Suprascapular with dorsal branches of subscapular; posterior scapular with costal and muscular branches of subscapular. Thoracic anastomosis between internal mammary and intercostals, with branches of axillary. 3. Axillary and brachial. Anastomosis varies with the position of the ligature, but is very free between the various muscular branches of these vessels. FOOTNOTES: [2] Erichsen, _Surgery_. Sixth edition, vol. ii. p. 121. [3] The line 3 in Plate I. shows the direction required. It will not be necessary to carry the incision so far up for the external as for the common iliac. [4] _On the Arteries and Veins_, p. 421. [5] _Cyclopædia of Practical Surgery_, vol. i. p. 277. [6] John Bell's _Prin. of Surg._, vol. i. 421; _Dublin Jour._, vol. iv. 321. [7] _Observations in Clinical Surgery_, Syme, pp. 171-3. [8] _Brit. Med. Jour._ 1867, Oct. 5. [9] _International Encyclopædia of Surgery_, vol. iii. p. 466. [10] Poland, _Guy's Hosp. Report_, ser. iii. vol. vi. [11] Mr. W. Thomson's most interesting paper on this subject is full of information down to the latest date. [12] _Lancet_, Jan. 5, 1867. [13] _Lancet_, May 1879. [14] _Dublin Quarterly Journal_, Nov. 1867. [15] W. Zehender--Monatsbl. für Augenheilkunde. 1868. [16] Butcher, _Op. and Cons. Surgery_, p. 861. [17] _Leçons Orales_, iv. 530. [18] _Ed. Med. and Surg. Journ._ vol. xlv. [19] _Observations in Clinical Surgery_, pp. 148, 149. [20] _Edin. Med. Journal_, March 1879. [21] See case of recurrence, Fergusson's _Practical Surgery_ 1st ed. p. 222. [22] _Operative Surgery_, p. 279. [23] _Surgical Operations_, p. 50. CHAPTER II. AMPUTATIONS. In ordinary surgical language the name Amputation is applied to all cases of removal of limbs, or portions of limbs, by the knife, though in strict accuracy it should be restricted to those cases in which a limb is removed _in the continuity of a bone_, its removal _at a joint_ being called a Disarticulation. The briefest outline of a history of amputation would fill a work much larger than the present. I may be allowed in a few sentences to attempt to show the principle on which such a sketch should be written, in describing the three great eras of progress in improvement of the methods of amputating.[24] I. Prior to the invention, or at least prior to the general introduction, of the ligature and the tourniquet, the great barrier to all improvement in operating was the impossibility of checking hæmorrhage during an operation, and after its conclusion. Many surgeons would not amputate at all, others only through gangrenous parts; others more bold, only at the confines of parts in which gangrene had been artificially induced by tight ligatures.