| OCR Text |
Show 216 ,UMBILICAL uremia. OF THE CATHETER. Being generally of long standing, and often containing much omentum (from its situation high in the belly), the sac and contents adhere; the sac becomes in places thin, and is even sometimes entirely absorbed, so that the omentum and com- mon external fat adheress, and the intestine being immersed in a mass of condensed and adhering omentum, it is some- CHAPTER IV. times confined and strangulated there. OF THE CATHETER. The truss described in Mr. Hey's Surgery, is the best for this kind of rupture. " See Sharpe's Critical Inquiry, p. 51. 'I‘HE occasions of using the catheter are, 1. Most free quently of all spasm of the sphincter muscles, which surround the urethra near the neck of the bladder, in come quence of debauch, or irregularities, or cold. 2. Too great fulness of the vascular tissue which surrounds the neck of the r~--~ ~MH'7MA/ run mum-rs: bladder. 3. Paralysis of the bladder. 4. Swelling of the prostate gland. 5. A bruise and extravasation in the perineum, or abscess by the side of the urethra or neck of the bladder. The first is merely a want of the usual consent betwixt the action of the bladder and the relaxation of the sphincter vesicw. It is often produced by the necessity of retaining the urine, when there has been frequent inclination to make it. It is this occasion of obstruction which is so apt to yield to the mere introduction of the bougie: for the withdrawing of the bougie, similar to the flow of urine along the passage, restores the consent of action in the bladder and sphincter. This cause of obstruction, too, when it combines With stricture, or indeed with almost any other cause of ob struction, makes the disease unusually complicated. That fulness of the numerous veins which surround the neck of the bladder, which sometimes follows upon irregu; larity, and is accompanied and marked by a sense of tension, throbbing, and often with piles, I have often thought to be a principal cause of obstructed urine. In this case, blood is very apt to follow the introduction of the catheter, and this generally procures relief. Yet this is not to recommend general bleeding: bleeding with leeches, and afterwards fomentations, VOL. 3. E 2 |
