46 C. W. M. Poynter 
second, Patruban (1844), is accepted by Krause, but Holzapfel 
considers this a case of low origin of the right subclavian and a 
bi-carotid trunk; this seems to me the correct interpretation of 
the case. 
(d) This group is similar to (a) except for a slight modifica- 
tion; the first trunk divides into the right subclavian, right and 
left common carotids and the right internal mammary ; the second 
trunk from the arch is the left subclavian. I know of only one 
example, that reported by Hyrtl (1841). 
(e) This group is like the one immediately preceding except 
that a thyroid ima takes the place of the internal mammary. 
Cases have been reported by Isaacs (1855), Paterson (1884) and 
Freyberger (1808). 
(f) In these cases there are two branches from the arch, one 
an innominate trunk made up of the right and left common caro- 
tids and the left subclavian, the other trunk the right subclavian. 
Only three examples are available; viz., Zagorsky (1809), 
Breschet (1826) and Dubrueil (1847). These cases are quite 
difficult to interpret. Krause classified Zagorsky’s case as one 
of right arch, although there was no mention made in the orig- 
inal of the direction of the arch; Tiedemann figured it, Plate IV, 
fig. 8; there was no figure in the original, and Quain copied his 
figure on Plate VI, fig. 8. It seems to me that instead of inter- 
preting these as cases of right arch we might consider them as the 
counterpart of the next group. 
(g) In this group the right aortic arch takes the place of the 
left; from the arch proper one trunk is given off, which divides 
into the left common carotid, right common carotid and right sub- 
clavian, from low on the arch, i. e., the descending aorta, the left 
subclavian arises. This condition has been reported by Henle 
(1843), Tiedemann (1846) and Dubrueil (1847). 
C. Number of Branches from the Aortic Arch Normal in Number 
but Abnormal in Arrangement 
1. Order of branches, innominate trunk made up of right sub- 
clavian, right common carotid, left common carotid, then left 
274 
