VOL. LXXXVI.] PHILOSOPHICAL TRANSACTIONS. (55 



XXI. Observations on the Changes which Blood undergoes, when Extravasated into 

 the Urinary Bladder, and retained for some Time in that Fiscus, mixed with the 

 Urine. By Everard Home, Esq., F. R. S. p. 486. 



A gentleman, 71 years of age, in the spring 17Q5, found that in making water, 

 the urine had the appearance of blood, and congealed into a solid mass as soon as 

 received into the vessel. This complaint appeared to have arisen from the rupture 

 of a vessel in one of the kidneys, for he had a pain in his loins, but none in the re- 

 gion of the bladder. He seemed to void no water, for the whole quantity which 

 was expelled at any one time, amounting to about 4 oz. formed itself into a coagu- 

 lum ; next day he voided bloody water, which did not coagulate. This continued 

 for 3 or 4 days, and then went entirely off. In the spring, 1796, he had a return 

 of the same complaint. It came on in the evening of the 3d of April ; on the 4th 

 it was very violent ; and in the afternoon there was a total suppression. A catheter 

 was passed 6 or 7 times ; but the oval holes near the end of the instrument were 

 always filled with coagulated blood, and no urine could be drawn off. On the 5 th, 

 a larger catheter was passed, with small round holes, less likely to have the coagu- 

 lum entangled in them, but no urine came away. In the evening it was introduced 

 again, having its cavity completely lined with a flexible gum catheter, which was 

 withdrawn as soon as the instrument was carried to the fundus of the bladder ; and 

 in this way 4 oz. of a . bloody fluid were drawn off, which on exposure coagulated. 

 On the morning of the 6th, a pint of bloody urine was drawn off; this operation 

 was repeated 3 times in the 24 hours, and the same quantity was brought away 

 each time. 



On the 7th, the urine drawn off was less tinged with blood; and when it was 

 allowed to stand, the upper part became tolerably clear. There was little change 

 in the circumstances for 6 days; but on the 13th the urine drawn off was of a 

 darker red colour, and in smaller quantity. On the 16th, the colour was more of 

 a light brown, and after standing some time, a whitish powder was deposited; the 

 urine drawn off in the morning on getting up, was nearly of the natural appear- 

 ance, but that brought away in the course of the day, had a deeper tinge, and 

 more of the white sediment, which evidently passed off only with the last part of 

 the urine. On the 19th, the urine was tolerably clear, and the white sediment 

 more completely separated, and in greater quantity. In the course of the night, 

 while laying in bed, the patient voided naturally in many different attempts, 4 oz. 

 of water, but could not make any when up. The urine now continued clear from 

 any tinge, but no more passed without the catheter being introduced, till the 28th, 

 when he again made some water naturally, but could not completely empty the 

 bladder; on the 2Qth, the quantity which required being drawn off was less; and 

 by the 5th of May he made water as usual, at which time the sediment began to 

 diminish, and gradually disappeared. From the symptoms which have been stated, 

 it appears that part of the blood which passed into the bladder from the kidney had 

 remained there, and formed a coagulum, which coagulum gave a bloody tinge to 

 VOL. xviii. K 



