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ENGRAVINGS 
 
 OF THE 
 
 ARTERIES. 
 
 % 
 
FINLEY'S SECOND EDITION. 
 
 ENGRATINGS 
 
 ARTERIES; 
 
 ILLUSTRATING THE 
 
 ANATOMY OF THE HUMAN BODY, 
 
 AND SERVING AS 
 
 AN INTRODUCTION 
 
 SURGERY OF THE ARTERIES. 
 
 Br 
 CHARLES BELL, Surgeon. 
 
 SECOND AMERICAN FROM THE THIRD LONDON EDITION, CORRECTED. 
 
 PHILADELPHIA: 
 PUBLISHED BY A. FINLEY, AT HIS MEDICAL BOOK-STORE. 
 
 William Fry, Printei-. 
 1816. 
 
 ■rk 
 
■ £ 
 
 TO 
 
 SIR CHARLES BLICKE, 
 
 SENIOR SURGEON OF ST. BARTHOLOMEW'S HOSPITAL. 
 
 ^C. ^c. ^c. 
 
 PLATES OF THE ARTERIES 
 
 ARE INSCRIBED, 
 
 AS A TRIBUTE OF RESPECT TO HIS 
 PROFESSIONAL TALENTS, AND EMINENT SKILL AS AN OPERATOR; AND 
 IN ACKNOWLEDGMENT OF HIS ATTENTION AND CIVILITIES TO 
 THE AUTHOR, WHILE YET A STRANGER IN LONDON. 
 
 J3 
 
PREFACE 
 
 TO THE 
 
 FIRST EDITION. 
 
 To facilitate the acquisition of the 
 leading principles ought to be the first 
 object of an elementary book, and most 
 of all ought we to study simplicity in a 
 work treating of Anatomy. When the 
 way is smoothed, the student feels a 
 rapid progress, and is pleased with his 
 own exertions; and it requires only a 
 little self-examination to be assured that 
 much of our partiality for any particular 
 
 424263 
 
8 
 
 line or object of study, often results from 
 a real or fancied superiority of know- 
 ledge; perhaps in Anatomy, more than 
 in any other pursuit, it is necessary to 
 make the student sensible of his pro- 
 gress, before he can feel any thing like 
 enthusiasm, or even partiality for it. 
 
 It is upon the simplicity of these 
 Plates, therefore, more than upon their 
 elegance, or their accuracy, (though I 
 am confident that in this last respect 
 they are not deficient,) that I would 
 place their merit. When the importance 
 of the study of the Arteries is consid- 
 ered — a point so fully enforced and il- 
 lustrated in the volume of the text to 
 which I mean these plates to be attach- 
 
ed — this book must, I think, be an 
 acquisition to the student, since I am 
 conscious that I should myself have 
 found it to be so in the commencement 
 of my studies; it is with this feeling that 
 I offer it with confidence to the public. 
 I am assured, also, that the study of the 
 Blood-vessels and Nerves from Plates, 
 prepares us better for undertaking any 
 surgical operation than that of bare 
 description, however accurate, however 
 simple, or however constantly the true 
 practical inferences may be kept in 
 view. It is upon the eye that the impres- 
 sion must be made, which is to enable 
 us, in looking upon a limb, to mark the 
 course of the Arteries: Drawings are a 
 kind of notes, too, more easily consult- 
 
10 
 
 ed; and bring to the mind, in a more 
 lively manner, all that was associated 
 in our first studies. 
 
 In following the course of the Ar- 
 teries we must have continual occasion 
 to observe, that if one branch deviate 
 from the more general course, or be 
 of an unusual size, the neighbouring 
 branches have also an unusual form. 
 In the arteries of the arm, for example, 
 were we to observe the great Thoracic 
 Artery of an uncommon size, and send- 
 ing large branches under the Latissi- 
 mus Dorsi, and under the Scapula; were 
 we to take our drawings of this Artery 
 as an example of a beautiful distribution 
 
11 
 
 of the external Mammary Artery, with- 
 out attending to the effect of such dis- 
 tribution on the Subscapular Artery; or 
 again, were we to draw the Subscapular 
 Artery of the great comparative size 
 which it not unfrequently takes; we 
 should not give a just representation of 
 the natural and most usual distribution 
 of those Arteries: for, as we find that 
 the distribution of the Thoracic Ar- 
 teries materially affects the distribution 
 of the Articular Arteries and of the 
 Profunda, although it be absolutely 
 necessary in the text to describe the size 
 and importance of this Artery, because 
 in our operations at this part we must 
 keep in view the more dangerous and 
 unfavourable circumstances, it does not 
 
12 
 
 follow that we are to make our drawings 
 by the same rule; we should by doing 
 so make them monstrous and unna- 
 tural. 
 
 We thus see the necessity of combi- 
 ning drawing with description. In the 
 latter we mark all the variety of dis- 
 tribution, and the peculiarities of each 
 branch considered individually; but 
 this again naturally produces intricacy, 
 unless, by comparison with the draw- 
 ings, and their short explanations, we 
 can take a rapid and general view of 
 the course of the vessels. The drawings 
 ought, therefore, to give the represent- 
 ation of the more general distribution, 
 while the varieties and peculiar forms 
 
13 
 
 are left to description. And here comes 
 a question of some consequence — How 
 is a selection from the great variety of 
 distribution of the vessels and nerves 
 of the body to be made? 
 
 I am very averse from the ideas 
 most prevalent regarding Anatomical 
 Tables, that it is impossible to make a 
 true representation of the parts from 
 any individual body; for, as we see, in 
 looking over the variety of Anatomical 
 Tables, that those which have the cha- 
 racters of the parts distinctly marked, 
 and have been evidently drawn from 
 the parts dissected and laid out before 
 the artist, are in greatest esteem for 
 the accuracy of the anatomy, and best 
 
14 
 
 bear the only true test of excellence, 
 the immediate comparison with the 
 subject in the dissecting room; so, on 
 the other hand, those made by first 
 drawing the outlines of the parts, and 
 then the vessels, are plans merely, in 
 which the character of the parts, and 
 the peculiar course and turnings of the 
 vessels, are lost. 
 
 But I hope I shall not be understood 
 to say, that if a drawing be made ac- 
 curately from the subject, it will there- 
 fore answer all the purposes required. 
 Of twenty bodies, not one, perhaps, 
 will be found fit for drawing; but still 
 I conceive that we are not to work out 
 a drawing by piecing and adding from 
 
15 
 
 notes and preparations; we are to select 
 carefully from a variety of bodies, that 
 which gives largeness of parts, where 
 the characters of parts are well mark- 
 ed, and where there is the most natural 
 and usual distribution of vessels. In 
 making our drawings of such dissec- 
 tions, let us allow ourselves no license, 
 but copy accurately. By noting in the 
 description any little deviation, every 
 necessary end is answered. 
 
 By long attention to the subject, I 
 hope that I have been able to make 
 these Plates simple, intelligible, and 
 accurate. While the design of this book 
 of Plates is to present to the student, 
 at one glance, the general distribution 
 
16 
 
 of the vessels, and to fix them in his 
 memory in a way which no descrip- 
 tion can accomplish, it will be found to 
 give the most usual distribution of the 
 branches; for I have been careful in the 
 selection of my subjects. 
 
 In studying the Arteries, or any part 
 of Anatomy, we should, in the first 
 place, run the eye over the corres- 
 ponding plate, then read the general 
 description in the text; and lastly, 
 proceed to study more closely, step 
 by step. 
 
 I know the difficulties which the 
 student must encounter in acquiring 
 a comprehensive knowledge of the 
 
17 
 
 nerves; the books on that subject be- 
 ing more confused and intricate to 
 study, than the most irregular dissec- 
 tion. The next part, therefore, of this 
 work, comprehends the Nervous Sys- 
 tem, though the present book I con- 
 ceive to be complete in itself. 
 
PREFACE 
 
 TO THE 
 
 SECOND EDITION. 
 
 In this edition, I trust, I have shown 
 my regard for the approbation of the 
 public, already bestowed upon this little 
 work, by endeavouring to improve it. 
 
 I have added a Plate of the Aortic 
 System, by my young friend and pu- 
 pil, Mr. Charles Cheyne, whose steady 
 pursuit of that science to which I am 
 devoted, has gained my esteem and 
 
20 
 
 confidence. I have added some other 
 Plates, in illustration, as of the foot, 
 hand, and jaw, where I thought the 
 smallness of the original scale preclu- 
 ded the possibility of fully disclosing 
 the anatomy. 
 
 I have also added some schemes of 
 arrangement, of the more intricate 
 branches, in foot notes. 
 
 The most essential addition, how- 
 ever, which I have made, is the intro- 
 duction of some rules for cutting down 
 upon the Arteries, in cases of dangerous 
 bleedings. They were taken by a pupil, 
 from my public lectures on the Ar- 
 teries, when I had the subject before 
 
21 
 
 me, and was describing and measuring 
 the depth of parts, previous to my 
 entering upon the rules deduced from 
 the projecting points of bone, and the 
 course of the tendons and muscles in 
 the living body. 
 
 London, 
 
 Leicester Street, Leicester Square. 
 
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EXPLANATION 
 
 PLATE I. 
 
 FORE AND BACK VIEWS OF THE HEART. 
 
 FIG. I. 
 
 (See Wistar's Anatomy., Vol. II. fi. SO — 61.) 
 
 Ji vieiv of the Heart, nearly in the Situation in 
 which it is seen when the Breast is opened. 
 
 A. The Superior Vena Cava, returning the blood 
 
 from the head and arms. 
 
 B. The Inferior Cava, tied where it pierces the 
 
 diaphragm to convey the blood from the 
 lower parts of the body into the right 
 auricle. 
 
24 
 
 c. The His^ht Sinus, or Auricle. 
 
 D. Tlie Iiiu;ht Ventricle. 
 
 E. The Fnlmonary Artery; it is seen to divide; 
 
 one branch to pass, under the arch of the 
 aorta, to the lungs of the right side; the 
 other to take an acute turn to those of the 
 left side. 
 
 F. The top of the Left Sinus of the Heart, or 
 
 that which is properly the auricle. 
 
 G. The Left Ventricle; it is seen Fig. II. A. 
 H. The Arch of the Aorta. 
 
 I. The Subclcn'ian and Carotid of the right side, 
 
 rising together from the Aorta. 
 K. The Carotid Artery of the left side. 
 L.. The SubclaTian Artery o^ the \eh side. 
 M. A Branch of the Right Coronary Artery. 
 N. The Left Coronary Vein, 
 o. A Branch of the Coronary Vein. 
 
25 
 
 FIG. II. 
 
 The Arteries and Veins, which are attached to 
 the Spine, are seen in this View, 
 
 A. The Left Ventricle of the Heart. 
 
 B. The Trunk of the Pnljnonary Artery. 
 
 c. The Riglit Branch of the Pulmonary Artery. 
 
 D. The Left Branch of the Pulmonary Artery. 
 
 E. The Buds of the Pulmonary Veins of the 
 
 left side, entering the left sinus of the 
 heart. 
 
 F. The Pulmonary Veins of the right side. 
 
 G. The Vena sine Pari, or Azygos; this vein lies 
 
 upon the spine, collects the blood from the 
 
 back part of the thorax, and conveys it to 
 
 the superior vena cava. 
 H. The Superior Vena Cava. 
 I. The Aorta, where it first touches the Spine. 
 L. The Left Carotid Artery, 
 M. The Left Subclavian Artery. 
 N. The Arteria Innominata, or common origin 
 
 of the subclavian and carotid of the right 
 
 side. 
 
 D 
 
SCHEME ,>tOi^ ARTERUL SYSTEM. 
 
 • Xm^tStth .tKmi^ i 
 
EXPLANATION 
 
 PLATE OF THE AORTIC SYSTEM. 
 
 (Wistar's Anatomy, Vol. II. Page 238 — 300.) 
 
 Branches of the Arteries. 
 
 Principal Divisions of the 
 Arteries, 
 
 A. Values of the Aorta. 
 
 B. The Ascending Aorta 
 
 [ 
 
 1. The Left Coronary Artery. 
 
 2. The Right Coronary Artery. 
 
 c. The Arteria Innominata.* 
 
 f 1. The Vertebral Artery. 
 I 
 
 2. The Internal Mammary. 
 
 3. The Lower Thyroid Artery. 
 
 4. The Ascendant Branch of the 
 Thyroid. 
 
 5. The Transversalis Colli. 
 
 6. The Transversalis Humeri. 
 
 7. The First and Second Intercos- 
 tal s. 
 
 (^8. The Suprascapularis. 
 
 * The Arteria Innominata commonly divides into the Right Carotid ami 
 Subclavian, but here the Left Carotid also is given from it. 
 
 D. D. The Subclavian <^ 
 
28 
 
 Princijiul Divisiona of the 
 Arteries. 
 
 K. E. Axillary Artery 
 
 F- v.The Brachial Artery* 
 
 G. The Radial Artery <^ 2. 
 13. 
 1. 
 
 H. The Ulnar Artery < 
 
 I. Interosseoiis Artery 
 
 K. Carotid Arterif, 
 
 2. 
 3. 
 
 u. 
 
 L. External Carotid <. 
 
 Bra nc he a of the Arteries. 
 
 Superior Thoracic Artery. 
 Thoracica Longior. 
 Thoracica Humeraria. 
 Subscapularis. 
 Circumflexa Posterior. 
 Circumflexa Anterior. 
 
 Profunda Humeri Superior.! 
 Anastomoticus Major. 
 
 Recurrens RacUalis Anterior. 
 Arteria Superficialis Volae. 
 Arteria Palmaris Profunda. 
 Recurrens Ulnaris Anterior. 
 Recurrens Uhiaris Posterior. 
 Arteria Dorsalis Ulnaris. 
 Arteria Palmaris Profunda. 
 
 Interossea Superior Perforans. 
 Recurrens Interossea. 
 
 Arteria Thyroidea Superior. 
 Arteria Lingualis. 
 Arteria Labialis vel Facialis. 
 Arteria Occipitalis. 
 Posterior Auris. 
 Arteria Maxillaris Interna. 
 Arteria Transversalis Faciei. 
 Arteria Temporalis. 
 
 * On the left side there is a high bifurcation of this Artery, 
 f The Lesser Profunda is seen at 16, Plate VI. 
 
^w^. 
 
 29 
 
 Principal Divisions of the 
 Arteries. 
 
 M. Internal Carotid 
 
 N. Vertebral Artery 
 
 o. Basilar Artery 
 p. Thoracic Aorta 
 
 Branches of the Arteries. 
 
 Q. Abdominal Aorta 
 
 R, Common Iliacs. 
 
 s. Internal Iliac 
 
 C\. Arteria Anterior Cerebri. 
 
 t2. Arteria Media Cerebri. 
 3. Arteria Communicans. 
 * Arteria Cei-ebelli Posterior and 
 Anterior. 
 
 {1. Arteria Communicans. 
 2. Arteria Cerebri Posterior. 
 1 to 10. Arteriae Intercostales.r 
 
 1. Arteria Phrenica. 
 
 2. Arteria Coeliaca. 
 
 3. Coronai-ia Ventriculi. 
 
 4. Arteria Hepatica. 
 
 5. Arteria Splenica. 
 
 6. Mesenterica Superior. 
 
 7. Arteriae Capsularis. 
 
 8. Arteriae Emulgentes. 
 
 9. Arteriae Spermaticae. 
 
 10. Mesenterica Inferior. 
 
 1 1 . Arteriae Lumbares. 
 
 12. Arteriae Media Sacra. 
 
 • 
 f 1 . Arteria Obturatoria. 
 
 2. Arteria Glutea. 
 
 3. Arteria Ischiadica. 
 .4. Arteria Pudica. 
 
 * For the Arteries of the Cerebellum, see Plate V. 10, 11, 12. 
 
 ■j- The Aorta, when it is behind the root of the lungs, gives three or four 
 arteries to nourish their substance, called Bronchial Ai'teries. Lying 
 beside the oesophagus, also, it gives to it a few arteries, the oesophagial 
 arteries. 
 
30 
 
 Princifial Divisions of the Branches of the Arteries. 
 
 Arteries. 
 T. External Iliacs. 
 
 1. Arteria Epigastrica. 
 
 2. Circumflexa Ilii. 
 
 u. Femoral I ^ , circumflexa Externa. 
 
 Artery ^ ,' 
 
 I 3. Profunda Femoris<J -2- Circumflexa Interna. 
 
 I Is. Perforantes. 
 
 V. Pojiliteal 
 Artery 
 
 1. Arteria Articularis Superior Externa. 
 
 2. Interna. 
 
 <( 3 Media. 
 
 4. Tnl'erior Externa. 
 
 3. — Interaa. 
 
 C\. Recurrens Tibialis Anticae. 
 
 I 2. Mallcolaris Interna. 
 x. Anterior Tibial Artery< 
 
 3. Externa. 
 
 L4. Arteria Tarsea. 
 
 . Plantaris Externa. 
 Y. Posterior Tibial Artery < 
 
 ' '" Interna. 
 
 Anterior. 
 
 z. Fibular Artery , „ r. 
 
 ' " Posterior. 
 
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EXPLANATION 
 
 PLATE 11. 
 
 E.jcplaining the JDiaphragm, the Situation of the 
 Heart, the Blood-vessels of the Breast, and the 
 Mdominal Aorta, 
 
 (Bell's Anat. Vol. II. pages 245 — 252, and 408.) 
 (Wistar, pages 258 — 261,276 — 277, 280, and 285.) 
 
 A. The Llaphragm, dividing the thorax from 
 
 the abdomen.* 
 
 B. The Heart, l^ing upon the diaphragm, and 
 
 with the apex obliquely to the left side.f 
 
 * A thrust made with a small sword on the left side of the 
 chesf, immediately above the seventh rib, perpendicularly to 
 the convexity of the chest, will pass through the diaphragm 
 into the stomach, the heart escaping. Jf 
 
 t A thrust immediately above the left pap, and above the 
 fifth rib, perpendicularly to the surface of the chest, transfixed 
 
32 
 
 c. The Bight Auricle. 
 
 D. The Left Auricle; that which receives the 
 
 blood from the lungs. 
 
 E. The Superior Vena C*«t'«, returning the blood 
 
 from the arms and head to the right 
 auricle. 
 
 the body of the left ventricle of the heart, perforating the ante- 
 rior and extreme margin of the right. 
 
 A thrust made perpendicularly to the convexity of the chest, 
 immediately under the anterior head of the fifth rib, will pass 
 through the anterior edge of the right lung, and pierce the 
 apex of the heart. 
 
 Perpendicularly to the convexity of the right side of the 
 chest, and immediately below the anterior head of the third rib, 
 the thrust made will pierce the lungs and mediastinum, and 
 pass through the right auricle. 
 
 A thrust perpendicularly down by the left side of the ster- 
 num, betwixt the fourth and fifth ribs, will pass through the 
 upper part of the heart, near the root of the pulmonary artery. 
 
 A thrust perpendicularly to the convexity of the chest, im- 
 mediately under the right pap, and of course the fifth rib, will 
 pass through the root of the lungs among the great vessels. 
 
 A thrust with the small sword, horizontally from the greatest 
 lateral convexity and upper edge of the seventh rib, will pass 
 through the middle of the lower portion of the posterior lobe 
 of the right lung, behind the heart, into the posterior mediasti- 
 num, where the aorta and oesophagus are about to pass through 
 the diaphragm. 
 
33 
 
 F. The Srch of the Aorta.* 
 
 G. The Pulmonic Artery. 
 
 H. H. The Right and Left Carotid Artery. 
 
 I. The Subclavian Artery. 
 
 K. The Internal Mammary Artery. 
 
 L. The Thyroid Artery, to the shoulder, the 
 
 neck, and the thyroid gland. 
 M. The Vertebral Artery. 
 N. The Lungs of the right side, 
 o. The Perforation of the Diaphragm, for the 
 
 transmission of the inferior cava, 
 p. The Hole by which the CEsophagus passes 
 
 into the abdomen. 
 Q. The Lesser Muscle of the Diaphragm. See 
 
 the text, p. 325, Vol. II. 
 
 * The arch of the aorta lies three fourths of an inch below 
 the level of the upper part of the sternum. 
 
 If the assassin strikes within the clavicle, obliquely down, with 
 the stiletto, the point ^jvill, at the depth of , pass into the 
 
 arch of the aorta, and occasion a more sudden death than if 
 struck into the heart; if the aorta should escape, some of the 
 great branches will be wounded; even if the great branches 
 should escape, and the trachea be wounded, the patient is in 
 danger of instantaneous death, from the blood passing into the 
 trachea suffocating him. 
 
 E 
 
34 
 
 11. s. The whole length of the Abdominal Aorta. 
 It is seen embraced by the diaphragm at 
 R., and immediately giving off the phrenic 
 and cceliac arteries. 
 
 1. The Right Phrenic Artery. 
 
 2. The Left Vhvenic Artery. 
 
 3. The Root of the Cceliac Artery^ (See Plate 
 
 YII.) 
 
 4. 4. The Upper Mesenteric Artery, (See Plate 
 
 VIII.) 
 
 5. 5. The Emulgent Arteries. 
 
 6. The Loiver Mesenteric Artery. 
 
 7. The Hcemorrhoiilal Artery, a branch of the 
 
 last. 
 8.8. The Common Iliac Arteries. 
 9. The Internal Iliac. It is seen to give off the 
 
 gluteal, the ischiatic, and obturator artery. 
 
I'hld III. 
 
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EXPLANATION 
 
 OF 
 
 PLATE III. 
 
 This and the following Plate illustrate the Tecct 
 of Bell, from pages 242 — 294; and Wistar, 
 pages 241 — 254. 
 
 A. The Common Carotid Artery.* 
 
 * To cut down for this artery, I would turn the chin towards 
 the same side, and then make an incision two inches and a half 
 in length along the anterior edge of the sternoid portion of the 
 cleido mastoideus. In doing this, the firm cellular membrane, 
 and some of the anterior fibres of the platysma myoides must 
 be cut. Having fairly laid bare the edge of the mastoideus, we 
 ought to do no more with the edge of the knife; we ought then 
 to hold aside the mastoideus, and, with the fingers and handle of 
 the knife, we dig down to the artery, and insulate it: We find a 
 small muscle, the omo-hyoideus passing obliquely over the arte- 
 ry, about an inch and a half from the head of the clavicle. The 
 
36 
 
 B. The Internnl Carotid Artery, or Artery of the 
 
 Cerehruin.* 
 c. Tlie EjL'ternal Carotid Artery. 
 
 D. The Lower Thyroid Artery, being a branch 
 
 of the Subchivian Arterj.f 
 
 E. The Upper Thyroid Artery, being the first 
 
 branch of the Carotid.J 
 
 great internal jugular vein is close on the outside of the artery, 
 the par vagum betwixt them, the sympathetic nerve below, and 
 close upon the vertebrae. If a small nerve be observed running 
 above the artery, it is the descendens noni. 
 
 If vessels bleed in making this incision, they are muscular 
 branches of the thyroid artery. 
 
 * Internal Carotid lacerated. — Abernethy*s Surg. Obs. 
 
 t The Inferior Thyroid lies in a situation not to be tied. It 
 lies near the side of the vertebrae, where it is, on the outer side 
 of the carotid artery, fully five fingers breadth from the clavicle. 
 It should be sought for directly under the omo-hyoideus, and 
 betwixt the carotid and the anterior edge of the scaleni. It can- 
 not be taken up there. In cutting for it, I cut the sympathetic, 
 and probably the phrenic nerve. It would be better to endea- 
 vour to reach the artery, by turning over the side of the gland 
 which lies before the carotid trunk. By thus stretching the 
 gland, we find the artery as if descending from above, in two 
 branches, to the lower part of the gland. 
 
 \ It may be proposed, previous to the attempt of extirpating 
 the thyroid gland, to tie the four arteries which supply it. We 
 
BRANCHES OF THE EXTERNAL 
 CAROTID ARTERY. 
 
 1. The Lingual Artery,* 
 
 2. The Fascial Artery or Labial Artery.-f 
 
 3. The Suhmental Artery. 
 
 4. The Upper and Lower Coronary Arteries. 
 
 5. The Inosculations of the extreme Branches 
 
 of the Fascial x\rtery, with the Ophthalmic 
 Artery, 
 
 cannot reach the inferior thyroid artery before it has passed 
 under the carotid: The only possible way is, to lift up the infe- 
 rior lobe of the tumour, separating the carotid from it; when 
 we find the inferior thyroid artery rising in two branches, to be 
 distributed to the gland. It would appear that these branches 
 were descending from the carotid, by the acute turn they take 
 downwards from their highest point on the neck. 
 
 * The Lingual Artery makes its great curve (being tor- 
 tuous) immediately above the great horn of the os hyoides; 
 it then passes under the mylo-hyoideus. Were it ever necessary 
 to cut upon it here, let the extreme point of the os hyoides be 
 the mark; for it turns just above it to pass under the mylo- 
 hyoideus. 
 
 t Fascial Artery, or Labialis, or Maxillaris Externa, or An- 
 gularis, often tortuous before rising over the jaw. This artery 
 
38 
 
 6. The Occipital Artery.* 
 
 7. The place where it frequently sends down 
 
 inosculations to the vertebral artery. 
 
 8. The Lesser Posterior Artery of the Ear. 
 
 9. A Branch sometimes called Posterior 
 
 Temporal Artery. 
 
 10. Posterior Artery of the Ear. 
 
 11. The continued Branch of the External 
 
 Carotid, or sometimes the Temporal Ar- 
 tery; it divides into the submaxillary and 
 proper temporal artery. 
 
 12. The Internal MaoLillary Jirtery. See the 
 
 distribution of this artery in the next Plate, 
 fig. I. 14, and fig. II. 
 
 left untied in operation, almost suffocated the patient after- 
 wards. See Abernethy's Surg. Observations. 
 
 * The Occipital is found immediately under the mastoid 
 process, from under the insertion of the mastoid muscle; it 
 runs backwards, on a level with the tip of the ear, under the 
 insertion of the trapezius, and, of course, under the superior 
 transverse ridge of the occipital bone, on the side of the neck. 
 On the side of the neck, the internal jugular vein is immediate- 
 ly under it; it is also under the origin of the digastricus, and 
 under the ninth pair of nerves. 
 
39 
 
 13. The Transverse Artery of the Face.* 
 
 14. The Temporal Artery^ dividiifg into anterior 
 
 and posterior temporal arteries. There are 
 other branches less superficial. The deep 
 Temporal is a branch of the Internal 
 Maxillary. 
 
 * This artery I have seen bleed very smartly. In cuts of the 
 face, when this or any of the other arteries of the face are open- 
 ed, we have only to use the twisted suture, taking pains to pass 
 the needle so near the bleeding orifice that it may receive the 
 full operation of the thread when twisted round the needle or 
 pin. This secures the artery, and at the same time brings the 
 lips of the wound neatly together. 
 
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EXPLANATION 
 
 OF 
 
 PLATE IV. 
 
 {Bell, 242—294. IVistar, 241 — 254.) 
 
 Being the Distribution of the Internal Carotid, 
 the Vertebral and Internal Maa^illary Arteries, 
 as seen upon making a vertical Section of the 
 Head. 
 
 FIG. I. 
 
 A. The Upper Jaw Bone; part of it is torn away. 
 
 B. The Lower Jaw Bone; all the angle of the 
 
 right side is taken away, to show the inter- 
 nal maxillary artery. 
 
 c. Tlie Tongue. 
 
 D. The Antrum Highmorianum, torn open. 
 
42 
 
 E. The Vertebrte of the Neck, cut to show the 
 
 passage of the artery, encased in the bones. 
 
 F. F. The Scull cap, sawn through exactly in 
 
 the length of the longitudinal sinus. 
 
 G. The Falx, which divides the hemispheres of 
 
 the Brain. 
 
 H. The Longitudinal Sinus. 
 
 I. The Fourth Sinus, returning the blood from 
 the lower sinus of the falx, and from the 
 vena galeni. 
 
 K. Right Lateral Sinus. 
 
 L. The Tentorium, which covers the cerebel- 
 lum, and supports the posterior lobes of 
 the cerebrum. 
 
 ARTERIES. 
 
 1. The Common Carotid Jlrtery. 
 
 2. The Internal Carotid Artery.^ 
 
 * Internal Carotid. In Dr. Hooper's collection of prepara- 
 tions, there is a curious example of the ulceration of this 
 artery. A man intending to destroy himself, attempted to swal- 
 low pins tied together; they stuck in the pharynx, and in time 
 penetrated to this artery, which suddenly cut him off". 
 
43 
 
 3. The Ea^ternal Carotid Artery. 
 
 4. The Vertebral Artery; the processes of the 
 
 vertebrae being cut away. 
 
 5. The last and violent turn of the Vertebral 
 
 Artery, before entering the foramen mag- 
 num of the occipital bone. 
 
 6. The violent contortions of the Internal 
 
 Carotid Artery, before entering the scull. 
 
 7. The point of the Internal Carotid Artery, 
 
 where, after making its turns in its pas- 
 sage through the bone, it appears by the 
 side of the sella turcica. See Plate V. 1. 
 
 8. The Ophthalmic Artery, derived from the 
 
 carotid. It is this artery which is seen to 
 inosculate with the Fascial artery, in the 
 preceding Plate, at 5. 
 
 9. The Thyroid Artery. 
 
 10. The Lingual Artery. 
 
 11. The Fascial Artery cut short; it is seen in 
 
 third Plate, fig. 2, passing over the jaw. 
 
 12. The Continued Trunk of the External Ca- 
 
 rotid Artery; it is about to divide into the 
 temporal and internal maxillary arteries. 
 See the precedin«; Plate (11.) 
 
44 
 
 13. Tlie Temporal Artery^ cut short. 
 
 14. The Internial Maccillary Artery. 
 
 15. That Branch of the Internal Maxillary Ar- 
 
 tery, which passes into the lower jaw. 
 
 16. The Great or Middle Artery of the Dura 
 
 Mater; a branch of the internal maxillary.* 
 
 17. The Artery of tlie Upper Jaw. 
 
 18. The Infra Orbital Artery; it is seen to pass 
 
 out upon the face. 
 
 * It is this artery which rises through the spinous hole in the 
 sphenoid bone, and then runs on the lower angle or spinous pro- 
 cess of the parietal bone: here it generally lies in a deep chan- 
 nel, and gives occasion to a kind of rule in surgery, to avoid 
 applying the trephine at this part. 
 
45 
 EXPLAIN ATION OF FIG. 11. 
 
 (5e//, 278—86. Wistar, 247—251.) 
 
 This is a Plan of the IXTERXJLL MAXIL^ 
 LARY ARTERY. 
 
 1. The Meningeal Artery^ or great middle 
 
 artery of the dura mater.* 
 
 2. The Lower Mamillary Artery.f 
 
 3. Irregular Arteries: the Ptei^ygoid Arteries. 
 5. The Deep Liternal Temporal Artery. 
 
 * This artery enters the scull by the foramen spinale of the 
 sphenoid bone, and is the same that makes the deep furrow in 
 the inside of the parietal bone. Mr. Walker, of Edinburgh, com- 
 municated a case where an arrow shot into the scull wounded 
 this artery. 
 
 t Lower Maxillary. This artery enters at the posterior fora- 
 men of the lower jaw-bone, and courses within the bone, and 
 appears on the chin, coming out through the mental foramen. 
 See Ofi. Surgery^ on the bleeding of small arteries from bone. 
 In pulling the last molaris of the lower jaw, if the inner plate 
 of the bone be broken ofF, and this artery to: n up among the 
 cells of the bone, the patient may die of bleeaing. 
 
46 
 
 6. The Artery of the Cheek. 
 
 7. The Artery of the Upper Jaw. 
 
 8. Tlie Infra Orbital Artery. 
 
 9. The Upper Palatine Artery, 
 
 10. The Orighi of the Upper Pharyngeal 
 Artery. 
 
/%U,' 
 
 t 
 
 1(1^1! 
 
 l'./.^'.// M. 
 
 C f^ ^yi^lf'ft .^t/A7. 
 
 /^iM-M .Vt'i: hiA' />v .-/.N/i/i-y r/i/M' 
 
EXPLANATION 
 
 OF 
 
 PLATE V. 
 
 ARTERIES OF THE BRJilJ^, 
 
 (^Bell, Vol. II. pages 295—317. Wistar,257-^'26l.) 
 DIVISIONS AND EMINENCES OF THE BRAIN. 
 
 A. A. The Anterior Lobes of the Cerebrum. 
 
 B. B. The Middle Lobes of the Cerebrum. 
 
 c. c. The Posterior Lobes of the Cerebrumy 
 which rest upon the tentorium. 
 
 D. The Right and Left Lobes of the Cerebel- 
 
 lum. 
 
 E. The Medulla Oblongata, 
 
 F. Tiie Optic JSTerves, cut at their union. 
 
48 
 
 G. The Corpora Jilhicantia; the Infnndibuhim is 
 seen betwixt these and the optic nerves. 
 
 H. H. The Crura Cei'ebri. 
 
 I. The Forts Varolii, or Tu!)erciilum Annulare. 
 
 K. The Eminences of tlie Medulla Oblongata, 
 called Corpora Pyramidalia, 
 
 JL. The Corpora Olivaria, 
 
 artehies. 
 
 1. 2. The Right and Left Carotid Arteries, 
 raised with the brain, and cut oft' as they 
 rise at the point marked in the preceding 
 Plate (7); that is, as they rise at the side 
 oftlie sella turcica. 
 
 3. 4. The Right and Left Vertebral Arteries, 
 
 5. The Union of the Vertebral Arteries to 
 
 form the Basilar Artery. 
 
 6. The Communicating Artery, or Anastomo- 
 
 sis, betwixt the Basilar Artery and Carotid. 
 
 7. The Union of Comniunication betwixt the 
 
 carotids of each side by the anterior arte- 
 ries of the cerebrum; these anastomoses 
 6 and 7 form the Circle of Willis. 
 
49 
 
 DIVISIONS OF THE INTERNAL CAROTID 
 ARTERY. 
 
 8. The Middle Jlrtery of the Brain passing into 
 
 the Fissura Silvii. 
 
 9. The Anterior Artery of the Cerehrum. 
 
 BRANCHES OF THE VERTEBRAL AND 
 BASILAR ARTERIES. 
 
 10. The Posterior Artery of the Cerebellum from. 
 
 the Vertebral Arteries. 
 
 11. Avery considerable branch of the Basilar 
 
 Artery to the pons varolii and cerebellun^^ 
 which however has no name. 
 
 12. The Anterior Ar^tery of the Cerebellum, 
 
 13. The Posterior Artery of the Cerebrum. 
 The lesser branches of vessels seen in this 
 
 Plate are mentioned in the text, but are 
 not distinguished by any particular name. 
 
b 
 
 ^ 
 
 V.l m'lf/ 
 
EXPLANATION 
 
 PLATE VI. 
 
 {Bell, pages 340—402. W^'is^ar, 264— 273.) 
 
 OF THE JIRTERIES OF THE JiRM. 
 FIG. I. 
 
 A. The Scapula. 
 
 B. The Pectoral Muscle held up. 
 c. The Beltoid Muscle. 
 
 D. The Biceps Muscle. 
 
 E. The Coraco-brachialis Muscle. 
 
 F. The Triceps ea^tensor Muscle, 
 
 G. The Te7'es Major. 
 
 H. The Tendon of the Lesser Fectoral Muscle. 
 I. The Supinator Lon^us. 
 
52 
 
 K. The EiVtensor Carpi RadiaUs. 
 
 L. The Tlejcov Carpi Ulnaris. 
 
 M. The Palmaris Longiis and Flea^or Muscles 
 of the Fingers. 
 
 From the Aorta till the Artery passes over the 
 first rib, it is called, 
 
 1. The Suhclariaii Artery. When this artery is 
 injected, and tolerably full, it makes two 
 pretty acute turns, in the form of an italic 
 8, before it escapes under the clavicle. Its 
 larger curve is just where it comes through 
 the anterior and middle portions of the 
 Scalenus muscle. It then descends directly 
 ac^ross the first rib. It then comes out 
 under the clavicle, three fingers breadth 
 from the inner extremity of the clavicle. 
 Just at this point, viz. w here it passes over 
 the bulging of the rib, it may be com- 
 pressed in the living body.* Its branches 
 are. 
 
 * To cut for the Subclavian Artery, beg-in the incision an inch 
 from the inner head of the clavicle; then carry it in a direction 
 slightly deviating from the line parallel with the clavicle, to- 
 
53 
 
 2. The Internal Mammm^y Artery.* 
 
 3. The Vertebral Arter . 
 
 4. The Thyroid Artery, 
 
 5. The Ascending Thyroid Artery, a 
 branch of the last. The Transversa- 
 lis Colli is also generally a branch of 
 the Thyroid, very irregular in its 
 origin. Sometimes it comes from the 
 Thyroid, and then receives the name 
 of Transversalis Humeri; sometimes 
 it comes from the place of the CervU 
 
 wards the Acromion Scapulae. The second incision cuts the 
 fibres of the Pectoralis Major, where they arise from the clavi- 
 cle; here we come upon a thick bed of cellular membrane, 
 which being lifted, we find the great subclavian vein, with the 
 cephalic vein joining it; under this vein, and a little further 
 backwards (more under the clavicle) the artery is found. 
 
 * Bva.nchesoh\\e Internal Ma77nnary jirtery. l.Tothe Thymus^ 
 2. Accompanying the Phrenic Nerve. 3. To the Pericardium. 
 4. To the Mediastinum. 5. Several branches to the Pectoral 
 Muscle and Mamma. 6. To the Diaphragm. 7. To the Ab- 
 dominal Muscles, inosculating with the Epigastric Artery. 
 If a thrust be made with a small sword in any part (below the 
 second rib) in a line parallel with the Sternum, and three 
 fourths of an inch from its edge, it will wound the internal 
 Mammary Artery. 
 
54 
 
 calis Superficialis, or even from the 
 Subscapiilaris; sometimes from the 
 Subclavian itself. 
 The Deep and Superjicial Cervical Avleries. 
 
 6. I'he Supra Scapular Artery. 
 The Jlailla. 
 
 7. The Trunk now assumes the name of Aa7- 
 
 illary Artery. Its branches are, three 
 or four to the chest; three to the 
 scapula and shoulder.* 
 
 8. The Lesser Superior Intercostal Artery, 
 
 or Superior Thoracic Artery, 
 
 9. The Greater or Longer Thoracic Artery, 
 
 or External Mammary Artery. 
 10. The Thoracica Acromialis, or Humera- 
 ria. 
 
 * .Axillary Artery. If we have to turn up the edge of the 
 Pectoralis Major, to tie the axillary artery, we find the artery 
 on the inside of the coraco brachialis; the external cutaneous 
 nerve is on the outside of the artery, the radial nerve on the 
 inside, and the muscular spiral below it; the vein is betwixt the 
 artery and the muscle; higher up in the axilla the artery is in- 
 volved in the plexus. 
 
 These descriptions of the exact seat of the arteries, are in- 
 tended to enable the surgeon to avoid them as well as to cut 
 
55 
 
 The Thoracica Maris is not in this 
 subject. 
 
 11. The Subscapular Artery; it is seen to 
 
 divide upon the edge of the Scapula, 
 into a deeper and a more superficial 
 branch. 
 
 12. The Posterior Circumflex Artery of the 
 
 arm. 
 
 13. The Anteinor Circumflesc Artery of the 
 
 arm. 
 In the Arm. 
 
 14. The Trunk now assumes the name of 
 
 Humeral Ai'tery;* it gives off these 
 branches: 
 
 upon them and take them up. By attending to the above cir- 
 cumstances, I cut a ragged ball out from behind the artery and 
 nerves without hurting either. White's Cases by Gun-shot. 
 Princifiles of Surgery^ 292. 
 
 * The Humeral Artery does not run a perfectly straight 
 course down the arm. When the subject is laid on its back, the 
 arm by the side, and the palm of the hand flat upon the table, if 
 we push a point horizontally under the arm-bone, one hand's 
 breadth from its head yVonz tvithout, the artery escapes. When 
 in the same horizontal direction, two hand's breadth from the 
 
56 
 
 15. The Superior, or Ch'eater Vrof Hilda. 
 
 16. The Lesser Profunda. 
 
 17. The Anastamoticiis Major; tlie lesser 
 
 anastamosing* hranch comes oft' high- 
 er up, and follows the same direction 
 round the inner condyle. 
 Arteries of the Fore Arm. 
 
 Extremity of the Humeral Artery. The 
 Artery divides three fourtlis of an 
 
 head of the bone, the artery is transfixed. Lower down the 
 arm, it again rises towards the fore part of the humerus. 
 
 To find the Humeral Artery before passing over the elbow 
 joint, we make the patient bend his arm against a force, to 
 show the expansion of the biceps. Having marked its place, we 
 put the arm into a relaxed position, and make an incision along 
 the inner edge of the biceps, or rather, we might say, just 
 where it begins to throw off its tendinous expansion, two fin- 
 gers' breadth from the inner condyle of the os humeri, carrying 
 it upwards. We find here not immediately the artery, but the 
 radial nerve covering the artery; laying this aside, we find the 
 artery lying betwixt its two venae comites. 
 
 I have found on dissection, that the surgeon had included 
 the radial nerve in the ligature of the humeral artery. I have 
 also found that he had put the ligature about the radial nerve, 
 mistaking it for the humeral artery. 
 
57 
 
 inch below the part of the Medean 
 Basilic Vein, wliere we generally 
 bleed. 
 
 18. IS. The Radial ^irtery. 
 
 19. 19. The Ulnar Artery. 
 
 The Interosseous .\rterj, which divides 
 into the Inner and Outer Interosseous. 
 
 The Recurrent Arteries from these last 
 are, the 
 
 Becurrens Badialis Jlnterior. 
 
 Becurrens Ulnaris Anterior. 
 
 Becurrens Ulnaris Posterior. 
 
 Recurrens Interossea. 
 20. At this point the Radial Artery turns 
 under the supinator tendon and ex- 
 tensor tendons of the thumb.* 
 
 * To find the Radial Artery in its course one-third down the 
 arm, cut on the outer edge of the supinator lo?igus^ first through 
 the third fascia — then lift the edge of the muscle, and under the 
 second fascia you find the radial artery, passing over the tendon 
 of they^rowa^or teres, 
 
 1. To take up this artery on the wrist, we cut a quarter of an 
 inch from the radial edge of the Flexor Carfii Radialis. N. B. 
 The insertion of the Supinator Radii Longus is on the outside, 
 but flat, giving no mark outwardly. The Extensor Primi In- 
 
 H 
 
58 
 
 Superficial Artery of the Palm. 
 21. The Ulnav Artery passing over the 
 wrist.* 
 Lovsalis Ulnai'is. 
 
 ternodii Policis comes obliquely over the head of the Radius, 
 and the insertion of the Supinator. 
 
 A fascia covers the artery here. A small nerve (from the 
 external cutaneous) runs above the fascia. 
 
 2. To cut for the Radial Artery, when it has passed from the 
 fore part of the wrist, we carry the knife on the outside of the 
 insertion of the Extensor Radialis Longior^ and the inside of 
 the Extensor Tertii Internodii Policis. Betwixt these tendons 
 the artery lies very deep, and over it the extreme branch of the 
 Muscular Spiral JVerve. 
 
 * Ulnar Artery. 1. In the middle of the fore arm the artery 
 lies under the fascia, and under the margin of the Flexor 
 Ulnaris and Flexor Digitorum Sublimis, rather more under the 
 margin of the last. To tie the artery, we would have to cut 
 down betwixt these muscles. The Ulnar JVerve lies on the 
 ulnar edge of the artery. 
 
 2. To cut for the Ulnar Artery near the wrist. We carry the 
 knife upon the inside of the Flexor Ulnaris Carpi; we raise the 
 fascia, which binds down the tendon; but still we have another 
 layer of the fascia, under which the artery and its Ventje Cornites 
 lie. The nerve is lying still more under the tendon of the 
 ulnaris than the artery, but close upon it. 
 
 Ulnar Artery tied for wound of the palm. Princifiles of Sur- 
 gery, 183. 
 
59 
 
 Arteria Palmaris Profunda Ulnaris. 
 
 22. The Great Palmar Arch, from which the 
 
 Arteries of the fingers are seen to 
 proceed. 
 
 23. This dotted line marks the seat of the 
 
 Lesser Arch under the tendons. 
 
 FIG. 11. 
 
 From this Sketch of the Arteries we can follow 
 in idea their continued course among the 
 muscles. 
 
EXPLANATION 
 
 OF 
 
 ADDITIONAL PLATE VI. 
 
 A. Arte^na Radialis. 
 
 B. Ramus Borsalis, 
 
 c. Palmar is Fvofunda. 
 
 D. Ramus ad Indicem. 
 
 E. Ramus ad PoUicem. 
 
ur 
 
 ^vS#? 
 
EXPLANATION 
 
 or 
 
 PLATE VII. 
 
 THE mSTRIBUTIOJ^r OF THE CCELMC 
 ARTERY. 
 
 (Bell,fiages 412—422. Wistar, 276-^280.) 
 
 A. The Liver raised so as to show its concave 
 
 surface. 
 
 B. The Gall Bladder. 
 
 c. The Stomach laid down to the left side, 
 
 D. The Omentum. 
 
 E. The Colon. 
 
 p. The Small Intestines, 
 
 1. The Jlorta. 
 
 2. The Root of the Coeliac Artery. 
 
64 
 
 3. The Superior Coronary Artery of the Sto- 
 
 mach. 
 
 4. The Splenic Artery. 
 
 5. The Gastro -Epiploic Artery, 
 
 6. The same Artery running upon the great 
 
 Arch of the Stomach. 
 
 7. The Pancreatica Buodenalis, a branch of the 
 
 last. 
 
 8. The Hepatic Arter'y; it is seen to divide into 
 
 the right and left hepatic arteries; the 
 right hepatic artery is seen to give oft' the 
 Cystic Artery; a small branch is seen 
 passing from the trunk of the hepatic ar- 
 tery to the Pylorus, viz. the Lower Pyloric 
 Artery, 
 
/'/,Uf iv/y. 
 
 I ' ^ ^• 
 
 /A ;^v/ ,/,•/, 
 
 Ly. C,/ir/i, .t,ri//l. 
 
 JhiHirhd M>K /S/L' ^r J.rir/n J'M^aif 
 
EXPLANATION 
 
 PLATE VIII. 
 
 THE MESEJSTTERIC ARTERIES, 
 
 (Bell, page 422. Wistar, pages 280 — 285.) 
 
 A. A. The Omentum held up, and bearing the 
 
 great Arch of the Colon. 
 
 B. The termination of the Intestinum Ileon in 
 
 the Caput Coli. 
 c. Caput Coli. 
 D. E. The Jlrch of the Colon, which stretches 
 
 across the belly. 
 
 F. The Sigmoid Eleacuve of the Colon. 
 
 G. The Rectum. 
 
 H. The Bladder of Urine. 
 
 I 
 
66 
 
 1. The Aorta. 
 
 2. The Coeliac Artery, 
 
 3. The root of the Upper Mesenteric Artery. 
 
 4. Tlic great Lash of Arteries which go to the 
 
 small intestines. 
 
 5. The Ileo-Colic Artery, 
 
 6. The Bight Colic Artery. 
 
 7. The Middle Colic Artery, 
 
 8. The Lower Mesenteric Artery, 
 
 • 9. The Left Colic Artery; this forming a great 
 inosculation hctwixt the Upper and Lower 
 Mesenteric Arteries. 
 
 10. The llcvmorrhoidal Artery descending with 
 
 the Rectum into the Pelvis. 
 
 1 1. Tlie Emulgent Artery of the left side. 
 
 12. Tlie Spermatic Artery. 
 
 13. The Middle Sacral Artery. 
 
 14. The Common Iliac Artery. 
 
 15. The Eccternal Iliac Artery. 
 
 16. The Internal Iliac Artery. 
 
t/>iu- J. v. 
 
 ■r. : y^ 
 
 Sj 
 
 
 {i /i// ,t.^. 
 
 ^. SM„< ^.y,//, 
 
EXPLANATION 
 
 PLATE IX. 
 
 OF THE ARTEEIES OF THE LOWER 
 EXTREMITY, 
 
 (Bell, page 452. TVistai; fiages 291 — 300.) 
 
 A. The Tendon of the External Oblique Muscle. 
 
 B. The Sartorius Muscle. 
 c. The Gracilis. 
 
 D. The Triceps Muscle. 
 
 E. The Rectus Femorls. 
 
 F. The Vastus Internns. ^^ 
 
 G. The Vastus Externas. \; 
 H. The Patella. 
 
 I. The Tibia. 
 
 K. The Head of the Fihula. 
 
 L. The Gastrocnemius Muscle. 
 
68 
 
 M. The Solens Muscle, 
 
 N. The Tibialis Anticus. 
 
 o. Tlie Extensov Tiudous of the Toes. 
 
 AnTEBIES. 
 
 1. The Femoral Artery. 
 
 2. The Epigastric Artery.* 
 
 * Rfiigastric Artery. This artery passes in a direction to- 
 wards the RectJis Abdominis, behind the spermatic cord; it is 
 consequently behind the neck of the sac in bubonocele Thou}3;h 
 rarely, yet sometimes it happens that the hernia conies down 
 behind the spermatic cord, or nearer to the pubes, or even so 
 as to split and separate the vas deferens, from the other sper- 
 matic vessels; in this case the epigastric artery lies on the in- 
 side of the sac I have seen this artery cut in the operation for 
 hernia. Ic has been opened in the operation of Paracentesis 
 Abdominis', and the patient lost by a hxmorrage into the belly. 
 
 Very often a considerable branch of this artery courses along 
 the edge of the Poupart ligament, towards the pubes. Its com- 
 mon distribution is thus: 
 
 1. To the cord and cremaster muscle. 
 
 2. Towards the back, of the os pubis. 
 
 3. Principal branch ascending upon the rectus. 
 
 4. Inosculating with the internal mammary. 
 
69 
 
 3. The Jlefiexa Ilii. 
 
 4. A Cutaneous Branch to the head of the Sar- 
 
 torius, and g-lands, and fat. 
 
 5. To the Inguinal Glands, and Fat; it sends 
 
 out a pudic branch also. 
 
 6. The External Pudic Jlrtery.* 
 
 7. The Profunda. 
 
 8. The Internal Circumjlecc Artery. 
 
 9. The Profunda, proceeding deep into the 
 
 flesh of the thigh before it gives off the 
 perforating branches. 
 The Branches of the Profunda are seen in the 
 interstices of the Rectus and Yastus Ex- 
 ternus.f 
 
 * The largest of these External Pudic Arteries gives out its 
 blood freely, when cut in the operation of vScrotal Hernia, or 
 extirpation of the testicle. 
 
 t They are these: 
 
 'To the Dorsum Ilii. 
 To the outside of the hip. 
 The greater and lesser descending 
 branches. 
 
 Arteria Circumflexa 
 
 Externa' 
 
 Interna. 
 
70 
 
 10. The Femoral Artery, where it lies betwixt 
 the triceps and vastus internus muscle, 
 before it perforates the triceps.* 
 
 ll,t 12, 13. Articular Arteries, branches of the 
 Popliteal Artery. 
 
 14. The Anterior Tibial Artery.X 
 
 * Femoral Artery. This artery, near the place of its perfora- 
 ting the triceps, is the subject of one of the most important 
 surgical operations, for popliteal aneurism. In dissection it may 
 be well to make this experiment: Place a string so as to reach 
 from the superior spine of the os ilii to the prominent part of 
 the inner condyle; mark the middle of the string; make an in- 
 cision a very little towards the inside of it, in the direction of 
 the string; first, you come to the sartorius muscle; next, lay- 
 ing that aside, to a fascia, which stretches from the triceps to 
 the vastus internus; when this is slit up you may see the artery; 
 observe its situation in regard to the -vein^ the ncrvus longus, 
 and the sheath which surrounds it. 
 
 t This branch (the first perforating branch of the Popliteal 
 Artery) is remarkably enlarged in Popliteal Aneurism. 
 
 \ The Anterior Tibial Artery lies so under the projection of 
 the Tibia, that it is not often wounded; yet it may be cut by a 
 deep wound, and the student should observe how it lies under 
 the fascia and muscles. 
 
 « The Anterior Tibial Artery comes through betwixt the 
 " bones, one inch below the projection of the knob of the Fibu- 
 " la; we then cut by the edge of the Peroneus Longus, and fol- 
 
71 
 
 15. The Reflected Branch of the Anterior Ti- 
 
 bial Artery. 
 
 16. The Jlnterior Tibial Artery^ continuing its 
 
 course, and distributing small branches to 
 the surrounding muscles. 
 
 17. At this part it passes under the Annular 
 
 Ligament. 
 
 18. The Internal Maleolav Artery. 
 
 19. The Eccternal Maleolar Artery. 
 
 20. The Tarsal Artery. 
 
 21. The Anterior Tibial Artery descending on 
 
 the fore part of the foot. 
 
 22. The part at which the Anterior Tibial 
 
 Artery sinks into the sole of the foot, 
 formuig communications with the Plantar 
 Arteries. 
 
 23. The last branch of the Anterior Tibial 
 
 Artery, the Arteria Borsalis Pollicis. 
 
 « low the partition fascia, which is betwixt this muscle and 
 " the head of the Extensor Digitorum Communis. This parti- 
 « tion carries us deep, and we find the artery lying on the in- 
 " terosseous ligament." 
 
 When the artery is to be tied lower down, after slitting up 
 the fascia, we must cut betwixt the Tibialis Anticus, and Ex- 
 tensor Pollicis. 
 
ri,Uc X 
 
 1/ °\. 
 
 / 
 
 
 
 I h 
 
 / ^ / 
 
 ■7K>^ 
 
 ^P •; 
 
 ci/f,-// M. 
 
 iy. Oc/f/f// .III////. 
 
EXPLANATION 
 
 OF 
 
 PLATE X. 
 
 (^Bellj/iage 442 to the end. IVistar, 291 — 300.) 
 
 A. The body of the last Lumbar Vertebra sa'vvii 
 
 through. 
 
 B. The Sacrum. 
 
 c. Ischiatic Ligaments, 
 
 D. The Lumhar Muscles. 
 
 E. The Great Gluteus Muscle. 
 
 F. The Lesser Gluteus Muscle. 
 
 G. The Gracilis Muscle. 
 
 H. The Vastus E^rternus Muscle. 
 
 I. The Outer Hamstrhig Muscles; i. e. the 
 
 Biceps. 
 K. The Inner Hamstring Muscles, i. e. the 
 
 Semi-tendinosus and Semi-memhranosus. 
 
 K 
 
74 
 
 L. L. The Triceps. 
 
 M. The Outer Condyle of the Thigh bone. 
 N. The Inner Condyle, 
 o. The Belly of the Gastrocnemius Muscle. 
 V. The Soleus Muscle. 
 Q. The Achilles Tendon. 
 R. The Tibia. 
 
 s. The Great Flexor Pollicis. 
 T. The Flexor Digitorum Coniraiinis. 
 1. The Internal Iliac Artery; giving off, 
 2. Hypogastric Artery. 
 
 3. 3. Ischiatic Artery.* 
 
 4. 4. I'he Pudic Artery. 
 
 * To hit upon the Ischiatic Artery as it comes out from the 
 Pelvis, begin the incision by the side of the Sacrum, three 
 fingers breadth from the posterior spinous process of the Ilium, 
 and carry it down, in the length of the fibres of the Gluteus 
 Maxinius, to the outside of the tuberosity of the Ischium. 
 Even in a thin man, the artery lies two inches deep. Now, push- 
 ing in the finger as if under the sacrum, we there feel the acuta 
 edge of the sacro-sciatic ligament; on the lower margin of the 
 sacro-sciatic hole, (which is distinctly felt with the finger 
 amongst the looser parts,) the autery is felt crossing the 
 LIGAMENT OBLIQUELY; ucar it, upou its outer side, are some 
 LESSER nerves; the great Sciatic Nerve is removed an inch 
 from it. 
 
75 
 
 5. The Obturator ^rtery.^ 
 
 6. 6. The Gluteal Artery.^ 
 
 7. A branch from the Internal Clrciimjiea; 
 
 Artery, 
 
 8. Branches of the Perforating Arteries of the 
 
 Frofumla. 
 
 9. The Popliteal Artery after it has pierced 
 
 the Triceps Muscle.J 
 
 * We see here what would be the situation of the Obturator 
 Artery^ if a Hernia should descend under Poupart's ligament 
 in a person having this distribution of the vessel. See Cooper 
 on Hernia. 
 
 t To strike upon the Gluteal Artery, we cut in the di- 
 rection of the fibres of the Gluteus Maximus, beginning about 
 TWO fingers' breadth beneath the posterior spine of the Ilium; 
 we cut through the Gluteus Maximus and Medius just upon 
 the lower edge of the Ilium; we find the trunk of this artery 
 rising to mount upon the back of the Ilium; we must observe, 
 too, that CONSIDERABLE branches are carried outwards 
 through the muscle, into which we must cut to arrive at the 
 seat of the trunk. 
 
 In case of a wound in this artery, and the consequent for- 
 mation of a false Aneurism, the surgeon, after puncturing the 
 tumour, has to push his finger deep amongst the blood until 
 he arrive at the trunk over the notch of the Ilium — compress- 
 ing it there, he may gain time. 
 
 ^ The Popliteal Artery wounded by a sabre; Princifiles of 
 
76 
 
 10. Those branches sent oft' from the main ar- 
 
 tery as it is passing the Tendon; they are 
 called the peribrating branches of the 
 Poplitel Artery. 
 
 11. The Upper and Inteinial Jlvlicular Artery. 
 
 12. The Upper Ejcternal Articular Artery. 
 
 13. The Lower Ejcternal Articular Artery. 
 
 14. The Lozver Internal Articular Artery. 
 
 15. The Posterior Tibial Artery; the Anterior 
 
 Tibial Artery (Plate IX. 16.) is a branch 
 sentofi'from this.* 
 
 16. The Peroneal Artery, or Fibular Artery, f 
 
 Surffery, 328 — wounded by the sharp projection of the femur 
 after fracture: 0/ierative Surgery, ii. 357, 
 
 * Posterior Tibial Artery gives off the outer Tibial; piercing 
 betwixt the heads of the bones exactly four fingers' breadth 
 below the upper end of the Tibia; lying upon the Popliteus 
 Muscle, it is about two fingers breadth removed from the inner 
 edge of the Tibia. 
 
 t Fibular Artery. It comes through the bones one inch below 
 the projection of the knob of the Fibula. To hit upon it, 1. We 
 cutthrough the strong fascia. 2. Betwixt the heads of the Ex- 
 tensor Digitoriim L,ongus, and of the Peroneus Longus, we 
 find it lying on the interosseous ligament. N. B. We must cut 
 thi'ough some of the fibres of the Extensor Digitorum Longus. 
 
 To cut for the Fibular Artery lower in the leg than a hands* 
 
77 
 
 17. The Posterior Tibial Artery appears here 
 again from under the Soleiis Muscle.* 
 
 breadth from the head of the Fibula. 1. The fascia. 2. By the 
 outside of the Tibialis Anticus; betwixt it and the Extensor 
 Profirius Pollicis. 
 
 It seems a shocking alternative to be obliged to saw out the 
 Fibula, in order to tie this artery. To find this artery two hands' 
 breadth from the heel, cut down on the outside of the Gastroc- 
 nemius, where it is becoming tendinous; turn up the edge of 
 the tendons; you then find the Flexor Pollicis Magnus covered 
 with its sheath. If you seek for the Fibular Artery, by going 
 deep into the leg without piercing this fascia, you find the Tibial 
 JVerve^ and may come on the Tibial Artery. To find the Fibu- 
 lar, then, we cut down by the side of the bone (fibula), and raise 
 the fibrous origins of the Flexor Pollicis. We then find the 
 artery by the acute edge of the bone, lying on the ligament, 
 accompanied only by its Venae Comites. 
 
 * The Posterior Tibial Artery. For complicated wounds in 
 the sole of the foot, this artery may require to be taken up be- 
 hind the ancle joint, and before it pierces under the Flexor 
 brevis pollicis pedes. We shall be directed to the exact place, 
 by observing the lowest projecting part of the Tibia. The ten- 
 dons, which run close upon this tuberosity of the bone, are the 
 Tibialis Posticus, and Flexor Communis; the first lies so close- 
 ly braced to the bone in its particular sheath, that it will not be 
 observed; the artery runs a little nearer the heel than the ten- 
 don of the Flexor Communis; a fascia braces down the artery, 
 the nerve is under the artery. 
 
78 
 
 18. The Fibtilai' Jlrtery; it is seen to form large 
 
 inosculations with the Tibial xlrtery. 
 
 19. A remarkable inosculation betwixt the Ti- 
 
 bial and Fibular Arteries. 
 
 20. The Ejctemal Plantar Ai^tery. 
 
 21. The Internal Flantar Artery. 
 
^ 
 
Date Due 
 
 
 
 
 1 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 Form 335— 40M— 6-40 
 
 
 
 ^ 
 

 611.13 B433E 
 
 424263 
 

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