Pathogenesis, Symptoms. 1037 



course of development, the disease of one of them or of the 

 related tracts eliminates the function also of the other centers 

 which may have remained healthy. As the spinal centers 

 are connected particularly intimately with the sympathetic 

 centers which immediately influence the motility of the bladder, 

 disturbances in the bladder become striking and persistent, 

 especially in lesions of the spinal centers which lie in the 

 posterior lumbar and anterior sacral section of the spinal cord, 

 the more so as in these cases the activity of the striped muscles 

 of the urinary organs and the reflex action of the sensory nerves 

 upon the urethra and the neighboring organs is necessarily 

 eliminated. In all diseases of the nervous system above the 

 sympathetic bladder centers there occurs more or less improve- 

 ment in the disturbance, probably owing to the increased ac- 

 tivity of the sympathetic centers. 



In unconsciousness retention of the urine takes place in such a manner 

 that the pressure of the urine is not felt or that the inhibitory action of the brain 

 upon the sphincter is not exerted. The same mechanism may probably be assumed 

 for the occurrence of that form of retention which is sometimes produced under 

 the influence of certain intense psychic stimulations (excitement) ; and a similar 

 origin is probably responsible for the retention which is frequently noted in the 

 course of paralytic hemoglobinemia. 



Symptoms. In paralysis of the Detrusor urinae the urine 

 fails of being voided for a considerable time (Ischuria, Retentio 

 urinae) ; owing to the constantly increasing tension of the 

 bladder the animals become restless and attempt to urinate, 

 provided the sensory conductivity is not interrupted as well. 

 In spite ot all efforts and of . the cooperation of abdominal 

 pressure they void only small quantities of urine in a thin 

 and feeble stream. Soon, however, the sphincter is relaxed by 

 the increasing tension, and dribbling of urine occurs. The 

 bladder is found to be greatly dilated on rectal exploration, 

 or in smaller animals by palpation through the abdominal walls 

 and by percussion; pressure upon the bladder causes large 

 amounts of urine to be discharged which ceases suddenly when 

 the, pressure is removed (Ischuria paradoxa). If a catheter 

 is introduced into the bladder, the urine flows out without force. 



In complete paralysis of the sphincter the animals cannot 

 retain the urine at all or only for a short time, and in con- 

 sequence this is discharged at very short intervals, in fact, 

 drop by drop at the commencement of total paralysis, wetting 

 the vicinity of the urethral opening or the pudenda (Inconti- 

 nentia urinae) ; in incomplete paralysis small quantities of 

 urine are voided at frequent intervals and without pain. 



Usually the paralysis occurs in both muscles simultaneously 

 and involuntary discharge is observed, or dribbling of the 

 urine at first when the bladder is very full, later when it is 

 only moderately filled. 



In the further course of the disease disintegration of the 

 urine commences already in the bladder, because bacteria easily 

 enter it through the incompletely closed neck; they multiply 



