[ 269 ] 



XVIII. On the Nervous Ganglia of the Uterus. By Robert Lee, M,D., F.R.S. 



Received and Read, June 17, 1841. 



IN a communication to this Society which was read on the 12th December, 1839, 

 I described four great plexuses under the peritoneum of the gravid uterus, which had 

 an extensive connection with the hypogastric and spermatic nerves. From their form, 

 colour, and general distribution, and their resemblance to ganglionic plexuses of 

 nerves, and from their branches actually coalescing with those of the hypogastric 

 and spermatic nerves, I was induced to believe, on first discovering them, that they 

 were nervous ganglionic plexuses, and constituted the special nervous system of the 

 uterus. 



Subsequent dissections of the unimpregnated uterus, and of the gravid uterus in 

 the third, fourth, sixth, seventh and ninth months of pregnancy, have enabled me not 

 only to confirm the accuracy of my former observations, but to discover the import- 

 ant fact, that there are many large ganglia on the uterine nerves, and on those of the 

 vagina and bladder, which enlarge with the coats, blood-vessels, nerves, and absorb- 

 ents of the uterus during pregnancy, and which return after parturition to their 

 original condition before conception takes place. 



The uterus and its appendages are wholly supplied with nerves from the great 

 sympathetic and sacral nerves. At the bifurcation of the aorta, the right and left 

 cords of the great sympathetic nerve unite upon the anterior part of the aorta, and 

 form the aortic plexus. This plexus divides into the right and left hypogastric 

 nerves, which soon subdivide into a number of branches to form the right and left 

 hypogastric plexus. Each of these plexuses, having the trunk of the hypogastric 

 nerve continued through its centre, after giving off branches to the ureter, perito- 

 neum, rectum, and trunks of the uterine blood-vessels, descends to the side of the 

 cervix, and there terminates in a great ganglion, which, from its situation and rela- 

 tions, may be called the hypogastric ganglion, or utero-cervical ganglion. 



This ganglion is situated by the side of the neck of the uterus, behind the ureter, 

 where it is passing to the bladder. In the unimpregnated state it is usually of an 

 irregular, triangular, or oblong shape, with several lobes or processes projecting from 

 it where the nerves enter, or are given off from it. In the long diameter it usually 

 measures from half an inch to three-quarters of an inch, varying in dimensions with 

 the size of the nerves with which it is connected. The hypogastric ganglion always 

 consists of cineritious and white matter like other ganglia, and gray and white nerves 

 issue from it, which proceed to the rectum, bladder, uterus and vagina. It is covered 

 with the trunks of the vaginal and vesical arteries and veins, and the ganglion has an 



2 N 2 



