DISEASES OF THE BLADDER. 93 



The first care is to ascertain if the urethra is pervious by passing a 

 human catheter. Tliis determined, the open urachus may be firmly 

 closed by a stout waxed thread, carried with a needle through the tis- 

 sues back of the opening and tied in front of it so as to inclose as little 

 skin as possible. If a portion of the navel string remains, the tying 

 of that may be all sufficient. It is important to tie as early as possible 

 so as to avoid inflammation of the navel from contact with the urine. 

 In sunnner a little carbolic-acid water or tar water may be applied to 

 keep off the flies. 



EVERSIOX OF THE BLADDER. 



This can only occur in the female. It consists in the turning of the 

 organ outside in through the channel of the urethra, so that it appeai-s 

 as a red, pear-shai^ed mass hanging from the floor of the vulva and 

 protruding externally between its lips. It may be a mass like the fist, 

 or it may swell up to the size of an infant's head. On examining its 

 upper surface the orifices of the urethra may be seen, one on each side, 

 a short distance behind the neck, with the urine oozing from them 

 drop by drop. 



This displacement usually supervenes on a flaccid condition of the 

 bladder, the result of paralysis, overdistention, or severe compression 

 during a difficult parturition. 



The protruding organ may be washed with a solution of 1 ounce of 

 laudanum and a teaspoonful of carbolic acid in a quart of water, and 

 returned by pressing a smooth, rounded object into the fundus and 

 directing it into the urethra, while careful pressure is made on the 

 surrounding parts with the other hand. If too large and resistant it 

 may be wound tightly in a strip of bandage about 2 inches broad 

 to express the gi-eat mass of blood and exudate and diminish the bulk 

 of the protruded organ so that it can be easily pushed back. This 

 method has the additional advantage of protecting the organ against 

 bruises and lacerations in the effort made to return it. After the 

 return, straining may be kept in check by giving laudanum (1 to 2 

 ounces) and by applying a truss to press upon the lips of the vulva. 

 (See E version of the womb.) The patient should be kept in a stall a 

 few inches lower in front than behind, so that tlie action of gravity 

 will favor retention, 



INFLAMMATION OF THE TRETHKA (URETHRITIS. OK GLEET ) . 



This affeclion belongs quite as much to the generative organs, yet 

 it can not be entirely overlooked in a treatise on urinary disorders. 

 It may be induced by the same causes as cystitis (which see) ; by the 

 passage and temporary arrest of small stones^ or gravel ; by the irri- 

 tation caused by foreigni bodies introduced from without ; by blows on 

 the penis by sticks, stones, or by the feet of a mare that kicks while 

 being served; by an infecting inflammation contracted from a mare 



