An American text-book of genito-urinary diseases, syphilis and diseases of the skin . rethral lesions is of common the infectious diseases, in states of profound systemic depression from anysystemic disease, in intoxications, in nervous diseases, there may be retentionof urine or retention with incontinence in which urethral infection may even develop in simple incontinentia urinse. The vesical infectionsoccurring as sequelae of stone, tumor, and prostatic disease are often of ure-thral origin. Whether or not the normal urethra always contains pyogenicmicro-organisms is
An American text-book of genito-urinary diseases, syphilis and diseases of the skin . rethral lesions is of common the infectious diseases, in states of profound systemic depression from anysystemic disease, in intoxications, in nervous diseases, there may be retentionof urine or retention with incontinence in which urethral infection may even develop in simple incontinentia urinse. The vesical infectionsoccurring as sequelae of stone, tumor, and prostatic disease are often of ure-thral origin. Whether or not the normal urethra always contains pyogenicmicro-organisms is not yet settled : certain it is that they are sometimes pres-ent. It is certain that in the conditions just enumerated the urethra is usuallyhealthy, while the bladder is ripe for infection. The modus operandi is, weadmit, not clear, but it is certain that in many cases of this class infectivecystitis occurs through a urethra not diseased, though it is usually due toinstrumentation. Infection through the healthy urethra may also occur fromdeferentitis not secondary to Fig. 106.—Urinary sepsis in an infant, secondary to stricture (Wistar Institute of Anatomy, Univ. of Penn.) Usually the urethral cystites are associated with urethral disease. Septicinfection may occur either in a healthy bladder or in a bladder made vulner-able by over-distention and retention of irritating urine. Infection is common in gonorrhea. Probably pyogenic bacteria alwaysplay an important role, though it is useless to discuss this question when theurethral bacteria are so little understood as at present. In acute gonorrheacystitis rarely occurs before the third week. It is caused by the passage ofbacteria through the sphincter vesicas or by extension in the mucous mem-brane or the submucosa. Sexual excitement and alcoholic beverages or highlystimulating foods by causing vesical congestion favor the ascent. 348 DISEASES OF THE BLADDER. In chronic gonorrhea, especially when the prostatic ur
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