MINUTE ORGANISMS TO INFLAMMATION 401 
the case of irritation of the urethra leading to disturbance of the kidney without 
any affection of the intermediate parts: the irritation applied to the urethra, 
the effect produced upon the kidney. This I conceive can only be explained 
through the nervous system. For instance, I have seen a strong and apparently 
healthy patient on whom lithotomy had been performed go on perfectly well 
until the first occasion of the passing of urine through the urethra as the wound 
healed. He then had a violent rigor, and from that moment there was com- 
plete suppression of urine. Death occurred from uraemic poisoning, and upon 
post mortem examination I found what had apparently been previously per- 
fectly healthy kidneys affected throughout with most intense inflammatory 
congestion. That I can only explain as occurring through the nervous system, 
by virtue of nervous sympathy existing specially between one part of the urinary 
tract and another. Again, I have known a medical man affected with stricture 
pass, after an interval of many years, a bougie upon himself. The first time 
he passed water after this had taken place he felt a cutting sensation in the 
urethra, and had a violent fit of shivering. He had all the appearance of being 
likely to follow the same course as the other patient—viz. that death would 
result from uraemia. He sent for me when suppression of urine had already 
fully declared itself. I had a piece of thin macintosh cloth put under his 
back, and on this piece of macintosh cloth, between it and the loins, I had 
placed a large mass of flannel wrung out of boiling water as hot as it could be 
applied, and the macintosh cloth drawn rapidly round the body and _ fixed 
in position with a sheet pinned over it. He, a medical man, accustomed to 
observe, told me afterwards that the effect of this seemed to be like the operation 
of a charm. He experienced an immediate sense of relief, and in a very short 
time he passed water again, the kidneys resuming their functions. Inflamma- 
tory congestion, caused sympathetically by irritation in the urethra, had been 
got rid of, and that by virtue of something acting on the principle of counter- 
irritation—an irritant applied to the skin of the loins, the part of the surface 
which is most in sympathy with the kidneys. It is the same sort of sympathy 
by virtue of which the accoucheur can induce the contraction of a relaxed 
uterus by applying a cold wet towel to the hypogastrium and the vulva—the 
special sympathy which, as John Hunter pointed out, exists between an internal 
organ and the integument nearest to that organ. 
Then, to take a very simple case, let me refer to the result of tight stitches. 
I once saw in a patient, about three days after removal of the mamma, where 
the edges of the wound had been brought together by interrupted sutures 
unusually tightly applied, an inflammatory blush extending up to the collar- 
bone. I took out the stitches and watched the result ; the fiery redness faded 
LISTER I pd 
