370 Case of Retention of Urine successfully treated. 
would not now consent to the operation. Nor was it urged, a¢ 
the bladder was greatly reduced in size. The tongue was still 
brown, and the other bad symptoms continued. 15th. The 
patient was nearly in the same state: stillicidium constant. 
16th. The tumour formed by the bladder is more prominent and 
circumscribed ; reaches about two inches above the umbilicus : 
in other respects the same :—pain decreased. The operation 
was now performed, and between two and three quarts of urine 
were taken away; it was not grumous, nor materially altered 
from that of a healthy person. During the operation the pulse 
fell, but soon regained its strength. A long elastic catheter was 
left in the wound, and properly secured. A cordial mixture was 
prescribed. In the evening the bougie used as a stilette was 
withdrawn, and the urine evacuated: no pain on pressure on the ab- 
domen, which was soft, and the tongue clean. 18th. The urine 
escapes by the side of the catheter, but is not effused into the cel- 
lular membrane ; adhesive inflammation was visible round the 
wound. The urine flows involuntarily, but he feels easy. He took 
broth yesterday: the tongue was clean, the pulse was stronger 
and slower. 19th and 20th. A slight blush of inflammation im- 
mediately around the wound: no pain experienced on pressure. 
21st. Has felt pain in the night, seemingly from a temporary ob- 
struction to the flow of urine,which was secon evacuated, and the 
pain went off. 22d. The catheter escaped during the night; but 
the urine flows freely from the orifice, and he continues to gain 
strength. From this period to August 28th convalescent. The 
passage of a small bougie has been attempted two or three times 
without success. ‘The patient complains of considerable pain in 
the urethra, which prevents his sleeping without opiates ; and he 
takes a grain of opium every night. He walks out, and his spirits 
are better. September ,10th. The quantity of urine discharged by 
the urethra has sensibly increased, until it all comes away by that 
channel. The openiug had closed a few days before, but it broke 
out when straining at stool; he does not know whether any urine 
escaped or not, but nothing comes from it at present. 17th. Much 
in the same state ; complains of soreness where the puncture was 
made, and a little matter oozes from it ; a considerable quantity 
of urine came through on the 13th and 14th. From this time 
he gradually recovered, and was discharged cured the beginning 
of November, since which he has not had any return of the com- 
plaint. 
To Messrs. Nicholson and Tilloch. Joun Taunton, 
4 
) 
LXXXI, Some 
