FOOT’S PRACTICE OF VESICA LOTURA, 765 
mucus cotes away with the urine, and at 
the same time the urethra has been carefally 
sdidtended by bougies ; in that case I should 
have no hesitation tn declaring, that thie ca- 
pacity of the bladder was contracted, and that 
its contraction was. just im proportion to the 
diminished quantity it would centain, from 
a comparative view fotmed with a sound 
bladder. Whereas in all other possible affec- 
tions of the bladder, there will be times when 
itis not contracted, that the full eontents of 
a capacious bladder can be evacuated. This 
is a distinction @ prior?; but injecting the 
bladder will readily decide the question @ pos- 
teriori, for just so much as the bladder will 
oven hold, can be injected ; and by the 
uid being measured when it is evacuated, 
any farther doubt about the nature of the 
case is completely removed.” 
Several cases are given in which the 
injection was used with success. A part 
“3 the first we shall quote, it is given in 
the patient’s own words. ; 
** To afford as clear an idea of my case as 
I possibly can, I conceive I should detail it, 
by stating what my symptoms were before 
the injection was applied to the bladder, and 
what they were after. 
** My symptoms before, were an almost 
continual inclination to urine, in the day 
time, and in-the night rising for that purpose 
from the bed seven, eight, and nine times, 
with seldom any thing like a continued stream 
of urine, the volume small, and the quanti 
from two to three spoonsful, and that wit 
reat uneasiness. From the first of my find- 
ing the difliculty of urining abovementioned, 
my urine, was accompanied with -mucus 5 
and it generally was of a strong red colour, 
mostly turbid, sometimes ropy, and it hath 
continued thus for many years. Another 
formidable symptom was growing on me 
apace, a constant state of irritability, and 
which the most trivial incident, notwith- 
standing my own niental precautions, would 
frequently provoke; feeling at these times 
great irritation and: uneasiness in the region 
of my bladder. Walking on wet grass, and 
being in damp rooms, would bring on a 
str ary. rey 8 eres ken cf 4 ay 
cade Sir, was my state as. nearly as I 
can recollect, 
injecting my bladder. ‘Fime-by neglect, and 
the want of pr 
dually reducing me to a worse and, worse 
condition. —% 
“TT he account of-my subsequent condition. 
will, happily. for me, be more comfortable 
and pleasing. My urine has been no wa 
pararted or mucus discharged, since Mare 
ast. J retain it much longer inthe day time, 
and I rise upon yn average three times in the 
night only, ‘I'he quantity of urine idischarg- 
“4 
in the night at those three-times, is genes 
y about three half pints. }he quantity 
my bladder would hold when you first began 
to inject it, cewld not possibly ever amount 
revious, to ,the operation of. 
organs, and thus explainsat. 
4 
to three ounces, with mucus included. You 
encreased the capacity of my bladder, so much 
by the operation of injection, as when you 
left off this time twelve month, it would con-* 
tain nearly fourteen ounces. And [ have by 
injecting myself occasionally since, ‘rather 
gained upon that quantity, although Ihave 
purposely discontinued i for more than a) 
fortnight at times, without finding thatL lost, 
sround. ‘The irritation of the bladder, L 
oe greatly though net entirely subdued, by 
a rigid adherence to your directions of iessen= 
ing my quantity of animal food; and L have 
experienced, that if at any time I forget my- 
self and indulge myself, 1am punished.” 
The term capacity of the bladder is how. 
ever liable:to some. misconception. A 
bladder may be so diminished in size 
from the thickening of its coats, or 
from _a condensation of mucus. into 
membrane lining its,cavity, that it acta- 
ally will not contain more than three or 
four ounces of liquid ;\ or it may, be- 
come so habitually irritable as not to al, 
low of being filled to more than three or » 
four ounces, without bringing on the na- . 
tural efforts to expel its contents., The” 
cases given by the author may be of a 
mixed kind, partaking of the nature of, 
both these morbid states; .and it ap- 
pears very largely of the latter ; since 
by, use of the injection, the irrita- 
bility of the bladder seems to have de-, 
clined in proportion as. its capacity for 
liquid has enlarged. , This is proyed,by. 
the circumstance that the time in which 
the injected liquid or the natural secre- 
tion could be retained, has lengthened,as 
its quantity has encreased. . It does not 
however detract from. the importance 
which, may attach to this practice... 
The-second part contains several ad- : 
ditional cases of irritability of the bladder 
and incontinence of urine, arising from 
abscess in the kidnies, some,of them, fae 
tal., The injection in some of them ap- 
pears to. have done what could rationally 
have been expected, that is, it proveda 
useful palliative for one of the most dis- 
oper treatment, of course gra- , Meseng-semptams of a dangegous and: 
commonly fatal disease. . ‘ 7 
The author in relating them takes an 
opportunity of throwing extreme censure 
on the use of the caustic in. strictures ; 
and he does not scruple to affirm that in 
two thirds. of the cases for which caustic 
is applied, no other obstruction is pre+ 
sent than what. arises, from the irritauon 
of.a diseased kidney; j 
The author considers phymosis. as. @ 
cause of disease of the whale urinary 
4 
mau 
k - Dit 4 - MAO VOUTOILY 
