ABDOMINAL VISCERA IN MAN. 187 



quite cursory, and on going through the diagrams I find that 

 very" many of the lines have become indistinct and others are 

 incomplete. Of the whole series only 18 remained sufficiently 

 good. 



The lines broadly represent the direction of the chief coils, 

 and that is all. Most of them show the upper jejunal coils 

 as having chiefly a horizontal direction, and in many of them 

 the vertical direction of the lower coils is brought out. Much 

 more than this cannot fairly be said about them. 



The horizontal direction of the upper coils, from side to 

 side, is shown in cases 12, 13, 17, 20, 29, 30, 34, and 35, and, 

 in considerable measure, in cases 8, 16, 18, and 31, as well as 

 in case 2, though in this case the coils were much displaced 

 downwards and to the left by the liver. Thus it may be fairly 

 said that in 60 per cent, of the cases the general direction of 

 about the upper third of the small intestine was horizontal. 

 The perpendicular arrangement of the lower coils is shown in 

 cases 13, 14, 16, 17, 20, 28, 30, 31, and 37, or 50 per cent.; in 

 some measure also in cases 2, 8, 34, 35, and 23. 



One point in connection with teaching may be mentioned. 

 I find that most students with a little practice are able to 

 tell clearly which is the upper end of an intestinal loop, 

 according to the direction of its mesentery. They are taught 

 to grasp it between the fingers and thumb of the left hand, 

 to pass them down on its mesentery to the vertebral column, 

 the fingers being placed on the upper or right aspect of the loop 

 according to its direction. Reaching the vertebral column 

 and determining either the absence of, or, by tracing it with 

 the fingers, the presence of a twist upon the mesentery, the 

 upper end or direction of the mesentery and attached bowel 

 is found, either the part near the thumb or the part near the 

 little finger, as the case may be. 



[Table VI. 



