464 SURGICAL APPLIED AN ATOM?, [ciup. xx. 



quadriceps may be ruptured by muscular violence. A 

 good example of such an accident is recorded by Mr. 

 Bryant (Mecl. Times, 1878). A man aged forty-two 

 stumbled in the dark, and fell down a pit ten feet 

 deep. On examination the tendon was found to be 

 torn across, and the gap above the patella produced by 

 the rupture occupied no less extent than the lower third 

 of the thigh. A somewhat more remarkable accident 

 is reported to have happened to the sartorius muscle. 

 This muscle, just before its insertion into the tibia, 

 gives off an aponeurotic expansion from its anterior 

 border to the capsule of the knee-joint. In the case 

 alluded to (Lancet, 1873), this expansion is said to 

 have been ruptured, and the muscle itself to have been 

 found dislocated backwards in consequence. The 

 accident befell a man aged forty, who was squatting, 

 in the position assumed by tailors, upon the floor of a 

 wagon, when his companion tripped over him, and 

 fell across his bent knees. Something was felt to 

 have given way near the ham, and on examination the 

 above lesion was diagnosed. 



The femoral artery may be ligatured at any part 

 of its course in the thigh, and the comparatively super- 

 ficial position of the vessel renders it very liable to be 

 injured. The thigh affords many instances of the 

 remarkable way in which isolated branches of a main 

 artery are often alone damaged. Thus, Langier relates 

 the case of a man-cook, who, in running round a table, 

 struck the upper and outer side of his thigh against 

 the corner of it. This led to a subcutaneous rupture 

 of the external circumflex artery. Unfortunately the 

 extravasation was cut into, and the patient, after 

 being subjected to many modes of treatment, died 

 from the effects of repeated haemorrhage. Dr. Butcher 

 (Dub. Joum. Med. Sc., 1874), gives the case of a man 

 who was stabbed in the thigh over the femoral vessels 

 during a scuffle. Profuse bleeding followed, and it was 



