Clinical lectures on stricture of the urethra and other disorders of the urinary organs . ty of urine are these : in an enfeebledperson it is apt to be followed by syncope, or, as I haveseen, when the distension is thus removed from offthe blood vessels of the parts, passive haemorrhage intothe bladder and out through the urethra has been theconsequence. Such a loss of blood has, in this way,been fatal in the course of a few days. These effectsare similarly observed after the rapid removal of fluidfrom other parts of the body. Syncope, after tappingfor ascites, is not uncommon, and in a case I
Clinical lectures on stricture of the urethra and other disorders of the urinary organs . ty of urine are these : in an enfeebledperson it is apt to be followed by syncope, or, as I haveseen, when the distension is thus removed from offthe blood vessels of the parts, passive haemorrhage intothe bladder and out through the urethra has been theconsequence. Such a loss of blood has, in this way,been fatal in the course of a few days. These effectsare similarly observed after the rapid removal of fluidfrom other parts of the body. Syncope, after tappingfor ascites, is not uncommon, and in a case I recentlysaw, the withdrawal of the ascitic fluid was immediatelyfollowed by violent haematemesis, which was fatal in afew hours. The removal of the tension from off theabdominal blood vessels was the only explanationof this. The bladder is also more likely to regainits muscular power when it is gradually emptiedthan if it were suddenly reduced to a flaccid con-dition. Hence it is a good rule, in the case of feeble personswho, for some days, have been suffering from retention, Plate E. THIRTEENTH LECTURE. 187 and where the bladder is considerably distended, todraw off the urine by degrees. The size and direction of the prostatic enlargementsometimes renders catheterism impossible, and thenthe question arises as to what is best to be catheterism, by which is meant driving theinstrument through the obstruction, and thus enteringthe bladder, is a means that has been advocated. Inthis specimen from the Museum (Plate E.) you willsee that this has been done, and the prostate com-pletely riddled with holes, as shewn by the pieces ofbougie which have been introduced through severalof the false passages. Though here the proceedingappears to have been, for a long time, practised withimpunity, it is not to be recommended, inasmuch as,apart from the haemorrhage and other damage it mayoccasion, it is calculated, from the force necessary, toset up inflammation around the gland, a
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