The Suprarenal Capsules and the Pancreas. 259 



jejunal angle and on the transverse meso-colon to the left 

 of the latter. The superior border has, above it, the solar 

 plexus and the coeliac axis, while the inferior border is the 

 dividing line for the two layers of the transverse meso- 

 colon. The excretory duct of the pancreas runs from left 

 to right, to unite, as already mentioned, with the common 

 bile duct in the walls of the descending part of the duo- 

 denum. The nerves are derived from the solar plexus 

 and have, in addition, a few filaments prolonged from the 

 right pneumogastric. 



Landmarks. On the anterior surface of the ab- 

 domen the head of the pancreas lies, disk-like in shape, 

 mostly to the right of the median line, and nearly two 

 inches above the umbilicus. The body, a little over an 

 inch in width, crosses the first lumbar vertebra from right 

 to left, in the direction of the tip of the ninth left costal 

 cartilage. The pancreas cannot be palpated on ..account 

 of its depth in the abdomen. 



Disease. Cysts in the pancreas may be due to the 

 retention of the normal pancreatic juice, but, according to 

 Senn, there is something more, viz. : "An arrest of absorp- 

 tion due to a loss of function of the vessels which perform 

 this task." A pancreatic cyst develops, as a rule, in the 

 body or tail, but very rarely in the head, and may present 

 itself in two ways, one, the more common, in which it 

 pushes forward the stomach, lying beneath the liver and 

 above the transverse colon; the other, in which it grows 

 between the two layers of the transverse meso-colon so 

 that the colon lies above it. 



Acute H&morrhagic Pancreatitis. In this the inter- 

 lobular tissue is infiltrated with blood and the characteris- 

 tic features are, sudden onset, intense colicky pain and 

 collapse. The latter symptoms are due to the disturbance 

 of the solar plexus, and have been referred to when dis- 

 cussing intestinal reflexes. 



