Tuberose

“ A blended perfume distilled by dew from Hersé's crystal fingers hovered over the Dingle, the cold, unctuous odor of tuberoses, the warm spice of carnations, and that clinging breath of wan lilies that evokes white faces and folded fingers of the dead, but stronger than all, the fragrance of wild grapes in creamy bloom. ”

“ In the female, the detailed arrangement of the two uterine tubules is not so easy to be followed, owing to dilatation of these organs with ripe ova. It can be seen, however, that the common conducting tube formed by the union of the two tubules opens by a transverse slit on the ventral surface of the body in the region between the juncture of the anterior fifth and the anterior fourth of the body length with the remaining portion. ”

“ If there is no tubal and ovarian displacement—that is, if the ovary is not prolapsed; if the uterus has not been retroverted; if there are no extensive tubal adhesions; and if there is no gross disease of the tube, such as pyosalpinx, hydrosalpinx, hematosalpinx, a thorough curetting of the uterus, or, if necessary, a trachelorrhaphy or an amputation of the cervix, will often relieve the woman of her suffering, and it may not be necessary to operate for the damaged tubes. ”

“ When urine contains a larger amount of chemical constituents than it can conveniently hold in solution, a certain quantity crystallizes out, and may be deposited in the kidney or in the bladder. If the crystals run together in the kidney the resulting concretion may either remain in that organ or may find its way into the bladder, where it may remain to form the nucleus of a larger vesical calculus, or, especially in the case of females, it may, while still small, escape from the bladder during micturition. ”

“ There grows out from the aorta, towards each, a bunch, of bloodvessels, the glomerulus (compare Section 62, Rabbit) . These tubuli ultimately become, in part, the renal tubuli, so that the primitive kidney stretches, at first, along the length of the body cavity from the region, of the gill-slits backward. The anterior part of the kidney, called the pronephros, disappears in the later larval stages. Internal to the kidney on either side there has appeared a longitudinal ridge, the genital ridge (g.r.) , which gives rise to testes or ovary, as the case may be. ”

“ In woman, this membrane is introduced by the os externum and penetrating on the one hand by the urethra, goes as in man upon the urinary organs; on the other hand, we see it enter the vagina, lining it, the uterus and the fallopian tubes, and afterwards becoming continuous with the peritoneum by the opening of these tubes. It is the only example in the economy, of a communication established between the mucous and serous surfaces. ”

“ Of this many die, who have drank much vinous spirit, and some of them recover by voiding a quantity of white mucus, like chalk and water; and others by voiding a great quantity of sand, or small calculi. This hardened mucus frequently becomes the nucleus of a stone in the bladder. The salts of the urine, called microcosmic salt, are often mistaken for gravel, but are distinguishable both by their angles of crystallization, their adhesion to the sides or bottom of the pot, and by their not being formed till the urine cools. ”

“ When there occurs an external ulcer in the perinæum, and the urine is in part discharged that way, the disease can not be mistaken. Otherwise from the quantity of matter, it is generally supposed to come from the bladder, or prostate gland; and the urine, which escapes from the ruptured urethra, mines its way amongst the muscles and membranes, and the patient dies tabid, owing to the want of an external orifice to discharge the matter. ”

“ Some anatomists have thought that the human form had, like those of certain quadrupeds; a membrane called allantois, destined [286] to receive the urine; and they have pretended to have found it between the chorion and the amnios, or in the middle of the placenta at the root of the umbilical cord, under the form of a very large bladder, in which the urine entered by a long pipe that composed part of the chord, and which opened on one side into the bladder, and on the other in this allantois membrane, being similar to the urachus in other animals. ”

“ After surrounding the small intestine it becomes the posterior layer of the mesentery and so again reaches the posterior abdominal wall, down which it runs until the rectum (R) is reached. The anterior surface of this tube is covered by peritoneum to a point about 3 in. from the anus, where it is reflected on to the uterus and vagina (V) in the female and then on to the bladder (B) ; in the male, on the other hand, the reflection is directly from the rectum to the bladder. ”

“ Small, round, or polyhedral cells are about the size of pus-corpuscles, or a little larger, with a single round nucleus. Such cells may come from the deeper layers of any part of the urinary tract. They are uncommon in normal urine. When they are dark in color, very granular, and contain a comparatively large nucleus, they probably come from the renal tubules, but their origin in the kidney is not proved unless they are found embedded in casts. Renal cells are abundant in parenchymatous nephritis, especially the acute form. ”

“ 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. ”

“ The tubules become blocked by the epithelium, and distended with the pent-up urine; this is one cause of the increase in size that the kidneys undergo in certain forms of Bright’s disease. The lesions in the tubules and in the glomeruli are not generally uniform. The interstitial tissue is always affected, and exudation, proliferation and formation of fibrous tissue occur. In the granular and contracted kidney the lesion in the interstitial tissue reaches a high degree of development, little renal secreting tissue being left. ”

“ Vesical epithelium is common. Numerous bacteria are always present (see Fig. 63) .
7. Vesical Calculus, Tumors, and Tuberculosis.—These conditions produce a chronic cystitis, with its characteristic urine. Blood, however, is more frequently present and more abundant than in ordinary cystitis. With neoplasms, especially, considerable hemorrhages are apt to occur. Particles of the tumor are sometimes passed with the urine. No diagnosis can be made from the presence of isolated tumor cells. In tuberculosis tubercle bacilli can generally be detected. ”

“ Hippocrates (iii. 17) says:
‘The end of the enema (i. e. the tube) is smooth like a sound. The tube is of silver. A perforation will be made in the side not far from the small tip of the tube (καθετήρ) . There will also be other perforations, which will be placed at equal distances on each side of the tube throughout its length. The extremity of the injection tube will be solid, all the rest hollow. To the tube will be attached the bladder of a sow, which has first been well scraped. ”

“ Inflammatory states of the tube may hinder conception, either mechanically, by swelling of the mucous membrane, or by obstruction of the lumen of the tube by exudations, by injury or destruction of the ciliated epithelium, by lesion of the musculature of the tube, affecting its peristaltic movements—all these hindering or entirely preventing the passage of the ovum downwards or of the spermatozoa upwards ”

“ The nucleus, or kernel, of these concretions is always formed in the kidney, as above described; and passing down the ureter into the bladder, is there perpetually increased by the mucus and salts secreted from the arterial system, or by the mucus of the bladder, disposed in concentric strata. The stones found in the bowels of horses are also formed on a nucleus, and consist of concentric spheres ”

“ All the open grooves have become closed tubes; the primitive kidneys are directed inwards. The letters have the same meaning in all three figures: h skin-sense layer, n medullary tube, u prorenal ducts, x axial rod, s primitive-vertebra, r dorsal wall, b ventral wall, c body-cavity or coeloma, f gut-fibre layer, t primitive artery (aorta) , v primitive vein (subintestinal vein) , d gut-fibre layer, a alimentary canal.)
As the two outer layers of the germinative area thus rise in a fold about the embryo, and join above it, they come at last to form a spacious sac-like membrane about it. ”

“ If our explanation of the causes and mode of formation of tubercle is correct, we must a priori expect to find that a tissue so soft and spongy as the lung, and which is so vascular and subject to such great and sudden alterations of pressure and relaxation, would naturally be the site of the first formation of tubercle. ”

“ The superficial fascia of the hypogastrium, the scrotum, and the perinaeum forming a continuous membrane, and being adherent to the several parts above noticed, may be regarded as a general double sac, which isolates the inguino-perinæal region from the femoral and anal regions, and hence it happens that when the urethra becomes ruptured, the urine which is extravasated in the perinaeum, is allowed to pass over the scrotum and the abdomen, involving these parts in consequent inflammation, whilst the thighs and anal space are exempt. ”

“ The presence of the growth may be determined by sounding the bladder, by the cystoscope, and by the finger in the rectum. If the growth invades the outlet, retention of urine may occur, and the surgeon may be compelled to open the bladder from the front of the abdomen. In cases where operation is out of the question, washing the bladder with hot boracic lotion may give great relief. The treatment of cancer of the bladder by operation is, as a rule, unsatisfactory, because of the close proximity of the growth to the ureters and to the rectum. ”

“ Yet another defect of development which, as Klebs has pointed out, may lead to sterility, is absence of the fimbria which normally retains the abdominal orifice of the Fallopian tube in proximity with the ovary, in which case these structures may be separated by a wide interval.
The entry of the ovum into the tube may thus be rendered difficult by abnormalities of the abdominal orifice of the tube or of the fimbriae; but still more is this the case when the mucous membrane of the tube is diseased. The fringed border of the tubal orifice has a distinct tendency to independent disease. ”

“ Their number, at the first view, appears very considerable; for the organs within which they are reflected are numerous. [2] The stomach, bladder, urethra, uterus, ureters, the intestines, &c., borrow from these membranes a part of their structure: nevertheless, if it be considered, that they are continuous throughout, that everywhere they are observed to be extended from one organ to others, arising, as they did at first, from the skin, their number will appear to be singularly limited. ”

“ Wherever the fertilized ovum remains and implants its villi the tube becomes turgid and swollen, and the abdominal ostium gradually closes. The ovum in this situation is liable to apoplexy, forming tubal mole. When the abdominal ostium remains pervious the ovum may escape into the coelomic cavity (tubal abortion) ; death from shock and haemorrhage into the abdominal cavity may result. When neither of these occurrences has taken place the ovum continues to grow inside the tube, the rupture of the distended tube usually taking place between the sixth and the tenth week. ”

“ It is generally admitted that the freshest tubercles, as found in the external coat of the smaller arteries of the pia mater, are composed of little else than a circumscribed accumulation of small, round cells, without a distinct reticulum. The giant-cells, the epithelioid cells, and the well-characterized reticulum appear as the tubercle increases in age. It is thought probable that the giant-cells represent the agglomeration of the small, round cells in pre-existing cavities, lymphatics, blood-vessels, or secretory canals. ”

“ To use the sac, remove the plug from the glass tubing, partly fill the sac with cultivation to be inoculated, by means of a sterile capillary pipette, and replug the tubing. When the abdominal cavity has been opened, remove the tubing and attached sac from the protecting test-tube, close the sac by tying a sterilised silk thread tightly around it a little below the end of the glass tubing, and separate it from the tubing by cutting through the collodion above the ligature, and the sac is ready for insertion in the peritoneal cavity. ”

“ If the urine escapes into the cavity of the abdomen, the patient inevitably perishes, and that very speedily; and when the cellular tissue of the pelvis is the seat of the extravasation, little hope can be entertained of recovery, though the fatal termination may not be so rapid as in the former case. When the urine is effused into more external parts, as into the perineum or scrotum, the danger is also imminent, if the fluid is allowed to accumulate and become extensively infiltrated ”