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Show )r.‘ .-41.-<_o g.» V. 0*? ._ . -"---« 266 or WOUNDED "reams. or woxmmm enemas. Wherever we have to pierce a fascia for such a purpose as this, it must be cut very freely. behind the ancle joint, and before it pierces under the abduct- TO CUT FOR THE ANTERIOR TIBIAL ARTERY, LOWER IN THE LEG. To cut upon the anterior tibial artery about the middle of the leg, I take the Spine of the tibia for my mark. I should cut through the strong fascia at such a distance from the ridge of the tibia, as to be able to carry my knife between the tibialis anticus and Extensor Policis Longus. To cut upon the artery as it passes over the lower end of 267 or policis pedis. We shall be directed to the exact place, by observing the lowest projecting part of the tibia. The tendons, which run close upon the tuberosity of the bone, are the Tibialis Posticus, and Flexor Communis ; the first lies so closely braced to the bone in its particular sheath, that it will not be observed ; the artery runs a little nearer the heel than the tendon of the Flexor Communis; a fascia braces down the artery, the nerve is under the artery. the tibia to go forward upon the foot, we make our incision between the projecting tendons of the Extensor Longus Policis and Communis Digitorum. r ~ m"? ~Ww-‘a-AFM A. ., a-» ‘d TO CUT FOR THE FIBULAR ARTERY. Ir seems a shocking alternative to be obliged to saw out the fibula, in order to tie this artery. I recommend that this should never be performed. To find this artery two hands' breadth from the heel, cut betwixt the Gastrocnemius and the Peroneus Lon gu-s, i. e. on the outside of the Gastrocneniius, where it is becoming tendinous ; turn up the edge of the tendon ; you then find the Flcxor Palicis Magnus covered with its sheath. If you seek for the Fibular Artery, by going deep into the leg without piercing this fascia or sheath, you find the Tibial Nerve, and may come on the Tibial Artery. To find the Fibular, then, we cut down by the side of the bone (fibula) and raise the fibrous origins of the Flcxar l'olicis We then find the artery by the acute edge of the bone, lying on the interosseous ligament, ackcompanied only by its Venue Comites. TO CUT FOR THE POSTERIOR TIBIAL ARTERY. T/zc Posterior Tibial Artery. For complicated wounds in the sole of the foot, this artery may require to be taken up i; ~v-vW " r i""'" ~ ‘I mm Meter, |