Account of the history and dissection of a case of malformation of the urinary bladder, with remarks / [Andrew Melville McWhinnie].
- McWhinnie, Andrew Melville, 1807 or 1808-1866.
- Date:
- [1850]
Licence: Public Domain Mark
Credit: Account of the history and dissection of a case of malformation of the urinary bladder, with remarks / [Andrew Melville McWhinnie]. Source: Wellcome Collection.
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![includes this well-known instance when he says:—“ Si Ton excepte an plus deux cas publies jusqu’a ce jour, la symphise est toujours plus ou moins imparfaitement fermee.” That tills absence of symphisis, and separation of the bones to a great ex¬ tent, may, on the other hand, be inde¬ pendent of any abnormal condition of the bladder, or even fissure in the integu¬ ments over that viscus, is proved by a specimen which was obligingly shown me by Mr. Mayo, of Winchester, and afterwards published by him in vol. ix. of the Provincial Medical and Surgical Journal. The subject was a woman, aged 29, who suffered from urinary cal¬ culus, and died from disease of the kidneys. Here the bladder, which contained a large stone, was perfect, hut the exter¬ nal organs of generation were defective. The ossa pubis were separated to the extent of five inches. Between the spines (which were seven inches apart) was stretched a ligamentous band, simi¬ lar to that in fig. 4, but half an inch in breadth. As Mr. Mayo observes, this state of the pelvis bears a resemblance to that of the female guinea-pig towards the end of pregnancy.* In the hypogastric region, just above this ligamentous band, (and in the situation occupied by the prolapsed malformed bladder, when it exists), “ an oblong pouch presented itself, and which appeared to be the result of the divergence of the recti muscles, whose tendons were inserted into the separated angles of the symphisis, and thus left the anterior part of the abdomen with¬ out any other protection than the skin and fascia, and the peritoneum which lined the pouch.” The model of the parts before dissection, together with the pelvis itself, are preserved in the Hunterian Museum. In speculating upon the nature and origin of the various deviations from their natural structure to which these parts are liable, and how far they may severally be considered in then- relation * In birds destitute throughout the class of a urinary bladder, the open condition of the pelvis is almost universal. The pubic bones in the two-toed sloth are permanently separated, and connected by a strong ligament, the bladder being perfect. In the mole, whose pelvis will scarcely admit a small probe, the ossa pubis unite to enclose the caudal vessels only, forming a simple haemal arch. to each other, as cause and effect,* the condition of the pelvis here described, unassociated as it was with any corre¬ sponding defect in the bladder, must be regarded with interest, and is directly opposed to some of the hypotheses which have been framed and supported by intelligent writers. Professor W. Vrolik, in his work, “ Sur quelques Sujets Interessants d’Anato- mie et Physiologic,” gives the details of a casef in which, although the pubic hones were separated, the bladder re¬ tained its integrity; but its anterior wall projected through a fissure in the abdominal parietes. In a preceding memoir]; the author had attempted a classification of these deformities, ac¬ cording to their degree, and observes— “ Que l’infirmite dans l’etat ou je viens de la decrire doit figurer la premiere dans une classification methodique des extroversions, comme etant le plus foible degre de I alteration, qui faisant des progres successifs, finit par constituer cette maladie sous ses differentes formes.” In the example furnished by Mr. Mayo there was a still minor degree of deviation from the natural state of the parts in the hypogastric region; for not only was the bladder entire, hut the in¬ teguments, fascia, and peritoneum covered the fissure between the abdomi¬ nal muscles, forming a kind of hernial sac in this situation.§ As regards the frequency in the oc¬ currence of th ese malformations of the bladder, it is sufficiently great to excite the interest of the profession generally. Nine cases, of which two were female, have fallen under my own observation. Of known and recorded examples, Isi¬ dore G. St. Hilaire says that a fourth * Cette accordance remarquable qu’expliquent parfaitement les organs sexuels avec les pubes, est une premiere preuve de la Constance du rap¬ port gdndral que jeddmontrerai plus tard exister entre les vices de conformations des parties molles et l’dtat de ddveloppement du systeme osseux.”—Isidore G. St. Hilaire, loc. cit. f Sur un vice de conformation accompagnde de la denudation de la moitid antdrieure de la vessie et de la division partielle du penis.” Also figured by the Professor in the Cyc. of Anat. and Phys. art. Teratology, fig. 605. t In the same volume—“ Mdmoire sur une extroversion accompagnee d’une portion re- tournde de l’intestin gr£le qui a perform la paroi posterieure de la vessie.” § The pelvis represented in fig. 4 is possibly the specimen described by Walter, in his work, Yon der Spaltung der Schaambeine, Berlin, 1782, and referred to by Vrolik and Meckel; and would, if it be the identical one, afford another proof that the symphisis may be defective with¬ out the existence of extrovers io vesicae.](https://iiif.wellcomecollection.org/image/b30384837_0006.jp2/full/800%2C/0/default.jpg)
