 


256 


R 


ffr. Epigast., and turns down- 
\ wards close to ext. iliac vein. 




L 


ffr. Epigast., and turns down- 
< wards at a considerable distance 












[from ext. iliac vein. 


257 


R 


fr. Int. Iliac. 














287 


R 


fr. Int. Iliac. 




L 


fr. Int. Iliac. 














288 


R 


fr. Int. Iliac. 


262 


R 


/fr. Epigast., and turns down- 
\ wards close to ext. iliac vein. 






("fr. Epigast., and turns down- 








L 


< wards close to ext. iliac 


L 


fr. Int. Iliac. 






L vein. 


i 











For an abstract of this table see the remarks on the obturator arteries. 



415 



THE ABDOMINAL AORTA. 

The aorta, detached from the vertebral column, is repre- 
sented in its whole length in plate 48 ; the abdominal part is 
shown in connexion with the trunk of the body, in plates 53 
and 54. 

The place of division. I have not observed any striking 
peculiarities in the disposition of the abdominal portion of the 
great artery. Those mentioned in the table (page 348, et seq.), 
have reference to the height at which it divides into the two 
common iliac arteries. In each case the place of division was 
noted, referring it to the vertebrae (as is customary in treatises 
on anatomy), and to the highest part of the crest of the iliac 
bone. This latter point of reference was added because of 
the importance to the surgeon, in planning an operation, to 
have for his guidance objects which may be felt or seen on the 
surface of the body. The umbilicus could not be included as 
a point of reference, all the bodies having been examined 
when their dissection was far advanced. Its position, a little 
to the right of the bifurcation of the aorta, is shown in 
plate 55. 

The following is an abstract of the cases noted in the 
Table :- 

A. Referring the division of the aorta to the vertebral column. 

The number of bodies set down in the Table 19b 

The division occurred on the 3rd J abo . v , e the middle . . 1 

. , on the middle . . . 2 

vertebra ' ' ' '[ below the middle . . 3 



between the 3rd and 4th vert. ..... 12 

(" above the middle . . 43 "I 

on the 4th vert. . . 4 on the middle, or nearly so 36 i- 126 
L below the middle . . 47 J 

between the 4th and 5th vert ....... 30 



On the5thve r , . . 

196 
B. Relation of the place of division to the crest of the iliac bone. 

("by 2 inches . . . 1"| 

It \vashigher than the highest part I more than 1, not exceeding 1. 3 I gg 
of the bone. . . . | more than , not exceeding 1 . 8 f 
Li inch and less . . 16j 

Q Q 



416 THE ABDOMINAL AORTA. 



It was opposite the same point, or nearly 26 

C inch and less . . 47"| 

. I more than A, not exceed. 1.11 I fi o 

' i more than 1, not exceed. H .4 [^ 
(_2 inches . . . . 1 J 

The entire number noted . . 117 

From the first of the foregoing abstracts, it appears that 
the aorta divided much more frequently on the fourth lumbar 
vertebra than on any other, and that in a very large majority 
of the cases 156 out of 196, or more than three-fourths 
the division lay either on that vertebra or on the intervertebral 
disc below it; and this space may, therefore, be considered the 
ordinary place of division (see plates 53 and 54). The highest 
place of division noted is the upper margin of the third ver- 
tebra.* Examples of its occurrence on the third, the fourth, 
and the fifth vertebrae, are contained in the first three figures 
of the fifty-sixth plate. A case is described by Petsche, ( from 
the collection of his " master," Cassebohm (Professor of Ana- 
tomy at Halle before the middle of the last century) which 
affords an example of higher bifurcation of the aorta than any 
other that I have found recorded. The division took place imme- 
diately after the origin of the right renal artery (the only renal 
artery that existed in the case) ; the inferior mesenteric artery 
arose from the left (common iliac) branch, and after its origin 
the two (common iliac) branches were connected by a transverse 
artery ; each then divided into the external and internal iliac. 
Here, doubtless, the division was not situated below the 
second lumbar vertebra. 

As regards the crest of the ilium : the abstract shows the 
bifurcation of the aorta to have commonly ranged within 
half an inch above and below the highest point of this part of 
the bone. It was placed within that interval in 89 bodies 
among 117, or in the proportion of about 9 in 11 ; and the 

* The case 19 b is erroneously marked in the Table as dividing on the second 
instead of the third vertebra. 

*f* " In prseparato quodam, in quo ren sinister deerat, arteria aorta inferior postquam 
arteriam renalem dextram dederat in duos ramos sequales dividebatur, a quorum 
sinistro oriebatur arteria mesenterica inferior, sub hac duo illi rami per alium trans- 
versalem inter e communicabant, deinde ramus sinister arteriam iliacam externam et 
internam sinistram formabat ; ramus vero aortse inferioris dexter arteriam iliacam 
externam et internam dextram constituebat. " Sylloge Observ. Anatom. Select., . 77, 
in Haller. "Disputat. Anatom." t. vi. p. 781. 



THE PHRENIC, OR INFERIOR DIAPHRAGMATIC ARTERIES. 417 

cases in which it occurred beyond th,e limits stated diminish 
rapidly in number as they depart from them.* 

In general, the end of the aorta is placed on the vertebra 
a little to the left of its middle, or to the left of what is called 
the middle line of the body ; but I have frequently observed 
it lying on the middle of the bone, without any deviation to 
either side, and in a few instances it was inclined to the right 
of that point (see plate 56). 

BRANCHES OF THE ABDOMINAL AORTA. 

Inasmuch as the peculiarities that take place in the 
branches derived from the aorta in the abdomen cannot be 
considered to have material influence with respect to the 
performance of surgical operations, I have not thought it neces- 
sary to make systematic or continuous observations on their 
arrangement. From time to time, however, the condition of 
a small number was marked in my note-book, and from these 
the following observations are drawn. 

THE PHRENIC, OR INFERIOR DIAPHRAGMATIC ARTERIES. 

The course of these arteries is represented in plates 53 and 
54. It must be premised that the following statement of 
their disposition is deduced from the observation regularly 
written down of only a small number (thirty-six). 

In their place of origin, the phrenic arteries were found to 
vary extensively, and they were given so frequently from a 
single or common trunk, that they may be placed in two 

* It is perhaps necessary to observe, in connexion with the foregoing observations, 
that the upper margin of the crest of the iliac bone is far from ranging with the same 
part of the lumbar vertebrae in different bodies. This fact will be evident on 
examining the figures referred to in the text (plates 53, 54, 56). With the view of 
illustrating it still further, I have, while writing these remarks, carefully observed, 
with reference to the point in question, six bodies of adults in the dissecting-room 
(skeletons or dried preparations are, for obvious reasons, inadmissible for the purpose), 
and they gave the following results : 

1. Male. The highest part of the crista ilii is opposite the upper margin of 4 h. vert. 

2. Female. " opp. the space betw. upper margin and middle 4 h. 

3. Male, opposite middle . . . . . 4 h. 

4. Male. " opposite middle . . . . 4 h. 

5. Female. " opposite lower margin . . . . 4 h. 

6. Male. opposite upper margin . . . 5 h. 

Q Q 2 



418 THE PHRENIC, OR INFERIOR 

classes, founded on its presence or absence. The first and most 
numerous class will consist of those cases in which the arteries 
of the right and left side arise separately one from the other ; 
in the second class will be comprised those in which a single 
small trunk gave origin to the two arteries. 

A. Where the two phrenic arteries arose separately, they 
were in some instances found to proceed from the same 
source, while in others, on the contrary, they emanated from 
different sources, as follows : 

1. Both arising separately from the same parent vessel were found to spring 
from the coeliac (plate 53, and 58, figure 4), in . . .4 cases 
from the aorta (plate 54, and 57, figure 3), in . . . . 1 " 
from the coronary artery of the stomach . . . . 1 " 
from the renal (plate 56, figure 5) 1 " 

2 Both arteries having origin from different sources they were thus disposed: 

One was given from the aorta, the other from the coeliac in . 6 cases 
from the aorta and the coronaria ventriculi (coeliac 

wanting in the case) 1 " 

from the coeliac and the coron. ventric. . . . . 2 " 

from the coeliac and renal 1 " 

from the coeliac and superior mesenteric . . . . 1 " 
from the coeliac (com. trunk of coron. ventric. and 
splenic), and the hepatic (this being given separately 

from the aorta) 1 

B. When both arteries arose by a single or common trunk, 
this was observed to issue either from the aorta or from the 
coeliac artery, and the number for each was 

From the aorta 12 

From the coeliac . 5 (plate 56, figure 6). 

The common trunk of the former of these two sets of cases 
was found to be connected with the aorta below the margin 
of the diaphragm in seven instances ; while in the rest 
(five) its commencement was covered by the diaphragm, 
and the division of a small portion of the muscle was 
necessary to display it fully. These conditions are illustrated 
in plate 57, figure 5, and plate 56, figure 4. 

Summary. The foregoing facts may be abridged as fol- 
lows : 

The right and left phrenic arteries either arise separately 



DIAPHRAGMATIC ARTERIES. 419 

one from the other, or they take their origin from a small 
trunk common to both, from which they speedily separate to 
their respective destinations. Among thirty-six cases, the 
former arrangement prevailed in nineteen, and the latter in 
seventeen. 

The phrenic arteries being given separately, and from 
different sources : One was furnished with more frequency 
from the coeliac than from any other artery ; the other was 
derived occasionally from one of the neighbouring large 
branches, but most frequently from the aorta itself. And 
both arising separately and from the same parent vessel : the 
place of origin was found to vary in different cases, but in a 
majority the coeliac artery was their source. 

The arteries of both sides taking their rise together from a 
single or common trunk : this was derived in two thirds of 
the cases from the aorta, and in the remainder from the 
coeliac. 

A few peculiarities of less frequent occurrence, which have 
fallen under my observation, and are not referred to in the pre- 
ceding remarks, maybe briefly noticed. The phrenic artery of 
the left side arose from the posterior aspect of the aorta in 
one case. There was a considerable difference in size between 
the arteries of both sides, the right being considerably the 
larger. One example of this peculiarity was observed. The 
right branch arose from the left side of the aorta and crossed 
above the cceliac to its proper position. It supplied branches 
to both the supra-renal capsules. The artery of the right side 
arose singly under cover of the diaphragm and passed forward 
through the fibres of this muscle, a little above its lower margin. 
Lastly, an example of a third phrenic artery occurred in the 
body marked 261 in the table. The additional branch was 
supplied by the left hepatic, and crossed the liver, with which 
it was in contact, in front of the Spigelian lobule. It is 
sketched in plate 56, figure 6. 



420 

CCELIAC ARTERY. CCELIAC AXIS. 

This artery is shown in plates 53 and 54, in which it is seen 
to be very short and thick and to divide at the same point 
into three branches, viz., the coronary artery of the stomach, 
the hepatic and the splenic. The divergence or radiation of 
these arteries from nearly the same point, gives rise to the name 
" axis," applied to the common trunk. The cceliac frequently 
gives origin to one and occasionally to both the phrenic arteries. 

The peculiarities of the coeliac artery which have come 
under my observation are the following : 

The origin was in a few instances found to be covered by a 
small part of the diaphragm. 

The artery was longer than usual in several instances, 
measuring about an inch and a half, and then the large 
branches did not separate from it at the same time. The 
branch for the stomach arose first, and the coeliac ended by 
dividing into the hepatic and splenic nearly in the manner 
sketched in plate 56, figure 4. 

In some cases the artery was smaller than usual, and 
furnished only two branches, viz., the splenic and coronaria 
ventriculi ; the hepatic being given from another source 
plate 56, figure 6. In a small number the analysis proceeded 
still further, and, the three branches arising separately from 
the aorta, the coeliac artery, did not exist. This peculiarity 
is represented in plate 57, figure 3. 

The opposite change to that noticed in the last paragraph, 
namely an increase in the number of the branches furnished 
by the coeliac artery, is but rarely met with. The examples 
that have come under my notice may be referred to a prema- 
ture division or splitting of one of the ordinary branches both 
the resulting parts being implanted on the coeliac. Thus the 
gastro-duodenal artery, usually a branch of the hepatic, has 
been found to arise from the coeliac, close to the hepatic ; and 
the coronaria ventriculi has occurred as two distinct branches, 
taking separate origin from the "axis." Under the same 
head may perhaps be mentioned the connexion at their origin 
between the coeliac and superior mesenteric arteries, of which 
I have seen a few examples. 



421 



CORONARY ARTERY. ARTERIA CORONARIA VENTRICULI. 

This artery, usually a branch of the coeliac, has, in a few 
instances, been observed to arise directly from the aorta, 
(plate 57, figure 3,) and it has been given from the coeliac 
in two separate parts. It not unfrequently furnishes a large 
branch to the liver. 

HEPATIC ARTERY. 

The name applied to this artery imperfectly expresses its 
destination ; for, after proceeding transversely to the right side 
for the space of a couple of inches, the trunk divides into two 
nearly equal parts, and one of these ascends towards the liver, 
being, therefore, the proper hepatic portion ; while the other, 
named the gastro-duodenal, turns downwards, and is distri- 
buted to the stomach with the great omentum, the duode- 
num and a part of the pancreas. See plates 49 and 50. The 
two divisions of the main artery (hepatic and gastro-duodenal) 
I have in a few instances (three) observed to take their rise 
separately from the cceliac. 

The most frequent change from the usual place of origin of 
the hepatic artery is its transference from the coeliac to the 
superior mesenteric (plate 56, fig. 6). It was found also to 
arise immediately from the aorta ; and this occurred when 
the splenic and coronary branch of the stomach took their 
origin separately in the same way (plate 57, figure 3), and 
likewise, though more rarely, when these arteries were given 
from a common trunk. 

An additional hepatic branch is often supplied by the coro- 
naria ventriculi to the left lobe of the liver. 

In one instance a supplemental or third phrenic artery was 
furnished from the left hepatic branch. It proceeded towards 
the middle of the diaphragm, in contact with the lower surface 
of the liver (plate 56, figure 6). And, likewise in a single case, 
one of the ordinary arteries of the diaphragm was given from 
the hepatic near its origin ; the hepatic being at the same 
time derived directly from the aorta. 



422 



SPLENIC ARTERY. 

The distribution of the splenic artery is displayed in plates 
49 and 50. The observations made with reference to the 
sufficiency of the designation of the hepatic artery, apply 
equally to this, for a considerable part of it is distributed to 
the organs which the hepatic supplies, with the exception of 
the duodenum. 

I have not remarked any peculiarities of the splenic artery 
which could be considered worthy of notice for the purposes 
of this work, excepting the change in the place of origin 
already referred to in the remarks on the coeliac artery, 
namely, the origin from the aorta, distinctly from other 
branches. 

SUPERIOR MESENTERIC ARTERY. 

This large artery and its branches are represented in plate 
51, and a specimen of the arrangement of its smaller branches 
is given in plate 50, figure 2. The branches furnished to the 
small intestines and to the transverse colon, lie between two 
layers of the peritoneum in their course to the intestine; 
those which supply the ascending colon are on the other hand 
covered only on the anterior surface by the serous membrane. 
The superior mesenteric is occasionally connected at its origin 
with the coeliac artery. In many instances the hepatic 
artery will be observed to spring from it, (plate 56, figure 6). 
I found the gastro-duodenal in one case a branch of the 
superior mesenteric. 

INFERIOR MESENTERIC ARTERY. 

The origin of the inferior mesenteric artery, and the 
branches furnished to the colon, are shown in plate 52 ; the 
pelvic part (haemorrhoidal) will be found in plates 59 and 60. 
Some of the branches of this artery lie between two laminae of the 
peritoneum, namely those distributed to the sigmoid flexure of 
the colon, and the commencement of the rectum ; the branches 
supplied to the descending colon are placed behind the 



RENAL ARTERIES. 423 

peritoneum, lying between that membrane and a layer of 
laminated cellular membrane,* (plate 52, e, e,) and the hge- 
morrhoidal branch has no connexion with the peritoneum as 
it approaches the lower end of the rectum, (plate 59", and 
plate 60 8 .) The place of origin of the inferior mesenteric 
artery has some connexion with the surgical anatomy of the 
lower part of the aorta, and on this account its distance from 
the bifurcation was in some cases marked in my notes. I 
subjoin an abstract of them. 

The space between the origin of the inferior mesenteric 
artery and the bifurcation of the aorta, was 

less than 1 inch in 5 cases 

1 inch in 10 

more than 1 inch, not exceeding 1 . in 48 
more than 1^ inch, not exceeding 2 . in 13 
more than 2 inches, not exceeding 2 in 4 

80 

The greater intervals placed at the lower part of this 
summary those, namely, in which the space of two inches and 
upwards intervened between the origin of the inferior mesen- 
teric and the end of the aorta coincided, for the most part, 
with the low division of the aorta, referred to in the observa- 
tions on the great artery. 

RENAL ARTERIES. 

The single artery which usually occurs on each side, divides 
into branches before entering the " hilus " of the kidney (plates 
53, 54). Between this condition and the increase in the number 
of the renal arteries, a gradation, or what may be considered 
such, is recognisable in different cases. Thus: the sub- 
division into branches increases, and it occurs at different 
points nearer to the origin of the artery. Of these changes 
various degrees are illustrated in plates 53, 54, and 56, 
figure 5. 

* It may not be unnecessary to mention, that Professor Tiedeinann in his plates of 
the ordinary disposition of the mesenteric arteries, unaccountably represents the right and 
left colic branches as having behind them as well as in front, an extensive layer of 
peritoneum both layers apparently stretching from the aorta to the intestine. See his 
"Tabulae Arteriarum," tab. 23, and 24, with the explanation of the plates. 



424 RENAL ARTERIES. 

Increase of number. From the arrangement represented in 
the figure last referred to, where the renal artery divides 
close to its origin, we are conducted to the augmented number 
of arteries. They may be found to be two, three, four, or 
five the highest numbers being the least frequent in their 
occurrence, (plate 57, figures 1, 2, 3, 4). I have not made 
observations to determine the proportionate frequency of the 
examples of the single and multiple condition of these arteries ; 
and I can only say, with reference to this point, that the devi- 
ations from the ordinary state (singleness), are very common. 

There is no correspondence in the number of branches met 
with on the two sides of the body. Indeed, the differences 
between their state on the right and left sides are so various, 
that every possible combination may be met with even in an 
inconsiderable number of bodies. In one case an increase of 
the number occurs on one side only on the right side in it 
represented in plate 57, figure 3 ; on the left side, in the 
second figure of the same plate. Again, the increase may 
exist on both sides at the same time, the number being equal, 
as illustrated in plate 57, figure 1 ; and lastly, the augmenta- 
tion existing on both sides, the number may be unequal. 

The place of origin. The renal arteries, even when con- 
siderably augmented in number are usually derived from the 
aorta, and as they are for the most part separated by inter- 
vals at their origin, the lowest is often implanted near the 
bifurcation of the great artery. In some rare cases, a renal 
branch has been found to proceed from the common iliac 
artery, as shown in plate 57, figures 3 and 4 ; and even from 
the internal iliac. Of the last peculiarity I have not hitherto 
met with an example ; one is figured in the posthumous work 
of Eustachius.* 

The arteries take their rise from the lateral aspect of the 
aorta ; and deviations from this position are very rarely met 
with. In one case mentioned by Portal, t the right and left 
renal branches were derived from a common trunk, springing 

* " Tabulae anatomicec * ( quas e tenebris tandem vindicatas * * prac- 
fationo ac notis illustravit, I. M. Lancisius." (Tabula tertia). 

f Cours d' Anatomic Medicale," &c., t. 3, p. 290. Faiis, An 121803. 



SPERMATIC ARTERIES. 425 

from the fore part of the aorta, at a very short distance from 
the superior mesenteric. In another which came under my 
own observation, one of several renal arteries was connected 
with the fore part of the aorta at its bifurcation, or with the 
fore part of the left common iliac artery at its origin. See 
plate 57, figure 3. 

Their entrance to the kidneys. The branches of the renal 
artery usually enter the depression on the inner side of the 
kidney. When, however, the number of arteries is increased, 
a branch will not unfrequently be observed to enter through 
the convex part near the upper or lower end of the organ. 
A still further change from the ordinary condition is occasion- 
ally met with. This consists in the enlargement of the " hilus," 
or depression which spreads to the anterior surface of the 
kidney, and receives the vessels at different points, as repre- 
sented in plate 57, figures 2, 3, 4. In one instance, I found 
an artery pass behind the kidney, and turn round the outer 
margin to arrive at the anterior surface, where it penetrated 
an extended depression of the kind mentioned, (figure 3). 
It will be observed, that the ureter is likewise connected to 
the fore part of the kidney in these cases. 

Absence of one artery. A few examples of the absence of 
one of the renal arteries have been recorded. I have met 
with only a single instance. 

SPERMATIC ARTERIES. 

The origin of the spermatic arteries, and their course as 
far as the entrance to the inguinal canal, are seen in plate 53 ; 
and one of them is represented in connexion with the sper- 
matic veins in plate 55. The distribution of the analogous 
artery (ovarian) in the female will be found in plates 59 and 63. 
I Instead of a single branch on both sides, two are not un- 
frequently met with on one side. Both are in general given 
from the aorta, but occasionally one is derived from the renal 
artery. An example of three spermatic branches is repre- 
sented in plate 57, figure 5 two arising from the aorta, the 
third from the renal. 



426 



AN UNUSUAL PULMONARY BRANCH. 

Besides the branches to the viscera and the muscles of the 
abdomen, the abdominal aorta was in one instance found to 
furnish an artery to the lungs. As it was of large size, and 
could not be regarded as a nutritious vessel, this artery 
must be considered to be in more than one respect remark- 
able. It was thicker than the coeliac artery, was in contact 
with that vessel at its origin, and gave off the right phrenic 
branch. After entering the thorax by the oesophageal opening 
of the diaphragm, this singular artery divided equally between 
both lungs, supplying their lower parts or bases, and anasto- 
mosing by small branches with those of the proper pulmonary 
artery, which had the ordinary disposition.* This malforma- 
tion was found in the body of a child aged seven years. No 
information could be got concerning the state of health during 
life ; but it is mentioned that the general conformation of the 
body was good affording no indication of continued ill health. 

VENA CAVA INFERIOR. 

Preparatory to mentioning some of the peculiarities of this 
vein, it will be enough for the purpose of comparison to say 
of its usual disposition, that commencing on one of the lowest 
lumbar vertebrae, where it results from the junction of the two 
common iliac veins, it lies to the right side of the aorta (plate 
55) ; receives the lumbar, the right spermatic, the renal and 
hepatic veins; perforates the tendinous centre of the dia- 
phragm, and ends in the right auricle of the heart. It is 
considerably longer than the abdominal part of the aorta. 
The greater length is owing to the shape of the diaphragm, 
and the situation of the openings through it for the vessels. 
The artery passes from the thorax to the abdomen, through, 
or rather behind, the lowest part of the muscular partition 
interposed between these cavities, while the vein perforates it 

* " Description d'une art&re pulmonaire considerable, naissaut do 1'aorte abdomi- 
nale, publi6e par A. Maugars d'Angers, etudiant en medecine," in the "Journal dc 
Me'decine, Chirurgie, Pharmacie, j&c., par les Cens. Corvisart, Lcroux et Boyer." 
Paris, An 10. 



VENA CAVA INFERIOR. 427 

at the highest or most convex part (see plate 53, and espe- 
cially plate 54). At the lower end, als6, the vein extends a 
little farther than the other vessel. 

Peculiarities of the vena cava inferior. The deviations from 
the usual conformation, which are various in their forms, though 
unfrequently met with, may be arranged into two series, 
according to the manner of the termination of the great vein. 
In one series will be placed those cases in which the vein ends 
in the heart in the ordinary way, and in the other will be 
ranged those in which it terminates in the vena cava superior. 

A. The vena cava inferior having the usual mode of termi- 
nation, is found to vary in its origin and course as follows : 

1. The two common iliac veins do not join, and the vena 
cava is not fully formed in the usual position. Instead of 
crossing, as ordinarily happens, to the right side to unite with 
the vein of the opposite side, the left common iliac vein, after 
sending a communicating branch across, where in the ordinary 
course it ends altogether, ascends on the left side of the aorta, 
and joins the left renal vein. The aorta, therefore, below the 
point at which it is crossed by the conjoined left iliac and 
renal veins, lies between two large venous trunks ; and in 
strictness it might be said, that the vena cava exists only at 
the upper part of the abdomen, while the common iliac veins 
have much more than their accustomed length. Examples of 
this disposition of the veins cannot be said to be uncommon. 
One of several which I have met with has been sketched in 
figure 4, plate 58. 

2. The two iliac veins are occasionally joined on the left 
side of the aorta, and the .vena cava continues for some space 
on the same side ; but after receiving the renal vein, it crosses 
over the great artery, and takes its ordinary place below the 
liver. This peculiarity is, according to my observation, much 
less frequent than that before described. A representation 
of it is given in plate 58, figure 2. 

3. The vena cava is formed, as in the preceding case, on 
the left side, and continuing in its whole course on the same 
side, it reaches the heart without any change in direction ; 
that organ, with others, having undergone the same change 



428 VENA CAVA INFERIOR. 

of position with the vessels. This alteration in the position of 
the vein is only met with under the circumstances indicated, 
namely, when the viscera of the thorax and abdomen are trans- 
posed. The figure 3 in plate 58 has been drawn from a case 
of this kind. 

B. Of the second class of the peculiarities of the vena 
cava inferior the most simple is 

1. That in which, the common iliac veins joining in the 
ordinary way, the great trunk resulting from their union 
enters the thorax without receiving the hepatic veins, and 
after being joined by the intercostal veins, turns forward 
above the root of the right lung to terminate in the vena cava 
superior. It is obvious that the large venous trunk of this 
case (except in so far as the hepatic veins are concerned,) 
represents the vena cava inferior and the vena azygos. See 
plate 5, figure 5. Examples of this conformation of the veins 
have been recorded by Abernethy* and Dr. Horner.-f- 

For the modifications of the large prse vertebral vein, which 
characterises this class of cases, we are prepared by some of 
the peculiarities noticed in the preceding class, to which they 
will be found to present a close analogy, thus : 

2. The common iliac veins are united on the left side of 
the aorta, and the large vessel formed by their union (vena 
cava), having entered the thorax on that side, turns behind 
the aorta and the thoracic duct, to the less anormal position 
on the right side, and terminates as in the preceding case. 
It is obvious that here the vena cava follows the course suc- 
cessively of the vena azygos minor and vena azygos major ; 
and the latter, it will be observed, on inspection of the 
figure, had its ordinary size below the place where it is 
joined by the great vein. The description given of this 
arrangement of the veins is taken from the case represented 
in the plate 58, figure 8.J In the same figure it will further 
be seen that the common iliac veins are not blended into a 

* Philos. Transactions, 1793. 

f Journal of the Academy of Natural Sciences of Philadelphia, vol. i. 
The case is described and figured by Gurlt, in an Essay to -which reference has 
already been made (ante, page 371), and likewise by Otto, in his " Neue seltene 
Brobachtungen. Zvveite Sammlung," S. 68. 



VENA CAVA INFERIOR. 429 

single trunk till they have reached upwards beyond the renal 
veins. In this respect their disposition accords with that of 
some cases included in the preceding class, but in the 
example before us, the trunk formed by the united renal and 
iliac veins of one side, crosses behind the aorta, not in front 
of it, as in the former. Compare the figures 4 and 8 of the 
plate last referred to. 

A preparation, showing nearly the same arrangement of 
the large veins, but having the usual disposition of the iliac 
veins, is said by Otto to be in the possession of Professor 
Jeffray, of Glasgow.* 

3. The large prevertebral vein has been found altogether on 
the left side, the vena cava superior having undergone a similar 
change of position. In this case the aorta and vena cava 
change places, and the change accompanies the general trans- 
position of the viscera. This condition of the vessels is in 
part represented in plate 5, figure 4. 

When the viscera are transposed, the relative position of 
the large blood-vessels, as might be expected, is likewise 
altered in the manner indicated in the last paragraph ; but 
there has been placed on record a case which is exceptional 
in so far as the position of the vena cava inferior is concerned. 
In this instance, the viscera being transposed, the large 
iliac veins united on the right side of the aorta ; the common 
trunk (vena cava) continued into the vena azygos on the same 
side, and inclined towards the left side to join the vena cava 
superior, only at the upper part of the dorsal region (plate 58, 

figure 7).f ' 

The position the vein has with respect to the diaphragm requires 
some notice. Inasmuch as the large vein, which belongs to 

* Einen gauz ahnlichlen Fall, der, so viel ich weiss, noch nicht beschrieben ist sah 
ich vor mehreren Jahren in der kleinen anatomischen Privatsammlung des Professor 
Jaffry (Jeffray ?) in Glasgow, nur mit dern Unterschiede, dass die vena cava, an ihrem 
unteren Ende nicht so friih, xvie in dem von mir beobachteten Falle, gespalten war, 
und dass noch eine eigene grosse vena hemiazygos vorhanden war, die sich in die linke 
vena jugularis thoracica nalie vor deren Theilung einrniindete. Ibid. S. 69. 

*f* " Beskrivelse over et menneskeligt Misfoster, &c. af. J. D. Herholdt," p. 11. 
Kjobenhvan, 1828. When referring to the figure of the veins, in the description of 
the plates (ante, page 370), I was acquainted with this case only through the notice of 
it in the work of a German author. Since then, my attention has been kindly 
directed to a copy of the original essay in the library of the College of Surgeons, by 
Mr. Lawrence, who placed it in that library. 



430 VENA CAVA INFERIOR. 

and characterises the second of the two classes of peculiarities 
here recognised, is at a certain point a large vena azygos, it 
would be expected to pass from the abdomen to the thorax in 
the place this (azygos) vein occupies under ordinary circum- 
stances. Such is reported to have been its position in Otto 
and Gurlt's case, and such also was its position in Mr. 
M'WhinmVs, as I have been informed by that gentleman. 
But Mr. Abernethy states of his case, that " The inferior 
vena cava past, as usual, through a tendinous ring in the 
right side of the centre of the diaphragm; it afterwards 
pursued the course of the vena azygos, the place of which it 
supplied." 

The peculiarities of the veins referred to the manner of their 
growth. The varied conformation of the veins mentioned in 
the preceding pages is to a great extent explicable by reference 
to the early conditions of the venous system, and the succes- 
sion of changes which takes place during its development. It 
is clearly ascertained that in mammiferous animals there are 
at an early state of growth two principal veins placed longi- 
tudinally one at each side of the vertebral column; and they 
receive the veins from the rudimentary lower limbs. But the 
blood from the limbs is subsequently diverted into the vena 
cava inferior, through anastomosing branches (iliac), and the 
symmetrical, longitudinal, or " cardinal " veins diminishing in 
proportional size and importance, are eventually represented 
by the " azygos" veins, 

The formation of the vena cava inferior is complex, and, so 
far as the facts have been ascertained, appears to take place 
as follows. A vein is developed opposite the lumbar part of 
the vertebral column, and between tlie Wolffian bodies, from 
which, and from the genital and urinary organs, it receives 
branches. To the lower part of the venous trunk, now 
referred to, the blood of the crural veins is, at a certain period, 
directed through anastomosing branches, which become the 
iliac veins, and its upper part joins at the liver with the 
omphalo-mesenteric vein, in which the hepatic veins terminate. 
When the development follows the course here indicated, it 
leads to the ordinary disposition of the vena cava and the 
manner of growth being different, if its stages should 



HEPATIC VEINS. 431 

be interrupted at any point of their progress, a deviation from 
that state will be the result. Thus : supposing the lower or 
geni to-urinary part of the vena cava to have received through 
the iliac veins the blood of the lower limbs, while, instead of 
being completed above by connexion with the other visceral 
veins at the liver, it pours its contents into a "cardinal vein" 
by one of the anastomosing branches which connect them, 
we should have the arrangement pointed out at page 428, 1, 
and sufficiently illustrated in plate 58', figure 7 ; or if it con- 
tinues partly into one and in part into the other of the same 
veins, the twisted course described at 2 in the same page, 
and figured at plate 58, figure 8, will be the result. And these 
peculiarities will therefore be regarded as the consequence of 
an " arrest of the development," or an interruption to the 
ordinary course of the development, of the vena cava inferior.* 

HEPATIC VEINS. 

When the vena cava inferior has the conformation usually 
met with, it receives the large veins by which the blood is 
conveyed from the substance of the liver. A remarkable 
case, which is in part exceptional, has been put on record. 
In the body of a man who had attained the age of fifty-one, 
and had been generally healthy during the greater part of his 
life, Rothe, a German military surgeon, found one of the 
large hepatic trunks, terminating not in the vena cava or even 
in the auricle of the heart, but in the right ventricle, and its 
opening in that cavity was guarded by valves. t There were 
in this instance, therefore, two veins in the situation of the 

* For a detailed account of the development of the venous system, reference may 
be made to Rathke, (Meckel's "Archiv." for 1830), and especially to the Essay of Stark 
(' Commentatio de Venae azygos vi atque munere ") in which the peculiarities met 
with in the vein forming the subject of the Essay, are associated with the manner 
of its growth. A concise statement of the facts ascertained concerning the development 
of veins will be found in Miiller's " Elements of Physiology," transl. by Dr. Baly, 
p. 1625, and in Burdach's " Physiologic," t. 3, p. 522 of the French translation. 

f* " Historia duplicis venae cavse inferioris, seu ascendentis, et insolitas dilatatae 
auriculae cordis dextrae." In the " Acta Academise Caes. Reg. Josephinse Medico- 
Chirurg. Vindobensis," T. 1, p. 233 and tab. 5. Vindobonse 1788 It should be 
stated, that the person in whose body this very unusual conformation of the vessels 
was found, appears to have died in consequence of disease of the two organs more 
immediately concerned with the peculiar disposition of the veins, namely, the Heart 
and the Liver. The time at which the diseased condition began to manifest itself is 
not mentioned ; but it is to be inferred that it was not till towards the close of life. 

R H 



432 VENA CAVA. 

inferior vena cava ; but I cannot, with the author of the 
paper in which it is described, regard it as an example of 
double vena cava.* 

In those cases in which the vena cava inferior ends in the 
superior cava, the hepatic veins open into the right auricle in 
the usual position of the great vein. And they generally unite 
into a single trunk before their termination ; but in the pre- 
paration described by Dr. Horner there appear to have been 
two separate openings into the auricle. In his account of 
the case, these words occur: " The hepatic veins empty into the 
inferior part of the right auricle at the usual place of the 
inferior cava. The right hepatic vein passes in singly, the 
middle and left form a trunk." t 

VENA. CAVA SUPERIOR. 

As no more suitable occasion can occur in the sequel of 
this work, a deviation from the usual arrangement of the 
principal veins of the upper part of the body may be noticed 
here, though not strictly the proper place. The innominate 
veins, which usually join to form a single trunk (vena cava 
superior), have, in several instances, been found to open sepa- 
rately into the right auricle. In these cases, the vein of the 
right side holds the ordinary course of the vena cava ; but 
that of the left side^ after sending a transverse branch to 
the former, extends downwards to the heart, and, turning 
round the left side of this organ, opens into the posterior 
part of the right auricle, in connexion with the coronary 
vein. This peculiarity is illustrated in plate 58, figures 6 
and 10. 

It is interesting to observe, that the conformation of the 
veins here described is the persistence of one which always 
exists at an early period of development in the human body ; 
and that an analogous disposition is permanent in birds, 
and some of the mammalia, as the rabbit and elephant. 

* I am not acquainted with any instance of what could strictly be considered a 
double vena cava inferior in the human subject. A well marked example found 
in a dog, has been figured by Kerkringius (" Observat." 29, pi. 11). The vena 
cava above the liver, is shown divided or split into two equal parts, which reunite 
immediately below the auricle of the heart. Instances of similar division in several 
oilier large veins, occurring in the human body, are mentioned in this work, 
f Loc. citat. p. 402. 



THE COMMON ILIAC ARTERIES. 433 

A pulmonary vein, joining the vena cava superior. A large 
pulmonary artery, derived from the aorta, having been men- 
tioned in a former paragraph (page 426), we may here notice 
an example of a conformation to a considerable extent similar 
occurring in the venous system. The right pulmonary veins 
terminated altogether in the superior cava. The subject of 
this singular departure from the usual course of things was 
an adult ; and it is stated that the malformation appeared 
not to have been attended with any disturbance of the healthy 
functions.* 

THE COMMON ILIAC ARTERIES. 

These arteries are shown in their natural position, but 
without the veins, in plates 53 and 54 ; with their accom- 
panying veins they will be seen in plate 55. 

The position of their origin. For the place at or opposite 
which the iliac arteries take their rise, it will be sufficient to 
refer to the place of division of the aorta, with which it obvi- 
ously must coincide; ante, page 415. 

The place of division, in different cases, is very various. The 
following summary will show, in a condensed form, its position 
in those contained in the Table. 

The artery divided on the 4th (in this case the last) lumbar ver- f R. 1 

tebra in \ L. 1 

2 

opposite the intervertebral disc between the 4th and 5th f R. 5 
lumbar vertebra . . . ,. .. ..,,.. \ L. 3 



JR. 4 

, 

On or opposite 



above the middle 

' - 8 
or opposite i f R 15 

the 5th / the middle, or nearly 60 ' . 'V J "" 1 " .-j L " g 

vertebra, ] ' 23 

below the middle . . ' ' ] L 

'31 
Opposite the intervert. substance, between the 5th vertebra and the JR. 12 

sacrum * . ...\L-.6 

-18 

{R 11 
L 16 
' 27 

* The case is delineated by I. F. Meckel in Fascic. 2, tab. 9, fig. 2, of his " Ta- 
bulae Anat. Pathol." It was met with, as he states, by his grandfather. 

R R 2 



434 



THE COMMON ILIAC ARTERIES. 



Below the margin of the sacrum, and down to the sacro-iliac articula- JR. 6 

tion, this included \ L. 14 

20 

r T> O 

Below the sacro-iliac articulation, and in the iliac fossa . 4 T ' A 

\L. 4 

It will be observed that the majority of these arteries divided 
between the middle of the fifth lumbar vertebra and the upper 
margin of the sacrum both these points inclusive ; the 
number contained in this interval was 99, while above it 
there were 1 8 cases, and below it 27. 

The artery of the left side most frequently descends to a 
lower level than the opposite. In the abstract, the arteries 
of the right side are most numerous at the upper part, while 
those of the left side preponderate towards the lower end. 
The latter, therefore, divide, for the most part, at a lower 
level than the former. 

The length is an important consideration in the anatomy of 
a common iliac artery, because if a ligature should be applied, 
with a view to the cure of aneurism, the space intervening 
between the ligature and either end of the vessel would mate- 
rially influence the result of the operation. The following is 
an abstract of the statements in the Table, with reference to 
this point. 



LBNGTH IK INCHES. 


Number 
on the 
right side. 


Number 
on the 
left side. 


Number on 
both sides. 


r ..-.....-. 


1 

3 


1 

4 


2 

7 


more than l,not exceeding 1 f . 
more than 1, not exceeding 2 % . 
more than 2, not exceeding 2 
more than 2, not exceeding 3 || . . . 
more than 3, not exceeding 3^ ^[ 
more than 3^, not exceeding 4 . . 
4 


20 
43 
43 
41 
16 
6 


17 
43 
48 
35 
18 
5 
1 


37 
86 
91 
76 
34 
11 
1 


4$** 


1 




1 












174 


172 


346 



* Illustrated in plate 57, figure 9, right side. 

f Plate 56, figure 3, left side Plate 57, figure 1, right side ; figure 7, both sides ; 
and figure 8, right side. 

t Plate 53, right side. Plate 56, figure 3, right side. Plate 57, figure 1, left 
side ; figure 3, left side ; and figure 9, left side. 

Plate 53, left side. Plate 54, hoth sides. Plate 55, both sides. Plate 56, 
figure 2, both sides. Plate 57, figure 6, right side. 

|| Plate 56, figure 1 , left side. Plate 57, figure 6, left side. 

If Plate 56, figure 1, right aide. ** Plate 58, figure 1. 



THE COMMON ILIAC ARTERIES. 435 

Thus it is shown : 

That the common iliac artery varies much in length. 

That in a large majority of our cases about five-sevenths, 
the number being 127 in 174 on the right side, and 126 in 
172 on the left side the length varied between an inch and 
a half and three inches ; and the cases were pretty evenly 
disposed over the different parts of that space. 

That one instance in eight measured within half an inch 
less than the length of the majority, varying between an inch 
and an inch and a half. And that about an equal proportion 
ranged within an inch above the average, measuring, there- 
fore, from three to four inches. 

The minimum of length recorded in the Table is three- 
fourths of an inch, the maximum four inches and a half (plate 
58, figure 1) ; and but a single example of each is mentioned. 
In one instance, I found the artery of one side no more than 
half an inch in length : this case is delineated in the eighth 
figure of the fifty-seventh plate. 

Relative length of the right and left common iliac arteries. 
Those anatomical writers who recognise a difference in this 
respect (e. g. Scemmerring after, as he states, Mayer and 
Walter Portal, Meckel, Harrison, and others,) represent the 
artery of the right side to be the longer. In our Table (page 
348, et seq.), the length of the arteries of both sides is men- 
tioned for 168 bodies; and, on comparing, in each of these, 
the measurement of the artery of one side with the other, 
they stand as follows with respect to their relative length. 

The arteries of both sides were equal in length in . . . . 53 
(This condition is illustrated in plate 56, fig. 2, and 57, fig. 7.) 

That of the right side exceeded the left in . . *- ' . '.' . 63 
(Plate 56, fig. 1, and 57, fig. 8.) 

The left exceeded the right in . . . . . . , . 52 

(Plates 53 and 57, fig. 1, 3, 6, 9.) 

In nearly a third, therefore, of these cases, both arteries 
were of equal length, and the difference existing in the re- 
mainder was somewhat more frequently in favour of the right 
than the left side. 

Where the arteries measured unequally, the difference be- 
tween them was in general small ; but instances from time to 



436 COMMON ILIAC VEINS. 

time occurred, which departed widely from this general state- 
ment, as exemplified in the eighth and ninth figures of the 
fifty-seventh plate. 

Absence of a common iliac artery. From the very early 
division of this artery, mentioned in a former paragraph, to its 
entire absence, the transition appears not to be difficult. Still 
no example of this condition has fallen under my notice, and 
the only one that I find to be recorded is mentioned by M. 
Cruveilhier. " In a preparation," says this anatomist, " con- 
tained in the Museum of the School of Medicine (of Paris), 
the right primitive iliac artery is altogether wanting; the 
aorta dividing into three branches, two on the right side, 
which are the hypogastric and the external iliac ; the other, 
on the left, is the primitive iliac, and this is disposed in the 
ordinary way."* 

Branches. The common iliac artery often gives to lym- 
phatic glands and the ureter or the psoas muscle a small 
branch of the kind delineated in plates 53 and 55. An offset 
of larger size (generally one of the lumbar arteries), is in 
some instances derived from it (plate 57, figure 6). 



COMMON ILIAC VEINS. 

The arrangement of the veins which accompany the common 
iliac arteries is shown in plate 55. 

The artery of the right side has more complicated connexion 
with veins than the left, for the latter has only its proper 
companion vein in its immediate neighbourhood, whereas the 
former has both the common iliac veins and the origin of the 
vena cava in contact with it. This arrangement is reversed 
where the vena cava is formed on the left side, as in cases 
described at page 427, et seq., and delineated in plate 58, 
figures 2 and 3. When the common iliac veins join at the 
upper part of the abdomen, instead of the usual position on 
the fourth or fifth lumbar vertebra, there is no material 
difference in the disposition of the veins with reference to the 
one artery and the other. 

* " Anatomic descriptive, par J. Cruveilhier." T. 3, p. 186. Paris, 1836. 



INTERNAL ILIAC ARTERIES. 437 

A common iliac vein is occasionally found to present what 
may be named a perforation, so that a space is formed through 
it, in which I have more than once observed a small artery to 
pass outwards. A larger extent of separation is sometimes 
met with, the trunk being parted into two equal divisions, 
which again coalesce after lying distinct and close one to the 
other for some distance ; in this case the common iliac vein 
is in great part double. The two peculiarities now noticed, 
which may be considered different degrees of the same 
arrangement, are delineated in plate 58, figures 5 and 6. 

INTERNAL ILIAC ARTERIES. 

The usual course of the internal iliac artery is shown in 
plates 53 and 54, and the connexion with veins in plate 55. 

The Length of this artery is worthy of particular attention, 
for the same reason that the length of other of the shorter 
arteries is so, viz. because the free space at each side of a liga- 
ture may determine the event in an operation for aneurism. 
Moreover, assuming other circumstances to be the same, (the 
place of division for example,) this additional importance 
attaches to the length of the internal iliac, namely, that, when 
short, it is deeply placed in the back part of the pelvis ; whereas, 
when the length is more considerable, a portion of the artery is 
likely to lie above the pelvic cavity, and therefore would be 
more easily accessible to the surgeon. 

The following summary of the table will show the length in 
inches of 297 cases : 

Not exceeding f inch . . . . . 7 (plate 58, fig. 1). 

More than ^, and less than 1 inch . . . 16 

1, and not exceeding 1$ ', . r -. ? ..., . 195 (about of the entire 

number plates 56, fig. 3 ; 57, fig. 6). 

More than 1^, not exceeding 2 . . . 57 (plate 56, fig. 1 and 2) 

More than 2, not exceeding 2 - . . 18 (plate 57, fig. 7 and 9) 

More than 2A, not exceeding 3 . . . . 4 

297 

The place of division varies considerably. It may be found 
as low as the margin of the sacro-sciatic foramen, as high as 
the upper margin of the sacrum, or at any intervening point. 
And the length withm the pelvis, of the large branches (glu- 



438 INTERNAL ILIAC ARTERIES. 

tial, sciatic, pudic), is inversely as the depth at which the 
parent trunk divides. The division is close to the sacro- 
sciatic foramen in plate 56, figures 1, 2, 3, and plate 57, 
figure 7 ; it is opposite the base of the sacrum in plates 59 
and 60 ; and it occurs between those two points in plate 58, 
figure 1. 

The place at which the internal iliac artery divides or gives 
off its large branches, is not devoid of interest in practical 
surgery, inasmuch as it is obvious that, if in two cases of 
equal lengths, the vessel divides in one opposite the inlet to 
the true pelvis, while in the other it sinks deeply into that 
cavity before dividing, the former would be reached with 
much more ease in a surgical operation. Two cases men- 
tioned in my notes may be mentioned in illustration. The 
internal iliac of both measures an inch and a half. But, in 
one this artery leaves the external iliac nearly at a right angle, 
dips at once into the true pelvis, divides into branches near the 
sacro-sciatic notch, and may be said to be altogether in the 
pelvic cavity. In the other case, the internal iliac arising 
higher, lies parallel with the external iliac and close to this 
artery in the greater part of its length, and divides on a level 
with the upper margin of the true pelvis. 

Relative lengths of the Arteries of the right and the leftside. A 
comparison of the internal iliac arteries one with the other 
in 137 bodies afforded this result : 

Both measured equally in . . .48 

The right exceeded the left in . . . . 41 
The left exceeded the right in ... 48 

137 

Neither artery, therefore, habitually exceeds the other in 
length. It is shown that in a third of a considerable number 
of instances the lengths of both were equal, and that where 
a difference existed it was as often in favour of one as of 
the other, or nearly so. 

Though a difference of length is observable in the greater 
number of bodies, it is for the most part inconsiderable in 
amount. Still we occasionally fall on examples of striking 
contrast, such as are represented in figures 8 & 9 of plate 57* 



INTERNAL ILIAC ARTERIES. 439 

The Branches. The internal iliac artery, in most cases, 
divides into two large parts, (one example, among many, will 
be found in plate 58, figure 1,) from which, branches are dis- 
tributed to the viscera of the pelvis, and to the muscles con- 
nected with it, especially those on the posterior aspect. The 
branches not unfrequently take their rise without the occur- 
rence of previous division of the trunk (plate 63, figure 3.) 

There are in many cases one or more branches given from 
the artery, above its division. A branch so placed requires 
especial notice, because of the effect it might have in the 
event of a ligature being applied to the main vessel, and its 
presence was always looked for in the cases set down in the 
Table. One such branch was found in eighty instances more 
than a fourth of the entire number noted and it took its 
rise from various parts of the trunk, thus : 

A single branch arose from the trunk above its middle in .16 

" " at the middle or nearly so 44 (Plate 57, 

fig. 3 ; and 65, fig. 7). 

" below the middle . . 20 (Plate 56, 

fig. 3). -80 

In a few instances (ten are marked in my notes) two 
branches were given in the course of the internal iliac artery, 
as illustrated in plate 57, figure 6 ; and in a smaller number, 
more than two presented themselves, an example is afforded 
by the case delineated in plate 56, figure 1. 

The branch most frequently found to arise in the manner 
here adverted to, namely, from the trunk before its division, 
was the ilio-lumbar ; the lateral sacral, and a visceral branch 
were likewise observed to occupy a similar position, but much 
more rarely. 

Returning now to the branches furnished from the two 
primary divisions of the trunk: They are numerous, and 
take their origin in an unusually small space. The visceral 
branches of the female pelvis are delineated in plate 59 and 
plate 63, figure 3 ; those of the male are contained in plate 
60, and plate 63, figure 2. And the distribution of the 
branches to the gluteal and other muscles on the posterior 
aspect of the pelvis are represented in plates 76 and 77. 



440 PUDIC ARTERIES. 

The vesico-prostatic, the pudic, and the obturator arteries 
being the only offsets of the internal iliac which have important 
bearings on some of the ordinary operations of surgery, will 
alone receive detailed observation in this work ; moreover, as 
it is when emanating from the epigastric that the position 
of the last named of these vessels has particular interest for 
the surgeon, the remarks on it will be more appropriately 
placed in connexion with the study of that (the epigastric) 
artery. 

Internal Iliac Veins. The internal iliac artery is deli- 
neated in its usual connexion with the internal iliac and the 
external iliac veins in plate 55. I have more than once seen 
the internal iliac vein double, and the artery placed over or 
between the two parts. One such case has been sketched in 
in plate 58, figure 6. 

PUDIC ARTERIES.* 

The pudic artery and branches of the female body are 
represented in plates 59 and 63, figure 1 ; those of the male 
in plates 60 and 63, figure 2. A view of a small portion of 
the same vessel, obtained by dissecting on the posterior sur- 
face of the pelvis, is contained in plates 76 and 77 ; and the 
position of the branches, as well as of the artery itself in the 
perinseum is displayed in plates 61 and 62. 

The origin of the pudic artery is from the anterior division 
of the internal iliac, and usually in connexion with the sciatic. 
The place at which it separates from this (the sciatic) varies, 
being in one case high in the pelvis and not far removed from 
the parent vessel (plate 60) ; in another, close to the sacro- 
sciatic foramen, (plate 63, figure 2) ; and in one instance and 
on the left side, I observed the separation to occur altogether 
outside the cavity of the pelvis. In my notes of this case, it 
is said " the pudic arises from the sciatic artery an inch 
beyond the point at which the common trunk has escaped 
from the pelvis. The coccygeal and the muscular branches 

* " Truncus est, quern nos mallemus, ob nimis incertum mediae, exterrue, internee, 
eommunisque pudendae sonum, alio nomine vocare, ut arteriam pudendam simpliciter, 
rcjectis prioribus omnibus nonainibus." Haller. Fascic. iv., p. 35 n. 12. 



PUDIC ARTERIES. 441 

usually furnished by the sciatic are given from an independent 
artery emerging from the pelvis, close to the sciatic." The 
pudic artery often springs from the internal iliac without any 
immediate connexion with the sciatic ; an example is afforded 
in plate 59. 

Deviations from the ordinary arrangement are not unfre- 
quently met with. They are of various kinds, and, as has 
been stated, with regard to several other arteries, a gradation 
of change can be recognised among them. Thus : the pudic 
artery having the accustomed course, and furnishing the usual 
branches, is reduced in size and is aided by a small accessory 
vessel, as shown in plate 64, figure 4, and 65, figure 1. 
Again : the artery is more defective, and fails to furnish one 
of the usual branches which then is derived from the accessory 
pudic. This arrangement is exemplified in plate 64, figure 5. 
In a more extended degree of the same form of departure from 
the usual conformation, the pudic artery ends with the branch 
given to " the bulb," and the J-wo remaining branches are 
supplied as in the preceding cases (plate 63, figures 3 and 4, 
and plate 64, figure 3 the right side). Lastly, the pudic 
may terminate with the superficial artery of the perinseum, 
and the branches to the penis are then given altogether 
from the supplemental artery. This rare variety is illustrated 
in plate 64, figure 3 the left side.* 

The form of the foregoing peculiarities which I have most 
frequently observed, is that in which the two terminal 
branches (" arteria profunda penis " and " dorsalis penis ") 
were supplied by the accessory artery, instead of emanating 
from the pudic. Other observations on this subject will be 
found further on, in the account of the " accessory pudic " 
artery. 

Branches. The various states of the principal branches 
being necessarily included to some extent in the remarks on 
the vessels from which they are derived viz., the pudic and 
accessory pudic special reference will only be made to one of 

* In the foot note to page 398, mention is made of a drawing in the possession of 
Mr. Listen, which illustrates this condition of the vessels. It should have been added, 
that the ninth plate of Professor Monro's work (" Anatomy of the Pelvis of the Male, 
illustrated by nine Engravings," 2dEdit., 1827) is a representation of the same case. 



442 ' ARTERIES OF " THE BULB." 

them, the artery of the bulb. This branch requires separate 
consideration, chiefly in consequence of the connexion it has 
with the operation of lithotomy. 

ARTERIES OF "THE BULB." ARTERIJE CORPORIS SPONGIOSI. 

The artery of the bulb has commonly somewhat more than 
the size represented in plate 62, and it springs from the pudic, 
opposite the point at which the urethra enters the " spongy " 
erectile tissue. The vessel ends, therefore, in that tissue, at 
some distance in front of the extremity of the bulbous en- 
largement ; and this circumstance is very apparent when the 
bulb being large extends backwards more than usual towards 
the rectum. 

From the more ordinary conformation here briefly stated, 
the artery of the bulb is often found to deviate more or less 
as follows : It is diminished in size (plate 64, figure 4, right 
side), and I have seen it in more than one instance altogether 
wanting on one side. On the other hand, more than one 
branch is occasionally to be met with ; two are present in 
the fourth figure of the plate last referred to. 

The variation of most importance in a surgical point of 
view consists in the change of position. Ordinarily, the artery 
of the bulb is so placed as to be a little in front of the point 
at which the knife is passed into the urethra in the operation 
of lithotomy; but in some instances, not of frequent occur- 
rence, it takes its rise considerably behind the usual place 
of origin, and ascends obliquely in the manner shown in plate 
64, figure 1. I have also observed the artery, after having 
taken origin as in the case just mentioned, to bend inwards 
for some space, and then turn upwards in a vertical direction 
to reach the bulb. See the second figure of the same plate. 
And Mr. Spence mentions an example of apparently greater 
curve. "In a subject" (he says) "which I dissected, the 
artery of the bulb arose from the pudic as usual, but then 
passed almost directly backwards to near the anus, whence 
it again curved upwards to gain the bulb."* I would add, 

* " Remarks on the Sources of Hemorrhage after Lithotomy, by James Spence ;" 
in the " Edinburgh Monthly Journal of Medical Science, edited by J. R. Cormack, 
M.D.," vol. i. p. 166, 1841. 



ACCESSORY PUDIC ARTERY. 443 

with respect to the foregoing peculiarities of position and 
direction, that the first mentioned is the only one of which 
I have seen repeated examples. 

Finally, the artery of the bulb may be found to arise from 
the accessory pudic; and when this happens, it lies, so far 
as my observation goes, somewhat in front of or above the 
position it occupies under the ordinary circumstances. 

ACCESSORY PUDIC ARTERY. 

1 venture thus to designate the vessel observed from time 
to time to take the place of a defective pudic artery. Though 
the instances of the occurrence of this artery are not frequent, 
and its presence must be considered much more the exception 
than otherwise ; still the connexion the vessel may have with 
the operation for stone entitles it to separate mention in a 
work chiefly occupied with the anatomy which has immediate 
reference to operative surgery. 

Origin. In this respect the accessory pudic varies, like 
most of the usual branches of the internal iliac. In one case 
it arises, with the other branches, from the internal iliac ; 
examples will be found in plate 63, figure 5, and in Professor 
Tiedemann's thirtieth plate. In another much more rare 
variety, it is furnished by the external iliac artery, through the 
medium of the obturator (plate 65, figure 1) ; and in one in- 
stance I observed it in a female to take rise from the epigastric.* 
But the most frequent place of origin among the instances of 
this peculiarity which I have observed, was the pudic artery 
itself, before its passage from the sacro-sciatic foramen, as 
shown in plate 63, figure 3. 

The Course within the pelvis, towards the prostate gland, 
differs in different cases according to the place of origin. 
Most frequently the artery proceeds forwards near the lower 
part of the urinary bladder ; it lay on the side of that organ 
in the body from which figure 5 in plate 63 has been drawn ; 
and when placed at the anterior part of the pelvis arising 
from the obturator or epigastric, it descends immediately 

* A drawing of this case, now before me, has been accidentally omitted from the 
plates. 



444 ACCESSORY PUDIC ARTERY. 

behind the body of the pubes. (See the plates already 
referred to.) 

In passing by the prostate and urethra and it is here that 
the exact situation of this artery is of serious concern to the 
practical surgeon the accessory pudic lies on the upper part 
of the gland, or, it may be, for a short space likewise on the 
posterior margin ; and then proceeding forward above the 
membranous part of the urethra, it reaches the perinseum and 
divides into the terminal branches. The position of the artery 
in the portion of its course here adverted to is illustrated in 
plate 63, figures 3 and 5, and plate 65, figure 1 ; and the 
point where it appears in the perinseum is shown in plate 64, 
figures 3 and 4. 

I have not seen the accessory pudic artery approach the 
side of the prostate in any case but one, and of this a draw- 
ing is given in plate 63, fig. 4. 

Branches. The accessory pudic has in some bodies the 
course of the vesico-prostatic, and, being substituted for this 
artery, or, more properly, perhaps, an extension of it, fur- 
nishes branches to the same organs in the pelvis. This cir- 
cumstance is in part exemplified in plate 64, figure 3. As 
regards the terminal branches, those, namely, which supply 
the penis or clitoris, their number depends on the state of 
the pudic artery, and is therefore very various. There may 
be but a single slender branch in connexion with the ordinary 
number from the pudic ; or one, two, or three branches 
absent from the artery just named are furnished from the 
supplementary vessel. These different states have been no- 
ticed, and references to illustrative figures have been made 
in the observations on the pudic artery. 

In one case the plan of arrangement did not conform with 
that above pointed out ; and it therefore requires separate 
mention. A single accessory pudic took, in part, the place of 
the pudic artery of both sides, supplying both the " cavern- 
ous" arteries (arteriaa profundae penis); and the pudic of the 
right side gave both the " dorsal" branches (plate 63, figure 5) . 



445 



VESICO-PROSTATIC ARTERIES. ARTERI.E VESICALES IMJE. 

The vesico-prostatic is the lowest of the three vesical 
branches usually recognised in anatomical works. Its posi- 
tion and size, together with the distribution of the branches, 
are displayed in plate 16, figure 2. 

The branches on the prostate are in some bodies of fuller 
size than usual ;* and a communication or anastomosis may be 
found to exist above and even below the prostate gland or the 
neck of the bladder between the arteries of the right and left 
sides, in the manner exhibited in plate 60. One of the pros- 
tatic arteries will occasionally be observed to exceed the others 
in size. Concerning such a branch a statement of the follow- 
ing kind occurs with respect to a few cases in the notes of my 
observations. "A good-sized branch runs over the lateral and 
the inferior surface of the prostate gland." A similar branch 
has been described by Mr. Spence. In the essay already 
quoted, this writer observes, " In several instances I have 
seen the prostatic artery gain the perineal surface of the 
prostate without dividing into minute branches ; and in eight 
of these cases the vessel was fully as large as the artery of the 
bulb." 

I may here observe that my attention was forcibly directed 
a few years ago to the small arteries on the prostate gland, 
by the following case : The lateral operation for the removal 
of a calculus from the urinary bladder was followed by exten- 
sive haemorrhage, and the patient, a very young man, died in 
two or three days. On examining the body, diffusive inflam- 
mation from infiltration of urine was discovered in the pelvis, 
and the arteries in question were clearly ascertained to be the 
source from which the haemorrhage had proceeded. The 
larger arteries, it should be added, were untouched in the 
operation, and the veins were not enlarged. 

Before ending the account of the arteries, which have now 
occupied attention at some length, one further circumstance 
claims attention, namely, the connexion existing between them. 
Haller described small branches extending onwards from 



446 OBTURATOR ARTERIES. 

the prostate to anastomose with the arteries of the penis.* 
A communication of this kind between the vesico-prostatic 
and the pudic arteries would be interesting, inasmuch as its 
presence would furnish means of demonstrating the manner 
of the production of some forms of the accessory pudic, on the 
principle pointed out when treating of several other arteries. 
In connexion with this subject mention should be made of 
the junction which careful dissection will show to be present in 
most instances, perhaps in all, between the accessory pudic 
and the branches of the proper pudic artery. Such anasto- 
mosis existed in the cases delineated in plate 64, figures 3 
and 4, and it is clearly represented in the former of these 
figures. 

Feins. The veins in the neighbourhood of the urinary 
bladder and the prostate are usually enlarged in aged persons, 
and in some forms of disease. They may be found so 
numerous and large as entirely to cover the gland : this is 
the case in the preparation from which figure 3, in plate 65, 
has been sketched. Moreover, fibrous membrane (fascia) 
covers the veins in this situation, and is so blended with them, 
that, like those in some other parts of the body, they do not 
collapse when divided. Practical inferences from the size 
and disposition of these vessels will find their proper place in 
another section of this work. 



OBTURATOR ARTERIES. 

Their Origin. General abstract of the Table (page 405. et 
seq.) with reference to the place of origin. 

The condition of the arteries of both sides of the body 
having been noted : 



Both were derived from the internal iliac . -, 

[ Female . 44 



Both from the epigastric . . { J^ - ^ " j 



^ 23 

* " Ergo a trunco eo hypogastricae, qui proximo umbilicalem dabit, frequenter om- 
iiino prodit ima vesicalis, euns ad parlem inferiorem vesicae antrorsum, versus urethrain, 
inter vesicam et rectum intestinuin, ad vesiculas seminales et ductum deferentem et 
prostatam, tarn superius quae propago cum arteria penis coit, quam inferius ad bulbum 
urelhrae, ubi cum arteria ejus bulbi anastomoses habet." Op. cit. Fascic. 4, p. 38, 
n. 16. 




OBTURATOR ARTERIES. 447 

If Right being from iliac 
Male < Left from iliac 
[ 
f Right from iliac 
Female < Left from iliac 

One (the right) from the int. iliac ; the other / Male 

equally from the int. iliac and epigastric . \ Female 

One (the right) from the epigastric ; the other "I F , 

equally from the int. iliac and epigastric . J 

One from the int. iliac ; the other from the ext. 1 ,., , 

iliac ....... J Male ' V , 

One from the epigastric j the other from the 1 ,, , 

ext. iliac ....... /*' 

In the following cases, the condition of the artery of one 
side only is mentioned in the Table : 

The artery arose from the internal iliac . 
From the epigastric ..... 



From the internal iliac and epigastric at the "1 ,, , 
same time . . . . . . W 

From the external iliac* 



1} 



From the same artery, by a common trunk with the internal circumflex of 
the thigh I have met with one example of this peculiarity (plate 72, 
figure 4). The case in which it occurred was not one of those included 
in the Table. 

Extracting from the foregoing abstract the sum of the 
examples of each kind of origin, and omitting the reference 
to the state in individual bodies, we obtain the following 
result : 

The place of origin of the arteries of both sides is 

noted in 159 bodies, making .... 318 instances. 
And that of the artery in one side only in . . . 43 
The entire number . * '. * . ' ' - 361 
The obturator was derived from the internal iliac in . 247 say as 2 in 3. 
from the epigastric . 103 say as 1 in 3. 

equally from the internal"! ^ 

iliac and the epigastric (by two roots). . . . J 

from the external iliac . 6 

- 361 

from the last-named artery, in combination with 

the internal circumflex (see above). 

* Allan Burns states, that in two subjects be " had found the obturator artery rising 
from the superficial femoral artery at the distance of two inches below Poupart's liga- 
ment." Observations on the Diseases of the Heart,' &c. Edinburgh, 1809, p. 315. 

s s 



448 OBTURATOR ARTERIES. 

The statements above made, with regard to the frequency 
with which the obturator arteries arise from one source and 
another, agree, to a great extent, with the observations made 
by M. Jules Cloquet * on 250 bodies ; and they do not very 
materially differ from the result of Hesselbach's (Adam 
Kaspar) account of the condition in 32 bodies, f Other 
writers, however, as Monro f and Velpeau, represent the 
proportions in which the epigastric furnishes the obturator 
to be widely different. But it must be borne in mind, that 
these anatomists confine themselves to general statements, 
and that, where facts of this kind are concerned, numbers 
only, and these deduced from cases noted written down 
while under observation, can be relied on. 

Where the obturator artery is stated in the table and in 
the abstracts, to be derived from the internal iliac, it is to be 
understood that it was given from one of the large divisions 
of the trunk, not from the trunk itself. It has been set 
down in the manner in which it occurs merely for sake of 
the shortness which is obviously necessary in constructing a 
table. 

As regards the epigastric artery, when affording origin to the 
obturator : it usually emanated from the external iliac, near 
Poupart's ligament, but occasionally from the same artery, at a 

* "Recherches Anatomiques sur les Henries de 1' Abdomen." pp. 72, 73. 
Paris, 1817. 

f "Die SScherste Art des Bruclischnittes in der Leiste." Bamberg und Wlirz- 
burg, 1819. 

$ " Baron Haller, Lieutaud, Richter, and Murray of Upsal, have described such an 
unusual origin of the obturator artery, but do not make mention of the proportion of 
cases iu which it occurs. 

"I have paid a good deal of attention to this department of anatomy. In my 
Observations on Crural Hernia (published in 1803), I have stated that I had not 
observed such a deviation from the usual distribution of arteries in above one of 25 or 
30 ; and, according to subsequent observation, such a distribution of arteries occurs 
in one of 20 cases." 

" The Morbid Anatomy of the Human Gullet," &c., p. 429. 

" Mais la variete'dont on a le plus parle est celle 6u 1'obturatrice et I'epigastrique 
naissent d'un tronc coinmun de 1'iliaque externe. C'est en effet la plus frequente. 
L'examen quo j'ai pu en faire sur plusieurs rnilliers de cadavres, soit dans les hfipitaux^ 
soit dans les amphitheatres a dissection, soit & 1'ecole pratique, ne me permet pas de dire 
qu'elle se rencontre une fois sur trois, ni sur cinq, iii m6me sur dix, mais bien seule- 
ment sur quinzek vingt." 4 Medecine Op6ratoire,' t. ii, p. 410. Paris, 1832. 

On the same subject, see Mr. Lawrence's " Treatise on Ruptures," 4th edition, 
p. 481. London, 1838. 



OBTURATOR ARTERIES. 449 

much higher point (plate 66, figure 2, artd plate 65, figure 5) ; 
and it was likewise found to deviate from the accustomed 
position in the opposite direction, taking origin from the 
femoral artery. In a few cases the epigastric and obturator 
had united to them the internal circumflex artery of the 
thigh ; and they have likewise been found conjoined with the 
circumflex iliac. See the observations on the epigastric 
artery, p. 460. 

The place at which the obturator separates from the 
epigastric, in other words, the length of their common trunk, 
will be noticed in a succeeding paragraph, in connexion with 
the course the artery follows, and the position it takes with 
respect to the femoral ring. 

When derived singly from the external iliac, without con- 
nexion with the epigastric or any other branch, the obturator 
was found commonly to arise a little above Poupart's liga- 
ment ; but it also though rarely took origin from that 
artery opposite the middle of the iliac fossa (plate 65, figs. 
6 and 7). 

The Gradation observable in the Changes of the Place of 
Origin. At first sight the transfer of the obturator from the 
internal iliac at the back part of the pelvis, to the epigastric or 
external iliac in front of this cavity, seems a larger change in the 
place of origin than is met with in other vessels ; but on closer 
examination and of a sufficient number of facts, it will be found 
that in reality there is a gradual transition from one of these 
states to the other, and it will perhaps be apparent that the 
principle determining this and other changes of the same 
nature is identical. To illustrate this statement, with respect 
to the artery under examination, the following cases have been 
selected. 

a. The obturator being furnished from the internal iliac, a 
branch from it ramifies behind the pubes and anastomoses by 
one or more minute ramifications with similar offsets of the 
epigastric artery. 

b. One of the anastomosing branches is slightly enlarged, 
and joins the two arteries more fully and directly than occurs 
in the preceding case, as shown in plate 66, figure 1. 

s s 2 



450 OBTURATOR ARTERIES. 

c. The artery proceeding from the posterior part of the 
pelvis is diminished in size, and the communicating branch 
descending behind the pubes is proportionably enlarged, so 
that the obturator may be said to arise equally from the 
internal iliac and the epigastric arteries. This condition of 
the vessels is exemplified in plate 66, figure 3. 

d. The posterior root decreases still further, arid the 
anterior one enlarges so much, that the obturator may be 
properly said to arise from the epigastric, receiving a slender 
branch of communication from the internal iliac. See plate 
65, figure 1, and 66, figure 2. 

It must further be mentioned, however, that the obturator 
artery, when springing from either of the principal sources is 
often without an anastomosing branch from the other at 
least it is so when the arteries are filled with ordinary coarse 
injection. But the communication is most probably never 
absent at an early period of the development of the vessels. 

Course and position. The observations to be made under 
this head will have reference to the obturator artery, only 
when it takes origin from the epigastric or external iliac, 
because it is in such case alone that it may have important 
bearing with respect to a surgical operation of ordinary 
occurrence. 

When derived from the epigastric artery, the obturator as 
it descends into the pelvis is close to the femoral ring, and, 
therefore, in the event of femoral hernia being formed, would 
be closely connected with the neck of the hernial sac. It is 
clearly of much importance to determine the position which 
the artery would be likely to hold with respect to the tumor, 
and with the view of ascertaining the position in a certain 
number of instances, the materials for the table were collected. 
It is obvious that the distance between the obturator as it 
descends into the pelvis and the external iliac vein is the chief 
means of determining, as far as it can be done, whether in 
such a conformation of parts the artery would have hernia 
on the inner or the outer side. The vein was therefore taken 
as the point of reference for the cases marked in the Table ; 
and the space between it and the obturator artery was 



OBTURATOR ARTERIES. 451 

observed in each. In this way, 101 cases were noted ; and 
they admit of being classified as follows : 

A. The obturator artery was close to the external iliac vein in 44 "| .. 

at a short distance from it in 10 J 
(Plate 66, figure 2). 

B. at a moderate distance from the vein . in 37 

(Plate 66, figure 1). 

C. at a considerable distance T. . : I . in 10 

(Plate 66, figure 3). 

Now, if a hernia were present, no doubt can exist as to the 
position the artery would occupy in the first and the last of 
these classes. In the one it must have been placed to the 
outer side of the hernia, and therefore, in the event of 
strangulation occurring, would not have been endangered 
in an operation for the relief of this (plate 68, figures 1 and 2). 
In the other (the third class) on the contrary, the artery 
would lie in front and on the inner side of the hernia, and 
an incision made through the boundaries of the femoral ring 
in any allowable direction, must be directed towards that 
vessel. This will be evident on observing figures 3 and 4 
of the same plate. 

But as to the cases included in the second class no incon- 
siderable number such certainty respecting the position the 
obturator artery would have does not exist, notwithstanding 
that there is between it and the iliac vein an interval of 
sufficient size to receive a hernial protrusion. The grounds 
of the uncertainty which I believe to attach to this point will 
be found in the following observations. 

In some cases a small number the obturator artery, crosses 
behind the femoral ring in such manner that it divides the 
aperture into two lateral parts, and the protrusion may 
therefore take place at either side of it; and if two small 
hernise should be formed, it is even possible that one should 
be placed on each side of the artery. An example of two 
hernial sacs so disposed was observed by Allan Burns.* (See 
plate 72, figure 2.) 

* " I dissected the body of an aged woman last summer, in which I found one sac 
in the sheath of the lymphatics, and another in the sheath of the vein. In this sub- 
ject the obturator and epigastric arteries came off by a short trunk from the external 



452 OBTURATOR ARTERIES. 

In a large majority of the cases of the second class the artery 
lay close to the inner side of the funnel-shaped opening of 
the femoral canal, or but a short distance from it, but did 
not arch inwards beyond the opening, and there appeared to 
be much more space for the descent of a portion of the con- 
tents of the abdomen on the outer than on the inner side of 
the vessel ; and yet, with a like disposition of the parts, a 
femoral hernia might not, I apprehend, have been placed in 
the former position, i.e., outside the artery. With the inten- 
tion of attempting to elucidate this point, I repeatedly made 
experiments on the dead body by forcing some convolutions of 
the small intestine towards the femoral ring, in order to 
ascertain the course any small piece that might be dislodged 
would follow. These trials were not in general satisfactory ; 
but in a few instances, in which I succeeded in forcing a knuckle 
of intestine through the ring, I observed that the obturator 
artery at first prevented the protrusion, and on continuing 
the force, the intestine appeared to have a greater tendency, 
if it may be thus expressed, to pass to the inner than to the 
outer side of the vessel, although from appearances I had antici- 
pated a different result. Under the influence of the pressure 
from above, the artery usually yielded, or retired towards the 
outer side, possibly because it is held more firmly on this side 
by reason of its connexions above with the epigastric artery, 
and below with the canal beneath the horizontal branch of 
the pubes ; any yielding in the opposite direction, could be 
effected only by stretching of the coats of the vessel. 

While engaged in these trials, I was led to form the opinion 
that, in the class of cases under examination, the position 
of the part to be protruded, or the direction in which it is 
impelled towards the aperture, has some influence in deter- 
mining its bearing with respect to the artery. 

The inferences, then, I am disposed to draw from the circum- 
stances set forth are, that, though there should be a certain 

iliac, and the obturator, in its way to the thyroid foramen, encircled the neck of the 
sac contained in the venous sheath. This new variety of arrangement shows that the 
general opinion respecting the safety of cutting towards the pubes, in those cases where 
the conjoined trunk of the epigastric and obturator is short, is not well founded." 
Oj>. citat., p. 313. 



OBTURATOR ARTERIES. 453 

amount of space between the obturator artery and the 
iliac vein, it does not necessarily follow that a hernia 
would have occupied that space in passing through the femoral 
ring ; and further, that it is not possible in many cases, by the 
inspection of the parts in the dead body, to state with confi- 
dence in what position the artery would lie with reference to 
the hernia, in a living body, with a similar arrangement of the 
vessels and the femoral ring. These observations cannot be 
closed without the distinct admission^that the experiments 
above noticed have little in common with the circumstances 
under which a hernia is produced in the living body. And 
the conclusions arrived at, it should likewise be understood, 
are offered merely as suggestions of what appears most pro- 
bable, or, in short, "guesses at truth." This I believe to 
be all the subject admits of. 

What determines the Position of the Obturator Artery, with 
respect to the Femoral Ring ? To this question attention has 
been directed by Professor Monro,* and other authorities of 
an older date, who connect the position of the artery with 
the length of the epigastric before the obturator arises from 
it, in other words, the length of the common trunk of these 
two arteries. In order to satisfy myself on the subject, I 
measured the length of the common trunk, and, at the same 
time, noted the position the obturator had in several of the 
bodies which are set down in the commencement of the Table. 
The results were as follows : 

When the common trunk was of unusual length, say 
1^- inch, it arose from the external iliac artery above the 
ordinary position, and commonly was expended in reaching 
the lower part of the abdomen, where the course of the 
epigastric upwards behind the anterior abdominal wall begins ; 
and the excess in length of the common trunk had not any 
apparent connexion with the position of the obturator did 
not remove the artery to a proportional distance from the 
iliac vein (plate 65, figure 5). Again : the common trunk 

* " When the trunk common to the obturator and epigastric arteries is of an 
inch or an inch and a half in length, the obturator artery is then situated between the 
symphysis pubis and the hernial eac." &c. Op. cit. p. 428. 



454 OBTURATOR ARTERIES. 

having the accustomed place of origin, and being of what in 
such case should be considered considerable length (f inch), 
the obturator artery was, in some instances, directed to one 
side, in others to the opposite side of the femoral ring, and 
likewise was observed to cross behind the middle of that 
aperture. And the same difference of direction and position 
was observable where the common trunk was very short (^inch). 

There is, in my opinion, little reason to doubt, that, if the 
direction of the obturator artery into the pelvis were the same 
in all cases, its position with regard to the femoral vein and 
the femoral ring would be determined or materially influenced 
by the place of its origin. But this is not the case : the 
direction is far from being invariable in one instance, the 
artery curves at first outwards, towards the iliac vein ; in 
another, it arches in the opposite direction, away from that 
vessel and on this circumstance, namely, the direction, in a 
great degree depends the relation it may have to the neck of a 
femoral hernia. (See plates 65, 66, and 68). 

I will conclude this discussion by referring to observa- 
tions made on the subject of it by Mr. Lawrence, in the 
latest (fifth) edition of the book on " Ruptures," which has 
come under my notice since the foregoing observations were 
prepared for the printer.* 

The remarks hitherto made have reference to the usual form 
under which the obturator artery has its origin in the inguinal 
region viz., in connexion with the epigastric. It remains to 
notice the course it takes when derived immediately from the 
external iliac. And this may be done in a few words. In every 
instance which has come under my notice, the obturator 
artery was directed at once into the pelvis, or was curved at 

* '* While these sheets are passing through the press, Mr. Wormald pointed out to 
me in the dissecting-room of St. Bartholomew's, an example of the obturatrix artery 
arising from the epigastric. The former made a considerable sweep in turning down 
to the obturator notch, running behind the crural ring in such a manner that a pro- 
trusion might have taken place either on its inner or outer side. A similar arrange- 
ment is seen in four crural hernia; in the museum in which this origin of the obturatrix 
exists, the artery being on the outer side of the rupture in the one, and on the inner 
side in the other three. Mr. Wormald therefore infers that its situation, in relation 
to the neck of the sac, depends on the course and position of the vessel itself, and 
not as Dr. Monro has conjectured, on the length of the common trunk, which may 
vary from two lines to an inch and a half." ' Treatise on Ruptures,' 5th edit. p. 482. 
See, likewise, a remark of Allan Burns, quoted in the foot note ante, page 451-2. 



EXTERNAL ILIAC ARTERIES. 455 

first slightly outwards, away from the femoral vein, and there- 
fore lay to the outer side of the femoral ring (plate 65, 
figures 6 and 7). My observation, in this regard, agrees with 
that of Allan Burns,* and is at variance with the state- 
ment of Dr. Monro.*|* 

Branches. Mention has already been made of branches 
ramifying behind the pubes, and of a communication with 
the epigastric artery. Besides these, and the ordinary 
muscular branches in which it ends, the obturator, in some 
rare cases, furnishes an offset to the side of the bladder, or 
to the iliac fossa ; the branch given in the latter situation 
would occupy the place of the iliac part of the ilio -lumbar 
artery. The accessory pudic and epigastric have likewise 
been observed to take origin from it (the obturator). (See 
the remarks on these arteries, and plates 65, figure 1, and 72, 
figure 1 .) 

The Obturator Vein or Veins. There are often two veins, one 
extending backwards with the artery to the internal iliac 
vein, while -the other curves round the inner side of the 
femoral ring. This arrangement occurred frequently among 
the bodies occupying the commencement of the Table, and I 
soon ceased to note it. In one body the vein arching over 
the femoral ring was of large size, and it opened into the 
external iliac vein by two mouths.J 

EXTERNAL ILIAC ARTERIES. 

The position of these arteries is exhibited in plates 53 and 
54 ; and they are seen associated with veins in plate 55. 

Length. Although the length of an external iliac artery 
will be found to vary even to the extent of some inches, yet 
as it is always so considerable that, after a ligature has been 
applied, no insecurity can be apprehended by the surgeon on 

* Loc. citat. p. 309. f Loc. citat. p. 430. 

; This disposition of the veins is delineated in Camper's work "Demonstr. Anatom : 
Pathol." Lib. 2, tab. 1. The greater part of the figure has been copied, \vith acknow- 
ledgment, into Professor Monro's " Anatomy of the Pelvis of the Male," &c. 
(plate 4, figure 3); but, by some oversight, the veins are (in the copy) lettered and 
coloured as arteries, and the arteries, with a large lymphatic gland, are, in the same 
way, represented to be veins. 



456 EXTERNAL ILIAC ARTERIES. 

the ground of inadequate length, I considered it is unnecessary 
to make any large series of observations respecting this point. 
The measurement in 127 cases is subjoined. 

The artery measured . . 2 inches . . . in 1 

more than 2 not exceeding 3 13 (plate 53) 

more than 3 not exceeding 3| 38 

more than 3 % not exceeding 4 44 

more than 4 not exceeding 4y 20 

more than 4 not exceeding 5 6 (plate 54) 

more than 5" not exceeding 5 5 

127 

Independently of the general effect of the size of the body, 
which has its influence on this as on most other arteries, the 
length of the external iliac depends exclusively on the place 
at which the common iliac divides, for it does not suffer change 
in the place of termination this being determined, not by the 
condition of the vessel, but by another structure (Poupart's 
ligament or the pubes) whose position is not liable to any 
changes peculiar to the individual, at least not to any ma- 
terial to the question before us. A n exception may be claimed 
for those rare cases in which the " profunda femoris " arises 
above the abdominal wall ; but even here, it would perhaps be 
convenient to regard the external iliac artery as ending in 
the usual place, and to consider the vessel to be double at 
the lower end. 

THE BRANCHES. 

The branches of the external iliac artery are few in number 
ordinarily two, the epigastric and circumflex iliac and they 
are usually given from the trunk, at or near its lower end. 

The number of the branches varies not unfrequently, and 
may be either augmented or diminished. The augmentation 
of number assumes several forms, thus : a. It occurs in 
consequence of the division of a branch ordinarily single into 
two parts, taking separate origin from the trunk. The 
branches liable to be so affected are the circumflex iliac and 
the common trunk of the epigastric and obturator (plate 65, 
figures 5, 6, 7; and 72, figure 4). b. A muscular branch for 
the psoas muscle is frequently added in the manner repre- 
sented in plates 54 and 55. Such a branch was observed, in 
the case marked 191 in the table, to turn round the external 



EPIGASTRIC ARTERY. 457 

iliac vein, and enter the psoas muscle behind the vein. c. A 
branch (the internal circumflex) usually given from another 
source, occasionally increases the number of those furnished 
from the external iliac (plate 74, figure 2). This is a very 
rare variety. 

As regards the diminution of the number of branches 
this change is effected by the transfer of the epigastric or 
circumflex iliac to another artery, commonly the femoral. 

It need scarcely be added, that, by the co-existence of a 
source of increase with one of diminution, the branches may 
be varied, whilst the number remains unaltered. 

The position at which the branches usually spring from the 
external iliac artery is not often altered to any considerable 
extent. Occasionally, however, the epigastric, the circumflex 
iliac, or the obturator, or more than one of these at 
the same time, is observed to occupy a much higher position 
than usual, e. g. 1 inch, or even, though very rarely, 2J inches 
above Poupart^s ligament (plate 65, figures 4, 5, 7). This 
fact may not be devoid of importance, with respect to the place 
of applying a ligature to the external iliac artery in a case of 
aneurism. 

In the foregoing statements reference has been made to the 
branches collectively, as connected with the surgical anatomy 
of the artery from which they are derived ; they will now be 
treated of individually and more in detail. 

EPIGASTRIC ARTERY. 

The place of origin of this artery was found among 213 
cases inserted in the table to be 

If inch above Poupart's ligament* .... in 2 (plate 65, fig. 5) 
More than 1 inch, not exceeding If above same 6 

More than , not exceeding 1 11 

1 inch and less 28 

Close to or opposite the same structure . . 149 

Below it from the femoral artery .... 16 (plate 67, fig. 4) 
from the " profunda femoris" ... 1 

213 

* The case sketched in plate 65, figure 4, is an example of a still greater interval 
between the end of the external iliac and the origin of the epigastric. The branch 
arises above the middle of the parent artery, and about 2f inches from Poupart's liga- 
ment. 



458 EPIGASTRIC ARTERY. 

I have not observed any greater departure from the usual 
place of origin than the above-mentioned variations in the 
position on the same trunk. But a deviation of more exten- 
sive kind has been placed on record. In the instance alluded 
to, the epigastric was found to arise from the obturator, and 
through this artery from the internal iliac, see plate 72, 
fig. 1. This arrangement is mentioned by Dr. Monro,* and 
A. K. Hesselbach,f who observed each a single example of it. 
Another peculiarity of this artery is mentioned by M. VelpeauJ 
as having been observed by Lauth. Here there were two 
epigastric branches, one furnished in the usual manner from 
the external iliac, the other from the internal iliac, and they 
were placed one at each side of the spermatic cord (internal 
inguinal ring). 

In the reports of the foregoing cases there are omissions 
requiring notice. It is not stated of the last mentioned 
(Lauth's) whether or not the usual epigastric branch took 
origin from the obturator artery; neither is it said if the 
two vessels were connected or not through small branches. 
The history of the other cases would have been more satis- 
factory if search had been made for a branch of communi- 
cation of any kind between the epigastric and the external 
iliac. But even in the absence of the facts adverted to, the 
cases appear to belong to the same form of change. And 
there is much probability that they are examples of different 
stages in a series by which the epigastric is transferred from 
the external iliac to the obturator and internal iliac stages of 

* " I have a specimen in which the epigastric artery takes its rise from the obtura- 
tor, and passes upwards and inwards to the rectus muscle." Op. cit. p. 427. 

J* *' Aus der hypogastrica kommt als erster Ast ein gemeinschaftlicher Stamm fur 
die glutaea, sacra lateralis, und ileo-luiubalis als zweiter Ast die umbilicalis, und 
BO nah hei dieser, dass man wahnt, sie batten beide nur einen Ursprung, als dritter 
Ast die obturatoria, welche sich, einen Zoll und vier Linien vom Ursprunge des 
innern Leistenbandes entfernt, in die eigentliche obturatoria und in die epigastrica 
theilt. 

" Erstere steigt nach vorne herunter zura eiformigen Loch, letztere geht an der innern 
Seite der vena cruralis fovt bis zum Leistenbande, wo sie sich umbeugt, und schief 
nach innen gegen die hintere Flache des geraden Bauchmuskels aufsteigt." The 
observation was made on the body of a female aged 26 years the eighth case in the 
author's table. Op. ante citat. 

I " Tout rdcemment, M. Lauth m'a ecrit qu'il en avait trouvd deux du meme cote, 
1'une venant de 1'hypogastrique, 1'autre de Piliaque externe, 1'une en dehors, 1'autre 
en dedans du cordon testiculaire." Op. cit. p. 452. 



EPIGASTRIC ARTERY. 459 

similar nature, but in the opposite direction, to those through 
which the obturator has been shown to pass from con- 
nexion with the internal iliac into connexion with the epi- 
gastric and external iliac. The same fulness of demonstration 
which appeared in the changes of the obturator must not, 
however, be looked for in those of the epigastric, seeing that 
alterations of the former are numerous and constantly occur- 
ring, whereas alterations of the latter are very infrequent. 

Direction and position. The epigastric artery first attains 
the posterior surface of the wall of the abdomen, and then is 
directed obliquely upwards and inwards to the rectus muscle, 
behind which its further course is continued. To reach the 
abdominal wall, the artery, when it rises above the usual 
position, descends over the external iliac artery (plate 65, 
figure 4) ; and in reaching the same point, I have repeatedly 
seen it, after arising from the femoral artery, to pass at first 
behind the femoral or the external iliac vein. 

The position of this artery in its course to the rectus 
muscle constitutes one of the most important points in 
the anatomical history of the ordinary forms of hernia. 
It is shown in connexion with an oblique inguinal hernia, in 
plate 66, figure 4; and in plate 67, figures 2 and 3, are 
exemplified the changes of direction and situation the vessel 
undergoes under the influence of the same form of hernia, 
when it is of long standing, and its mouth becomes enlarged. 
The position the artery has with respect to direct inguinal 
hernia is exhibited in plate 67, figure 1. And the bearing 
with regard to femoral hernia is shown under various aspects 
in plate 67, figure 4, and the several figures of the 68th 
plate. 

Branches. Small branches of the epigastric artery ramify 
behind the pubes, and they will be found in many cases to an- 
astomose with the obturator. The branches here adverted to 
differ in number, and somewhat likewise in size, but, except 
in cases in which one of them is enlarged, as occurs when a 
free communication exists with the obturator, in the manner 
of plate 66, figure 1, it is difficult to understand that death 
should result from the division of vessels so small in the short 



460 CIRCUMFLEX ILIAC ARTERIES. 

incision required for the relief of strangulated femoral hernia 
Yet this is stated to have happened.* 

I have met with an accessory pudic furnished by the epi- 
gastric ; it was of small size, and descended behind the pubes 
to end in the clitoris. 

The epigastric is occasionally connected with or gives origin 
to the internal circumflex (plate 74, p. figures 1 and 3); 
with that branch and the obturator at the same time (plate 74, 
figure 4). I have observed it joined with the circumflex iliac 
(No. 252 in the table), and it has been found united with the 
internal circumflex and circumflex iliac together.! The com- 
binations of the epigastric with other arteries, except the 
obturator, are rare in their occurrence. With this (the 
obturator) it is associated very frequently, as has been fully 
made to appear in the account given of that artery (ante, 
page 446). 

OBTURATOR ARTERY. 

The obturator sometimes springs directly from the external 
iliac. Five instances are mentioned in the table. In three 
of these the branch was given off at the distance of 1-* inch 
above Poupart's ligament (plate 65, figure 7) ; and in the 
others it arose near to the ligament (plate 65, figure 6). 

For further details concerning this vessel, see the observ- 
ations on it among the branches of the internal iliac artery. 

CIRCUMFLEX ILIAC ARTERIES. 

The following is an abstract of the Table, with respect to 
the place and manner of origin of the circumflex iliac artery. 
The origin was 

More than --inch, not exceeding 1, above Poupart's ligament, in 7 cases. 

i-inch, and less in 20 

Opposite the same structure or nearly so . ., . in 147 
Below it, (from the femoral artery) in 19 

* " Chez quelques sujets, 1'artere epigastrique nait de la partie anterieure de 
1'iliaque ; il n'est pas rare alors qu'elle fournisse plusieurs petites branches irregulieres 
qui se portent vers la symph) se du pubis, en passant derriere le ligament de Gimbernat : 
on a vu le debridement porte sur ce ligament donner lieu a une hemorrhaaie mortelle 
due a la section de ces arte'rioles." * De la Me'decine Operatoire, par R. B. Sabatier, 
nouvelle edition, faite sous les yeux de Dupuytren, par Sanson et Begin.' T. iii. p. 608. 
Paris, 1832. 

f A. K. Hesselbach found the epigastric, obturator, and circumflex arteries springing 
from a single trunk in the body of a female (the twentieth case in the Table of the 
Essay before quoted). 



CIRCUMFLEX ILIAC ARTERIES. 461 

Instead of a single branch, there were 

Two, having separate origin in 12 cases. 

Three distinct branches were present . . . . . in 2 

Examples of double circumflex iliac, noticed at the end of 
the preceding abstract, are contained in plate 58, figure 1, and 
72, figure 4. 

Besides the variations of position and number above men- 
tioned, the origin of this artery undergoes, very unfrequently, 
however, a change of different kind. This change consists in 
the connexion with other branches (the epigastric, or the 
epigastric and obturator, at the same time) in place of pro- 
ceeding immediately from the external iliac. 

Branches. The principal branch arises usually near the 
anterior superior spine of the ilium, and is directed upwards 
through the abdominal wall, (plate 53, 18 ). The size of this 
branch varies considerably : in the plate referred to it is of 
more than ordinary dimensions.* To this, (the abdominal 
branch of the circumflex iliac,) or the attendant vein, has been 
attributed the hsemorrhage found to attend the operation of 
paracentesis abdominis, when performed towards the lateral 
part of the abdomen, midway between the umbilicus and the 
spine of the ilium.f 

The division of the circumflex iliac for the artery might 

* " Sometimes this branch is small ; but at other times it is so large as almost entirely 
to annihilate the branch of the vessel which ought to follow the course of the crista 
ilii." Allan Burns. Op. citat. p. 317. 

' This vessel " (the large abdominal branch of the circumflex iliac) " seems to occur 
once in 200 cases, were I to conclude from those I have met with ; though this artery, 
upon a small scale, may be detected often, and seems the cause of the bloody tinge 
which occasionally appears in even successful operation" (alluding to paracentesis 
abdominis). Extract from an " Account of Unusual Conformations of some Vessels, 
by Alexander Ramsay, M.D., Lecturer on Anatomy, Edinburgh ;" in " The Edinburgh 
Medical and Surgical Journal," vol. viii. p. 283. 1812. 

f " The large ascending branch of the circumflex artery may be wounded in 
performing the operation of paracentesis of the abdomen. In one case I saw its 
accompanying vein opened by the trocar. The patient, a young woman, had the 
operation performed six times, and in all of them the perforation was made midway 
between the spine of the ilium and the umbilicus. At each time, the trocar was entered 
within the eighth part of an inch of where it had formerly passed. In the four first 
operations, the fluid was very readily removed without the effusion of any blood ; but 
in removing the water the fifth time, it was found tinged with blood ; and when the 
canula was withdrawn, a stream of venous blood issued from the wound. The further 

effusion of blood was prevented by pressure, &c On inspecting the body after 

death, it was found that the stilet had punctured the ascending branch of the vena cir- 
cumflexa ilii, which was preternaturally large." Allan Burns. Op. citat. p. 317. 



462 CIRCUMFLEX ILIAC ARTERIES. 

be considered to divide where the large branch takes its rise 
has in a few instances been observed to occur close to the 
external iliac trunk, in the manner of the case drawn in plate 
73, figure 1 ; and this premature division may doubtless be 
looked on in the light of an intermediate stage or step to a 
peculiarity before indicated, namely, the entire separation 
into two parts having distinct origin. 

In a former paragraph, this artery has been described as 
entering into unusual combinations with other arteries at its 
origin. There are some others with which, likewise, it has 
been observed to enter into connexion, but these arteries are 
here set down among the branches of the circumflex iliac, 
because, while it retains the ordinary position, they are 
removed to some distance from their accustomed place. These 
unusual branches are the internal circumflex, and the exter- 
nal circumflex. See the remarks on the " profunda femoris" 
and its branches, as well as plate 74, figures 1 and 5. 

Still another unusual branch seems to require notice. Dr. 
Monro, in the work already more than once referred to, 
mentions one which took a very unexpected course, in the 
following words : " I have seen a branch of this artery nearly 
as large as the epigastric, pass under the crural arch, about 
two inches from the symphysis pubis, and it then divided into 
branches which were distributed upon the symphysis pubis/ 1 
&c. ; and the branch is, at the same time, spoken of as one 
which " may be divided in performing the operation for the 
crural and inguinal hernise." 



463 



EXPLANATION OF PLATE LXIX. 



THE femoral artery of the left side and its branches are 
displayed in this plate. The fascia, the veins, and the greater 
part of the nerves, with a portion of the sartorius muscle, 
were removed. The lower part of the artery was not brought 
into view, a part of the fibrous membrane, extending from the 
adductor longus to the vastus internus, having been allowed 
to remain over it. 



External oblique 
abdomen. 
Sartorius. 
Iliacus internus. 
Pectineus. 
Adductor longus. 



muscle of the i / 



Gracilis. 
Rectus femoris. 
Vastus internus. 
Tensor fasciee latae. 
Spermatic cord. 



ARTERIES. 



Common femoral. 

Superficial femoral. 

External pudic. 

External epigastric. 

External circumflex-iliac. 

Profunda femoris. 
6f. The same artery below the origin 
of the internal circumflex and ex- 
ternal circumflex branches. 



7. Internal circumflex. 

8. External circumflex. 



9. Femoral vein, the upper and the 
lower ends. 

10. Anterior crural nerve. 

11. Long saphenous nerve. 



EXPLANATION OF PLATE LXX. 



THE upper part of the femoral artery of the right side 
is here represented with the fascia lata, the superficial and 
deep veins, and some lymphatic glands. A portion of the 
fascia was cut away, and the fibrous sheath of the femoral 
vessel was laid open. 



a Superficial fascia. 

b External oblique muscle of the 
abdomen. 

c Fascia lata, cut. 

cf External or iliac part of the fascia 
lata, where it is blended with the 
inner side of the funnel-shaped 
sheath of the femoral vessels. 



Sheath of the femoral vessels laid 

open. 
Partition of the sheath separating 

the femoral artery and vein. 
Sartorius muscle partially exposed. 
Anterior superior spinous process 

of the iliac bone. 
Spermatic cord. 



T T 



464 



EXPLANATION OF THE SEVENTY-FIRST PLATE. 



ARTERIES. 



1. Femoral. 

The superficial arteries of the in- 
guinal region are likewise shown, 



viz., the pudic, circumflex-iliac, 
and epigastric. 



VEINS. 



2. Femoral. 

3. Long saphenous. 

4. An accessory saphenous. 



5. Superficial or external epigastric. 

6. circumflex iliac. 



EXPLANATION OF PLATE LXXI. 



External oblique muscle of the ab- 
domen. 

Anterior superior spinous process 
of the iliac bone. 

Spermatic cord. 

Fascia lata. 

Sartorius muscle. 



Iliacus internus. 
Rectus femoris. 
Pectineus. 
Adductor longus. 
Adductor magnus. 
Gracilis. 
Vastus internus. 



ARTERIES. 



1 . Femoral. 

If. Two trunks, into which the super- 
ficial femoral divides. 



VEINS. 



4. Femoral. 

5. Saphenous. 



Profunda femoris. 
External circumflex. 



6. Anterior crural nerve. 



FIGURE 1 is the representation of deeper dissection of the 
veins and nerves in the neighbourhood of the femoral artery, 
than that exhibited in the preceding plate. 

Figure 2 is an example of double femoral artery. Below 
the origin of the " profunda," the superficial femoral artery 
divides into two equal parts, which reunite at a short distance 
above the place where the adductor magnus is perforated by 
the vessel. 



465 



EXPLANATION OF PLATE LXXII. 



THE sketches marked 1 and 2 are supplemental to the 
illustrations of the anatomy of the epigastric and obturator 
arteries. The remaining figures show some of the variations 
in the place of origin of the " profunda femoris." 

/ Adductor longus. 
g Rectus femoris. 
h h Sacs of two femoral hernia?. 
i Pectineus muscle. 
k Rectus abdominis its posterior 
aspect. 



Sacrum. 

Anterior superior spinous process 

of the iliac bone. 
Pubes. 

Poupart's ligament. 
Sartorius muscle. 



External iliac. 
Internal iliac. 
Obturator. 
Epigastric. 
Circumflex iliac. 



ARTERIES. 

i 6. Superficial femoral. 



| 7. 

li 

VEINS. 



10. External iliac. 



Deep femoral " profunda femo- 
ris." 

External circumflex. 
Internal circumflex. 



11. Long saphenous. 



Figure 1 has been copied on a reduced scale from an Essay 
of A. K. Hesselbach.* It represents the right half of the 
pelvis, and a part of the abdominal wall of an adult female 
body, seen on the inner or posterior surface. The object of 
the drawing is to show the epigastric artery taking its rise 
from the obturator this being an offset of the internal iliac. 
From the place of its origin, the epigastric ascends obliquely 
to its usual position behind the rectus muscle, passing close to 
the external iliac vein. 

Figure 2 has been reduced from the sketch given by 
Professor Monro,f of a case observed by Allan Burns. The 

* " Die sicherste Art des Bruchshnittes in der Leiste, von Adam Kaspar Hessel- 
bach." Bamberg und Wurzburg. 1819. 

f " Mr. A. Burns observed this variety, and from his preparation the figure is taken " 
in " The Morbid Anatomy of the Human Gullet, Stomach, and Intestines," by 
Alexander Monro, &c., p. 482 and plate 16, figure 2. Edinburgh, 1811. 



466 EXPLANATION OF THE SEVENTY-THIRD PLATE. 

obturator artery is placed between the sacs of two femoral 
hernise. 

Figure 3. The deep femoral artery (" profunda femoris") 
arises from the external iliac an inch above Poupart's liga- 
ment. 

In figure 4 the same artery takes its rise at or under 
Poupart's ligament. The obturator and internal circumflex 
arteries arise by a common trunk which springs from the 
internal division of the main artery (superficial femoral), 
under Pouparfs ligament. 

Figure 5. Here, three arteries, which in other cases are 
given from a common trunk (the profunda), take their origin 
from the main artery, separately and at considerable intervals. 
The internal circumflex arises at the distance of about half an 
inch from Poupart's ligament; the external circumflex at 
the distance of about two inches ; and the origin of the third 
branch the common trunk of the perforating arteries (pro- 
funda I) is four inches removed from the same structure. 

Figure 6. In this outline, representing the vessels on the 
left side, the same arteries are likewise seen to arise from the 
femoral artery separately ; but the two circumflex branches are 
placed opposite one to the other, and the third (profunda ?) 
is not so far distant from the commencement of the femoral 

as in the case delineated in figure 5. 

*.doj 



EXPLANATION OF PLATE LXXIII. 



SOME of the peculiarities which occur in the arrangement 
of the branches of the deep femoral artery are here displayed. 
But the figures were specially intended to illustrate the varied 
forms of the external circumflex. 



a Anterior superior spine of the ilium. 

b Pubes. 

c Poupart's ligament. 

d Sartorius muscle. 



e Adductor longus. 

/ Femur. 

y Rectus femoris muscle. 

h Part of the fascia iliaca. 



EXPLANATION OF THE SEVENTY-THIRD PLATE. 467 



ARTERIES. 



1 . External iliac. 

2. Internal iliac. 

3. Obturator. 

4. Circumflex iliac. 

5. Epigastric. 

6. Common femoral. 



7. Superficial femoral. 

8. " Profunda fermoris." 

9. External circumflex, or the 
branches which represent it. 

10. Internal circumflex. 



VEINS. 

11. External iliac. 113. "Profunda." 

12. Saphenous. I 14. Femoral. 



.htiitehnui v. 

Figure 1. The external circumflex is given from the fe- 
moral separately, and above the origin of the profunda. 

Some circumstances connected with other vessels in this 
figure are not undeserving of notice : Several branches arise 
close to Poupart's ligament. The circumflex iliac artery 
divides immediately after its origin into two branches of con- 
siderable size. From the epigastric, a long slender branch 
runs backward on the outer part of the external iliac vein. It 
supplies the lymphatic glands. The position which the " pro- 
funda," the femoral, and the external iliac veins hold with 
respect to the arteries is fully displayed. 

Figure 2. Here likewise several branches arise in the 
immediate neighbourhood of Poupart's ligament. The circum- 
flex iliac consists of two separate parts, one of which springs 
from two short roots. 

The external circumflex is represented by two branches 
having distinct origin : the descending branches, for the 
supply of the anterior and outer side of the thigh, arise from 
the femoral ; the circumflex and ascending part, from the 
profunda. 

This drawing was taken from a dried preparation. 

Figures 3 and 4 represent portions of two femoral arteries 
of the right side the oblique line at the top indicating the 
place of Poupart's ligament. 

They are intended to show the external circumflex taking 
origin from the femoral artery in separate parts, and in 
different positions. 



468 EXPLANATION OF THE SEVENTY-FOURTH PLATE. 

Figure 5. The descending part of the external circumflex 
artery takes its rise above the profunda, and from this (the 
profunda) the remainder of the same artery, viz. the ascend- 
ing and circumflex portion is given. 

Figure 6. Both the circumflex arteries are furnished from 
the common femoral, by a common trunk, which takes origin 
above the profunda. 

The external circumflex appears here, as in several cases 
shown in preceding figures, in two parts having separate origin. 
The profunda is reduced to the trunk from which the per- 
forating arteries are furnished. 



EXPLANATION OF PLATE LXXIV. 



THIS plate contains further illustrations of peculiarities 
occurring in the branches of the femoral artery, particularly 
in the internal circumflex. 



a Anterior superior spine of the ilium. 

b Pubes. 

c Poupart's ligament. 

d Sartorius muscle. 



e Adductor longus. 

/ Pectinens. 

g Rectus femoris. 

h Vastus internus. 



ARTERIES. 



1 . External iliac. 

2. Obturator. 

3. Epigastric. 

4. Circumflex iliac. 

5. Superficial femoral. 



6. " Profunda femoris." 

7. External circumflex. 

7 l . A branch of same, given from the 
circumflex iliac. 

8. Internal circumflex. 



Figure 1. A portion of the external circumflex artery is 
given from the circumflex iliac. The internal circumflex is 
derived from the epigastric, and is directed backward between 
the femoral artery and vein. The arteries from which both 
these branches were furnished arose under Poupart's liga- 
ment; which was moved upwards while the drawing was 
made, in order that the vessels might be more fully displayed. 

Figure 2. In the preparation from which this outline of 
the arteries has been drawn, the internal circumflex of the 



EXPLANATION OP THE SEVENTY-FIFTH PLATE. 469 

left side takes origin as a separate brancji from the end of the 
external iliac artery. 

Figure 3. The internal circumflex arises from the epigas- 
tric artery, and curves over the femoral vein. 

Figure 4. The epigastric, obturator, and internal circum- 
flex arise from a common trunk, under Poupart's ligament. 
This structure was raised during the delineation in order to 
expose the branches. The internal circumflex turns round 
the femoral vein in passing backwards to its destination. 

The sartorius muscle in this case is directed towards the 
inner side of the limb more speedily, and covers the femoral 
artery at a higher point than usual. 

Figure 5. The internal circumflex branch is given by the 
circumflex-iliac. It was directed inwards behind the femoral 
artery and vein. 



EXPLANATION OF PLATE LXXV. 

SOME peculiarities in the conformation of the femoral vein 
are represented in this plate. All the figures are drawn on 
a reduced scale, in the same manner as the veins of other 
parts. 

a Anterior superior spine of the I d Sartorius muscle, 

ilium. J e Adductor longus. 

b Pubes. i / Rectus femoris. 

c Poupart's ligament. 1 g Vastus niternus. 

1. Femoral artery. 

VEINS. 

2. Femoral. | 2f. Divisions of the same. 

3. Saphenous. 

Figure 1. The femoral vein divides into two equal parts, 
which after lying close together for the space of about two 
inches, again unite into a single trunk. A portion of the 
artery was removed for the purpose of more fully displaying 
the veins. 



470 EXPLANATION OF THE SEVENTY-FIFTH PLATE. 

Figure 2. In the case here delineated the principal vein 
divides and the parts reunite, in the same manner as in the 
preceding figure ; but one of the divisions turns obliquely over 
the femoral artery. 

Figure 3. The femoral vein is double in the greater part 
of its extent, so that the artery lies over two large veins. 

Figures 4 and 5. Small venous branches pass in different 
directions across the femoral artery. Several of these open 
into the femoral vein at both ends. 



471 



EXPLANATION OF PLATE LXXVI. 



THIS plate shows the arteries on the back part of one (the 
right) side of the pelvis, the gluteus maximus having been 
removed. The upper and lower ends of the muscle still 
remain, and on the left side, it is seen entire. 

The integuments having been taken from the lower part of 
the thigh, the fascia is displayed ; and the appearance of the 
ham-string muscles, and of the entrance to the popliteal space 
before the division of that membrane, is discernible. 

The lower part of the rectum was brought into view, in 
consequence of the previous dissection of the perineum. 



Gluteus maximus muscle. 
Gluteus medius. 
Pyriformis. 
Obturator internus. 
Gemellus superior. 
Gemellus inferior. 
Quadratus femoris. 
Great sciatic ligament. 
Tuberosity of the ischium. 



i Smaller trochanter of the femur. 

k Rectum (intestinum rectum). 

/ Great trochanter of the femur. 

m Biceps femoris muscle. 

n Semi-tendinosus. 

o Gracilis. 

p Part of semi-membranosus. 

q Adductor magnus. 

r Fascia lata, turned back. 



ARTERIES. 



Gluteal. 

Sciatic. 

Pudic dissected out to a consi- 
derable extent. It is seen before 
emerging from the pelvis, and 
in turning upwards (after again 
entering it), on the inner side 



of the obturator internus muscle 
above the tuberosity and the 
ramus of the ischium. The 
pudic nerve accompanies the 
artery. 

End of the internal circumflex. 

Perforating branch. 



6. Great sciatic. 



NERVES. 

I 7. Small sciatic. 



EXPLANATION OF PLATE LXXVII. 



A DEEPER view of the arteries of the back of the pelvis than 
the preceding one is represented in this plate. A considerable 
part of the popliteal artery has likewise been exposed ; and, 
by the division and separation of the ham-string muscles, the 
arteries from the anterior surface of the thigh are displayed 
most of them perforating the adductor magnus muscle. 

u u 



472 



EXPLANATION OF THE SEVENTY-EIGHTH PLATE. 



a Crest of the ilium 

b Tuberosity of the ischium. 

c Great trochanter of the femur, 

cf Small trochanter. 

rj Great sacro-sciatic ligament. 

(I Gluteus maximus muscle. 

e Gluteus medius its lower end. 

f Gluteus minimus. 

</ Pyriformis. 

h Obturator internus. 

i Gemellus superior, 

if Gemellus inferior. 



k Tendon of obturator externus. 

/ Quadratus femoris. 

m Adductor magnus. 

n The conjoined upper extremity of 

biceps and semi-tendinosus. 
wf Semi-tendinosus. 
o Long head of biceps, 
of Short head of same. 
q Semi-membranosus. 
r Gracilis. 

s Heads of gastrocnemius. 
t Rectum (intestinuni). 



1. Gluteal. 

2. Sciatic, 

3. Pudic. 



ARTERIES. 

4. Internal circumflex. 

5. Perforating arteries. 

6. Popliteal. 



7. Great sciatic. 

7f. Small sciatic. It had fallen in- 
wards from its natural position 
before the drawing was made. 

8. External popliteal or peroneal. 



NERVES. 

9. Internal popliteal, or posterior 

tibial. 
2. Two cutaneous branches, one being 

the short saphenous. 



EXPLANATION OF PLATE LXXVIIL 



a Semi-tendinosus muscle. 

b Semi-membranosus. 

&f Tendon of same. 

c Biceps. 

cf Tendon of same. 

d Heads of gastrocnemius. 

e Part of adductor magnus. 

/ Vastus externus. 

/t Vastus internus. 

1 . Popliteal. 

2, 3. Superior articular. 
4, 5. Inferior articular. 
6. Sural branches. 



g Upper end of plantaris. 

h Popliteus. 

i Tendon of sartorius. 

k Tendons of gracilis and semi-ten- 
dinosus. 

/ Peroneus longus. 

m Fibula. 

n Fascia of the leg. 

i o Patella. 

ARTERIES. 

j 7. Anastomotic. 

8. Anterior tibial. 

9. Posterior tibial. 
I 10. Peroneal. 



External, or short saphenous. 

External popliteal, or peroneal 
Part of long saphenous. 



VEINS. 
11. Popliteal. | 12. 

NERVES. 

13. Internal popliteal, or posterior I 14. 
tibial. I 15. 

Figure 1 is a view of the popliteal space of the left limb, 
and the artery is shown in connexion with the veins and 
nerves. The preparation consisted in the division of the 
integuments and fascia, and the removal of fat from around 
the vessels and nerves. 

Figure 2. The popliteal artery of the left side, and its 
branches fully exposed by the removal of the muscles, are here 
viewed from behind in connexion with the lower part of the 



EXPLANATION OF THE SEVENTY-NINTH PLATE. 473 

femur and the upper extremities of bones of the leg, together 
with portions of some of the muscles. 

Figure 3. The parts represented in the preceding figure 
are here shown from the inner side. The aponeurosis of the 
vastus internus was removed to some extent, in order to bring 
into view the arterial branches in contact with the femur. 



EXPLANATION OF PLATE LXXIX. 

THE branches of the popliteal artery are exhibited in the first 
figure; and in the remaining figures some peculiarities of the 
artery are delineated. 



a Femur. 

b Fibula. 

c Tibia. 

d Patella. 

e Part of adduct or magnus muscle. 

/ Tendon of semi-membranosus. 



h Tendon of Sartorius. 

i Tendons of gracilis and semi-ten- 

dinosus. 
k External lateral ligament of the 



g Popliteus. 

ARTERIES. 



knee-joint. 
Tendon of biceps muscle. 



5-J-. Superior internal articular. 

6. Inferior external articular. 

7. Recurrent branch of anterior tibial. 

8. Terminal branch of profunda fe- 



1. Popliteal. 

2. Anterior tibial. 

3. Posterior tibial. 

4. Peroneal. 

5. Superior external articular. 

Figure 1 shows the ordinary branches at the outer side of 
the knee-joint. 

Figure 2. In this series of sketches, the intervals between 
the origin of the arteries of the leg are illustrated. The 
oblique -line indicates the lower margin of the poplitetis 
muscle. The distance of the division of the posterior tibial 
from the origin of the anterior tibial is observed to be gradually 
augmented from A to E. 

Figure 3. The popliteal artery divides behind the middle 
of the knee-joint, and the anterior tibial continues close by 
the larger vessel to the point at which it is directed forward 
to the fore part of the limb. 

Figure 4. The anterior tibial is directed under the popliteus 
muscle, and after passing in front of that muscle, reaches the 
anterior aspect of the leg in the usual position. 

Figure 5. In this example of premature division of the popli- 
teal, the anterior tibial and peroneal form a common trunk. 

Figure 6. The posterior tibial, anterior tibial, and peroneal 
arteries, arise together from the end of the popliteal artery. 



474 

EXPLANATION OF PLATE LXXX. 

THE figures of this plate illustrate some of the peculiarities 
of the veins, and of one of the muscles in immediate connexion 
with the popliteal artery. 



a Femur. 

b Adductor magnus muscle, cut. 

c Part of the gluteus maximus. 

cf Vastus externus. 

d Biceps. 



/ Semi-membranosus. 

g Gastrocnemius. 

#f An unusual (third) head for same. 

h Plantaris. 

i Soleus. 



Semi-tendinosus. 

ARTERIES. 

1. Femoral. j 2. Popliteal. | 3. Profunda femoris. 

VEINS. 

6. Popliteal joined with the profunda 



vein. 



4. External saphenous. 

5. Popliteal. 

5f. Double popliteal. 

NERVES. 

7. Internal popliteal or posterior I 8. External popliteal or peroneal. 
tibial. 

Figure 1. The position of the popliteal artery and vein is 
reversed. The artery is the more superficial and external, 
and the external saphenous vein turns round it to terminate 
in the large vein. 

Figure 2. The popliteal vein is double, and one of the 
parts lies at each side of the popliteal artery. 

Figure 3. The popliteal vein, instead of being placed with 
the artery in the same aperture of the adductor magnus, per- 
forates that muscle much higher up, and joining the profunda 
vein, comes into contact with the femoral artery, for. the first 
time, at the groin. The upper part of the popliteal and the 
superficial femoral artery are accompanied by two small vense 
comites. 

The external saphenous vein, instead of ending in the popli- 
teal, joins with a muscular branch in the adductor magnus. 

Figure 4. A small unusual muscle arising from the inner 
condyle of the femur, separates the internal popliteal nerve 
from the blood- vesseis, and joins the anterior or deep surface 
of the gastrocnemius by a slender tendon. It may be consi- 
dered a third head of the gastrocnemius muscle. 

Figure 5. A bundle of fleshy fibres, taking origin from the 
external condyle of the femur, crosses between the popliteal 
artery and vein, and is blended with the internal head of the 
gastrocnemius. 



FEMORAL ARTERIES. 



THE following Table has reference to the Deep Femoral arteries and two of the 
Branches usually derived from them viz., the External Circumflex and the 
Internal Circumflex. Other Branches furnished by the Femoral arteries, e.g., the 
irregular " Muscular " branches, and those occasionally transferred to the Femoral 
from the External Iliac, will be noticed in the Commentary. And in the same place 
will be found an explanation of the term " usual," often applied to the principal off-sets. 



THE DEEP FEMOKAL (" PROFUNDjE") AND THEIR BRANCHES. 


No. 


li 

a 


V.* 

5 ao-O 

c * a 

X r^ 3 O. 

PH 


Ext. 

Circumflex 
its manner of 
origin, &c. 


Int. 
Circumflex 
its manner of 
origin, &c. 


No- 


Side of the 
body. 


Distance in 
inches nf 
Profunda fr. 
Poup. lifft. 


Ext. 
Circumflex 
its manner of 
origin, &c. 


Int. 
Circumflex- 
its manner of 
origin, &c. 


3b 


L 


under 








L 


1 


usual . 


fr. Feral, at 






the lig- 














same height 






ament. 














as Profund. 


5t 


L 




fr. Feml. un- 


usual. 


14 


R 


1 


fr. Feml. at 


usual. 








der Poup. 










same height! 








ligament. 










as Profund. 




8 


L 


2 


usual. 


fr. Feml. at 




L 


1 


fr. Feiiil. at 


usual. 










same height 








same height 












as Profund. 








as Profund. 




9 


R 


2 


usual. 


usual. 


15 


R 


2* 








L 


2| 


usual. 


fr. Feml. | 




L 


1 


in two parts : 


fr. Feml. 1 










inch below 








both arising 


inch below 










Poup. ligt. 








fr. Profund. 


Poup. ligt. 


10 


R 


3 


fr. Femoral 


fr. Femoral 


15b 


R 


2 


usual. 


usual. 








above Pro- 


above Pro- 


















funda. 


funda. 




L 


b 


usual. 


usual. 


lOa 


R 


2 


in two parts : 


usual. 


16 


R 


3 












the descend- 




















ing one fr. 






L 


2 












Feml. close 




















to Profund. 




19b 


L 


H 


fr. Femoral. 


usual. 


11 


R 


under 






19c 


R 


2* 


fr. Femoral 


usual. 






Poup. 












above Pro- 








liga- 












funda. 








ment. 


















L 


2 


usual. 


usual. 


19e 


R 


2 


fr. Feml. 1 usual. 


















inch below 




13b 


R 


21 












Poup. ligt. 





X X 



476 



FEMORAL ARTERIES. 



THE DEEP FEMORAL ("PROFUND JS") AND THEIR BRANCHES. 




1. 


'a * "rt . 


Ext. 


Int. 




1 Ml 


Ext. 


Int. 


No. 


of 


Hid 


Circumflex- 
its manner of 


Circumflex 
its manner of 


No. 


o-tjlljl 


Circumflex ' 
its manner of 


Circumflex- 
its manner of 




i* 


PP 


origin, &c. 


origin, &. 







1*1* 


origin, &c- 


origin, &c. 


21 


R 


1 


fr. Femoral 


usual. 


31f 


R 


2 


usual. 


fr. Feml. at 








below Pro- 












same height 








funda. 












as Profund. 




L 


M 


fr. Feml. at 


usual. 


31$ 


L 


2 


usual. 


fr. Feml. at 








same place 












same height 








as Profunda 












as Profund. 


23 


R 


i* 


fr. Feml. 1 


usual. 


31a 


R 


2 


usual. 


usual. 








inch below 




















origin of 






L 


under 


A descending 


usual. 








Profunda. 








the 


br. arises 


















ligt. 


above Poup 






L 


2 


usual. 


usual. 








ligt. 




23a 


R 


H 


fr. Feml. \ 


fr. Feml. at 


31f 


R 


under 












inch below 


same height 






the 












Poup. ligt. 


as Profund. 






ligt. 








L 




usual. 


fr. Femoral. 


32 


R 


2 






26 


L 


3 


usual. 


fr. Femoral 




L 


2 














above Pro- 




















funda. 


32a 


R 


1 






29 


R 


1 








L 


2 


in two parts : 


usual. 


















both arising 






L 


1 












fr. Profund. 








above 




















(helig- 






32b 


R 


11 










ament. 


























33a 


R 


2 


usual. 


usual. 


30 


R 


1 




























L 


2_L 


usual. 


fr. Circumfi. 




L 


2 










2 




iliac ; and 




















crosses in- 


30a 


R 


2 


usual. 


fr. Femoral 










ward be- 










above Pro- 










hind Feml. 










funda. 










artery and 




















vein. 




L 


2 


usual. 


fr. Femoral 




















above Pro- 


34e 


L 


H 


usual. 


usual. 










funda. 






















36 


R 


li 


in two parts : 


usual. 


31 


L 


2 


fr. Feml. 1 










the descend- 










inch above 










ing one fr. 










Profunda. 










Feml. below 




















Profunda. 




31* 


L 


2 


fr. Femoral 


usual. 


















close to Pro- 






L 


li 


same as on 


usual. 








funda. 


f 








right side. 





FEMORAL ARTERIES. 475 


THE DEEP FEMORAL ("PROFUNDA") AND THEIR BRANCHES. 




| 


2t s*a 


Ext. 


Int. 




J 


s s*s 


Ext. 


Int. 


No. 


:P 

09 


B 


Circumflex- 
its manner of 
origin, &c. 


Circumflex 
its manner of 
origin, &c. 


No. 


9 


Mi 


Circumflex 
its manner of 
origin, &c. 


Circumflex 
its manner of 
origin, &c. 


37a 


R 


2 








L 


3 




fr. Femora 




















above Pro- 




L 


2 














funda. 


37b 


R 


]i 


fr. Feml. at 


usual. 


48 


R 


2 


usual 


fr. Feml. at 








same height 












same height 








as Profund. 












as Profund.. 


38 


R 


2| 


usual. 


usual. 




L 


2 


fr. Feml. a 


usual. 


















same heigh 






L 


2f 


usual. 


usual. 








as Profund 




40a 


R 


1 


fr. Feml. at 


usual. 


50 


R 


2 


usual 


fr. Feml. at 








same height 
as Profund. 












same height 
as Profund. 




L 


1 


same as on 


usual. 




L 


2 


fr. Feml. at 


usual. 








right side. 










same height 




42 


R 


2 












as Profuud 






L 


2 


usual. 


fr. Femoral 
above Pro- 
funda. 


51 


R 


3 


n two parts : 
a descend- 
ing br. fr. 


two branches; 
one (a small 
one) arises 


43 


R 


2 


usual. 


usual. 








Feml. above 
Profunda. 


above Pro- 
funda. 




L 


1* 


isual. 


fr. Feml. at 
same height 




L 


3 


ame as right 
side 


usual. 










as Profund. 












44 


R 


2 l 






52 


R 


n 


usual. 


usual. 




L 


1 








L 


1 


usual. 


usual. 


46 


R 


2 


usual. 


usual. 


53 


R 


1"! 


usual. 


usual. 




L 


H 


fr. Feml. at 


usual. 




L 


2 


usual. 


r. Feml. at 








same height 
as Profund. 












same height 
as Profund. 


46a 


R 


under 






54 


L 


2 


usual. 


usual. 






he lig- 




















ament. 


























55 


R 


i 


n two parts : 


usual. 


47* 


R 


2 


usual. 


usual. 








a descend- 




















ing br. fr. 






L 


2 


usual. 


usual. 








Feml. 1 




















inch below 




48 


R 


3 


usual. 


fr. Femoral 








Profunda. 












above Pro- 




















funda. 




L 


* 


sual. 


sual. 



X X 2 



478 



FEMORAL ARTERIES. 



THE DEEP FEMORAL ("PROFUNDA") AND THEIR BRANCHES. 


No. 


1. 
1 


llj! 


Ext. 

Circumflex 
its manner of 


Int. 

Circumflex- 
its manner of 


No. 


!* 


li 


Ext. 
Circumflex 
its manner of 


Int. 
Circumflex- 
its manner of 




a 
02 




origin, &c. 


origin, &c. 




S" 1 
53 




origin, &c. 


origin, &c. 


56 


R 


H 


in two parts ; 


r. Feml. 




L 


2 


usual. 


arises fr. Pro- 








a descending 


above Pro- 










funda ; and 








br. arises fr. 


funda. 










ascends to 








Feml. above 












gain the in- 








Profunda. 












termuscular 




















space, in 




L 


i^ 


usual. 


usual. 










which it is 




















directed 


57 


R 


H 


isua.. 


usual. 










backwards. 




L 


H 


usual. 


usual 


64 


R 


If 


usual. 


fr. Feml. at 


__ 


R 


a 














same height 




*\ 


* 














as Profuud. 




L 


1 






65 


R 


H 


usual. 


usual. 


59 


R 


li 


n two parts : 


usual. 


















the descend- 




66 


R 


1 












ing one fr 




















Feml. at 
same height 




67 


L 


3 












as Profund 
























68 


R 


ji 








L 


2 


fr. Feml. a 


fr. Feml. at 


















same heigh 


same height 




L 


li 












as Profund 


as Profund. 






















69 


R 


li 


in two parts 


usual. 


60 


R 


li 












both being 




















fr. Feml. ; 






L 


li 












thecircumfl, 




















part above 




61 


R 


li 


usual. 


fr. Feml. 
above Pro- 
funda. 








Profunda, 
and the de- 
scending be- 
low same. 






L 


H 


usual . 


fr. Feml. 
above Pro- 




L 


2 


usual. 


usual . 










funda. 






















70 


R 


2 


fr. Feml. at 


ascends after 


62 


R 





usual. 


usual. 








same place 
as Profund 


its origin to 
insinuate it- 




L 


U 


usual. 


usual. 










self betw. 




















the psoas 


63 


R 


2 


in two parts 


fr. Feml. at 










and pectine- 
us muscles. 








the descend 


1 inch fr. 


















ing one fr 


Poup. ligt. 




L 


4 


fr. Feml. 2 


fr. Feml. j| 








Feml. 1 inc 










inches be- 


inch below 








above Pro 










low Poup. 


Poup. ligt. 








funda. 










ligament. 





FEMORAL ARTERIES. 



479 



THE DEEP FEMORAL ("PROFUND^n AND THEIR BRANCHES. 


No. 


Sideofth* 
body. 


Distance in 
inches of 
Profunda fr. 
Poup. ligt. 


Ext. 
Circumflex 
its manner of 
origin, &c. 


Int. 
Circumflex 
its manner of 
origin, &c. 


No. 


Side of the 
body. 


Distance in 
inches of 
Profunda fr. 
Poup. liet. 


; Ext. 
Circumflex- 
its manner of 
origin, &c. 


Int. 
Circumflex- 
its manner of 
origin, &c. 


71 


R 


2 


in two parts : 


usual. 




L 


ii 


in two parts: 


usual. 








the descend- 










the descend- 










ing one fr. 










ing one fr. 










Feml. above 










Feml. 3 in- 










Profunda. 










ches below 




















Poup. ligt. 






L 


If 


usual. 


usual. 






















79 


R 


i 


in two parts: 


usual. 


72 


R 


If 


usual. 


fr. Feml. f 








the descend- 












inch below 








ing one fr. 












Poup. ligt. 








Feml. 1 inch 






L 


li 


fr. Feml. 1 


fr. Feml. 1 








below Poup. 
ligament. 










inch below 


inch below 


















Poup. ligt. 


Poup. ligt. 


80 


R 


2i 


usual. 


usual. 


73 


R 


2 


usual. 


fr. Feml. at 




L 


21 


usual. 


usual. 










same height 
as Profund. 


81 


R 


lf 








L 


H 


usual. 


usual. 




L 


$ 


usual. 


usual. 












82 


R 


12. 


usual. 


fr. Feml., a 


74 


R 


n 


usual. 


usual. 










little above 




















Profunda; is 




L 


i 


in two parts : 


usual. 










small. 








one (a small 




















br.)fr.Feml. 






L 


2 


usual. 


fr. Feml. a 








above Pro- 












little above 








funda. 












Profunda. 


75 


R 


a 

4 


usual. 


usual. 


83 


R 


2 


usual. 


usual. 




L 


2 


in two parts : 


fr. Feml. 1^ 




L 


H 


usual. 


usual. 








the descend- 
ing one fr. 


inch below 
Poup. ligt. 


84 


R 


If 


usual. 


usual. 








Feml. at 1| 
inch below 






L 


1 


usual. 


usual. 








Poup. ligt. 




85 


R 


2 


usual. 


usual. 


76 


R 


1| 


usual. 


usual. 




L 


2 


usual. 


usual. 




L 


ji 


usual. 


usual. 


86 


R 


f 


n two parts, 


fr. Feml. at 


















both arising 


same height 


77 


R 


H 


usual. 


usual. 








from Pro- 
funda. 


as Profund. 




L 


if 


usual. 


usual. 




L 


1 


usual. 


usual. 


78 


R 


H 


usual. 


usual. 


87 


L 


1 


usual. 


usual. 



480 



FEMORAL ARTERIES. 



THE DEEP FEMORAL ("PROFUNDA") AND THEIR BRANCHES. 


No. 


3. 

9 

to 


Distance m 
inches of 
Profunda fr. 
Poup. ligt. 


Ext. 

Circumflex- 
its manner of 
origin, &c. 


Int. 
Circumflex- 
its manner of 
origin, &c. 


No. 


Side of the 
body. 


Distance in 
inches of 
Profunda fr. 


Ext. 

Circumflex 
its manner of 
origin, &c. 


Int. 
Circumflex- 
its manner 
of origin, &c. 


88 


R 


if 


usual. 


usual. 




L 


1 


usual. 


usual. 




L 


2 


usual. 


usual . 


97 


R 


2 


fr. Feml. at 


usual. 


















same height 




89 


B 


2 


n two parts: 


usual. 








as Profund. 










the descend- 




















ing one fr. 






L 


2 


usual. 


usual. 








Feml. a 




















little above 




98 


R 


1| 


fr. Feml. at 


usual. 








Profunda. 










same place 




















as Profund. 






L 


*i 


n two parts : 


usual. 


















both arising 




99 


R 


i 


usual. 


usual. 








fr. Feml. : 




















the descend- 






L 


1 


usual. 


usual. 








ing one 




















above Pro- 




100 


R 


2 


usual. 


fr. Feml. at 








funda, the 












same height 








other (cir- 












as Profund. 








cumflex) 




















below same. 






L 


1 


usual. 


usual. 


90 


R 


n 


usual. 


usual. 


ioi 


R 


2 


usual. 


fr. Feml. 1 




















inch below 




L 




usual. 


usual. 










Poup. ligt. 


91 


R 


i 


usual. 


usual. 




L 


1 


in two parts : 


fr. Feml. at 


















the descend- 


Poup. ligt. 




L 


i 


usual. 


usual. 








ing one aris- 




















ing fr. Feml. 




92 


R 


H 


usual. 


usual. 








3 inches be- 




















low Poup. 






L 


if 


usual. 


usual. 








ligament. 




93 


R 


i 


fr. Feml. at 


usual. 


102 


R 


H 


usual. 


usual. 








same height 




















as Profund. 






L 


2J 


usual. 


fr. Fern, at 1 




















inch from 


94 


R 


2f 


usual. 


fr. Feml. 1 










Poup. ligt. 










inch below 




















Poup. ligt. 


103 


L 


2 


usual. 


fr. Fern, op- 




















pos. Profun. 




L 


H 
















95 


R 


3 


fr. Feml. 1 


usual. 


104 


R 


is 


usual. 


usual. 








inch from 
Poup. ligt. 






L 


H 


usual. 


usual. 




L 


1 


usual. 


usual. 


105 


R 


H 


usual. 


usual. 


96 


R 


1 


usual. 


usual. 




L 


2 


usual. 


usual. 



FEMORAL ARTERIES. 



481 



THE DEEP FEMORAL ("PROFUND^Z") AND THEIR BRANCHES. 


No. 


Side of the 
body. 


Distance in 
inches of 
Profunda fr. 
Poup- ligt. 


Ext. 

Circumflex 
its manner of 
origin, &c. 


Int. 
Circumflex 
its manner of 
origin, &c. 


No. 


OS 


Distance in 
inches of 
Profunda fr. 
Poup. ligt. 


Ext. 
Circumflex 
its manner of 
origin, &c. 


Int. 
Circumflex 
its manner of 
origin, Sec, 


106 


R 


If 


usual. 


usual. 




L 


4 


fr. Feml. at 




















same height 








14 


usual. 


usual. 








as Profund. 




'107 


R 


2 






116 


L 


li 


fr. Feml. at 


usual. 


















3 inches fr. 




108 


R 


ji. 


fr. Feml. at 


usual. 








Poup. ligt. 










same height 




















as Profund. 




117 


R 


2 


usual. 


usual. 




L 


2* 


same. 


usual. 


118 


R 


Ml 


usual. 


usual. 


109 


R 


2| 


usual. 


usual. 




L 


2 


usual. 


usual. 






2 


usual. 


usual. 






















119 


R 


ji 
2 


fr. Feml. at 


T. Feml. at 


110 


R 


1| 


Descending 


usual. 








same height 


same height 








part fr. Fein. 










as Profund. 


as Profund. 








oppos. Pro- 




















funda. 






L 


11 


Descndg.part 


usual. 


















fr. Feml. at 






L 


1 


same. 


usual. 








1 inch fr. 




















Poup. ligt. 




111 


R 


l-i 


usual. 


fr. Feml. op- 




















pos. Profun. 


120 


R 


If 


usual. 


fr. Feml. at 




















1 inch fr. 




L 


1 


usual. 


usual. 










Poup. ligt. 


112 


R 


If 


Descndg.part 






L 


If 


usual. 


fr. Feml. at 








fr. Feml. at 












f inch fr. 








Poup. ligt. 












Poup. ligt. 




L 


2 i 

* 


usual. 


usual. 


121 


R 


!i 


Part fr. Fern. 


fr. Feml. at 
















4 


at Poup. 


Poup. ligt. 


113 


R 


2 


usual. 


usual. 








ligament. 






L 


11 


usual. 


usual. 




L 


f 


fr. Feml. at 


fr. Feml. at 


















same height 


same height 


114 


R 


H 


arises in two 


usual. 








as Profund. 


as Profund. 








parts, from 




















Feml. ; cir- 




122 


R 


if 


usual. 


usual. 








cumflex at 




















1 inch fr. 






L 


H 




usual. 








Poup. ligt. : 




















and descnd. 




















part at 3 




















inches. 




123 


R 


2 


usual. 


usual. 




L 


*i 


usual. 


usual. 




L 


I* 


usual. 


usual. 


115 


R 


if 






124 


R 


H 


usual. 


usual. 



482 



FEMORAL ARTERIES. 



TUB DEEP FEMORAL ("PROFUNDA") AND THEIR BRANCHES. 


No. 


Side of the 
body. 


Distance in 
inches of 
Profunda fr. 
Poup. list. 


Ext. 
Circumflex- 
its manner of 
origin, &c. 


Int. 
Circumflex 
its manner of 
origin, &c. 


No. 


Side of the 
body. 


Distance in 
inches of 
Profunda fr. 
Poup. ligt. 


Ext. 

Circumflex 
its manner of 
origin, &c. 


Int. 
Circumflex 
its manner of 
origin, &c. 




L 


1 


usual. 


usual. 


134 


R 


2* 


usual. 


fr. Feml. at 




















2 inches fr. 


125 


R 


2 


usual. 


usual. 










Poup. ligt. 




L 


H 


fr. Feml. - 


usual . 




L 


2 


fr. Feml. at 


usual. 








inch fron 










same height 










Poup. ligt. 










as Profund. 




126 


R 


H 


fr. .Feml. 2| 


crosses pec- 


135 


R 


|| 


fr. Feml. at usual. 








inches fr 


tineus and 








same height 










Poup. ligt. 


passes back 








as Profund. 












to its inner 




















side. 


L 


!? 


usual. 


usual. 




L 


li 


same. 


same. 


136 R 


2 


usual. 


two brs.; one 


















slender fr. 


127 


R 


li 


fr. Feml. a 


usual. 








Feml. at 1 








1 inch from 












in. fr. Poup. 








Poup. ligt. 












ligt. : other 




















fr. Profund., 




L 


H 


fr. Feml. a 


usual. 










and lower 








same heigh 












than usual. 








as Profund 


























L 


21 


usual. 


very small. 


128 


R 


1|- ' usual. 


usual. 




















137 


R 


|l 


fr. Fern, close 


usual. 




L 


1 usual. 


usual. 








to Profund 




129 


R 


] ^ usual . 


usual. 




L 


1 


usual. 


usual. 




L 


1 


usual. 


usual. 


138 


R 


If 


usual. 


usual. 














L 


4 


usual. 


usual. 


130 


R 


1| usual. 


usual. 




















139 


R 


i 


usual. 


usual. 




L 


1 


usual. 


usual. 
























L 


i 


usual. 


usual. 


131 


R 


n 


usual. 


usual. 


140 


R 


if 


usual. 


usual. 




L 


i 


usual. 


isual. 




L 


if 


usual. 


usual. 


132 


R 


U 


fr. Feml. at 


usual. 


141 


R 


i 


usual. 


usual. 








2 inches fr. 




















Poup. ligt. 






L 


4 


Par tfr. Fern. 


usual. 


















at 2 in. fr. 






L 


i* 


same. 


isual. 








Poup. ligt. 




133 


R 


2 


usual. 


isual. 


142 


R 


1| 


isual. 


isual. 
















1 






L 


H 


usual. 


usual. 


143 


R 


2* 1 usual. 


isual . 



FEMORAL ARTERIES. 



483 



THE DEEP FEMORAL ("PROFUND^;,") AND THEIR BRANCHES. 




1 


fl .; . 

o*tt 


Ext. 


Int. 




2 


;=i 


Ext. 


Int. 


No. 


3! 

m 


Distant 
inches 
Profundi 
Poup. li 


Circumflex- 
its manner of 
origin, &c. 


Circumflex 
its manner of 
origin, &c. 


No. 


It 

m 


SIR 

5- s S 


Circumflex 
its manner of 
origin, &c. 


Circumflex 
its manner of 
origin, &c. 




L 


2* 


usual. 


usual. 


157 


R 


1 


usual. 


usual. 


144 


R 


1 


Descend.part 


usual. 




L 


If 


usual. 


fr. Feml. at 








fr. Feuil. at 












same height 








1 in. from 












as Profund. 








Poup. ligt. 
























159 


R 


If 


usual. 


usual. 




L 


i$ 


usual. 


fr. Feml. at 




















same height 


160 


R 


1 


fr. Feml. at 


usual. 










as Profund. 








2 inches fr. 




















Poup. ligt. 




145 


R 


if 


usual. 


usual. 
















l 






L 


if 


usual. 


usual. 




L 


ii 


usual. 


usual. 






















165 


R 


f 


fr. Feml. op- 


usual. 


146 


R 


fi 


usual. 


usual. 








posite Pro- 




















fnmla. 




147 


L 


*i 


fr. Feml. at 


usual. 


















same height 






L 


if 


fr. Feml. 


usual. 








as Profund. 










inch below 












* 








Poup ligt. 




148 


R 


ii 


usual. 


usual. 
















m 






166 


R 


i 


usual. 


usual. 




L 


2 


usual. 


usual. 
























L 


2 


usual. 


usual. 


149 


R 


2 


usual. 


usual. 






















167 


R 


H 


usual. 


usual. 




L 


2 


usual. 


usual. 
























L 


1 


usual. 


fr.Feml.at 


150 


R 


1 


usual. 


usual. 










inch below 




















Poup. ligt. 




L 


1 


usual. 


usual. 












152 


R 


2 


usual. 


usual. 


169 


R 


3 

4 


usual. 


usual. " 




L 


fl 


usual. 


usual. 


169 m 


R 


If 


usual. 


usual. 


153 


R 


If 


usual. 


usual. 




L 


il 


usual. 


usual. 




L 


If 


usual. 


usual. 


169n 


R 


under 


in two parts : 


usual. 


155 


R 


1 


usual. 


usual. 






the 
ligt. 


both from 
Femoral. 






L 


If 


usual. 


usual. 




L 


1 


fr. Feml. op- 


usual. 


156 


R 


1 


Br. to vast, 
intern, at 4 


usual. 








posite Pro- 
funda. 










inches from 




















Poup. ligt. 




169 


R 


2 


fr. Feml. at 


fr. Feml. at 


















3 inches fr. 


1 inch from 




L 


*i 


usual, 


usual. 








Poup. ligt. 


Poup. ligt. 



484 



FEMORAL ARTERIES. 



THE DEEP FEMORAL (" PROFUND JB") AND THEIR BRANCHES. 


No. 


1 Side of the 
1 body. 


Distance in 
inches of 
Profunda fr. 
Poup. lifft. 


Ext. 

Circumflex 
its manner of 
origin, &c. 


Int. 
Circumflex- 
its manner of 
origin, &c. 


No. 


Side of the 
body. 


Distance in 
inches of 
Profunda fr. 
Poup. ligt. 


Ext. 
Circumflex- 
its manner of 
origin, &c. 


Int. 
Circumflex- 
its manner of 
origin, &c. 




L 


2 


n two parts: 


fr. Feml. at 


173* 


R 


I 


usual. 


usual. 








one fr. Fern. 


1^ inch fr. 


















the other fr. 


Poup. ligt. 






* 


usual. 


usual. 








Profunda. 
























174 


R 


H 


usual. 


usual. 


170 


R 


1 


fr. Feml. 


usual. 


















opposite 






L 


it 


usual. 


arises from 








Profunda. 












Epigastric. 




L 


i 

4 


usual. 


usual. 


176 


R 


i* 


usual. 


usual. 


171 


R 


n 


usual. 


usual. 




L 


i 


usual. 


usual. 




L 


i* 


n two parts : 


usual. 


177 


R 


2 


usual. 


usual. 








both from 




















Fern.: one at 






L 


2 












1^ in. from 




















Poup. ligt., 




178 


R 


1* 


usual. 


usual. 








the other 3 




















inches from 






L 


If 


usual. 


fr. Feml. at 1 








same. 












inch below 




















Poup. ligt. 


171f 


R 


i 


in two parts : 
one( circum- 


usual. 


179 


R 


n 


usual. 


usual. 








flex) from 
Profunda, 






L 


i 


usual. 


usual. 








the other 




















(descndng.) 




180 


R 


ti 


usual. 


fr. Feml. at 








fr. Feml. at 












1 inch below 








2 in. below 












Poup. ligt; 








Poup. ligt. 












is small. 




L 


* 


in two parts, 


usual. 




L 


n 


usual. 


from Feml. 








fr. Profund. 












above Pro- 








and Feml.; 












funda. 








descending 




















brs.fr. latter 
at 2 inches 




181 


R 


if 


usual. 


usual. 








below Poup. 
ligament. 






L 


H 


usual. 


usual. 


I72f 


R 


n 


usual. 


usual. 


182 


R 


H 


usual. 


fr. Feml. at 
same height 




L 


H 


usual. 


fr. Feml. at 










as Profund. 










same height 
as Profund. 




L 


jf 


usual. 


usual. 


173 


R 


H 


usual. 


usual. 


184 


L 


li 


from Feml. a 


usual. 


















little below 








2 


usual. 


usual. 








Profunda. 





FEMORAL ARTERIES. 



485 



THE DEEP FEMORAL ("PROFUND.^") AND THEIR BRANCHES. 


No. 


1 Side of the 
1 body. 


Distance in 
inches of 
Profunda fr. 
Poup. list. 


Ext. 
Circumflex 
its manner of 
origin, &c. 


Int. 
Circumflex 
its manner of 
origin, &c. 


No. 


Side of the 
1 body. 


Distance in 
inches of 
Profunda fr. 
Poup. ligt. 


Ext. 
Circumflex 
its manner of 
origin, &c. 


Int. 
Circumflex- 
its manner of 
origin, &c. 


185 


R 


If 


Torn Feral. 


Vom Feml. a 


193 


R 


li 


usual. 


usual. 








close to Pro- 


little higher 


















funda, 


than Pro- 




L 


i 


Descending 


usual. 










funda. 








part from 




















Feml. close 






L 


1| 


from Feml. 


usual. 








to Profund. 










close to Pro- 




















fuiida. 




195 


R 


H 


in two divi- 


usual. 


186 


R 


1* 


usual. 


from Feml. a 
little above 
Profunda. 








sions : the 
dscndg. prt. 
fr. Feml. at 
3 ins. below 






L 


1 


usual. 


usual. 








Poup. ligt. 




187 


R 


1 


usual. 


fr. Feml. at 
same height 
as Profund. 




L 


I* 


A portion of 
dscndg. prt. 
fr. Feml. at 
2 ins. below 


usual. 




L 


1 


usual. 


usual. 








Poup. ligt. 




189 


L 


U 






196 


R 


1J 






190 


R 


U 


usual. 


Fr. Feml. at 


197 


R 


H 


usual. 


usual. 










same height 




















as Profund. 




L 


H 


usual. 


usual. 




L 

^ 


ii 


usual. 


as on right 
side. 


198 


R 


w 


usual. 


usual. 














L 


i 


Descending 


usual. 


191 


R 


if 


fr. Feml. at 


usual. 








prt.fr.Feml. 










same height 










at 2 ins. 










as Profund. 










below Poup. 




















ligament. 






L 


i 


in two parts : 
both from 


usual. 


200 


R 


it 


usual. 


usual. 








Profunda : 
and des- 






L 


2 


in two parts : 


usual. 








cending pt. 










one fr. 
Feml. 1 










arises first. 










inch above 




















Profunda. 




192 


R 


ii 


in two parts ; 


usual. 


















the descend- 
ing fr. Fern. 




201 


R 


1 


usual. 


usual. 








above Pro- 
funda : rest 






L 


If 


usual. 


usual. 








from Pro- 




















funda. 




202 


R 


1 


usual . 


fr. Feml. op- 




















posite Pro- 




L 


2* 


usual. 


usual. 










funda. 



486 



FEMORAL ARTERIES. 



THE DEEP FEMORAL ("PKOFUNDJ2") AND THEIR BRANCHES. 


No. 


Side of the 
body. 


Distance in 
inches of 
Profunda fr. 
Poup. ligt. 


Ext. 

Circumflex- 
its manner of 
origin, &c. 


Int. 

Circumflex- 
its manner of 
origin, &c. 


No. 


Side of the 
body. 


Distance in 
inches of 
Profunda fr. 
Poup. ligt. 


Ext. 

Circumflex 
its manner of 
origin, &c. 


Int. 
Circumflex- 
its manner of 
origin, &c. 




L 


1 


in two divi- 


usual. 


215 


R 


2. 

4, 


Descending 


usual. 








sions, given 










brs. arise 










separately, 










fr. Feuil. in 










by Pro- 










two parts, 










funda : the 










at 1| inch 










descending 










and 2.^ ins. 










part arises 










belovvPoup. 










above the 










ligament. 










other. 


























L 


under 


A descending 


usual. 


207 


R 


1 


fr. Femoral 
close to 


usual. 






the 
liga- 


br. fr. cir- 
cumflex ili- 










Profunda. 








ment 


ac; circum- 
flex part fr. 








i 


usual. 


usual. 








Feml. at 2| 
ins. below 




2076 


L 


ft 


usual. 


usual. 








Poup. ligt. 




207c 


R 


it 


fr. Feml. at 
same height 
as Profunda 


usual. 


216 


R 


n 


usual. 


V. Femoral 
opposite 
Profunda. 




L 


i 


usual. 


usual. 


219 


R 


u 


usual. 


fr. Feml. op- 
posite Pro- 


210 


R 


H 


usual. 


usual. 










funda. 




L 


i* 


usual. 


fr. Feml. 
opposite to 
Profunda. 




L 


it 


A portion of 
descending 
branches is 
given sepa- 


fr. Feml. at 
1 inch be- 
low^ Poup. 
ligament. 


212 


L 


if 


usual. 


usual. 








rately by 
Profunda. 




213 


R 


i 


in two parts, 
given sepa- 


fr. Feml. 1 
inch below 


222 


R 


i 


usual. 


usual. 








rately, by 
Profunda. 


Profunda. 




L 





usual. 


usual. 




L 


i 


usual, 


fr. Feml. at 


223 


R 


H 


usual. 


usual. 










same height 
asProfunda. 




L 


fr* 


usual. 


usual. 












224 


R 


1 


usual. 


fr. Feml. 


214 


R 





in two parts; 


arises from 


















the descend. 


Feml. at 1^- 




L 


U 


usual. 


usual. 








ing one 


inch below 


















arises fr. 


Poup. ligt. 


225 


R 


U 


fr. Femoral 


usual. 








Feml. 2 










above Prof. 










ins. below 




















Poup. ligt. 






L 


i 


fiv Feml. op- 




















posite Pro- 


usual. 




L 


1 


usual. 


usual. 








funda. 





FEMORAL ARTERIES. 



487 



THE DEEP FEMORAL ("PROFUND^l") AND THEIR BRANCHES. 



No. 


ideoftbe 
body. 


lit 


Ext. 
Circumflex- 
its manner of 
origin, &c. 


Int 
Circumflex 
its manner of 
origin, &c. 


No. 


it 


jSij 


Ext. 

Circumflex 
its manner of 
origin, &c. 


Int. 
Circumflex- 
its manner of 
origin, &c. 




02 


-** 








'& R"0LJP< 






226 


R 


H 


fr. Feml. op- 


usual. 


234 


R 


2 

4 


usual. 


from Feml. 








posite Prof. 












close toProf. 




L 


if 


usual. 


fr. Feml. a 




L 


li 


n two parts: 


usual. 










little higher 








descending 












than Pro- 








one below 












funda. 








Profunda. 




227 


R 


H 


fr. Feml. 


usual. 


237 


R ! 1 


jivenfr.Prof. 


usual. 


















close to its 








ji 


usual. 


fr. Feml. at 








origin. 












| inch be- 




















low Poup. 




















ligament. 


241 


L 


1 


usual. 


fr. Feml. op- 




















posite Pro- 


;228 


R 


11 


Descndg. prt. 


usual. 










funda. 








arises from 




















Feml. in 




241' 


R 


l 


usual. 


Fr. Feml. op- 








two brs. : 












posite Pro- 








one oppos. 












funda. 








Profunda, 




















the other at 




242 


R 


14 


Part of de- 


usual. 








3 inches be- 










scendg. brs. 










low Poup. 










fr. Feml. 2 










ligament. 










inch, below 




















Poup. ligt. 






L 


11 


arises in two 


usual. 


















parts from 




242* 


R 


li 


fr. Feml. at 


usual. 








Profunda : 










same height 










the descndg. 










as Profund. 










part being 




















the first. 




245 


R 


If 


usual. 


usual. 


229 


R 


l 


usual. 


usual. 


246 


R 


H 


usual. 


usual. 




L 


l 


usual. 


usual. 




L 




usual. 


usual. 


230 


R 


M 


usual. 


usual. 


247 


L 


ii 


usual. 


usual. 




L 


if 


Fr. Femoral 


usual. 


248 


R 


i 


usual. 


usual. 








close to Pro- 




















funda. 






L 


H 


usual. 


usual. 


231 


R 


i 


























249 


R 


2 


Dscndng.brs. 


fr. Feml. at 


233 


R 


11 


usual. 


fr. Feml. 








with one 


1 inch 


















ascndg.arise 


belowPoup. 




L 


i 


in two parts : 


fr. Feml. at 








by a com. 


ligament. 








the descndg. 


f inch fr. 








trunk fr. 










one fr. Fern. 


Poup. ligt. 








Feml. at 1 










alittle below 










inch below 










Profunda. 










Poup. ligt. 





488 



FEMORAL ARTERIES. 



THE DEEP FEMORAL ("PRC-FUND^E" AND THEIR BRANCHES. 


No. 


Side of the 
body. 


Distance in 
inches of 
Profunda fr. 
Poup. liart. 


Ext. 

Circumflex 
its manner of 
orig in, &c 


Int. 
Circumflex 
its manner of 
origin, &c. 


No. 


I Side of the 
body. 


Distance in 
inches of 
Profunda fr. 
POUD. list. 


Ext. 
Circumflex 
its manner ol 
origin, &c. 


Int. 
Circumflex 
its manner of 
origin, &c. 




L 


2 


usual. 


usual. 


259 


R 


H 


usual. 


usual. 


250 


R 


11 


fr. Feml. b 
com. trun 
w. Int. cir 


fr. Feml. at 
1 in. below 
Poup. ligt., 




L 


*i 


usual. 


fr. Feml. at 

same height 
as Profund 








cumf. at ! 


by a corn. 


260 


L 


H 


fr. Feml. a 


usual. 








inch below 


trunk with 








same heigh 










Poup. ligt. 


ext. circ. 








as Prof. 










arises in tw 




261 


R 


1 


usual. 


usual. 








parts. 
















L 


If 


arises in tw 
pts. fr.Prof 


usual. 




L 


H 


in two parts 
descending 
one arise 


fr. Feml. at 
f in. below 
Poup. ligt. 


252 


R 


4 


usual. 


usual. 








fr. Feml. a 
f in. below 






L 


1J 


usual. 


usual. 








Poup. ligt 




253 


L 


1J 


One of the 
descending 
brs. arise 


usual. 


26-2 


R 


* 


usual. 


fr. Feml. a 

little above 
Profunda. 








fr. Feral. \ 






L 


If 


fr. Feml. a 


usual. 








inch below 










same heigh 










Profunda. 










as Profund 




254 


L 


*1 


usual. 


usual. 


263 


R 


H 


n two parts, 


usual. 


255 


R 


1 


usual. 


fr. Feml. a 
little below 








both arising 
fr. Profund. 












Profunda. 




L 


if 


n two parts, 


isual. 


















both being. 






L 


I* 


fr. Feml. in 


usual. 








fr. Profund. 










two parts ; 




















one, which 




264 


R 




usual. 


sual. 








gives the 




















circumflex 






L 


I* 


sual. 


sual. 








and ascend. 




















brs., arises 






R 


i| 


n two parts, 


-. Feml. 1 








at ^ inch 










both from 


inch below 








belowPoup. 










Profunda : 


Poup. ligt. 








ligt. ; the 










the descend- 










other, con- 










ing one 










sisting of 










arising first. 










thedescend- 
ingbrs., at 






L 


I* 


ame as right 
J A 


sual. 








2| inches 










side. 










below same. 




267 


R 


i* 


rom Feml. 


sual. 


255' 


R 


H 


n two parts : 










above Prof. 










one arising 






L 


i 


om Feml. 


sual. 








fr. Feml. 










close above 










above Prof. 










Profunda. 





FEMORAL ARTERIES. 



489 



THE DEEP FEMORAL ("PROFTJNQA") AND ITS BRANCHES. 




1., 


S**'tt 


Ext. 


Int. 




j 


MS 


Ext. 


Int. 


No. 




Pi^ 


Circumflex- 
its manner of 


Circumflex- 
its manner of 


No. 


It 


Illi 


Circumflex- 
its manner of 


Circumflex 
its manner of 




in 


|-2|l 


origin, &c. 


origin, &c. 




'in 


5' s fi 


origin, &c. 


origin, &c. 


268* 


R 


1* 


in two parts, 


fr. Feml. and 


275 


R 


k 


usual. 


fr.Feml.close 








the descend- 


is partly 










to Poup. lig. 








ing one fr. 
Feml. in. 


joined with 
Profunda. 




L 


If 


usual. 


fr. back part 








below Poup. 












of Feml. 








ligament. 












under Poup. 




















ligament. 




L 


2 


fr. Feml. f 


fr. Feml. op- 


















inch below 


posite ext. 


277 


R 


H 


usual. 


fr. Feml. 








Poup. ligt. 


circumflex. 










inch below 




















Poup. ligt. 


270 


R 


]-V 


usual. 


usual. 
























L 


i* 


in two parts: 


fr. Feml. at 




L 


1* 


fr. Fern, and 


usual. 








the circum- 


same height 








inpartjoind 










flex br. fr. 


as Profund. 








to Profund. 










Profunda, 




















the other fr. 




271 


R 


i 


fr. Feml. at 


usual. 








Feml. at 










^ in. below 
Poup. ligt. 


- 








same height 
as Profund. 






L 


jl 


n two parts, 


fr. Feml. a 


263 


R 





usual. 


fr. Femoral 








both arising 


little above 










opposite 








fr. Profund. 


Profunda. 










Profunda. 


274 


R 


ji 


n two parts, 


usual. 




L 


i 


usual. 


fr. Femoral 








fr. Feml.: 












opposite 








one at same 












Profunda. 








height as 




















Profunda, 




284 


R 


U 


usual. 


usual. 








the other 1 




















inch lower. 






L 


U 


usual. 


usual. 



* In this case the superficial femoral artery is divided at three inches below Poupart's ligament into two equal parts 
vhich re-unite a little above the foramen in the great adductor muscle. 



POPLITEAL ARTERIES, AND THE ARTERIES OF 

THE LEG. 



The explanation of the term " usual," in the following Table, will be found in the 
Commentary on the artery to which it is applied. 



Number. 


Side of 
the body. 


Popliteal. 


Anterior tibial. 


Posterior tibial 
and Feroueal. 


1 


Si 

| 


Popliteal. 


Anterior tibial. 


Posterior tibial 
and Peroneal. 


It 


R 


usual. 


is small and, Post, tibl. is 


10 


R 


usual. 


usual. 


usual. 








ends oppo- 


very small ; 


















site ankle 


above lower 




L 














joint in 


ankle it 


















the Antr. 


receives fr. 


13a 


R 


usual. 


usual. 


usual. 








Peronl. wh. 


Peronl . a 


















becomes 


large br.wh. 




L 


usual. 


usual. 


usual. 








the Dorsal 


crosses ob- 


















artery of the 


liquely in- 


15 


R 


divides 


usual. 


Post. Tibl. is 








foot. 


wards over 






into Ant. 




wanting. At 










the deep 






Tibl. and 




lower part 










muscles. 






Peronl. 




of leg, Pe- 










Peronl. re- 










ronl. (which 










inforces An- 










is of large 










terior Tibl. 










size) sends 










and Post. 










inwards a 










Tibl. 










large br. to 




















take the 


3b 


L 


usual. 


usual. 


Post. Tibl. is 










place of the 










very small, 






Eachdi- 




Post. Tibl. 










and is join- 


"\(\n 


R 


vides 














ed above 


OUW' 




, above 














ankle by a 






the po- 














large br. of 






pliteus 














Peronl. 






, muscle 






4b 


R 


usual. 


usual. 


usual. 


31a 


R 


usual. usual. 


Post. Tibl. is 




















wanting on 




L 


usual. 


usual. 


usual. 




L 






both sides ; 




















Peronl. in 


5* 


R 


usual. usual. 


usual. 










each case 


















takes the 




L 




is of large 


nearly usual. 










place of that 








size. 












vessel near 




















the ankle. 


5f 


R 




is very small, 


Peronl. is 


















and is join- 


large ; its 


31/ 


L 


usual. 


is small, and 


Ant. Peronl. 








ed above 


Anter. br. 








its place on 


becomes 








ankle by a 


becomes the 








the dorsum 


Dorsal art. 








large Ant. 


Dorsal art. 








of the foot 


of foot. 








Peronl. 


of the foot. 








is taken by 




















a large Ant. 






L 




usual. 


usual. 








Peronl. 





POPLITEAL ARTERIES. ARTERIES OF THE LEG. 



491 



Number. 


1 Side of 
(the Body. 


Popliteal. 


Anterior Tibial. 


Posterior Tibial 
and Peroneal. 


Number. 


I Side of 1 
[the Body. 


Popliteal. 


Anterior Tibial. Posterior Tibial 
and Peroneal. 


32a 


L 


usual. 


same as pre- 


same as pre- 


41a 


R 


usual. 


usual. 


usual. 








ceding. 


ceding. 












36 


R 


usual. 


usual. 


Post. Tibl. is 




L 


usual. 


usual. 


usual. 










very small, 
and is rein- 


44 


R 


usual. 


usual. 


usual. 










forced near 




L 


divides in- 


usual. 


Peroneal 










ankle by 
Peronl.,wh. 






to Ant. 
Tibl. and 




takes place 
of Post. 










is of pro- 
portionally 
large size. 






Peroneal. 




Tibl. near 
ankle. The 
latter artery 




L 


isual. 


usual. 


usual. 










is altogether 




















absent. 


37a 


R 


usual. 


usual. 


usual. 














L 


usual. 


usual. 


usual. 


48 


R 


usual. 


usual. 


usual. 


37b 






s of large 


Post. Tibl. is 




L 


usual. 


usual. 


usual. 








size; and af- 
ter penetra- 


small, and 
is aided by 


50 


R 


usual. 


usual. 


usual. 








ting to the 


Ant. Tibl. 




L 


divides a- 


arises above 


usual. 








sole of the 


in foot. 






bove the 


popliteus, 










foot gives 








popliteus 


and runs be- 










more Digi- 








muscle. 


neath (be- 










tal brs. 










fore) the 










than usual. 










muscle in 




















its course 




40 


R 


usual. 


usual. 


usual. 








to the fore 






L 


isual. 


usual. 


Post Tibl. is 








part of the 












small, and 








leg. 












is reinforced 
above inner 


52 


R 




usual. 


usual. 










ankle by 
Peronl. 




L 




usual. 


usual. 


40b 


R 


divides in- 




Post. Tibl. is 


53 


R 


usual. 


usual. 


usual. 






to Ant. 
Tibl. and 




wanting. 
Peroneal 




L 


usual. 


usual. 


usual. 






Peroneal. 




turns in- 
wards above 


54 


R 


usual. 


usual. 


usual. 










the ankle to 




L 


usual. 


usual. 


usual. 










give the 




















Plantar ar- 


55 


R 


usual. 


usual. 


Behind the 










teries. 










ankle, Post. 




















Tibl. is ex- 


41 


R 


isual. 


usual. 


usual. 










tern, to the 




















nerve. Per- 




L 


divides in- 


usual. 


Peronl . at 










onl. is small 






to Ant. 




lower part 
















Tibl. and 




of the leg 




L 


usual. 


usual. 


Peroneal is 






Peroneal. 




takes the 










larger than 










place of Post 










ordinary. 










Tibl. which 




















is absent. 


56 


R 






usual. 



Y y 



492 



POPLITEAL ARTERIES. ARTERIES OF THE LEG. 



ti 


^3*0* 


I 




|j 


t' 








| 


5 


Popliteal. 


Anterior Tibial. 


Posterior Tibial 
and Peroneal. 


X 


a- 


Popliteal. 


Anterior Tibial. 


Posterior Tibial 
and Peroneal. 


7. 


M 5 








& 


j 








57 


R 


divides a 


arises above 


usual. 


67 


L 


usual. 


usual. 


usual. 






ittleabov. 


popliteus, 


















popliteus 


and passes 




68 


R 


usual. 


usual. 


usual. 






muscle. 


under (be- 




















fore) that 




69 


L 


usual. 


usual. 


usual. 








muscle. 
































Tost. Tibl. 


58 


R 


usual . 




Post. Tibl. is 










wanting on 










small,andis 










both sides ; 










joined near 






each di-\ , ., 


and in each 










the ankle 


70 


R 


vides in- l on ea . 81 . a 


Peroneal 










by Peronl., 




( 


to Ant.). J f S lven . 


takes its 










which is pro- 




L 


Tibl. and P ia 9 e 


place above 










portionally 






Peroneal.J -^ nter * " en "- 


inner ankle. 










large in size. 










There is no 




















Anter. Per- 




L 


usual. 


usual. 


usual. 










oneal br. 


*59 


R 


usual. 




Post. Tibl. is 




















extern, to 


71 


R 


usual. 


usual. 


usual. 










nerve behind 




















inner ankle. 




L 


usual. 


usual. 


usual. 










Peroneal 




















usual. 


73 


R 


usual. 


usual. 


usual. 




L 


usual. 


usual. 


usual. 




L 


usual. 


usual. 


usual. 


60 


R 






usual. 


74 


R 


usual. 


usual. 


usual. 


61 


R 


usual. 


usual. 


usual. 




L 


usual 


usual. 


usual. 


62 


R 


usual. 


usual. 


usual. 


75 


R 


usual. 


usual. 


usual. 


63 


L 


usual. 


usual. 


Anter. Per- 




L 


usual . 


usual. 


usual. 










onl.wanting. 




















Post. Tibl. 


76 


R 


usual. 


usual. 


usual. 










usual. 
























L 


usual. 


usual. 


usual. 


64 


R 


usual. 


usual. 


usual. 














L 




usual. 




77 


L 


usual. 


usual. 


usual. 


65 


R 


usual. 


usual. 


usual. 










usual, except 
that Ant. 




L 




usual. 




78 


R 


} usual. 


usual . 


Peroneal of 
left side is 


66 


L 


divides be- 


at origin is 


Post. Tibl. a- 










of consider- 






hind knee 


conjoined 


rises behind 










able size. 






joint. 


with Peronl 


knee-joint. 




















Pernl. forms 


79 


R 


usual. 


is small, and 


Ant. Peronl. 










a common 








does not 


is of large 










trunk with 








furnish, the 


size, and be- 










Ant. Tibl. ; 








Dorsal ar- 


comes the 










Ant.Peronl. 








tery of the 


Dors.artery 










wanting. 








foot. 


of the foot. 


In this case, both superficial Femoral arteries are plugged with lymph; and the Profunda, its branches, and an artery ir 
the sciatic nerve, are much enlarged in size. Through these vessels the injection was conveyed to the Popliteal and Tibia 



POPLITEAL ARTERIES. ARTERIES OF THE LEG. 



493 



Number. 


t 

l 


Popliteal. 


Anterior Tibial. 


Posterior Tibial 
and Peroneal. 


Number. 


i! 


Popliteal. 


Anterior Tibial. 


Posterior Tibial 
and Peroneal. 




.L 


usual. 


usual. 


usual. 




L 


usual. 


is directed 


usual. 


















outwards to 




80 


R 


usual. 


usual. 


usual. 








margin oi 
fibula above 




















malleolus : 






L 


usual. 


usual. 


usual. 








and after 




















receiving a 


* 


81 


R 


usual. 


usual. 


usual. 








small Ant. 
Peronl. br., 




















regains usu- 






L 


usual. 


usual. 


usual. 








al position 




















on the foot. 








On each' 
side the 
artery is 
separated 

^t TlA 






85 


R 


usual. 


gives a br. to 
take place 
of Anter. 
Peroneal, 


Peroneal is 
small; gives 
no Anter. 
br. and ends 


82 


R 


me 
vein by a 
small slip 
of mus- 


usual. 


usual. 




L 


usual, 


usual. 


above the 
ankle. 

usual. 






cle which 
ends by 
joing. in- 
ner head 
of gastro- 






86 


R 
L 


> usual. 


(""usual, but 
I is of hirge 
] size on 
L left side. 


> usual. 






cnemius * 


























88 


R 


usual. 


a of small 


The Dig. brs. 


















size, and is 


are all fur- 


83 


R 


isual. 


at lower part 


isual, except 








expended 


nished fr. 








of leg is di- 


that Post. 








on the dor- 


the two 








rected out- 


Tibial fur- 








sum of foot 


Plantar ar- 








wards to 


nishes all 








without giv. 


teries. 








fibula, and 


the Digital 








Digital, brs. 










again cross- 


arteries. 


















es the foot 






L 


usual. 


usual. 


usual. 








inwards to 




















reach the 




89 


R 


divides 


arises above 


usual, except 








interval be- 








above po- 


popliteus, 


increased 








tween first 








pliteus 




length of 








two meta- 








muscle. 




Post. Tibl. 








tarsal bones; 




















is small 






L 


usual, 


usual. 


usual. 








and gives no 




















Digital brs. 




90 


R 


usual. 


usual. 


usual. 




L 


usual. 


usual. 


usual. 




L 


usual. 


usual, 


usual. 


84 


R 


usual. 


usual. 


Post. Tibl, is 


91 


R 


usual. 


is large and 


Post Tibl, is 










small, and 








compensates 


small, and 










is joined 








for small 


is aided in 










near ankle 








size of Post. 


the foot by 










by Peronl.; 








Tibial. 


Ant. Tibl. ; 










wh. is pro- 










Peronl.does 










portionally 










not join 










large. 










Post. Tibl. 



Y Y2 



FOTUTEiL 



if! r~ 









. - -. 

: - . 



95 ft 




M L 

1 

K ?. 

I ^ 
M S 



11* K 



*- 



I ;. 



: : 



"^ 



MS L iaL L <nnL 



L L MI- 

111 E WOL HHi. 

IIS E ' L. IMA 

t _L . 

US E _L nL 

11* E . 






FOH1TEL1L 



OF THE LEG. 



'- 



-; . '.: t 
acorn 4 
T5L 



, 



u u - 



::-: 



ft 

L. 



-, . .. u:: 

.: t - ..-.- -" 
- .;.-. : : ;'..;. 






- ;-: - ; : 



132 K 



i 

::- i 

i 

:.. L 

L 



CiHiaiL 
. 



U ' 






496 



POPLITEAL ARTERIES. ARTERIES OF THE LEG. 



I 


lj 


Popliteal. 


Anterior TibiaL 


Posterior Tibial 
and Peroneal. 


IS umber. 


Bj 


Popliteal. 


Anterior Tibial. 


Posterior Tibial 
and Peroneal. 




L 


usual. 


urns out- 


usual. 


148 


R 


divides 


usual. 


Post. Tibial 








wards to fi- 








into Ant. 




is wanting; 








bulaatlower 








Tibial and 




and Peronl. 








end of leg J 








Peronl . 




which is 








and inclin- 












large, takes 








ing inwards 












its place at 








regains its 












lower end 








usual place 












of the leg. 








on tarsus. 






L 


usual. 


is close to 


Peron. arises 


















fibula at 


close to ori- 


135 


R 


usual. 


usual. 


usual. 








lower end 


gin of Post. 


















of the leg 


Tibial. 




L 


usual. 


isua'l. 


usual. 








and is there 




















joined by a 




136 


R 


usual. 


usual. 


usual. 








br. of Ant. 
Peronl.; in- 






L 


usual. 


las usual size 
and is joined 
by a branch 
of Peronl. 


usual. 








clines in- 
wards to 
usual posi- 
tion over 
the tarsus. 










near ankle. 
























149 


R 


divides 


usual. 


Post. Tibl. 


137 


R 


usual. 




usual. 






into Ant. 
Tibl. and 




wanting ; 
Peroneal 




L 


usual. 




usual. 






Peroneal. 




takes its 
place near 




















the ankle. 


138 


R 


usual. 


usual. 


Peron. arises 
near origin 




L 


usual. 


usual. 


usual. 










ofPost.Tib. 


150 


R 




usual. 






L 


usual. 




same as on 
right side. 


152 


R 


usual. 


usual. 


usual. 














L 




usual. 












In both legs 
the arteries 


153 


R 


usual. 


usual. 


usual. 


139 


R 
L 


y usual. 


usual. 


are connect- 
ed near the 
ankle by a 
thick branch 
wh. crosses 




L 


usual. 


is directed 
out to fibula 
at lower end 
of leg; again 
turns in wds 


usual. 










over the 
deep mus- 

1 AQ 








to take the 
usual place 












\ CicS. 








on the foot. 




141 


L 


usual. 


usual. 


usual. 


154 


R 


usual. 
















155 


R 


usual. 


usual. 


usual. 


145 


R 


usual. 


usual. 


usual. 
























L 


usual. 


usual. 


usual. 




L 


usual. 


usual. 


usual. 






















157 


R 


usual. 


usual. 


usual. 


146 


R 


usual. 


usual. 


usual. 




L 




usual . 





POPLITEAL ARTERIES. ARTERIES OF THE LEG. 



497 



Number, 


| Side of 
(the Body. 


Popliteal- 


Anterior Tibial. 


Posterior Tibial 
and Peroneal. 


Number. 


SI 

l 


Popliteal. 


Anterior Tibial. 


Posterior Tibial 
and Peroneal. 


165 


R 




usual. 




168 


R 


usual. 








L 




usual. 






L 


usual. 


gives a consi- 




















derable br. 




172 


L 


dividesinto 












before reach- 








three brs. 
Pt.Tbl. 












ing fore part 
of leg. 








Ant.Tibl. 




















and Perl. 






188 


R 


usual. 


usual. 


usual. 


174 


R 


usual. 


usual. 


usual. 


189 


R 






Peronl. is a 




L 


usual. 


usual. 


usual. 










little larger 
than Post. 


175 


R 


usual* 


usual. 


usual. 










Tibl., and 
joins it by a 


176 


L 


usual. 


usual. 


usual. 










br. which is 
smaller than 


177 


R 


usual. 


usual. 


usual. 










that on left 
side. 




L 




usual. 


























L 


usual. 




Pernl. larger 


178 


R 


usual. 


is very s