141 



no condyloid origin, and the muscle arose from the lower part of the 

 tubercle of the radius as described by Janser, (" Nederlandsch. Lancet," 

 1850, Jan. p. 431). In these cases the anomaly seems to arise from 

 the presence of the accessory palmaris, of which the last is a rare spe- 

 cimen. Its insertion has varied also in some instances during the past 

 Session. I have found it forming a large portion of the origin of the 

 abductor pollicis. In another instance there was the following curious 

 arrangement ; a muscular band, arising from the inner condyle, was 

 inserted into the inner border of the ulna near its middle ; its insertion 

 detached a tendon which terminated in the annular ligament. 



The palmaris accessorius in another instance arose from the fascia 

 over the ulnar artery, descended for about two inches, and then becom- 

 ing tendinous, was inserted into the annular ligament and palmar fascia. 

 I have likewise seen the tendon of this muscle springing from the 

 antebrachial aponeurosis in the usual position behind, and internal to 

 the normal palmaris, and inserted into the annular ligament without 

 any vestige of a fleshy belly. Before passing from the varieties of this 

 muscle, it might be useful to present a table of all the recorded anoma- 

 lies of which it is the subject. The muscle may be: — 1, absent; 

 2, double and ordinary ; 3, double, one (the inner) being inverted ; 

 4, the inverted muscle alone may exist, with a flat aponeurotic tendon 

 of origin, or with a round tendon ; 5, a single intermediate belly and 

 tendons of origin, and of insertion (these tendons I have seen both round 

 or both flattened, but usually one — that of origin most commonly — is 

 flattened, and the other is rounded) ; 6, it may be fleshy for its whole 

 length ; 7, it may be tendinous for its whole length ; 8, may arise from 

 above the internal condyle ; 9, it may arise from the internal condyle 

 beneath the origin of the flexor sublimis ; or, 10, it may arise from the 

 coronoid process alone (Meckel), or have a second head from it ; 11, it 

 may have a second origin from the tubercle of the radius (Janser \ or 

 may have this as its only attachment ; 12, or, as above described, it may 

 have an origin from the radial head of the flexor sublimis digitorum ; 

 13, it has been seen as a slip derived from the flexor sublimis digitorum ; 

 or, 14; from the flexor profundus (Fleischmann " Abhandlung der 

 Physik.Med. Soc. in Erlangen" Band i., p. 25), and the same occurred in 

 one instance during the past Session; 15, a slip from flexor carpi ulnaris 

 may supply its place ; 1 6, or from the flexor carpi radialis (Wood) ; or, 

 17, two tendons spring from one fleshy belly (Wood) ; or, 18, a tendon 

 arising from the epicondyle was inserted into the fascia (Dursy) ; or, 

 19, I have seen it represented by a thin slip arising over the ulnar 

 artery from the fascia of the forearm. Its insertions have been found 

 to vary likewise by its being attached to the (20), pisiform bone; 

 21, or into the origin of the abductor pollicis; 22, or being connected 

 to the ulna, as above described. The Palmaris accessorius may be as 

 a tendinous band, as a muscular belly over the ulnar artery, or may be 

 inserted into the abductor minimi digiti (Wood, " Proc. El. Soc," June, 

 1864). Of the twenty varieties just recorded, the second, fifth, sixth, 

 seventh, eighth, ninth, fifteenth, seventeenth, eighteenth are undoubted 



