Macalister — On Multii^U Renal Arteries. 625 



"witli the form, to be hereafter noticed, of a renal branch from the 

 supra-renal). These multiple branches have been described by most 

 anatomists, so I need not give references. Cases of five on the right 

 are described by Otto and Meckel, and other multiple forms are 

 recorded by many of the older anatomists. 



2. Varieties of Origin. — Additional renals often spring from other 

 sources, in the following order of frequency : — (a), The supra-renal, a 

 very common source of an upper renal artery ; (/S), the second, or 

 (y), the third lumbar artery ; (8), the right hepatic ; (e), the colica 

 dextra ; (^), the external iliac ; (77), the internal, or (^), the common 

 iliac ; or (t), from the middle sacral. Of all but the fij'st I have seen 

 but single instances. Parallel cases, however, are quoted by Otto, 

 who has seen two instances of the last form where the anomalous 

 branch went respectively to the right and to the left kidneys. Otto 

 also records a curious and unique example, in which a branch from 

 the right common iliac supplied the left kidney. 



The most remarkable instance of this class of variety which I have 

 noted is one "which I have preserved in our University Anatomical 

 Museum, taken from a male adult subject. 



In this case, on the right side, there are three renals, two from the 

 aorta, a normal, and an inferior, and one from the capsular artery. 

 There is no capsular branch of the aortic renal on this side. On the 

 left side there are six renals from the following varied sources : — 

 three from the trunk of the abdominal aorta, a normal, an inferior, and 

 a superior, which arises directly below the left aortic supra-renal, and 

 sends an inferior capsular branch to that organ, and enters the superior 

 extremity of the kidney. The normal renal bifurcates before it reaches 

 the hilus. 



A fourth renal artery springs from the front of the aoita, im- 

 mediately above its bifurcation, and Avith its origin a little to the 

 right of the middle line. If this origin were a quarter of an inch 

 lower it would be comparable with Otto's otherwise singular instance 

 above quoted. The fifth renal arises from the sacra media, about half 

 an inch below the origin of that vessel, crosses over the left common 

 iliac artery underlying the ureter, and entering the lower part of the 

 hilus of the kidney. The sixth and lowest branch arises from the 

 internal iliac artery immediately at its point of division, ascends, 

 crosses the common iliac, and pierces into the lower part of the gland. 

 This instance is thus remarkable as combining in itself three of the 

 rarest forms of anomaly hitherto described. 



3. Anomalies of branching of the renals are very common ; indeed, 

 the number of branches whereby the normal renals enter the substance 

 of the kidney is very inconstant ; three or four are the commonest 

 numbers, but I have seen up to ten penetrating branches. I have, 

 however, preserved no record of the relative frequency of these. Otto 

 describes the renals in one case as branching into very many branches. 

 The other extreme, that is, the entrance of the renal by a single 

 branch into the glandular substance, is rarer than multiple division. 



