780 THE LYMPHATICS IN PARTICULAR. 



the lymphatics of the anterior part of the body, play the same part as the 

 sublumbar glands do to the vessels of the posterior region. 



Before arriving at this common point of convergence, they are intercepted 

 on their course by other glands, which form four principal groups : 1. The 

 guttural or pharyngeal glands. 2. The submaxillary glands. 3. The prescapidar 

 glands. 4. The brachial glands. 



In studying these different glandular groups in succession, with their afferent 

 and efferent vessels, a sufficient idea will be afforded of the entire lymphatic 

 apparatus in the region which remains to be examined. 



1. Prepectoral Glands.^ 



These form, on each side of the terminal extremity of the jugular, within 

 the inferior border of the scalenus muscle, a very large mass which extends into 

 the chest by passing beneath the axillary vessels, and ascends to the inner face 

 of the first rib on each side. 



Into these glands pass the lymphatic vessels emerging from the prescapular 

 and axillary glands, those which descend along the trachea with the common 

 carotid, and which come from the pharyngeal glands, as well as the majority of 

 those which follow the internal thoracic vessels. 



They give rise to several short and voluminous branches : those from the 

 glands of the right side form, by their junction, the great lymphatic vein ; and 

 those from the left side join the thoracic duct, or enter separately beside the 

 latter, at the summit of the anterior vena cava. 



2. Pharyngeal Glands. 



Very numerous, soft, and loosely united to one another, these glands are 

 disposed in an elongated mass that occupies the lateral plane of the pharynx,, 

 below the guttural pouch, and is prolonged backwards, even beyond the thyroid 

 body. 



They receive all the lymphatics from the head ; some come directly from 

 the base of the tongue, the soft palate, the pharyngeal walls, and the larynx ; 

 the others are derived from the submaxillary glands, and from a lobule lodged 

 in the substance of the parotid gland. 



The efferent branches which leave it are four or five in nmnber. Always 

 voluminous, they descend along the trachea, some separately, but the majority 

 are united in a fasciculus which follows the carotid artery. They have on their 

 course several elongated glands, to which the lymphatic radicles that arise from 

 the cervical portion of the trachea r^nd oesophagus pass. On arriving near the 

 entrance to the chest, they are generally lost in the prepectoral glands ; though 

 some of them traverse these without dividing, and directly enter — on the left — 

 the thoracic duct, and on the right, the great lymphatic vein. It has been even 

 possible for us to inject the latter vessel by one of these vessels exposed on the 

 right side. 



3. Submaxillary or Subglossal Glands. 



They represent a fusiform mass situated at the bottom of the submaxillary 

 space, in the receding angle comprised between the digastricus on the one side, 



' These are glands, we believe, which ought to be regarded as the representatives of the 

 axillary glands of Man. 



