Sessional_Paper_1905 — Page 434

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"THE MESENTERIC GLANDS vary in number from a hundred and thirty to a “hundred and fifty or more; and in the healthy state they are seldom larger than an "almond. The largest are placed around the trunk of the superior mesenteric artery, but the greater number lie within the loops formed by the blood- "vessels, between the layers of the mesentery, becoming smaller and increasing in "number. as they are nearer to the intestine. They are most numerous in that part "of the mesentery which corresponds to the jejunum ; and, except at the lower part "of the ileum, they are seldom found closer to the intestine than an inch and a half or two inches. Small glands in limited numbers are also disseminated irregularly "between the layers of the pertioneal folds connected with the large intestine.

"THE LACTEALS take their origin in the wall of the intestines, where they form "two chief plexuses, one beneath the mucous membrane, and the other between "the layers of the muscular coat. They leave the intestine at its attached border, and "ascend through the mesenteric glands, gradually diminishing in number and in- creasing in size, to near the root of the superior mesenteric artery, where they are "joined by the efferent vessels of the coeline glands, and terminate sometimes in a "single intestinal lymphatic trunk, sometimes in three or four vessels, which open "into the lower end of the thoracic duct. The lymphatics from the descending "colon and the sigmoid flexure usually join some of the lumbar lymphatics, or turn "upwards and open by a separate trunk into the thoracic duct.

"THE COELIAC GLANDS, from sixteen to twenty in number, and of large size, "surround the cœliac axis, and cover the aorta above the superior mesenteric artery. They receive the lymphatic vessels derived from the stomach, spleen, pancreas, and "the greater part of the liver; and their efferent vessels pass with the trunks of the

lacteals to the thoracic duct.

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"THE LYMPHATICS OF THE STOMACH commence in the wall of that organ, and pass upwards and downwards over its surface to the small and great curvatures res- pectively, where they traverse a few small gastric glands lying along the attached "border of the corresponding omenta. The lymphatics of the small curvature ac- company the coronary vessels to the cardiac orifice, and then turn downwards be- "hind the pancreas to enter the coeliac glands; those of the great curvature are "directed towards the pylorus, along with the right gastro-épiploic artery, and, "after being joined by the lymphatics from the upper part of the duodenum, also open into the coeliac glands. A third series of lymphatic vessels proceed from the “left end of the stomach, and, following the course of the gastric branches of the "splenic artery, unite with the lymphatics of the spleen.

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"The LYMPHATICS OF THE SPLEEN are placed, some immediately under its peritoneal covering, others in the substance of the organ.

Both sets converge to

"the inner side of the spleen, come into contact with the blood-vessels, and, accoin- panying these, pass through a series of small glands, to terminate in the coeliac glands. Lymphatics emerge from the pancreas at different points, and join those "derived from the spleen.

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“THE LYMPHATICS OF THE LIVER are divided into superficial, which run beneath "the peritoneum on the upper and lower surfaces of the organ, and deep, which "accompany the blood-vessels within its substance. On the upper surface of the liver, the lymphatic vessels are disposed in the following groups, which differ in "their course and termination, viz. :-(.) Those from the mesial portions of both. "lobes ascend in the falciform ligament, and pass through the diaphragm behind the "ensiform process to enter the glands of the anterior mediastinum. (2.) The lateral lymphatics of each lobe are directed backwards to the corresponding lateral ligament, "and descend to the coeline glands. (3.) The lymphatics from the hinder part of "this surface converge to the coronary ligament, perforate the diaphragm, and ter- "minate in a small group of glands surrounding the upper end of the inferior vena (4.) At the fore part of the liver a few vessels turn downwards and join "those of the inferior surface.

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cava.

"The greater number of the lymphatics of the under surface of the liver con- verge to the transverse fissure, and descend with the deep lymphatics issuing at £6 that part in the small omentum, but some from the lateral part of each lobe run "backwards and descend on the vertebral portion of the diaphragm, those of the left "side joining the lymphatics from the sinall curvature of the stomach, to the toeliac

glands.