DIGESTION 101 



look upon the rudimentary caecum, with its liability to inflam- 

 mation, as a permanent burden on the human race. In justice 

 to the appendix, however, it must be pointed out that it has 

 acquired its criminal reputation during the past twenty years. 

 The frequency of appendicitis has increased so enormously 

 during this period that it ought to be possible to correlate its 

 prevalence with the introduction of the cause upon which it 

 chiefly depends. 



The colon has a length of about 5 feet. Its greatest width, 

 about 3 inches, is at its commencement, but it is everywhere 

 much wider than the small intestine. Whereas the wall of the 

 small intestine is smooth externally, the wall of the colon is 

 sacculated. Three muscular bands constrict it longitudinally ; 

 circular bands at intervals of about 1 inch or 1J inch throw 

 it into pouches. It ascends on the right side, lying far back 

 against the body-wall, to which it is bound by peritoneum, 

 which in this part of its course covers only its anterior surface. 

 Having touched the under side of the liver, it loops forwards 

 and to the left side, crossing the middle line just above the 

 umbilicus. On the extreme left side it touches the spleen, 

 getting very near to the back of the abdominal cavity. It 

 then descends on the left side, again bound to the body-wall 

 by peritoneum, although not so closely as on the right side, 

 until it reaches the inner lip of the crest of the hip-bone. From 

 here onwards the fold of peritoneum which attaches it allows 

 it a free movement. This portion of the large intestine, the 

 sigmoid flexure, may even fall over into the right groin. 

 Lastly it curls backwards into the pelvis, as the rectum. 



Movement of the contents of the alimentary canal may be 

 favoured by judicious pressure, or massage. From the descrip- 

 tion of the situation of its several parts given above, it will be 

 understood that if the right hand be placed on the abdomen 

 immediately beneath the ribs, with the fingers well round to the 

 left side, the stomach will be covered. Pressure from left to 

 right will tend to drive its contents towards the pyloric valve. 

 The small intestine is so irregular in its course as to preclude 

 the possibility of following it with the hand. Pressure first 

 on one side and then on the other, with a general tendency to 

 work from above downwards, tends to press forward its 

 contents ; but, owing to its circular form and strong muscular 



