Page:Proceedings of the Royal Society of London Vol 4.djvu/216

Rh under the peritoneum, crossing tlie body of the uterus ; and several branches, apparently nervous, proceeding from this band, were distinctly continuous with some of the smaller branches of nerves accompanying the uterine veins. The preparation of the parts was placed in the Museum of St. George's Hospital, on the 1st of Octo- ber, 1838 ; and several anatomists w^ho examined it were of opinion that they were absorbents accompanying the uterine veins, and ten- dinous fibres spread across the posterior surface.

Dr. Lee availed himself of another opportunity which presented itself, on the 18th of December of the same year, of examining a gravid uterus in the sixth month of pregnancy, which had the spermatic, hypogastric and sacral nerves remaining connected with it ; and during the last ten months, he has been diligently occupied in tracing the nerves of this uterus. He believes that he has ascer- tained that the principal trunks of the hypogastric nerves accompany, not the arteries of the uterus, as all anatomists have represented, but the veins ; that these nerves become greatly enlarged during pregnancy ; and that their branches are actually incorporated, or coalesce with the branches of the four great fasciculated bands on the anterior and posterior surface of the uterus, bearing a striking resemblance to ganglionic plexuses of nerves, and sending nume- rous branches to the muscular coat of the uterus.

The author gives the following description of the nerves of the gravid uterus in the sixth month, and of these fasciculated bands as displayed in the dissection.

Behind the uterus, the aortic plexus divides into two portions, to form the right and left hypogastric plexuses. These plexuses, after an intimate union with the nerves accompanj'ing the ureters, descend to the neck of the uterus, upper part of the vagina, and contiguous parts of the bladder and rectum, where they are joined by branches from the third and fourth sacral nerves. The left hypogastric plex- us, about two inches below the aortic plexus, sends off a large branch, which passes on the inside of the ureter to the superior uterine vein, where it is about to terminate in the hypogastric vein. Here the nerve suddenly expands, becomes broad and thin, and passes into a great plexus of nerves, which completely encircles the vein. This plexus, surrounding the uterine vein, is joined below by two large branches, which proceed from the hypogastric plexus nearer the vagina, and lower down, and from which branches pass on the outside of the ureter. From the upper part of this plexus, surrounding the uterine vein near its termination, three large trunks of nerves proceed upwards with the vein to the superior part of the uterus, and enlarge as they ascend. The posterior branch of these hypogastric nerves sends off in its course smaller branches, which accompany the ramifications of the uterine vein on the posterior surface of the uterus. Passing upwards beyond the junction of the spermatic with the uterine vein, and running between the peritoneum and the left posterior fasciculated band, it spreads out into a web of thin broad branches and slender nervous filaments, some of which are inserted into the peritoneum^ and others follow the vein to the