A lecture, delivered before the Royal College of Surgeons : being a commentary on Mr. John Hunter's Preparations of the diseases of the urethra and bladder / by Charles Bell, F.R.S.

  • Charles Bell
Date:
1830
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Licence: Public Domain Mark

Credit: A lecture, delivered before the Royal College of Surgeons : being a commentary on Mr. John Hunter's Preparations of the diseases of the urethra and bladder / by Charles Bell, F.R.S. Source: Wellcome Collection.

Provider: This material has been provided by The University of Glasgow Library. The original may be consulted at The University of Glasgow Library.

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    ceive that, wliilst the bladder is singularly contracted and thickened in its walls, the whole extent of the canal, from the sphincter of the bladder to the back of the stricture, is enormously dilated. This, by the by, is another proof of the want of muscularity in the pas- sage, and that the supposed muscular texture around the urethra has nothing in common with the detrusor urince, or muscular coat of the bladder, in the discharge of urine ; otherwise, those fibres, if they existed, would have partaken of the excitement and develope- ment which has produced so singular a change on the bladder, and they would have resisted the dilatation. But it is to the practical inference to be drawn from this fact that I beg your undiminished attention. If I could show you the trouble and expense I have been at to ascertain and demonstrate this fact by dissection, you might, perhaps, consider it with more interest. I remember to have seen a surgeon puncture the bladder, as he thought: by dissection I afterwards ascertained that he had punctured the urethra! and you see, by these preparations, how possible this is, from the large diameter of the canal behind the stricture. And thus we learn that, after a long-continued stricture, at a time when it is impossible to puncture the bladder, from its contracted state, it is perfectly possible to give instant relief, by opening the urethra behind the stricture. The case to which I allude is this : — A man has a stricture so narrow that the point of the finest bougie cannot be made to enter it, much less can it be forced by the catheter. To burn it by the caustic is of no avail, since the process of sloughing is very slow, and the symptoms are urgent. The patient is making attempts c 2
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