Part 37

In wounds of any part of the intestine, whether of X, the caecum, W, the sigmoid flexure of the colon, or Z, the small bowel, if sufficient time be allowed for Nature to establish the adhesive inflammation, she does so, and thus fortifies the peritoneal sac against an escape of the intestinal matter into it by soldering the orifice of the wounded intestine to the external opening. In this mode is formed the artificial anus. The surgeon on principle aids Nature in attaining this result.

DESCRIPTION OF PLATE 24.

A. The thyroid body.

B. The trachea.

C C*. The first ribs.

D D*. The clavicles, cut at their middle.

E. Humeral part of the great pectoral muscle, cut.

F. The coracoid process of the scapula.

G. The arch of the aorta. G*. Descending aorta in the thorax.

H. Right bronchus. H*. Left bronchus.

I. Oesophagus.

K. Vena azygos receiving the intercostal veins.

L. Thoracic duct.

M M*. Seventh ribs.

N N. The diaphragm, in section.

O. The cardiac orifice of the stomach.

P. The liver, in section, showing the patent orifices of the hepatic veins.

Q. The coeliac axis sending off branches to the liver, stomach, and spleen. The stomach has been removed, to show the looping anastomosis of these vessels around the superior and inferior borders of the stomach.

R. The inferior vena cava about to enter its notch in the posterior thick part of the liver, to receive the hepatic veins.

S. The gall-bladder, communicating by its duct with the hepatic duct, which is lying upon the vena portae, and by the side of the hepatic artery.

T. The pyloric end of the stomach, joining T*, the duodenum.

U. The spleen.

V V. The pancreas.

W. The sigmoid flexure of the colon.

X. The caput coli.

Y. The mesentery supporting the numerous looping branches of the superior mesenteric artery.

Z. Some coils of the small intestine.

2. Innominate artery.