78 



inserted into tli3 bladder, the recognition is still more satisfactory. 

 The polypi attached by narrow necks may be removed by surgical 

 operation, but for those Avith broad attachments treatment is emi- 

 nently unsatisfactory. 



DISCHARGE OF URINE BY THE NAVEL — PERSISTENT URACHUS. 



This occurs onl}- in the new-born, and consists in the non-closure of 

 the natural channel (urachus), through which the urine is discharged 

 into the outer water-bag (allantois) in foetal life. At that early stage 

 of the animal existence the bladder resembles a long tube, which is 

 prolonged through the navel string and opens into the outermost of 

 the two water-bags in which the foetus floats. In this way the urine 

 is prevented from entering the inner water-bag (amnios), where it 

 v/ould mingle with the liquids, bathing the skin of the foetus and cause 

 irritation. At birth this channel closes up, and the urine takes the 

 course normal to extra-uterijie life. Imperfect closure is more fre- 

 quent in males than in females, because of the great length and small 

 caliber of the male urethra and its consequent tendencj' to obstruc- 

 tion. In the female there may be a discharge of a few drops only at 

 a time, while in the male the urine will be expelled in strong jets coin- 

 cidently with the contractions of the bladder and walls of the abdomen. 



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

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

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

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

 skin as i^ossible. If a ]3ortion of the navel string remains, the tying 

 of tliat may be all suf&cient. It is important to tie as early as possible 

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

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

 keep off the flies. 



EVERSION OF THE BLADDER. 



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

 organ outside in through the channel of tlie urethra, so that it appears 

 as a red, pear-shap)ed mass hanging from the floor of the vulva and 

 l^rotruding 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, over distention, 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 i^ressing a smooth, rounded object into the fundus and 



