THE LYMPHATICS OF THE PELVIS. 551 



Poupart's ligament, and one or two smaller ones at a higher level. They receive 

 the efferent vessels from the inguinal glands, as well as deep lymphatics from the 

 abdominal wall, accompanying the epigastric and circumflex iliac vessels ; and their 

 efferent vessels pass upwards to the lumbar glands. 



The internal iliac lymphatic glands, a numerous series placed along the 

 internal iliac vessels, and the sacral glands, placed in the hollow of the sacrum, 

 receive the lymphatics from the pelvic viscera and parietes. 



The lymphatics of the bladder are few and small, and their course and 

 termination are not sufficiently known. From a plexus over the base and the 

 adjoining part of the abdominal surface of the organ a trunk passes on each side to 

 enter a gland below the external iliac vein (Mascagni, Sappey) ; and other vessels 

 derived from the pubic surface form a small trunk which traverses a gland lying 

 against the obliterated hypogastric artery on its way to the internal iliac glands 

 (Mascagni). The lymphatics of the prostate also ascend to glands below the 

 external iliac vessels. The lymphatics of the vesicula seminalis and of the ampullary 

 portion of the vas deferens are numerous, and enter one or two glands placed near the 

 base of the former body (Sappey). 



The lymphatics of the uterus are numerous, and become much enlarged 

 during gestation. Those from the lower part of the organ converge on each side of 

 the cervix to two or three large vessels, which are joined by lymphatics from the 

 upper end of the vagina, and then pass backwards to enter the glands upon the 

 internal iliac artery, thus following the course of the principal uterine blood-vessels. 

 Others, proceeding from the upper end of the uterus, run outwards in the folds of 

 peritoneum which constitute the broad ligaments, and, joining the lymphatics 

 derived from the ovaries and Fallopian tubes, ascend with the ovarian vessels to the 

 glands placed on the aorta and vena cava. There are also in some cases one or two 

 small lymphatic vessels passing from the uterus forwards along the round ligament 

 to one of the superficial inguinal glands. The lymphatics from the greater part of the 

 vagina enter the lowest of the internal iliac glands ; but those from the lower end 

 join the vessels of the external generative organs passing to the superficial inguinal 

 glands. 1 



The lymphatics of the rectum are frequently of considerable size ; imme- 

 diately after leaving the intestine, some of them pass through small glands which lie 

 contiguous to it, and finally, they enter the lymphatic glands situated in the hollow 

 of the sacrum. At the anus, their capillary network is continuous with that of the 

 cutaneous lymphatics. 



The lumbar lymphatic glands are very numerous and are disposed in three 

 groups, a median and two lateral. The glands of the median group are of large 

 size, and lie along the common iliac vessels, the aorta and the vena cava ; they 

 receive the efferent vessels of the external and internal iliac, and of the sacral glands, 

 the lymphatics from the kidneys, suprarenal bodies and testicles (or ovaries with a 

 part of the uterus), some of the efferent vessels of the lateral lumbar glands, and the 

 lymphatics of the vertebral portion of the diaphragm. The glands of the lateral 

 group are much smaller ; they lie behind the psoas muscle, in the intervals between 

 the transverse processes of the vertebrae, and receive the deep lymphatics of the 

 hinder part of the abdominal wall. The greater number of the efferent vessels of 

 the lumbar glands are generally united on each side into a short stem, the lumbar 

 lymphatic trunk, which, with several smaller vessels, opens into the commencement 

 of the thoracic duct. 



The lymphatics of the kidney consist of a deep and a superficial set. Those 

 placed upon the surface of the organ are comparatively small ; they unite at the 



1 P. Poirier, " Lymphatiques des organes genitaux de la femme/' Paris, 1890. 



