Page 197, after line 8, please to add_, 'Where the difficulty of breathing
is very urgent in the croup, bronchotomy is recommended by Mr. Field.'
Memoir of a Medical Society, London, 1773, Vol. IV.

* * * * *

ADDITION.

* * * * *

INABILITY TO EMPTY THE BLADDER.

To be introduced at the end of Class III. 2. 1. 6. on Paralysis Vesicae
Urinariae.

An inability to empty the bladder frequently occurs to elderly men, and is
often fatal. This sometimes arises from their having too long been
restrained from making water from accidental confinement in public society,
or otherwise; whence the bladder has become so far distended as to become
paralytic; and not only this, but the neck of the bladder has become
contracted so as to resist the introduction of the catheter. In this
deplorable case it has frequently happened, that the forcible efforts to
introduce the catheter have perforated the urethra; and the instrument has
been supposed to pass into the bladder when it has only passed into the
cellular membrane along the side of it; of which I believe I have seen two
or three instances; and afterwards the part has become so much inflamed as
to render the introduction of the catheter into the bladder impracticable.

In this situation the patients are in imminent danger, and some have
advised a trocar to be introduced into the bladder from the rectum; which I
believe is generally followed by an incurable ulcer. One patient, whom I
saw in this situation, began to make a spoonful of water after six or seven
days, and gradually in a few days emptied his bladder to about half its
size, and recovered; but I believe he never afterwards was able completely
to evacuate it.

In this situation I lately advised about two pounds of crude quicksilver to
be poured down a glass tube, which was part of a barometer tube, drawn less
at one end, and about two feet long, into the urethra, as the patient lay
on his back; which I had previously performed upon a horse; this easily
passed, as was supposed, into the bladder; on standing erect it did not
return, but on kneeling down, and lying horizontally on his hands, the
mercury readily returned; and on this account it was believed to have
passed into the bladder, as it so easily returned, when the neck of the
bladder was lower than the fundus of it. But nevertheless as no urine
followed the mercury, though the bladder was violently