A manual of modern surgery - an exposition of the accepted doctrines and approved operative procedures of the present time, for the use of students and practitioners (1899) (14780478964)

Identifier: manualofmodernsu1899robe (find matches)
Title: A manual of modern surgery : an exposition of the accepted doctrines and approved operative procedures of the present time, for the use of students and practitioners
Year: 1899 (1890s)
Authors: Roberts, John B. (John Bingham), 1852-1924
Subjects: Surgical Procedures, Operative Surgery
Publisher: Philadelphia : Lea Brothers & Co.
Contributing Library: Francis A. Countway Library of Medicine
Digitizing Sponsor: Open Knowledge Commons and Harvard Medical School



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septic in-struments have introduced the germs into the bladder, or an injury haspermitted easy transit from the bowel. Infection through the bloodstream is possible, but uncommon. It is believed by some that theingestion of cantharides and the terebinthinate preparations may causecystitis. This is probably erroneous. The so-called catarrhal cystitis,not due to bacterial causes, is probably apocryphal. Abscess of thebladder walls, pericystic inflammation and a diphtheritic inflamma-tion leading to desquamation and necrosis of the epithelium and mu-cous membrane may occur. Symptoms.—All forms of cystitis are characterized by frequencyand urgency of urination, pain in urination and the constant presenceof pus in the urine. The acute form is accompanied at times by chills,fever, and severe burning pain in the bladder and perineum, extendingto the head of the penis and down the thighs. The bladder may en-deavor to empty itself every few minutes, even if it contains very little Fig. 406.
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Internal appearance of the bladder in some cases of inveterate cystitis ; mucosa sacculated by columnsof hypertrophied submucous and muscular tissue. (Launois.) urine. This vesical tenesmus is accompanied by increased pain. Theremay be, on the other hand, retention of urine ; the passage of a littleblood as the last drops of urine are voided ; or spasmodic contractionof the sphincter, so that only a little urine escapes at each attempt toempty the bladder. At the beginning of the disease the pus in theurine may be scarcely recognizable; but soon the urine becomescloudy or milky, very fetid, highly ammoniacal, and separates on stand-ing into a thick, tenacious precipitate of pus, mucus and crystals and 728 DISEASES OF THE URINARY ORGANS. a thin, supernatant liquid. Pressure on the hypogastrium is verypainful. Recovery occurs in about two weeks, the acute inflamma-tion is succeeded by the chronic form, or death takes place. Theprostatic urethra is often inflamed when cystitis is present