mence at the crest of the ilium, as the circumflexa iliaca artery and
vein, with some cellular substance, are situated between the muscles
at that point. The internal surface of the transversalis is in contact
with the peritoneum, except near Poupart's ligament, where a mem-
brane called the facia transversalis lines the muscle. To obtain a
view of this facia, the peritoneum must be dissected from the trans-
versalis, or the muscle must be reflected from the ribs and cautiously



THE MUSCLES. 47

serrated manner, with portions of the serratus ma-
jor anticus ; and generally coheres to the pectoralis
major, intercostals, and latissimus dorsi ; which last
covers the edge of a portion of it extended from the
last rib to the spine of the os ilium. From these
origins, the fibres run down obliquely forwards,
and terminate in a thin broad tendon, whose fibres
are continued in the same direction.

Inserted into the whole length of the linea alba, *
becomes thicker towards the lower part of the ab-
domen, and is perforated in the middle by the
umbilicus, t On the outside of the rectus muscle,
the tendon of the external oblique appears whiter



removed from the peritoneum. It will then be seen arising from Pou-
part's ligament, and ascending upon the inner surface of the trans-
versalis. About midway between the pubis and the anterior superi-
or spinous process of the ilium, there is an opening in this facia of a
crescentic form, through which the spermatic cord in the male, and
the round ligament in the female, passes. This is the internal open-
ing of the inguinal canal, into which the hernia must enter before it
can appear at the external opening.

The rectus muscle lies in a sheath formed by the tendons of the
three broad muscles upon the external^side of the linea alba. To ex-
pose it, an incision should be made through the sheath, along the
linea alba, and the muscle detached, so as to be elevated from the
posterior layer of the sheath. The relation of the epigastric artery
to the internal inguinal opening, and to the posterior surface of this
muscle should not be overlooked.

* The linea alba is formed by the tendinous fibres of the two ob-
lique and transverse muscles, interlaced with those of the opposite
side, the whole way from the cartilage ensiformis to the os pubis ;
so that some think they should be called three digastric muscles,
with a broad middle tendon and two fleshy bellies.

f- The umbilicus was originally the passage for the vessels that
connected the foetus to the secundines ; and is really a hole through
the teguments and tendons filled only by a cellular substance, and
covered within by the peritoneum.



48 DESCRIPTION OF

than elsewhere, by its being there connected with
the tendons of the internal oblique and transverse
muscles; so that this part has been called Linea
semilunaris, from its curved shape. The under
part of the tendon divides into two columns, which
leaves an oval space between them, named the
ring of the external oblique muscle, for the passage
of the spermatic cord in the male, or round liga-
ment of the womb : the anterior superior column
passes over the cartilage between the ossa pubis,
and is fixed to the opposite os pubis ; the other is
fixed to the os pubis of the same side. It is also
inserted, tendinous and fleshy, into the middle of
the spine of the ilium.

From that part, which is named its anterior su-
perior spinous process, it is stretched tendinous to
the os pubis, and is named Pouparfs or Fallopius's
ligament. * From this ligament, it sends a ten-



* Pouparfs or Fallophts's ligament^ is the inferior part of the
tendon of the external oblique, extending from the anterior superior
spinous process of the ilium to the os pubis, where it is thickest, in
order to strengthen the inferior part of the abdomen : here it passes
over the blood vessels of the inferior extremity : and in women, from
the greater size of the pelvis, is longer and looser, by which they
are more subject to crural hernias ; but, by the size of the spermatic
cord, men are more liable to the inguinal.

This ligament splits into three fasciae, two superior and one infe-
rior. The first passes behind she transversalis muscle, and has been
called by Mr. Astley Cooper, the fascia transversalis { the second,
which has-been described by Gimbernaut, passes upon the iliacus in-
ternus muscle ; and the third, is the anterior part of the
fascia lata of the thigh. Through the fascia transversalis passes the
spermatic cord from the abdomen, the cord being united to the edge
of the aperture, by a thinner fascia than that of the transversalis.
Thus, then, the cord passes through the fascia transversalis, and
through the ring of the external oblique muscle.



THE MUSCLES. 49

dinous layer, which is lost in the membranous fas^
cia of the thigh.

Use. Supports and compresses the peritoneum
and adbomen; assists the evacuations of faeces and
urine, and likewise in the exclusion of the foetus ;
thrusts the diaphragm upwards, and draws down
the ribs in expiration ; bends the body obliquely
when the ribs are fixed, and raises the pelvis
obliquely.

Obliquus exlernus abdomims, Albinus.

Obliquus descendeiiS) Douglas.,

2. OBLIgUUS ASCENDENS INTERNUS,

Arises from the spine of the ilium, the whole
length between the posterior, and superior an-
terior spinous process ; from the os sacrum and the
three undermost lumbar vertebrae, by a tendon
common to it and to the serratus posticus inferior
muscle; from Poupart's ligament, at the middle of
which it sends off the beginning of the cremaster
muscle; and the spermatic cord in the male, or
round ligament of the womb passes under its thin
edge, except a few detached fibres.

Inserted into the cartilage ensiformis, into the car-
tilages of the seventh and those of all the false ribs;
but, at the upper part, it is extremely thin, resem-
bling a cellular membrane, and only becomes fleshy
at the cartilage of the tenth rib. Here its tendon
divides into two layers ; * the anterior layer, with



* To obtain a proper view of the two layers of the tendon of the
internal oblique muscle, both the oblique muscles should be raised
as far forwards as their joining near the linea semilunaris ; then the

D



50 DESCRIPTION OF

a great portion of the inferior part of the posterior
layer, joins the tendon of the external oblique, and
runs over the rectus to be inserted into the whole
length of the linea alba. The posterior layer joins
the tendon of the transversalis muscle as low as
half-way between the umbilicus and os pubis ; but
below this place, only a few fibres of the posterior
layer are seen, and the rest of it passes before the
rectus muscle, and is inserted into the linea alba ;
so that the whole tendon of the external oblique
muscle, with the anterior layer of the internal ob-
lique, passes before the rectus muscle; and the
whole posterior layer of the internal oblique, toge-
ther with the whole tendon of the transversalis
muscle, excepting at the inferior part, pass behind
the rectus, and are inserted into the linea alba. At
its undermost part it is inserted into the linea part
of the os pubis.

Use. To assist the former; but it bends the
trunk in the reverse direction.

Obliquus internus abdominis, Albinus and Wins-
low.

Obliquus ascendens, Douglas.

3. TRANSVERSALIS,

Arises tendinous, but soon becoming fleshy from



tendon before the rectus must be cut parallel to the linea alba, and
turned outwards as far as the outer edge of the rectus ; by which the
whole of the rectus is brought into view, and the tendons are pre-
served. But Douglas directs to cut the posterior layer of the inter-
nal oblique, where it joins with the transversalis : by this method
the rectus is laid bare ; but the structure of the tendinous sheath,
which encloses it, is destroyed.



THE MUSCLES. 51

the inner or back part of the cartilages of the seven
lower ribs, where some of its fibres are continued
with those of the diaphragm and the intercostal
muscles, by a broad thin tendon, connected to the
transverse processes of the last vertebra of the back
and the four superior vertebrae of the loins : fleshy
from the whole spine of the os ilium internally, and
from the tendon of the external oblique muscle,
where it intermixes with some fibres of the internal
oblique.

Inserted into the cartilago ensiformis, into the
linea alba, and into the pubis.

Use. To support and compress the abdominal
bowels ; and it is so particularly well adapted for
the latter purpose, that it might be called the pro-
per constrictor of the abdomen.

Transversus abdaminis, Albinus.

The long muscle in the middle is named,

RECTUS ABDOMINIS,

Arises, by two heads, from the ligament of the
cartilage which joins the two ossa pubis to each
other ; runs upwards the whole length of, and par-
allel to, the linea alba, growing broader and thin-
ner as it ascends.

Inserted into the cartilages of the three inferior
true ribs, and often intermixes with some fibres of
the pectoral muscle.

It is generally divided by three tendinous inter-
sections ; the first is at the umbilicus, the second
where it runs over the cartilage of the seventh rib,
the third in the middle between these ; and there






DESCRIPTION OF

is commonly a half intersection below the umbili-
cus; these seldom penetrate through the whole
thickness of the muscle ; they adhere firmly to the
anterior part of the sheath, but very slightly to the
posterior layer.

Use. To compress the forepart, but more par-
ticularly the lower part of the belly ; to bend the
trunk forwards, or to raise the pelvis. By its ten-
dinous intersections, it is enabled to contract at any
of the intermediate spaces ; and, by its connection
with the tendons of the other musclesj it is prevent-
ed from changing place, and from rising into a
prominent form when in action.

A principal use of the tendinous intersections of
this muscle is to prevent its fibres being separated
by the pressure of the viscera.

The short muscle in the middle is named

PYRAMIDALIS,

Arises along with the rectus ; and running up-
wards within the same sheath, is

Inserted, by an acute termination, near half-way
between the os pubis and umbilicus, into the linea
alba and inner edge of the rectus muscle.

As it is frequently wanting in both sides, with-
out any inconvenience, its

Use seems to be to assist the inferior part of the
rectus.



THE MUSCLES. 53



CHAP. XVI.

MUSCLES ABOUT THE MALE ORGANS OF
GENERATION.

THE testicles are said to have a thin muscle com-
mon to both, and have one proper to each.

The supposed common muscle is called the

DARTOS.

This appears commonly to be no more than a
condensation of the cellular membrane lining the



* The muscles of the perineum claim a considerable share of the
student's attention, as they are of the first importance in a surgical
point of view. Great care and management will be requisite to dis-
sect tli em properly. The subject siiould. De placed as in the lateral
operation of lithotomy, a staff introduced into the bladder through
the urethra, and the rectum distended with hair or tow. The parts
will thus be put upon the stretch, and the subsequent steps of the
dissection materially facilitated. An incision should now be made
across the root of the scrotum, extending about three inches. From
the extremities of this, another should run on each side to the tube-
rosity of the ischium, and carried beyond the anus ; while another
should pass behind the anus and join these together. By reflecting
this insulated portion of skin, a considerable quantity of fatty cellu-
lar substance will be brought into view. This receives the name of
external facia of the perineum, which should be cautiously raised
from the muscles and carefully examined. The muscles should now
be dissected, and as the transversus perinei is apt to be removed with
the fat, it ought to be cleaned first. As it runs directly across the
perineum from the tiiberosity of the ischium, its origin should be
first displayed, and the muscle then traced to its insertion. The ac-
celerator urinse covers the bulb and a considerable portion of the
urethra, and is prominent in the middle of the perineum. The erec-
tor penis lies on the outside of the ejaculator seminis, and conceals
the crus of the penis, to which it firmly adheres. The relation of
these two muscles to each other should be carefully noted, as the



54- DESCRIPTION OF

scrotum ; yet the skin here is capable of being cor-
rugated and iclaxed in a greater degree than in
other places, and in some subjects muscular fibres
can be seen.

The muscle proper to each testicle is the

CREMASTER.

Arises from the internal oblique, where a few
fibres of that muscle intermix with the transversa-
lis, near the junction of the os ilium and pubis,
over which part it passes, after having pierced the
ring of the external oblique ; and then it descends
upon the spermatic cord.

Inserted into the tunica vaginalis of the testicle,
upon which it spreads, and is insensibly lost.

Use. To suspend and draw up the testicle, and
to compress it in the act of coition.



The penis has three pair of muscles.

1. ERECTOR PENIS,

Arises, tendinous and fleshy, from the tuberosity



surgeon must cut between them in the operation of lithotomy. The
sphincter ani encircles the anus ; but is connected both to the tip of
the coccyx and muscles of the perineum by slips of muscular fibre.

The deep-seated muscles of the perineum lie within the pel vis, and
cannot be completely exposed by removing the superficial. The levator
ani is the great deep-seated muscle of the perineum ; the ischio-coccy-
geus may be viewed as a part of it. Upon removing the superficial
muscles, the student should attend to the following points : 1st, To
the bulb of the urethra : 2dly, To the triangular ligament under the
pubes : 3dly, To the relation of the urethra, where it passes through
this ligament, to the pubes : and 4thly, To the manner in which
the levator ani grasps the neck of the bladder and prostate gland.



THE MUSCLES. 55

of the os ischium, and runs upwards, embracing
the whole crus of the penis.

Inserted into the strong tendinous membrane
that covers the corpora cavernosa penis, near as
far up as the union of these bodies.

Use. To compress the crus penis, by which the
blood is pushed from it into the fore-part of the
corpora cavernosa ; and the penis is by that means
more completely distended. < The erectores seem
likewise to keep the penis in its proper direction.

Ischio cavernosus, Winslow.

2. ACCELERATOR URIN^ SEU EJACULATOR
SEMINIS,

Arises, fleshy, from the sphincter ani and mem-
branous part of the urethra; and tendinous from
the crus, near as far forwards as the beginning of
the Corpus cavernosum penis; the inferior fibres
run more transversely, and the superior descend
in an oblique direction.

Inserted into a line in the middle of the bulb,
where it joins with its fellow, by which the bulb is
completely enclosed.

Use. To drive the urine or semen forwards;
and, by grasping the bulb of the urethra, to push
the blood towards its corpus cavernosum and the
glans, by which they are distended.

Sulbo-cavernosusy Winslow.

TRANSVERSUS PERI'NEI,

Arises from the tough fatty membrane that covers
the tuberosity of the os ischium ; from thence it
runs transversely inwards, and is



56 DESCRIPTION OF

Inserted into the accelerator urinse, and into
that part of the sphincter ani which covers the
bulb.

Use. To dilate the bulb, and draw the perineum
and verge of the anus a little outwards and back-
wards.

Transversalis urethra, Winslow.

Transversus perinei, Albinus.

Levator parvus, seu externits, Douglas.

There is often a fourth muscle, named

TRANSVERSUS PERINEI ALTER,

Arises behind the former, runs more obliquely
forwards, and is

Inserted into that part of the accelerator urina?
which covers the anterior part of the bulb of the
urethra.

Use. To assist the former.

Inferior prostate, Winslow.

Transversus perinei alter, Albinus*



CHAP. XVII.

MUSCLES OF THE ANUS.
THE anus has a single muscle, and one pair.
The single muscle is

SPHINCTER ANI,



THE MUSCLES. 57

Arises from the skin and fat that surround the
verge of the anus on both sides, near as far out as
the tuber of the os ischium ; the fibres are gradu-
ally collected into an oval form, and surround the
extremity of the rectum.

Inserted, before, by a narrow point, into the pe-
rineum, acceleratores urinae, and transversi perinei;
behind, by an acute termination, into the extremity
of the os coccygis.

Use. Shuts the passage through the anus into
the rectum ; pulls down the bulb of the urethra,
by which it assists in ejecting the urine and se-
men.

Sphincter externus, Albinus and Douglas.

Sphincter cutaneus, Winslow.

N. B. The sphincter internus of Albinus and
Douglas, is only that part of the circular fibres of
the muscular coat of the rectum which surrounds
its extremity.

LEVATOR ANI,

Arises from the os pubis 'within the pelvis, as far
up as the upper edge of the foramen thyroideum
and joining of the os pubis with the os ischium ;
from the thin tendinous membrane that covers the
obturator internus and coccygeus muscles; from
the spinous process of the os ischium ; and its fi-
bres run down like rays from a circumference to a
centre.

Inserted into the sphincter ani, acceleratores uri-
nae, and anterior part of the two last bones of the
coccyx; surrounds the extremity of the rectum,
.neck of the bladder, prostate gland, and part of






58 DESCRIPTION OF

the vesiculse seminales ; so that its fibres behind
and below the os coccygis joining it with its fel-
low, they, together, very much resemble the shape
of a funnel.

Use. To draw the rectum upwards after the eva-
cuation of the faeces, and to assist in shutting it, to
sustain the contents of the pelvis, and to help in
ejecting the semen, urine, and contents of the rec-
tum ; and, perhaps, by pressing upon the veins, to
contribute greatly to the erection of the penis.



CHAP. XVIII.

MUSCLES OF THE FEMALE ORGANS OF
GENERATION.

THE clitoris has one pair.

ERECTOR CLITORIDIS,

Arises from the crus of the os ischium internally,



* The muscles of the female organs of generation cannot be pro-
perly understood until the external organs themselves be explained.
Upon the pubis and origin of the recti muscles is a fatty eminence,
the mons vencris. From this the external laUae descend, and meet
about an inch before the anus. The space between the junction of
the labiae and anus forms the perineum. By separating the labiae we
discover the clitoris, which, like the male organ, is surrounded by a
duplicature of skin called the prepuce. From each side of the pre-
puce a folding of the integuments, or a triangular flap, descends upon
the inner side of the external labia, and disappears about its middle.
These are the nymphce, or labice minores. About an inch below the
clitoris, and between the nymphae,. the orifice of the urethra appears,
and below that, the opening of the vagina, which is generally partially



THE MUSCLES. 59

and in its ascent covers the crus of the clitoris as
far up as the os pubis.

Inserted into the upper part of the crus and body
of the clitoris.

Use. Draws the clitoris downwards and back-
wards ; and may serve to make the body of the
clitoris more tense, by squeezing the blood into it
from its crus.

First muscle of the clitoris, Douglas.

The vagina has one pair.



SPHINCTER VAGINA,

Arises from the sphincter ani, and from the pos-
terior side of the vagina, near the perineum ; from
thence it runs up the side of the vagina, near its
external orifice, opposite to the nymphae, and co-
vers the corpus cavernosum vaginae.

Inserted into the crus and body, or union of the
crura clitoridis.

Use. Contracts the mouth of the vagina, and
compresses its corpus cavernosum.

Constrictor cunm, Albinus.

Second muscle of' the clitoris, Douglas.



closed in the child, by a crescentic-like membrane, the hymen. Au-
thors comprehend all these parts under the general appellation, vulva.
The muscles of the female organs are always weakly marked, and
consequently with difficulty brought into view. The sphincter va-
ginae surrounds the orifice of the vagina, but is often so pale that its
fibres can hardly be recognised. The erector clitoridis is situated
upon the outer side of the vagina, and covering the crus of the clito-
ris. The transversus perinei is likewise smaller, and embedded in
more fat than in the male subject.



GO DESCRIPTION OF

The perineum has one pair.

TRANSVERSUS PERINEI,

Arises, as in the male, from the fatty cellular
membrane which covers the tuberosity of the os
ischium.

Inserted into the upper part of the sphincter ani,
and into a white hardish tough substance in the
perineum, between the lower part of the pudendum
and anus.

Use. To sustain and keep the perineum in its
proper place.

The anus, as in the male, has a single muscle,
and one pair.

SPHINCTER ANI,

Arises, as in the male, from the skin and fat sur-
rounding the extremity of the rectum.

Inserted, above, into the white tough substance
of the perineum ; and, below, into the point of the
os coccygis.

Use. To shut the passage into the rectum; and,
by pulling down the perineum, to assist in con-
tracting the mouth of the vagina.

LEVATOR ANI,

Arises, as in the male, within the pelvis, and
descends along the inferior part of the vagina and
rectum.

Inserted into the perineum, sphincter ani, extre-
mity of the vagina, and rectum.

Use. To raise the extremity of the rectum up-



THE MUSCLES. 61

wards, to contract the inferior part of the rectum,
and to assist in contracting and supporting the
vagina ; and, perhaps, by pressing on the veins,
to contribute to the distension of the cells of the
clitoris and corpus cavernosum of the vagina.



CHAP. XIX.

MUSCLES SITUATED WITHIN THE PELVIS.

'
Or these there are two pair.

1. OBTURATOR INTERNUS,

Arises from more than one half of the internal
circumference of the foramen thyroideum, formed
by the os pubis and ischium ; its inside is covered
by a portion of the levator ani ; and appears to be
divided into a number of fasciculi, which unite and
form a roundish tendon, that passes out of the pel-
vis, between the posterior sacro-ischiatic ligament
and tuberosity of the os ischium, where it passes
over the capsular ligament of the thigh bone : it is
enclosed, as in a sheath, by the gemini muscles.

Inserted, by a round tendon, into the large pit,
at the root of the trochanter major.



* Besides the obturator internus and coccygeus, the levator ani
may be considered as a muscle situated within the pelvis, for it is
found there covering the obturator internus. After the obturator in-
ternus escapes from the pelvis, it lies under the gluteus maximus and
between the gemini. The coccygeus is connected to the posterior
margin of the levator ani, and may be said to eke out that muscle.



62 DESCRIPTION OF

Use. To roll the os femoris obliquely outwards.

Marsupialis, seu Obturator interims, Douglas.

N. B. The insertion of this muscle should not
be prosecuted, until the muscles of the thigh, to
which it belongs, are dissected. Vid. Chap. xxix.

2. COCCYGEUS,

Arises, tendinous and fleshy, from the spinous
process of the os ischium, and covers the inside of
the posterior sacro-ischiatic ligament; from this
narrow beginning, it gradually increases, to form
a thin fleshy belly, interspersed with tendinous
fibres.

Inserted into the extremity of the os sacrum,
and near the whole length of the os coccygis late-
rally.

Use. To support and move the os coccygis for-
wards, and to tie it more firmly to the sacrum.



CHAP. XX.

MUSCLES SITUATED WITHIN THE CAVITY
OF THE ABDOMEN.

THESE consist of a single muscle, and four pair.

DIAPHRAGMA.

This broad thin muscle, which makes a com-



* The muscles wit-Inn the abdomen cannot be examined till the
abdominal viscera be removed, and the peritoneum dissected from



THE MUSCLES. 63

plete septum between the thorax and abdomen, is
concave below and convex above; the middle of it
on each side reaching as high within the thorax of
the skeleton as the fourth rib, and is commonly
divided into two portions.

1. The Superior or Greater Muscle of the
DIAPHRAGM,

Arises, by distinct fleshy fibres, from the carti-
lago ensiformis, from the cartilages of the seventh,
and of all the inferior ribs on both sides. The
fibres from the cartilage ensiformis, and from the