Congenital Anomalies of Arteries and Veins 25 



vessels will arise from a common stem. Broman (1908) thinks 

 that the latter occur through fusion rather than atrophy of one of 

 the trunks. The number of lumbar trunks will depend upon the 

 interpretation of the intercostals. Haller, Theile, and Sabatier 

 consider the last thoracic the vessel between the nth and 12th 

 thoracic vertebra, while Soemmering, Weber, and Poirier call the 

 subcostal the last thoracic; with the latter Levi (1902) agrees and 

 so considers that there is no 5th lumbar. In 20 per cent, of a 

 series of 40 bodies I examined the 4th lumbar was irregular in 

 origin, varying from an origin in common with the second lumbar 

 to one from the lateral sacral or directly from the hypogastric. In 

 3 cases the 4th lumbars came from a common trunk from the right 

 common iliac. In 6 cases symmetrical vessels which must be in- 

 terpreted as 5th lumbars arose from the middle sacral. These 

 figures agree quite closely with those of Levi. Ernst (1900) re- 

 ports all of the intercostals and lumbars arising by a common stem 

 for each segment. 



A. Sacralis Media 

 Young (1898) considers that this artery is not the continuation 

 of the aorta, but his conclusions have not been well received, 

 Broman (1908). This vessel may spring from the 4th lumbars or 

 they from it, Young, Levi (1902), Thomson (1894) 9 per cent., 

 Poynter. Other variations have been analyzed by Thomson for 

 400 bodies and Broman has very fully discussed the embryology 

 of its variations. 



A. Cosliaca 



This artery shows a marked tendency to irregular arrangement 

 and its anomalies have created a wide interest. The most exten- 

 sive study was made by Branco (1912), and other papers deserving 

 special mention are those of Rossi e Cava (1904), Leriche et 

 Villemin (1907). Descomps (1910), Piquand (1910), Eaton 

 (1917), and Lipschutz (1917). 



Our knowledge of the development of the vessels rests on the 

 work of Frederic (1898). Mackay (1889), and Tandler (1904). 

 The latter has shown how four trunks from the ventral aspect of 

 the aorta form a longitudinal anastomosis, and from this the ca^liac 

 complex and the superior mesenteric are formed. From this it is 



