ABDOMINAL VISCERA IN MAN. 195 



Avas adherent either to the back of the CcTecum or to the large 

 intestine in the iliac fossa, and did not possess a peritoneal 

 fold, were not dissected to determine the vascular arrangements, 

 so that I cannot criticise this statement of Jonnesco. 



The superior border of the ileo-colic fold is attached a vari- 

 able distance along the ileum at its termination — usually about 

 4 cm. The outer border, directed somewhat upwards, is 

 attached on to the caecum, whilst the opposite internal border, 

 the longest, free, and somewhat crescentic, is directed down- 

 wards and inwards, with various obliquities. The lower border 

 is attached to the back of the caecum adjoining the appendix 

 to the appendix itself or to its mesentery for a variable 

 distance. 



Case 25 presented perhaps the most sharply-defined pouch, 

 with the quadrilateral shape of the fold well shown. 



(13.) The Meso-Appendix (fig. 11 a). — This fold contains an 

 appendicular branch of the ileo-colic artery, and is variously 

 attached. Its attachments conveniently fell into four groups, 

 and the frequency of these different positions in the 40 cases 

 is herewith given : 



(1) Attached wholly to the inferior aspect of the mesentery, 

 8 cases. 



(2) Attached partly to the inferior aspect of the mesentery, 

 and partly to the back of the caicum, 13 cases. 



(3) Attached wholly to the back of the caecum or the 

 beginning of the ascending colon, 15 cases, of which the 

 diagrams in 4 cases are unsatisfactory. 



(4) Irregular attachments ; where the appendix is bound by 

 the peritoneum to the back of the ctecum and ascending colon, 

 3 cases — Nos. 14, 15, and 39 ; and in one case (No. 3) to the 

 floor of the iliac fossa. 



The cases presenting an ascending meso-colon, in which the 

 appendix was mostly found attached on the outer side of the 

 colic mesentery, come under Group 3. 



Progressive displacements from its original attachment at the 

 back of the mesentery, by the growth of the ctecum and colon 

 dragging the peritoneum away and absorbing it, render the 

 progressive changes in the position of the attachment of the 

 meso-appendix from the back of the mesentery to the back of 



