A CASK OF LITHOTOMY. 
367 
my hand into the rectum to examine the state of the bladder, the 
pony strained to resist its being passed, groaning from the pain 
this straining occasioned. On passing my hand into the rectum, 
and examining its inferior surface, I found two large tumours, 
apparently in connexion with the neck and cavity of the urinary 
bladder. The most posterior of them was of a large size, of an 
oblong form, and extending from the left tuberosity of the ischium 
obliquely across the outlet of the pelvis to the right thyroid fora- 
men. The swelling felt soft nnd yielding, of a lobulated nature, 
and pressure on this part alone did not seem to give much pain. 
The anterior tumour rested upon the symphysis pubis : in size it 
was considerably smaller than the former. It felt slightly rough- 
ened and hard, of an ovoid form, and seemed to be contained in 
the cavity of the bladder, the coats of which felt firmly contracted 
upon it. With a little care, however, these could be raised from 
it, and could be made to slide upon its surface, which motion 
produced immediate symptoms of pain, followed by the discharge 
of a few drops of bloody urine. 
Extending forward on each side of the bladder, between it and 
the rectum, the ureters were found to be enlarged to four times 
their natural size, and somewhat tortuous in their course. On 
being grasped between the fingers, and pressed in the direction 
of the urinary bladder, their size became diminished, in conse- 
quence of their contents being discharged into the comparatively 
pre-occupied bladder, from which it was immediately discharged 
by the urethra. 
From the circumstances indicated by this examination I drew 
the following conclusions : first, that the posterior swelling was 
a large tumour developed around the prostatic portion of the 
urethra, and extending along a great portion of the right side of 
the bladder, between it and the levator ani muscle, and, from 
the colour of the pony, and its lobulated feel, I suspected it to 
be encysted melanosis. It was not in communication with the 
cavity of the bladder, as firm and continued pressure did not pro- 
duce any change in its size. I also concluded that the anterior 
tumour was a calculus. 
The only means which I could, therefore, propose for the relief 
of the animal was that of extraction. From the smallness of the 
animal, however, the pre-occupation of the outlet of the pelvis, 
and the large size of the stone, I anticipated considerable diffi- 
culty in the performance of it. But, as the symptoms were urgent, 
and as no other means could be advised, the owner, after being 
made aware of the circumstances, agreed to subject the animal 
to the operation, which, after a week’s preparation, was accord- 
ingly performed on the 1st of the present month. 
