Remarkable case of extrophy of the urinary bladder, with remarks / by P.D. Handyside.

Date:
[1839?]
Catalogue details

Licence: Public Domain Mark

Credit: Remarkable case of extrophy of the urinary bladder, with remarks / by P.D. Handyside. Source: Wellcome Collection.

Provider: This material has been provided by the Royal College of Physicians of Edinburgh. The original may be consulted at the Royal College of Physicians of Edinburgh.

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    become much impaired, and his body emaciated, and now lie suf- fers considerably more than he used to do from a malformation in the genito-urinary organs, a great part of the urinary bladd er being everted, and its delicate mucous surface likewise in a very ir- ritable condition. In height, this man measures five feet four inches and seven- eighths, while between the extremities of his middle fingers, his arms being fully expanded, he measures six feet two inches and seven-eighths. This disparity is remarkable, for although between eight and ten years ago, a curvature forwards in the dorsal region of the spine contributed materially to lessen his stature, yet very nearly the same amount of disproportion in his body was conge- nital, since we find that his height at the period of maturity did not exceed five feet nine inches.* At birth the subject of this narration was observed to have in the hypogastric region, a small reddish tumour, to the upper part of which the umbilical cord was attached; but all trace of the latter disappeared very shortly afterwards. He is the oldest of a healthy family of seven, (four of which number are males), and is the only one among his relatives exhibiting any malforma- tion. As he advanced to maturity, the tumour increased rapidly, though not in an equal ratio to what it latterly has done, since eight years ago, it was in bulk one-half smaller in every way than it now is, and about three years ago, when I first saw him, it was one-fourth smaller in size than at present. It now presents the following characters. [See Plate IV.] The anterior wall of the hypogastric region of the abdomen in the situation of the lower third of the linea alba is deficient at a part corresponding to the base or neck of the tumour, which con- sists of the everted posterior wall and lower fundus of the urinary bladder, protruded so as to form an elongated oval eminence, hav- ing its long axis placed transversely. The skin of the abdomen continuous with the upper part of the neck of the protrusion pre- sents a triangular cicatrice two inches and a half broad, by one inch and a quarter in elevation, the base of which unites with the surface of the bladder. The integument closely bordering on the It is perhaps not superfluous here to remark, that, six years ago, I made a series of careful observations with the view of ascertaining the accuracy of a measurement of the expanded human body given by Du Piles, as taken trom the statues of the ancients by M. du Krcsnoy, and which measure is by artists assumed to be true in nature, viz. that a man, when his arms are stretched out, is, from the longest finger of his right hand to the longest of his left, as broad as he is long. (See Sir Joshua Reynolds' Works, by Malone, edit. IH09, Vol. iii. pp. 115, I KJ.) By induction from the first twenty-five experiments of this nature made by me, I found that, at the period of maturity, there is a preponderance in the breadth over the height of the expanded body, amounting on an average to rather more than two inches and a half.