coat quite developed. Mucous surface nowhere smooth, and in man}' parts covered with shreds, and rough eleva- tions from the thickening of the submucous coat. The sac is, perhaps, half as large again as the bladder itself; and the opening between the two is from two to three inches in diameter. The left ureter opens into the sac, half an inch from the bladder, and is considerably dilated, as is also the pelvis of the kidney, which contains a dark, irregular calculus.
From a hostler, set. thirty-five years, who had had dys- uria for a month or more before he applied for medical ad- vice. Pain in the region of the kidneys was severe, with tenderness over the bladder, and occasional retching and vomiting ; and he died not long afterward of peritonitis. 1867. Dr. R. M. Hodges.
Calculus in the bladder in situ. (See No. 2464.) 2489. A tumor projecting into the cavity, and from the fundus the bladder, is perfectly defined, of a circular form, about 4 in. in diameter and 2 in. in elevation ; the mucous membrane stopping abruptly around the base. It had a dead-white color, a fibrinous consistence, and consider- able friability, so that it had been broken into in some places by handling. The external surface was rough, but the general form rounded. In structure it was uniform, nowhere at all vascular, and showed nowhere any of the usual appearances of cancer. Under the miscroscope, Dr. Ellis -found no cancer cells, nor, indeed, any definite ap- pearances. Not very far from the tumor was a white deposit in or beneath the mucous membrane, and about a line in diameter ; and otherwise the bladder appeared quite healthy, being neither fasciculated nor remarkable as to its size. Upon the peritoneal surface, corresponding to the tumor, there was no appearance of moi'bid deposit.
The patient was a shoemaker, of good general health, and fifty years of age. When first seen by Dr. C., about two years before his death, he had had frequent and irre- sistible calls to urinate for about eight years, and until the last two years this had been the only symptom ; but, afterward he had had considerable pain during micturition, with constant uneasiness, and sometimes a smarting, cut-
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