Chap, xvi.] THE ABDOMINAL PARIETES. 273 



of the internal mammary, and the abdominal divisions 

 of the lumbar arteries. The superficial vessels are 

 of small size, although Verneuil reports a case of 

 fatal haemorrhage from the superficial epigastric 

 vessel. 



The superficial veins on the front of the abdomen 

 are numerous, and are very distinct when varicose. A 

 lateral vein uniting the axillary and femoral veins is 

 often rendered in this way very prominent. It has 

 been shown by Mr. Fenwick that the surface 

 abdominal veins probably take no part as alterna- 

 tive blood channels in cases of obstruction of the 

 inferior vena cava. Clinical experience shows that 

 these veins may be also enormously varicose in 

 instances where the inferior cava is quite patent. In 

 one case under my care there was extensive varicosity 

 of the surface veins from the pectoral region to the 

 groin that involved one side of the body only. It 

 has been shown, moreover, that the valves of these 

 vessels are so arranged that the blood in the surface 

 veins above the navel goes to the axilla, that in the 

 veins of the sub-umbilical region to the groin, while 

 the blood in the immediate vicinity of the umbilicus 

 flows either up or down, occupying indeed a kind of 

 neutral position. 



As regards the surface lymphatics of the front of 

 the abdomen, it may be said in general terms that 

 those above the umbilicus go to the axillary glands, 

 and those below to the glands of the groin. 



Nerves. The abdominal wall is supplied by the 

 lowest seven dorsal or intercostal nerves, and by the 

 first two lumbar nerves. These nerves run obliquely 

 to the long axis of the abdomen downwards and 

 inwards from the sides to the middle line. Their 

 direction is represented by a continuation of the 

 lines of the ribs : they are placed parallel to one 

 another, and at fairly equal distances apart. It is 



