c. Lymphatics.—The lymphatic vessels are tolerably distinct, more particularly inferiorly and about the cervix. They intermingle with the lymphatics of the rectum and of the neigh bouring organs, and ultimately lead to the internal iliac or hypogastric glands. Indepen dent of dissection, the existence of absorbents in the bladder is proved by its functions, or by the changes which the urine undergoes when long retained in this cavity,—a portion of its water is absorbed, and the residue be comes pungent, high-coloured, and acrid.
d. Nerves.—The nerves of the bladder are derived from the hypogastric plexus, which is constituted of two orders of nerves, viz. some from the sacral plexus of the spinal system, and others from the sympathetic or ganglionic system. This two-fold supply of nerves accords with the functions of this organ, and entitles it to be placed, as far as relates to the properties of its muscular coat, among the mixed muscles, being in part voluntary and in part involuntary : the former endowment will, of course, depend on its share of spinal nerves, the latter on the sympathetic. It may also be observed that the branches of the latter are principally distri buted about the cervix and inferior region, while those of the former are seen distinctly on the sides and superior regions ; hut in all these situations these nerves are more or less intermingled.
The cervix of the bladder is of a com pressed conical form, longer below and on the sides than above. It is surrounded in the male by the prostate gland ; only a small portion of this is upon its upper surface : in the adult the neck is placed nearly horizontally below the pubis and behind the triangular ligament. In the female the cervix vesica is closely sur rounded by a whitish compact follicular tex ture, not possessing any perfect capsule, and therefore without the accurate form of or any resemblance to the prostate gland in the male. The cervix in the child is more distinctly conical, and is placed in a more oblique or vertical direction than in the adult. The term cervix is not very definitive, as there is no exact limit, at least in the human subject, to mark this region as in quadrupeds ; according to most writers on human anatomy, it is syno nymous with the prostatic portion of the urethra, and the full description of it is given by such in connexion with the anatomy of the urethra. We consider the neck of the bladder to be that contracted portion of the viscus which is embraced by the base only of the prostate gland, and which contains internally and below the slight elevation named the uvula of the bladder, and laterally and above the peculiar structure which fulfils the office of a sphincter.
Having particularly noticed the situation of the bladder, and the slight change of position it admits of in consequence of its change in form, we shall next consider its attachments, or the media by which it is retained in its posi tion, for it may be considered as nearly a fixed viscus. The bladder is held in its position principally by three connexions ; first, by the peritoneum; secondly, by the reflections of the pelvic fascia; and, thirdly, by the continuity of its cervix with the urethra, the commence ment of the latter being fixed by ligamentous connexions to the arch and rami of the pubes. First, the bladder is connected by certain folds of the peritoneum to the parietes of the pelvis and abdomen; these folds are named the " false ligaments" of the bladder, and are five in number, two lateral, two posterior, and one superior. Each of the lateral ligaments or folds extends from the lateral region of the bladder to the iliac fossa, and contains in its duplicature the visa deferentia in the male, and the round ligament of the uterus in the female.
The posterior folds or ligaments are also two in number; they lead from the fore-part of the rectum to the back part of the bladder. Each of these folds is of a semilunar form, (the concavity looking forwards and upwards,) and contains the ureter posteriorly, and the obliterated hypogastric artery anteriorly. When the bladder is distended, these posterior folds are very short ; but when it is contracted, they are distinct and long. Between them the pelvic cul-de-sac of the peritoneum descends, which in the empty state of the bladder and rectum appears deep, narrow, and distinct, but in the distended condition of these organs, particu larly of the former, it is of much less extent and depth, as the bladder in becoming dis tended rises upwards and draws with it the cul-de-sac of the peritoneum : hence in the distended state of this organ the triangular portion of its inferior region which is uncovered by peritoneum is increased in extent, and is larger than when the organ is contracted. Between the two posterior ligaments one or two semilunar folds of the peritoneum may be generally observed on the posterior surface of the bladder, provided the latter be in a con tracted state ; these folds are expanded as the bladder enlarges, and thus they serve to ac commodate the serous membrane to the varying conditions of the bladder without stretching or extending the former—a purpose which perito neal folds or ligaments in general are intended to answer.