256 TRANSACTIONS OF THE [May 18, 
forating the Coraco-brachialis, passes first between the 3d and 
4th additional heads, and subsequently turns down to lie be- 
tween the accessory heads, a short distance above their junction 
with the tendon of insertion, and the Brachialis anticus. 
The semilunar fascia is well developed, scattered fibres ex- 
tending up over the brachial artery as high as the internal 
epicondyle. 
This case only differs from the preceding one in the separa- 
tion of the fourth accessory head from the Coraco-brachialis. 
3. g, Germany, aet. 62. November 29, 1894. 
Plate XLII. Right upper extremity. 
A combination of an additional gleno-ulnar head with inter- 
mediate pectoral tendon attachment, and a fourth internal hu- 
meral head, arising between the Coraco-brachialis and Brachialis 
anticus. 
The insertion is peculiar. The radial tendon is formed by the 
long head (gleno-radial) and by the deep portion of the coracoid 
and additional internal humeral heads (coraco-radial). The re- 
maining superficial portion of the regular coracoid and of the 
internal humeral head (coraco-ulnar) is joined by the entire ad- 
ditional glenoid muscle (gleno-ulnar) and passes superficially 
inward into a strong tendinous semilunar fascia which is well 
separated from the radial tendon. 
4. , U. S. white, aet. 63. November 7, 1894. 
Plate XLIII. Right upper extremity. 
The gleno-radial and gleno-ulnar heads are well defined at 
their origin, fusing before meeting the coracoid segment. The 
4th head is derived from the outer margin of the regular 
coracoid head (coraco-radial?), 5 cm. below level of lesser 
tuberosity, as a slender slip, about 10 cm. long, which joins the 
inner margin of the glenoid portion, before the latter fuses with 
the main coracoid muscle. 
5. 2, U.S. white, aet. 26. November 28, 1894. 
Plate XLIV. Left upper extremity. 
A,third internal humeral head arises from the shaft of the 
humerus at the Coraco-brachialis insertion and joins the regular 
coracoid head along its ulnar margin, 2.5 cm. above the level of 
the elbow. (Coraco-radial and Coraco-ulnar). 
The fourth head (gleno-ulnar) is derived from the long ten- 
don, along its outer margin, under cover of the Pectoralis, by a 
tendon which becomes muscular at the lower border of the 
pectoral tendon and fuses about the middle of the arm with the 
external and anterior part of the Brachialis anticus. 
Macalister * has found a similar slip once. 
-* Op. cit., p. 83. 
