DR. LEE ON THE NERVOUS GANGLIA OF THE UTERUS. 
271 
ganglion then sends forward a large branch which terminates in the middle vesical 
ganglion. 
This ganglion sends off a great number of large nerves to the bladder. Some of 
these accompany the arteries, and can be seen ramifying with them upon the whole 
of the superior part of the organ, even to the fundus. Filaments of these nerves, 
scarcely visible to the naked eye, are seen ramifying upon the bundles of muscular 
fibres, occasionally forming loops, and inclosing them, or passing down between them 
to the strata of fibres below. Some of the smaller branches of the middle vesical 
ganglion do not accompany the arteries, but are distributed at once to the parts of 
the bladder around the ureter. 
The external vesical ganglion is formed entirely upon the nerves which proceed 
from the hypogastric ganglion, and pass on the outside of the ureter. This is a small 
thin ganglion, the branches of which are sent immediately into the muscular coat of 
the bladder. It usually sends down a long branch to anastomose with the nerves 
and ganglia situated on the side of the vagina. 
From the inner surface of each hypogastric ganglion numerous small, white, soft 
nerves pass to the uterus, some of which ramify upon the muscular coat about the 
cervix, and others spread out under the peritoneum, to coalesce with the great 
ganglia and plexuses situated on the posterior and anterior surfaces of the organ. 
Large branches also go off from the inner surface of the hypogastric ganglion to the 
nerves surrounding the blood-vessels of the uterus, which they accompany in all their 
ramifications throughout its muscular coat. Other branches of nerves pass down from 
the ganglion between the vagina and bladder. Soon after conception the blood- 
vessels of the nervous ganglia and plexuses now described enlarge, and the ganglia 
and plexuses themselves expand with the uterus. The long diameter of the hypo- 
gastric ganglion at the end of the ninth month measures about an inch and a half. 
I have published a full description, with illustrations of the great ganglionic nerves 
surrounding and accompanying the blood-vessels, and of the ganglia and plexuses, 
situated on the body of the uterus*. The appearances presented in the fourth month 
of pregnancy by the hypogastric ganglia, and the ganglia and nerves of the rectum, 
bladder, vagina and uterus, and also the great plexuses of nerves situated on the 
anterior surface of the uterus, are seen in the Plates which accompany this paper. 
From an examination with the microscope of portions of the plexuses under the 
peritoneum of a gravid uterus of nine months, which had long been immersed in rec- 
tified spirit, Professor Owen and Mr. Kiernan were led to conclude that they were 
not nervous plexuses, but bands of elastic tissue. 
“The tissue of the broad, white, reticularly inter-communicating bands of fibrous 
matter resembling nerves of the uterus,” observes Professor Owen, “consisted of mi- 
nute fibres, which were solid, smooth, equal-sized, cylindrical and nearly transparent, 
irregularly interblended in their course ; their diameter does not exceed T W .d o ' o th of 
a line. These bands correspond in structure with the fibrous modification of cellular 
* The Anatomy of the Nerves of the Uterus. London, 1841. Fol. 
