300 CLINICAL APPLIED ANATOMY. 



They may undergo compensatory enlargement when the operation 

 of splenectomy has been performed. They sometimes form the 

 starting point of tumours, and have been found embedded in the 

 tail of the pancreas. 



Abscess of the spleen is usually of embolic origin, but may 

 invade the viscus from without. Primary abscesses may rupture 

 into the left subphrenic space in which the spleen lies, or may 

 discharge into the stomach, colon, or left pleural sac. An ulcer 

 of the stomach may become adherent to the gastric surface of 

 the spleen and give rise to a local abscess. 



THE SUPRARENAL BODIES. 



Addison's disease is nearly always due to tuberculosis of the 

 suprarenal bodies. The infection is usually secondary to a lesion 

 elsewhere and conveyed to the glands by the blood. The vascular 

 supply to the suprarenals is very free, there being no fewer than 

 three capsular arteries supplied to each. Since both bodies lie 

 in contact with the spinal column, from which they are only 

 separated by the crura of the diaphragm, it is not surprising 

 that tuberculous caries of the lower dorsal and upper lumbar 

 spine sometimes invades them by contiguity. 



The semilunar ganglia and the solar plexus of the sympathetic 

 are intimately connected with the suprarenals and may be involved 

 by the spread of inflammation from them. At one time the 

 symptoms of Addison's disease were exclusively attributed to 

 implication of these nervous structures. 



The receptaculum chyli is separated from the right suprarenal 

 by the crus of the diaphragm, but there is no distinct evidence 

 of obstruction to the lymph flow in Addison's disease. 



A solitary thin-walled vein emerges from each capsule. That 

 from the right passes directly into the inferior vena cava ; that 

 from the left pours its contents into the left renal vein. The 

 efferent lymphatics accompany the veins and terminate in glands 

 adjacent to the aorta. A few lymphatics perforate the crura 

 of the diaphragm ending in small glands between the crura and 



