MAMMARY GLANDS. 
mary, and there is generally a large vessel 
entering the pectoral or costal surface of the 
_ breast and sending its branches through the 
gland to meet the others upon the surface of 
the organ. The branches from the axillary are 
given off by the superior and long thoracic 
_ arteries; those from the internal mammary are 
_ either derived directly from that vessel or from 
_ its intercostal branches. “ The arteries upon 
_ the cutaneous surface of the breast are lodged 
in the festoons formed by the ligamenta sus- 
_ pensoria, and proceed to the nipple. There 
their extreme branches pass each other at the 
_ base of the nipple. They send branches for- 
_ wards from the base to the apex of the nipple, 
_ which are parallel to each other and divide into 
_ Yery minute branches which supply the papille 
: and the ducts. They also send branches from 
_ the base of the nipple backwards into the 
_ gland at its centre, and they freely anastomose 
_ with those arteries which enter the back of the 
gland, and they then distribute their ramifica- 
_ tions to its substance.” 
__ Veins.—“ The branches of the veins arising 
_ from the nipple pass from its papille in parallel 
_ branches to its’ base, and then form radii to an 
_ ellipse behind the areola at its margin.” Their 
minute divisions in the papille with the cor- 
responding divisions of the artery constitute 
the erectile tissues. From the ellipsis of veins 
four principal branches proceed, beside others 
which are less important: these are distri- 
_ buted on the fore part of the breast, forming a 
_ net-work by their free anastomoses. 
4 They terminate, 1st, by two large branches 
in the axillary vein, and by several branches in 
_ the vein accompanying the arteria thoracica 
_ longa; 2d, in the cephalic; 3d, in the internal 
-Mammary vein by branches which pass between 
g cither the first and second or the second and 
_ third ribs; 4th, by a deep-seated vein which 
_ enters the fourth mammary intercostal vein ; 
_ 5th, a plexus of veins passes over the clavicle 
to terminate in the external jugular and sub- 
clayian veins. 
Nerves.—These are derived from the dorsal 
_ division of the spinal cord. The third dorsal 
nerve descends upon the vessels which are distri- 
_ buted to the nipple and gland, the fourth and 
fifth are distributed directly to the breast, and 
_ the sixth sends some filaments upon the extre- 
_Mities of those arteries which have passed the 
_ nipple, but which send branches into the gland. 
_ It also receives a supply from the grand sym- 
_ pathetic nerve. 
Absorbents.—These vessels are described by 
Sir Astley Cooper as follows :— 
“ These vessels always exist in great numbers 
in the breast, and when the gland is in a state 
of lactation they are readily injected and 
demonstrated. 
“They are divided into a superficial and 
deep-seated order. The first are cutaneous 
and are most connected with the nipple and 
the mucous glands of the skin, and the second 
arise from the interior of the glandular and 
secretory structure of the mamma. 
“The superficial arise from the nipple, 
249 
and they pass principally upon the surface of 
the gland, behind the skin, Opts axillary 
side. 
“ In my injections I find them as follows :— 
“ First, they pass upon and then under the 
superficial fascia, and between it and the 
aponeurosis of the pectoral muscle. They are 
next continued over the intercostal muscles. 
“ Here they enter the absorbent or cribriform 
Opening, or sometimes there are two openings 
in the fascia axilla, as it there passes from the 
edge of the pectoralis major to that of the teres 
major and latissimus dorsi muscles, and which 
fascia shuts up and forms the floor of the 
axilla. 
“« Having passed through this fascia into the 
axilla they enter the first set of axillary absorb- 
ent glands, and form a considerable plexus of 
absorbent vessels between them. 
“‘ They then rather descend to the third and 
fourth ribs to enter another set of absorbent 
glands, which are placed between the third and 
fourth ribs and second and third intercostal 
spaces, and they then ascend to the second 
rib. 
“ Here they form a large and elaborate 
plexus upon the axillary vein, from one to two 
inches below the clavicle, and reaching the first 
rib they again enter absorbent glands. 
“« From these glands, situated upon the first 
rib, an absorbent trunk is formed, of the size of 
a large crow-quill, which is placed close to the 
inner side of the axillary vein and between the 
first rib and the clavicle, and this absorbent 
trunk terminates at the angle formed between 
the right jugular and right subclavian vein, 
where the absorbents of the right arm and those 
of the right side of the neck also end in the 
veins. 
“ There is an opening formed for this vessel 
under the costo-clavicular ligament with a 
distinct margin on each side. 
“ The place of termination of the absorbents 
in the vein is a little above and behind a line 
drawn from the middle of the clavicle above 
the first rib. 
“On the left side the absorbents of the 
breast form a similar absorbent trunk, which 
terminates at the angle of the left jugular and 
subclavian veins, at which angle the thoracic 
duct also ends. 
“ Besides this course of the absorbents from 
the breast and through the axilla there are 
other absorbent vessels which pass behind the 
axillary vein, artery, and axillary plexus of 
nerves to join the absorbents of the arm. They 
also pass through several absorbent glands, and 
ascending before the axillary plexus of nerves, 
they mount behind the clavicle and before the 
axillary bloodvessels, to terminate on each side 
at the angle of the jugular and subclavian 
veins. 8 
“« Thus there are two courses of the absorbents 
from the breast through the axilla; one internal 
to the bloodvessels and between them and the 
ribs ; the other, which is more external, joins 
the absorbents of the arm, and passing behind 
the vessels and nerves of the arm, then crosses 
