ABDOMINAL YISCEEA IN MAN. 299 



situated 2-5 cm. below E.F. The anterior border of the spleen 

 passes, as a rule, nearly directly upwards at 11-5 cm. from the 

 middle line for nearly 5 cm. above E.F. ; it then bends inwards 

 in the concavity of the diaphgram until just inside the lateral 

 line, where it attains its highest point at 87 cm. above E.F., and 

 11 cm. below the infra-sternal notch. From this point the 

 border turns inwards and downwards, until at a distance of 3-6 

 cm. from the middle line the spleen attains its innermost 

 point, which is, as a rule, where the spleen overlaps the 

 summit of the left supra-renal capsule, at a height of 5 cm. 

 above E.F. 



Variations. — The highest point of the spleen in relation to 

 the infra-sternal notch is fairly constant. 



In 30 cases, or 75 per cent., it varied from 1 cm. above the 

 notch up to 2-5 cm. below it. There were 4 cases more than 

 1 cm., up to 2-5 cm. (in case 10), higher than the notch, and 

 there were 6 cases in which it was more than 2-5 cm. below 

 the notch, the lowest being 5 '5 cm. in case 27. 



There were 26 cases, or 65 per cent., in which the lowest 

 point of the anterior border of the spleen varied from 2 cm. 

 above E.F. to 3 cm. below. There were 10 cases more than 

 3 cm. below E.F., the lowest being 7"5 cm. in case 2. There 

 were 4 cases in which this point was more than 2 cm. higher 

 than E.F., the extreme being 4-5 cm. in case 37. 



The cases in which the spleen reached lowest down were, 

 successively, cases ;?, 17, 27, 38, 11, 36, 20, and 25. 



The cases in which the upper pole of the left kidney was 

 lowest down were, successively, cases 2, 29, 39, 7, 14, 27, and 

 28. 



The cases in which the lowest point of tlie spleen was highest 

 up in the abdomen were, successively, cases 37, 8, 4, 3, 10, 12, 



18, and 21. 



The cases in which the upper pole of the left kidney was 

 highest up were, successively, cases 23 and 24, 21, 4, 34, 3, 16, 



19, 12, and 36. 



The figures in italics show the cases which were common to 

 the two groups. 



A consideration of these cases in the various tables and 

 diagrams does not appear to establish any direct relationship — 



