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

822 Ammonicemia, [October,all, requires a considerable time. With the torpor advancedto a moderate degree, there remains always a certainquantity of urine in the bladder, although the patient thinksit completely empty. Upon strong and continued pressurehe is astonished to see the flow commence again. Thisstagnant quantity of urine augments in proportion to theincreasing torpor, and frequently forms the basis of acutechronic vesical catarrh. Cinder such circumstances, a slightcold, or an intentional repression of urine, are often sufficientto create complete paralysis of the bladder.This paralysis occasionally occurs as a symptom in otherdiseases, for instance, typhoid fever. Here it happens especially,when the conscience is disturbed, the sensibilitysuppressed and the muscles weakened to nearly paralysis ;if overlooked, an extensive stagnation of urine follows,commonly inducing vomiting in spite of the unconsciousness.This emesis is only removed by evacuation of thebladder, by means of the catheter. Amnioniremia may alsoarise during typhoid fever, in consequence of other morbidprocesses dependant upon the fever, for instance, catarrh ofthe mucous membrane of the bladder, or croupy exudationon its internal surface. In some cases, however, theseconditions are present, without exciting any symptom ofammoniaemia.Next to typhoid fever, acute diseases of the brainsuch as extensive meningitis and cerebri tis, induce not unfrequentlyparalysis of the bladder. A careful examinationhere always prevents the development of ammonioemia.But this cannot se easily be accomplished, where the paralysisfollows diseases of the spinal marrow, and appears inassociation with paralysis of the lower extremities.In vessical paralysis of a peripheric origin, combinedwith cntaneous adynia, from suspended innervation of thedetrusor muscle, I have never observed any symptom ofammoniaemia, but this disease occasionally appears under avery obstinate form in conjunction with dysentery. Thensecale oornutum is the remedy.In all these remarks there is nothing particularly new : Ihave only collected and arranged under a system what waswell known to Boerhaave, Morgagni, Van Swieten, Stoll,Lentin, P. Frank, Soemmering, and others. That they explainedthe symptoms they observed as urinary metastases,don't matter.Although it was not my purpose to give a complete and