Anatomy of the Abdominal Viscera. 159 



the individual separated viscera are represented, grouped along the 

 various planes used to divide the abdomen, on the one-ninth scale in 

 different parts of the paper ; and in various other manners by means 

 of diagrams, curves, and tables their correspondence and variations 

 with regard to the surface and to one another are set forth. Finally, 

 full details of all the measurements of the viscera, and their averages, 

 are given in the Measurement Tables in the Appendix. 



Various hardened, foetal, and adult preparations have been made to 

 elucidate or illustrate different points in the paper. 



In the course of the paper each organ is considered somewhat as 

 follows : Its average position in regard to the surface ; its variations 

 in regard to the surface ; its average position in relation to other 

 viscera ; its different variations in regard to them ; the causes of its 

 variations ; its shape and movements. 



Remits. 



The value of the method of the proportionate division of the abdo- 

 men, already described, for the purposes of surface marking is well 

 established. Indicating some of the chief points 



First, concerning tJie upper transverse abdominal line, halfway between 

 the pubes and the supra-sternal notch : 



It is found to practically correspond with the disc between the first 

 and second lumbar vertebrae in 67 '5 per cent, of the cases it was 

 within half an inch of this disc ; its greatest distance from the disc, and 

 that only in one case, was 1 inch. It corresponded in the average at 

 the costal arch with the tip of the 9th costal cartilage ; but it is 

 superior to that part for surface-marking purposes because (a) its 

 vertebral variation was not so great, and (b) it can always readily be 

 obtained, whilst the tip of the cartilage in many subjects cannot be 

 localised. 



In regard to deeper parts, a horizontal plane at this level (a) practically 

 bisects the stomach as it overlies the middle line in the average of cases. 



(b) In 72-5 per cent, of the cases it was correct as a guide to the 

 level of the pylorus ; in these cases either passing through the pylorus 

 or corresponding with one of its borders. 



(c) In the right lateral line it represents the place where the gall 

 bladder overlies the duodenum, and, when the liver is not enlarged or 

 displaced downwards, the plane passes just above the highest point of 

 the hepatic flexure of the colon. 



(d) To the left of the middle line, nearly halfway between the middle 

 line and the lateral line, it indicates the highest point of the duodeno- 

 jejunal flexure and the upper border of the mesentery, which in 85 per 

 cent, of the cases were not situated more than 2 cm. away from the 

 plane one way or the other. 



