R. Lower end of radial artery.
S. Lower end of ulnar artery, in company with the ulnar nerve.
T. Pisiform bone.
U. Extensor metacarpi pollicis.
Plate 16
COMMENTARY ON PLATES 17, 18, & 19.
THE SURGICAL DISSECTION OF THE WRIST AND HAND.
A member of such vast importance as the human hand necessarily claims a high place in regard to surgery. The hand is typical of the mind. It is the material symbol of the immaterial spirit, It is the prime agent of the will; and it is that instrument by which the human intellect manifests its presence in creation. The human hand has a language of its own. While the tongue demonstrates the thought through the word, the hand realizes and renders visible the thought through the work. This organ, therefore, by whose fitness of form the mind declares its own entity in nature, by the invention and creation of the thing, which is, as it were, the mind’s autograph, claims a high interest in surgical anatomy; and accordingly the surgeon lays it down as a rule, strictly to be observed, that when this beautiful and valuable member happens to be seriously mutilated, in any of those various accidents to which it is exposed, the prime consideration should be, not as to the fact of how much of its quantity or parts it can be deprived in operation, but rather as to how little of its quantity should it be deprived, since no mechanical ingenuity can fashion an apparatus, capable of supplying the loss of a finger, or even of one of its joints.
The main blood vessels and nerves of the arm traverse the front aspect of the wrist, and are distributed chiefly to supply the palmar surface of the hand, since in the palm are to be found a greater variety and number of structures than are met with on the back of the hand. The radial artery, A, Plate 17, occupies (as its name indicates) the radial border of the forepart of the wrist, and the ulnar artery, C, Plate 17, occupies the ulnar border; both vessels in this region of their course lie parallel to each other; both are comparatively superficial, but of the two, the radial artery is the more superficial and isolated, and thereby occasions the radial pulse. The anatomical situation of the radial artery accounts for the fact, why the pulsation of this vessel is more easily felt than that of the ulnar artery.