Sessional_Paper_1905 — Page 432

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"THE SUPERFICIAL INGUINAL GLANDS vary much in number, amounting on an average to eight or ten: they are divisible into a superior or oblique and an 'inferior or vertical set. The oblique glands lie in the line of Poupari's ligament "and receive lymphatics from the integument of the trunk, gluteal region, peri- neum, and genital organs; the vertical glands surround the upper end of the long "saphenous vein, and extend two or three inches downwards along the course of "that vessel; they receive the superficial lymphatics of the limb. The efferent "vessels of the superficial inguinal glands perforate the fascia, a large number "passing through the saphenous opening, and some enter the deep inguinal glands, "while others are continued upwards with the deep vessels into the abdomen, and "join the lymphatic glands which lie along the external iliac artery.

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"The Deep-Seated Inguinal Glands, less numerous than the superficial, sur- "round the femoral artery and vein, and one is constantly placed in the crural ring. They receive the deep lymphatics of the limb and some of the efferent vessels of the superficial inguinal glands. The efferent vessels of the deep glands proceed upwards with the blood-vessels, the greater number passing through the crural "ring, and terminate in the external iliac lymphatic glands.

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"The Superficial Lymphatics of the Lower Limb arise in two sets, one from "the inner part of the dorsum and sole of the foot, the other from the outer. The "inner vessels, the more numerous, follow a similar course to that of the internal "saphenous vein passing partly in front of and partly behind the inner ankle, "they ascend along the inner side of the knee and front of the thigh, and terminate "in the superficial inguinal glands. The outer vessels, ascending from the outer "side of the foot, pass in great part obliquely across the popliteal space to join the "inner set above the knee; in part they reach the inner set by crossing in front of the tibia; and a small number of them, accompanying the external saphenous vein, dip down between the heads of the gastrocnemius muscle, and end in the popliteal glands. From the middle line of the back of the thigh lymphatics pass "round on both sides to reach the inguinal glands. (Mascagni, "Vasorum

Lymph. Historia," 1787.)

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"THE DEEP-SEATED LYMPHATICS OF THE LOWER LIMB are associated in their "whole course with the deep blood-vessels. In the leg they consist of three "divisions, namely, anterior tibial, posterior tibial, and peroneal. Neither these nor the superficial absorbents pass through any lymphatic gland in the leg, "unless it be those lymphatics which accompany the anterior tibial artery, near LL which a small gland is sometimes found on the front of the interosseous mem- "brane above the middle of the leg. The several sets of deep lymphatics in "the leg enter the lymphatic glands situated in the popliteal space. The efferent "vessels from those glands are joined by other lymphatics in contact with the "branches of the femoral artery, and enter the deep inguinal glands. Other deep "lymphatics derived from the muscles of the gluteal region, and many proceeding from the adductor muscles of the thigh, enter the cavity of the pelvis in company "with the gluteal, sciatic, and obturator arteries, and open into a series of glands "placed along the internal iliac vessels. The deep lymphatics of the buttock are. "sometimes interrupted by two or three small glands, situated in the neighbour- "hood of the great sacrosciatic foramem.

"THE SUPERFICIAL LYMPHATICS OF THE LOWER HALF OF THE TRUNK Converge "to the superficial inguinal glands, the direction of some of them being indicated "by the superficial circumflex iliac and epigastric, and the external pudic arteries. "Externally they converge to the groin from the gluteal region and from the lower "part of the back, those from the latter part crossing others which pass upwards "to the axillary glands. Anteriorly they descend from the great part of the sur- "face of the abdomen, crossing and mingling above the umbilicus with vessels "which ascend towards the axillary glands.

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"THE SUPERFICIAL LYMPHATICS OF THE PENIS usually form three vessels, two being placed at the sides and the other on the dorsum of the organ, Com- "mencing in the prepuce, and beneath the skin of the glans and the mucous lining "of the urethra they pass backwards, unite on the upper surface of the penis, and, again subdividing, send branches on each side to the oblique inguinal glands. "The deep seated lymphatics of the penis pass with the pudic vessels under the

pubic arch, and end in the glands on the internal iliac artery.

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"The Lymphatics of the Serotum pass to the superficial inguinal glands along "the course of the external pudic arteries. The lymphatics of the external genera- "tive organs in the female present a disposition similar to that existing in the male.