oot
of the neck, involving the glands of this latter region also in the
disease.

The contractile motions of the pectoral muscle, E, of the male body,
Plate 13, are during life readily distinguishable; and that boundary
which it furnishes to the axillary region is well defined; but in the
female form, Plate 14, the general contour of the muscle E, while in
motion, is concealed by the hemispherical mammary gland, F, which,
surrounded by its proper capsule, lies loosely pendent from the fore
part of the muscle, to which, in the healthy state of the organ, it is
connected only by free-moving bonds of lax cellular membrane. The
motions of the shoulder upon the trunk do not influence the position of
the female mammary gland, for the pectoral muscle acts freely beneath
it; but when a scirrhus or other malignant growth involves the mammary
organ, and this latter contracts, by the morbid mass, a close adhesion
to the muscle, then these motions are performed with pain and
difficulty.

When it is required to excise the diseased female breast, (supposing the
disease to be confined to the structure of the gland itself,) the
operation may be performed confidently and without difficulty, in so far
as the seat of operation does not involve the immediate presence of any
important nerves or bloodvessels. But when the disease has extended to
the axillary glands, the extirpation of these (as they lie in such close
proximity to the great axillary vessels and their principal branches)
requires cautious dissection. It has more than once happened to eminent
surgeons, that in searching for and dissecting out these diseased
axillary glands, H, h, Plate 14, the main artery has been wounded.

As the coracoid process points to the situation of the artery in the
axilla, so the coraco-brachialis muscle, C, marks the exact locality of
the vessel as it emerges from this region; the artery ranges along the
inner margin of both the process and the muscle, which latter, in fleshy
bodies, sometimes overhangs and conceals it. When the vessel has passed
the insertion of the coraco-brachialis, it becomes situated at the inner
side of the biceps, which also partly overlaps it, as it now lies on the
forepart of the brachialis anticus. As the general course of the
artery, from where it leaves the axilla to the bend of the elbow, is one
of winding from the inner side to the forepart of the limb, so should
compression of the vessel, when necessary, be directe