Illustrations of the anatomy of the pelvis / By Alexander Monro.

  • Alexander Monro
Date:
1827
Catalogue details

Licence: Public Domain Mark

Credit: Illustrations of the anatomy of the pelvis / By Alexander Monro. Source: Wellcome Collection.

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    20 PLATE IX. AN unusual branch is sometimes sent off from the internal iliac artery, which passes along the side of the blad- der and prostate gland. 7 This deviation from the usual distribution of arteries is not very rare, and merits particular attention. HALE, in his 4th Fasciculus, observes, that the older anatomists have described the Pudic artery as pass- ing along the prostate, and under the symphysis pubes. In my Outlines of Anatomy, I have mentioned that the late Mr ALLAN Burns of Glasgow shewed me two instances in which a branch of the pudic artery followed such an unusual course. TIEDEMANN, in his 30th plate, has represented the left dorsal artery of the penis as passing over the prostate gland; and in a note to the explanatory text of the plates, he observes, that he had met with a similar distribu- tion of the arteries on both sides, in the person of a man of 20 years of age, and also in a boy; and that he had seen a similar distribution in the arteries passing to the clitoris. Mr Harrison of Dublin has observed, that the internal iliac had given off a distinct branch, which ran along the side of the bladder and prostate gland, and passing beneath the arch of the pubes with the dorsal veins, be- came the dorsal artery of the penis. “ Should such a variety exist,” he adds, “ in one who was to become the subject of the lateral operation of lithotomy, I fear this artery must be wounded; and, judging from its size and situation in those cases in which I have seen it take this course, I should apprehend very serious consequences from its division.” It is not improbable but that some of those alarming cases of hamorrhage which have occurred even to the best of operators, may have depended on this variety. Mr Suaw of London was so unfortunate as to operate upon a man in whom such a distribution existed. He observes, “ feeling the staff through the face of the prostate, I cut upon it, and carried my knife forward through the membranous part of the urethra and prostate, following and directing the point with the fore-finger of my left hand. On making this incision, there was a gush of fluid. I thought that it was urine ; but on observing it flowing over the back of my left hand, I saw that it was blood. The patient died the same day, in consequence of bleeding.” — 7 I have seen two cases lately, in which there was such an unusual distribution of arteries. One of these was shewn to me by Dr MiLuicaNn: the other occurred in a small subject, in which a branch of the Pudic artery passed along the ilial side of the bladder of urine, and about one inch and a half from the urethra, and then pass- ed through the ilio-vesical fascia, and divided into three branches, one of which entered the bulb of the urethra, a second the crus penis, and the third ran along the dorsum of the penis. The internal Pudic artery, which was smaller than usual, followed its usual course: it passed between the sacro-sciatic ligaments, then passed on the inner side of the tuberosity of the ischium, and sent off the external hemorrhoidal and perineal arteries. A, The Anus. B, One of the Thighs. C, C, C, The skin turned back. D, The tuberosity of the Ischium. C, The Crus penis, covered by its erector muscle E. I’, The trunk of the internal Pudic artery. G, The Bulb of the Urethra. H, The continuation of the unusual branch from the internal Iliac, which passed along the side of the bladder and the prostate gland, and becomes the Dorsal artery of the Penis.
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