Can we feel the normal kidney? The only place where it is accessible to pressure is just below the last rib, on the outer edge of the ‘erector spinæ.’ I say accessible to pressure, for I have never succeeded in satisfying myself that I have distinctly felt its rounded lower border in the living subject, nor even in the dead, with the advantage of flaccid abdominal walls and the opportunity of making hard pressure with both hands, placed simultaneously, one in front of the abdomen, the other on the back. For these reasons, although we can easily ascertain its degree of tenderness, we cannot actually feel it unless it be considerably enlarged. We must be on our guard not to mistake for the kidney an enlarged liver or spleen, or an accumulation of fæces in the lumbar part of the colon. 84. =Large intestine.=--Let us now trace the large intestine and see where it is accessible to pressure. The ‘cæcum,’ or ‘caput coli,’ and the ileo-cæcal valve lie in the right iliac fossa. The ascending colon runs up the right lumbar region over the right kidney. The transverse colon crosses the abdomen two or three inches above the umbilicus. The descending colon lies in the left lumbar region in front of the left kidney. The sigmoid flexure occupies the left iliac fossa. Throughout this tortuous course, except at the hepatic and splenic flexures, the colon is accessible to pressure, and we could, under favourable circumstances, detect hardened fæces in it. In a case which occurred in St. Bartholomew’s Hospital, a collection of fæces in the transverse colon formed a distinct tumour in the abdomen. All the symptoms yielded to large and repeated injections of olive oil. In another case an accumulation of fæcal matter in the sigmoid flexure during life was mistaken for a malignant disease. 85. =Colotomy.=--The operation of opening the colon (colotomy) may be done in the right or left loin, below the kidney, in that part of the colon not covered by peritoneum. The landmarks of the operation are:--(1) The last rib, of which feel the sloping edge; (2) the crest of the ilium; (3) the outer border of the ‘erector spinæ.’ The incision should be about three inches long, midway between the rib and the ilium. It should begin at the outer border of the ‘erector spinæ,’ and should slope downwards and outwards in the direction of the rib. The edge of the ‘quadratus lumborum,’ which is the guide to the colon, is about one inch external to the edge of the ‘erector spinæ,’ or three full inches from the lumbar spines. The line of the gut is vertical, and runs for a good two inches between the lower border of the kidney and the iliac crest on the left side; rather less on the right. =Small intestines.=--All the room below the umbilicus is occupied by the small intestines. The coils of the jejunum lie nearer to the umbilicus (one reason of the great fatality of umbilical herniæ). Those of the ilium are lower down.