Gynecological diagnosis . is seldom seen before the ulcerative stage,although there is a catarrhal stage which precedes it. In thecourse of time caseation occurs and the tubercles break down,leaving a deep, ragged-edged ulcer; the urine containing pus, blood,and mucus. The disease may be confined to definite patches in CYSTITIS 469 the bladder; the trigone, base, and posterior walls being mostoften involved; the ulcerations advance slowly in any event; invery bad cases the entire bladder may be ulcerated. The disease runs a chronic course of many years duration. Inmaking the diagnosis of tuber
Gynecological diagnosis . is seldom seen before the ulcerative stage,although there is a catarrhal stage which precedes it. In thecourse of time caseation occurs and the tubercles break down,leaving a deep, ragged-edged ulcer; the urine containing pus, blood,and mucus. The disease may be confined to definite patches in CYSTITIS 469 the bladder; the trigone, base, and posterior walls being mostoften involved; the ulcerations advance slowly in any event; invery bad cases the entire bladder may be ulcerated. The disease runs a chronic course of many years duration. Inmaking the diagnosis of tuberculous cystitis the history is of aid,and if gonorrhea can be ruled out in a patient having a distinctfamily history of tuberculosis, the probability is that the diseaseis tuberculous, especially if the cystitis occurs in a young appearances of the bladder are more or less characteristic:glistening, opaque tubercles on a reddened base, breaking downto form ulcers with irregular sharp edges and granulating Fig. 187.—Tuberculosis of the Left Ureter and Bladder, Showing Crater-likeUreteral Orifice and Tubercles of the Bladder Wall. (Knorr.) In the late stages the bladder shows contracted areas and ulcera-tions. Finding the tubercle bacilli in the urine makes the diagnosispositive. In the early stages of the disease they may be few innumber and hard to find; later, there will be no difficulty, asabundant bacilli are in the urinary sediment. Hunner and Casper have been able to find tubercle bacilli ineighty per cent of all their cases of tuberculosis of the urinary sys-tem. Hunner gives the following steps of his technique for findingthe bacilli:—A catheterized specimen of urine is allowed to stand afew hours in a conical urine glass; 5 to 10 cubic centimeters aretaken from the bottom with a pipette and centrifugalized. Theheavy deposit is spread on two glass slides that have been pre- 470 DISEASES OF THE BLADDER viously cleansed of grease by alcohol, and are a
Size: 1586px × 1575px
Photo credit: © The Reading Room / Alamy / Afripics
License: Licensed
Model Released: No
Keywords: ., bookcentury1900, bookdecade1910, booksubjectwomen, bookyear1910
