182 PROFESSOR CHRISTOPHER ADDISON. 



to the right, in front of the fourth part, below the anterior 

 border of the pancreas, as far as 3 cm. to the right of the 

 middle line, where it turned abruptly forwards and became free 

 as the jejunum. The line of the attachment of the mesentery 

 ran along the lower border of the fifth part, and the transverse 

 meso-colon was attached along its upper border. There was a 

 small pouch at the junction of the fourth and fifth parts ; the fold 

 doubtless representing the remains of the meso-duodenum at 

 this part. At the termination of the duodenum there were 

 two large folds, running to the transverse meso-colon, enclosing 

 a pocket between them. The upper fold, which was opposite 

 the beginning of the mesentery, seems to represent an un- 

 obliterated portion of a meso-duodenum at this place. The 

 lower fold was not dissected, but it seemed to have been produced 

 secondarily by the downward loop of the hepatic flexure 

 of the colon. 



If the figs. 9 and 10 be considered, and the duodena from 

 cases 5 and 7 be compared with that from case 40, they 

 suggest that the condition in case 40 embodies the two condi- 

 tions presented by cases 5 and 7- If the condition in case 7 

 were exaggerated so that the third or ascending part of the 

 duodenum were displaced more to the right and came to lie 

 behind the second or descending portion, and if at the end of the 

 duodenum the additional fifth jejunal part passing to the 

 right — such as case 5 possesses — were added on, a state of 

 affairs like that existing in case 40 would be produced. 



The relations of the pancreas to the duodenum in case 40 are 

 sufficiently displayed on fig. 10. 



The Duodenal Pouches. 



The minute observation and record of the various duodeno- 

 jejunal fossae did not form a part of this research ; and no attempt 

 was made to arrange them under any special classification, such 

 as M. Jonnesco's, and certainly not under the very complex and 

 somewhat bewildering classifications occasionally met with. 



The Inferior Duodenal Pouch, that is a pouch with the 

 opening directed upwards, more or less at the side of the fourth 



