Page:Proceedings of the Royal Society of London Vol 4.djvu/217

Rh fundus uteri, which they completely surround as the vein passes down into the muscular coat of the uterus.

Some of the branches of this nerve, near the fundus uteri, are distributed to the muscular coat, but these are small and few in number.

The middle and anterior branches of the hypogastric nerves ad- here closely to the uterine vein as they ascend, and form around it several plexuses, which completely invest the vessel. From these plexuses branches are sent off to the anterior surface of the uterus, some of which, in an arborescent form, follow the trunk and branches of the uterine artery. These two hypogastric nerves ascend, and closely unite with the left posterior fasciculated band.

On the left side of the uterus this band arises near the mesial line, on the back of the uterus, midway between the fundus and cervix, from a mass of fibres, which adhere so firmly both to the peritoneum and muscular coat that it is difficult precisely to determine their ar- rangement. From these fibres the band proceeds across the uterus, in the form of a thin web, to the point where the spermatic vein is lea\dng the uterus. After closely uniting with the hypogastric nerves, this band proceeds outwards to the round ligament, becoming less firmly adherent to the peritoneum, where it unites with the left anterior band, and spreads out into a great web, under the perito- neum. The left posterior band is loosely attached, through its whole course, to the subjacent muscular coat by soft cellular membrane.

The spermatic nerves on the left side pass down to the ovarium with the spermatic artery, and first give off several branches to the corpus fimbriatum. A few small branches are then sent into the outer end of the ovary. The spermatic nerves afterwards leave the artery, and proceed with the veins to the uterus, where they firmly unite to the outer extremity of the left posterior band ; and after the junction of this band with the prolongations of the anterior band under the round ligament, numerous small, delicate filaments, apparently nervous, are sent to the base of the ovarium.

On the right side of the uterus, the author finds that the distribu- tion of the hypogastric and spermatic nerves does not essentially differ from that now described as seen on the left side. The form and situation of the right posterior band is, he states, much more clearly seen than on the left side, and presents the appearance of a white pearly fasciculated membrane about a quarter of an inch in breadth, proceeding from the mesial line at right angles to the hj^pogastric nerves, across the body of the uterus, to the round ligament, where it unites with the anterior band. Numerous branches, strikingly resembling the branches of nerves, are sent off from the upper and lower edges of this band, and from its posterior surface to the mus- cular coat of the uterus. An extensive and intimate union at various points is distinctly perceptible between these branches sent off from the band and the branches of the hypogastric nerves. On the an- terior and upper part of the neck of the uterus, there is a great mass of reddish-coloured fibres, firmly interlaced together, resembling a ganglion of nerves, into which numerous large branches of the hy-