This statement appears pertinent, at this stage of the autopsy, in order to explain—
V. Interior of Band.
We here describe (1) the hepatic pouches; (2) the umbilical pouches; (3) the vascular structures of the band; (4) the diaphragms; (5) the ensiform cartilages.
1. The hepatic pouches.—The photograph (Fig. [2]) indicates the position of the right lobe of Eng’s liver in the right hypochondriac region. The right lobe of Chang is of course not seen in the figure, since it lies on the side of the body which is not in the field of vision. It must follow from the rights and lefts of the two individuals being opposites that, in drawing a line between the livers (which, as already seen, occupy normal positions as to right and left) across the band, such a line will be diagonal to the axes of the ensiform cartilages; Chang’s half of the band having the line enter the band from his “right,” Eng from his “left.” It will also follow that any pouches of peritoneum which might accompany this line will pursue a similar direction—be on the same plane—be right or left with respect to the axis of that plane. Now it was actually demonstrated that such a line did extend between the livers, and was accompanied by such peritoneal pouches. These pouches were termed the hepatic pouches, and may be described as follows:—
Chang.—The subject lying on the table with rights and lefts determined as in the acquired position, the finger could be inserted behind the suspensory ligament (Fig. [7]) in a pouch lying directly beneath the ensiform cartilages, into which passed an extension of liver-like tissue.
Eng.—This fact could not be well demonstrated in Eng in this position, but is well seen in Fig. [8].
It follows that the two hepatic pouches are on nearly the same plane, and that each approaches the central point of the band diagonally from the right side of the subject with whose abdominal cavity it is continuous.
2. The umbilical pouches.—Beneath the hepatic pouches, and between them and the inferior border of the band, were two pouches which, from their association with the round ligament, have been termed the umbilical pouches.
When the finger was passed toward the band from the abdomen of Chang, and following the peritoneum of the anterior wall of the abdomen, it passed into a pouch of the band directly over the skin covering, across the band, over the umbilicus, and was received within the folds of the suspensory ligament of the liver of Eng. This pouch was so superficial that while the finger was in the pouch any motion of the finger was readily followed by the observer.
In the same way as above, if the finger was introduced behind the suspensory ligament of Eng, it slipped into a pouch which passed across the median line of the band, and was received within the folds of the suspensory ligament of the liver of Chang.