ADDENDA TO THE DISEASES OF THE KIDNEYS. 



391 



-duces a peritonitis ; or a cystitis is developed which is accompanied 

 by nephritis or hydronephrosis and uremia.^ 



In the first case the pains cease suddenly. In making a rectal 

 exploration we find the bladder completely empty. The escape of 

 the urine into the abdominal cavity is soon indicated by very ex- 

 pressive symptoms ; the urinary excretion is suppressed, the circu- 

 lation is accelerated, the temperature increases, the general condition 

 becomes more serious, there are chills and general muscular trem- 

 blings, the expirations and cutaneous perspiration spread a urinous 

 odor, the abdominal cavity becomes more and more filled. The 

 animals are taken off by a diffuse peritonitis which is complicated 

 by uremia. Death ensues very rapidly in the horse and dog, pre- 

 ceded by ischuria which is from one to three days old ; it often 

 occurs a few hours after the tearing of the bladder. In the ox, 

 on the contrary, it only takes place after eight, fourteen, or even 

 eighteen days (Haubner-Siedamgrotzky). According to Stor, 

 Cruzel, and others, the patients may survive from four to five 

 weeks after rupture of the bladder. (Some practitioners — Jacobi 

 and Huth among others — speak of having observed in the ox a 

 healing after the confirmed rupture of the bladder ; such assertions, 

 however, seem to us more than doubtful). 



In the second case, death is preceded by symptoms of gangrenous 

 cystitis, acute nephritis, and uremia ; this termination is very rare. 



Differential diagnosis. Retention of the urine may be con- 

 founded with ordinary colics, in which affections micturition is 

 often suspended and on rectal exploration a distention of the blad- 

 der is observed ; the diagnosis, however, may be made by an atten- 

 tive examination of the patients. While the true colics are mainly 

 associated with symptoms of an intestinal affection, the retention 

 of urine is accompanied by manifestations indicating a vesical 

 alteration : a continual desire to urinate, a stretched position, un- 

 sheathing of the penis, and great agitation of the tail, etc., ischuria 



1 At the autopsy of a cow which Éloire believed to be affected by "hematuria" 

 was found a remarkable example of double hydronephrosis produced by polypus or 

 fungi of the bladder. These tumors, which are developed at the surface of the 

 terminal openings of the ureters, produced an incomplete occlusion of these openings. 

 In preventing the escape of the urine they had little by little created an enormous 

 ■dilatation of the ureters and the kidneys. The ureters had acquired a circumference 

 of sixteen to twenty centimetres, according to the points of measurement. The kid- 

 neys measured thirty centimetres in length, fifteen in width, and ten in thickness. 

 The pelvis, which was considerably enlarged, was filled with purulent urine. — n. d. t. 



