The international encyclopaedia of surgery; a systematic treatise on the theory and practice of surgery . tening, I said, These openings look nearly expression was infelicitous. Every careful anatomist knows that the openings are notround ; their shape is different in different individuals. The general condition is that the inno-minate and subclavian openings are nearly semicircles, having their flat sides opposed at a con-siderable angle to each other, so that they are more widely separated in front than behind. Inthe wider part of this interval, and generally anterior to both the o
The international encyclopaedia of surgery; a systematic treatise on the theory and practice of surgery . tening, I said, These openings look nearly expression was infelicitous. Every careful anatomist knows that the openings are notround ; their shape is different in different individuals. The general condition is that the inno-minate and subclavian openings are nearly semicircles, having their flat sides opposed at a con-siderable angle to each other, so that they are more widely separated in front than behind. Inthe wider part of this interval, and generally anterior to both the other orifices, is the openingof the left carotid, rliomboid in shape, and with its short end behind, so as pretty accuratelyto fit the above-described interval. ANEURISM OF ARCH OF AORTA. 523 the ridge on the distal margin of the brachio-cephalic trunk is particularlystrongly marked, and there is also a smaller ridge in the innominate itself,running from the proximal opening of the left carotid. In two dissections, Ihave found the left carotid arising altogether from the commencement of the Fig. Arch of aorta and large branches, showing oblique roots of great vessels, and ridges running from orifices on aortic walls. innominate. An aneurism of that vessel, occurring in such a subject, wouldgive rise to some considerable embarrassment of diagnosis, and many doubtsas to which point should be chosen as that to which surgical treatment shouldbe directed. For instance, this was evidently the original state of the vesselin the aneurism here depicted; in the preparation, the peculiar anatomy ofthe left carotid can be more clearly made out than in the drawing (Fig. 548).Now if these conclusions be correct; if there be in the aorta varying ratesof current, and if there be districts of that vessel appertaining to the dif-ferent branches, so that the blood which flows over or near any particularportion of its wall must pass into a given vessel, it follows that an aneurismin one situ
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