12 ORGANS OF DIGESTION. 



is, it forms an oblong prominent ridge, reaching to the upper ex- 

 tremity of the bladder; and, as regards each umbilical artery, 

 the duplicature is of a variable breadth in different individuals; 

 but always forms a well marked falciform process, reaching 

 from near the umbilicus to the lower side of the bladder, and di- 

 viding the inguinal region into two parts or fossse, one next to 

 the pubes, and the other near to the ilium. In the undistended 

 state of the bladder the peritoneum reaches to the pubes, is re- 

 flected from the latter to the upper, and then goes over the pos- 

 terior surface of the bladder. In the male, it goes from the 

 posterior lower end of the bladder to the rectum, but, in the fe- 

 male it does not descend so low there, and passes from the blad- 

 der to the vagina and uterus, and afterwards to the rectum. 



In the concavity of the ilium, and in the lumbar region, the 

 peritoneum is attached by long loose cellular substance, which 

 permits it to be stripped off easily, simply by tearing. In these 

 several regions it encounters the colon, over which it is reflected, 

 and thereby forms the Mesocolon; thence it passes in front of 

 the kidneys, but separated from them by a thick layer of cellu- 

 lar and adipose matter, and immediately afterward it is thrown 

 into a Jong duplicature, extending obliquely across the lumbar 

 vertebrae from above, downwards, and to the right side. This 

 duplicature includes the small intestine, and is the Mesentery.. 



In the highest regions of the abdomen, the peritoneum is in the 

 greater part of its extent uniformly reflected over the concave 

 surface of -the diaphragm, and adheres so closely to it, as to re- 

 quire a cautious and protracted dissection for its entire removal. 

 As the remains of the umbilical vein of the fetus are still found, 

 but in a ligamentous condition, going from the navel to the un- 

 der surface of the liver, their existence gives rise to the falci- 

 form ligament, abroad duplicature of peritoneum, which passes 

 from the upper half of the linea alba and from the middle line 

 of the diaphragm to the liver. Another line of attachment, or 

 of reflection, of this membrane to the liver, is found all along 

 the posterior margin of the latter. In the same region, it is also 

 reflected from the diaphragm to the spleen and to the stomach. 

 Such is the general account of the course of the peritoneum. 

 Each of the duplications has a distinct name, and some peculi- 

 arity of organization or of relation, which will require a specific 

 description and a frequent allusion to it. 



