"The patient, aet. 44, of spare habit, but not otherwise unhealthy, had an aneurism of the external iliac artery, of such extent as to prevent any chance of success from tying the iliac artery above the tumor. It was accordingly determined to tie the femoral artery on the distal side of the aneurism, according to Brasdor's plan. This operations was performed on June 2, 1829. The patient appeared to be going on well until the 12th, after which the tumor gradually increased; and on the 24th the integuments were tense and shining, and there was considerable pain."* Mr. James accordingly felt it his duty to give his patient the only remaining chance, by putting a ligature round the aorta. The operation was accordingly performed, on the 5th of July, in the manner practised by Sir A. Cooper. We shall find, farther on, that the aorta may in general be tied without wounding the peritoneum; but in this case it would have been impracticable, as the serous membrane adhered firmly to the anterior surface of the tumor. The patient died on the evening of the day on which the operation was performed; and on opening the body a remarkable anomaly was observed; the external iliac artery divided, above Poupart's ligament, into two branches; one of which gave off the epigastric, and afterwards represented the profunda, while the other took the course of the femoral artery.

* Surgical Essays, vol. i. p. 114. 21.