64 Anatomy Applied to Medicine and Surgery. 



radial to form the cephalic vein. The communication, 

 above referred to, of the superficial with the deep veins 

 is of great importance in connection with the operation of 

 phlebotomy, as will be seen presently, and the veins, on 

 which this operation is usually performed, are the median 

 basilic and the median cephalic. The median basilic is 

 larger and more fixed than the median cephalic, and for 

 these reasons it is generally the one selected from which 

 to bleed, in spite of its close relationship to the brachial 

 artery, which, running beneath it and separated from it 

 by the bicipital fascia only, is in danger of being wounded 

 if the operation be carelessly performed, with the probable 

 production, when so wounded, of an arterio- venous 

 aneurism. As far as the arrangement of the superficial 

 nerves with reference to these veins is concerned, they 

 stand in danger of being wounded, especially, if the median 

 basilic be the one chosen from which to bleed, since the 

 internal cutaneous nerve passes, partly behind, and, partly 

 in front, of this vein, whereas, the external cutaneous lies, 

 as a rule, entirely behind the median cephalic. Should 

 either of these nerves be injured, sufficient irritation may 

 result as to cause, on the one hand, traumatic neuralgia 

 if the internal cutaneous be injured, or flexion of the 

 forearm if the external cutaneous be wounded, since, the 

 latter nerve supplies the biceps and the brachialis anticus 

 muscles flexors of the forearm. In view of these 

 objections to bleeding from, either the median cephalic, 

 or the median basilic vein, one would think it prefer- 

 able to employ other superficial veins, such as, the ulnar, 

 the radial, or the median ; and so it would, were it not 

 for the fact that the amount of blood, that can be drawn 

 from the latter veins, is comparatively insignificant, as 

 compared with that, from the median cephalic, or the median 

 basilic, which communicate with the deep veins of the 



