tained
there by the muscular force, the surgeon counteracts this force upon
mechanical principle; but while he puts this principle in operation, he
also acknowledges to the paramount necessity of ministering to the ease
of Nature as much as shall be consistent with the effectual use of the
remedial agent; and in the present state of knowledge, it is owned, that
that apparatus is most efficient which simply serves both objects, the
one no less than the other. And, assuming this to be the principle which
should always guide us in our treatment of fractures and dislocations, I
shall not hesitate to say, that the pad acting as a fulcrum in the
axilla, or the perineal band bearing as a counterextending force upon
the groin (the suffering body of the patient being, in both instances,
subjected for weeks together to the grievous pressure and irritation of
these members of the apparatus), do not serve both objects, and only one
incompletely; I say incompletely, for out of every six fractures of
either clavicle or thigh-bone, I believe that, as the result of our
treatment by the present forms of mechanical contrivances, there would
not be found three cases of coaptation of the broken ends of the bone so
complete as to do credit to the surgeon. The most pliant and portable of
all forms of apparatus which constitute the hospital armamentaria, is
the judgment; and this cannot give its approval to any plan of
instrument which takes effect only at the expense of the patient.

DESCRIPTION OF PLATES 13 & 14.

PLATE 13.

A. Axillary vein, drawn apart from the artery, to show the nerves lying
between both vessels. On the bicipital border of the vein is seen the
internal cutaneous nerve; on the tricipital border is the nerve of
Wrisberg, communicating with some of the intercosto-humeral nerves; a,
the common trunk of the venae comites, entering the axillary vein.

B. Axillary artery, crossed by one root of the median nerve; b, basilic
vein, forming, with a, the axillary vein, A.

C. Coraco-brachialis muscle.

D. Coracoid head of the biceps muscle.

E. Pectoralis major muscle.

F. Pectoralis minor muscle.

G. Serratus magnus muscle, covered by g, the axillary fascia, and
perforated, at regular intervals, by the nervous branches called
intercosto-humeral.

H. Conglobate gland, crossed by the nerve called "external respiratory"
of Bell, distributed to the serratus magnus muscle. This nerve descends
f