The surgical anatomy of the principal regions of the human body / [Thomas Morton].

  • Morton, Thomas, 1813-1849.
Date:
[1838]-1850
Catalogue details

Licence: Public Domain Mark

Credit: The surgical anatomy of the principal regions of the human body / [Thomas Morton]. Source: Wellcome Collection.

    74/106 (page 58)
    SECTION II. DEVELOPEMENT OF THE PERINEUM. In tlie first stages of intra-uterine existence, tlie perinseiim of tlie male presents an open hollow or cleft in the mesial line, which causes it to resemble at this period the vulva of the female. This condition of the parts may remain permanently, in consequence of an arrest of the progress of development, and then the individual will present the appearances which have been so frequently observed in one class of those persons who are exhibited to the public as hermaphrodites. As the formation of the urethra proceeds gradually from be- hind forwards, its completion may be arrested at any point; and thus the external orifice of the canal, instead of being situated, as is usual, at the extremity of the glans penis, is placed upon some part of the inferior surface of the organ, constituting the malformation denominated hypospadias. The urinary bladder, in the foetus, is situated rather in the hypogastric region of the abdomen than in the cavity of the pel- vis, and reaches nearly as high as the umbilicus. Sometimes the anterior surface of the bladder is wanting, and then the lower part of the linea alba is deficient also; so that the mucous membrane of the bladder protrudes upon the external surface, a little above the pubes, under the form of a red vascular tumour, near the centre of which the orifices of the ureters may be distin- guished, and the urine seen to distil from them.* In such cases the urethra is commonly incomplete. Several instances are recorded in which the urachus remained pervious after birth, and permitted the urine to escape from the umbilicus. The lower part of the rectum is sometimes wanting, and this defect may be accompanied or not with the absence of all appearance of the anus. In these cases there is sometimes a communication between the rectum and the bladder. When the lower part of the rectum is thus deficient, the surgeon may * In the course of last winter, a middle-aged man, who was the subject of this malformation, which is termed extrophy of the bluddeV) was for some time a patient, under Mr. Liston, in the University College Hospital.