The Abdomen 229 



through the muscular wall (B) and mucosa at the distal extremity 

 of the incision. Two sutures (F) of fine black silk threaded to a 

 fine straight cambric needle are passed through the muscular wall 

 of the bladder and continued through the muscular wall of the 

 ureter, avoiding the lumen as far as possible, at a point which will 

 permit the ducts to project into the bladder. By means of the trac- 

 tion sutures the ureter is approximated to the bladder, while the 

 sutures (F) are tied. Guided by a grooved director, the needle 

 holding the traction suture (A) is passed through the opening (E) 

 into the interior of the bladder and made to emerge through its wall 

 a little further on. In this manner the end of the ureter is 

 pulled through the opening. A third suture is then passed through 

 the bladder muscle and ureteral muscle at the edge of the opening. 

 Finally, the deflected peritoneum is united by the interrupted sutures 

 (G) and the traction suture pulled out after cutting one strand. 

 By intersuturing the bladder and ureter in the above-described man- 

 ner a broad surface of adhesion is obtained through which a maxi- 

 mum amount of tension is resisted. 



BIBLIOSRAPHT. 



Barbat — Jonrn. of Amer. Med. Assn. 1901. 



Boree — Ann. of Surgery. 1897, p. 66. 



Kelly — Ann. of Snrgery. 1894. 



Sutton— 111. Med. News. 1889, p. 121. 



Tlszoni & Poggi — Bicostruzlone della vesica orlnarla. Bologna. 1891. 



Tnffier — Arch, de Phys. Norm, et Path. 1893. 



Van Hook — Joum. of Amer, Med. Assn. 1893, p. 911. 



The Bladder 

 EXAMINATION. 



Affections of the bladder are diagnosed by functional symptoms 

 supplemented by abdominal, rectal, and vaginal palpation. 



The functional symptoms consist of abnormal micturition and 

 changes in the physical and chemical properties of the urine. Blood 

 when it originates in the bladder is usually expelled at the end of 

 micturition. 



A sample of the urine for examination may be obtained at the 

 time of its expulsion from the body by catching it in a receptacle or 

 causing the animal to urinate on a concreted surface; otherwise it 

 is drawn off by catheterization. By abdominal palpation the bladder 

 when empty can be distinguished only with difficulty. When it is 



