64 PROFESSOR A. BIRMINGHAM. 



the former measures from 1| to 1^ inches, the latter from 1 to 

 Ij- inches. 



Pancreas. 



The neck (specially described by Symington) forms as distinct 

 and definite a division as any other portion of the gland. The 

 omental tuberosity is very rarely, if ever, I think, as large, when 

 normal, as is represented in His's model, which appears to 

 have been prepared from an imperfectly hardened pancreas. 

 Generally, the tuberosity is insignificant, and is probably due to 

 the pressure of the duodeno-jejunal flexure below, and of the 

 suspensory muscle of Treitz behind, on this part of the gland. 

 When the stomach is empty and contracted, the tuberosity will 

 often be found not above the lesser curvature, but projecting 

 below the pyloric part of the great curvature. 



I can see no reason for altering the description of the surfaces 

 and borders of the pancreas which I have already given in tlvk 

 JouT'iml} 



I have never failed to find an accessory pancreatic duct joining 

 the duodenum in any case in which I have made a thorough 

 search for it. It opens into the duodenum about | inch above, 

 and somewhat in front of {i.e. ventral to), the pancreatic duct. 

 From the duodenum it runs to the left and downwards, and soon 

 divides into two or more branches, one of which joins the 

 pancreatic duct ; the others pass down and receive the ducts 

 from the lower part of the head. 



The blood-vessels of the pancreas are, as a rule, very loosely 

 described. The following account gives briefly the average of 

 several dissections : — The superior (or anterior) 2^^>^creatico- 

 duodenal artery runs down on the front of the head, sending 

 branches outwards to the duodenum, as well as numerous twigs 

 into the substance of the pancreas. (2) The inferior (or posterior) 

 pancreatic duodenal — a branch of the upper part of the superior 

 mesenteric artery — runs upwards and to the right across the 

 back of the head of the pancreas, and sends branches to it and 

 to the duodenum, one of which runs between the head and the 

 duodenum. These two arteries anastomose by several branches 



1 October 1896. 



