216 Proceedings of the Royal Irish Academy. 



ing a sort of bed for the csecum (Huschke's Eingeweidelehre, p. 79 ; 

 Jourdan's Trans. 1845, p. 90) ; here the fold is produced by the descent 

 of the csecnm, and the intestine accurately fits the fossa. In speaking 

 also of the peritoneal investment of the caecum, he says, that the begin- 

 ning of the right colon has often a peritoneal ligament attached (right colic 

 ligament of Sensing,) which raises itself from the right iliacus muscle, 

 and often forms a fossa of which the opening receives the colon ; this 

 he calls the caecal ligament. The marks whereby this is distinguished 

 are its accurately corresponding to the caecum, and being formed by 

 that intestine, and bounded externally by Sensing' s'"' ligament. 



Waldeyer f cites a case of the existence of what he names a fossa 

 caecalis ; but it is different from either Huschke's, Leeper's, or mine, 

 and also received the end of the caecum. It occurred in a girl who died 

 of acute Endocarditis ; its right boundary was Sensing' s ligament 

 (Huschke's caecal ligament) ; its left fold went to the angle of fusion 

 of both plicae which bound the ilio-csecal recess. We will have more 

 occasion to notice this instance presently. Langer | has also 

 described an instance in a young soldier which corresponds closely 

 to that given by "Waldeyer, and which also corresponded to the 

 fundus of the well-descended caecum ; but like the former case there is 

 no record of a fold of iliac fascia as related to the sac, although both 

 Langer and "Waldeyer were acquainted with Huschke's description. 

 Treitz § notices cases likewise of its occurrence in children and young 

 persons, its occurrence being due to the descent of the cEecum — 

 " durch das Herabsinken des Co cum wird in der That manchmaldas 

 Peritoneum der Fossa iliaca etwas eingestiilpt und bildet eine sehr 

 flache, nach aufwarts sehende Tasche, in die sich das Cocum legt." 



The instance described by Leeper differs from all these in having 

 no relation to the caecum or to any intestine, and being a primary fold 

 of the iliac fascia clothed by peritoneum. 



My specimen is likewise peculiar in its extending inwards behind 

 the psoas, in its lower position regarding the ilium, in its having a 

 perfect flooring of iliac fascia, and in its co-existence with no ligament 

 of Housing. 



The same subject had a large subsplenic fossa, and the left obtu- 

 rator foramen had a shallow peritoneal involution capable of receiving 

 the tip of the middle finger, and about three quarters of an inch deep. 

 This ran inwards and forwards under the pectineus, and lay over the 

 obturator vessels and nerves. 



The causation of these pouches in this subject is also a point of con- 

 siderable interest ; the old woman was a victim to tight lacing, and pre- 

 sented many of the pathological phenomena arising from that condition ; 



* Hensing's description is in Haller's Collect. Dissert. Inauguralis Gottin- 

 gen, vol. i., p. 177. 



t Loc. cit., p. 81. 



+ Wochenblatt der Gesellschaft der Wiener Aertze, 1862, No. 17, p. 130. 



§ Hernia Retroperitonealis, Ein Beitrag zur GescMchte innerer Hernier. Prag. 

 F. A. Credner, 1857, p. 110. 



