8o Anatomy Applied to Medicine and Surgery. 



of its nerves and arteries is of assistance to the surgeon 

 in the diagnosis of certain injuries and diseases of the 

 limb. For instance, tenderness in a direction downwards 

 and outwards from the internal condyle, accompanied by 

 pain on pronation, would indicate a strain of the pronator 

 radii teres, as in "lawn tennis" arm ; or, a swelling run- 

 ning obliquely downwards and outwards from the 

 middle of the posterior surface, and passing over the 

 outer border of the lower part of the forearm, would mean 

 inflammation of the sheath around the extensor ossis meta- 

 carpi and the internodii pollicis tendons, as in ' ' washer- 

 woman's " strain, brought about by a sudden and severe 

 external rotatory movement of the hand ; or, a pain darting 

 down the middle line, when the forearm is suddenly pro- 

 nated, would indicate pressure on the median nerve as it 

 passes between the two heads of the pronator radii teres. 

 Again, pressure along the lines of the nerves would be of 

 great assistance in the diagnosis of neuritis or inflam- 

 mation of these structures. 



Operative Work on the Forearm. Ligation of 

 the ulna? attery in the upper third of its course is very 

 rarely called for, and when it is, is difficult of performance, 

 since the curve, which represents this part ol the vessel, is 

 deeply placed beneath the flexor muscles and can be ap- 

 proached from the inner side only, of the torearm. If it 

 be decided to ligate the vessel in this situation an incision, 

 with its centre one and a half inches below the internal 

 condyle, should be made in the line of the vertical part of 

 this artery, i.e., in a line drawn from the anterior surface 

 of the internal condyle to the radial side of the pisiform 

 bone. On exposing the deep fascia, a distinct white band 

 formed by a thickening of the aponeurosis will be ob- 

 served. This band passes downwards and outwards and 

 its anterior margin corresponds to the interval between 



