162 Topographical Anatomy of the Abdominal Viscera. 



3. Although the ascending colon usually makes a considerable 

 impression on the right kidney, yet that part of the bowel is not an 

 indispensable support of the right kidney ; the bowel may be displaced 

 away from a right kidney situated at a level, as high, or higher than 

 usual. The right kidney is chiefly maintained in its position by the 

 strong attachments of its enveloping connective tissue, particularly to 

 the right crus of the diaphragm. 



4. Prolapse of the mesentery is commonly associated with prolapse 

 of the splenic flexure of the colon, but more directly associated with the 

 condition of the liver and stomach, as far as the forces above it are 

 concerned. 



The costo-colic ligament is the chief agent in determining the 

 position of the splenic flexure of the colon, and, though commonly 

 giving way before a liver and stomach displaced or enlarged down- 

 wards, may maintain the position of the splenic flexure of the colon in 

 spite of them. 



5. Although in the foetus the arrangements of the coils of the small 

 intestine perhaps generally follow certain plans, as far as these cases 

 go, the coils do not appear to maintain these arrangements in the adult 

 with any special uniformity. 



Many other points in the paper of importance do not admit of being 

 explained or indicated in an abstract they are especially the parts 

 dealing with the variations in the level of the cardiac orifice of the 

 stomach, and the relative levels of the two orifices of the stomach the 

 varieties in shape of 1 the stomach, how that there appear to be four 

 chief types, and that the first and commonest is particularly noticed in 

 those cases in which the transverse colon occupies a high position the 

 relations of the stomach to the liver the shape and moulding of the 

 pancreas by the stomach, and how that the presence of a well-defined 

 omental tuberosity on the pancreas is associated with a distended and 

 low position of the stomach, not especially with distension only the 

 abnormalities of the duodenum as illustrated in these cases the 

 position, direction, and moveability of the lower end of the ileum the 

 peritoneum on the large intestine the classification of the position 

 and attachments of the vermiform appendix, the changes in its position 

 with regard to the caecum, and the associated conditions ; and the 

 changes in the position of the caecum itself and the associated condi- 

 tions the varieties in shape of the transverse colon ; prolapse of the 

 transverse colon and the associated conditions the description of the 

 meso-sigmoid, especially the length and attachments of its outer limb, 

 and the resulting condition of the upper part of the sigmoid flexure of 

 the colon. 



