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The conditions are not exactly symmetrical, since in some instances a metacarpal or metatarsal bone is wanting; or, to put it otherwise, two are welded together. It will be seen that the upper extremities are so short that the tips of the digits will only just touch the iliac crests.

When gangrene follows occlusion of the external iliac or of the femoral artery above the origin of its deep branch, the death of the limb extends as high as the middle or upper third of the thigh.

There was subsequent bulging low down in the right iliac fossa, caused by the presence of a fluid, which chemic and microscopic examination proved was chyle. From five to eight ounces a day of this fluid were discharged, until the tenth day, when the bulging was opened and drained. On the fifteenth day the wound was healed and the man left the hospital quite restored to health.

As examples of proximal ligation for secondary hæmorrhage may be cited ligation of the hypogastric artery for hæmorrhage in the buttock, of the common iliac for hæmorrhage in the thigh, of the brachial in the upper arm for hæmorrhage from the deep palmar arch, and of the posterior tibial behind the medial malleolus for hæmorrhage from the sole of the foot.

This, however, is a large enough risk to be worthy of serious consideration; and in view of the fact that the mortality of operations done between attacks is less than one per cent, it is generally the feeling of the profession that, where there is any appreciable soreness, or tenderness, or liability to attacks of pain in the right iliac region, in an individual who has had one attack of appendicitis, the really conservative and prudent procedure is to have the source of the trouble removed once and for all.

An apparent anomaly exists in the absence of valves from parts where they are most needed, as in the venæ cavæ, spinal, iliac, hæmorrhoidal, and portal. The azygos veins have imperfect valves.

In 1821 "he performed the first operation for osteo-sarcoma of the lower jaw. In 1822 he introduced his original operation for immobility of the lower jaw. He was the first surgeon who removed the lower jaw for necrosis, and the first to tie successfully the primitive iliac artery for aneurism.

Momburg recommends an elastic cord wound round the body between the iliac crest and the lower border of the ribs, but this procedure has caused serious damage to the intestine.

Robinson was lying near the long brass gun, which was pointed out of the foremost port, his head pillowed upon the body of the French captain, who had fallen by his hand, just before he had received his mortal wound. A musket-ball had entered his groin, and divided the iliac artery; he was bleeding to death nothing could save him.

But the more distant branches of lymphatics, which are less strictly associated with it, act with increased energy; as the cutaneous lymphatics in the cholera, or iliac passion, above described. And other irritative motions become decreased, as the pulsations of the arteries, from the extra-derivation or exhaustion of the sensorial power.