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interfering with the comfort, if not with the 
health, of the entire system. 
_ It is composed of two bones, the tibia and 
4 la, with accompanying masses of muscles 
before and behind, which act upon the 
If we divide the leg into anterior, external, 
and posterior regions, we find in the anterior 
‘the tibialis anticus muscle, the extensor com- 
munis digitorum, extensor proprius pollicis, 
and peroneus tertius; in the external region, 
the peroneus longus and brevis; and poste- 
, the two gastrocnemii, popliteus, plantaris, 
is posticus, flexor longus digitorum, and 
exor longus pollicis. Among these are run- 
ag the anterior and posterior tibial and pero- 
arteries, with their accompanying veins, 
lerves, and absorbents; all these bound toge- 
her, and supported by strong fascial coverings, 
d enveloped in the general integument. Be- 
_ tween this and the fasciz just mentioned, is an 
‘important layer of cellular tissue, (fascia super- 
 ficialis,) enclosing the two saphene veins, major 
and minor, and the superficial nerves and ab- 
sorbents. 
It may be well to make some few obser- 
Pitone upon the external form and characters 
_ of the leg, before describing the deeper seated 
parts. The leg, comprising all that part of the 
er extremity between the knee above and 
the ankle below, is somewhat of a conoidal 
tapering figure, rather flattened on its anterior 
and outer aspect, full and round posteriorly. 
This shape renders permanent compression by 
means of a bandage very difficult. The con- 
traction of the gastrocnemii, especially during 
walking, rarely fails in a short time to separate 
the turns of the bandage below, causing the 
_ lower ones to overlap each other, and producing 
constriction, irritation, and excoriation of the 
_ skin, above the malleoli. If this difficulty 
| were more considered, and the importance of 
the bandage in diseases of the leg duly appre- 
ciated, we should see more pains taken in ac- 
_ quiring the art of its application than is now 
common ; though we are happy to find that the 
minor operations of surgery are now beginning 
9 receive much more attention than formerly, 
and to form a part of the general system of 
demonstrative instruction. Assuredly the ag- 
gregate amount of suffering relieved would be 
far greater by attention to these minutie of 
_ surgery, than by the more striking, though not 
more important details of operations, which to 
__ the mass of practitioners can occur but seldom, 
| ifatall. 
_ The projection of the muscles at the back 
part of the leg, produced by the two gastro- 
_ enemii, and known under the name of the calf, 
forms a characteristic peculiar to man. No 
_ inferior animal possesses it, not even the ourang 
outang ; and the feeble and uncertain gait of 
_ these animals, when in the erect position, at 
once demonstrates the value of the muscles of 
the calf of the leg, and that this position is 
natural only to man himself. The form and 
expression of this part of the leg varies much 
_ according to age, sex, and general habit. In 
Seafancy the gastrocnemii, in common with the 
ef 
= 
| 
REGIONS OF THE LEG. 
127 
developement of the whole lower extremity, 
are small and feeble. The upper extremities 
are, in early infancy, even larger than the lower; 
these latter do not acquire their full growth 
and proportions till adult age. In the female, 
the general form of the leg is less marked and 
prominent, and more rounded than in the male, 
while, in this last, the leg presents every pos- 
sible variety of proportion, according as habits 
of exercise on foot, robust health, or long conti- 
nued sickness, has invigorated or enfeebled the 
muscular system at large, or this portion of it 
in particular. The broad and rounded surface 
of the calf of the leg is contracting as it de- 
scends, and at the lower part projects like a 
kind of cord, representing the tendo Achillis. 
In contraction, the calf shows two portions, 
marked out by a double fissure, which indi- 
cates the situation wher the gastrocnemius 
join the soleus, the lower elevation being 
formed by this last muscle, which extends 
lower down the leg than the gastrocnemius. 
This projection of the soleus is in some much 
more marked than in others, and is indicative of 
considerable power when it reaches lower down, 
much more so than when the whole prominence. 
of the calf is high up. In persons celebrated 
for pedestrian powers we have observed this 
projection of the soleus in a marked degree. 
In the anterior region of the leg, the form is 
considerably flatter than in the posterior, and 
narrows as we proceed downwards, at the 
lower part becoming almost round. During 
extension of the foot, this region is marked by 
longitudinal elevations and depressions, indi- 
cative of the situations of the, muscles, and: of 
the connecting portions of aponeurosis. An 
examination of these points will assist us in 
cutting down upon the arteries here, as the 
depressions mark the exact boundaries of the 
muscles, being produced by the aponeurotic 
processes, which dip between them. 
The integument of the anterior region, gene- 
rally covered with hair in man, and of a some- 
what dense structure, enjoys sufficient mobility 
to admit of wounds being united by the first 
intention, provided the loss of substance be 
not great. Not being very extensible, abscesses, 
tumours, &c., have great difficulty in projecting 
externally in front of the limb, and consequently 
for the most part remain more or less flattened. 
The posterior part of the leg has an integument 
more soft and elastic, and possessing fewer 
hairs than the anterior, particularly on the inner 
side. The position of the skin, with relation 
to the parts which it covers, occasions a marked 
difference in the mode of repaizing the ravages 
of extensive ulcerations or sloughings. On 
the front and outer part of the leg, where the 
skin is somewhat stretched over the tibia and 
fibula, the process of cicatrization can only 
draw together the sound parts to ‘a small de- 
gree. In consequence the healing process is 
slower in completion, and the cicatrix less de- 
pressed in proportion than when it is situated 
posteriorly. On the contrary, in this latter 
situation, the skin being stretched only over 
soft parts, when a considerable portion of it has 
been destroyed, the contractile force of the new 
