CHAPTER II 



SURGICAL ANATOMY OF THE ABDOMEN 



A THOROUGH knowledge of the regional anatomy of the 

 abdomen is absolutely essential to the determination of a 

 definite diagnosis. The man who has strongly insisted 

 upon that, and devoted an enormous amount of time 

 and thought to the subject, is Lieutenant-General Fred 

 Smith. It is the result of his wprk that forms the 

 subject-matter of the present chapter, and I take this 

 opportunity of thanking him for his kindness in allowing 

 me to incorporate it with this volume. In his letter 

 granting me permission to use it he says : ' The infor- 

 mation in these few pages represents an immense amount 

 of work. I do not remember, now, how many dissections 

 I made in the upright position, but a large number.' 

 ***** 

 For surgical purposes the abdomen is best divided 

 into a superior and inferior zone by a line drawn horizon- 

 tally from the hip-joint to the ribs. These zones are 

 further subdivided into three parts by means of two 

 vertical lines carried round the abdomen, one from the 

 body of the first lumbar vertebra, and the other passing 

 just in front of the anteroinferior spinous process of the 

 ilium. By these means we have the abdomen mapped 

 out into a superior and inferior zone, and each zone into 



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