BLADDER, ABNORMAL ANATOMY. 



389 



Pctrop. vol. v. Noot, DC structura ct nsu vcslca; 

 urinaiiiu clique uretcrum, 4to. Lugd. Ijat. 1767. 

 liueckhoven dn Wind, De ureteribus ct vcs. urin. 

 4to. Lugd. Mat. 1784. Richerand, Mem. sur 1'ap- 

 parcil urinairc, in Mem. de la Soc. Med. d'Einulat. 

 An viii. Bell on the muscles of the ureters, Med. 

 Chir. Trans, v. iii. Wilson, Lectures oil the struc- 



BLADDER, ABNORMAL ANATOMY 

 OF THE URINARY. Under this deno- 

 mination it is proposed to include all variations 

 from the natural condition of the organ, whe- 

 ther the particular variety be a congenital vice 

 of conformation or a consequence of extra- 

 uterine disease. 



turo and physiology of the male uiinary organs, c. 

 8vo. Loud. 1821. 8 co also the different systems 

 of anatomy, the Tabulx Septendecim of Santorini 

 and his Observationcs anatomies, and the recent 

 Memoir of Mr. Guthrie on the anatomy and diseases 

 of the neck of the bladder, &c. 8vo. 1834. 



( R. Harrison.) 



In the following synopsis may be seen the 

 several affections included, as well as the order 

 in which they will be described in the present 

 article. 



Changes 



'Congenital 



Numerical 



\ 



Of conformation 



^Acquired 



'Of conformation 



Plurality. 

 f Septa. 



< Extrophy or extroversion. 

 C. Persistance of the urachus. 

 f Sacculi or cysts. 

 J Capacity, increase <>f. 

 j dec/ ease of. 



v Introversion. 

 Hernia;, inguinal. 



Of position 



Of structure 



Of function 



To 



some persons, the introduction of two 

 functional diseases, paralysis and spasm, in 

 an article on pathological anatomy, may appear 

 objectionable ; but as they are sometimes con- 

 sequences of structural change, we hold that 

 we have a perfect justification for their ap- 

 pearance. 



CONGENITAL CONDITIONS. 



Numerical changes. Absence. Among the 

 single organs of the body, one degree of nu- 

 merical diminution only is possible, namely, 

 their absence. Such an anomaly, if we except 

 true cases of monstrosity, should be extremely 

 rare, and indeed it is so; for as all unique 

 portions of the organization are called upon 

 to perform functions, to which they are more or 

 less exclusively devoted, it is rarely that any 

 other can supply their place, and in conse- 

 quence, when the organ is wanting, the func- 

 tion is also wanting. 



There are upon record a certain number of 

 instances of absence of the urinary bladder ; 

 in some of these cases the ureters have been 

 found to terminate directly in the urethra, in 

 others they have been inserted into the rectum, 

 in others they have communicated with the 

 vagina. Of the first species we have the fol- 

 lowing examples : Lieutaud * mentions the 

 case of a man, aged thirty-five, in whom the 

 ureters, the capacity of which was much aug- 



* Hist. Anat. Med. Liber primus. Ol>s. 1361, 



femoral, 

 perincal. 

 vaginal. 



"Inflammation with its consequences. 

 Idiopathic softening. 

 Rupture. 

 Fistulas. 

 Haemorrhage. 

 Fungoid tumours. 

 Varices. 

 Scirrhus. 

 t Paralysis. 

 ( Spasm. 



mented, terminated immediately below th c 

 pubis near the orifice of the urethra. Binnin" 

 ger* describes the case of Abraham Clef, in 

 whom there was no urinary bladder, and the 

 ureters opened upon the urethra. A stylet, 

 introduced into the urethra, passed alternately 

 into the one and the other ureter ; the ureters 

 were afterwards separated from the kidneys, 

 and the stylet, introduced in the opposite di- 

 rection, met with no obstacle to its passage into 

 the urethra. 



Of the second species we have, in the se- 

 venth volume of the Philosophical Trans- 

 actions, the history, given by Richardson, of a 

 lad residing in Yorkshire, who lived to the age 

 of seventeen, without ever having passed urine 

 through the urethra, and who had still enjoyed 

 good health. The only inconvenience he suf- 

 fered was a consequence of the passage of the 

 urine into the rectum, by which a troublesome 

 diarrhoea was kept up. Camperf speaks of 

 five similar cases, one of which was that of 

 a female. Klein \ also speaks of a case. In 

 the Nov. Acta Acad. Nat. cur. ami. i. obs. 38, 

 there is another in which 

 intestinum insertus fuit." 

 de 1'Acad. ami. 1752, 



n 



" ureter in rectum 



And in the Hist. 



4, there is one de- 



Obs. Mod. 24, cent. 2. 



t In Mem. pour le Prix, &c. 8vo. edit, tome v. 

 P . 9. 



J Rachit. congenit. Nov. Epli. Ac. Nat. Cur, 

 vol. i. obs. 38. 



