BLADDER, NORMAL ANATOMY. 381 



than those in the corresponding coat in most and which constitutes the true sphincter. Some 

 of the other hollow viscera, being intermediate of those longitudinal fibres, particularly more 

 in these respects to those of the stomach and laterally, pass so deep in this situation as to 

 oesophagus ; this tunic, however, presents great be very distinctly seen, when the bladder is 

 diversity as to colour and density in different opened, through the mucous lining of the orifice 

 individuals. In the contracted state of the of the urethra. This disposition of the longitu- 

 bladder, it of course appears more dense than dinal fibres we consider as important, as it must 

 in the distended ; in the latter, but particularly enable them during their contraction to draw 

 in the over-distended state, it appears thin and out or expand the sphincter, so as to allow of 

 imperfect in some places, in consequence of the escape of the urine. Laterally these longi- 

 the fasciculi being separated from each other, tudinal fibres are attached, a few of them to 

 In the young, cateris paribuSy it is stronger the margin of the prostate, while others expand 

 than in the old, and in the female than in the over the lateral lobes of this gland, and are in- 

 male ; but long-continued irritation at any age serted into the fascia which covers it. Poste- 

 and in either sex has the effect of thickening it, riorly these fibres are very distinct, particularly 

 as also any disease which causes obstruction to near the inferior surface of the bladder between 

 the flow of urine. If the bladder be removed the two ureters ; to these last-named tubes seve- 

 from the body, slightly distended and sub- ral of these fibres are connected : some ascend 

 jected to maceration for a few hours, this tunic upon them in arches concave upwards ; these 

 will admit of more distinct examination ; its we have traced several inches along the ureters ; 

 fibres will then be seen to take such different while others descend in the same course with 

 directions as to admit of a tolerably easy, them, and are inserted into the trigone of the 

 though not a perfectly natural separation into bladder. The longitudinal fibres collect into a 

 distinct laminae, the fibres in the first or super- strong flat band between and beneath the two 

 ficial of which have a longitudinal course ; be- vesiculae, over which however no fibres pass 

 neath this is a second stratum, whose fibres as they do over the prostate, which circum- 

 are transverse or circular ; and in some situa- stance clearly separates these vesicles from, 

 tions even a third lamina can be distinctly while the contrary disposition rather connects 

 seen, the fibres of which are by some des- the prostate with, the urinary excretion. This 

 cribed under the name of oblique, but the band of fibres can be followed near to the base 

 term reticular would appear more correct : in of the prostate ; some of its fibres are then in- 

 general these three laminae can be made dis- serted into the submucous fibrous tissue in this 

 tinct, particularly on the anterior part of the situation, others into the base of the gland itself; 

 bladder. The first or longitudinal lamina con- and very generally one long delicate but distinct 

 sists of the longest, strongest, and most nu- band enters the notch in the base of the gland, 

 merous fasciculi ; many of these are connected passes beneath the uvula and middle lobe of 

 superiorly to the urachus, thence they descend the prostate, into which it is sometimes insert- 

 principally on the fore and back part of the ed, but it can frequently be traced nearly an 

 bladder, a few only along the sides ; inferiorly inch further forward to be inserted by a delicate 

 they terminate about the neck. These fibres are tendon beneath the seminal caruncle or the 

 very parallel, and much stronger on the an- verumontanum, which is partially covered over 

 terior and posterior aspects than upon the sides, by a fold of mucous membrane or by a sort of 

 where they run more obliquely or irregularly, prepuce. The effect of this band of the longitu- 

 and decussate with one another. The inferior dinal fibres must be to depress the uvula, and 

 attachment of these fibres in the male subject thus to open the orifice of the urethra, and also 

 may be ascertained by careful dissection to be to depress and to draw the seminal caruncle (a 

 as follows : those on the fore part of the bladder sort of organized glans) downwards and back- 

 are connected chiefly to the anterior ligaments, wards within the prepuce or sinus pocularis, 

 or to the reflections of the fascia from the pubis which covers it, and thus protects it from the 

 on this organ ; these appear as shining and dis- irritation of the urine. In the female the lon- 

 tinct as tendons, and have been by some con- gitudinal fibres are inserted anteriorly and late- 

 sidered as such to these muscular bands. Above rally into the cellular, glandular, and vascular 

 this insertion these longitudinal fibres appear tissue which surrounds the neck of the bladder, 

 very numerous, and those on the right and and posteriorly into a more dense tissue which 

 left of the median line distinctly decussate or connects the urethra to the vagina; some fibres 

 interlace. Several here also take a transverse or also pass in deep, as in the male, to be attached 

 an arched or semicircular course; some of these to the sphincter. This muscular lamina is de- 

 are very distinct and are inserted laterally ; scribed by the older authors as a distinct mus- 

 they must serve to strengthen and to bind cle, the ' detrusor urinaj arising from and 

 down the longitudinal fasciculi. The latter around the urachus by numerous fibres, which 

 in this situation can be divided into layers, thence descend and expand over the whole 

 the superficial of which only are inserted, surface, and again concentrate towards the neck 

 as has been described, into the anterior of the bladder to be inserted by one or two 

 ligaments of the bladder, and through these tendons into the ossa pubis. This account, 

 into the pubis. The deeper set are inserted, however, is by no means perfectly correct ; for 

 some into the dense cellular tissue about the on attentively examining this muscular lamina, 

 upper surface of the prostate, and some pass we frequently find strong transverse fasciculi 

 deeper, and intermingle with that circular mus- crossing superficially to the longitudinal fibres, 

 culo-cellular tissue which surrounds the cervix, most frequently on the anterior region, but also 



