276 SURGICAL APPLIED ANA TO MY. [Chap. xvi. 



the intermediate trunks can be readily estimated. 

 Pain referred to districts supplied by the lower ab- 

 dominal nerves in connection with spinal caries may 

 mislead the surgeon from the real seat of the malady, 

 and may arouse a suspicion of mischief in the kidneys 

 or bladder. 



It may be noted that some of these nerve disturb- 

 ances, especially the sense of a constricting band, 

 are common in certain affections of the spinal cord, 

 such as locomotor ataxia, etc. 



These nerves of the belly- wall have still more 

 important associations. Not only are they supplied 

 to the skin of the abdomen, and to the abdominal 

 muscles, but they also share in the nerve supply of the 

 abdominal contents. It is well known that the most 

 conspicuous supply of the abdominal viscera is derived 

 from the sympathetic. This nerve cord receives many 

 contributions from the spinal nerves, and the mixed 

 trunks thus formed are distributed to the various 

 organs. It, however, happens that that segment of 

 the gangliated cord of the sympathetic that is within 

 the abdomen (viz. the lumbar segment) has practically 

 nothing to do with the strictly abdominal viscera. 

 The lumbar cord communicates with the lumbar 

 nerves, but only two of these have any concern 

 with the abdominal parietes, and that concern is of 

 very insignificant extent, and relates rather to the 

 pelvic than to the abdominal parts of the parietes. 

 The spinal nerves mostly concerned with the belly- 

 wall are the last seven dorsal. These nerves have 

 communication with the lower seven sympathetic 

 ganglia in the thorax, and it is to the thoracic sympa- 

 thetic that we must look for some more direct interest 

 in the abdominal nerve-supply so far as it affects the 

 viscera. This connection is afforded by the splanchnic 

 nerves that come off from the lower seven or eight 

 thoracic ganglia, and are in communion with the 



