. On retro-peritoneal hernia . Ileum. process. The chief branch of this last vessel is one whicharises at, or very near to, the lower margin of the ileum, andruns with a curve downwards and to the right, and againarches upwards and to the left between the layers of the bloodless fold of Treves near the free edge. The importanceof these vessels becomes apparent when we study the foldsand fossae. THE FOLDS AND FOSSM 77 THE FOLDS AND FOSS^. The primary folds are : 1. The anterior vascular, or ileo-colic fold. 2. The accessory anterior vascular fold. 3. The intermediate, or ileo-appendicular fold.
. On retro-peritoneal hernia . Ileum. process. The chief branch of this last vessel is one whicharises at, or very near to, the lower margin of the ileum, andruns with a curve downwards and to the right, and againarches upwards and to the left between the layers of the bloodless fold of Treves near the free edge. The importanceof these vessels becomes apparent when we study the foldsand fossae. THE FOLDS AND FOSSM 77 THE FOLDS AND FOSS^. The primary folds are : 1. The anterior vascular, or ileo-colic fold. 2. The accessory anterior vascular fold. 3. The intermediate, or ileo-appendicular fold. 4. The posterior vascular fold, or meso-appendix. The fossae formed by them are: 1. The anterior vascular, or ileo-colic fossa. 2. The accessory anterior vascular fossa. 3. The ileo-appendicular fossa. In about 5 per cent, of cases there is found to be a thirdfossa between the termination of the enteric mesentery andthe meso-appendix. This, the inferior ileo-csecal fossa ofHartmann, will be referred to in detail Fig. 25.—The Anterior Vascular (Ileo-Colic) Fold and Fossa. The Anterior Vascular Fold—The Ileo-Colic Fold—The Fold ofLuschka {Superior ilcu-cacalfold, \\aldc}er, Hartmann, Treves,Tufficr; Ileo-colic fold, Lockwood and Rolleston, Kclynack,Berry; Superior ccecal fold, Perignon ; Mesenterico - ccecal,anterior ileo-ca;cal, or pre-ilcal, Jonnesco—Fig. 25).—This foldis raised up by the branch of the ileo-colic artery already 78 THE CmCUM AND VERMIFORM APPENDIX referred to, which, continuing the Hne of direction of themain trunk, runs over the anterior aspect of the ileo-coHcjunction. The fold is constant. In embryos, children, andyoung adults, it is always well and clearly defined. In theaged and in the obese, it may become very indistinct andflattened out; but, so far as my experience goes, if carefullylooked for when the ileum and caecum are very moderatelydistended, it will ahvays be found. In nearly 200 bodies thatI have examined on this point,
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