Book 2
4
OF the diseases in the bladder no one is mild: the acute proving fatal by inflammation, wounds, spasm, and acute fevers; while an ulcer, abcess, paralysis, or a large stone, are chronic and incurable. For it (a large stone?) can neither be broken by a draught, nor by medicine, nor scraped outwardly, nor cut without danger. For the small ones of the bladder are to be cut out, but the other proves fatal the same day, or in a few days, the patients dying from spasms and fevers; or, if you do not cut him, retention of the urine takes place, and the patient is consumed slowly with pains, fevers, and wasting. But if the stone is not very large, there is frequent suppression of urine; for by falling readily into the neck of the bladder, it prevents the escape of the urine. Although it be safer to cut in these cases than for the large stones, still the bladder is cut; and although one should escape the risk of death, still there is a constant drain of water; and although this may not be dangerous, to a freeman the incessant flow of urine is intolerable, whether he walk or whether he sleep; but is particularly disagreeable when he walks. The very small ones are commonly cut without danger. If the stone adhere to the bladder, it may be detected with care; and, moreover, such cases prove troublesome from the pain and weight, even when there is no dysuria, but yet the patient may have difficulty of making water. You may diagnose all cases of stone by the sediments of sand in the urine, and, moreover, they have the genital parts enlarged by handling them; for when they make water, and there is a stone behind, they are pained, and grasp and drag the genital parts, as if with the intention of tearing out the stone along with the bladder. The fundament sympathises by becoming itchy, and the anus is protruded with the forcing and straining, from the sensation, as it were, of the passage of the stone. For the bladder and anus lie close to one another, and when either suffers, the other suffers likewise. Wherefore, in inflammations of the rectum, the bladder is affected with ischuria; and in acute pains of the bladder, the anus passes nothing, even when the bowels are not much dried up. Such are the sufferings connected with calculi.
