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rectum are supplied with motor fibres from the anterior roots of certain of the sacral
nerves (2nd and 3rd, and in part the 1st in the dog), which nerves also supply inhibitory
fibres to the circular coat, whereas the fibres of the hypogastric plexus which supply
the circular muscular tissue with motor fibres, are derived from white rami com-
municantes of the anterior roots of certain of the lumbar nerves, which join the
sympathetic chain and lose their medullary sheath before passing to their distribution
in the muscular coat. Pilliet has noted the presence of Pacinian corpuscles upon
some of the nerves distributed to the anal mucous membrane.



EECENT LITERATURE OF THE INTESTINES.

Angler, L., Contribution h V etude du diverticule de Vileon ou diverticute de Meckel, These,
Havre, 1888.

Ball, C. B., The anal valves; their origin and pathological significance, Mathews Medical
Quarterly, Louisville, April, 1894.

Ballowitz, E., Bemerkung uber die Form und Laye des memchlichen Duodenums, Anat.
Anzeiger, Bd. x., 1895.

Bennett, W. H., and Rolleston, H. D., Abnormal arrangement of the ileo-ccecal portion of the
intestine, Journal Anat. and Phys., vol. xxv., 1890.

Berkley, Henry J., The nerve endings in the mucosa of the small intestines, muscularis mucosce.
and cortex of the kidney, Bulletins of the Johns Hopkins Hospital, vol. iii., 1892 ; The nerves and
nerve endings of the mucous layer of the ileum as shewn by the rapid Golyi method, Anat. Anzeiger,
Jahrg. viii., 1893.

Berry, R. J. A., The anatomy of the ccecum ; and The anatomy of the vermiform appendix,
Anat. Anzeiger, Jahrg. x., 1895.

Birming-ham, Ambrose, Absence of ileo-ccKcal valve, Tr, 11. Acad. Medic., Ireland, vol. ii., 1893.



118 ORGANS OP DIGESTION.

Bizzozero, G., Ueber die Regeneration der Llemente der Schlauchformigen Druscn und des
Epithets des Magendarmkanals, Anatom. Anz., Jahrg. iii., 1888; Sulle ghiandole tululari del tubo
gastro-enterico, <f-c., Atti di accad. di sci. di Torino, 1888-89.

Blaney, A. J. , Report upon the frequency of the presence of the diverticulum ilei of Meckcl,
Trans, of the Roy. Acad. of Med. of Ireland, vol. ix., 1891.

Bodenhamer, W., Observations on the normal sacculi of the anal canal both in health and
disease, New York Medical Record, vol. xxxiii., 1888.

Bodeiihaur, W., Some anatomical recollections pertaining chiefly to that portion of the intestinal
canal denominated rectum, New York Med. Journ.. 1891.

Brooks, H. St. John, On the valvulee connivcntev in man, Brit. Med. Journ., Feb., 1890 ;
Anat. Anzeiger, Bd. vii., 1892.

Bruyne, de, De la presence da tissu reticule' dans la tunique musculaire de rintestin, Comptes
rendus, t. cxiii. , 1891.

Bryant, J. D. , The relations of the gross anatomy of the vermiform appendix to some features of
the clinical history of appendicitis, Annals of Surgery, vol. v.

Buchanan, A. M., Diverticulum (MeckeVs] of small intestine, Journ. Anat. and Phys. , vol. xxvii.,
1892.

Cajal, S. B., Los ganglios y plexos nerviosos del intestino de los mammiferos, Madrid, 1893 ; Sur
les ganglions et plexus nerveux de Vintestin, Mem. soc. biol.. t, v., 1893-4.

Chaput & Lenoble, Etude sur le calibre normal de Vintestin grele, Bull. soc. anat., Paris, 1894,

Clado, Sur I'appcndice ccecal, Memoires de la societe de biologic, 1 892.

Clarkson, G. A., and Collard, F. S., Abnormal position of MeckeVs diverticulum, Journ. Anat.
and Phys., vol. xxvi., 1891.

Curschmann, H., Die Anomalicn derLage, Form u. Grosse des Dickdarmes, cOc, Deutsch. Arch.
f. klin. Med., Bd. liii., 1894.

Czermack, N. , Einige Ergebnisse itber die Entwickelung, Z usammensetzung und Function der
Lymphknotchen der Darmwand, Arch. f. mikrosk. Anat., Bd. xlii., 1893.

Davidoff, v., Ueber das Epithel des Darmcs u. seine Bezithungen zum lymphoiden Gewebe,
Miinchener medicinische Wochenschrift, Jahrg. xxxiii.

Debierre, C., La valvule de Bauhin consideree comme barriere des apothicaircs, Lyon medical,
tome 1., 1885.

Dreike, P., Ein Bcitrag zur Kenntniss dtr Ldnge des menschl. Darmkanah, Diss., Dorpat, 1894.

Ferguson, John, Some important points regarding the appendix vermiformis, The American
Jouru. of Med. Sci., vol. ci., 1891.

Frenzel, Johannes, Bcitrage zur vergleichenden Physioloijie und Histologie der Verdauung,
Archiv f. Anat. u. Physiol., Physiolog. Abt., Jahrg. 1892.

Gennet, Diverticule de Meckel, Bull, soc, anat., Paris, 1894.

Gerold, E., Untersuchungen uber den Processus vermiformis des Menschen, Diss., Miinchen, 1891.

Grb'nross, Hjalmar, Ueber einen Fall abnormer Lagerung des Darmkanals bcim Eruachsencn,
Anat. Anzeiger, Bd. ix., 1894.

Gruber, W., Fdlle von ungewohnlicher Stellung der Flexura sigmoides bei rechts-scitigcr Lage des
Rectum in Erwachsenen, Virch. Arch, fiir path. Anat., Bd. xcix, 1887.

Gruenhagen, A., Ueber Ftttresorption und Darmcpitftel, Archiv fiir mikros. Anat., Bd. xxix.

Hartmann, H., Lesfossettes ueo-ceecales et la hernie de Rieux, Bull, de la societe anat. de Paris, 1888 ;
Sur quelques points de 1'a.natomie du duodenum, Bull, de la societe anat. de Paris, 1889.

Heidenhain, R., Beilrdge zur Histologie und Physiologic der Dunndarmschleimhaut, Archiv f.
die gesammte Physiologic, Bd. xliii., 1888, Supplementheft.

Henseler, M., Zwci Fdlle v. zahlreichcn Divertikeln des Dunndarms, Diss., Kiel, 1890.

Hewson, A., Anatomy of the vermiform appendix, Amer. J. of Med. Sc., vol. cvi., 1893.

Hildebrand, Die Lageverhaltnisse des Caecum und ihre Beziehung zur Entstthung von ausscrcr
CcRcalbriichen , Deutsche Zeitsch. f. Chirurgie, Bd. xxxiii., 1892.

Hudson, L., Congenital abnormalities of the ileum, Trans. Path. Soc., Lend., 1P.

Hunter, H., The occurrence of Meckel's diverticulum in the ileum, Trans, of the Roy. Acad. of
Med. Ireland, vol. ix., 1891.

Huntington, G. S., Caecum and vermifcrm appendix, New York Medical Rep., 1893-94.

Jacobi, Le rectum chez Venfant, Annales de gynecologic et d'obst., tome xxv.

Jonnesco, Sur I' anatomic topcgraphique du duodenum, Progres medical, 1889; Bull. soc. anat.,
Paris, 18S9; Le colon pelvien pendant la vie intra-uterine, Paris, 1892.

Jonnesco et Juvara, Anatomie des ligaments de Cappendice vcrmiculaire et de la fcssette ileo-
appcndiculaire, Le Progres medical, Annee 22.

Kazzander, Julius, Ueber die Fatten der Dunnd-drmschleimhaut des Menschen, Anatom. Anz..
Jahrg. vii., 1892.

Kelynack, Cases of MeckeV s diverticulum, Journ. Anat. and Phys., vol. xxvi., 1891 ; A contribu-
tion to the pathology of the vermiform appendix, Manchester, 1893.

Klaatsch, Hermann, Ueber die Beteiligung von Drusenbildungen am Aufbau der Peyer'schen
Plaques, Morph. Jb., Bd. xix., 1892.

Kraus, Oskar, Zur Anatomie der Ileocoecalklappe, Archiv f. klin. Chirurgie, Bd. xliv., 1892.

Krehl. Ludolf, Ein Beitrag zur Ftttresorption, Archiv f. Anat. u. Physiol., Anat. Abt., 1890.

Kuczynski, Antoni, Beitrag zur Histologie der Brunner' sclun Drusen, Intern. Monatssch. f
Anat. u. Physiol., Bd. vii., 1890.

Lafforgue, E. , Rechcrches anatomiqucs sur I'appcndicc vermiculaire du caecum, Internat.
Monatssch. f. Anat. u. Phys., 1893.



LITERATURE OF THE INTESTINES.

Laimer, E., Beitrag zur Anatomic des Mastdarms, Wiener med. Jahrbiicher, 1883.

Lang-er, C. v., Ueber das VerhaUen der Darmschleirnkaut an der Riocoecal-Klappe, nebst Bemer-
kungen iiber ihre Entwickelung, Wiener Denkschriften, 1887.

Lardennois, H., Diverticule de Meckel. Bull. soc. anat., Paris, 1894.

Legmen, La situation du caecum chez les enfants, Bull. soc. anat., 1891.

Lock-wood, C. B., Retroperitoneal hernia of the vermiform appendix, Trans. Path. Society of
London, vol. xli.

Lockwood, C. B. and Rolleston, H. D. , The fossce round the caecum, and the position of the
vermiform appendix, with special reference to retroperitoneal hernia, Journal Anat. and Phys., vol. xxvi. ,
1891.

Majewski, Adam, Ueber die Veranderungen der Becherzetten im Darmkanal wdhrend der
Secretion, Internat. Monatsschr. f. Anat. u. Physiol., Bd. xi., 1894.

Mall, Die Blut- und Lymphu-ege im Dunndarm des Hundes, Abhandlungen der kgl. Sachs.
Gesellsch. d. Wiss., 1887.

Stanley, Thomas H. , The anatomical position of the caput coli ; deviations from the normal
type, Buffalo Med. and Surg. Jonrn., vol. xxx., 1891.

Mathews, J. M., The anatomy of the rectum and its relation to reflexes, New York Medical
Record, vol. xxii., 1887.

Melsome, W. S. , Variation of the sigmoid flexure of the colon, Proc. Anat. Soc. of G. Britain and
Ireland, Feb., Journ. of Anatomy, 1893.

Moody, R. O. , A study of the muscular tunic of the large and small intestine of man, Proc.
Assoc. Arner. Anatomists, 1894.

Muller, Erik, Zur Kenntniss der Ausbreitung und Endigungsweise der Magen-, Darm-, und
Pankmisnrri-en, Archiv f. mikroskop. Anat., Bd. xl., 1892.

Nicolas, A. , Sur les cellules d grains du fond des glandes de Lieberkuhn chez qu.elqu.es mammi-
feres et chez le lezard, Bulletin des seances de la societe des sciences de Nancy, 1890 ; Recherches sur
Vepithelium de Vintetstin grele, Internat. Monatssch. f. Anat. u. Physiol., Bd. viii., 1891.

O bregia, Alexander, Ueber die Nervenendigungen in den glatten Muskelfasern des Darms beim
Hunde, Verhandl. des X. internat. medic. Kongresses, Berlin, 1890, Bd. ii., Abt. 1, Anatomic.

Otis, W. J., Anatomical, researches in the human rectum, Jj'c. ; part 1, The sacculiof the rectum,
Leipzig, 1887.

Panetti, Josef, Ein Beilrag zur Kenntniss der Lieberkuhn 'schen Krypten, Centralbl. f.
Physiologic, 1887 ; Ueber die secernierenden Zellen des Dunndarm- Epitliels, Archiv fur mikroskop.
Anat., Bd. xxxi.

Pilliet, A., Note sur la presence des corpuscles de Pacini dans la muqueuse anale de Vhomme,
Bull. soc. anat., Paris, 1892 ; Diverticules multiples du gros intestin, Bull. soc. anat., Paris, 1894.

Purser, Cecil, and Rennie, George E., The position of the vermiform appendix, Tr. Inter-
Colonial Med. Congress, Sydney, 1892.

Quenu, Etude sur les veines du rectum et de I' anus, Bull. soc. anat., Paris, 1892 ; Les arteres du
rectum et de I' anus chez Vhomme et chez la femme, Bull. soc. anat., Paris, 1893 ; Vaisseaux lympha-
tiqucs de I' anus, Bull. soc. anat., Paris, 1893.

Ransshoff, Considerations on the anatomy, physiology and pathology of the caecum and appendix,
Journ. Amer. Med. Assoc., 1888.

Ranvier, ~L,.,D.es chyliferes du rat et de V absorption intcstinalc, C. r. de 1'acad. des sc., Paris,
t. cxviii., 1894.

Rawitz, Bernhard, Ueber ramificirte Darmzotten, Anat. Anzeiger, Bd. ix., 1894.

Retterer, Ed., Origine et developpemcnt des plaques de Peyer chez le lapin et le cobaye, Comptes
rendus hebdom. de la socie'te de biologic, 1891 ; Des glandes closes de Vepithelium digestif, Journ.
d'Anat. et dePhys., Annee xxix., 1893.

Ribbert, Beitrdge :ur normalen und patholojischen Anatomic des Wurmfortsatzcs, Virchow's
Archiv f. path. Anat., cxxxii., 1893.

Rogie, Etude sur la fossette inter sigmoide, Lille, 1891; Anomalies de regression du canal vitellin,
diverticule de Meckel, Journ. d. sci. med. de Lille, 1892 ; Sur I'anatomie normate et pathologique de
I' appendice ileo-ccecal, Journ. d. sci. med. de Lille, 1893.

Rolleston, H. D., Two specimens of duodenal pouches, Proc. Anatomical Society of Great Britain
and Ireland, Journ. of Anat. and Physiology, 1893-94.

Rolssen, T., Beitrag zur Kenntniss der Langenmansse des deutschen Darmcs, Diss., Dorpat, 1890.

Riiding-er, N., Ueber die Umbildung der Lieberkuhn schen Drilsen durch die Solitarfollikel im
Wwrmforttatz des Menschcn, Sitzungsb. der math.-physik. Klassederk. B. Akad. der Wissensch. zu
Muuchen, 1891.

Samson, Claudius v., Zur Kenntniss der Flexura sigmoidea Coli, Dorpat, 1890 ; Einiges iiber
den Darm, insbesondere iiber die Flexura sigmoidea, Archiv f. klin. Chirurgie, Bd. xliv., 1892.

Schaffer, J., Beitrdge zur Histologie menschlicher Organe : 1. Duodenum, 2. Dunndarm,
3. Mastdann, Sitzungsb. der kaiserl. Akad. d. Wissenschaften in Wien, Jahrg. 1891.

Schlefferdecker, P., Beitrdge zur Topographic des Darmes, Archiv f. Anat. u. Phys., Anatom.
Abt., 1886.

Schmauser, J., Die Schicksale der DiinndarmdivertikeL Diss., Kiel, 1891.

Sernoff, Die Lage und die Form des Intestinum mcsenterialc (Jejunum et Ileum), Moskau,
1894 ; Zur Kenntniss der Lage und Form des mesenterialen Teiles des Diinndarmes und seines
Gekroses, Internat. Monatssch. f. Anat. u. Physiol., xi., 1894.

Stocquart, Les anomalies de Vappcndke ccecal chez Vhomme, Bull. soc. anthrop., Bruxelles,
1892-93.



120 OKGANS OF DIGESTION.

Stohr, Philipp, Ueb^r die Lymphk note hen des Uarmes, Archiv f. mikroskop. Anat., Bd. xxxiii.,
1889.

Struthers, Jolin, On varieties of the appendix i-ermiformis, ccucum, and ileo-colic valve in man,
Edinburgh Med. J., Is93.

Symington, J., The. rectum and anus, The Journ. of Anatomy, vol. xxiii., 1888 ; The relations
of the peritoneum to the descending colon in the human subject, Journal Anat. and Phys., vol. xxvi,,
1892.

Tarenetzky, C. A., Beitrage zur Anatomic des .Darmkanals, Mem. Acad. St. Petersburg, 1881.
. Thomson. A., Second Annual Report of the Committee of collective Investigation of the Anat.
Soc. of Great Britain and Ireland: Divcrticulum llei, Journal of Anat. and Phys., vol. xxvi., 1892.
' Toldt, C., Die Formbildung d. menschl. Blinddarmes u. die Valv. Coli, Sitz. der Wiener Akad.,
Bl ciii., 1894.

Tomarkin, E., LieberMhn's?he Krypten und ihre Bezichungen zu den Follikcln beim Meerschwein-
chen, Anat. Anzeiger, Jg. viii., 1893.

TuflEler, Conformation exterieure et raisseaux du caecum, Bulletins de la societe anatomique de
Paris, Annee Ixi., 188b'.

Uhlyarik. P. and Tolti, L., Ueber die histoloyische Struktur der JJiinndarmzotten und tiler
Fcttrcxorption, Aus dem physiolog. Institut der k. Ungar. Veterinar-Lehranfetalt zu Budapest, Mathemat.
u. naturwissenschafte Berichte aus Ungarn, Bd. vi., 1887-88.

Windle. B. C. A., Notes on an abnormal arrangement of the large intestine, Journ. of Anat. and
Phys., vol. xx.

Youngr, B. Bruce, Abnormal disposition of the colon, Journal Anat. and Phys. vol. xix. , 1884.

Zuckerkandl, E., Uebcr die Obliteration des Wurmfortsatzes beim Menschen, Anat. Hefte, B. iv.,
1894.



THE LIVER.



THE LIVER.

The liver is the largest gland in the body, and by far the mustr bulky of
the abdominal viscera. Its shape is liable to considerable variations, but is
essentially that of a right-angled triangular prism, with the right angles rounded
off. If the upper part of the abdomen be supposed to be occupied by a cuboidal
mass divided into two by a cut passing from its upper left edge to its lower right
one, the position and shape of the liver will be represented by the upper and right
half of this mass. The liver has five surfaces, viz., anterior, posterior, superior,
inferior, and right. The anterior and posterior surfaces are triangular, one of their
angles, which is situated above and on the right side, being rounded off, while the
remaining two are acute, and placed one above and on the left side, the other below
and on the right.

Dimensions and Weight. The greatest vertical extent of the liver is near its
right surface, where it measures, on an average, from five to seven inches. This
diameter gradually diminishes from right to left, the organ ending on the left side
in a thin sharp border. Its greatest transverse diameter is usually one or two inches
more than the corresponding vertical one, but is sometimes less. The autero-
posterior diameter is greatest on the right side of the vertebral column, and just
above the right kidney ; here it measures from four to six inches. In front of the
vertebral column its antero-posterior extent is considerably reduced, being in the
median plane only about two-and-a-half to four inches. The ordinary bulk of the
liver is 90 to 100 cubic inches, and its average weight between 50 and (JO ounces.
According to the facts recorded by Eeid, the liver weighed, in 43 cases out of 82,
between 48 and 58 ounces in the adult male ; and, in 17 cases out of 3(1, between
40 and 50 ounces in the adult female. It is generally estimated to be equal to about
l-30th of the weight of the whole body ; but in the foetus, and in early life, its
proportionate weight is greater. Thus at birth it is about 1-1 8th of the body
weight.

Vicrordt (Anatom. Daten u. Tabellen) gives the following approximate numbers for the
adult : Weight, male 1,579 g., female 1.526 g. ; volume, 1,720 cubic cent. ; length, 320 mm. ;
sagittal diameter, 200 mm.

The specific gravity of the liver is between T05 and 1'06 ; in fatty degene-
ration this is reduced to 1-03, or even less.

The liver is solid to the touch, but easily torn. Its colour is a dull reddish-
brown, with frequently a dark purplish tinge along the anterior margin. Duiing
life it is probably softer than after death, as when hardened in situ it shows
impressions for all the viscera that are in contact with it.

The liver is divided into two unequal lobes, a right and a left, and on the
under and posterior surfaces of the right lobe are three secondary lobes, named the
lobe of Spigelius, the caudate or tailed lobe, and the quadrate lobe.

The right and left lobes are separated from each other on the under surface by
the umbilical fissure (fig. 147, u.f.j, and on the posterior surface by its prolongation,
the fissure for ike ducius venosus (f.d.r.). On the anterior and upper surfaces the
only indication of a separation between them is the line of attachment of the fold of
peritoneum, termed the falciform or broad ligament, except below, where the
umbilical fissure is prolonged upwards on the anterior surface for a short distance,
forming the umbilical notch (fig. 14(J). The right lobe is much larger and thicker
than the left, which is very variable in extent, and ordinarily constitutes only about
one-fifth or one-sixth of the entire gland.

Surfaces. The anterior (fig. 14G) is frequently the largest of all the surfaces.
It is smooth and triangular, and united with the upper and right surfaces by



122 ORGANS OF DIGESTION.

rounded borders, but separated from the under surface by a sharp margin, which
can often be felt in the living body. This surface is formed by both the right and
left lobes, the separation between which is indicated by the umbilical notch and the
attachment of the falciform ligament. To the right of the umbilical notch the
lower margin of this surface presents an excavation situated over the fundus of the
gall-bladder. The peritoneum covers the whole of the anterior surface, except along
a narrow line between the two layers of the above-named ligament.

The posterior surface (fig. 147) is triangular, very uneven, only partially covered
by peritoneum, and not so distinctly marked off from the under surface as is the
anterior. It includes : 1. A portion of the left lobe which lies immediately in front
of the cardia, and abuts against the anterior wall of the omental sac. The upper
part (fig. 147, (7), which is in contact with the cardia, is concave, but the remainder




Fig. 146. ANTERIOR SURFACE OF THE LIVER. (J. S.)
R, right lobe ; L, left lobe ; B, fucdus of gall-bladder ; C, round ligament of liver.

forms a considerable protuberance (omental tuberosify, i,o.} projecting over the lesser
curvature of the stomach. This posterior surface of the left lobe passes with
a gradual slope into the under surface. 2. The Spigelian lobe (lolulus Spigelii, L.S.)
and the caudate lobe (L.C.). The latter is a narrow ridge prolonging the Spigelian
lobe towards the under surface of the right lobe. It runs behind the portal fissure,
and lies immediately above the foramen of Winslow. The Spigelian lobe is
separated from the left lobe by the fissure of the ductus venosus, and from the
posterior surface of the right lobe by the fossa for the vena cava. Its free surface
looks directly backwards, and is nearly vertical and slightly concave from side to
side. Superiorly it slopes over towards the upper surface of the organ, while its
inferior border is divided by a notch into a right part, which joins the caudate lobe,
and a left portion, ending in a small tubercle (tuber papiUare, His). The Spigelian
lobe is opposite the tenth and eleventh dorsal vertebras. It rests against the
diaphragm, the two opposing surfaces being covered by peritoneum belonging to the
lesser sac. Behind its upper left hand corner the lower end of the oesophagus passes
obliquely into the cardia. Lower down behind the left border is the end of the
thoracic aorta, separated, however, from the liver by the diaphragm. 3. A strip



THE LIVER.



of the right lobe 2| to 3 inches broad ; convex for the most part, except for
a small depression at its lower and mesial corner, which receives the right supra-renal
capsule (impressio supra-renalis, i.sr.). In consequence of the separation of the
layers of the coronary ligament, this surface of the right lobe (fig. 147, X'} is not
covered by peritoneum except at its right extremity. It rests against the ascending
part of the diaphragm, and superiorly passes gradually into the upper surface.
Inferiorly it is separated by a sharp margin from the renal impression on the under
surface. This margin is sloped obliquely downwards and outwards, following
the line of the eleventh and twelfth ribs. The mesial border often projects over the
inferior vena cava.

The upper surface of the organ is smooth, covered by peritoneum and



f.&v.



L.L.




Fig. 147. THE LIVER OF A YOTTNG SUBJECT, SKETCHED FKOM BELOW AND BEHIND. (The drawing has
been made by Mr. Wesley from a cast prepared under the direction of Prof. His of Leipzig.) ^

R.L., right lobe; L.L., left lobe; L.S., lobe of Spigelius ; L. C., caudate lobe; L. Q,., quadrate
lobe; p, portal fissure; u.f., umbilical fissure ; f.d.v., fissure of the ductus venosus ; g. bl. , gall-
bladder ; v.c.i., vena cava inferior ; i.g., impression on the under surface of the left lobe corresponding
to the stomach ; C, position of the cardia ; t.o., projection of the posterior surface of the left lobe against
the lesser omentum (tuber omentale, His); i.e., impressio colica ; i.r., impressio renalis ;. i.sr.,
impressio supra-renalis ; i. d. , impressio duodenalis ; p l , p 2 , p 3 , p*, lines of reflection of the peritoneum ;
X, surface of the liver uncovered by peritoneum.

exactly moulded to the under surface of the diaphragm. Near the median plane it
gives attachment to the falciform ligament. It has two rounded convex portions
separated by a shallow concavity corresponding to the situation of the heart. The
right convexity is much larger and more prominent than the left one.

The under surface is concave, uneven, and looks downwards, backwards,
and to the left. It is invested with peritoneum everywhere except where the gall-
bladder (fig. 14:7, g.bl) is adherent to it, and at the portal fissure (p), where the fold
of peritoneum termed the lesser omentum, which encloses the blood-vessels and
ducts of the viscus, comes off, and passes to the smaller curvature of the stomach.
The under surface of the left lobe ('.#.) is moulded over the subjacent cardiac part of
the stomach, and over that part of the anterior surface of the stomach which is
next to the lesser curvature.



124



OKGANS OF DIGESTION.



The under surface of the right lobe may be regarded as divided by the fossa
which lodges the gall-bladder (fossa sen impressio vesicalis) into two unequal
portions. Of these the lateral is by far the larger, and is mainly occupied by two
large shallow concave impressions, one situated anteriorly being produced by the
hepatic flexure of the colon (impressio colica, i.e.}, the other and posterior one being
caused by the right kidney (impressio renalis, i.r.). These two impressions
are separated from one another by a low ridge. At the mesial border of the renal
impression is a third narrow and but slightly marked impression, corresponding to
the descending part of the duodenum (impressio duodenalis, i.d.},

The mesial of the two parts into which the fossa of the gall-bladder subdivides
the under surface of the right lobe is somewhat rectangular and oblong, having the
antero-posterior diameter greater than the transverse ; it is known as the quadrate
lobe (L.Q.). It is immediately over the pyloric end of the stomach and the




o



Fig. 148. CORONAL SECTION OF PART OF THOKAX AND ABDOMEN OF FEMALE CHILD, AGED ONE YEAR

AND TEN MONTHS. THE LIVER IN THE INFANT IS RELATIVELY LARGER THAN IN THE ADULT.

(J. S.)

R.L., right lung ; L.L., left lung ; R.A., right auricle of heart ; E.V., rij;ht ventricle, distended with
injection ; S, stomach, empty and contracted ; P, pylorus, situated in the median plane just beneath the
longitudinal fissure of liver ; D, first part of duodenum in contact with quadrate lobe of liver ;



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