Fig. 141. Retroperitoneal Lymphatic Glands and Vessels. 



The whole of the Anterior Abdominal Wall and the lower part of the Anterior Tlioracic Wall have 

 been removed in a male infant, 4 weeks old. A small area of peritoneum has been left over the right 

 kidney ; the Receptactihim Chyli has been exposed to view by cutting away a short piece of the Aorta. 

 The renal lymphatics are described after Stahr; the lymphatics of the testicle partly after Most and 

 partly after B r u h n s whose description has been adopted for the deep inguinal glands. 



Apart from the glands above the fascia lata of the thigh described in Fig. 166, deep 

 glands demand consideration both as regional and as intermediate to the deep lymphatic 

 vessels of the lower limb. As a rule, they are small and only 1—4 in number; their efferent 

 vessels run, as shewn in the figure, along the inner border of the Femoral Vein and along the 

 outer and anterior surfaces of the vessels of the thigh into the Pelvis. The former path leads 

 to Cloquet's Gland, the outer tract to a (usually) very large gland just above Pol'Part's 

 Ligament. 



The large lymphatic vessels (4 to 6) of the testicle have a very long course before 

 they arrive at their regional glands (the lumbar glands:; occasionally, there is an intermediate 

 gland on the course of the Spermatic Vessels (black spot on the right side at the level of the 

 Rectum). The regional glands on the right side are usually at a lower level than on the left 

 side; with the Vas Deferens lymphatic vessels run to the base of the bladder. The lym- 

 phatics of the inferior half of the Ureter pass to a Pelvic Gland, those of the superior half 

 to a Lumbar Gland. 



The Lymphatics of the Kidney form on its surface a network quite distinct from the 

 Stellate Veins of Verheyn. 



The efferent vessels (2 — 4) pass with the renal blood-vessels either directly or through 

 an intermediate gland to the group of lymphatic glands situated at the angle formed by the 

 Renal V'eins and the Inferior Vena Cava. When accessory renal vessels are present (cf Fig. 164) 

 lymphatic vessels with a special regional gland usually accompany them (Frohsel 



As the Peritoneum gives a covering to all the abdominal viscera its lymphatics do 

 not correspond to the limitations of each viscus (cf. peritoneum over right kidney after Stahr 

 who has kindly allowed us to make use of his hitherto unpublished figures). 



All the lymphatics referred to, as well as those from the Intestine which convey the 

 Chyle, directly or indirectly pass into the Receptaculum which lies behind the Abdominal 

 Aorta and from which the Thoracic Duct leads. The Aorta and Inferior Vena Cava are 

 surrounded by a network of lymphatics and glands. 



General Remarks on Lymphatic Glands. 



As many regional glands are secondary to other organs it remains that only a few- 

 intermediate glands (a collection of lymphoid tissue on the course of a lymphatic vessel) are 

 purely regional. 



From pathological observations, lymph nodes or small collections of lymphoid tissue 

 are frequently found on the course of lymphatic vessels ; Frohse and Hein have seen in a 

 case of Arterio-Venous Aneurj'sm (the injected specimen of an amputated arm) 6 large glands 

 situated along the radial and ulnar arteries. 



Hein has further observed in an apparently healthy arm a small gland near the ulnar 

 nerve, just below the Elbow-Joint. Frohse found in a case of Carcinoma Mammae with 

 obstructed axillarj- lymphatics 4 newly formed glands on the clavicle and in yet another 

 pathological case 14 axillary glands on the healthj' side and 31 on the diseased side; — to sum up: 

 pathological conditions favour the new-formation and development of lymphatic glands. In 

 some cases the lymphatic glands are not visible to the naked eye but when injected with 

 mercury even a gland of the size of a pin's head can be recognized because it becomes 

 distended by preventing the passage of mercury. 



