Volume 1

Descriptive catalogue of the pathological specimens contained in the Museum of the Royal College of Surgeons of England.

  • James Paget
Date:
1882-1885
Catalogue details

Licence: Public Domain Mark

Credit: Descriptive catalogue of the pathological specimens contained in the Museum of the Royal College of Surgeons of England. Source: Wellcome Collection.

Provider: This material has been provided by King’s College London. The original may be consulted at King’s College London.

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    six inches in length and three in width. Its walls are propor- tionally strong; about half an inch thick. The fasciculi of the muscular coat are large, compact and cord-like : the fibro-cellular tissue connecting them is closer and tougher than in the ordinary condition, yet not morbidly indurated. The mucous membrane is thick and, in many places, pushed out in small pits through the meshes of muscular fasciculi which project in thick round ridges on the inner surface of the bladder; but the surface of the mucous mem- brane is smooth and velvet-like, and its tissue, though more compact than is usual, is not indurated : it appears only to have acquired additional strength in correspondence ■wdth the other hypertrophied textures of the organ. Hunterian *. The bladder in such cases [of obstruction to the passage of urine] having more to do than common, is almost in a constant state of irritation and action; by which, according to a property in all muscles, it becomes stronger and stronger in its muscular coats; and I suspect that this disposition to become stronger from repeated action is greater in the involuntary muscles than the voluntary; and the reason why it should be so is, I think, very evident: for in the involuntary muscles the power should be in all cases capable of overcoming the resistance, as the power is always performing some natural and necessar)' action; for whenever a disease produces an uncommon resistance in the involuntary parts, if the power is not proportionally increased, the disease becomes very formidable ; whereas in the voluntary muscles there is not that necessity, because the will can stop whenever the muscles cannot follow; and if the will is so diseased as not to stop, the power in voluntary muscles should not increase in proportion. I have seen the muscular coats of the bladder near half an inch thick, and the fasciculi so strong as to form ridges on the inside of that cavity f; and I have also seen the fasciculi very thin, and even wanting in some parts of the bladder, so that a hernia of the internal coat had taken place between the fasciculi and formed pouches. These pouches arise from the thin parts * Part of the preparation is engraved in Sir E. Home's ' Practical Ohser- vations on the Treatment of the Diseases of the Prostate Gland/ vol. i. pi. iv. London, 1811. t This appearance was long supposed to have arisen from a disease of this viscus; hut upon examination I found that the muscular parts were sound and distinct, that they were only increased in bulk in proportion to the power they had to exert, and that it was not a consequence of inflam- mation, for in that cmj parts are blended into one indistinct mass.''