The Meckel diverticulum / by D.S. Lamb.

  • Lamb, Daniel Smith, 1843-1929.
Date:
1893
Catalogue details

Licence: Public Domain Mark

Credit: The Meckel diverticulum / by D.S. Lamb. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    in the jejunum or duodenum: duodenum, 7 cases; jejunum, 14. These deserve to be considered somewhat critically. In 7 cases it was said that the anomaly was in the jejunum; in 1 case, in the middle of the jejunum ; once, in the third or fourth inch ; once, in the lower part. In 4 cases the jejunum was implied; as, once, where it was 2 feet from the pylorus; once, 40 inches from the duodenum ; once, in the first 3 feet of the small intestine ; once, 15 feet from the ileo-colic valve. The reporters or these cases were as follows: One by Cornillon,. Anatomical Society, Paris; one by Buzzi, Virchow’s Archiv; one by Moore, London Pathological Society; one by Beale, London Patho- logical Society; two by Dr. Elliott Coues, in which he says “ jejunum ; ” one by Clarkson and Collard, Journal of Anatomy and Physiology, Lon- don, who say, “ in jejunum, 2 feet from pylorus ; ” one in the Museum of St. Bartholomew’s Hospital; one in the Museum of Ft. Pitt, Chatham; one in the pathological catalogue of the College of Surgeons, London ; two in Museum of the Medical College, Madras; one in St. George’s Hos- pital Museum ; one in Charing-Cross Hospital Museum. I see no reason to doubt the accuracy of these statements, although it is possible that one or more may not be correct. As to the duodenum, 7 cases are reported. In 4 there is simply the statement that the anomaly was in the duodenum; in 1, in the upper part of the duodenum; in 1, in the middle; in 1, about 10 inches from stomach. One of the cases is reported by Albers in his work on Patho- logical Anatomy; he saw the anomaly in the transverse portion. The specimen in the St. George’s Hospital Museum, London, is described as a rounded pouch on the duodenum; the 3 cases in the Pathological Museum, Royal College of Surgeons, London, as pouches on duodenum ; no further details. There are 2 cases in the Army Medical Museum, Washington; published in the catalogue of 1867. One of these is from. Dr. S. S. Bond, of Washington, and shows a diverticulum two inches long, evidently from the middle of the duodenum, from a dark mulatto, aged seventy-one ; the mucous membrane of the pouch is distinct, but the outer walls are so thin that there is a doubt whether any muscular fibres are present. The second specimen was contributed by a Dr. W. C. Miner, U. S. Army, whom I personally knew, and who was in good repute as an anatomist and pathologist. The specimen is described as from the upper part of the duodenum, about ten inches from the stomach. These two statements are not consistent. An examination shows the specimen to be from the ileum; how low down I cannot say, but there are no valvulse conniventes. How, or by whom, this mistake was made cannot now be ascertained, but that it is a mistake is beyond a doubt. The 4 cases in the London Museums are too briefly described to war- rant any expression of opinion other than that the statements are prob-