t
 
THE
ANATOMICAL REMEMBRANCER,
                OB,
    Compile pocket Anatomist:
)	CONTAINING	
r*	A CONCISE DESCRIPTION OF	
THB STRUCTURE OF THE HUMAN V		BODY".
	SECOND AMERICAN, FEOM THE FOUBTH LONDON EDI1	
                    WITH
       COBEECTIONS AND ADDITIONS

                    fBT /  .
               C. E. ISAACS.':HI).,
    Demonstrator of Anatomy in tJie University q/2tew York.




jffe            NEW TOEK:            ^ »
         SAMUEL S. <fc WILLIAM WOOD,
]              261 PEAEL STKEET. 
f^ \A v«.  '<■-  *\
    as   „
  Entered according to Act of Congress, in the year 1855,
                By S. S. & W. WOOD,
In the Clerk's Office of the District Court of the United Sta'
         for the Southern District of New York.
B. CRAIGHEAD, PRINTER,
   03 Vent Strett, Wew Vort. 
PREFACE  TO THE  FIRST EDITION.
  The sole object of this little Manual is to recall
to the mind of the Student in Anatomy the inform-
ation he  may have acquired,  either by actual
dissection,  or by the  perusal  of works Avhieh
profess to treat more fully on  the subject.  The
Author, therefore, presumes it will be found highly
useful to those who are preparing for examination
at the Royal Colleges of Surgeons and Societies of
Apothecaries. 

PREFACE  TO THE  FOURTH  EDITION.
  In the attempt to introduce the more important
modern discoveries in Anatomy, the  Editor has
experienced difficulty in keeping this  work to its
proper limits: he hopes, however, that it will be
found to contain sufficient  to recall to  the Student
in Anatomy that  information which  he has ac-
quired in  the  Dissecting Rooms.  He has endea-
vored to simplify the description of certain regions,
which  conflicting  inaccuracies  have  rendered
almost unintelligible.  Foremost amongst  these
stands " the perineum," which is justly regarded
by the Student as an incomprehensible  riddle ;
next  comes the anatomy of the brain; thirdly,
the muscles of the back.   The minute structure  of
bone and  of some of the more important glandu-
lar structures has for the first  time  been intro-
duced, such  information  being  required  by tho
examining Boards of the Profession.

    October, 1860. 
PREFACE  TO THE SECOND AMERICAN
                EDITION.
   This work, as its name indicates, is intended as
 a Pocket Companion, and aid to the memory of the
 Student, and especially while engaged in the details
 of Practical Anatomy.
   Several errors in the last  edition have been cor-
 rected, and some  additions  made  to  the present,
 which semed to be useful, and demanded by  the
 advanced state of the science.  Hernia is  one of
 the  subjects which  usually present the greatest
 difficulty to Medical Students : such a description
 has* therefore been given of its anatomy and  dissec-
 tion, as from long experience  I  have  found to be
 most easily comprehended^voiding aLbunnecessary v
 complexity and detail, or reference to discordant j
 statements of different authors.                  -*
  It  is hoped that this book, in its present form,
will  be of increased utility to those for whose use
it was especially designed.
                           C. E.  Tsaacs, M.D.  J

          c, 
/
 A 
INDEX.
OSTEOLOGY,
Minute Structure  of Bone
The Spinal  Column  ....
  Common characters of a true vertebra
  Characters of the lumbar vertebrae
  Deviations   ....
  Characters of the lorsal vertebra?
  Deviations   ....
  Characters of the cervical vertebrae
  Deviations
  False vertebra?
  Os sacrum
  Os coccyx
The Thorax
  Common characters of a rib
  Deviations
  The sternum  .
The Pelvis.....
  Os ilium ....
  Os pubis ....
  Os ischium
The Bones of the Superior Extremity
The Bones of the Lower Extremity
The Sesamoid Bones
The Skull and Face
  Frontal bone  .
  Parietal bone  .
  Occipital bone. 
   Temporal bone
   Ethmoid bone .
   Sphenoid bone.
   Malar bone
•  Superior maxillary bone .
   Palate bone
   Inferior spongy bone
   Lachrymal  bone
   Nasal bones
   A'omer  ....
   Inferior maxillary bone  .
   Os hyoides
The Cranial and Facial Sutures
The Orbits ....
The Temporal Fossae .
The Zygomatic Fossae .
The Pterygo-Maxillary Fissures
The Articulations
   Temporo-maxillary articulation
   Occipito-atlantoid articulation
   Occipito-axoid articulation
   Atlanto-axoid articulation
   Common vertebral articulation
   Costo-spinal articulation .
   Chondro-sternal articulation
   Lumbo-sacral articulation
   Ilio-sacral articulation
   Saero-coccygeal articulation
   Pubic articulation  .
   Sterno-clavicular articulation
   Scapuloclavicular articulation
   Coraco-clavicular articulation
   Ligaments  of the scapula
   Humero-scapular articulation 
  Humero-cubital articulation  .
  Superior radio-ulnar articulation
  Inferior radio-ulnar articulation
  Radio-carpal articulation
  Carpal articulations
  Carpo-metacarpal articulations
  Metacarpo-phalangeal articulations
  Inter-phalangeal articulations.
  Ilio-femoral articulation  .
  Femoro-tibial articulation
  Tibio-fibular articulation.
  Articulation of the ankle
  Articulations of the tarsus
  Tarso-metatarsal articulations.
The Muscles    ....
  Muscles of the head
  Muscles of the external ear
  Muscles of face
  Muscles of lower jaw
  Muscles on anterior and lateral parts of
      the neck  ....
  Muscles of the pharynx  .
  Muscles of the palate
  Muscles of the larynx
  Deep muscles  on anterior and  lateral
      parts of the neck
  Muscles of the thorax
  Muscles of the back
  Muscles of shoulder and arm .
  Muscles of fore-arm and hand
  Muscles of abdomen
  Deep muscles of  abdomen
  Muscles of male perinseum
  Muscles of female perinseum .
Page 
X INDEX.	
Muscles of inferior extremity .	Page 105
Muscles of hip.....	107
Muscles on back of thigh	108
Muscles on anterior and external part o:	
leg.......	109
Muscles on outer part of leg .	110
Muscles on back of leg .	110
Muscles of foot.....	111
Muscles of orbit.....	113,
Muscles of internal ear .	114
The Brain and its Membranes .	115
Dura mater......	115
Sinuses . ......	116
Tunica arachnoidea ....	118
Pia mater......	119
Cerebrum.....	119
Cerebellum.....	m
Medulla oblongata ....	127
Base of the brain ....	128
Origins of the cerebral nerves	130
Distribution of the cerebral nerves.	. 131
Ganglions in connexion with the fiftl	i
pair......	. 134
Spinal nerves.....	. 139
Cervical plexus ....	. 140
Brachial plexus ....	. 141
Dorsal nerves.....	. 144
Nerves of AVrisberg.	. 145
Lumbar plexus ....	. 145
Sacral plexus .....	147
Sympathetic nerves	. 148
Cervical ganglions ....	. 149
Cardiac nerves ....	. 150
Cardiac plexus ....	150
 
  Thoracic ganglions .
  Semi-lunar ganglions
  Solar plexus  .
  Renal plexus  .     .
  Inferior mesenteric plexus
  Lumbar ganglions  .
  Sacral ganglions
  Ganglion impar
The Thorax and its Contents
  Pleura?   .    •     •
  Anterior mediastinum
  Middle mediastinum
  Posterior mediastinum  .
The Lungs .
  Trachea and its Ramifications
TnE Heart and Pericardium
The Arteries
The Veins  .
The Digestive Apparatus
  Mouth
  Teeth
  Pharynx .
  Oesophagus
  Stomach .
  Duodenum, jejunum, and ilium
  Ccecum  .
  Colon
  Rectum  .
  Parotid glands
  Submaxillary glands
  Sublingual gland   .
  Liver
  Pancreas .
  Spleen 
The Urinary Apparatus
  Kidneys  .....
  Ureters  .....
  Urinary bladder   .     ...
The Peritoneum ....
The Male Organs of Generation
  Testicles.....
  Spermatic chord
  Yesiculac seminales and prostate gland
  Cowper's glands
  Penis.....
  Urethra  .....
The Female Organs of  Generation
  Mammte.....
The Organs of the Senses .
  Organ of touch
  Organ of smell
  Organ of taste
  Organ of vision
  Appendages of the eye  .
  Organ of hearing
  Absorbent system .
Peculiarities of the Foetus
  Cervical fascia....
  Superficial fascia of the abdomen
  Fascia transversalis and fascia iliaca
  Superficial perinseal fascia
  Deep perineal  fascia, or triangular Liga-
       ment of the urethra .
  Fascia of upper extremity
  Fascia lata    ....
 The Larynx    ....
 The Thyroid Body
 Hernia..... 
                THE

ANATOMICAL  REMEMBRANCER.
         MINUTE STRUCTURE OF BONE.
 Bone is composed of gelatine and phosphate, and
 carbonate of lime.  It is surrounded by a fibrous
 vascular membrane (periosteum): the long bones
 are  lined by an internal membrane called me-
 dullary.   The minute vessels of bone, all of small
 size, run in canals called Haversian; from the
 Haversian canals  radiate minute  tubes, which
 abstract the phosphate of liine from the blood;
 they are called " calcigerous" tubes, or canaliculi,
 and terminate in bone cells, or lacuna?.  If bone
 be cut transversely, it seems under the micro-
 scope composed of rods, placed side by side, in
 the centre of each of which is a Haversian ca-
 nal, sending off its radiating calcigerous tubes,
 and surrounded by concentric rings of bone cells.

                 OSTEOLOGY.
  The assemblage of  bones,  constituting the
fi-amework of  the human body, is termed the
skeleton ; it is divided into head, trunk, superior
and inferior extremities.  The whole number of
bones is 211.
                     1 
2
  The Trunk consists of the spine or vertebral
column, and includes the thorax and the pelvis.
  The Spinal ar Vertebral Column, situated in
the posterior part of the trunk, supports the
head, and is supported by the pelvis.   The bones
which enter into its formation are called verte-
brae, of which there are two classes, the true and
thefalte.
  The true vertebra, twenty-four in number, are
subdivided into three classes, viz., seven cervical,
twelve dorsal, and five lumbar.
  The false vertebra; are coalesced to form two
pieces, viz., the os sacrum and os coccyx, both of
which bones enter into the formation of the pel-
vis.   The  sacrum  is composed of five  and the
coccyx of four pieces of bone.

  COMMON CHARACTERS OF A TRFK VERTEBRA.

   A ring of bone,  the opening of which is called
the  spinal or vertebral foramen.
   The body, a mass of bone placed anterior to
the  ring,  thick, spongy, and presenting many
small hole8 for blood-vessels.
   Lamina, two lateral plates which pass hack-
 wards from the posterior part of the body, form-
 ing the  sides of the ring, and terminating poste-
 riorly in the spinous process, from the existence
 of which the vertebral column has been called
 spine.
   Two  transverse processes, which pass outwards
 from the sides of the laminee. 
3
    Four articular processes, two upon the upper
 and two upon the lower surface of each vertebra,
 situated at the roots of the transverse processes,
 and articulating with the vertebra?  above and
 below.
    All these processes  differ  from the  body in
 being formed of more compact bony texture.
    Four notches, two above and two below, which
 are formed by the lamina being  grooved out
 where they join the body.  Each of these, with
 the corresponding notch above and below, forma
 a lateral hole, the intervertebral  foramen, for the
 exit of the spinal  nerves and  the entrance of
 blood-vessels.

     CHARACTERS OF TnE LUMBAR VERTEBRAE.  "

   1st. They are the largest of the three  classes.
   2nd. The bodies are very broad transversely,
 of oval form,  deepened upon their upper  and
 lower surfaces by  a more compact  lamina of
 bone,  which, projecting  beyond their  bodies,
 renders them slightly concave from above down-
 wards upon their fore part
   3rd. The spinous processes are broad, thick,
 and short.
   4th. The transverse processes  are long, thin,
arid horizontal, and are regarded by some anato-
mists as abdominal ribs.
   5th. The superior articulating  surfaces  are
oval, concave, and look inwards and backwards;
the inferior being oval and convex, directed out- 
                      4

wards and forwards; from each of the superior
articular processes, which are wider apart than
the inferior, there projects backwards the " tu
bercle."
  6th.  The vertebral foramen is  of  triangular
Bhape, and larger than  in the dorsal vertebra?.
  7th.  The notches, particularly the inferior, are
very large, and form larger foramina than at any
other part of the spine.

                 DEVIATIONS.
   The last lumbar vertebra has its body cut off
obliquely upon  its  sacral  aspect,  so  that it is
much thicker before than behind.   Its  transverse
processes also are short and rounded.

    CHARACTERS OF THE DORSAL VERTEBRAE.
   1st.  They are intermediate in size between the
cervical and lumbar vertebra?.
   2nd.  Their bodies are thicker behind than be-
fore, and more convex  transversely,  assuming
upon their surfaces a triangular rather than an
oval form.  On either side at the upper and in-
ferior margins each body presents two small de-
pressions, the upper being the larger, which, with
the intervertebral cartilage and the contiguous
vertebra, form depressions for lodging the heads
of the ribs.
   3cZ.  The spinous processes are long, prismatic,
tnberculated at their extremities, and  directed
obliquely downwards. 
5
   4th. The transverse processes are long, and di-
 rected backwards; on the extremity and ante-
 rior aspect of each is an oval articular surface
 for the tubercle of the rib.
   5th. The articular processes are nearly  verti-
 cal, the superior looking backwards, the inferior
 forwards.
   6th. The vertebral foramen is smaller than in
 the cervical or lumbar vertebra?, and is of oval
 shape.
                  DEVIATIONS.
   The first dorsal vertebra has a full depression
 for the head of the first rib, besides the half de-
 pression for the second; its body is longer in the
 transverse direction, its spinous process is strong
 and horizontal, and its articular  processes  are
 oblique.
   The 11th and  12^ have each  a full depres-
 sion upon the body for the corresponding rib,
 but want the depression on the transverse pro-
 cesses ; the 11^ and 12th have very short trans-
 verse processes, and the 12th resembles a lumbar
 vertebra in the shape of its body, and of its in-
 ferior articular processes.

      Characters of the Cervical Vertebra.
   1st.  They are the smallest of the three classes.
   2nd. Their bodies, deeper before than behind,
 and long  transversely, are concave from side to
side upon  their upper surface, and concave from
before backwards upon their lower. 
c
  3rd!. The lamina are broad and thin.
  4th. The spinous processes are short, horizontal,
and bifid.
  5th. The transverse processes are bifid  and
short, grooved upon  their upper surface for the
spinal nerves, and perforated by a round hole at
their basis for the vertebral artery, the direction
of which is upwards.   Each transverse process
has two roots;  the  posterior springs  from be-
tween the articular processes, at the junction of
the pedicle with the  arch, as is the case with the
transverse processes in the dorsal and  lumbar
regions:  the anterior arises from the side of the
body of the vertebra.
  6th. The articular surfaces are oval in shape,
the superior being  convex, and directed  ob-
liquely backwards and  upwards;  the  inferior
being concave, and directed  obliquely forwards
and downwards.
  7th. The notches,  nearly  of  equal size, are
small, and anterior to the articular processes, as
in the other vertebra?;  but are behind the ante-
rior root of the transverse processes.
  8th. The vertebral foramen is large  and tri-
angular.
                 DEVIATIONS.

  The first, or atlas, consists of a large bony
ring enclosing  an irregular hole, which in the
fresh  state is divided into two parts by the trans-
verse ligament;  the  anterior being occupied by
the odontoid process  of the axis, the posterior 
1
 by the spinal chord.  Instead of a " body," it
 presents anteriorly a small arch of bone, marked
 by a tubercle in front, and a smooth oval surface
 behind, which articulates with the odontoid pro-
 cess of the axis.   At the extremities of this an-
 terior arch the bone acquires great density and
 thickness, and presents upon its upper and lower
 aspects the articular processes, the superior  of
 which, horizontal  and  oval from before back-
 wards, look upwards and inwards, and articulate
 with the condyles of the occipital bone; the in-
 ferior, circular, slightly oval, and directed  down-
 wards and inwards, articulate with the second
 cervical vertebra.   The parts of the  vertebra
 which support the  articular processes are called
 the " lateral masses," and are marked internally
 by rough surfaces, which afford attachment  to
 the  transverse ligament.   The  transverse pro-
 cesses are long,  and terminate in a  tubercle;
 they are pierced at their  basis by the foramen
 for the vertebral artery, the direction of  which
 is upwards and backwards ; behind the superior
 articular surface is a groove, which marks the
 continued  course of this  vessel.   The spinous
process is represented by a small tubercle upon
 the middle of the posterior segment of the ring,
 which is considerably larger than the anterior.
   The second,  or axis, is distinguished  by  its
large tooth-like, or odontoid, process.  This pro-
cess presents anteriorly an oval surface for arti-
culation with the ring of the  atlas, and posteri-
orly a  smooth surface, which  moves against the 
8
transverse ligament, whilst its apex presents an
acuminated  top, to which the check ligaments
are attached.  The laminae  are very thick and
strong, and terminate behind in the spinous pro-
cess, which is strong  and bifid: the vertebral
foramen is heart-shaped, the apex being behind.
The  superior articular surfaces are large, and
directed  a little outwards,  whilst the inferior,
looking downwards  and forwards, are smaller
and flat.
  The transverse processes, not bifid, are short
and directed downwards, the aspect of the fora-
men for the vertebral artery being directed ob-
liquely upwards  and  outwards;  the superior
notches are behind the superior articular  pro-
cesses, whilst the inferior notches are before the
inferior processes.
  The seventh cervical vertebra is called vertebra
prominens, from the length of the spinous pro-
cess, which  projects backwards and terminates
in a tubercle; the foramina, when they exist in
the transverse processes, give passage to the ver-
tebral veins: the transverse processes  are often
of such length as to resemble rudimentary ribs.
  In examining the peculiar characters of the
different vertebrae, it is best to select one from
near the centre of each class: thus the 3rd lum-
bar, the 6 th or 7 th  dorsal,  and  the  4th or 5th
cervical, offer the best examples of the class to
which each belongs;  for as the cervical vertebrae
approach the dorsal, they begin to assume more
or less the characters of the latter, and the last 
9
  dorsal vertebra, upon its under surface, presents
  the characters of a lumbar vertebra.  But there
  is no difficulty in determining the region from
  which any vertebra comes, however faintly its
  characters may be marked.  The transverse pro-
  cesses of all the cervical vertebrae are perforated
  by a foramen which transmits the vertebral ar-
  tery or vein; the dorsal vertebra  present upon
  the bodies a smooth surface of articulation for
 ihe head of the rib: the lumbar vertebra? are dis-
  tinguished by the absence of these characters.

               FALSE VERTEBRA,
 eight or nine in number: the five superior form
 the sacrum, the four inferior the coccyx.

                  Os Sacrum.
   Figure, triangular, the base resembling a lum-
 bar vertebra; the apex presenting a small oval
 surface to  articulate with the os coccyx;  the
 sides presenting two surfaces: the superior, large
 and irregular for articulation with the ilium;
 the inferior thin for the attachment of the sacro-
 sciatic ligaments.
   Pelvic surface, anterior, smooth, concave from
above downwards, traversed by four transverse
lines, and presenting on either side of the median
line four holes, called anterior sacral, for  the
transmission of the anterior sacral nerves.  The
projection which the sacrum forms with the last
lumbar vertebra is called " the promontory."
                     2 
10
"  Dorsal surface, irregularly convex, rough, pre-
senting in the median line irregular processes of
bone  (spinous processes), and  more externally
on either side tubercles of bone analogous to the
articular processes of  the true vertebrae.  On
either side of the  median line are the posterior
sacral foramina, for the transmission of the pos-
terior sacral nerves.
   Vertebral canal, at the base large, and of tri-
angular form, runs at  the dorsal  aspect of the .
bone, and terminates in a triangular fossa at its
apex, where it is bounded on either side by two
tubercles, which are in general prolonged to join
the base of the os coccyx.   It contains the cauda
equina.
                  Os Coccyx.

   Figure, triangular, the base  articulating with
the sacrum.
   Anterior surface, smooth, and supports the
extremity of the rectum.
   Posterior  surface,  rough, for attachment  of
ligaments and muscles.
   Cornua,  are two,  placed superiorly, which
unite with the last tubercles of the sacrum.
   The coccyx is  usually composed of  three  or
four pieces, of which the first,  which articulates
with the sacrum,  is the largest.

                  THE  TnORAX

is formed by the dorsal vertebrae posteriorly, the
ribs laterally, and the sternum anteriorly. 
11
                   The Ribs,
 twelve in number, are  divided  into seven true
 and five false ;  the two lowest of the false being
 called abdominal, or floating ribs.
    The true ribs are each attached to the ster-
 num by separate cartilages.
    The three superior false ribs have their carti-
 lages attached to each other and to the cartilage
 of the seventh rib.
    The false or floating ribs have their cartilages
 free.
          Common Characters of a Rib.

    The head, round, and divided  by a ridge into
 two articular surfaces, which are received into
 depressions on the  sides of the bodies of the dor-
 sal vertebras,  thf ridge affording attachment to
 a ligature whicn connects the rib to the inter-
 vertebral fibro-cartilage.
   The neck,  narrow and round; at  its union
 with the shaft is
   The tubercle,  a  prominence of bone, with a
 smooth surface looking backwards to articulate
 with the transverse process of the vertebra be-
 neath, and a rough surface for the  attachment
 of the posterior costo-transverse ligament.
   The angle, is marked by a rough  line, and is
 the point  where the rib makes its great turn to
 circumscribe the thorax.
   The shaft, that portion of the rib which ex-
tends from the angle to its sternal end,  presents
an external smooth  convex surface, and an inter- 
12
nal concave one; its upper edge being round and
smooth, its lower edge thin, and grooved for the
intercostal vessels, and its sternal extremity of-
fering an oval pit for the reception of the costal
cartilage.

                 DEVIATIONS.

                  First Rib,

  Has no angle, is short  and flat, the head arti-
culating with only one  vertebra, has no ridge,
and one articulating surface; its sternal extre-
mity  being thick  and strong;  one surface is
directed  upwards,  the other downwards;  the
superior presenting a ridge for the attachment
of the anterior scalenus muscle, which separates
two grooves, one for the  subckvian artery, the
other for the subclavian vein.

               The Second Rib,
  Longer than the first, presents externally an
oblique prominent ridge for  the attachment of
the first digitation of the serratus magnus muscle.

          Eleventh and  Twelfth Ribs,

have  neither angle, tubercle, nor  groove, are
very short, and the head resembles that of the
first.
                THE STERNUM,

  Consists of three pieces. 
13
   Figure, flat, elongated, broad above, narrower
 in the centre, and pointed inferiorly.
   Anterior surface, is marked by four transverse
 lines, and is rather convex.
   Posterior surface, smooth and concave.
    Upper piece, quadrilateral and thick, is con-
 cave from side to side upon its upper edge,  and
 presents  at each superior angle two semilunar
 depressions for articulation with the clavicles;
 its lower edge is united to the second piece ; its
 lateral edges receive on either side the cartilage
 of the first rib and half that of the second.
   Middle piece, long and  narrow; receives,  by
 five depressions upon  its  lateral edges, the car-
 tilages of the five inferior true ribs, and by a
 notch at its superior angle half the cartilage of
 the second rib.   Its inferior extremity is long
 and thin, and ends in a cartilaginous epiphysis,
 called the
   Ensiform cartilage, which  is generally bifid,
 and pierced by a  foramen,  its direction  being
 variable.
                  THE PELVIS,

   Is formed of the os  sacrum,  os  coccyx (both
of which bones have  been  already  described),
and the two ossa innominata.

              OS INNOMINATHM,
  Consists in early life of three bones, the ilium,
ischium, and pubes.  "We shall describe each of
these bones separately. 
14
                  OS ILIUM.

  Situation, upwards and outwards in regard to
the pelvis, forming the  upper part  of the ace-
tabulum, and bounding the lower lateral part of
the abdomen.
  It forms the upper and outer part of the ace-
tabulum, joining the pubes  anteriorly, and the
ischium posteriorly.
  The dorsum is rough  at the posterior fifth for
the gluteus maximus; and  presents two semicir-
cular  lines, of which the  superior passes from
the anterior superior spine to the sacro-sciatic
notch, and the inferior from the anterior inferior
spine  towards  the same notch:   the  gluteus
minimus arises from between the curved lines:
the gluteus medius from the space between the
superior curved line and the rough surface for
the gluteus maximus.   In the centre  is a nutri-
tious  foramen.  The venter, which  forms the
iliac fossa, has also a nutritious foramen ; there
is a rough articular surface for connection with
the side  of the sacrum,  and a  small  portion
smooth and immediately above the sciatic notch,
which enters  into the  formation  of the true
pelvis.

                  Processes.

  The crest, which forms the upper  border  of
the bone.
  The anterior superior spine, which terminates
the crest anteriorly. 
15
    The  anterior  inferior spine,  immediately
 above the acetabulum.
    Beth spines are separated by a notch.
    The posterior superior  spine, which termi-
 nates the crest behind.
    The posterior inferior  spine, separated  from
 the former by a small notch.
    The Pio-pectineal eminence, marks the union
 of this bone with the following,

                  os  PUBIS.
   Situation, fore part of  pelvis, and  internal
 part of acetabulum.
   Body, forms the internal and superior part of
 the acetabulum.
   Horizontal ramus, passes inwards to meet the
 opposite ramus.  Descending ramus passes ver-
 tically downwards from the inner extremity of
 the horizontal ramus to join the ramus of the
 ischium.
   Symphysis pubis, is  formed  by the apposition
 of both descending rami.
   The angle is formed by the junction of the
 horizontal  and  descending rami.  From   the
 angles, a rough fine, the crista, about an  inch in
 length,  runs horizontally  outwards,  and  ter-
 minates in a tubercle called the spine.
  The obturator groove, for the obturator  ves-
sels and nerve, is  situated  upon the under  sur-
face of the horizontal ramus.
  The obturator or thyroid  foramen is the  oval 
16
space bounded by the pubes above, and by the
ischium below.
                THE ISCHIUM.
  Situation, lower, outer and back part of the
pelvis.
  Body, forms the outer and back part of the
acetabulum ; immediately beneath this cavity is
a groove  for the tendon of  the obturator ex-
ternus muscle.   The anterior thin edge of the
body  assists  to  form  the  obturator  foramen,
the posterior to form the sciatic notch.
  Spine, projects backwards  and inwards, and
gives attachment to the lesser sacro-sciatic liga-
ment.
  Tuberosity, the thickest part of the bone, on
which we rest when sitting: gives attachment
to the greater sacro-sciatic ligament.  Between
this process and  the spine is  a  pulley-like  sur-
face, for  the  tendon of the obturator  internus
muscle.
  Ascending ramus, turns  forwards,  upwards,
and inwards, and joins the descending ramus of
the pubes ; it bounds the obturator foramen by
its outer  thin edge," and the lower  aperture of
the pelvis by its  thick one.

                ACETABULUM.
  Is formed by the union of the ilium,  ischium,
and pubes; the  ilium  forming less than two-
fifths ; the ischium more'than two-fifths ; and the
pubes the smallest part.   It presents an articular 
17
 surface  for the head  of the  femur, and is sur-
 rounded, in the greater part of its circumference,
 by a margin, which is prominent at the upper
 and outer part; but deficient  at the lower and
 inner part, towards   the  obturator  foramen.
 The part where the margin is wanting is called
 the cotyloid notch; to its borders is attached
 the ligamentum teres of the hip joint.

            ' SUPERIOR EXTREMITY,
   Consists of the shoulder, the arm, the forearm,
 and the  hand.

         THE BONES OF THE SnOULDEE,
   Are the clavicle and the scapula.

               THE CLAVICLE.
   Situation, from the notch in the upper piece
 of the sternum, to the acromion process of the
 scapula.
   Figure, curved like the italic/.
   Sternal end,  thick,  presenting a triangular
 articular  surface; its  edge is rough for  liga-
 ments.
   Body,  cylindrical  towards sternum,  flat and
expanded towards its  acromial end.  Upon its
under  surface  are, 1, towards the  sternal ex-
tremity, a rough surface for the costo-clavicular
ligament;  2, towards the acromial extremity, a
rough line for  the  coraco-clavicular ligaments,
and between both  a groove for the subclavius
                      3 
18
muscle, in which  groove is found the nutritious
foramen.
  Acromial end,  rough and flattened,  passes
over the coracoid process to meet the acromion,
with which it articulates by a small oval sur-
face.
                  SCAPULA.

  Situation, upper  and back  part of thorax,
extending from the second to the seventh rib.
  Figure, triangular.
   Costa or edges.—The superior or cervical is
the shortest, and  is  interrupted by a notch  for
the suprascapular nerve; the inferior or axillary
is next in size, and is the thickest; the posterior
or vertebral is the longest, and is also called the
base of the scapula.
  Angles.—The superior posterior angle is acute
and prominent, the inferior angle is thicker and
rounded, and the anterior angle has connected
to it the neck of the bone.
   Costal surface, or subscapular fossa, is  slightly
concave and divided  by three or four lines,
which run from above obliquely downwards and
inwards.
   Dorsal surface is divided unequally,  by  the
spine, which thus  gives  rise  to  the  spinous
fossae.
   Spine arises, by a small triangular surface, at
 the vertebral  margin, and  proceeds forwards,
becoming more  elevated,  and terminates in the
 acromion,  which surmounts the shoulder joint 
19
 and articulates  with the acromial end  of the
 clavicle by a small oval surface.
   Supraspinous fossa, situated above the spine,
 is deep, and presents  a nutritious foramen; it
 lodges the supraspinatus muscle.
   Infraspinous fossa, larger, irregularly concave
 and convex, affords attachment to the infraspina-
 tus muscle,  the  teres minor muscle, and by an
 inferior  rough  surface,  to   the  teres  major
 muscle.
   Coracoid  process  overhangs the  inner  and
 upper part of* the glenoid cavity.  This process
 has a crooked appearance, and gives attachment
 to the pectoralis minor, the short head  of the
 biceps  and  coraco-brachialis  muscles,  also to
 ligaments.
   Glenoid cavity,  articulates with the head of
 the humerus, is shallow and oval, being broader
 below,  and  giving  attachment by its  upper
 narrow part to  the  long head of the  biceps
 muscle.
   Neck is the contracted portion of the scapula
 immediately behind the glenoid cavity; it gives
 attachment  to the capsular   ligament  of  the
joint.
                 OS  HUMERI.

   Articulates with the scapula above and radius
and  ulna below.
   Head forms a small section of a large sphere,
is  smooth and covered  with  cartilage in  the
recent state.   Its direction is  obliquely back- 
20
wards and inwards to the glenoid cavity of the
scapula.
  Neck, a  slight  contracted line, rough for the
attachment of the  capsular ligament.   It is
united to the shaft at an obtuse angle.
  Tuberosities exist at the junction of the shaft
with the  neck.   The largest is  posterior,- and
affords attachments by three flat surfaces to the
supra-spinatus, infra-spinatus, and  teres  minor
muscles;  the  smallest being anterior, is more
prominent, and gives attachment to the subscapu-
lar muscle.
  Bicipital groove is between both tuberosities,
lodges the long biceps tendon, and affords attach-
ment by its  anterior margin to the pectoralis
major muscle, and by its  posterior margin to the
latissimus dorsi and teres major muscles.
  Shaft  is rather twisted, the  upper extremity
cylindrical, the lower flattened; two longitudinal
ridges, arising one from the outer, the other from
the inner condyle, and affording  attachment to
intermuscular septa, divide it  into an anterior
and a posterior region.   The external longitudi-
nal ridge  is  interrupted by  an oblique  groove
which indicates the course of the muscular-spiral
nerve and vessels: upon the external and central
aspect  is  a rough portion for insertion  of  the
deltoid muscle, and upon the inner side of the
bicipital groove  is  a slight rough line for  the
insertion of the coraco-brachialis  muscle.  The
nutritious  foramen  is  directed  downwards
towards the elbow joint. 
21
   Internal condyle  is  prominent  and  sharp,
 affording attachment to  the pronator and flexor
 muscles and to the internal lateral ligament.
   External  condyle is  less prominent,  but
 descends  nearer  the elbow  joint,  and gives
 attachment to the supinator and extensor mus-
 cles, and to the external lateral ligament.
   Articulating surfaces.  First, a  small  round
 head, situated externally and nearer the anterior
 than  the  posterior part of the  bone, for  the
 radius.  Second,  the trochlea or pulley-like sur-
 face placed internally for the ulna; being much
 below the level of the head, so as to give the
 articular surface an oblique direction from above
 downwards and inwards.
   Small sigmoid fossa at the fore part of the
 trochlea to receive the  coronoid  process in the
 bent position of the forearm.
   Great sigmoid fossa at  the back part of  the
 trochlea, to receive the  olecranon process in the
 extended position of the forearm.

                    ULNA.
   Situation at the inner side of the forearm.
   Upper extremity articulates with the humerus
and radius.
   Olecranon process, forming the projection of
the elbow, is the highest point of the bone, and
by its extremity gives attachment to the triceps
muscle;  beneath  this it is smooth for  a bursa
mucosa.
   Coronoid process, anterior to the olecranon, is 
                     no

smaller than it, and gives attachment  to  the
brachialis anticus  muscle,  some ol the  flexors
and pronators of the forearm, and to the internal
lateral ligament.
  Lesser sigmoid cavity, oval, receives the side
of the head of the  radius.
  Greater sigmoid cavity has its long axis from
before backwards,  is divided in  the centre by a
transverse line, and by a vertical ridge, into two
lateral portions, is bounded above by the ole-
cranon process, below by the coronoid process, and
receives the articular extremity of the humerus.
  Shaft presents three surfaces and three edges;
the anterior  surface affords attachment to the
flexor digitorum profundus muscle, and is pierc-
ed by the nutritious foramen,  which is directed
upwards.  The  posterior  gives attachment to
the anconeus muscle and to the extensor muscles
of the thumb; the internal is subcutaneous for
its greatest extent.  Of the edges, that directed
towards the radius is the best marked; it gives
attachment to the interosseous ligament.
   Carpal extremity slender and  rounded, pre-
sents the head, which by its side articulates with
the  radius,  and by its  carpal  aspect  with the
fibro-cartilage  of  the  wrist-joint;   also  the
styloid process at  the iimer margin, which by
its apex  gives attachment to the internal lateral
ligament of the carpus, and by a depression  at
its  root, to  the fibro-cartilage;  posteriorly  it
presents a groove for the  tendon of the flexor
carpi ulnaris muscle. 
23
                    RADIUS.

   Situation,  external  to  the ulna; it is  also
 shorter than  that  bone, by the length of the
 olecranon.
   Head, a superficial circular cavity, articulating
 above with the humerus, and latterly with the
 lesser sigmoid cavity of the ulna.
   Neck, an inch in length,  narrow and rounded,
 and terminating in the
   Tubercle, a prominent process  into which the
 tendon of the biceps muscle is inserted.
   Shaft,  triangular, by  its  anterior  surface
 affording attachment to the flexor longus pollicis
 and pronator quadratus muscles, by its posterior
 convex surface to the supinator radii brevis and
 extensor  muscles  of  the  thumb-; its  external
 surface being  round and convex, and rough near
 its centre for the  pronator  radii teres muscle.
 The inner edge of the shaft is  sharp for  the
 attachment of the interosseous ligament, and the
 nutritious foramen  upon the anterior surface of
 the shaft  is directed upwards.
   Carpal extremity expanded, gives attachment
 by its anterior edge to the anterior carpal liga-
 ment;  upon  its'  posterior edge to  a  shallow
 groove  at its ulnar side for  the  extensor com-
 munis digitorum and indicator muscles, a second
 more externally,  narrow  and oblique  for  the
 tendon of  the extensor  secundi internodii pollicis
muscle, and a  third more external than the last
for the tendons of  the extensores carpi radiahs 
24
longior  and brevior.   Upon the radial edge of
this extremity is the mark of the passage of the
extensor ossis metacarpi and the extensor primi
internodii pollicis muscles.
  Styloid process, prolonged on the  outer side
of the bone  downwards, giving attachment to
the external lateral ligament of the carpus.
  A cavity on the inner border of the carpal
extremity for articulation with the ulna.
   Carpal aspect presents two articular surfaces,
divided by a  slight elevation;  the external being
triangular for articulation with the os scaphoides,
the internal square for the os lunare.

                   CARPUS.
   This  part consists of two rows of small bones,
four bones in each row, placed between the fore-
arm and metacarpus.   It is convex  and rough
upon its dorsal aspect,  and  concave upon its
palmar  aspect, where the  vessels, nerves, and
tendons of the flexor muscles are situated ;  to-
wards the radius and interarticular cartilage of
the wrist, it  is convex; towards the metacarpus
it presents articular surfaces for the metacarpal
bones.
                  FIRST ROW.

                 Os Scaphoides.

   Situation, on outer and upper part  of the
 carpus, next the styloid process of the radius.
   Articulations,  with  the radius above, with 
25
 trapezium and trapezoides below, and with the
 lunare and magnum internally.

                  Os Lunare.
   Situation, between the scaphoides and cunei-
 forme.
   Articulations, with the radius above, with
 the magnum and unciforme  below,  with the
 scaphoid  externally,  and with the cuneiforme
 internally.
                Os Cuneiforme.

   Situation, at the internal and  upper part of
 the carpus between the lunare and pisiforme.
   Articulations, with the lunare externally, with
 the carpal fibro-cartilage  above, with the unci-
 forme below, and  upon its palmar aspect with
 the pisiforme.
                Os Pisiforme.
   Situation, upon the inner  and palmar, aspect
 of the cuneiforme.
  Articulation, by a circular small surface with
 the cuneiforme.

                SECOND ROW.
                Os Trapezium.

  Situation, between the  scaphoides and meta-
carpal bone of the thumb.
  Articulations, with the scaphoides above, with
the metacarpal bone  of the thumb below, and
                     4 
                        •*3
                    26

internally with the trapezoides and side of the
metacarpal bone of the index finger.
  Groove, upon its palmar aspect for lodging the
tendon of the flexor carpi radialis muscle.  The
surface which articulates with the first metacar-
pal bone is concave in one direction, convex  in
the other.

               Os Trapezoides.
  Situation, between the trapezium, magnum,
scaphoides,  and metacarpal  bone of the index
finger.
  Articulations, with the scaphoides above, the
trapezium  externally, the magnum internally,
and below with the metacarpal bone of the in-
dex finger.
                Os Magnum.

  Processes, head, neck, and body.
  Situation, between the scaphoides and lunare,
and  the second, third, and fourth metacarpal
bones.
  Articulations, by its head with the scaphoides
and  lunar above, by its  base with  the  second,
third, and fourth metacarpal bones below, ex-
ternally with  the trapezoides,  and internally
with the unciforme.

               Os Unciforme.

   Situation, between the cuneiforme and meta-
carpal bones of the ring  and little fingers. 
27
   Articulations, with the lunare above, the mag-
 num externally, the  cuneiforme  internally, and
 below  with the  fourth  and  fifth  metacarpal
 bones.
   Process, a hook-like process upon  its palmar
 aspect.
   The carpal bones in their natural state are so
 arranged that the os magnum and os unciforme
 form a convex head which  is received into a
 concavity formed by the ossa  scaphoides, lunare,
 and cuneiforme.  The trapezium and trapezoides
 form a concavity which receives the convex sur-
 face of  the os scaphoides.

                METACARPUS.

   This  part consists  of five long bones placed
 between the carpus and the fingers.
   Bases,  irregularly  flattened for articulation
 with the second  row of carpal bones,  with
 rough surfaces  for  the attachment of, ligaments.
   Heads, convex, and rounded for articulation
 with the first bones of the fingers, and affording
 attachments  for the  capsular, transverse,  and
 lateral ligaments.
   Bodies.—The first, for the thumb, is the thick-
 est and  shortest; its carpal articulating  surface
 corresponds  with   the saddle-like articulating
surface  of the os trapezium;  the second, third,
and fourth present on the dorsal aspect of  each
a prominent fine, which bifurcates  towards the
head; the fifth presents an oblique  line on its 
28
dorsal aspect, which divides it into two surfaces.
The third is the longest.

                  FINGERS.
  The fingers are composed of three phalanges,
except the thumb, which has only two.
  The Metacarpal,  or first Phalanges, are five
in number, their bases presenting  oval  concavi-
ties  for  the  heads  of  the  metacarpal bones;
their anterior extremities are convex from before
backwards, and concave from side to side, to ar-
ticulate with the second phalanges.
  The Middle, or  second Phalanges, are four in
number,  and smaller than the first; their bases
present  pulley-like  surfaces,  to form a gingly-
moid joint with the first phalanges, and at their
anterior  extremities resemble the first.
   The Ungual, or  third Phalanges, are five in
number, and the smallest.   By their bases they
form a  ginglymoid joint with the middle pha-
langes ;  and their extremities are  convex upon
their dorsal aspects for the support of the nail,
whilst their palmar aspects are irregularly tuber-
culated for the extremities of the fingers.
   The Sesamoid  Bones are  sometimes absent.
In  general  two are to be  found  between the
metacarpal bone of the thumb and its  first pha-
lanx, and one or two at the corresponding joint
of the index finger.

              LOWER EXTREMITY.
   The bones proper to the lower  extremity are 
29
 the femur, the tibia, the fibula, the patella, seven
 tarsal bones, five metatarsal bones, and fourteen
 phalanges.
                  THE FEMUR.
   Head,  forms nearly two-thirds of a sphere,
 and is  received into the acetabulum, being di-
 rected  forwards, upwards, and inwards; below
 its centre is a rough pit for the ligamentum teres,
 and its junction with the neck is marked by a
 rough line.   With the exception of these parts
 it is covered by cartilage in the recent state.
   Neck, extends obliquely downwards and  out-
 wards from the head to the shaft, which it joins
 at an obtuse angle;  it is flattened anteriorly and
 posteriorly, and its lower  edge is much  longer
 than its upper.
   Great trochanter, is continued upwards from
 the shaft, but  does  not  extend as  high  as the
 head, is situated  externally, and gives attach-
 ment to the gluteus medius, gluteus  minimus,
 and pyriformis muscles.
  Digital fossa, is situated at the root  of the
 great trochanter, and affords insertion to the ex-
 ternal rotator muscles.
  Lesser trochanter, is situated posterior and in-
 ternal to the shaft, and has inserted into it the
 common tendon of the psoas and iliac muscles.
  Intertrochanteric  line, as  the  name implies,
passes  (obliquely)  from  one trochanter to the
other.
  Shaft, is broad at either  extremity,  particu- 
30
larly towards the knee, and is narrow and  tri-
angular in the centre ; it is  arched and smooth
anteriorly, where it affords attachment to  the
crureus muscle ;  at  its  posterior part it is con-
cave, and presents a  rough  line called linea
aspera, about the upper third  of which, and di-
rected upwards, is the foramen for the nutritious
vessels.
  Linea aspera, for the attachment of muscles,
is best marked for the central third of the shaft;
towards the upper third it bifurcates, one ridge
running  to  each trochanter; inferiorly it  also
divides into two ridges, which pass to either con-
dyle, the inner one being  interrupted where the
popliteal vessels pass over it.  By these inferior
ridges a  flat triangular surface of the femur  is
bounded laterally, which  receives the name  of
popliteal surface.
  External condyle, is larger and projects more
upon the anterior surface  of the femur than the
internal: its artioulating surface is broader and
ascends higher upon the shaft.
   Internal condyle, narrower than the external;
it also descends lower, in order  that both  con-
dyles should rest upon the tibia in the natural
oblique direction of the femur.
   External tuberosity, above the external  con-
dyle for the attachment of the external lateral
ligament of the knee-joint.
   Internal tuberosity, above the internal  con-
 dyle and more prominent than the external, for 
31
 the internal lateral ligament and the insertion of
 the great adductor tendon.
   Trochlea, between the condyles on their ante-
 rior aspect, supports the patella when the leg
 is extended.
   Intercondyloid fossa,  is situated posteriorly
 between the condyles.

                   PATELLA.

   Shape, triangular, the  base superiorly having
 the  extensor muscles inserted into  it, the apex
 below, to which is  attached the  ligainentum
 patellae.
   External surface,  presents a fibrous  appear-
 ance, and is convex.
   Internal surface, presents two articular sur-
 faces, divided by a prominent edge; the  internal
 surface  is the  deepest,  whilst the  external is
 broad and shallow.

                    TIBIA.
  Shaft, is triangular, presenting three surfaces,
 separated by  corresponding edges.   The  inner
 surface is subcutaneous, except at its upper part,
 where the tendons of the •sartorius, gracihs and
 semitendinosus muscles pass over it; it termi-
 nates in the inner malleolus; the external surface
is covered by the  belly of the tibialis  anticus
muscle for its apper two-thirds, and is here con-
cave ;  interiorly the bone  is flattened to  support
the tendons of the extensor muscles of the toes; 
32
the posterior surface presents  an oblique fine
directed upwards and outwards for the attach-
ment of the soleus,  popliteus,  and deep flexor
muscles: the nutritious foramen, which is the
largest in the body, is a little below^this fine, and
directed downwards.  Of the edges, the anterior
is most prominent and subcutaneous ;  the inner
is  less defined, and  the  outer  is well marked,
affording attachment to  the interosseous liga-
ment.
   Upper or femoral extremity, which articulates
with the femur, is expanded from side to side;
anteriorly its circumference is convex;  posterior-
ly it is slightly hollowed.  Two concave surfaces,
condyles, of which the inner is the deeper,  re-
ceive the condyles of the femur.  Between  the
condyles is the spine, a bifid eminence, before and
behind which are depressions for the insertion of
the crucial  ligaments  and the semilunar carti-
lages.
   Tuberosities, are three  in number, two lateral,
and one anterior; the anterior is most prominent
for the insertion of the ligament of the patella;
the inner is less so, and affords attachment to the
internal lateral ligament  of the knee-joint, and
the semimembranosus muscle;  the outer is  the
least developed, and  has  an articulating surface
for the fibula.
   Lower or  tarsal extremity,  is much smaller
than  the upper and quadrilateral,  the anterior
edge being convex for the passage of the extensor
tendons; the posterior, marked by a groove, for 
33
 the passage of the tendon of the flexor longus
 pollicis muscle ; the external presenting a rough
 triangular surface for the fibula, and the internal
 terminating in the internal malleolus.
   Internal malleolus, is convex and subcutane-
 ous internally; its articular aspect being smooth,
 to articulate with the astragalus; it gives attach-
 ment by its inferior border to the internal lateral
 ligament of the ankle-joint, and is grooved poste-
 riorly for the tendons of  the tibialis posticus and
 flexor longus digitorum muscles.
   Inferior articular surface,  rests upon the
 crown of the astragalus; it is quadrilateral and
 concave from before backwards, and joins the
 small articular surface of the internal malleolus
 at a right angle.

                   FIBULA.

   Situation, on the outer side of the tibia.
   Shaft, triangular and twisted, gives attachment
 to the peronei muscles by its external surface, to
 the soleus and flexor pollicis muscles by its pos-
 terior surface, and to  the extensor muscles  by its
 anterior surface.  Its inner edge is well develop-
 ed to afford attachment  to the interosseous liga-
 ment, and the nutritious foramen, directed down-
 wards, is placed upon the posterior aspects  of
the bone.
  Head, articulates with  the  tibia by a  small
circular surface directed  upwards and inwards,
and  affords attachment  to the external lateral
                      5 
34
ligament of the knee-joint, and the biceps flexor
muscle by a rough projection situated posteriorly.
  Neck, is the  small constricted  part by which
the head is united to the shaft.
  Tarsal extremity, presents a large oval process
called the external malleolus, about two inches
and a half above which the shaft is constricted.
  External malleolus, is larger than the inter-
nal, on a line posterior to which it is situated;
by its edge it affords attachments to the external
lateral ligaments of the ankle joint.   Its outer
surface is convex and subcutaneous, the inner or
articular being smooth to  articulate with the
outer side of the astragalus; above this surface
is a triangular rough aspect for the inferior con-
nection of the bone with the tibia.

                   TARSUS.

  Forms the posterior part of the foot; the bones
which compose it are seven in number, and ar-
ticulate with each other.  It is connected above
to the tibia and  fibula, below it  is hollow, and
anteriorly  it unites by articular surfaoes with
the five  metatarsal bones.  The  seven tarsal
bones are  the calcaneum, astragalus, navicular
or scaphoid, cuboid, and three cuneiform.

          CALCANEUM, OR OS  CALCIS.
  Situation, at the posterior and under part of
the tarsus.
  Posterior aspect, elongated  to  form the heel, 
35
 presents a smooth surface above for a bursa mu-
 cosa, and a rough surface below for the insertion
 of the tendo-achiUis.
   Anterior aspect articulates by a smooth surface
 with the cuboid bone.
   Superior aspect presents two articular surfaces,
 which support the astragalus; they are separat-
 ed by a groove, into which a strong interosseous
 ligament is inserted.
   Inferior aspect is irregular, and presents two
 small tubercles, and two lines for the attachment
 of muscles and ligaments.
   External aspect presents  a small tubercle for
 the insertion of the middle external lateral liga-
 ment of the ankle-joint; it is also slightly groov-
 ed for the passage of the peronei tendons.
   Internal aspect presents  a projection for the
 internal lateral ligament, and a fossa for the lodg-
 ment of posterior tibial vessels and nerve and
 tendons of muscles.

                 ASTRAGALUS.
   Situation, at the upper and middle part of the
 tarsus, between the malleoli at either side: the
 tibia above, and the os calcis below.
   Grown,  broader anteriorly than posteriorly,
 presents three articular surfaces;  one,  large su-
 periorly, to articulate with the tibia; the others,
 one on either side, to articulate with the malleoli.
  Head, convex and smooth, is direoted forwards
and inwards, and is larger than  the concavity of
the navicular bone with which it articulates. 
36
  Neck,  the contracted portion  between  the
crown and the head is rough for the attachment
of ligaments.
  Inferior aspect presents two articular surfaces
for connexion with the os calcis: they are sepa-
rated by a groove, from which ligaments pass to
the groove in the os calcis.
  Posterior  aspect is narrow, and presents  a
groove for the tendon of the flexor longus polli-
cis muscle, and a pointed  eminence for the  pos-
terior external lateral ligament of the ankle-joint.

                 NAVICULARS.
  Situation, middle of the tarsus.
  Posterior aspect is  smooth and concave, to ar-
ticulate  with the head of the astragalus.
  Anterior  aspect presents two  vertical lines,
which divide it  into three smooth surfaces for
articulation Avith the three cuneiform bones, and,
in general, a small articular surface, externally,
where it touches the cuboid bone.
   Tubercle,  situated  internally for the insertion
of the tendon of the  tibialis posticus muscle.

                   CUBOIDES.

   Situation, outer and anterior part of the tarsus.
    Upper surface, flat and rough for ligaments.
   Lower surface, tubercular behind, for the cal-
 caneo-cuboid ligament, and presenting a groove
 anteriorly for the tendon of the peroneus longus
 muscle. 
37
   Posterior surface, smooth and concave trans-
 versely, to articulate with the os calcis.
   Anterior surface presents  two articular sur-
 faces ; the external triangular to articulate with
 the metatarsal bone of the little toe, the inner
 square for the fourth metatarsal bone.
   External surface narrow and free.
   Internal surface presents posteriorly a small
 articular surface for the naviculare, and anteri-
 orly another, which is larger, to articulate with
 the outer side of the external  cuneiform bone.

          INTERNAL CUNEIFORM BONE.
   The largest of the  three  articulates  behind
 with the navicular; before, with the first meta-
 tarsal bone; externally, with  the middle cunei-
 form and side of the second metatarsal bone.
   Tubercle is situated interiorly for the insertion
 of the tendon of the tibialis anticus muscle, and
 part of the tendon of the tibialis posticus.

           MIDDLE CUNEIFORM BONE.
   The smallest, articulates behind with the na-
 vicular bone; before, with  the second metatar-
 sal bone;  externally, with the external cunei-
 form;  and  internally, with the internal cunei-
 form.
         EXTERNAL CUNEIFORM BONE.
  Articulates behind with the navicular bone;
before, with the third  metatarsal bone; inter-
nally, with the middle cuneiform and side of the 
38
second metatarsal bone; and externally, wilsh
the cuboid and fourth metatarsal bone.

                 METATARSUS
is the middle part of the foot, and is composed
of five long bones placed between the tarsus and
the toes.
          FIRST  METATARSAL BONE,
the shortest and  thickest, is  convex above and
concave below.
  Posterior extremity is smooth and oval, to ar-
ticulate with the internal cuneiform bone.
  Anterior extremity, round, to  articulate with
the first phalanx of the great toe.  The under
surface  of this extremity articulates with two
sesamoid bones, and receives the insertion of the
tendon of the peroneus longus.

          SECOND METATARSAL BONE,
the longest.
  Posterior extremity articulates with the three
ouneiform bones, and also with the third meta-
tarsal bone.
  Anterior extremity presents a round head, for
articulation with the second toe; it is separated
from the shaft of the bone by a groove.

          THIRD METATARSAL BONE.
  Posterior extremity articulates with the third
cuneiform bone. 
39
    Anterior extremity resembles the second, and
 articulates with the third toe.

           FOURTH METATARSAL BONE.

    Posterior extremity articulates with the cuboid
 bone, and by its inner side with the third cunei-
 form.
    Anterior extremity .resembles the second, and
 articulates with the fourth toe.

            FIFTH METATARSAL BONE.
    Posterior extremity articulates with the cuboid
 bone by a surface directed obhquely upwards and
 outwards.
   Anterior extremity resembles the second, and
 articulates with the fifth toe.

             PHALANGES, OR TOES,
 are composed of fourteen bones, three to each
 toe, except the first, which has only two.

               FIRST PHALANGES.
   Shape, convex above, concave below, and the
 longest.
   Anterior  extremities,  convex  from above
 downwards,  and concave  laterally;  form gin-
 glymoid articulations with the second phalanges.
   Posterior extremities  are large,  and present
rounded concavities for the heads of the meta-
tarsal bones. 
40
             SECOND PHALANGES.

  Anterior extremities resemble those of the first
phalanges.
  Posterior  extremities,  concave  from,  above
downwards, and convex transversely, articulate
with the first phalanges.

             THIRD PHALANGES.

  Anterior extremities, pyramidal in form, sup-
port the nails on their upper surface, and are
rough on their under surface.
  Posterior extremities resemble the posterior
extremities of the middle phalanges.

               SESAMOID BONES

are uncertain in  developement; two are gene-
rally found at the base of the first phalanx of the
great toe, and one at that of the fifth toe.   They
are also frequently developed in  the tendons
which cross  the sole of the foot in those situa-
tions where they are subjected to much pressure.
               THE SKULL,

  Consists of eight bones, four of which are sym-
metrical, viz. the frontal, the ethmoid, the sphe-
noid,  and the occipital; and  four arranged in
pairs, viz. two parietal, and two temporal. 
41
                FRONTAL BONE.

   Situation.—Upper and anterior part of the
 skull.
   External, or frontal  aspect,  is convex and
 arched, and presents a median vertical depres-
 sion, which marks the original division of the
 bone into two.
   Nasal spine, at the inferior part of the median
 depression or line.
   Frontal eminences, on either side of the median
 fine,  marking  the  points of ossification of the
 bone.
   Superciliary arches, two convexities which
 extend for about an inch on either side of the
 median line inferiorly.
   The glabella, or eminence of frontal sinuses,
 between,  but  a  little  above,  the superciliary
 arohes.
   Orbital arches, form the upper edges of the
 orbits, and present towards their inner third the
 supraorbital holes or notches, for the passage of
 the frontal nerve and artery.
   External angular processes,  at the outer ter-
 minations of the orbital arches.
   Internal  angular processes,  at the inner ter-
 minations of the orbital arches.
   Temporal ridges, extend backward  and up-
 wards from the external angular processes.
   Internal  or 'cerebral aspect, is concave, and
presents in the median fine a groove, which cor-
responds to  the superior longitudinal sinus. 
42
   Crest, at the commencement of the median
 groove, gives attachment to the falx.
   Foramen cacum, at the root of the crest, gives
 passage to a vein which opens from the nose into
 the longitudinal sinus.
   Eminences, and depressions, on either side of
 the median line, commonly stated to correspond
 with the convolutions of the brain.
   Orbito-ethmoidal aspect, is irregular, forming,
 on either side, part of the orbits, and in the mer
 dian line part of the nose.
   Ethmoidal notch,  quadrilateral,  articulates
 with the  ethmoid bone  by a serrated margin;
 its edges  being  cellular to unite with the eth-
 moidal cells.
   Anterior and posterior ethmoidal foramina,
 along the margins of the ethmoidal notch, giving
 passage to the nasal twig of the ophthalmic nerve
 and the ethmoidal arteries.
   Orbital processes, triangular, and on either side
 of the ethmoidal notch, form the roofs of the or-
bits  by their smooth  concave surface, and on
 their convex surface are marked by the convolu-
 tions of the brain.   Towards the external angu-
lar process of each is the fossa  for lodging the
lachrymal gland, and  at the  nasal margin is  a
depression for the reflected tendon of the supe-
rior oblique muscle.
  Frontal sinuses,  which exist only in the adult
at the antero-inferior part of the bone, and be-
tween its two tables, open at either side of the
nasal process. 
43
 •  It articulates with twelve bones, viz., the sphe-
 noid, ethmoid, two parietal, two nasal  bones,
 two ossa unguis, two superior maxillary, and two
 malar.
                PARIETAL BONES.

   Situation, upper and lateral parts of cranium;
 they are quadrilateral.
   External surface, convex, and marked by a
 semicircular ridge, which is continued.from the
 temporal ridge of the frontal bone.
   Four edges.  The upper is the longest,  and
 joins its fellow,—the anterior joins the frontal
 bone,—the posterior is  very irregular, and joins
 the occipital,—and the  inferior is thick where it
 joins the mastoid  process, but thin and semicir-
 cular where it  is  overlapped by the squamous
 portion of the temporal bone.
   Four angles.  The anterior inferior is long and
 curved,  and joins  the sphenoid bone; upon its
 cerebral aspect  is a canal or a groove, for the
 trunk of the middle meningeal artery.  The pos-
 terior inferior angle is grooved upon its cerebral
 aspect to lodge part of the lateral sinus.  The
 superior angles are rather rounded.
   Internal surface, concave, and marked by the
 convolutions of the brain and the ramifications
 of the middle meningeal  artery, presents along
 its upper edge a shallow groove, which, with its
 fellow, accommodates the superior longitudinal
sinus;  external to  this  groove are depressions
marking where the glandul® Pacchioni externea 
44
were situated.  Each  parietal articulates with
five bones, viz., the frontal,  sphenoid, occipital,
temporal, and with its fellow of the opposite side.

               OCCIPITAL BONE.

  Situation, posterior and inferior part of cranium.
  Tuberosity, near the centre of external surface.
  Superior transverse  ridge, leads  from either
side of the spine transversely outwards.
  Inferior transverse ridge, midway between tu-
berosity and foramen magnum.
  Spine, leads from tuberosity down to the fo-
ramen magnum.
  Foramen magnum, larger internally than ex-
ternally, is of oval form, and transmits the me-
dulla spinalis, vertebral arteries, and spinal ac-
cessory  nerves.
  Basilar process, passes forwards and upwards
to join the sphenoid bone, is rough inferiorly for
the attachment of the pharynx; and upon its
cerebral aspect is smooth and concrfVe from side
to side to  support the  pons  Varolii  and basilar
artery, and  marked laterally by two superficial
grooves, which lodge the inferior petrosal sinuses.
  Condyles, smooth and oblong, look down-
wards, outwards, and backwards;  each presents
a roughness internally for the check ligaments.
  Anterior condyloid foramina, situated before
the condyles for the passage of the ninth pair of
nerves.
  Posterior condyloid foramina, behind the con- 
45
 dyles, for the passage of small veins.  They are
 sometimes absent.
   Jugular eminences, external to either condyle;
 they form with the temporal bone the foramen
 basis cranii posterius.
   Crucial ridges, on the cerebral aspect, formed
 by a transverse and vertical line: they give at-
 tachment to the falx major by the upper half of
 the vertical  line, in which is a groove  for the
 termination of the longitudinal sinus, and to the
 falx minor or falx cerebelli by its  lower half;
 the transverse ridge gives attachment to the ten-
 torium, and also presents a groove on either side
 for the lateral sinuses.
   Four fossa, two  superior  for the posterior
 lobes of the cerebrum, and  two inferior and
 deeper for the lateral lobes of the cerebellum.
   Grooves for the termination of  the  lateral
 sinuses, on each  side of the foramen magnum
 above the jugular eminences.
   It  articulates with  six  bones, viz., the two
 parietal,  the  two temporal, the sphenoid, and
 the atlas.
               TEMPORAL BONE.

   Situation,  at the lateral, middle, and inferior
part of the skull.   It is divided  into squamous,
mastoid, and petrous portions.
   Squamous portion, semicircular, flat, and thin,
forming part  of the side of the skull  and  of the
temporal fossa.
   Zygomatic process,  arises by  two roots, one 
46
anteriof bounding the front of the glenoid cavity,
the other  posterior, which is  bifurcated;  the
process then passes forwards,  and presents a
serrated edge to unite with the malar bone.
  Zygomatic tubercle, is situated  at  the union
of the zygomatic  roots, and gives attachment to
the external lateral ligament of the lower jaw.
  Glenoid cavity, transversely oval, deep ante-
riorly for the reception of the maxillary condyle,
and shallow behind, where it lodges a portion of
the parotid gland.
  Glasserian fissure, crosses the glenoid cavity
in a direction obliquely forwards and inwards.
It transmits the  chorda tympani  nerve,  the
laxator  tympani  muscle,  and  lodges the pro-
cessus gracilis of the malleus.
  Auditory process, commencing by the external
meatus, leads inwards and forwards to the mem-
brana tynipani, and presents externally a rugged
edge for the attachment  of the cartilage of the
ear.
  Internal surface of squamous plate, is marked
by the convolutions of the brain and by blood-
vessels.
  Mastoid process, at the posterior and inferior
aspect of the bone.
  Mastoid grooves, internal to the mastoid pro-
cess for posterior belly of the digastric muscle.
  Mastoid foramen, posterior to mastoid pro-
cess for the transmission of a vein.
  Mastoid fossa, m the  cerebral aspect, for the
lateral sinus. 
41
   Mastoid  cells,  in  the  interior of  mastoid
 process.
   Petrous portion, containing in its interior the
 internal ear, extends  forwards  and inwards,
 and presents three aspects, being of a prismatic
 form.
   Aqueduct of the cochlea,  a minute foramen
 on the under surface, posterior to the  styloid
 process.
   Styloid process, long  and tapering, descends
 obliquely forwards and inwards, gives origin to
 the styloid muscles and ligament.
   Vaginal process, a plate of bone between the
 glenoid cavity and the carotid foramen.
   Stylo-mastoid foramen, between the  styloid
 and mastoid processes for the exit of  the portio
 dura  nerve : near the stylo-mastoid foramen is a
 minute aperture for the auricular branch of the
 pneumo-gastric nerve.
   Carotid canal,  commences in front  of the
 Styloid process, turns  forward, upwards and in-
 wards, and  terminates by the side of the body
 of the sphenoid bone.
  Jugular fossa, a smooth surface behind and
 a little external to  the carotid foramen : it forms
 with  the occipital bone  the  foramen lacerum
posterius, which transmits  the  eighth  pair  of
nerves  and  the  jugular  vein.   In  the bony
septum,  between  the  jugular  fossa  and the
carotid canal, is a small foramen, which trans-
mits the nerve of Jacobson to the tympanum.
  Processus  cochleariformis, a  thin  plate  of 
48
bone separating two canals, which are situated
in the angle between the petrous and squamous
portions ;  the superior of which transmits  the
tensor tympani muscle; the inferior forming the
bony part of the Eustachian tube.
   Superior petrosal ridge, separates the ante-
rior from the posterior surface;  it gives attach-
ment to the tentorium, and is grooved for  the
superior petrosal sinus.
   Depression for Gasserian ganglion, on the an-
terior extremity of the superior surface.
   Hiatus Fallopii, a foramen on  the superior
surface for the passage of the Vidian nerve.
   Meatus auditorius internus, on the posterior
surface, for the transmission of the seventh pair
of nerves and a small artery.
   Aqueduct  of  the  vestibule, a small slit-like
opening posterior to the meatus  internus.
   The  superior  semicircular canal,  forms an
eminence on the superior petrosal surface.
   The temporal articulates with five bones, viz.,
the parietal, malar, inferior maxillary, sphenoid,
and  occipital.  It is connected  also to the os
hyoides by the stylo-hyoid ligament.

               ETHMOID BONE.
   Situation, in  the ethmoidal notch  of  the
frontal  bone.
  # Crista  galli,  an  angular  process which di-
vides the cerebral  aspect  into  two  equal  por-
tions, to which is attached the commencement
of the falx cerebri. 
49
   Cribriform plate, on  either side of the crista
galli, concave, to lodge  the olfactory bulbs, and
perforated with holes,  for the passage of the
filaments  of the  olfactory nerves,  the  nasal
division  of the ophthalmic  nerve,  and  some
small blood-vessels.
   Nasal plate or lamella, descends from the
under  surface  of the  crista  galli,   joins the
sphenoid bone posteriorly, the vomar  and  nasal
cartilage inferiorly, and  the os frontis and nasal
bones anteriorly.
   Orbital plate, or Os planum, a smooth square
plate of bone situated  externally, and forming
part of the orbit; in its  upper edge are two
notches, which, with those in the frontal  bone,
form the  anterior  and  posterior   ethmoidal
foramina.
   Ethmoidal  cells, between  the orbital  plate
and the nasal plate, being ten pr twelve in num-
ber.    They are  divided into  anterior  and
posterior.  The  former, the  most  numerous,
communicate with the middle meatus;  the latter,
few and  small  in  size,  open into the superior
meatus of the nose.
   Superior  spongy bone, descends in a curved
manner outwards from the upper and posterior
part  of the bone, forming a short channel, called
the superior meatus of the nose.
   Middle spongy bone, larger and more curved,
descends outwards, forming  the middle meatus
of the nose.
  Infundibulum, a smooth groove leading from
                     7 
50
the  anterior  ethmoidal  cells  to  the  middle
meatus.
  The ethmoid articulates with thirteen bones,
viz., sphenoid, frontal, vomer,  two nasal, two
superior maxillary, two ossa unguis, two palatal,
and two inferior spongy bones.

                SPHENOID BONE.
  Body, corresponds  to  the "median line, and
presents six aspects.
  Posterior aspect, is rough  for connexion with
the basilar process of occipital bone.
  Anterior aspect, presents the openings of the
sphenoidal sinus.
  Inferior aspect, presents the rostrum or azygos
process, which articulates with the vomer.
  Superior or cerebral aspect, presents  a fossa,
called sella turcica.
  Lateral aspects, join the great alae or wings.
  Sella turcica, a deep  fossa on  the cerebral
aspect of the  bone,  for  lodging  the pituitary
body.
  Posterior clinoid processes, two rounded emi-
nences posterior to the sella turcica.
  Anterior clinoid processes, two rounded emi-
nences  situated external and  anterior  to the
sella turcica.
   Olivary process,  an eminence  between  the
anterior clinoid processes, and anterior to the
sella  turcica, on  which  the optic commissure
rests. 
51
    Carotid grooves, one on either  side  of the
 sella turcica for the internal carotid arteries.
   Processes oflngrassias or lesser wings, two thin
 plates of bone extending forwards and outwards
 from the  anterior clinoid  processes, presenting
 anteriorly a spine in the  median fine, to unite
 with the ethmoid bone, and a serrated margin on
 either side to unite with the frontal bone.  Their
 posterior free edges afford attachment to  the
 sphenoidal folds of the dura mater.   The exter-
 nal extremity of each terminates in an acute
 point, their cerebral aspect being smooth, to sup-
 port the anterior lobes of the brain.
   Great wings, extend laterally from the sides of
 the body: each presents three  aspects, one  an-
 terior and smooth to assist in forming the outer
 part of the orbit; the second posterior, concave,
 and marked by cerebral convolutions, to assist in
 forming the middle cranial fossa; and the third
 external, being divided by a crest;  the portion
 above, which forms  part of the temporal fossa,
 and the portion  below,  part of the zygomatic
 fossa.
  Spinous processes, extend backwards and  out-
 wards from the  posterior  termination of each
 great wing.
  Pterygoid processes, two on  either side,  de-
 scend from the angle of junction of each great
 ala  and the body.   The external is broad and ir-
 regular; the internal  is long and narrow,  and
terminates in a hook called the hamular process. 
52
  Pterygoid fossa, is  the hollow between the
pterygoid processes posteriorly.
  Sphenoidal  fissures  or foramina lacera, on
either side  of the sella turcica, are placed be-
tween the greater and  lesser wings; each gives
transmission to the third, fourth, first branch of
the fifth, and the sixth nerves, and to  the oph-
thalmic vein.
  Foramina  optica, at the  roots of the lesser
wings, give passage  to  the  optic  nerves and
ophthalmic arteries.
  Foramina  rotunda, posterior, and a  little
external to the bases of the foramina lacera, give
passage to the second division of the fifth nerve.
  Foramina ovalia, near thev posterior termina-
tions of the great wings, give passage to the third
division of the fifth nerve.
  Foramina  spinosa,  in  the spinous  processes,
give  passage  to the middle meningeal artery of
either side.
  Foramina  pterygoidce,  at the roots of the
pterygoid processes,  for   the  passage  of  the
Vidian nerves.
  The sphenoid articulates with all the bones of
the  cranium,  and with several of those of the
face, viz., the vomer, two malar, and two palate
bones.
              BONES OF THE FACE.
                 MALAR BONE.
   Situation,  at the outer and under part of the
 orbit, forming the cheek. 
53
   Internal surface, convex, and  of irregular
 quadrilateral form.
   External angular  process, at the upper and
 outer edge, joins the frontal bone.
   Maxillary process, serrated, and rests at inner
 edge on the superior maxillary bone.
   Zygomatic  process, passes backwards, and
 supports the zygomatic process of the temporal
 bone by a  serrated edge.
   Upper  edge,  forms the  outer  and inferior
 margin of the orbit.
   Orbital  process, a thin plate of bone, which
 passes from the upper edge backwards and in-
 wards.
   Lower edge, thick and  uneven for the attach-
 ment of the masseter muscle.
   Temporal aspect, behind  the zygomatic pro-
 cess, is smooth for the lodgment of the temporal
 muscle.
   Foramina,  two or  three in number  on its
 cutaneous  aspect, for vessels  and  branches of
 lachrymal nerves.  It articulates with the frontal,
 superior  maxillary,  temporal,  and  sphenoid
 bones.                             ^

         SUPERIOR MAXILLARY BONE.
   Body,  quadrilateral, presents  anteriorly  the
 canine fossa for the levator anguli oris muscle, a
slight depression above the sockets of the incisor
teeth, the myrtiform fossa, for the depressor alaa
nasi muscle, and the opening of the infra-orbital 
54
canal for the superior maxillary nerve.  Inferior-
ly it is bounded by the alveolar border.
  Malar process, external and superior, presents
a rough surface which  supports the malar bone.
  Nasal process, internal and superior, is serrated
above to join the frontal bone, and presents a
groove to support the nasal bone.  Its cutaneous
aspect is perforated by two or three small holes
for  blood-vessels, its posterior aspect is deeply
grooved  to assist in forming the fossa for the
lodgment of the lachrymal sac and duct,  and its
internal or nasal aspect is divided by a ridge,
which supports the inferior spongy bone.
  Orbital plate, triangular,  assists to form the
floor of the orbit.
  Infra-orbital canal, passes from behind for-
wards between the plates of the orbital process,
and terminates  in the infra-orbital foramen,
which transmits the infra-orbital nerve. It gives
off  a smaller canal, anterior dental, which con-
ducts a small nerve to  the incisor teeth.
  Temporal  aspect, presents behind the malar
process a  smooth  depression for the temporal
muscle,  and more  posteriorly and inferiorly  a
tuberosity  which  corresponds to  the dens sapi-
entiao.
  Posterior dental foramina are three or four
small holes which give passage to  the posterior
dental nerves, and are found near the tuberositj'.
  Palatine process is thick internally, and rough
where it joins its fellow; its circuinference cor-
responds to the alveolar  processes, and  its pos- 
55
 terior edge is thin and serrated where it joins
 the palate bone; its upper surface is smooth and
 concave from side to side, forming part of the
 floor of the nose, and its under surface is rough,
 forming, with the gum, part of the hard palate.
   Nasal Crest, at the union  of the palatine pro-
 cesses, projects upwards to receive the vomer.
   Nasal  spine projects forwards,  above and
 between the central incisor teeth.
   Foramen incisivum, is common to both bones,
 and  exists inferiorly at the anterior union of
 their  palatine plates;  superiorly it  bifurcates
 and opens  by two foramina,  one to each nostril.
   Antrum maxillare or Antrum Highmori, a
 large cavity in the  body of  the bone, bounded
 above by the orbital plate, below by the alveoli
 of the molar teeth, anteriorly by the canine fossa,
 and posteriorly by the temporal aspect:  exter-
 nally it corresponds to  the  malar process, and
 internally it presents a large  irregular opening.
   The  superior  maxilla  articulates  with  its
 fellow of the opposite side, with the  frontal, os
 nasi, os unguis, ethmoid, with the malar, vomer,
 inferior spongy bone, palate, and occasionally
 with the sphenoid.

                PALATE BONE.
   Horizontal or palate plate, quadrilateral, is
 concave and smooth above,and completes the floor
 of the nose, and rough below, where it completes
 the hard palate.  Its anterior edge is serrated to
join the superior  maxillary  bone, its posterior 
56
edge is concave and gives attachment to the soft
palate, its inner edge is serrated where  it joins
its fellow, and sends a crest upwards to  support
the vomer;  its outer edge joins the nasal plate, j
  Naval  spine  projects  backwards  from the
union of the palate plates.
  Nasal process, broad and thin;  its  inner sur-
face is divided into two by a ridge which sup-
ports the inferior spongy bone: above and below
this ridge the process is slightly concave, to
assist  in forming the  inferior   and   middle
meatuses: its  external surface is rough, and
marked by  the posterior palatine vessels and
nerves; its anterior thin edge assists to close the
antrum, and the posterior edge joins the ptery-
goid processes of sphenoid bone.
  Pterygoid process,  the thickest part of the
bone, of a wedge  shape, inclines backwards and
outwards; it  presents  three grooves, a central
one,  smooth,  which  completes  the pterygoid
fossa, and a rough one on either side to articulate
with the  extremities of the  pterygoid processes.
   Palatine foramina, at the junction of ptery-
goid and palatine processes, give passage to the
posterior palatine nerve and vessels.
   Orbital plate surmounting the nasal process
is divided  into two  by  a  notch, which  forms
with the sphenoid bone  the spheno-palatine
foramen.
   Orbital process, is  large and hollow, and of
triangular form;  it presents five surfaces, three
 articulated, two free.  The anterior articulates 
57
 with the superior  maxilla;  the  posterior with
 the sphenoid; the internal  with the ethmoid.
 The superior forms part of the floor of the orbit:
 the external looks into the zygomatic fossa.
   Sphenoidal process, articulates  with the body
 of the  sphenoid bone, and is also hollow, form-
 ing the pterygo-palatine canal.
   It articulates with six  bones, viz., the corre-
 sponding  palate bone, the   superior maxilla,
 ethmoid, sphenoid, vomer, and inferior spongy
 bone.
            INFERIOR SPONGY BONE.
   Rough and convex towards the septum of the
 nose, and concave externally; presents  a free
 margin inferiorly, and is  attached above to the
 os unguis, and  to  the ridge on the superior
 maxillary and  palate bones.  It perfects  the
 nasal duct inferiorly.

                  os UNGUIS.

   Situation, inner and anterior part  of orbit.
   Edges, serrated to join  the os  frontis  above,
 the maxillary  bone  below, the nasal  bone ante-
 riorly, and the ethmoid bone  behind.
   External surface, divided  by a perpendicular
 ridge,  presents  a  groove  anteriorly for  the
 lachrymal sac, and  a smooth surface behind to
 assist in forming the orbit.
   Internal surface, covers the anterior ethmoi-
dal cells.  It is sometimes, although  rarely,
wanting. 
58
                NA8AL BONES.
  Situation, beneath the nasal process of frontal
bone and between the nasal processes of superior
maxillary bones.
  External  surface,  convex,  presents  small
foramina for blood-vessels.
  Internal surface, concave, and grooved by the
nasal nerves.
  Superior edge, thick and serrated, to join the
frontal bone.
  Inferior  edge, thin and expanded, joins the
lateral nasal cartilages.
  External edge is the longest, and  is serrated
to join the superior maxillary bone.
  Internal edge is  flat, and joins its fellow.
  The nasal bone  articulates  with the frontal
superior maxilla, opposite bone, ethmoid  bone,
and nasal cartilage.

                    VOMER.  "■»
  Situation, in the median fine of nose.
   Superior edge, grooved to receive the azygos
process of the sphenoid bone.
   Anterior edge or lamella, slightly grooved to
receive the nasal plate and nasal cartilage.
   Posterior  edge,  free,  looks  towards  the
 pharynx.
   Inferior edge, the longest, is received into the
 nasal crest of the  superior maxillary and  palate
 bone3. 
59
          INFERIOR MAXILLARY  BONE.
   Body, the anterior portion, projects inferiorly
 into mental process or chin, superiorly  is sur-
 mounted by alveoli of four incisor teeth,—ante-
 riorly has on each side a depression for muscles,
 and posteriorly, two depression* for the digastric
 muscles, above  which are two  pair of spines;
 the inferior for the geniohyoidei, and the supe-
 rior for the genio-hyo-glossi muscles.
  Symphysis,^, vertical ridge in the centre of body.
   Horizontal rami.   On the  outer surface of
 each  is an  oblique ridge for muscles; on  the
 inner is the mylo:hyoidean ridge, above which
 is a depression  for  the sublingual gland,  and
 another below for the sub-maxillary gland.  The
 lower edge  or base is rounded  and grooved for
 the facial artery, and  upon the  upper edge are
 alveolar processes.
   Angle, obtuse and rough for muscles.
  Ascending rami, are thick  and round posteri-
 orly—externally smooth—internally grooved.
   Coronoid process, passes upwards from anterior
 part of ascending ramus.
  Condyle, transversely oblong to articulate with
 temporal bone.
  Neck, constricted part below condyle.
  Sigmoid notch, between condyle and coronoid
process.
  Inferior dental foramen, situated at internal
surface of ascending ramus, and surmounted by
a spine. 
60
  Mental foramen, situated at anterior surface of
bone external to body.
  Dental canal, traverses bone between the two
foramina, and communicates with each alveolus.
This canal contains  the inferior dental  nerve
and artery.
                 OS HYOIDES.
  Situation, in the  anterior  part of the neck
between the chin and larynx.
  Body, square, is rough anteriorly for muscles,
smooth and concave posteriorly.
  Greater  cornua, pass  obliquely  backwards
from the sides of  the body, and end in  tuber-
cles.
  Lesser cornua,  are  very small, and pass ob-
liquely backwards and upwards from the point of
junction of the great cornua and body, and con-
nect the bone with the styloid process of tempo-
ral bone by means of the stylo-hyoid ligaments.
 _ The bones of the ear are described in connec-
tion with the organ of hearing.

      SUTURES OF THE CRANIUM AND FACE.

  Coronal suture, commences a little behind the
external angular process of the frontal bone, at
the upper termination of the  great wing  of the
sphenoid bone, and, inclining backwards, extends
across the cranium to the opposite corresponding
point,  connecting in its course the frontal to the
parietal bones.
  Lambdoid suture, commences at the union of 
                      61

 the petrous portion of the temporal bone with
 the parietal and occipital bones,  and extending
 across the posterior part of the cranium to  the
 opposite corresponding point, connects the occipi-
 tal to the parietal bones.
   Sagittal suture, extends from the angle of the
 occipital bone forwards, connecting in its course
 the parietal  bones  and corresponding to  the
 median fine; it generally terminates in the coro-
 nal suture, but is occasionally prolonged to  the
 nasal bones, dividing the frontal bone.
   Squamous  suture,  corresponds to the semi-
 circular  edge of the squamous portion  of  the
 temporal bone, and connects it to the great wing
 of the sphenoid bone, and to the parietal bone.
   Additamentum  sutura lambdoidalis,  extends
 from the termination of  the lambdoid suture to
 the  foramen lacerum posterius, and unites the
 mastoid  process of the  temporal bone to the
 occipital.
   Additamentum'  sutura  squamosa,  extends
 nearly horizontally backwards from the posterior
 termination of the squamous suture to the lamb-
 doid suture, connecting  the upper extremity of
 the mastoid portion of the temporal bone to the
parietal bone.
   Sphenoid suture, extends around the irregular
margins of the sphenoid  bone  connecting it to
all the bones  of the  head, and  to the malar,
superior maxillary, and palate bones.
  Ethmoid suture, surrounds the ethmoid bone,
connecting it to the frontal, nasal, superior max- 
62
illary, lachrymal, and palatine bones, and to the
vomer.
  Transverse suture, connects the bones of the
face to those of the head.
  Zygomatic suture, corresponds to the junction
of the temporal with the malar bone.

                   ORBITS.

  The orbits  are  two pyramidal cavities, the
bases of which look outwards and forwards, and
their apices in the contrary direction;  so that
two lines passing through their axes if prolonged
posteriorly would decussate at the sella  turcica.
Each  orbit is  formed of seven bones, three  of
which—viz. the frontal, sphenoid, and ethmoid,
are common to both orbits; the other four—viz.
the lachrymal, superior  maxillary,  malar,  and
palate bones belonging to the orbit of their cor-
responding side.   The roof is formed  by the
lesser wing of the sphenoid bone and the orbital
plate  of the frontal.  At the outer angle  is a
depression for the lachrymal gland; at the inner a
depression for the pulley  of the  trochlearis
muscle.   The floor is formed by the superior
maxilla, the malar and  palate bones, and con-
tains the infra-orbital canal.  The outer Avail is
formed by the malar and sphenoid bones; it is
pierced by some small foramina for  nerves; the
inner is formed by the os planum of the ethmoid,
the os unguis, superior maxilla, and a bit of the
sphenoid.  It  is perforated by the anterior and 
63
  posterior ethmoidal foramina.  The foramina in
  the base of the orbit are, the supra-orbital, the
  infra-orbital, and the upper orifice  of the nasal
  duct: within the orbit are the optic  foramen,
  the superior foramen lacerum, and  the spheno-
  maxillary fissure.   Through the optic foramen
  passes the optic nerve and ophthalmic artery.
  Through the fissura lacera the third,  fourth
  ophthalmic division of the fifth nerve, the sixth
  nerve, and the ophthahnic vein.

               TEMPORAL FOSSA,

   Placed on the side of the cranium, is bounded
  by  the frontal,  sphenoid,  malar, parietal, and
  temporal bones, and lodges the temporal muscle.

               ZYGOMATIC FOSSA.

   Extends from  the temporal fossa downwards,
 and is bounded by the zygomatic arch, the supe-
 rior maxillary bone, and the portion  of the great
 wing  of  the sphenoid  bone below its  crest.
 Between the great wing of the sphenoid and the
 border  of the superior  maxillary bone is  the
 spheno-maxillary fissure, which opens into  the
 orbit.
         PTERYGO-MAXILLARY FISSURE,
  Lies deep in the zygomatic fossa, is bounded
by the pterygoid processes, the tuberosity of the
superior  maxilla, and the  nasal plate  of the
palate bone; and communicates with the spheno- 
64
maxillary  fissure.   The angle of union of. the
spheno-maxillary and pterygo-maxillary fissures
is called the pterygo-maxillary fossa, into which
five foramina open; foramen  rotundum, for se-
cond  branch of fifth cerebral nerve;  foramen
pterygoideum  for  the vidian nerve; pterygo-
palatine for  a small artery;  posterior  palatine
for nerves and arteries; spheno-palatine, which
lodges the spheno-palatine ganglion.
             ARTICULATIONS.

     TEMPORO-MAXILLARY ARTICULATION.

  Bony formation.  Glenoid cavity of temporal
bone and condyle of inferior maxillary bone.
  External lateral  ligament,—origin, zygoma-
tic  process  and  external meatus.   Insertion,
outer side of the neck of condyle of lower jaw.
  Internal lateral  ligament,—origin, spinous
process of sphenoid  bone.  Insertion, spinal ori-
fice of inferior dental canal.
  Stylo-maxillary  ligament,—origin,  styloid
process of temporal bone.   Insertion, angle of
inferior maxilla.
  Synovial membranes; two; one is reflected
from the cartilaginous  surface  of  zygomatic
eminence  and glenoid cavity over the superior
surface of the fibro-cartilage;  the other  covers 
65
 the under surface of the fibro-cartilage, and is
 reflected over the condyle.
   Inter-articular,  or  fibro-cartilage,  of  oval
 figure, thick in its circumference, thin in  the
 centre,  where   it  is  sometimes   perforated.
 Divides the joint into two.
   Capsular  ligament,—origin, zygomatic emi-
 nence, and glenoid  fissure.  Insertion,  neck of
 lower jaw.

       OOCIPITO-ATLANTOID ARTICULATION.
   Bony formation, condyles of occipital bone
 and superior articular processes of atlas.
   Capsular ligament, imperfect.
   Synovial membranes, cover the opposed carti-
 laginous surfaces.
   Anterior occipito-atloidean ligament,—origin,
 anterior edge of foramen  magnum.   Insertion,
 upper edge of atlas,  anterior  to its articular pro-
 cesses.
   Posterior  occipito-atloidean  ligament,—ori-
 gin, posterior edge of foramen magnum.  Inser-
 tion, upper  edge of atlas behind its articular
processes.

        OCCIPITO-AXOID ARTICULATION.

   Check, or  oblique ligaments,—(syn.)  Ligam.
ala/ria ;  odontoid ligaments,—origin, from each
side of odontoid process.  Insertion, inner side
of each occipital condyle.
  Apparatus ligovmentosus, or occipito-axoidean
                     9 
66
ligament,—origin,  lower   part  of   basilar
process,  being posterior to  odontoid process.
Insertion, superior part of transverse ligament
of atlas and bodies of second and third vertebrae,
where it is continuous with the posterior com-
mon ligament.

        ATLANTO-AXOID ARTICULATION.

  Bony formation.—The anterior portion of the
spinal hole of the atlas, and the odontoid process
of axis; no intervertebral substance.
  Anterior and posterior ligaments, as in all the
other vertebrae.
  Transverse ligament, attached on each side  to
inner edge of articular process of the atlas, and
by means of apparatus ligamentosus  to basilar
process above, and body of axis below.
  Synovial membranes.  One between posterior
surface of odontoid process, and  anterior surface
of  transverse ligament.  Another covers the
opposed cartilaginous surfaces of the atlas and
odontoid process.

      COMMON VERTEBRAL  ARTICULATION.
  Bony formation.—Opposed  surfaces of the
bodies and articulating process of the vertebrae.
  Anterior  vertebral  ligament, extends from
axis to sacrum, adhering to  the bones and the
inter-vertebral substances.
  Posterior vertebral ligament, extends  along
the posterior part of  bodies of  vertebra within 
67
 the  spinal  canal.  It  is separated from  the
 bodies of the vertebrae by some large veins.
   Inter-vertebral ligaments, or fibro-cartilages,
 are placed between the bodies of all the verte-
 brae, except the atlas and dentata, and united to
 their flat surface above  and below.  They are
 thicker in front than behind  in the neck and
 loins,  and the  contrary  in  the  back:  in  the
 dorsal  region they are attached  to the heads of
 the ribs.
   Synovial membranes  and ligamentous  fibres
 connect the articulating processes.
   Ligamenta  sub-fiava,  composed of yellow
 elastic tissue, are  situated between  the laminae
 of the vertebrae from the second to  the sacrum,
 completing  the  posterior  part of the spinal
 canal.
   Supraspinous  and inter-spinous  ligaments,
 connect the spinous processes of the vertebrae.
   Inter-transverse ligaments, connect the trans-
 verse   processes.   The  Ligamentum   Nuchas
 extends from 7th  cervical  vertebra   to the
 occiput.

         COSTO-SPINAL ARTICULATIONS.

   Bony formation.—Heads, and tubercles of
ribs, and bodies and transverse processes of ver-
tebrae.
   Anterior ligament,—origin, front of head of
rib.  Insertion, side of the vertebra above and
below, and to the inter-vertebral substance by 
68
radiating fibres, hence sometimes called " stellate
ligament."
  Inter-articular ligaments,—origin, projecting
ridge in the articular surface of each rib.  Inser-
tion, cavity in the inter-vertebral substance in
which  the  head is  received.  The  upper  and
lower divisions of this joint have distinct syno-
vial membranes.
  Costo-transverse ligaments, three in number.
  Internal  costo-transverse  ligament,—origin,
neck of each rib.  Insertion, transverse process
of the vertebra above.
  Posterior costo-transverse  ligaments, connect
the tubercle of each rib to the corresponding
transverse process.
  Middle or interosseous costo-transverse liga-
ment connects the neck of  the rib to the con-
tiguous transverse process:  to see it, the bones
must be forcibly separated.
   Synovial membranes are between the tuber-
cles and transverse processes.

        OHONDRO-STERNAL ARTICULATION.

   The ribs are connected to the sternum through
the  intervention of their cartilages, which form
a joint lined by synovial membrane and secured
anteriorly and posteriorly by ligamentous fibres.

          LUMBO-SACRAL ARTICULATION.

   Bony formation.—Last lumbar vertebra and 
69
 sacrum.   These are joined together in the same
 manner as the other vertebrae.          '
   Hio-lumbar   ligament,—origin,  transverse
 processes of fifth  lumbar vertebra.   Insertion,
 posterior  superior spinous  process and  crest of
 ilium.             .
   Sacro-vertebral  ligament extends almost ver-
 tically  downwards from transverse  process  of
 last lumbar vertebra to base of sacrum.

           ILIO-SAORAL  ARTICULATION.

   The ilium and sacrum are connected anteri-
 orly and posteriorly by short ligamentous fibres.
   Great   sacro-sciatic  ligament,—origin,  pos-
 terior inferior spine of ilium and side of sacrum
 and coccyx.  Insertion,  lower edge of tuber
 ischii.  Along the ramus of the ischium it sends
 a falciform process which covers  the obturator
 internus muscle.
   Lesser sacro-sciatic ligament,—origin, side  of
 sacrum  and  coccyx.    Insertion,   spine  of
 ischium.
  These ligaments  convert the  great  lateral
 pelvic notch into foramina, called the greater
 and  lesser sacro-sciatic foramina.  The former,
 superior, transmits  the  pyramidalis muscle, the
great sciatic nerve, the sciatio vessels, and  the
gluteal vessels  and nerve;  the latter, inferior,
and  bounded by the  two ligaments, transmits
the tendon of the obturator internus muscle  and
the internal pudic vessels and nerve. 
70
       SA0RO-0O0CYGEAL ARTICULATION.
  The sacrum and coccyx are united together
by  a similar substance to the inter-vertebral,
and  by ligamentous bands anteriorly and pos-
teriorly.
            PUBIC ARTICULATION.
  Fibro-cartilage, which attaches  closely  the
bones of the pubes; also ligamentous fibres.
  Sub-pubic ligament, passes from the ramus of
one bone to the other, and rounds off the angle
formed by their union.
  Obturator ligament, attached to  the circum-
ference of obturator foramen, except superiorly,
where the obturator nerve and vessels pass.

      STERNO-CLAVICULAR ARTICULATION.
  Anterior  ligament,—origin, anterior surface
of sternal end of clavicle.  Insertion, anterior
surface of sternum.
  Posterior ligament.—origin, posterior surface
of sternal end of clavicle.  Insertion, back part
of sternum.
  Costo-clavicular ligament,—origin, lower sur-
face of sternal end of clavicle.  Insertion, carti-
lage of first rib.
  Inter-clavicular  ligament extends from the
sternal extremity of one clavicle to that of the
other, dipping down in its course to become  at-
tached to the upper surface of the sternum.
  Inter-articular cartilage, thin below and  at-
tached to  sternum, thick above and attached to 
71
  clavicle; having a synovial membrane connected
  to each surface and its corresponding bone.

       SCAPULO-CLAVICULAR ARTICULATION.

   Superior acromioclavicular ligament,—ori-
 gin, upper surface of acromion.  Insertion, upper
 part of clavicle.
   Inferior  acromioclavicular ligament.—At-
 tached to under surface of each bone.
   Synovial  membrane covers  the  articulating
 surfaces in the usual manner.

      CORACO-OLAVICULAR ARTICULATION.

   Conoid ligament, triangular; base connected
 to the  tubercle on inferior surface  of  clavicle,
 apex at the broad part of coracoid process.
   Trapezoid  ligament, attached  above  to  an
 oblique fine on the clavicle; below to upper part
 of the coracoid process.

         LIGAMENTS OF THE  SCAPULA.

   Coraco-acromial  ligament,—origin,    broad
from coracoid  process. Insertion, narrow into
point of acromion.
   Posterior or coracoid ligament,—origin, supe-
rior  costa of scapula behind the notch.   Inser-
tion, base of coracoid process.  This ligament
converts the  notch  into  a  foramen,  through
which passes the suprascapular nerve. 
72
       HUMER0-S0APULAR ARTICULATION.

  Bony  formation.—Head  of  humerus  and
glenoid cavity ot scapula.
  Capsular ligament,—origin, circumference of
neck of scapula.  Insertion, around the neck of
humerus.   It is strengthened by the  coraco-
humeral  ligament, and by prolongations from
the tendons of the supra and infra spinatus and
teres minor muscles.
  Coraco-humeral  ligament,—origin,  coracoid
process.  Insertion, anterior part of great tube-
rosity.
  Synovial membrane is reflected over  the sur-
face of the glenoid cavity around the glenoid
ligament; lines the  capsular ligament,  head of
humerus, and bicipital groove.
  Glenoid  ligament, closely connected with  the
tendon of the biceps flexor cubiti,  encircles  the
glenoid cavity, and by elevating the border, adds
to the depth of the articulating surface.

       HUMERO-CUBITAL ARTICULATION,
  Bony formation, articular processes of hume-
rus, great sigmoid cavity of ulna, head of radius.
  External lateral ligament,—origin, external
condyle of humerus.   Insertion,  annular liga-
ment of radius.
  Internal lateral  ligament,—origin,  internal
condyle.  Insertion, inner edge of olecranon  and
ooronoid processes. 
73
   Anterior  ligament, consists of thin  fibres,—
 origin, principally from the above internal con-
 dyle and depression on the forepart of humerus;
 insertion, annular ligament of radius and syno-
 vial membrane.
   Posterior  ligament  is  composed of fibres
 which extend from one condyle to the other, and
 are attached to the synovial membrane.
   Synovial membrane  is reflected from behind
 the anterior ligament to neck of radius  and an-
 nular ligament; it then lines the sigmoid cavities
 of the ulna, and is reflected to the lateral liga-
 ments and tendon of the  triceps muscle, which
 conducts it to  the posterior depression of the
 humerus; it is then expanded over its articular
 processes.

      SUPERIOR RADIO-ULNAR ARTICULATION.

   Bony formation, lesser sigmoid cavity of ulna
 and inner side of head of  radius.
   Coronary  ligament—origin, anterior border
 of lesser sigmoid cavity of ulna; insertion, pos-
 terior border of the same  cavity.   It encircles
 the neck of radius.
   Oblique ligament—origin, coronoid process of
ulna.   Insertion, radius below its tubercle.
  Interosseous ligament connects  the   opposed
edges of radius  and ulna,  its fibres descending
obliquely inwards from the former bone to  the
latter.
                    10 
74
    INFERIOR RADIO-ULNAR ARTICULATION.
  Bony formation, round head of ulna, and sig-
moid cavity of radius; the bones are united by
some fibrous bands, which are so thin as not to
need description.
  Fibro-cartilage—origin, styloid process of ul-
na.  Insertion, inner edge of radius below the
ulna.
  The synovial  membrane,  called  sometimes
membrana sacciformis, extends horizontally be-
tween the extremity of the ulna and the fibro-
cartilage,  and vertically between the opposed
articulating surfaces of the radius and ulna.

         RADIO-CARPAL ARTICULATION.

  Bony formation, lower end of radius;  sca-
phoid, lunar, and cuneiform bones.
   The extremity of the ulna is separated from
the joint by the fibro-cartilage.
   External lateral  ligament—origin,  styloid
process of radius.  Insertion, scaphoid bone, and
by some fibres into annular ligament and trape-
zium.
   Internal lateral ligament—origin, styloid pro-
cess of ulna.  Insertion, cuneiform  bone  and
pisiform bone.
   Posterior ligament—origin, posterior part  of
radius and fibro-cartilage.   Insertion, back part
of superior row of carpus.
   Anterior ligaments-origin, anterior part  of 
75
 radius and fibro-cartilage.   Insertion, fore part
 of first row of carpus.
   The synovial membrane lines the head of the
 radius, the fibro-cartilage, and  is then reflected
 over the three carpal bones.

            CARPAL ARTICULATIONS.

   The bones of  the carpus are articulated by
 ligamentous bands, both anteriorly and posteri-
 orly.
   The scaphoid, lunar, and cuneiform bones are
 connected by dorsal and palmar ligaments, ex-
 tending from bone to bone: between the opposed
 surfaces are interosseous fibro-cartilages.
   The pisiform bone possesses  a distinct fibrous
 capsule and synovial membrane.
   The trapezium, trapezoides, magnum, and un-
 ciforme, are also connected by dorsal and palmar
 ligaments.
   Interosseous fibro-cartilages are found on either
 side .of the os magnum.
   Lateral ligaments extend on the radial side from
 the scaphoid to the trapezium; on the ulnar side,
 from the cuneiform to the unciform.
   The carpal synovial  membrane extends be-
 tween the first and second row of carpal  bones,
 andls prolonged to the carpal extremities of the
four inner metacarpal bones.   The  trapezium
articulates with the  metacarpal  bones of the
thumb by a distinct capsule and synovial  mem-
brane. 
                     76

  Annular  ligament—origin,  trapezium and
scaphoid bones.  Insertion, cuneiform and unci-
form and pisiform bones.

      CARPO-METACARPAL ARTICULATION.
  The  carpus  and metacarpus  are secured by
fibrous bands, which pass in different directions,
and cover the synovial membranes.

   METACARPO-PHALA XOEAL ARTICULATIONS.
  The  heads of the metacarpus and  first pha-
langes are secured by lateral ligaments, and are
lined by synovial membranes ; a transverse liga-
ment connects the digital extremities of the me-
tacarpal bones one with another.

      INTER-PHALANGEAL ARTICULATIONS.
  The phalanges are connected to each other by
means of two lateral ligament?, one anterior liga-
ment, and between each of  their joints is  a
synovial membrane.

        ILIO-FEMORAL ARTICULATION.

  Bony formation,  acetabulum and  head and
part of neck of femur.
  Cotyloid ligament, a fibro-cartilaginous circu-
lar band adhering to the margin of  the  aceta-
bulum.
  Transverse ligament, attached to the opposite 
                       77

 points of the notch of the acetabulum, and partly
 filling it up.
    Capsular ligament—origin, circumference of
 acetabulum and transverse ligament  Insertion,
 below root of trochanter major, and  the two
 inter-trochanteric lines.
   Accessory or iliofemoral  ligament—origin,
 anterior inferior spinous process of iliuin. Inser-
 tion, anterior trochanteric line.
   Synovial membrane, reflected from inside of
 capsule  upon periosteum of neck, and cartilagi-
 nous surface of head;  is continued over inter-
 articular ligament, and thence is reflected  upon
 the cartilaginous surface of the acetabulum.
   Inter-articular ligament, or ligamentum teres
 —origin, depression on head  of femur. Inser-
 tion, by two bands  into the extremities of the
 notch, and  into the transverse ligament.

         FEMORO-TIBIAL ARTICULATION.

   Bony  formation, condyles of femur,  head of
 tibia and the patella.
   Ligamentum patella—origin, lower  angle of
 patella.  Insertion, tubercle of tibia.
   Posterior ligament—origin, tendon of semi-
 membranosus muscle at internal and posterior
 part of  tibia.   Insertion, external  condyle of
 femur.
   Internal  lateral  ligament—origin,  internal
 condyle of femur.  Insertion, internal condyle of
tibia and semilunar cartilage. 
78
  External  lateral ligament—origin,  external
condyle of  femur.  Insertion, head of  fibula.
This ligament is often divided into two by the
tendon of the biceps muscle.
  Synovial membrane lines the back part of the
patella, from which it is reflected two or three
inches on the fore part of the femur, and on its
condyles;  from thence it is conducted by the
crucial ligaments to the semi-lunar cartilages, and
head of tibia.
  Alar ligaments arise from each side of patella,
and unite below that bone.  They are mere folds
of synovial membrane.
  Ligamentum  mucosum—origin, fatty sub-
stance behind ligamentum patellae.  Insertion,
hollow between  the condyles.  It also is a fold
of synovial membrane.
  Transverse ligament, attached to the anterior
portion of each semi-lunar cartilage.
  Anterior crucial ligament—origin, inner side
of external  condyle.   Insertion,  near  the  fore
part of head of tibia, where it is connected to the
cornu of the internal semilunar cartilage.
  Posterior crucial ligament—origin, outer side
of internal  condyle.   Insertion,  depression on
back part of head of tibia, and  external semi-
lunar cartilage.
  Semi-lunar cartilages, thick externally, thin
internally:  concave  above,  flat  below.   The
outer convex edge of  the internal is attached to
the lateral ligament; the inner edge is free; the
anterior and posterior extremities of each are 
79
 attached to the head of the tibia.   The outer
 cartilage is circular, the inner is semi-circular.

         TLBIO-FIBULAR ARTICULATION.
   The head of the fibula is attached to the tibia
 by anterior and posterior fibrous  bands and sy-
 novial membrane.
   Interosseous membrane extends from one bone
 to the other, nearly the whole length.
   The lower extremities of the tibia and fibula
 are connected together by anterior and posterior
 ligaments ; the synovial membrane  is a prolon-
 gation of that which lines the ankle joint.

        ARTICULATION OF THE ANKLE.
   Bony formation,  lower ends of tibia, fibula,
 and astragalus.
   Internal  lateral  ligament—origin,  internal
 malleolus.  Insertion, astragalus, naviculare, and
 os calcis.
   External lateral ligament has three parts; all
 take their origin from the  external malleolus.
 Insertion of anterior, upper and  outer part of
 astragalus.   Insertion"of middle, os calcis.   In-
 sertion of posterior, ridge on the back of astra-
 galus, which bounds the groove for the flexor
 longus pollicis.
  The synovial membrane covers the opposed
surfaces of the bones, and sends upwards a pro-
longation into the  inferior  tibio-fibular articu-
lation. 
so
        ARTICULATIONS  OF TOE  TARSUS.
  The astraga'us and os calcis have two articu-
lar surfaces, covered by synovial membranes.
  Interosseous ligament passes nearly perpendi-
cularly from the groove which separates the in-
ferior articular surfaces  of the astragalus, to the
corresponding groove in the os calcis.
  Posterior ligament is  attached to the posterior
edges of the astragalus and os calcis.
  External lateral ligament passes from the as-
tragalus to the outer surface of the os calcis.
  There are two synovial membranes: one pos-
terior to the interosseous ligament, between the
astragalus and os calcis: a second anterior to the
interosseous ligament,  between the  astragalus
and os calcis,  and  continued forwards between
the astragalus and os naviculare, over the calca-
neo-navicular ligament.
  The bones of the tarsus are connected on their
dorsal and plantar aspects by numerous ligamen-
tous bands.
  Calcaneo-scaphoid ligament—origin,  inferior
surface of os calcis.   Insertion, i nferior surface of
os naviculare.
  It is composed  of elastic tissue, and  is sup-
ported inferiorly by the tendon of the tibialis
posticus muscle: superiorly it forms with the os
calcis and os naviculare  a  cup, which receives
the head of the astragalus.
   Inferior calcaneocuboid  ligament—origin,
posterior  inferior  part  of os calcis.  Insertion, 
                     81

 under part of cuboid bone, and third and fourth
 metatarsal bones.
   The superficial fibres, longer than the deeper,
 form the " ligamentum longum plantae."  There
 is a  distinct synovial membrane  between the
 ealcaneum and cuboid bones.
   The three cuneiform bones  are connected by
 dorsal, plantar, and interosseous ligaments:  one
 synovial membrane is reflected  over  their op-
 posed surfaces with the os naviculare.

      TARSO-METATARSAL  ARTICULATIONS.
   These joints are secured by dorsal and plantar
 ligaments, and are fined by synovial membranes.
 The metatarsal bones  are secured to the phalan-
 ges, and the phalanges to  each other, by lateral
 ligaments and  synovial membranes.  There is
 one synovial membrane  between  the internal
 cuneiform bone and the first  metatarsal bone ; a
 second between the os cuboides  and the fourth
 and fifth metatarsal bones.  The second and third
 metatarsal bones form  part of the articulation be-
tween the cuneiform and the navicular bones.
                 MUSCLES.

                   HEAD.

  Occipito-frontalis.—Origin,   two  external
thirds of superior semicircular ridge of occipital
                     11 
82
 bone, and posterior external part of mastoid pro-
 cess of temporal bone.  Insertion, integuments
 of eyebrows,  when the fibres become blended
 with those of the pyramidalis nasi, the corruga-
 tor supercilii,  and the orbicularis palpebrarum.

         MUSCLES OF EXTERNAL  EAR.
   Attollens aurem.—0. cranial  aponeurosis
 above external ear.  I.  upper and anterior part
 of cartilage of ear.
   Attrahens aurem.—0. posterior part of zygo-
 matic process and cranial aponeurosis.  I. ante-
 rior part of helix.
   Retrahens aurem.—0. mastoid process.   /.
 back part of concha.

                    FACE.

   Orbicularis palpebrarum.—0. Internal angu-
lar process of os frontis  and upper edge of tendo
palpebrarum.   I. nasal process of superior max-
illary bone and inferior edge of tendo palpebra-
 rum.
   Tensor tarsi.—0. posterior edge of os unguis.
JT.  lachrymal ducts as far as puncta.
   Corrugator  supercilii.—0. internal  angular
procoss of os frontis.  /. middle of eyebrow.
  Pyramidalis nasi.—0. occipito-frontalis mus-
 cle, descends along nasal bones.   I. compressor
 nasi muscle.
   Compressor  nasi.—O. canine fossa in superior
maxilla.  I. dorsum of nose. 
83
    Levator labii superioris alaque nasi.—0. up-
 per extremity of nasal process of superior max-
 illa, and from edge of orbit above  infra-orbital
 hole.   /. ala nasi, upper lip, and orbicularis oris
 muscle.
   Zygomaticus minor.—0. upper part of malar
 bone.   I. upper lip, near commissure.   Some-
 times wanting.
   Zygomaticus major.—0. lower part of malar
 bone, near zygomatic suture.  /. angle of mouth.
   Levator anguli  oris.—0. canine  fossa above
 alveola of the first molar tooth.   I. commissure
 of lips and orbicularis oris.
   Depressor labii superioris  almque nasi.—0.
 myrtiform fossa above canine and incisor teeth
 of superior maxilla.   /.  integuments of upper
 lip and fibro-cartilage of septum and ala nasi.
   Depressor anguli.—0. external oblique line
 on lower jaw, extending from anterior edge of
 masseter muscle to mental foramen.   I. commis-
 sure of lips.
   Depressor  labii inferioris.—0. side and front
 of lower maxilla,  above  its base.   /.  half of
 lower lip and orbicularis oris.
   Levator labii inferioris.— 0. alveoli of incisor
 teeth of  lower jaw.   I. integument of chin.
   Orbicularis  oris  surrounds mouth by  two
 fleshy fasciculi.
   Buccinator,—0.  two last alveoli  of superior
 maxilla and external surface of posterior alveoli
 of lower maxilla, and from a ligament (pterygo-
maxillary)  which  extends  from the internal 
84
pterygoid plate of the sphenoid bone to  the  ex-
tremity of the mylo-hyoid ridge of the  inferior
maxilla.   I. commissure of lips.

           MUSCLES  OF LOWER JAW.
  Masseter consists  of two portions : Anterior
portion.   0. superior maxilla where it joins ma-
lar  bone, and  inferior edge of latter.  I. outer
surface of angle of lower jaw.
  Posterior portion.—O. edge of malar bone, and
zygomatic arch, as far as glenoid cavity.   J.  ex-
ternal side of angle and ramus of lower  jaw.
  Temporal.—0. side of cranium, beneath semi-
circular ridge on parietal bone, temporal fossa,
and aponeurosis.  I. coronoid process of inferior
maxilla to last molar tooth.
  Pterygoideus internus.— O. internal pterygoid
plate and pterygoid fossa  of  palate bone.   I.
inner side of  angle  of  jaw  and rough surface
above.
  Pterygoideus externu$.—0. outer side of ex-
ternal  pterygoid plate, spinous process  of sphe-
noid bone and tuberosity of superior maxilla.  I.
anterior and internal part of neck of lower jaw,
cartilage, and capsular ligament.

MUSCLKS OF ANTERIOR AND LATERAL PARTS  OF
                   NECK.
  Platysma-myocles.—O.   cellular  membrane
covering  upper  and outer part of deltoid  and
great pectoral muscles.   I.  chin; fascia along 
85
 side of lower jaw; and fascia covering parotid
 gland.  Some of the fibres become blended with
 those of the depressor labii inferioris and anguli
 oris.
   Sterno-cleido  mastoideus.— 0. upper and an-
 terior  part of the first bone of sternum and
 sternal third, sometimes half, of clavicle.  I. up-
 per part of mastoid process and external  third
 of superior transverse ridge of occipital bone.
   Sterno-hyoideus.—0. posterior surface of first
 bone of  sternum, cartilage of first rib, sternal
 end of clavicle, and sterno-clavicular articulation.
 I. lower border of body of os hyoides.
   Sterno-thyroideus.—0.  posterior  surface of
 first bone of sternum and cartilage of second rib.
 I. oblique line on ala of thyroid cartilage.   It is
 broader than the preceding.
   Omo-hyoideus.—O. behind semilunar notch in
 scapula, from the ligament which passes over the
 notch, and from  base  of coracoid process.   I.
 lower border of os hyoides, at the junction of its
 body and great cornu.   It  is  a double-bellied
 muscle, the mesial tendon being bound down by
 a pulley of cervical fascia.
  Digastricus.—A double-bellied muscle.  Pos-
 terior belly.   0. groove internal to mastoid  pro-
 cess.   Anterior  belly,  0.  rough depression on
 inner surface of base of jaw,  near its symphy-
 sis.   The two bellies unite at an angle,  in a
 tendon  which passes through  the fibres of the
stylo-hyoid muscle, and is  inserted into the os
hyoides. 
86
  Mylo-hyoideus.   0. mylo-hyoid ridge of infe-
rior  maxilla.  I. base of os hyoides, chin,  and
middle tendinous line common to it and its fellow.
   Genio-hyoideus.   0. inner side of chin, above
the digastricus.  /. base of os hyoides.
  Hyo-glossus.  0. great cornu and part of body
of os hyoides.  I. side of tongue.
   Genio-hyo-glossus.  0. eminence inside chin,
below frsanum linguae.   I.  mesial line of tongue
from apex to base, and body and lesser cornu of
os hyoides.
  Lingualis consists of  fasciculi of fibres, run-
ning from base to apex of  tongue, and lying be-
tween  the genio-hyo-glpssus,  and the  byo and
stylo glossi.
,  Stylo-hyoideus.   0. outer side of styloid  pro-
cess, near its middle. I.  cornu and body of os
hyoides.
  Stylo-glossus.  0. styloid process, near its tip
and  the  stylo-maxillary hgament.  I. side of
tongue, as far as the tip.
  Scylo-pharyngevs.  0. inner part of root of
styloid process.  I. side  of pharynx, cornu of os
hyoides, and thyroid cartilage.


          MUSCLES  OF THE PHARYNX.

   Constrictor pharyngis  inferior.   0. side of
cricoid cartilage, inferior  cornu,  and  posterior
edge of thyroid cartilage.  I. with its fellow,
along mesial line on back of pharynx.
   Constrictor pharyngis mcdius.  0. great cornu 
87
 and also lesser cornu of os hyoides, stylo-hyoid
 and thyro-hyoid ligaments.  I. mesial tendinous
 fine, and basilar process of occipital bone.
    Constrictor pharyngis superior.  0. petrous
 portion of temporal bone, lower part of internal
 pterygoid plate, also pterygo-maxillary ligament,
 posterior third of mylo-liyoid  ridge, and side of
 base of tongue.  I. basilar process of occipital
 bone and mesial line of pharynx.

           MUSCLES OF  TnE  PALATE.

   Levator palati.   0. petrous portion  of tem-
 poral  bone in front of foramen caroticum, and
 from  cartilage  of  Eustachian  tube.  I. broad,
 into the velum.
   Tensor, vel circumflexus palati.   0.  spinous
 process of sphenoid, and fore part of Eustachian
 tube;  tendon turns round hamular process.   /.
 into velum, meeting its fellow in the mesial fine.
   Levatores uvula.  0. posterior  extremity  of
 spine of palate bones.  I. cellular tissue of uvula.
   Palato-glossus.  0. inferior  surface of velum.
 I. side of tongue.   It forms anterior half arch.
   Palato-pharyngeus.   0. inferior surface of pa-
 late.   I. side and back of pharynx, and superior
 cornu  of thyroid cartilage.  It forms the poste-
 rior half arch.
                   LARYNX.
   Thyro-hyoideus.   0. oblique  ridge on ala of
thyroid cartilage.   I. lower edge of great cornu
of os hyoides. 
88
  Crico-thyroideus.  0. fore part of cricoid car-
tilage.  I. lower border of thyroid cartilage.
  Thyro-arytenoideus.  0. posterior surface of
thyroid cartilage, near its angle.   I. anterior edge
of arytenoid cartilage.
  Crico-arytenoideus lateralis.   0. upper edge
of side of cricoid cartilage.  I. base of arytenoid
cartilage.
  Crico-arytenoideus posticus.  0. depression on
posterior surface of cricoid cartilage.  /. outer
side of base of arytenoid cartilage.
  Arytenoideus fills the interval between aryte-
noid cartilages, and consists of two arrangements
of fibres: oblique, run from apex of one cartilage
to base of opposite one; transverse, are attached
to posterior surface of each cartilage.

DEEl' MUSCLES ON ANTERIOR AND LATERAL PARTS
                 OF THE NECK.

  Longus colli.   Divided into two portions, ver-
tical and oblique.  Vertical portion.  0. bodies
of three  upper dorsal and four lower cervical
vertebrae, and the intervertebral fibro-cartilages.
I. bodies of second and third cervical vertebrae.
Oblique portion.   0. anterior part of transverse
processes of third,  fourth, and fifth cervical ver-
tebrae.   I. body of the atlas.
  Rectus capitis anticus major.   0. anterior tu-
bercles of transverse processes  of four  inferior
cervical vertebra).   I. basilar process of occipital
bone. 
89
   Rectus capitis anticus minor.   0. transverse
process of atlas.  I. basilar process of occipital
bone.
   Rectus capitis lateralis.  0. transverse process
of atlas.  I. jugular process of occipital bone.
   Scalenus anticus.  0.  anterior  tubercles of
transverse processes of third, fourth, fifth, and
sixth cervical vertebrae.   /. upper surface of first
rib, just anteriorly to its middle.
   Scalenus medius.  0. posterior tubercles of
transverse processes of four or five inferior cer-
vical vertebrae.  I. upper edge of first rib.
   Scalenus posticus.  0.  posterior tubercles of
two or three  inferior cervical vertebrae.  I. up-
per edge of second rib between its tubercle and
angle.
                   THORAX.

   Pectoralis major.   0. sternal half of clavicle,
anterior surface of sternum, cartilages of second,
third, fourth,  fifth, and  sixth  ribs, and aponeu-
rosis common to it and external oblique muscle.
I. by a flat tendon into anterior edge of bicipital
groove, and by an  aponeurosis  into fascia of
forearm.
  Pectoralis minor.  0. external surfaces and
upper edges of third, fourth, and fifth ribs, some-
times from  second.   I. inner and upper surface
of coracoid process of scapula.
  Subclavius.   0. cartilage of first rib.  I. ex-
ternal half of inferior surface of clavicle.
  Serratus magnus.   0. by eight or nine fleshy
                     12 
90
slips, from eight or nine superior ribs.   I. base
of scapula.  •       j.
  Intercostafes' are wenty-two in number  on
each side: eleven internal and eleven external.
The fibres of the external pass obliquely from
behind, forwards and downwards ;  those of the
internal in the opposite direction.
  External.   0. inferior edge of each rib, com-
mencing at transverse processes of vertebrae.  I.
external lip of superior edge of rib  beneath, ex-
tending to costal extremities of cartilages.
  Internal.   0. at sternum from the inner  lip
of lower edgo of each catrilage and rib as far as
angle.   I. inner lip of superior edge of cartilage
and rib beneath.
  Levatores  costarum.   0. extremity  of each
dorsal  transverse process.  I. upper edge of  rib
below, between tubercle and angle.
   Triangularis sterni.   0. posterior surface and
edge of lower part of sternum and ensiform car-
tilage.   I. cartilages of fourth,  fifth, and sixth
ribs.

            MUSCLES OF THE BACK.

                 First Layer.

   Trapezius.   0.  internal  third  of  superior
transverse ridge  of occipital bone, ligamentum
nuchae, and spinous process of last cervical and
all dorsal vertebrae.  I. posterior border of  ex-
ternal  third of clavicle, acromion  process, and
superior edge of spine of scapula. 
91
   Latissimus  dorsi.   0.  six  inferior  dorsal
spines,  and by lumbar fascia from all lumbar
spines, from back of sacrum, posterior third of
crest of ilium, and  from three to four inferior
ribs.  /.  posterior edge of bicipital groove of
humerus.
                Second Layer.
   Rhomboideus minor.   0. lower part  of liga-
mentum nuchae and last cervical spinous process.
I. base of scapula, opposite to its spine.
   Rhomboideus major.  0. four or five superior
dorsal spines.  I. base of scapula from spine to
inferior angle.
   Levator anguli scapula.  0. posterior tuber-
cles of transverse processes of four or five supe-
rior cervical vertebrae.  I. base of scapula, be-
tween spine and superior angle.
   Serratus posticus superior.  0. ligamentum
nuchae, and two or three dorsal spines. /. second,
third, and fourth ribs,  external to angles.
   Serratus posticus inferior.  0. two last dorsal
and two superior lumbar spines.   I. lower edges
of four inferior ribs anterior to angles.
   Splenius muscle, flat and oblique, single at its
origin;  divides at its insertion into two portions,
the splenius colli, and splenius capitis;  the former
attached  to the cervical vertebrae, the latter to
the cranium.   0. from spines of five  superior
dorsal and last cervical vertebra, and from liga-
mentum  nuchae as high  as the third  cervical
vertebra.   I. the  lower  portion,  splenius colli, 
92
the smaller, into posterior tubercles of transverse
process of three or four superior cervical verte-
brae.   Upper portion, splenius  capitis, into pos-
terior  part of mastoid process, superior curved
ridge of occipital  bone,  and the rough surface
below  it.
                 Third Layer.
  The following muscles lie beneath the serrati,
and • a fascia called  the vertebral  aponeurosis.
The fleshy mass occupying the vertebra groovea
of  either side  is  called erector spinas,  and it
divides opposite the  last rib into two portions,
sacro-lumbalis, and longissimus dorsi.
  Erector spina.  0.  from a  dense fascia con-
nected with the spines of the  sacrum, from the
posterior third of the  crista of the ilium, from
the posterior surface of the sacrum, and from
the sacro-sciatic ligaments.  The outer portion,
called  sacro-lumbalis, is inserted into the angles
of six or seven lower ribs.  Musculus accessorius
ad sacro-lumbalem, a continuation of sacro-lum-
balis.  0. angles  of six  or seven  lower ribs,
internal to the tendons of preceding muscle.   I.
angles of six upper ribs, and into  transverse
process of last cervical vertebra.
   Cervicalis ascendens, the continuation of sacro-
lumbalis  into  the neck.   0.  from angles  of
third,  fourth, fifth, and sixth ribs.  I. transverse
processes of third, fourth, fifth, and sixth cervi-
cal vertebno.
  The inner portion of erector spinao, longissimus 
93
 dorsi, is inserted into transverse processes of all
 the dorsal and lumbar vertebrae and into all the
 ribs between their tubercles and angles.  Trans-
 versalis colli, a continuation of the  longissimus
 dorsi.  0. transverse processes of third, fourth,
 fifth,  and sixth dorsal vertebrae.  I. posterior
 tubercle of transverse processes of second, third,
 fourth, fifth, and sixth cervical vertebrae.
   Trachelo-mastoid, -the  prolongation of  the
 longissimus  dorsi  to the head.  0.  transverse
 processes of four upper dorsal and four lower cer-
 vical vertebrae.  I. posterior margin of mastoid
 process.
   Complexus.  0. transverse  and oblique pro-
 cesses of three or four inferior cervical and  five
 or six superior dorsal vertebrae. I. into occipital
 bone between its two transverse ridges.

                Fourth Layer.

   Semi-spinalis colli.  0. extremities of trans-
 verse  processes of  five or six superior  dorsal
 vertebrae.  I. by four heads into spines of second,
 third,  fourth, and fifth cervical vertebrae.
   Semi-spinalis dorsi.  0. by five or six tendons,
 from transverse  processes  of  dorsal vertebrae,
 from fifth to eleventh.  I. extremity of spines of
 two inferior cervical and three or four superior
 dorsal vertebra.
   Multifidus  spinm.  0. first fasciculus  arises
from spine of vertebra dentata, and  is inserted
into transverse process of third, each successively
in a similar  manner down  to the  last, which 
94
arises from  the spine of last lumbar vertebra,
and is inserted into transverse process of sacrum.
  Interspinales—are  situated between spinous
processes of vertebrae: they are in pairs in the
cervical region.
  Intertramversales—attached and situated as
their name implies.
  Rectus  capitis posticus mmajor.   0. spinous
process of second vertebra.   I.  inferior trans-
verse ridge of os occipitis.
  Rectus  capitis posticus minor.   0. posterior.
part of atlas.  I. occipital bone, behind foramen
magnum.
   Obliquus capitis inferior.   0. spinous process
of second vertebra.   I. extremity of transverse
process of atlas.
   Obliquus capitis superior.   0. upper  part of
transverse process of atlas.  I. occipital bone,
between its transverse ridges, posterior to mas-
toid process.

               UPPER EXTREMITY.

                Shoulder Arm.
   Deltoideus.   0. lower edge of spine of scapula,
anterior edge of acromion, and external third of
clavicle.   /.  rough  surface on  outer  side of
humerus, near its centre.
   Supra-spinatus.    0.   all  scapula above the
spine, which forms supra-spinous fossa, and from
fascia covering muscle.   I. upper and fore  part
 of great tuberosity of humerus. 
95
    Infraspinatus.  0. inferior surface of spine
 and dorsum of scapula beneath, except near the
 neck, as low down as posterior ridge on inferior
 costa.   I. middle of great tuberosity of humerus.
    Teres minor.    0.  depression  between  the
 two ridges on inferior  costa of scapula, from
 fascia covering  it,  and  ligamentous  septa.  I.
 inferior depression on great tuberosity of humerus.
    Subscapular is.  0. all  the surface and circum-
 ference  of subscapular fossa.  I. lesser tubercle
 of humerus, and  a small portion of the neck of
 the bone.
    Teres major.   0. rough  surface on inferior"
 angle of scapula, below infra-spinatus.  I.  pos-
 terior edge of bicipital  groove.
    Coraco-brachialis.  0. coracoid process and
 tendon of short head of biceps.  I. internal side
 of humerus about its middle.
   Biceps.   0. short head, from coracoid process ;
 long head,  from  upper edge of glenoid cavity.
 7".  into  tubercle of radius.  It gives off an
 aponeurosis at  the bend of the arm.
   Brachialis anticus.   0. centre of humerus by
 two slips on either  side of insertion of deltoid,
 and fore part  of  humerus  to its condyles.  I.
 coronoid processof uhia and rough surface beneath.
   Triceps extensor cubiti.  0. long head, from
 lower part of neck of scapula and inferior costa.
 Second head, from  ridge on humerus, below
insertion of teres minor.  Third  head, from
ridge below insertion of teres major, leading to
the internal condyle, and from  internal inter- 
96
muscular ligament.   I.  olecranon process of
ulna, and fascia of forearm.

             Forearm and Hand.
  Palmaris brevis, lies between the skin and the
palmar fascia.  0. annular-ligament and palmar
fascia.   I. integuments on inner side of palm.
  Pronator radii teres.   0.  anterior part of
internal condyle, fascia of forearm, intermuscular
septa, and, by a small slip, separated  from the
larger head by the median nerve, from coronoid
process of ul na.  I. outer and back part of radius,
about its centre.
  Flexor carpi radialis.   0.  inner condyle and
intermuscular  septa.   I.  base  of metacarpal
bone of index finger.
  Palmaris  longus.   0.  inner  condyle  and
fascia of  forearm.  I.  annular ligament  and
palmar  aponeurosis, near root of thumb.
  Flexor  carpi  ulnaris.  0. inner condyle,
inner side  of olecranon, a tendinous  band
between these points, under which passes the
ulnar nerve,  inner edge of nearly whole length
of ulna, and fascia of forearm.  I. os pisiforme
and base of fifth metacarpal bone.
  Flexor   digitorum  sublimis perforatus.   0.
inner condyle, internal lateral ligament, coronoid
process, and  radius below tubercle.   I. anterior
part of  second phalanges of each finger.
  Flexor digitorum  profundus pe>forans.   0.
upper three-fourths of anterior surface of ulna
by  two  heads, which embrace the insertion of 
97
  the brachialis anticus, internal half of interosse-
  ous ligament.  I. last phalanx of each finger.
    Flexor pollicis longus.   0. fore part of radius
  below the tubercie, from interosseous membrane
  to within two inches of carpus, and from coro-
  noid process.  I. last phalanx of thumb.
    Pronator  quadratus.   0.  inferior  fifth of
  anterior surface of ulna.   I.  anterior  part of
  inferior fourth of radius.
   Supinator radii longus.   0. external ridge of
 humerus to within two inches of outer condyle,
 and from intermuscular ligament. I rough surface
 on the outside of radius, near its styloid process.
   Extensor  carpi radialis longior.  0- ridge of
 humerus, between supinator longus and external
 condyle.  I. back part of  the carpal extremity
 of metacarpal bone of index finder.
   Extensor carpi radialis brevior.  0. inferior
 and posterior part  of external condyle, and
 external lateral  ligament.  I. carpal extremity
 of third metacarpal bone.
   Extensor digitorum communis.   0. external
 condyle, fascia of forearm and its intermuscular
 septa.   I.  posterior aspect of ah the phalanges
 of four fingers.
   Extensor carpi ulnaris.   0. external condyle,
 fascia, and septa, and  middle third of ulna.  i".
 carpal end of fifth metacarpal bone.
   Anconeus.   0. posterior and inferior part of
 external condyle and  lateral ligament.  I. ex-
 ternal surface of  olecranon, and superior fifth of
posterior surface  of ulna.
                      13 
98
  Extensor minimi digiti.   0. in common with
and between extensor digitorum communis and
extensor carpi ulnaris.   I.  posterior  part of
phalanges of little finger.
  Supinator radii brevis.  0. external condyle,
external, lateral,  and  coronary ligaments, and
from a ridge on outer side of ulna, which com-
mences below its lesser sigmoid cavity.   I. up-
per third  of  external  and anterior surface of
radius, from above its tubercle to the insertion
of pronator radii teres.
   Extensor ossis metacarpi pollicis, lies  imme-
diately below the  border of the supinator radii
brevis.   0. middle  of  posterior  part  of ulna,
interosseous ligament, and posterior surface of
radius.  I.  base of metacarpal bone of  thumb.
   Extensor primi internodii pollicis.   0. inter-
osseous  ligament,  radius,  and occasionally  a
small portion of the ulna. I. base of first phalanx.
   Extensor secundi internodii pollicis.   0. pos-
terior surface of ulna, above its centre, and from
interosseous ligament.   I. base of last  phalanx.
   Extensor indicis.   0. middle of posterior sur-
face of ulna, and  interosseous ligament.  I se-
cond and third phalanges, uniting with  the ten-
don of the common extensor.
   Abductor pollicis.   0. anterior surface of an-
 nular hgament and os scaphoides'.   I. outside of
 base of first phalanx, and by an  expansion into
 both phalanges.
   Opponens pollicis.   0. annular  ligament and 
99
os trapezium.  I. anterior extremity of meta-
carpal bone of thumb.
  Flexor pollicis brevis.   0. external head, from
inside of annular ligament  and trapezium and
sheath of the flexor carpi radialis.  /.  external
sesamoid  bone and  base  of  first phalanx  of
thumb. Internal head.   0. from os trapezoides,
os magnum, and base  of metacarpal bone  of
middle finger,  I.  internal sesamoid bone and
base of first phalanx.
  Adductor pollicis.   0.  three-fourths of ante-
rior  surface of the third  metacarpal bone.   I.
inner side of base of first phalanx of thumb.
  Abductor indicis.  0. metacarpal bone of fore
finger and one-half of that of the thumb. I. outer
side of base of first phalanx.  The radial artery
passes between its two heads.
  Lumbricales.  0. outer side of the tendons of
flexor profundus, near the carpus, a little be-
yond annular ligament.  /. middle of first pha-
lanx into tendinous expansion covering the back
of each finger.
  Abductor minimi  digiti.   0.  annular liga-
ment and os pisiforme.  I. ulnar side  of first
phalanx.
  Flexor brevis minimi digiti.   0. annular liga-
ment and unciform bone.   I. base of first pha-
lanx  of little finger.
  Abductor minimi digiti.  0. internal to  last,
and  overlapped  by it.  /.  all the  metacarpal
bone of little finger.
  Interossei palmares, three in  number.    0. 
100
sides  of  metacarpal bones.  I.  first  phalanges
and tendinous expansion covering the dorsum of
each finger.
  1st, arises from ulnar side of second metacar-
pal bone; 2d, arises from radial side of fourth
metacarpal bone; 3d, arises from radial side of
fifth metacarpal bone;  each,  joining with the
tendons  of common extensor, is inserted into
the base of the first phalanx of the correspond-
ing finger.
  Interossei dorsales, four in number.   O. op-
posed sides of two  metacarpal  bones.   I. base
of first  phalanx of each finger and posterior
tendinous expansion.
   1st, has been already  described  under the
name of abductor indicis.
   2d, arises from second  and third metacarpal
bones, inserted into radial side of base of first
plalanx of middle finger.
   3d, arises  from  third and  fourth metacarpal
bones inserted into ulnar side  of  base of first
phalanx of middle finger.
   4th, arises from  fourth  and fifth metacarpaf
bones, inserted into ulnar side of base of first
phalanx of ring finger.
   All the palmar interossei are adductors, and all
the  dorsal  interossei  are abductors  to  a line
drawn longitudinally through the middle finger.

                   ABDOMEN.

   Obliquus  externus vet descendens.   0.  exter-
nal  surfaces of eight or  nine inferior ribs at a 
101
 little distance from their cartilages.  I. the fibres
 end in a broad aponeurosis, inserted  into ensi-
 form-cartilage, linea alba, os pubis, Poupart's li-
 gament.   It is also inserted into anterior supe-
 rior spinous process of ilium, and outer edge of
 anterior half of crista ilii; a triangular opening,
 formed by the separation of  the  aponeurotic
 fibres,  the inner passing to the symphysis pubis,
 the outer to the spine of pubes, is called the ex-
 ternal abdominal ring.
   Obliquus  internus  vel ascendens.   0. fascia
 lumborum, anterior two thirds of crista ilii, and
 external  half of Poupart's ligament,  I. carti-
 lages of  five inferior ribs, ensifcirm  cartilage,
 linea alba, also by conjoined tendons into upper
 edge of pubes, and into linea ileo-pectinea.
   Cremaster.  This muscle, formed by the low-
 er fibres of internal oblique, is here  described,
 though being a muscle of the testicle.   0. inner
 surface of external third of Poupart's ligament,
 and from lower edge of obliquus internus, and
 also from transversalis;  the fibres pass through
 the external abdominal ring, forming loops, both
 in front  and behind the spermatic  cord.   I.
 crest of the pubes.
  Transversalis.  0. fascia lumborum, anterior
 three fourths of crista ilii, iliac  third of Pou-
 part's hgament, and inner side of  six or seven
 inferior ribs.   I along with posterior  lamina of
obliquus internus, into the whole length of linea
alba, upper edge of pubes, and the linea ileo-
pectinea. 
102
  Rectus.  O. upper and anterior part of pubes.
I. ensiform cartilage,  costo-xiphoid  ligament,
and cartilages  of fifth, sixth, and seventh ribs.
  Pyramidalis.    0. broad  from  pubes.  I.
linea  alba, mid-way to umbilicus;  sometimes
wanting.

      DEEP MUSCLES OF THE ABDOMEN.
  Diaphragm, is  a thin muscular and aponeu-
rotic  septum  between  the chest and the abdo-
men.   0. posterior surface of xiphoid cartilage,
internal surfaces of  cartilages of the last true
and all  the false ribs, external or false ligamen-
tum  arcuatum," and convex  edge  of true liga-
mentum arcUatum.   I. cordiform tendon.
  Crura of diaphragm.  0.  right  crus,  from
fore  part of bodies of second, third, and fourth
lumbar  vertebrae.    Left crust from the  sides
of  the  second and third  lumbar vertebrae.
/. posterior border of cordiform tendon.  There
is a foramen in the  diaphragm, for the  passage
of the vena  cava, one for the oesophagus, and
another for the aorta,  thoracic  duct and vena
azygos.    It also  transmits  the  great  sympa-
thetic and the splanchnic nerves.
  Quadratus  lumborum.   0. posterior fifth of
spine of ilium, and from ilio-lumbar" ligament.
/. extremity of transverse processes  of four su-
perior lumbar vertebrae,  also inner surface of
posterior half  of last rib.
  Psoas parvus.   0. side of last dorsal and first
lumbar vertebrae.  I.  linea ileo-pectinea, fascia 
103
 iliaca, and fascial lata, behind the femoral ves-
 sels ; sometimes wanting.
   Psoas magnus.   0.  sides of  bodies of last
 dorsal, and from bodies and transverse processes
 of all the lumbar vertebra?; also  from inter-ver-
 tebral ligaments.  I. inferior part of lesser tro-
 chanter and ridge below that process.
   Iliacus internus.   0. iliac  fossa,  with inner
 margin of  the crista; two anterior  spines of
 ilium, and  intervening notch, base of the sa-
 crum, iiio-lumbar ligament, and capsule of hip-
 joint.   I.  common  tendon with  psoas mag-
 nus;   the inferior fibres  are  inserted into an-
 terior and inner surface of femur,  below tro-
 chanter minor.  This muscle, with  the  lower
 part of the psoas magnus, is bound down by the
 fascia iliaca.

         MUSCLES OF MALE  PERINSEUM.

   Sphincter ani.    0.  ano-coccygeal  ligament.
 I. into raphe, superficial  fascia, and common
 central point of perinaeum.
   Sphincter internus encircles the lower part
 of the rectum.
   Erector penis.   0.  inner  surface  of  tuber
ischii,  and from insertion of  great  or inferior
sciatic hgament.   I.  fibrous membrane of crus
penis.                                     •
   Accelerator  urina.   0. central tendon and
raphe  of  perineum.   I. posterior fibres into
ramus of pubes;  anterior  fibres into body of 
104
penis:  middle fibres surround  the  bulb and
neighbouring corpus spongiosum urethrae.
  Transversalis perinai.  0.  inside  of  tuber
ischii, I. central point of perinaoum.
  Levator  ani   0.  posterior  part of body  of
pubes, spine of the ischium, and  between these
points the angle of division of deep pelvic fascia
into obturator and  vesical.  7".  anterior  fibres
into  central  point of perineum  and  prostate;
middle fibres into side of rectum, posterior fibres
into back part of rectum and os coccygis.
  Compressor urethra.   0. From the posterior '
surface of the pubes, near its lower edge and a
little  on  each side of the symphysis.  I. below
membranous portion of urethra, into the narrow
tendinous line, which becomes lost in central
point of perineum.*
  Coccygeus.   0.  inner  surface  of spine  of
ischium.   I.  extremity of sacrum and side of «
coccyx.

        MUSCLES  OF  FEMALE PERINSEUM.

  Sphincter ani, as in the male.
  Levator ani.   0.  as in the male.  I. it forms
a loop round the vagina as well as around the
urethra and rectum.
  Coccygeus, as in the male.

  * This muscle is more correctly described as arising by a
narrow tendon from the ramus of the pubes on either side,
and  as terminating in fleshy fibres, which decussate in the
mesial line, some passing above,  others passing below, the
membranous portion of the urethra. 
105
   Transversalis perinai, as in the male. '
   Erector clitorutis.   0.  inner  surface of tuber
 ischii, and insertion of great sciatic ligament.  I.
 fibrous membrane of cms clitoridis.
   Sphincter vagina represents the accelerator
 urinae in the male, and extends from the clitoris
 superiorly, around each side of vagina, to central
 point of perinseum, in front of anus.

     MUSCLES OF  THE INFERIOR EXTREMITY.

      Fore Part  and Sides of the Thigh.

   Tensor vagina femoris.   0. external part  of
 anterior superior spine of  ilium.  I.  fascia lata
 about  three or  four  inches below  the great
 trochanter.
   Sartorius.   0.  anterior  superior  spine  of
 ihum  and notch beneath  it.  I. inner side  of
 upper  end of tibia, below its tubercle.
   Rectus femoris.   0. by two strong tendinous
 heads: the  outer from rim of acetabulum; the
 inner from  anterior inferior spine of ilium.   I.
 upper  edge  of patella.
   Vastus externus.   0. root and anterior part
 of great trochanter, outer  edge  of linea aspera,
 oblique ridge leading to external condyle, exter-
nal surface of femur, and fascia lata.  /. external
edge of tendon of rectus, side of patella.
   Vastus internus.  0. root of small trochanter
and line leading from it to  linea aspera, anterior
part of femur, inner edge  of linea aspera, and
                     14 
106
ridge leading to inner condyle.  I. Inner edge of
tendon of rectus and patella.
   Crureus.   0. anterior and external part of fe-
mur, commencing at linea inter-trochanterica,
and extending along three-fourths of the  bone,
as far outwards as linea aspera.  I. upper and
outer edge of patella.
  The rectus, crureus, and two vasti, are some-
times described as one muscle, named quadriceps
extensor cruris.
  Subcrureus or capsularis.  0. inferior fourth
of anterior surface of femur.  I. Synovial mem-
brane of knee joint.
   Gracilis.    0. lower part of body and ramus
of pubes, and part of ascending ramus of ischium,
from a surface two inches and a half in length.
I. superior part of internal surface of tibia, just
below its tubercle.
  Pectineus.  0. pectineal line  external to spine
of pubes, and smooth surface of bone in front.
I. rough ridge leading from lesser trochanter to
linea aspera.


          Triceps adductor femoris.

  1st, adductor longus.    0. anterior surface of
pubes, between spine and symphysis.  I. middle
third of linea aspera.
  2d, adductor brevis.   0. anterior  inferior sur-
face  of pubes, between symphysis  and thyroid
foramen.  I. superior third of internal root of 
107
 linea aspera to three inches below lesser tro-
 chanter.
   Sd, adductor magnus.   0. anterior surface of
 descending ramus of pubes, ramus  of  ischium,
 and external border of its tuberosity.  I. rough
 ridge leading  from  great  trochanter  to linea
 aspera,  linea aspera, and  internal  condyle  of
 femur.

               MUSCLES OF HIP.
   Gluteus maximus.  0. posterior fifth of cris-
 ta ilii, the rough surface between it, and supe-
 rior semi-circular ridge, posterior ilio-sacral liga-
 ments, lumbar fascia, spines of sacrum,  side  of
 coccyx,  and great sciatic ligament.   I. rough
 ridge  leading  from great trochanter  to linea
 aspera, upper  third of linea  aspera, and fascia
 lata.
   Gluteus medius.   0. deep surface of fascia
 covering it, anterior three-fourths of crista ilii,
 superior semi-circular ridge, and surface  of ilium,
 above and below it.  I. upper and outer part of
 great trochanter.
   Gluteus minimus.    0. inferior semi-circular
 ridge on dorsum of ihum, rough surface between
 rt  and edge of acetabulum.   I. upper and ante-
 rior part of great trochanter.
   Pyriformis.    0. concave  aspect of second,
third, and fourth divisions of sacrum, upper and
back part of ilium,  and anterior surface of great
sciatic ligament.   I.  upper part of great tro-
chanter, behind the  insertion of gluteus minimus. 
108
  Gamellus superior.  0. spine of ischium.   I.
root of great trochanter.
  Gamellus inferior.   0. upper part of tuber
ischii, and great sciatic ligament.  I. root of great
trochanter.
  Obturator internus.   0. pelvic surface of ob-
turator ligament, circumference of obturator fo-
ramen,  and obturator  fascia.   I. root of great
trochanter.
  Quadratus femoris.   0. external surface of
tuber ischii.  /. linea quadrata.
  Obturator externus.    0. inferior surface of
obturator ligament and surrounding surfaces of
pubes and ischium.   I. root of great trochanter.

      MUSCLES ON BACK  PART OF THIGH.

  Biceps flexor cruris.   Long head.   0. outer
and back part of tuber ischii, by a tendon com-
mon to it and to the semitendinosus.  Short head.
0. linea aspera, from below insertion  of  gluteus
maximus to within two inches  of external con-
dyle.   I. head of fibula.
  Semitendinosus.   0.  tuberosity of ischium,
and from three inches of the tendon of the long
head of biceps.  I. inner surface of tibia, below
tubercle.
  Semimembranosus.  0. upper  and outer part
of tuber ischii.   /.  inserted by three portions:
1st, into head of tibia,  the tendon passing under
internal  lateral  ligament;  2d, into the fascia
covering the.popliteus muscle; 3d, into exter- 
109
 nal condyle  of femur, crossing  the knee joint,
 and forming the ligamentum  posticum Wins-
 lowii.        a


 MUSCLES ON ANTERIOR AND  EXTERNAL PART OF
                     LEG.

   Tibialis anticus.   0. outer part of two supe-
 rior thirds  of tibia, inner half of interosseous
 hgament, fascia of leg, and intermuscular septa.
 I. inner side of internal cuneiform bone, and base
 of first metatarsal bone.
   Extensor digitorum longus.   0. external part
 of head of tibia, head and three-fourths of fibula,
 part  of interosseous ligament, fascia  of leg, and
 intermuscular septa.  I. last  phalanges of four
 outer toes.
  Extensor pollicis proprius.  0. inner edge of
 middle third of fibula, interosseous ligament,
 and lower part of tibia.  I. base of second pha-
 lanx of great toe.
  Peroneus  tertius.    0.  anterior surface  of
lower third of fibula.   I. base of fifth metatarsal
 bone.
  Extensor digitorum brevis.   0. upper and an-
terior*part of os calcis,  calcaneo-astragaloid, and
annular ligaments.  I. internal tendon into base
of first phalanx of great toe; the  three others
 join the outer edges of corresponding tendons of
extensor digitorum longus. 
110
      MUSCLES ON OUTER PART OF LEG.

  Peroneus  longus.    0.  uppei^wo-thirds of
outer surface of fibula, small poroon of tubero-
sity  of  tibia,  fascia of leg, and inter-muscular
septa.  I. tendon passes in a groove in os cuboi-
des obliquely across the sole of the foot, to be-
come attached to the  tarsal end of metatarsal
bone of great toe.
  Peroneus  brevis.   0. outer and back part of
lower half of fibula and intermuscular septa.  I.
base of metatarsal bone of little toe.

          MUSCLES OF  BACK OF LEG.

            •  Superficial Layer.
   Gastrocnemius.   0.  internal head, upper and
back part of internal condyle of femur,  and ob-
lique ridge above it; external head, from above
external condyle.  I. lower and back part of os
calcis.
   Plantaris.   0. back part of femur above ex-
ternal condyle, and posterior hgament of knee.
/. posterior  part of os  calcis.
   Soleus.  0. external head, from back part  of
head and superior third of fibula; internaUiead,
from middle third of  tibia, below  insertion of
popliteus, and from a tendinous arch extending
between  the  bones over the  posterior tibial
vessels:   unites  with  gastrocnemius  to form
tendo Achilfis.   /.  lower and back part of os
oalcis. 
Ill
   Popliteus.  0. depression on outer condyle of
 femur.  I. flat triangular surface, occupying the
 superior posterior fifth of tibia.
   Flexor  digitorum longus.   0. posterior flat
 surface of tibia, from below popliteus to within
 three inches of ankle,  fascia, and intermuscu-
 lar  septa.    I.  last phalanges of  four lesser
 toes.
   Tibialis posticus.   O. posterior internal part
 of fibula, upper part of tibia,  and nearly whole
 length of interosseous ligament.  I. inferior" and
 internal tuberosity on os naviculare, internal cu-
 neiform and cuboid bones, and second and third
 metatarsal bones.
   Flexor pollicis longus.  0. two inferior thirds
 of fibula.  I. last phalanx of great toe.


               MUSCLES  OF  FOOT.

                 First Layer.

   Abductor pollicis.   0. lower and inner part
of os calcis,  internal annular  hgament, plantar
aponeurosis,   and internal  intermuscular  sep-
tum.   7". internal side of base of first phalanx of
great  toe;  there is a  sesamoid  bone in  the
tendon.
   Flexor digitorum brevis perforatus.   0. infe-
rior and internal part of os calcis,  plantar apo-
neurosis, and intermuscular septa.  /. second
phalanges of four lesser toes.
   Abductor minimi digiti.   0. outer side of os 
112
calcis, ligament extending from os calcis to out-
er side  of fifth metatarsal bone, plantar fascia,
external intermuscular septum, and base of fifth
metatarsal bone.   I. outer side of base of first
phalanx of httle toe.

                Second Layer.
  Musculus accessorius.  0. inferior and internal
part of  os calcis.  I. outer part of tendon  of
flexor digitorum longus.
  Lumbricales.   O. tendons of flexor digitorum
longus.   I. internal side of first phalanges  of
four lesser toes.   Between the flexor brevis and
flexor accessorius he the external  plantar ves-
sels and nerve.

                 Third Layer.

  Flexor pollicis brevis.    0.  by a pointed pro-
cess from inner border of os cuboides and from
external cuneiform bone.   I. by two  divisions
into outer and inner border of base of first pha-
lanx of  great toe : the tendons contain sesamoid
bones.
  Abductor pollicis.    0. os  cuboides,  base of
third and fourth metatarsal bones and sheath of
peroneus longus.  I. base of first phalanx of great
toe.
  Transversalis pedis.   A  narrow fasciculus
stretched beneath the digital extremities of the
metatarsal bones.
  Flexor brevis minimi digiti.  0. fifth  metatar- 
113
sal bones and sheath of tendon of peroneus longus.
I. inner side of base of first phalanx of little toe.

                 Fourth Layer.

   Seven interossei muscles.   Three on sole of
foot, and four upon its dorsum.
   Inferiores, vel plantares.
   1st. 0. inner side of third metatarsal bone.  I.
base of first phalanx of the same toe.
   2nd. 0. inner side of fourth metatarsal bone.
I. inner side of first phalanx of the same toe.
   3rd. 0. fifth metatarsal bone.   I. inner side
of base of first phalanx of little toe.
   Superiores, vel  dorsales; they arise by two
heads from the contiguous surfaces of the meta-
tarsal bones.
   1st. 0.  internal side  of second metatarsal
bone and outer side of  first.   I.  inner side of
base of first phalanx of second toe.
   2nd. 0. opposite sides of second and third me-
tatarsal bones.   I. outer side of first phalanx or
second toe.
   3d. 0. opposite sides of third andfourt* meta-
tarsal bonee.   I. outer side of first phalanx of
middle toe.
  4th. 0. opposite sides of the fourth and fifth
metatarsal bones.  I. outer side of the first pha-
lanx of fourth toe.

,         THE  MUSCLES OF THE ORBIT.

  1. Levator  palpebra superioris.   0.  uppe
                       1* 
114
 edge of the foramen opticum.  I. superior bor-
 der of tarsal cartilage.
   2. Obliquus superior.   0. foramen opticum.
 I. sclerotic coat  between superior and external
 rectus.
   3. Obliquus inferior.   0. orbital edge of su-
 perior maxillary bone.  I. sclerotic coat between
 it and external rectus muscle.
   4. Rectus superior.
   5. Rectus inferior.
   6. Rectus internus.
   7. Rectus externus.
   [All arise round optic foramen, the external
 rectus being also attached to margin of sphenoi-
 dal fissure, near the origin of the superior rectus,
 and they are inserted about a quarter of an inch
 behind cornea.  The internal rectus is the mus-
 cle most frequently divided in the operation for
 strabismus.]
   The third, fourth, nasal division of fifth, sixth
 nerves, and the ophthalmic  vein, pass between
 the two heads of the rectus externus.

          MUSCLES OF INTERNAL  EAR.
  Stapedius.   0. within  pyramid.   I. neck of
stapes.
   Tensor tympani.   0. canal in petrous  portion
of temporal bone, above Eustachian tube.  /.
short process below neck of malleus.
  Laxator tympani.  0. spinous process of sph e-
noid  bone  and Eustachian  tube.  I. processus
gracilis of  malleus. 
115
       BRAIN AND ITS MEMBRANES.

                 DURA MATER.

    A firm, dense, fibro-serous membrane, adhering
 by its outer surface to the bones of the cranium,
 its inner surface being intimately connected with
 the arachnoid membrane.   It defends the brain,
 acts as an internal  periosteum to the  bones of
 the skull, forms the sinuses, and sends envelopes
 upon  the several nerves as they pass through the
 cranial holes.  It sends off the following pro-
 cesses.
   Falx cerebri commences narrow at crista galli,
 and arches backwards between the  lobes of the
 cerebrum, becoming deeper until it meets the
 tentorium, with which process it is continuous on
 either side.  Its convex edge corresponds to the
 median groove of the os frontis,  the sagittal edges
 of the parietal bones, and the upper half of the
 perpendicular ridge of the occipital bone.   The
 great longitudinal sinus is in its upper edge, and
 the lesser longitudinal sinus in its inferior free
 concave edge.
   Tentorium cerebelli  extends  in a horizontal
 manner above the cerebellum  and  below the
 posterior lobes of the cerebrum.  Its  convex
 edges contain the lateral sinuses, and  correspond
to the  transverse ridges of  the  occipital bone,
the inferior posterior angles of the parietal bones,
the superior angles of the petrous portion of the 
116
temporal bones, and to the clinoid processes of
the sphenoid bone.   It separates the  cerebrum
from the cerebellum, and is bony in the carni-
vorous animals.
  Falx cerebelli is attached to the lower half of
the perpendicular ridge  of the occipital bone,
and extends between the  lobes of the cerebellum
towards the foramen magnum.
  Sphenoidal folds are attached to the lesser
wings of the sphenoid bone.

                  SINUSES.

   Great longitudinal sinus, of triangular form,
extends  along  the  convex margin  of the  falx
cerebri.  It commences by a  small vein  in the
foramen coecum, and increasing in size as it pro-
ceeds backwards, pours its blood into the torcu-
lar Herophili.   Its interior is crossed  by small
bands  called chorda Willisii, and  presents the
openings of the veins  which course upon the
upper surface of the cerebral hemispheres, and a
number of small whitish granules  called glan-
dula Pacchioni.  They are also found upon the
outer surface of the upper wall of the sinus, be-
tween it and the cranium.
  Inferior longitudinal sinus is very small, runs
along the concave edge of the falx cerebri, and
terminates in the  straight sinus.
  Straight sinus passes from the termination of
the inferior longitudinal  sinus downwards  and
backwards, receiving the blood of the venae 
117
Galeni, and empties itself into the torcular He-
rophili.
   Lateral sinuses, each corresponds to the trans-
verse groove in the occipital bone, the groove
in  the posterior inferior angle of the parietal
bone, the mastoid  fossa of the temporal bone,
and the groove in the  occipital bone on either
side of the foramen magnum; it passes through
the foramen lacerum posterius and becomes the
jugular vein.
   Torcular Herophili corresponds to the centre
of the crucial spine of the occipital bone; six
sinuses communicates with it, viz., the two la-
teral, the great longitudinal, the  straight,  and
the two occipital.
   Cavernous sinuses, each extends from the an-
terior clinoid process to the petrous  portion of
the  occipital bone; and, upon  being cut into,
presents a cellular appearance.   The  internal
carotid artery, the sixth nerve, and branches of
the  sympathetic nerve, are found within each,
but  separated from the blood by  the reflected
venous fining membrane.   In the  outer wall of
each rim the third  and fourth nerves, and the
first branch of the fifth; the sinus of either side
presents the openings of the ophthalmic vein, of
the two petrosal  sinuses,  and  of the circular
sinus.
  Circular sinus surrounds the pituitary body,
and is formed of an anterior and posterior trans-
verse' vein which extends  from one  cavernous
sinus to the other. 
118
   Superior petrosal sinuses,  each passes from
the cavernous sinus along the upper angle of the
petrous portion of the temporal bone, to the late-
ral sinus.
   Inferior petrosal sinuses, each passes from the
cavernous  sinus  downwards and backwards,
along the line of contact of the  petrous portion
of the temporal bone, and the occipital to the
lateral sinus, just  where this  terminates in the
internal jugular vein.
   Transverse sinus crosses the basilar process of
the occipital bone, and connects  the inferior pe-
trosal sinuses.
   Occipital sinuses,  two  in number,  are con-
tained in the falx  cerebelli, and open  into the
torcular Herophili.
            TUNICA ARACHNOIDS A.

  Belongs to the class of serous membranes, is
spread over  the  surface of the brain without
penetrating between its convolutions, and is re-
flected upon the dura mater, in those situations
where the nerves and veins pierce this fibrous
membrane;  thus, after the manner of all serous
membranes, it forms a shut sac, and consists of
a parietal and a visceral layer.  It is stated to
gain access  to the  interior of the brain by the
great transverse fissure, and to line the free sur-
faces of the ventricles.                    • 
119
                 PIA  MATER.

  The vascular  covering  of the brain fines its
entire surface, dipping between its convolutions
and sending numerous blood-vessels into its sub-
stance ; it is intimately connected to the arach-
noid  membrane by its outer surface, except at
the base and sulci  of brain;  and entering the
ventricles by the great transverse fissure, gives
them a lining membrane, and forms the choroid
plexuses.
                THE BRAIN.

   The brain is subdivided into three portions,
 viz., the cerebrum, the cerebellum, and the me-
 dulla oblongata.

               THE CEREBRUM.

   This is the largest of the three divisions, is of oval
form and divided into two equal portions, called
hemispheres, by a fissure (superior longitudinal)
which extends along the median line upon its
upper surface, and contains the falx cerebri and
the arteries of the corpus callosum.  At the base
of the brain the hemispheres are divided at each
extremity by this fissure, but in the centre they
are united.
  Hemispheres, right and left, are convex supe- 
120
riorly and externally, and  flat towards each
other, where they correspond to the falx.
  Lobes.  Each hemisphere is divided into three
lobes upon its under surface; the anterior, which
is the smallest, rests upon the roof of the orbit
and presents  a  groove for the lodgment of the
olfactory nerve; the middle, prominent and con-
vex,  lies in the  middle fossa, in the base of the
cranium;  and the posterior rests upon the ^ten-
torium.
  Fissura Sylvii  separates the anterior from the
middle lobe, and corresponds to the lesser wing
of the sphenoid bone and its fold of dura mater.
The  cerebral surface of this fissure  is pierced by
small arteries, branches of the middle  cerebral
artery.
  Convolutions, or gyri, are eminences longitu-
dinal and rounded, but directed in  various ways
upon the surface of each hemisphere.
  Sulci are the fissures which separate the con-
volutions from each other, over which the arach-
noid membrane  passes, but into which the pia
mater dips.
  Cineritious substance of brain is of a yellow-
ish-grey colour, from three to four  lines in thick-
ness, soft and very vascular, and  for the most
part situated upon the outer surface of the brain.
It is however found in striae and masses in the
interior of the brain, and  surrounded by the
medullary substance.   In  some  situations  its
colour  assumes a dark hue, as is  seen when a
 section of the crus cerebri is made.   Microsco- 
121
  pic  examination shows that it  is composed of
  vesicles, containing nuclei and granules:  hence
  it is sometimes called " vesicular matter."  This
  grey vesicular or nucleated cell material, is be-
  lieved to have the power of generating or pro-
  ducing nervous influence, while the white fibrous
  or tubular substance merely acts as a  conduc-
  tor.
   Medullary substance, white and fibrous, forms
  the greater part of the brain.
    Centrum ovale minus, a term applied to the
  appearances brought into view by making a sec-
  tion  of each hemisphere  within a few lines of
  the corpus callosum ; an oval mass of white mat-
  ter is seen surrounded by the grey cortical sub-
  stance.
   Centrum  ovale magnum,  a term applied to
 the mass of medullary structure,  which is ren-
 dered apparent by slicing both  hemispheres on
 a level with the corpus callosum.
   Corpus  callosum, unites the hemispheres to
 each  other, is about three inches in length, and
 presents upon its upper surface the raphe, which
 corresponds to the anterior cerebral arteries, and
 from  which,  on either side,  pass the connecting
 transverse  fibres of the hemispheres, called lineae
 transversa).  It unites by its posterior extremity
 with the fornix and the hippocampus, major and
 minor; its anterior extremity being curved upon
itself and continuous with the optic commissure
and tuber cinereum at the base of the brain.
  Septum lucidum descends from the raphe of the
                      16 
122
corpus callosum to the fornix, separating  the la-
teral ventricles from each other.  It consists of
two layers, which are composed of white and
of grey  matter,  and  lined by epithelium; the
cavity between them is called the fifth ventricle:
its form is triangular,  the apex corresponding to
the union of the corpus callosum and the fornix,
the base anterior, corresponding to  the  curved
portion of the corpus  callosum.
  Lateral ventricles, each consists of a body and
three cornua, the body corresponding to the cen-
tre of each cerebral hemisphere, the  cornua pro-
ceeding one to each lobe. .  The bodies  of the
ventricles are separated from each other  by the
septum lucidum.
  Corpora striata, two pear-shaped bodies, their
large bulbous extremities being contained in the
anterior cornua of the  lateral ventricles, their
narrow stalk-like  extremities  being  directed
backwards into the bodies of the ventricles; they
are cineritious on  their surface, but when cut
into  present alternating striae of cineritious and
medullary  matter;  and hence their name.
   Optic  thalami, two large bodies placed behind
and between the corpora striata;  each presents
upon its  superior surface two  tubercles, called
corpora geniculata.    Towards the  median line
the  optic thalami are  flat and  united  to  each
other by a soft cineritious structure, called com-
missura mollis ;  upon their external surface they
are white,  but their interior is grey.  The cor-
pora striata and optic thalami, like the cineri- 
123
 tious surface of the brain, are very vascular, hence
 all these parts are apt to be  the most  frequent
 seats of apoplectic effusions.
   Tania  semicircularis, a  narrow  medullary
 band, situated in the groove between the optic
 thalamus and corpus striatum of either side.
   Fornix, a longitudinal commissure, placed ho-
 rizontally beneath the septum lucidum  and cor-
 pus callosum,  and composed of medullary struc-
 ture, arches above the third ventricle,  and lies
 upon the velum interpositum and choroid plexus.
 It commences by its two posterior crura, which
 arise from the h ippocanfpi  majores in the infe-
 rior cornua of the lateral ventricles; these unite
 in the  median line, and form  what is called the
 body of the fornix, which passes forwards and
 terminates in the anterior  crura: finally,  the
 anterior crura descend to the base of the brain,
 and terminate in the  corpora mammillaria,  or
 albicantia.
   The lyra, is the appearance presented upon
 the under  surface of the fornix by some white
 fibres which connect, by a transverse  commis-
 sure, the hippocampi and the posterior crura of
 the fornix.
   Choroid plexus, the fold of  pia mater which
lies upon the optic thalamus, and which enters
the body of the lateral ventricle by the  inferior
cornu;  the choroid plexus of either side passes
forwards and  inwards, and both unite in the
foramen commune anterius.
   Velum interpositum, lying underneath the for- 
124
nix, unites the choroid plexuses  of either side;
it is composed of arachnoid  membrane and pia
mater,  and  contains  in  its centre  the  venae
Galeni.
   Vena Galeni, contained in the  velum inter-
positum, pass from before backwards and ter-
minate in the straight sinus.  These veins return
the blood from  the  choroid  plexuses and from
the parts within the ventricles.
  Pineal body, a small conical cineritious mass
containing  in general sandy matter, which has
been found to consist of phosphate and carbonate
of lime.   It is placed upon the corpora quadri-
gemina, and is connected with the optic thalami
by two peduncles.
  Hippocampus minor, an  oval  eminence in
the posterior cornu of the lateral ventricle ; me-
dullary externally, and cineritious in its interior.
  Hippocampus major, a similar eminence to the
minor, but larger, and placed in the inferior cor-
nu of the lateral ventricle.
  Pes Hippocampi, the tuberculated appearance
which  the extremity of the hippocampus major
presents.
  Tania hippocampi, or  corpus  fimbriatum,
the free margin of the posterior crus of the for-
nix, where  it is connected with the hippocam-
pus major.
  Corpus denticulatum, a cineritious  serrated
fine in the inferior cornu of the lateral ventricle,
and which is exposed upon removing the taenia
hippocampi, beneath which it hes. 
125
   Third ventricle, a deep  fissure between the
 optic thalami, exposed  by separating these bo-
 dies.  It is bounded anteriorly by the descend-
 ing crura of the fornix  and  the anterior commis-
 sure, posteriorly by the posterior commissure and
 the tubercula quadrigemina, laterally by the op-
 tic thalami: its floor corresponds to the locus
 perforatus,  tubercinereum and infundibulum; it
 is covered in by the velum interpositum and for-
 nix.
   Foramen commune anterius, a hole by which
 the  choroid plexuses unite anteriorly.  It  forms
 a medium of communication for the two lateral
 and the third ventricle.
   Infundibulum,  a hollow funnel-shaped pro-
 cess of grey matter leading from the anterior and
 inferior part of the third ventricle to the pitui-
 tary body.
   Iter  e tertio ad quartum ventriculum, an
 opening in  the posterior part of the third ven-
 tricle, under the  posterior commissure and tu-
 bercula  quadrigemina,   and leading obliquely
 backwards  and downwards to the fourth ven-
 tricle.
   Anterior commissure,  a medullary, round cord,
 anterior  to  the crura of the fornix, and pass-
ing transversely from one corpus striatum to the
 other.
   Posterior commissure,  extends transversely
from one optic thalamus to the other.   It is
shorter and smaller than the anterior commis-
sure. 
126
   Tubercular  quadrigemina,  four  eminences,
called also nates and  testes, situated under the
posterior  part of the velum interpositum;  the
two anterior (the nates) are connected to the op-
tic thalami; the posterior  (the testes) are con-
nected to the  cerebellum by the  following pro-
cesses.
   Processus e cercbello ad testes, two medullary
bands or  plates, which pass obliquely from the
cerebellum upwards and inwards  to the testes.
   Valve of Vieussens, a layer of cineritious and
medullary substance, of triangular form, attached
by its sides to the processus e cerebello ad testes,
by its base to the cerebellum, and by its  apex
to the testes.
  Fourth ventricle, is exposed by cutting through
the valve of Vieussens.  It is  bounded anteri-
orly by the pons Varolii, laterally by the  pro-
cesses e cerebello  ad testes, superiorly by the
valve of Vieussens, inferiorly by  pia mater and
arachnoid membrane,  and posteriorly by the
cerebeUum.
   Calamus scriptorius, the fissure seen upon the
posterior  surface of  the pons Varolii, in the
fourth ventricle, from either side of which  four
or five white lines proceed.
   Choroid plexus  of fourth ventricle, a small
fold of pia mater, which enters the ventricle as
this membrane is passing from the cerebellum to
the 6pinal cord. 
127
                CEREBELLUM,
   Consists of a  central portion called superior
and inferior vermiform  processes, and of two
hemispheres,united inferiorly by the pons Varolii.
   Hemispheres,  are flat  superiorly, where they
correspond to the tentorium, and convex inferi-
orly, where they lie in the inferior occipital fos-
sa : the  surface of each presents semicircular
narrow lines, arising from the laminated arrange-
ment of the cineritious portion of the organ ; be-
tween these laminae the pia mater enters, but the
arachnoid passes over them.
   Crura cerebelli, two medullary  cords which
pass from either hemisphere and  unite  in the
pons Varolii.
   Superior vermiform process, a  small conical
eminence corresponding to the superior and cen-
tral part of the cerebellum.
   Inferior vermiform process, larger than the
superior, and corresponding to the inferior and
central part of the cerebellum.
   Arbor vita, the  branching of the medullary
substance of the cerebellum, exposed by making
a vertical section of it.
   Corpus dentaium, a small oval mass of cineri-
tious substance, surrounded  by a yellow zigzag
line, and exposed upon making a section  of the
cerebeUum, parallel to, but an inch  distant from,
the median line.
            MEDULLA OBLONGATA,
   A large conical process of medullary structure, 
128
extending  from the lower margin of the pons
Varolii to  the commencement  of the spinal
cord.    It is  rather  more  than an  inch  in
length, and presents the foUowing bodies, which
are  separated  from  each  other by distinct
grooves.
   Corpora pyramidalia, or the anterior  pyra-
mids, the two anterior eminences of the meduUa
oblongata.
   Corpora olivaria, smaller than the pyramidal
bodies, situated laterally.
   Corpora restiformii, large, and situated  pos-
teriorly;  the posterior pyramids, small  and
cord-like, lie within the restiform bodies  upon
the posterior surface of the cord.

             BASE OF THE BRAIN
Presents on  either side of the median line the
anterior and middle lobes of the cerebrum, sepa-
rated from each other  by the fissure of Sylvius,
and  a lobe of the  cerebellum  resting upon the
posterior lobe of the cerebrum.  In the median
line, proceeding from before  backwards, is the
anterior  extremity of the median fissure (on
either side of which run the olfactory nerves),
the lower extremity of the  corpus callosum, the
optic commissure, the  tuber cinereum, the  cor-
pora albicantia, the pituitary body and infundi-
bulum, the locus pcrforatus (on either side of this
is  the crus cerebri),  the pons Varolii, the me-
dulla oblongata, and lastly  the posterior  extre-
mity of the median fissure. 
129
   The brain consists—
   1. Of certain masses of grey, or cineritious
 matter, microscopically consisting of nucleated
 cells, and having white or tubular matter inter-
 mixed or passing through it.  To these  masses
 the name of " ganglia" has been applied.  Ex-
 amples : the cortical surface of the brain and
 cerebellum, the corpora striata, optic thalami,
 locus niger, etc., etc.
   2. Of commissures, or bands of union, connect-
 ing these ganglia and other parts.  Thus, the
 corpus callosum unites the hemispheres, the an-
 terior commissure, the corpora  striata, the mid-
 dle and  posterior  unite the  optic thalami, the
 pons Varolii unites the two lobes of the cerebel-
 lum, etc., etc.  Many of these commissures are
 formed of converging fibres.
   3. Of diverging fibres.  These can be traced
 upwards from the columns of the spinal cord into
 the medulla oblongata, where they form the cor-
 pora pyramidalia, olivaria, and restiformia, etc.
 The corpora pyramidalia are continuous with the
 antero-lateral columns of the spinal cord, from
 which motor nerves arise; they can be traced up
 under  the  pons Varohi, expanding always as
 they pass through grey matter, passing on to help
form the crura cerebri, stiU expanding they pass
through the optic thalami and  corpora striata,
until they spread out in the convolutions  of the
brain.   Motor  nerves  arise  from  the corpora
pyramidalia, from its continued track, as traced
upwards.   The corpora  pyramidalia decussate
                      17 
130
below the pon9 Varolii.  This explains  the fact
that when pressure is made upon one hemisphere
of the brain, as by depressed bone, etc., the pa-
ralysis wiU generally be found to affect the oppo-
site side of the body.

      ORIGIN OF  THE CEREBRAL NERVES.

  First nerve (olfactory), arises  by three  roots,
the external, long and white, from the fissure of
Sylvius;  the internal, also white, from the pos-
terior internal surface of the under part of the
anterior lob^ and the middle short and cineri-
tious, from a grey tubercle upon the under sur-
face of the anterior lobe.
  Second pair  (optic), arise  by  two roots from
the corresponding nates and from the  corpora
geniculata;  the roots unite and form the tractus
opticus, which passes around and becomes slight-
ly attached  to the crus cerebri; the tracts, one
from either side, then unite in the optic commis-
sure, having previously received a few  fibres
from the tuber cinereum; from the anterior part
of this commissure proceed the optic nerves.
   Third pair  (motores oculorum), arise from
the inner side of the crus cerebri, near the pons
Varolii.
  Fourth pair (trochleares), arise from the valve
of Vieussens, by several delicate filaments which
meet those of the opposite side in the mesial line.
  Fifth nerve (trigeminal), consists of two por-
tions, one for sensation, the other for  motion. 
131
 The motor division, the smaUest, arises from the
 corpus pyramidale, in the substance of the pons
 Varolii;  and the sensory division, from the angle
 between the crus cerebelli and the pons Varolii.
   Sixth pair (abducentes), arise from the corpus
 pyramidale near jts j unction with the pons Varolii.
   Seventh nerve consists of the portio dura, or
 facial, and the portio mollis, or auditory.  The
 portio dura arises from the groove between the
 corpus restiforme and olivare, near the pons Va-
 rolii.   The portio mollis arises by three or four
 white fines from  the calamus scriptorius  in the
 fourth ventricle.
   Eighth nerve consists  of the glossopharyn-
 geal, pneumo-gastric, and spinal accessory.  The
 glossopharyngeal arises  from  the  groove be-
 tween  corpus olivare and corpus restiforme, by
 four or five filai nents.   The pneumo-gastric arises
 in the  same groove, but  below the glosso-pha-
 ryngeal, by eight or ten filaments, and the spinal
 accessory arises from the side of the spinal cord,
 as low as the six'th cervical vertebra, by several
 filaments.
  The ninth pair (linguales} arise by seven  or
 eight filaments from the groove between the py-
 ramidal and  olivary bodies, about half an inch
 below the origin of the sixth.

      DISTRIBUTION OF CEREBRAL NERVES.

  First pair (or olfactory), sends off three sets
of branches to the upper part of the nose.  In- 
132
ternal branches to septum nasi; middle branches
to mucous membrane of roof of each nostril; and
external branches to spongy bones.
  Second pair (or optic), pierce  the sclerotic
coat of the eye, and form the retina.
  Third pair (or motores oculorum).   Superior,
or smaller branch, supplies the superior  rectus,
and  the levator palpebrae.  Inferior, or larger
branch, supplies the internal  rectus, the inferior
rectus, and the inferior oblique; and also sends
a branch to the lenticular ganglion.
  Fourth pair (or trochleares), are distributed
to superior oblique muscles of eye.
  Fifth pair (or trigemini), first form the  Cas-
serian ganglion,  and  divide into three main
branches—viz., ophthalmic, superior, and  infe-
rior maxillary.
  Ophthalmic division.—Divides  into—1.  La-
chrymal  nerve, which, passing along the outer
wall of the orbit, sends a branch downwards to
the  orbital branch  of the  superior  maxillary
nerve; then gives filaments to the  lachrymal
gland and the conjunctiva; and finally, perforat-
ing the fibrous attachment of the  upper eyelid,
terminates in the Integument  of the forehead.
2. Frontal nerve, enters the  orbit  above the le-
vator palpebrae; it divides into supra-orbital and
supra-trochlear:  supra-orbital  nerve, escaping
through  the  supra-orbital  notch, is  distributed
to the integuments of the forehead;  the supra-
trochlear, passing above the pulley of the troch-
learis muscle, sends a filament to the infra-troch- 
133
 lear  branch of the nasal nerve, and terminates
 in the mucous membrane of the inner cauthus
 and in the integuments of the forehead.  3. Na-
 sal nerve, enters the orbit between the two heads
 of the rectus externus muscle.  It gives a fila-
 ment to the lenticular ganglion, two or three cili-
 ary nerves, and the infra-trochlear branch; the
 nerve then enters the skuU by the foramen eth-
 moideum anterius^and escaping into the nose by
 a fissure in the cribriform plate of the ethmoid
 bone, terminates at the tip of the nose: the ter-
 minal filament is called naso-lobular.
   Superior   maxillary  division.—1.   Orbital
 branch, which sends on a malar twig and a tem-
 poral twig.   2. Two  branches to  Meckel's gan-
 glion.  3. Posteriol dental, which sends off an
 anterior branch  to the  buccinator muscle and
 gums, and a posterior branch to the molar teeth.
 4. Anterior dental, to the antrum and teeth.  5.
 Infra-orbital, distributed to the face.
   Inferior maxillary division.—1. The superior
 or external branch, which is joined by the motor
 portion of the fifth  nerve, sends off deep tempo-
 ral twigs—a masseteric branch to masseter mus-
 cle and temporo-maxillary articulation, a buccal
 branch to the buccinator and  temporal muscles,
 and a pterygoid branch  to the pterygoid and
palatine muscles.   2. Inferior or internal branch,
sends  off the inferior dental (which gives off the
mylohyoid nerve), it supplies the teeth, and ter-
minates in  the mental  nerve; the gustatory,
which goes  to the glands, mucous membrane, 
134
and papillae of the tongue, and is joined by the
chorda tympani nerve;  and the auriculo-tempo-
ral, which supplies the external ear, and the in-
teguments of the side of the head.

GANGLIONS IN CONNEXION WITH THE FIFTH PAIB.

  Casserian ganglion.—A large grey semi-lunar
body, analogous  to  the ganglion  upon  the pos-
terior roots of the  spinal nerves.  It  lies  in  a
depression at the end of the petrous portion of
the temporal bone, and presents anteriorly a con-
vex border, from which proceed the three main
divisions of the fifth, just described.  The motor
root of the fifth nerve  joins the inferior maxil-
lary division  only.
  The lenticular ganglion  is situated  between
the optic  nerve  and external rectus muscle;  it
receives at its posterior superior angle a long fila-
ment from the nasal branch of the fifth, and by its
posterior inferior angle a branch from the in-
ferior division of the third.   Its anterior angles
furnish the ciliary nerves, about twenty in num-
ber,  which run along the optic nerve, pierce the
back part of the sclerotica, run forward between
it and the choroid coat, enter the ciliary liga-
ment, and are ultimately distributed to the iris.
  Meckel's ganglion.—A  little, red body of tri-
angular shape, situated deep in the fat and cel-
lular  tissue of the  pterygo-maxillary  fossa;  it
communicates superiorly  by two small nervous
twigs with the second division of the  fifth, and 
135
 sends off-—1. Spheno-palatine nerve to the mu-
 cous membrane of  the superior and  middle
 spongy bones;  it  gives  off the  naso-palatine
 branch which runs along the septum nasi, and
 terminates in the foramen incisivum.  2. Palatine
 nerve, which descends in the palatine canal, and
 divides into anterior branches which supply the
 teeth, and posterior and middle branches which
 supply the amygdalae, soft palate, and uvula.  3.
 Vidian nerve, which passes  backwards through
 the  Vidian canal,  enters the cranium by the
 foramen lacerum anterius, and divides into an
 inferior and a superior branch,  having first sent
 filaments  to  the sphenoidal sinus: the inferior
 branch enters the carotid canal, and unites with
 the branches of the sympathetic, whilst the su-
 perior branch runs beneath the Casserian gan-
 glion on  the petrous portion of the temporal
 bone, enters the hiatus FaUopii, attaches itself to
 the portio dura  nerve, leaves it, and enters the
 tympanum a little below the pyramid, and is
 here called chorda tympani.   It then passes be-
 tween the long crus of the incus and the handle
 of the malleus, emerges from the tympanum by
 the Glasserian fissure, unites with the gustatory
 nerve, and at the submaxiUary gland terminates
 in a small ganglion named after Boch.
  Otic ganglion, a smaU body connected with
the inferior maxiUary nerve, near the foramen
ovale;  it  receives the lesser petrosal nerve of
the glosso-pharyngeal.
  The naso-palatine ganglion lies in the anterior 
136
palatine hole, and is formed by the anterior pala-
tine branches from Meckel's ganglion.
   The submaxillary ganglion lies at the edge of
the submaxillary gland, and is  formed by  the
termination of the chorda tympani nerve.
   Sixth pair, or abducentes, are distributed to
the external rectus muscle of each side exclu-
sively, but receive two filaments from the sym-
pathetic in the cavernous sinus.
   Seventh pair consists of two portions,  viz.,
Portio dura and portio molhs;  both enter  the
meatus auditorius internus.
   Portio dura, or facial nerve,  passes into  the
aqueduct of Fallopius, and escapes by the stylo-
mastoid foramen.  It gives off, 1, a branch to
the stapedius muscle;  2, the chorda tynipani;
3, posterior auricular; 4, digastric; 5, stylo-hyoid
nerves: and then divides into,  1, cervico-facial
division, which sends  off branches to the muscles
of the face and to the platysma myoides; and 2,
temporo-facial division, which sends off temporal,
malar, and buccal branches.  The  interlacement
of the branches of the facial nerve, as it passes
through the parotid gland, is caUed " pes anseri-
nus."
   Portio mollis, or auditory nerve.—1. Branch
to cochlea.   2. Branch to vestibule and semi-
circular canals.
   Eighth nerve consists of  three  portions,  viz.
glosso-pharyngeal, pneumo-gastric, and spinal ac-
cessory.  They escape  from  the  skull  by the
jugular foramen. 
137
    Glosso-pharyngeal,  or  first  branch of the
 eighth, gives off;  1, Jacobson's nerve,  which
 enters the tympanum by a smaU foramen upon
 the  under surface of the temporal bone, and
 6ends a filament (small petrosal) to the otic gan-
 glion, and carotid filaments which ramify on the
 coats of the vessel, and communicate with the
 sympathetic and vagus nerves.   2. Branches to
 the pharyngeal plexus.  3. Branches to the ton-
 siUitic  plexus.  4. Branches to the stylo-pha-
 ryngeus and superior and middle constrictors of
 the pharynx, mucous membrane of fauces, &c.
 5.  Branches to the papillae  and mucous mem-
 brane at the root of the tongue.
   Pneumo-gastric, or  second branch  of  the
 eighth, gives off, 1. Branches to unite with the
 spinal accessory, glosso-pharyngeal, Ungual, and
 sympathetic nerves.  2. Branches  to  assist in
 forming the  pharyngeal plexus.   3.  Superior
 laryngeal nerve, which is the nerve of sensation
 of  the larynx, gives off an  external laryngeal
 branch to the exterior of the  larynx, the inferior
 constrictor and pharynx, and crico-thyroid mus-
 cle, and  then pierces the thyro-hyoid membrane
 in company with the superior laryngeal artery,
 and supplies the  epiglottis, mucous membrane,
 and arytenoid muscles.  4.  Cardiac branches, to
the cardiac nerves of the sympathetic,  is the
nerve of motion of  the  larynx.   5. Inferior
laryngeal or recurrent nerve, which sends off
cardiac filaments, branches  to the fore part of
the trachea and thyroid gland, and branches to
                      18 
138
the  pharynx, laryngeal  muscles,  and mucous
membrane,  on which they communicate with
branches of the superior laryngeal.  6. Pulmo-
nary branches, which send off branches in front
of the bronchial  tubes to form  the anterior or
lesser pulmonic plexus; this plexus  sends fila-
ments to the pulmonary vessels, also to the lungs
and pericardium,  and  to the posterior pulmonic
plexus.  7. Posterior, or greater pulmonic plexus,
is formed by the  pneumo-gastric nerves,  which
increase in size at  the root of each lung, and
subdivide and  unite in an areolar manner.  This
plexus is joined by several branches of the sym-
pathetic nerve, and  its branches accompany the
bronchial tubes through  the substance of the
lung.   8. (Esophageal plexus, or plexus gulae, is
formed  by the communications of both nerves,
encircling the  oesophagus in their  course  along
this tube.   9. Gastric plexus is formed by both
nerves dividing, subdividing,  and uniting upon
the stomach.  The  left pneumo-gastric nerve is
anterior upon the stomach, and sends branches
to the lesser omentum and Uver; the right is
posterior.
  The pneumo-gastric supplies the  pharynx, the
larynx,  the  trachea,  the  bronchial  tubes, the
oesophagus, the heart,  lungs, and stomach.
  Nervus  accessorius,  or  third  branch of the
eighth.  1. Branches  to communicate with the
eighth,  ninth,  and sympathetic  nerves.  2.
Branches to the  sterno-cleido-mastoid muscle, 
139
 which muscle it then perforates.   8. Terminal
 branches to the trapezius muscle.
   Ninth pair, or lingual.   1. Descendens noni
 unites with the internal descending branches of
 the cervical  plexus, forming a small plexus, in
 loops, the branches of which  pass to the omo-
 hyoid, sterno-hyoid, and sterno-thyroid muscles.
 2.  A branch to the  thyro-hyoid  muscle.   3.
 Branches  to  the hyoglossus  and surrounding
 muscles, and to the gustatory branch of the fifth
 pair.  4. Terminal  branches to  the genio-hyo-
 glossus muscle, and muscular structure of the
 tongue.
                SPLNAL NERVES.

   Symmetrical, thirty pairs, viz., eight cervical,
 twelve dorsal,  five  lumbar,  and  five  sacral,
 Each  spinal nerve has two  roots,  an anterior
 and a posterior.   The anterior is smaU, and is
 the motor division.  The posterior large, with a
 ganglion  upon it, and is for sensation.   These
 roots are separated by the  cord itself, and  by
 the ligamentum dentetum.   The anterior root is
 connected to the posterior root beyond the gan-
 glion.  On  the  outer side of the ganglion both
 nerves unite  in  a single cord, which, after a
 short course, divides into an anterior and pos-
 terior  branch.   The posterior  branches of this
 division  are the  smaUer  (except that of the
 second cervical),  and are  distributed to the
dorsal muscles and integuments.   The anterior
branohesform the several plexuses which supply 
140
the muscles  and  integuments anterior to the
spine, and also the extremities.

DISTRIBUTION  OF THE EIGHT  CERVICAL NERVES
          AND FIRST  DORSAL NERVES.

  Posterior  branches are  small,  except  the
second cervical, which perforates the complexus
muscle, and accompanies the occipital artery;
the rest are  lost in the neighbouring muscles
and integuments.
  Anterior branches.  The first, or sub-occipital,
twists round the atlas, to unite with the second,
forming the nervous  loop of the  atlas : and the
second, having received the first, descends  to
unite with the third.   The third unites in like
manner with the fourth, and thus is formed, by
the anterior  branches of the four first cervical
nerves, the
              CERVICAL  PLEXUS.

  From this plexus proceed:—
  Branches to the platysma, integuments, paro-
tid gland, ear, and back of the head.
  1.  Great auricular, arises  chiefly from  the
third cervical, and is  distributed  to the ear; it
accompanies the external jugular  vein.
  2.  Small occipital, which,  arising from .the
second cervical, pierces  the fascia behind  the
sterno-mastoid, and is distributed to the integu-
ments of the scalp.
  3.  Descending branches from third and fourth 
141
 cervical, which are divided into sternal, clavicu-
 lar, and acromial, and supply the integuments.
    4. Branches, generally two in number, which
 form loops with the descendens noni in front of
 the jugular vein.
    5.  Phrenic,  or internal respiratory, which
 arises  from the third and fourth cervical, and
 has a small filament also from the fifth cervical:
 it  sends branches,  to the liver, pericardium, infe-
 rior cava, and terminates in the  diaphragm. The
 phrenic is the most important  nerve in the hu-
 man body, as upon it depends the action of the
 diaphragm.
    6.  Muscular branches, which are given to the
 sterno-mastoid and trapezius (these muscles are
 also supplied by  the spinal accessory);  to the
 levator  anguli  scapulae, the scaleni/and  recti
 capitis antici.

            THE BRACHIAL PLEXUS,

 Is  formed by the union of the anterior branches
 of  the four inferior  cervical  and  first  dorsal
 nerves.  From the plexus proceed:—
  1. A branch to join the phrenic nerve.
  2. Branches to  the longus coUi, scaleni,  and
subclavius muscles.
  3.  The external  respiratory nerve  of Bell,
which, arising from the fifth and sixth  cervical,
passes  behind the axillary vessels, and  is distri-
buted to the serratus magnus.
  4. Thoracic nerves, three or four in  number, 
142
 which form loops round the axiUary artery, and
 supply the pectoral muscles.
   5. Suprascapular nerve, which passes through
 the notch in the scapula, and supplies the supra-
 spinatus,   infra-spinatus,  and  teres  minor
 muscles.
   6. Subscapular  nerves are  three  or four  in
 number; they descend behind the vessels to the
 subscapular, latissimus dorsi, and teres  major
 muscles.
   7. Internal cutaneous nerve, sends one branch,
 which descends over the bend of the  elbow  as
 low  as  the wrist,  and another branch  which
 descends  towards  inner  condyle,  and  sends
 branches to inner and posterior part of the fore-
 arm.
   8. External cutaneous, musculo-cutaneous  or
 perforans Casserii, which sends branches  to the
 coraco-brachialis, biceps,  and brachialis anticus;
 branches to the integuments  of the fore arm,
 an anterior branch to the baU of the thumb and
 palm of the hand;  and a posterior branch to the
 dorsum of the hand.
  9.  Median nerve, sends branches to the super-
ficial and deep pronators and flexors of the fore-
arm, except the flexor carpi  ulnaris, and  half
the flexor digitorum profundus, which are sup-
plied by the ulnar nerve;  the anterior interosse-
ous nerve, which sends a branch to the pronator
quadratus,  and  another to the dorsum of the
hand; a superficial branch which is given off
above the wrist, and which runs to the palm  of 
143
 the hand; and five digital branches, which sup-
 ply the thumb, index,  and middle fingers, and
 the radial edge of the ring finger.
   10.  Ulnar nerve, sends muscular branches to
 skin of forearm, flexor profundus, and flexor
 carpi ulnaris muscles ;  the nervus dorsalis carpi
 ulnaris to the integuments on the dorsum of the
 hand and the three inner fingers; the superficial
 palmar branch, which divides into three digital
 branches for  the supply of the  little finger and
 the  ulnar edge of the ring finger;  and the deep
 palmar branch to form the  deep palmar arch,
 which supplies the interossei  muscles, two inner
 Iumbricales, and the adductor pollicis muscle.
   11. Musculo-spiral, or  radial  nerve, sends
 branches to the triceps, through which it winds;
 a long cutaneous branch to the elbow;  branches
 to the supinators and extensors;  the anterior or
 radial branch, which runs along the inner side of
 the  supinator radii longus, and  sends a branch
 to the integuments of the thumb, and another
 to the dorsum of the hand, which supplies the
 index and middleflfingers, and communicates with
 the dorsahs ulnaris;  and a deep branch, or pos-
 terior interosseous, which supplies by superficial
 and  deep branches the  extensor  muscles and
 terminates in a ganglion  on the wrist.  The
 median and ulnar nerves supply the flexors; the
 extensors  are supplied  by the muscular spiral
nerve.  This may be caUed the  great  extensor
nerve.
  12. Circumflex nerve, sends branches  to the 
144
deltoid  and  teres  minor  muscles,  ekin,  and
shoulder joint.  Injury of this nerve, in disloca-
tion of the shoulder, is sometimes the cause of
subsequent wasting and paralysis of the limb.

      TWELVE  PAIR OF DORSAL NERVES.

  Posterior branches are small, and  pass back-
wards to  the muscles  and integuments of the
back and loins.
  Anterior branches, or  Intercostals.   First is
the largest; it  contributes to the formation of
the brachial plexus.   Second and  third  run
backwards and  outwards, and at the angle of the
ribs  pass  between the intercostal muscles, and
running along the lower edge of each rib supply
the surrounding  muscles: opposite the axilla
they send off the intercosto-humeral nerves, of
which one, joining a branch from the  brachial
plexus,  forms the nerve of Wrisberg, for the
skin of the arm, and the terminal branches sup-
ply the  muscles and skin upon the  lateral  and
fore part  of the thorax.   Fourth  to  twelfth,
inclusive, are similar to the second and  third in
distribution, supplying the intercostal and adja-
cent muscles:  the two last  go chiefly to the
diaphragm, and the  twelfth sends a branch to
join the first  lumbar.  [All  the intercostals are
connected  by two short branches to the  gan-
glions of the sympathetic.'*
• 
145
         FP7E PAIR OF LUMBAR NERVES.

   They are larger than the dorsal, and like them
 divide into posterior and anterior branches.
   Posterior branches are distributed to the lum-
 bar muscles.
   Anterior branches unite  in the substance of
 the psoas muscle, to form the lumbar plexus.

               LUMBAR PLEXUS.

   It is formed by the last dorsal and four first
 lumbar nerves.
   Branches.—1.  External   inguino-cutaneous,
 sends branches to the abdominal muscles, a cuta-
 neous branch to the integuments on the outer part
 of the thigh, and the ilio-scrotal.
   2. Middle inguino-cutaneous to the abdominal
 muscles  and  skin, on the outer part of  the
 thigh.
   3. Internal  inguino-cutaneous,  or  genito-
 crural, sends  a branch to the spermatic cord,
 which accompanies the spermatic vessels, and a
 branch  to the integuments and glands of  the
 groin.
   4. Anterior crural nerve, formed by  the
second, third, and fourth nerves,  passes beneath
Poupart's ligament, and divides into two fasciculi.
The superior fasciculus sends four or five long
branches,  which  pierce  the fascia  late, and
descend to the knee: some of them accompany
the saphena vein; the  deep fasciculus  sends
                      19 
146
external   muscular  branches  to  the  vastus
externus,  rectus,  iliacus  internus muscles, and
internal branches to the sartorius, vastus inter-
nus, and crureus: branches  also accompany the
femoral artery, near to the knee, the internal
saphenous nerve, which joins the saphena  vein
at the knee, lying between  the tendons of the
gracihs and sartorius, goes on to the inner side
of the foot, sending off numerous branches to
the integuments.  -
  5. Obturator  nerve  sends  branches to the
obturator  internus,  an anterior branch to the
adductor brevis and pectineus, and a posterior
branch to the gracihs, the adductor magnus and
longus muscles:  articular nerves are  given to
the hip and knee  joints.
  6. Lumbosacral  nerve proceeds  from the
fourth and fifth  lumbar into  the  pelvis, and
divides into the superior  gluteal and the commu-
nicating nerve; the superior gluteal is distribut-
ed  to  the gluteus medius, minimus, and tensor
vaginae femoris muscles:  and the communicating
branch joins the first sacral nerve.

        FIVE PAIR OF SACRAL NERVES.

  Posterior branches,  very small,  to  muscles
and integuments.
  Anterior  branches,  very  large, particularly
the three superior: these five, with the commu-
nicating branch of the  1 umbo-sacral, form the
sacral plexus. 
147
                SACRAL PLEXUS.

   It is formed by the last lumbar and four first
 sacral  nerves.  Sends off  internal  or  pelvic
 branches, which are named Haemorrhoidal,Vesi-
 cal, Uterine, and Vaginal.  External branches.
   1. Muscular nerves, to the pyriformis, obturator
 internus, gemeUi, andquadratus femoris muscles.
   2. Lesser sciatic nerve, to the gluteus maximus
 and integuments of the buttock.
  ■ 3. Posterior cutaneous nerve, to the  back part
 of the  thigh and leg.
   4. Pudic  nerve,  which  sends  an inferior
 branch to the  muscles of the perineum and to
 the scrotum; and a superior branch which passes
 along the dorsum of the penis to its glans.
   5.  Great Sciatic nerve, sends off several bran-
 ches to supply  the semimembranosus, semitendi-
 nosus, biceps and adductor magnus muscles, also
 the hip joint;  it divides at the upper and outer
 part of the popliteal space into two branches, viz.
 the peroneal and the popliteal nerves. The pero-
 neal nerve first sends off the external cutaneous
 nerves of the leg, which communicate with the
 external saphenous  nerve;  it next gives off the
 musculo-cutaneous nerve, which divides into an
 internal and an  external branch, the former being
 distributed to the integuments of the first and
 second toes, and the latter to the integuments of
 the third, fourth, and fifth toes;  and lastly, the
 anterior tibial,  which winds round the head  of
the fibula, and supplies the  integuments on the 
148
 anterior part of the leg, the tibialis anticus, the
 extensor digitorum longus, the extensor pollicis,
 and the  extensor  digitorum brevis  muscles,
 and terminates  at the first interosseal space by
•communicating with the plantar  nerves, having
 first supplied the inner interosseous muscle.  The
 popliteal division of the great sciatic first  sends
 off the external saphenous nerve, and branches
 to the gastrocnemius, soleus, plantaris, and pop-
 liteus muscle.  At the lower border of the pop-
 liteus  muscle it becomes  the posterior  tibial,
 which supplies the tibialis posticus, flexor longua
 digitorum, and  flexor longus pollicis;  it finally
 divides into the internal and external plantar
 nerves ; the former sending  branches to the
 plantar muscles and skin, and four digital bran-
 ches to  supply  the 1st, 2d, 3d toes, and  inner
 side of the 4th  toe, and the latter a superficial
 branch to the little toe and outer  side of the 4th
 toe, and a deep branch of the plantar  and in-
 terossei muscles.

 SYMPATHETIC OR GANGLIONIC SYSTEM OF NERVES.
   The  sympathetic  nerves,  characterised by
 their reddish or grey color, and by their nume-
 rous ganglia, form  a  system, which communi-
 cates with all  the cerebral nerves,  except the
 three nerves of special sense [viz. the olfactory,
 the optic, and the  auditory] and with all the
 spinal nerves.   In the chest and  abdomen  largo
 plexuses  are formed  in front of the vertebral
 column. 
                     149^'" ^

          THE CERVICAL  GANGLIONS,

 Are three in number,
   Superior cervical ganglion extends from the
 first to the third cervical vertebra, and sends off,
 1, two superior branches,which ascend along with
 the carotid artery in the carotid  canal to the
 cavernous sinus, where they communicate with
 the sixth or abducens nerve, and with the Vi-
 dian nerve.  2. Descending or inferior filaments,
 which join the laryngeal and pneumo-gastric
 nerves, the superior cardiac nerve, and the middle
 cervical  ganglion, if it exists; if not, they join
 the  inferior  ganglion.   3.  Internal branches,
 which unite with the pharyngeal plexus.  4. Ex-
 ternal branches, to join  the superior cervical
 nerves.  5. Anterior branches, which unite with
 the pneumo-gastric and facial nerves, and form
 a plexus around the carotid  artery, from which
 branches proceed along the external carotid and
 its divisions.
   Middle cervical ganglion, placed  opposite the
 fifth or sixth cervical vertebra, is sometimes ab-
 sent ; when present it  sends branches  to unite
 with the vagus and cervical nerves, and branches
 to join the cardiac nerves.
  Inferior cervical ganglion is situated between
the transverse process of the last cervical verte-
bra and the neck of the first rib; it sends branches
to the  phrenic  nerve, brachial plexus, subcla-
vian artery, and its ramifications, and branches to
the inferior cardiac nerve. 
   Cardiac Nerves are three in number, and are
 named superior, middle, and inferior.  1.  Supe-
 rior Cardiac Nerves arise by two or three fila-
 ments from the superior cervical  ganglion, com-
 municate with the vagus  and laryngeal nerves,
 and with the middle and inferior cervical gan-
 glia, pass along the coats of the arteria innomi-
 nate on the right side, and  between the left ca-
 rotid and left subclavian  on the left side of the
 aorta, and here communicate with the recurrent
 nerves, and the middle and inferior cardiac nerves,
 and the  cardiac ganglion or plexus.  2. Middle
 Cardiac Nerves.  That of the right side is gene-
 raUy the largest;  on the left side it is sometimes
 wanting.  They enter the thorax  anterior  to the
 subclavian artery, are joined by  branches from
 the pneumo-gastric and recurrent nerves, and,
 passing along the arteria innominata, terminate
 in the cardiac ganglion and plexus.   3. Inferior
 Card iac Branches.  The right descends along the
 arteria innominata to the forepart of the arch of
 the aorta, and terminates in the anterior cardiac
 plexus;  some branches pass between the  aorta
 and pulmonary artery to the cardiac ganglion;
 on the left these  nerves accompany the subcla-
 vian artery, and partly join the middle cardiac
nerve, and partly the cardiac plexus.
  ,Cardiac Plexus or Cardiac Ganglion, is situ-
ated behind the ascending  aorta, near its origin
in front of the trachea and right pulmonary ar-
tery ;  it consists of a plexus of nerves formed by
the cardiac nerves of the opposite sides and
• 
151
 branches of the eighth pair and recurrent.  In
 the meshes of this plexus several smaU ganglions
 are enclosed, and  to  these conjointly the term
 cardiac ganglion is appUed.   Branches proceed
 from this plexus to the coronary and pulmonary
 vessels, to  the aorta and vena cava, and to the
 substance of the heart itself.
    Thoracic  Ganglions are twelve on each side,
 sometimes only eleven, the last cervical and first
 dorsal  being united.  1. Branches  to the medi-
 astinum, which ramify on the aorta and adjacent
 vessels, and  communicate with the  pulmonary
 plexus. 2. Great Splanchnic Nerve, is formed
 by distinct roots, from the 6th, 7th, 8th, and 9th
 ganglions; uniting  on the 9th  dorsal  vertebra
 into one cord, it enters the abdomen along with
 the aorta, or separated from it by a fasciculus of
 the diaphragm, and expands  into the semilunar
 ganglion.  3. Lesser Splanchnic Nerve arises by
 two roots from the 10th and 11th  ganglions;
 uniting on the side  of the last  dorsal vertebra,
 it enters the  abdomen  through the  crus of the
 diaphragm, and ends partly in the renal plexus
 and partly in the semilunar ganglion.
   Semilunar  Ganglia are situated on the dia-
 phragm, partly on the aorta, and on either side
 of the  cceliac axis, and above and behind  the
 supra-renal capsule.  They are the  largest gan-
 glia  of  the sympathetic; several nervous fila-
 ments, on which smaU ganglia are placed, pass
from one to the other surrounding the  cceliac
axis, forming a plexus,  called the 
152
  Solar Plexus, which  is situated  behind the
Btomach, above the pancreas, and in front of the
aorta.  It gives off, 1. Branches in  various di-
rections,  accompanying the blood-vessels, form-
ing plexuses around each,  and named accord-
ingly, hepatic,  splenic,  and gastric, and these
communicate with the eighth pair.  2. Branches
descending in front of  the aorta, which sub-
divide at the renal and  mesenteric arteries, ac-
companying them, and forming plexuses, named,
accordingly, renal, superior, and inferior mesen-
teric, and into each of these branches of the
lumbar ganglions enter.
  Renal  Plexus receives the lesser  splanchnic
nerves; from it descends the spermatic plexus,
which goes to the testicle in the male, and to the
ovarium  and uterus in the female.
  Inferior Mesenteric  Plexus sends branches
which descend  to the brim of the pelvis, unite
with others from the lumbar ganglions, and form
a plexus around the internal iliac artery and its
branches, named hypogastric plexus.  It is joined
by numerous filaments from the lumbar and sa-
cral ganglions of the sympathetic, and communi-
cates with  the pelvic  branches of the  sacral
plexus.
  Lumbar Ganglions are five on each side, some-
times only three or four.   1. Filaments to an-
terior branches of lumbar spinal nerves.   2.
Filaments to assist in forming the several ab-
dominal plexuses.
  Sacral Ganglions are three or four  in number. 
153
1. Filaments to sacral nerves.  2. Filaments to
hypogastric and pelvic plexuses.  3.  A  smaU
branch from the  last ganglion, which passes in
front of  the coccyx, there forming with its fel-
low the
   Ganglion Impar, which sends branches to the
coccygeus, levator, and sphincter ani muscles.
   The sympathetic nerve twines around and en-
ters the coats of the arteries of the viscera, con-
tained in the cranium, the  neck, thorax, abdo-
men, and pelvis.  Hence it  has  been called the
Great Visceral nerve.   It is believed to preside
over the functions of  secretion, nutrition, and
involuntary motion.
   THE  THORAX AND  ITS CONTENTS.

   The thorax is bounded anteriorly by thejster-
num and cartilages of the ribs, posteriorly by the
vertebrae and lesser circle of the ribs, and on ei-
ther side by the shafts of the ribs and the inter-
costal muscles.  Its upper orifice is transversely
oval, and allows the exit and entrance of vessels,
nerves, and muscles, to and from its cavity; its
inferior orifice,  or  circumference, being much
larger, and closed by the diaphragm.
  The thorax contains the heart and lungs, and
also several vessels,  nerves, glands, &c, to be
noticed as we proceed.
                      20 
154
                 THE PLEURA

Are two serous membranes, one on either side,
which cover the inner surface of the thorax, and
are reflected upon the outer surface of the parts
contained in its  cavity.  That  portion of the
pleura which lines the thorax is called the pari-
etal layer, and that which  lines the contained
parts the visceral layer.  Each pleura  can be
traced in the following manner:—From the pos-
terior surface of the sternum it passes backwards
until it meets with the anterior surface of the
pericardium, along the side of which it passes to
the anterior surface of the root of the lung; from
this it passes upon the lung, and is reflected over
the entire surface of the  organ, until it arrives
at the posterior surface of its root and of the pe-
ricardium, from whence it passes upon the sides
of the bodies of the vertebrae, reaching as high
as the transverse process of the sixth cervical
vertebra on the right side, the seventh on the
left, and descending to the diaphram, the tho-
racic aspect of which it covers; it finally lines
the ribs and intercostel  muscles, until it arrives
at the portion which was opened, and which cor-
responds to the posterior aspect of the sternum.
  Ligamentum latum pulmonis (one on either
side) is merely a triangular fold of pleura, formed
by the reflection of the membrane from the lower
edge of the root of the lung upon the vessels
from the heart. 
155
             ANTERIOR MEDIASTINUM.
    A triangular cavity formed by tearing through
  the cellular tissue, which connects the right and
  left pleura behind the  sternum;  the base is
  formed by the sternum, the sides by the sepa-
  rated pleurae, and the apex corresponds to the
  anterior surface  of the pericardium, where the
  pleurae separate  to  enclose ' this  bag.    Thus
  formed,  it contains the  origins of the sterno-
  hyoid and sterno-thyroid muscles, the remains
  of the thymus gland with its vessels, lymphatic
  glands and absorbents, the  triangularis, sterni
  muscles, and loose cellular tissue.
             MIDDLE MEDIASTINUM

 Is of oval shape, and is formed by the reflection
 of the pleurae upon the sides of the pericardium;
 it consequently  contains  this.bag and its con-
 tents, viz. the heart, with its vessels; also the
 phrenic nerves.

            POSTERIOR  MEDIASTINUM

 Is formed by the reflection of the pleurae upon
 the sides of the bodies  of the vertebrae; it is of
 triangular form, the apex anterior corresponding
 to the posterior surface  of the pericardium, the
 sides formed by the pleurae, and  the base repre-
 sented by the anterior  surfaces of the bodies of
 the vertebra; it  extends from the third to the
 tenth dorsal vertebra, and contains the following
parts:—the bifurcation of  the trachea, the ccso- 
156
phagus and pneumogastric nerves, the thoracic
duct, the vena azygos,' the  thoracic aorta, lym
phatic glands, absorbents,  bronchial  and oeso-
phageal arteries, and loose cellular tissue.

                 THE LUNGS

Are two soft, spongy, vascular bodies, one con-
tained on each side of the cavity of  the  chest.
Each lung resembles a cone, with  that side cor-
responding to the median line truncated;  the
base,  concave, corresponds to  the diaphragm;
the obtuse rounded apex rises in the neck, a little
above the  level of the first rib; the external
convex  surface corresponds to the internal con-
cave surface of the thoracic parietes, and the flat
or truncated surface corresponds to the medias-
tina.  The posterior  edge  of the lung  is thick
and rounded, whilst the anterior is thin and irre-
gular.  Each lung  is  distinguished  into  lobes,
which are separated from each other by fissures;
a little  above  the centre  of each is the  root
formed by the pulmonary vessels and bronchial
tube, connected to each other by cellular tissue,
and invested by the pleura.  The bronchial tube
is situated posterior and superior to the pulmo-
nary vessels; the two pulmonary veins are placed
anterior and inferior to the artery and bronchus,
and the pulmonary artery is placed between the
bronchus and the pulmonary veins, but behind
the pulmonary veins and  before  the bronchus.
 On the left side, the bronchus, more oblique than 
157
 its fellow, descends near the root of the lung so
 as to lie between the artery and vein.  The root
 of each lung has anterior to it the phrenic nerve
 and filaments of the pneumo-gastric nerve, pos-
 terior to it the pulmonic plexus.  The root of the
 right lung has the vena azygos arching over it.
   The right and left lungs differ from each other
 in some important particulars:  the right lung ia
 broader and shorter than the  left, and consists
 of three lobes, separated by two  fissures;  the
 right also ascends higher in the neck, and the
 anterior edge  of the left presents a notch where
 it corresponds to the apex of the heart.
  The intimate structure of the lungs consists of
 the ultimate ramifications of the bronchial tubes,
 which are the continuations of  the trachea, and
 the branches of the pulmonary artery and veins;
 the larger tubes at the root of  the lung receive
 bronchial arteries for their nutrition.

       TRACHEA AND ITS RAMIFICATIONS.

  The wind-pipe,  or  trachea,  is  a cylindrical
tube, extending from the cricoid cartilage of the
larynx to the level of the third dorsal vertebra.
It consists of from seventeen to twenty fibro-
cartilaginous rings, truncated behind, and con*
nected to each other by an elastic membrane;
about the  posterior fourth of each ring  is defi-
cient, and its place is supplied by fibrous  mem-
brane and unstriped or involuntary muscular fibre.
  Opposite the third dorsal vertebra the trachea 
158
 divides into the right and left bronchial tubes;
 the right bronchus, larger  than the left,  runs
 transversely into the root of the lung and divides
 into three branches;  the  left bronchus passes
 under the arch of the aorta, to the  root of the
 left lung, and divides into two branches.
   The  bronchia consist of  cartilaginous rings,
 but as these tubes advance into the substance of
 the lung they diminish in size and firmness, until
 their place is supplied  by  fibrous tissue, invo-
 luntary muscular fibres,' which tissue also disap-
 pears, and at length nothing remains  but the
 mucous membrane, which terminates in the air-
 cells, upon which ramify the ultimate ramifica-
 tions of the pulmonary artery and the commenc-
 ing radicles of the pulmonary veins.
   The  ramifications  of the pulmonary artery
 communicate with those of the pulmonary veins,
 beneath the mucous  membrane of the air-ceUs,
 and are enveloped in fine  cellular tissue;   and
 except this cellular tissue the lung has no proper
 parenchyma, its structure being entirely vascu-
 lar.   The roots of the lungs are supplied  with
 blood by the bronchial arteries, derived from the
 thoracic aorta; these vessels run along the bron-
 chial tubes, subdivided as they proceed, and form
m, minute network on the attached surface of the
"ronchial mucous membrane;  the  blood  they
 convey to the  lungs is  returned  to the vena
 azygos, or superior intercostal.  The  nerves dis-
 tributed to the lungs  are derived  from the eighth
 pair, and from the sympathetic. 
159
           HEART AND  PERICARDIUM.

   The pericardium consists of two layers,  an
 outer, or proper fibrous layer, and an inner, or
 serous layer.  It is of conical form, the base be-
 low connected to the central division of the cor-
 diform tendon of the diaphragm, the apex above
 corresponding to the great vessels at the base of
 the  heart, along the outer  coats  of which the
 fibrous layer  is graduaUy lost;  it is connected
 lateraUy to the pleura and to the pulmonary ves-
 sels ; the phrenic nerves,  one on either side, run
 in close contact with it to the diaphragm.  Upon
 laying open the cavity of the pericardium, the
 serous layer is exposed, and, like aU serous mem-
 branes, it consists  of two portions—a parietel
 layer, which hnes the inner surface of the fibrous
 pericardium,  and a visceral layer, which fines
 the outer surface of the heart and great vessels.
 When the pericardium is fuUy opened, we bring
 into view, covered by the serous membrane, the
 right auricle,  the venae  cavae, the left auricular
 appendix, the  right ventricle, the tip of the left
 ventricle (which forms the  apex of  the heart),
 the aorta, the pulmonary artery, and the ante-
 rior  branches  of the coronary vessels, with the
ramifications of the cardiac nerves.  Upon turn-
ing up  the heart its posterior surface  wiU be
brought into view, presenting  the left auricle
(proceeding to which, on either side, are the
pulmonary veins) and the  left ventricle.
  The  serous  membrane may be traced in the 
160
foUowing manner:—After having  lined the fi-
brous pericardium it is reflected on the superior
cava and aorta, and the pulmonary artery, as these
vessels are passing through the fibrous membrane,
ascending highest, however, upon the aorta;  in-
feriorly it is partly reflected around the inferior
cava, as this vessel pierces the fibrous pericardium
to enter the right auricle, and lateraUy it is re-
flected upon the pulmonary veins as these vessels
pierce the fibrous pericardium to enter the left
auricle;  from these different points it reaches the
surface of the heart, which it completely covers.
  The heart, of conical shape, is situated ob-
liquely between the lungs, its base being supe-
rior, posterior, and to the right side, its apex
pointing towards the cartilage of the sixth rib of
the left side.  The axis of the heart is obliquely
from right to left, and from behind forwards.   It
is retained in its situation by the great  vessels
and the reflections of the serous membrane.
  The heart consists of four  cavities, two auri-
cles and two ventricles; the auricles are sepa-
rated from each other by a partition,, called sep-
tum auricularum, the ventricles by the septum
ventriculorum.  We shall examine these cavities
in the order of the circulation.
  The right auricle is placed between the two
venae cavae, the t lood conveyed by which it re-
ceives and  transmits to the right ventricle •  the
smaU loose portion is caUed the auricular  ap-
pendix, and  the portion between  the cavae the
sinus of the auricle.   Upon laying  open this au- 
161
 ricle, by a perpendicular cut from the superior
 cava to within a few lines of the entrance of the
 inferior cava, and by a second cut from the cen-
 tre of this at right  angles towards the auricular
 appendix,  the foUowing  parts  present  them-
 selves.
   Tuberculum Loweri, an eminence upon the
 under surface  of the sinus of the auricle, and
 placed between the orifices of entrance of the
 venae cavae.
   Septum  auricularum, a membrano-muscular
 partition separating this auricle from the left.
   Fossa ovalis, an oval depression in the septum,
 which marks the situation of the foramen ovale,
 or the oval  communication which existed be-
 tween both auricles in the foetus.  The edges of
 this fossa present a thickened margin.
   Eustachian valve, a semilunar fold of the lin-
 ing membrane, the anterior aspect of the inferior
 vena cava.
   Musculipectinati, the muscular bands situated
 in the auricular appendix.
   Openings of the  Vena  Cava.  The superior
 cava opens at  the upper and back part of the
 auricle, its direction being downwards, forwards,
 and inwards; the inferior cava opens beneath,
 in a direction upwards, backwards, and inwards.
   Opening of the Coronary Vein is situated be-
tween the Eustachian valve and the right  ven-
tricle, and is guarded by a semilunar valve (the
valve of the coronary vein).
   Opening of the Auricular Appendia, is small
                     21 
162
i
and circular, and exists where this portion of tho
auricle joins the sinus.
   Foramina Thesebii, smaU orifices on different
parts of the auricle, supposed to be the openings
of veins.
   Right Auriculo-ventricular opening, the large
opening by which the auricle communicates with
the ventricle, the boundaries of each cavity be-
ing marked by a white line.
  Right ventricle, of conical form, is joined by
its  basis to the right auricle,  its  apex being
above the apex of the heart, in consequence of
the apex of this organ being formed by the left
ventricle.
  Septum ventriculorum, a thick muscular par-
tition which separates one ventricle from  the
other.
   Cornea columna, the muscular projections in
the interior of the ventricle, which give it its
irregular appearance.
 _ Chorda tendinea, the delicate but strong ten-
dinous cords which are  connected by one ex-
tremity to the carneao columnse, and by the other
to the tricuspid valve.
   Tricuspid Valve, three triangular duplicatures
of the lining membrane of the  heart, strength-
ened  by the chordae tendineae which pass from
their  apices to their bases.  These triangular
valves are  attached  by their bases  to the right
auriculo-ventricular opening, and by their apices
to the chordae tendineae, and prevent the regur-
gitation of the blood from the ventricle into the 
163
 auricle, by  closing the opening of communica-
 tion between both cavities, when the ventricle
 contracts.
   Orifice of the Pulmonary Artery  is situated
 at the left extremity of the base of the ventricle,
 close to the right auriculo-ventricular opening,
 which is situated inferior, posterior, and to its
 right, and separated from the mouth of the ar-
 tery by the largest triangular division of the tri-
 cuspid valve.
  Pars planum is a name given to that  smooth
 portion of the ventricle which leads to the mouth
 of the pulmonary artery.
  Pulmonic Semilunar Valves extend from the
 line of junction of the pulmonary artery  and
 right ventricle into the cavity of the  former.
 These three valves are duplicatures of the lining
 membrane,  and are attached  by their  convex
 edges to the roots of the pulmonary artery; their
 free concave margins  presenting in their centre
 a small tubercle, caUed corpus sesamoideum, or
 corpus arantii.  These valves, when the blood
 passes  from this  ventricle into  the pulmonary
 artery, are thrown down, and thus,  by  closing
 the opening, prevent a reflux of  the blood back
again into the ventricle.
  Left auricle is placed at the upper and back
part of the  heart, and is of quadrilateral form.
It is smaller than the right auricle, and receives,
at its four angles, the openings  of the pulmonary
veins;  its parietes are much  thicker than the
 right;  its auricular appendix  emaUer, but  the 
164
 musculi pectinati are the stronger:  with the ex-
 ception of the auricular appendix its inner sur-
 face is smooth, and it communicates with  its
 corresponding ventricle by the left auriculo-ven-
 tricular opening, which is situated inferior to the
 opening of the auricular appendix, and is marked
 by a whitish hne.  The septum auricularum pre-
 sents towards this auricle a smooth  aspect, from
 circumstances already explained.
   Left ventricle is longer, stronger and smaller
 than the right; from its greater length it  forms
 the apex of the heart;  from its greater strength
 it is of power sufficient  to  propel  the  arterial
 blood through the aorta and its ramifications.
 We consequently find the carneae columnae, the
 chordae tenaineae, the bicuspid, or mitral valve,'
 the parietes of the cavity,  the aorta,  which
 arises from it, and the semilunar valves with their
 corpora sesamoides, which guard the opening of
 this vessel, much stronger than in the right di-
 vision of the heart.
   The left auriculo-ventricular opening, and the
 mouth of the aorta, are situated at the base of
this cavity, and are close to each other, the aortic
 opening being anterior, and both being separat-
 ed, as in the right ventricle, by  the  larger divi-
sion of the bicuspid valve.  With the exception
 of the  peculiarities just mentioned, the left
 auricle  and ventricle are, in their anatomical
 configuration,  simfiar  to the  right, and the
 several  valves, muscular eminences, tendons
 cords, &c, serve similar  purposes:  the  septum 
                     165

ventriculorum belongs chiefly to the left ven-
tricle.
                  ARTERIES.

                  THE AORTA,
 Is divided into three portions—viz., the arch of
 the aorta,  the thoracic aorta, and the abdomi-
 nal aorta.

           THE ARCH OF  THE AORTA
 Sends off five branches.
   A. Arteria coronaria dextra, which sends a
 branch to the right auricle, a branch to the an-
 terior part of the right ventricle, and  a  branch
 to the posterior part of the right ventricle.
   B. Arteria coronaria sinistra, which sends a
 branch to the left auricle,  and a branch to the
 left ventricle.
   C.  Arteria innominata, which divides into the
 right carotid and right subclavian arteries.
   D.  Left carotid artery.
   E.  Left subclavian  artery.

            THE COMMON CAROTIDS

Divide opposite the upper corner of the thyroid
cartilage into two branches.
  A.  External carotid artery.
  B. Internal carotid artery. 
166
           THE  EXTERNAL CAROTID

Sends off ten branches, viz.:—
  A. Superior thyroid, which sends off—1st, a
hyoidean branch;  2d, a superficial branch;  3d,
a laryngeal branch;   and 4th,  a  thyroidean
branch.
  B. Lingual, which sends off—1st, a hyoidean
branch;  2d, the  dorsalis linguae artery;  3d,
the subhngual   artery;  and 4th,  the  ranine
artery.
  C. Facial, which sends off—1st, the inferior
palatine; 2d, the tonsillar; 3d, the  glandular;
4th, the submental;  5th,  the  inferior  labial;
6th, the inferior coronary; 7th,  masseteric; 8th,
superior coronary;  9th,  the  lateral  nasal; and
10th, the angular, which anastomoses  with  the
ophthalmic.
  D.  Muscular.
  E.  Occipital,  which  gives  off the princeps
cervicis, the inferior meningeal, and the terminal
branches, of which one enters the mastoid fora-
men; the others ramify in the scalp.
  F.  Posterior auris, which gives off  the nms-
cular, the glandular, and the stylo-mastoid.
  G.  Ascending pharyngeal, which gives  off
the pharyngeal branches and the meningeal
branches.
  H. Transverse facial.
  I. Superficial temporal, which gives off—1st
the anterior auris; 2d, the capsular branches • 
167
 3d, the middle temporal;  4th, the posterior tem-
 poral ;  and 5th, the anterior temporal.
   K. Internal maxillary, which gives off—1st
 the tympanic, which enters the fissura Glasseri;
 2d, the meningea media, which enters the fora-
men spinosum; 3d, the inferior maxiUary or den-
tal, which enters the dental canal; 4th, the deep
temporal; 5th, the pterygoid ;  6th, the massete-
ric ;  7th, the buccal; 8th, the alveolar; 9th, the
infra-orbital;   10th, the  descending palatine;
11th, the vidian; 12th, the pterygo-palatine;
13th, the spheno-palatine.
            THE INTERNAL CAROTID

 Supplies no vessels in the neck, but in its  pass-
 age through the petrous portion of the temporal
 bone, gives off—
   A. The tympanic.
   B. The arteria receptaculi, or vessels to the
 cavernous sinus.
   C. The anterior meningeal.
   Opposite the anterior clinoid process it di-
vides into—
   A. Ophthalmic  artery, which sends off—1st,
the laehrymal; 2d, the centralis retinae; 3d, the
supra-orbital;  4th, the cUiary branches; 5th, the
muscular;  6th, the posterior ethmoidal;  7th, the
anterior ethmoidal;  8th, the palpebral;  9th, the
nasal; and 10th, the frontal.
  B.  Anterior cerebral,  which  sends off—1st, 
168
the anterior communicans; 2d, the arteria cor-
poris caUosi.
  C. Arteria media cerebri.
  D. Posterior communicans.
  The anterior cerebral  arteries are united by
the anterior communicans, the posterior commu-
nicans passes back to join the posterior cerebral
(a branch  of  the  basilar), and. in this manner
is formed an arterial circle, caUed  the  circle of
WiUis.
           THE SUBCLAVIAN ARTERY
Is divided for  surgical purposes into three por-
tions—1st, on the right side it extends from the
arteria innominata, to the inside of the scalenus
anticus.  2d, the second portion lies under the
scalenus anticus.   3d, the third portion extends
from the scalenus  anticus, to the  lower border
of the first rib.   On the left  side, the left sub-
clavian extends from the arch of the  aorta to
the inside of the scalenus anticus  muscle.  2d,
the second portion of the left  subclavian, like
that of the right side, lies under  the scalenus
anticus.  3d, the third portion of the  left sub-
clavian, also like that of the right, extends from
the scalenus anticus to the lower border of the
first rib.   The third portion of the subclavian
arteries is the one usually ligated.
  A. Vertebral, which gives off—1st, the arte-
riae medullae spinalis transversa?; 2d, the menin-
geal ; 3d, the  inferior cerebeUar; 4th, anterior
and posterior spinal.  The basilar artery, formed 
169
 by the union of the two vertebrals, gives off
 transverse branches to the pons, a small branch
 enters the meatus auditorius internus; and ter-
 minates by dividing into four large vessels—the
 posterior cerebral and  superior  cerebeUar of
 either side.
   B. Internal mammary, which gives off—1st,
 the anterior  intercostal;  2d,  the mediastinal;
 3d, the comes nervi phrenici; 4th, the musculo-
 phrenic ;  and 5th, the superior epigastric.
   C. Thyroid axis, which divides into—1st, in-
 ferior thyroid, which gives off the cervicalis as-
 cendens;  2d,  supra-scapular, which  gives  off a
 supra-acromial branch, and then passes into the
 supra-spinous fossa  of the  scapula, over the
 notch; 3d, posterior scapular, which gives off a
 superficial cervical branch, and then terminates
 in the muscles of the scapula.
   D.  Cervicalis  profunda,  anastomoses  with
 princeps cervicis  from the occipital.
   E.  Superior intercostal, supplies the two or
 three first intercostal spaces.

            THE AXILLARY ARTERY,

Extends from  first rib to the lower border of the
tendon of the latissimus dorsi; it sends off seven
branches.
  A.  Acromial thoracic.
  B.  Thoracica suprema.
  C.  Thoracica alaris.
  D. External mammary, or long thoracic.
                      22 
170
   E.  Subscapular, which sends off an anterior
and a posterior branch.
   F.  Posterior circumflex.
   G.  Anterior circumflex.

           -THE BRACHIAL  ARTERY
Extends from the lower border of the tendon of
the latissimus dorsi  to a  finger's breadth be-
low the bend of the elbow, and sends off four
branches.
   A.  Profunda superior, which sends off—1st,
an ascending branch;  and 2d, the  musculo-
spiral branch.   It  accompanies the  musculo*
spiral nerve.
   B.  Nutritia humeri.
   C.  Profunda inferior, which accompanies the
ulnar nerve.
   D.  Anastomotica magna.

             THE RADIAL  ARTERY
Sends off ten branches. 1
   A.  Recurrent radial.    It anastomoses with
the profunda superior.
   B. Muscular.
   C. Superficialis vola, anastomoses  with the
ulnar to form the superficial palmar arch.
   D. Anterior carpi  radialis.
   E. Dorsalis carpi radialis.
   F. Dorsalis pollicis.
   G. Dorsalis indicis.
   H. Princeps pollicis. 
171
  I. Radialis indicis.
  K. Palmaris profunda.

             THE ULNAE ARTERY
sends off eight branches.
  A. Anterior recurrent.
  B. Posterior recurrent.
  C. Interosseous, which sends off—1st, the an-
terior recurrent; 2d, the anterior  interosseous;
3d,  the  posterior interosseous; 4th, the poste-
rior recurrent ; and 5th, the posterior descending
branch.
  D. Muscular.
  E. Carpi ulnaris anterior.
  F. Ulnaris posterior.
  G. Arteria communicans.
  H. Palmaris superficialis, which anastomoses
with the superficialis volae to form the superficial
palmar arch.  A long branch comes off from the
ulnar or  interosseous, caUed the comes nervi me-
diani;  it is of uncertain size.

              PALMAR ARCHES.
  The deep palmar arch is formed by the pul-
maris profunda of the radial, uniting with the
arteria communicans from the ulnar; it sends off
five small branches to supply the interossei mus-
cles.
       THE SUPERFICIAL PALMAR  AROn
is formed by the  arteria palmaris  of the ulnar,
uniting with the  superficialis volaB from the ra-
dial.  It sends off four branches. 
172
   A. Branches to ulnar edge of little finger. ^
   B. Branch to  cleft between little and ring
fingers.                        #
   C. Branch to  cleft between ring and middle
fingers.
   D. Branch to cleft between middle and index
fingers.
             THE THORACIC AORTA
sends off five sets of branches.
   A. Pericardiac.
   B. Mediastiful.
   C. Bronch ii'il.
   D. Qy-ophageal.
   E. Intercostals: each divides into—1st, the pos-
terior branches; and 2d, the anterior tranches.

           THE AORTA ABDOMINALIS
sends off the foUowing branches:—
   A. The two phrenic arteries.
   B. The caliac axis.   From this  axis arise—
1st, the superior  gastric artery, which divides
into a superior and an inferior branch; 2d, the
hepatic artery, which gives off the superior py-
loric artery, the gastro-duodenal  artery, which
divides into the arteria  pancreatica duodenalis,
and the arteria gastro-epiploica dextra.  The he-
patic artery then divides into the left hepatic and
right hepatic arteries, from the last of which pro-
ceeds a small branch to  the gaU-bladder, called
arteria  cystica;  3d,  the splenic artery,  which
sends off the pancreatica? parvae, the pancreatica 
173
 magna, the vasa brevia, splenic branches, and the
 gastro-epiploica sinistra.
   C.  The superior mesenteric artery, which gives
 off—1st, the colica dextra, which divides into a
 superior and an inferior branch; 2d, the cohca
 media, which divides into a right and left branch;
 3d,  the ileo-colica, which divides into a superior
 branch, a middle branch, and an inferior branch;
 and lastly, the mesenteric branches, from fifteen
 to twenty in number.
   D.  Two capsular, to the renal capsules.
   E.  Two renal, to the kidneys.
   F.  Two spermatic, to the testicles.
   G.  Inferior mesenteric, which sends off—1st,
 the colica sinistra, which divides into an ascend-
 ing  branch and a descending branch; 2d, the
 sigmoid artery; and 3d, the superior  hsemor-
 rhoidal artery.
   H.  Ureteric arteries.
   I.  Lumbar arteries.
   K. Sacra media.

         THE COMMON  ILIAC ARTERIES
 extend from  the bifurcation of the aorta to oppo-
 site the sacro-iliac symphysis;  the right is usu-
 aUy longer than the left:  they extend into two
 branches, viz.
   The internal, and
   External iliac arteries.

         THE INTERNAL ILIAC ARTERY
sends off eleven branches in the female. 
174
  A. Arteria ilio-lumbalis, which  sends  off—
1st, ascending branches;  2d, external branches;
and 3d, descending branches.
  B. Lateral sacral.
  C. Middle hamorrhoidal.
  D.  Vesical.
  E.  Umbilical.
  F.  Uterine.
  G.  Vaginal.
  H.   Obturator,  which sends  off—-1st, the
branches within  the  pelvis; and 2d, branches
without the pelvis.
  I. Gluteal, which sends off—1st, a superficial
branch; and 2d, a deep branch.
  K.  Ischiatic, which sends off—1st, the coccy-
gaeal branch; 2d, the arteria comes nervi ischi-
atici;  and 3d, the muscular branches.
  L. Pudic, which sends off—1st, the external
haemorrhoidal arteries;  2d,  the perinaeal;  3d,
the transversalis  perinaei;  4th, the arteria cor-
poris bulbosi, which gives a branch to Cowper's
gland, and a branch to the corpus spongiosum;
5th, the arteria corporis cavernosi penis; and
6th, arteria dorsafis penis.

             THE EXTERNAL ILIAC
sends off two branches.
  A.  Epigastric, which sends off—1st, a sper-
matic  branch,  and 2d,  the  muscular arteries.
The epigastric anastomoses  with the internal
mammary. 
175
   B. Circumflexa ilii, anastomoses with the ilio-
 lumbar.
            THE FEMORAL  ARTERY
 extends from Poupart's  hgament to  an opening
 in the tendon of the adductor magnus, where it
 becomes  "popliteal."  At  Poupart's ligament,
 the femoral vein is on the inside of the femoral
 artery, the  anterior  crural nerve is on the out-
 side of the  artery.   In  the upper third of the
 thigh,  the  femoral artery  lies in  a triangular
 (Scarpa's space) space, bounded on the outer side
 by the sartorius, inside  by  the adductor longus
 brevis and the pectineus, and superiorly by Pou-
 part's ligament.  In the middle of the thigh the
 artery is overlapped by the sartorius.  In ligatur-
 ing the femoral artery here, an incision is to be
 made on the inside of the sartorius.  It sends off
 the foUowing branches:—
   A. Superficial epigastric.
■   B. Pudenda superficialis.
   C. Circumflexa ilii superficialis.
   D. Profunda femoris, which sends off—1st,
 the circumflexa  externa, from which arise the
 ascending branches, the circumflex branches, and
 descending branches; 2d, the circumflexa interna,
 from which arise arterial branches to the mus-
 cles  of the  hip-joint, and  a branch to the in-
 terior of the hip-joint; 3d, the arteria perforans
 prima;  4th,  the perforans secunda 5 5th, the per-
 forans tertia.
   E.  Anastomotica magna. 
176
           THE POPLITEAL ARTERY

lies upon the ligamentum posticum Winslowii,
and upon the popliteus muscle; and divides into
anterior and posterior tibial;  it sends  off seven
branches.
  A.  Superior muscular.
  B. Articularis superior externa, which sends
off a superficial branch, and a deep branch.
  C. Articularis superior interna, which sends
off a superficial branch, and a deep branch.
  D.  Azygos branch, which perforates the liga-
mentum posticum Wiuslowii.
  E. Articularis inferior externa.
  F. Articularis inferior interna.
  G.  Inferior muscular.
            THE TIBIALIS POSTIOA

lies upon the tibialis posticus, and flexor longus
digitorum, and is bound down by the deep fas-
cia of the leg.  It is accompanied by two  veins
(venae comites) and  by the posterior tibial nerve
—sends off—
  A. Muscular.
  B. Peroneal, which sends off—1st, the nutritia
fibulae;  2d, the muscular; 3d, the anterior pero-
neal ;  and 4th, the posterior peroneal.
  C. Nutritia tibia.
  D. Internal plantar.
  E. External plantar. 
177
             THE TTBIALIS ANTICA
 passes through the interosseous space, and send
 off the following branches.
   A. Muscular.
   B. Recurrent.
   C. Internal malleolar.
   D. External malleolar.
   E. Tarsal branch.
   F. Metatarsal  branches.                  s
   G. Arteria pollicis.
   H. Arteria communicans.

             THE PLANTAR ARCH
is formed by the external plantar artery uniting
with the arteria  communicans of the anterior
tibial; it sends off two sets of branches:—
   A. Arteria perforantes.
   B. Arteria digitales.

          THE PULMONARY ARTERY
divides into  two branches:—
  A. Right pulmonary.
  B. Lejt pulmonary.
                  VEINS.

  The veins are not  so uniform in their distri-
bution as the  arteries.  Besides the numerous
superficial veins  which ramify on the skin, one
                     23 
178
or two are found to accompany each artery.  In
the extremities there are generaUy two to each
artery, and in these situations they receive the
name of vena comites.   When, however,  an
artery is of great size, as the  femoral or the
axiUary,  it is accompanied  but by one  vein,
which receives the same name as the artery.

       VEINS  OF THE HEAD AND NECK.
  The veins which accompany  the branches of
the internal maxillary artery, form the internal
maxiUary vein.
  External jugular vein, formed by the junction
of the internal maxiUary and one temporal vein,
descends obhquely backwards, and joins the sub-
clavian vein;  after crossing the sterno-mastoid
muscle it receives the  supra and posterior sca-
pula veins.
   Internal jugular vein, commences at the ter-
mination of the lateral sinus, descends  along the
outer side of the common  carotid  artery, and
joins the subclavian vein at the sternal extre-
mity of the clavicle.   It  receives the superior
thyroid,  Ungual, facial, occipital, and ascending
pharyngeal  veins.

      VEINS  OF THE SUPERIOR EXTREMITY.
   The Cephalic vein is formed by the union of
 several veins from the back of the hand.  It as-
 cends along the radial  side of the extremity,
 and, passing along the interval between the pec- 
179
 toralis major and deltoid muscles, terminates in
 the axillary vein.
   The Basilic vein commences by a smaU vein
 from the Uttle finger  (vena salvatella), ascends
 along the inner side of the extremity, and  ter-
 minates in the axillary vein, or joins one of the
 vena  comites  which  accompany the  brachial
 artery.
   The Median vein commences at the fore part
 of the wrist and hand,  ascends along the anterior
 aspect of the forearm, and at the elbow termi-
 nates by dividing into two branches.  One of
 these  joins the basilic vein, and is  named the
 median  basilic; the other joins the  cephalic
 vein, and is named median cephalic.
   The Axillary vein, formed by the union of the
 veins just described, and by the brachial vena
 comites,  ascends in front of the axiUary artery,
 receiving the thoracic veins, and passes beneath
 the clavicle,  where it terminates in  the subcla-
 vian vein.
   The Subclavian vein passes inwards over the
 anterior   scalenus  muscle,  receives  numerous
 veins from the  neck and shoulder, also the ex-
 ternal jugular and vertebral veins, and joins the
internal jugular vein behind  the sternal extre-
mity of the clavicle.
   Vena innominata, formed by the union of the
internal  jugular and subclavian  veins, on  the
right side is very short, and  descends into  the
thorax; the left vena innominata, which is much
longer, enters the thorax in a transverse direc- 
180
tion in  front of the trachea to join the right
vein, and in its course receives the thyroid veins,
and veins from the  anterior mediastinum.  By
the union of the venae innominatae is formed the
   Vena cava superior, which descends in front
of the right pulmonary vessels, enters the peri-
cardium, and opens  into the right auricle.

               VENA AZYGOS,
commences on the first lumbar vertebra by one
or two smaU veins from the renal or from the in-
ferior vena cava, gains the posterior mediastinum
by passing through  the aortic  opening of dia-
phragm, ascends along the right side of the bodies
of the dorsal vertebrae, curves forwards over the
root of  the  right lung, and  terminates at the
posterior aspect of  the  superior vena  cava, as
this vessel is entering the pericardium.  In  its
course it receives the lower intercostal veins of
each side, oesophageal veins,  the azygos minor,
right bronchial, and  sometimes the right superior
intercostal veins.  It has no valves.

     VEINS OF  THE INFERIOR EXTREMITY.
  Internal saphena vein, commences at the inner
part of the foot, ascends along the inner side of
the leg and knee, behind the inner condyle, be-
comes more anterior upon  the thigh, and, reach-
ing to within about two inches of Poupart's liga-
ment, passes through the saphenic opening of the
fascia lata, and joins the femoral vein. 
181
  External saphena vein, commences at the outer
part of the foot, ascends along  the back part of
the leg and ham, and joins the popliteal vein.
  Both these veins are superficial, and in their
course  receive several veins from  the integu-
ments.
  Deep veins of the leg, two veins (venae comites)
accompany each artery in the leg, and terminate
in the foUowing:—
  Popliteal vein: this  vessel accompanies  the
artery of the same name, and having received the
external saphena vein, and the veins of the knee,
terminates in the femoral  vein.
 ■ Femoral vein accompanies the femoral artery,
and having received the  profunda vein, the in-
ternal saphena vein, and  a few muscular veins,
passes beneath the crural arch, and ends in the
external iliac vein.
  External iliac vein accompanies the external
iliac artery.  This vein  is below, and to the in-
side of the artery.
  Internal iliac vein is formed by the union of
the veins which accompany the branches of  the
internal iUao artery, and joins the external iliac
vein at the sacro-iliac symphysis.
  Common iliac vein, formed by the union of the
internal and external iliac veins, joins its feUow
at the right side of the body of the fourth lumbar
vertebra to form the inforior vena cava.
  Inferior vena cava ascends along the right side
of the bodies of the lumbar vertebrae, behind the
liverr and passes through the quadrilateral open- 
182
ing in the tendon of the  diaphragm, and opens
into the right auricle of the heart at its lower and
back part.  It receives the middle sacral, one,
and sometimes both spermatic veins, the emul-
gent and capsular veins, the venae cavae hepaticae,
and the phrenic  veins.

                VENA PORT^E
commences on the back' of the rectum by one of
the hamorrhoidal veins, ascends towards  the
meso-colon, and  unites with the inferior mesen-
teric vein ; this trunk next unites with the supe-
rior mesenteric vein, and  behind the pancreas it
unites with the  great splenic vein, and receives
veins  from the  stomach,  duodenum, and pan-
creas.  The vena portae thus formed ascends to
the right side, inclosed in the capsule of Glisson,
and reaches the  transverse fissure of the fiver,
where it divides  into two branches: these enter
the liver,  ramify through its substance like an
artery, and its Wood is returned to the inferior
vena cava by the venae cavae hepaticae, which are
three or four in number, and open into the cava as
this vessel is entering its opening in the diaphragm.
The vena  porta  represents a tree, the roots of
which are in the stomach, intestines, pancreas,
and spleen;  they graduaUy converge to form a
large trunk, which passes up  to the transverse
fissure of  the hver,  and  divides into  branches
which subdivide like the branches of a tree, and
terminate in the  minute lobules of the liver. 
183
       THE DIGESTIVE APPARATUS.
                 THE MOUTH.
   This cavity is bounded superiorly by the hard
 and soft palate, inferiorly by the tongue and the
 reflections of mucous membrane from it to the
 gums, and laterally by the  cheeks.  Its anterior
 opening, which forma the commencement of the
 digestive canal, corresponds to the lips; and pos-
 teriorly it  communicates  with  the  pharynx
 through the opening called isthmus faucium, the
 boundaries of which are the soft palate and uvula
 superiorly, the tongue inferiorly, and the piUars
 of the palate and tonsils lateraUy.  Within the
 mouth we observe the opening of the three  sali-
 vary glands and foUicles, and the teeth of either
 side.   The parotid gland opens by a single orifice
 opposite the second superior molar tooth; the
 sub-maxillary gland of either  side, by a single
 orifice at the anterior part of the tongue, by the
 side of the reflection of mucous membrane, caUed
 frenum Unguae, and the third  sahvary gland or
 sublingual by several small orifices (eight or ten)
 on either side of the frenum linguae.

                 THE TEETH.

  The number of teeth in  the adult is  thirty-
two, sixteen  in  each jaw; and to distinguish
them from the teeth of the child they are caUed
permanent.  They are divided into eight met- 
184
sors, four canine,  eight bicuspids, and twelve
molars.  The last  molar does not appear until
late in life, and hence has been called the wis-
dom tooth.  It is, however, sometimes want-
ing.
  In the child the number of teeth is only twenty,
and are  called  milk,  deciduous, or  temporary
teeth.  They are divided into eight incisors, four
canine, and eight molars.

                THE PHARYNX
is a musculo-membranous bag of conical shape
extending by its base from  the posterior part of
the mylo-hyoid ridge and base of the skuU, to the
posterior aspect of the cricoid cartilage, where it
terminates in the oesophagus.  It is connected by
its posterior waU to the vertebrae  by loose cel-
lular tissue, and interiorly it corresponds to the
mouth and larynx.            '
  On laying open the cavity of the pharynx by
a perpendicular incision along its posterior me-
dian line, the internal mucous lining of the bag
wiU be exposed, and the foUowing openings viz
superiorly, one  on either side of the mesial line
the openings of the posterior nares; more ex-
ternally,  one on either side of the openings of
the Eustachian tubes; inferior  to these is the
opemng of the  mouth into the pharynx or the
isthmus faucium;  posterior and inferior to the
tongue is the superior opening  of the  larynx
and, lastly, the  opening of the pharynx into the
oesophagus. 
185
               THE OESOPHAGUS
extends from the termination of the pharynx to
the stomach; it is placed above, between the
vertebrae and the trachea, inclines at the inferior
part of that tube to the left side, and passes be-
hind its left  bifurcation to reach the posterior
mediastinum.   In  the mediastinum it descends
forwards,  above  the  thoracic  aorta,  passes
through the oval muscular aperture of the dia-
phragm, to terminate in the stomach.  The mu-
cous membrane of the mouth, pharynx, and oeso-
phagus, is covered  by epithelium.

                THE STOMACH.
  A large pyriform musculo-membranous bag,
situated in the epigastric and left hypochondriac
regions, communicating at one extremity with
the oesophagus, and at the other with the duo-
denum.
   Connexions.—Its large extremity, or fundus,
to the spleen by the gastro-splenic omentum; its
upper concave, small edge, to the liver, by the
gastrohepatic omentum; and its lower, convex
large edge, to the colon by the gastro-colic omen-
tum.  Its oesophageal, or cardiac orifice, situated
between the fundus and lesser curve, connects it
to the diaphragm,  and its pyloric orifice to the
duodenum.   The superior-anterior surface of the
stomach looks towards the diaphragm, ribs, and
left lobe of the liver; the posterior-inferior sur-
face towards the meso-colon.
                      24 
186
  The stomach is composed of three tunics, con-
nected by ceUular tissue, an external  peritoneal
coat, an internal mucous coat, and between both
the muscular coat.  The  muscular fibres of the
stomach  observe three directions; the longitu-
dinal are seen along the edges or curves, the ob-
lique on the fundus, and the circular are weU de-
veloped at the  centre of the organ,  and  at its
pyloric orifice.   The mucous coat, smooth, and
of light pink colour, is thrown into folds {plica),
which intersect  each other, inclosing irregular
quadrilateral spaces.  Numerous mucous glands
are found along the curves and at the pylorus:
in the fundus smaU glands  exist, which secrete
the gastric juice.  At the pyloric orifice the mu-
cous membrane  is thrown  into a circular fold,
which forms an imperfect valve between the
stomach  and duodenum;  and at the oesophageal
opening the epithelial  lining is  observed to ter-
minate in a fringed edge.

              SMALL INTESTINES.
are divided into  duodenum, jejunum,  and ileum.
  Duodenum, the  shortest portion of the  small
intestines,  forms a curve in the concavity of
which is situated the head of the pancreas; it is
divided into a superior transverse portion, a mid-
dle perpendicular portion, and an inferior trans-
verse portion.   The transverse portion mounts
upwards and to the right to the under surface
of the liver and neck of the gall bladder; the 
187
 descending extends as low as the body of the
 third  lumbar vertebra;  the transverse portion
 crosses to the left side of the body of the second
 lumbar vertebra, and then  opens into the jeju-
 num.   The superior part is covered by perito-
 neum on both its surfaces, and on this account is
 more moveable than the perpendicular or  infe-
 rior portions.
   Besides the numerous mucous glands which
 open on its interior  surface, the pancreatic duct
 and the common biliary duct enter at its per-
 pendicular division, either by a common aper-
 ture, or in close proximity.    These  ducts gene-
 raUy open about from three to  four inches, below
 the pyloric  orifice of the stomach.   This intes-
 tine differs not only in these particulars from the
 rest of the smaU intestines, but also in being
 much larger, more dilatable,  more fixed to its
 position, in having  a greater number of valvulae
 conniventes (or  circular  folds  of  the mucous
 membrane), and in its  muscular fibres being
 much stronger. It also contains Brunner's glands,
 which are smaU  conglomerate glands near the
 pylorus.
  The duodenum has also been caUed ventriculus
 succenturiatus.
  Jejunum and Ileum form  the longest part of
 the intestinal tube,  being in  general  from 24
 to 30 feet  in  length;  the upper two-fifths  are
 given to the jejunum, and the remainder to the
ileum,  but there is no anatomical foundation for
this  arbitrary boundary, as the intestines run 
188
Into each other insensibly, and from the duode-
num the remainder of the small intestinal-tube
gradually diminishes in thickness, has fewer val-
vulae conniventes, and exhibits less vascularity;
so much so, that the termination of the ileum is
much thinner and paler than the upper part of
the jejunum, and it  is in these situations only
that the differences  between both  are marked
and  striking.   The  mucous membrane  of the
smaU intestine is studded with glands of two
orders, viz. the glandula solitaria, and the glan-
dula agminata.  The solitaries are disseminated
Like  granules  over the mucous membrane, and
the agminatae are placed in oval clusters.  These
last  sets of glands are termed Payer's  glands.
The fibres of the muscular coat of the small in-
testines take a circular and longitudinal direc-
tion, the latter being placed externally.
   Peyer's plates, or glands, situated in the lower
part of the ileum; they are often  ulcerated in
typhus fever, and sometimes in tubercular dis-
ease of the lungs; they do not always exist.

               LARGE INTESTINE,
divided into the ccecum, colon, and rectum, forms
about one-fifth of the intestinal canal.  It differs
from the smaU intestine in its great size, in being
sacculated,  in having small processes along  its
entire course, called appendices epiploica, in pre-
senting three well defined longitudinal bands, in
being thinner, and in having no valvulse conni- 
189
 ventes.   It is composed of  an external serous
 coat, an internal mucous coat, and between both,
 a muscular coat. The fibres of the muscular coat
 are longitudinal and circular; the former are col-
 lected into three bands, which being shorter than
 the intestine throw it into sacculi: the latter re-
 semble the  circular fibres of the small intestine.
   Oacum or caput coli, placed in the right iliac
 fossa and connected to the ihacus and psoas mus-
 cles, is fixed in  its situation by  the peritoneum,
 which only covers it anteriorly and somewhat
 lateraUy; it receives  at its inner side the ileum,
 which  terminates  in its  cavity by a slit-like
 opening,  which is guarded by the ilio-coecal
 valve;  this, in health, allows the transit of aU-
 mentery and excremental matter from the ileum
 to the colon, but not in the reverse direction.
 The appendix vermiformis  is a smaU diverticu-
 lum which  proceeds  from the posterior part of
 the coecum; it is the size of a goose-quill in dia-
 meter, and  from three to five inches in length;
 its orifice of entrance  into the coecum is guarded
 by a smaU valve: sometimes foreign bodies, as
 bird-shot, cherry stones, &c., get into the cavity
 of the appendix  and  excite ulceration, perfora-
 tion,  and fatal  peritonitis.   The  appendix is
 sometimes 8 or  9 inches long, and may become
 constricted  in a hernial sac:  the coecum  has
 no valvulse conniventes, but is thrown into irre-
gular sacculi by the three longitudinal bands.
  The colon extends from the coecum to the rec-
tum, and  is divided into four portions, viz.  the 
190
right or ascending colon, the'middle or transverse,
the left or descending, and the sigmoid flexure.
  The rectum extends from the sigmoid flexure
of the colon to the  anus; its upper third is
wholly covered by peritoneum, its middle  third
is only covered by this membrane upon its ante-
rior aspect and sides, and its inferior third has
no peritoneal covering.  In the male subject the
antero-inferior aspect of the rectum is connected
to the inferior surface of the bladder, the vesi-
culae  seminales,  and the  prostate gland, and in
the female to the uterus and vagina.   The rec-
tum has the longitudinal fibres scattered over its
whole surface,  and is not sacculated Uke the
other parts of the large intestine.

              SALIVARY GLANDS.
are three in number, viz. the Parotid, the Sub-
maxillary, and the Subungual.
  Parotid gland, the largest  of the  three, is
bounded superiorly by the zygoma, posterior-
ly by the mastoid  process  and sterno-mastoid
muscle, and advances on the side  of  the face
partly resting upon the masseter  muscle.   It
sends off processes which fill the posterior part
of the glenoid cavity, the fossa between  the
ear,  ramus  and angle of the lower jaw, and
the intervals between  the  pterygoid, digastric
and  styloid muscles; it  often unites with  the
submaxfilary gland.   Its duct  (duct of Steno)
passes across the masseter muscle,  pierces  the 
191
buccinator muscle, and opens into the mouth op-
posite  the  second  superior molar tooth.   The
portio dura nerve, the internal maxillary artery,
and the external jugular vein, pass through the
substance of the parotid gland. This gland cannot
therefore be extirpated, without destroying the
above  named vessels and nerve.   Two or three
lymphatic glands are sometimes found on the
surface of the parotid which may become en-
larged and form tumours, which may be mistaken
for those of the parotid itself.   A smaU  gland
(socia parotidis)  occasionally is  found between
Steno's duct and the zygoma, the duct of which
unites with that of  the  parotid gland.
  Submaxillary gland,  placed in the digastric
space, and  covered by the skin, platysma-myoi-
des muscle, and  superficial fascia,, is  of oval
figure,  and  much smaUer than the parotid.  Its
duct (Whartonian) turns round the posterior
edge of the mylo-hyoid muscle, and runs for-
wards and inwards, upon the hyoglossus muscle,
towards the franum lingua, at the side of which
it opens into the mouth.
  Sublingual gland, placed between  the mu-
cous membrane of the mouth and the mylo-hyoid
muscle, is the  smaUest  of the  sahvary glands,
and opens  by several ksmaU ducts (Rivinian),
which perforate the mucous membrane, reflected
from the side of the tongue.

                   LIVER.
Situated in the right hypochondriac, the epigas- 
192
trio, and partly in the left hypochondriac regions,
is the largest gland in the body.   It presents an
upper convex  surface, a lower irregularly  con-
cave surface, a posterior thick margin attached
to the diaphragm, and an anterior inferior mar-
gin which is  free.   The upper  surface is une-
qually divided by the falciform ligament into  a
right and left lobe.  The  inferior  surface pre-
sents the foUowing fissures and depressions.
  1. Longitudinal fissure extends from a notch
in the anterior thin edge of the Uver backwards
and upwards, defining  the boundary between
the right and left lobes of the organ ; it crosses
the transverse fissure at right angles, and is con-
tinued to the superior edge of the posterior  sur-
face of the  liver, by a canal often concealed in
the substanee  of the liver.   As far as the trans-
verse fissure it contains the  remains of the obli-
terated umbilical vein:  beyond  that point, the
obliterated ductus venosus.
   2.  Transverse fissure extends  from the longi-
tudinal  fissure into the right lobe of the liver;
it  contains the trunks of the right and left hepa-
tic arteries,  the trunk and branches of the portal
vein, the hepatic extremities of the biliary ducts,
the hepatic plexus of nerves and absorbents.
  3. Fissure of the vena cava,  situated  to the
right of the horizontal  fissure and  behind the
transverse fissure, forms the right boundary of
the lobulus  Spigelii.
   4. Depression for the gaU-bladder, situated to
the right of the lobulus quadratus. 
193
   5. A broad notch in the posterior thick edge
of the liver, which corresponds to the right crus
of the diaphragm.   Besides these there are su-
perficial depressions for the colon, right kidney,
and stomach.
   Lobes of the liver.  1st, right lobe, the largest;
2nd, left lobe, separated from the right by the
horizontal fissure ; 3rd, lobulus  Spigelii, bound-
ed  before by  the transverse  fissure, and placed
between  the  ductus venosus and vena cava;
4th, lobulus caudatus, extending from the lobu-
lus Spigelii along the right lobe,  and lying pos-
terior to the transverse fissure;  5th, the lobulus
quadrates, which is bounded  behind by the
transverse fissure, to the  left  by the horizontal
fissure,  to the right  by the gaU-bladder, its an-
terior edge being free.
   Vessels of the liver.—1st, the hepatic artery;
2nd, the vena portae; 3rd, the venae cavae hepa-
ticae ; 4th, the biliary or hepatic ducts;  and 5th,
the absorbents.  The hepatic artery is the nu-
trient vessel of the liver;  its terminal branches
open into the subdivisions of the vena portae
The vena portae conveys, like  an  artery,  the
blood for secretion of the liver.   Its first  divi-
sions, interlobular, pass between  the lobules in
company with branches of the  hepatic artery
and biliary ducts, and form the vaginal plexuseSj
which apply themselves to the walls of the canals
in which the vessels  run :  the interlobular veins
open by the lobular veins into a vessel which
commences in the centre of each lobule, the in- 
194
 tralobular vein, the commeneement of the he-
 patic veins.  The intralobular vein opens into
 the  sublobular vein, and the sublobular veins
 from the  venae  cavae  hepaticae.  The  biliary
 ducts commence amongst the lobular veins.
   Ligaments of the Limer.—Besides  the liver
 being invested with a proper fibrous  capsule, it
 is also covered by peritoneum, which forms four
 of its ligaments, viz. 1st and 2nd, a  right and
 left lateral, triangular in form, and connecting
 the right and left lobes to the diaphragm; 3rd
 a suspensory or falciform ligament, which con-
 nects its upper convex surface to the right rec-
 tus muscle, and to the diaphragm;  and 4th, the
 coronary ligament, which connects the superior
 thick border of the diaphragm.   There  is also
 a fifth  ligament (ligamentum teres), the  oblite-
 rated umbiUcal vein, which extends obhquely
 from the  umbilicus upwards  and  backwards to
 the anterior portion of the horizontal  fissure.'
   Gall-bladder,  pyriform in shape,   and com-
 posed of  an internal  mucous coat,  a  proper
 fibrous coat,  and  a partial serous covering, is
 lodged in  a depression on the under  surface of
 the right lobe of the liver.  Its large extremity,
or fundus, is directed downwards and  forwards •
its upper extremity terminates in the cystic duct
about an inch and a half in length, which unites
with the hepatic  duct, formed by the union of
the light and left ducts from the correspond
ing lobes of  the  liver.  The common  biliary
duct thus  formed by  the  cystic and hepatic 
195
 ducts is called the ductus communis choledochus,
 which is about three inches in length, and con-
 veys the bile to the duodenum.

                  PANCREAS.
 A flattened oblong gland from five to six inches
 in length, similar in its formation to the salivary
 glands.  It consists of a left caudal extremity,
 situated in the lower part of the left hypochon-
 drium, a body which crosses, anterior to the left
 crus of the diaphragm, the aorta and  the vena
 portae, to the right side; and a right extremity
 (the head) which is the largest part of the gland,
 and which is surrounded by the duodenum.  Its
 duct, of a  whitish  colour, extends along  the
 centre of the gland from left to right, but lying
 near its  posterior aspect; receiving the  small
 ducts from the granules of the pancreas, it finally
 opens  into the duodenum, close to  the ductus
 communis  choledochus,  which  it  sometimes
joins.
                 THE SPLEEN,
 Connected to the large  extremity of the sto-
 mach by blood-vessels and peritoneum,  and situ-
 ated between the  stomach and ribs of the  left
 side, is of a deep blue venous colour, and varies
 in weight from six to fifteen ounces, its figure
 being oval.  It presents a convex surface, which
 corresponds to the ribs, and a concave surface
 towards the stomach; it  is enveloped by a pro- 
196
per fibrous membrane, and a  peritoneal  coat.
Its  interior is composed of cells separated by
septa, with white granules intermixed.  It has
no  excretory duct.  Its function is  not under-
stood ; it is supposed by some  to be concerned
in the formation of the red corpuscles of the
blood.
URINARY APPARATUS.
               THE KIDNEYS.

  Two glandular bodies of oval form, situated
behind the peritoneum, in each lumbar region,
lying  upon the diaphragm, psoas magnus, and
quadrates lumborum muscles, and enveloped in
a thick layer of adipose tissue.  The right kid-
ney, which is rather lower than the left, is be-
low the liver, above the ccecum, and behind part
of the duodenum and  the ascending colon; the
left being bounded above by the spleen, below
by the sigmoid flexure of the colon, and an-
teriorly by the descending colon.  The extremi-
ties and outer border of each kidney are convex,
whilst the inner margin presents  a concave as-
pect called the renal fissure, which contains the
trunks of  the  blood-vessels  and its excretory
duct,  observing in general the following order,— 
197
the veins anterior, the arteries behind these, and
the ureter obliquely  behind both.   Besides the
adipose capsule which envelopes each kidney, it
also has a  proper fibrous coat,  which adheres
closely to its outer surface, and sends prolonga-
tions into its interior, as far as the calyces.
  The structure of the kidney is essentially tu-
bular.   On  splitting open  a kidney lengthwise
we find that it evidently consists of two distinct
portions, the cortical and the medullary.  The
cortical substance forms  the whole  circumfe-
rence of the kidney; it is about two to three
lines in thickness, of a reddish brown colour,
very vascular, and from its inner surface pro-
cesses pass down, separating the pyramids of the
medullary portion from each other.  The  corti-
cal portion consists of myriads of intricately
convoluted uriniferous tubes, and of minute ar-
teries, veins, and capiUaries.  An immense num-
ber of smaU spherical  bodies are found  in the
cortical substances, to which the name' of Cor-
pora Malpighiana has been apphed.  They con-
sist of a ball  of convoluted capiUaries.  If we
trace  up a convoluted tube in the cortical sub-
stance, we  find  that it graduaUy expands, and
forms a capsule, which embraces and surrounds
the Malpighian body.  The medullary portion
is  arranged in masses of a pyramidal  shape,
caUed the  pyramids of Malpighi.   Their, bases
are turned towards the cortical  substance, their
pointed extremities project free  into the  calices
of  the  kidney, and are  caUed  papulae.  The 
198
number of the pyramids is from 9 to 20.  They
are composed of straight uriniferous tubes, con-
verging from the base of  the pyramid to its
apex.  They are also very vascular.  The tubuli
uriniferi both in the cortical and medullary por-
tions are lined by epithelium.   Those of the cor-
tical portion  lie in the midst of  a plexus of
capillaries, and of minute veins.  It is  believed
by Bowman that the uriniferous tubes, by means
of their epithelial lining, separate the urine from
the blood of the vessels which are in  contact
with them—the water of  the urine being de-
rived from the Malpighian body, the saline por-
tion from the plexus of minute veins.
  The  Calyces  are  small membraneous  sacs
which surround one or more papillae.
  The Infundibula are three funnel-shaped tubes
formed by the union  of the calyces.
  The  Pelvis  is the  membraneous  reservoir
formed by the union of the three infundibula.
  The watery parts of the urine are secreted by
the Malpighian bodies, which lie in small sacs,
the commencement of the uriniferous  tubules;
the sahne parts are separated from the  blood of
the venous capiUaries, which convey the blood
back to the renal vein.
  The ureters extend from the termination of
the pelvis of either kidney to the bladder.  Each
ureter about eighteen inches long and of the dia-
meter of a moderate sized quill, passes behind
the peritoneum, lying anterior to the psoas mag-
nus muscles and to the iliac vessels, and gaining 
199
the inferior and posterior part  of the  bladder,
passes obliquely between its coats and  perfo-
rates its interior  at  the outer angle of its tri-
gone.*

            THE URINARY BLADDER.
  This musculo-membranous viscus, when mode-
rately distended, is of ovoid figure and occupies
the lower region of the pelvis, behind the sym-
physis pubis,  and anterior and superior  to the
rectum in the  male, and the uterus and vagina in
the female.
  Ligaments of the bladder are divided into true
and false. The true ligaments are four in number,
viz., two anterior and two lateral.  The anterior,
white and chordlike, extend from the posterior
surface of the pubes to the front of the prostate
and neck of the bladder: the lateral, thinner and
wider, pass from the sides of the prostate and
bladder to the sides of the pelvis, and thus form
the  pelvic partition, between the parts  in the
pelvis, and those in the perinceum.  The  lateral
ligaments constitute the vesical fascia.   Both are
reflections of pelvic fascia.   The false ligaments
are  five in number,  viz. two posterior,  two
lateral, and one superior, and are  formed by the
reflections  of  the peritoneum, some of  which
partially enclose the obliterated umbilical arte-
ries, and the urachus.              ___________
  • To gain a view of the parts just  described, a perpendicu-
lar section of the  gland should be made  from Its convex to
its concave margin. 
200
  The regions  of the bladder are divided into
six.  1st.  The superior region, to which are at-
tached the  urachus and  obliterated  umbilical
arteries.   2d and 3d. The  lateral regions, on
which  the vesical fascia of either side passes.
4th. The  anterior region, the aspect of which
looks towards the recti muscles, and the posterior
surface of the pubes.  When the bladder is dis-
tended, the anterior region rises above the pubes,
and presents a surface uncovered by the peri-
tone/im;  through this region an opening  may
then be made to relieve retention of urine, or for
the high operation of Lithotomy.   5th.  The pos-
terior region, the aspect of which looks towards
the rectum  in  the male, and the uterus in the
female.  6th. The inferior region or fundus,
which rests on the vesiculae seminales, the pro-
state gland, and the rectum in the male, and. on
the uterus and  vagina in the female.
   Coats  of  the  bladder.—Besides the partial
peritoneal covering which invests all the poste-
rior region and the posterior parts of the upper
and lateral regions, there are also three proper
coats: 1st.  The muscular, placed externally, the
fleshy  fibres of which teke two  directions ; the
external  run longitudinaUy (the anterior  and
superior  fibres, being stronger, have been distin-
guished by the name of detrusor urina),  deep
fibres immediately in connexion with the mucous
coat, are circular and best developed around the
neck of the bladder.  2d. The cellular coat, and
3d. The mucous, which is exposed on opening 
201
 the bladder.  This coat is in general thrown into
 rugae by the projection of the muscular fibres.
   The trigone or  vesical triangle is the namo
 given to a smooth space enclosed between the
 openings of the ureters into the bladder, and the
 vesical orifice of  the urethra.  It is the  most
 sensitive portion of the bladder.
   The uvula is a smaU duplicature of the mucous
 membrane on the  under surface of the vesical
 orifice of the urethra, and corresponds to  the
 third lobe of the prostate gland.
   The urethra, which terminates the urinary ap-
 paratus in the male, being more connected with
 tie reproductive  organs, we shall  defer its con-
 sideration for the present.

              THE PERITONEUM,

 The largest serous membrane in the body, fines
 the parietes of the abdomen, and invests almost
 all the abdominal viscera; like aU serous mem-
 branes, it is distinguished  into two layers, a
 parietal and a visceral.  The abdominal parietes
 being  divided by  a  transverse incision corre-
 sponding to the umbilicus, the uninterrupted con-
 tinuity of the peritoneum, and  the  different
 productions it forms in its course,  may  be thns
 demonstrated:—lining the inner surface of the
 upper section of the abdominal parietes, it ascends
 to the margin of the thorax, and lines the inferior
surface of the diaphragm; from this muscle it is
reflected  on  the spleen on the left side, and on
                      26 
202
the liver on the right side, forming its ligaments
(vide ligaments of liver).  From the transverse
fissure of the liver, the two layers which cover
the convex and  concave aspects of this gland
meet, and are conducted by the hepatic vessels to
the lesser curvature of the stomach, thus forming
the gastro-hepatic omentum, which contains the
hepatic  artery,  portal vein, and  biliary ducts,
surrounded by a fibrous structure, called GUsson's
Capsule.  The artery lies to the left, the ductus
communis  choledochus  to the  right, and  the
portal vein between and  behind.  At the lesser
curve of the stomach the two laminae of  the
gastro-hepatic omentum separate and enclose this
organ, passing  from its  left extremity to  the
spleen, thus forming the gastro-splcnic omentum ;
at the great curve of the stomach,  and lower ex-
tremity of the spleen, the two laminae again meet,
and descend in front of the colon  and the small
intestines  to the lower  part of the abdomen;
they then turn upon themselves  backwards, and
ascend, forming the great omentum, to the trans-
verse arch of the colon, where they separate to
enclose  this intestine.   Having  enclosed  the
colon, the  layers again unite and form the trans-
verse meso-colon, which passes backwards to the
spine;  having  arrived  at the  spine, the two
laminae separate into a descending and an ascend-
ing layer; the descending layer passes into tho
lumbar  regions,  where it is reflected upon  the
ascending  and  descending colon,  forming  tho
right and left lumbar meso-colon;  it attaches it- 
203
self to the left sides of the bodies of the lumbar
vertebrae, forming the anterior lamina of the root
of the mesentery; from this fixed point it is con-
tinued around  the jejunum and ileum, forming
the peritoneal coat of these intestines, and returns
again to the spine, forming the  posterior lamina
of the root of the mesentery.  This layer of the
transverse meso-colon having  thus formed the
mesentery, stiU pursues its  descending course,
and passes into either ihac region, and into the
pelvis;  on the right it attaches the caecum to the
right iliac fossa, thus forming the meso-caecum ;
on  the left side it attaches the sigmoid flexure of
the colon  to the left iliac fossa, forming the sig-
moid meso-colon;  and in the middle it connects
the upper portion of the rectum to the  upper and
anterior part of the sacrum, forming the meso-
rectum.   StiU pursuing its  course  downwards,
and covering the upper and anterior aspect of the
middle  third of the  rectum, it is at length re-
flected on the posterior surface and sides of the
bladder to the  superior  region of this viscus,
from which,  and from the ihac fossa, it is re-
flected on the inner surface of the lower section
of the abdominal parietes to the transverse in-
cision, from the upper edge of which the descrip-
tion was commenced.  Having thus traced the
descending layer of the transverse meso-colon, the
continuity of the ascending layer remains to be
noticed :—ascending in front of the inferior and
middle portions of the duodenum  and of the
pancreas,  it is conducted  to the diaphragm by 
204
the vena cava where it becomes continuous with
the peritoneum, which has been reflected from
the posterior aspect of the liver.*
  Foramen of Winslow.—By this opening the
cavity which is between the layers of the great
omentum communicates with the general perito-
neal cavity of the abdomen.   It is of oval form,
being bounded anteriorly  by the gastro-hepatic
omentum, posteriorly by the ascending layer of
the meso-colon, superiorly by the liver, and infe-
riorly by the duodenum.
  Inguinal Pouches.—As  the peritoneum is
ascending on the lower part of the  abdominal
parietes, it is thrown into  four pouches, two on
either side, by the obliterated hypogastric artery.
The external pouch, between the ilium and hypo-
gastric  artery, is the largest, and corresponds to
the internal abdominal and the femoral rings;
the internal corresponding to  the external ring.
  In the female the peritoneum passes from the
rectum on the upper and back part of the vagina,
from which it ascends on the uterus,  forming on
each  side its broad ligaments, and is reflected
from the anterior part of the uterus to the back
of the bladder.
 * This, the usual description of the peritoneum, leaves un-
explained the way in which the hepatic vessels reach the
liver without perforating the membrane. This point can be
understood only by referring to the history of the develop-
ment of the foetus, in which the intestinal tube, nearly verti-
cal, is bound to the spinal column by two folds of peritoneum
between which lie the aorta and its branches. When the
viscera assume the position known in the adult, it is imnossi
We to traco all the peritoneal folds.               *^ 
205
    MALE ORGANS OF GENERATION.

                THE TESTICLES

 are two in number, of oval form, are contained
 in  the scrotum, and are likewise enveloped by
 proper tunics.
   Tubuli seminiferi are numerous small tubes,
 which form  the body of each testicle.  They
 are very long and tortuous, and are arranged in
 conical lobules, which are separated from each
 other by fibrous bands, derived from the tunica
 albuginea.  Lauth states the number of tubes to
 be  840, and the length of each to be 27 inches.
   Vasa recta, from sixteen to twenty in number,
 are formed by the union of the tubuli seminiferi,
 and are contained between the layers of the cor-
 pus Highmorianum.  The vasa recta  terminate
 in  a kind of  plexus or network called the rete
 testis.  From the rete testis proceed from 12 to
 18  ducts, caUed  vasa efferentia. These  are so
 convoluted as to form the coni vasculosi.  Tho
 coni vasculosi form the globus major, or head of
 the epididymis, which is situated at  the upper
 part of the body of the testicle;  still convoluted,
 it is traced downwards, forming the body of the
 epididymis, which is narrow, and placed at the
 posterior part of the  body of the testicle, and
 arriving at the inferior part of the gland it forms
the globus  minor (or tail of the epididymis).
The vas deferens  having thus fonned  the epidi- 
206
dymis, escapes from the globus minor, and hav-
ing increased in size and density, ascends along
the inner aspect of this body, until it becomes
connected to the spermatic vessels and cremas-
ter muscle;  it then passes through the external
abdominal ring and the inguinal canal, and hav-
ing passed through the internal abdominal ring,
it  separates from the spermatic vessels, and  is
conducted by the false lateral Ugaments of the
bladder to this viscus, along the side and inferior
part of which it runs, lying internal to its corre-
sponding vesicula seminalis.  It here approaches
its fellow of the opposite side, and both ducts be-
coming flattened arrive at the base of the pro-
state gland, where they are joined by the ducts
of the vesiculae seminales, their union forming the
common ejaculatory ducts; these run through
the prostate gland, and open into the prostatic
portion of the urethra, at the side of the veru-
montanum.   The  canal of the vas deferens  is
small.   Surrounding this canal, are organic mus-
cular fibres, by the action of which the semen
can pass upwards from the testicle against the
force of gravity.

      PROPER COATS OF  EACH  TESTICLE.

   Tunica albuginea.—A strong fibrous invest-
ment, of opaque white colour, which forms the
capsule of the gland.  From its inner surface it
sends two laminae, which project into the back
part of the  testicle for about two linos, forming 
207
the body called corpus Highmorianum:  from
the free edge of this proceed the fibrous bands,
already mentioned as separating the conical bun-
dles of tubuli seminiferi.
   Tunica vaginalis.—A serous membrane, con-
sisting of two layers, one covering the testicle,
caUed tunica vaginalis testis, the other lining the
scrotum, caUed tunica vaginalis scroti.  When
the tunica vaginalis scroti is divided, its continu-
ity with the visceral layer may be demonstrated
by tracing the membrane, when it will be found
to be reflected on the side and fore part of tho
epididymis and testicle, forming  a  pouch be-
tween these bodies, and also for a short distance
on the fore part of the chord.  Hydrocele is a
collection of serum in the tunica vaginalis.
   Tunica communis, formed by the fibres of tho
cremaster muscle  and ceUular membrane, sur-
rounds the chord and the fore part and sides of
the testicle.

    COMMON COVERINGS  OF BOTH TESTICLES.

   The scrotum, a prolongation of the common in-
tegument, is of brownish colour, slightly studded
with hairs and sebaceous folhcles, presenting in
the median line a  hard  ridge, called the raphe,
from either side of which it is thrown into ruga;.
   The dartos,  composed of elastic  tissue, mixed
with unstriped muscular fibres, is formed by the
subcutaneous ceUular tissue and the ramifications
of numerous bloodvessels, which were formerly 
20S
supposed to give this coat a reddish appearance.
The vermicular or roUing motion of the testicles
is caused by the action of the dartos.
  The superficial fascia Ues immediately under
the dartos, is derived from the superficial fascia
of the abdomen, and is continuous with the su-
perficial fascia of the perineum.
  Septum scroti.—This partition, which divides
the scrotum  into two, is formed by the dartos
and superficial fascia, these membranes being at-
tached to the raphe, and from thence ascending
between the testicles to the urethra.
  Each testicle is supplied with blood by the sper-
matic artery, the blood of which is returned by
the spermatic veins; it receives nerves from the
spermatic plexus, which is formed by branches
from  the renal and aortic plexuses of the sym-
pathetic.
   The spermatic chord is composed of the vas de-
ferens, with  its small artery, derived from the
vesical; the spermatic artery, veins, and nerves;
the genito-crural nerve, the ilio-scrotal nerve, an
artery to the cremaster coming off from the epi-
gastric and absorbents; all of which are  con-
nected to each other by fine cellular tissue, and
are enveloped by fascia and the cremaster mus-
cle.   The chord, thus fonned, extends from the
epididymis to the internal abdominal ring, where
its constituents separate from each other.
   Corpus pampiniforme is  the name given to
the venous plexus formed by the spermatic veins
after  these vessels have escaped from  the testi- 
209
 cles.  The spermatic vein on the  right side en-
 ters the vena cava at an acute angle; on the left
 side, it joins the renal vein at  a right  angle.
 This may be given as one reason why varicocele
 is more common on the left side.
   The vesicula seminales are two oblong flat-
 tened bodies, situated at the inferior fundus of
 the bladder, behind the prostate  gland, and on
 the outer side of the vasa deferentia.  Each semi-
 nal vesicle is about two inches long, and consists
 of a long tortuous membranous tube convoluted
 on itself, the smaU excretory duct of which joins
 its corresponding vas deferens.
   The prostate gland is a flat conoidal body, the
 base being posterior, corresponding to the vesi-
 culae seminales, the apex anterior, corresponding
 to the  vesical  extremity of the urethra.  It is
 divided into three lobes; two lateral, large, and
 united in the mesial line, their union being mark-
 ed by a slight groove; and a third or small lobe,
 situated in the angle between the two lateral
 lobes towards the base of the gland. The pros-
 tate gland is firm and resisting to the touch, and
 composed of numerous foUicles,  with  minute
 ducts, which unite to form larger tubes, the open-
 ings of which,  ten or twelve in number, are on
 the under surface of the urethra, on either side
 of the verumontenum.  Posterior to the base of
 the prostate is a triangular space, bounded on
 each  side by the vasa deferentia, anteriorly by
 the prostate, and posteriorly by the reflection of
the peritoneum.  In  this space the bladder may
                      27 
210
be punctured through the rectum in certain cases
of retention of urine.
  Cowper's glands are two smaU oblong-round
bodies, placed before the prostate gland, and im-
mediately behind the bulb.   They lie below the
layers of the triangular ligament.  The duct of
each gland having run a course of about an inch,
opens into the urethra a little anterior to its bulb.

                 THE  PENIS.
  This organ  consists  of two long cylindrical
bodies, named corpora cavernosa, and a body
named corpus spongiosum, which contains the
urethra, all these parts being connected together
and surrounded by the superficial fascia and the
common integuments.
   The corpora  cavernosa  are  two cylindrical
bodies, united to each other in the mesial line.
They are composed of erectile tissue, vessels and
nerves, surrounded by a dense fibrous covering.
   Each  corpus cavernosum commences by the
crus penis,  which is the narrowest part,  and
which is attached to the rami of the ischium and
pubes, covered by the erector penis muscle.   At
the symphysis pubis both  crura unite, forming
the chief part of the body of the penis, and ter-
minate anteriorly in an obtuse point, to which is
intimately attached the glans penis.
   Septum pectiniforme, a  partition, imperfect,
as its name implies, which corresponds to the
mesial line, and marks the division of the  cor-
pora cavernosa. 
211
   The urethra is a membranous canal, extend-
 ing from the neck of the bladder to the extremi-
 ty of the glans penis, its length and width vary-
 ing according to the erect or collapsed state of
 the organ.  In the latter condition its length is
 from seven to eight inches long, and its calibre
 about three or four lines.  It is lined by mu-
 cous membrane, and is distinguished  into,  1st,
 the prostatic portion, which is an  inch and a
 quarter m length ; 2d, the membranous portion,
 which is about three quarters of an inch long;
 and 3d, the spongy portion, which occupies the
 remainder of its length.
   The corpus spongiosum urethra is a cellulo-
 vascular tube surrounding the urethra, and oc-
 cupying the under mesial line of union of the
 corpora  cavernosa ; it  commences in the bulb
 of the urethra, and extends along the canal to
 its extremity, where it terminates in the glans
 penis, the bulb and glans penis being merely ex-
 pansions of this structure.
   Upon  exposing the  mucous  surface  of  tho
 urethra  by an incision, we observe, 1st, a slit-
 like contraction at the orifice; 2d, behind this a
 dilatation, called fossa navicularis; 3d, the con-
 stant diameter of the canal  until we  arrive at
 the bulb, where it becomes gradually and very
 slightly dilated; forming,  4th, the sinus of the
 bulb;  5th, the  narrowest part of the canal,
 which corresponds to the  membranous portion;
 6th, the  dilatation  corresponding to prostate
gland; and 7th, a contracted  orifice at its ter- 
212
ruination in the bladder.  In the prostatio por-
tion of the urethra, a prominent fold of mucous
membrane, called verumontanum, projects from
its  under surface,  and presents in its  centre a
large lacuna, the sinus pocularis, the orifice of
which is directed forwards.  The verumontanum
is the point to which LaUemand's caustic is to
be applied, in cases of spermatorrhoea,  &c,  at-
tended with great irritability of the urethra. On
either side of the verumontanum the prostatio
sinuses are situated.  Upon the upper surface of
the urethra, from the orifice to the bulb, are the
openings of numerous mucous foUicles,  directed
forwards, the largest of which is about an inch
from the orifice, and is called, from  its size, la-
cuna magna.   This, with the other  mucous fol-
licles, is  often the seat of obstinate  gonorrhoea.
The ducts of  the mucous foUicles open on the
surface of the urethra : the orifices of Cowper's
glands open a little anterior to the sinus of the
bulb, the common ejaculatory  ducts on  either
side of the verumontanum, and the  ducts of tho
prostate in the prostatic sinuses.
  The superficial fascia, which envelopes the
penis, is  derived from that of the abdomen, and
terminates at the corona glandis.  It is strong
where it  passes from the hnea  alba upon the dor-
sum of the penis, forming the suspensory liga-
ment, but is exceedingly deUcate and loose upon
the body of the organ.
  The skin of the penis is remarkably  thin and
loose, and extending for an  indefinite length be- 
213
yond the organ, is  reflected inwards, and intr-
matoly attached to the corona glandis; the loose
fold thus formed being caUed the prepuce. From
the corona glandis it is continued along the
glans until it becomes identified with the mucous
membrane at the orifice of the urethra, having
first  formed the fold which lies  posterior and
inferior to this opening, called franum preputii.
  Glandula odorifera are a  number of smaU
sebaceous glands  which surround the  corona
glandis, and which lie beneath the skin.
 THE FEMALE ORGANS OF GENERATION.
   The ovaries are two ovoidal bodies, placed, one
 on either side of tho womb, in the  duphcatures
 of tho peritoneum, caUed the broad ligaments of
 the uterus.  Each ovary, enveloped by  a white
 fibrous membrane, consists of a pulpy brownish
 grey substance, highly vascular, and containing
 from fifteen to twenty minute vesicles,  each of
 which is composed of a thin membrane contain-
 ing a viscid yeUowish fluid; these are called the
 Graafian vesicles.
  The Fallopian tubes are tho excretory ducts
 of the ovaries;  each is about  four inches  in
 length, and is contained in the broad ligament,
 one extremity being attached to  the  superior
angle  of  the uterus into which it opens by a 
214
small orifice (orificium uterinum),the other being
free, and surrounded by a fringe (corpusfimbria-
tum), in the centre of which is the  peritoneal
aperture (orificium superius)..  At this point the
mucous membrane of the Fallopian tube  com-
municates Avith the serous membrane, the peri-
tonaeum, forming the only exception to the rule,
that the serous membranes are perfect bags or
sacs, and have no opening.
  Tho  uterus is  a  hollow  organ of pyriform
shape, and is distinguished into the fundus, the
body, and cervix.   The  fundus is superior and
posterior, and receives at either angle the Fallo-
pian  tube:  the  body is intermediate between
the fundus and the  neck, the  latter being infe-
rior and anterior, and surrounded by the vagina:
at the extremity of the neck is a small eUiptical
opening, surrounded by a thick margin, which,
from its resemblance to the mouth of a tench,
has been called os tinea, as weU as os uteri. The
cavity of the uterus is small compared  to  tho
thickness of its waUs, and is of triangular shape;
its superior  and outer angles  presenting the  ori-
fices  of the  Fallopian tubes, the  inferior anglo
presenting the os tincae.   The uterus is placed
between the bladder and rectum.
   The vagina is a membrano-vascular tube,  ex-
tending from the neck of the uterus to the  ex-
ternal  outlet, where it is continuous with  the
surface.  It is composed of mucous membrane,
surrounded by cellular tissue, a vascular net-
work, and the sphincter vaginae muscle; its length 
215
 is about four or five inches, its breadth one; but
 being very distensible these measurements vary.
 Its lining  membrane is thrown into transverse
 rugae on its anterior and posterior surface, and
 is studded with the orifices of numerous mucous
 foUicles.   The colour of the membrane  varies,
 at the external orifice being  red, and of a grey
 and sometimes marbled colour as it approaches
 the uterus.
   The mons veneris is a soft adipose eminence,
 situate on the upper and anterior part  of the
 pubes, covered by  common integument, which
 in the adult is thickly set with hairs.
   The vulva is the fissure extending from the
 mons veneris to the perineum.
   The labia magna are large folds of the integu-
 ments which bound the vulva on either side, and
 unite below in acrescentic edge (the four chette).
 They  contain large mucous  glands about the
 centre.
   The clitoris,  a smaU  oblong conical body,
 placed between  the  upper extremities of the
 labia.   It  consists of a structure similar to the
 corpus cavernosum in the male, and arises by
 two crura  from the pubes; these unite to form
 its body, at the extremity of which is placed a
 red protuberance, caUed  the  glans clitoridis,
 over which is thrown a loose fold of integuments
 (the prepuce).
  Meatus urinarius is about half an inch below
tho clitoris.
  Labia parva, or nympha, are two red  cres- 
216
centic  folds of  mucous membrane,  enclosing
erectile tissue; they descend, one on each side,
from the prepuce  of  the clitoris, and are lost
about the centre of the vulva.
  The  Hymen, when it exists, is a crescentic fold
of mucous membrane,  surrounding the sides and
inferior orifice of the vagina.
  The  caruncula myrtiformes are smaU reddish
bodies  surrounding the orifice of the vagina:
they are sometimes described as the remains of
the hymen.

                THE  MAMMAE
are two in number, situated at the anterior and
superior  part of the  thorax, and connected to
the great pectoral  muscles by a capsule of con-
densed ceUular tissue.   Each of these glands, of
a hemispherical  shape,  consists of vessels and
numerous lactiferous tubes, arising from dilated
blind extremities, or ceUs: the tubes are group-
ed together to form lobes and lobules; as they
approach the nipple  they become considerably
dilatod, and form sinuses, but in the nipple they
are again reduced in  size, and terminate  at the
apex by  open orifices surrounded  by delicate
muscular tissue.  The  nipple is a conical process,
surrounded by a brownish areola, and composed
externally of the integuments,  which are very
thin, and internally of the lactiferous tubes, to-
gether with numerous blood-vessels, from which
the nipple  derives its property of  occasional
erection. 
217
         ORGANS OF THE SENSES.

             THE ORGAN OF TOUCH.
   The skin is composed of the cuticle, or epi-
 dermis, the rete mucosum,  and the corion or
 cutis vera.
   The cuticle is composed of epithelium ceUs, of
 which the more superficial are flattened and
 dried; they are deposited in thickest layers upon
 the soles and palms.
   The deepest layer of cells of the cuticle, or
 that which Ues immediately upon the cutis vera,
 is coloured, in the negro and other dark-skinned
 races.   To this coloured layer the name of Rete
 Mucosum has been apphed.  The cuticle with its
 pigment is removed by maceration.
   The corion is a dense strong membrane, con-
 sisting of  fibres interwoven with  each  other,
 which  are  more firmly compacted the nearer
 they are to its outer surface.   Its internal sur-
 face is cellular, its  external very vascular, and
 presenting numerous smaU  conical  papiUao; at
 the extremities of the fingers these papiUao are
 best developed, are furnished with minute nervous
 filaments, and  covered  with very thin cuticle;
thus affording a delioacy of organization neces-
sary for tho greater perfection  of the  sense of
touch.
  The  arrangement of the blood-vessels varies
according to the delicacy of the sense of touch.
  Tho  capillaries of the papfilao end in loops.
                     28 
218
  The skin is studded with  minute hairs, and
with sudoriparous and sebaceous glands.
  The sudoriparous or sweat glands consist of a
convoluted tube, which opening upon the surface
of the cuticle, may be traced downward through
the skin, until it ends in a coil, forming a smaU
rounded body in one of the meshes of the corium.
            THE ORGAN OF SMELL.
  The nose is bounded  superiorly by the nasal,
frontal,  ethmoid, and sphenoid bones; inferiorly
by the palatine plates of the superior maxillary
and palate bones ; externaUy on  either side  by
the superior maxillary, lachrymal, inferior spongy,
ethmoid, and palate bones, and  by the internal
pterygoid plates of the  sphenoid bone.   It is
divided  into the two nares by the septum nasi,
which is formed by  the azygos  process  of the
sphenoid bone, the nasal plate of the ethmoid
bone, the vomer, and the mesial spines  of the
superior maxillary and  palate bones.  Besides
the bony boundaries, the nose presents, anterior-
ly, bve cartilages, which form the anterior nerves
or the nostrils.  The middle vertical cartilage is
of triangular form, and rests in the fissure of the
vomer inferiorly, is attached to the vertical plate
of the ethmoid bone above, and presents ahteri
orly a subcutaneous, free, thick edge, and thus
completes the septum nasi.    The lateral carti
lages which form the wings of the nose are also
triangular, are attached to the superior maxillary 
219
 and nasal bones, and in the median line to the
 vertical cartilage.  The inferior lateral fibro-car-
 tilages are attached to the three cartilages just
 described, are thick  and semicircular, forming,
 with the vertical cartilage, the  anterior-inferior
 oval openings of the nostrils.
   The posterior  nares are of  oval shape, and
 open into the upper part of the pharynx; they
 are separated from each other by the posterior
 free edge of the  vomer, are bounded superiorly
 by the body of the sphenoid bone, inferiorly by
 the palate bones, and externally by the internal
 pterygoid plates of the sphenoid bone.  The ex-
 ternal lateral waU of each nostril, from the ar-
 rangement of the spongy bones, fonns three fossa?,
 caUed meatuses, with which several orifices com-
 municate.
   In the inferior meatus, at the junction of its
 anterior with its midcUe third, is the opening of
 the nasal duct, and posteriorly,  on a level  with
 the inferior spongy bone, is the  opening of the
 Eustachian  tube.   In the middle meatus is the
 slit-like opening of the antrum maxiUare, anterior
 to  which is  the groove caUed infundibulum,
 which leads from the  frontal sinus,  and into
 which open the anterior ethmoidal cells.
  Into  the  superior meatus, the posterior eth-
 moidal cells and the sphenoidal sinus open.  The
 interior of the nose is lined with the Schneide-
 rian membrane,  which  is highly vascular  and
sensitive, and consists of two layers; a fibrous
layer, which is the periosteum, or perichondrium 
220
of the nasal cavities, and  a mucous membrane.
The nerves which supply the nasal cavities are
the  olfactory (which pass through the cribriform
plate of the ethmoid bone), the internal nasal of
the  ophthalmic,   and  branches  derived  from
Meckel's ganglion.

            THE  ORGAN OF TASTE.
  The tongue presents  several papillae  covered
by mucous membrane.  It is of triangular form,
is connected by its base to the  os hyoides, by
folds of mucous membrane to the epiglottis and
palate, and by muscles to the lower jaw.   It is
highly vascular, and receives six nerves, three on
either side, viz. the gustatory branch of tho fifth
for taste, the ninth, or  lingual, for motion, and
the glosso-pharyngeal, the  function of which is
doubtful, but most probably is connected  with
the sense of taste.
  The papillae are of three  orders,—the filiform,
situated at the tip and sides; the fungiform scat-
tered over  the dorsum; the circumvallata) at
the root.

            THE  ORGANS OF VISION
  Consist of the globes of the eyes and their ap-
pendages.  The eye-ball is composed of mem-
branes and fluids, called humours.
  The sclerotic coat, occupying about four-fifths
of the globe, is a strong fibrous  structure, and
thicker behind and anteriorly than in its centre. 
221
 Its outer surface is in contact with the adipose
 tissue of the orbit, the tendinous expansions of
 the muscles of the eye, and anteriorly with the
 conjunctiva;  its inner surface is lined by the
 choroid coat.   It presents posteriorly a smaU
 aperture for the transmission of the optic nerves,
 and an anterior large one, about six or seven
 fines in diameter, for the cornea.
   The cornea, which forms the anterior fifth of
 the globe, is smooth and transparent.  It consists
 of three layers, viz. the conjunctival layer exter-
 naUy, an elastic layer internally, and between
 both, the proper cornea, which is composed of
 fibres connected together by fine cellular tissue.
  The choroid coat is a thin vascular membrane,
 situated between the sclerotic coat and the reti-
 na ; it  extends  from the entrance of the optic
 nerve to the ciliary ligament, to which it is firm-
 ly connected; it is then  directed  inwards, and
 forms the folds called ciliary processes.  Its  in-
 ternal surface is covered by a dark brownish  se-
 cretion, called nigrum pigmentum,.its outer sur-
 face being connected to tho sclerotic coat by fine
 ceUular tissue, and  by the ciliary vessels and
 nerves;  on this surface the veins observe  an
 arched  arrangement, and are  called  vasa vor-
 ticosa.
  Tho ciliary ligament is about a line and a half
in breadth, of a greyish white cellular structure,
and corresponds to the circle of junction of tho
cornea and sclerotic coat externally, and of tho
choroid and iris  internally. 
222
  The ciliary processes  vary in number from
sixty to seventy, and are  productions or continu-
ations  of the choroid coat; each ciliary process
is of a triangular figure, the anterior edge being
attached to the ciliary ligament, the posterior to
the hyaloid membrane, and the internal free pro-
jecting into the posterior  chamber of the aqueous
humour, towards the  lens, but not attached to
this body.
  The Iris is a  circular  membrane placed in a
transverse vertical position, attached by its larger
circumference to the ciliary ligament, floating in
the aqueous humour, and presenting a circular
opening in its centre called the pupil. • It divides
the space between  the anterior surface  of  the
capsule of the lens, and the posterior surface of
the cornea, unequally, into what are termed the
chambers of the aqueous humour, the anterior
chamber being much the largest;  both cham-
bers, however, communicate through the pupil.
The anterior surface of the iris presents a radi-
ated appearance, and varies in colour in different
individuals; the posterior surface is covered by
nigrum pigmentum, and has received the name
of uvea.   The iris  is supplied  by the ciliary
nerves and vessels.
  The retina, placed between the choroid coat
and vitreous humour, consists of three layers, an
external or serous layer, called from its discover-
er  membrana Jacobi,* an internal or vascular

  *  The membrana  Jacobi is not a serous  membrano, but
consists of rod-shaped  bodies possessing high power of
refraction. 
223
 layer,  and between  both the  nervous layer.
 About two Unes on the temporal side of the en-
 trance of the optic nerve the retina presents a
 smaU hole surrounded by a yellow margin called
 the foramen of Sammering, round  which the
 retina is thrown into a fold.
   The aqueous humour is contained in the an-
 terior and posterior chambers of the eye, is per-
 fectly transparent, and is from four to five grains
 in quantity.
   The vitreous humour occupies about the three
 posterior fourths of the eye ;  it is  contained in
 the hyaloid membrane, which not only envelopes
 it, but sends numerous partitions from its inner
 surface to form  ceUs in which this transparent
 fluid  is  deposited.   The vitreous  humour thus
 contained  in its capsule is  convex posteriorly
 and on its lateral circumference, but presents an-
 teriorly a concavity for the reception of the
 crystalline lens; around the  circumference of
 this cavity the vitreous humour presents a striat-
 ed  appearance, caused by the marks of the cili-
 ary processes, to which the term corona ciliaris
 is applied.
  The crystalline lens, enclosed in its capsule
 and placed in the anterior depression of the vi-
 treous humour, is a transparent body, presenting
 an anterior and posterior convex surface, the lat-
ter being the more prominent.  Its  external sur-
face is  soft and pulpy, gradually increasing in
density towards  its centre.
  The capsule of this body, like the lens itself, 
224
is  transparent,  and composed of homogeneous
membrane.
  The lens and its capsule derive their nutriment
from the vessels of the retina.   Opacity of the
lens constitutes cataract.
  Liquor Morgani is a fluid found some hours
after death between the lens and its capsule.
  Canal of Petit.—The  lens is retained in its
situation by the hyaloid membrane, which, split-
ting into two laminae at  its circumference, pass
one anterior the other posterior to its capsule;
a triangular canal is thus  formed, which is inter-
sected by  minute septa; this is the canal of
Petit, and  may be demonstrated by distending
it  with  air, when it  wiU  present a vesicular
appoarance.

         THE APPENDAGES OF  THE EYE.

  The lachrymal gland, placed in the upper and
outer part of the  orbit, behind the external an-
gular process of  the os  frontis, and about  the
size of a small almond, is of greyish color, con-
sists of numerous granules united by an imperfect
capsule,  and pours forth its secretion of tears
by  means  of five or  six minute  ducte, which
open  behind the upper eyelid, in the  angle
formed by the reflection of the conjunctiva.
  Tunica  conjunctiva,  a  mucous  membrane
which lines the interior of each eyelid, and is re-
flected on the anterior  part of the globe of  tho
eye.  At the inner angle of the eye it  forms a 
225
small fold called plica semilunaris,  covers  the
caruncula  lachrymalis,  and  having lined  the
lachrymal sac and. duct becomes continuous with
the mucous membrane of the nose.  The epithe-
lial layer of this membrane is continued over the
cornea.
   Caruncula   lachrymalis,  a smaU  vascular
body  composed  of mucous glands and  ceUu-
lar tissue situated in the  nasal angle of  the
eye, and covered by the  membrana  conjunc-
tiva.
   The palpebra or eyelids, semicircular in form,
are composed of skin externally, which is very
fine, the tunica conjunctiva  internaUy, and  be-
tween both the orbicularis palpebrarum muscle,
the tarsal cartilages and their ligaments, and tho
Meibomian glands, together with blood-vessels,
nerves, and absorbents.
   The superior eyelid, besides being the largest,
has also peculiar to it the levator palpebrae supe-
rioris muscle.
   The tarsal cartilages  are thin  cartilaginous
plates  of a semicircular form, the superior being
the largest; to their convex margins are attached
thepalpebral ligaments.
   The Meibomian glands, of ayeUow colour,  are
very numerous, particularly in tho upper eyelid,
and are arranged in vertical rows.
   The opposed edges of the eyehds are thick,
and are bevelled off obliquely towards the eye,
bo that when closed they only touch at their  an-
terior edges, thus leaving a triangular canal,  the
                     29 
226
base of which is formed by the tunica conjunc-
tiva, along which the tears are conducted to the
puncta lachrymalia.
  The cilia or eye-lashes, attached by their roots
to the opposed margins of the eyelids, observe
a curved arrangement, their convexities looking
towards each other.
  The puncta lachrymalia are the two minute
orifices of the lachrymal canals,  placed within
two or three lines of the nasal terminations of
the eyelids and upon their opposed edges.
  The lachrymal canals, the superior of which
is longer and. curved, the inferior being nearly
straight, lead from the puncta lachrymalia to the
lachrymal sac.
  The lachrymal sac, placed in the fossa formed
by the lachrymal and superior maxillary bones,
behind the fibrous expansion from the tendon of
the orbicularis palpebrarum, is of oval form, re-
ceives the lachrymal secretion by the puncta la-
chrymaha,  and transmits it to the nasal duct,
with which it is connected inferiorly.
  The nasal duct, enclosed  in a bony canal
formed  by the lachrymal,  superior  maxillary,
and inferior spongy bones, passes obliquely down-
wards, backwards and outwards, and terminates
in the inferior meatus of the nose.

          THE ORGAN OF HEARING.

  This organ consists of the external ear, includ-
ing the auricle and  meatus  auditorius externus • 
227
  the middle ear, including the cavity of the tym-
  panum and its appendages;  and the internal ear
  or labyrinth, including the vestibule, semicircular
  canals, and cochlea.
   The external ear consists  of a fibro-cartilagi-
  nous plate covered by skin, and so moulded as to
  form different elevations and depressions, which
  have been described with more minuteness than
  they deserve.
   The helix is the semicircular eminence which
 forms the outline of the external ear.
   The antihelix commences  superiorly by two
 roots, which enclose a fossa (fossa navicularis),
 and is situated inferior to the helix.
   The tragus is an eminence placed anterior and
 inferior to the meatus  externus.
   Tho antitragus is a smaller eminence posterior
 to the meatus externus.
   The  lobule is a pendulous body placed under-
 neath  tho antitragus.
   Tho concha, a deep conoidal cavity which leads
 to the meatus externus, and in which the several
 depressions formed by the eminences just  de-
 scribed terminate.
   The meatus externus is a curved  canal which
leads from the concha to the membrana tynipani;
it is lined  by skin, beneath which are placed
small glands (glandula ceruminosa), which secrete
the ear-wax (cerumen).   The inner half of this
canal is surrounded by  bone.
  The membrana tympani,  separating the exter-
nal from the middle ear, is of oval form,  and 
228
 consists of three layers, viz. the external or cuti-
 cular, the internal or mucous, and between both
 a fibrous layer.   To its inner aspect is attached
 the crus  of the malleus, which, by drawing it
 towards the middle ear, gives it a concave aspect
 externally.'
   The middle ear consists of the cavity of the
 tympanum and the smaU bones of the ear  and
 their muscles.
   The cavity of the tympanum is  an irregular
 cylindrical space, closed externaUy by the  mem-
 brana tympani,  and bounded  interiorly  by a
 bony partition which separates it from the laby-
 rinth. It presents the following eminences and
 foramina, viz. tho promontory, a  convex emi-
 nence situated on its internal  side, and which
 marks the situation of the vestibule;  the fora-
 men ovale, placed above the promontory, and to
 which the base of the stapes is affixed; the fora-
 men rotundum, below the promontory, closed by
 a membrane (lesser tympanum) which separates
 the scala tympani of the cochlea from the cavity
 of the tympanum; the opening of the mastoid
 cells,  situated posteriorly and  superiorly;  the
pyramid,  a bony  projection placed below  tho
 opening of the mastoid cells, hollow within and
 containing the stapedius muscle; a small fora-
 men, below the pyramid for the  transmissjon of
 the chorda tympani nerve; anteriorly  the open-
 ings  of the two bony  canals,  the  superior of
 which lodges the tensor tympani muscle, the in-
 ferior forming the bony part of the Eustachian 
229
tube;  inferiorly is the opening of the Glasserian
fissure, and superiorly are several smaller fora-
mina for blood-vessels.
   The bones of the ear are three in number, very
small, and contained within the cavity of the
tympanum.
   The malleus is divided into the head, which is
smooth and articulates with the incus; the neck,
which is smaU, and connects the head to the shaft;
the handle or shaft, which descends from the
neck, and is attached to  the membrana tympani;
and the processus gracilis, which passes from the
neck to the Glasserian fissure.
   The incus is divided into its body, which pre-
sents  a cup-like  cavity for the head  of the mal-
leus ;  a superior crus, which is short and lies in
the mastoid cells; and a long crus, to the extre-
mity  of  which  is attached a small process of
bone, considered by some as a distinct bone, and
called os orbiculare.
   The stapes  presents a smaU head, which is
attached to the orbicular process; a short neck;
two curved crura, which terminate  in the base;
and the base itself, which is of oval shape and
connected tothe foramen ovale.
   The internal ear or labyrinth contains—
   1. The vestibule, placed behind the cochlea and
before the semicircular canals.  It is  a smaU oval
cavity lined  by a membrane common to  tho
labyrinth, contains a watery fluid,  and presents
the foUowing openings;  viz. the  foramen ovale,
the five orifices  of the  semicircular canals,  tho 
230
 orifice of  the  scala  vestibuli of  the cochlea,
 and the orifice of the aqueduct  of the vesti-
 bule.
   2. The semicircular canals, placed behind the
 vestibule, are three in number, two vertical and
 one horizontal; of the former, one is superior,
 and the other posterior.  The openings of these
 canals are only five in number, in consequence of
 one opening of the vertical canals being common
 to both.
   3. The cochlea, of conical form, the base towards
 the internal meatus, the apex towards the caro-
 tid canal, is composed of  a bony  tube  which
 makes twro  turns and a half round  a central pil-
 lar called the modiolus.   This tube is  divided
 longitudinally by  a thin  plate, half bony half
 membraneous, called  lamina spiralis, into two
 independent cavities; the two tubes thus formed
 are called the scalae of the cochlea, they both
 unite at the apex in a cavity caUed  infundibu-
 lum, and at the  base of the  cochlea they sepa-
 rate,  one called scala vestibuli, which opens
 into the vestibule,  the other called  scala tym-
pani, which opens into the  tympanum by the
 foramen rotundum.    From the scala tympani
 proceeds a narrow bony canal called the aque-
 duct of the cochlea, which terminates  in a slit-
 like opening in the inferior border of the petrous
 bone.
  4. The auditory nerve gains the internal ear by
 the minute foramina at the base of the  meatus
 auditorius internus, and is expanded in the form 
231
of soft pulpy filaments in the cochlea and ves-
tibule.
        THE ABSORBENT SYSTEM.

   Comprehends—1st, the vessels which convey
 the lymph and chyle into the veins, and 2d, the
 enlargements which occur in their course caUed
 glands or ganglia.
   The lacteal or chyliferous vessels commence on
 the villi of the mucous surface of the intestines, pass
 through the mesenteric  glands backwards  to-
 wards the spine, where  they terminate in the
 thoracic duct.
   The lymphatic vessels are found in most situa-
 tions of the body, and generally observe a deep
 and superficial arrangement.
   Lymphatics  of the lower extremities.—The
 superficial set accompany the external and inter-
 nal saphena  veins: they communicate freely in
 their course with the deep lymphatic trunks
 which accompany the deep vessels.  Those which
 accompany the external saphena vein enter the
 glands in the popliteal space, whilst those accom-
 panying the internal saphena vein ascend to tho
 groin and pass through the inguinal glands, hav-
ing formed numerous connections  with  the su-
perficial lymphatics of the abdomen, tho perine-
um, and the genitals.   The deep lymphatics of
tho hip and perineum  are conducted by the
branches of the internal  iliac  vessels  into the 
232
 pelvis,  and  pass through the pelvic  glands.
 From the inguinal and pelvic glands the lympha-
 tics pass through the iliac vessels to the recepta-
 culum chyli.
   The  Thoracic Duct.—This  canal commences
 by a dilatation caUed receptaculum chyli, placed
 on the body of  the second  lumbar vertebra;
 passing between the crura  of  tho diaphragm it
 gains the posterior mediastinum, where  it lies
 between the  aorta and tho  vena azygos;  at the
 fourth dorsal vertebra it crosses the spine oblique-
 ly to the left side, passing behind the oesophagus
 and arch of the aorta, and placed behind the left
 pleura and between the left carotid and left sub-
 clavian arteries:  it  is then conducted by the
 oesophagus to the left side of the neck as high as
 the sixth  cervical  vertebra, where, making a
 slight curve downwards and outwards, it opens
 close to the external angle formed by the left sub-
 clavian  and jugular veins.
   Lymphatics of the  upper  extremities.—Tho
 superficial  set accompany  the superficial veins,
 and pass through  two or three glands situated at
 the inner condyle; having joined the deep lym-
 phatics  which accompany the venae comites, they
 proceed onwards to the axilla,  and pass through
 the axillary glands; following the course of the
axiUary vein, they pass beneath the clavicle, join
the lymphatics of the neck, and terminate in the
thoracic duct. The lymphatics of the right up-
per extremity  and right  side of the  neck
unite  to  form  the right or lesser thoracic 
233
 duct, which opens into tho right vena innomi-
 nate.
   The lymphatics of the trunk consist of a deep
 and superficial set; in the chest the former are
 seated  between the muscles and pleura, in the
 abdomen between the muscles and peritoneum,
 the superficial being subcutaneous.   The viscera
 contained in the chest and abdomen also have a
 superficial and deep layer of lymphatics, the deep
 being distributed through the  peculiar tissue of
 each organ, the superficial running beneath the
 membranous envelope.
   Lymphatics have been seen in the membranes,
 but not in tho proper substance of the brain and
 spinal cord.


     PECULIARITIES OF THE FCETUS.

   The principal anatomical peculiarities of the
 foetus, by which it is distinguished from the adult,
 are the following:—
   The thymus gland occupies the anterior medi-
 astinum,—the kidneys are lobulated, and each is
 covered by a ceUulo-vascular body called Renal
capsule, which is larger than the kidney itself,—
the liver is very large, particularly its left lobe,
—the lungs are compact,  of a deep red colour,
and sink  in water, the bronchial tubes and their
ramifications being void of air,—the auricles  of
the heart communicate with the foramen ovale,
—at the bifurcation of the pulmonary artery an
                     30 
234
arterial trunk about nine lines in length, called
ductus  arteriosus, proceeds to the  aorta,  into
which vessel it opens,—the umbilical vein pro-
ceeds to the hver, where having distributed some
branches to its left lobe, it divides into the com-
municating branch, which unites into the portal
vein, and  the ductus venosus, which opens into
the vena cava inferior,—the internal iliac arte-
ries, under the name of umbilical or hypogas-
tric, turn  upwards and forwards along the sides
of the bladder, pass through the umbilicus,  and
run a  tortuous course along the umbilical vein
to the placenta,—and the urinary bladder is in
the abdominal part of the pelvis, from the sum-
mit of which a ligamentous cord, called urachus,
passes to the umbilicus.   Until the seventh month
the pupU is closed by a membrane, called mem-
brana pupillaris, and in the male the testes are
contained  in the abdomen.
              CERVICAL FASCIA.
   The superficial fascia is  thin and consists of
two layers, between which are placed the fibres
of the platysma myoides.   Tho deep fascia binds
down and invests the muscles of the neck.  It is
a strong, dense, pearly  white structure, attached
behind to the spines of the cervical vertebrae, in
front to the mesial line, and below to  the clavi-
cle and sternum;  above it is connected with the
jaw and parotid  gland; and it senda  a process
from tho styloid process to tho angle  of the 
235
jaw known as the stylo-maxiUary ligament. The
sterno-mastoid, the omo-hyoid, and the subcla-
vius muscles, receive complete sheaths from it.
  The carotid artery, pneumogastric nerve, and
the internal jugular vein, with its accompanying
chain of lymphatic glands, are contained in  a
sheath,  which lies underneath the deep cervical
fascia.  These glands sometimes become greatly
enlarged, and form either benign  or  malignant
tumours, which are bound down firmly by this
strong, resisting fascia.
               THE FASCLE.
     SUPERFICIAL FASCIA OF THE ABDOMEN
passes downwards from the thorax over the ab-
dominal muscles and Poupart's hgament to the
thigh. In the median line it passes off the pubes
upon the penis, forming its suspensory ligament,
and in the female it descends into the labia.  In
the male it passes on either side round the  sper-
matic cord into the scrotum, and becomes con-
tinuous with the fascia of the perinaeum.  After
having passed over Poupart's ligament it forms
envelopes for the inguinal glands and adheres to
the fascia lata, presenting a  cribriform appear-
ance  (vide  Fascia lata); and continuing its
course downwards becomes  identified  with the
subcutaneous ceUular  tissue of the  lower ex-
tremities. 
236
   FASCIA TRANSVERSALIS  AND FA8CIA  ILIACA.
   The fascia transversalis is placed between the
transversalis muscle and the peritoneum; it is
very strong inferiorly, and is connected to the
internal lip of the ilium and to the whole length
of Poupart's ligament, and is continuous, behind
the rectus muscle, with the fascia of the opposite
side.  As the external iliac vessels are passing
beneath Poupart's ligament, a production of this
fascia extends along the anterior aspect of their
sheath, and becomes identified with the cribri-
form fascia in the groin.  The spermatic chord in
the male, and the round ligament in the female,
pass through a foramen in this fascia about half
an inch above  Poupart's ligament, and midway
between the spine of the ilium and the symphy-
sis pubis; this opening is the internal abdomi-
nal ring;  from its margin is prolonged over the
cord a funnel-shaped process, called the infundi-
buliform fascia.  The fascia transversalis fonns a
covering  in  aU  the  varieties  of abdominaj
hernia.
   The fascia iliaca is much stronger than the
fascia transversalis; it  is connected to the inner
lip of the ilium, passes  over the iliacus internus
muscle, adheres  to Poupart's  ligament, from
which it passes behind the sheath of the femoral
vessels into the thigh, and is connected with tho
capsule of the hip-joint and the pubic portion of
the fascia lata.    The  processes  of fascia trans-
versalis and fascia iliaca, passing one in front and 
237
the other behind the femoral vessels, and uniting
at the outer  and inner border, form the sheath
of tho vessels.  Femoral  hernia is covered by
the  sheath of the vessels heie described.   The
fascia iliaca continued into the pelvis  becomes
the pelvic fascia; it lines the parietes of this cavi-
ty as far as the upper origin of the levator  ani
muscle, where it divides  into two  layers; one
layer  (the outer)  called the  obturator fascia,
descends between the obturator internus muscle
and the levator ani, and is inserted into the great
sciatic ligament, the tuberosity of the  ischium,
and pubes.   The internal layer of the pelvic fas
cia,  called also vesical fascia,  passes downwards
along the inner surface of the levator ani muscle
to the inferior margin of the  symphysis pubis,
from which it is reflected  on  the prostate gland
and neck of the bladder, forming the  anterior
true ligament of the bladder, and laterally it
is reflected on the sides  of this viscus, fonmng
its true lateral  ligaments.   This vesical fascia
passing from the side of the  prostate and blad-
der to the side of the pelvis, forms the " pelvic
partition."
        SUPERFICIAL PERINEAL FASCIA
strongly adheres to the rami of the ischium and
pubes of  either  side,  and  extends across the
perinaeum, being continuous anteriorly with the
superficial fascia of the scrotum derived from the
superficial fascia of the abdomen.  At the central 
238
tendinous point of the perinaeum,, it passes back-
wards to join the anterior layer of the triangular
ligament.  In cases of rupture of tho urethra,
this fascia prevents the urine from passing out-
wards upon the groin and thigh; while it allows
it to mount upwards, in the loose cellular tissue
of the scrotum, which it often entirely destroys.

   TRIANGULAR LIGAMENT OF THE URETHRA.
  The triangular ligament between the rami of
the pubes is  an interosseous ligament, like the
membrane filling up the obturator foramen; it is
connected,  on either  side, to  the rami of the
ischium and pubes, its base looking towards the
rectum, its  apex towards the sub-pubic ligament;
it is pierced by the membranous portion of the
urethra, which passes through the hgament about
three quarters of an inch below the pubes.  It
consists of two layers, between which are situat-
ed the artery of the bulb and Cowper's  glands;
one layer (the anterior) is expanded on the bulb,
keeping  that body  in  its situation; the other
(the posterior) is continued along the  membra-
nous portion of the urethra to the prostate gland,
forms its capsule, and becomes continuous on the
bladder with the vesical layer of the fascia iliaca.
The ligament is sometimes caUed the deep peri-
neal fascia.  Urine, when it escapes  from the
urethra,  lies  under the superficial fascia,  and
makes its way into the scrotum.  It cannot make
its way into the thigh, on account of the attach- 
239
 ment of the superficial fascia to the rami of the
 ischia and pubes.  Tho triangular Ugament ex-
 tends for a very Uttle distance below the urethra.
 In the female it is smaUer than in the male.

          FASCIA OF  UPPER EXTREMITY
 consists of tenchnous fibres, which are stronger
 in some situations than others;  it invests the
 entire arm, and sends partitions between the seve-
 ral muscles. It takes its origin superiorly from the
 spine of the scapula, adheres to the condyles of
 the humerus, and to the ridges which lead to
 them; passes from thence on the forearm, where
 it is very strong, particularly at its posterior part,
 and, binding down the  several muscles, reaches
 the wrist-joint, to the annular ligaments of which
 it is connected.
   The palmar fascia, of triangular form, is very
 strong, and takes its origin from the anterior
 annular ligament;  from this it expands over the
 palm, and near the fingers divides into four fas-
 ciculi, each of which is forked and inserted into
 either side of the sheaths of the flexor tendons,
 and into the ligaments of the first  phalanges. ,_

                FASCIA LATA.

  The fascia lata takes its origin from the crest
of the  ihum, the spines of the sacrum, tho os
coccygis, Poupart's ligament, the tuberosity of
the ischium, and the rami of the ischium  and 
240
pubes.  From this extensive connexion it extends
down  the thigh, confining the different muscles
in their situation, and also sending partitions be-
tween them.  At the posterior part of the thigh
it adheres intimately to the linea aspera, and at
the knee-joint to the condyles of the femur; it
is then continued over the heads of the tibia and
fibula, to which it adheres and forms the fascia
of the leg.
   Upon the anterior and upper part of the thigh,
the fascia lata, from its special arrangement, has
been divided into the  iliac and  pubic portions,
and about an  inch  and a half below Poupart's
ligament, and between the iliac  and pubic por-
tions, it presents the opening for the saphena vein.
This opening  is semilunar, the concavity being
directed towards Poupart's hgament; it presents
an internal  and external cornu, and its edge,
turning inwards on itself, becomes continuous
with the sheath of the femoral vessels.
   The pubic portion of the fascia lata covers the
pectineus  muscle, adheres to  the spine  of the
pubes and the Unea Ueo-pectinea, passes  behind
the sheath of  the femoral vessels, and becomes
continuous with the fascia iliaca.
   The iliac portion of the fascia lata covers the
sartorius, tensor vaginae femoris,  rectus and iliac
muscles, and presents, towards the pubic portion,
a crescentic or falciform edge, the aspect of which
is directed downwards and  inwards; the  infe-
rior cornu of  this edge is continuous with the
outer cornu  of the saphenic opening, and its su- 
241
 perior cornu extends along Poupart's ligaments,
 crosses the femoral vessels, and is  inserted into
 Gimbernat's hgament, and the linea ileo-pectinea;
 the upper  part  of the  falciform edge is caUed
 Hey's ligament.
   The cribriform fascia.  The superficial fascia,
 in passing over Poupart's ligament to the groin,
 adheres to the crescentic edge of the fascia lata,
 and to the edge of the saphenous opening, and is
 attached to that layer of the fascia transversalis
 which passes anterior to the sheath of the femoral
 vessels; this portion  of  the superficial  fascia is
 perforated by numerous  smaU bloodvessels, and
■ by the anterior superficial absorbents of the limb,
 which gives  it, when  dissected, a cribriform
 appearance, from which  it derives its name.
   The fascia of the leg  adheres to the heads of
 the tibia and fibula, and to the spine of the
 tibia, to the annular Ugaments of the ankle-joint,
 and to the maUeoU; it binds down  the muscles
 sends  partitions between them, which pass from
 its posterior surface to the bones  of the leg  and
 interosseous membrane,  and from  the anterior
 annular ligament it is continued  thin upon the
 dorsum of the foot.
   The plantar fascia is very strong, and arises
from the under aspect of the os calcis, is attached
to the sides  of tarsus and metatarsus, and sends
two processes between the muscles of the sole of
the foot, dividing them into an internal, a middle,
and an external set.   At the base of the toes it
divides into five  portions, each of which bifur-
                     31 
242
cates, and is inserted by two  fasciculi into the
lateral ligaments  of the joints,  and into the
sheaths of the  flexor tendons.   This fascia  is
strengthened by transverse fibres.
              THE LARYNX. '

  Besides the muscles, vessels, nerves, and mu-
cous membrane which enter into the formation of
the larynx, there are four cartilages and one
fibro-cartilage.
  The thyroid cartilage,  the largest, presents
anteriorly a prominent  angle  called  pomum
Adami, which is formed by the meeting of its alae.
Each  ala is of quadrilateral fonn and presents
posteriorly two cornua; the superior cornu is the
longest, and is connected  to the great cornu of
the os hyoides by the thyro-hyoid ligament; the
lesser, or inferior cornu, being connected to the
side of the cricoid cartilage  by synovial  mem-
brane and Ugaments.
   The upper margin of each ala is connected to
the os hyoides by the thyro-hyoid  membrane,
the inferior margin being connected  to the cri-
coid  cartilage  by the crico-thyroid  membrane,
which is of yeUow colour and elastic; the outer
surface of each is rough,  and divided unequally
by an obfique ridge, the inner  surface being
smooth and covered by mucous membrane.
   The cricoid cartilage is next in size, and forms 
243
a ring ;  it is narrow before and deep behind; its
inferior edge is connected to the first ring of the
trachea; its superior edge, anteriorly, is connect-
ed by the crico-thyroid ligament to  the thyroid
cartilage; posteriorly  it supports  the  arytenoid
cartilages; its inner surface is covered by mucous
membrane, and its outer surface  is rough, and
presents posteriorly a vertical ridge for the at-
tachment of muscles.   The operation  of Laryn-
gotomy is performed in  the  space between the
thyroid and cricoid cartilages.  The  crico-thy-
roid membrane, which is formed of yellow elastic
tissue, must be incised transversely.
  The arytenoid ea/rtilages, two in number, and
of triangular shape, are the smaUest:  the apex
of each is surmounted  by a  smaU  moveable
cartilaginous appendix; the base, concave, moves
upon  the cricoid cartilage ; the posterior surface,
concave, lodges the arytenoid muscles, the exter-
nal edge is convex for the attachment of muscles,
and the inner  edge is  flat.  The apex  of each is
connected to the epiglottis by a fold of mucous
membrane called the aryteno-epiglottidean fold,
and the base is connected to the cricoid cartilage
by synovial membrane and ligament.
  The epiglottis, resembling in form an artichoke
leaf, or rather  the lateral half of  the  kernel  of
the butternut,  is connected by a stalk-like pro-
cess to the angle of the thyroid cartilage; ante-
riorly it is attached to  the body of the os hyoides
by cellular tissue and mucous membrane, and  to
the base of the tongue by three folds of mucous 
214
membrane, the  central one of which is  called
franum epiglottidis;  posteriorly  extend  the
aryteno-epiglottidean folds of mucous membrane.
The dangerous disease, oedema of the larynx, is
situated in the loose cellular tissue of these folds
and of that of the surrounding parts.  It is here
that scarification may be employed, according to
the plan of Dr. Gurdon Buck of New York.
   The  glottis is the  superior opening of the
larynx, and is of triangular form, its base being
anterior, formed by the epiglottis, its apex pos-
terior and inferior,  formed by the  appendices of
the arytenoid cartilages, and its side formed by
the aryteno-epiglottidean folds.
   The rima  glottidis is also of triangular form,
and placed beneath the glottis: the base is poste-
 rior, is  formed by the bases of the arytenoid
 cartilages; the apex is anterior, corresponding to
 the angle formed  by  the ahe  of the thyroid
 cartilage; and the sides are formed by  the infe-
 rior or true  chordae vocales.
   The  chorda vocales, two on either side, arise
 from the anterior aspect of the  arytenoid carti-
 lages, and approaching each other are inserted
 into the angle formed by the alae of the thyroid
 cartilage: the superior is semilunar, the inferior
 horizontal,  and between  the vocal chords of
 either side is a  smaU oval fossa, caUed the ven-
 tricle of the larynx; from the ventricle a pouch
 extends upwards between the thyroid  cartilage
 and the superior  vocal chord; it is called the
 sacculus laryngis. 
245
          THE THYROID BODY,

of a reddish-brown colour, consists of two lateral
lobes and a connecting middle lobe.  The lateral
lobes are placed by the sides of the trachea and
larynx, and the middle lobe rests upon the ante-
rior aspect of the two or three first rings of the
trachea.  Each lateral lobe is of pyriform shape,
the base inferior, and the apex ascending to the
thyroid cartilage;  both lateral lobes overlap the
carotid vessels, the inferior thyroid artery, and
the recurrent nerve, and  are  covered by the
sterno-hyoid,  sterno-thyroid,  and  omo-hyoid
muscles, the cervical  fascia, and the integuments.
This body or gland is supplied with blood by the
superior thyroid arteries from the external caro-
tid, the inferior thyroid arteries from the thyroid
axis, which is a branch of the subclavian artery,
and sometimes by an artery from the arteria
innominata, or  from the aorta  itself, caUed the
middle thyroid artery; its blood is returned by
the thyroid veins, which descending on the ante-
rior aspect of the trachea empty themselves into
the left vena innominata.   No excretory duct
has been discovered emerging from this body.
The names of Goitre  and Bronchocele, have usu-
ally been given to enlargement of the  thyroid
gland. 
24G
                 HERNIA.

  Before commencing the study of Inguinal, and
more  especially that of Femoral Hernia, it is
absolutely necessary, that the student should be
weU acquainted with the anatomy of the os
innominatum, and particularly with that of  the
pubic and iliac portions of that bone.   It is also
of great advantage  to obtain a pelvis, upon
which Poupart's ligament is well preserved, with
that portion of it to which the name of Gimber-
nat has been applied.   The distance  from  the
anterior superior spinous process of the ilium to
the symphisis pubis, in most subjects, is about
six  inches.  The Spine of the pubes  is an inch
and a quarter from the symphysis.   From  this
spine, a sharp ridge or border extends obliquely
backwards and outwards, and is caUed the Unea
ileo-pectinea, and which in the subject is covered
bya ligamentous expansion—an inch and a quarter,
on  the outside of  the  spine of the  pubes,  is  a
depression on the upper face of the bone, upon
which we find the femoral absorbents, the femoral
vein, and outside of the vein, the femoral artery.
  Poupart's ligament extends from the anterior
superior  spinous  process  to the spine  of  the
pubes, where it is  inserted; a portion of  this
ligament extends backwards and  inwards, and  is
inserted into the hnea  ileo-pectinea.   This  is
called Gimbernat's ligament.  It presents exter-
nally a sharp lunated border, which looks towards
the femoral vein. 
247
                   HERNIA.
   Hernia is a protrusion of an organ from the
 cavity in which it is naturally placed.   All  the
 great cavities of the body, as that of the cranium,
 thorax, abdomen, and pelvis, are lined by a serous
 membrane, which is protruded before the organ,
 as it is  escaping from its cavity, and is caUed
 the hernial sac.   Hernia may therefore occur
 from any of the great  cavities; but for several
 reasons is most commonly met with in the region
 of the abdomen.   To understand the  nature of
 abdominal hernia, it is necessary to consider the
 structure of the walls of the abdomen, and  the
 organs contained in that cavity.   In looking on
 the inside of the anterior wall of the  abdomen,
 we find it smooth and polished, which appearance
 is due to the serous  lining* or peritoneum.   On
 stripping off this membrane we expose  to view a
 strong, dense white fascia, the fascia transversa-
 lis, so called because  it lines the posterior surface
 of the transversalis muscle. This fascia is of very
 great extent; commencing below, we find it
 attached to the whole  extent of Poupart's liga-
 ment, to the internal Up of the crest of the ilium;
 it becomes weak and thinner towards  the linea
 alba; superiorly it may be traced  as high as the
 diaphragm.  From the great extent of surface of
 this membrane, lining as it does the whole ante-
 rior  and muscular wall  of the abdomen,  and
 having the peritoneum attached to its posterior
surface,  it is evident that any organ or viscus 
218
which tends to push the peritoneum before it,
must  also  protrude  the fascia  transversalis.
This fascia therefore  must necessarily form  a
covering to aU kinds of abdominal hernia.  The
next layer, passing from within outwards, is the
muscular waU of the abdomen, consisting of five
pair of muscles with their tendons, their fibres
running in various directions,  some downwards,
some  upwards,- and others transversely, while
some  again are  arranged vertically.   By the
decussation of these fibres in so many various
directions, the muscular  and  tendinous waU of
the abdomen is rendered very strong and resist-
ing ; and were it as much so in aU points as has
been described, it is difficult to conceive how a
hernia could ever take place. Upon the outer sur-
face of the muscles we find the superficial fascia
and fat, and upon this the skin.   The posterior
wall of the abdomen  is formed by the  lumbar
vertebrae, psoas  magnus quadrates lumborum,
and superiorly the abdominal  cavity is bounded
by  the  diaphragm,  inferiorly it communicates
with  that of the pelvis.   The  viscera of the
abdomen, which are most likely to protrude and
form hernial  tumors,  are those which  are en-
dowed with the greatest mobility.   Accordingly
we find that the smaU and large intestines, and
the omentum, are most frequently found in hernial
protrusions.  In a few rare casts,  nearly all the
viscera have been seen in a hernial sac, with the
exception of the kidneys, pancreas,and duodenum.
From the description of the great strength of 
249
 the muscular, tendinous, and fascial structures,
 entering  into the formation  of the abdominal
 Avail, it might be asked, how is it ever possible
 for hernia to occur ?  We shall find that it does
 so only at certain points, which are congenitelly
 defective, or which are weakened by the transit
 of  certain organs, which  in their progress of
 development  are  necessarily obliged  to pass
 through the  anterior abdominal wall.   It now
 becomes necessary to examine the situation and
 nature of these various openings, from which the
 different varieties of hernia protrude.
  If a hernial tumour presents at the superior
 part of the groin, above Poupart's ligament, pass-
 ing down in the scrotum and towards the testicle,
 it is called Inguinal Hernia.  If the tumour shall
 have followed the course of the spermatic cord,
 it is caUed oblique;  if  it has not  done so,  but
 passed directly out of the cavity of the abdomen,
 passing out of the external  ring, it is then  called
 direct Inguinal Hernia.  The anatomy of Hernia
 can never be comprehended, without  a careful
 dissection of the dead body.   The  mode  of
 making  the  dissection  will therefore  here  be
described, and in the simplest manner, for the
 benefit of those who  are just entering upon their
 anatomical studies.  A block being placed  under
the loins  of the  subject, and the thighs widely
separated, the legs lying over each side of  the
table, make an incision from the umbilicus  to the
symphysis pubis, another from the umbilicus out-
wards towards tho lumbar vertebrae.  This inci-
                      32 
250
sion should be made  carefuUy through the skin
and superficial fascia, down to the tendon of the
external oblique.   The superficial fascia should
be cautiously raised  from the tendon,  and the
flap dissected  back  towards the crest  of the
Uium;  when some of the muscular fibres of the
external oblique will be displayed.  On approach-
ing Poupart's hgament, the superficial fascia will
be found  closely adhering  to  it,  and  can be
separated  or detached  with tho handle of the
knife; the superficial fascia is formed of condens-
ed ceUular tissue and fat, and has several smaU
vessels ramifying in its substance.  The  tendon
of the  external obhque  is now fairly exposed;
the direction of its fibres is downwards;  at the
upper  part  of  the groin, the tendon becomes
thickened, and  forms a  strong tendinous band,
called  Poupart's ligament, which extends from
the anterior superior spinous process of the ihum,
to the spine of the pubes.   A rounded reddish
cord is seen emerging from the abdomen through
an opening in the tendon of the external obhque.
This cord is the spermatic cord, which consists
of the vas  deferens, which is the excretory duct of
the testicle; the spermatic artery and vein, the
cremasteric  artery,  the  artery of the  vas
deferens, the nerves  of  the  testicle, the absorb-
ents, and the cremaster muscle, which covers or
is spread out over the other constituents  of the
cord.  The opening in the external obfique tendon,
through which the cord passes, is the  external
abdominal ring. A thin fascia proceeds from the 
251
 edges of the ring, downwards upon the cord, and
 is caUed intercolumnar fascia.  When this fascia
 is dissected away, the ring and cremaster become
 distinctly seen.  The " ring " is now seen not to
 be circular, but triangular.
   The portion of tendon which passes above the
 cord is called  the superior column of the ring; it
 passes over the symphysis  pubis, and interlaces
 Avith its feUow of the opposite side.   The portion
 of tendon passing below the cord is inserted with
 Poupart's ligament into the spine of the pubes,
 and is called the inferior column of the ring.  It
 is  often important,  as in  the  examination of
 recruits for  the army or navy, &c, to ascertain
 Avhether a tendency to a hernia exists, and there-
 fore to know the  exact place  at which such
 tumour Avill protrude, or  in  other words the
 situation of the external ring.  This is about one
 inch or an  inch and a quarter from the centre
 of the symphysis pubis, and may be easily found,
 by  grasping  the  cord with  the  fingers and
 thumb, and tracing it up to the ring.  It now
 becomes necessary to trace the course of the cord,
 from the ring upwards, and  to ascertain the rela-
 tion of the surrounding parts to it.   An incision
 is to be made through the external oblique ten-
 don, commencing  near the outer extremity or
attachment  of Poupart's ligament, and carried
parallel with the ligament (and about a quarter
of an inch above it) almost to the external ring,
but so as to preserve the ring, and then turning
suddenly upwards towards the median line. 
252
  The flap is then to be  raised, when the mus-
cular fibres of the internal oblique are brought
into view, as well as the  fibres of the cremaster,
which originate from it, and also from Poupart's
ligament.  The muscular fibres  of the internal
oblique  and transversalis arise from  the outer
half of Poupart's ligament, arch over the cord, and
their fibres become united, forming the conjoined
tendon, Avhich passes inwards and downwards,
and is inserted  into the linea ileD-pectinea, and
into Gimbernat's  hgament, hereafter to be des-
cribed.  If the internal oblique and transversalis
are now carefully detached from Poupart's liga-
ment, the fascia transversalis is seen as a  dense
whitish membrane,  the  muscle3 may be stiU
further raised up,  when the fascia can  be  traced
to the outer edge  of  the  cord, and from  thence
to  the edge of  the  rectus  muscle,  gradually
becoming very thin and delicate towards the
median line.  On first inspection the cord appears
to pass through an opening in the fascia trans-
versalis ; this point is called the internal abdo-
minal ring, and is just half Avay between the
anterior  superior  spinous process of the  ilium
and the symphysis  pubis, and half  an inch
above Poupart's ligament.   The ring, however, is
not an opening, but a  funnel-shaped process of
the fascia, sent down upon the  cord;  and it  is
in  this funnel  that  the  hernia engages  as  it
descends. 
253
   COVERINGS OF OBLIQUE INGUINAL HERNIA.
   As the intestine or  omentum protrudes from
 the abdomen, it pushes' before it:  1. The peri-
 toneum.  2. It enters  the funnel-like process of
 the fascia transversalis, and  is covered  by it.
 3. It passes under the fibres of the cremaster, and
 is covered by that muscle.  4.  It is next invested
 by the  intercolumnar fascia.  5.  Its last or
 external covering is from the superficial fascia
 and skin.

          OF THE EPIGASTRIC  ARTERY.
   This artery is a branch of the external iliac,
 and is given off from it close to the upper margin
 of Poupart's ligament, and sometimes behind it.
 At first it passes slightly downwards, then up-
 wards and inwards, toAvards the edge of the rectus
 muscle, to which  it sends many branches.  It
 inosculates Avith the internal mammary.  It lies
 on the inner edge of the internal abdominal ring
 and behind the fascia transversalis; consequently
 Avhen tho intestine descends in oblique hernia,
following necessarily the course of the cord, it
must push the epigastric artery to the inside.

           OF THE INGUINAL CANAL.
  This  is merely the space  which the  cord
occupies between   the external  and  internal
abdominal rings.  Anteriorly, it is bounded by
the tendon of the external oblique, posteriorly, 
254
 by the conjoined tendon and fascia transversalis,
 and inferiorly by the upper grooved border of
 Poupart's ligament.   The obhquity of this canal
 is a considerable  protection against  the  occur-
 rence of hernia, which Avould doubtless have been
 much more frequent had the cord passed directly
 from the  cavity  of the abdomen.   When the
 abdominal muscles are  in  strong action they
 act as a valve pressing together the sides  of the
 inguinal canal,  and thus tend  to prevent the
 descent of the viscera.

           DIRECT INGUINAL  HERNIA.
   The conjoined tendon formed by the internal
 oblique and transversalis muscles,  passes behind
 the outer edge of the rectus muscle, to be insert-
 ed into the linea ileo-pectinea, and into Gimber-
 nat's ligament.   This conjoined tendon is closely
 attached to the inner portion of the fascia trans-
 versalis,  or in  other words-to  that  part of it
 which extends from the inner margin of the
 internal ring, inwards toAvards the  rectus muscle,
 and dowmvards towards the pubes.   This close
 attachment of the conjoined tendon to the inner
 portion of the transversalis is of great importance,
 as preventing the occurrence of direct hernia,
 inasmuch as the  powerfid  contraction of the
 internal oblique and transversalis upon the con-
joined  tendon  tightens and braces the  fascia
 transversalis, to  Avhich it is  attached.  On ex-
 amination  it wiU  be  found, that the conjoined 
255
 tendon and fascia transversalis close up and pro-
 tect a triangular space, between the  epigastric
 artery, the outer edge of the rectus, and the
 pubes below.   In most subjects, this combination
 of fascia and  tendon is strong enough to  resist
 the tendency of the viscera to protrude  when
 violently compressed by the abdominal muscles;
 but in some subjects, these parts are naturaUy
 imperfect, or so weak as to be incapable of resist-
 ance to the passage of a hernial tumour.  When
 this protrudes through this  deficiency in the
 conjoined tendon and fascia it affords an example
 of direct inguinal  hernia.  As we trace the
 progress of the hernia,  we find that it continues
 to descend to the external ring, through which
 it passes, receiving as it goes through that ring,
 the intercolumnar fascia, and then the superficial
 fascia and skin.  It wiU thus be seen, that this
 variety of hernia is weU named, inasmuch as its
 course is straight forwards or direct, from the
 deficiency in the conjoined tendon to the external
 ring. It differs from oblique inguinal hernia, as it
 leaves the cord to the outside, and is not covered
 by the cremaster—as it  passes down, it pushes or
 leaves the epigastric artery to the outside.   The
 form of the direct  hernial tumour is generally
 rounded,that of the oblique most usuaUy pyriforru.

   COVERINGS OF A  DIRECT INGUINAL  HERNIA.
   1. The peritoneum.  2. The fascia transver-
saUs.   3. Intercolumnar fascia.  4. Superficial
fascia and skin. 
>o 6
               OF THE STRICTURE.
   1. The stricture may be caused by the external
 abdominal ring.  2.  By the constricting edges
 of the  internal oblique  and transversalis mus-
 cles, where they arch over the cord.  3.  By the
 edges of the opening in the conjoined tendon.
 4. More frequently at the  internal ring, or in
 the  neck of the sac itself.  In aU cases of stran-
 gulated hernia, it is safest to divide the stricture
 directly upwards.
                    TAXIS.
   The patient should  lie upon his back, a pillow
 should be placed under the  pelvis and another
 under the shoulders, the thighs should be raised
 to a right angle Avith the body, and the knees
 brought  close together.   In applying the taxis
 in oblique  hernia, the pressure  On the tumour
 must be made in the direction of the course of
 the cord or towards the anterior superior process
of the ilium.   In direct hernia, the pressure may
be made directly  upwards  and  backwards  in
accordance Avith  the direction in which  the
hernia came down.   In using the taxis, great
gentleness and caution are to be observed.

              FEMORAL HERNIA.

  Supposing  that the  dissection for inguinal
hernia has been made on the left side, continue
the incision from the spine  of the pubes down-
AA'ards for five inches in a perpendicular direc- 
257
 tion, from the termination of which, a second
 incision is to be made across the fore part of the
 thigh so as to alloW a flap of the superficial fascia
 and  skin  to be  reflected outwards!  In raising
 up the superficial fascia, the fascia lata, on which
 it reposes, will be exposed.   This must be done
 with caution, so as to avoid injuring the saphena
 vein,  or the fascia  lata—frequently using  the
 handle  of the knife to separate the parts.   A
 number of lymphatic glands or vessels, and small
 arteries  and  veins, are involved in  the layers of
 the superficial fascia.  Commence the separation
 of the superficial fascia from the fascia lata; from
 the inner portion of Poupart's ligament and  the
 pubic part of the fascia lata;  loAver  down, find
 the saphena  vein, separate the superficial fascia
 from the vein, which is to be left, reposing upon
 the fascia lata.  This vein passes  up from  the
 inner part of the foot and leg, to join the femo-
 ral vein at  tho  upper and inner  part of  the
 thigh.
  By noAv gently pushing Avith tho handle of the
 knife on the  pubic side of the  fascia  late, from
 above downwards and inwards, upwards under
 the vein, and upAvards and to  the outside of it,
 we bring into view a  lunated edge of an opening
 in the fascia lata.   This edge or border is to be
 carefully traced upAvards  and outAvards; when,
if wo continue cautiously to separate  as  before,
it will have the appearance of a falciform mar-
gin or process, passing up to be inserted into the
inner portion  of Poupart's ligament.  The lunated
                     33 
25s
and falciform edges or borders above described,
will be found to form the margin of an opening
in the fascia lata for the passage of the saphena
vein, and hence caUed the saphenous opening.
   The femoral  artery and vein, side by side, lie
in a sheath of areolar or ceUular tissue of con-
siderable thickness, which  occupies the  saphe-
nous opening.   The femoral vein is on the inside
of the artery.   This sheath is closely connected
with  the superficial fascia  of the groin  which
covers over the saphenous  opening, adhering
closely to its margin.  This superficial  fascia is
now to be removed from the saphenous opening,
but in such manner as to leave a large portion
of ceUular and  adipose tissue,  covering the
vessels, and Avhich in fact constitutes the ante-
rior part of the sheath of the vessels above men-
tioned.
  The fascia lata is now seen as a dense, strong,
fibrous membrane, covering the muscles on the
upper  portion  of  the thigh.   Its outer part, or
iliacportion, is attached to the crest of the ileum,
and to the whole inferior border of Poupart's
ligament, and is on a  higher plane than the
pubic  portion, which is attached to the  symphy-
sis, spine of the pubes, and linea ileo-pectinea.
By extending the thigh and throwing it strongly
outwards, Poupart's  ligament  and the  upper
portion of the fascia lata are  put strongly upon
the stretcli.  On the other hand, by flexing the
thighs towards  the abdomen and turning the
knee  inwards, the same parts become greatly 
259
relaxed.   This fact is important to be  remem-
bered in the reduction of hernia.
  The abdomen may now be opened by cutting
in the Une of the first median and transverse
incisions into that cavity.  The peritoneum may
now be  cautiously  separated  from the  fascia
transversalis, beginning on the outside, near the
middle of the crest of the ihum, and passing
inwards towards  the median line.  The fascia
transversalis is attached to the crest of the ilium,
to the  whole extent  of Poupart's ligament, and
can be traced under Poupart's ligament to become
continuous with the  cellular and adipose tissue
which covers the femoral artery and vein, as they
lie  in the saphenous opening.   The peritonaeum
is iioav to be detached from the parts in the iliac
fossa, Avhen a strong pearly white fascia is ex-
posed  which  is called the fascia iliaca.  The
fascia  iliaca  covers  over the psoas magnus and
iliacus internus muscles; it is attached to the
inner lip of the crest of the ilium where  it meets
the transversalis fascia  in a  seam;  also in  a
similar manner it is attached to the outer half
of Poupart's ligament; it then passes underneath
the external  iliac artery and  vein, these  vessels
reposing upon it.  It can noAV be  traced, under
Poupart's ligament, becoming  continuous with
the pubic portion of the  fascia lata of the thigh.
The fascia transversalis dips doAvn  on the  inside
of Gimbernat's ligament to join the fascia iliaca.
It wiU thus be seen that by the fascia transver-
salis, passing down from the abdomen over the 
260
anterior surface of the  femoral  vessels as they
pass under Poupart's  ligament, and by the  pas-
sage of the fascia iliaca underneath these vessels,
a large  funnel-like sheath is formed, in which
the  vessels are enclosed, and Avhich  is called
the  '■'•sheath of the  vessels,"  or the '■'■femoral
sheath."1,1  The  finger  may now  be inserted on
the inside of the external iliac vein between the
vein and the sharp lunated border of Gimbernat's
ligament, when it will easily pass into an open-
ing called the femoral ring.  The finger is now
in the funnel-like sheath of the vessels, and by a
little pressure passes easily under Poupart's liga-
ment, stiU covered by tho anterior part of  the
sheath which was left on the vessels when  the
superficial  faseia  was removed  from over  the
saphenous opening.   It  is through the femoral
ring that  a femoral  hernia descends from  the
abdomen,  passing down into the femoral sheath,
pushing the anterior layer of the sheath (which
is  the fascia transversalis) before it, and then
emerging from  the saphenous opening upon  the
anterior and upper portion of the thigh, where
it  is then  covered by the superficial fascia and
skin.  While the finger  is in the ring, it Avill be
found to  pa^s  most  readily  downwards  and
forwards, Avhich is the general course of a femo-
ral hernia,  sometimes  turning  upwards over
Poupart's  ligament;   Avhile the  finger of  an
assistant is passed  into the  ring and  femoral
sheath, this last may be opened, to understand
more readily how the sheath envelops or encloses 
261
 the hernia.   The fascia iliaca may now be raised
 up from the  iliacus internus and psoas  magnus
 muscles, and cut away from its attachment to
 the crest of the ilium and Poupart's ligament.
 The fossa  of the iliac bone will be seen to be
 filled up by the above named muscles; next Ave
 find passing towards  the  median line,  the  ex-
 ternal iliac artery, next the external iliac vein,
 then  the femoral ring; after that we come to
 the lunated border of Gimbernat's ligament.   We
 thus  perceive  that all the space between  the
 anterior superior spinous  process of the ilium
 and the femoral ring, and between the iliac fossa
 and Poupart's ligament, is  occupied  by  muscles
 and by the femoral vessels,  and strengthened by
 the meeting together of the fascia transversalis
 and fascia  iliaca (in a seam) from the crest of
 the ilium to the outer side of the external iliac
 artery.  As the fascia transversaUs passes down
 upon  the vessels, and while under Poupart's
 ligament, it sends down a partition or septum of
 fascia, between  the external iliac  artery  and
 vein,  and another, which  passes down  on  the
 inside of the vein, forming the outer waU of the
femoral ring.  The inner wall of this ring or
opening is  formed  by a septum or partition of
fascia, passing downwards from the fascia trans-
versalis to the fascia iliaca, and lining tho lunate
border of Gimbernat's ligament.   It thus becomes
evident that the parts Avhich separate and shut
the abdomen from  the thigh, are so arranged
that there  is only one place  where femoral 
262
hernia is likely to occur, and that is at the point
already designated as the femoral ring.   In the
natural condition of the parts this ring is occu-
pied by a small absorbent gland, lymphatic3,
and  a  smaU quantity of cellular and  adipose
tissue.

          OF THE EPIGASTRIC ARTERY.

  This artery ordinarily arises from the external
iliac close  to the upper margin  of  or behind
Poupart's ligament.   Its course is at first slightly
downwards, then upwards and inwards, to  the
outer border of the  rectus muscle.  When a
femoral hernia descends, the epigastric is pushed
to the outer side of the hernial tumour.  Occa-
sionally the obturator, instead of  coming off, as
it usually does, from the internal iliac, arises by
a common  trunk with the epigastric from the
external iliac; and in such cases the hernia is
almost  encircled  by the  artery.   This  variety
is said by Cloquet and others to  occur once in
about three or four cases : but in the majority
of instances  the tumour, in its descent, would
probably  evade the  artery,  which  would  be
pushed  to the outside  and beloAV the hernia.
The possibility, however, of the hernia becoming
encircled by the artery should  always be kept
in mind, and should suggest great  caution in
dividing the stricture, cutting or rather nicking
it only so much as is just sufficient  to liberate
the constricted part. 
263
               OF TnE STRICTURE.
   A femoral  hernia may be constricted.   1. In
 the femoral sheath and by the falciform edge of
 the fascia lata, as it passes up to be inserted into
 Gimbernat's ligament. 2. By the posterior edge
 of Poupart's hgament.  3. More frequently in the
 neck of the  sac itself.  As the hernia passes
 through the femoral ring It is greatly constricted,
 this  ring being  bounded  on the inside by the
 sharp lunated border of Gimbernat's ligament,
 superiorly  by  the  posterior  edge of  Pouparts
 ligament, inferiorly by the fibrous  covering of
 the os 2jubis and pubic portion of the fascia lata,
 while tho  outer  boundary is the femoral vein;
 and it  is only in this direction that  the  ring,
 admits  of  much dilatation.   As  the  hernial
 tumour  is  nearly  surrounded  by  dense   and
 fibrous tissues, delay in relieving the strangula-
 tion is  more dangerous than in inguinal hernia.

      COVERINGS OF A FEMORAL HERNIA.
   As it descends, entering the femoral ring, it
 pushes  before  it—1.  The peritoneum.  2.  A
 smaU lymphatic gland, absorbent vessels, ceUular
 tissue, and fat, Avhich  fiU up the femoral  ring,
 and  together  constitute what  has been called
the septum crurale.  3. The transversalis fascia,
or the anterior AvaU of  the funnel-like or femoral
sheath.   4. The superficial fascia and skin.
                   TAXIS.
  In applying the taxis the abdominal muscles 
261
must be relaxed as much as possible, the thighs
are flexed towards the abdomen, the knees turned
inwards.  The hernia should be pressed gently
backwards, as it were  into  the thigh, and then
upwards.  If it  has turned up  over Poupart's
ligament, it  must  be carefully disengaged from
it, brought down, and then  pressed  backwards
and upwards  as  before.   Femoral hernia  is
usually very smaU,  especially when recent.   It
is often  mistaken  for an  enlarged  lymphatic
gland, and such errors are not unfrequently fatal.
If a patient, and  especially a feinale, is seized
with nausea and vomiting, pain in the abdomen,
and obstinate constipation, the possibility of tho
existence of a strangulated hernia should never
be forgotten, and the necessity of an  immediate
and  careful  examination of the points where
hernia (and particularly femoral) may  occur,
should be insisted upon.  From false  motives  of
delicacy, but more frequently from  ignorance,
an examination has not been made; or if so, the
tumour, which is  generally small, if recent, has
been mistaken for a lymphatic gland, and poulti-
ces have sometimes been applied to what Avas
supposed to be  a suppurating tumour,  which
being opened  by an incision, faeces Avere  dis-
charged from the wound, the patient dying soon
afterwards.  Another very  dangerous  error  is
that of mistaking  crural for  inguinal  hernia,
inasmuch as the mode of applying the taxis and
of operating, is essentiaUy different in the two
kinds of hernia. 
265
  Diagnosis.—-The neck of the hernial tumour
is situated above Poupart's ligament in inguinal
hernia.  In femoral hernia it is below, and if the
tumour is drawn down in femoral  hernia, Pou-
part's ligament may be traced above 'it.  The
neck of the tumour in inguinal hernia is above
the spine of the pubes, that of femoral hernia is
below and to  its outside.  Femoral hernia  may
also be mistaken for psoas abscess, and for other
diseases, but the history of the case and a careful
examination of the parts wiU generaUy suffice to
determine the character of the disease.
  The student may now remove the ceUular and
adipose tissue from the femoral artery and vein,
in such manner as  to  get a  clearer and more
distinct view of  the saphenous opening.  He
may then remove all  the cellular and adipose
tissue from the vessels, above and under Pou-
part's hgament,  when he-wiU obtain a more
perfect idea of Gimbernat's ligament, and of the
manner in which the fascia  ihaca  passes under
the great vessels to become continuous Avith the
pubic portion of the fascia lata.
  The  parts  in  hernia should be carefuUy and
repeatedly dissected, and may be compared with
the description  here given.   The knowledge
obtained from reading alone  is worse than use-
less, and it would be much better for the student
never to read a  word upon  hernia until, with
scalpel in hand, and his book open before him, he
commences his dissection upon the  subject
                     34 
 
               SELECTIONS FROM

 S. S. &  W.  WOOD'SjyiEDICAL CATALOGUE.

                    Just published,
           CLINICAL LEC1URES ON THE

  §i$mm    of   Wlamu   atiir   Clrilta.

             Bt G. 8. BEDFORD, M.D.,
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         Children, and Clinical Midwifery, in the
               University of New York.
          Price $2 75 by  mail, free of postage.
   "It is fuU of  practical precepts, and discusses, with *he
 ability of a master, the various diseases  incident to women
 and children.'"—New York  Evening Post.


         IJrinripIes   at  ppolrxp.

   Designed for the use of Schools, Academies, Colleges, and
 the general reader.  Comprising a familiar explanation of the
 structure and functions of the organs of man, illustrated by
 comparative reference to those of the inferior  animals.
                        Also,
      An Essay on the Preservation of Health,
 With fourteen quarto plates, and over eighty engravings on
 wood, making in all nearly 200 figures.
   By J.  C. COMSTOCK and B. M. COMINGS, M.D.
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 Jl  tot §00lt 0f  IJrattital ^naiamg.
      By ROBERT HARRISON, M.D., M.R.S.A.
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 160 engravings.
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                                               i
S. S. & W. Wood's Medical Catalogue.
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          IN HEALTH  AND  DISEASE.

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Hill Hassall, M.B., Member of the Royal College of Surgeons
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  "Theroos'.      '.ete in this department."—Nelson's Ame-
rican Lancet.
  "It is magnificently published.  It is the only complete
work oi the kind in the English language, and reflects nigh
credit upon its learned and indefatigable author."—Southern
Medical and Surgical Journal.
          $ljt  guulin  jjEJissettioi;

     OR  MANUAL  OF  ANATOMY.
  Comprising a description of the Bones, Muscles, Vessels,
Nerves, and Viscera; also the relative anatomy of the dif-
ferent regions of the  human  body, with the Elements of
Pathology.
         By ROBERT HARRISON, A.M., M.B.
  Professor of Anatomy in the Royal College of Surgeons in
Ireland, &c.  Third edition,  with  additions  by Robert
Watts, Jr., M.D., Professor of Anatomy in the College of
Burgeons, New York.
  "A work of such sterling merit may well be the companion
of every student in the dissecting room."—Penin. Journal of'
Medicine.
  "Its descriptions are clear and accurate, and its instruc-
tions to the dissector are such as to make tho most advan-
tageous use of material."—Buffalo Medical Journal* 
«'t .. qiflj. 
NATIONAL LIBRARY OF MEDICINE










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