"The patient, a gentleman aged forty, perceived, on the 10th of November, a small hard tumor in his left groin, above the centre of Poupart's ligament. Three days afterwards he had severe pain in the part, and on the following day the swelling increased in size, accompanied with pulsation. It was resolved, in consultation, to apply a ligature to the common iliac artery, which operations was performed on December the 3d. The incision was begun two inches and three-quarters above the navel, and three inches from the median line, and was carried six inches downwards in a semicircular direction, with a prolongation of an inch and a half in a straight line outwardly. The layers of muscles and fascia transversalis having been divided to the whole extent of the incision, the peritoneum was gently separated from the parts beneath, and the common iliac artery was easily reached. A little time was occupied in scratching through the sheath with the point of the aneurism-needle, after which it was passed under the artery from within outwards, armed with a double ligature of stay-maker's silk, and the operation completed. The pulsation in the tumor ceased immediately after the artery was tied. The tumor gradually subsided in size. A week after the operation, pulsation was felt in the anterior tibial artery. On the twenty-eighth day the ligature was found loose in the wound and removed. About the 20th of January the patient was free from complaint and was able to walk about."*

When the flow of blood through the common iliac artery is prevented, the internal mammary supplies the limb through the epigastric; the inferior lumbar arteries supply it through the glutaeal and ilio-lumbar; and the internal iliac of the sound side, through the communicating branches of the internal iliac of the diseased side.

* Med. Press, vol. ii. p. 299.

The common iliac artery may be arrived at for the purpose of including it in a ligature, by the proceeding recommended for tying the internal iliac.