The Intestines. 223 



position ; in the presence of appendices epiploicae ; in the 

 arrangement of its peritoneal attachments and in its longi- 

 tudinal musclar fibres, the latter in the case of this bowel, 

 being arranged in muscular bands about the width of the 

 little finger, whereas, in the small intestine, the longitu- 

 dinal muscular coat is spread uniformly over its surface. 

 The first portion of the large intestine the ccecum or blind 

 extremity is situated in the right iliac fossa, measures 

 three inches in width and two and a half inches in height, 

 and terminates above at the ileo-caecal valve. It rests on 

 the ilio-psoas muscle and is entirely surrounded by peri- 

 toneum. In the foetus, the apex or conical end of the 

 caecum, becomes the appendix in the adult, and the longi- 

 tudinal muscular bands form a part of this conical end just 

 as they do in the rest of the large intestine. The normal 

 type of the caecum in the adult is not conical like it is in 

 the foetus, since, in tl^ former, the right portion and an- 

 terior wall have developed to a greater degree than the re- 

 mainder of the caecum, with the result that this portion 

 lies nearest Poupart's ligament, while the appendix itself 

 is carried upwards and backwards with the rest of the 

 caecum, towards the ileo-caecal valve, so that the base of 

 the appendix is situated about two-fifths of an inch below 

 th'is valve. The apex, or tip of the caecum, formed by this 

 enlarged right extremity, lies, as a rule, opposite a point a 

 little to the inner side of the middle of Poupart's ligament 

 and about one inch above it. 



The Appendix Vermiformis. The original apex of the 

 foetal caecum, which has thus become displaced to the in- 

 ner and posterior aspect of the caecum, is termed, in the 

 adult, the appendix, and averages about three and a half or 

 four inches in length. It has a meso-appendix coming off 

 from the left leaf of the mesentery and attached, as a rule, 

 to the proximal third or half of the appendix, the remain- 



