It was afterward elicited that the patient had practiced urethral masturbation with the tail of this animal. Morand relates the history of a man of sixty-two who introduced a sprig of wheat into his urethra for a supposed therapeutic purpose. It slipped into the bladder and there formed the nucleus of a cluster calculus. Dayot reports a similar formation from the introduction of the stem of a plant. Terrilon describes the case of a man of fifty-four who introduced a pencil into his urethra. The body rested fifteen days in this canal, and then passed into the bladder. On the twenty-eighth day he had a chill, and during two days made successive attempts to break the pencil. Following each attempt he had a violent chill and intense evening fever. On the thirty-third day Terrilon removed the pencil by operation.
Symptoms of perivesical abscess were present, and seventeen days after the operation, and fifty days after the introduction of the pencil, the patient died. Caudmont mentions a man of twenty-six who introduced a pencil-case into his urethra, from whence it passed into his bladder. It rested about four years in this organ before violent symptoms developed. Perforation of the bladder took place, and the patient died. Poulet mentions the case of a man of seventy-eight, in whose bladder a metallic sound was broken off. The fractured piece of sound, which measured 17 cm.
in length, made its exit from the anus, and the patient recovered. Wheeler reports the case of a man of twenty-one who passed a button-hook into his anus, from whence it escaped into his bladder. The hook, which was subsequently spontaneously passed, measured 2 1/2 inches in length and 1/2 inch in diameter.
Among females, whose urethrae are short and dilatable, foreign bodies are often found in the bladder, and it is quite common for smaller articles of the toilet, such as hair-pins, to be introduced into the bladder, and there form calculi. Whiteside describes a case in which a foreign body introduced into the bladder was mistaken for pregnancy, and giving rise to corresponding symptoms. The patient was a young girl of seventeen who had several times missed her menstruation, and who was considered pregnant. The abdomen was more developed than usual in a young woman. The breasts were voluminous, and the nipples surrounded by a somber areola. At certain periods after the cessation of menstruation, she had incontinence of urine, and had also repeatedly vomited. The urine was of high specific gravity, albuminous, alkaline, and exhaled a disagreeable odor. In spite of the signs of pregnancy already noted, palpitation and percussion did not show any augmentation in the size of the uterus, but the introduction of a catheter into the bladder showed the existence of a large calculus. Under chloroform the calculus and its nucleus were disengaged, and proved to be the handle of a tooth-brush, the exact size of which is represented in the accompanying illustration. The handle was covered with calcareous deposits, and was tightly fixed in the bladder. At first the young woman would give no explanation for its presence, but afterward explained that she had several times used this instrument for relief in retention of urine, and one day it had fallen into the bladder. A short time after the operation menstruation returned for the first time in seven months, and was afterward normal. Bigelow reports the case of a woman who habitually introduced hair-pins and common pins into her bladder.
She acquired this mania after an attempt at dilatation of the urethra in the relief of an obstinate case of strangury. Rode reports the case of a woman who had introduced a hog's penis into her urethra. It was removed by an incision into this canal, but the patient died in five days of septicemia. There is a curious case quoted of a young domestic of fourteen who was first seen suffering with pain in the sides of the genital organs, retention of urine, and violent tenesmus. She was examined by a midwife who found nothing, but on the following day the patient felt it necessary to go to bed. Her general symptoms persisted, and meanwhile the bladder became much distended. The patient had made allusion to the loss of a hair-pin, a circumstance which corresponded with the beginning of her trouble. Examination showed the orifice of the urethra to be swollen and painful to the touch, and from its canal a hair-pin 6.5 cm. long was extracted. The patient was unable to urinate, and it was necessary to resort to catheterization. By evening the general symptoms had disappeared, and the next day the patient urinated as usual.
There are peculiar cases of hair in the bladder, in which all history as to the method of entrance is denied, and which leave as the only explanation the possibility that the bladder was in communication with some dermoid cyst. Hamelin mentions a case of this nature. It is said that all his life Sir William Elliot was annoyed by passing hairs in urination. They would lodge in the urethra and cause constant irritation. At his death a stone was taken from the bladder, covered with scurf and hair. Hall relates the case of a woman of sixty, from whose bladder, by dilatation of the urethra, was removed a bundle of hairs two inches long, which, Hall says, without a doubt had grown from the vesical walls.
