298 professok chllistopher addison. 



The Pancreas. 



The alterations in level of the pancreas, the relative size of 

 its surfaces, the position or absence of its omental tuberosity, 

 and the shape and changes in position of its head, have been 

 dealt with under the stomach and the duodenum. 



As the pancreas passes to the left across the face of the left 

 kidney, it frequently presents a slight twist, bringing its 

 inferior surface to look downwards and a little to the right. 



The upper border in the middle line averages 2*4 cm. above 

 E.F., its anterior (or lower) border being 1-5 cm. below. The 

 vertical depth of the body of the pancreas in the middle line 

 was therefore 3*9 cm. The head extends to the right in 

 the bend of the duodenum to within -5 cm. of the right 

 lateral line. 



In the left lateral line its anterior border is -3 cm. above E.F., 

 and its upper border 3*4 cm. ; the gastric surface measuring 

 3-1 cm. vertically. Maintaining the same level for a further 

 3 cm. outwards, the tail terminates behind the hilus of the 

 spleen, abutting on the basal surface, at a distance of 9-13 cm. 

 from the middle line. 



The constancy of E.F. with relation to the head of the 

 pancreas has already been pointed out. 



In 5 cases the anterior border in the left lateral line was on 

 the same level as E.F. ; in 23 other cases it was not more than 

 2 cm. away from that line, either upwards or downwards ; so 

 that in 28, or 70 per cent., of the cases it was not more than 

 2 cm. from E.F. one way or the other. There were 7 cases 

 in which it was more than 2 cm. above than E.F., the highest 

 l)eing 4 cm. in cases 6 and 31. 



There were 5 cases more than 2 cm. below E.F. up to 6 cm. 

 below in case 2. 



The Spleen. 



The anterior border of the spleen terminates 1-4 cm. below the 

 plane of E.F., a little internal to a line drawn upwards from the 

 left anterior superior iliac spine. The lowest point of the 

 spleen, usually at the posterior aspect of the basal surface, is 



