270 DR. LEE ON THE NERVOUS Gx\NGLIA OF THE UTERUS. 



artery of considerable size^ which enters it near the centre, and divides into branches 

 which accompany the nerves given off from its inner surface, and from its anterior and 

 inferior borders. The hypogastric nerve, after separating into a plexus, enters its 

 upper edge, and branches from the third and other sacral nerves its posterior border, 

 and the whole of its outer surface. None of the branches of the sacral nerves pass 

 over the ganglion to the bladder, though some of them enter its anterior edge where 

 the vesical nerves are given off. 



From the inner and posterior surface of each hypogastric ganglion, numerous large 

 nerves are given off, which go backward to anastomose with the haemorrhoidal nerves, 

 which accompany the arteries to the rectum, and pass with them between the muscular 

 fasciculi of the organ. An extensive connection is thus established between the two 

 hypogastric ganglia and the nerves of the rectum, and many large broad nerves pass 

 off from the posterior and inferior part of these ganglia to ramify on the sides of the 

 vagina, and between the vagina and rectum. 



From the inferior border of each hypogastric ganglion several fasciculi of small 

 nerves are sent off, which pass down on the sides of the vagina, and enter several 

 large flat ganglia about midway between the os uteri and ostium vaginae. From 

 these vaginal ganglia, innumerable filaments of nerves, on which small ganglia are 

 formed, extend downwards to the sphincter, where they are lost in a white dense 

 membranous expansion, from which they cannot be separated without laceration. 

 From this great web of ganglia and nerves on the sides of the vagina, by which it is 

 completely covered, numerous branches are sent to the sides of the bladder, which enter 

 it around the ureter. All these nerves of the vagina are accompanied with arteries, 

 and they often form complete rings of nerve around the trunks of the great veins. 



From the anterior margin of each hypogastric ganglion, large white and gray 

 nerves are sent off, some of which pass on the outside, and others on the inside of 

 the ureter, and these branches meet in front of the ureter in a ganglion, which may 

 be termed the middle vesical ganglion. There are other two ganglia formed on 

 these nerves, one between the uterus and ureter, and the other between the ureter 

 and vagina. These may be called the internal and external vesical ganglia. The 

 ureter is thus inclosed within a great ring of nerve, which resembles the oesophageal 

 ganglion in some of the Invertebrata. The trunks of the uterine artery and vein are 

 likewise encircled by a great collar of nervous matter, between which and the hypo- 

 gastric ganglion, several large and some small branches pass. 



The internal vesical ganglion, which usually has a flattened or long bulbous shape, 

 is formed entirely upon the nerves which pass from the hypogastric plexus and gan- 

 glion, and run between the uterus and the ureter. It has an artery which passes 

 through its centre. It first gives off a large branch to the ring of nerve or ganglion 

 which surrounds the uterine blood-vessels ; it then sends branches to the anterior part 

 of the cervix uteri, and afterwards a great number of small filaments to the muscular 

 coat of the bladder behind, where it is in contact with the uterus. The internal vesical 



