282 PROFESSOR CHRISTOPHER ADDISON. 



was not prolapsed, it presented a twist-like appearance, as if 

 the lower part had passed upwards and inwards in front of the 

 ileo-colic junction (case 23). The condition appeared to be 

 produced by the peritoneum having firmer attachments to the 

 front of the colon, just above the ileo-colic junction, fixing this 

 part of the bowel more or less, and allowing the anterior and 

 lower parts to move upwards. In some of these cases the 

 lowest part of the large bowel was not caecum. 



The shapes of the cseca in these cases do not conform very 

 well to any system of varieties of type. It would seem that the 

 third and fourth types of Treves (15) are chiefiy, and about 

 equally represented, and the second type in 5 cases. 



The Ascending Colon. — The distance of the outer border of the 

 ascending colon, from the middle line in the plane of CD., did 

 not present much variation. It had an average of ll'S cm., and 

 34 cases, or 85 per cent., varied between 10 and 12*5 cm. 



The spot along the outer border of the ascending colon, where 

 it definitely bends forward as the hepatic fiexure, averaged 9 cm. 

 from the middle line ; 35 cases being between 8 and 10 '5 cm. 

 The variations in level of this point will be considered with the 

 transverse colon. Two points deserve notice. 



In many cases the ascending colon, about the level of the iliac 

 crest, had a well-defined kink in it, brought about by its being 

 in these cases very strongly bound down to the back abdominal 

 wall by its peritoneal attachments. In some cases, as in No. 40, 

 these were sufficiently strong to effectually bar the distension of 

 this part of the bowel, although the neighbouring parts were 

 very much distended. (See also cases 13, IG, 15, 17, 39, 10, 11, 

 and 12). 



At the beginning of this work, on account of the well-marked 

 facet produced on the lower part of the right kidney by the 

 colon in hardened specimens, the colon was looked upon as con- 

 tributing in a considerable degree to the support for the kidney. 

 But it is clear, although the ascending colon often presses well 

 on the lower part of the right kidney, that the kidney is often 

 as high or higher than usual when it is quite devoid of support 

 from the colon below. Cases 24, 36, 15, and 7 very clearly 

 show this point. 



The Transverse Colon. — The point already spoken of as that 



