SYMPATHETIC RELATION OF THE GENITALIA TO THE
One's rainbow of desires changes color with the passing years.
It is when you come close to a man in conversation that you discover
what his real abilities are. - Samuel Johnson
It is a curious fact that even laymen have for ages
noted that the organ of smell is closely related to the generative organs,
but it is very recently that specialists (gynecologists and rhinologists)
are putting together the connected story. The relation of the olfactory
organ and nasal mucous membrane with the genitals are by way of the sympathetic.
The anatomic path of travel from the nasal mucous membrane to the genitals
is through the fifth cranial nerve, or trigeminus which is supremely the
ganglionic cranial nerve. It is the type of mixed nerves. It
has eight ganglia situated on its branches. It also sends a large branch
to the mucous membrane of the nose - the nasal nerve.
This will at once explain its wide influence in reflection or disease,
because of its extensive influence over the caliber of adjacent blood and
lymph vessels and the extensive periphery in the nasal mucosa, allowing
opportunity for numerous reflexes.
Let us examine for a moment the ganglia of the trigeminus
(trifacial or fifth cranial nerve - the ganglionic nerve of the brain).
A significant statement may precede the short description, by saying that
one of the chief offices of a ganglion is to demedullate nerves. 1, We
may note the Gasserian ganglion of the fifth cranial nerve, situated in
a depression in the apex of the petrous portion of the temporal bone.
The ganglion is as large as the end of the little finger. The ganglionic
nature of this swelling was perceived by Raimund Balthasar Hirsch, a Vienna
anatomist, in 1765, who christened it the "Ganglion Gasserii" in honor
of his teacher, Gasserius, who in 1779 was "Privat Docent" in anatomy under
Prof. Joseph Jans, in Vienna. Since Du Bois-Remond announced
from personal experience that he thought facial neuralgia was due to spasmodic
contraction of the blood vessels controlled by the sympathetic, surgeons
have attempted to cure facial neuralgia by destruction of Gasser's ganglion.
This is at least a recognition of the sympathetic nature of the Gasserian
ganglion, and its consequent influence over the caliber of the blood vessels.
The Gasserian ganglion has close and intimate connection
with the sympathetic nerves. The blood vessels alone which are necessary
to supply the Gasserian ganglion would produce a close and intimate relation
between the sympathetic and trifacial. The trigeminus shows a very
intimate and extensive connection with the tonsils, the sebaceous glands
of the face and genitals. This is seen at puberty of both boys and
girls (facial acne), and in the menopause. The changes in voice of
boys at puberty, and the changes of voice of women at the monthly, may
be easily worked out anatomically, by dissecting out the connection between
the superior cervical ganglion and the pneumogastric and glosso-pharyngeal.
Also the spheno-palatine sends branches to the tonsils in the descending
palatine nerves. One may find from three to five branches of nerves
passing from the superior cervical ganglion to the glosso-pharyngeal and
pneumogastric nerves. During menstruation the vocal cords are congested
and hence the hoarse, husky voice; and a similar but permanent physiological
process of congestion and growth occurs in the boy at puberty. Hence
the close and intimate relations of the vocal cords (voice) and nasal mucosa
(smell) and reflex action with the genitals, have a distinct, concrete,
anatomical explanation. Besides, the larynx is supplied by the sympathetic
branches which accompany the superior and inferior recurrent laryngeal
2. The ophthalmic, lenticular or ciliary ganglion
is a pinhead sized ganglion situated in the orbit. It is closely
connected by roots with the nasal branch of the fifth nerve, i. e., has
relations with the nasal mucosa, by a sympathetic branch from the cavernous
plexus. It is also connected with the third cranial. This second
ganglion has intimate connections with the nasal mucosa. Joseph Guiscard
Duverny (1648-1730), a French anatomist, discovered this ganglion.
3. The spheno-palatine, or Meckel's ganglion,
situated in the sphenopalatine fossa and on the superior maxillary branch
of the trifacial, is a large mass of nerve cells. It is intimately
connected with the nasal mucosa by the descending palatine nerves.
The spheno-palatine ganglion was discovered and described by Johann Friedrich
Meckel (1717-1774), a celebrated German anatomist. Like all the other
ganglia of the fifth cranial nerve, it possesses motor, sensory and sympathetic
roots. It sends a considerable nerve supply to the tonsils.
Hence we again observe that this ganglion shares in distributing nerves
to the nasal mucosa and the region of the tonsils. But the premise
of our argument is that the fifth nerve, being studded by eight sympathetic
ganglia, is intimately and closely connected, anatomically and functionally,
with the genitals. Therefore what affects the fifth nerve will affect
the genitals, and vice versa.
4. The optic or Arnold's ganglion is located
just below the foramen ovale, on the inferior maxillary branch of the trifacial.
Its sympathetic branches are derived from the sympathetic plexuses which
surround the adjacent middle meningeal artery. It is connected with
the facial and glosso-pharyngeal nerves and sends branches to the tensor
palati. In our library may be seen Friedrich Arnold's " Anatomie
des Menschen, " 3 vols. On page 909, Vol. 11, Arnold says, "Der Ohrknoten
wurde von mir im Winter 1825-26 endeckt." In English, "The optic ganglion
was discovered by me in the winter of 1825-26. " Professor Arnold noted
75 years ago that many tried in vain to show that others than himself discovered
the ganglion. This ganglion shows connection with the larynx by way
of the glosso-pharyngeal and tensor palate; and, through the Vidian nerve
and Meckel's ganglion, with the nasal mucosa.
5. The submaxillary ganglion is situated on
the lingual branch of the inferior branch of the trifacial nerve.
Its sympathetic branch is derived from the plexus which surrounds the adjacent
facial artery. This ganglion was discovered by Meckel in 1748.
It has been named after him - Ganglion Meckelii Minus. The ganglion
communicates with the facial or the seventh nerve.
| Fig. 207.
Nerves of internal genitals, pelvic brain, dissected under alcohol.
6. The sublingual or Blandin's ganglion is
situated on the branch of nerves going to the sublingual gland. This
collection of nerves may be only a plexus or a ganglion. It should
have a similar connection with the submaxillary ganglion. Phillippe
Frederic Blandin (1798-1849), a French surgeon. first described this ganglion
7. The ganglion of Bockdalek is located at
the junction of the middle superior dental nerve with the anterior superior
dental nerve. It is not constant, and besides, the swelling may not
always be a ganglion, i. e., may not contain nerve-cells. It lies
above the upper canine tooth. Its discovery is due to Victor Alexander
Bockdalek, Professor of Anatomy in Prague until 1869 (papers published
in 1866), and Victor Bockdalek, his son, also an anatomist in Prague.
However, it appears to be the father who discovered this ganglion, previous
8. The ganglion of Valentine is situated at
the junction of the middle superior dental nerve and posterior superior
dental nerve. It is located above the second bicuspid tooth.
The ganglion was discovered by Gabriel Gustave Valentine (1810-1888), a
German anatomist. All the ganglia of the fifth cranial or trifacial
have systematic connections.
We should have known that the trigeminus is supremely
the ganglionic cranial nerve; that it is closely and intimately connected,
especially with the genitals by way of the sympathetic tracts; also that
the trigeminus is closely and intimately connected, especially with the
nasal mucosa, and to a considerable extent with the larynx and vocal cords.
There are found to be numerous and intimate connections between the fifth
cranial nerve (the trigeminus) and the seventh cranial nerve (the facial).
Observation shows the intimate relation is accomplished by means of the
sympathetic nerves, especially the ganglia on the trifacial. This
physiologic relation of the genitals to the trifacial and facial nerves
may be plainly observed in the sexual relations and cohabitations of animals.
Irritation of the nasal mucosa will cause congestion
and erection. Occasionally irritation of the genitals will cause
congestion of the face or the region of the trigeminus. Urethral
irritation will induce "gritting" of the teeth, i. e., action of the masseter
muscles, supplied by the inferior branch of the fifth.
Dr. A. G. Hobbs describes two cases of severe priapism, accompanying
acute rhinitis (Jour. Am. Med. Assn., 1897). On
spraying the nasal mucosa with cocaine the priapism immediately subsided.
Opium affected the priapism in each case, but only to slight degree.
A reflex sneeze is not infrequent previous to erection.
In preparations for coition the involvement of the nasal mucosa is quite
apparent in animals, as the horse, dog, bull, etc. In monkeys the
nasal mucosa is not only involved in coition, but it is evident that the
larynx is highly involved, from the active and vigorous chattering, emitted
previous to and during coition. The mare neighs at the approaching
of the stallion or cow bellows at the approach of the bull, the growling
of dogs, noise of cats and cackling of hens, are doubtless not accidental
at times of coition, but due to irritation of nerve tracts.
The tissue covering the turbinated bones is quite
erectile. A nasal reflex will induce an erectile action in the corpora
cavernosa. We know that the genitals are intimately and profoundly
supplied by the sympathetic nerves. We know that the fifth nerve
is supremely the ganglionic (sympathetic) nerve of the brain. The
fifth nerve sends a rich supply to the nasal mucosa and to the larynx through
the vagus and glosso-pharyngeal.
Clinically and anatomically we note a close and
intimate relation between the genitals and the nasal mucosa, the larynx
and the sebaceous glands of the face. The whole manifestation is
due to reflex action carried through the sympathetic nerves. The
frequent hemorrhages from the nose during and subsequent to puberty in
both sexes, demonstrate the intimate relation of the nasal mucosa.
Again, why is it that so many women we note with chronic uterine disease
also have rhinitis in different forms? A typical example came to
my office a few days ago. She was 24years old and single. At
20 she began to be irregular in menstrual function, and to have menorrhagia.
Digital examination revealed quite a large, hypertrophic, metritic uterus,
fixed by old adhesions, with distinct retroflexion. She said she
bled frequently at the nose. The tissues covering the turbinated
bones were thickened, inflamed and congested. Chronic rhinitis and
Many diseased generative organs co-exist with diseased
nasal mucosa. The eight ganglia on the fifth cranial nerve - (l)
Ganglion Gasser; (2) Ophthalmic; (3) Spheno-palatine; (4) Optic; (5) Submaxillary;
(6) Sublingual; (7) Bockdalek; (8) Valentine - not only show the sympathetic
nature of the fifth cranial nerve, but also intimate relation with the
nasal mucosa, larynx, abdominal brain, and especially with the genitals.
The relationship between the nasal mucous membrane
and the sexual apparatus is often forgotten. One should always remember
that there is always a woman behind the uterus. In cases of persistent
dysmenorrhea relief may sometimes be afforded by painting the genital spots
in the nose with 1 per cent solution of cocaine, as demonstrated by Schiff,
Emil Ries, Fliess and others. During menstruation there is congestion
of the Schneiderian membrane not present during the rest of the month;
a congestion which may also be produced by violent sexual excitement -
the popular expression "bride's cold" being a laity recognition of the
relation between the nose and the sexual sphere. In most people there
is a temporary swelling of the nasal mucous membrane just preceding and
during the sexual act disappearing with detumescence.