Anatomico-chirurgical remarks on the different portions of the axillary artery : with a case in which this vessel was successfully tied / by G.C. Monteath.

  • Monteath, George Cunningham, 1788-1828.
Date:
[1827]
Catalogue details

Licence: Public Domain Mark

Credit: Anatomico-chirurgical remarks on the different portions of the axillary artery : with a case in which this vessel was successfully tied / by G.C. Monteath. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    ' ' / Distribution of the Venous System. carryino- on a part of the blood which the cava would other- wise have been obliged to convey to the heart, but might have | finished on the left side, as an azygos, what the lower vein (p) li as an azygos had begun. To determine these points, it was resolved to make free i with the preparation, and to remove a portion of the aorta | that covered what was conjectured to be the termination of the vein p, and another portion that obscured the beginning ! of the vein o ; when our suspicions were confirmed; for the I vein p Avas iioav seen distinctly to be a large branch rising upwards from the left emulgent, and entering obliquely into the cava inferior, as high up as the coeliac artery ; and the vein o Avas as distinctly seen to be a branch nearly as large, sent off', nearly opposite the head of the 7th rib, by the inferior cava, • which, like a river, had here split into two streams, leaving a deltoid space betAveen. It had also been observed, that the cava inferior became suddenly enlarged at q. The cause Avas now evident. At that point, the blood of the large vein p had been poured in. The chief peculiarities in this case seem to be—That the vena cava, in passing up behind the liver, avoided all connexion with the hepatic veins—That there was, strictly speaking, no vena azygos either on the right side or the left—That the cava inferior, when it came up to the heart, divided into two unequal branches, the larger turning to the right, and the smaller to the left, but both avoiding the heart—That the branch on the right side, which may be called the cava inferior dextra, followed the course of the vena azygos, and ended as if it had been the azygos, in the cava superior, Avhile the other, which may be called the cava inferior sinistra, ended in the left subclavian vein—That the dextra, while it continued to do its duty as cava, assumed the office of azygos also, by receiving the parietal veins, as soon as it passed the right emulgent vein—That the sinistra, having come off from the dextra, in the thorax, could not only act as an auxiliary cava, in the left side of the thorax, but could also do the duty of an azygos there ; but while in this Avay the duties of azygos would be performed to the whole of the right side and the upper part of the left, the loAver part of the left would have been neglected; to guard against which, the left emulgent sends up the large vein p, Avhich, while it conveyed to the cava inferior a part of the renal blood, must have also done the duty of an azygos to the parts in its vicinity, as into it the lumbar veins are seen entering—Lastly, That all the blood, Avith the exception of that from the hepatic and coronary veins, must, in this case, have been poured into