Swim bladder

“ The patient should gain the habit of making water slowly, which is a matter of the utmost consequence, as it prevents the distention, and consequent rupture, of that part of the urethra, which is between the stricture and the neck of the bladder. ”

“ To enter into a description of the pathological condition of the bladder in the several states of irritability, paralysis, and inflammation, would be to swell this article to an inordinate length, and serve no useful purpose—the symptoms and treatment comprising the most essential knowledge for the patient to possess. It may be briefly stated, that the bladder is less subject to become disorganized (the function being chiefly the disordered symptom) , and sooner even regains its tone than other organs not less important to life. ”

“ The division of the bladder into different lobes has proceeded from a very sufficient reason. When the bladder has only one cavity, as in the case of fishes of prey, the motion of ascent or descent takes place slowly, and without a break; because, as they compress the whole bladder at once, the whole body is moved horizontally, upwards or downwards, as the case may be; a circumstance which has the effect of lessening, in consequence of the resistance of the water, the swiftness of those tyrants of the deep. ”

“ The bladder is sometimes apt to expel the water which is injected, if the patient is not well under the influence of the chloroform; but when the vapour has been continued for a few minutes, and the narcotism is complete, the bladder will, I believe, always hold water as well as if the operation were performed in the waking state, and generally much better. There are some surgeons who occasionally raise the breech of the patient for a short time during this operation, so that the head becomes considerably lower than the body. ”

“ Cold air and cold water will increase the quantity of urine by decreasing the absorption from the bladder; and neutral and alcalious salts and cantharides by stimulating the neck of the bladder to discharge the urine as soon as secreted; and alcohol as gin and rum at the beginning of intoxication, if the body be kept cool, occasion much urine by inverting the urinary lymphatics, and thence pouring a fluid into the bladder, which never passed the kidnies. ”

“ Stricture of the urethra, prostatic disease, and gravel, or stone in the bladder, are all capable of producing obstruction to the free flow of the urine.
How Slight Ailments become Dangerous Diseases. As we have before stated, the mucous membrane lining the bladder is reflected upwards into the ureters, lining these canals. By reason of this continuity of mucous surfaces, patients suffering from urethral, prostatic, and bladder affections, often die from disease of the kidneys. ”

“ But if the urine is in great quantity in the bladder, and it has acquired by remaining in it a long time that deep colour which indicates the concentration of its principles, then the irritation that it produces on the organ brings powerfully into action the sensible organic contractility; the bladder contracts, and in spite of the animal, there is an evacuation of urine. ”

“ In some old people, who have experienced a long retention of urine, the bladder never regains the power of completely emptying itself; and many who are beginning to be weak from age can make water a second time, a few minutes after they supposed they had emptied the bladder.
I have believed this pain to originate from sympathy with some distant part, as from ascarides in the rectum, or from piles in women; or from caruncles in the urethra about the caput gallinaginis in men ”

“ Anomalies of the Bladder.—Blanchard, Blasius, Haller, Nebel, and Rhodius mention cases in which the bladder has been found absent and we have already mentioned some cases, but the instances in which the bladder has been duplex are much more frequent. Bourienne, Oberteuffer, Ruysch, Bartholinus, Morgagni, and Franck speak of vesical duplication. There is a description of a man who had two bladders, each receiving a ureter. Bussiere describes a triple bladder, and Scibelli of Naples mentions an instance in a subject who died at fifty-seven with symptoms of retention of urine. ”

“ When the part becomes morbidly enlarged, it acts as a mechanical impediment to the passage of urine from the bladder, but from this circumstance we cannot reasonably infer, that while of its normal healthy proportions, its special function is to facilitate the egress of the urine, for the female bladder, though wholly devoid of the prostate, performs its own function perfectly. ”

“ The patient passes urine often in small quantity, and with whines or cries. He walks slowly and stiffly with the back arched, and compression of the abdomen and especially of the prepubian region is painful to a marked degree. The tense elastic bladder may often be distinctly felt through the abdominal walls. The inflamed bladder is liable to paresis and paralysis with great overdistension, and aggravation of the general symptoms, the eyes sunken, and dullness, stupor and coma betraying uræmic poisoning. Some claim rupture of the bladder as is so common in the ox. ”

“ When full, the bladder is pear-shaped; when empty, it is collapsed and lies low in the pelvis. The functions of the bladder are to collect and retain the urine, which has reached it drop by drop from the kidneys through the ureters, until a certain quantity accumulates, and then to expel it from the body. ”

“ To test this function place the patient on the bed pan into which a pint of hot water has been put, and give her a reasonable time to make the effort to pass her water. Should she fail, take an ordinary small bath towel and wring it out of very hot water, just as hot as she can tolerate, and spread it over the region of the bladder and genitals: if there is running water in the room, turn it on full and let it run while the towel is in position as above. If the bladder is full, there is a peculiar, irresistible desire to urinate when one hears running water. ”

“ The diagnosis of eversion of the bladder presents no difficulty. The everted mass appears to have a narrow neck opposite the meatus, and is seen to form a reddish, unctuous mass. The mucous membrane now forms the external coat and appears covered with mucus so long as inflammation does not occur.
The urine continually escapes from the ureters (which open on the surface of the mucous membrane) as it is formed, and flows away by the lower commissure of the vulva. The vulva is half open, and the prominence formed by the bladder projects beyond it. ”

“ Fill a bladder about two-thirds full of air at the sea level, and take it to the summit of Mount Blanc. As you ascend, the bladder becomes more and more distended; at the top of the mountain it is fully distended, and has evidently to bear a pressure from within. Returning to the sea level you find that the tightness disappears, the bladder finally appearing as flaccid as at first. ”

“ Whenever found in stagnant water the bladders swarm with insects, crustaceans, larvæ, and fresh-water worms, in various stages of decay. The animals enter the bladder by bending in the free edge of the valve, which shuts again instantly. How it is that such weak and minute animals get into the bladders is not yet understood, but they do succeed in entering as do inanimate objects, if laid upon the valve. ”

“ Unless a specialist of experience be consulted, the bladder will most probably be examined, and medicine will be prescribed only to excite the kidneys to secrete more urine, which does harm instead of good; the disease slowly, but surely progressing. Patients often write us that they have had something wrong with the bladder for a number of years, having to urinate more frequently than they ought ”

“ We have shown that all causes producing a contraction of the blood-vessels have the same effect on the muscles of the bladder. I have often seen excitable, good-tempered dogs, in whom caresses and the sight of food were sufficient to produce such a contraction of the bladder, that the urine was expelled; and this suffices to confirm the fact that in [221] our organism the same phenomena may be produced by opposite causes. ”

“ Abnormal conditions of the bladder will cause difficulty in retaining the urine for a normal length of time. An inflammation of the bladder is greatly exaggerated by the [Pg 387] presence of urine, therefore an irritation would be set up which would result in a desire to empty the bladder. This would invariably result in nocturnal enuresis. An interference with the transmission of motor mental impulses to the sphincter muscle would be another cause for bed wetting. In this case, it would be impossible to retain the urine after a certain amount had passed into the bladder. ”

“ On the other hand, the diseases incident to the bladder are various, but principally arise from debility, spasms, and calculous concretions; for an account of which, we refer to the articles Gravel, Stone, and Urine. At present, we shall confine ourselves to the inflammatory state of that vessel, which requires immediate relief. This dangerous malady is occasioned by stimulating medicines; gravel or stones lodged in the orifice of the bladder; violent exercise after a long retention of urine, and especially in hot weather ”

“ Prophylaxis.—Certain directions are helpful and by occupying the patient's mind will overcome certain physical factors that underlie the affection. It is important that the bladder should not be allowed to be full, above all, not to be over-distended at night. Some care should be exercised in not taking too much to drink shortly before going to bed and the bladder should be faithfully emptied before retiring. The weight of a large amount of urine in the bladder pressing down upon the seminal vesicles situated below and behind it causes them to contract rather easily. ”

“ When the urine is too long retained, it is not only resorbed, or taken up again into the mass of fluids, but by stagnating in the bladder it becomes thicker, the more watery parts flying off first, and the more gross and earthy remaining behind. By the constant tendency which these have to concrete, the formation of stones and gravel in the bladder is promoted. Hence it comes to pass, that indolent and sedentary people are much more liable to these diseases, than persons of a more active life. ”

“ And these off-branchings of the veins terminate in the bladder. For the bladder lies at the extremity, and is held in position by the ducts stretching from the kidneys, along the stalk that extends to the urethra; and pretty well all round it is fastened by fine sinewy membranes, that resemble to some extent the thoracic diaphragm. The bladder in man is, proportionately to his size, tolerably large. ”

“ We first, however, rubbed the bladder gently with oil, so as to make it air-tight, by closing its pores with the oil. We tied the bladder tightly round the mouth of the vial, which we had inserted in it, and with a piece of waxed thread to make it fit better and more tightly, and then placed the vial on some hot coals in a brazier. The vapor or steam of the spirit, dilated and become aëriform by the heat, gradually swelled out the bladder, and stretched it in every direction like a sail. ”

“ One of them usually lies in a more advanced position than the other. The ureters lead from the kidneys to the urinary bladder, which in its form and relations is quite distinctive of the Mammalia. The bladder is formed out of the remains of the allantois, and is therefore not the exact homologue of the bladder of the frog, which is the equivalent of the entire sac which grows out of the cloaca in the mammal, and is the foetal allantois. The ureters open into the bladder in the higher Mammalia, but lower down in the urino-genital passage in the more primitive mammals. ”

“ By putting various substances in the bladder, you will find that solid particles and things which will not dissolve in water keep inside the bladder, whereas sugar and salt, and many other things which dissolve in water, will make their way through the bladder into the water outside, and will keep on passing until the water in the basin is as strong of sugar or salt as the water in the bladder. This property which membranes such as a bladder have of letting certain substances pass through them is called osmosis. You will at once see how important a part it plays in your own body. ”

“ The use of hot fomentations over the kidneys and bladder will often hasten the evacuation of urine if it has been unduly delayed. If the secretion seems highly concentrated, a drop of sweet spirits of niter in a teaspoonful of water may be given every two hours. ”

“ They each begin as an [Pg 101] outgrowth from the fore part of the alimentary tract, the only difference being that the air-bladder usually rises dorsally and the lung ventrally. The fact already cited, that the pneumatic duct is always present in the larval form in fishes that possess a bladder, is equally significant. All the facts go to show that the introduction of external air into the body was a former function of the air-bladder, and that the atrophy of the duct in many cases, and the disappearance of the bladder in others, are results of the loss of this function. ”

“ In many cases of disease and irritation in the bladder, attended with frequent desire to make water, and pain after its evacuation, also in disorders of the urinary organs, accompanied with the lithic acid, or phosphatic deposit in the urine, I have seen a very liberal internal use of the water decidedly beneficial; and elderly persons, afflicted with organic changes in these organs, have often acknowledged to me that they live in greater comfort, and are freer from irritation or pain, at Malvern than elsewhere. ”