520 DISEASES OF THE BLADDER. 



the cavity of the bladder itself, and afterwards passing into the urethra 

 and vagina. The bladder thus becomes totally displaced, and appears 

 between the lips of the vulva, resting on the inferior commissure, and 

 forming a mass the size of an orange. 



Eversion cannot occur unless the ligaments of the bladder have 

 become relaxed, stretched or ruptured. Expulsive efforts and the 

 pressure of the intestinal mass complete the process, the peritoneum 

 and peri-vasicular layers of connective tissue being torn. 



Diagnosis. The diagnosis of eversion of the bladder presents no 

 difficulty. The everted mass appears to have a narrow neck opposite 

 the meatus, and is seen to form a reddish, unctuous mass. The mucous 

 membrane now forms the external coat and appears covered with mucus 

 BO long as inflammation does not occur. 



The urine continually escapes from the ureters (which open on the 

 surface of the mucous membrane) as it is formed, and flows away by 

 the lower commissure of the vulva. The vulva is half open, and the 

 prominence formed liy the bladder projects beyond it. 



Prognosis. The prognosis is grave, because reduction is difficult, 

 and may be accompanied by rupture of the organ; also because even 

 in favourable cases it is invariably followed by acute cystitis. 



Treatment. Treatment is confined to reduction. Before attempting 

 this, measures must be adopted to prevent straining, either by passing 

 a rope round the animal's body, thus causing it to flex the vertebral 

 column, or by puncturing the rumen or performing tracheotomy. The 

 open hand is then applied to the surface of the swelling, Avliich is gently 

 compressed and thrust in turn through the meatus and urethra. The 

 portions nearest to the urethra should first be returned. It is some- 

 times necessary to use both hands, and even to employ a catheter with a 

 large round head, to reduce the eversion effectually. After reduction a 

 truss or vulval clamp should be applied. Subsequent treatment con- 

 sists in the administration of sedatives — (■.(/., laudanum, mucilaginous 

 drinks, barley-water, pellitory, etc. 



H/EMATURIA. 



Hfematuria, ;'.(., the passage of blood-stained urine, is in itself only 

 a symptom, which may accompany very varying conditions, such as 

 the congestion peculiar to the early stages of nephritis, traumatic 

 lesions of the kidneys, ulceration of the uriniferous tubules, or of the 

 pelvis of the kidney, lesions of the ureters, bladder, etc., etc. The term, 

 therefore, does not indicate a disease, but nevertheless in bovine practice 

 the term hfematuria has acquired a special significance. 



This hfematuria of bovine animals is clinically indicated by the 

 presence of blood in the urine ; anatomically by lesions of the bladder, 



