THE LYMPHATICS OF THE ABDOMEN. 553 



the spermatic vessels in the abdomen to enter some of the lumbar lymphatic glands 

 below the renal vessels. 



The deep lymphatics of the abdominal wall in part pass along the circumflex 

 iliac and epigastric arteries to the external iliac glands, the circumflex iliac set often 

 traversing one or two small glands at the fore part of the iliac crest ; others 

 accompany the ilio-lumbar and lumbar arteries, and, after being joined by lymphatics 

 from the muscles of the back and the spinal canal, enter the lateral lumbar glands. 

 The lymphatics from the upper part of the anterior wall ascend with the internal 

 mammary vessels, and enter the sternal glands in the thorax. 



The mesenteric glands vary in number from a hundred and thirty to a 

 hundred and fifty or more ; and in the healthy state they are seldom larger than an 

 almond. The largest are placed around the trunk of the superior mesenteric artery, 

 but the greater number lie within the loops formed by the blood-vessels, between the 

 layers of the mesentery, becoming smaller and increasing in number as they are 

 nearer to the intestine. They are most numerous in that part of the mesentery 

 which corresponds to the jejunum ; and, except at the lower part of the ileum, they 

 are seldom found closer to the intestine than an inch and a half or two inches. A 

 considerable cluster of ileo-colic glands lies in the angle between the ileum and 

 ascending colon. Small mesocolic glands in limited numbers are also disseminated 

 irregularly between the layers of the peritoneal folds connected with the large 

 intestine. 



The lacteals take their origin in the wall of the intestines, where they form two 

 chief plexuses, one beneath the mucous membrane, and the other between the layers 

 of the muscular coat (see the anatomy of the intestinal canal, in Vol. III). They 

 leave the intestine at its attached border, and ascend through the mesenteric glands, 

 gradually diminishing in number and increasing in size, to near the root of the 

 superior mesenteric artery, where they are joined by the efferent vessels of the coeliac 

 glands, and terminate sometimes in a single intestinal lymphatic trunk, sometimes in 

 three or four vessels, which open into the lower end of the, thoracic duct. The 

 lymphatics from the descending colon and the sigmoid flexure usually join some of 

 the lumbar lymphatics, or turn upwards and open by a separate trunk into the 

 thoracic duct. 



The coeliac glands, from sixteen to twenty in number, and of large size, 

 surround the coeliac axis, and cover the aorta above the superior mesenteric artery. 

 They receive the lymphatic vessels derived from the stomach, spleen, pancreas, and 

 the greater part of the liver ; and their efferent vessels pass with the trunks of the 

 lacteals to the thoracic duct. 



The lymphatics of the stomach commence in the wall of that organ, and 

 pass upwards and downwards over its surface to the small and great curvatures 

 respectively, where they traverse a few small gastric glands lying along the attached 

 border of the corresponding omenta. The lymphatics of the small curvature 

 accompany the coronary vessels to the cardiac orifice, and then turn downwards 

 behind the pancreas to enter the coeliac glands ; those of the great curvature are 

 directed towards the pylorus, along with the right gastro-epiploic artery, and, after 

 being joined by the lymphatics from the upper part of the duodenum, also open into 

 the coeliac glands. A third series of lymphatic vessels proceed from the left end of 

 the stomach, and, following the course of the gastric branches of the splenic artery, 

 unite with the lymphatics of the spleen. 



The lymphatics of the spleen leave the organ at the hilum with the blood- 

 vessels, and, accompanying these, pass through a series of small splenic glands lying 

 against the tail of the pancreas, to terminate in the cceliac glands. 



The lymphatics of the pancreas emerge therefrom at different points, and 

 enter the cceliac glands at its upper border. 



