Chap, xviii.] THE BLADDER. 355 



extensive suppuration in this area followed upon 

 aspiration of the bladder above the pubes, and led to 

 death. In rupture of the anterior wall of the viscus 

 the mine escapes into this district of cellular tissue; a 

 limited suppuration may follow and recovery ensue. 



The bladder, although fairly fixed, has been found 

 in inguinal, femoral, and vaginal hernise. In the 

 erect position its neck (in the male) lies on a 

 horizontal line drawn from before backwards through 

 a point a little below the middle of the symphysis, 

 and is placed about one and a quarter inches (3 cm.) 

 behind that articulation (Tillaux). 



Relations to the peritoneum. The anterior 

 surface is entirely devoid of peritoneum, while the 

 superior surface is entirely covered by that membrane. 

 At the sides there is no peritoneum in front of, or 

 below, the obliterated hypogastric arteries. On the 

 posterior aspect of the bladder the serous membrane 

 extends down as far as a transverse line, uniting the 

 upper parts of the two seminal vesicles, so that the 

 upper ends of the vesicles, as well as the ureters, 

 where they enter the bladder, are covered by peri- 

 toneum. This recto-vesical pouch of peritoneum 

 extends to within about three and a half or four 

 inches of the anus, and does not reach below a line 

 one and a quarter inches above the base of the 

 prostate. 



Puncture of the bladder per rectum. 

 The base of the bladder is adherent to the rectum by 

 dense areolar tissue over a triangular area, the apex of 

 which is formed by the prostate, the sides by the 

 diverging seminal vesicles, and the base by the recto- 

 vesical fold of peritoneum. This triangle is equi- 

 lateral, and in the dissected specimen measures about 

 one and a half inches on all sides. It corresponds to 

 the trigone on .the inner surface of the viscus. It is 

 through this triangle, and as near as possible to the 



