664 THE LYMPHATICS 



oesophagus, and then, after receiving tlie lymphatics from the up])erand left portion 

 of the left lobe of the liver, turn downwards behind the pancreas to join the coeliac 

 glands. 



The inferior gastric or gastro-epiploic glands, six or eight in number, lie 

 along the greater curve of the stomach Ijctwcen the layers of the great omentum. 

 They receive the inferior gastric lymphatics and the lympliatics of the great omen- 

 tum. Their efferent vessels pass with the lym^jhatics from the ui)])er jjart of the 

 duodenum into the coeliac glands. 



(2) The lymphatic vessels of the intestine are divided into the lymphatics 

 of the small intestine and the lymphatics of the large intestine. 



The lymphatics of the small intestine are called the lacteals, because they 

 carry the cliyle as well as the lymph from the intestinal walls. Beginning })artly 

 beneath the peritoneal coat — but chietly in two plexuses, one between the muscular 

 coats, and one beneath the mucous membrane — they pass round the intestine with 

 the blood-vessels to the mesenteric attachment, and thence between the layers of the 

 mesentery to the mesenteric glands. 



The lymphatics of the large intestine are disposed of as follows: — (a) Those 

 from the ca.^cum and ascending colon pass between the layers of the meso-colon to 

 the meso-colic glands, (ft) Those from the transverse colon and upper half of the 

 descending colon pass with the middle colic artery between the layers of the meso- 

 colon, also to the meso-colic glands, (c) Those from the lower half of the descend- 

 ing colon and sigmoid flexure pass into the left lymphatic trunk of the lumbar 

 glands. The lymphatics of the rectum are described with the lymjihatics of the 

 pelvis (page iWyl ). 



The lymphatic glands of the intestines are the mesenteric and meso-colic. 



The mesenteric glands, some one hundred and tift}' to two hundred in number, 

 lie l)etween the layers of the mesentery. They are arranged roughly in three sets: 

 (a) A primary set, about two inches from the intestinal margin of the mesentery, 

 receive the lymphatics from the intestine. The efferent vessels from these glands 

 pass into the next or secondary set. (ft) The secondary set are situated about the 

 primary loops of the superior mesenteric artery; they are more numerous than the 

 primary set, and receive the efferent vessels of the latter. Their efferent vessels 

 end in the tertiary set. (c) The tertiary set of glands lie along the course of the 

 trunk of the superior mesenteric artery. They are larger than the secondary set, 

 and closer together. Their efierent vessels unite to form three or four trunks, or 

 perhaps more often a single trunk (the intestinal lymphatic trunk) wdiich, after 

 receiving the efferent vessels from the meso-colic glands, oj)ens, either separately, 

 or together with the efferent ducts of the coeliac glands, into the receptaculum chyli. 



The glands and lacteals of the jejunum are more numerous than those of the 

 ileum. 



The meso-colic glands, twenty to thirty in numl)er, are placed between the 

 layers of the meso-colon. They receive the lymphatics from the ca?cum, ascending 

 and transverse colon, and from part of the descending colon. Their efferent vessels 

 join the efferent vessels from the tertiary set of mesenteric glands, and open with 

 them into the receptaculum chyli. 



(3) The lymphatics of the liver consist of a superficial and deep set. The 

 former are arranged in a plexus beneath the peritoneal covering; the latter accom- 

 pany the blood-vessels in the substance of the organ. 



(a) The superficial set of lymphatics form groups, and run in various direc- 

 tions. Those on tlic upper or convex surface of the liver are disposed of as 

 follows: — (i) The lymphatics of the left half of the right lobe, and of the right half 

 of the left lobe, converge towards the falciform ligament, U]) which they run to the 

 diaphragm. They then pass through the costo-xi])lioid s])ace, and enter the 

 anterior mediastinal chain of glands, and thus open in part into the right lymphatic 

 duct, (ii) The lymphatics on the anterior part of the convex surface pass over 

 the anterior margin, and along the course of the longitudinal fissure to the he})atic 

 glands in the gastro-hepatic omentum, (iii) The lymphatics along the posterior 

 margin of the liver pass between the layers of the coronary ligament to the dia- 

 phragm, which they perforate, and end in small glands about the u])])er part of the 

 vena cava (Quain). (iv) A group from the right half of the right lobe pass out- 



