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STRAUB, M.D. G IVING in plain view, on one side of the sheet 74 x 10 inches, the Clinical Record of the sick, including Date, Name, Residence, Occupation, Symptoms, Inspection (Auscultation and Percussion), History, Respiration, Pulse, Temperature, Diagnosis, Prognosis, Treatment (special and general), and Remarks, all conveniently arranged, and with ample room for recording, at each call, for four different calls, each item named above, the whole forming a clinical history of individual cases of great value to every Practitioner. Published in stiff Board Tablets of 50 sheets each, at 50 cts. net per tablet, and in Book-form, flexible binding, with Alphabetical Marginal Index, at 75 cts. net. THE F. A. DAVIS COMPANY, Publishers, 1914-16 CHERRY ST., PHILADELPHIA, PA. Professor of Physiology in the Medico-Chirurgical College of a cannula was inserted and connected with a Philadelphia. burette filled with a warm, weak, saline solurhythmic action of the uterus, vagina, tion. The top of the burette was connected THE thy, maghragm, find, under certain by rubber tubing to Ellis's piston-recorder, conditions, of the sphincters, is well known. With the exception of the sphincters, these movements are chiefly due to an action of the muscular fibre itself and its contained ganglia. Now, when a cat's bladder is distended by a weak saline solution at a temperature above 70° F. there ensues a series of contractions which at least continue several hours. They are increased by heat and diminished by They continue after division and destruction of the spinal cord from the dorsal segment downward by means of a wire repeatedly thrust down it. At times the bladder makes a very great contraction, which is usually made up of a series of contractions, each gradually going higher, but receding a little after each contraction, so that it makes a step-like series of contractions represented in Fig. 1, Exp. 27, which was obtained during faradic irritation of the sciatic nerve, but happens quite as well in normal conditions. Not only is there a step-doses per jugular. It greatly increased the like ascent, but a descent by steps is also seen. extent of the contractions even when the Faradic irritation of the sciatic does not have spinal cord was destroyed from the dorsal segany inhibitory power over these rhythmic ac- ment downward (experiment 9). Ergotine, tions. Galvanism, by means of sponge electrodes curare, and (experiment 17) strychnia, in doses applied to the bladder, causes a prolonged of grain per jugular, also augmented the tonic contraction, as is seen in Fig. 2, Exp. 27. height of the contractions even when the It occurred to me that these rhythmic actions | lumbar cord was destroyed (experiment 19). which wrote the contraction upon the smoked drum of Ludwig's kymographion, moved by the hand. In the study of the action of potash and lactic acid they were not injected, but mixed with warm water in the burette and then run into the bladder. A compress of absorbent cotton soaked with the solution was also permitted to lie on the bladder. Some expericold.ments were made to determine the normal rhythm of the bladder, and, whilst there was some irregularity about it, yet the marked results of drugs enabled us to draw definite conclusions as to their effects. We generally took a five minute group of contractions for several periods and then compared the number and contraction-height with those occasioned by the drug. The wellknown effect of ergot on unstriped fibre of the uterus led us to try it upon the bladder. I used both ergotine and ergotole in six-drop Atropine, in quantities of grain, also in- | together, it is highly probable that the creased the contractions in height (experi- rhythmic actions of the bladder are dependent ment 20). Lactic acid and potash also increased the height of the contractions. But, of all these agents, ergotine and potash were the most active in increasing the activity of the rhythmic contraction of the bladder. Now, in cases of prostatic obstruction and normally with a full bladder we have these rhythmic contractions. In the patients with prostatic obstruction they com plain of a "heaving up" by the bladder, as they express it. Now, ergot has been empirically given in cases of prostatic obstruction, on the theory that it produces an anæmia of the prostate and contraction of the unstriped fibre of the gland. These experiments show that it has a powerful action on the bladder,probably on its unstriated muscles, for it is a great stimulant of unstriped muscle elsewhere. But these experiments reveal the powerful action of potash upon the contractions of the bladder, an action equal to, if not greater than, that of ergot. in Minutes. 6 gtt. of ergotole per jugular. 334 3∞∞ Sum of Heights of Vesical Contractions for Five Minutes, in Millimetres. II 160 Air Temp. 70 Air Temp. 69 30 168 35 93 40 4 219 45 186 50 8 316 55 8 36 179 The question now arises: Upon what part do these agents act? Frommel,* in his experiments upon the rhythmic contractions of the uterus of the rabbit, found that they continued when it was completely isolated from nervecentres. Jastreboff,† in a study of the contractions of a rabbit's vagina, arrived at the conclusion that the rhythmic action lay in the nerve ganglia seated in the muscular structure of the vagina. Langley and Anderson have confirmed Sokownin's discovery that the inferior mesenteric ganglion is the seat of reflexes for the bladder. Now, these experiments lead us to regard the vesical rhythmic movements to in Minutes. be due to extra or intra- vesical ganglia acting upon the unstriped muscle; and, as in From mel's and Jastreboff's experiments they were due either to involuntary muscular fibre, or to ganglia seated in them, or to both acting * Du Bois's Archiv, 1883. Du Bois's Archiv, 1884. grain of atropine per jugular. EXPERIMENT 19. Cat Time, Air Temp. 70 |