INVERSION OF THE BLADDER. 617 



carefully examined it, but was unable to satisfy himself as to what it really was. He 

 therefore caused the Mare to rise, which was done with difficulty, owing to weakness. 

 The creature made repeated efforts to void its urine, from time to time ejecting it to a 

 considerable distance. Canu did not even suspect inversion of the bladder, as he had 

 never seen or read of such an accident. The tumor was red, thickened, and bloody, 

 and an examination by means of a candle proved the vagina to be all right. P'oUowing 

 the floor of that canal, however, the meatus urinarius could not be found, and the tumor 

 commenced where that conduit should be ; at the same time the Mare violently expelled 

 some urine, and it was now surmised that it was really the bladder that was depending 

 from the vulva. A close scrutiny led to the discovery that the organ was torn at the 

 fundus, through the owner's efforts to replace it ; he had used all his force, and the 

 Mare at the same time struggled violently. After considerable deliberation, nothing 

 was done, except abstracting a quantity of blood and reducing the diet. At the end of 

 three days, the mammary secretion proving troublesome, the foal was restored to the 

 Mare. The bladder was then swollen and black, and the thighs were excoriated from 

 the constant flowing of urine. On the fourth day, in consultation with another veter- 

 inary surgeon, it was decided to pass a ligature around the organ, behind the orifice of 

 the ureter. This was done, and the owner was entrusted with the task of tightening 

 the ligature every day. Next day the Mare showed symptoms of colic, and it was found 

 that the ligature had slipped upwards for more than an inch, and closed the ureters — 

 thus causing uneasiness from retention of urine in these ducts. The bladder being py- 

 riform — the pedicle next the vulva — it was difficult to keep the ligature in its place. 

 This was ultimately accomplished, however, by passing two small pieces of wood 

 through the tumor behind the ligature, and attaching the latter to them. Every day the 

 constriction was increased until the whole mass — weighing nearly six pounds, and very 

 foetid — was held only by a narrow band ; this was divided without any haemorrhage. 

 The remaining portion was immediately retracted as far as the meatus urina?-ius, when 

 the lips of the vulva closed, leaving nothing to be seen. The urine, however, continually 

 flowing through the ureters, accumulated in the vulva, whence it was frequently ejected, 

 and running down the thighs excoriated them still more. 



Canu {hen determined to have a little projecting spout of tin made, with brass wires 

 to attach it to the vulva. This was fitted below the inferior commissure of that open- 

 ing the wires serving to fasten it to a crupper worn by the animal ; the hair of the tail 

 was tied up so that it might not disarrange the apparatus. By this means the urine was 

 thrown beyond the hocks, and a few emollient lotions healed the excoriations. The 

 Mare was put to work six" weeks after the accident, and in three months it was sold at a 

 fair. 



3. Lecoq [Ibid., 1837, p. 252) mentions that a draught Mare, after difficult parturi- 

 tion, and expulsion of the foetal membranes, without the slightest warning protruded a 

 round dull-colored body as large as a fist, from the vulva. Next morning this had a 

 fleshy appearance, was pyriform in shape, as large as a three-pint bottle, and eight or 

 nine inches in length. It was soft, and only some small transverse rugae were apparent 

 on its surface. On the hand being introduced into the vagina, it was evident that this 

 body was continuous with it; and on separating the labia of the vulva, on the upper 

 surface of the part, at a short distance from each other were two nipple-shaped bodies, 

 the size of a pea, from the centre of which, at every effort made by the Mare, a faintly- 

 tinged fluid was projected. It was therefore evident that the tumor was the inverted 

 bladder. Reposition could not be effected, owing to the struggles of the Mare, the con- 

 striction and engorgement of the sphincter, and the thickening of the parietes of the 

 bladder ; so to save the animal, amputation was resolved upon. " Having prepared a 

 strong waxed thread, many times doubled, and to the extremities of which we had at- 

 tached two small pieces of wood to facilitate tightening the ligature, we passed it round 

 the body of the bladder, an inch and a half below the orifices of the ureters, and drew 

 the knot as tightly as possible. In exploring the bladder, we perceived that it con- 

 tained some fluid, and on cutting into its fundus about a pint of light-red odorless liquid 

 — the product of the exhalation from the utero-vesical portion of the peritoneum — es- 

 caped." 



The Mare's health appeared to be scarcely affected by the operation. Three days 

 afterwards the efforts to micturate were less violent; the bladder below the ligature 

 was flaccid, livid, and like macerated flesh ; the parts above, and in immediate pro.ximity 

 to the ligature, were red and inflamed. Every time the animal strained, a jet of urine 

 escaped from the ureters, and in the intervals between these efforts it ran continually 

 from the vulva, though without causing any apparent inconvenience. A new ligature, 

 tightly drawn, was placed above the other, at which the parts were becoming gangren- 

 ous. Six days subsequentlv, the t^ini or was excised an inch below the ligature, and the 

 remaining part was well washed with camphorated spirit of wine. Suppuration speedily 

 set in, and in another fifteen days the part had healed. The Mare was put to work in 



