SECTION HI. 

 DISEASES OF THE BLADDER. 



CHAPTER I. 



CATARRH OF THE BLADDER CYSTITIS CATARRHAL1S. 



ETIOLOGY. Catarrh of the urinary bladder may arise : 1. From 

 lirect irritation of the vesical mucous membrane. Unskilful injections 

 in gonorrhoea, frequent or rude catheterization, foreign bodies, espe- 

 cially calculi, may also produce the affection. The admixture of acrid 

 substances in the urine, or the formation of irritating matter in the 

 bladder, owing to decomposition of the urine, may give rise to a most 

 intense form of catarrhal cystitis. To this class the vesical catarrhs 

 belong, which are induced by the misuse of cantharides and of balsam 

 copaiba, as well as those which arise in cases of spinal disease, typhus, 

 stricture, and enlargement of the prostate, and other conditions caus- 

 ing retention of urine. In the same way, drinking of new beer will 

 occasion a very transient catarrh of the bladder.* 2. In other cases 

 catarrhal cystitis arises from the extension of an inflammatory irrita- 

 tion from other organs to the bladder. First under this heading stands 

 the cystitis which accompanies inflammation of the prostate, and in 

 many cases of gonorrhoea, and which often long outlasts the original 

 disease. 3. Chilling of the skin, especially of the feet and abdomen, 

 not unfrequently results in catarrh of the bladder. 4. Finally, a symp- 

 tomatic vesical catarrh is one of the concomitants of growths and 

 other grave disorders of the bladder. 



ANATOMICAL APPEARANCES. In acute cases the mucous mem- 

 brane of the bladder is reddened, swollen, and relaxed. Its surface is 

 covered with mucus, mixed with detached epithelium and young cells 

 in variable quantity. 



In chronic catarrh of the bladder this redness of the mucous mem- 

 brane fades, and the color sometimes becomes a dirty gray. The mu- 

 cous membrane is swollen and thickened. The submucous and inter- 



* Or is this annoying but harmless and transient malady due to acute irritation of 

 the urinary passages by large sharp crystals of oxalate of lime, which may appear after 

 drinking bad beer containing much carbonic acid ? I have often urged my students 

 (but hitherto in vain) not to miss an opportunity of examining microscopically the 

 urine passed during such an attack. 



