•'££:

'.fcWtfwr;:^
■r:-'.r..>i,i:Jtvi!!i:


M.*..:w
!.'".',?'
  ^'riTO«:.r'*&r&V:-■»•<•••:'■-  *•■■


  '\ ~r,V,/; vt'wv; ."H^v:-•'*;.<.*,,
"■• ;>v;«^^..v.^,1,7l*.:;;*.!i:;-.*.,-',':r;<;:








    ..,'tv  ,"'rv>. ii.ii.'*»i't.,'| •*; ..»■>«!■
  ....;&•? ^<^i:ri;-7//rxvi.)!-,/1yl*1

  ;.-i4ip*wl.-:--.,.;:»,i "vy* v|..: ■''.'.?, I'


  f..fx'- '•  ,v.y.\.,o.- '.:,'f..,.:.:,<- :v',

  •^4!^l-;V;-::;> v:v'^ A':A;: ':■:'
  f;-fy.^--'iV.:.!:-;.\'.'.-'.:i;:i..'r.'::;. .'
  ^iW,:,',!-' ■ .•'•"/: \ ,.v,^ ..•.,:  '•,'
  ;;,'.".'M-'r.-t',.'"■'.>'•• '.•■•..',•,;:■•.'(.•;  .'<
  ■■ ■yt'\':-,>';■■■:.f'.:,w",,-J .■•.,:rr.<\.,>,':■',■:.'

    t4»X^.'!1':;'->;7r^ft:M.Vi:i','.:,,1-..'


    I J'f'f' ■•'< '■■■''■'.' x ■'  ' <■» • I  r ' .
•Vi^;r;?ti;'':;-,;.:;:1.
^J5??»S^i;»:'!ii;i0vi,;-;:,1i,.;.^-'
■..v?^X'H\.;';v.r

!-/:.>p.r;j'V';:!i;vL..

^■■' ;:;7.''- r.v>. ■'••.-.'  ;


::;:rV-,;::;v:'i;:.'v-::
r^^S'S^i»^;:K'i^^^ ^.- -; :■■'•..; lev-,













^^•^Hwwv,;;>,>Li,.v)V ■    •  :.i:v-•;:,;;:;•;• ■'


fr&iv&W'lj*1^  ••■"'  •:■■-■;'::■••• '
^•^!:K-■:£.■'";;■■'•'■:.'•■.•:■: ■. ..v


fef^4'':^  ■■'•!';'.•'■'"■:•..   •'.•■■.
;MA;^:K'/'''  '::■■•.;■.'/■:■■.  '
mm
 ''iVv.'l'JI

 V'Jr rFv  *

 ^{'^ ?■•••• i









'''''I'v,'!'',:' •
'   :?r,v,?i


€■';■ •&
"Vi.:'.. '■•.,«*:
 ■■■'■■  ■'■"%■


        H.M;
.•.•"■. -/''vBft
 :.:■-.■   ' f*-Wi



■-.' -• ■■• »w.r

■■■•■••-•   '..>«■«!* 
< 
 
2.

 
ANATOMICAL INVESTIGATIONS,
                     COMPRISING


          DESCRIPTIONS OF VARIOUS FASCLffi


                       OF THE



                HUMAN  BODY;


Toe Discoveries of the Manner in wbich the Pericardium is formed from the Superficial
 Fascia; the Capsular Ligamem of the Shoulder Joint from the Brachial Fascia; and the
 Capsular Ligament of toe Hip Joint from the Fascia Lata.


                  TO WHICH IS ADDED


AN ACCOUNT  OF SOME IRREGULARITIES OF STRUCTURE


                         xsv



        MORBID   ANATOMY;



              WITH A DESCRIPTION OF A NEW


           ANATOMICAL TABLE.
                               /
           BY JOHN D. GODMAN, M. D.

          LECTURER ON ANATOMY AND PHYSIOLOGYJ

BBITOB OP THE JOUBWAL OP POREISIf MEDICINE ; PBOPESSOR OP PHYSIOLOGY
  TO THE PHILADELPHIA MC8EUM ;  MEMBER OP THE ACADEMY OP HATUBAl
  SCIENCES ;  HOKORARY MEMBER OP THE MEDICAL SOCIETIES OF PHILADEL-
  PHIA, MARYLAND, BALTIMORE, LBXIHGTOBT, CIKCISITATI, PITTSBURG, &C.






                  ^  ■■•■
                  Plft^AWIiPHIA:

   H. C. CAREY ft. I.  LEA.-CHESNUT STREET.
1834. 
Q&
<?587a.r
 iSjz4-
     EASTERN DISTRICT OF PENNSYLVANIA, TO WIT:

 *********   BE IT  REMEMBERED, that on the eighteenth day of
            *June, in the  forty-eighth year of the Independence of the
            ^ United States of America, A. D. 1824,
            *
            J         H. C. CAREY AND I. LEA,
 *********
 of the said district have deposited in this office the title of a book, the  right
 whereof they claim as proprietors, in the words following, To wit :

  " Anatomical Investigations, comprising descriptions of various fasciae of the
    Human Body; The Discoveries of the Manner in which the Pericardium
    is formed from the Superficial Fascia; the Capsular Ligament of the
    Shoulder Joint from the Brachial Fascia;  and the Capsular Ligament of
    the Hip Joint from the  Fascia Lata.   To which is  added an account
    of some irregularities of structure and Morbid Anatomy; with a description
    of a new Anatomical Table.  By John  D. Godman, M. D. lecturer on
    Anatomy and  Phisiology; editor of  the Journal of Foreign Medicine;
    professor of Physiology to the  Philadelphia  Museum; member of the
    Academy of Natural Sciences ; honorary member of the Medical Societies
    of  Philadelphia, Maryland,  Baltimore,  Lexington,  Cincinnati,  Pitts-
    burg, kc."

  In conformity  to the act of the Congress of the United States, entitled, "An
Act for the Encouragement of Learning, by securing the copies of Maps, Charts.
and Books, to the authors and  proprietors of such copies, during the times
therein mentioned;—And aiso to the  act, entitled, " An Act supplementary to
an Act, entitled " An Act for the Encouragement of Learning, by securing the
copies of Maps, Charts, and Books, to  the  authors and proprietors  of  such
copies daring the times therein mentioned," and  extending the benefits thereof
to the arts of designing, engraving, and etching historical and other prints.
                                               D. CALDWELL,

                        Clerk of the Eastern District of Pennsylvania. 
                 TO
   STUDENTS OF MEDICINE
             IN PARTICULAR,
AND LOVERS OF IMPROVEMENT GENERALLY,
           THESE FIRST FRUITS OF THE

          OF STUDYING AND TEACHING
             ANATOMY
        ARE MOST RESPECTFULLY
             DEDICATED
                 BY
                     THE AUTHOR. 
 
INTRODUCTION.
  The following investigations were begun without
reference to any system, and without the slightest
wish to support any preconceived  opinions.   The
conclusions drawn were unavoidable, even at first
inspection, and  their correctness was more firmly
established by every subsequent examination.   The
researches  were originally made, in every instance,
in the presence of a class of students, most of whom
had attended two courses of anatomical lectures, and
were considerably experienced in dissecting.  They
were stationed as near as possible to  the table and
requested to suffer nothing to  pass them as ascer-
tained, of which they were not entirely satisfied  by
the demonstration.   They saw every touch  made
with the knife,  and were thoroughly  able to  judge
of the difference between what  really existed, and
what might have been accidentally produced.   The
results of all the investigations made in the presence
of the class, and before the members of the profes-
sion especially invited to witness them, exactly cor-
responded with the descriptions here given.  There
was no ambiguity either in the continuation, extent,
or density of the Fasciae and processes. 
Vi               INTRODUCTION.
  It is much easier to demonstrate  the whole of
these structures, than to convey an accurate idea of
them by description, as to the repetition of techni-
cals, and the reader's want of precise recollections
of the  parts referred  to,  necessarily give an ap-
pearance of obscurity to a minute anatomical detail.
  The mode of teaching anatomy by a pure Analy-
sis, which it has been  my happiness first to  intro-
duce and establish by the fairest experiment,  is the
only method which can free us from the trammels
of long reigning prejudice,  or the  dominion of an-
cient errours, that  have become  prescriptively es-
tablished by  frequent repetition  in  " systematic
works."  By this  method  the teacher is always
placed in the condition of a learner,  and no autho-
rity is  accredited but demonstration—no book is va-
lued until its descriptions have been tested by a rigid
scrutiny, in direct comparison with the structure as
fairly exposed,  and competently observed.   This
appeal  from books  and authorities  to  nature,  dis-
perses  the clouds which have too long involved the
science of  Anatomy—removes the  difficulties  that
have impeded the advances of the inquiring student,
and opens the way to improvement, discovery, and
truth.   In  order to satisfy such  as may not  have
read the exposition of this method, which was pub-
lished  a few months since, the following extract may
be advantageously presented. 
INTRODUCTION.
vii
  «In consequence of a careful investigation of the
modes of teaching anatomy, I have been induced to
resort solely to the method of Analysis or decompo-
sition.   The subject  is placed  before the learner
untouched ;  the knife is not used to clear obstruc-
tions from the way of the  teacher, previous to the
lecture.  The student sees the relation of parts—
the Anatomy, as it is  left by the hand of nature: he
observes the manner in which they are to be suc-
cessively removed—he sees the  situation and com-
pany with which they are  always to be found, and
perceives that in this  mode of examination there are
no  difficulties to  impede his  progress, but inatten-
tion or  neglect.   The body is  decomposed by the
knife in his sight, and he soon acquires a clearness
of information on the connexion of parts existing in
the living system,  which enables him at any mo-
ment to recollect  what is to be encountered  in any
portion of the frame.  The physiology he  learns
does not consist of a collection of scraps and frag-
ments relative to each part separated, but it is the
whole that can be learned, from the whole in combi-
nation.   Should  the teacher even be inadequate to
the task of telling him all that is necessary,  yet as
the student sees  the veritable anatomy for himself,
his subsequent reading  is always aided by recol-
lecting the actual condition of the structure."
   «In fact we believe no cause has acted more pow- 
vm
INTRODUCTION.
erfully in retarding the advancement of the science
of medicine,  thau the injudicious mode of teaching
anatomy synthetically.  In this way,  we can easily
account for the limited and unphilosophical views
of physiology and pathology which have been given
to the world.  One teacher acquires a habit of pay-
ing an exclusive attention to the nerves, and all his
views ore, nervous—another scrutinizes  the arteries,
and all the theories he forms are inflammatory;  a
third studies the veins,  and congestions and en-
gorgements are the night-mares that oppress him; a
fourth pores over the absorbents, and he is in conti-
nual dread, lest the balance of the system  should
be destroyed; a fifth looks entirely to  the muscles
and his mind can perceive nothing but alternations,
of laxity and tension, of tonic and clonic contrac-
tions, of debility and spasm!"
  ——" In teaching anatomy by the analytic me-
thod, the teacher has not so good an opportunity of
making the parts look beautiful as in the ordinary
modes of  instruction.   He  must of necessity show
the structure  exactly as it is ; and must be content
with the advantages his class receives from correctly
understanding the subject.   While learning the re-
lation of parts, the class is in general too usefully
and agreeably employed, to think of the sights they
might have, were the lecturer at  liberty to prepare
them before hand, at the trilling expense of destroy- 
                   INTRODUCTION.                IX
  ing a few fasciae arteries,  veins, nerves, tendons or
  muscles !  It is true, that in this mode of teaching,
  the lecturer will find it no easy task to commit a
  lesson  to memory, and  he may occasionally err in
  his descriptions; yet as he  opens  the faultless  vo-
  lume of nature before the eyes of his class, an error
  in  his speech docs  not place a veil over their sight;
  nor does an inaccuracy in his  detail, produce any
  inaccuracy in their perceptions."*
    The discoveries now announced are the immedi-
  ate fruits of the adoption of this method of teaching,
  and their importance may be gathered from a con-
  sideration of the following particulars.  The fasciae
  of  the human body have heretofore been considered
  very numerous, and in a great degree independent
  of  each other.  One fascia  has frequently been  de-
  scribed under many  different names.   By these re-
  searches all the fasciae have been reduced to  three,
  all of which are fairly continuous  at certain points.
  We show that all the fasciae  heretofore described,
.  (with the exception of the temporal,  palmar and
  plantar aponeuroses) are  offsets or processes from
  these three fascias.   The first and most striking  ad-
  vantage is  the  simplification of what has till now
  been unnecessarily esteemed complex.  By explain-
  ing the connexion of the processes with the parent
   •  See the Introductory Lecture on " Analytic Anatomy," published by
  the  class,  Feb. ]^'2>i
                         w 
-\
INTRODUCTION.
 fasciae,  and pointing  out  their relations  with  the
 different structures, we are enabled to form a clearer
 idea of the natural and morbid  condition of  the
 parts;  this is an advantage only to be appreciated
 by those who know how miserably inaccurate the or-
 dinary  conclusions relative to  functions are,  when
 drawn from the knowledge of the  structure, obtain-
 ed in the usual synthetic maimer.
   The  discovery of the formation of the Pekicak-
 dium from the fascia superficialis removes a  great
 stumbling block from the path of  the student, who
 is inevitably bewildered when he tries to compre-
 hend how a delicate serous membrane, the pleura,
 can form  a strong fibrous capsule such as the Pe-
 ricardium, as is usually taught.
   By demonstrating that the sheaths of the vessels
 are formed not from mere cellular  substance hut by
 processes of a dense fibrous  membrane, which of-
 fer an equal resistance to  the dilatation of the blood-
 vessels, a great difficultyis removed, which has \oiit,
 existed  relative to the physiology of the circulation ;
 so much  has been said about the elasticity of the
vessels that many have been induced to believe them
entirely free from the ordinary laws of hydrostatics.
The formation of the  sheath  shows us, that  they
must be when distended,  nearly in the condition of
rigid tubes ; this enables us to perceive satisfactorily
how an impulse given by the heart can effect wiih 
INTRODUCTION.
 the slightest loss  of  power, the whole column of
 blood from the centre to the circumference of the
 system, and does away the necessity of looking for
 other causes than the heart to propel the circulating
 fluids.
   Among  the most interesting parts of these re-
 searches,  is the demonstration of  the  manner  in
 which the  capsular ligaments of the great joints are
 formed. I am by  no  means anxious to claim great
 merit for proving the  continuity of fasciae, and the
 connexions thus produced between different parts—
 although Bichat contented himself with asserting
 that the fibrous  membrane may be traced into the
periosteum.  But I do expect the thanks of anato-
 mists and  physiologists for having pointed  out the
mode in which the  capsular ligaments are made up
from the coverings of the muscles, and thus  render-
ing their natural conditions more intelligible and
opening the way to new views of their possible si-
tuations resulting from disease or accident.  I  am
sure of receiving  the grateful applause of every un-
prejudiced  student  for having in this part  of the
science substituted  simplicity for complexity  and
regularity for confusion.
  Nor is it pretended that this subject is exhausted ;
other investigators  may make such  discoveries as
will entitle them to  correct  and modify some of the
details  herein advanced.  But  we  have repeated 
XU                INTRODUCTION.
the examinations too frequently, and in the presence
of too many critical judges, to have any fear for the
general principles proposed.   With a full assurance
that a repetition of these dissections will convince
even the  most prejudiced, they are offered to the
professional world, and we await with  pleasure, the
decisions of such as examine for themselves. Those
who do not examine, have no right to offer any de-
cision,  whatever  notions they may entertain.  In
matters of probability men may judge  from a state-
ment of the reasons  for and against a conclusion:
but when facts are announced, whose  existence can
be established or  denied by demonstration and ex-
periment alone, he who neither experiments nor de-
monstrates must be  silent, or speak in vain.   We
ask  no man  (e to vouch for" the truth of  what  is
here advanced—we  wish all to examine, and their
testimony will be favourable.
   The  novelty of these descriptions will, perhaps,
be the greatest impediments to their general accep-
tation, for  it has been Very correctly  remarked by
an illustrious anatomist,* that there are many per-

  tC * Que de  personnes- s'effarouchent de  la  seule announce
d'idees nouvelles ?  Si j'ai la conviction qu'on m'ait attaque sans
m'avoir corapris, je me dispenserai de repondre.   Car, a quoi bon
se tourmenter pour prouver, qu'on a cu raison ?  Le temps met
chaque chose a sa place.'1
                           (rEOlFFIOY S\T\T Hir,AIK> 
                 INTRODUCTION.              Xlll
sons who become furious at the mere annunciation
of new ideas:—like him, however we  shall wait
patiently, convinced that time fixes every thing in
in its place. 
 
ANATOMICAL INVESTIGATIONS-
                  SECTION  I.

            The Fascia Superjicialis.
   Various parts of the human body are so  imper-
 fectly and obscurely described, as often to excite a
 doubt of their true nature.   This evil is of great
 magnitude, and results from various causes, none of
 which are so active as a habit,  becoming too gene-
 ral, of considering the  structure of individual tex-
 tures insulated  from all others aud independent of
 their relations—as concerned in a single disease or
 connected with  a particular operation in surgery.
   Hence small  portions of the same membrane  are.
 known by different  names, and very minute  de-
 scriptions are given of each separately,  so as to
 convey to the mind an idea of several distinct mem-
branes,  where there is in reality but one.  Even if
this conclusion  be not drawn by the uninstructed,
it 'is  very certain,  that every  person,  from mere
reading,  infers  that these membranes, fasciae, &c.
are extremely difficult to be understood, and that a 
16        ANATOMICAL INVESTIGATIONS.
thorough  knowledge of  them can scarcely be ac-
quired.   Some pupils are  so  strongly impressed
with this idea, that they avoid the examination of
such parts, and pass them by, as things on which
much time may be spent, without the attainment of
any equivalent good.
  The fibrous membrane which covers the whole
of the trunk, and  a very considerable part of the ex-
tremities of the body, is one of the really important
and  perfectly  simple structures,  which has   been
made difficult, solely by  considering  it in frag-
ments, and describing those with  most tedious mi-
nuteness—though  without any compensating clear-
ness of arrangement, or accuracy  of  detail.  With
a hope  of exhibiting this part of  anatomy more
advantageously to the student, and of removing
some of the obstacles before mentioned, these in-
vestigations  are beguu—and should the effort  be
followed by any  success,  the  author will be en-
couraged  to extend his attention to  other parts of
equal importance, which hitherto have been offered
to the learner under a similar veil.
  By making a crucial incision through the integu-
ments of the abdomen, from the ensiform cartilage
to the pubis, and from the crest of one ileum to the
other, going no deeper than the loose cellular  sub-
stance, we may reflect the integuments on all sides,
«o as U) leave  the fascia swperficudis  untouched. 
          ANATOMICAL INVESTIGATIONS.       17
If we then lightly make another crucial incision,
we divide the fascia superjicialis, and encounter a
layer of cellular substance,  more delicate than that
which lies between the integumeut and  fascia, yet
in general  very distinctly perceptible.  By dis-
secting cautiously, the fascia may be  reflected in
every direction, though it can be done with more
ease where it lies over the tendon,  than where it
covers the muscular fibre.
   Let us first examine the  inferior part, which we
shall find descending towards the top of the thigh,
slightly connected by the intervening cellular tex-
ture to the tendons of the abdominal muscles, until
it reaches Poupart's ligament, to the external or iliac
portion of which it is more closely attached.  As
we approach the os pubis, near which it covers  the
spermatic ring and cord,  the handle of the knife
may be used to separate it from the tendons—and
by looking  under  the fascia,  when thus  raised,
without  reflecting it,  we obtain  the fairest view of
the  real  character and situation of the spermatic
cord.  The fascia receives a  very considerable
thickening near the pubes from the lamina of cellu-
lar  substance exterior to  it—and  it is continued
over the corpora cavernosa penis, as well as sends
down a strong sheet into the scrotum, which has re-
ceived the name of  Camper's ligament.   This por-
 tion descends  obliquely in the direction of the
                         C 
 18       ANATOMICAL INVESTIGATIONS.
 cord, which it covers, and of the testicle, which it
 surrounds.    The  external  portion  passes down-
 wards, over  the whole of Poupart's ligament, to
 the  upper part of  the  thigh,  lying immediately
 under the  integuments,  and over  the cluster  of
 lymphatic glands and vessels, which fill up the de-
 pression  below Poupart's  ligament.   As  it  ap-
 proaches the top of the thigh, it gradually becomes
 thinner, and loses its regularity of texture, verging
 to the appearance  of common  cellular tissue :  it
 may still be traced some distance down the inner
 part of the  thigh, until it is lost in common cellular
 texture, lying in contact with the fascia lata and in-
 teguments.  We may next raise the  fascia superfi-
 cialis from over the crest of the ilium,  and pursue
 it backwards  to the spine,  and we may follow it
 downwards covering the whole of the gluteal mus-
 cles, where it is strengthened by large additions of
 cellular  texture.   As   we  approach  the tubera
 ischii, the fascia becomes more  closely attached to
 the surface, and in many instances seems to termi-
 nate there.  This,  however, is  not  the case, as it
 may be followed across  covering  the whole  of the
 perineum, forming the strong fascia, which presents
to the knife immediately after the first  incision in
lithotomy.   We trace  it from  the  perineum up-
 ward, until  we lose it on the under surface  of the
penis,  where  it  mingles with the covering which 
ANATOMICAL INVESTIGATIONS.
19
this  organ  derives  from  the  anterior  part  of the
fascia.
  Returning to  the central part  of  the  abdomen,
we prosecute our  dissection upwards.   We raise
the fascia superficialis from the tendinous sheath of
the rectus with facility,  but find it so closely adhe-
rent to the proper coat of the  muscular fibre, as to
require some care for its separation.   This, how-
ever, may be effected with comparative  ease,  and
we lift it from over the lower part of  the sternum
and pectoral muscle,  and from the superior part of
the  external oblique.   We trace the fascia  with
great facility towards the spine, and find it giving
a strong covering to the muscles of the  back.
   When we raise the  anterior part  to within  a
hand's breadth of the clavicle, we see the platysma
myoides  is on the outside of the fascia, and in im-
mediate  contact with the integuments,  stretching
obliquely upwards  to the angle of the jaw,  its an-
terior  fibres ascending  to the angle of the mouth,
and the posterior  in  many instances rising to the
zygoma, and connecting itself with the  outer  part
of the orbicularis oculi.*
   Having removed the platysma carefully, we then
  * As this first  section was sometime  ago  published, I have
thought it best not  to change it materially in this  work.  The
truth of this description will not be affected by the slight modifica-
tions made after other more careful researches. 
 20       ANATOMICAL INVESTIGATIONS.
 obtain a view of the superficial facia covering the
 whole of the neck, ascending in front  to  the  edge
 of the chin, where it is lost in cellular and muscu-
 lar substance.   As we pass towards the angle of
 the jaw,  we find it rising higher,  (though  thin,)
 covering  the masseter muscle, attaching itself to
 the zygoma  with firmness, and extending towards
 the ear, so as entirely to overlay the parotid gland,
 and prevent us from obtaining any distinct idea of
 its precise figure.   From the back and upper part
 of the zygoma we see it passing up on the outside
 of the temporal fascia, and  including in its' sub-
 stance the anterior auris and  attollens aurem. The
 portion covering the  shoulders  and  back of the
 neck continues over the occipital belly of the occi-
 pito-frontalis, and may be traced over this muscle,
 and continuous with  the lateral  portion until the
 muscle becomes united with the scalp.
   After gaining this  view  of the exterior of the
 superficial fascia, let us return to the anterior part,
 and make a careful incision from the centre of the
 sternum to the centre of the  chin.   Then  we reflect
 the superficial fascia  towards  the shoulder,  and
 thus uncover the sub-maxillary glands  and bellies
 of the digastric muscles above,  and  the sterno-
 cleido-mastoideus, throughout.  Tracing  the fascia
to the posterior edge of this muscle, we shall  find
it  to split, or  form two  portions, the anterior of 
          ANATOMICAL INVESTIGATIONS.       21
which (the part reflected)  doubles immediately
around the sterno-cleido-mastoideus, and goes for-
ward again towards the trachea, and anterior part
of the neck, covering the muscles  of  the os hy-
oides, &c,  the  trachea, and thyroid gland.  Be-
low  it may be traced the edge of the clavicle, and
above the os hyoides and thyroid cartilage.   The
other part runs outwards and  backwards from the
posterior edge of the mastoideus—extending down-
wards, attaching itself to the  acromion and spine of
the scapula, where it gradually blends with the
general superficial  fascia  on  the back.   Thus the
sterno-cleido-mastoideus is enclosed in a  distinct
sheath, the same fascia forming both the deep and
superficial covering of the  neck.   This  part  of
anatomy, although it  may have been knoivn, has
never been described  with  precision, and  I may
claim the merit of a discovery with much less dan-
ger of losing my title than has occurred in the case
of others.   Even Colles,  with all his minuteness,
nas  not attended to this really beautiful arrange-
ment, which enables us to understand the anatomy
and  pathology of this region with much  more clear-
ness, than  if we considered these to be distinct
structures.
   The last part of the fascia  superficialis to be
traced  is  that  which we find  extending from the
pectoral muscle and clavicle  over the deltoid, and 
 22        ANATOMICAL INVESTIGATIONS.
 surrounding the muscles of  the  arm,  continuing
 over the elbow, exterior to the fascia of the  biceps
 muscle, down to the back of the fingers.
   After the general examination of the extent  and
 relations  of the  fascia  superficialis, we may with
 great profit attend to the different modes in  which
 it may affect the conclusions of the physician or
 the operations of surgery.  In doing this, for  the
 sake of regularity,  we may begin with the superior
 portion.   Here we  may observe that the manner in
 which it is attached to the zygoma and covers  the
 parotid gland will prevent  us from  readily  dis-
 covering a fluctuation.  The peculiar  arrangement
 of the fascia,  which  encloses  the mastoideus,  en-
 ables us  to understand why a suppuration of  this
 gland always breaks anterior to the muscle, and why
 the matter does not find its way among  the deeper
 seated parts of  the  neck.   Jf we consider that
 the portio dura,  or respiratory nerve of the  face,
 comes out through  the parotid after having passed
 through  the foramen auditorium   internum,  we"
 shall not be surprised  at the extreme pain in  the
 ear produced by an inflammation of the gland which
 must violently compress this nerve through the  agen-
cy of the  fascia  superficialis  and  the surrounding
bony structure.   The  anterior portion covering  the
submaxillary gland will exert a pressure of the same
kind, though by no means so great, as the surround- 
          ANATOMICAL INVESTIGATIONS.        23
ing parts are very different in character.  Over the
pectoral and other muscles, this fascia  will neces-
sarily exert a similar influence when tumours form
or# suppurations ensue.  By attending to the differ-
ences in the strength and degree  of attachment of
this fascia  in  various situations, we may form a
tolerably  correct  idea of the course that matter
would follow.  Certain diseases convince us clearly
of this, as may be learned from the following dis-
section  made during  the  last winter.  A patient
died  of infiltration  of urine,  succeeding to a rup-
ture of the urethra in perineo.  The urine had
gradually made its way upward,  and had passed
into the scrotum, which was in a state nearly ap-
proaching to putrefaction.  The urine had followed
the course of the cord, and had separated the fascia
superficialis  from the  tendon  of the  external ob-
lique, considerably above the crest of the  ilium.
Here the  attachment  was too close to permit  its
passage farther.  Below it was bounded by the  at-
tachments  to the  tubera ischii, and on the upper
and inner  part of the thigh  by the attachment to
the fascia lata.
  It is  almost unnecessary for me to dwell on the
importance of the anterior portion of the fascia to
the surgeon.   In hernia it is frequently very much
thickened,  and its  appearance entirely altered  by
inflammation.  In scirrhus of the testicle  it may 
24        ANATOMICAL INVESTIGATIONS.
also be changed in character, and by this change
add materially to the unfavourableness of our prog-
nosis.  Whenever we  are to operate in this region,
we  should recollect that  the fascia  superficiajis
comes into view as soon as we have divided the in-
teguments and a portion of cellular substance.
  That part of the fascia superficialis which covers
the gluteal muscles is also well worthy of consid-
eration.  Sometimes the matter  of lumbar  abscess
makes its way out of the ischiatic notch, following
the cellular substance surrounding the vessels.   In
one case, which fell within  my own  observation,
the appearances presented by a collection of matter
were such  as to deceive several  skilful surgeons as
to the real nature of the case.  It appeared to be a
circumscribed, or an encysted tumour.   There was
nothing in the history of the case to induce a sus-
picion of its real nature, so that  it was  resolved to
remove it with the knife.  A  crucial incision was
made and the  flaps dissected back, so  as to disco-
ver the surface of a large sac, occupying nearly-the
whole  extent  of the buttock.  When  the operator
began to cut round the base of the tumour, the na-
ture of the disease was at once seen.   An opening,
made by the knife,  let out a vast quantity of flaky
matter peculiar  to  scrofulous abscesses, and the
patient, in a few weeks, exhibited  signs of hectic,
soon succeeded by colliquative diarrhoea and death. 
         ANATOMICAL INVESTIGATIONS.        25
This case will point  out the propriety and impor-
tance of making a small puncture with a needle or
a lancet in every tumour of doubtful  character, as
advised  by Pott in the case of diseased testicle,
and by  Abernethy as a general rule.   Had it not
been  for this  posterior portion of the superficial
fascia, the matter of this abscess would have found
its  way down to the extremity of the limb, as it
would  have  been  entirely external  to the fascia
lata.  It is solely by the acquisition of a thorough
knowledge of the relations of parts, that a surgeon
or physician can properly decide on  the true cha-
racter of diseases.
  The  fascia superficialis is neither  very vascular
nor sensible.   Its arteries  are derived anteriorly
from the extreme branches of the intercostal, mam-
mary and epigastric arteries—posteriorly, from the
branches which nourish the muscles of the back.
There are in front two veins  descending from  the
navel to the top of the thigh,  running over Pou-
part's ligament, which  are the only vessels worthy
of  notice,  though  they are  not very important.
They help to return the blood sent out by the  su-
perficial arteries, and empty into the  great vein be-
low the ligament.   The nerves of this fascia  are
very few, although it is perforated  in many places
by the  extreme branches  of  the intercostal nerve.
It cannot be supposed that a fascia of this kind is
                       D 
26       ANATOMICAL INVESTIGATIONS.
possessed of any remarkable degree of sensibility,
or that it  is  supplied with  a greater  number of
nerves than is required to maintain it in proper
relation with the rest of the  system.
   I  am  well aware that  in many cases the fascia
superficialis does not,  at first view, appear continu-
ous to the entiie extent herein described.  That in
certain situations it is  more closely attached  to  the
subjacent parts than in others, is also well known
—yet as we frequently find subjects in  which  the
closest of these attachments offer no obstruction to
the raising of the fascia as above pointed out,  we
see no reason why it should  not be described as a
general fascia, which it really is, instead of a num-
ber of disconnected  fragments, scarcely  reducible
to order, and almost  unintelligible.  By the for-
mer  method  we  avoid confusion,   and assist  the
learner  to form correct opinions of its general cha-
racter and uses : by the latter, a needless perplex-
ity is occasioned,  and the advances of the student
are injuriously retarded. 
ANATOMICAL INVESTIGATIONS.
27
                 SECTION II.

               Fascim of the Neck.

   One of the most interesting arrangements obser-
ved, is that of the facia superficialis, on the  front
and lateral parts  of the neck.   The first section
contains a description of the manner in  which the
sterno-cleidomastoideus is included by the external
and internal layer of the superficial fascia, which
last has heretofore been considered to- be the  deep
seated fascia of the neck.  By my more recent ex-
aminations, the correctness of what was  advanced
relative to  the  sheath  of the  mastoideus  was
throughout confirmed—But I have been led to re-
mark that the arrangement of the  fascia  below this
muscle is very different from what is usually repre-
sented, and that its true character has not hitherto
been made known.
  In order to  make the description as clear as pos-
sible, it will be necessary to repeat a small part of
what was before stated concerning the fascia,  as it
passes from over the thorax to ascend on the neck,
and also slightly to modify the description. 
 28       ANATOMICAL INVESTIGATIONS.
   If we begin about midway between the clavicle
 and fifth rib,  to  raise  the fascia superficialis  to-
 wards the clavicle, we shall find when we arrive at
 the origin of the platysma myoides, that a layer of
 the  fascia,  which is  thin and delicate,  goes over
 the surface  of this muscle, while  a stronger and
 denser layer, continuous with  the part raised from
 the thorax,  runs underneath the platysma, and ex-
 tends upwards to the zygoma.   By this the masse-
 ter muscle and parotid gland are covered, and their
 figures  concealed.  Should we  now commence in
 the centre  and dissect the platysma myoides care-
 fully off, we have a fair view of the external layer
 of the fascia superficialis, leaving out of the ac-
 count the slight covering of the platysma myoides.
  Next  make an  incision over the centre of the
trachea,  extending from the base of the os hyoides
to the top  of the  sternum through this external
layer.   It may then be raised easily, towards the
outside  of the neck, until we have  fairly laid bare
the whole of the sterno-cleidomastoideus.   If we
cut off the origins of this muscle, and raise it care-
fully from  its bed towards its  insertion,  without
cutting the fibre of the muscle  or the subjacent fas-
cia,  we  shall see  that the portion  of fascia traced
from the front of the neck  over the last  named
muscle, splits just at the outer edge  of the mas-
toideus,  sending  one  layer outwards and back- 
          ANATOMICAL INVESTIGATIONS.       29
wards,  (over  the  muscles of the neck and head)
while the other runs inwards and forwards towards
the centre of the trachea,  and thus forms the lower
part of  the sheath for the mastoideus.   This layer,
immediately under the mastoideus, covers the inter-
nal jugular vein,  the omo-hyoideus, and near the
centre of the neck lies  over the sterno-hyoideus.
Thus far my researches were extended in the for-
mer essay, but it will be seen that the subsequent
inquiries have led  to a more extensive acquaintance
with the true character of the  fascia of  the neck,
and  enable  us to understand the manner in which
the sheath for the great vessels  is formed.   To be
convinced of the fact that all the fasciae of the neck
are  processes of  the fascia superficialis—to be as-
sured that there are six distinct  layers, or processes
of this  fascia on the front of the neck, and that the
sheath for the vessels is formed  by horizontal slips
stretching from the anterior  to the posterior por-
tion, above, below, and between the jugular vein,
carotid artery and eighth pair of nerves, it will be
sufficient to pursue the following  order  of exami-
nation.
   Suppose the superficial layer, or portion covering
the mastoid,  to be turned back  as  far as the outer
edge of this muscle, and the muscle  raised so as
to  exhibit the continuity of the outer and  second
 layer.   Then make an  incision over the  sterno- 
 30       ANATOMICAL INVESTIGATIONS.
 hyoideus (through the second layer,) from its ori-
 gin to its insertion, and  raising this layer towards
 the  outer part of the neck,  we shall find it form
 ing a beautiful sheath for the omo-hyoideus,  pre-
 cisely analogous to  that made  by the  superficial
 portion for the  mastoideus, but being oblique to suit
 it to the position of  the omo- hyoideus.  Tracing
 this layer to the outer edge of this muscle, we  raise
 the muscle from its bed, without injuring the subja-
 cent fascia, and  then we have this under portion,
 lying over the thyroid gland, and immediately co-
 vering the sterno-thyroideus  muscle.
   Let an incision next be made through this third
 layer, over the sterno-thyroideus in its length, and
 we  raise the  fascia as  far toward  the  outside  of
 the neck as to  the carotid artery, and then we shall
 see how beautifully the  process for  the  omo-hyoi-
 deus sets off from this third  layer, which is on a
 level with  the  jugular vein,  and continuous  with
 the sheath of the mastoid muscle.
   There is  yet another  distinct process  going off
 from the fascia, where it touches the lower  edge
 of the  carotid artery.  This fourth  process  runs
forwards and inwards, covers the thyroid gland,
 and stretches across the  front of  the trachea under
the sterno-thyroideus.  If this layer be turned back
towards the carotid artery, and the vein and artery
be raised by pulling the superficial fascia upwards, 
          ANATOMICAL INVESTIGATIONS.       31
we see a perpendicular process of the fascia, reach-
ing from the under surface of  the  vessels to the
muscles  lying immediately  on the  bodies  of the
vertebrae.  This perpendicular process is double.
One part goes outward and backward, till it reaches
the transverse processes  of the vertebrae  where  it
is attached or inserted, while the inner portion goes
immediately over the rectus internus, capitis major
and longus colli,  across the  bodies of the verte-
brae, extending under the oesophagus,  and is con-
tinuous with the corresponding layer of the oppo-
site  side.
   The formation of  the sheath for  the great ves-
sels of the neck now remains to be  described, and
may be  easily understood,  when it is recollected
how the layers of the fascia are disposed.  A co-
vering is formed over the jugular vein by the fas-
cia, where it is passing  under the  mastoideus.
Then another slip passing from the  anterior  to the
posterior division of the fascia, runs below the vein,
and separates the jugular from the  artery and par
vagum, and the lower portion is formed by a con-
tinuation of the  fascia  under the  carotid artery.
From  the centre of this lower part of the sheath,
the double perpendicular process descends.
   To  demonstrate this  most satisfactorily and  ea-
sily, make an incision  through the fascia  under
the mastoideus, in the course of the  internal jugular 
 32       ANATOMICAL INVESTIGATIONS.
vein—raising this covering of the vein, we should
then take an inch or two of the vein from its bed,
without  wounding the  parts below,  and we  shall
see the  slip of fascia  separating the vein from the
artery and par vagum.  In like manner, if we cut
through  this partition and carefully  raise the ar-
tery,  removing an inch or two of the vessel, we
then perceive  the lower part of the  sheath lying
immediately under the par vagum  and artery.   By
breaking through the lower part of the sheath, we
may separate the layers of the perpendicular,  or
fifth and sixth processes. 
ANATOMICAL INVESTIGATIONS.
33
                SECTION III.


Formation of  the  Pericardium  from  the  Fascia
                  Superficialis.

   The  layer  of the fascia  superficialis,  imme-
diately covering  the  thyroid  gland,  described as
the fifth process [p. 31.]  passes under the sternum
to the  surface of the arteria innominata where it is
joined by  the  outermost layer of this fascia, co-
vering the lateral and back parts  of the neck.   To-
gether  they form a covering for  the artery  as  it is
passing  between  the scalenus anticus  and medi-
us.—Over  the  subclavian artery, from its  inferior
edge, the fascia extends outwards and downwards,
running immediately  below the subclavius muscle.
Near the external edge of this muscle, we find the
fascia  superficialis continuous with that portion of
the brachial fascia,  which extends to the thorax
under the pectoralis major.
   We  now  cut away the cartilages of the  four
upper ribs on each side,  and remove the sternum
                       E 
34        ANATOMICAL INVESTIGATIONS.
from the clavicles, having divided this bone trans-
versely bejow the fourth rib.   We  are  thus ena-
bled to separate the upper part of the mediastinum
and bag of the pleura from the pericardium.   We
then trace the fifth process or  thyroid  layer,  (in
union  with  the outer part,) of  the fascia  superfi-
cialis down to that part of the arch of  the aorta,
where the serous membrane of  the pericardium is
reflected to form  the immediate covering of  the
heart.   Then we clearly perceive, that the Peri-
cardium  is formed from the Fascia Superficialis,
which is uninterrupted and entirely continuous with
the capsule of the heart.  The serous membrane
being cut through, we can raise the fascia from the
surface of the aorta, down to the commencement of
the fleshy fibres of the heart, with as much ease as
we can elevate the outer or floating portion.
  However,  singular it may  appear that this  ar-
rangement should not have been  discovered until
this  time,  it is by no means  as singular, as  that
anatomists during so  long a time  should have re-
mained contented to believe  that  a serous mem-
brane  like the  pleura, could  form a  strong fi-
brous membrane like the pericardium !
   If the descriptions here given appear difficult to
those who have studied anatomy in the usual mode,
we are sure that their surprise could only be equal- 
          ANATOMICAL INVESTIGATIONS.        35
led by their  pleasure on  witnessing the facility
with which all these arrangements may be demon-
strated and the  beautiful simplicity of these struc-
tures incontestibly established. 
36
ANATOMICAL INVESTIGATIONS.
                SUCTION IV.

Arrangement of the Brachial Fascia and formation
  of the Capsular ligament of the shoulder joint.

  When  we have  removed the integuments and
superficial  fascia from the muscles of the shoulder
and  arm,  we find  a  strong fibrous membrane co-
vering the biceps,  which has been hitherto consi-
dered as the peculiar fascia of that muscle.  If we
cut through this fascia directly over the  centre of
the biceps, in its length, and raise the portions to-
wards the  outside and  inside of the arm, we per-
ceive that this muscle is enclosed in a sheath very
analogous to that formed for the sterno  mastoideus
in the neck, and the sartorius on the thigh.  There
is this difference, however, the fascia is not simply
continuous  beneath the muscle,  but  the outer and
iuner portions run  towards  each other,  under the
muscle and in the  centre both  portions penetrate
its substance, where the two distinct heads may be
said  to cease and the single fleshy belly to  begin.
On the outer  edge of the biceps,  along  the line  of
the humerus, we find the fascia attached  to  the 
ANATOMICAL INVESTIGATIONS.
37
bone, and where this attachment is cut through, we
then see that it is continuous over the whole of the
triceps, where its strength is increased.
  Returning to the opening  made over the centre of
the biceps we may pass a knife handle under it, on
the short head of the biceps, towards the  scapula.
This will lead us to remark, the manner in which
this fascia as it passes along under the edge of the
deltoid muscle is attached thereto, and also sends a
delicate  portion  over the  edge  of the pectoralis
major.  But on raising the  pectoralis major with-
out removing the instrument passed under the fas-
cia, we shall find the main  sheet of fascia  passing
to the thorax, covering the  pectoralis minor, going
under  the  subclavius  and  clavicle  into the neck,
where it is continuous, with the fascia superficialis
as before-mentioned.   If we have pressed the knife
handle upwards directly in the course of the  short
head of the  biceps,  we find  the instrument reaching
to the coracoid process,  and by cutting the fascia
open,  thus far we see it continuing to  the edge of
the glenoid  cavity,  forming all of the fibrous  part
of the capsule  of the shoulder joint.
  To  render the demonstration  still more conclu-
sive, cut through the deltoid muscle transversely
immediately over the shoulder joint, being careful
not to  injure the subjacent fascia.   Having cleared
away the deltoid from about the joint, we return to 
38       ANATOMICAL INVESTIGATIONS.
the outer portion of the fascia, where it covers the
biceps.  There we find the fascia  continuing over
the inside of the arm to the triceps as before stated,
and dissecting up this stronger portion,  we  shall
be  surprised and  pleased to  see how  distinctly it
runs up to the edge of the glenoid cavity and under
the scapular  portion  of  the  deltoid,  forming the
whole of the capsular ligament.  When the fascia
is laid open, we have a beautiful  view of the re-
flection of the  synovial membrane  and are tho-
roughly satisfied that  there  is no distinct or inde-
pendent  capsular  ligament,   but  that  this  fascia
forms the whole of what has been hitherto so cal-
led.
  The fascia is attached  strongly to the neck and
inferior costa of the scapula at the  upper part, but
when  this attachment is cut through we find the
fascia  forms a  continuous  sheet  with the strong
covering of the infra  spinatus muscle.
  The sheath for the brachial vessels  is formed in
a manner analogous to the formation of  the cervical
and femoral sheaths, that is by slips of the brachial
fascia passing over the surface, between and below
the vessels and nerves.
  Resuming  our examination of the  brachial fas-
cia, towards the elbow we find it continuing over
the bend  of  the  arm,  receiving  a  considerable
thickening from the lower extremity of the biceps 
ANATOMICAL INVESTIGATIONS.
39
and then being laid over the whole of the fore-arm
forming distinct  sheaths for the muscles, through-
out analogous  to the  arrangement of  the  fascia
lata.  On the outside of the arm the attachments of
the brachial fascia to the radius  and ulna  are
strong,  and the texture of the whole of the portion
on the  back of  the forearm  becomes much more
dense,  as  it  is employed  in  forming  distinct
sheaths for  the muscles in precisely the same way
as on the inside of the fore-arm. 
40
ANATOMICAL INVESTIGATIONS.
                 SECTION V.

        Arrangement of the Fascia Lata.

  In  examining  this  fascia,  after having  studied
the arrangement of the fascia of  the neck,  the ob-
server will be surprised and delighted to find that
there  is a most striking similarity existing between
them, not only in the manner in  which they relate
to the muscles, but in the formation of the sheath of
the vessels.
  To begin  this examination, we remove  the in-
tegument  and  fascia  superficialis  from  the  pos-
terior part of the nates, and are enabled to see how
far  the  fascia lata extends  on the ilium from the
part which may be properly considered as  its ori-
gin ; being all the edge of the ilium not occupied by
the origin of  the glutaeus maximus, out to that por-
tion of the border of  the ilium giving  origin to the
tensor vaginae femoris, immediately behind  the an-
terior superior spinous process.   The  tensor va-
ginae  is fairly enclosed between  two layers of the
fascia lata, which joining at  the interior and infe-
rior parts of the muscle, form that strongest part of 
          ANATOMICAL INVESTIGATIONS.        41
the fascia denominated  the iliac portion, or  part
covering the haunch.
   This iliac portion advances very little at .the up-
per part,  before it again separates into two layers,
the one going over the sartorius muscle, and the
other under it.  The superior layer is thinner than
the common fascia, and allows us to see  the mus-
cular fibre through it—while the fibres of the mus-
cle on  the outer part of the thigh, are entirely
hidden by the thickness and opacity of the  fascia.
In consequence of  the  separation mentioned,  a
beautiful  sheath is  formed for the sartorius,  resem-
bling in every particular that formed by the super-
ficial fascia in the neck for the sterno-cleido-mas-
toideus.
   If we cut  through the layer covering the sarto-
rius, in the direction of the  muscular fibre,  a short
distance  from its  outer edge,  and  then  raise this
external  portion towards the ligament of Poupart,
we find that it reunites with the inferior layer just
beyond the internal edge of the tensor.  Let us
now cut for the tenth of an inch through this union
and we shall see  the fascia again  separating into
two layers, having a considerable interspace, which
in many subjects contains an appreciable quantity
 of fatty matter.  This part of the fascia is situated
 anterior  to the upper  part of the  sartorius, and
 would be contained in a triangle made by drawing
                         K 
 12       ANATOMICAL INVESTIGATIONS.
 a line from the middle of the  symphysis  pubis  to
 the  sartorius,  having the ligament of Poupart for
 the  opposite side of the triangle, and the muscle
 for its base.  Having made the opening required,
 we may then push the handle of the knife up to the
 lower border of Poupart's ligament,  below the an-
 terior superior spine of the ilium, and by continuing
 the pressure downward and inward,  we may carry
 the instrument  entirely to the extremity of that du-
 plicature which  is  called the falciform  process,
 semilunar  process,  or  Hey's  ligament,  without
 using any violence.  By this last view we are made
 acquainted  with  the manner  in  which the pubic
 portion comes up under the vessels to join the parts
 described.
   Were our examinations to cease here, they would
 be of comparatively little value, however  interest-
 ing the  research might prove  to the  individual.
 But 1 flatter myself that the discovery of the pecu-
 liar  arrangements of this  fasciae,  will  lead us  at
 once  to a better acquaintance with its physiology.
 The outer layer,  or  that part which may be consi-
 dered as the continuation of the external part of the
 sheath of the sartorius, is continuous with  the  ten-
don of the external oblique muscle, which is  thus
 enabled  to act  very advantageously on the fascia.
The fascia lata is  provided with  a muscle whose
peculiar  business is  to tighten  this great sheath of 
           ANATOMICAL INVESTIGATIONS.        43
 <he thigh;  as the tensor vaginae femoris is situated
 nearly in a line with the external condyle of the
 femur, which is by no means so low,  or  rather so
 long as the internal, of necessity,  in tightening the
 outer part of the fascia to the  greatest degree,  it
 must relax the inner portion  (covering the gracilis,
 adductors, &c.) at the upper  and inner part of the
 thigh, which is by no means within its sphere of ac-
 tion.  The  arrangement mentioned, the continuity
 (of  the external  layer of the  iliac portion) of the
 fascia lata with the tendon of the external oblique,
 compensates for the defect that would otherwise
 exist, and tightens  the part of the  fascia lata co-
 vering the upper and inner part of the thigh.  In
 saying that the fascia is continuous with the tendon
 of the external oblique,  we do not say that no con-
 nexion exists between  the  internal and external
 layers, just where the outer one joins the tendon of
 the  oblique.  But this union  is effected by a very
 delicate portion,  not much more than  perceptible,
 while the junction between the  outer  layer of the
 fascia,  the   continuity  with  this  tendon,  is fair
 and  strong,  perfectly visible  and palpable.   To
prove  how  thoroughly this arrangement serves the
the purpose mentioned, it is only necessary to make
a slight pressure on  the external oblique, or to pull
its tendon with the forceps  when the subject  is 
 44       ANATOMICAL INVESTIGATIONS.
 placed on its back,  and the iuteguments  and fascia
 superficialis are removed.  We shall then be con-
 vinced that a very slight contraction of the  muscle
 is capable of affecting the state of tension of the fas-
 cia lata on the inner part of the thigh.
   The arrangement  of  the internal  layer forming
 the under part of the sheath for  the sartorius is very
 interesting,  and in relation to the  formation of the
 sheath for the vessels, precisely similar  to  that of
 the third layer of the superficial fascia in  the neck.
 At the outer edge  of  the sartorius the fascia splits,
 to send one portion outwards and backwards over
 the surface of  the muscles, while the inner portion
 doubling  inwards  and  forwards,  runs  under the
 sartorius  muscle.   It may be  considered  as the
 continuation of the external layer—and  after thus
 forming the sheath of the sartorius, it runs onward
 to cover the great  artery of the thigh, just at the
 inner or pubic side of which,  the iliac  and pubic
 portions of the fascia are united.
  We may  now with  great facility raise the layer
going  over  the artery.  Then  we  may  raise any
portion of the artery from its bed,  leaving the pro-
 cess between the artery and vein—after this we can
raise this  portion,  cut and. lift up a part  of  the fe-
moral vein,  and show the lower part of the sheath
 strong and fair, going beneath it.  From  the lower 
ANATOMICAL INVESTIGATIONS.
45
part of the sheath, we find a single perpendicular
process going down to be fixed  into the linea as-
pera.
   The fascia lata forms all the sheaths for the mus-
cles of the thigh, and continues to form the sheath
of the vessels after the  artery has passed through
the tendon of  the triceps.   The pubic portion near
the  ligament  of  Poupart,  passes under the  great
vessels, and is connected or rather continuous with
the  fascia transversalis  or interna.   This part
of the investigation must  be left until  we give a
description  of the  researches made relative to the
internal fascia.
   However  difficult the study of the fascia lata may
appear  from the  description, it is by no means so
difficult to comprehend when it  is examined with
the  knife.  When studied  in the manner here  di-
rected,  the  satisfaction  derived  from the  clearer
understanding  of the physiology  of all  the  neigh-
bouring parts,  will  more then compensate for the
difficulties surmounted by the application necessary
to see all  that is  described.  The  important influ-
ence exercised by the processes of this fascia (form-
ing  sheaths for the vessels and  muscles) over va-
rious surgical  diseases and operations, can only be
perceived by  one  who  is thoroughly  acquainted
with its  true  character,  extent  and connexions.
The establishment of the fact that there  is but one 
46        ANATOMICAL INVESTIGATIONS.
fascia forming all the processes about the neck, and
another all those of  the thigh, and that in both the
sheath for a particular muscle as well as the sheath
for the great vessels  are  formed in the same man-
ner,  is a circumstance of  very interesting character
and  may lead  us  still farther  in  our researches
concerning the various parts  they surround or se-
parate. 
ANATOMICAL INVESTIGATIONS.
47
                 SECTION VI.

Arrangement of the Fascia Interna Abdominis, and
  formation  of the capsular ligament of the Hip
   Joint, from the Fascia Lata.

   The fascia  which is at present to be described
has hitherto only been examined at particular points
and under different names, in consequence of which
much  confusion has  been produced and the diffi
culties  of acquiring an accurate knowledge of its
relations needlessly augmented.   The fascia trans-
versalis, fascia iliaca, fascia prostrata, fascia pel-
vica,  are  all parts of the same fascia, which bears
a sufficiently close resemblance to the fascia super-
ficialis in the manner of its application to the whole
of the cavity of the abdomen and pelvis, to justify
us in bestowing on it the name of fascia interna
abdominis,  in contra-distinction.
  The fascia interna, lies between  the inner
surface of the  abdominal muscles and peritoneum.
To examine it most satisfactorily, after  having re-
moved the external portion  of  the  sheath  of the
rectus below the navel, and raised this muscle from 
48        ANATOMICAL INVESTIGATIONS.
its bed,  make an incision from  the  umbilicus  to
the  anteriour superiour spinous  process  of  the
ilium,  through the  abdominal muscles.  This cut
brings us down to the strongest part of the fascia
interna.   We then clear off the abdominal muscles
without wounding the fascia so as to expose all the
iliac and hypochondric regions, and to the  edge of
the sheath of the rectus  near the median line of
the body.  If we make a small  hole through the
fascia  interna, midway between the  spine of the
ilium and umbilicus, we may introduce a knife han-
dle between this fascia and the peritoneum and se-
parate them from each other throughout the lateral
and back parts of the abdomen, till we have passed
over the liver to the under surface of the diaphragm.
Having thus raised the fascia  interna, we  may by
blowing into the opening inflate the sac and exhibit
it fairly detached from the peritoneum.  Making
an incision through the fascia in the  same direc-
tion as the first cut through the muscles and cutting
from the crest of the ilium to the last rib, we  turn
this upper flap over and follow it towards the  cen-
tre, under the inner portion  of  the sheath of the
rectus.  Here we find it more closely attached than
at  any other  part both to the  tendon  of the trans-
versalis and the peritoneum, yet by careful dissec-
tion  it may be fairly separated from both,  without
wounding either, so as to show its continuity en- 
ANATOMICAL INVESTIGATIONS.
49
tirely across  the anterior part of the inner surface
of the abdominal muscles.
  The  fascia interna is  attached with firmness to
the whole of the crest of the ilium from the anterior
superior spinous process backwards; it also is fixed
to the transverse processes of the loins, where  it
forms the covering of the quadratus lumborum, and
also separates this  muscle from the external mus-
cles of  the back.
  Returning to the  lower portion of the fascia in-
terna we raise it from the anterior superior spine of
the ilium to the  pubis, and in doing this we have a
beautiful view of the internal abdominal ring, the
space by which  the  spermatic cord  goes through
this fascia to emerge on the pubis  after passing
through the tendon  of the external  oblique or ex-
ternal abdominal ring.  This is the portion of the
fascia interna, heretofore called fascia transversalis,
and whose real  character is of so much importance
to the surgical practitioner.  This  part  of the fas-
cia  interna fills  the vacancy that would otherwise
exist between the inferior edges of the internal ob-
lique and transverse  muscles and* the edge*pf the
pelvis,  and was called fascia transversalis because
it was thought to be continuous with the transverse
muscle.
  Below the internal abdominal ring the fascia in-
terna touches the  ligament of  Poupart to which 
 50       ANATOMICAL INVESTIGATIONS.
 it is attached,  but it docs not cease there,  being
 continued down on the great vessels  of the thigh.
 It is usually stated that the fascia  interna is here
 so arranged as to descend in the form of a funnel
 for a certain distance before and behind the great
 vessels; to  be reflected at the distance of three-
 fourths of an inch below  Poupart's ligament and
 thus  to prevent any communication  between  the
 pelvis and top of the  thigh.  This is very far from
 the  true state of the  fact; the fascia interna is
 indubitably continuous with the fascia lata femoris,
 both  on the superior and inferior surface of  the
 great vessels, concerning the sheath for which we
 have spoken in a preceding section, and the com-
 munication  is prevented by cellular  attachments.
 To be couvinced of this, let us return to the crest
 of the ilium, and cut  through  the attachment of the
 fascia interna to the bone.  We find this attachment
 to be a short perpendicular process, which  when
 cut through  leaves  the continuity of the fascia in-
 terna and the covering of  the  internal iliac muscle
 uninterrupted.   This last portion is  what has been
heretofore named* the  iliac fascia.   We  raise  the
 fascia interna from over the  iliac muscle towards
the edge of the psoas magnus, where it separates
 so as  to form  a sheath for this muscle and after-
wards goes to the common  iliac artery, below, and
directly in a line  with which  the fascia interna  is 
           ANATOMICAL INVESTIGATIONS.        5i
 attached to the linea ileo pectinea and to the bodies
 of the lumbar vertebrae.
   Now cut up  the  pubic extremity of Poupart's
 ligament and reflect it carefully towards the ante-
 rior superior spine.  Then follow the iliac portion
 of the fascia interna downwards till it passes under
 the  vessels and together with the superior portion
 forms  the funnel shaped process  of Professor
 Colles.*  We now find this lower or iliac part of
 the internal fascia is  perfectly continuous with the
fascia lata, and we may be still more clearly satis-
 fied of this, by cutting across and removing about
 an inch or so of the femoral artery, which exhibits
 this continuity without turning the  fascia interna
 from its  place.  The cellular attachments which
 prevent the communications between  the pelvis and
 top of the thigh are also now made evident.
   From the pubic extremity of Poupart's ligament
 we find the fascia interna passing into the pelvis
 where we shall  presently find it forming the ante-
 rior  ligaments of the  bladder and triangular liga-
 ment of the urethra,  while  a process  which goes
 down  over the  levator ani and obturator internus,
forms the fascia of  the prostrate gland.
  But the most  interesting  and surprising part  of
the arrangement of these  fasciae  is the manner in
i: See his excellent, treatise on Surgical Anatomy 
52        ANATOMICAL INVESTIGATIONS.
which the great  capsular ligament  of the thigh
bone, is formed from the fascia lata femoris, which
we could not well explain until the  fascia  interna
had been described.   If we  trace the fascia  lata
upwards from between the vastus externus and glu-
teus  maximus,  we follow it over the great  tro-
chanter, and  see  it extending  over  the  edges of
the glutseus medius and minimus.  This  will give
us  the  external layer of the outer part of the cap-
sule.  If we cut up the head  of the rectus  femoris
(from the anterior inferior spinous process) we shall
find the lower part of its sheath forming  the outer
layer of the anterior part of the capsule.  Raising
this portion,  and then cutting  through the lower
part  of the sheath of the femoral vessels, (so as to
get between the parts going towards the inner  and
outer parts of the thigh,) we raise the outer  portion
to the capsule so as to show how it forms the mid-
dle part of its thickness.  If  we now return to the
pubis and cut through the pubic portion of the  fas-
cia down to the bone, we raise this part, (which is
continuous with  the  fascia  interna,) towards  the
joint, and  thus  uncover  the  anterior  part of the
joint, with the  exception of the delicate synovial
membrane.   Thus we are satisfied that this  power-
ful capsule derives all its strength from the  succes-
sive additions of the fascia lata, and has  no exist-
ence as a separate or independent ligament. 
ANATOMICAL INVESTIGATIONS.       53
               SECTION VII.

           Irregularities of Structure.

   Departures from the ordinary  structure  in the
human body are much more numerous and frequent
than  is generally imagined.   But  as few persons
are exclusively devoted to anatomical research, the
opportunities of collecting a sufficient number of ob-
servations to  lead to any important general conclu-
sion are rare,  and the facts are seldom recorded,
because they are  observed at distant periods and
excite but a temporary interest.
   If we were now in possession of a carefully ob-
served and fairly written statement of all the aber-
rations  which have been examined since anatomy
has been correctly studied, we should doubtless be
enabled to draw some general conclusion of practical
utility,  no less than to explain many pathological
circumstances which still continue to be mysterious.
Previous to the systematic essay of Dr. Duncan on
the malformations  of the urinary and genital organs,
published in the  Edinburgh  Journal it was sup-
posed that each irregularity had an individual and 
 54       anatomical investigations.
 appropriate character, which made the case merely
 an object of curiosity.  By an examination of his
 paper it will be seen that a very striking similarity
 existed  in the cases he observed  as to the manner
 in  which nature accommodated the system  to the
 defective organization.  Almost all  the cases re-
 lated  in  the  periodical papers since Dr. Monro's
 essay are similar to some of those  he has described.
 or are species of the same genera.
  In order, therefore, to induce others to commu-
 nicate the results of their experience, I shall at-
 tempt to arrange  the instances of irregularity which
 I  have  witnessed in various parts  of  the body,
 hoping that those who are possessed of similar ob-
 servations will be induced to  contribute them for
 the general good.

            I.—The Osseous System.

  In this system, there is seldom any irregularity
 of structure.   All the departures from the ordinary
 arrangement in the cases I have examined were the
the  results  of accident or constitutional disease.
These accidental appearances, or results of morbid
action are very numerous, and to  be  considered in
another place. 
anatomical  investigations.
55
           II.—The Muscular System.

  We observe a considerable number of interesting
and  peculiar irregularities  in this  department.
Some  muscles, as  the pyramidales  the  palmaris
longus, zygomaticus minor  and plantaris  are  fre-
quently deficient, and  the  proper motions or ac-
tions do not appear to be injured in consequence.
It does not often  happen that  any attempt is made
by nature to compensate for their absence ; in one
case, however,  where the palmaris longus  was de-
ficient,  I  found a considerable strip of  muscular
substance  arising from the annular ligament,  just
above the wrist, and ascending one third of the fore-
arm, to be attached to the common fascia.
  In  one  instance,  instead of the usual  arrange-
ment,  the muscle  corresponding to the  serratus
major  anticus,  whose  office is  to draw the base of
the scapula downwards,  inwards,  and forwards,
took its origin by two distinct portions from the la-
teral conversity of the second, third, and fourth, and
from the sixth, seventh, and eighth ribs, and these
portions were inserted  separately into the inferior
angle of the scapula,  and into the base, from the
superior angle  only to the extremity of the spine,
leaving an interspace of three inches. 
 56       ANATOMICAL investigations.
   The biceps brachii flexor iu three bodies exami-
 ned about the same time was found to have an ad-
 ditional slip or third head coming off from the infe-
 rior third of the os humeri along the line extending
 to the inner condyle.  This slip was  half an inch
 in breadth, and was inserted into the  fascia, going
 from the tendon of the biceps over the flexor and
 pronator muscles, arising from the inner condyle.
 In these three cases the origin and insertion of this
 slip was precisely similar.   In a fourth  and fifth
 case presented a few days after, a distinct and beauti-
 ful fleshy belly arose about half an inch above the ori-
 gin of the brachialis  internus, fairly separated from
 it and the biceps by cellular substance.   This ex-
 tra portion continued distinct until  near the elbow
joint, when it was inserted into the under surface of
 the common tendon of the biceps.
   The muscle of the THYROID GLAND,  was
 found in the Philadelphia anatomical  rooms, twice
 during the winter and four times during the month
 of March (1824.)  The first instance  was observed
 by a member of my class, Mr. Alfred Hartwell, of
 N. C.   In four of these  cases the muscle  was on
 the left  side, arising from the upper edge of the
 left lobe, and  going up to be inserted into the os
 hyoides  halfway between the base and appendix of
 that bone.  In the other two instances the  muscle 
Vagi <'<■•'
Muscle  of the Thyroid Gland
J. Drayton Sc ■ 
 
ANATOMICAL INVESTIGATIONS.
57
  arose from  the  centre of both  lobes, through their
  whole extent,  and was inserted directly  into the
  centre of the base of  the os hyoides.
    This singular muscle arising from a gland and
  inserted into a bone,  was first described by Soem-
  mering, and is  said  to occur once in five  hundred
  subjects." Dr.  Horner mentions in his Anatomy,
  that he  has not met with  it in  an experience of
  many years.  From the results of our observations
*  during the  last session, I  am inclined to believe
  that it occurs at least in three cases out of five, if it
  is not to be found in every case.  That it may be
. very easily overlooked  when it is confined to the
 left side, is  not surprising when we  observe that it
 runs almost directly in the same  course with the
 thyrohyoideus,  from which  it is separated  only by
 very delicate cellular substance, and  the portion
 extending below the origin of the muscle last-men-
 tioned so nearly resembles  in colour the ordinary
 appearance of the membrane covering the gland, or
 the gland itself.   Certain it is,  that since our atten-
 tion has been called to the subject, this  muscle has
 been found  in every body  examined  for the pur-
 pose.
   The most  singular sport of nature, in the muscular
 system,  which has fallen under my notice, is one
 which occurred in a subject very carefully dissected
 by one of my class, Mr. Isaac Brinckerhoff of N. Y.
                        H 
58        ANATOMICAL INVESTIGATIONS.
  This muscle arose from the fascia covering the
latissimus dorsi and teres major, just  within  the
border of the axilla, and ascended to be inserted by
a beautiful tendon into the coracoid process of the
scapula, between  the insertion  of the pectoralis
minor and the shorter head of the biceps.   A deli-
cate sheet of silvery tendon extending from its in-
sertion  over to the edge of the biceps.  This  mus-
cle  which was about two inches  long  crossed the
axilla beneath the brachial plexus, as may  be seen
in the admirably correct  delineation of it  by Mr.
Rembrandt Peale,  (p. 8.)  What purpose it served
it is not very easy to perceive ; it could have tight-
ened  the fascia over the latissimus and teres, but
this is not very necessary as  we  never  see  any in-
strument particularly designed to  produce such an
effect.   It is  nevertheless singular, that a structure
so purely accidental should  be  formed with such
perfect symmetry and regularity.

           HI.—Thfe Arterial System.

  Tha  irregularities of the  arterial  system have
been more attended to, than those of any other part
of our structure.   The most  remarkable instance I
have  met with was in an infant subject dissected by
Mr. Robert Young of Indiana, Pa.  The  arteries
instead of going  off from the  arch of the aorta  in 
           ANATOMICAL INVESTIGATIONS.        59
 the usual manner, came off thus ; 1st, the right caro-
 tid artery, 2d, the left  carotid artery, 3d, the left
 vertebral artery, 4th, the left subclavian,  5th, the
 right subclavian.   The  right carotid artery crossed
 over  the trachea  to get to the right  side of  the
 neck; the right subclavian arose from the back pari
 of the aorta after it had described its curvature,
 running  behind the oesophagus and trachea towards
 the edge of the clavicle. The left vertebral artery
 not less  singular in its origin, began from the arch
 of the aorta just behind and below the left carotid,
 instead of being given  off  by the left  subclavian;
 the only instance I ever saw  of such  an origin to
 this  vessel,  though I have read of two  or three
 cases somewhat resembling  it; this subject was in-
jected and the drawing was made very carefully;
 there were possibly some  singularities in  the  ve-
 nous system, but my attention was not called to this
 subjeet until the rest of  the structure was removed
 to exhibit the arteries, (plate 8, fig. 1,  2.).
  During this winter,  (1823-4,) we  found  three
instances in which the arteria  innominata gave
off the right and left carotids and the right subcla-
vian artery.  This distribution cannot  be exceed-
ingly rare, since we have found  it so often during
a single session, and moreover, in subjects injected
for the purpose of making anatomical preparations 
60        ANATOMICAL investigations.
alone, comprising  a very small  part  of the  whole
number of subjects dissected.
  If  the  operation of tying up  the  arteria  inno-
minata were  performed on a patient,  in whom the
arteries were thus  distributed, what would be the
immediate consequence?   The whole  amount of the
circulation would at once be cut off from the right
arm,  from the upper and central parts of the right
side of the thorax, from the whole of the anterior
of the neck  and the parts about the tongue,  the
whole of  the face and scalp, and from the whole of
the anterior part of the brain. The only blood which
would flow  directly to the  brain would be by the
left vertebral artery, which as it  ascends to the
brain through the  long canal formed  in the  trans-
verse processes of the cervical vertebrae,  could
scarcely be dilated sufficiently to carry the  whole
quantity of blood  necessary to this  organ.   The
inosculations  of  the left  ascending  thyroid—of the
lower intercostals, of the  epigastric, with the inter-
nal mammary—and of the dorsal branches with the
cervical vessels,  would  form nearly  the   whole
chance  of the preservation  of the  arm, neck  and
face,  allowing that one vertebral  artery could con-
vey blood enough  for the brain.   The  possibility
of this distribution should at last make  us cautious
of recommending  this operation,  without  haviug 
 
Prt.tiA
7	1
JDr	1
 
          anatomical investigations.       61
most  attentively examined all the chances of its
failure; even though ever so correctly performed.
  In  one instance there was found a singular  com-
munication existing between the right  colic artery
and the hepatic, a trunk as large as the original
artery continuing from the one to the other.
  A very interesting case of high bifurcation of the
femoral artery,  was met with during the month  of
March, in an adult subject, whose vessels were in-
jected.  What renders  this case more peculiar  is
that we find  the same  distribution on  both sides,
the profunda femoris being given off at a Very short
distance below Poupart's ligament, and the circum-
flexa externa arising as a large distinct trunk from
the femoral,  all these  branches lying  immediately
under the fascia lata.  On the left side of this body,
the arteria obturatoria  was given off by  the Epi-
 gastric.   The dissection from which Mr. Lesueur
made his drawing was very carefully prepared  by
 Messrs. Price and Corastock, members of the class. 
62        ANATOMICAL INVESTIGATIONS.
               SECTION VIII.

          MORBID  ANATOMY.

                 Oseous System.

   One of the most  singular appearances met with
during this season,  is the distorted pelvis of which
views are given in plate 5.
   It seems  to have arisen from the dislocation of
the pubic bones, by means of which one is made to
project beyond  the other, so as to give a sharp pro-
minence both on the outer and inside of the pelvis.
The degree  in which this displacement affected  the
diameters of the  pelvis is very accurately figured
by Mr. Lesueur's drawing.  The right kidney lay
considerably within the ilium over the iliac muscle.
The left  was not so low  but  considerably lower
than ordinary.  The cartilage at the symphysis  al-
though so much distorted appeared to be very little
different  from the natural  condition,  and no idea
could be formed of the cause producing the  defor-
mity.  The  womb of this subject was also diseased
as will be hereafter described. 
Dream ic Eng'd Jy JDruytoit. 
 
          ANATOMICAL INVESTIGATIONS.       63

  Plate 6, gives a representation of a very interest-
ing case of exostosis, occurring in the body of an
old woman apparently 65  years of  age.  A part of
the large  mass near the lower extremity projected
through an immense ulcer  of  a very  disagreeable
appearance.  The whole  extent of these bones is
covered by the sharp irregular spines, which give
to the fibula  a  considerable resemblance to a sta-
lactite.  In other respects  this subject showed no-
thing extraordinary, nor had we an opportunity of
forming any opinion as to the cause producing the
diseased  appearance of the bones.  It may have
been owing to the effects of venereal taint.
   In another instance, the lower part of the femur,
the  tibia  and fibula were enlarged  and gibbous
through their whole extent, and in this case, there
was sufficient reason to believe that the immediate
cause of the evil was the venereal  disease.
   A highly interesting result was  obtained by exa-
mining the body of a female who  had perished by
falling  into the fire during aii epileptic fit.  The
viscera of the chest, abdomen, &c. were perfectly
natural.  Within the head a bony tumor was found
growing from the  internal surface  of the scull cap,
about half an inch from the longitudinal sinus, and
which encroached on the brain nearly  half an inch.
On separating the hemisphere so as to examine the
falx a large irregular ossification, was found upwards 
 64       ANATOMICAL INVESTIGATIONS.
 of three fourths of an inch in length  projecting on
 both sides so  as to press considerably on the brain.
 In  the  course  of the longitudinal sinus, several
 spiculse  very  singular and pointed,  presented their
 cutting edges  toward  the brain.   A view of  those
 ossifications is given  in  the  plate.  One side of
 this  scull was much less  convex than  the other, as
 if it had been flattened in early life  by long con-
 tinued pressure.
  I have dissected the head of a black man whose
 scull was as well  shaped  as the  generality of per-
 sons of colour. He had been lunatic during several
 years previous to  his death, and on dissection,  the
 falx of the dura mater was found to contain  three
 considerable  patches  of  ossification.   The mem-
 branes of the  brain,  showing  evident appearances
 of having been inflamed shortly  previous to death,
 but it  was not possible to determine whether  the
 ossification had been the  immediate exciting cause
 of the inflammation.

               Muscular System.

  The only morbid  appearance observed  in this
 system,  was the change of the gastrocnemius and
soleus  of one  leg, into a substance somewhat  re-
sembling a mixture of ligament and  cartilage, hav-
 ing no  trace throughout of  proper muscular struc- 
P. 64
Ful.l.*.a.«.a. Deifications  *ith< F*lx of a* D.mateir, *uwn an  mnn  sides. ]^  fig
Fit/.3. a. ©Sgifracatiom,growing  from, the inside of the.  Scull. 
 
          ANATOMICAL INVESTIGATIONS.         65
ture.   In colour  it  differed  but little  from  the
                                 «
common appearance of the tendo achillis,  when it
has been for a short time exposed to the air.

                 Arterial System.

   The most frequent alteration observed in the ar-
teries  was  the deposition of bony matter  in their
coats.   This generally was found in greatest quan-
tity in the  aorta.   In one instance it extended  to
the arteries of the brain and indeed throughout the
body.   But in the brain all  the  vessels  down to
such  as  were not  much  larger than a bristle  or
horse  hair, were almost entirely bony.*

                  Venous System.

   The veins were  in many instances  in a varicose
state  especially in the inferior extremities.   The
vessels  were much more varicose when they  were
seated between the skin and fascia of  the leg.   Af-
ter passing under the fascia, the veins were seldom
as much diseased  as where they were not subjected
to this pressure.   In two cases of varicose veins of
   * In a case of general or at least very extensive  ossification of
the capillary vessels, how could  the circulation be  continued, ac-
cording to the notions of those who think the capillaries possess
the power of propelling their contents, independent of the heart?
                         I 
66
ANATOMICAL
INVESTIGATIONS.
 the leg, encysted melicerous tumours were  found
 near to that part of the adductor which is perforated
 by the a*tery.

               Respiratory System.
   Many cases of tuberculous lungs were examined
 and a great variety of appearances  indicative of
 their  different  states  remarked.   In  several in-
 stances the whole hemisphere was found hepatized
 or  resembling  the  liver in  texture,  while only  a
 small  part of the opposite hemisphere remained fit
 for the purposes  of respiration.
   In one case a  body was  examined which  exter-
 nally exhibited no peculiarity,  and the whole body
 seemed plump and fleshy, on examining the chest,
 on  the left side instead  of lung was found a large
 irregular  sac, apparently made up of the  pericar-
 dium  and pleura massed  together, filled with  a
 bloody and offensive fluid.  There was no  pecu-
 liarity  in the right lung.
  From the appearance of the sac and the state of
 the lung we should hardly suppose that the changes
could be effected in a short time, yet the quan-
tity of fat and  the general fulness  of  the body
seemed to indicate any thing rather than long con-
tinued  disease. 
ANATOMICAL INVESTIGATIONS.
67
                Digestive System.

  Diseased  appearances of the stomach were not
very frequent.  Effusions  and adhesions  were of-
ten found  in different parts of the belly.  In some
cases there were well marked evidences of general
inflammation of the bowels.  One of these cases
was very  interesting on  account  of the great ex-
tent of  the  mischief produced  in consequence of
the inflammation.
  The  whole of the abdominal viscera were  so
massed  together as  to render it almost impossible
to separate the  parts without cutting through them.
The liver  was uncommonly enlarged,  the left lobe
compressing the stomach and the right thrusting the
bowels towards the centre  of the abdominal cavity.
The convex surface of the liver had  elevated the
diaphragm to the greatest degree it was capable of,
and it was evident from  the slight effects produced
by  very considerable pressure, that the motion of
the diaphragm must have been almost  entirely sus-
pended  for  some time  before death.  Throughout
the whole of the abdomen, and between the lamina
of the mediastinum there were tubercles resembling
glands in appearance, from the size of a small pin's
head, up to the magnitude of a large walnut.  The
lungs were very much compressed, not only by the 
68        ANATOMICAL INVESTIGATIONS.
enlargement of the liver and elevation of the dia-
phragm but by the large quantity of fluid effused in
the cavity of the chest and  pericardium.   The
brain  also contained a  considerable  quantity of
fluid,  but gave no well marked traces of inflamma-
tion.   In such a case, it is  wonderful  that life
should have been continued during a period suffi-
ciently long to allow these changes to take place.
I  have  dissected  one  subject, a  mulatto  female,
about 24 or 25 years of age, in whom something of
a similar displacement of the thoracic and abdomi-
nal viscera,  had  been  produced  by tight lacing.
The ribs and cartilages were so  much  drawn in
as to give quite  a conical  appearance to  the lower
part of  the chest.
   On inspecting the cavity of the abdomen the liver,
stomach and spleen, were much  elevated and the
diaphragm so much pushed up as  to encroach con-
siderably on the  lungs.  When the upper part of
the thorax was examined, a very large  portion of
the apex of the lungs extended above the clavicles,
under the scaleni, within the triangle of the pleura
which under ordinary circumstances is quite small.
It seemed as if the system had made an effort to com-
pensate for the loss of space in the  thorax produced
by the encroachment of the abdominal viscera on
its cavity.  The  impediment thus  produced to the
proper passage of the blood through  the lungs, the 
ANATOMICAL INVESTIGATIONS.
69
hindrance of the motions of the diaphragm, and the
disturbance caused in the stomach and liver, must
convince every candid examiner of the pernicious
tendency of this preposterous mode of dressing.

                Excretory System.

  In an old female  subject,  an appearance of pus
in the vagina led  to the scrutiny of  the  uterus as
being the probable seat of an abscess.   But instead
of an abscess, there was a fistulous opening through
the posterior wall of the uterus,  and this opening
was found to  be  continuous with a long fistulous
tube extending from the pelvis of the right kidney.
At the commencement of the ureter a calculus had
become so fixed as to  prevent the flow of urine,
though it did  not  entirely fill up the ureter.  The
consequence had  been the ulceration of  the pelvis
of the  kidney and  the eventual establishment of this
outlet  through the  vagina.  It is not  difficult  to
suppose that a case of this kind must  have been
attended with a great deal  of distress, and it is very
probable that all the treatment was directed  to the
uterus.  This must have been totally ineffectual
as the  cause was so  little connected with this organ.
 We have no diagnostic which  could enable us  to
determine with any thing like  certainty, the true
seat of such a  disease, 
70
ANATOMICAL INVESTIGATIONS.
                 Genital System.

   Several  highly interesting  cases  of  diseased
womb were met with ; two  of them we have been
enabled  to  preserve.  The  first occurred in  the
body of  a female whose distorted pelvis is figured
in plate 5,  and a  sketch of  the diseased womb is
given in another plate.  At  first sight this womb
appeared to be double, but on examination this ap-
pearance was discovered to be owing to two fleshy
tumors  growing from its sides, and lying between
the layers of the lateral ligaments, about two inches
in length by one in breadth.   They had no open-
ings into their substance.   Some small fleshy bo-
dies hung from the internal surface into the cavity
of the womb, resembling polypi by their slender
necks and broad pendulous extremities.
   The other case, figured in plate 5, is a  globular
tumor growing out of the posterior wall of the  ute-
rus, nearly filling its  cavity.   Previous to mak-
ing an incision  through  the walls,  this uterus  had
all the external appearances of being impregnated,
or containing an ovum, six weeks developed.
   Some  bodies about the  size of a small rifle  ball
were found between the layers of peritoneum form-
ing the broad ligaments.   Externally they were
quite smooth, hard and white, and  when closely 
Dbealed  rteru*.  tip. 2. fhmf van Fi.,. 2. ?.«,-*  view. a.a. Mmhler. M.  (he  tumors. 
 
          ANATOMICAL INVESTIGATIONS.        71
examined were  seen to be  entirely composed of
bony matter.  A substance in every respect simi-
lar was found in the neighbourhood  of the  emul-
gent vein of the  right side in the same subject.
   If we recollect how small  a proportion of the
bodies which annually die  are dissected—and how
small the number of those  dissected are thoroughly
examined, we need not feel surprised that so many
irregularities of  structure  are presented, or  that
anomalies should occasionally be observed.   Per-
haps  a more universal  and careful examination of
the dead will hereafter convince us, that what have
heretofore  been  recorded   as irregularities, may
occur too frequently to permit us  even to consider
them as exceptions  to a general rule.  It is much
to be hoped that physicians will improve  every op-
portunity of making careful examinations by dis-
section,  and thus fix pathology on the  only basis
which can  withstand the  destructive influence of
change and time. In our large cities very praise-
worthy efforts to. collect such knowledge  are daily
made,  but to be useful, the practice should  be uni-
versally diffused. 
72
ANATOMICAL INVESTIGATIONS.
                SECTION IX.

                THE  HYMEN.


  No  better proof can be given of the imperfect
manner in which  observations are  made,  or  the
precipitancy  with  which conclusions  have been
drawn concerning  structure,  than is exhibited in
the history of opinions  relative to this membrane.
Some persons have  found it in  almost  every  in-
stance, others have never  been able  to see it—one
party has  declared it inseparable from the condi-
tion  of youth and  virginity—another, that it never
had an existence.  Among foreign writers  the dis-
cussion  has been for a long time kept up, and  in
this  country opinion  is  not  altogether  settled.   A
paper was  read  to the  Medical Society of Phila-
delphia by a gentlemau  of large experience, during
the last session, in  which the very existence of this
membrane was denied,  and the origin of ihe gen-
eral  opinion ingeniously accounted for.   Three
days after the reading of this paper a female sub-
ject about  twelve years of age was brought to  the
rooms.  On  examination,  the. hymen  was found 
Taqt p
J>

\
§i   . i

     1
4   (

r^

I  >

i\l

! V'


4  "-if   i


/ 
 
ANATOMICAL INVESTIGATIONS.       73
very perfect, and corresponding in all things  to the
descriptions  heretofore  given by  anatomists.   In
consequence of the doubts which  had been excited
by Dr. Rousseau's paper  relative to its  existence,
I had a drawing made of it in its recent state  by
Mr. C. A. Lesueur,  (whose name is synonymous
with truth in all that pertains to graphic delinea-
tion,)  and the whole genital apparatus was care-
fully preserved in spirits  by Mr. Leyburn the  at-
tentive student to  whom  the subject  belonged.*
This was  the third instance in which  the  hymen
was found entire  during  this  session.    The first
was in the body of a black  girl between fourteen
and sixteen  years of age, and the second  in  the
body of a female infant about three  years  of age.
As the last  two cases occurred sometime previous
to  the reading  of the paper that reiterated  the
doubts of the existence of the hymen, no drawing
was made, nor were the parts preserved.
   Although there can be no doubt of the regular ex-
istence of the hymen, still its existence is not proof
positive of  spotless chastity, as women have been
impregnated without  rupture of this membrane  and

  * The preparation made  by this young gentleman of the whole
subject is one of the most admirable display, of the arterial systems
in its minuteness, that I have ever seen.  The cabinets of Phi-
ladelphia, New York, and Baltimore, which I have examined con-
tain no preparation that can be compared with this as a whole.
                         K 
  t4         ANATOMICAL INVESTIGATIONS.

 many  instances  are  recorded  in  which  pregnancy
  was produce;! notwithstanding  the existence of an
 external  malformation,  utterly forbidding the in-
 troduction of the male organ.   This  fact,  unfortu-
 nately for some  ingenious  theorists  on generation,
 is too well established,  to  suffer their  speculations
 to be credited.*

   * " The Hymen (so named from  the Greek word ufaiv, a  mem-
 brane,) is formed by four angular duplicatures of the membrane  of
 the vagina, the union of which may be discovered by corresponding
 lines on  the hymen.  At the upper  part there  is a semilunar va-
 cancy, intended for the transmission  of the menses, so that  it as-
 sumes the form of a crescent; a  circumctance which  affords the
 true explanation of the origin and meaning of the symbol so charac-
 teristically assigned to Diana.   In some rare cases, the hymen is
 an imperforate circular membrane,  attached to the edge of the
 orifice of the vagina in every part,  so as to  close the canal  com-
 pletely.  The girls, in whom this fault  of  confirmation existed,
 were called by the Greeks «7^7«/; the physicians who have written
 in Latin amongst  us have  given them  the name of Imperforatce,
 clauses, or  velatce; and the Italians  that of Coperchiate.  The
 Romans had no appropriate  word to denote this malformation, and
 they were therefore obliged to express  it by some circumlocution:
 it is thus that Cicero (De Divinat.  lib.  ii.) speaks of a dream,
 where a woman was seen " quae ohsignatam habebat naturam;" and
that Pliny (Hist.  Nat. lib. vii. c.  16.) relates, Cornelia, the mother
 of the Gracchi, " concreti  genitali nata fueral."   In many  cases.
 the membrane appears never to have been formed; while, in others,
 ts'extreme tenuity has occasioned its  rupture  and destruction in
 early lifer it may, moreover, have  been destroyed  by disease, by 
ANATOMICAL INVESTIGATIONS.         75
    In addition to what we have demonstrated  rela-
 tive to the hymen in the human female, it may be
 of advantage  in ending all doubt on this subject, to

 noxious habits, or by acrimonious  discharges.  This extreme un-
 certainty has  led many  authors,  of no inconsiderable  eminence,
 to  deny its  existence;  while others have  acknowledged  its occa-
 sional  presence,  but  have  attributed  its formation to  disease.
 Graaf, Penius, Buffon,  Dionis, declare  that, by dissection of girls
 of all ages, they have never been able to  discover it: on the other
 hand, the  reality of  this membrane  has  been maintained by
 Berenger de Carpi (In Isagoge Anatomica,) Vesalius  (De Corp.
 Huma.  Fabric. \v.  c.  15,) Fallopius  (In  Observat.   Anatom.)
 Voleherus  Coiterus  (In  Tabul.  Anatom.,) Varolius (Jlnatom.
 lib.  iv. c. 4,) Riolanus  (Anthropog.  lib. i. c. 16,)   Bartholin
 (Anal. lib. i. c.  31,)  Weisus (Observat.  lib. i. et de Lamiis lib.
 iii.  c.  20,)   Spigelius  (De  Hum.  Corp. Fabrica,) lib. viii. c.
 18,) Diemerbroeck  (Anatom.  lib. i. c. 16,)  Swammerdam  (De
 Uteri Mulieb. Fabrica,) Techmeyer (Inslitut. Medicin. Legal et
 Forens. c. iv.,) and all  the more learned and able anatomists of the
 sixteenth and seventeenth centuries.   Heister (Compend Anatom.
 and Ephem.  Nat.  Curios.  Cent. viii.  Observ. 69,)  Frederick
 Ruysch (Thes. Anatom. iii. no. 16; vi. no. 1;  vii. no.  60,)  Mor-
 gagni (Adversaria Anatom. i. 29; iv. 23,) and Winslow (Exposit.
 Anatom. no. 653,) all describe this membrane, and assert that they
 have found it in every young girl they have had occasion to examine.
 Astruc (on the Diseases of Women, vol. i. p. 123,) in referring to
the above learned  authorities, observes  that " the inference must
 necessarily be, that those who deny ever to have, seen it, must either
have examined only such girls as had lost their virginity, or prepos-
sessed with the false  notion that the hymen must always close the
entrance to the vagina  entirely,  they have mistaken it at the  tyne 
 76        ANATOMICAL INVESTIGATIONS.

 subjoin the following statement  of the  existence of
 this membrane in inferior animals, from a work of
 high authority in natural history.
   "This singular  character  does  not  exclusively
 belong to the female organs  of the  human  species.
 It is now ascertained that all female  mammifera,
 previous to copulation this sign of virginity  present
 in different degrees;  and  hence,  it is  not as Hal-
 ler  supposed  for a moral reason  that the mem-
 brane has been given to women.   A strong  fold of
 the  lining membrane  of the vagina  has been  ob-
 served in female elephants, before they have  brought
 forth.   Steller has  made the  same observation  on
 the  females of the  seal and the lamantin  of the

 it was before their eyes, and have even sometimes given the de-
 scription of it, without mentioning the name."  After this literary
 history of the question, we may very safely conclude that the hymen
 is a perfectly natural structure, occurring in the virgin, and that by
 sexual intercourse  it is ruptured;  after which it is shrivelled into
 several small excrescences at the  orifice of the urethra,  called the
 carunculm myrtiformes.   But,  since it is liable to such variations
in appearance,  and to accidental rupture,  from the slightest causes,
its absence can never be received as evidence of defloration; nor
can its presence be considered as an unequivocal proof of virginity;
for it has been asserted by indisputable authority, that it is not al-
 ways ruptured in coilu.  Ruyseh has said, that, if the coitus take
place immediately  after the menstrual excretion, this membrane is
not [ruptured, (Observ. Anat. Chirurg.  xxii.)  See Lond. Med.
and Phys. Journal, p. 21L vol. li. 
          ANATOMICAL INVESTIGATIONS.        77
north, (rytina.)  Carnivorous animals such as cats,
dogs, the hyena and otter have a strictured circle or
hymen separating  the vulva, from the vagina pro-
per.  The female bear and coati present a  divided
membrane,—in the daman, (hyrax capensis) it is a
circular fold.  The ruminants and solipeds, (such
as mares and asses) previous  to  engendering  have
an  analogous membrane.   Among the apes  and
monkeys,  the hymen consists of two crossing mem-
branes placed on each side of the canal of  the  va-
gina, their extremities being supported  on  a longi-
tudinal  roll which extends through the upper and
lower part of the vagina.   The same  circumstance
is remarked in the  American apes as in the coa'itis,
marikinas, wistitis  and other sagouins." [Nouveau
Dictionnaire d'histoire JVaturelle.   p.  515. 
78
ANATOMICAL INVESTIGATIONS.
                SECTION X.

       VENA AZYGOS DORSALIS.


   In plate 7, is given a very correct representation
of a  vein not figured nor described in any book of
Anatomy to which I have had access, and for which
I have proposed the name of azygos dorsalis from
its peculiar character.
   This vein lies immediately under the integuments
of the back, and emerges at a short distance above
the  origin of the trapesius muscle.   It  ascends
external to the trepesius as a  distinct trunk, re-
ceiving branches from both parts of the muscle un-
til it has  risen as  high  as  between the third and
fourth dorsal vertebrae.   Then  it separates into two
trunks,  which diverge an inch  or more from the
spine, and penetrate the  muscle immediately above
the second dorsal vertebra and  empty their blood
into  the subclavians by means of the deep seated
cervical veins.   The ordinary veins of the back
send their blood more directly to the heart by pour-
ing it at once into the branches of the  intercostals
terminating in the vena azygos, interna. 
FIATE   /
Page ?#
JJlraxton Sc. 
1 
ANATOMICAL INVESTIGATIONS.
79
  The drawing of this vein, made by Mr. TV. B.
Fahnestock, a member of the class gives a very ac-
curate  idea  of the situation and character of this
vessel. . 
90       ANATOMICAL INVESTIGATIONS.
                SECTION  XL

Description of the Table invented for the Philadel-
            phia Anatomical Rooms.

  This beautiful  and most  excellent table was
devised by Mr. Coleman Sellers of Philadel-
phia,  October 4823;  after having  seen how ina-
dequate the common table was for showing with
any advantage to the class, almost all the necessary
views  in anatomy. Anatomical tables have hith-
erto been made  so as to turn on a pivot, to allow
the subject to be  presented  to  every part of the
room.  When it is necessary to elevate the whole
or a part of the subject on the common  table, blocks
of wood are employed, and if it  be required to
change  the position during the time of lecturing  it
cannot be done without much inconvenience.
   Mr.  Sellers'  Anatomical  table  is six  feet in
length and is supported on one strong column of
wood about six inches in  diameter.  This  upright
is bored to receive the strong iron pivot more than
two feet  long which is fixed to the  floor by strong
screws.  The top  of  the  table is  formed  of four 
          ANATOMICAL investigations.        &i
parts, jointed in such a manner as to allow their
positions  to  be readily changed.   In the  centre
both sides are hinged to a strong transverse piece
of timber,  and at six inches  from one end,  and at
eighteen inches from  the extremity at  the  opposite
end, there is  a hinge which allows these portions to
be raised to a level with the general surface of  the
table or to be depressed to any degree in the quad-
rant of the circle described by folding it  down to
the extent permitted by the hinge.  The larger and
smaller divisions are sustained  on strong  and  ea-
sily managed  iron racks,  which  keep  the part
raised  in  whatever portion it  may be left.  The
smaller racks at the extremities are governed by a
thumb  piece,  which when  slightly touched throws
the rack off its rest and  allows the leaf to  descend.
To raise the  greater racks  bearing  the larger parts
of  the  table  it  is only necessary to push  them
slightly with the foot,  by which stooping  is ren-
dered unnecessary.
  Besides  the general  and partial  elevation, and
depression of the extremities,  this table  may be
elevated or depressed  laterally  to any useful  de-
gree.   This is effected  by  a broad and strong joint
formed in the lower part of the  transverse  piece of
timber  to which  the  extremities  of the table  are
hinged.  The table is kept at any degree of lateral
elevation  or  depression by  a very beautiful  and
                        L 
 82       ANATOMICAL INVESTIGATIONS.
 simple mechanism.  A small  piece  of mahogany
 is hinged to the  side of the table, and at  the
 angle it forms  with the  supporting column,  the
 lower  part being mortised to the proper distance
 to allow  this piece to traverse on a wood screw
 by which it  is firmly held at whatever degree of
 elevation or depression is required.  Both extremi-
 ties of the table  are perforated in various places by
 small parallel mortises through which straps with
 buckles are passed, for the purpose of keeping  the
 subject in its place whenever the position of  the
 table is changed.
   The great superiority of this table over every other
 consists in the facility with which the subject m%y
 be moved in various  directions, so as to give  the
 class better views  not only of different parts,  but
 various views of  the same  parts;  and  doing away
 the necessity of the clumsy blocks commonly used,
 and  the unpleasantness of calling in  assistants to
 drag the subject into a different  position.   Another
 very decided advantage,  is,  that  we  can  with
 this table  exhibit almost every part of the body in
its natural situation.  Thus,  we do  not  show  the
muscles destined to move  the arm and trunk with
 the subject stretched horizontally,  but sitting up in
an unconstrained position.  By this the student is
 saved the trouble of reversing every thing demon-
 strated, in his mind, in order to get some idea of 
          ANATOMICAL INVESTIGATIONS.        3*
its natural relations.  By depressing both extir
mities  to  the  utmost,  and having the subject pla-
ced directly over the centre, we  can with this  ta-
ble give views of the abdomen, thorax and pelvis,
altogether impossible with the ordinary table.   In
demonstrating the brain or other parts  about the
head,  we cannot with blocks  do more  than raise
the head in  a  very unsteady manner  to  a cer-
tain  degree, with this table it may be  raised  at
pleasure,  so as not only in an instant  to  be de-
pressed, but depressed to the slightest degree,  mo-
ving the fourth of an inch at each time to accommo-
date the head to the immediate section made.
   When we are demonstrating the organs of sense,
or other parts, where we do not use the whole sub-
ject, then by  elevating both leaves of the table to
a certain degree,  and  depressing the extremities
until they are brought level, we  are thus furnished
with two very convenient stands  at the ends of  the
table,  for our  specimens or preparations,  while  the
basin, sponge, towel,  &c. may be placed  in  the
centre.  This arrangement  is the more excellent as
it brings the  specimens nearer  to  the eye of  the
student, and saves  the teacher from the fatigue  and
unpleasantness of stooping.
   The strength of this  table is  very great and far
beyond any weight  to which  it is to be  subjected.
The motions are so easy and the positions may be 
>i4        ANATOMICAL INVESTIGATIONS.
varied with so much facility,  that they sometimes
are changed ten or twelve times during a single lec-
ture,  to accommodate to particular parts of  the
class.   The  circular motion is  so easy, that with
a large subject  on the  table, the  slightest  touch
is  sufficient to carry it  round  the circle.  A full
view  of the  table is  given in the accompanying
plate.
  The following sketches will give a good idea of
some  of the  various positions  that this table may
be placed  in.  Their uses  will be readily under-
stood  by any one acquainted with the objects  a
teacher of  anatomy has  in view.





                   r-    |------*




  [Mr. John James, Jr. No. 24 N. 5th Street, who made this,
has the model and can furnish similar tables at a short notice.] 
          A  TREATISE

                ON THE

MINUTE  ANATOMY

                OP THE



      TRANSLATED FROM THE LATIN

                   os

       ANTONIO SCARPA, M. D.

   Professor of Anatomy in the University of Pavia;

      BY JOHN D  GODMAN, M.  D.
     LECTURER ON ANATOMY AND PHYSIOLOGY,
             PHILADELPHIA. 
 
A TREATISE
                     ON THE

    MINUTE  ANATOMY

              OF THE BONES.

  Although  the osseous  system has for a long
time been carefully studied, and every thing pecu-
liar to it is thought to be well known—though we
possess  both  learned and  laboured  treatises  on
the human  bones, with  most beautiful engravings,
delineating them  as is  said,  " to  the  life"—and
though  there  are  many anatomical teachers, who
(on account of the immense  quantity  of  minutse
gradually accumulated)  hang over  them during
whole months, exhibiting to their auditors all their
inequalities, and  pursuing every  individual de-
pression and spiracle to its termination—neverthe-
less,  without  sneering  or  arrogance,  it may be
stated that an addition may be advantageously made
to our knowledge of their minute anatomy.  Re-
linquishing  and   rejecting  the   hypothesis  pub- 
 88       ANATOMICAL investigations.
 lished by Gagliardi, concerning the corrugated la-
 mina, and  the quadruple  order of  hooks joining
 these lamina together, as well as Vhat Havers has
 written relative to the spiracles conveying an  oily
 fluid into the  bones,  we  shall find that the more
 recent doctrines relative  to their minute anatomy,
 are neither  more correct, nor more useful.   Teach-
 ers  say,  as with one voice,  announcing  it as  a
 thing  thoroughly investigated  and  clearly esta-
 blished, that  the bones  are composed  of fibres,
 layers,  or tables,  placed  upon, or so connected  and
joined with  each  other, as to have their strata in-
 termingled.  They say,  moreover, that the  fibres
 are stretched out  in cylindrical  bones according to
their length, but in flat bones are disposed from the
centre to the periphery, and lastly, that the strength
 of the bones depends on the size,  number,  and
length of the layers.   Those who attempt  to sup-
port this doctrine, seem  to have  very slightly stu-
 died the nature and  truth of the fact, when they
produce calcined* bones,  which split into leaves
 and  tables,  and add the testimony of surgeons who

  * In my experiments to test the accuracy of Scarpa's observa-
tions, I found that the apparent lamination of bone was never
produced, except when the surface  was suddenly and unequally
heated.  Bones calcined with a slow and  steady fire, never gave
 me the least appearance of fables.
                                         j. r> g. 
ANATOMICAL INVESTIGATIONS.         89
daily see caries removing layers and plates from
the  sound bone—thus yielding their belief to  de-
ceptive appearances, instead of making anatomical
researches.
   An attentive examination of the minute structure
of the internal surface of young,  as well as of the
harder part of adult bones,  will convince any one
from the first step that the former doctrines have
been too  hastily  advanced and  too rashly adop-
ted.  A careful observer would find, that the whole
of what is called fibre  in bone,  is  a mere mistake,
and the short lines to which name of fibre is incor-
rectly given, occupy a very small space, and join at
different angles with other  very short  tracts of the
same kind, and by their successive apposition,  ea-
sily impose on the careless observer, as  if  they
were filaments  continued throughout the substance
of  the bone.   By the  use of good  microscopes,
every one will readily perceive that these tracts are
branched*—unite  with  the  nearest  portions at  an-
gles of different degrees of acuteness, and being in-
terwoven in a multiplex way,  constitute a reticular

  * Malpighi formerly observed the same thing, Anal. Plantar.
" These  filaments are  not all parallel  to each other, and hence
short appendices are given off,  without  being bound together, form
a net, differing very little from the nature of bark, the area  of
which being larger, and the whole compages of fibres expanding,
swells with an osseous juice.
                         M 
90       ANATOMICAL investigations.
 structure,  which may be plainly  seen  throughout
 the  whole superficies of a bone,  whether it be flat
 or cylindrical.
   In relation to the  layers and tables stratified in
 bones, every proper  observer will understand and
 confess,  that calcination  is too rude  a prbcess, to
 to give anatomists any right to conclude that bones
 naturally are formed of  many  strata,  or by the
 coalescence  of  superimposed layers.   Although
 these  are the hardest organs of  animals,  yet  they
 are  not  throughout  the whole  of their peculiar
 structure of the same density,  and held together at
 all points by an equally cohesive force ; when acted
 on by heat, they must necessarily  separate  une-
 qually and split in strata,  although this  is very far
 from being the  natural structure of the bone.   Be-
 cause during life  caries separates  plates from the
 bone, it is not therefore fair for anatomists to assert,
 that  the  bones  are naturally formed  by superim-
 posed  tables—since sometimes the softest parts of
 the human body, and particularly the skin, is re-
 moved in gangrenous crusts and layers, from the
 supposed sound parts, while there is nothing better
 ascertained in the whole human structure, than that
 the  substance  and texture of the skin  differs as
much as  possible from lamination.
  Not only is the outer surface of the bone, which
may  be easily seen by any one,  of this character. 
          ANATOMICAL INVESTIGATIONS.       91
but 1 pronounce and affirm  that even the  greatest
part of the-whole osseous  system is reticular or
cellulous.   To demonstrate this I  do not impose a
very severe task on myself.   It will be sufficient to
show all the bones split,  as Cheseldeu did, and I
was accustomed to do  during many years, before
my class.   By this simple  method of treating the
whole skeleton, it is made evident at a glance  even
to the  most inexperienced, that the largest portion
of the bones is cellulous  or reticular—the residue
being  a hard concrete and  stony  substance which
surrounds  the reticular  structure  like  a  bark.
The quantity of this cortical matter in proportion to
the spongy part is very small in  the scapula  and
ilia, and is still  smaller in the bodies of the ver-
tebrae, when a large mass  of spongy substance is
but slightly  covered by a  thin bony  crust.  The
lower jaw clavicle, and especially the sternum and
ribs are in great  part  spongy.  The bones of the
carpus, metacarpus,  tarsus and  metatarsus,  and
joints  of the finger and toes, have a  quantity of
spongy, loose, and cellular texture, so far exceed-
ing their external  crust, that the bones of the  hand
and feet may without impropriety be termed spongy.
In relation to the rest of the joints,  it is very com-
monly known, that the middle of the cylindrical
bones, as the arm and thigh bones, the radius, ulna,
tibia, and fibula, are very hard and firm,  but as we 
92       ANATOMICAL INVESTIGATIONS.
gradually approach their  extremities, the  texture
becomes looser,  and they swell out in light and
spongy protuberances  covered  by  a thin external
osseous sheet.  Not only do we observe this  in all
the bones of the skeleton,  but in the cartilages, as
those of the ribs and of the larynx, which some-
times, though rarely do ossify.   When these are
split  through the middle,  there will be perceived
nearly the same  proportion  as in  the true bones,
between their external compact crust and their  re-
ticulated alveolar substance.
  The whole controversy, therefore, relative to the
minute anatomy of the bones, as far as I can judge,
returns to this—not whether the  structure of  the
greatest part of the  bones is generally cellular or
not, (as this is  sufficiently proved by the sections
made with the saw before-mentioned,) but whether
the hard and almost rocky walls of the bones, and
their compact external crust no less than their in-
ternal substance,  partake of this cellular texture.
That I may answer  this question  as satisfactorily
as possible,  I have  thought it  best first to investi-
gate  the  subject synthetically,  and then  analyti-
cally. Hence I began by examining the bones  in the
first rudiments of animation, that is, when the car-
tilage first changes, and the earliest traces of the
future  bone begin  to appear  at  the same  time.
Then I deprived the  hardest bones of an adult of 
ANATOMICAL INVESTIGATIONS.       93
their earthy particles, and reduced  them to their
original softness and pellucidness, thinking, as was
proved  by the experiment, that however entire the
maturity of these bones might  be,   their minute
structure would  exhibit the  same order and rela-
tion  as  was seen in the embryos.  I therefore re-
peated  Haller's experiments  on the formation of
bone, in the incubated egg,  the chief of which  I
subjoin  entire, as they are recorded in my notes.

            Eighth Day of Incubation.

   The  femur and tibia were properly formed, but
entirely cartilaginous, flexible,  pellucid, in  which
no dissimilar  point could  be  observed with the
most powerful glasses.  When  dried they had the
appearance of desiccated gum.

                   Ninth Day.

   A yellowness begins to  appear about the middle
of the femur and tibia.  The cartilage in that place
begins to be somewhat wrinkled and crisped, but
the rest light and pellucid.
                    Tenth Day.

   The  femur  and  tibia much more  yellow and
wrinkled in the  middle  than  yesterday.   These 
94       ANATOMICAL INVESTIGATIONS.
wrinkles magnified  by a  good microscope,  exhi-
bited a very beautiful network,  the lines mutually
concurring at  acute  angles—yet this network was
still cartilaginous and flexible,  differing in nothing
from the rest of the cartilage of the future bone, ex-
cept in opacity, yellowness,  and a slight degree of
roughness.

                  Eleventh Day.

   In the middle of the femur and tibia the rough-
ness, or network, begins to harden.   Being  dried
both sustain  themselves by the middle, while the
rest of the cartilage of the  tibia and  fibula collap-
ses  and  appears  like  a  gummy  substance.   The
middle portion, which is not destroyed by drying,
is a bony,  rough reticulated crust, which is  only a
little thicker in the middle  than at the extremities.
Moreover, near the lower part of the tibia and fi-
bula, red spots begin  to appear, which show the
situation of the inferior nutritious  artery.

                   Twelfth Day.

   About the middle of the  tibia, the network,  or
original ossification, is terminated by two red  points,
one above and the other below.   The superior nu-
tritious  artery begins  to  be visible.   The  bone 
          ANATOMICAL INVESTIGATIONS.       95
when  dried,  preserves  its cylindric  form in the
middle.

                 Fourteenth Day.

   The opake,  reticular,  and  anteriorly  osseous
middle of the femur and tibia, is perceptibly ex-
tended towards the extremities, and terminates  in
both  directions in zones,  very full of  red blood,
surrounding  both ends.  These very delicate be-
ginnings of ossification  are very plainly discovera-
ble by microscopes of  ordinary power, and show
that the structure of the bone  is by no means fi-
brous, but altogether reticular,  cellulous,  and floc-
culent, and is manifestly formed from  very short
lines or tracts running together at acute angles.

                  Fifteenth Day.

   The whitish,  reticulated osseous  substance  is
much more extended towards the epiphyses.   The
zones of blood-vessels situate at the extremities  of
the ossification, were broader and exhibited a  more
vivid  redness.  The reticulated osseous  structure
was very conspicuous to the naked eye.   Splitting
the femur  and tibia in their length, the  internal
part of the bony tube was formed of  reticulated
matter—the  walls  of  the tube  throughout  their 
 96       ANATOMICAL INVESTIGATIONS.
 whole length were  downy or flocculent,  having no
 vestige of tables or lamina arranged over one ano-
 ther.  But the blood-vessels which went from the
 zones, from the beginning, both in giving and re-
 ceiving the little twigs, follow precisely the same
 order, and exhibit the reticular structure.

                 Sixteenth Day.

   The reticular osseous structure of the  femur  and
 tibia reaches nearly to  the epiphyses—even on the
 cartilage which tips the  extremity of the bone, a
 rough  surface is visible, which is  the rudiment of
 the future bone—and nothing is wanting to change
 this roughness into real  bone, but the  deposition
 of  earthy particles.   The redness of  the  zones
 is greater than on  the fifteenth:  from  either ex-
 tremity of the bone,  towards the middle  it is in-
creased  and expanded,  so  that  the  whole  bone
seems suffused,  as with a sanguineous dew.  The
femur beirig split through  its length,  gave no indi-
cation in any part of the bony tube of a  lamellated
 structure, but every where appeared flocculent, re-
ticulated and cellular.

                Eighteenth Day.

  The reticulated osseous crust occupies the whole
of both bones,  except a small part of the cartilage 
ANATOMICAL INVESTIGATIONS.
97
on the extremities of the tibia and fibula.  The su-
perior anik-inferior vascular  zones  are very much
expanded,  and  nearly  meeting and  intermixing
with each other in the centre, tinge the whole femur
and  tibia with redness.   Both  bones  being split
in their  length, their walls throughout appear al-
veolar and cellular, and also stronger  than in the
sinuosity of the femur of the opposite side.  The tube
of both bones was here and there interrupted and con-
fined  by cartilaginous partitions.  The  internal pe-
riosteum,  exhibited the appearance of many blood-
vessels collected  together,  and  was intensely red.
But near the epiphyses, the cartilage which remain-
ed of the diaphysis of the whole bone, was elongated
in the form of a cone in the  medullary tube, or
bony pipe, which cone  gradually  terminated in a
point near the middle of the bone.  Through this
cartilaginous  cone on  the  extremities of the bones,
some vessels passing  from  both  zones,  reach to the
epiphyses with a bifurcated, termination.  The front-
tal bones were still very flexible, and almost carti-
laginous, yet were in no point fibrous,  being in all
parts manifestly reticulated.

Twenty-first Day.—A chicken near being hatched.

   The femur  and tibia were not so red externally,
as on the former days.   In the  middle of both
                        N 
98       ANATOMICAL INVESTIGATIONS.
bones the reticular structure was more  close  and
compact  than  usual,  and the lines appeared to
run  together  at  more acute  angles than on the
first days after iucubation—hence  it happens  that
those  small  tracts  concurring  at  acute angles
readily deceive superficial observers,  as if they
were fibres extended  in  the  length of the bone.
The femur  and tibia being vertically divided, the
internal  periosteum presented, covered  by an oily
mucus, and he medullary tube was filled, by small
cartilaginous tubercles.  But in the extremities of
the  same bones, the cartilage which rose in the
form of a cone through the bony tube, was changed
to  a pellucid  sponge  of cartilaginous  elasticity,
grooved by oblong depressions and sinuses.  It ne-
cessarily follows, from the evolution of this conical
cartilage, and from the separation of the same into
pits and  cells, that the proportion of these  protu-
berances  is very much increased at the diaphysis
of the bones,  on account  of their greater amplitude
and the swelling of this conical cartilage, which
far exceeds the diameter  of the bony tube.

      A chicken two days before being hatched.

   There was  nothing of cartilage in the extremi-
 ties of the  femur and tibia,  except the epiphyses.
 When the periosteum was removed,  the  blood- 
          ANATOMICAL INVESTIGATIONS.        99
vessels  appeared every  where  mixed and inter
woven with the bony net-work.  Both bones being
divided as usual, the internal periosteum was very
red, and the vessels of the marrow, bedewed with
much oily mucus, were extended from the extremi-
ties toward the centre of  the bone.  In the middle
of the femur and tibia, where, from the commence-
ment of the ossification, the whole external surface
of the bony tube was downy and flocculent  was
now seen a hardened covering, manifestly drawn
and crowded together in tracts and areolae of  reti-
cular structure.   The cartilaginous cone  which I
saw on  the former days in both extremities of the
bone, drawn  out into depressions and  little cir-
cles, and very tumid, I find has become a fragile,
bony sponge, forming the  protuberance of the bones.
Moreover, I again see red vessels pass from  both
extremities of the bone  to the epiphyses, to form
the ossification of their cartilaginons appendages in
the usual way.
  Thus far  the observations were  made on the in-
cubated egg,  and the original structure of bone in
human  embryons when  about twenty-eight  lines
long.  For in  these, as in the chick about the four-
teenth day of  incubation, the middle of  the femur
and tibia, which scarcely equalled two-thirds of the
whole length  of the  bone, was osseous—the re- 
100      ANATOMICAL INVESTIGATIONS.
maiuder was cartilaginous.   The external  surface
of both bones stripped of the periosteum, and exa-
mined with the best glasses, appeared beautifully re-
ticular, very short branching lines  running toge-
gether at  acute angles,  altogether resembling the
first evolutions of the bones in the incubated egg.
The embryon bone split through the middle, exhi-
bited the  downy and flocculent  substance both in-
ternally and externally.   Although  the frontal and
occipital bones were  so pellucid and flexible that
they  appeared entirely cartilaginous, yet the mi-
nute  structure  was manifestly reticular—both the
whole of  the scapulae and ilia were  spongy, being
still unprovided  with any harder external  cove-
ring.
  The  conclusions which  are to be drawn from
these observations,  unless I  am very much de-
ceived, are the following :
  1.  That the cartilages  were  the  models  of the
future bone,  and all  the parts of the bone  visible,
existed in the form of cartilage.
  2.  The reticular  or  cellulous  bony structure
which first began to appear about the middle of the
cylindrical bones, was always immediately prece-
ded by a wrinkling of this part.
  3.  That the cartilaginous model  is changed  to
bone by the action of the sanguiferous vessels and 
           ANATOMICAL INVESTIGATIONS.       101
 the addition of earthy matter, in the rugose cartila-
 ginous tracts, by which means the osseous net-work
 is  made.
   4.  In  the  incipient  state  of  ossification,  the
 whole height and thickness of the bony pipe of the
 cylindrical bones, both without and within, is light,
 downy and cotton like,  having no trace of hard co-
 vering externally.
   5. When the ossification is perfected,  the walls
 of the cylindricial  bones receive  an increase of
 density about the middle  of the bone, wkh a di-
 minution of breadth, as the reticular texture is more
 closely drawn together  than before,  and compacted
 in the  tracts and alveoli.  What  forms the exter-
 nal crust or  cortex of the bone, is nothing more
 than the light, reticulated cellulous structure brought
♦ into a hard body near the  surface of the bone; and
 this, both in the cylindrical  and  flat bones, does
 not appear about their middle or centre, before the
 entire ossification of the cartilaginous model.
   6. The sponginess, which is greatest in the ex-
 tremities of long bones, is by no means derived, as
 many anatomists teach,  from those lamina, or ta-
 bles,  which pass from  the walls of the bony tube
 and go into  the  medullary  cavity, but it  is to  be
 referred  to the primordial cartilage, which at first
 stretches the cones  upwards through Ihe medullary 
102      ANATOMICAL INVESTIGATIONS.
cavity, and at length the areolae and cancelli  being
removed, expands more fully, and swells very much
like  tuberous sponge in the extremities of the long
bones.
  7. Finally,  the original more  minute texture of
the cylindrical and flat bones, both in the incuba-
ted egg and the very early human foetus,  (when in-
deed both the bones, scarcely begun, are still flexible
and light,) are nothing but a slightly reticulated or
cellular  substance—and  moreover,  if  sometimes
distinct .little spots, remote from  the centre of ossi-
fication, occur in  the progress of ossification, they
are  at length  consolidated  and  peculiarly  inter-
woven with the portions next them, the whole bone
being thus formed of retifonn structure.
  In the  next place, since we  find this to be the
fact  in the first evolution of bone, let us consider
the more minute structure of the bones in detal—
especially  the nature of  the corticil  substance of
the bone,  which is most manifestly made up from
the compacted osseous net-work.    This, which has
been detected by the synthetic method,  I felt sure
of confirming  by analysis, as the hard external of
bones could be wholly cleared of their earthy par-
ticles, and then might be gradually loosened,  until
their peculiar structure could be fairly shown.
  Therefore I kept the tibia of an adult, in  dilute 
          ANATOMICAL INVESTIGATIONS.      10J
muriatic acid sufficiently long to  extract the earthy
particles—by this process, common to anatomists,
*he very hardest bones are converted into a cartila-
ginous  substance of great flexibility  and translu-
cency,  without in the  slightest degree changing
their  natural forms.  When  I had reduced these
bones to  this state, I mascerated the cartilaginous
residue in pure water, in the same manner as is
done  when we  wish to reduce membranes,  viscera,
skin,  tendons, or aponeuroses to  cellular substance.
By a long continued experience, I have at length
learned to reduce the external covering of the tibia
of an adult to a downy reticular texture, similar to
that which is found in the extremities of the bone,
except that the close and much compressed texture
of  the cortex,  appears loose and dissolved, in the
meditullium  and  tuberosity of the same tibia.   In
fact when the parenchyma of the tibia was cut per-
pendicularly, no vestige was found either externally
or  internally of fibres,  not the slightest  indication
of lamination, or plates,  in the thickness of the bony
tube—but the whole of the hardest crust of the tibia
throughout its  extent,  appeared to be formed of
cellulous structure, so disposed in cancelli and tracts
of  net-work, that what belonged to the superficies
of  the tibia was much compressed and gathered on
itself.   The cancelli gradually relaxed, and en- 
104      ANATOMICAL INVESTIGATIONS.
larged more and more,  until they were swelled out
to that sponginess  found in the  medullary cavity
and extremities of the bone.*
   I have  with much  pleasure  observed  that the
compact substance of the  tibia now under conside-
ration,  is of a cellulous reticular  structure,  when
this cortex has been deprived of its earth and mois-
ture, and  afterwards placed in  oil  of  turpentine.
For on account of the  high  degree of pellucidness
of.a bone thus treated,  the slight net-work of which
it is ultimately composed,  may be  clearly seen—
and the  naked  ey«, can  discover without  error,
that the very hard  crust of bone is really of a cot-
ton-like texture, and made up of very short branch
ing  tracts, variously joined and  interwoven.
   The  same circumstances were manifested by a
section  of the very hardest portion taken  from the
middle  of an adult  tibia,  suspended in  spirits of
wine after  the earthy  matter  was  removed,  and
carefully examined by  reflected and refracted light.
The  soft cellulous  texture  was  shown, in which
small cones of the same soft substance  of difterent

   ■ I have  repeated all Scarpa's experiments on adult bones, and
have  examined in the same manner the very hardest parts  of the
cylinder of the thigh bone.  The results have been so uniformly
similar to those above related, that it is not possible to avoid adop-
ting the author's conclusions
                                         .1 d t; 
          ANATOMICAL INVESTIGATIONS.      105
figures  adhering together, formed  here and  there
larger and smaller areolae, nearly like the soft cel-
lular texture.
  The  reticular structure is  not only to be seen in
the cylindrical, but also in the compact tables of the
flat bones in adults.  Thus the internal and exter-
nal crust of the frontal  and occipital bones,  being
made flexible and pellucid,  and suspended in oil
of turpentine, the  whole is  found to be in every
part reticular.   So great is the resemblance of this
crust to the structure of cellular  texture, that it
might readily be mistaken for a membrane reduced
to a  cellular web, by long  continued  maceration.
However, I have remarked the form of the cells in
in the crust of flattened bones,  to be different from
those peculiar to the net-work of cylindrical bones ;
that, for instance,  the areolae in flat bones are more
oblong than in the cylindrical—as if the cellulous
spaces and areolae of the flat  bones had  been drawn
in different directions,  while the  bones were  yet
soft  and  cartilaginous.   Hence analytic examina-
tion of the cortex  of hard adult bones,  sh»ws that
there is almost the same disposition of principles in
the construction of the hardest parts of their bones,
as in the embryo at their first evolution 5 and the con-
version  of .cartilage into bone—that all the bones,
even the very hardest, are composed of a collection
of small  tracts, which  extend  through very short
                       C) 
106
ANATOMICAL INVESTIGATIONS.
spaces, and  unite at difterent  angles, forming a
net work.  It is  not from conjecture, therefore, but
the force of  positive observation, that we  declare
the opinion  hitherto taught in anatomical schools,
that bones are formed by tables, lamina, and fila-
ments, is unfounded, and  must be rejected  as un-
true—and we affirm, that  all the bones,  whatever
be their figures, are in their minute  structure cellu-
lous and reticular, sometimes  very close and com-
pact, as in the cortex of very hard bone—at others,.
loose and free, as in the cavities and  tuberous ex-
tremities of cylindrical boues.  Those short tracts
which  anatomists have mistaken for bony fibres, can
neither be followed in the length nor breadth of  the
bone, nor do they ever attain any notable length.
  In fact,  as often as I attentively examine the mi-
nute cellular texture under consideration, and  ob-
serve that it is very close  and compact  at  the
surface,  and grows gradually looser and looser  as
it approaches the internal part,  and the spaces and
cells become very much larger, and at length form
the spongy structure of the meditullium, and extre-
mities  of the bones, I cannot avoid concluding that
there is  in  this construction of the bones, a great
resemblance with the texture  of  the true  skin of
animals.  For this corium, which is beypnd doubt
of a cellular texture, where  it covers the external
surface,  has its  cells drawn together and  closely 
           ANATOMICAL INVESTIGATIONS.      10?
 compressed, is very firm and  compact,  but its in-
 ternal surface, has its cellular structure more and
 more relaxed and enlarged, till at length by the in-
 troduction of air it is easily swollen, the and sub-cu-
 taneous net-work is loosened and enlarged.  Thus
 in bones I see a cellulous net-work, very close and
 firm on the outer surface of the bone forming a hard
 crust, and the same substance gradually becoming
 loose toward the centre of the  bone, enlarging and
 swelling out to an osseous sponge.
   Since then it  is demonstrated, that the minute
 structure  of the  crust and meditullium of bone  is
 entirely of the same cellular structure, it will not be
 difficult unless I am much mistaken, to understand
 why the cylindrical  bones of very young foetuses,
 which in the beginning throughout the whole extent
 of the walls of the long tube,  are equally light and
 cotton-like, should with increase of age  be exter-
 nally covered by a hard and  compact crust—also
 why it happens that the cortex of the bone is  uni-
 formly in  inverse proportion to the  meditullium, or
 what is more remarkable, why the cortex should
 be thick and very hard where the spongy substance
 is in smallest quantity—and on  the contrary, the
 cortex is  slightest where  it  covers the greatest
 quantity of spongy texture.  From what I have ad-
 vanced relative to the commencement of ossification
in the incubated egg,  and in the human  foetus, it 
J Oh
ANATOMIC
AL INVESTIGATIONS.
appears, that perhaps, a greater quantity of osseous
substance does not exist in the middle of cylindri-
cal bones; than in their extremities, that, such is the
condition of the cartilaginous model  of  the  future
bone, that the portion of this cartilage belonging to
the extremities,  which hardens latest, is more ex-
tended and spread out over larger spaces, alveoli
and  depressions,  than the  middle portion of the
cartilaginous model.  Therefore, since  the texture
of the cortex and meditullium is entirely the same
as before stated, reticular and  cellulous, nature in
her own way and at the proper place, as  in the
middle  of the cylindrical  bones,  constringes  and
compacts  it  to  form a  hardened  cortex—but in
other parts, as in the tuberous extremities of bones,
she loosens and  spreads the same  material  like a
sponge.  In fact,  no one should think this compac-
tion  and change of a lax cellular texture iuto a
solid and hard body to be the only example occur-
ring  in  the  animal economy, and merely contrived
and  designed for giving strength to the bones, since
nature employs exactly the same means  in all ani-
mals, and in all organs composed in a great degree
of soft cellular  texture,  for keeping  them in their
places, and giving them more solidity and  strength.
If this  should appear  doubtful,  nature  herself
teaches,  that  the  soft membranes of the  embryon
are changed and  hardened into firm  tunics, elastic 
          ANATOMICAL INVESTIGATIONS.      109
ligaments, and tewdons, articular capsules, and vas-
cular, coats.   Those who have hitherto  supposed
the minute structure of bones to  be formed in strata
and tables, have  been accustomed to support their
notion by imagination, faucying that the middle of
of every cylindrical bone, when it is hardest and
firmest, is composed of numerous tables, and as we
gradually recede  from this tabulated centre towards
the extremities,  that they  become  diminished in
length, and those that are turned  towards the me-
dullary cavity, become so inclined, that  at  length
meeting together  in the middle of the bone, they are
in a multiplex manner admixed and interwoven with
each other, and changed into  the spongy substance
of the meditullium and tubers.  The whole of this
hypothesis falls  of itself, if the facts are properly
weighed, which  we have demonstrated  relative to
the minute primordial  cellulo-reticular textures of
bone.   Moreover,  even this tabular structure ad-
mitted, it would  be impossible  to understand how
the same strata of bone could be driven,  as  Holler
thinks  by the dilatation  of the arteries, from the
superficies of the bone towards  its medullary tube,
till at leugth by  their meeting, the form  and condi-
dition of a spongy mass is produced.
   But  although  the natural course and order of os-
sification is,  that  the cellulo-reticular  substance
which is placed  in the middle of the bones,  should 
 110      ANATOMICAL INVESTIGATIONS.
 change with the maturation of themnimal, gradually
 contracting its cells, and hardening the little por-
 tions of cellular texture—and while solidifying, the
 cellulo-reticular structure  of the  extremities and
 tuberosities, should at the same time ejrtend the can-
 celli, and enlarge the net-work, so as  to increase
 the whole size of  the bone—nevertheless, observa-
 tions furnished by  pathology  are  not wanting,  to
 show that a faculty and aptitude exists  in the very
 hardest cortex of adult bones,  which enables them
 under  certain  circumstances,  like the cellulous
 structure  of the extremities, to swell and enlarge
 beyond their natural condition.
   Although 1 had suspected  that  this remarkable
 power of  nature in relaxing and enlarging the ex-
 ternal covering of the hardest bones, was often re-
 sortejl to  by  her  in curing diseased bones, yet  I
 nevef was so clearly and undeniably satisfied of it,
 as in the  case of a puppy,  whose leg I  had freely
 broken.   I  opened the tibia of this dog,  down to
 the miditullium, and by this opening, introduced  a
 probe and destroyed the marrow of the bone, fil-
 ling up the  cavity with lint, not without much in-
jury to the inner wall of the tube.   On the follow-
 ing day the whole leg swelled  violently.   About
the sixth day, a free discharge of pus ensuing, the
 tumefaction  of the soft parts about  the wound sub-
 sided—the tibia at the same time was found to be 
          ANATOMICAL INVESTIGATIONS.       Hi
very tumid, and gradually to increase in size, until
about the fortieth day, it had  the appearance of a
great exostosis.  The  dog  was killed,  and this
tibia was  examined  by cutting through its length,
when the whole of the cortex was found to  be ex-
panded to cellulous texture, and moreover, the walls
of the tibia of this puppy that were  scarce  half a
line in thickness, were now  changed into a spongy
substance,  of  more  than six lines in  thickness
throughout the length of the  bone.
  Similar  circumstances  are frequently found in
the  human  race,  as  when  any  cause  injures
the meditullium of bones leaving the corticil part
untouched,  or  when the nutrition  and  increment
of  the  bone from  the  internal  texture  is  injuri-
ously hindered by  the   presence of some foreign
body.  For in either case nature provides for the
preservation of the continuity and strength of the
diseased bones, relaxes with great effort their com-
pact external surface, which enlarging  to a spongy
consistence,  and being  prolonged internally, com-
pensates for the loss of  the  meditullium—or swel-
ling outwards increases  the  height and breadth of
the bony tube—or,  at length  by surrounding the
injured bone with the sponginess from the cortex,
receives  and contains it  in a sort of sheath.   This
spongy sheath in the beginning is light, flexible,
and cotton-like,  but gradually hardening  by the 
112      ANATOMICAL INVESTIGATIONS.
acquisition of earthy matter, it comes at last to per-
form  the office  of the  sound bone—the  primitive
bone wastes away, and  at length loses its continuity
with the osseous case.
   We may reasonably  demand of those who teach
that the  hard walls of  bones are made from many
plates  or tables superimposed,  how they can re-
concile such facts with their  hJ^)othesis.  For it is
certain and manifest under the circumstances  men-
tioned, that the. bones neither separate into layers,
nor, properly speaking,  does  nature  generate  a
new bone to replace the miditullium, or to include
the injured  internal wall in the bony  sheath, but
only allows the compact and much compressed tex-
ture of the outer part of the bone to become freely
enlarged and expanded.
  But while engaged in writing this essay, 1  have
before me another most excellent example of this
change and transition of the compact substance of
the bone into a  cellular  mass,  furnished by the
bones  of children,  in whom  the hardest parts of
the bone, and especially of the joints, are reduced
by  disease to the  softness  of  wax,  and  become
almost pellucid.  In consequence of this disease,
the bones being deprived of  their earthy particles,
or the  necessary deposit of earth withheld, grow at
last so soft and pellucid, as to be easily cut with a
knife,  exactly like those bones which  have long 
            ANATOMICAL INVESTIGATION*?.       113-
  been macerated in diluted mineral acids.   Diseased
  bones of this kind have their substance  like carti-
  lage, very light and flexible, and more delicate and
  spongy  within than  it  is  possible  to  describe.
  Having cut one of them through its length and  sus-
  pended  it in spirits of turpentine, it was translu-
  cent like  jelly,  exhibiting the  minute structure
  throughout  reticulated,  and  particularly evinced
  and confirmed  the  fact of the cellular  nature of
  the  external crust of bone.
     While  speaking  of bones  deprived  of their
  earthy matter by disease,  it presents  a fair oppor-
'  tunity for observing what happens sufficiently often,
  that bones  from some peculiar  virus may become
  diseased, not throughout the whaie body, as in ge-
  neral  rachitis, with softening, but  are deprived of
  their earth  in a particular spot, and are affected by
  a local rachitis, making them soft within certain de-
  fined limits.  Where  this occurs, the cellular  tex-
  ture of the bone loses its character and  rigidity as
  bone,  at the point whence  the  earthy matter is re-
  moved, and assumes the flexibility and ductility of
  cartilage, becoming subject to distension and swel-
  ling, like the soft organs,  such as membranes,  ten-
  dons, ligaments, vessels, and other parts composed
  of cellular  substance.  Under such circumstances,
  if the softened bone is exposed by the want of an
  outlet to the action of acrimonious  fluids, it  swells^
                          P 
 114      ANATOMICAL INVESTIGATIONS.
 becomes  violently distended and  red,  and  soon
 forms  an irregular fungous mass,  similar to excre-
 scences  of  diseased  flesh.*   The phenomena  of
 spina ventosa  and psedarthrocace, are well  known
 to surgeons, the bones at first softening so slightly
 as by no means to allow of the introduction of a
 probe—at length becoming  a sort of  fleshy  matter,
 the  skin is burst up and presents a wretched spec-
 tacle—the tumour bleeds on  the  slightest touch,
 and pours out a fetid discharge.  This change of
 the  bone into a substance similar to  flesh,  and its
 easy distension, shows  that there is  much  simili-
 tude between the cellular texture of  the  substance *.
                      >
 of the bone, and the commou cellular texture, whose
 great ductility anuV the facility with which it forms
 fleshy  tumours,  is equally well  known to physio-
 logists and pathologists.

   'In one case to which I was called, there was an enlargement of
 the tibia about two hand-breadth's below its head, with a large open-
 ing through wich an ill-looking fleshy mass  could be seen within, and
 from  this opening a very unpleasent  discharge was kept up.  The
 patient about fifteen  years old, sufferred  greatly, was  extremely
 emaciated, and had regular hectic paroxysms.   A probe could be
passed in any  direction through  the diseased part of  the  tibia.
When the foot was  raised it was  evident that both bones were
fairly softened,  and might be bent  almost to any degree.   Am-
 putation was recommended—some delay was occasioned.  The pa-
tient  began to take bark freely for  the debility,  and in a very
 short  time entirelv recovered.                     J.  D. G. 
          AK ATOMIC AX INVESTIGATIONS.       115
   Sometimes it happens fortunately, that the bones
 swell  to an  extraordinary size, from the  softening
 of their cellular structure, without injury to the ani-
 mal.   In fact, we  think  in opposition to  the com-
 mon opinion of surgeons, that this peculiar  soften-
 ing and germination, like fleshy substance from
 bones, is  determined  and promoted  by a salutary
 effort of nature, to repel  injuries  done to the bone,
 or to restore the continuity when it  has been bro-
 ken.   After fractures we see the points of  broken
bof es first grow soft by the absorption of the earthy
matter—afterwards  from  these points, already of a
cartilaginous  flexibility,  we  perceive a red  sub-
 stance to sprout forth, called by Celsus caruncula—
and this caruncle extending  according  to the dis-
placement of the broken bones,  assuming various
sizes  and forms, connects the points together and
fills  up the  vacancies caused by any loss of sub-
stance.  In  the living state  this caruncle  is red,
but after death, being freed from blood and mace-
rated,  has the appearance and character of cartila-
ginous substance.   In the living body this carun-
cle  is well supplied with -blood-vessels, which de-
positing earthy particles, gradually  impart  greater
consistence,   and proper  osseous character,  when
the name of callus  is bestowed on the mass by the
surgeon. 
116      ANATOMICAL INVESTIGATIONS.
  In relation to the organic nature of callus,  my
own experiments, after those of Dktlkf,  Haller,
Bonn  and Bohmer,  do not allow me  to  doubt.
Those who have hithertofore taught that callus was
something similar to  gluten concreted with  earthy
matter, always appear to me to  have very  rude  no-
tions  of the animal economy,  and have not  re-
marked that callus  once  formed in  young animals,
grows as it advances in age in the same proportion
as the other bones,  and is changed in colour by the
use of madder, just as they are.   The blood-vis-
sels  of callus may be minutely  injected:  and in
short, callus  when acted on by  mineral  acids, is
deprived of earthy matter and  resolved into a car-
tilaginous substance similar to the other undoubted
bones.  Such teachers, moreover,  seem not to have
observed, if it has happened before them, that when
bones  formerly joined and restored by callus are
seized by rickets and softening,  this  callus, like
the other bones  of the  animal,  becomes softened
and preternaturally tumid.
   1 have removed from the surface of the tibia  in a
full grown man soon aftet death, a portion of callus
almost four inches long and one broad,  still soft,
altogether  cartilaginous and  easily  cut with  a
knife—this specimen  is preserved in spirits of wine.
Its external surface has the appearance  and form 
           ANATOMICAL INVESTIGATIONS.      i!7
 of  the osseous crust—but  the internal  surface that
 adhered to the tibia, exhibited a most beautiful net-
 work, which at first sight could not be distinguished
 from common  cellular  substance.  By examining
 this structure with  a  microscope of high power, it
 was plainly demonstrated to be cavernous, and al-
 together cellular, have many  very  minute  earthy
 particles  in it, especially  in its  external  surface,
 which was firmer and more rigid  than  the opposite
 side.
   It is wonderful to see the celerity with which
 the  soft caruncle, filled with blood-vessels, shoots
 forth on the bones of  birds that have been stripped
 of periosteum, first changing to cartilage, afterwards
 into a light downy bone,  delicately reticular both
 externally and internally.
  I have  made the same experiments on the bones
 of kittens, which though not effected  with the same
 celerity, yet terminated in a similar manner.
  The tibia of a cat,  from which  a soft callus had
 grown  after the periosteum  had  been  removed
 from two-thirds of the  whole circumference of  the
 bone,  was  macerated  in  muriatic  acid until  the
 whole bone  became  pellucid  and   flexible.   By
 placing this bone in oil of  turpentine, I found that
 the  caruncle,  or rudiment of the  future callus was
continued from the cartilaginous model of the bone,
 and was nothing more than a germination and intu- 
118      ANATOMICAL INVESTIGATIONS.
mesceuce of the cartilaginous substance of the tibia.
I have seen the same thing  plainly in  the tibia of
an adult man, who had suffered a vast laceration of
the soft  parts and  periosteum, two months before
death—the caruncle  was sufficiently produced,  and
part of it had begun  to change to bone.   When the
whole tibia was freed from earthy particles by the
aid of mineral acid,  and rendered pellucid,  it ap-
peared that the perfect callus, as  well  as the ca-
runcle, formed one  and  the same substance with
the whole parenchyma of the tibia—that is,  the
cartilaginous nucleus of the tibia was expanded into
the callus, and was prolonged  and  stretched out
uncommonly.
  In  another  cat whose  tibia was  deprived of  a
long and broad portion of periosteum,  a  recently
formed callus swelled out—when  I had filled the
arteries very  minutely with  red  wax,  this  callus
was  handsomely tinged red, and  the  colour  was
distinct from that of the rest of  the tibia.   But
when I  had  removed the earthy  matter by acids
from the  whole tibia, and rendered it soft  and pel-
lucid, and examined it opposite to the light,  I dis-
covered an immense number of blood-vessels scat-
tered through the callus.
  Besides  the  proofs heretofore  given, that the
callus is  formed by the intumescence, or germina-
tion, of the parenchymatous cellular texture of the 
           ANATOMICAL INVESTIGATIONS.      119
 bones, we may add,  that whether we consider  the
 formation of callus and the process of ossification,
 or look to the  minute structure  when the  bone is
 perfected,  we shall find  all  the circumstances  of
 the original ossification  and formation of callus  are
 alike.  The caruncle  does not harden by the whole
 quantity of  earth being deposited  at once,  but re-
 ceives  the earthy substance as in the formation of
 bone in the incubated egg,  where the blood-vessels
 appear, carrying red  blood, and supplying at  the
 same time the  necessary  earthy particles.   Since
 this condition of the vessels takes place  unequally,
 as well in the cartilaginous model  of bones as  in
 the rudiment of future call as, it hence necessarily
 happens,  that in both, small distinct spots appear at
 the commencement of ossification without any order,
 which  finally unite together  in  the  cartilaginous
 model of  the embryon,  or after fractures cover  up
 and take place of the caruncle.   As soon however
 as the caruncle is wholly ossified we find the callus,
 like the original ossification in the incubated egg,
 entirely cotton-like,  reticular,  spongy, and equally
 light and delicate throughout its whole extent.  It ap-
pears as if forcibly compressed, and becomes more
and more  condensed until it hardens and is covered
with an external crust  or bark,  which  substance,  as
in the bones of embryons near the full time, in- 
 120      ANATOMICAL INVESTIGATIONS.
creases more in length in proportion to the diminu-
tion of the cellulo-reticular structure.
   The origin of exostosis, is  undoubtedly similar
to the formation of callus.  For  in such cases,  the
surface of the bone being,  for ever so small a dis-
tance, deprived of  the  periosteum,  becomes  sof-
tened, is followed by a germination of the caruncle
from this spot, which is  lengthened and  increased
from the fluids circulating in it—hardens finally by
the deposition of earthy matter, and produces a tu-
mour whose minute structure does not differ, in the
slightest degree, from that peculiar to the  bones, if
we except this circumstance,  that  the tumour  is
sometimes  harder  than the bone itself, in  conse-
quence of the  greater quautity of earthy  matter it
has  received.  I speak now of the true and legiti-
mate exostosis, which may have been originally
caused by some virus—and although this has, by
treatment  or spontaneously, been removed,  still
the exostosis does not cease, because the  caruncle
shooting from the  surface of the softened bone,  ob-
tains the  nutritious  gluten along with the  earth
from the common cement, and assumes  the osseous
character.  A few years  since I had occasion to re-
move the  tibia and fibula near the knee,  where a
great exostosis swelled out, in a man of about forty
years.  1 amputated the leg at the usual distance 
          Anatomical investigations.       121
from  the patella,  through  the  exostosis.   The
wound in a short time was healed without being af-
fected  by the exostosis—-the cut bones  adhering to
the integuments were covered by a firm cicatrix.
   Caries is separated from the sound  bone almost
always in the same way that callus is formed.   At
the extremities of a bone suffering under caries, the
earth is  absorbed  by the action of the  proper ves-
sels, and from this spot the caruncle shoots forth,
which  being  treated with bland and emollient ap-
plications, separates the carious bone  in  every di-
rection, and  throws it off from the  sound.  When
this happens, the caruncle which, as we  have de-
monstrated, is very vascular, before  it wholly ossi-
fies, forms anastomoses  with the surrounding soft
parts,  and even with the skin itself.   On this ac-
count, after the cure has been entirely effected, we
find about this caruncle, that the integuments are at-
tached to the subjacent bone, and  that there is  a
dense concave cicatrix formed thereby.
   Therefore, in addition  to the   anatomical  re-
searches and observations made relative to the for-
mation of foetal bones,  and their structure in adult
animals,  various  morbid  affections, the-  chief  of
which 1  have mentioned above, show that  the mi-
nute structure  of the hardest of these organs differs
very slightly from  the structure  and  properties of
cellular  texture, if  we except  that  the  common
                        Q 
122
anatomical investigations.
 cellular substance is very soft  and  juicy,  and
 the cellular texture of bones in consequence of the
 earth it receives, begins  early to harden and has its
 strength and  density increased by the daily addi-
 tion of earthy matter.   It  is nevertheless  equally
 certain,  where  the cellular texture of  the  bone is
 first deprived  of  its earthy particles,  it becomes
 flexible and ductile, like many other parts o& ani-
 mals which are called soft  and distensible, having
 as great an aptitude to swell or enlarge as the com-
 mon cellular substance.   As sometimes it happens
 in  ulcers which are treated by an  unskilful sur-
 geon, by oily  and relaxing remedies  longer than is
 proper, the cellulous  subcutaneous texture swells
 and rises  above the skin  like a  fungus  tumour,
 so it naturally occurs when the cellular texture of
 bone  is  deprived of its earthy matter,  the same
 vital action forms and  germinates  the caruncle,
 which  sometimes only unites the points of a broken
 bone, and at others,  wonderfully replaces the ma-
 terial that  has been  lost.  The celebrated Haller
 formerly taught,  that the cellular texture was the
 great foundation of the  animal  structure,  because
 all  the membranes without exception, the .vessels
 which  are  hollow membranes,  the  greatest part of
the  viscera, tendons, aponeuroses, ligaments  and
integuments of the whole body,  are  made  of this
 cellular texture.  This is not only true,  but an ad- 
          anatomical investigations.      123
dition of the bones may be made to this catalogue,
on the authority of the most careful observations.
  I have taken care to examine the minute anatomy
of the bones in other  animals, as in amphibia, rep-
tiles, and fishes.   In  the great whale called balsena
mysticetes,  the  cellulo-reticular structure is most
fully evident, both in the bones of  the head and
shoulder blades, and  in the cortex of the lower jaw,
and the longest of the  ribs.   There is  no great
acuteness  of  sight requisite to detect the same
structure in the bones of the  delphinus phocaena,
because the  reticular structure in this animal  is
more visible, since there is but  a small quantity of
earthy matter concealed in it.  The same  structure
is very  manifest in the bones of the sea turtle, and
in reptiles of every kind.  In cartilaginous  fishes,
as the shark, frog-fish, sting-ray, and others of the
same  kind, whose bones contain  even less earth
than those of the  dolphin, the  reticular texture of
the cortex is also far more conspicuous.   In the
scaly fishes, as in the pike,  although the bones are
very hard and contain much  earth, yet the cellulous
texture is very perceptible, and  the branching tracts
concur at acute angles, wonderfully and beautifully
reticulated.
   The  salutary changes which  we have mentioned
heretofore as occurring in the bones, being effected
and continued by the vital power and action of the 
124      ANATOMICAL INVESTIGATIONS.
vessels,  it  follows,   evidently,   that  the bones,
besides the  great quantity of lymphatic  vessels,
are  also  possessed  of a  vast number  of blood-
vessels, and are really more  vascular than  any
one  not accustomed to minute anatomy can  have
any  idea  of.   The celebrated Albinu*,  indeed,
taught a long time since, that a vast number of ves-
sels  passed from the periosteum  into  the cortex,
through the numerous spiracles  of Havers,  and
these vessels,  with  others of. the same character
running through the meditullium, properly called
nutritious arteries, anastomosed,   and  passing by
particular openings through  certain parts of the
bony crust,  enter the medullary cavity, bestowing
the  most minute ramifications on  the  marrow and
its  membranes.   But Albinus,   when  he  wrote
this, thought that the blood-vessels  immediately
after entering the pores of the cortex, went in right
lines between the strata of plates and tables.   This
1 certainly  know to be far from  the  truth, and fo-
reign to the structure of the bones and  the real dis-
tribution  of the blood-vessels.  When I had  filled
the  vessels  of the bone in a  young  and  immature
foetus with  most minute injection, 1 found the ves-
 sels of the  periosteum immediately on  entering the
 pores of  Havers, not going off in right lines, but
 giving and receiving frequent  branches,  encircling
 the  reticulated structure of the cortex, and joining 
           ANATOMICAL INVESTIGATIONS.      125
each other at the shortest intervals,  following the
course of the osseous net-work.   Where the cortex
of the bone internally began to loosen to the spongy
substance of the meditullium, the  blood-vessels  of
the cortex also inclined to the centre, and their
trunks joined at certain places, with those  going
to the marrow, as before stated.   This  seems to  be
a wise provision of nature, that at the same time
the external crust of the bone  is supplied with a
large quantity of blood, a full  and manifold com-
munication should exist by these almost innumera-
ble anastomoses, between the external and internal
structure.  I  pointed  out the mode of distribution
of the blood-vessels  in bones,  as  shown  by injec-
tions,  in  the incubated egg of  the sixteenth day,
when  the  red zones which  surround both the ex-
tremities of the tibia, being broadly expanded, meet
in the centre  of the bone.  Under these circum-
stances, even should the external periosteum be  re-
moved, the cortex of these delicate bones is suffused
with so great a redness by the abundance of vessels,
that  it seems to be covered with a sort of sangui-
neous dew.
   Since the bones enjoy vitality, are nourished and
 grow like  other parts,  it is in perfect agreement
 with  analogy to  believe, that besides  the great
 number  of blood-vessels, they are supplied with
 nerves,  although  these can scarcely  be  demon- 
126
ANATOMICAL INVESTIGATIONS.
strated,  not only on account of ther tenuity, but
perhaps—because, as  in  many other  parts, the
very small  nerves  enter the foramina of .bones  in
coalescence with the  arteries.  But if pathological
observations may be allowed  any weight, I  may
state, that I have more  than once produced a  sense
of pain by scraping and abrading living bone.   I
have also observed that the caruncle which shoots
from the substance of bones is endowed with sensi-
bility, and have  lately had a most excellent opportu-
nity of confirming this statement.  On a part of the
tibia of a man, five inches long and one broad, that
had been removed by the natural process—I wet the
caruncle with camphorated spirits of wine, of which
the patient, who was by no means timid, complained
much—shortly after,  1 wet the point of a soft pen-
cil with  spirits of sal ammoniac,  and when it was
applied to the caruncle, the patient cried out.  Now
that the caruncle,  which is  nothing but the  bone
itself deprived of earthy matter, is entirely insensi-
ble and destitute of nerves, it is altogether absurd
to assert.
  The  following  questions may be asked relative
to the minute anatomy of the bones.  Is the diploe
present in  the cranial  bones of  the foetus  or  not ?
Are the  pituitary sinuses altogether wanting in the
bones of the foetus at  full time ? that is,  are the
frontal,  (ethmoidal, maxillary,  and  sphenoidal  si- 
          ANATOMICAL INVESTIGATIONS.       127
nuses  present? relative  to  which anatomists are
yet undecided.
  In relation to the first question, if any one atten-
tentively examines a perpendicular section of the
cranial bones in an immature foetus, with the aid of
a good glass he will find a very singular  and re-
markable circumstance.   The reticulated  cellulous
texture of the foetal cranium on the inside is already
solid, smooth and compact, and has already formed
that table which is called  vitreous—but the external
surface of  the cranium still remains light,  reticular
and flocculent,  as  it were  surrounded by an osseous
down.  After birth,  and  especially in childhood,
this reticular down is in  greater quantity, the can-
celli and areolae are  more and more drawn together,
and solidified  into a thin crust under the  pericra-
nium.   This crust,  moreover, envelopes the whole
reticular substance  of the  cranium, and  whatever
remains after the formation of the two tables is con-
fined between them and receives the name of diploe*
If  the ossification advanced beyond  the  middle,
the portion of  the  reticulo-cellular substance be-
tween the two tables would be added  to either the
external or internal, and then  the  adult cranial
bones  would be entirely  without diploe,  but would
constantly acquire a hardness and thickness beyond
what is common.  Wherefore, so far is it from fact
that the diploe  is  wanting in the  foetus, that  it 
128      ANATOMICAL INVESTIGATIONS.

should rather be stated that all the external surface
immediately under the pericranium  is nothing but
diploe.
  In  relation to the  pituitary sinuses of the nose,
among the dissectors who affirm these cavities to be
entirely wanting in the foetus at nine months,  (for
many anatomists .are of this belief,) some  teach that
these receptacles in  adults are to  be attributed to
the action of absorbent  essels.   For,  say they, the
material is absorbed from the middle of the frontal,
sphenoid and maxillary  bones, and is replaced at
the margin  forming  new and large cavities.  I
freely confess that there is  much  excellent  testi-
mony to prove the great power Which  the absorbent
vessels possess in  removing  both fluids and solids.
Nevertheless, granting all this power to  the absor-
bents, 1 do not understand why they do not equally
remove the whole substance of the  bone,  as  well as
make local excavations at certain points.   But pas-
sing over these disquisitions  and doubts,  we cannot
withhold our admiration  at some of the recent wri-
ters on osteology,  who deliver it as thoroughly in-
vestigated  and certainly established,   that  these
sinuses are wanting in the foetus at birth*—not re-

 v * What would Scarpa think of the positive  assertions made very
recently, and worst of all, republished in Philadelphia, that the
frontal s'muses do not exist  in every  individual—and  that " a geu- 
           ANATOMICAL INVESTIGATIONS.       129
 collecting that the celebrated Albinus has described
 many of these sinuses in the foetus of nine  months,
 and illustrated them  by plates.  In fact I have be-
 fore me, in a foetus of this age, the ozthmoid cells as
 delineated by Albinus, and  also the maxillary and
 spheno-basilar sinuses proportionably as distinct as
 in the adult.   The spheno-basilar sinus,  at  this
 tender age,  is  not only begun, but  it  is  already
 fairly divided  into  two  pa   s  by  an  interseptum.
 The  frontal sinus is the only one  whose rudiments
 are obscure in the foetus of nine months, yet it is not
 entirely wanting—but at  that age  the frontal sinus
 is not sufficiently distinct from the sethmoid cells,
 as is  shown by the  flatness  above the  nose in the
 foetus,  and the formation of a continued series  be-
 tween the frontal sinus  and aethmoid cells in the
 adult.
   The pituitary sinuses of  the nose,  like many
 other  parts which are  delineated  in the  embryon,
 are only evolved with the increment  of the whole
 body.   For the purpose of effecting this, in addition
 to the remarkable powers through  whose action the
nutrition  and increase  of the  animal  organs  are
tleman of the medical profession,  who had finished his  studies at
 Edinburgh,'''' dissected carefully at Paris for  " seventeen months,"
and could not find the frontal sinus, except in a single instance,
and that in the head of a "madwoman!!"   See Combe's Essays
on Phrenology, p. 83 passim.                    J. D. Cr.
                         K 
 130      ANATOMICAL INVESTIGATIONS.

kept up, I think that faculty of the animal economy
by which the primordial, light, reticular, and cellu-
lar texture,  at  certain places and different  periods
of time becomes  more condensed, or relaxed and
spongy,  as  may be necessary,  does much in  the
increment and evolution  of  the  pituitary sinuses.
Indeed,  in  the first  instance,  it  follows  from
mechanical  necessity,  that  the cavity surrounded
by the osseous sponge, which is contracted and
changed into a  hard thin crust, should be increased.
 This is  certainly manifest in the cylindrical bones,
which  are spongy and cotton-like throughout their
whole  extent in the embryon,  and  as soon they
begin to  harden and form their cortex  in the middle/
the tube of the bone becomes apparent.
  In addition to the causes stated above, it is very
probable that another circumstance  takes place in
the  increment  and evolution  of  the pituitary si-
nuses—that is,  as the body increases, the capacity
of these  sinuses gradually enlarges, and the extent
of the  spongy bone surrounding them is increased,
at the  sanK time its thickness  is  diminished, until
this bony sponge forms the walls of the pituitary
sinus.   There  will be less doubt in relation to this,
if skulls of all ages,  from the foetus  at birth to the
adult,  be carefully examined,  in  which it  is very
manifest that the amplitude of these  sinuses are in
the inverse  ratio of the spongy cellulous substance 
           ANATOMICAL INVESTIGATIONS.       131
of the bone, which in the foetus surrounds these ca-
vities.  But to these causes promoting the increment
of the pituitary sinuses that may be properly called
primary,  I think that those secondary cases should
be added, depending from the change of figure and
position which the surrounding bones  of the em-
bryon are subject to.
   The convexity of the superior and middle turbi-
nated bones being increased towards the  septum
narium, favours the expansion of the sethmoid cells,
and the appearance of the molar teeth in the child,
with an increased'convexity of the  alveolar process,
aids  much in  developing  the  maxillary  sinus—in
proof of  which,  the maxillary  cavity is much les-
sened when the molares  fall  out,  and the alveolar
arch  is removed.  When the root of the  nose and
and  outer surface of the frontal bone is raised  in
children, this  causes the sethmoid cells to  be raised
upwards  along with them, so that the superior cells
get a new place and name, and are called frontal
sinuses.  Should any one  suppose  the air during
respiration to be impelled throughout these sinuses,
I should  not be  much disposed to  object.*   I will
  * The air has access to the sinuses during respiration, when they
are not diseased—but it is not  necessarily changed at every breath-
ing, as is evinced  by the occasional retention of a peculiar odour
which is proved by its re-appearance after a  lapse of time, and our
removal from the spot where it was first experienced.   J. D. G. 
132      ANATOMICAL INVESTIGATIONS.
end this essay  by pointing  out the propriety,  in
similar researches, in order to  understand the most
interesting articulations of the body, of employing
a recent  subject in  which the bones are held toge-
ther by their own peculiar ligaments.   Experience
has taught me that  dissectors have often fallen into
error, from want of a recent  subject before them to
examine  and correct their notions.
  In dried bones,  for instance, deprived of their
ligaments,  any one  would say,  judging from  the
appearance of the head of the  bone and the aceta-
bulum,  that  a man  could readily move the thigh
bone in every direction—could  flex,  extend, ad duct,
or draw one thigh to the other.  Nothwithstanding,
I venture to  assert,  that  it is most certain we  have
not the power of extending  the femur, that is, to
carry it behind  the perpendicular line of the whole
body.   If we  stand on  one foot,  and attempt to
move the thigh behind the perpendicular line of the
body, we find that we are altogether unable to ac-
complish it, and  if we appear at all  to succeed,  it is
only in proportion as  we  bend the  trunk  forwards
above the hip joint.   The unequal thickness of the
capsular ligament of the hip  joint, and the peculiar
disposition and  insertion of this ligament into the
neck of the femur, prevents the extension.*
   ■: By reference to  the description  given in  the previous part of
of this volume of the manner in which the capsular ligament of the 
            ANATOMICAL INVESTIGATIONS.     133
  The capsular  ligament below the psoas  magnus
and  iliacus internus  is  very thin,  aud  is  thinnest
behind,  where it  is  covered  by the quadratus  fe-
moris.   But on  the  outer part where the capsular
ligament is thickest and densest, it does not go  di-
rectly downwards, but  passes obliquely from  the
outer part of the brim of the acetabulum, aud  is in-
serted in the interior  surface of the root  of the neck
of the  thigh  bone.f   On account of  this insertion,
as we  attempt to  carry the femur backwards,  the
anterior, which is firmer and denser than  the pos-
terior part, is strained  to  the utmost and  forcibly
extended,  preventing entirely the tension  beyond
the  perpendicular line.   That  this principally  de-
pends on  the  unequal thickness of the capsular li-
gament, is shown and proved by opening this liga-
mentous capsule on the side of the foramen  ovale,
 and thence introducing a knife so that the round li-
gament may be divided—nevertheless,  although in
the  most recent  subject,  we cannot perceptibly move

hip joiut  is formed from the fascia  lata, the reader will be better
 able  to perceive the correctness of Scarpa's assertions, inasmuch as
 he will find another  reason for  their truth in the connexion which
 all the muscles of the  thigh have with the capsule. He will also
 be well prepared  to understand the cause of the inequalities in the
 thickness of this ligament.                      J. D.  G.
   t  See Weitbrecht, Syndesmologia, Tab. xviii. fig. 53. God-
 man's Anatomical Investigations, Sec. v. 
 134      ANATOMICAL INVESTIGATIONS.
 it backwards beyond the perpendicular line.  How
 much these facts will assist in more clearly under-
 standing the circumstances which in health to per-
 tain to the mechanism of standing, walking,  leap-
 ing, or in disease, to the diagnosis and removal  of
 luxations of the thigh, it is unnecessary for me to
 point out to any one at all acquainted with the sub-
ject. 
                             ERRATA.

Page 6,—3d line from top; ufter " than" strike out "to."
    16,—4th line from the bottom, for " ileum" read ilium.
    45,—9th line from the bottom, for " then" read than.
    47,—for " prostrata" read prostatas.
    51,—3d line from bottom, for " prostrate" read prostate.
    55,—6th line from bottom, for " conversity" read convexity.
    73,—2d line of the note, for " display" read displays. 
s
^
w 
 

 
V-SHX V®V Vry
*+.