VOL. XXIII. ] PHILOSOPHICAL TRANSACTIONS. 687 



and firmly tied above the aneurism; and if it afterwards happen, as it has fre- 

 quently been known, that the flux of blood to the aneurism in the artery is 

 not very much abated, though the artery has been tied above, the operator in 

 that case must make another ligature on the trunk of the artery below its aneu- 

 rism ; these collateral communications of the trunk of the artery at the bend- 

 ing of the cubit, preserve the circulation of the blood in the cubit and hand, 

 though the trunk be totally compressed both above and below, and the same 

 trunk afterwards divided between those ligatures ; hence it is, if one ligature 

 made above the wound in the artery is not sufficient, but the blood still pours 

 out from below, the patient will sooner recover the action and strength of the 

 muscles of the cubit, than those in whom the upper ligature proves sufficient ; 

 the reason of which is obvious to any who consider, that the communicant 

 branches must be larger where the lower ligature is required, than when the 

 superior ligature only is sufficient ; these communicant branches, as I have seen 

 them in some subjects, are here marked out in pricked lines. — While these 

 papers were lying by me, the two following instances happened, in which the 

 communications of the large trunks of the arteries of the cubit and arm were 

 remarkable. The first was, a boy of 13 years of age, who, about 3 weeks 

 before I saw him, received a wound near the middle of the cubit in which the 

 trunk of the artery (marke'd -j-) was divided. The surgeon who was first called 

 had frequently bound up the wound, and put a stop to the several discharges of 

 blood, amounting to 6 or 7 quarts at times, but not without a compress on 

 the trunk of the artery, above the wound. Ou another impetuous flux I vas 

 called ; but seeing no small quantity of blood discharged, I was contented to 

 let the wound be bound up, in the same manner as it had been done before ; 

 omitting the compress on the trunk of the artery above, and adding a piece of 

 deal-board, on which the hand and cubit were fastened, to prevent any motions 

 of those parts, as well as of the fingers ; 3 days after, the applications were 

 taken off:, and little or no blood appeared; but 2 or 3 hours were scarcely 

 elapsed before I was alarmed with notice of a fresh flux ; the by-standers being- 

 instructed in that case to compress the trunk of the artery above the cubit, they 

 had thereby prevented no small efflision of blood, which must otherwise have 

 happened; his surgeon being out of the way, I laid the trunk of the artery 

 bare above the wound as expeditiously as I could, being forced more than once 

 to let loose the compress above to discover its orifice by the flux of blood; I 

 passed a needle with strong waxed thread under the artery, and made a ligature 

 on its trunk, which lay concealed in the interstice of the muMnilus flexor digi- 

 torum, and the musculus ulnaris flexor carpi ; but notwithstanding this ligature 

 on the trunk of the artery above the wound, the blood still flowed from the 



