GENERAL ACCOUNT OF THE GREAT VEIN OF THE ARM. 321 



brachial veins which has been opened by the same puncture, 

 SO as to receive the blood of the artery and transmit it exter- 

 nally through the ve7ia communicans into the superficial veins 

 at the bend of the arm, which form then an elongated pulsa- 

 tory tumor. Both punctures made with the lancet through 

 the median basilic vein, healing up in this case without forming 

 a communication with the artery. A patient presenting this 

 form of disease is now under my care. By pressing with the 

 finger between the place of puncture of the lancet, and the 

 outer end of the vena communicans which is usually below the 

 former, the pulsation of the veins above is arrested. This con- 

 stitutes one means of diagnosis of a peculiar form of aneurysm, 

 which sometimes gives rise to serious results, when meddled 

 with by the usual form of operation. — 



There are frequently two other branches of the basilic vein. 

 One, which is small, passes down on the ulnar side of the 

 anterior part of the fore-arm, but does not extend to the wrist. 

 The other passes down on the ulna, and gradually proceeds to 

 the back of the hand, when it divides into several branches, 

 one of which is generally appropriated to the little finger. 



The Axillary vein, after the Basilic leaves it, sometimes 

 divides into two branches, and sometimes continues undivided. 

 In either case it accompanies the humeral artery, and takes the 

 name of Humeral Vein or Veins. It sends off branches which 

 correspond to those of the artery, and continues to the bend of 

 the elbow ; here it is so divided, that two of its ramifications 

 accompany each of the three arteries of the fore-arm. These 

 ramifications sometimes communicate with each other by 

 anastomosing branches near the elbow, and they communicate 

 also with the superficial veins. 



The superficial veins of the arm are so different in different subjects, that a 

 general description will rarely apply accurately to an individual case. It 

 may, however, be observed that a Cephalic vein will generally be found, 

 which very frequently arises from the subclavian instead of the axillary, and 

 commonly continues to the hand on the radial side of the arm. The super- 

 ficial veins, on the ulnar side of the fore-arm very frequently are branches 

 of a large vein which accompanies the humeral artery to the elbow, namely, 

 the basilic ; but the median vein, formed by branches of the cephalic and 

 basilic veins, is very often not to be found. 



