Journal : Photographic review of medicine & surgery ; vol. 1., no. 6.
Philadelphia : J. B. Lippincott & Co., 1870-71.
Description : pp. 69-70, [1] pl. ; ill.: 1 stereo. ; 24 cm.
Photograph : stereoview.
Subject : Bladder — Polyps.
Notes :
THE accompanying photograph represents the bladder of a man, aged about fifty, who died in Charity Hospital. The patient was in a comatose state when he reached the hospital, and died eight hours after admission. Shortly before death, the house-surgeon introduced a catheter and drew off some bloody urine, which was strongly ammoniacal.
No difficulty was encountered in passing the catheter, though blood flowed freely through the instrument, and passed from the urethra after withdrawal of the catheter.
The autopsy, made thirty-six hours after death, revealed disease of the heart, pericardium, kidneys, and bladder. The pericardium was greatly distended with serum, and its surfaces covered with recent lymph. The aorta, together with its valves, was the seat of atheroma. The bladder was hypertrophied, and contained several polypi, which were bloody and of a fungoid appearance.
The largest of these polypi arose from the posterior surface of the bladder by a thin pedicle, the body of which was fimbriated and measured two inches in its longest diameter. On the right side, just above the neck, was another polypus, the size of the thumb-nail, springing from a very slender pedicle. Directly below this last-described growth, and passing across the neck of the bladder, were two distinct bands, and from the left side of the upper band arose another polypus, which dropped down into the neck of the organ, and which, together with a smaller growth from the lower band, must have acted as a barrier to the flow of urine. Several small excrescences were situated in the same region.
The left kidney was very much enlarged and waxy, and its pelvis and calyces greatly distended.
The right kidney was exceedingly small, and what little kidney structure was presented was lobulated, as in the foetus ; its pelvis, however, was greatly distended, and contained nearly three ounces of urine. Both ureters were enlarged, and the right distended with urine, and no communication could be discovered between it and the bladder. The prostate body was not enlarged.
Microscopical examination of these growths revealed nothing malignant in their structure. The great rarity of this form of disease renders the case interesting and deserving of a place on record.
[As will be seen, the two photographs have been arranged in the form of an ordinary stereoscopic card. The picture is viewed to greatest advantage by placing it before the stereoscope and obtaining the usual effect of the instrument. — EDS.]