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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 
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