532 PROSTATE GLAND. 



The Mucous coat is thin and smooth and exactly moulded upon 

 the muscular coat, to which it is connected by a somewhat thick 

 layer of submucous tissue, called by some anatomists, the nervous 

 coat ; its papillae are very minute, and there is scarcely a trace of 

 mucous follicles. This mucous membrane is continuous through 

 the ureters with the lining membrane of the uriniferous ducts and 

 through the urethra, with that of the prostatic ducts, tubuli semi- 

 niferi, and Cowper's glands. 



Upon the internal surface of the base of the bladder is a triangu- 

 lar smooth plane of a paler colour than the rest of the mucous mem- 

 brane ; the trigonum vesicae, or trigone vesicale. This is the most 

 sensitive part of the bladder, and the pressure of calculi upon it gives 

 rise to great suffering. It is bounded on each side by the raised 

 ridge, corresponding with the muscles of the ureters, at each pos- 

 terior angle by the openings of the ureters, and in front by a slight 

 elevation of the mucous membrane at the entrance of the urethra, 

 called the uvula vesicce. 



The external surface of the base of the bladder corresponding 

 with the trigonum, is also triangular, and is separated from the 

 rectum merely by a thin layer of fibrous membrane, the recto- vesical 

 fascia. It is bounded behind by the recto- vesical fold of peritoneum ; 

 and on each side by the vas deferens, and vesicula seminalis, which 

 converge almost to a point at the base of the prostate gland. It is 

 through this space that the opening is made in the recto-vesical 

 operation for puncture of the bladder. 



PROSTATE GLAND. 



The prostate gland (rfgottfTxifjii pro3ponere) is situated in front of the 

 neck of the bladder behind the deep perineal fascia and upon the 



half of the orifice, which, being carefully dissected, will be found to run in a semi- 

 circular form round the urethra. These fibres make a band of about half an inch in 

 breadth, particularly strong on the lower part of the opening, and, having mounted a 

 little above the orifice, on each side, they dispose of a portion of their fibres in the 

 substance of the bladder. A smaller and somewhat weaker set of fibres will be seen 

 to complete their course, surrounding the orifice on the upper part ; to these sphincter 

 fibres a bridle is joined, which comes from the union of the muscles of the ureters.' 



" After repeated observations on this point, I have come to the conclusion that Mr. 

 Bell has indicated a real structure ; but my own dissections have resulted as follows : 

 The inferior semicircumference of the neck of the bladder is surrounded by a thick 

 fasciculus of muscular fibre, half an inch wide, running in a transverse direction, and 

 having its ends attached to the lateral lobes of the prostate gland, being above the third 

 lobe of the latter. This fasciculus is perfectly distinct from the ordinary muscular 

 fibre of the bladder, and resembles in its texture the musculo-fibrous coat of the arte- 

 ries. The superior semicircumference is also surrounded by a thin layer of muscular 

 fibres of an ordinary kind, forming a broad, thin band of a crescentic shape, the lower 

 ends of which are insensibly lost in the adjacent muscular coat of the bladder by being 

 spread out. And, lastly, beneath the mucous membrane of the vesical triangle there 

 is a triangular muscle of the same size as the vesical triangle. Having elongated 

 angles, the anterior angle may be traced to the posterior part of the caput gallinaginis, 

 and the posterior angles to the orifices of the ureters and the adjacent part of the 

 bladder. The texture of this muscle is also like that of the musculo-fibrous coat of 

 the arteries. When a bladder is recent, this detail of structure is made out with diffi- 

 culty : it requires to be previously hardened in spirits of wine. That a power exists 

 in the neck of the bladder of retaining completely the urine, has been satisfactorily 

 demonstrated to me in a case of fistula in perineo, which was presented to the notice 

 of the late Dr. Physick and myself, a few years ago." 



