On the Causes and Symptoms of Acute Diseases (2.10)

THE bladder is a dangerous part to suffer in acute diseases, even when it merely sympathizes with other parts; but more dangerous and fatal if the affection begin with itself; for it is very potent to make the other parts sympathise with it, as the nerves and the understanding: for the bladder is a cold and white nerve, at a very great distance from the innate heat, but very near the external cold: for it is situated in the lowest part of the belly, at the greatest distance from the chest. But, also, its office is of vital importance, namely, the passage of the urine.

Even, then, when the passage is only stopped by stones, or clots, or from any native or foreign mischief, it is of a deadly nature. In women, the phlegmonous tumour of the uterus may compress it; and in men, the straight intestine at the end bowels, called the Rectum. In many cases, too, owing to involuntary restraint from modesty in assemblies and at banquets, being filled it becomes distended; and, from the loss of its contractile power, it no longer evacuates the urine. When, then, the urine is stopped, there is fulness of the parts above, namely, the kidneys; distension of the ureters, grievous pain of the loins, spasms, tremblings, rigors, alienation of mind. But if it suffer from an ulcer or inflammation, there are, indeed, many bad symptoms; but death from the ulcers is by far the most speedy. With regard, however, to the ulceration and purulent abscess, and those other affections which are not very acute, they will be treated of among the chronic diseases; but such as are acute, and prove fatal in fourteen days, or a little earlier or later, such as inflammation, thrombus, or a stone falling down to the neck of the bladder, of these I will now treat. If, therefore, any of these occur, there is retention

of urine; swelling in the hypogastric region; acute pain all over the abdomen; distension of the bladder; a sallow sweat on the tenth day; vomitings of phlegm, then of bile; coldness of the whole body, but especially of the feet: but, if the mischief spread farther, there come on fevers attended with hiccup, pulse irregularly frequent and small, redness of the countenance, thirst, distress of mind, delirium, spasms. From deleterious substances, such as cantharides and buprestis, both the bladder is distended with flatus, and the whole belly suffers violence; and all things get worse, and death cannot be long delayed.

The bladder also sometimes suffers from hemorrhage; the blood there is bright and thin, but the patients never die from it, although it may not be easy to stop. But from the clots and the inflammation there is danger; for the coldness, mortification, gangrene, and the other evils consequent upon it readily prove fatal.

Winter and autumn bring on these diseases. As to age, manhood, but still more old age. The other seasons and periods of life do not generally produce the diseases, and they very rarely prove fatal. Of all others, infants are most free from danger.