Licence: Public Domain Mark
Credit: The anatomy of the human body / By J. Cruveilhier. Source: Wellcome Collection.
Provider: This material has been provided by the University of Massachusetts Medical School, Lamar Soutter Library, through the Medical Heritage Library. The original may be consulted at the Lamar Soutter Library at the University of Massachusetts Medical School.
895/944 (page 871)
![The tubal nerves are also derived from tne ovarian plexuses. The uterine nerves derived from the hypogastric plexuses are divided into ascending branches, which run upward along the lateral borders of the uterus, pass forward and backward upon the surfaces of that organ, and terminate in its substance ; and into de- scending branches, which run along the sides of the vagina, and terminate in it. These vaginal nerves appear to be inseparably blended with the vesical and hemorrhoidal nerves.* Such are the divisions of the hypogastric plexuses ; analogy, rather than direct obser- vation, has led to the admission of the existence of gluteal, ischiatic, and internal pudic plexuses ; in fact, of plexuses around all the branches of the internal iliac arteries. The Sackal Portion of the Sympathetic System^ The sacral portion of the sympathetic (s s,Jig. 302) is formed on each side by a cord en- larged at intervals, and situated on the inner side of, and along the anterior sacral fo- ramina. It forms a continuation of the lumbar portion of the sympathetic ; but sometimes there appears to be an interruption in the ganglionic chain, between the fifth lumbar ganf^lion and the first sacral. This interruption is merely apparent; it is never complete. The sacral trunks of the sympathetic of the right and left sides gradually approach each other as they descend, corresponding in this respect to the anterior sacral foramina. The sacral ganglia, which are rarely five, more Commonly four, and sometimes three in number, are occasionally collected into a small gangliform enlargement, situated be- tween the first and second anterior sacral foramen ; the first sacral ganglion is some- times double, and at other times it rather resembles a gangliform cord than a true gan- glion. The mode of connexion between the first sacral and the last lumbar ganglion is sub- ject to much variety.t The manner in which the sacral portion of the sympathetic ter- minates is also somewhat variable. The following is the arrangement most generally admitted : a filament proceeds from the last sacral ganglion, which is usually the fourth, and forms an anastomotic arch with its fellow of the opposite side, in front of the base of the coccyx. At their point of junction is often found a small ganglion {ganglion im- par, c), from which certain terminal filaments are given off. Sometimes there is neither a coccygeal ganglion nor any anastomosis, properly so called, but the terminal filaments are distributed in the usual way. I have not been able to trace these filaments beyond the periosteum of the coccyx and the sacro-sciatic ligaments. Like the other ganglia of the sympathetic, the sacral ganglia present communicating branches with each other; rather large external brayiches derived from the corresponding sacral nerves; internal branches, which anastomose with those of the opposite side, in front of the sacrum, and surround the middle sacral artery. Some of these filaments I have distinctly seen entering the substance of the sacrum ; and, lastly, very small ante- rior branches (y), some of which join the hypogastric plexuses, while the others termi- nate directly upon the rectum. General View of the Sympathetic System. The following dissection is necessary, in order to present a correct general idea of the sympathetic system. Take a spinal column which has been macerated in diluted nitric acid, remove the bodies of the vertebrae, leaving, if it be wished, the inter-vertebral substances; be very careful to preserve the branches of communication between the sympathetic aad the cra- nial and spinal nerves. It is then clearly seen that the two gangliated trunks of the sympathetic are connect-, ed with the cerebro-spinal axis by as many roots, or small groups of roots, t as there are cranial and spinal nerves; it is, moreover, no less evident that the^ communicating branches between the ganglionic chain and the spinal nerves do not pi'oceed from the ganglia, but from the spinal nerves; so that it may be stated as a demonstrated ana- tomical fact, that the sympathetic system has its origin in the cerebrospinal system.^ * [Dr. Lee has recently examined minutely the distribution of the nerves of the unirapr^gnated and gravid; uterus. He has described {Anatomy of the Nerves of the Uterus, with plates, 1841, and Proceedings of the Royal Society, No. 49) several large uterine plexuses; also, several large ganglia on the uterine nerves, and! on those of the vagina and bladder ; and, farther, two great ganglia situated on the sides of the neck of the. uterus.] t In one case, the continuation of the lumbar portion of the sympathetic deviated outward, and joineditfts fifth lumbar nerve ; a very small filament only formed the communication between the last lumbar gangliiis' ^ and the first sacral. In another case, these two filaments proceeded from the last lumbar ganglion of the-ij^ jj. side, the inner of which joined the first sacral ganglion of the opposite side, crossing over the sacro-veJitRif j^j angle. i It must be remembered that there are always two, and sometimes three communicating branches; biW ween the sympathetic and each of the spinal nerves. (l These facts in human anatomy are in perfect accordance with the observatioiis in comparative^ a „jf made by Meckel and Weber, namely, that the development of the sympathetic system is-in direct ua'tio with- that of the cerebro-spinal system ; that the former is more developed in maa than in.any. othet aioiaaal and is proportionally larger in the foetus than in the adult,](https://iiif.wellcomecollection.org/image/b21196801_0895.jp2/full/800%2C/0/default.jpg)
