ABDOMINAL VISCERA IN MAN. 197 



testine. Case 39 is interesting as showing a short appendix 

 adlierent to the back of the Ccecum internal to a retro-colic (or, 

 in this case, retro-csecal) pouch. 



Case 27 (fig. 11) shows an interesting position of the 

 appendix. The greater part of it was firstly bovmd by the 

 peritoneum to the back of the large intestine ; the root was 

 situated behind the cfecum, and the tip projected from out of a 

 pouch external to the ascending colon at the level of the iliac 

 crest. The case probably represents an appendix passing 

 upwards outside the reflection of the peritoneum on to the 

 ascending colon, the peritoneal folds having become obliterated 

 at its proximal part. 



The nature of the retro-colic fold does not seem to be related 

 to the fold of the gubernaculum. It apparently represents an 

 unabsorbed fold of the peritoneum behind the large intestine 

 at this place. 



(E) The Peritoneum on the Colon. — For the appended de- 

 scription see figs. 3 a and B, Part 1, and fig. 12. The Plates 

 of the large intestine on the reduced scale with the peritoneal 

 lines in the whole series of cases will appear in Part IV. 



The Ime of the reflection of the peritoneum from the lower 

 end of the mesentery, which, it will be remembered, is situated 

 midway between the plane of CD. and that of the anterior 

 superior iliac spines at a distance of 4 cm. from the middle line, 

 turns somewhat abruptly outwards and upwards to reach the 

 inner side of the ascending colon, and crosses the plane of CD., 

 as it passes upwards, at a distance of 7 cm. from the middle 

 line or a little outside the right lateral line; then, inclining 

 a little further outwards, it extends upwards to half-way between 

 CD. and E.F., passing for a short distance along the outer side 

 of the second part of the duodenum and crossing the lower end 

 of the right kidney. It then bends inwards towards the middle 

 Ihie across the duodenum and the head of the pancreas, and 

 becomes the lower layer of the transverse meso-colon. This 

 point, where the peritoneum can fairly be said to begin its 

 inward inclination to form the commencement of the lower 

 layer of the transverse meso-colon, is 7*5 cm. from the middle 

 line, 6"45 cm. below E.F. 



