Ill V mm NATIONAL LIBRARY OF MEDICINE Washington Founded 1836 U. S. Department of Health, Education, and Welfare Public Health Service >■* «ufew vuo^wvwct A DESCRIPTION OF THE ARTERIES OF THE HUMAN BODY. REDUCED TO TABLES. BY ADOLPHUS MURRAY, M. D. R, and O. Professor of Anatomy and Surgery at TRANSLATED FROM THE ORIGINAL #*0ft l'' ■',1'-S#; BY ARCHIBALD SCOTT. fa /' ^l *Cy PHILADELPHIA: PUBLISHED BY JAMES WEBSTEK. 1816. TO Dr. BARCLAY. Dear Sir, Nothing but the desire of complying with your request, and the confidence I had, as a pupil, in your assistance in every difficulty, could have in- duced me to attempt the following Translation. From the high approbation I have heard you so often express of the original in your Public Lec- tures on Anatomy, I am happy to think that, at a time when literary productions are less easily procured from the Continent, I have it in my power, by the Translation I now present to you, to render these Tables of the Arteries more generally known. I am, Dear Sir, With sincere esteem, Your affectionate Pupil and Friend, Edinburgh, Dec. 1800. ARCHd. SCOTT. zr THE TRANSLATOR'S PREFACE. \^thile Professor Murray's Description of the Arteries (Published at Upsal in 1798) is not inferior in minuteness and accuracy to those of Haller, Sabatier, and Meyer, it far exceeds them with respect to conciseness, clearness, and arrangement. It is divided into two Sections: the first, comprehending the branches from the Arch; the second, the branches from the Descending Aorta. In both Sections, the First, Second, and Third, and all the succeeding series of arteries, are, when de- scribed, either distinguished by peculiar marks, or printed in a different character. The reader, there- fore, can easily perceive, by a glance of the eye, to what series an artery belongs; and may, if he choose, peruse the description of any particular series of branches independently of the rest. The fulness and accuracy of the description; the decided superiority of arrangement; the facility with which it may be consulted; and the numerous advantages it presents to students of anatomy— were thought, with other motives, sufficient induce- vi THE TRANSLATOR'S PREFACE. ments to undertake the translation. In performing which task, I have constantly endeavoured to render faithfully the meaning of my author, and to do it as clearly as the idioms of the two languages would admit. I have ventured, however, to change the names of a few muscles for those synonymes by which they are better known in this country: and where a muscle was expressed by a single epithet, as profundus interosseus, I have preferred the Latin to the English name; as the former is not only equally familiar, but, when it is a noun of the second declension, distinguishes also the muscle from the artery by its termination. As Professor Murray, in describing the arteries of the hand, has substituted the terms Radial, Ulnar, Voral, and Dorsal, for the vague and relative terms External, Internal, Anterior, and Posterior, I have extended his mode of expression to the foot; and instead of Internal and External Side, have substituted the terms Tibial and Fibular. For this reason, the word Peroneal, when applied to an artery, has been rejected, as being of Greek origin, and as not entering so properly into compounds with the Latin terms. Where he has used sometimes more, and some- times fewer epithets, in describing the artery, I have regularly, where there was no danger of am- biguity, preferred the lesser number, and have THE TRANSLATOR'S PREFACE. vii ventured to convert them into compounds. Thus, I have called a branch of the Humeral Profunda the Profunda Radial, instead of the Larger Communi- cating Radial branch of the Profunda Humeri. I have only to add, that in all those cases where Ulnar, Radial, Tibial, and Fibular, are the last words of a compound, they denote situation or direction; and when the first, situation or origin. Where any other changes are made, intimation is given in the Notes. My reason for prefixing a Table of Contents in English and Latin, including the names of the prin- cipal arteries, with a reference to the pages where they are described, requires, I hope, no explanation. The utility of this Table will soon be perceived by the young Anatomist. THE AUTHOR'S PREFACE. As the mind of man cannot be more agreeably oy more usefully employed, than in the investigation of those arts and sciences, which no less tend to pre- serve and augment our happiness than to obviate the evils to which we are subject; so, in examining the different parts of the human body, anatomists have particularly attended to the properties and courses of the vessels, considering that this study would afford an easy access to the knowledge of the differ- ent functions of the animal economy, and with more certainty enable them to cure those disorders which arise from any lesion of the parts. Accordingly, those who anciently cultivated anatomy, as well as the re- storers of that science, were principally occupied in describing the vessels, and exploring their distribu- tions, directions, and varieties; which laudable in- dustry has been so well supported by later ob- servers, and the doctrine of the vessels so fully treated of in many elegant works, that the subject seems to be exhausted. B X THE AUTHOR'S PREFACE. But as the honour of discovering the circulation is due to the immortal Harvey, so it is chiefly owing to him that anatomists have studied the arteries with such attention, without confining them- selves so particularly as the ancients, to the descrip- tion of the veins. The circulation being discovered, the inquirers into nature soon invented the art of imitating it, by means of a ceraceous preparation, in the dead subject, and thereby of investigating the vessels with more accuracy. They perceived soon, that the distribution of the arteries, even where their ramifications are most minute, are much more re- gular than the veins; and that the branches of these last, being infinitely diversified, seem scarcely to admit of a certain and uniform description. By such discoveries, an ardent and inflexible perseverance being roused in anatomists, they began to scrutinize every part of the human body separately; and not only corrected many ancient errors which had crept into the science, but observed also, in every part, the principal varieties which sometimes take place in the distribution of its arteries; and thus, as might well be expected, obtained a much more accurate knowledge of the structure than could be acquired by those who examined the whole body in a super- ficial and general manner. I forbear mentioning those authors who have de THE AUTHOR'S PREFACE. ,xi scribed the arteries, since to those who have been initiated into anatomical studies the most of them are known or recommended. The great defect of these illustrious writers is, that almost all of them have capriciously changed the ancient denomina- tions of the ramifications, and imposed new ones of their own. By this means the young inquirer is led into many errors, and the study of anatomy itself has been not a little retarded. To remedy these in- conveniences was the design of the illustrious Haller. He, as it were, having made this branch of anatomy his own, explained their distributions more accurately and elegantly than had hitherto been done: nor was this all; but whenever he saw it necessary to substitute new or more apt denomina- tions, he still took notice of the old ones in their proper place. Few, it is to be regretted, make suf- ficient use of this rich treasure of anatomical know- ledge, and examine properly those excellent draw ings in the work, which are nature itself. Among those, however, who deserve praise for their inquiries into this subject, I cannotforbear men- tioning with approbation Sab a tier and Meyer. These anatomists have indeed changed many of the names imposed by Haller; but their writings are remarkably perspicuous, and they have faithfully xii THE AUTHOR'S PREFACE. given the observations of Haller in their com- pends. The figures which accompany the work of Meyer are reduced to a smaller form; but are ac- curate, fair, and extremely useful in dissection. The great scope of this illustrious author seems to have been to furnish a rule to young dissectors; to which, in examining the human body, they might reduce their inquiries, and, at the same time, that they might be able, by his short compend, to commit their observations more easily to memory. It seemed to me, however, more useful to reduce into scia- graphical tables the divisions of the ramifications which proceed from the Aorta; so that any observa- tions concerning a particular branch might more readily strike the eye, and be remembered with greater facility. Having derived great advantage from tables of this kind which I had formed for my private use, I could not help communicating them to my illus- trious colleagues, by whom they were exhibited as exercises; and they are now presented to the public in a more polished and correct form. I have followed everywhere the draughts of the illustrious Haller; which, as well as those observations I was accus- tomed to write down upon dissecting bodies, 1 have frequently and carefully examined. These have THE AUTHOR'S PREFACE. xiii led me, in some places, to invert the order in which the smaller branches rise from their trunks. I have no- where changed the nomenclature of Haller, since I willingly followed the authority of so great a man. Lest these tables should have too much the appear- ance of a catalogue, I have briefly described the course of every particular branch, if not very ano- malous. I earnestly wish that this essay may be generally useful, and especially to young anatomists, for whom it was principally intended. CONTENTS. THE aorta, AORTA, PAGE 1 SECTION I. BRANCHES from the ARCH of the AORTA. I. Right Coronary, II. Left Coronary, III. Right Subclavian, IV. Common Carotid, Common Carotid, External carotid, Superior tbyroid, Lingual, Labial, Ascending pharyngeal, Occipital, Posterior auricular, Superficial temporal, Internal maxillary, Internal carotid, Posterior of the receptacle, Anterior of the receptacle, Opthalmic, Communicating, Anterior carotid, Posterior carotid, Two nameless branches. Subclavian, Internal mammary, Inferior thyroid, Superior intercostal, Arteria Coronaria Dextra,ib. Sinistra, 5 Subclavian, - 6 Carotis Communis, ib. Carotis Communis, 7 Arteria carotis externa, ib. thyroidea superior, ib. lingualis, 8 labialis, 9 pharyngea ascendens, 13 occipitalis, 14 auricularis posterior, 15 temporalis superficialis, 17 19 24 25 26 ib. 31 32 33 maxillaris interna, CAROTIS INTERNA, receptaculi posterior, receptaculi anterior, opthalmica, communicans, carotis anterior, carotis posterior, Subclavia, Arteria mammaria interna, thyroidea inferior, intercostalis superior, 34 35 37 41 XVI CONTENTS. Vertebral, Deep cervical, Superficial cervical, Axillary, Highest thoracic, Long thoracic, Humeral thoracic, Alar thoracic, Inferior scapular, Posterior circumflex, Anterior circumflex, Humeral, or Brachial, Large profunda, Large nutritious of the"> humerus, 5 Lesser profunda, Large anastomotic, Ulnar, Highest interosseal perfo- rant, Ulnar recurrent, Nutritious of the ulna; Common interosseal, Dorsal of the hand, Ulnar profunda, Vola ulnar of the little fin- ger, First vola-digital, Second vola-digital, Third vola-digital, Large anastomotic, Nameless branches. Arteria vertebralis, cervicalis profunda, cervicalis superficialis, Axillaris, Arteria thoracica suprema, longior, humeraria, alaris, scapularis inferior, circumflexa posterior, anterior, PAGE 42 47 48 ib. 49 ib. 50 51 52 53 54 Humeraria, s. brachialis, 55 Arteria profunda humeri, 56 nutritia magna humeri, 58 profunda minor, - ib. Ramus anastomoticus magnus, 59 Cubitalis, 60 Arteria interossea perforans su- prema, - 61 recurrens cubitalis, ib. nutritia uln?e, 62 interossea communis, ib. dorsalis manus, 65 cubitalis manus profunda, 66 Arteria volaris cubitalis digiti mi- nimi, - 66 digitalis volaris prima, ib. secunda, 67 tertia, ib. Ramus anastomoticus magnus, 68 Radial, Radial recurrent, Superficial volar, Dorso-radial of the thumb, Dorso-ulnar of the thumb, Radialis, - - ib. Arteria recurrens radialis, 69 superficialis vols, 71 dorsalis pollicis radialis, 72 ulnaris, ib. CONTENTS. xvn Dorso-carpal, Dorso-radial, Pollicar, or artery of the") thumb, 5 Superior volar perforants, Inferior volar perforants, PAGE Arteria dorsalis carpea, 73 C interossea indicia ma- £ jor, s. radialis, 74 princeps pollicis, - ib. perforantes superiores, 75 inferiores, ib. SECTION II. BRANCHES from the DESCENDING AORTA, Thoracic aorta, Aorta thoracica, 77 78 Superior and posterior pe- ricardiac, Common bronchial, Right bronchial, Left bronchial, Inferior bronchial, Oesophageal, Inferior intercostals, Arteria pericardiaca posterior su- perior, - ib. bronchialis communis, ib. dextra, ib. sinistra, 79 bronchialis inferior, ib. oesophagese, - ib. intercostales inferiores, 80 Ventral aorta, Phrenic—right and left, Coeliac, Superior coronary, Hepatic, Splenic, Superior mesenteric, Posterior pancreatics, Left inferior duodenals, Superior colic, Ileo-colic, Inferior mesenteric, Left colic, Internal hemorrhoidal, Capsular, or atrabiliary, Renal, or emulgent, Spermatic—right and left, Adipose—right and left, Aorta ventralis, 81 phrenica, dex. et sinistra, 82 COELICA, coronaria superior, hepatica, - • splenica, 84 ib. 86 90 MESENTERICA superior, 91 pancreatics posteriores, 92 duodenales infer, sinist. ib. colica superior, ib. ileo-colica, - - 94 MESENTERICA INFERIOR, 96 colica sinistra, - ib. hxmorrhoidalis internalis, 98 capsulares, s. atrabiliaris, ib- renalis s. emulgens, - 99 C sperm atica—dextra et t\ sinistra, <■ • 100 adiposa—dextra et sinist. 102 xvm CONTENTS. Ureterics, Lumbar—right and left, Common Iliac, Internal Iliac, Ileo-lumbar, Sacro-laterals, Umbilical, Inferior vesicals, Middle hemorrhoidal, Uterine, Obturator, Posterior iliac, or gluteal, Ischiadic, Common pudic, or pudic, External Iliac, Epigastric, Circumflex iliac, Common femoral, Superior external pudic, Middle external pudic, Inferior external pudic, Deep Femoral, External circumflex, Internal circumflex, First perforant, Second perforant, Superficial femoral, Large anastomotic, Superior perforant, Inferior perforant, Popliteal, page ureteric*, - - .^ lumbalis—dextra et sinist. ib. Iliaca communis, Arteria iliaca interna, 105 107 Ileo-lumbalis, sacra; laterales, umbilicalis, vesicales imse, hamorrhoidea media, uterina, obturatoria, iliaca posterior, s. glutea, 115 ischiadica, - 118 Arteria pudenda communis, 119 108 109 ib. 110 111 112 113 Iliaca Externa, 124 Arteria epigastrica, - 125 circumflexa ileum, &c. 127 Femoralis communis, 129 Arteria pudenda exter. superior, 130 externa media, ib. externa inferior, ib Femoralis profunda, - 131 Arteria circumflexa externa, 132 interna, - 135 perforans prima, - 138 secunda, 140 Femoralis superficialis, 142 Ramus anastomoticus magnus, 143 perforans superior, 144 inferior, 145 POPLITEA, 146 Superior externo-articular, Arteria articularis super, externa, 147 Superior interno-articular, super, interna, ib. CONTENTS. Xix PAGE Middle articular, Arteria articularis media, s. azygos, 148 Inferior externo-articular, infer, externa, 149 Inferior interno-articular, infer, interna, ib- Anterior tibial, Tibialis antica, - 151 Tibial recurrent, Arteria tibialis recurrens, 152 Internal malleolar, malleolaris interna, - 153 External malleolar, externa, ib. Transverse tarsal, or tarsal, Arteria tarsea, - - 154 Transverse metatarsal, metatarsea, 156 Dorso-metatarsal, dorsalis externa halucis, 157 Deep anastomotic, Ramus anastomoticus profundus, 157 The Posterior tibial, Tibialis postica, - 158 Posterior interosseal, Arteria interossea posterior, 159 Common fibular, j peronea communis, ib. External plantar, plantaris externa, 164 Internal plantar, interna, 169 A DESCRIPTION OF THE ARTERIES OF THE HUMAN BODY; REDUCED TO TABLES. THE AORTA. The large artery, termed aorta, opens with a wide orifice in the superior and posterior side of the left ventricle of the heart. Its roots seem in- corporated with the substance of the heart itself; as it is not only closely united with its internal surface, but some muscular striae of the ventricle are also mixed with the white line, which is called 2 THE AORTA. Tendo Arteriosus, and which defines the extent of the muscle. Some transverse fibres of the heart are united to the aorta from without, and cover it for a line and an half, though a little more loosely at the extremity. The aorta having left the heart, is immediately expanded; nor does it again recover its first diameter till it reaches the place where it sends off the subclavian artery of the right side. In its ascent, it is first inflected to the right, behind and beyond the pulmonary artery; it then gradually inclines itself to the left, till, having formed a transverse arch, it is seen projecting be- hind the lungs, at the left side of the vertebrae. From these it receives its chief support, and de- scends along with them in the same straight line; till at last, having entered the abdomen, it again begins to turn towards the right, or rests upon the middle of the vertebrae. By the arch of the aorta, is understood that part of it which is bent nearly in the form of a parabola, and which maintains the curved direction already mentioned, though its right pillar at first stretches to the right, and then proceeds to the left, while the left advances almost in a straight line. I exclude the ancient and now absolete distinction of the aorta into the ascending, transverse, and descending. When we consider the whole extent of the arch, we observe that it leaves the ventricle at the THE AORTA. 3 inferior margin of the third rib, and rises in an oblique and winding course to the lower margin of the first rib; and that its diameter must be so re- ferred to the external parts, as that its exterior and right extremity shall correspond to the middle of the cartilages of the ribs; and its left extremity, concealed by the left lobe of the lungs, and pro- ceeding onwards, shall, in like manner, correspond to the vertebral extremity of the ribs. SECTION I. BRANCHES FROM THE ARCH OF THE AORTA. I. The two Coronary Arteries of the Heart, viz. the Right Inferior and Left Superior. These being sent off above the interior and poste- rior semilunar valves, form, in returning to the heart, an acute angle with the rising trunk. II. The Right Subclavian or Innomi- NATA. III. The Left Common Carotid. IV. The Left Subclavian. The three last arise as distinct branches from the superior convexity of the arch. The first of them passes obliquely over the Trachea or Wind- pipe, upwards, and to the right; and after advanc- ing about two inches, divides at its right extremity into the right common carotid, and the right subclavian, which passes under the Clavicle to the arm. The other two branch out from the Aorta near to the former, and are also similar to them. I. The Right Coronary—is larger than the Left. Being covered with fat, it runs between Sect. I. ARCH OF THE AORTA. 5 the auricle and ventricle to the flat surface and apex of the heart, inosculating freely with the left coronary, both by its branches and the extremity of its trunk. These branches are, a. One running on the right to the aorta, and on the left to the pulmonary artery. b. A number going to both sides of the right au- ricle—to the two vense cava—to the sinus be- hind—to the aorta—and to the pulmonary veins. c. Five branches winding on the convex surface of the heart; the longest of which unites with the left coronary branches beyond the septum, near the apex. d. Branches passing over the plain surface and right ventricle, as far as the apex of the heart. II. The Left Coronary—after going out be- tween the pulmonary artery and the left auricle, divides into two branches— a. An anterior Branch, running upon the convex surface of the heart, towards the septum, in a winding direction, to the apex, where it is reflected on the posterior surface of the heart. This gives, 1. Branches, to the trunks of the arteries, uniting with those of the right coronary. 2. Numerous branches to the left ventricle. b. A Circumflex Posterior Branch, which, wind- ing between the left sinus and the ventricle to D 6 BRANCHES FROM THE beet. i. the rounded extremity of the heart, terminates towards the apex, upon the flat surface. It gives * Branches, running upwards, and extensively ramified on the left sinus and the left auricle, and proceeding at last to the inferior vena cava. * * Branches, losing themselves in the muscle of the left side of the heart. -ect. 1. oideus, and the tendon of the digastric. As- cends, in a tortuous manner, forwards, through the depression for the maxillary gland, and, winding above the maxilla, follows the an- terior margin of the masseter;—afterwards branches out, under the zygomatic muscles, in serpentine windings, upon the face and the sides of the mouth and nose. The numerous branches proceeding from this artery are di- vided into two classes: The first, compre- hending those arteries that leave the trunk be- fore it reaches the maxilla, from 1 to 6; the second, the branches distributed on the face itself, from 7 to 12. 1. The Ascending Palatine—covered by the styloid muscles—-lies upon the sides of the pharynx, near the external margin of the in- ternal pterygoid muscle. Twigs being sent from it to these muscles, to the tongue, the tonsils, and the Eustachian tube, it is divided, near the sides of the levator palati, into * A Superficial Palatine Branch—following the course of the circumflex muscle of the palate, and distributing twigs to the pendulous velum and its glands. * * A Deep Palatine Branch—perforating the velum under the levator palati, and copiously supplying with branches the uvula, palate bone, tonsils, and tendinous expansion of the circumflex. 2. Minuter branches to the stylohyoideus, the stylopharyngeus, the hyoglossus, and glands. 3. The Tonsillar Branch—sometimes wanting__ near the insertion of the styloglossus pene- Sect. I. ARCH OF THE AORTA. 11 trates the lateral parts of the pharynx to the tonsils, and exhausts itself in numerous small branches, spreading on their surface, and reaching to the tongue. 4. A cluster of twigs, regularly sent off from the trunk in the furrow or depression already mentioned, and beautifully subdivided on the maxillary glands. Some of them run to the pterygoideus, the tongue, the integuments of the neck, the chin itself, and even to the mas- seter. 5. The Pterygoid Branch—often double—dis- tributed to the internal pterygoid, the mylo- hyoideus, the superior constrictors, the con- strictors of the isthmus of the fauces, and sometimes to the tongue. 6. The Submental Branch—goes out near the bend of the trunk, above the maxilla, between the anterior part of the digastric, the mylo- hyoideus, and the margin of the maxilla, al- most to the symphysis of the chin, where it divides into /3 and y. When it supplies the place of the sublingual, it distributes a great abundance of twigs; and commonly x. A number of branches, variously ramified on the maxillary glands, the skin, the mylohyoi- deus, and the mouth. &. A superficial Branch—ramified on the qua- dratic, or depressor of the inferior lip, and the skin. y. A Deep Branch—covered by the quadratic, distributed to the levator menti, the triangu- laris, or depressor of the angle of the mouth, the orbicularis, and skin, and inosculating with live branches of the inferior labial. 12 BRANCHES FROM THE Sect I. 7. The Masseteric Branch—United with abranch of the temporal artery of the same name upon the surface of this muscle. 8. The Inferior Labial, or Superficial Branch— rises, often double, from the trunk, goes for- wardsj and, having sent branches to the buc- cinator, the depressors of the angle of the mouth and lips, and the orbicular, distributes others, uniting with the inferior labial of the opposite side, with the inferior coronary, and the inferior maxillary; and then passes under the depressor of the angle of the mouth to the inferior lip, dividing into two, and sometimes producing the inferior coronary of the lip. 9. Many branches, spreading outwards above the buccinator, and interwoven with the transverse of the face, the buccal, and the alveolar. 10. The Coronary of the Inferior Lip—goes off near the angle of the mouth, and, covered by the depressor of the angle and the orbicular, proceeds towards the cavity of the mouth, in a winding and transverse direction, under the membrane of the mouth, to its fellow of the opposite side, with which it inosculates. From this are distributed, 1. Branches to the masseter, the parotid gland, Steno's duct, the buccinator, and the orbicular. 2. Brandies descending to the quadratus and skin, and inosculating with the neighbouring arteries. 11. The Coronary of the Superior Lip—like the preceding, but larger and more tortuous, passes under the greater zygomatic and the orbicular muscles, runs along the margin of the superior lip, and gives ARCH OF THE AORTA. 13 1. Branches to the orbicular muscle and levators of the superior lip. 2. The Lateral Nasal Branch—uniting with the naso opthalmic, and forming a beautiful vascu- lar plexus upon the alee of the nose. 3. The two Nasal Branches of the Septum—rising upwards from the middle of the lip, and run- ning as far as the point of the nose. 12. Two or three branches, uniting, under the levator labii superioris proprius, with the in- fraorbital, and other smaller branches perforat- ing this levator muscle, and uniting also with the palpebral arteries. . The ascending pharyngeal artery of Haller—issues near the lingual, or from the bifurcation of the carotid, but more posteriorly from the trunk. The auricular excepted, it is the smallest of the branches. It is united by the tela cellulosa to the long anterior rectus muscle, and rises anteriorly towards the foramen lace- rum, through which it passes to be lost in the dura mater. The branches which go off in its ascent may be divided, in regard to their situation, 1. Into those passing Inwards, viz. a. An Inferior Pharyngeal Branch—stretching down, and supplying the lower part of the mus- cular sac. b. A Middle Pharyngeal Branch—distributing many twigs in the region of the larynx, pharynx, and Eustachian tube, after having united itself with the superior thyroid artery. c A Higher Pharyngeal or Palatine Branch—dis- tributing some twigs to the superior constric- 14 BRANCHES FROM THE Sect. I. tors, the stylopharyngeus, the Eustachian tube, and the pendulous velum; others to the rectus minor, the cuneiform bone, the cartilage oc- cupying the anterior part of the foramen lace- rum—and others to the internal parts of the nostrils, and the pterygoid canal. 2. Those passing Outwards.—Ofwlaich the most remarkable are, a. Branches to the first intercostal ganglion and the par vagum. p. Branches to the sternomastoid and the con- globate glands of the neck. y. A branch passing through the opening with the jugular vein, and extending its minute twigs even to the cavernous sinus. E. The occipital artery—passes transversely before the jugular vein, above the rectus la- teralis, proceeding between the transverse pro- cess of the atlas and the mastoid process, to the back part of the neck, and rises, in many wandering branches, to the occiput. In its course it is covered by the digastric, the trachelomas- toid, the splenius, and complexus; and becomes subcutaneous as it reaches the occiput. Its branches are, a. One to the digastric and stylohyoideus. 6. Branches to the glands of the neck and the ' sternomastoid, inosculating with the ascend- ing thyroid artery. c A Meningeal Branch—which enters the cra- nium along with the jugular vein, and is dis- tributed to the surface of the dura mater of the cerebellum. d. An AuricuIarBranch-distributed to the lesser Sect. I. ARCH OF THE AORTA. 15 lobe and the helix, and sometimes behind on the concha. e. Branches to the splenius and trachelomastoid. Of these, the descending branches go to the lateral and oblique recti muscles. f. A Large Cervical Branch—passing to the ex- terior margin of the complexus, and going- down between this and the trachelomastoid. -f- A Superficial Branch—descending often to the middle of the neck; and, giving twigs to the splenius, complexus, and skin, at last inoscu- lates with the transverse thyroid artery of the neck. _}- _j_ A Deep Branch—distributed to the obliqui recti and complexus, and uniting with the ver- tebral artery under the transverse process of the atlas. g.The artery, having now bent towards the vertex of the head, branches go off in a retrograde course to the splenius and complexus; whilst other branches are so extensively ramified, that a great number of them inosculate with the higher twigs of the temporal artery. Of these, one perforates the occipital ridge, and another the posterior mastoid hole—both of them going to the dura mater. F. The posterior auricular, or styloma- stoid.—This artery rises from the trunk in . the parotid gland, above the digastric muscle, and before the styloid process, and passes trans- versely to the ear. As it ascends in a curved direction behind the ear, it inclines to the posterior part of the squamous bone, inos- culating, first with the temporal, and then 16 BRANCHES FROM THE Sect. I. with the occipital arteries. It divides into, a. Numerous branches, going to the parotid gland, the digastric and sternomastoid muscles. b. A branch, passing through a particular open- ing in the meatus auditorius of infants, is distri- buted to its membrane. c. The Stylomastoid Branch—passing outward to the stylomastoid hole, where it enters, and ex- hibits the following branches: 1. An external one to the cartilaginous part of the meatus. 2. The First Branch of the Tympanic Artery.— This, in passing along with a twig of the arti- cular artery of the maxilla, sends out the coro- nary branch, which surrounds the osseous part of the meatus auditorius, and, descending to the membrane of the tympanum, shoots out into the most beautiful ramifications, 3. Branches to the mastoid cells, the muscle of the stapes, the external semicircular canal, and the nerve. 4. A branch, anastomosing at the superior and posterior part of the tympanum with the menin- geal branch, passing through the aqueduct of Fallopius to the cavity of the ear. d. Minute branches to the sternomastoid muscle, the skin, and vertex of the head. e. Branches behind the ear to the posterior auri- cular, the occipital and splenius muscles, and distributed more deeply to the mammillary process, the pericranium, and the occipital bone. /. A branch, winding on the posterior part of the concha of the ear, and sending twigs to the cartilage, to inosculate with the ramuli of the anterior auricular artery. Sect. I. ARCH OF THE AORTA. 17 g. Higher branches, spreading under and above the aponeurosis of the temporal muscle, and inosculating before with the temporal, and be- hind with the occipital branches. G. The superficial temporal.—This artery, concealed at first in the parotid gland, rises in a straight line above the zygomatic arch, between the maxilla and meatus auditorius, and is at last extensively ramified on the aponeurosis of the temples and the neighbouring parts. In this course are sent off, 1. A number of branches to the parotid gland, equally irregular in size and number. 2. The Articular Artery of the Maxilla—running to the posterior part of the meatus auditorius; sending branches to the articular cartilage, and transmitting two twigs along the portio dura, through the fissure of the articulation, where they reach the muscle of the malleus, and, in- osculating with the stylomastoid, form the other half of the coronary artery of the tym- panum. 3. Two or three masseteric branches, going to the masseter muscle, and afterwards inosculating with the branches of the coronary artery of the inferior lip and the buccalis, or artery of the cheek. 4. The Transverse Artery of the Face—rising under the zygoma from the parotid gland, it proceeds transversely to the face along with the salivary duct. In this course, if double, it gives branches to the pai'Otid gland, the arti- culation of the maxilla, the masseter, the skin, the zygomaticus, and the orbicularis palpe- brarum. It inosculates with the alveolar, pal- 18 BRANCHES FROM THE Sect. 1. pebral, infraorbital, and coronary arteries of the upper lip; and sometimes gives rise to masseteric branches. 5. The Middle or Deep. Temporal Branch— sent off below the zygoma. This Branch passes over the zygomatic arch, and is im- mediately covered by the aponeurosis of the muscle, where it extends to the anterior part of the temporal muscle, to the external angle of the orbit, and inosculates with the palpebral artery. 6. The Anterior Auricular Arteries—rising above the origin of the middle temporal. Some of these perforate the meatus auditorius, and form a retiform plexus with the posterior auricular artery; others go to the helix and antihelix, the anterior auricular muscle, and meatus auditorius. 7. The Orbicular Branch—rising often from the temporo-frontal artery, passing above the zygo- matic arch, sends a small branch, in a tortuous direction, to the external canthus of the eye* which, running under the orbicularis, reaches the internal angle of the orbit. In this course, it inosculates with the palpebral and frontal branches, and, with the frontal, forms the superciliary arch. 8. The Temporo-frontal, or Internal Anterior Branch—distributed extensively towards the forehead, and sometimes reaching as far as the glabella. It sends branches, which rise almost at right angles from the trunk, to the orbicu- lar, corrugator, frontal muscles, and aponeu- rosis. 9. The Temporo-occipital, or External Posterior Sect. I. ARCH OF THE AORTA. 19 Branch—bending towards the ear, backwards and behind it, forming, as it were, a continua- tion of the trunk—is distributed, in numerous ramifications, to the occipital and lateral parts of the head; inosculates with the occipital about the lambdoidal suture, with the temporo- frontal before, and above with the branches stretching from the opposite side. N. B. The Temporal Artery gives many minute branches to the pericranium, and the bone. H. Internal maxillary.—This artery is lar- ger than the temporal: It rises above the la- teral ligament of the maxilla, about the middle of the ramus of the inferior maxillary bone, before the external pterygoid; and, bending in- wards, forwards, and downwards, is concealed under the maxilla. It then rises obliquely up- wards and forwards, to the space lying between the tuber maxillare and the pterygoid process; and as it proceeds in a tortuous manner, it is lost here in three or four branches, or rather in the spheno-maxillary fissure. In this course it gives 1. The Deep Auricular Artery—going to the posterior part of the meatus auditorius, and giving twigs to this and the neighbouring glands. It is sometimes wanting. 2. The Artery of the Tympanum—which, having sent ramuli to the fat of the maxillary articu- lation, passes through the fissure of Glasserus to the anterior muscle of the malleus. 3. The Small Meningeal Artery—running to- wards the basis of the skull, parallel to the 20 BRANCHES FROM THE Sect, i- middle meningeal. It gives in its course branches to the external pterygoid, to the palatine muscles, and to the third branch of the fifth pair of nerves. It then passes through the foramen ovale, to the membranes of the receptacle, between the pterygoid process and the circumflex muscle. 4. The Middle Meningeal Artery—passing in a straight direction to the foramen spinosum, where it enters this hole; and is there so rami- fied upon the surface of the dura mater, that some branches are carried transversely under the temporal bone to the occipital, others to the posterior sinus of the falx, while others bend a little more anteriorly. All of these have frequent anastomosings with one another, as also with the posterior meningeal branches rising from the vertebral and occipital arteries, and with the anterior branches from the opthalmic. Before reaching the foramen spinosum, it sometimes gives branches to the sphenoid bone, and through that bone to the dura mater, and others to the external ptery- goid, and the muscles of the Eustachian tube. Having passed the foramen spinosum, it sends -f- Three or four branches to the junction between the petrous and squamous portions of the tem- poral bone. ^---1_ Two branches passing through the aque- duct of Fallopius; one of them following the course of that canal, the other going to the in- ternal muscle of the malleus, and the cavity of the tympanum. + + + Branches, which sometimes pass through Sect. I. ARCH OF THE AORTA. 21 hole of the large wing of the sphenoid bone, going to the os malae and the lachrymal gland. The meningeal artery sometimes sends off the la- chrymal artery within the cranium. 5. The Inferior Maxillary Artery—going down, in company with the nerve of the same name, to the inframaxillary canal. As it enters the canal along with the nerve, it sends branches to the internal pterygoid and the mylohyoide- us; and is so distributed on the canal of the bone, that some posterior branches go to the dentes molares and the bone itself, while an- terior twigs enter the alveolar process of the incisores: Then passing through the infra- maxillary hole, it inosculates with the labial branches, and is distributed to the adjacent muscles and lip. 6. Pterygoid Branches—.varying in number—-and. distributed, both superficially and more deeply, on the pterygoid and buccinator muscles. 7. The Deep External Temporal Artery—before the trunk is concealed by the zygoma, gives a branch, which, in its ascent, rests upon the tendon of the temporal muscle, and terminates in this muscle and adjoining parts; while an- other, which some call the masseteric, is sent outwards and forwards between the processes of the maxilla, to the external pterygoid and masseter muscles. 8. The Deep Internal Temporal Artery—rising in that part where the trunk proceeds transversely near the antrum Highmorianum, terminating in the temporal muscle, and transmitting a F 22 BRANCHES FROM THE Sect. i. twig through the cheek-bone, to supply the fat and periosteum of the orbit. 9. The Buccal, or Artery of the Cheek—irregular in its origin, arising, sometimes from the ex- ternal deep temporal artery, sometimes from the alveolar, and sometimes from the infraor- bital—penetrates the buccinator; and, winding on its surface, gives branches to the zygomati- cs, the levator, the glands, and the adipose substance. 10. The Alveolar Artery—proceeding in a tor- tuous direction, above the alveolar processes and the superior maxillary bone, towards the cheek and face—where it gives, a. Branches to the buccinator, fat, and internal surface of the cheek bone, and the gums. b. Branches entering, by minute holes, the antrum Highmorianum. c. The Superior Maxillary Artery of the Teeth— passing through the perforation in the tuber maxillare; and as it runs along the canal of the bone, giving branches, with some from the in- fraorbital, to the dentes molares,.canini and in- cisivi. 11. The Infraorbital Artery—rising in the sphe- nomaxillary fissure, near the infraorbital groove; and, passing along this canal, emerges at last upon the face through the infraorbital hole. Before the trunk reaches the canal, branches are distributed to the fat and dura mater of the orbit, to the lachrymal gland, and to the inferior oblique muscle of the eye. From the canal, -f Branches go to the orbicular muscle, the la- chrymal sac,- and the nose. Sect. I. ARCH OF THE AORTA. 23 -J—(- Branches, through the bone, to the antrum Highmorianum, or maxillary sinus, and its membrane. Beyond the canal, and upon the face, a. Branches anastomosing with the nasal, labial, the transverse of the face, and buccal arteries. (3. Branches to the buccinator muscle, the levator anguli oris, and the levator labii superioris. 12. The Superior Palatine, Descending^ or Ptery- gopalatine Artery—rising, often double, from the trunk, that is divided into three branches at the sphenomaxillary fissure. It enters the pterygopalatine canal; and there, if not sooner, divides into two branches; a. A Posterior Branch—turning backwards through the posterior palatine hole, going to the extremity of the palatine bone and the velum palati, and communicating with the ascending palatine branch. b. An Anterior Branch—larger than the last, pas- sing forward under the roof of the mouth, and forming a vascular plexus in the palate. A single twig ascends through the foramen incisivum to the inner side of the nose, or inosculates with the nasal branch as it passes down. 13. The Highest Pharyngeal Branch—rising in he place already mentioned; stretching be- hind the sphenoidal sinuses, to the upper, posterior, and lateral parts of the pharynx— where it gives x. Nutritious branches, entering their several aper- tures in the sphenoid bone and the pterygoid processes. ($. A Branch, going to the pterygoid hole, and in- osculating with a branch, rising either from the internal carotid, the pharyngeal, or the middle meningeal arteries. 24 BRANCHES FROM THE Sect. I. y. A branch to the cartilage of the Eustachian tube. I have sometimes found this pharyngeal branch entirely wanting. 14. The Nasal Artery—the last branch of the trunk, and often double, passing through the spheno-palatine hole, and dividing, at the su- perior and posterior part of the nose, into a. A small branch, going to the posterior ethmoid cells. b. Branches to the sphenoidal sinuses. c. Larger branches to the septum of the nose. d. A large branch, passing through the superior and inferior spongy bones to the bottom of the nose; giving twigs to the antrum and the mem- branes of the nostrils, and inosculating with the anterior palatine branch as it passes through the foramen incisivum. (II.)The Internal Carotid, or Cerebral Artery.—This artery, as it rises to its canal, is connected before, by means of cellular substance, to the par vagum and intercostal nerves; and be- hind, to the rectus anticus muscle. Sometimes it forms above the vertebrae a larger or a smaller pro- jecting curvature. In this course no branches are, in general, given off. At last it enters the foramen caroticum; and, passing along this canal, undergoes many remarkable inflections. On its first entering the foramen, where it forms an obtuse angle, the artery proceeds upwards, inwards, and a little for- wards. As it begins to rise from the canal forwards and upwards, the second curvature appears very obtu*. Having at last reached the posterior part Sect. I. ARCH OF THE AORTA. 25 of the sella turcica, it is so inflected in the caver- nous sinus or receptacle, as to run in a horizontal direction to the anterior clinoid process. It here rises perpendicularly, perforates the internal surface of the dura mater, and proceeds, near the bottom of the brain, backwards to the cerebrum. Through this tortuous course, the five following branches are chiefly remarkable: A. One to the pterygoid canal, inosculating with a branch of the highest pharyngeal from the internal maxillary. B. A branch, spreading out in the canal itself, going to the cavity and promontory of the tympanum, and anastomosing with a branch of the meningeal, passing under the fissure of the aqueduct. C. The posterior artery of the receptacle or cavernous sinus—rising from the trans- verse part of the carotid concealed in the re- ceptacle, and going to that part of the dura mater which covers the posterior clinoid pro- cesses and the cuneiform occipital process; in- osculating with branches of the vetebral artery rising without the cranium, and entering it through the foramen magnum. a. Many branches, distributed extensively on the dura mater. b. Branches to the 4th, 5th, and 6th, pairs of nerves. c. Branches to the pituitary gland, its periosteum, and the cuneiform bone. 26 BRANCHES FROM THE Sect. I. D. The anterior artery of the receptacle— rising above the root of the intercostal nerve. Some anatomists, from supposing the intercostal to have its origin from the first branch of the fifth pair, have mistaken this artery for a nerve. *. Branches to the 3d, 4th, and the three divi- sions of the 5th pair, with which they go out. /8. Many branches to the dura mater of the re- ceptacle, near the sphenoidal fissure, and some to the pituitary gland. E. The opthalmic artery—rising in the angle where the carotid artery leaves the sphenoid bone, near its anterior clinoid processes, and running with the nerve which accompanies, and rests upon it, through the optic hole, to the orbit of the eye. In mentioning its branches, and their subdivisions, I shall observe the order which Nature generally points out in sending them from the trunk. After lying by the ex- ternal side of the optic nerve, it passes obliquely forwards over the nerve; and reaching the in- ternal angle of the eye above its adductor mus- cle, divides into two branches; and these again into the following smaller branches: l.The Lachrymal—risingfrom the opthalmicar- tery, about two lines after it enters the orbit, between the abductor and the levator; and then running above the abductor, proceeds to the lachrymal gland. It sometimes goes off from the middle meningeal artery. a. A recurrent branch to the receptacle and the dura mater, giving twigs to the fifth pair of nerves. Sect. I. ARCH OF THE AORTA. 27 b. Branches to the periosteum of the orbit. c. A branch to the levator palpebrae and the optic nerve. d. A branch to the abductor muscle. e. A branch perforating the zygoma, and inoscu- lating with the internal deep temporal artery. f. Many branches, expended on the lachrymal gland. g. The Inferior External Tarseal Branch—form- ing the tarseal arch at the margin of the lower eye-lid, with the inferior palpebral branch. h. The Superior External Tarseal Branch—form- ing a similar arch with the superior palpebral branch. 2. The Long Ciliary Branch.—A description of the Ciliary arteries will be given below. 3. The Supraorbital or Superior Muscular Branch —rises, while the trunk crosses the nerve, un- der the periosteum of the orbit; then bending to the levator palpebrae, proceeds forwards, and, after passing through the supraorbitary hole, is distributed, upon the forehead, in two separate branches. a. Branches going to the superior oblique, the levator palpebrae, the superior recti muscles, the sclerotic coat, and the periosteum. b. An Inferior Branch—widely distributed on the periosteum of the os frontis, and inosculating with the temporal and frontal branches.^ c. An External Branch—covered by the orbicular muscle, to which it gives twigs, as also to the corrugator. It forms many anastomoses with the neighbouring branches, 4. The Central Artery of the Retina—rising from the inferior side of the opthalmic trunk as it lies upon the optic nerve; or sometimes from 28 BRANCHES FROM THE Sect. L the ciliary arteries. It then sinks into the nerve; runs along its axis; penetrates, often double, the medullary expansion of the retina; and, branching into many new divisions, is exten- sively ramified on its internal surface. Of these, some extending as far as the corpus ciliare, form a circle between it and the vitre- ous humour, giving twigs to the crystalline lens; while a particular branch passes through the centre of the vitreous humour to the pos- terior side of the lens. 5. The Long Internal Ciliary Artery. 6. The Inferior Muscular Artery—rising from the trunk at the interior margin of the optic nerve, very often between the ciliary arteries, and transmitted, either under the eye, or above the adductor muscle, to the inferior palpebra. a. Many branches to the deprimens oculi, adduc- tor, optic nerve, and sclerotic coat. b. Branches to the inferior oblique. c. Branches inosculating with the infraorbital, and winding on the periosteum of the orbit. d. Branches running to the inferior eye-lid, the tunica adnata, and sometimes reaching the lachrymal sac. 7. The Inferior Ciliary Artery.—This is want- ing sometimes. The three ciliary arteries mentioned above, com- monly arise from the opthalmic artery, in such a way, that the external follows the external margin of the nerve; the internal, the inner margin; while the inferior, with similar wind- ings, runs near the inferior muscular, along the lower margin of the nerve. There are some- Sect. I. ARCH OF THE AORTA. 29 times six ciliary arteries, which, whether they arise from the opthalmic or its branches, spread into several ramifications and enter the sclerotic in such a manner as naturally to fall under three classes. 1. Short, or Posterior Ciliary Branches—aris- ing from the superior and inferior muscular branches, and from the ethmoidal. They are often thirty in number; perforating the sclerotic coat, near the optic nerve, while they pass to the choroid coat, behind. 2. Long Ciliary Branches—Two in number, en- tering obliquely the posterior part of the sclero- tic, dividing into two branches as they ap- proach the ciliary circle, and inosculating round the greater circle of the iris. 3. Anterior Ciliary Branches—rising either from the muscular, opthalmic itself, or the palpebral. They accompany the recti muscles; and, be- ing divided at a little distance from the cornea into three or four branches, enter the sclero- tic, and are distributed among the long ciliary branches on the uvea. To all these, forming a singular vascular plexus, the choroid coat, the ciliary circle with its processes, and the iris, owe their origin. 8. The Posterior Ethmoidal Artery—running be- tween the levator and adductor muscles, above the greater oblique; enters the posterior orbi- tary hole; passes through the cribriform plate into the cranium; and, reaching near the dura mater, inosculates with the anterior ethmoidal branches. The rest of the trunk is distributed to the nose. x. A branch to the superior oblique and the ad- ductor. G 30 BRANCHES FROM THE Sect. I. /S. A branch to the posterior cells of the ethmoid and sphenoid bones, where it inosculates with branches of the internal maxillary nasal branch. 9. The Anterior Ethmoidal Artery—rises where the trunk, as it passes over the fourth pair of nerves, reaches the trochlea. It then enters the anterior orbitary hole, and proceeds into the cranium through a peculiar opening near the ethmoid cells, distributing some ramuli, to the nose. a. Branches to the frontal sinuses, to the anterior ethmoidal and nasal sinuses, inosculating freely with the nasal branches. b. Branches, distributed to the dura mater and the falx. 10. The Inferior Palpebral Artery—rising often along with the superior palpebral, at that place where the trunk generally leaves the tendon of the superior oblique. a. A branch to the tarseal ligament, angle of the eye-lids, the caruncula lachrymalis, and the tunica adnata. $. Branches to the anterior ethmoid cells, inoscu- lating with the anterior ethmoidal, and passing with the infraorbital branch to the lachrymal sac. y. Branches running along the margin of the tar- sus, forming with the lachrymal the tarseal artery, or inferior tarseal arch. 11. The Superior Palpebral Artery__ 1. Branches going to the superior part of the orbicular muscle, to the ligament of the palpe- brae, and to the caruncula lachrymalis. 2. A branch, forming with the lachrymal artery, near the tarseal cartilage, the superior tarseal arch. 12. The tool Artery-rising over the superior Sect. I. ARCH OF THE AORTA. 31 part of the lachrymal sac and the ligament of the eye-lids, goes to the nose. a. A branch to the glabella and the frontal mus- cles; from which a twig runs transversely. b. A branch, passing down beyond the tarseal liga- ment to the lachrymal sac, and then to the or- bicular, where it inosculates with the infraor- bital branch. c. A branch, running down on the side of the nose, where it forms a beautiful plexus, by frequent communications with the labial arteries. Having passed through the bone and nasal cartilage, it is lost on the Schneiderian or pituitary membrane. 13. The Frontal Artery—at first subcutaneous- passes over the orbicular muscle, and then sinks in the corrugator. Its branches are, «. A Superciliary Branch—distributed to the eye- brows and muscles; and inosculating with the temporal and lachrymal arteries. £. A Superficial Frontal Branch—-extensively dis- tributed on the glabella, and rising as high as the fontanelle or bregma. y. A Deep Frontal Branch—lying under the mus- cles, and distributed to the pericranium by many ramuli, some running externally, and others. more internally. F. Minute branches, rising separately from the trunk, and distributed to the optic nerve, the infundibulum, the pituitary gland, and the lower part of the plexus choroides. G. The communicating artery.—This, along with the deep branch of the vertebral artery of the cerebrum, forms the circle of Willis. It is tortuous; but when it leaves the tunica arachnoides, proceeds in a straight line back- 32 BRANCHES FROM THE Sect. I. wards and inwards, along the sides of the cor- pora mammillaria, near the infundibulum, where it reaches the artery already mentioned, and there forms an obtuse angled quadrangular space. It varies in size, and sends a. Branches to the corpora mammillaria. b. Branches to the infundibulum. c. Branches to the optic nerve. d. Branches to the crura cerebri, inosculating with the posterior carotid. H. The anterior carotid artery, or arteria callosa.—The internal carotid, at that place where the anterior lobe of the brain is separated from the posterior, divides into two branches of nearly equal size; of which the anterior pro- ceeds immediately inwards, and a little for- wards; then bends above the corpus callosum, between the hemispheres, to the posterior lobes of the brain: In which course it gives «. Branches to the optic and olfactory nerves. &. Many branches, winding outwards to the ad- joining anterior lobes of the brain. y. A Communicating Branch—inosculating with its fellow of the opposite side. This branch is short and transverse, and sends + A branch to the anterior part of the third ven- tricle. + + A branch to the fornix, the anterior com- missure, and the septum lucidum. + + + Branches to the pia mater, lining the neighbouring part of the cerebrum. *. Branches to the inferior side of the anterior lobe, and to its flat and internal surface, where Sect. I. ARCH OF THE AORTA. 33 the falx separates the two hemispheres. They run in circuitous windings, penetrate deeply the substance of the brain, and in many places inosculate with the posterior carotid. t. Many branches to the corpus callosum and ad- jacent cerebrum, sinking into the posterior lobe, forming inosculations with the posterior carotid and vertebral arteries, and extending even to the tentorium. I. The posterior carotid, or the artery of the fossa sylviana—This second division of the trunk enters the fossa Sylvii that separates the anterior and posterior lobes,* and gives to each numerous superficial branches, spreading on the circumvolutions of the cerebrum, and several deep ones, ramified backwards. a. Branches to the optic nerve and choroid plexus. b. Branches to the pia mater, covering the basis of the brain. c. Numerous branches, inosculating with the ra- muli of the former trunk and vertebral artery, and amongst themselves entering into various anastomoses. * Murray assigns only two lobes to each hemisphere 34 BRANCHES FROM THE Sect. I. DISTRIBUTION OF THE SUBCLAVIAN ARTERY AND ITS BRANCHES. The same division is common to the branches of the right and left subclavian arteries; but they so far differ, that the right subclavian is much larger, passes obliquely over the trachea, and sends off the common carotid. Having left this branch at the side of the trachea, it is now more properly the right subclavian; and, still continuing larger than the left, proceeds nearly in a transverse direction. The left subclavian, on the other hand, while it gradually ascends from the inclining part of the arch, passes on to its place of destination with a more rapid and extensive curvature. These two arteries run in such a direction, above the^ superior margin of the first rib, as to be concealed for some time by the clavicle. They then proceed, with the brachial plexus, across that space lying between the first and second scalene muscles; and, being covered by the flattened ex- tremity of the clavicle and the pectoral muscle, bend to the axillae, where they take the name of Axillary Arteries. The branches of the subclavian arteries, and their ramuli, present so many varieties Sect. I. ARCH OF THE AORTA. 35 that no description, either as to their number or their direction, can in every respect correspond with Nature. In general, however, the four first branches arise before the artery sinks under the scalenus, while the rest are sent off beyond the margin of this muscle. These are, A. The internal mammary artery—going off from the lower and anterior part of the trunk, at the highest part of the pleura, where, ascending gradually, and again bending down- wards to the sternum, it reaches the margin of the first rib, under which it passes; and, run- ning between the pleura and middle part of the cartilages of the ribs, descends between the in- ternal intercostal and the sterno costal muscles, as far as the diaphragm. It then passes between the diaphragm and the ribs, and, dividing into many twigs, is lost under the rectus of the ab- domen. From its origin to the third rib, it bends towards the sternum, then gradually in- clines outwards. Its branches are, a. A Recurrent Branch—passing in the direction of the clavicle to the muscles of the neck, and distributing to these muscles small irregular ramuli. b. The Thymic Branch—which is often double, and varies very much in the distribution of its twigs to this gland; which also receives arteries from those of the mediastinum and pericardium. c. A branch accompanying the phrenic nerve— of small size, supplying the neighbouring BRANCHES FROM THE Sect. I. parts with twigs, and afterwards uniting at the diaphragm with the phrenic artery of the aorta. d. The Superior and Posterior PericardiacBranch —rising sometimes from the mammary, and sometimes from the subclavian artery; some- times from the aorta or from the common carotid; and as it winds to the upper and back part of the pericardium, distributes itself upon the trachea, the glands, the coats of the pul- monary artery, the pericardium, and oeso- phagus. e. Many Mediastinal Branches—rising between the third and sixth ribs; some of which go to the thymus gland, and a larger one to the diaphragm. /. Sternal Branches—spreading variously on the back of the sternum, and uniting with branches from the opposite side. g. Smaller branches to the pericardium and glands, lying on the vena cava. h. Many branches to the adjoining surface of the LUNGS. i. Many branches going outwards, entering the intercostal spaces of the six superior ribs; the first of which are bent to the sternomastoid, the sternohyoid, and the sternothyroid. Others form, at each interstice of the ribs, along with the thoracic and intercostal arteries, double inosculating rings; and others, arising from these annuli, go to the intercostal and pectoral muscles, the mamma, the obliquus descendens, and the skin. Sect. I. ARCH OF THE AORTA. 37 k. The Phrenico-pericardiac Branch—descending above the pericardium to the diaphragm, and sometimes stretching near the ensiform car- tilage to the rectus muscle. /. The Musculophrenic—rising in a large branch at the sixth interstice of the ribs, turns out- wards, between the cartilages and the sterno- costal; then proceeds obliquely to the inter- stices of the seventh, eighth, and ninth ribs, where it forms inosculating rings with the in- ferior intercostal arteries; and here sending many twigs to the diaphragm, at last spreads at the tenth rib on the transverse muscle of the abdomen. m. A branch, winding on the surface of the ensi- form cartilage, and inosculating with the branches of the opposite side, or going down as far as the rectus muscle. Sometimes passes through the ensiform process. n.The Epigastric Branch.—A continuation of the trunk: as it leaves the thorax by the side of the ensiform cartilage at the seventh rib, is covered by the abdominal muscles, and divided into «. An Internal Branch—going down to the rectus muscle, often as far as the umbilicus, and in- osculating with twigs of the epigastric. ft. An External Branch—going to the transversalis, and inosculating with the epigastric, intercos- tal, and lumbar arteries; sometimes sent from the musculo-phrenic; and if that be smaller, this supplies it with many brandies. B. The inferior thyroid, or anterior cer- vical artery—rising from the fore part of the trunk, near the mammary and vertebral H • 38 BRANCHES FROM THE Sect. I. arteries; and being covered by the sternomastoid, and bent a little upwards and outwards, imme- diately divides into four principal branches 1. The Transverse Scapular—the lowest branch of the thyroid artery, but sometimes of consi- derable size—is covered at first by the sterno- mastoid, and passes transversely to the scapula, under the trapezius. The superficial cervical sometimes supplies the place of its superior scapular branch. a. Branches going separately to the sternomastoid, the sternohyoid, the omohyoid, and the subcla- vian muscles, the coats of the arteries and veins, and the skin of the neck and breast. b. The Superficial Scapular Branch—giving twigs to the integuments on the top of the shoulder and surface of the trapezius and deltoid. c. Branches to the posterior part of the trapezius. d. Branches to the levator scapulae, and the ser- fatus. Thus is the artery often whoilly expended. At other times, it sinks deep under the trapezius, in many tortuous windings, where it properly takes the name of superior scapular, or dorso- scapular; and is chiefly divided into two smaller trunks, sending previously off a. Branches to the subclavian and adjoining part of the trapezius muscle. /B. Branches to the lesser portion of the serratus major anticus, and adjoining rhomboid, near the superior angle of the scapula. y. A branch, running upon the surface of the su- praspinal to the concave side of the acromion; inosculating, near the coracoid process, with the humeral thoracic of the axilla, and again Sect. I. ARCH OF THE AORTA. 39 communicating, at the superior angle, with the superficial artery of the base. i. Abranch, passing over the outer surface of the spine of the scapula; and, after giving twigs to the bone and the neighbouring muscles, inos- culating with the inferior circumflex scapular in the intraspinal cavity. Under the Trapezius, it divides into a. The Superspinal—the first branch of the divided artery, passing through the semilunar notch, and distributing many twigs to the supraspinatus, is continued onwards, in two branches, under the acromion process and supraspinatus, where it begins to send branches to the scapula itself, the capsular ligament, the infraspinatus, the teres minor, and at last inosculates with the inferior circumflex scapular. b. The Superficial Branch of the base of the Sca- pula—larger—proceeds near the lower part of the levator scapulae to the base, and, going down between the serratus major and the rhom- boid, reaches the inferior-angle of the scapula. In this course, it gives many branches to the rhomboid and serratus; and through them to the trapezius, the serratus posterior, the skin, and subscapular muscle: afterwards forms, near the inferior angle, with the inferior scapular branch, a beautiful circle upon the surface of the serra- tus; from which branches descend to the latis- simus dorsi. Thus does the above remarkable artery, as well as the superspinal, arise often from the superior or dor so-scapular. I have observed, however, that the transverse scapular sometimes sends off the superspinal branch only, and that the other proceeded from the superficial cervical artery. 40 BRANCHES FROM THE Sect. I. 2. The Transverse Cervical—running, by the side of the neck, transversely and upwards, to the cervix, where it is concealed by the trapezius. Its various branches sometimes arise from the superficial cervical artery. a. Branches to the sternomastoid and skin. b. Branches to the trapezius, levator scapula:, and splenius. e. A large branch, ascending between the splenius and trapezius, giving ramuli to both these and the complexus, and at last inosculating freely amongst the muscles with the descending branch of the principal occipitocervical artery. d. A branch, descending to the trapezius, rhom- boid, complexus, and supraspinatus muscles, and inosculating with the superficial cervical and the transverse scapular branches. 3. The Ascending Thyroid Artery—rising be- tween the rectus anterior and scaleni muscles, upon the fore-part of the transverse processes, as high as the second vertebra; varying in size and in the number of its branches. It exhibits -J- Superficial branches. From which a. Branches are sent, transversely and outwards, to the angularis, splenius colli, sternomastoid, and scaleni muscles. b. Branches to the rectus, winding variously on the anterior surface of the vertebrae. c. Branches to the tenth pair of nerves and the ganglion olivare; inosculating with the pha- ryngeal artery. _|_ -f- Deep branches, which are sunk between the vertebral interstices as the artery ascends. Of these are reckoned, a. Brandies to the intertransversarii, scaleni postici, and the origin of the splenii muscles. Sect. I. ARCH OF THE AORTA. 41 b. Branches passing through the openings for the intercostal nerves to the involucra of the spinal marrow, and inosculating with twigs of the vertebral artery. 4. The Thyroid Branch of the Thyroid Artery.— In this the whole trunk is expended. It bends under the carotid to the side of the larynx; and, after repeated windings, reaches the inferior part (of the thyroid gland. It sinks into the gland; and, while it divides into many ramifi- cations, is partly distributed to the whole gland, and partly inosculates with the superior thyroid. It gives, 1. Lesser branches to the outer muscles of the os hyoides and larynx, to the superior cartilages of the trachea, and the inferior thyroid gan- glion. Of these, the branches which go to the larynx form the inferior laryngeal. 2. Pharyngeal branches to the inferior constrictor muscles, the oesophagus, and the posterior mus- cles of the larynx. 3. The Superior Tracheal or Thoracic Branch— often double or triple. One of the branches, descending with the trachea into the cavity of the thorax, and there forming above the tra- chea a beautiful plexus, communicates with the inferior bronchial and the higher intercostal branches. C. The superior intercostal artery—rises more externally than the vertebral, from the upper and posterior surface of the trunk; then ascends with it to the hollow that is formed by the anterior scalenus, the surface of the first rib, and bodies of the vertebrae. It is there suddenly reflected; and, proceeding to the 42 BRANCHES FROM THE Sect. i. roots of the first and second ribs within the thorax, gives, a. Ascending branches, irregular in number and size, to the scaleni, the longus colli, and the nerves. *. Branches to the intercostal muscles of the first and second interstices, which run along the margins of the ribs, forming circular inoscula- tions with the higher thoracic branch and the branches of the internal mammary. c. Numerous Oesophageal Branches—inosculat- ing with the superior tracheal branch of the thyroid artery. d. Branches sent through the openings for the nerves to the hollow of the spine, and there distributed both to the involucra and the me- dulla. e. Branches passing over the third rib, and inos- culating with twigs of the first inferior inter- costal. f. Deep branches, passing through the intercostal spaces to the deep muscles of the back and neck. D. The vertebral artery—larger than the former, rises from the superior side of the subclavian; and, ascending a little backwards, covered by the ganglions of the intercostal and the cellular membrane, reaches the perforations of the transverse processes of the cervical ver- tebrae. Through these it penetrates, and, rising perpendicularly from the sixth, or sometimes from the fifth or fourth opening, reaches the aperture of the atlas, where it bends a little Sect. I. ARCH OF THE AORTA. 43 outwards; and having passed through, undergoes another more extensive flexion hackwards and inwards, by which it is carried transversely in a groove, between the occipital bone and the atlas, to the foramen magnum. Through this open- ing, having at last entered the cranium, it pro- ceeds upwards and forwards, and at the basilar apophysis, under the medulla oblongata, meets, at an acute angle, with the vertebral artery of the opposite side, forming the basilar artery to be distributed to the cerebrum and cerebellum. It gives, in this course, 1. Lateral branches to the muscles between the transverse processes, and others, near to the vertebrae. 2. Larger branches, passing through the inter- vertebral openings for the nerves, to the cover- ings of the medulla, and inosculating with the anterior and posterior spinal branches. 3. A branch going, with various twigs, from the first bend of the artery to the rectus posticus major and minor, the obliquus major and mi- nor, the trachelomastoid, and complexus; and inosculating with branches reaching from the occipital artery. 4. Posterior Meningeal Branches—proceeding from the second and third flexures, and wind- ing forwards upon the dura mater of the cerebellum, as far as the clinoid processes and receptacle, and backwards towards the occiput. Before the formation of the basilar artery, there are sent off in the cranium itself— 44 BRANCHES FROM THE Sect. I. 5. The Inferior Artery of the Cerebellum—.issuing at a right angle from the trunk, near the me- dulla oblongata, between the tenth and acces- sory nerves. It not only distributes many branches to the lower surface of the cerebel- lum, but, being concealed between the medulla oblongata and the crura of the cerebellum, is so bent backwards and upwards, as to terminate in the vermiform process of the cerebellum and fourth ventricle. In this course are given, 1. Branches to the tenth and eleventh nerves. 2. Branches to the anterior and lateral surfaces of the medulla oblongata, 'and corpora olivaria. 3. Branches to the posterior surface of the me- dulla oblongata, and the choroid plexus of the fourth ventricle. 6. Branches sinking into the furrow that sepa- , rates the corporapyramidalia from the tuber annulare. 7. The Posterior Spinal Artery—rising often from the inferior artery of the cerebellum; and, bending from the anterior to the posterior sur- face of the medulla oblongata, descends tortu- ously on the spinal marrow, and inoscurates freely in its descent with its fellow and with other branches, as they pass to the medulla through the openings for the nerves. It ter- minates on the surface of the medulla at the second lumbar vertebra; and through its whole course supplies, with minute twigs, the me- dulla, and its several nerves, as they pass out. 8. The Anterior Spinal Artery—rising, at an acute angle from the trunk, near its fellow, and, descending in a retrograde course, pro- Sect. I. ARCH OF THE AORTA. 45 ceeds in a winding direction upon the anterior surface of the medulla, inosculating by trans- verse branches in the region of theneck and back with the artery of the opposite side, to which it is parallel. The two arteries at last uniting near the termination of the medulla, form a trunk, which is sent to the extremity of the os sacrum; and which, if emptied of its blood, assumes the appearance of a nerve: whence the ancient error as to a JVervus Azygos. It distributes numerous branches to the neigh- bouring parts, and to the nerves as they go out, and enters into frequent anastomoses with the spinal branches, penetrating the inter- stices of the vertebrae. The basilar artery, being formed as above, occupies the depression in the middle of the tuber annulare, and at its anterior part divides into four parallel branches, proceeding from the trunk at right angles. Of these, the posterior go to the cerebellum; and the two anterior, ramified on the cerebrum, unite with the com- municating arteries of the carotid, and form the Great Circle of "Willis. From the trunk a. Many branches proceed, transversely and out- wards, distributed to the surface of the me- dulla oblongata, the corpora olivaria and pyra- midalia, the tuber annulare, the inferior sur- face of the cerebellum, and the neighbouring pairs of nerves. Of these, a branch, accompany- ing the auditory nerve, passes to the labyrinth of the ear. *. The Deep Arteries of the Cerebellum—Right I 46 BRANCHES FROM THE Sect. I. and Left—winding behind the crura of the , cerebrum to the superior part of the cerebel- lum, and there exhibiting, -{- A Short Anterior Branch—distributed to the crura cerebelli, the cerebellum, the vermiform process and the choroid plexus, lying on the thalami. -J- -j- A Middle Branch—winding extensively on the upper side of the cerebellum; inosculating freely with the inferior of the cerebellum; en- tering the different sulci, and supplying the thalami, nates, testes, and pineal gland. _|- _j_ _£. A Deeper Branch—following the same course; spreading, with minute twigs, on the crura cerebri, the thalami, nates, pineal gland, choroid plexus, the processes of the cerebellum at the testes, the valve of Vieussenius, and the fourth ventricle. c. The Deep Artery of the Cerebrum—.larger than the last, and separated from it by the third pair of nerves. Turns upwards along with the former, between the cerebellum and posterior lobe of the cerebrum; and gives, 1. Smaller branches, running to the bottom of the third ventricle, the thalami, optic nerve, the mammillary eminences, the corpora quadrige- mina, and fornix. 2. Communicating Branches—forming the circle of Willis, and frequently of unequal size. They proceed forwards, almost at a right angle, to meet the communicating artery of the carotid, and give minute twigs to the adjacent parts. 3. A branch, going to the sides of the crura of the cerebrum and the lateral ventricle, and distri- buting small branches above the thalami, to the corpora quadrigemina, the pineal gland, the cho- Sect. I. ARCH OF THE AORTA. 47 roid plexus covering these parts, to the fornix, the corpora striata, and the third ventricle. 4. A branch, the greatest part of which is sent, im- mediately with its very numerous twigs, into the sulci of the posterior lobe; from which, again, smaller ramifications arise, to be distri- buted, as in Number 3d, to the corpus callosum and septum lucidum, 5. Branches, representing the continuation of the trunk, and inosculating with ramuli of the ca- rotid. E. The deep, or posterior cervical artery— Irregular in its origin, size, and extent, and, like the superficial cervical, or transverse sca- pular of the thyroid, spreads, sometimes more, and sometimes less extensively, with its branches. I have sometimes observed it the smallest of all, and proceeding from the superior intercostal. It generally issues from the subclavian, beyond the margin of the scalenus, though sometimes sooner under this muscle. It then winds upwards and backwards, between the deep muscles of the neck and the sixth vertebra; and is at last so dis- persed among the muscles, as to bestow its ultimate branches on the complexus, near the occiput. It usually gives, a. Branches winding on the surface of the bodies of the vertebrae. b. Branches distributed to the scaleni muscles. c. Branches to the spinal muscles of the neck, the trachelomastoid, splenius, and intertrans- versarii. d. Branches to the complexus, often interwoven with the occipital branches. 48 BRANCHES FROM THE Sect. I. D. The superficial cervical—rises about half an inch, or an inch, from the first scalenus, at the upper and anterior side of the subclavian where it begins to bend downwards; imme- diately hides itself among the brachial nerves; and, spreading out afterwards, towards the superior costa of the scapula, divides into many irregular branches. Of these, the most remark- able are, -f- Branches distributed amongst the scaleni and brachial nerves. -J- + A Transverse Branch—bending upwards under the levator, and sending superficial branches to this muscle, the trapezius, and skin, and deeper ones to the splenius and com- plexus. If larger than usual, it runs in the di- rection already mentioned, and sends out either the superspinal or the superficial of the base of the scapula. It generally forms many anasto- moses with the branches of the thyroid and the deep cervical. DISTRIBUTION OF THE AXILLARY ARTERY. The Subclavian Artery, as it bends from its first situation, between the breast and scapula, to the humerus, assumes the name of Axillary. Passing out, under the arch of the clavicle, it is sur- rounded by the nerves of the brachial plexus, the veins, glands, and a quantity of fat; lies in the Sect. I. ARCH OF THE AORTA. 49 hollow of the axilla, between the subscapular and serratus major; and, protected externally by the pectoral muscles, it soon approaches forwards to the arm and the interior margin of the biceps. At last, proceeding from the axilla to the inferior border of the tendon of the latissimus dorsi, it takes the name of Humeral Artery. It sends off, A. Small branches to the scalenus, first rib, coracoid process, the adjacent muscles, and nerves. B. The highest thoracic branch—arising above the second rib, or at the inferior margin of the first, and distributed in the upper region of the thorax, between the serratus and small pectoral—divides into, + A Transverse Ascending Branch—covered by the serratus, to which it sends a recurrent twig, and inosculates twice or thrice at the first interstice of the ribs with the internal mammary and superior intercostal. -f- -f- A branch, going down beyond the second and third interstices, and at last receiving some twigs of the long thoracic. From this proceed, a. A large branch to the serratus magnus. b. Two branches, uniting at the second intercostal space with the internal mammary and intercostal. c. Two branches to the third interstice, where this ramus generally terminates. d. Branches to the pectoral muscles and skin. C. The long, or superior thoracic, or ex- ternal mammary—running down as far as 50 BRANCHES FROM THE Sect. I. the fifth costal interstice. It sometimes arises from the circumflex, or from the inferior scapu- lar. ». Branches to the glands of the axilla and mam- ma, running sometimes to the nipple. /3. Many branches, irregular in series and situa- tion, to the serratus major and minor; and, passing the second and fourth interstices, to the great pectoral and mamma, anastomosing with the highest thoracic. y. Branches sinking deeper, forming double cir- cles with the internal mammary and the in- ferior intercostal, as low as the interstice of the fifth rib, and sending branches to the inter- costal muscles. D. The humeral thoracic—rising from the anterior part of the trunk, between the second rib and the coracoid process^ to the upper margin of the lesser pectoral; penetrates the in- terstice of the deltoid and pectoral muscles; and in its course sends, a. A deep branch to the serratus major. b. Branches to the deltoid, to the great pectoral and subclavian muscles, and rising, above the clavicle, to the neck. c. A branch, running along the subclavian muscle to the pectoral; and, in the space between this and the deltoid, distributing its branches to the pectoral muscle, the clavicle, and skin, and at last inosculating with the transverse scapular. d. Another branch to the pectoral and deltoid. e. A branch, near the coracoid process, descend- ing to the axillary glands. Sect. I. ARCH OF THE AORTA. 51 /. A Circumflex Branch—winding backwards, under the muscle, round the origin of the deltoid. From which proceed, -f A Cutaneous Descending Branch—attending the cephalic vein, and terminating at the top of the humerus and the pectoral muscle. _j_ _J_ A Superficial Branch—passing along the outer edge of the deltoid, and the adjoining margin of the acromion. _j_ _j___|_ A Deep Branch to the articular capsule, the coracoid process, and the deltoid. _|_ _|___(_ _J. Abranch to the spine of the scapula, uniting with the superspinal thyroid and the posterior axillary circumflex. E. The alar thoracic.—This artery is some- times wanting, though at other times it is large, and sends numerous branches to the axillary glands, and some also, spreading extensively in various directions, to the subscapular, pectoral, and serratus. N. B. The number and distribution of the tho- racic arteries are so irregular, that anatomists have sometimes enumerated six separate trunks distributed to the thorax. F. Two or more large branches, rising near the upper and inferior margin of the scapula, send- ing twigs to the nerves, serratus, levator scapulae, latissimus dorsi, and particularly the subscapular; inosculating, partly with the super- ficial thyroid scapular of the base, and partly disappearing among the muscles. G. The inferior scapular, or infrascapu- lar, or subscapular—rising at the inferior 52 BRANCHES FROM THE Sect. 1. mafrgin of the subscapular muscle, divides into conspicuous branches, which run in various directions. Arises, also, sometimes among the thoracic branches, when, bending downwards, it sends et. A branch to the surface of the subscapular, the capsular ligament, and the muscles at- tached to the coracoid process. /S. A Deep Branch—winding, with its twigs, through the subscapular to the naked scapula, after giving twigs to the teres major and latis- simus dorsi. y. A Muscular Branch—large, and sometimes rising separately. Sending branches to the sub- scapular, extending as far as the base of the scapula; and distributing extensively large branches to the teres major, the serratus, the latissimus dorsi, and axillary glands. 3. A Conspicuous Branch—running closely along the margin of the subscapular, and forming, at the inferior angle of the scapula, which it tra- verses, a large circle with the superficial thy- roid scapular of the base. It rises sometimes from the muscular branch. ». A branch, parallel to the inferior costa, and ex- tending to the teretes, the long extensor, and the glands. JV. B. All these branches present frequent varia- tions, and often distribute more ramuli, which, for the sake of conciseness, I omit. {. The Scapular Circumflex—The branches al- ready enumerated having supplied the inner Sect. I. ARCH OF THE AORTA. 53 part of the scapula, this large trunk bends be- tween the inferior costa of the scapula and teres major, to the intraspinal cavity, near the cervix, and proceeds, under the teres minor and infraspinatus, to the spine; giving -J. Branches to the teretes and long extensor or scapular head of the triceps. _i___i_ A number of Descending Branches—wind- ing in the hollow, as far as the base of the scapula, and inosculating with neighbouring twigs. _f_ _|___J. An Ascending Articular Branch—be- tween the neck and spine of the scapula; which sends a. Branches to the infraspinatus. b. An Anastomotic Branch—uniting with the superspinal thyroid. c'. A Coronary Branch to the spine and capsular ligament. d. A Branch to the supraspinatus, where it inos- culates again with the superspinal. e. A branch to the deltoid. H. The posterior circumflex artery—issu- ing between the subscapular and teres major; it sinks between them, winds round the neck of the humerus, under the long extensor, and afterwards bends transversely, under the del- toid, backwards and outwards, from the inner side of the arm. It sometimes gives rise to the anterior circumflex, and the deep branch of the humerus, or humeral profunda; and sends a. A branch to the capsule and the circumflex nerve, which it accompanies. K 54 BRANCHES FROM THE Sect J. b. A branch to the coracobrachial, internal anco- neus, and the teres minor. c. Branches to the humerus and bicipital groove. d. Many branches to the subscapular, the long anconeus, the back of the scapula, and the bone. e. A branch, variously ramified on the capsule, the anconeus, and periosteum; anastomosing freely with branches from the subscapular, and running transversely, in a circular course, to the deltoid. I. The anterior circumflex artery—of smaller size—sent out near the former, above the teres major, proceeds round the humerus, under the biceps and coracobrachial, to the outer part of the arm, where it either disappears under the deltoid, or enters this muscle; and sends a. Many branches to the subscapular, the latis- simus dorsi, and the long extensor. They are often wanting. b. Branches to the bone and periosteum, inoscu- lating with the profunda. c. Branches to the biceps, capsule, coracobrachial, and deltoid. d. A branch, sunk in the bicipital groove; and, at the capsular ligament, inosculadng, by an as- cending twig, with the superior branches of the posterior circumflex, and, by a descending twig, with the deep branch of the humeral profunda, in the bicipital groove. e. A Branch to the deltoid; but which is often wanting. Sect. I. ARCH OF THE AORTA. 55 DISTRIBUTION O.F THE BRACHIAL OR HUMERAL ARTERY. The Axillary Artery is first known by the name of Humeral or Brachial, where it pro- ceeds from the axilla to the internal side of the arm. Having left the cavity of the axilla, and passed to the internal surface of the tendon of the teres major, it continues its course above the internal brachial to the inner side of the biceps, and gradu- ally runs along the middle of the arm to the an- terior surface of its extremity; where at last, con- cealed under the aponeurosis of the biceps, it divides, near the bend of the fore-arm, into the Ulnar and Radial Arteries. A. A branch—going down, near the tendon of the teres major, under the coracobrachial, to the bicipital groove, and giving recurrent twigs to the head of the humerus and capsule. B. Branches to the long and internal anconei, and coracobrachial. C. Many branches—-going out, in.various places, to the biceps, the internal brachial, and bone. D. The deep branch of the humerus, the large collateral, or large humeral pro- funda—sometimes double—rising, from the 56 BRANCHES FROM THE ^ect- l- inner side of the trunk, at the inferior margin of the teres major; but sometimes sooner, from the inferior scapular or posterior circum- fiex. It proceeds backwards, with a gentle curve; and, accompanying the long extensor, runs to the cavity between the anconei mus- cles, where, in the passage of the spiral nerve, it divides into two branches, at the upper junc- tion of the external anconeus and internal brachial. It gives a. A branch to the long and external anconei. b. A branch to the biceps, coracobrachial, the pe- riosteum, the tendon of the teres major, and the deltoid; inosculating with twigs of the an- terior circumflex, and with other branches of the humeral artery. c. A branch, ramifying on the coracobrachial, in- ternal brachial, the bicipital groove, and the bone. d. Many distinct branches, sent off from the trunk in its descent; some of them ascending to inosculate with branches of the humeral and scapular arteries, and others descending to be ramified on the muscles. e. The Large Communicating Radial, or Profun- da-radial.—The external branch of the divided trunk, which, winding between the external anconeus and brachial to the spine of the con- dyle, forms, around the external or extensor condyle, anastomotic arches with the radial re- current, the lesser profunda, and superior in- terosseal perforant. Sect. I. ARCH OF THE AORTA. 57 k. Branches to the neighbouring muscles. fi. Nutritious branches, winding on the periosteum. y. Cutaneous branches, emerging through the in- terstices of the muscles. J. Branches, inosculating, on the posterior and an- terior surface of the condyle, with the radial recurrent and interosseal branches. e. A Deep Branch—covered by the radial extern- sor and long supinator, and forming many in- osculations with the radial recurrent and lesser profunda. f. The Large Communicating Ulnar, or Profunda- ulnar—the interior and deeper branch of the divided trunk, bending between the internal anconeus and brachial, to the internal ovflexor condyle; and sending -j- Branches to the anconei and coracobrachial; inosculating with a branch of the humeral. _|___y A branch, passing out between the hume- rus and anconeus to the deltoid, the internal brachial, and the skin. It is often wanting. _i_ _j___i_ Deep branches to the adjoining muscles, and communicating under them with the dorsal arch. Some of these inosculate, near the elbow, on the internal anconeus, with the large anas- tomotic; others communicate with the brachial arch, winding on the back of the condyles; and others with the ulnar recurrent. ' E. A branch to the coracobrachial and internal brachial. F. A branch—descending on the surface of the internal anconeus, and communicating, near the bend of the elbow, with the ulnar BRANCHES FROM THE Sect. I. recurrent, the great anastomotic, or sometimes with both. G. A branch—which, after having sent off twigs to the adjoining anconei and coracobrachial muscles, proceeds upon the inner surface of the arm, as far as the olecranon, and inosculates with branches of the ulnar recurrent and dorsal arch. N. B. These two branches are usually called the LESSER COLLATERAL. H. Branches ramified on the biceps and cora- cobrachial, irregular both in number and origin, and distributing their twigs both upwards and downwards. I. The large nutritious artery of the hu- merus—arising at the inferior part of the co- racobrachial, bending outwards, and sending off a. A branch to the external anconeus and skin; inosculating with the other branches distribut- ed to that muscle. b. A Deep Branch to the internal brachial, at last terminating in the deltoid. c Branches entering the bone in several places. d. Branches, inosculating, at times, with the large anastomotic or lesser profunda. K. The lesser profunda—rising externally from the trunk; penetrating the internal bra- chial, and winding between the supinator and the radial extensor, to the outer or extensor Sect. I. ARCH OF THE AORTA. 59 condyle. By its ascending twigs, it inosculates with the nutritious, and by its descending, with the radial recurrent. These likewise pass some- times to the articular ligaments. L. The large anastomotic—rising, sometimes double, from the internal side of the trunk, a few inches above the joint; but immediately dividing, it passes, in a transverse course, upon the surface of the internal brachial, to the flexor condyle, where, perforating the intermuscular ligament, it runs upwards to the cavity, between the condyle and olecranon, covered by the tendon of the triceps and the ulnar flexor of the carpus. It sends off a. An Ascending Branch—sinking in the anco- neus, and anastomosing with the large com- municating ulnar. b. A Descending Superficial Branch—to the pro- nator, sublimis, and internal brachial. It inos- culates with superficial twigs of the ulnar re- current; and, after perforating the muscl#, again anastomoses, upon the periosteum and capsule of the fore-arm, with branches of the radial recurrent, where it forms, around the articulation, the anterior arch. c. Many Cutaneous Branches to the brachial muscle andfexor condyle. d. A Deep Descending Branch—anastomosing, anteriorly, with the ulnar recurrent, and pos- teriorly with the same recurrent and interos- seal artery. e. A Transverse Branch—which, with the pro- 60 BRANCHES FROM THE Sect. I. funda-ulnar, the profunda-radial, the lesser profunda, and all the recurrents, forms, above and below the condyle, the posterior dorsal arch of the humerus. This arch distributes many branches to the joint and the neighbouring parts. M. Smaller branches to the internal brachial, and the muscles arising from the flexor con- dyle. The Ulnar Artery.—The humeral artery sometimes undergoes the division already mention- ed at the middle of the humerus, or even higher. This, however, is the largest artery which arises from the trunk at the bend of the arm. Scarcely has it arisen, when it sinks deep into the cavity that is occupied by the tendon of the biceps, the nerve, blood-vessels, and fat. It then bends, near the interstice of the bones, under the pronator teres,. radial flexor, palmaris longus, and sublimis, to the ulnar side of the fore-arm, proceeding gradually, with many deflections, between the sublimis, the profundus, and ulnar flexor, to the wrist. Passing over the wrist, it forms the superficial arch of the hand, which gives beautiful arteries to the fingers, and finally inosculates at the palm with the radial artery. The more remarkable branches which it sends off are, A. A branch to the pronator teres and the com- mon head of the flexors. Sect. I. ARCH OF THE AORTA. 61 B. The highest interosseal perforant—go- ing first to the internal brachial and capsule, where it forms the anterior arch, by a branch inosculating with the anastomotic and the ra- dial and ulnar recurrents. After perforating the interstice of the bones, it sends, under the small anconeus, a number of recurrent branches upwards to the dorsal arch, and downwards to the extensor muscles. The whole artery often rises from the common interosseal. C. The ulnar recurrent—sent off" from the ulnar side of the trunk, a little above the com- mon interosseal; and, having passed through the flexor muscles, is reflected to the posterior part of the internal condyle. In which course are distributed, a. A branch to the capsule, the flexor muscles, and ulna. b. A superficial Branch—covered by the prona- tor, and ascending beyond the termination of the brachial muscle, to the anterior part of the condyle, inosculates upon the internal brachial, with the anastomotic. In this course it distri- butes many branches to the neighbouring parts. c. A Deep Branch—running between the sub- limis and profundus to the cavity between the olecranon and flexor condyle; giving _J_ A branch to the sublimis and profundus. _i_ _j_ Branches to the ulnar flexor, and extensor of the carpus, and to the periosteum. _i_ _i_ _i_ Inosculating Branches—uniting, in many L 62 BRANCHES FROM THE Sect. I. places above the cavity just mentioned, with branches of the communicating ulnar, the anas- tomotic, and the interosseal, contributing to form the dorsal arch. -)—|---(- -f- Many branches to the joint. D. The nutritious artery of the ulna—run- ning on the anterior surface of the bone, near the origin of the profundus. E. The common interosseal—rising at the higher extremity of the profundus—running on the interosseous ligament, between the flexor pollicis and profundus, to the pronator qua- dratus, and there dividing into the two arteries k and /, gives, in this course, a. Branches to the radial flexor of the carpus, pronator rotundus, profundus, and sublimis. b. A Small Perforant Branch—to the supinator brevis and capsule. c. Abranch to the flexor of the thumb and tendon of the biceps. d. A Nutritious Branch of the Ulna—-entering the middle surface of this bone. e. The Highest Posterior Interosseal Perforant__ rising, sometimes wholly, from the ulnar, as at B—sometimes double, when its largest divi- sion communicates, by its recurrent twigs, with the former; but sends off, at the same time, a large descending branch, running with the extensor of the little finger, by which it is covered, as far as the extremity of the fore. arm, where at last it inosculates with the pos- terior dorso-interosseal. It gives Sect. I. ARCH OF THE AORTA. 63 «. Reflex branches to the supinator brevis and the origin of the common extensor. 0. Branches ramified on the radial and ulnar ex- tensors of the carpus. y. Branches to the extensors of the thumb, the common extensor, and abductor. $. Many branches—uniting with the inferior per- forants. f. A large branch to the profundus, winding ex- tensively downwards on this muscle. g. The JVutritious Artery of the Radius. h. Many branches—going, in the descent of the trunk, to the profundus and the flexor of the thumb. i. Small Interosseal Perforants—from four to seven in number; rising separately from the trunk; perforating, in different places, the in- terosseous ligament; and passing into the com- mon extensor, supinator brevis, ulnar extensor of the carpus, the extensors of the thumb, fore finger, little finger, and periosteum, they all enter into various inosculations with one another; and the superior are larger than the inferior. k. The Posterior Dorso-Interosseal—the larger branch of the divided artery; rising at the in- ferior margin of the pronator quadratus; and, having passed over the interosseous space, branching out at the posterior extremity of the ulna and wrist, divides into three branches— and gives a. A branch to the pronator quadratus in its pas- i| sage. /S. Branches to the tendons of the radial extensors and periosteum; inosculating with inferior branches of the radial artery. 64 BRANCHES FROM THE Sect. I. y. A branch, anastomosing with the highest inter. ossealperforan t. J". The Ulnar Branch—the first artery of the divid- ed trunk, bending to the posterior surface of the ulna, along with the tendon of the ulnar ex- tensor; and inosculating with the perforating branches of the radial artery, the middle branch, and the dorsal of the hand. t. The Middle Branch—larger than the rest; sink- ing under the ligament of the carpus to the ten- dons, the ligaments, and skin; forming a plexus with the perforating branches, the dorso-carpal, and its fellows. £. The Radial Branch—accompanying the second tendon of the radial extensor, and inosculating with the preceding twig under the ligaments, as also with the first metacarpal branch of the dorso-carpal, and the radial perforants. These three, in conjunction with the dorso-carpal and dorsal of the hand, form a beautiful plexus around the carpus. I. The Vola-interosseal—the other branch of the trunk covered by the pronator, running to the naked ligaments of the carpus, where, after supplying with many twigs the ulna, radius, and the articulation of the wrist, it forms a vascular plexus with the recurrent branches of the deep volar arch. In this course it forms other minute inosculations with the radial and ulnar. F. Many branches—rising from the descend- ing trunk; irregular in number and situation, and going to the long flexor of the thumb, the radial nerve, the radial and ulnar flexors, the palmaris, sublimis, profundus, and skin. Sect. I. ARCH OF THE AORTA. 65 D. The dorsal of the hand—rising at the lower side of the ulna, near the pronator qua- dratus, at the distance of an inch from the pisiform bone; winding, under the ulnar flexor, to the back of the hand, and proceeding to the ulnar side of the little finger. From this are sent a. A branch to the;pronator quadratus, inos- culating with a twig of the radial. b. A branch to the ulnar extensor, and anasto- mosing, beyond the ulna, with the ulnar branch of the dorso-interosseal. c. Branches to the articulation of the radius with the ulna, to the junction of the pisiform bone with the cuneiform, and of the unciform with the metacarpal bone. d. Branches to the nearest dorsal tendons. e. Branches, inosculating on the back of the hand with the perforants and the third metacarpal; winding externally round the articulation of the hand and ulna. /. The Dorso-ulnar of the Little Finger—ter- minating in the first phalanx, as it unites with the volar branch of the same finger. It is often, however, expended much sooner about the carpus. H. A branch, distributed extensively above these to the flexor tendons. I. Branches to the pisiform bone, the palmaris brevis, and the internal ligament of the car- pus. These rise from the trunk, as it pro- ceeds between the pisiform bone, and the car- pal ligament, to the hand. 66 BRANCHES FROM THE Sect. 1. K. Branches to the abductor of the little finger, its flexor, adductor, and palmaris brevis, com- municating with the dorso-ulnar of the same finger. L.The ulnar profunda, or deep ulnar branch of the hand—rising at the inferior margin of the carpal ligament; concealed between the ab- ductor and flexor of the little finger; and, pro- ceeding to the deep volar arch, gives a. Branches to the skin, palmaris brevis, and ad- jacent muscles. b. Lesser Deep Branches—inosculating with the fifth inferior and the third superior radial or volar perforants. c. A Deep Circumflex Branch—uniting with the radial artery, and forming, under the tendons, the deep volar arch. Even when double, it ex- hibits a continuation of the trunk, and sup- ports a communication between the two arches, M. The vola-ulnar of the little finger— rising near the former, and having distributed branches to the metacarpal, adductor, abductor, and the fourth lumbrical, and others communi- cating with the ulnar profunda and the fifth in- ferior volar perforant, runs to the other ex- tremity of the fifth metacarpal bone, where it inosculates with the dorso-ulnar of the little finger. N. The first vola-digital—rising near the fifth finger, from the trunk as it bends trans- versely above the flexor tendons, where the Sect. I. ARCH OF THE AORTA. 67 superficial arch is formed, divides, at the root of the fingers, into the digito-radial of the little finger, and the digito-ulnar of the ring finger. Each of these runs tortuously along the sides of the fingers, as far as the apex. This digital likewise gives a. Branches to the third and fourth lumbricals and the tendons of the flexors. b. A branch, communicating with an inferior volar perforant at the bifurcation. c. A branch, forming a small arch upon the points of the fingers with the volar artery of the op- posite side. d. Many cutaneous branches to the dorsal and volar or concave and convex surfaces of the joints of the fingers. e. A branch, reflected to the back of the fingers, round the root of the nails. O. The second vola-digital—divided into the digito-radial of the ring finger, and the digito-ulnar of the middle finger. From this proceed, + Two branches to the third and fourth lumbri- cals, inosculating with the inferior perforants of the deep arch. + -f Branches similar to those of N. P. The third vola-digital—divided into the digito-radial of the middle, and the digito-ulnar of the fore finger. The last of which inosculates, on the concave surface, with the digito-radial of the fore finger. It gives + Branches to the first and second lumbricals. BRANCHES FROM THE Sect. I. + -f Branches, inosculating with the deep arch and its perforants. -J- -f -f Branches similar to those of N. Q. Branches to the first lumbricals, the abduc- tor, adductor, and flexor of the thumb, the tendons of the flexors, and the skin. R. A large anastomotic branch—uniting with the radial artery, near the superior margin of the adductor of the thumb. From this in- osculation a trunk is formed, which gives out the vola-radial of the fore finger, and the vola- ulnar of the thumb; or sometimes the vola-ulnar only. S. Many minute branches—issuing from the concave surface of the arch, and ramified upon the tendons; afterwards sinking deeper to the wrist, inosculating with many twigs of the vola- interosseal. Thus do all the digital branches receive, at the commencement of the bifurcation, the volar perforants and the metacarpals from the deep arch and the dorso-carpal; but as they advance, distribute twigs both to the sheaths and tendons of the extensors. The largest of these inos- culates upon the back of the finger, at the second joint, with its fellow of the opposite side. Near the nail they form the small dorsal, and at the apex the small volar arch of the fingers. he Radial Artery—the smallest of the branches- which proceed from the division Sect. I. ARCH OF THE AORTA. 69 of the humeral. It runs down, in a straight line, upon the surface of the pronator, and gradually in- clines towards the radius, between the long supina- tor and radial flexor, resting on the flexor of the thumb. At the lower extremity of the radius, where it is easily felt between the styliform process and the trapezium, on the back of the hand, it bends under the abductor and extensor of the thumb, near the first radial extensor; then penetrating the abduc- tor or semi-interosseous of the fore finger, between the metacarpal bone of the fore finger and thumb, bends, while there concealed, to the palm, between the fibres of the adductor pollicis, and forms, in the hollow of the hand, under the flexors, and above the'interosseous muscles, the deep volar arch, in which it terminates. A. A branch, dividing upwards and downwards, to the supinator longus and the radial exten- sors; sometimes inosculating with the small humeral profunda. B. The radial recurrent—reflected round the tendon of the biceps, to the external condyle; concealed between the long supinator, the short radial extensor, and internal brachial, where it forms, like the ulnar recurrent, important in- osculations, and gives a. Branches to the pronator rotundus, short supi- nator, and radial extensors; which, in their de- scent, inosculate with other recurrent ramuli. M 70 BRANCHES FROM THE Sect. I. b. Branches proceeding, at various places from the trunk, to the radial extensors, long supina- tor, the extensor of the fingers, the ulnar ex- tensor, and skin. Of these, the branches re- flected to the extensors inosculate with the highest posterior interosseal perforant. c. The Superficial Anastomotic Branch—inoscu- lating on the surface of the internal brachial with the small humeral profunda, and the pro- funda-radial of the arm, as they wind near the spine of the condyle, under the superior fleshy part of the supinator and the radial extensor. d. A branch sunk in the internal brachial, and forming, round the joint on the capsule and periosteum, the anterior arch, with the large anastomotic branch of the humeral. e. Branches to the articular ligaments. f. The Deep Anastomotic Branch—running ex- tensively between the long supinator and the bone, or betwixt the radial extensorand triceps, to the posterior surface of the external condyle, where it inosculates with a branch of the small profunda, and the profunda-radial of the arm. g. Branches spreading, near the termination of the trunk, on the skin of the arm. C. Many branches—as the trunk runs superfi- cially on the pronator rotundus, to the radial extensors, the two supinators, the pronator ro- tundus, and radial flexor. Some of these usually inosculate with twigs of the common interosseal. D. Branches—rising from the artery as it leans on the radius, sinking into the sublimis, flexor of the thumb, radial flexor, and palmaris longus, Sect. I. ARCH OF THE AORTA. 71 and in many places inosculating with branches of the ulnar going to the same muscles. E. A branch to the pronator quadratus, inoscu- lating with twigs of the vola-interosseal. F. Branches to the tendons of the supinator, ra- dial, abductor of the thumb, and bone of the radius; uniting with the dorso-interosseal. G. Branches running on the hand to the tendons of the flexors. H. The superficial volar—rising at the in- ferior extremity of the radius, where the trunk begins to bend to the back of the hand, and proceeding, near the os trapezium, beyond the tendon of the radial flexor, runs to the palm, under the skin, and above the short abductor of the thumb. This artery is sometimes large, and presents many varieties; and at other times is so small as not to pass the abductor. If large, it commonly sends 0. Many branches—issuing, at various places, to the surface of the carpal ligament, the tendon of the radial, the abductor, and opponens pol- licis. /3. A branch, inosculating with the dorso-radial of the thumb. y. An Anastomotic Branch—uniting with the ulnar artery, near the termination of the flexor of the thumb, to which it gives twigs. It is sometimes wanting. 3. Branches to the first and second lumbricals, in- osculating with twigs of the ulnar. t. The Vola-ulnar of the Thumb—rising some- 12 BRANCHES FROM THE Sect. I. times from the trunk (as below;) at other times exhibiting beyond the adductor, a con- tinuation of the trunk on the ulnar side of the thumb, where it inosculates, near the apex and articulation, with the vola-radial. I. A branch—ramified on the ligament of the carpus, the bone of the radius, and the flexor tendons. K. Branches to the tendons of the abductor and radials, inosculating with the dorso-radial of the fore finger. L. Branches to the neighbouring bones and their articulations. M. A branch to the abductor brevis, and oppo- nens pollicis. N. The dorso-radi al of the thumb—rises from the trunk as it bends to the back of the hand, near the os trapezium, and accompanies the metacarpal bone of the thumb, running along the external insertion of the opponens. a. Branches to the tendons of the extensors, ab- ductor and opponens of the thumb, forming, in many places above its metacarpal joint, a vas- cular arch with the pollicar, or principal artery of the thumb. b. A branch—uniting at the last phalanx of the thumb with the vola-radial. O. The dorso-ulnar of the thumb—rising near the os trapezoides, under the tendons of the ab- ductor and long extensor. c Branches to the abductor and articulation of the fore finger or index, inosculating with the dorso-radial of the index. Sect, I ARCH OF THE AORTA. 73 b. A branch, terminating in the first phalanx of the thumb, and inosculating with the vola-ulnar and the dorso-radial. P. The dorso-carpal—issues from the trunk, near the tendons of the radial, and proceeds transversely above the carpus, and underijthe tendons of the extensors, to the ulnar side of the wrist, where it forms an extensive plexus with the branches of the dorso-interosseal, and completes the dorso-carpal arch with the dorsal of the handi At the same time sends off a. The First Metacarpal, or Dorso-interosseal*— descending beyond the carpus, upon the sur- face of the first interosseous muscle, between the fore and middle fingers; and inosculates with the third vola-digital at its bifurcation. In which course it gives _r_ Branches communicating, in two places, with the superior perforant. j___j_ Branches distributed to the interosseous muscles, the joint, and extensors of the index. b. Branches to the bones of the carpus and joint, inosculating with the branches of the dorso- interosseal. c. The Second Metacarpal, Dorso-interosseal— running in the interosseous space to the roots of the third and fourth fingers. * From the circumstance of their running in the metacarpal inter- stices, I have ventured to distinguish the branches a, c, d, by the epi- thet Metacarpal, rather than by that of Dorso-interosseal; under which name they are apt to be confounded with the branches of the common interosseal.—Translator. BRANCHES FROM THE Sect. I. -{-Double branches, inosculating with the superior volar perforants. -j- -j- Branches communicating with the first and third, and distributing twigs, similar to the former, at a. d. The Third Metacarpal, or Dorso-interosseal— •t running, like the last, in the fourth interval of the fingers, and forming similar inosculations with the adjoining arteries. Sometimes one or other of the metacarpals is produced from the perforants; Q. The DORSO-RADIAL, Or LARGE, or RADIAL interosseal of the index—rising between the first and second metacarpal bones, while the trunk penetrates the inferior margin of the abductor or semi-interosseus; and, following the course of the interosseous, inosculates on the index with the volar artery of the same finger. a. Branches to the abductor, articulation, and ex- tensor tendons of the index. b. Branches inosculating with the dorsal of the thumb. R. The pollicar, or principal artery of the thumb—rising from the radial trunk, where it sinks among the muscles to the palm of the hand between two metacarpal bones; and, di- viding into two branches, runs to the volar side of the thumb, between its abductor and adduc- tor muscles. It generally gives a. Many branches to the back of the metacarpal bone and adductor of the thumb. (5. A Deep Branch to the radial and ulnar sesa- Sect. I. ARCH OF THE AORTA. 75 moid bones, distributed to the back of the thumb and the neighbouring muscles. c. Branches going down to the hollow of the car- pus. d. Anastomotic branches, interwoven with one or other of the arteries of the thumb. e. The Digito, or Vola-radial of the Ind^x^jam- ning to the radial side of the. fibre finger, and uniting, beyond the adductor of the thumb, with the interosseal of the index, or a superfi- cial branch of the ulnar. f. The Digito, or Vola-radial of the thumb—the outer branch of the trunk, as it divides at the lower extremity of the metacarpus, sends many twigs to the back of the thumb from its radial side, and inosculates upon its apex with g. The Digito, or Vola-ulnar of the Thumb—the internal branch of the same trunk, rising often from the superficial vola-radial, reaching to the thumb, and inosculating with the super- ficial arch. It gives J. Branches to the adductor, flexor brevis, &c. _j_ _}_ Branches to the sesamoid bones and the thumb, as above. S. The superior volar perforants—three in number, proceeding from the concave margin of the deep volar arch as it rests on the interosse- ous muscles; and, penetrating near the superior extremity of the metacarpal bones, at the back of the hand, they produce, as it were, middle metacarpals, interwoven with the branches of the dorso-carpal. T. The inferior vol ar perforants, or VOL AR- 76 BRANCHES FROM THE Sect. I interosseals*—rising, six or seven in number, from the convex margin of the deep arch. They occupy the metacarpal interstices; and, winding round the radial and ulnar sides of each bone, inosculate, at the roots of the fingers, with the metacarpal and vola-digital branches. % U. Two or THREE RECURRENT BRANCHES to the carpus, anastomosing with ramuli of the vola- interosseal, and with some twigs of the radial and ulnar. V. A branch, completing the deep arch, by in- osculating, near the little finger, with the ulnar profunda of the hand. We must here stop in the description of the Ar- teries of the hand, which exhibit almost an end- less variety in their distribution. * The epithet Volar Interosseal should be rejected, for the same reason as Dorso-interosseal when employed to distinguish the metacar- palbranches.—Translator. SECTION II. BRANCHES FROM THE DESCENDING AORTA It appears, from the general description of the Aorta, that, after the formation of the arch, it bends gradually behind the lungs to the left side of the vertebral column; and, lying close upon this column, penetrates, in a straight line, behind the pleura, through the cavity of the thorax, to the muscular crura of the diaphragm, directing its course in the abdomen to the inferior lumbar ver- tebrae. Anatomists have therefore properly divided the DESCENDING AORTA into the thoracic and ventral; whose limits are defined by the diaphragm, which allows, by the separation of its crura, a convenient passage for the descending trunk. N 78 BRANCHES FROM THE DISTRIBUTION OF THE THORACIC AORTA. Through its whole descent, the thoracic aorta inclines to the left; though near the lesser or inferior diaphragm it seems gradually to ap- proach the middle of the vertebrae. The numerous branches which it sends out, though not large, are yet worthy of notice. These are, I. The superior and posterior pericardiac artery—rising from the concave surface of the arch; most commonly, however, from the subclavian or internal mammary—which see. II. The common bronchial artery—rising from the fore part of the thoracic aorta, and immediately dividing into the right and left bronchial arteries. Both of these, as they go down the anterior part of the trachea, are ra- mified on the bronchi, their glands, and ves- sels: The left on the posterior surface of the lungs; and the right on the oesophagus also. Sometimes this artery is wholly wanting, or supplies the functions of the following arteries. III. The right bronchial artery—rising sometimes from the aorta; at other times from the superior, of the inferior intercostals; send- ing its twigs, both before and behind the right Sect. II. DESCENDING AORTA. 79 bronchus, to the air-vessels and adjoining glands; and giving others to the neighbouring lobes of the lungs, the pleura, the posterior part of the pericardium, the pulmonary sinus, and, finally, to the oesophagus. IV. The left or superior bronchial—rising transversely to the left bronchus, or left division of the trachea, and giving branches similar to the former. V. The inferior bronchial—issuing from the aorta at the fifth vertebra, and accompanying the bronchi, in the course of the pulmonary vein, to the internal parts of the lungs; distribut- ing twigs similar to the former bronchial. N. B. Although the bronchial arteries de- serve our attention from their inosculations in the substance of the lungs with the small branches of the pulmonary artery; yet, like other smaller vessels, they exhibit new varieties in almost every subject. VI. Oesophageal arteries—five or six in number—slender—issuing, at different places, from the trunk, under the bronchials, or some- times from the bronchials themselves. They wind on the surface of the oesophagus, run- ning afterwards to the posterior mediastinum and the pericardium. Of these, the largest enters the abdomen with the oesophagus, and generally inosculates with the coronary [ceso- BRANCHES FROM THE Sect. II phageal, or ascending coronary branch of the cxliac and the phrenic arteries. , VII. The inferior, or aortic intercostals— from eight to ten in number—rise from the posterior and lateral sides of the trunk, and, bending to the interstices of the ribs, run along their inferior margins. As the branches of the right side must pass over the bodies of the vertebrae, they are longer than those of the left. The four or six superior ones are smaller, and ascend a little; while the inferior proceed transversely. The. first superior, rising at the fourth vertebra, and running in the third or fourth costal interstice, inosculates with the superior intercostal of the subclavian. The last, rising behind the crura of the diaphragm, passes over the quadratus lumborum; and, following the margin of the last rib, is distributed to the aponeurosis of the transverse muscle of the ab- domen. They all send, A. Three Branches—.running, near the heads of the ribs, to the spinal cavity: the^r-s* entering the bone; the second, the dura mater; and the third, where the costal nerve comes out, enter- ing the spinal marrow. B. Deep Dorso-muscular Branches—sent to the dorsal muscles; and forming a plexus on the back. A*. B. The preceding twigs sometimes unite into one trunk. C. A number of branches to the intercostal mus- cles; and, after penetrating these,distributed to Sect. II. DESCENDING AORTA. 81 the serratus anticus, pectoralis, latissimus, and external oblique. D. The Superior Costal Branch—the smaller di- vision of the trunk—winding from the angle of the rib to its superior margin, and some- times forming, as it runs along, the superior ring or inosculation. E. The Inferior Costal Branch—exhibiting a continuation of the trunk; uniting above with the thoracics and internal mammary; below, on the fore part of the abdomen, with the epigas- tric and lumbar branches. It forms the principal ring vi'ith the mammary; and in its course gives everywhere twigs to the neighbouring parts. distribution of the Ventral aorta. The ventral, or abdominal aorta, is the lowest part of the common trunk. It passes from the thorax, through the inferior muscle of the dia- phragm, to the right side of the oesophagus, in a straight direction, inclining rather to the left; and proceeds gradually through the abdomen, upon the surface of the vertebral column, to the fifth lumbar vertebra, or to the thick ligament connecting the fourth and fifth. The inner or long crura of the diaphragm, variously interwoven behind the oeso- phagus, separate anteriorly on the aorta, allowing a passage, through which it descends resting poste- $2 BRANCHES FROM THE Sect. II. riorly on the vertebral column. This passage is considerably larger than the trunk, loose cellular substance, connecting the pleura and peritoneum, being interposed. The aorta at this place is sepa- rated from the vena cava by the left lobe of the liver, a part of the diaphragm, and a large quantity of cellular substance; but in the space between the kidneys and the liver, these two vessels approach so near, that the right margin of the artery is partly covered by the vein that afterwards sends some of its branches anteriorly across. The Ventral Aorta is divided at the vertebra, mentioned above, into two branches of equal size, forming an acute angle as they run towards the brim of the pelvis. These, anatomists have called Iliaca Communes, or Common Iliacs. The branches of the ventral aorta are best described in the order in which they occur. I. The Phrenic artery—Right and Left—very irregular in origin and division. Sometimes a single trunk, rising above the cceliac, divides into the right and left phrenic: Sometimes, again, and indeed most frequently, the right rises from the ceeliac, and the left from the aorta; while, at other times, they have been observed rising together, both from the cceliac, or both from the aorta. Sometimes the single trunk, or common phrenic, being larger than usual, con- stitutes the fourth branch of the caliac; and Sect. II. DESCENDING AORTA. 83 then forms the superior coronary branch of the stomach. There are sometimes three or four phrenic arteries, which, as soon as they arise, bend obliquely outwards, before the crura of the diaphragm, to the inferior margin of its tendinous alaa; and, while they here wind tor- tuously under its fleshy fibres, distribute various twigs, upwards, outwards, inwards, and down- wards. Bending at last to the external margin of the tendon, and, passing between the muscu- lar layers, they run forwards, and inosculate, upon the costal muscles, with the thoracic ves- sels and the artery of the opposite side. At the end of the artery, however, they send a larger branch to the posterior and inferior portion of the diaphragm as it rises from the ribs. Besides the branches of the diaphragmatic tendon and muscle, the following likewise merit attention: A. Branches going to the two sides of the renal capsules, and adipose substance lying on the kidneys. See a description of these arteries below. B. Branches—uniting, after penetrating the dia- phragm, with the accompanying branch of the phrenic nerve, and the other phrenics rising from the mammary. C. Branches—some passing on the right side to the pancreas, liver, and vena cava; others ac- companying the vena cava to the pericardium, the posterior surface of the liver, and its sus- pensory ligament; inosculating, in many 84 BRANCHES FROM THE Sect. II. places, with the hepatic arteries. Upon the left, they run to the left lobe of the liver, the ligament of the spleen, the oesophagus, and cardia. *V. B. The diaphragm sometimes receives wan- dering branches from the cceliac, inferior in- tercostals, the capsulars, and the lumbars, par- ticularly from the second lumbar. II. The coeliac artery—short, but of large diameter—rising between the crura of the dia- phragm, above the eleventh dorsal vertebra, from the anterior part of the aorta, and at the superior margin of the pancreas, between the papillary lobule, or lobule of Spigelius, and the left side of the lesser arch of the stomach. It then descends, in a tortuous manner, forwards and to the right, and, running about the third of an inch, ultimately separates into three branches, in such a manner, that the two on the right seem to arise from a common base; while the left is more distinct at its origin. These are, A. The Superior Coronary, or Great Left Gas- tric, or Superior or Left Gastro-hepatic— smaller than the other branches, if reflected only to the stomach; but almost equal in size to the splenic, if, as sometimes happens, it sends a branch also to the liver. It appears sometimes to issue from the splenic; ascends to the left, and forwards to the cardia and lesser arch of the stomach; then bending downwards, and to the right, reaches the margin of the stomach, where it distributes Sect. II. DESCENDING AORTA. 85 extensively its circuitous branches, forming a corona, to both sides of the stomach. Of these, the principal are, a. A Superior Branch—running transversely upon the anterior surface to the greater arch of the stomach, and that place where the oesophagus is dilated into a sac. «. An Ascending Branch—passing up with the oesophagus into the thorax, and inos- culating with the inferior (esophageal. |S. Branches to the diaphragm, the lesser omentum, the glands, and left renal cap- sule, dividing sometimes into more, and sometimes into fewer, ramuli. y. A Transverse Branch—traversing the left extremity of the stomach, and running, with descending branches, to its greater arch, where it inosculates with some ; branches of the vasa brevia. b. The Inferior or Bight Coronary—sometimes i double—descending, by the lesser arch of the stomach, towards the pylorus; and in its course giving k. Many Anterior and Posterior Gastric Branches—winding between the coats of the stomach, and at last inosculating with the gastro-epiploics. (S. The Superior Pyloric—the last branch of the trunk—running along the superior mar- gin of the stomach, in such a way, that its twigs are distributed partly to the stomach, and partly to the pylorus. The small artery itself disappears in the right superior pyloric branch of the hepatic artery. c. The Left Hepatic.—This artery, when present, terminates the trunk. Sometimes the gastric, after the former branches are sent off, runs im- o 86 BRANCHES FROM THE Sect. II. mediately upwards, and to the right; and, sink- ing between the lesser arch of the stomach and the left lobe of the liver in the transverse fossa, is variously ramified to the left lobe, the lobule of Spigelius, the umbilical fossa, and the venous duct; at other times these branches arise from the cceliaco hepatic. B. The Hepatic—This artery, which in adults is smaller than the splenic, but in children larger, rises from the right side of the cceliac, or, as sometimes happens, from the superior mesenteric; when, turning upwards near the outer point of the lobule of Spigelius, it is concealed by the pancreas; then proceeding forwards, upwards, and to the right, behind the right extremity of the stomach and the duo- denum, it observes the same obliquity as the lesser arch; and, after running an inch, or an inch and a half, divides, below the neck of the gall bladder, into the right transverse and left ascending hepatics; entering, at last, with the other hepatic vessels, the transverse fissure or fossa of the liver. Inclosed in the capsule of Glisson, it occupies a middle space between the biliary ducts and the vena porta. Before its division, it sends a. Many small pancreatic branches. b. Minute branches to the lesser omentum and vena porta. c. The Duodena-Gastric, or Gastro-duodenal, or Pan- creattco-duodenal—rising at a right angle from the trunk, and, behind the pylorus, proceeds forwards between the commencement of the duodenum and the head of the pancreas, and, without forming a connexion with this gland, Sect. II. DESCENDING AORTA. 87 reaches the last curvature of the duodenum; then incliningto the larger arch of the stomach on the left, and entering the web of the omentum, it inosculates, in the middle of the great arch of the stomach, with the left gastroepiploic. From this are sent, a.. Small Pancreatic Branches. (3. The Inferior Pyloric—passing to the right, and distributing its branches, under the duodenum, to the space between the curvatures of the stomach and the first .flexure of the intestine; some of which in- osculate with the superior pylorics, and others with the right gastro-epiploic. y. Small Duodenal Branches—passing from the" trunk behind the commencement of the duodenum. Sometimes wanting. $. The Right Superior Duodenal— sometimes double or triple, and frequently issuing from the hepatic. Passing the choledic duct, it winds on the posterior surface of the first transverse and descending flexion of the duodenum; when, turning to the right margin of the pancreas, and the lowest posterior part of the second flexion of the duodenum, it inosculates on the left with the inferior mesenteric duodenal. It sometimes winds, in a similar manner, on the posterior surface of the duodenum; and upon its anterior with the pancreatico- duodenal. It gives J_ Branches anastomosing with the pylorics. r i Branches to the biliary ducts, accom- panying them to the liver. e. The Pancreatico-duodenal—traversing the inner curvature of the duodenum in the form of a semicircle, and sending numerous 88 BRANCHES FROM THE Sect. II. branches outwards to the perpendicular and second transverse portions of the duo- denum; and inwards to the head of the pancreas; at last inosculates with the duo- denals of the mesenteric. f. The Transverse Pancreatic—rising, near the inferior margin of the first flexion of the duodenum; and, passing to the left, over two-thirds of the posterior surface of the pancreas, gives everywhere twigs to the substance of the gland and mesocolon. It sometimes rises from the mesenteric, and sometimes from the splenic. vi. The Right Gastro-epiploic, or Right Gastric, or Inferior Coronary—exhibiting a conti- nuation of the trunk as it bends to the greater arch. Passing obliquely down- wards, behind the pylorus, to the posterior side of the stomach, it is connected, by means of the omentum, to the greater arch; and, traversing its margin to the left, at last disappears in the left gastro epiploic. From this proceed, -}- The Great Posterior Epiploic—to the right side of the large or gastro colic omen- tum. -J. -J- Small Epiploics to the same omen- tum and colon, inosculating, on this intes- tine, with the medio-colic. -\---1---y Gastric Branches—running to each side of the stomach, and inosculating with the former gastrics. -f -f + + Numerous branches to the glands. d. The Superior Hepatico-Pyloric—Small Right Gastric—or Lesser Coronary.—According as the hepatic divides, sooner or later, this artery arises from its trunk or its left branch; and, reflected, with a very acute angle to the lesser arch, there Sect. II. DESCENDING AORTA. 89 inosculates, in various places, with the pyloric of the coronary artery; and sends, -f- Branches to the biliary ducts, inosculat- ing with the cystic arteries, and to the smal- ler gastro hepatic omentum. -\—U. Branches to the Pylorus—communi- cating with the inferior pyloric, gastro-epi- ploic, and superior duodenal. e. The Left Hepatic—the lesser branch of the divided trunk, and often wanting when the hepatic rises from the coronary. It first proceeds, with the trunk, parallel to the vena porta; then mounting over the trunk, enters the umbilical fossa; where it sends, «. Branches to the substance of the liver near the venous duct, to the lobule of Spigelius, the left lobule, and lobulus anonymus. |8. Branches passing through the umbilical fossa to the round and suspensory liga- ments, inosculating anteriorly with twigs of the epigastric, and posteriorly with phre- nic or mammary twigs. f. The Right or Biliary Hepatic—covered by the biliary ducts, conceals itself in the right extre- mity of the transverse fossa—sometimes rises from the superior mesenteric—is sometimes dou- ble—giving rise to the -J- Cystic Branch—not unfrequently double —winding, upon the left side of the cystic duct, to the fundus of the gall bladder; at last exhausting itself on the substance of the liver, it sends * Branches to the biliary ducts, uniting with those of the duodenal. * * Branches, winding circuitously between the coats of the gall bladder. ~J- -f- Large Branches—running deep intp the right lobe and the lobulus anonymus. 90 BRANCHES FROM THE Sect. II. C. The Splenic—While this artery runs along the upper surface of the pancreas, and passes transversely to the depression of the spleen, it exhibits large and repeated flexions, upwards and downwards, bending in a circular or spiral form. Approaching the substance of the spleen, it divides into many branches, which are equally tortuous; and of those that sink into the spleen, some smaller ones return through \ its substance to the diaphragm or stomach. Its most remarkable branches are, a. The Great Pancreatic—irregular both in size'and direction. The whole branch is sometimes co- vered by the pancreas; and, passing to the right extremity of this gland, supplies it with twigs; sending others, at times, to the adjoining duo- denum and mesocolon. If the trunk divides, another branch, bending to the left, supplies the place of the transverse pancreatic. It inoscu- lates with the pylorics and duodenals. b. Small Pancreatics—descending from the splenic, in great numbers, through its whole extent. c. Posterior Gastrics—two or four in number__ sometimes wanting—rising from the middle of the trunk as it passes to the spleen, and as- cending with the omentum to the posterior surface of the large extremity of the stomach. d. The Left Gastro-epiploic, or Left Gastric__often double—rising near the commencement or left extremity of the pancreas, where the trunk begins to divide; bends downwards, and to the right, with its two branches to the fundus and larger arch of the stomach; and, like the right gastric, with which it inosculates, follows the large curvature of the stomach. Sect. II. DESCENDING AORTA. g\ «.. Pancreatic Branches. (Z. Large Epiploics—three or four in number; one of which is usually larger than the rest, but all distributed to the omentum and colon. y. Gastric Branches—inosculating with the co- ronaries on the surface of the stomach. e. The Vasa Brevia, or Short Branches—three or four in number—issue from the trunk as it reaches the depression of the spleen; and dis- tribute their ramuli to the fundus of the sto- mach, where they spread, in various directions, on its surface, and inosculate with many of the neighbouring branches. N. B. A branch is sometimes sent from the splenit to the transverse colon, anastomosing with the medio-colic. III. The superior mesenteric—the largest of the abdominal or ventral branches—rising be- tween the crura of the diaphragm, three or four lines below the cccliac, from the anterior part of the aorta, and under the lower edge of the pancreas; proceeds between this gland and the inferior transverse flexion of the duo- denum. Passing over this portion of the in- testine, it bends to the right under the meso- colon; where, received near the vertebrae into the folds of the mesentery, it first inclines to the left, and then to the right; where the whole artery, advancing to the right ileum, assumes the form of the Roman S, with the concave side of its large curvature looking to the right. After giving off smaller branches, the trunk sends from its right side only two branches to 92 BRANCHES FROM THE Sect. If. the large intestines; but from the left it gives a greater number of branches to the small intes- tines. These are, A. Posterior Pancreatics—numerous—penetrat- ing the right and left sides of the pancreas, and inosculating with the pancreatico-duodendl, transverse pancreatic, and the splenico-pan- creatics. Some of these pass through the mesocolon to the colon itself. B. The Left Inferior Duodenal—two or three of them—rising from the left side of the trunk, and stretching to the inferior and left curva- ture of the intestine. While some twigs are reflected, upwards and backwards, in the form of arches, the rest inosculate variously with the superior duodenals, the pancreatico-duo- denal before this gland, and with their fellows. These branches, however, are very irregular. C. The Superior or Medio-colic—rises sometimes above the duodenal branches; but generally be- low them, under the duplicature of the meso- colon, and runs along the transverse mesocolon from the left, forwards, and to the right, to the right colon and adjoining part of the transverse colon. It sometimes rises double; but more frequently, after running a short way upon the mesocolon, divides into two branches, viz. a. The Transverse Colic—passing, in the duplica- ture, along the middle of the mesocolon, to the concave side of the transverse colon, after hav- ing first divided, sooner or later, about three inches from the edge of the intestine, into two diverging branches, viz. Sect. II. DESCENDING AORTA. 93 -J- The Right Anastomotic Branch—bending to the right side of the transverse colon, and forming an arch with the ascending anastomotic branch of the right colic. From the convexity of this arch, as from that of all the other arches formed on the concave side of the large intestines, many parallel branches rise, about two inches in length, which, as they approach the intestine, divide into twigs, entering the concave arch of the tube, and circling round on the opposite sides, till they meet and inos- culate at its convexity. These minute twigs inosculate freely with the small epiploics of the coeliac artery, and are ramified simi- larly, both on the large and small intes- tines, although on the former they be less numerous. _i_ _J_ The Left Anastomotic Branch—ac- companying the left part of the transverse colon with a similar and parallel arch, and at last inosculating, freely and elegantly, with the large anastomotic branch of the left colic, proceeding from the inferior mesenteric. Thus is formed the great me- senteric arch. Intestinal branches, rising from the arch, are similar to the former. b. The Superior Right Colic—sometimes rising, by a separate trunk, from the mesenteric; proceeds transversely and to the right, in the duplicature of the mesocolon, to the hepatic flexure of the colon; and where it approaches the intestine, gives, _f. A Large Ascending Anastomotic Branch —bending to the middle of the colony P 94 BRANCHES FROM THE Sect. II. forming an arch with the right anastomotic branch of the transverse colic. -J. _j_ Two or three branches, descending a short way to the right colon; forming sometimes together smaller arches. _|_ _J_ _f_ The Last Descending Branch- inosculating with the curved ascending branch of the ileo-colic, and forming here another new and larger arch. D. The Ileo-colic.—This artery rises single from the right side of the trunk, about an inch or two below the last, and below the transverse mesocolon. It afterwards proceeds behind the right mesocolon, and descends beyond the psoas muscle to the junctionof the ileum andcoecum. Its principal branches are, a. A Curved Ascending Branch—distributing twigs to the right colon, and uniting with the descending branch of the superior right colic. b. Inferior Right Colics—rising sometimes from the former, and running, with a double branch, to the adjoining intestine. c. A Ccecal Branch—larger than the former, and directing its course, with its trunk the ileo-colic, to the coecum. It gives out, a. The Anterior Ccecal—passing along the an- terior fold between the ileum and coecum, and distributing its branches upon the an- terior part of the coecum. (S. The Posterior Ccecal— running to the poste- rior surface of the ccecum, giving branches to the root of the vermiform process, and inosculating, near the right of the coecum, with the former artery and with the appen- dicular. Sect. II. DESCENDING AORTA. 95 y. The Appendicular—reaching, behind the coecum, to the small mesentery of the ver- miform process; and, as it runs along this, giving straight and short twigs to the pro- cess. <$•. An Iliac Branch—winding to the left, and forming an arch, near the ileum, with the extremity of the mesenteric trunk, from which the ileum receives new branches. Branches, varying in number, from twelve to twenty, rise close to one another from the left convex side of the superior mesenteric, dis- tributing ramuli to the ileum and jejunum. Of these, the superior are short and slender; the middle long and thick; the inferior shortest; and the last branch of all, as observed above, inosculates with the ileo-colic. Running near and parallel to each other, they first proceed 1 transversely; then, rising between the layers of the mesentery, divide into smaller branches, which so diverge, that in whatever direction they go, they are soon after divided into two. These branches, as they meet, form various arches, from whose convex margin new parallel branches arise; which again soon di- viding, inosculate with the adjacent branches, forming smaller and more numerous arches. From the convexity of these arches other branches arise, forming a third series of arches; and where the branches are longest, even a fourth or fifth series; till the last branches, near the intestines, dividing into anterior and posterior, encircle these viscera, and, gradually penetrating their coats, form most beautiful ar- 96 BRANCHES FROM THE Sect. II. borescent ramifications on their cellular mem- brane. These arches, by means of their twigs, not only form various inosculations among themselves, but also with the arborescent ramifications of the two surfaces. The inner intestinal coat is so covered by these branches and the veins, as to give it the appearance of being wholly vascular. The" trunks of these arborescents lie on the roots of the valvule. The arches are polygons; and the first series larger than the rest. The lymphatic glands, and coats of the vessels, are surrounded with numerous and various twigs as variously dis- tributed. M B. The more slender branches of the mesen- teric generally inosculate freely with the sper- matic arteries, near the duodenum and com- mencement of the small intestines, and with the capsular and adipose branches. Singular, likewise, is that inosoulation which the mesenteric forms with the epigastric in the foetus. IV. The inferior mesenteric, or left colic. —This artery rises, between the renal and com- mon iliacs, from the anterior and left side of the aorta; descends behind the peritoneum to the left side of the trunk; and having reached that place where the aorta divides into two remark- able crura forming the iliacs, sends off a large branch; and, after passing the iliac artery, sinks behind the rectum into the pelvis. As it here rises forward and to the right, it enters the Sect. II. DESCENDING AORTA. 97 duplicature of the mesorectum, and accom- panies the intestine as far as its internal sphinc- ter. It sends out, A. One or two branches, near its origin, distri- buted to the lumbar glands and the perito- neum, and inosculating, upon the leftside, with some branches of the spermatics. B. The Left Colic—a thick, but very short artery; often about two lines in length, and issuing from the place just mentioned, runs in the duplicature of the left mesocolon to the left side, and divides into three widely diverging branches, viz. a. The Ascending Branch—rising to the left angle of the transverse mesocolon; and reaching this, divides into, -J- A Large Anastomotic Branch—bending to the right, and forming the large mesente- ric arch with the left anastomosing branch of the transverse colic. When this branch is Large, it contributes more to the formation of the arch than the transverse colic. _i_ _J- A Small Branch—sent transversely, above the kidney, to the splenic flexure of the colon, and left colon; afterwards uniting with the following branch, by means of the arch, which gives out many straight twigs to the intestines. b. The Transverse Branch—running, often double or triple, to the left colon; but first dividing, and sending a branch, which inosculates up- wards with the ascending, and downwards with the descending branch. The Descending Branch—running to the last BRANCHES FROM THE Sect. II. portion of the left colon and its iliac flexure; varies in the size and number of its branches, according as the curvature of the intestine is greater or less. It is often divided into three branches, which form anastomotic arches among themselves, and with the former. JV. B. The Left Colic gives out also branches, forming a plexus with the lumbar branches, and with smaller twigs of the spermatics. C. The Internal Hemorrhoidal.—This name is given to the trunk when it reaches and runs along the posterior part of the rectum. It gives out a. One or two branches to the lower part of the colon. b. Branches encircling the rectum, and uniting anteriorly, without forming an intermediate arch. c. Branches which, with the middle hemorrhoidal, the lowest vesical, or uterine branch of the hypo- gastric, inosculate freely at the inferior part of the intestine, which this artery does not reach. . Capsular, or atrabiliary—Right and Left. These are distinct small arteries; which, though never wanting, as they distribute many branches to the capsular gland, yet, in almost every indivi- dual, they present irregularities in number, size, or direction. They do not, like the vein, issue from one common trunk, but from various branches, coming together near the seat of the gland; and may therefore be divided into three classes. A. The Superior Capsular Branches—from two to four in number—rising from the inferior phrenicsfvom their common trunk, or from the Sect. II. DESCENDING AORTA. 99 transverse branch; spread variously upon both sides of the gland, and supply the fat, which surrounds the kidneys, with various twigs. B. The Middle Capsulars—very often double— sent from the aorta, between the phrenics and superior mesenteric. These smallbranches,pro- ceeding transversely to the gland, soon divide; and give a. Anterior and posterior branches to the gland. b. Small Phrenic and Adipose branches. c. Branches, running, upon the right side, to the nearest part of the liver, the vena cava, the co- verings of the duodenum, and the right meso- colon; and upon the left, to the surface of the spleen and adjoining mesocolon. They frequent- ly unite with the arteries belonging to those viscera. C. The Inferior Capsulars—two or three in number—rising from the superior edge of the renal artery. They ascend outwards; and, after reaching the gland, if they be of considerable size, communicate wandering but numerous branches to the neighbouring viscera, the renal fat, and the adjacent arteries, particularly the spermatics. VI. The renal, or emulgent artery—Right and Left.—It is unnecessary to enumerate the varieties which anatomists have observed as to the number, origin, and magnitude of this artery. It generally rises single from the side of the aorta, between the superior and inferior mesenteric arteries, from which it descends transversely at less than a right angle. The left, which is rather shorter than the right, BRANCHES FROM THE Sect. II. and more posterior in its origin, turns, near the kidney, over its concomitant vein; while the right, which is longer, is covered by its concomitant vein. Approaching the renal de- pression, it divides into two or four branches; which, sinking separately before and behind the pelvis of the kidney, are again divided, and dis- tribute their spreading branches to the papil- lary cones. These, as they encircle the convex margin of the papillae, form arches with the ad- joining branches, and seem to separate the cortical from the tubular substance. From the convex and concave margin of each arch rise in- numerable small arteries; of which the former encircle the cortex, and with some of their branches pass through its substance, and dis- appear on the fat; while the rest are chiefly dispersed and exhausted upon the tubular part. Before entering the kidney, the renals give out, A. The Inferior Capsulars. B. Small Phrenics to the crura of the diaphragm. C. Many Adipose Branches. See below. D. The Superior Ureteric. See below. E. Spermatic Arteries, inosculating sometimes with the spermatic branches. F. Smaller branches, distributed to the meso- colon of each side. VII. The spermatic artery—Right and Left. —This artery is very slender, but, considering the smallness of its diameter, is the longest that rises from the lateral part of the aorta. Sect. II. DESCENDING AORTA. 101 It generally has its origin between the renal and mesenteric arteries, though the right and left do not always issue from the same place; the left often rising higher, and proceeding frequently from the renal or the inferior cap- sular. I have observed, at times, two on each side. It descends from the aorta somewhat tortuously, at a very acute angle, behind the peritoneum, and passes before the vena cava on the right side. It is more tortuous in wo- men than in men, in whom it passes through the abdominal ring. It joins its concomitant vein upon the surface of the psoas muscle. Received by the spermatic cord, it is divided, at some inches before reaching the testes, into five branches: two of which go to the head and opposite extremity of the epididymis; while the rest, running down to the testicle itself, penetrate the tunica albuginea, and send off new branches in every direction; which, pro- ceeding in a winding course, and reflected to the inferior margin of the testes, are partly ex- hausted on its substance, and partly on the convolutions of the seminiferous ducts. With- out any perceptible diminution of diameter, the artery sends out in this course, A. Middle and Inferior Adipose Branches— traversing the middle region of the kidney. See below. ' B. Superior Ureterics. See below. C. Branches to the duodenum, the vena cava, and Q 1Q2 BRANCHES FROM THE Sect. II. liver on the right; and to the mesocolon on the left. D. Branches to the lumbar glands, peritoneum, and the spermatic veins. E. Branches terminating in the spermatic cord, and chiefly in the cremaster muscle and the septum of the scrotum. In females the artery does not pass through the ring, but, entering the broad ligament, divides into, _|_ Posterior Branches—going to the convex side of the ovarium, and entering the ovula by minute twigs. ^___|_ Anterior and External Branches—winding through the alse to the Fallopian tube, and from the tube to the posterior surface of the uterus. They also run down, and inosculate with other uterine arteries, and with the branches of the opposite side. Some of them even descend from the abdomen with the round ligament through the ring, and inosculate upon it with the small artery of the epigastric, and with the external pudic branches. VIII. Adipose arteries—Right and Left.— These vessels, distributed to the adipose sub- stance round the kidneys, are, on account of their number and origin, divided, like the cap- sular, into certain classes. 1. Superior Adipose Branches—rising from all the capsulars, viz. the phrenic, aortic, renal, and first lumbar, running extensively upon the superior, posterior, and exterior adipose sub- stance of the kidney. 2. Middle Adipose Branches—sent out, below the renal artery, from the renal spermatic and the Sect. 11. DESCENDING AORTA. 103 aorta, to the middle adipose substance of the kidney. 3. The Inferior Adipose Branchy—rising from the spermatic, below the lower extremity of the kidney; and, bending to its posterior and in- ferior adipose substance, inosculates with the superior adipose branches, the ileo-colics, and twigs from the spermatic. IX. The ureteric arteries—which may be reckoned among the smallest branches of the aorta, approach the ureter in different places; and may likewise be divided into, 1. Superior Ureterics—rising from the renal artery, the inferior capsulars, and spermalics, run to the pelvis of the kidney, and the up- per part of the ureter. 2. Middle Ureterics—issuing from the aorta, a little above its bifurcation, or from the common iliac or spermatic, run, with minute twigs, ex- tensively, upwards and downwards, upon the middle part of the ureter, proceeding to the peritoneum of the pelvis and the lumbar glands. 3. The Inferior Ureteric—rising from the in- ferior vesicals or uterine, near the insertion of the ureter into the bladder, inosculates, upon the bladder, with the former branches, sending off, in every direction, minute ramuli through the whole of the canal. X. The lumbar arteries—Right and Left— Five in number; issuing from the lateral and posterior part of the aorta, at nearly a right angle. The first runs transversely under the first vertebra of the loins. The ffth, between 104 BRANCHES FROM THE Sect. II. the last vertebra and os sacrum, and the rest between the vertebral interstices; while all of them, after being reflected round the spine, sink into the intervening spaces of the verte- brae. The right are longer than the left. The superior proceed in a straight line, while the inferior incline a little downwards. Two some- times arise from a single trunk; and all, except the first, are covered by the psoas muscle. They agree in this, that each sends to the adjoining intervertebral space A. Two Spinal Branches—rising sometimes separately, but most commonly by one trunk, and running in the course of the nerve, as it comes out from the spinal marrow. The first is larger, entering the involucrum that lines the vertebrae, forming a plexus with the neighbouring arteries, and constituting arches that encircle the membrane. The second, after sending a branch to this membrane and the bone, sinks into the medulla. B. Muscular Branches—which are again divided into s a. Anterior Branches—distributed to the psoas, lumbar, quadratus, and abdominal muscles; and interwoven anteriorly with the intercostals, the epigastrics, and the adjoining arteries of the same class. b. Posterior Branches—ramified on the posterior lumbar muscles; inosculating upon these and the surface of the bones; and running, with various twigs, to the skin. The first lumbar passes behind the crura of the diaphragm, and, penetrating the psoas, Sect. II. DESCENDING AORTA. 105 bends anteriorly between the transverse muscle and the internal oblique. Besides the spinals, already mentioned, it gives 1. A Phrenic Branch—inosculating with the former phrenics and adipose branches. 2. Branches to the quadratus, psoas, and dorsal muscles. 3. Branches to the abdominal muscles, where they reach the inferior intercostals and the following lumbars. The fourth lumbar sometimes goes out from a common trunk with its fellow. Of its anterior branches, one winds around the crest of the ileum, and is exhausted upon the transverse and the internal iliac muscles, where also it in- osculates with the branches of the ileo-lumbar. The fifth lumbar, shorter than the others, arises, from the common iliac, or sometimes from the ileo-lumbar; gives posterior branches similar to those of the preceding arteries; but its an- terior branches go only to the internal iliac muscle, and inosculate with the sacra-lateral artery. DISTRIBUTION OF THE COMMON ILIAC AND ITS BRANCHES. The common iliacs, which, as noticed al- ready, exhaust the whole of the aorta, observe a similar direction upon the right and left sides. 106 BRANCHES FROM THE Sect. II. The Right Iliac crosses the lower part of the vena cava, near the origin of the iliac vein. The Left leans on the outside of its concomitant vein, but does not cover it. A little below, each divides into two branches: The one, named the Internal Iliac or Hypogastric, sinks into the cavity of the pelvis; the other, called the External Iliac, passes to the thigh, where it takes the name of Femoral. Except the sacro-median, and, at times, some minute ureterics, inosculating, upwards and downwards, with branches of the same name, and others dis- persed to the adjoining fat of the peritoneum and the lumbar glands, no other arteries, in general, take their origin from the common iliacs. The sacro-median—of the same size as the lum- bar, is an azygous artery; and, rising from the bifurcation, or a little higher from the middle of the aorta, or from one of the lumbars, or sometimes from the iliac, runs down along the middle of the anterior surface of the os sacrum, as far as the coccyx, where it forms, with the sacro-laterals, an arch that is convex down- wards. In its descent it gives a. Transverse Branches—three or four in num- ber—running outwards in undulating lines, and communicating, upon the surface of the sacral vertebrae, with the sacro-laterals. The first generally inosculates with the last lumbar and ileo-lumbar. Sect. II. DESCENDING AORTA. 107 b. A branch, rising to the rectum, so large as at times to supply the place of the hemorrhoidal, and reach to the bladder. c. Branches sent, in a radiated form, from the small arch, and distributed to the neighbouring muscles and membranes. (I.) The internal iliac, or hypogastric. Five times larger in the foetus than the external; but, after a year, only equal in size; for while the umbilical continues pervious, exhausting almost the whole blood of the trunk, it seems continued into this artery, forming an arch that is convex down- wards, and from whose circumference the other small arteries of the pelvis are sent off. About to pass the brim of the pelvis, behind the peritoneum, it lies, with a more obtuse angle, in the middle, be- tween the ileum and sacrum; thence bending gradually downwards, between the pelvis and its viscera. When the umbilical artery decays, the trunk distributes its numerous branches in so vari- ous directions, that none of them seem to follow its course, or to represent its continuation. As the common pudic and ischiadic, however, are the lowest, and those which run most directly downwards, they have generally been considered by anatomists as the terminating branches. Its branches, though con- stant, are often irregular in their origin; sometimes issuing from the trunk, at other times from the 108 BRANCHES FROM THE Sect. II. larger branches. Of these, some remain within the pelvis, and are regularly distributed to its viscera; while others, emerging from the pelvis, run to its external and adjoining parts. A. The ileo-lumbar, or small iliac—rising from the posterior part of the trunk, before or after the sacro-laterals, bends upwards, and concealing itself, near the crest of the ileum, between the psoas and internal iliac muscles, sends a. Branches to the Psoas. b. An Ascending Branch—between the last lum- bar vertebra and the ileum; where it gives -f- A Branch to the iliac muscle, the ileum and sacrum, and the transverse muscle. _L -(- A branch, passing between the vertebrae to the spinal marrow; inosculating with the ad- joining lumbar and sacro-lateral. c. A Transverse Branch—running, under the psoas, to the hollow of the ileum; divided into -L. A Superficial Br. nch—passing-, along the sur- face of the iliac muscle, to the crest of the ileum; and giving * Branches to the adipose substance, and the iliac and transverse muscles, where the trunk terminates. * * Branches anastomosing with the femora- abdominal. -L. -f. A Deep Branch—traversing the surface of the bone under the iliac muscle, and supplying its nutritious arteries. Sect. II. DESCENDING AORTA. 109 B. The sacro-lateral arteries—irregular in origin and number. Sometimes only one, some- times more, even to five, come off from the trunk, from the posterior iliac, or the ileo-lumbar. If only one be present, it goes down, near the foramina of the sacrum, as far as the coccyx, and there forms the arch already mentioned. If more, the superior inosculate among themselves; while the inferior terminates in the sacro-me- dian. They always give a. Anterior Branches—running to the bodies of the vertebrae; inosculating with the Sacro-me- dian and other neighbouring arteries; and ra- mifying on the adjoining muscles and nerves. b. Spinal Branches—four or five in number, each of them entering the sacral holes, and distri- buted to the spinal cavity. _L An Anterior Branch—forming a plexus in- ternally upon the membranes sheathing the cauda equina, and inosculating with the supe- rior spinal arteries. _i_ _L A Posterior Branch—passing through the posterior hole of the sacrum, and supplying twigs to the ganglion of the nerve, the peri- osteum, the ligaments, the multifidus spina:, and the longissimus dorsi; inosculating with its fellows and the ischiadics. C. The umbilical artery—which, in the foetus, was the real trunk of the hypogastric, reflected upwards to the umbilicus, is, in the adult, con- verted almost wholly into a soft spongy liga- ment, lying in the folds of the peritoneum. A certain portion of it, however, nearest to the R 110 BRANCHES FROM THE Sect. II. trunk, continues open. After having issued from the anterior part of the internal iliac, it runs down, transversely and inwards, to the lower part of the bladder; but gradually closes as it is reflected on its posterior side. The ligament- ous part which remains, rises still higher upon the sides of the bladder; inclines gradually to its fellow of the opposite side, and at last is insert- ed, along with the urachus, in the umbilicus. The portion of the artery which is open in the male, sends out, a. Vesicals—two or three in number; winding upon the inferior, middle, and superior part of the bladder, and inosculating with the other vesical arteries. b. Branches to the ureters and vas deferens, anastomosing with the pudics. c. Hemorrhoidal Branches to the lateral parts of the rectum. In the female, a. Branches, variously distributed, to the sides of the bladder, uterus, and vagina. b. A few straight branches to the rectum. D. The inferior vesical arteries—varying in number, according as the other branches of the bladder are more or less ramified upon it. One, at least, is always present, rising often from the hypogastric, near to the umbilical; which, after running forwards to the lower part of the bladder towards the urethra, sends smaller twigs to the rectum, or to the DESCENDING AORTA. Ill vagina of the female. This artery is larger in men where the uterine is wanting; or if two be present, either both, or one at least, arises from the middle hemorrhoidal. The illustrious Hal- ler has observed, that they have sometimes given origin to the pudic, ischiadic, and obtura- tor. a. A branch to the vesiculae seminales, vas de- ferens, and prostate gland—running up be- tween the bladder and rectum, and inosculating both at the vesiculae and beyond the prostate gland, with the profunda penis, or deep perineal, and the branch from the opposite side. b. A branch—going to the bulb, and anastomos- ing with branches of the common pudic. E. The middle hemorrhoidal artery-—ir- regular in its origin, and sometimes wanting; but, in general, rises between the pudic and posterior iliac, or the pudic itself. After various flexions near the bladder and the vagina, it at- taches itself to the rectum, on whose anterior surface it runs as far as its sphincter muscle. Sometimes it is so large as to give off both the uterines and sacro-lateral.—In men it gives, a. Numerous branches, winding on the rectum through its whole descent, and inosculating often with the mesenteric hemorrhoidal and the branches of the opposite side. b. Branches, runningdown to the external sphinc- ter, the levator, and the skin, and anastomos- ing freely with the external hemorrhoidals. 112 BRANCHES FROM THE Sect. II. c. Branches distributed upon the bladder, urethra, seminal vesicles, and prostate gland, as the artery runs between the bladder and the rec- tum. If the midde hemorrhoidal only send branches to the rectum, these sometimes form a single trunk. In women it gives, a. Intestinal Branches. b. Conspicuous Branches—distributed to the vagina, where it lies upon the rectum. These often form a particular vaginal trunk. F. The uterine—a large artery, peculiar to the female. It issues, in such a manner, from the hypogastric trunk, near the hemorrhoidal,pudic, or umbilical, as to have often the appearance of being a branch of one of them. Between the cervix uteri and the bladder it touches these viscera; traverses the sides of the uterus, and, finally, winds upon its posterior surface. It gives a. A Vesical Branch—distributed, often double, to the bladder, where it rests upon the com- mencement of the vagina. b. A Descending Branch—straight; often con- sisting of many twigs, spreading extensively upon the vagina, and sending forwards some small vesicals. If many vaginal branches be present, they here inosculate with its various twigs. c. An Ascending Branch-—giving out numerous serpentine branches, running between the outer coat of the Fallopian tube, ovarium, and uterus. These inosculate freely with the sper- Sect. II. DESCENDING AORTA. 113 matics, and often with the artery of the opposite side. N. B. The artery frequently rises by itself from the hypogastric, and chiefly from the middle hemorrhoidal; which, under the name of va- ginal, is extensively distributed upon the vagina, as far as its external parts. In that case, the descending branch of the former artery is wanting; and some twigs of this one, ascending to the cervix, inosculate with the uterine. In other cases, the vaginal branches are much smaller than those which go the uterus. G. The obturator artery—rising sometimes from the epigastric branch of the external iliac, and running down towards the pelvis; some- times, and indeed more frequently, issuing from the trunk of the hypogastric, the posterior iliac, the ischiadic, or ileo-lumbar. It runs down- wards and forwards, connected with the bones of the pelvis by cellular membrane, following the superior edge of the obturator internus; and, passing through the sinuous depression of the thyroid hole, runs to the thigh with its con- comitant nerve and vein. In the pelvis, it gives a. Branches to the glands situated among the iliac vessels; but which are often wanting. b. Branches to the levator ani, iliacus internus, psoas, and bone—also often wanting. c. Branches to the inferior part of the bladder, rectum, seminal vesicles, and prostate gland, inosculating with the pudic. These also are often wanting, though at times they are of con- 114 BRANCHES FROM THE Sect. II. siderable size, and divide into many smaller branches, running as far as the corpora caver- nosa penis. d. A Coronary Branch—running along the supe- rior and internal margin of the os pubis; pro- ceeding under the periosteum, and inosculat- ing with its fellow of the opposite side. From this branches ascend to the abdominal mus- cles, especially the recti, and to certain ramuli of the epigastric. e. Branches shooting out to the obturator inter- nus, in its passage through the thyroid hole. Beyond the pelvis, it divides into /. The External Branch—running down betwixt the two obturator muscles, following the ex- ternal margin of the foramen, and bending to the tuberosity of the ischium: afterwards de- scending to the back part of the thigh, between the acetabulum and tuberosity, under the femoral quadratus. Gives out «. Branches to both the obturator muscles. (i. External Branches to the capsule of the joint. y. A Deep Branch—sinking into the acetabulum, and distributed to the inter-articular fat, the round ligament of the joint, and periosteum. J*. A branch, which, after inosculating with the internal branch, is spent upon the large femoral adductor. e. A branch, inosculating, and forming a coronary plexus, near the tuberosity of the ischium, with the internal branch. C. A branch, distributed to the posterior part of the capsule, the periosteum of the tuberosity, the adductor magnus, and the quadratus. n. Many anastomotic branches, interwoven with the descending branch of the internal circumflex on DESCENDING AORTA. 115 the quadratus; with the ischiadic near the qua- dratus; and with the external hemorrhoidals of the pudic at the tuberosity of the ischium. S. Branches—sometimes wanting—distributed, af- ter perforating the quadratus, to the higher ex- tremity of the semitendinosus, biceps, semi- membranosus, and surface of the tuberosity of the ischium. g. The Internal Branch—running first back- wards, under the obturator externus to the inner margin of the foramen, and inosculating, by its extreme branches beyond that muscle, with the branches of the internal circumflex. From this go a. Branches to the obturator muscles. 0. A branch, extending beyond the obturator, above the adductor brevis, to the gracilis and symphysis pubis, and disappearing upon the skin of the genitals. This branch inosculates with those of the pudic. y. Branches, distributed to the capsule, long ad- ductor, and quadratus, after the artery has pass- ed the obturator, and inosculating, on the tri- ceps, with the internal circumflex. S. A branch, forming a coronary arch with the ex- . ternal branch at the tuberosity of the ischium. From this are sent twigs to the adductor mag- nus and biceps, anastomosing with the common pudic. The remaining trunk, which here runs into the circumflex, is sent to the quadratus and the heads of the adductor. But this artery is throughout very irregular. H. The posterior iliac, or gluteal—the lar- gest of all the arteries, issuing from the hypo- gastric. It rises early from the back part of the trunk, below the sacro-laterals and obtu- 116 BRANCHES FROM THE Sect. II. rator; passes deeply, upwards and backwards, to the superior edge of the pyriform muscle, till, concealed by the two trunks of the is- chiadic nerve, it leaves the pelvis: then wind- ing externally around the pyriformis, it dis- tributes its branches among the gluteal mus- cles. Within the pelvis, it sometimes gives rise to the ileo-lumbar, obturator, sacro-laterals, is- chiadic, and common pudic. Before leaving the pelvis, it gives 1. Branches to the rectum; though often wanting. 2. A Nutritious Branch to the ileum and internal iliac muscle. 3. A branch, ramified on the pyriformis, middle and lesser gluteus, and inosculating with the ischiadic. On leaving the pelvis, or soon after, the trunk is divided into a. The Superficial Branch—running down be- twixt the pyriformis and middle gluteus, under the great gluteus; and again divided into a. An Ascending Branch—bending upwards around the margin of the middle gluteus, and distri- buting its ramuli to the middle gluteus, the superior part of the great, gluteus, the os sacrum, and adjoining part of the ileum. It in- osculates at the sacrum with the posterior sacrals, and on the surface of the ileum with the deep branch. Some branches perforate the gluteus, and become cutaneous. /3. A Descending Branch—which soon ramifies__ running between the middle and great gluteus; then to the great gluteus; which, having per- forated, it terminates in the skin. It gives also Sect. II. DESCENDING AORTA. 117 _j_ A branch to the pyriformis. _j__|_ A branch to the ligaments of the ileum, which, after perforating these externally, is distributed to the sacrum. b. The Deep Branch—concealed under the mid- dle gluteus, where it divides into two branches; of which the «.. Superior Branch—traversing the brigin of the lesser gluteus as far as the spine of the ileum, forms an arch, running forward, between the anterior muscles of the thigh, to the skin. It gives -j- Branches proceeding from the convexity of the arch, to the middle gluteus and crest of the ileum. j___l Branches from the concave part of this arch, running between the lesser gluteus and the ileum to the capsule, and com- municating with the branches of the pro- fundissima. _j___i_ i A Posterior Nutritious Branch of the ileum. R. A Transverse Branch—running forward, under the middle gluteus, on the surface of the lesser gluteus, and terminating in its muscular fibres. It gives besides _i_ Numerous branches to the middle gluteus, j__l The Profundissima, or Deepest Artery of the ileum—running down, on the sur- face of the ileum, and beyond the fleshy part of the lesser gluteus, towards the trochanter and anterior parts of the ileum. In this course it sends off, around the tro- chanter, some branches to the periosteum, and others to the crest of the ileum, the margin of the acetabulum, and the lesser s BRANCHES FROM THE Sect. II. gluteus; inosculating with the abdominal, with the superior ramulus of the deep branch, and at the upper extremity of the sartorius with branches of the external circumflex. I. The ischiadic—smaller than the former ar- tery, but observing the same course with the hypogastric. It passes from the pelvis, between the lower edge of the pyriformis and the levator ani, and descends, under the great gluteus, parallel with the larger ischiadic ligament. I have observed the trunk divided into two, sending off the middle hemorrhoidal and pudic. —Within the pelvis, it gives a. Many, but irregular, branches to the rectum, uterus, bladder, and obturator internus. b. Branches to the pyramidalis, inosculating, at the passage of the trunk, outwards with the pudic branches. Without the pelvis, c. The Coccygeal—concealed by that portion of the great gluteus which is attached to the sacrum, coccyx, and the large sacro-sciatic ligament, and running under this ligament to the coccyx. It is singularly ramified, and gives origin to *. Branches, perforating the fibres of the ligament and great gluteus, running to the coccygeus and fat around the levator. fi. A Deep Branch—distributed to the coccygeus, the bone, and the levator ani; inosculating with the pudic. y. Many Anastomotic Branches—forming inoscula- tions with the sacro-laterals on the outer side of Sect. II. DESCENDING AORTA. 119 the sacral holes; or, passing through the holes, in the cavity of the pelvis. d. The Concomitant Ischiadic—first approaching the great gluteus, and then running extensive- ly on the surface of the nerve, till, at last, it meets with similar arteries, arising below the quadratus from the internal circumflex, or the first perforant, with which it inosculates. e. Branches, anastomosing, beyond the tuberosity of the ischium, with the common pudic and internal circumflex. f. A branch, which is often divided a second time, bending, downwards and forwards, be- tween the gemelli and pyriformis, to the tro- chanter, distributing its twigs to the lesser and middle gluteus, obturator, gemelli, pyriformis, the nerve, the quadratus, trochanter, articular capsule, and the periosteum of the acetabulum. Of these, some generally inosculate, beyond the pyriformis, with the deep branch of the posterior iliac, and still deeper, under the mus- cle, with the posterior trochanteric of the inter- nal circumflex. Sometimes a smaller trunk sends off a few arteries; of which the moslj regular and constant are those which lie deep, and anastomose. g. A Deep Branch—running down, before the obturator, to the tuberosity of the ischium; sending twigs to the tuberosity and its mus- cles, and inosculating with the pudic and obturator. h. Gluteal Branches—numerous—terminating in the great gluteus and the adjoining adipose substance. These exhaust the rest of fhe trunk. BRANCHES FROM THE Sect. II. K. The common pudic—the pudic—circum- flex, internal, middle, or external pu- dic—rising, often from a common trunk, with the ischiadic, but is easily distinguished by its smaller size, by its bending more forwards and inwards while in the pelvis, by its passing out between the pyriformis and the posterior part of the levator ani, and by its greater distance from that extremity of the pyriformis which is attached to the sacrum. No sooner has it passed from the cavity of the pelvis, than it is concealed by the great sacro- sciatic ligament, under which it runs to the spine of the ischium, and enters the space be- tween the lesser and greater sacro-sciatic liga- ments. Having passed the spine, it next runs to the surface of the tuberosity of the ischium which looks inwards to the pelvis; where, being- attached to the bone by the aponeurosis of the obturator internus, and following the curved margin of the ischium, it bends forwards to its ramus. The artery is here exhausted by two branches sent off near the transverse muscle of the perineum. Its branches form three classes. The first, comprehending those arteries which rise from the trunk as it descends within the pelvis, viz. a. Small branches to the rectum and its conglo- bate glands. b. Vesical Branches to the lower part of the blad- der; and if the branch be large, to the prostate Sect. II. DESCENDING AORTA. 121 gland, the seminal vesicles, or the vagina. These, as well as the former, are often want- ing. c. A branch to the obturator internus. The second class, the branches issuing from the trunk while situated between the two ligaments, and afterwards traversing the curved margin of the tuberosity of the ischium. These are, a. Branches, passing before the ligament to the pyriformis and great gluteus. b. A branch, descending beyond the gemelli and obturator, and inosculating with the internal circumflex and obturator. It is often wanting. c. A branch—running transversely, along the margin of the superior gemellus, to the tro- chanter and its periosteum; sending off two ramuli, to be distributed under the obturator internus on the ischiadic portion of the aceta- bulum; others inosculating with the obturator and circumflex; and still others, sinking into the gemelli, obturator, and trochanter. This branch sometimes rises from the ischiadic, as was mentioned ajbove at f. d. Branches going outwards, in the course of the artery, under the ligaments, to the obturator, the periosteum of the tuberosity, and beyond that to the origin of the semitendinosus and triceps magnus. These also generally inoscu- late freely, around the tuberosity, with the internal circumflex and the obturator. e. Branches, issuing from the inner side of the artery; running xleep to the coccyx, and inos- culating with the ischiadic coccygeal. f. External Hemorrhoidal Branches—a number 122 BRANCHES FROM THE Sect. II. of them spreading inwards on the levator ani, the surrounding fat, and the sphincter. Some twigs, having perforated the levator, reach the rectum, and inosculate with the middle hemorrhoidal. g. A branch, rising from the inner margin of the trunk, and divided, near the transverse muscle, to the sphincter, perineum, and transversus perinei. The third class comprehends those branches is- suing from the trunk as it bends forwards, with- out the pelvis, to the ramus of the ischium. Near to the transverse muscle of the perineum the pudic artery divides, and sends out a. The Superficial Perineal—running, in men, beyond the transversus perinei, in the trian- gular space between the bulbo-cavernosus or ■accelerator urinae, and ischio-cavernosus or erector penis, where it ascends under the skin, or between the muscular fasciculi; and at last disappears, in many branches, upon the sur- face of the genitals—proceeding, in females, between the ischio-cavernosus and the con- strictor cunni or vaginal sphincter. From this arise, a. The Transverse Perineal—running transversely, and sending twigs to the transverse muscle, anal sphincter, and skin: advancing in females to the vaginal sphincter and labia. {I. Branches to the bulbo-cavernosus. y. Branches to the ischio-cavernosus, or erector of the clitoris. i\ Long Scrotal Branches—winding in the cellular substance of the dartos, as far as the testes: ir the female ramified within the labia. Sect. II. DESCENDING AORTA. 123 f. Branches to the corpora cavernosa of the penis or clitoris. t. Branches, inosculating with the externalpudics, and rising from the trunk, where it approaches the labia or penis. b. The Deep Perineal, or Deep Artery of the Penis or Clitoris—in males, after lying deep under the transversus perinei, between the bulbo-cavernosus, and the ischio-cavernosus, it passes upwards, attached by cellular mem- brane, to the bone, between the ramus of the ischium and pubis and the corpus cavernosum; at last reaching the synchondrosis pubis and the * penis, at the junction of its cavernous bodies, is there divided.—In females, it runs between the vaginal sphincter, the erector of the clitoris, and its cavernous substance; passing after- wards between this and the os ischium and pubis to the body of the clitoris. In this course are sent off in males, «. Two large branches, running into the urethra and its cavernous substance, and afterwards to the penis. (J. Smaller branches, rising from each side of the trunk; going to the ischio-cavernosus, obturator internus, bulbo-cavernosus, the crura of the corpora cavernosa, Cowper's glands, and the prostate. Those which run to the prostate inosculate with the inferior vesicals. From the above division of the artery proceed y. The Dorsal of the penis—running superficially under the integuments, and through the whole length of the penis, surrounding it behind the glans: giving off 124 BRANCHES FROM THE Sect. II. 1. Many branches, inosculating with the for- mer scrotal branches. 2. Branches to the surface of the corpora ca- vernosa and the prepuce. 3. Branches, inosculating, near the glans, with similar branches of the opposite side. 4. Branches to the preputial frenulum. 5. Branches sinking into the glans. S. The Profunda or Deep Branch of the Penis- after anastomosing with its fellow, enters the corpus cavernosum of its own side, through which it passes, in a straight line, to its other extremity. Many of its branches open into the cavernous cells of the penis; some into the ca- vernous substance of the urethra; and others, after perforating the septum of the penis, into the cells of the opposite side. Thus are the cel- lular parts of the penis distended with blood during erection. From the Deep Perineal, or Deep Artery of the Clitoris, in females, arise, «. Branches from different parts of the trunk, run- ning to the transversus perinei, the fat, erector of the clitoris, clitoris, urethra, and the vagina beneath its sphincter. From the divided trunk issue, /S. A Large Vaginal Branch. y. The Superficial Dorsal of the Clitoris. ^ cus, and plunging deep into the cavity of the abdomen, along with the umbilical vein and arteries, whose course they generally follow. These branches, sent towards the bladder and liver, inosculate with a certain branch from the hepatics, and with others from the vesicals. 4. 4. Branches, under the rectus, anastomo- sing, in many places above the umbilicus, with the internal epigastric branch of the mammary. C. The circumflex iliac, abdominal, or small external iliac—generally smaller than the last, and sent off a little lower from the BRANCHES FROM THE Sect. II. external side of the trunk; passes, upwards and outwards, in a retrograde course, under the peritoneum; reaches the crest of the ileum; and bending, parallel to the arched circumference of this bone, to the highest part of the crest, proceeds between the extremity of the iliacus internus and transversalis, as also betwixt the transversalis and obliquus internus, where it is finally expended among the abdominal muscles. From this arise, a. A branch, ramified on the iliacus internus, sartorius, fat, and inguinal glands. b. A branch to the spermatic cord; often wanting. c. Branches, running, from various places, to the psoas, crural nerve, and iliacus internus; inos- culating frequently with the transverse branch of the ileo-lumbar. d. Four branches, or sometimes more, of which the exterior are the largest, running to the transversalis and obliquus internus; and, after penetrating this muscle, passing, under the obliquus externus, with many branches, to the anterior part of the abdomen, inosculating with branches of the intercostal, lumbar, and mammary arteries. e. A branch, forming, on the midde of the crest, a double anastomosis with the ileo-lumbar. f. An Ultimate Branch—exhausting the artery; winding anteriorly between the obliquus and transversalis. As it here subdivides into branch- es, rising as high as the ribs, it disappears on the skin, and forms a plexus with the adjoining vessels. Sect. II. DESCENDING AORTA. 129 THE COMMON FEMORAL. The common femoral is a continuation of the External Iliac, where it runs without the Fal- lopian ligament in the groin. The femoral vein, under which it lies, conceals its internal margin, while the whole is covered by a large quantity of cellular substance, fat, a number of inguinal glands, and the broad fascia of the thigh. After advancing about two inches, it divides, on the outer and muscular part of the iliacus internus, into two arteries of nearly equal size. Of these, the one, which is a continuation of the trunk, is called the Superficial Femoral; and the other, which rises from the back part of the trunk, the Deep Femoral, or Femoral Profunda. From the common trunk generally issue A. Small branches—passing over the Fallopian ligament, and running extensively upwards to the skin of the abdomen. B. Inguinal branches—varying in number; wandering through the fat, and chiefly dis- tributed to the inguinal glands. C. A smaller branch—which immediately di- vides into ramuli, running outwards and trans- 130 BRANCHES FROM THE Sect. II. versely, to the upper extremity of the sartorius, the iliacus internus, the crest of the ileum, the broad fascia, and the middle gluteus. D. Minute branches—terminating in the ilia- cus, psoas, and pectineus; inosculating with the internal circumflex branch, and sometimes sinking deep among the muscles. E. The superior external pudic—running upwards and inwards, above the genitals, to the pubes, where it is dispersed upon the subcuta- neous fat and the upper part of the genitals. F. The middle external pudic—divided into many branches; passing, in males, transversely and inwards, above the pectineus and adduc- tor longus, to the sides of the scrotum, and running, subcutaneous, along the penis to the prsepuce: But in. females, proceeding to the labia and the prepuce of the clitoris. G. The inferior external pudic—rising often from the superficial femoral artery, and, after leaving the adductor and gracilis, sinking deep into the scrotum; where it inosculates freely with the superficial perineal, the hypogastric scrotals, the former branch, and with branches of the obturator and internal circumflex: Send- ing twigs, also, to the glands and the spermatic cord, or the labia. H. A branch to the sartorius and rectus, often accompanying the crural nerve deep amongst the muscles. Sect. II. DESCENDING AORTA. 131 N. B. All these arteries vary often in number and distribution, and are very irregular in the order in which they are sent off. (I.) The deep femoral—concealed, at its origin, by the superficial femoral, the glands, and a quantity of fat, lies in the deep triangular cavity, between the iliacus, pectineus, and adductors; and, bending with a flexure, convex outwardly, over the united iliacus and psoas, runs, backwards and downwards, to the higher extremity of the vastus internus. As it reaches the bottom of this cavity, it again bends gently forwards; and, passing between the long and short adductors and the vastus internus, runs, downwards and backwards, near to the middle of the femur. At last, entering the space between the long and short adductors, or perforating this last muscle, it reaches, the adductor magnus, and passes through it, with various branches, run- ning among the posterior muscles of the thigh. The first direction and size of the trunk vary considerably, according as it issues, sooner or later, from the common femoral, and according to the number and size of the branches which it sends off. Of these, some are of little consequence; but four of the following merit attention. A. Many small branches—some of which are often wanting; rising either separately, or form- ing together a common trunk—distributed, in BRANCHES FROM THE Sect. II. various places, to the iliacus internus, capsule, skin, sartorius, vastus externus and internus, and the heads of the triceps; and inosculating, on these muscles, with small twigs of the in- ternal and external circumflex. At times they send off some external pudic branches. B. The external circumflex—a conspicuous branch, and often the first when it arises from the common trunk; though it sometimes issues from the superficial femoral. It bends outwards, between the iliacus internus, the rectus and sartorius, and between the tensor of the broad fascia and the anterior surface of the middle gluteus; and, passing transversely under the tendinous head of the vastus externus, disap- pears at last near the root of the large trochan- ter. In this course, its principal divisions are, a. A branch, sinking in the iliacus internus, and returning to the cavity of the pelvis. b. Another branch, extending, under the iliacus, to the inner side of the femur; inosculating, near the trochanter minor, with a branch of the internal circumflex. c. The Large Transverse Branch—constituting the superior part of the trunk, where it lies under the vastus; and giving out, near to its origin, «. Branches to the iliacus, tensor of the broad fas- cia, and the higher extremity of the sartorius and rectus. Sect. II. DESCENDING AORTA. 133 p. Many branches, rising from the anterior part of the trunk, bending upwards and outwards, and terminating, in various ramifications, on the ten- sor of the broad fascia, the middle gluteus, and sometimes on the anterior and lower portion of the great gluteus. y. A Branch, winding outwards between the ilia- cus and lesser gluteus, and spreading on the ex- ternal surface of the pelvis, where it inosculates with the profundissima or deepest branch of the ileum. S. The Anterior Trochanteric Branch^—of small size (sometimes very small)—lying betweeo the iliacus internus and the anterior' margin of the vastus externus. It runs, under the middle and lesser gluteus, on the anterior part of the trochanter major, where, concealed by a quan- tity of fat, and terminating in the trochanteric fossa, it inosculates with the posterior trochan- teric, after sending branches to the foresaid muscles, the bones, and the capside. t. Two or three large Transverse Branches—the last ramifications of the trunk—covered by the vastus externus; winding round the root to the back part of the trochanter, and anastomosing, upon the tendon of the greater gluteus, or be- yond it, near the bone, with the transverse- branch of the first perforant and the descending branch of the posterior trochanteric. From these proceed, _i_ Branches to the cruralis and vastus ex? ternus. j___i_ Minute Nutritious Branches to the surface of the trochanter and femur. _l _|_ -|_ Subcutaneous Branches, forming a circle at the root of the large trochanter. u BRANCHES FROM THE Sect. II. d. The Large Descending Branch—rising from the trunk, where it seems continued into the great transverse branch already mentioned, it winds under the rectus to the anterior margin of the vastus. In its course to the patella, it is covered, near the cruralis, by the margin of the vastus externus; sending branches to the latter, but not to the former. A little above the knee, and near the patella, it approaches so near the surface, that its last inosculation with the ex- ternal articular is frequently seen through the substance of the muscle. It sends k. A Large Branch to the rectus, descending on its posterior surface, to which it gives a number of branches—communicating with the anastomo- tic of the superficial femoral by a double branch, that sends a twig through the vastus internus to the inferior extremity of the rectus. d. Transverse Branches—from three to six—irre- gular in size, origin and distribution; rising variously from the outer side of the descending trunk upon the vastus muscle, and running backwards to the posterior parts. Of these, a superior branch unites with the transverse twigs of the first perforant; the inferior unite with the external transverse of the second perforant, and with the inferior perforant of the superficial ar- tery. N. B. Besides the inosculations of this trunk with the superior externo-articular, it forms another inosculation with the superior interna- articular and the anastomotic, by sending a branch, between the cruralis and rectus, to the inner side of the femur, near the patella. The artery varies much in size. ect. II. DESCENDING AORTA. 135 e. The Small Descending Branch—rising some- times from the superficial, sometimes from the large transverse branch of the circumflex: first sending twigs, under the rectus, to the sartorius and vastus internus; then winding in- wards through the substance of this muscle, inosculates at last, under the tendon of the triceps, with the inferior perforant of the superficial femoral, or, more frequently, with the large anastomotic. I have observed it, at other times, pass outwards to the cruralis and vastus externus. C. The internal circumflex—rises, near the origin of the external circumflex, from the in- ternal and posterior part of the trunk; passes to the interior and middle part of the pectine- us through the adipose substance, between this muscle and the tendon of the psoas, and runs deeply and transversely backwards, above the trochanter minor. Concealed here by muscles and fat, it divides into branches, between the short and great adductor, or between the ad- ductor and pectineus. Of these branches, the largest, considered as the trunk, approaches the neck of the femur, acetabulum, and obtu- rator externus, and, proceeding outwards and backwards to the interstice between the qua- dratus and adductor magnus, divides into two branches and is partly expended on the mus- cles attached to the femur, and partly through the interstice to the flexors of the thigh. Thus are produced, in the following order, 136 BRANCHES FROM THE Sect. II. a. Branches to the iliacus internus, psoas, pecti- neus, and capsule. b. Transverse Branches to the pectineus, long and short adductor, and gracilis, interwoven every where, upon their surface, with branches of the superficial femoral and external circum- flex, and more deeply with twigs of the ob- turator; inosculating, also, withpudic branches by a less obvious twig, running behind the gracilis to the penis. All these branches are generally sent off before the trunk is concealed by the pectineus. c. Many branches, rising separately while the trunk passes under the head of the femur, be- tween the trochanter minor and the acetabu- lum; distributed to the heads of the triceps, pectineus, and capsule, and inosculating fre- quently with other branches of the deep femoral or profunda. d. The Superior Branch, or Superior Anterior Ascending—of greater size, seemingly one- half of the trunk—runs transversely, between the short and great adductors, towards the symphysis pubis, sometimes disappearing there upon the skin—sends «. A branch through the depression in the aceta- bulum to the glands, cartilages, and round liga- ment of the joint. p. A branch, ramified on the obturator externus. y. Branches, distributed to the capsule, and in many places to the great and short adductors. $. Branches, derived from the former, or rising separately; inosculating, at the external and Sect. II. DESCENDING AORTA. 137 posterior margin of the thyroid hole, with the external and internal branch of the obturator. The rest of the artery, after distributing, in this course, various branches to the adductors, gracilis, and genital integuments, inosculates with the external pudics. e. The Inferior Branch, or Inferior Posterior Circumflex—exhibiting a continuation of the trunk—runs, over the lesser trochanter, to the neck of the femur; distributing, in its course, small branches to the capsule of the joint, the acetabulum, obturator, and great adductor. Between the quadratus and great adductor, it divides into, 1. The External, or Superior External Branch— often called the Posterior Trochanteric.— This smaller ramulus, concealed by the quadratus, runs obliquely, outwards and upwards, to the posterior part of the bone, and, as it approaches the trochanter, divides into two branches; the larger ascending obliquely upwards to the trochanteric fossa, and the smaller descending in a different course. Thus are produced, «. Branches to the great adductor and obtu- rator externus; inosculating frequently with the external branch of the obturator. p>. Branches to the capsule, bone, and quadra- tus. y. A branch, inosculating, near the origin of this smaller trunk, with the concomitant ischiadic, which sends a twig between the quadratus and the great adductor. S. Branches, inosculating, at the root of the trochanter major, on both sides of the apo- neurosis, with the transverse branches of the external circumflex. BRANCHES FROM THE Sect. II. From the Ascending Branch of the divided trunk proceed, * A branch, communicating, behind the quadratus and gemelli, with the deep branch of the ischiadic, and with a twig of the com- mon pudic, that runs down beyond the gemelli. This last one the illustrious Hal- ler considers as a trunk, and gives it the name of superficial; but regards the other as a branch of this superficial, and de- nominates it the posterior trochanteric. * * Branches, inosculating, in the trochante- ric fossa, with the anterior trochanteric and the profundissima of the posterior iliac. From the Descending Branch proceeds, -\- A considerable ramulus, receiving a twig from the first perforant, above the higher part of the adductor, near the root of the trochanter. 2. The Internal Branch, or Inferior Internal— gene- rally larger than the former—rises, near the tuberosity of the ischium, between the quadra- tus and adductor; and, passing through the adipose substance, which is here so largely ac- cumulated, runs to the common origin of the flexors of the thigh. It here spreads into numer- ous ramifications, distributed, partly to the tuberosity itself, where inosculations are form- ed by the branches of the ischiadic, obturator, and pudic; partly to the flexors, but chiefly to the great adductor. D. The first perforant—running backwards from the trunk, below the small trochanter; and between the pectineus and short adductor, or between its fibres, proceeds, near the vastus internus, in such a manner as to pass obliquely DESCENDING AORTA. 139 outwards, between the femur and that part of thevgreat adductor which is attached to the bone. About an inch from the great trochanter, it perforates the adductor in two places, under the covering of the great gluteus; to which, along with the flexors, it distributes its ultimate branches. From this arise, a. Large Branches—sometimes rising separately from the deep femoral—exhausting themselves upon the vastus internus, and the short and great adductors. b. Branches, spreading out from the concealed trunk to the adductor, quadratus, and trochan- ter. c. An Ascending Branch—forming, above the superior extremity of the great adductor, an elegant inosculation with the descending branch of the posterior trochanteric. d. A Large Transverse Branch—sometimes double—running, under the adductor, to the gluteus; and, after perforating the tendon of this muscle, proceeding outwards, round the root of the trochanter, to the vastus externus, where it inosculates with the large transverse branch of the external circumflex. e. A Branch—often double—rising, as it were, from the former; passing through the adduc- tor to the great gluteus, and there dividing into various branches, inosculating with the, gluteal branches of the ischiadic. f A Nutritious Branch—running down upon the surface of the bone, and anastomosing with a nutritious branch of the second perforant. 140 BRANCHES FROM THE Sect. II. g. A Descending Perforant—passing through the great adductor, and running extensively on the inner surface of the flexor muscles. As it here divides into many branches, spreading out- wards and inwards, it distributes several to each of the flexors and the great adductor, and forms many superficial and deep communica- tions on these muscles with the internal branch of the inferior circumflex, with some recurrent branches of the second perforant, and some- times, though more rarely, with twigs of the superior perforant rising from the superficial. These elegant inosculations are more fre- quently observed upon the semimembranosus, adductor, biceps, and on the nerve. E. The second perforant—exhibiting a conti- nuation of the trunk—passes, sometimes single, and at others double, through the small space between the long and short adductor, or through the long adductor itself; then proceed- ing obliquely outwards and downwards, be- tween the femur and great adductor, and pene- trating the adductor near the linea aspera, at the middle of the thigh, and inner side of the short head of the biceps, is exhausted, like the last artery, among the flexor muscles by a descend- ing perforant branch. To this artery are re- ferred, a. Large Branches—sinking into the vastus inr ternus and long adductor, before the immer- sion of the trunk. b. Another Branch, partly distributed to the vastus, partly entering the bone by two twigs, Sect. II. DESCENDING AORTA. 141 and inosculating with the large nutritious artery. c. A Large Branch—often double—entering, like the trunk, the long adductor, but higher; terminating in the substance of the adductor, or, as sometimes happens, sending an artery through the belly of the muscle to the flexors. d. An Ascending Branch—inosculating, near the trochanter, upon the back part of the bone, with the first perforant. e. A Superior Transverse Branch—running, either transversely or obliquely, a little below the tendon of the great gluteus, between this mus- cle and the femur, to the substance of the vas- tus externus, and anastomosing with the trans- verse branches of the large descending branch of the external circumflex. Before the trunk sinks in the vastus, a branch sometimes rises suddenly from this one, beyond the great ad- ductor, distributed to the external flexors, and known by the name of the third perforant. f. An Inferior Transverse Branch—running in the same direction as the last; and, about two or three inches below the tendon of the great gluteus, passes, under the short head of the biceps to the vastus externus. If the artery proceeds farther, it gives rise, like the last, to a fourth perforant. It gives a. Many Branches, winding on the adductor. a. The Large Nutritious Branch of the Femur— running down, near the short head of the biceps, to the outer side of the linea aspera; inosculat- ing with a small inferior nutritious branch from the inferior perforant of the superficial femoral, and penetrating the bone with a larger externa. 142 BRANCHES FROM THE Sect. II. branch. This artery is irregular both in origin and direction. y. A Branch, concealed in the substance of the bi- ceps. &. Branches, meeting the descending branch of the circumflex on the vastus externus, and sometimes the superior externo-articular, with a large twig. They appear to rise from the nutritious branch in such a manner, that it seems to be inflected through the short head of the biceps to the vastus externus. g. Many Branches, distributed to the short head of the biceps. h. A Descending Perforant—passing under the flexors, after perforating the adductor, and transmitting ramuli to the external and inter- nal flexors. Like g of the first perforant, it forms, upon the surface and substance of these muscles, inosculations upwards with this ar- tery, and downwards with the perforant of the superficial. (II.) The superficial femoral artery— lying near the external integuments; covered, through its whole course, by the broad fascia, by the inguinal glands above, and on the middle part by the sartorius as it runs obliquely across the femur. It then proceeds downwards, inwards, and backwards, passing gradually from the anterior to the inner surface of the thigh, and from that to the posterior part and hollow of the ham or poples. At first it is separated from the deep femoral by a quantity of fat and by the glands; then lies upon the vastus internus; and, passing along in a declivity Sect. II. DESCENDING AORTA. 143 between the vastus internus and adductors, enters the oblique canal in the common tendon of the ad- ductors. Having passed through this canal, it takes the name of Popliteal Artery, where it runs from the inner to the back part of the thigh. Before reach- ing the posterior part, it passes over two-thirds of the femur; and though the thigh be here more slender than at the superior part, it lies deeper con- cealed among the muscles. A. Numerous branches—irregular in distance, order, and situation—rising from the trunk as it runs along the anterior and inner part of the thigh, and distributed to the inguinal glands and sartorius, and through this to the skin; also to the rectus, vastus internus, long and short adductors, and gracilis. Of these, some are larger, vsome less—entering the muscles, in different places, from three to six. B. The large anastomotic branch—rising from the inner surface of the trunk, at the su- perior margin of the tendinous canal; and, bending downwards, spreads, with many ser- pentine ramifications, on the vastus internus, into which it sinks. From this proceed, a. A Branch to the sartorius and skin. b. A Branch—running to the outer margin of the tendon of the sartorius before the trunk reaches the vastus internus; and passing, along with the tendon, over the joint of the knee, disappears on the fascia and skin of the leg. It first, however, gives many branches to the 144 BRANCHES FROM THE Sect. II knee, inosculating with the inferior articulare, and with the recurrent branch of the anterior tibial. Like the following artery, it often rises separately from the femoral trunk. c. A Branch—rising in the tendinous canal, and accompanying the tendon of the triceps which covers it, to the inner condyle of the femur, where, running downwards, it spreads into various ramifications. It also sends off a branch under the tendon, as it is attached to the con- dyle, which runs transversely, upon the perios- teum of the condyle, to the common tendon of the extensors and the external condyle, where it forms an arch, around this extremity of the femur, with the superior and inferior externo- articulars, and also distributes twigs to the cavity of the joint. d. A Branch—running transversely, perforating the vastus near the rectus, and inosculating, on the substance of this last muscle, with a branch of the external circumflex. e. A Branch—rising in a similar manner from the vastus, and inosculating, on the surface of the knee, with the articular branches. /. A Branch—passing upwards, anastomosing, upon the vastus or cruralis, with the small descending branch of the circumflex. C. The superior perforant—issuing from the outer side of the trunk, where it lies concealed by the tendon of the triceps; and, bending transversely backwards, between the posterior surface of the bone and the inferior muscular part of the great adductor, near the origin Sect. II. DESCENDING AORTA. 145 of the short head of the biceps, penetrates the fibres of this muscle, or those of the adductor, to the flexors of the thigh—Sending off, in this course, a. Branches to the adjacent muscles. b. A Perforating Branch—which, soon ramify- ' ing, inosculates in the substance, or on the surface of the flexors, with ascending and descending twigs, but chiefly on the long head of the biceps with descending branches of the second perforant, and with ascending branches of the inferior perforant. N. B. The perforating branch of this and the following artery is sometimes wanting; and the trunk is inflected under the biceps only to the vastus externus, where it passes into many branches, inosculating variously with the neighbouring articular artery. D. The inferior perforant—issuing a little be- low the last, from the external margin of the trunk; running transversely, under the adduc- tor magnus, at the posterior surface of the fe- mur, to the short head of the biceps, and un- der that to the muscular substance of the vastus externus. It sometimes extends to the cruralis, and is often double. It gives a. Minute branches to the adjacent muscles. b. The Inferior Nutritious Branch—sent upwards from the trunk as it passes under the short head of the biceps; inosculating, on the femur, near the linea aspera, with the superior nutri- tious branch, and distributing its last ramuli 146 BRANCHES FROM THE Sect. II. in the substance of the bone. It is sometimes sent off from the former perforant. r. A Perforating Branch—running, in the hollow of the poples, to the semimembranosus, and inosculating, on its surface, with the superior perforant. It is sometimes wanting. • d. Branches—.uniting, on the vastus externus, with the larger and lesser descending branches of the external circumflex. e. A Branch—bending to the vastus internus, and sometimes inosculating, under the tendon of the triceps, with a lesser descending branch. The popliteal artery—that part of the Superficial Femoral which runs along the hollow of the poples. As its limits should be accurately defined, on account of the numerous branches which arise from it, we observe, that its superior part is bounded by the posterior margin of the tendon of the triceps, and its inferior by the higher extremity of the soleus muscle, under which it divides into the Anterior and Posterior Tibial Arteries. Being covered externally by the aponeurosis which surrounds the joint, it runs obliquely, outwards and downwards, through the adipose substance between the flexor tendons, passing into the cavity between the con- dyles and the heads of the gastrocnemii. As it pro- ceeds over the joint of the knee, it lies upon the capsule, and afterwards on the popliteal muscle. The numerous branches to which, in this course, it gives origin, are divided into Articular and Muscu- lar. Of these, the first are, Sect. II. DESCENDING AORTA. 147 A. The superior externo-articular—ascend- ing, on the periosteum of the femur, from the outer side of the trunk, above the condyle, and running, on the periosteum, towards the origin of the short head of the biceps; then bending, under the common tendon of the biceps, to the posterior margin of the vastus internus, divides into two ramuli. a. Many branches of smaller size, running up- wards and downwards, distributed to the peri- osteum, capsule, biceps, and gastrocnemii. b. The Deep Branch—passing through the vas- tus muscle, which it supplies with ramuli, to the periosteum of the external condyle, and there spreading into various ramifications. Of these, some are distributed to the lateral liga- ment and skin; some are interwoven with the inferior externo-articular, and the perforating branches of'thesuperficialfemoral; while others run transversely to the internal condyle, and inosculate with the superior interno-articular. c. The Superficial Branch—winding on the sur- face of the vastus externus, near its extremity, towards the upper edge of the patella, and anastomosing by an ascending branch with the extremity of the large descending branch of the circumflex, and, under the tendon of the rectus, with a branch of the large anastomotic; winding also round the patella, and uniting, by various descending twigs, with the vascular plexus of the knee, formed by all the articulars together. B. The superior interno-articular—run- 148 BRANCHES FROM THE Sect. II. ning, above the inner condyle, from the inte- rior edge of the trunk, in a transverse or oblique direction, under the tendon of the tri- ceps, to the patella. It is sometimes double. a. Smaller Branches—distributed, in the hollow of the poples, to the periosteum, capsule, con- dyle, and flexor tendons. b. A Superficial Branch—exhibiting a continua- tion of the trunk—running, between the ten- don of the biceps and the vastus internus, to the surface of the knee, and there forming a vascular plexus, by its numerous branches. It inosculates, near the lateral ligament, with an ascending branch of the inferior interno-arti- cular, and, by sending out branches that ob- liquely perforate the ligamentous strata, is extensively ramified below the patella. JY. B. A Deep Branch arises from the large ana- stomotic branch of the femoral. C. The middle articular, or azygos—irre- gular in its origin—rising sometimes from the posterior and outer surface of the popliteal, at other times from the external or internal supe- rior articular; runs always to the posterior li- gaments of the knee and the middle of the cap- sule; and divides into, a. An External Branch—winding extensively between the condyles; running to the poste- rior and crucial ligament, and the semilunar cartilages, and inosculating here with all the adjoining branches. b. An Internal Branch—distributing its twigs, in the inner side of the capsule, to the fat of the Sect. n. DESCENDING AORTA. 149 poples, to the bone, crucial ligament, and capsule. D. The inferior externo-articular—rising below the knee joint, under the plantaris and external head of the gastrocnemius; runs, out- wards and upwards, to the top of the fibula, and there entering, under the external lateral ligament and aponeurosis, a groove which is formed in the external semilunar cartilage, proceeds, between the femur and the head of the fibula, to the patella. a. Separate Branches—distributed to the po- pliteus, styleus, gastrocnemius, skin, and pe- riosteum. b. A Branch, forming a conspicuous inosculation with the tibial recurrent. c. A Superficial Branch—sent off while the trunk rests upon the cartilage; transmitting many small ramuli to the vascular plexus of the knee, the aponeurosis, and skin; and inoscu- lating with the superior externo-articular. d. Small Branches—entering the semilunar car- tilage, periosteum, and capsule. , e. A Deep Branch entering the capsule near the patella, and spreading out its various ramifications within the cavity of the joint. E. The inferior interno-articular—de- scending a litde, as it runs inwards below the joint, between the superior edge of the popliteus and the gastrocnemius, to the posterior angle of tlu condyle of the tibia; and then passing, un- der the internal lateral ligament of the knees BR ANCHES FROM THE Sect. II. and the tendons of the internal flexors, to the lower margin of the patella. a. Many Branches—terminating in the popliteus, posterior and crucial ligaments, capsule and tendons of the flexors; one of them inosculating with thenutritious branch of the posterior tibial. b. Superficial Branches—dispersed on the apo- neurosis, to the inferior edge of the patella, and communicating there with the anterior tibial. c. Branches exhausted on the common tendon of the extensors and ligament of the patella. d. Branches to the ligament of the patella, inos- culating with the superior and inferior exter- no-articular. e. A Deep Branch—running along the edge of the internal semilunar cartilage, and inoscu- lating, by a transverse branch, in the hollow of the joint, under the patella, with the inferior externo-articular. N. B. The vascular plexus, covering the knee, is formed by all the articular arteries, the recurrent tibial, circumflex, large anastomotic^ and some twigs of the perforants. F. Of the muscular branches, which are infi- nitely varied, the following chiefly merit atten- tion. a. Two or three Conspicuous Branches—though often wanting—distributed to the flexors, but chiefly to the semimembranosus, biceps, and nerve. These sometimes supply, by reflex branches, the want of perforants from the superficial femoral. b. Two Gastrocnemial Branches—running, in Sect. II. DESCENDING AORTA. 151 parallel lines, between the heads of the gas- trocnemius, and penetrating, with various ramifications, the internal side of the muscle, in which they terminate. Of these, one runs, on the surface of the muscle, to the tendo Achillis, and its insertion into the os calcis. c. Two Branches to the soleus; but sometimes wanting. d. Branches to the substance of the plantaris, periosteum, vessels, and nerves. (I.) The anterior tibial artery—some- what smaller than the Posterior—rises anteriorly from the popliteal, at the inferior margin of the popliteal muscle, and, perforating the interrosseous ligament, runs from the posterior to the anterior part of the leg. It here descends close to the liga- ment, at first between the tibialis anticus and com* mon extensor, and then between the anticus and the extensor longus of the great toe. In this course, it lies nearer to the fibula than the tibia; but having gradually separated from the ligament, it turns now more forwards and inwards the farther it descends; and passing over the lower extremity of the tibia, and over the tarsus, along with the extensor tendons, under the crucial ligament, divides, between the first and second metatarsal bones, into two branches: of which one, sinking between the bones to the planta of the foot, inosculates with the external and internal plantar branches of the posterior tibial, while the other, passing along the dorsum of the foot, runs 152 BRANCHES FROM THL Sect. II to the great toe. The most remarkabje branches issuing from it in this course are, A. A Branch to the origin of the posterior tibial muscle, or soleus. B. An ascending branch—transmitting twigs, under the popliteus, to the external and poste- rior part of the tibia and capsule, and thence to the head of the fibula, the origin of the so- leus and joint; which, as they are reflected for- wards, inosculate with the inferior articular branches. N. B. These branches are sent off before the ar- tery passes out of the ham. C. The tibial recurrent—winding to the an^ terior surface of the knee, between the superior part of the tibial and extensor muscles, or bend- ing upwards through the substance of these muscles; and giving, a. Many Branches to these muscles and the ligaments connecting the bones. b. A Branch—winding round the head of the fibula as it passes outwards under the common extensor of the toes, and the peroneus longus, and inosculating with the branch B. c. Branches—running to the vascular plexus on the ligaments of the knee, and forming nume- rous inosculations with the inferior articular. . D. A large branch—running down upon the fibula, between the tibialis and peroneus longus, and between the same peroneus and extensor communis, and inosculating, near its inferior extremity, with the fibular. Sect. II. DESCENDING AORTA. 153 E. Many minute branches—rising, through the whole course of the artery, between the two bones of the leg, distributed to the tibialis anticus, extensors, peronei, aponeurosis and pe- riosteum of the bone, chiefly of the tibia; vari- ously interwoven with one another, and below with the fibular. F. Branches—partly sent off to the extensor ten- dons while the trunk lies upon the naked tibia, partly spreading, in a retrograde course, on the surface of the bone, covered by the aponeuro- sis, and meeting here the posterior tibial and an terior fibular. G. The internal malleolar—spreading vari- ously while running down on the inner ankle; inosculating, by ascending branches, with the preceding ramuli, and stretching, with descend- ing branches, to the capsule, astragalus, os na- viculare, and cuneiforme; and uniting, in vari- ous places, with branches of the internal plan- tar. H. The external malleolar—forming a large communication, in the interosseous space, or a little below it, with the anterior fibular, or some of its branches—winding to the external ankle, where it sends, if not sooner, branches to the peroneus brevis, the joint, the short common extensor, and the tendons of the pe- ronei; forming, under these tendons, many in- osculations with the posterior fibular, and an- teriorly with the anterior fibular. It at last 154 BRANCHES FROM THE Sect. II. reaches the tarsal arch. It often exhausts the whole anterior fibular, or rather this takes the course of the malleolar. I. Many branches—passing, under the transverse ligament, to the extremity of the tibia, the hol- low of the tarsus, capsule, extensor tendons, the most of the tarsal bones, particularly the as- tragalus and the short extensor. Some of these, winding on the tarsal bones, and bending with ramuli to the planta, run on one side, near the tendons of the peronei, to the fibular; and, on the other, beyond the inner margin of the tar- sus to the internal plantar. K. The transverse tarsal, or tarsal—sent from the external side of the trunk, outwards and downwards, under the extensor brevis, to the surface of the second row of tarsal bones, uniting, at the edge of the fifth metatarsal bone, with the external plantar; and thus forming the tarsal arch. From this trunk generally proceed, a. A Branch—running outwards, between the articulation of the tibia and fibula, with the astragalus; and, after sending twigs to each articulation, inosculating with the posterior fibular and external malleolar. b. A Branch—sinking deep into the fovea or pit of the tarsus, and there supplying its ligaments and fat. c. Branches—rising, in various places, and ex- hausted on the extensor brevis. d. Branches—distributed between the cuneiform bones and cuboides of the tarsus. Sect. IL DESCENDING AORTA. 155 e.The First Dorso-metatarsal,ov Dorso-interosseal —lying in the space between the second and third metatarsal bones and the interosseous muscle; and, after running to the root of the toes, and giving branches to the extensor ten- dons, and others, to inosculate with the poste- rior and anterior perforants and transverse metatarsal, exhausting itself in the bifurcation of the plantadigital artery. f. The Second Dorso-metatarsal, or Dorso-inter- osseal—running, like the last, to the third interval, and terminating in a similar manner. g. The Third Dorso-metatarsal, or Dorso-inter- osseal—rising near the os cuboides; running in the fourth interval of the metatarsal bones, and supplying similar branches as the former metatarsals. h. A Branch—rising at the fifth metatarsal bone from the inosculation of the transverse tarsal and external plantar; running along this bone, and exhausting itself, by some ramuli, upon the adductor of the little toe. JV. B. The Dorso-metatarsals, or Dorso-interos- seals, often arise from the transverse metatar- sal; in which case, the transverse tarsal only produces minute branches, inosculating, near their origin, with the dorso-metatarsals. Some- times, also, the dorso-metatarsals give origin, by meeting with the perforants, to one or two planta-digital branches; or produce other digi- tals, spreading on the back of the toes, and inosculating with the true digitals of the ex- ternal plantar; or producing, as in the hand, BRANCHES FROM THE Stect. II. dorsal branches. The anterior perforants, penetrating, near the roots of the toes, the metatarsal interstices, seem to arise from these dorso-metatarsals; or, if they have issued from the plantar metatarsals and digitals, anastomose with them in the same place. L. Branches—distributed, from the inner edge of the tibial artery, to the internal side of the tibia, the extensor tendons, the pt riosteum, the tendon of the tibialis anticus, and the navicu- lare and first cuneiform bone. M. A branch—running on the surface of the na- viculare towards the plantar side of the foot, where, covered by the abductor pollicis, to which it gives branches, it inosculates with one or two branches of the internal plantar. N. A branch to the abductor pollicis, first run- ning along the margin of the first metatarsal bone, and then disappearing on the inner side of the dorsum of the great toe. O. A branch—issuing from the external edge, between the transverse tarsal and transverse metatarsal arteries, giving twigs to the extensor tendons and the short common extensor. P. The TRANSVERSE METATARSAL ARTERY__Va- rying in size, and sometimes entirely wanting according to the number and magnitude of the branches which are sent off from the transverse tarsal. It runs to the commencement of the first and second dorso-metatarsal bones, and, passing transversely to the little toe, gives rise to metq- Sect. II. DESCENDING AORTA. 157 tarsal branches, if they have not already been supplied by the transverse tarsal. Though smal- ler and shorter than usual, it generally gives origin to the metatarsal of the third interval, and the dorsal branches of the third toe. Its ultimate branch, winding, near the os cuboides, under the tendon of the small peroneus, is partly exhausted on the abductor of the little toe and peroneal tendons, and partly on the plantar in- teguments. Q. The DORSO-METATARSAL, Or EXTERNAL DOR- SAL of the great toe—the superficial branch of* the anterior tibial artery as it is now about to terminate. It traverses, on the interosseous muscle, the outer margin of the first metatarsal bone; and gives, a. Minute Branches—spreading on the surface of the metatarsal bones; inosculating either with the transverse tarsal, or transverse meta- tarsal, and running to the extensor tendons. b. The Dorso-tibial, or Internal Dorsal Branch of the Second Toe—running along the inner or tibial side of this toe. c. The Dorso-fibular, or External Dorsal Branch of the Great Toe—uniting first with the ex- ternal plantar of the great toe, and running afterwards to the termination of the toe. R. The deep anastomotic branch—sinking into the plantar side of the foot, where it again appears; and, after sending branches to the abductor and adductor, inosculating with the plantar arch. From this inosculation, or some- z 158 BRANCHES FROM THE Sect. II. times sooner, arises the planta-pollicar, a remark- able artery on the plantar side of the great toe, of which I shall give a description along with theplantar branches. (II.)The posterior tibial—the other branch of the Popliteal Artery, where it divides at the superior extremity of the soleus—passing down, under the soleus, upon the posterior surface of the flexor longus and tibialis posticus, to the lower ex- tremity of the tibia, is afterwards inflected inwards to the plantar side of the foot, running between the tendo Achillis and the epiphysis of the tibia, behind the internal ankle. While there covered by the laciniated ligament, and involved in fat, it meets, on the inner side of the foot, the broad extremity of the abductor pollicis, and divides into two branches: One of which, passing to the great toe, I call the Internal Plantar; the other, denominated External Plantar, runs to the sole, between the flexor brevis and longus, and under these, still deeper, to the fifth metatarsal bone. Here returning to the great toe, by an oblique and transverse flexion under the tendons of the flexor longus, it forms the plantar arch. The branches issuing from this artery I shall enumerate in the order in which they are exhibited. A. Branches to the inner head of the gastrocne- mius; often wanting. B. The large nutritious artery of the tibia, or posterior interosseal—spreading exten- Sect. II. DESCENDING AORTA. 159 sively downwards, between the flexor of the toes and posterior tibial, above the interosseous ligament, and inosculating with the fibular at the inferior extremity of the tibia. From this issue, a. A Branch to the soleus, popliteus, and perios- teum of the tibia, communicating with the descending branch of the inferior interno- articular. b. A Branch to the tibialis posticus. c. A Nutritious Branch—entering the bone, and distributing its twigs upwards and downwards. d. Branches—winding, through the whole course of the artery, partly on the periosteum of the tibia, and partly on the tibial muscle and the common flexor. C. A large branch—winding round the exter- nal head of the fibula, under the muscles, after giving a twig to the soleus, and receiving some anastomotic branches of the tibial recurrent. D. Many large branches to the soleus, inter- woven everywhere with fibular twigs. E. Some cutaneous branches—running out far with the veins and nerves, and anastomosing, upwards and downwards, with the anterior ti- bial. F. The common fibular, or peroneal—very irregular in size and the distribution of its branches. It often equals in dimension the an- terior tibial; at some times is entirely wanting; and at other times is rather smaller than the posterior tibial. After rising, near the superior 160 BRANCHES FROM THE Sect. II. extremity of the tibialis posticus, it descends between this muscle and the flexor pollicis. A little lower, it is covered by the flexor pol- licis; and at last escapes the eye of the dissec- tor between the two bones, where it touches the interosseous ligament. Near the inferior extremity of the bones, where they are more closely connected, it divides into the anterior and posterior fibular arteries. It gives, a. Branches—passing through the soleus to the skin, inosculating with other inferior fibular twigs, and with branches of the posterior tibial. b. A Brunch—penetrating the peroneus longus and the skin- c. Branches—partly exhausted on the tibialis and the common flexor of the great toe, and partly spreading on the periosteum of the fibula. of. Many Branches—windingtortuously, in various places, under the flexor pollicis and peroneus longus, to the anterior part of the fibula, inos- culating there, upwards and downwards, with twigs from the anterior tibial. e. Many Branches—rising, in various places, from the descending trunk, and distributed to the tibialis posticus, peronei, flexor pollicis, the inferior tendon of the soleus and gastroc- nemius, the periosteum, and skin. Of these, some perforate the interosseous ligament, and terminate between the anterior muscles. f. The Nutritious Artery of the Fibula—the last of the branches which rise from the trunk be- fore it is covered by the flexor pollicis, rami- Sect. II. DESCENDING AORTA. 161 fying on the periosteum and the substance of the bone. g. The Posterior Fibular—the largest and most regular branch of the common fibular. As it proceeds from its cavity, backwards and out- wards, it begins to descend; and, after running behind the external malleolus, to the outer and hollow surface of the os calcis, it inosculates, under the abductor of the little toe, before the tuberosity of the os calcis, with some branches of the external plantar, or sometimes is wholly expended on this abductor muscle and the skin. It often gives, «. Branches to the long flexors of the toes and the peronei. /J. A Large Transverse Anastomotic Branch—unit- ing, on the periosteum of the tibia, and under the tendons of the gastrocnemius, and the other muscles, with the posterior tibial, and some branches of the dnterior tibial. Other ramuli are sometimes sent from this branch to the ankle joint and tendo Achillis; which, uniting with others from the fibular and the external malleolar of the anterior tibial, reach the outer surface of the os calcis. y. A Branch—sometimes single, sometimes double __forming a plexus in the external cavity of the calcaneum, or os calcis, and anastomosing fre- quently with the anterior tibial branches. i. A Branch—as the artery runs to the external side of the calcaneum, forming, under the liga- ment that unites the tibia and fibula, a new communication with the posterior tibial, and, by twigs sent outwards, with the external malleolar. ;. Branches to the peroneal tendons and sheaths, forming a plexus with the anterior fibular when present. 162 BRANCHES FROM THE Sect. II. r\ Branches—reaching, in the sinuosity of the os calcis, to the fore part of this bone, and inoscu- lating with similar branches of the posterior tibial (see L), at the same time giving out others, thinly ramified on the bone, and termi- nating, by many minute twigs, on the fat and skin. n. Branches to the abductor of the little toe, entering, like the terminating trunk, into a remarkable, and almost constant, inosculation witli the external plantar. h. The Anterior Fibular—often wanting—when present, passes through the interstice of the crural bones, running, downwards and for- wards, in the angle between the extremities of the tibia and fibula, behind the extensor pollicis and the short peroneus, where it in- osculates with the external malleolar; and then proceeding, under the tendon of the peroneus, to the os cuboides, where it lies concealed be- tween this bone and the abductor muscle, in- osculates partly with the external plantar, and partly terminates on the skin. From this arise, a. A Branch—running upwards to the fibula and periosteum of the tibia. &. Branches—interwoven, in the neighbourhood of the external malleolus and peroneal tendons, with the former artery. y. A Transverse Anastomotic Branch—forming, behind the extensors, and on the periosteum, a remarkable inosculation with the anterior tibial, sending also twigs to the capsule and tendons. S: A Branch—sinking into the capsule of the joint, after inosculating with various metatarsal branches. e. Many Branches—scattered among the ligamen- tous sheaths of the peroneal muscles, and inos- Sect. II. DESCENDING AORTA. 163 culating, in many places, at the exterior side of the calcaneum, with the posterior fibular. £. Branches—inosculating with the transverse tar- sal, on the surface of the os cuboides, and there contributing to the formation of the tarsal arch. yi. Branches to the abductor of the little toe, often terminating the trunk, or sent off*, near the union of the trunk, with the plantar. G. Numerous branches—distributed, in the course of the artery, to the adjoining flexor muscles, tibialis posticus, soleus, tendo Achil- lis, nerve, and skin. H.Transverse branches—often double—anas- tomosing, as already noticed, with the posterior fibular. I. A branch—forming a plexus, at the epiphysis of the tibia and its malleolus, upon the perios- ' teum, with some superior branches of the pos- terior tibial and internal malleolar, and sending sometimes twigs to the capsule of the joint. K. Branches to the flexor tendons and their sheaths. L. Two large branches—issuing from the trunk as it runs along the lateral concavity of the heel, at the tuberosity of the calcaneum, spread- ing out upon its periosteum and aponeurosis, as also upon the abductor pollicis and skin; and inosculating with branches of the fibular. M. A deep branch—passing under the tendons, to the capsule of the astragalus and calcaneum, and the bones. N. Another deep branch—running out to the 164 BRANCHES FROM THE Sect. II other adjoining bones and their ligaments, and to the articulation of the tibia and astragalus. O.The external plantar—the larger branch of the posterior tibial—passing, gradually outwards and forwards, between the short flexor of the toes and the massa carnea; or, under this mus- cle, to the inner edge of the abductor of the little toe. As it proceeds to the base of the metatarsal bone of the little toe, between the flexor brevis and abductor, it runs gradually inwards to the great toe, with alternate flexions; and, passing over the interosseous muscles, forms the plantar arch; which, at last, is wholly received by the anterior tibial, in the first interstice of the metatarsal bones, under the adductor pollicis. Its branches are, a. A Transverse Anastomotic Branch—running outwards upon the naked bone, along the an- terior tuberosity of the os calcis, and forming a large inosculation with branches of the an- terior tibial, at the inner side of the tuberosity, and with the posterior fibular at the outer side; constituting, at the same time, a vascular plexus, from which many branches are sent to the bone, flexor brevis, aponeurosis, and skin. b. Branches to the large ligament of the calcaneum. c. Many Branches—while the trunk runs above or below the massa carnea, and passes, exposed, between the flexor and abductor minimus, sent to this muscle and the flexor brevis, and thro' this, or near its external margin, liberally dis- tributed to the aponeurosis and skin. Sect. II. DESCENDING AORTA. 165 d. The First Deep Branch, or First Profunda— running to the abductor and flexor of the little toe, and uniting with the posterior fibular on the external and lateral part of the calcaneum, and with the deep branch of the internal plantar upon the surface of the calcaneum on the in- ternal side of the same bone. e. The Second Deep Branch, or Second Profunda —rising at the termination of the os cuboides; and, while it observes the same course outwards as the last, forming similar and new inoscula- tions with the anterior fibular and transverse tarsal. It also contributes to the plexus that is spread out in the cavity of the foot, and among the ligaments of the tarsal bones. /. Branches—sent to the abductor of the little toe, and the periosteum of the adjoining bones; spreading variously among the bones, and in- osculating with the neighbouring ramuli. g. The Planta-digital, or External Plantar of the Little Toe—issuing from the trunk as it touches the base of the fifth metatarsal bone, and begins the formation of the arch. While it accompanies this bone forwards, covered by the flexor and adductor of the little toe, it distributes branches to these muscles and skin. At the other extremity of this fifth metatarsal bone, it receives a transverse twig from the external plantar, or the adjoining digital; then passes over the inferior or plantar surface of the bone, and, on the outer or fibular side, reaches the apex of the little toe. h. The Second Planta-digital,—rising in the fourth interstice of the metatarsal bones, above the 2 A 166 BRANCHES FROM THE Sect. II. interossei, at the basis of the toes, and, while there, covered by the transverse muscle, di- viding into the digito-tibial, or internal plantar, of the little toe, and the digito-fibular, or exter- nal plantar of the fourth toe.—Sending out, ec. Numerous Branches to the skin. 0. Branches to the abductor of the little toe. y. Branches—anastomosing with the/>/a«ta meta- tarsal and others uniting with the metatarsals. i.The Third Planta-digital—runningbetween the third and fourth metatarsal bones, and giving origin to the digito-tibial of the fourth toe, and the digito-fibular of the third. From this arise, «. Branches—uniting with the external branch of the internal plantar atf. jS. Small and Superficial branches to the adjoining lumbricals and transverse muscle. y. Anterior Perforants—dispersed in this third in- terstice to the capsules of the joints. k. The Fourth Planta-digital—running between the second and third metatarsal bones, and giving rise to the digito-tibial of the third toe, and the digito-fibular of the second. From this branches issue, similar to those at i. Between these digitals, two or three deep in- ter osseals, or planta-metatarsals, and four per- forants, issue from the plantar arch, whose di- rection, though very irregular, deserves to be noticed. I. A Planta-metatarsal, or Deep Interosseal Branch —rising near the planta-digital oi the little toe, and running between the sixth and seventh in- terosseous muscles. After sending off many ramuli to the adjoining muscles, it inosculates Sect. II. DESCENDING AORTA. 167 with the dorsal or anterior perforant* of the dorso-metatarsal of the fourth interstice, and unites, near the metatarsal articulation of the fourth and fifth toe, with the dorsal and plantar branches of the digitals. It sometimes gives a dorso-metatarsal to the fourth and fifth toes. See a description of the Dorso-metatarsals, page 155 and 157. m. Another Deep Planta-metatarsal—the second arising from the arch, and running out, in the third interstice, between the fifth and sixth interosseous muscles. In other respects, its distribution is similar to the last, and to that of the third deep planta-metatarsal, when present. n. The Plantar, or Posterior Perforant of the Fourth Interstice—emerging to the dorsum of the foot, and uniting with the metatarsal, after having distributed twigs to the interos- seous muscles and the ligaments of the meta- tarsal articulation. o. The Plantar,or Posterior Perforant ohhe Third Interstice—passing to the transverse metatarsal after perforating the interstice of the bones. p. The Plantar, or Posterior Perforant of the Second Interstice—similar to the former, and sending off twigs to the adductor pollicis. q. The Plantar, or Posterior Perforant of the First Interstice—terminating in the transverse metatarsal. JV. B. These Plantar Perforants, besides, give a branch, which runs, with the metatarsal of its * Professor Murray calls those perforant* which run from the dor- sum to the planta, anterior perforants; and those which run from the planta to the dorsum, posterior perforants—-Trans** tor. 1§8 BRANCHES FROM THE Sect. II. own interstice, as far as the toe. The planta- metatarsals, after reaching the metatarsal bones, inosculate with branches of the trans- verse tarsal or metatarsal, and dorso-digitals. r. Three branches, running, in a retrograde course, from the concave margin of the arch, and forming, in the cavity of the tarsus, a plexus with the deep branches of the internal and external plantars; distributing ramuli to the ligaments, adjacent muscles, the sheath of the peroneus longus and tibialis posticus, the aponeurosis, and skin. The External Plantar, bending to the first meta- tarsal interstice, becomes larger by its inoscula- tion with the anterior tibial; and running for- wards, under the adductor, to the fibular side of the metatarsal bone of the great toe, where it sends abranch to the flexor brevis, gives rise to, s. The Planta-pollicar, or Internal Pollicar.—Thi& remarkable artery appears, at times, rather to arise from the anterior tibial, which then pre- sents another anastomotic branch, uniting with the external plantar. Between the first and se- cond toes, there spring from this common trunk, tn. A Branch—sending out the digito-tibial of the second toe, and the digito-fibular of the great toe; inosculating with the profunda fibidar of the internal plantar. R. The Digito-tibial of the Great Toe—passing over the inferior or plantar surface of the meta- tarsal bone cf the great toe, under the flexors and adductors, and spreading on the inner or tibial side of this toe, as far as its apex. It receives Sect. II. DESCENDING AORTA. 169 the profunda-median and profunda-tibial of the internal plantar. r y. The Dorso-tibial of the Great Toe—bending outwards, and generally running to the termina- tion of the second phalanx and nail, and forming an arch with the dorso-fibxdar, which rises from the anterior tibial. N. B. All the Digitals send many twigs to the skin, bones, and ligaments; and unless separate dorsal branches are formed by the union of the metatarsals and perforants, these give origin to dorsal branches, reflected upwards, and which form small arches around the root of the nails; while the trunks themselves, mu- tually inosculating, form, on the plantar side of the apex of the toes, arches similar to those upon the volar side of the fingers. P. The internal plantar—the smaller branch of the divided trunk—after rising, on the tibial side, in the sinuosity of the calcaneum, between the tendon of the tibialis posticus and the origin of the abductor pollicis, it runs along, covered by this muscle, and divides, under it, into four branches, which follow the course of the abduc- tor and flexor brevis of the great toe, to the in- ferior extremity of the metatarsal bone of this toe, and terminate in branches of the planta- pollicar that issues from the anterior tibial and external plantar. It sends of, a. A Branch—bending, under the abductor, to the tendons of the tibialis posticus and flexors, and the periosteum of the astragalus, variously interwoven with the internal malleolar, and with the branches at (I.) of the anterior-tibial. BRANCHES FROM THE Sect. II. b. Branches to the abductor and flexor brevis communis. c. A Branch—running deeply outwards, between the large'ligament of the calcaneum and the massa carnea, distributing ramuli to the flexor brevis, the massa carnea, and ligament, and inosculating with branches of the deep exter- nal plantar, running to the tuberosity of the os calcis. d. The Profunda-tibial, or Internal Deep Branch of the Internal Plantar—the first ramulus of the four branches that exhaust the internal plantar—rising at the os naviculare, and fol- lowing the inner border of the abductor polli- cis, or inner margin of the planta; and disap- pearing, at last, in the digito-tibial of the planta-pollicar. It gives rise to, a.. Many Cutaneous Branches. (3. Branches—sent to the dorsum of the foot, and inosculating with branches of the anterior tibial. y. Branches—winding on the periosteum of the tarsal bones. e.The Profunda Median, or Deep Middle Branch of the Internal Plantar—-the second twig of the internal plantar after its division___It lies under the abductor, and, after running along the middle cuneiform bone and the first me- tatarsal bone, unites with the planta-pollicar, or digito-tibial branch of the pollicar. It sends also twigs to the fat and skin, and others inos- culating with the former. /. The Profunda Fibula r, or D eep External Branch of the Internal Plantar—the third branch of the trunk—rising at the beginning of the cuneiform bone. After running forwards, be- Sect. II. DESCENDING AORTA. 171 tween the flexor brevis and abductor pollicis, towards the second toe, it at last unites with the digito-tibial of the second toe, and the digito-fibular of the great toe. It gives, a. Branches to the flexor of the great toe, the com- mon flexor, and abductor. R. Cutaneous Branches—winding superficially out- wards. y. A Small Branch—bending outwards, between the plantar aponeurosis and the flexor brevis, beyond the lumbricals, to the third interstice of the toes, and there inosculating with the digital branches, and chiefly with the third planta-digi- tal. Here, as if forming a superficial arch, it distributes ramuli to the adductor, lumbricals, flexor, aponeurosis, and skin. .Y. B. From these three branches, the planta pollicar, arising from the communication of the anterior tibial and external plantar, re- ceives a considerable increase. g. The External Branch of the Internal Plantar —the fourth division of the trunk—issuing, a little sooner, near the adductor; winding, va- riously outwards, between the massa carnea and ligament of the calcaneum, to the os cuboides, and sending twigs to the neigh- bouring muscles, the tarsal ligaments, and the whole plantar cavity. It anastomoses with the profunde, with recurrent branches from the arch of the external plantar, and with branch (c) of the internal plantar. A branch of this artery sometimes enters the first metatarsal interstice, and inosculates with the transverse tarsal. But it should be remembered, that the branches of the plantar present as numerous varieties as the other arteries of the foot. 172 THE PULMONARY ARTERY. The pulmonary artery, which Professor Murray has omitted, requires little description. It is furnished, like the aorta, with three semilunar valves at its commencement; ascends, gently in- clining to the left, from the upper and anterior part of the left ventricle; and, approaching the concave side of the aortic arch, divides into two similar branches: The Right, which is longest, passing through the arch, behind the vena cava, to the right lobes; and the Left, running before the descending pillar, to the left lobes of the lungs. On reaching the lungs, they immediately divide into a number of lesser branches, which are ramified on all the pul- monary cells, and which, in various places, inoscu- late, by numerous twigs, with the bronchials. The pulmonary artery conveys to the lungs the venous blood which returns from the different parts of the system; and which is changed, by the action of the air, from a deep purple to a florid red, before it is circulated again in the aorta. " FINIS. Medu- Hist. Mil X16