508 CYSTITIS, FOLLOWED BY RUPTURE OF THE BLADDER. 
being most worthy of our consideration, and in my opinion 
more difficult to understand than at first sight might he 
imagined. If the immediate or exciting cause of this lesion 
be apparent, nevertheless the remote or predisposing cause 
seems difficult to understand. I think, however, we may 
safely state that, if any organ is structurally deficient in any 
of its parts, either congenitally or acquired, it is thereby pre¬ 
disposed to yield to undue pressure. Having this fact in 
view when I examined the coats of this organ, and com¬ 
paring them with what I considered would be their natural 
thickness, and also their normal condition, I was forced to 
the conclusion that the anterior fundus, for some little dis¬ 
tance around the opening alluded to, was unusually thin, not, 
I thought, from disease, but from a congenital deficiency of 
structure. In neither of the coats, not even the mucous 
membrane, did I observe the slightest trace of ulceration; I 
therefore infer that they gave way from undue pressure, in 
consequence of their being structurally weak. The opening 
had all the appearance of a rent, and although small while 
the bladder was in the extremely contracted state, it never¬ 
theless would be much larger when the organ was partially 
or wholly distended. Then, as it regards the form of this 
opening. A rupture at this part of the bladder is said to be 
always circular; which I think is explained by the course of 
the fibres of the middle coat at this part of the organ. With 
reference to the nature and extent of the disease, I must 
think that it was not so extensive as might be supposed, or 
its ravages so great as the symptoms would lead those who 
witnessed them to conjecture they would be. That it was 
primarily a case of cystitis there cannot be a doubt, involving 
more or less the entire structure of the bladder, but the 
inflammatory action had not been so intense as to produce 
that extreme lacerated state of the tissues which sometimes 
is met with; nevertheless I believe it was sufficient to render 
the coats of the bladder, particularly at that part which I 
think was already congenitally weak, more easily ruptured. 
There seems to be no evidence that disease of the bladder 
existed prior to parturition; it was therefore most likely pro¬ 
duced during that act, and it existed in a subacute form up 
to the time the mare was covered by the cart’stallion, on the 
ninth day after she had foaled. I think it is very probable 
that during this act increased inflammatory action was in¬ 
duced, which, conjoined with the congenitally weak condition 
of the organ, finally led to the rupture, and, of course, the 
escape of the urine into the peritoneal cavity, thereby causing, 
as would be expected, peritonitis, followed by death. 
