390 



BLADDER, ABNORMAL ANATOMY. 



scribed under the head : " Uretra in intestinum 

 patens." 



Of the third species, cases are cited by 

 Haller* and by Schrader.f In these cases there 

 was no other malformation. In the foregoing 

 enumeration we have purposely avoided the 

 introduction of cases of general monstrosity in 

 which the urinary bladder was absent. 



Plurality. There are upon record a certain 

 number of cases in which two or more urinary 

 bladders are said to have existed. Of these 

 some appear to me to have been cases in which 

 the plurality was maintained merely because 

 the organ was divided into compartments, 

 either as a consequence of arrested develop- 

 ment or of the formation of pouches, by the 

 protrusion, or hernia of the mucous membrane 

 of the organ. The following case related by 

 Blasius belongs, I apprehend, to the former 

 species. A person died phthisical, having a 

 " double bladder." When the external sur- 

 face was examined, it appeared to be an unique 

 organ, but upon being opened a membranous 

 septum was discovered, by which the organ 

 was divided into two distinct cavities. The 

 narrator adds, that by dissection he separated 

 the one from the other, so that the longitudinal 

 septum was formed by the parietes of the two 

 bladders, which were in contact, and had 

 become united the one to the other. There is 

 a case of a similar nature described by Brom- 

 field ; and many more are recorded by Mor- 

 gagni and others. 



We know of no instance in the human sub- 

 ject, with the exception of that related by 

 Molinetti,J in which a plurality of urinary blad- 

 ders distinct from each other existed. In this 

 case there does not appear to have been any 

 thing abnormal in the organisation except in 

 so far as concerned the urinary organs. " A 

 woman had five urinary bladders, as many 

 kidneys, and six ureters, two of which were 

 inserted into a bladder which was much 

 larger than the others!! the remaining four 

 ureters terminated in as many small bladders, 

 which poured their urine by particular canals 

 into the larger bladder." Another but less 

 carefully described case of the same kind is 

 mentioned by Fantoni, in his Anat. Corp. Hum. 

 diss. 7; and in the Acta Physico-Medica 

 Academisc Csesarese Nat. Curios, vol. i. obs. 



' Element. Physiologiae, vol. vii. p. 297. 

 t Nov. Ephem. Acad. cur. Nat. vol. i. obs. 38, 

 et die 42, obs. 68. [The Editor has in his posses- 

 sion the preparation of a female fetus which lived 

 some days, where the ureters opened through the 

 abdominal parietes on each side of the pubic region 

 in the form of little pouches or sacs, in which was 

 a continuation of their lining membrane. The 

 urine, as it distilled from the kidney, accumulated 

 in each of these sacs (in very small quantity, as 

 they were incapable of containing more than a 

 drop or two,) prior to its oozing out upon the raw 

 cutaneous surface. This latter was deficient of 

 cuticle for a surface about an inch and a half in 

 diameter ; the pubic bones and the inferior fourth 

 of the recti and tendinous expansions of the obliqui 

 were absent. There was also only about an inch 

 of large intestine (co?.cum). ED.] 



Dissert. Anat. Pathol. lib. vi. cap. 7. 



83, may be found a well-marked case of 

 duplicity of the urinary bladder described by 

 Zuinger, whose account is accompanied by a 

 plate, which perfectly confirms the description ; 

 but this case occurred in an ox. 



Septa. Occasionally, within the cavity of 

 the bladder, more or less perfect septa are 

 found, by which that organ is divided into two 

 or more compartments. This condition is met 

 with or occurs under two very different circum- 

 stances : in one it is a congenital affection, 

 and this it is our business to consider in this 

 section ; in the other it is produced by and is 

 not an uncommon consequence of retention of 

 urine during extra-uterine life. In the de- 

 scription of these two very dissimilar affections 

 much confusion has occurred, in consequence 

 of an almost universal impression that they 

 were similar the one to the other. If the 

 theory of the eccentric development of organs, 

 proposed by Geoffroy St. Hilaire, and extended 

 by M. Serres, be admitted, all difficulty in 

 explaining this seemingly singular congenital 

 phenomenon vanishes. M. Serres conceives 

 that he has triumphantly established the fact, 

 that the hollow organs, which are single and 

 placed on the median line, are composed of 

 two moieties, primitively distinct and sepa- 

 rate; so that according to him, at a certain 

 period of uterine life, there exist two aortas, 

 two basilar arteries, two superior cavoe, and 

 so on. Now if there exist two vaginae, two 

 bladders, two uteri, at a certain epoch of 

 embryotic life, the evolution of these organs 

 should necessarily present three successive 

 periods: a first, characterised by their du- 

 plicity and their complete isolation ; a second, 

 by their mutual approach and union upon the 

 median line; a third, by their complete fusion, 

 which constitutes their permanent condition 

 in man and the mammalia. We can therefore 

 conceive that at the moment of the second 

 period, when the two primitive organs are 

 united, the parietes of both being entire and 

 in contact on the median line, there will be 

 a perfect septum separating the one organ 

 from the other. At the commencement of 

 the third period in the process of develop- 

 ment, the septum is destined to disappear, 

 the two cavities merge into one, and the 

 work of development in the organ is com- 

 plete. Now, in the evolution of all the organs, 

 development may be arrested at any period of 

 its progress: it may be arrested before the 

 organs come into contact, in which case there 

 would be two bladders ; it may be arrested 

 after they have formed a junction, in which 

 case a complete septum would exist, as in the 

 case described by Blasius ; or the check may 

 not occur until a greater or less portion of the 

 septum shall have disappeared. 



To distinguish the congenital affection which 

 is a consequence of arrested development, 

 from the acquired affection which is an extra- 

 uterine disease, and is commonly an effect of 

 retention of urine, is not difficult. In the 

 former we shall always find that the entire 

 of each pouch is invested by a layer of mus- 

 cular fibres ; in the latter, it will be found that 



