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Mesentery and Its Diseases

disease, glands, mesenteric and vertebral

MESENTERY AND ITS DISEASES. The mes entery derives its name from being eonnected to the middle portion (Gr. of the small intestine (ivrepov). It is a broad fold of toneum (the great. serous membrane of the abdo men), surrounding the jejunum and ilemn. and attached. posteriorly to the vertebral column. Its breadth between the intestinal and vertebral borders is about four inches; its attachment to the vertebral column is about six inches in length, and its intestinal border extends from the duodenum to the end of the small intestine. It serves to retain the small intestines in their place, while it at the same time allows the maps sary amount of movement. and it contains be tween its layers the mesenteric vessels, the lacteal vessels, and mesenteric glands. These glands are 100 to 1St) in number, and are about the size of an almond. They exert an organizing action on the contents of the lacteals. the chyle being more abundant in librineĽ and in corpuscles after it has passed through them. The most important affection of these organs is their tubercular degeneration, which gives rise to the disease known as tubes niesenterica, a disease most com mon in childhood, but confined to no period of life. In the great majority of eases it is asso ciated with other results of tubercular infection, such as pulmonary consumption, tubercular peri tonitis. caries of the spine. rickets, etc.; but sometimes the mesenteric glands seem almost ex clusively affected, in which case the disease be comes sufficiently distinet to allow of easy detec tion. The leading symptoms are those of early

tuberculosis, with loss of color and flesh, derange ment of the digestive organs (constipation or diarrhdea, and occasional vomiting), a steady pain in the region of the navel, increased by pressure; but perhaps the most characteristic symptom is tumefaction and hardness of the abdomen, with general emaciation. The enlarged glands can sometimes he detected by a careful examination with the hand, especially in advanced cases. The progress of the disease is generally slow, but at length 'hectic fever sets in, the emaciation becomes extreme, dropsical effusion appears, and the pa tient dies exhausted, if not cut off by the access of some acute inflammation.

The treatment mainly consists in the adminis tration of cod-liver oil. iodide of potassium. and laxatives. When the disease has advanced to a considerable extent, medicines are of little use, except to palliate some of the more urgent symp toms.

Independently of the disease that has just been notieed, inflammation of these glands is by no means uncommon when the mucous membrane of the small intestine is ulcerated, as, for example, in typhoid or enteric' fever.

The mesentery may be the site of hemorrhages, as in aneurism or some infectious diseases, as smallpox; of endadism ur thrombosis; of cysts or tuners.