THE NERVES OF THE GENITAL TRACT
(NERVI TRACTUS GENITALIS) - (A) ANATOMY, (B) PHYSIOLOGY.
The American government is not in any sense founded upon the Christian
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The appointive power of a political party vitalizes its energy and
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The origin of genital nerves are: I, nervus vasomotorius
(sympathetic-abdominal brain); II, spinal cord (medulla spinalis), through
rami communicantes and rami nervorum sacralium (II, III, IV), cerebrum
The three major nerve streams to the tractus genitalis
are (a) the plexus interiliacus (which is a continuation of the plexus
aorticus) originating in the abdominal brain; (b) the plexus ovaricus originating
from the whole plexus aorticus; (c) plexus sacralis spinalis (rami nervorum
sacralium - II, III, IV). The minor nerve streams to the tractus
genitalis are: (d) lateral lumbar ganglia (truncus nervus lumbales vasomotorius);
(e) lateral pelvic ganglia (truncus nervus pelvis vasomotorius); (f) nerves
of the uterine artery (nervi arteriou uterinae); (g) nerves of the hypogastric
artery (nervi arteriac bypogastricac) richly demonstrated in infant cadavers.
Also nerves of the round ligament and hemorrhoridal arteries.
Practically the nerves supplying the tractus genitalis
are solidly and compactly anastomosed connected with the whole abdominal
vasomotor nerves (sympathetic), especially with the giant ganglion coeliacum
- the abdominal brain - the great assembling center of the vasomotorius
abdominale or sympathetic nerve plexus. The anastomosis or connection
of the genital nerves to the nervus vasomotorius (sympathetic) and cerebro-spinal
is vast and profound. The order of solidarity or compactness of anastomosis
or profundity of connection of the vasomotor nerves (sympathetic) to the
abdominal viscera is the following, viz.: (A) nervus vasomotorius to the
tract - is vascularis (blood and lymph vessels); (B) nervus vasomotorius
to tractus intestinalis; (C) nervus vasomotorius to tractus genitalis;
(D) nervus vasomotorius to tractus urinarius. However, all the abdominal
viscera are solidly and compactly aliastomosed, connected to the central
abdominal sympathetic or vasomotor nerve that no one visceral system can
become disturbed, deranged, without affecting profoundly all other visceral
systems. The derangement arising in the several abdominal visceral
systems caused by irritation or disease in any one abdominal visceral system
is produced by reflexes, resulting in the disturbed common visceral function
- peristalsis, secretion, absorption, sensation. So far as I am able
to observe, the reflexes, or irritation in the tractus genitalis produces
the most profound and vast derangement of function in other abdominal viscera
of any single visceral system, e.g., irritation, disease in the tractus
genitalis, passes to the abdominal brain (over the plexus interiliacus
and plexus and plexus aorticus) where it is reorganized and emitted to
the tractus intestinalis or tractus urinarius, deranging the common function
of peristalsis (rhythm), secretion, sensation and absorption - causing
deficient, excessive or disproportionate peristalsis, secretion or absorption.
The older anatomists, like the philosophic Willis (1622-1675), who was
the Sedlian professor in Cambridge, claimed that the nerves supplying the
tractus genitalis arose from the intercostal nerves, that is, by means
of the rami communicantes, truncus vasomotorius - lateral ganglionic chain
and nervi splanchnici. This is as true today as in the days of the
ever-memorable Willis; however, we ascribe today more to independent, more
differentiation to the vasomotor nerves (sympathetic) than did Willis.
These so-called intercostal nerves (rami communicantes) form a nervous
center - the abdominal brain - secondary to the cranial brain, which has
differentiated functions of the first magnitude as regards existence of
life itself. Hence, today we are inclined to believe from experimentation
and clinical data that the chief origin of the nerves of the tractus genitalis
is the abdominal brain - cerebrum abdominale, and since this giant ganglion
controls the vascular supply of the abdominal viscera it should be termed
cerebrum vasculare abdominale. In the consideration of the nerve
supply of the tractus genitalis it is favorable for convenience of description
and practical purposes to present a major and minor nerve stream.
The following table presents in a bird's-eye view the major and minor nerve
supply to the genital tract:
Major Nerve Supply.
A. Plexus interiliacus (sympathicus).
B. Plexus ovaricus.
C. Plexus sacralis spinalis (rami nervorum sacralium).
Minor Nerve Supply
D. Lateral lumbar ganglia (truncus nervus sympathicus
E. Lateral pelvic ganglia (truncus sympathicus sacrales).
F. Nerves of the uterine artery (nervi arteriee
G. Nerves of the hypogastric artery (nervi arteriae
H. Nerves of the round ligament artery (nervi arteriae
I. Nerves of the haemorrhoidal artery superior et
medius (nerve arteriae hemorrhoidalis superior et medius).
The major nerve supply consists of (A) plexus ovaricus;
(B) plexus interiliacus (vasomotorius); (C) plexus sacralis spinalis rami
nervorum sacralium (II, III, IV).
(A) Plexus Ovaricus.
Origin. - According to my dissection the main
origin of the ovarian nerves is from the ganglion ovaricum proximal, a
definite ganglion of irregular form and dimension located at the origin
of the arteria ovarica on the aorta. However, the plexus ovaricus
arises also from the adjacent regions in the plexus aorticus both proximal
and distal to the ovarian ganglion, especially it may be noted that the
renal ganglia contribute ovarian nerves. Frankenhauser (1867) in
one of his tables marks the origin of the ovarian nerves extending from
the root of the arteria renalis to the interiliac nerve disc located on
the sacral promontory. He notes the ovarian nerve composed at the
origin of some twelve separate strands, and as they pass distalward on
the vasa ovarica coalesce into three main trunks, studded with ganglia.
In dissecting it will be observed that the ganglia renalia and ganglia
ovarica are closely associated in a solidly fenestrated network indicating
identical origin from the Wolffian body. I could not discover such
an abundant ovarian nerve supply neither from such an extensive area of
the plexus aorticus, as reported by Frankenhauser. However, the explanation
may lie in the fact that Frankenhauser dissections were from non-pregnant
and infant genitals. The sections disclosed large numbers of nerve
fibres originating in various regions from the plexus aorticus, especially
the ganglia renalia and ganglia ovarica proximal and directing themselves
toward the vasa ovarica coalesce into some three nerve trunks. The
ovarian nerves coerce with the ovarian vessels, forming an elongated wide
network studded with nerve ganglia limited in number and dimension and
located at the crossing, junction of the nerve strands.
The ovarian nerves arise from the ganglion ovaricum
proximal in the form of a plexus or a leash which accompanies and ensheaths
the arteria ovarica to the union with the vena, ovarica, where both the
vein and artery share more equally the attention of the ovarian nerves.
The plexus ovaricus in general arises from the following ganglia, viz.:
(a) ganglion ovaricum (proximal); (b) ganglia renalia; (c) ganglion mesentericum
inferior; (d) ganglia luinbalis. The above ganglia are solidly and
compactly connected with the ganglion coeliacum.
(Note. - It should be remembered that the numerous
pains of which woman complains as being in the ovaries are not located
in the ovaries, but reside in the cutaneous distribution of the ileo inguinal
and ileo hypogastric nerves. It is hyperesthesia of the skin).
The plexus ovaricus arises from the following plexuses:
(a) plexus aorticus; (b) plexus renalis; (c) plexus mesentericus superior;
(d) plexus mesentericus inferior; (e) plexus ureteris (where the vasa ovarica
cross ventral to the ureter the plexus ovaricus becomes anastomosed with
the plexus ureteris, further solidly anastomosing the plexus ovaricus with
the plexus renalis); (f) plexus interiliacus; (g) the plexus ovaricus receives
branches from the genito-crural nerve, again solidly anastomosing the plexus
lumbalis (spinal) with the plexus ovaricus (sympathetic).
Course. - The plexus ovaricus accompanies the vasa
ovarica in their extended journey to the pelvis in erect animals in the
form of sheathed network of nerves with extremely elongated fenestra.
The plexus ovaricus in its course is studded with spare ganglia of various
size. The nerves of the plexus, like many other sympathetic plexuses,
are cylindrical - not flat like those of the plexus uterinus - and retain
their caliber throughout their course. Toward the distal end of the
vasa ovarica the vein and artery. become more branched, occupying more
space, whence the plexus ovaricus divides its branches to accompany the
additional vessels. The distal end of the plexus ovaricus divides
and supplies: (a) the ovary; (b) the oviduct; (c) ligamentum latum; (d)
the lateral border of the uterus; (e) it anastomoses with branches of the
(B) Plexus Interitiacus (Vasomotorius).
The interiliac plexus extends from the interialic
nerve disc to its union with the sacral nerves of the cervico-vaginal junction.
It is the major nerve supply of the genitals. it is elsewhere described
(C) Plexus Sacralis Spinalis (Rami Nervorum Sacralium).
The second, third and fourth sacral, spinal nerves
emit branches (pelvic splanchnics) which join, coalesce, with the distal
branches of the interiliac plexus to form the pelvic brain (ganglion cervicale
- which issues the white rami communicantes) practically the plexus uterinus,
plexus vesicalis, plexus rectalis, plexus vaginalis, plexus clitoridis,
plexus pudendalis. The spinal sacral nerves passing to the pelvic
brain gave rise to the idea that they supplied the cervix uteri, and that
they are sensory nerves of the uterus. So far as I have been able
to observe, all branches of the sacral spinal nerves first enter the pelvic
brain before passing to the uterus and vagina. One nerve from the
second sacral passes directly to the bladder without first passing through
the pelvic brain. The branches of the sacral nerve passing to the
pelvic brain vary in number, origin, arrangement, length, and dimension.
They are the most accurately demonstrated in infant cadavers preserved
in alcohol. The blending or coalescence of the branches of the sacral
nerves (pelvic splanchnics) ( I to IV) with the distal branches of the
plexus interiliacus (vasomotorius) results in the pelvic brain - a plexiform,
multiple, nodular ganglionic nerve mass located where the rectum joins
the cervicovaginal junction, and being of irregular form, dimension,
weight. The pelvic brain is practically the source of the genital
nerves. The minor nerve supply of the tractus genitalis consists
of D, E, F, G, H, I.
(D). The lateral lumbar trunk ganglia send nerves to the plexus
aorticus and plexus interiliacus.
(E). The lateral pelvic trunk ganglia send nerves to the genitals
by way of the pelvic brain. It sends nerves to the distal ureter.
(F). The nerves accompanying the internal iliac artery continue
their course over the arteria uterine as the nervi arteriae uterinae.
(G). The nerves of the hypogastric artery (nervi arteriae hypogastricae)
carries larger numbers of nerves to the genitals in the infant. It
also emits branches to the ureter and bladder. With atrophy of the
hypogastric artery many nerves fade with the artery.
(H). Nerves of the round ligament artery (nervi arteriae ligamenti
rotundi) pass from the external common iliac artery to join with the plexus
ovaricus and plexus uterinus.
(I). Nerves of the hemorrhoidal artery superior and medial (nervi
arteriae haemorrhoidalis superior et medius) emit nerves to the genitals.
It will be observed that the major and minor nerve supply of the genitals
is so extensive, so solidly and compactly anastomosed that severing the
genital nerves for experimentation is incompatible with life, and consequently
reports of such experiments are of limited value only.
The Plexuses of the Pelvic Brain.
The pelvic brain practically emits the nerves to
the pelvic viscera, but especially the plexuses of the genital tract.
The table represents the scheme:
Plexuses of the Pelvic Brain. - l. Plexus
uterinus. 2. Plexus vaginalis. 3. Plexus vesicalis. 4. Plexus rectalis.
1. Plexus uterinus is emitted to the uterus
from the pelvic brain. In infant cadavers I have counted as many
as eight different strands of nerves passing from the pelvic brain to the
uterus. In the infant cadavers one can observe several nerves passing
from the pelvic brain over the external border of the ureter to penetrate
finally the myometrium. The first proposition to assert is that the
uterus is practically supplied by two plexuses, viz.: (a) the plexus interiliacus
(hypogastricus) sends one (two or three) branches directly to the uterus
without first entering the pelvic brain; (b) the plexus uterinus, which
passes directly from the pelvic brain to the uterus, where it anastomoses
with the branches of the plexus interiliacus. Hence the uterus is
supplied by branches of the plexus interiliacus directly from the abdominal
brain and the plexus uterinus directly from the pelvic brain - leaving
the abdominal brain as the chief ruling potentate of the abdominal viscera,
while the pelvic brain is a subordinate, local, ruler of the pelvic viscera.
The plexus uterinus accompanies the uterine vessels in general only - not
in particular like the intimate relation of the plexuses of the abdominal
brain to its visceral vessels. The plexus uterinus presents large,
strong branches to the cervix uteri, which is unusually rich in nerve supply.
The order of richness of nerve supply to the uterus is (a) cervix, luxuriant;
(b) corpus, rich; (c) fundus uteri, abundant. The form of the nerve
supply to the uterus imitates it, viz.: fan-shaped. In the illustrations
of the nerves of the uterus what is presented is the main superficial branches
of the plexus interiliacus and plexus uterinus which accompany the major
uterine arteries the most intimately along the lateral uterine borders
(see figure 3).
The branches from the plexus interiliacus (one to
three) are distributed on the dorsal wall of the cervix, becoming distributed
on the dorso-lateral border of the fundus uteri, where they anastomose
with the branches of the plexus ovaricus at the junction of the uterus
and oviduct, where is located (especially marked in infants) a ganglion.
The dorsal surface of the fundus also receives numerous branches from the
branches of the plexus interiliacus. Finally the branches directly
from the plexus interiliacus (which is directly from the abdominal brain
through the plexus aorticus) supply strong, large nerves which are richly
distributed to the cervix, corpus, fundus, and oviduct. They anastomose
solidly and compactly with the plexus ovaricus and plexus uterinus from
the pelvic brain. The plexus uterinus - major nerve supply to the
uterus - originates in the pelvic brain. The plexus uterinus, like
the plexus interiliacus, approaches the uterus from the neck and lateral
border. This leash of ganglionated uterine nerves from the cervico-uterine
ganglion in contradistinction to the branches of the plexus interiliacus,
supplies the ventro-lateral border of the uterus, and courses more intimately
in relation with the uterine segment of the utero-ovarian artery.
Many of the large nerves of this plexus are superficial, simulating the
superficial position of the artery. As the branches of the plexus
interiliacus (direct from the abdominal brain) richly supply the dorsal
surface of the corpus and fundus uteri so that the plexus uterinus (directly
from the pelvic brain) luxuriantly supplies the ventral surface of the
cervix, corpus and fundus uteri. Branches from the vesical ganglia
pass to the plexus
uterinus, thus aiding to make the uterus and bladder act clinically
as one organ. The solidly anastomosed plexuses of the uterine nerves
continually increasing their area of distribution and their number of multiplying
peripheral branches as they proceed toward the fundus, finally sends branches
to anastomose with the plexus ovaricus, especially at the oviductal junction,
where lies a marked ganglion. This utero-oviductal ganglion appears
to be the nerve center from which radiate nerves to the fundus uteri and
distal oviduct as well as to the muscular plates lying in the ligamentum
latum. The entire uterus is surrounded and traversed by a closely
woven network of ganglionated nerve plexuses. The microscopic ganglia
are most numerous in the region of the cervix, especially adjacent to the
pelvic brain. The uterus is abundantly and luxuriantly supplied by
vasomotor sympathetic nerves from which, could we dissolve the substance
of the uterus, leaving the network, they would appear like a spider's web.
It must be remembered that the uterus is a coalesced organ, and hence the
adult nerve supply is a complex affair resembling the adult circulation,
which is most extraordinarily demonstrated by corrosion anatomy.
2. Plexus vaginalis is emitted from the pelvic
brain to the vagina. The vaginal plexus is a rich leash or ganglionated
plexus of nerves which surround the vagina like a network of cords surrounding
a rubber ball. The vaginal nerve plexus and vaginal vein plexus,
both rich, complicated and abundant, intertwine and interweave with each
other. The rich vaginal plexus is bedecked with numerous ganglia
at the points of nerve convergence. The meshes of the vaginal plexus,
being occupied by fatty tissue, connective tissue, lymph and blood vessels,
its dissection is accompanied with difficulty. Infant cadavers should
be chosen to facilitate correct exposure of the finer constituents of the
vaginal plexus. As the bladder is supplied by a large branch from
the third sacral nerve, so the vagina is supplied from a large branch of
the fourth sacral nerve. The ganglionated nerve cords from the pelvic
brain surround the vagina like a mighty network, ventrally and dorsally.
The vaginal plexus also emits many large nerves to the rectum and bladder.
The ventral vaginal nerve leashes course proximalward and distalward.
The larger ganglia of the vaginal leash or plexus occur at the proximal
ventral vaginal fornix, while on the distal ventral end of the vagina the
ganglia are numerous, but more limited in dimensions. The ganglia
of the dorsal vaginal wall is limited in number. The entire vagina
is completely surrounded by a closely woven ganglionated nerve network.
These perivaginal and paravaginal plexuses stand in intimate relation with
the pelvic brain.
Toward the central longitudinal axis of the uterus
and vagina the genital plexuses diminish, simulating exactly the genital
blood and lymph supply.
3. Plexus vesicalis is emitted from the pelvic
brain to the bladder. The vesical plexus is of the powerful, rich,
ganglionated plexuses or leashes of the pelvic brain. It is solidly
andcompactly anastomosed to the plexus rectalis, but especially to the
plexus uterinus, inducing the rectum, uterus and bladder to act clinically
or symptomatically as one apparatus. For description see nerves of
4. Plexus rectalis is emitted from the pelvic
brain to the rectum as rich network of nerves bedecked with ganglia limited
in number and dimension. The rectal plexus emitted by the pelvic
brain is a fine plexiform leash of nerves which passes distalward on the
lateral borders of the rectum, intimately blending with the tissues of
the rectal wall. The rectum has not only a rich and complicated nerve
supply, but it has a mixed nerve supply. The following table presents
a general view of a rectal nerve supply:
Rectal Nerve Supply.
1. Plexus hemorrhoidalls superior (from the arteria
2. Plexus interiliacus (from the abdominal brain).
3. Plexus hemorrhoidalis medius (accompanying the
arteria haemorrhoidalis media).
4. Plexus hemorrhoidalis inferior (from the arteria
hemorrhoidalis inferior and plexus pudendalis sacralis - mixed vasomotor
and spinal nerves).
5. Plexus rectalis (from pelvic brain - a powerful,
rich nerve plexus solidly anastomosed to the plexus uterinus and vesicalis).
6. Plexus sacralis spinalis (branches from the second,
third and fourth sacral nerves).
7. Truncus pelvis sympathicus (lateral sacral ganglia).
The three great haemorrhoidal plexuses arriving
at the rectum via the three haemorrhoidal arteries invest it with a network
of rich nerve plexuses. A rich leash of nerves passes to the rectum
from the plexus interiliacus. Part of the branches of the plexus
pass proximalward on the rectum to anastomose with the plexus haemorrhoidalis
inferior (from the inferior mesenteric plexus) while part passes distalward
on the rectum, penetrating its coats. Some of the branches of the
haemorrhoidal plexus supply the bladder and genitals. From this anatomic
distribution of the haemorrhoidal plexus - to genitals, rectum and bladder
- it is obvious that the genitals, rectum and bladder are solidly and compactly
anastomosed. Clinical work demonstrates this balanced union of organs
in the pelvis through nerve connection, as rectal or genital operations
will induce inability to micturate. The plexus haermorrhoidalis medius
(and inferior) corresponds to the plexus pudendalis on the arteria pudenda.
For further description of the rectal nerve supply, see tractus intestinalis.
The nervous apparatus ventral, lateral and dorsal to the vagina, that supplying
the ureter, that coursing through the parametrium and perimetrium, that
supplying the bladder, rectum and ureter, are solidly and compactly anastomosed.
They form an inseparable nerve plexus bedecked with ganglia of greater
and lesser dimensions surrounding the cervico-vaginal junction. The
vast plexuses of the pelvic brain, rich in ganglia, extend from the cervico-vaginal
junction distalward to the pelvic floor surrounding with a luxuriant closely
woven network, uterus and vagina (tractus genitalis), the rectum (distal
tractus intestinalis), the bladder and ureter (distal tractus urinarius).
The physiology of the nerves of the tractus genitalis
comprises the function of the genital organs, which are in order of origin:
1, ovulation; 2, absorption; 3, secretion; 4, peristalsis (rhythm); 5,
menstruation; 6, gestation; 7, sensation.
First it should be observed that the abdominal brain
originates the plexus aorticus, and the plexus aorticus gives origin to
two great nerve plexuses, viz., plexus interiliacus and plexus ovaricus.
The plexus interiliacus, so far as the genital tract is concerned, divides
into two, i.e., one, the larger branch, terminates in the pelvic brain,
while the smaller branch terminates directly in the uterus without first
passing through the pelvic brain. The plexus ovaricus arises from
the plexus aorticus and terminates practically at the ovary; this plexus,
however, proceeds to anastomose with the plexus uterinus in the ligamentum
latum. Hence, a larger portion of the nerves which supply the genital
tract arise in the abdominal brain and pass to it directly through the
plexus interiliacus and plexus ovaricus. On the other hand, a massive
plexus (the uterine modified by the sacral spinal nerves) passes through
the pelvic brain before it arrives at the genital tract. These anatomical
facts demonstrate how solidly and compactly the tractus genitalis is anastomosed
to the whole abdominal sympathetic. Besides this must be held in
view the modifying influence on the genital tract of the sacral (spinal)
nerves through their coalesces with the distal end of the plexus interiliacus,
i. e., through the pelvic brain.
Peristalsis - Rhythym of the Tractus Genitalis.
Peristalsis, or rhythm, of the genitals, though one
of the common functions of all abdominal viscera (under control of the
abdominal brain), is particularly specialized in the tractus genitalis
- uterus and oviducts - to a degree of popular demonstration. Rhythm
of the uterus to the ordinary observer is its chief characteristic phenomenon.
The rhythm, or peristalsis, of the uterus under the direct command of the
sympathetic nerve, differs not, except in degree, from the rhythm of other
viscera under direct command of the sympathetic, such as the enteron, colon,
ureter, spleen, liver pancreas. Such organs as the lungs, heart,
stomach, and bladder, though dominated by the sympathetic, yet are so powerfully
supplied by the cranial nerves (vagi) and the spinal nerves (sacral) that
their rhythm is modified. The periodic rhythm and stately peristalsis
of the uterus has induced observers of all time to enquire and wonder as
to its cause. That irritation of the plexus interiliacus and of the
plexus uterinus is followed by the rhythmical movements of the uterus,
is the main testimony of a vast majority of investigators. The myometrium,
the complicated muscle of the uterus in general, is maintained and completely
developed by menstruation and gestation, otherwise it would atrophy.
In the uterus are located nerve ganglia, little brains, smaller ganglia
- extended or transported from the pelvic brain to the uterus, which I
termed fifteen years ago automatic menstrual ganglia. They are local
rulers of muscle or myometrial rhythm. When the automatic menstrual
ganglia are periodically bathed in extra blood (which is a stimulant or
excitant) they explode rhythmically, the uterine muscle or myometrium assumes
an active, vermicular movement; thus the myometrium or uterine muscle is
preserved from atrophic death. Extra absorption of the uterine glandular
apparatus is due to the extra trauma of the muscular bundles on the utricular
glands. The myometrium thrashes, massages, and whips the glands to
extra secretary labors. Myometrial activity and glandular activity
are concomitant - cause and effect. The chain of events is: extra blood
to the automatic menstrual ganglia induces extra myometrial rhythm.
Extra uterine peristalsis induces extra massage, excitation, to the uterine
glands, which results in extra secretion. Therefore, be it observed
the dominating nerve of the uterus - the sympathetic functionates as a
unit - no conflict, in rhythm which develops the myometrium. During
gestation the automatic menstrual ganglia become bathed with continual
extra blood. Profound congestion, progressive exalted engorgement,
produce extra nourishment and multiply elements until the gestating uterus
is perhaps fifty times the dimension of the resting uterus., The gestating
uterus is always in motion - rhythm. One curious feature I have noted
in the arteries of gestating uteri of animals and man, and that is, that
the uterine artery was enlarged, hypertrophied, exactly from its origin
in the internal iliac. No part of the iliac was enlarged. Hence
gestation belongs entirely to the tractus genitalis, to the utero-ovarian
arterv. The function is distinct, does not glide into any other visceral
tract. The sympathetic nerve has through aeons of ages become, differentiated
to perform separately and distinctly the important functions of the tractus
genitalis. The sympathetic nerve, nervus vasomotorius, originally
belonged to the arterial system. It is differentiated at present
to control some veins and also the gradually added tractus lymphaticus.
Great importance lies in the tractus vascularis and its ruler, nervus vasomotorius.
The future problems, especially as regards shock, must be solved in the
wide field of the sympathetic nerve and circulatory system.
Besides rhythm or peristalsis the nerves of the uterus preside
over the functions of absorption, secretion, menstruation, gestation, and
sensation of the uterus, a description of the physiology of which space
forbids. The physiology of the oviduct is under the control of the
sympathetic nerve and we may note the following points in its functional
The object of the oviduct is transportation - export
and import service - of spermatozoa proximalward and of ova distalward,
forcing the impregnated ovum distalward to the uterine cavity. The
following are the main physiologic factors in oviductal transportation:
1. The periodic congestion of the genitals,
stimulation of the automatic menstrual ganglia by extra blood.
2. The cilia of the oviductal mucosa whip
continually toward the uterus distalward, not only forcing the ova distalward,
but also creating a fluid current.
3. The congestion induces the endosalpinx
to secrete a fluid which makes the oviduct a canal to float the ovum distalward:
4. Congestion induces continual oviductal
peristalsis, which forces the ova distalward.
5. The contraction of the muscular processes
in the ligamentum latum enhances the peristalsis.
6. The shortening of the fimbria ovarica which
induces the infundibulum to apply its mucous surface to the ovary, capturing
7. The congestion induces the secretion of
mucus and glues the infundibulum on the surface of the ovary.
8. Intra-abdominal pressure aids the distal
progress of the ova.
9. The enlarging of the ovum approaching the
10. Secretion of the endosalpinx produces
a fluid medium adjacent to the proximal oviductal end and the cilia of
the fimbriae induce a current toward the abdominal ostium.
11. The oviduct has an import (spermatozoa)
and an export (ova) service. It is analogous to the vas deferens
in the male. The spermatozoa pass through the oviduct proximalward,
while the ova pass through it distalward.
12. The oviduct is a temporary (or pathologic
permanent) depot for conception. The oviduct (ampulla) is a physiologic
sporting ground for ova and spermatozoa. It has three general physiologic
offices to fulfill, viz.: (a) to secure and transport the ovum (distalward)
to the cavity of the uterus; (b) to conduct spermatozoa proximalward; (c)
to serve as physiologic temporary (or pathologic permanent) depot of conception.
All the physiologic statements in regard to the ovary will be, that the
rich plexus ovaricus rules ovulation, but also, perhaps, some form of internal
ovarian secretion is necessary for the best normal corporeal existence.
The physiology of the tractus genitalis is vigorous, as it is supplied
by a luxuriant system of sympathetic nerves. With the higher forms
of differentiated animals the magnitude and influence of the genitalis
increases. The higher the animal the more thought is applied to the
genitals, the more periodic congestion and permanent increase of nerve
and blood supply. The intense attention paid to sex in higher animals,
such as monkey and man, is a remarkable phenomenon, and attention induces
blood flow, congestion. At the bottom of the sex lie ambition, hope,
and much of the pride of life. Man's life and thoughts are arranged around
sex as a center. Hence the genital nerve and blood supply and consequent
genital physiology will remain an increasing maximum. For the detailed
physiology noted in the subjects "Abdominal Brain" and "Pelvic Brain" the
reader is referred to the Medical Age for July, 1905, and the Medical Review
of Reviews for November, 1905.
NERVES OF THE TRACTUS GENITALIS
An illustration of the pelvic brain (B) and the nerve supply
in the pelvis, uterus and bladder and rectum. Ut, uterus
(with its plexus uterinus); Vs, bladder (with its plexus vesicalis)
; Ov, ovary (with its plexus ovarica) ; Od oviduct (with its
plexus oviductus) ; R, rectum (with its plexus rectalis) ;
Gs , great sciatic nerve; 5L, last lumbar nerve; I, II, III,
IV, sacral nerves. The nerves supplying the ureter are
from (a) the I sacral ganglia (see u on ureter) ; (b), hypogastric
plexus (at P) ; (c) the III sacral nerve (at X); (d), pelvic
brain (at B). The pelvic brain(B) originates the plexus
uterinus, plexus vaginalis, plexus rectalis. Suggestions for
this drawing were employed from Frankenhauser. H, interiliac
nerve disc (the original visceral ganglion located at the
aortic bifurcation - at present a dorsoventrally flattened
nerve disc with limited number of ganglion cells). S.
G. the five sacral ganglia. 16 (a), right ureter at junction
with vasa ovarica. Note astomosis of plexus ureteris
and plexus ovarica explaining pain of ureteral calculus in
testicle and in ovary. 16, some relations on left
side. For illustrations of the nerves of the tractus
genitalis see previous figures.
NERVES OF TRACTUS GENITALIS PREGNANT ABOUT THREE MONTHS
This illustration presents the nerves on its genital vascular
circle at about three months gestation. The fundus of
the uterus is drawn distalward, exposing its dorsal surface.
A, abdominal brain. The pelvic brain is faintly represented.
The plexus ovaricus is carefully presented.
GENITAL NERVES OF INFANT (PELVIC BRAIN OF AN INFANT)
The plexus interiliacus in this infant extends from the discus
interiliacus (D) to the pelvic brain. (A) A segment of the
ureter (Ur) is removed in order to expose the interiliac plexus
as it is in relation with the rectum (R). Observe first
that the interitiac plexus receives contributing nerves from
the I, II and III sacral nerves. Second observe that
the interiliac plexus emits three nerve strands to the uterus
(Ut), which do not first pass through the pelvic brain. (A)
Third, note the large nerve supply that the rectum receives
from the plexus interiliacus. This illustration I dissected
under alcohol and it was drawn by the aid of a highly magnifying
lens. A non-developed pelvic brain. The plexuses
of the pelvic brain - uterine, vaginal, vesical and rectal
- are distinct.
GENITAL NERVES OF ADULT (PELVIC BRAIN)
This specimen I dissected with care under alcohol. The
plexus interiliacus extends from the discus interiliacus (1)
to the pelvic brain (A). Observe: (1) Three nerve strands
are emitted from the interiliac plexus to the uterus previous
to passing through the pelvic brain (A). (2) Note the contribution
of the lateral sacral chain of ganglia and 11, III and IV
sacral nerves to the plexus interiliacus. (3) Bear in mind
the intimate relation of the plexus interiliacus to the rectum
proximalward and distalward. Observe the ganglionated
plexuses from the pelvic brain - uterine, vaginal, vesical,
THE NERVES OF THE TRACTUS GENITALIS
This illustration is a dissection I made ten years ago from
a spare subject. The trunk of the cadaver I preserved in alcohol
for six months. The vesical, rectal, uterine and vaginal
plexuses are evident as they issue from the pelvic brain,
which is an elongated ganglionic mass.
CIRCULATTON OF THE PUERPERAL UTERUS
Arterial Circulation of the Puerperal Uterus.
Four Hours Post Partum. - Life Size.
Illustrating the Utero-Ovarian Vascular Circle (the Circle of Byron
A reasonable estimate of the richness of the vasomotor nerves
(sympathetic) to an organ is made throuph the number and dimensions
of the arteries which are ensheathed by a plexiform, nodular,
nervous web. The quantity of nerve supply to the uterus