1038 Pai?alysis of the Bladder. 



readily in the dammed-up urine, and in a short time catarrh 

 of the bladder develops. 



Diagnosis. In paralysis of the bladder due to transverse 

 lesions of the spinal cord above the posterior lumbar segment, 

 also in retention of the urine during loss of consciousness or 

 after violent psychic influences, the urine is voided in a strong 

 stream, at long intervals or after external mechanical influences 

 upon the region of the bladder; the discharge of the urine 

 does not cease immediately with the cessation of the pressure 

 upon the bladder, and if a catheter is introduced into the 

 bladder, the urine flows out in a vigorous stream. Inflammatory 

 processes and mechanical impediments in the lower urinary 

 passages can easily be excluded by local examination. Polyuria 

 and frequent micturition might be mistaken for paralysis of 

 the sphincter, but are readily differentiated by considering 

 the other symptoms of the basic affection. 



Treatment. In order to prevent thi& consequences of re- 

 tention of urine as much as possible, the urine should be re- 

 moved several times daily with a clean catheter, or the bladder 

 should be made to empty itself by gradually increased pressure. 

 It is well to apply a drying or disinfecting, salve to the skin 

 in order to keep the region of the urethra clean. In cases where 

 no severe organic disease exists, the relief of the paralysis 

 may be attempted by cold applications to the region of the 

 sacrum, irrigation of the bladder with cold water, or friction 

 on the region of the bladder. Faradic electricity (the positive 

 pole on the sacrum, the negative on the pudenda in retention, 

 on the perineum in dribbling) is powerless. — ^Parascandolo be- 

 lieves that certain cases of paralysis of the bladder may be 

 relieved by operative treatment. 



Literature. Luciani, Physiologie, 1906. II. 433 (Lit.). — Miiller, Deutsche 

 Zeitsehr. f. Nervenheilk., 1902. XXV. 86 (Lit. on animal experim.). — Parascandolo, 

 D. t. W., 1901. 477. 



Spasm of the Bladder. This is said to originate without local 

 disease of the urinary tract, when the animals are "obliged to retain 

 urine for a long time on account of protracted work (Roll). But 

 psychic influences, colicky pains and tetanus may also produce the 

 trouble. In spite of repeated attempts the animals are not able to void 

 the urine (Ischuria spastica), or at most a few drops are discharged at 

 one time (Dysuria spastica). The bladder is greatly dilated and sensi- 

 tive to pressure. The history as well as the absence of local pathologic 

 changes (calculus, swelling, etc.) afford sufficient diagnostic indications. 



In horses the spasm usually disappears spontaneously if they are 

 allowed to rest on clean straw or in a sheep barn. In horses and also 

 in other animals sponging of the region of the bladder is indicated, also 

 a gradually increasing pressure upon the bladder. Lukewarm enemas, 

 chloral hydrate (25-50.0 or 1-2.0 gm.) per rectum hasten recovery; also 

 morphine injections. If in spite of these measures no urine is voided, 

 a catheter covered with morphine ointment may be used, or punetare 

 of the bladder may be required. 



