de. The
first patient died in five days and the second in two days after the
onset of the illness. At the autopsies the rent was found to be in both
instances in the posterior wall of the bladder a short distance from
the fundus; the peritoneum was not inflamed, and there was absolutely
no inflammatory reaction in the vesical wound. From the statistics of
Ferraton and Rivington it seems that rupture of the bladder is more
common in intoxicated persons than in others--a fact that is probably
explained by a tendency to over-distention of the bladder which
alcoholic liquors bring about. The liquor imbibed increases the amount
of urine, and the state of blunted consciousness makes the call to
empty the bladder less appreciated. The intoxicated person is also
liable to falls, and is not so likely to protect himself in falling as
a sober person.

Gunshot Wounds of the Bladder.--Jackson relates the remarkable recovery
of a private in the 17th Tennessee Regiment who was shot in the pelvis
at the battle of Mill Springs or Fishing Creek, Ky. He was left
supposedly mortally wounded on the field, but was eventually picked up,
and before receiving any treatment hauled 164 miles, over mountainous
roads in the midst of winter and in a wagon without springs. His urine
and excretions passed out through the wounds for several weeks and
several pieces of bone came away. The two openings eventually healed,
but for twenty-two months he passed pieces of bone by the natural
channels.

Eve records the case of a private in the Fifth Tennessee Cavalry who
was shot in the right gluteal region, the bullet penetrating the
bladder and making its exit through the pubis. He rode 30 miles, during
which the urine passed through the wound. Urine was afterward voided
through the left pubic opening, and spicules of bone were discharged
for two years afterward; ultimate recovery ensued.

Barkesdale relates the history of the case of a Confederate soldier who
was shot at Fredericksburg in the median line of the body, 1 1/2 inches
above the symphysis, the wound of exit being in the median line at the
back, 1/2 inch lower down. Urine escaped from both wounds and through
the urethra. There were no bad symptoms, and the wounds healed in four
weeks.

The bladder is not always injured by penetration of the abdominal wall,
but may be wounded by penetration through the anus or vagina, or even
by an instrument entering the buttocks and passing through the small