DOI: 10.7925/drs1.ucdlib_280117
title: Malignant disease of the bladder

description: Watercolour medical illustration depicting malignant disease of the bladder. It has the alternative reference number 1218, 3 and P6A on the front. The Richmond Hospital Museum reference is A.b.1. The entry for this in P263/1 pg. 6 reads 'Malignant disease of the bladder. Aet 60 Dr Hutton'.
description: Scope and content: The typed note on the back reads 'Malignant disease of the bladder. Dr Hutton brought under the notice of the Society a specimen illustrative of cerebriform disease of the bladder. The patient, a man of sallow and emaciated appearance, about sixty years of age, was admitted into the Richmond Hospital upon the 29th of November last, complaining of symptoms very analogous to those of prostatic disease. He had great irritability of the bladder, being obliged to leave his bed to pass water as often as twenty times during a single night, voiding on each occasion but a very small quantity of dark-coloured urine, mixed with mucus and clots of blood. When making water, he also complained of having pain along the course of the ureters, and across the hypogastric region. Upon examining the prostate gland it did not appear to have undergone any sensible degree of enlargement, but a soft spot could be felt in the gland, between the lateral lobes, which gave rise to the supposition that the middle lobe was probably the seat of an abscess. It was, therefore, regarded as a case of prostatic disease affecting the middle lobe of the gland, attended with catarrh of the bladder. The usual remedies for a case of this description were employed, and, strange to say, with temporary good effect, as often as they were adopted. After some time he became unable to empty the bladder without at the same time going to stool, when he succeeded in passing urine in very small quantities only, and with considerable straining and tenesmus, the flow being preceded on almost every occasion by the expulsion of small clots or drops of blood. After being under treatment for some time the quantity of the urine underwent a considerable diminution, and the patient, who previously made water fifteen or twenty times in the night, now micturated but four or five times only in the same period. Shortly after his admission the sediment contained in the urine was examined under the microscope, and found to contain a large number of the crystals of the triple phosphate of ammonia, mixed with globules of blood and mucus, but there were no traces of the nucleated cells of malignant disease. The man now began to become more and more emaciated every day, and finally he sank and died about a week ago. Autopsy: After death an examination was made of the whole urinary apparatus. The kidneys were extremely small, but at the same time healthy, so far as their cortical and tubular structure was concerned. The pelvis of each organ was, however, considerably dilated, as were also the ureters. The latter were not, however, in the least degree obstructed. Upon opening the bladder a tumour was observed, chiefly occupying the right side of the organ; it filled up fully half of the bladder, and presented a well-marked specimen of encephaloid disease; portions of it were so soft as to be almost ulcerated, and in many places in a state of slough; but not the slightest disease could be detected in the prostate gland. Dr Hutton exhibited an admirably executed drawing, taken from the recent specimen by Mr Conolly. Museum, Richmond Hospital'.
description: Numbering/sequence: Original reference number: 1218.
description: Date details: This illustration is undated, approximate dates are given based on dates for the entire collection.