296 PROFESSOR CHRISTOPHER ADDISON. 



The difterence between these two averages indicates that 

 when the liver is displaced upwards it leaves the right kidney 

 to some extent. On the other hand, the figures show that when 

 the liver is lower than usual it moves down, to some extent, 

 on the surface of the right kidney. But from this latter con- 

 clusion it does not follow that the liver in its descent does not 

 push the right kidney down in some measure. From its firm 

 position and attachments, we should not expect that in any one 

 case the kidney would move downwards as much as the more 

 movable liver. 



If the outlines on Plate LIL, Part II., be consulted, it will be 

 seen that, in the foregoing cases of low livers, the duodenum 

 was, in all of them except Nos. 27, 32, and 11, almost wholly 

 pushed off the right kidney. On the other hand, the cases 

 of high position of the liver will be seen to be those pre- 

 eminently in which the duodenum passed on to the kidney at 

 or near its upper end. 



That the liver in its growth or displacements downwards 

 increases the hepatic surface of the right kidney and pushes the 

 duodenum off the kidney seems quite clear. 



Consider, further, case 16. The upper pole of the kidney in 

 this case was 2*6 cm. higher than the average, both above E.F. 

 and the first lumbar intervertebral disc, and nearly the whole 

 of its anterior aspect was in contact with the large liver, which, 

 with its upper border considerably lower than usual, had ex- 

 tended far down into the abdominal cavity. It cannot be con- 

 sidered that in this case the liver had displaced the kidney 

 downwards at all. 



If, however, we consider side by side those cases in which the 

 right kidney was lowest down as regards both E.F. and the 

 intervertebral disc, we find that they include a considerable 

 number of cases in which the liver also was low down. 



We should, of course, expect a certain correspondence between 

 the levels of the various viscera in any one case, in the absence 

 of exceptional displacing forces. 



In the case of those instances in whicli the kidney was 

 highest up, we find, again, a considerable number of those 

 having high positions of the liver. 



It would seem, therefore, that whilst the general levels of the 



