232 
follow the course of the vein over the digastric 
and stylo-hyoid muscles, where it meets 
with lymphatic glands which it enters; the 
posterior group aecompanies the occipital and 
ee auricular veins, traverses the glands 
hind the mastoid process, and afterwards 
those situated at the back and me part of 
the neck. The facial lymphatics, like the facial 
veins, receive branches from the forehead and 
a pass from the inner canthus of the eye 
along the side of the nose and over the bucci- 
nator muscle, where they meet with one or two 
small glands ; they then gain the anterior edge 
of the masseter, from whence they pass be- 
low the margin of the jaw, to traverse the 
glands there situated. ‘These three groups of 
vessels communicate freely with each other 
in the cervical glands, and are joined by some 
of the deep-seated lymphatics. These latter 
may be divided into those of the cranium 
and those of the face; the former as well as 
the lymphatics of the interior of the orbit are 
not sufficiently known to admit of our stating 
the exact course which they take. Fohmann 
and Mascagni both conceive that they have 
discovered the lymphatics of the brain and its 
membranes and have had them delineated in 
their published plates; but they differ so ma- 
terially from each other, and their descriptions 
are so far from satisfactory that we must be 
content to say that we are ignorant not only of 
the course they take but even of their existence. 
Fohmann represents them to be very large and 
numerous, situated principally between the 
arachnoid membrane and pia mater, while 
Mascagni figures them on the pia mater as 
exceedingly small and as accompanying some 
of the veins; others are also depicted as asso- 
ciated with the meningeal vessels ; the trunks 
of these vessels are supposed to descend with 
the carotid, vertebral, and meningeal arteries 
and with the internal jugular veins; while 
Fohmann throws out a hint that they may ter- 
minate in the venous system within the cra- 
nium. 
The deep-seated lymphatics of the face are 
associated with the bloodvessels; those accom- 
panying the internal maxillary arteries enter 
the gland or glands in the substance of the pa- 
rotid, and join the temporal lymphatics. The 
rest accompanying their bloodvessels reach the 
upper cervical glands, and communicate freely 
with the superficial lymphatics already traced 
to the same glands ; the further progress of the 
lymphatics in the neck is regulated by the 
position of the glands, which it will be re- 
membered form two groups, one situated be- 
tween the stetto-siesbsld muscle and the 
trachea, and associated more with the internal 
jugular vein, the other located in the cellular 
interval between the sterno-mastoid and tra- 
pezius muscles in the neighbourhood of the 
external jugular. The former receives the lym- 
phatics from the tongue, pharynx, and larynx, 
and lower down from the thyroid gland, 
trachea, and esophagus; while the latter col- 
lects them from the muscles of the posterior 
recion of the neck and of the shoulder. The 
afferent and efferent vessels of these two 
ABNORMAL ANATOMY OF THE LYMPHATIC SYSTEM. 
series of glands have uent communica- 
tions with each other. At the root of the neck 
they unite freely with the lymphatics emerging 
from the chest and with those of the uppel 
extremities, until ultimately one large ve ol is 
formed on either side, which receives the con- 
tents of the whole, and which terminates eit 
by opening separately into the internal ju sul 
vein close to the entrance of the lymphat 
trunk, or into that trunk itself. @ 
(S. Lane.) 
LYMPHATIC SYSTEM, ABNO 
ANATOMY.—The congenital variations fro 
the normal distribution of the lymphatic syste 
which have naturally most attracted attentio 
are those of the thoracic duct, or of the rig 
lymphatic trunk; the remainder of the sj 
lying too minute for general investigation, am 
the mode of its examination being within | 
“a of only a few. a 
he thoracic duct frequently varies as to t 
precise point at which it opens into the venou 
system, sometimes opening into the subclayia 
vein, at others into the jugular. A ve 
striking departure of it from its usual arrange 
ment is when it is found opening into the veil 
on the right side, just as it ordinarily does | 
the left. I saw an instance of this duril 
the winter of 1834, in the body of a child di 
sected by Mr. Skey. The duct folle it 
usual course as high as the fifth dorsal vertebr 
it then inclined to the right side, and opene 
into the angle between the right jugular an 
subclavian veins. It was remarkable that— 
this subject the right subclavian artery w; 
abnormal in its mode of origin; it arose fro 
the extreme left portion of the arch of the aort 
and passed to its destination behind the e 
and cesophagus. A similar transposition of th 
thoracic duct occurs in cases of general t 
position of the viscera. 
The thoracic ducts have been found somi 
times both terminating on the same side, som 
times on opposite sides. It has also be 
found dividing into two large trunks which pas 
upwards parallel to each other for a conside 
able distance, and then unite again. Variet 
have been observed as regards its mode 
opening into the jugular and subclavian vei 
Instead of terminating as a single trunk, it! 
been found to subdivide into two or thn 
branches, which open separately into the su 
clavian or jugular veins. At its termina 
the duct experiences generally some degree 
dilatation—in some instances I have seen’ 
so considerable as to have the ap nee of: 
aneurismal enlargement. The duct has f 
wise been found to empty itself into the vel 
azygos. In the pig, according to Panizza, 
communication between the duct and this ¥ 
is constant and normal. = 
The varieties in the course and distribution 
of the lymphatic vessels and in the number 
and position of the glands are doubtless as 
numerous as those of the veins. y! 
The diseased states of this system may bi 
examined, first, as regards the lymphatic and 
lacteal vessels ; secondly, with reference to the 
a 
