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the multiplicity of viscera which this cavity contains, and from the relations of contiguity and of sympathy, which serve to connect them. It, therefore, becomes an object of no mean importance to distinguish them with respect to the regions we have just enumerated.
« In the first place, the epigastrium contains a portion of the stomach and of the pancreas, the smaller lobe of the liver, the duodenum, a part of the colon and omentum, the trunk of the inferior vena cava, of the vena portarum and aorta, the coeliac and superior mesenteric arteries, and the inferior extremity of the thoracic duct.
“ Secondly, the right hypochondrium incloses the great lobe of the liver, the gall-bladder, and part of the colon.
“ Thirdly, in the left hyochondrium are the spleen, the greater extremity of the stomach, a portion of the pan. creas, of the colon and omentum.
Fourthly, we find beneath the umbilicus, the middle portion of the omentum, the middle convolutions of the intestinum jejunum, a part of the mesentery, the trunks of the inferior vena cava and abdominal aorta.
“ Fifthly, in the right flank, the right convolations of the jejunum, the ascending colun, the right kidney, and commencement of the corresponding ureter.
“ Sixthly, in the left flank, the left convolutions of the jejunum, the descending colon, the left kidney, and beginning of its ureter.
“ Seventhly, the hypograstrium lodges the middle convolutions of the ileum and the termination of the colon.
Eighthly, the right iliac region, the right convolutions of the ileum, the cæcum, and right uretet; in the male subject, the spermatic vessels; and in the female, the broad ligaments of the uterus, and the Fallopian tube and ovary of the same side.
“ Ninthly, the left iliac region covers the left convolutions of the ileum, the sigmoid flexure of the colon, the ureter; and moreover, in the male, the spermatic vessels; the broad uterine ligament, the left ovary and Fallopian tube, in the female.
Tenthly, in the region of the pubis are comprehended the bladder of urine, the rectum; the vesiculæ seminales of the male subject; the uterus in the female.
“ Lastly, we encounter in each groin, the origin of the femoral vessels and nerves, the inguinal glands; the spermatic chord of the malé; she round ligaments of the uterus, in the female.
“ An intimate knowledge of the different relations of the several organs thus acquired, we are enabled to apply it
with advantage, to the discrimination of abdominal diseases. For this purpose, it does not suffice to collect from the patient merely a statement of his sensations, or to note with the eye those changes, more or less decided, which the abdomen suffers in form and volume. The physician ought always to examine with his hand, the different regions of this cavity; so as to inform himself correctly of its degree of softness, sensibility, tension, hardness, and temperature; and hence to discover the precise seat of the lesions from which it may be suffering. We proceed to this examination by placing our patient in such a position that his abdominal muscles inay be in a perfect state of relaxa. tion. With this view, we lay hiin on his back; the head somewhat elevated; the thighs bent upon the pelvis; the legs upon the thighs; the heels brought together, the knees a little separated. The muscles thus relaxed, we exercise light pressure with the fingers upon the various regions of the abdomen, in a direction successively perpendicular, horizontal, and oblique. We employ percussion, if the existence of ascites be suspected ; and thus cause the column of Auid to undulate to and fro from one hand to the other.”
The article closes with an enumeration, not very systematic or correct, of the morbid affections to which the abdomen and its contained viscera are prone. This it is needless to transcribe.
Rarely, we are persuaded, is the importance of relative anatomy justly appreciated by the physician and surgeon, until the opportunities of cultivating it in the dissectingroom are irrevocably gone by. Young men commonly exhaust their time and energies in storing their memory with insulated facts. They pride themselves on being able to demonstrate every projection, and fissure, and orifice, of the sphenoid bone by its appropriate name, to number the muscles on the anterior part of the neck and recollect the precise points of their attachment, to con over the branches and subdivisions of the great subclavian artery, to trace the wanderings of the important par vagum, or depict in fluent language, the mysterious structure of the brain. The anatomy of situation, the survey of the precise relations which exist between different organs and parts of the various systems, in different aspects and attitudes of the body, has formed no part of their studies; or has been regarded as a subordinate consideration. But practice will, ere long, shew them the importance of the inquiries, thus neglected, and the futility, without it, of the inform
ation which they have acquired at such labour and ex. pence. Let the man, whose attention has been thus injudiçiously diverted from the essential object of anatomical research, be called upon to describe the parts and vessels injured in a large transverse wound of the throat; to trace the direction of a bayonet in the left region of the thorax; the course of a musket-ball
, protruded thro' the parietes of the abdomen ; or to discriminate a morbid affection of one of its more deeply seated viscera : How great would be his embarrassment and confusion! We have been induced by considerations like these, to select the preceding article from the French Dictionary. The attempt of the writer, though laudable, is certainly not so successful as it might have been. His description does not, for obvious reasons, apply to very young subjects; por might it have been amiss to note the variations which occur in the site of some of the abdominal organs from the ascent and descent of the diapbragm, in the process of respiration.
In conformity with our proposed plan, we now proceed to notice the corresponding article, as given in the two British Dictionaries of Medical Science.
The Edinburgh Medical and Physical Dictionary accords with the French in the derivation of the term abdomen; but argues, that it may also be compounded of the Latin noun, omentum, added to the verb. It describes correctly the boundaries of the cavity; and simply enumerates the contained viscera and organs; but not the various regions, at least, with the requisite minuteness. It speculates upon the uses of the abdominal muscles in respiration, in speech, in the expulsion of the feces and urine, and in the act of vomiting. A sinus is described on each side of the xiphoid cartilage, between the transversalis and rectus muscles; into which the stomach may be protruded by violent vomiting: Gastrocele is a rare disease; but, when existing, attended by extreme pain in the erect posture, incessant sickness and rejection of ingesta, and consequent atrophy, The subsidence of the pain in the horizontal posture constitutes the pathognomic sign of the affection. The tumour must be returned, and confined by a truss. The result of an operation, if the return by the hand prove impracticable, would be doubtful,
Rheumatism, affecting the abdominal muscles, may be mistaken for colic, or inflammation of the contained vis, cera : but the usual symptoms of inflamed viscera are wanting, and the medicines, which relieve colic, are unavailing in this affection,
The author of the London Medical Dictionary does not differ from the French or Edinburgh writers in the etymology of the word abdomen, which, we are told, in rather a pedantic tone, is also called Imus venter, Alous, Gaster, Katocælia, Dertron, Nedys: the contained viscera, Nedya : the bottom of the belly, Neiera. The regions and boundaries of the abdomen are slightly touched upon; the general application of the peritoneum to the viscera cursorily described : The principal arteries and nerves of the abdômen, with the bones and muscles, as well common as proper, which contribute to its formation, are detailed with tolerable accuracy. On the physiology and morbid affections of the abdominal muscles, the remarks of the Edinburghi Dictionary are here repeated with very few, and those unimportant, alterations, and even its verbal inaccuracies propagated. This, considering the pompous pretensions of the late Dr. Parr, we were somewhat surprized to discover.
Mindful of our promise, we shall remain silent on the relative merits of ihe three works in the article now selected. Certain it is, that they are all exceedingly defective; and by no means so extended or correct as the importance of the subject demands, or the existing state of the medical sciences will allow.
Ere we conclude this examination, some detailed account of the structure of the French Dictionary, and an enumeration of the men engaged in it, may not be unacceptable to the British reader. In our foriner critique, we mentioned, that fifty-eight writers were ernployed upon it. This distinguished society has since received some valuable accessions of taleni. Heurteloup, one of its most worthy members, is dead. He was Surgeon in chief of the French armies.
The names of the writers are, Adelon, Alard, Alibert, Barbier, Bayle, Biett, Bouvenot, Boyer, Breschet, Cadet de Gassicourt, Cayol, Chaumeton, Chaussier, Coste, CulJerier, Cuvier, Delpech, Desgenettes, Dubois, Esquirol, Flamant, Fournier, Gall, Gardien, Geoffroy, Guersent, Guilbert, Hallé, Heurteloup, Husson, Itard, Jourdan, Keraudren, Laennec, Landré-Beauvais, Larrey, Le Gallojs, Lerminier, Lullier-Winslow, Marc, Marjolin, Me*rat, Montegre, Mouton, Murat, Nacquart, Nysten, Pariset, Percy, Petit, Petroz, Pinel, Renauldin, Richerand, Roux, Royer-Collard, Savary, Sédillot, Spurzheim, TolJard, Villeneuve, and Virey.
A Prospectus of eigliteen pages by Pariset, detailing the plan and objects of the work, opens the first volumé. This is followed by a most eloquent and animated jotroduction from the pen of Renauldin, occupying more than one hundred and fifty pages. In this introduction are traced the progress and revolutions of medical science, from its infancy to the present time; but we shall do well to let the author speak for himself on this subject.
“ To present a rapid sketch of the principal vicisitudes which this art has experienced ; to display the important services of men by whom its boundaries have been ex. tended ; to expose the errors which have retarded its progress; to review the different systems by which it has been modified ; to point out the influence which great discoveries have exerted upon its reform; to glance over the catalogue of new diseases, and of the exotic remedies, by which its empire and resources have been enlarged; to record the assistance which it has received from the accessory sciences, in its advancement to perfection: in fact, to follow its steps to the present period, contemplating, at the same time, whatever of the more remark. able its different branches may exhibit: such is the task we impose upon ourselves in this introduction. It is a great and arduous enterprize. Developed in the extent and accuracy of which it is susceptible, it would constitute a complete history of medicine, &c."
This task, M. Renauldin has executed in a manner highly honourable to his talents and erudition. We are particularly pleased with the fair and generous tribute which he pays to those philosophic men of our own island, who have contributed to raise medicine to its present splendor and reputation. As an example of this, we shall transcribe his notice of the great but fanciful author of Zoonomia. We deem it just in criticism, as elegant in composition.
“One of the most celebrated works on physiology, which has appeared in mudern times, is that of Erasmus Darwin. He was a man of splendid imagination, un. common sagacity, and great experience. His Zoonomia comprehends not only the theory of life in organized beings, but that of their lesions, and the means of restor ing them to the natural state. Thus it is, in fact, physi. ology applied to pathology and therapeutics. For the explanation of his' ideas, frequently original, the author has created a peculiar language; and his extraordinary fondness for certain terms, as association, concatenation, configuration, sensorial power, is but too conspicuous.