Cystitis in women : with report of forty-five cases, studied cystoscopically and some modifications of treatment / by Ellice McDonald.

  • McDonald, Ellice, 1876-1955.
Date:
[1908]
Catalogue details

Licence: In copyright

Credit: Cystitis in women : with report of forty-five cases, studied cystoscopically and some modifications of treatment / by Ellice McDonald. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

    13/26 (page 11)
    mation of the trigone, or trigonitis, is usually one which results from a simple hyperemia and conges- tion of the vessels; actual infection may precede or follow the congestion. The line of separation between chronic congestion and chronic inflamma- tion of the trigone is often hard to determine. There is usually marked hyperemia with marked dilatation of the blood-vessels. The intimate rela- tion between the vesical arteries and those of the neighboring pelvic organs makes this very easy. The membrane loses its luster, the mucosa becomes reddened and there is evidence of flaky desquama- tion and exfoliation of epithelial cells, leucocytes, and pus. In a later stage, the mucosa of the trigone becomes velvety in appearance and, in some cases, there are proliferative processes, which may lead to papillary or papilloma-like excrescences. These cases of trigonitis show epithelial proliferation, marked round-celled infiltration, involving particu- larly the submucosa. In addition to these changes Heyman ® has drawn attention to a change in the epithelial elements from the normal bladder mucosa to flattened epithelium. The epithelium is thick- ened and papillary projections may rise above the surface. These processes may take alveolar arrange- ment below the level of the surface. In chronic cystitis, the changes are more gen- eral : the mucous membrane has lost its normal pinky white appearance, and appears more or less generally reddened. This reddening and inflamma- tion may appear generally or only in certain patches, and cases have been noted in this series, in which the inflammation extended in streaks along the line of the blood-vessels of the bladder wall. The mu- cosa is dull red in appearance and may here and there show small ulcerations. There is frequently