224 LYMPHATIC AND LACTEAL SYSTEM: 
hernia, he unsparingly divides the principal 
lymphatics and glands in the inguinal region. 
In the next place these vessels vary so 
much in number, and consequently in position 
in different individuals, while there exist so 
many where their presence is rather 
presumed than demonstrated, that a general 
outline of their course is all that can be re- 
quired or depended upon. In the distribution 
of these vessels two principal objects are spe- 
cially provided for; the conveyance of the 
lymph to its appropriate glands, and after- 
i from them to the two trunks of the sys- 
tem. We, consequently, first notice an evident 
tendency of the vessels from the structures in 
which they take origin towards the glands 
which intervene between them and the trunks 
of the system; secondly, their necessary course 
from these glands to the trunks themselves. 
With this key to the distribution of these 
vessels, I propose to describe, first, the posi- 
tion of the glands, then to treat of the trunks 
of the system; and, lastly, having these two 
fixed points, to trace the vessels throughout their 
course. 
In the lower extremities the conglobate glands 
are chiefly found in the inguinal region, where 
they are divided into a superficial and deeper 
seated cluster; a few small glands are situated 
in the popliteal space surrounding the bloodves- 
sels. We rarely meet with one between the 
popliteal space and the inguinal region, and they 
are only occasionally met with below the knee, 
and then isolated and extremely small. In the 
eppes extremity the large and clustered lym- 
phatic glands are only found in the axillary 
space; a single gland is generally located just 
above the internal condyle of the humerus; 
below this point a distinct gland is rarely met 
with, 
In the cervical region the principal lympha- 
tic glands are situated in two cellular intervals, 
found at the upper part between the omo-hyoid 
and lecenie cloves mamterl muscles, and below 
between the latter muscle and the trapezius. 
The glands in these positions are ranged in a 
line so as to form a sort of chain of glands, 
hence the term glandule concatenate as applied 
to them. 
On the head and face the glands are few, 
small, and isolated. One may be pretty con- 
stantly met with behind the ear over the mas- 
toid process of the temporal bone, another in 
front of the ear in the neighbourhood of the 
parotid gland. One or two will be found 
under the margin of the lower jaw, both in the 
median line and also more laterally situated. 
A small lymphatic gland will usually be distin- 
guished amonst the numerous but small buccal 
and labial glands. 
In the cavity of the cranium no lymphatic 
glands have been discovered, but in the abdo- 
minal and thoracic cavities they are very nume- 
rous. In the abdomen they are chiefly situated 
in the neighbourhood of the larger bloodvessels. 
In the pelvic region they form clusters, or rather 
chains of glands accompanying the external, in- 
ternal, and common iliac vessels, and in the 
lumbar region they are similarly arranged on 
either side of the aorta, as high as the pe Fe 
origin of the superior mesenteric artery. . 
The absorbent glands which intercept 
lacteals in their course towards the receptacu 
chyli are large and numerous; they are s 
ated between the folds of the mesentery, ; 
accompany the trunk and some of the t 
of the superior mesenteric 3 th 
usually semed mesenteric glands. he 
ing lymphatic glands of the abdominal viseer 
though numerous, are smaller and more isolat 
they will generally be found one ee ‘ter 
of the viscera to which they belong, n 
quently between the folds of the peritonet 
Of this description may be considered the 
accompanying the hepatic and splenic vess 
the coronary and gastro-epiploic arteries of th 
stomach, the small glands of the mesocolon ¢ 
epiploon, those associated with the renal ¢ 
spermatic arteries. 7” 
The largest absorbent glands of the thora 
cavity are those which receive the lymphati 
from the lungs; they are situated at the roo 
of the lungs, pretty closely attached to | 
bronchi; they are generally of a dark cok 
and are called bronchial glands. Those 
ciated with the lymphatic vessels of the he: 
are few and small ; two or three may general 
be noticed of the size of millet-seeds on 
aorta and pulmonary artery, where these vs 
are invested by the pericardium. In the post 
rior mediastinum close to the thoracie duc 
three or four large lymphatic glands are usu: 
met with, as well as several smaller ones in 
intercostal spaces, not far from the thor 
duct. In the anterior mediastinum also son 
small glands may be observed imbedded — 
loose cellular tissue in the neighbourhood — 
the internal mammary vessels. Occasioua 
a small gland may be seen on the convex su 
face of the diaphragm. a 
In the substance or parenchyma of the 
ferent organs no lymphatic glands have b 
detected. They have never been seen in 
brain, spinal marrow, in the lungs, liver, splee 
kidney, or testicles, in nerve, muscle, or bom 
Having given this general outline of 
position of the lymphatic glands, I shall no 
proceed to describe the trunks of the system. 
The thoracic duct, (fig. 53,) or pri 
trunk of the lymphatic system, generally e 
mences on the body of the second lu: 
vertebra pretty exactly in the median li 
concealed behind the root of the right em 
gent artery, bounded on the right by ther 
crus of the diaphragm, and to the left by 
aorta, to which it is connected by cellular t 
It may be said to be formed by the union 
the lymphatics of the lower extremities w 
the trunks of the lacteals proceeding from 
intestines. At the conflux of the p inci; 
vessels from these three sources,—and here 
be more than one from each,—a dilatation 
sometimes found, which has been called th 
receptaculum chyli. From the body of the se= 
cond lumbar vertebra the thoracic duct ascen 
into the thorax between the aorta and ve 
azygos. In the thorax it is situated behi 
the right pleural fold of the posterior medias: 
7 
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