The workes of that famous chirurgion Ambrose Parey translated out of Latin and compared with the French. by Tho: Johnson. Whereunto are added three tractates our of Adrianus Spigelius of the veines, arteries, & nerves, with large figures. Also a table of the bookes and chapters.

CHAP. XXI. The distribution of the Subclavian Vein, and first of the Cephalica, or Humeraria.

TWo large Veins descend from the Subclavian, the one from the lower-side, the other from the higher. Yet sometimes, and most usually, both these proceed from the same common orifice, as in men of a low stature in the Arm. The one of these is called the Ax∣illaris,* 1.1 the other the Humeraria, or Cephalick; therefore this Cephalick passing forth of the Sub∣clavian runs superficially along the fore-side, between the Muscle Deltoides, and the Tendon of the pectoral Muscle, and descends in the midst between the common Coat of the Muscles, and the fleshy pannicle, even to the bending of the cubit, where in lean bodies it is plainly to be seen, whereas in fat bodies it is hardly to be perceived, being, as it were, buryed in abundance of fat. This vein having, in its descent, sent forth some small branches, both to the skin, as also to certain Muscles over which it runs, is divided into two, a little above the outward protuberation of the Arm. One of the branches into which it is divided descending obliquely to the fore-part of the cubit, a little below the bending of the cubit, it meets, and is united with the like branch in the same place, as shall be shown hereafter.

* 1.2That which arises from this concourse, is called the Median-vein, because it arises from two branches, and is seated between them. They usually open this Median-vein in the diseases of the head and Liver, which require Phlebotomy; but if it shall not be sufficiently manifest, when you judg it must be opened, for a general evacuation of the whole body; you may cut one of these branches, by whose concourse it is made, which you shall think the fitter; and because each branch draws from the next parts, according to the straightness of the fibers, rather than from the opposite side; if you would evacuate the Head, and Liver equally, by opening either of these branches, it is convenient that opening that branch (for example) which comes from the Cephalick, you pre∣sently lay your Thumb upon it, until you suppose you have drawn a just quantity of blood from the Liver, by the Basilica, or Liver-vein; which done, you may take off your Thumb, and suffer the

bloud to follow freely, by the open branch of the Cephalick, until you have drawn as much bloud as you shall judge requisite; otherwise you will draw it but from one part, to wit, the head. So you shall evacuate it only from the Liver, if you open the branch which comes from the Basilica, and concurs to the generation of the median.

Moreover, when there is need to open the Basilica, and it shall be no where conspicuous, the Cephalick or median being easie to be discerned at the same time, you may in stead thereof open the median, or, if it be not to be found, the Cephalick, pressing but the trunk thereof with your thumb, as we said before, lest the head should be evacuated in stead of the liver. You may do the same in the Basilica, if when there shall be necessity to open the Cephalick, it shall not appear. Most of those which at this day open a vein, in stead of the median, open that branch of the Basi∣lica which ascends together with the Cephalick to make the median. But you must understand that the median descends between the two bones of the cubit, even to the end thereof; and then divided into many branches, it is at length spent on the back of the hand behind the thumb, the fore and middle fingers, or the after-wrist. Sometimes it runs back into the following branch, and then at the wrist it departs from it, to be bestowed upon the forementioned parts. The other branch of the Cephalick, which we may call the fore and outward Cephalick, descending directly down to the midst of the wand, thence wanders overthwart into the hind part of the arm, where encreased with a branch from the Basilica, it is distributed over all the back of the hand, which with the median it nourisheth. But the branches of these veins do so run through the fore-named parts, that by the way they yield them necessary provision.

Notes

• * 1.1

  The Cepha∣lick vein.
• * 1.2

  The median vein. How by ope∣ning the medi∣an vein, you may draw more or less blood from the head or liver.