Chap, xxiii.) THE ANKLE AND FOOT. 515 



plantar artery. As a matter of practice, however, 

 elevation of the limb, together with pressure upon the 

 wounded point, and compression of the main artery, 

 are sufficient to check most haemorrhages from the 

 plantar arch. 



It must be remembered that this arch can be 

 wounded by penetrating wounds inflicted upon the 

 dorsum of the foot ; and Dr. Delorme has shown how 

 readily various parts of the arch may be ligatured from 

 the dorsum after portions of one or other of the meta- 

 tarsal bones have been removed Thus by resecting 

 the upper part of the shaft of the fourth metatarsal 

 bone in one case, the main part of the shaft of the 

 third bone in another, and the upper part of the 

 shaft of the second bone in a third instance, he has 

 been enabled to expose and ligature the greater part 

 of the plantar arch from the dorsal aspect of the 

 foot. 



The dorsalis pedis artery, from its superficial 

 position and its close contact with the bones of the 

 foot, is frequently divided in wounds, and ruptured in 

 severe contusions. The posterior tibial artery at the 

 ankle is well protected by the projecting malleolus, 

 the dense annular ligament, and the tendons that 

 run by its side. 



The superficial veins of the foot, like those of the 

 hand, are found mainly upon the dorsum of the 

 member. The sole, as a part exposed to pressure, is 

 singularly free from them. About the malleoli, and 

 especially about the inner process, these veins form a 

 considerable plexus. Hence it is that appliances that 

 fit tightly around the ankle are apt to produce 

 oedema and pain in the parts beyond. The dull pain 

 in the feet that is often caused by tight elastic-side 

 boots is probably due to the same cause. It will be 

 understood that wounds and suppurations about the 

 dorsum of the foot are more apt to be attended by 



