Issue 10, pp. 753-832, October 1861, SMSJ

820 Arnmoniccraia. [October,combined with the use of some acidulous or ferruginatedmineral water.Strictures of the urethra have often been overlooked ; Ithink they alone have given rise to the haemorrhoids of thebladder, that we used to hear so much about in times notlong gone. Of equal importance with the strictures arediseases of the prostate in connection with ammonisemia.Amongst them are, atrophy in consequence of precedinginflammation, general or partial hypertrophy and developmentof an accessory tumor, pressing on the urethra or theneck of the bladder. They impede, more or less, theevacuation of the urine, cause torpor of the bladder, hypertrophyof its walls, diseases of the ureters and kidneys,and consequently ammoniamiia, which sometimes appearssoon, but often only after a long time. The difficulties ofa successful surgical treatment, in such cases, render theprognosis rather unfavorable. Hypertrophy of the prostatewill often yield to a strong ointment of iodide of potassiumapplied to the perineum, and combined with the internaluse of acidulated waters. With the cautious use of thecatheter, and a decoction of secale cornutum, exhibited internally,the alread} r developed torpor of the bladder, andother symptoms, even of chronic ammonisemia, may be relieved.A long practiced intentional retention of urine is apt toend in the highest development of ammonieemia, withoutany difficulty in, or around the urethra. The greater thechange in the textures, following this cause, the smaller isthe prospect of recovery.That stones in the bladder result fatally through ammoniaemia,has been long known to surgeons; the disease Idesignate by this name is well described, with all its symptomsin their books. It certainly plays a very importantpart in its connection with urinary concretions. Withoutan operation death is certain to follow, while success with asurgical proceeding depends completely upon the presenceand extent of ammoniaBmia. Under the influence of bloodpoisoned by ammonia, diphtheritic processes and exulcerationsin the artificial wounds are unavoidable.Cancer of the bladder is always, in the end, accompaniedby ammonisemia. Medullary carcinoma of the inner surfaceof the bladder induces 'hemorrhage, and thereby decompositionof the urine.Mechanical obstruction of the ureters, or destructive dis-