Rupture of Bladder from Kick by a Bullock

Sik.?One Subharan cultivator, aged about 30 years, was admitted into this dispensary on the 21st June 1908 with the following history :? On the 15th June at about 4 A.M., while feeding his bullocks, he approached one bullock from behind with the fodder in his arms. The bullock kicked him on the pubes. He fell down and remained unconscious for a few minutes on account of acute pain caused by the injury. At the time of injury his bladder was full, as he had uot passed urine since before retiring to rest. He treated himself locally with fomentations and other household remedies. After the injury he passed mine drop by drop until the 6th day, when retention took place, for which condition he sought advice. On admission the penis was found to be very much swollen, the swelling having extended down to the prepuce, and caused marked phimosis. Over the pubes there was a swelling about the size of a cricket ball boggy in feel, the skin over it being livid. A soft catheter No. 9 was passed with great difficulty, and clear but offensive urine was drawn otf. Next morning the swelling on the pubes was incised and gave vent to stinking urine and breaking down bloodclots. After this there was a continuous flow of urine from the wound, no urine being passed per uretliram. On the morning of the 23rd (on the 9tli day) the Civil Surgeon, Major W. D Sutherland, saw him and decided to operate as it was evident that rupture of the bladder, probably extraperitoneal, had occurred. The parts were much congested and hemorrhage was profuse, and controlled with some difficulty, The ruptured spot in the bladder wall could not be detected, so the Cavura Retzii was plugged with gauze and the wound treated by the open method. The inflamed tissues sloughed and left a large granulating surface in the hypogastrium and over the pubes which slowly healed, a few skin grafts being applied, The patient passed urine through the wound until the 1st of August, and was discharged cured having been in hospital for 52 days. This case appears to be of interest owing to the long period passed before active treatment was applied. The temperature chart showed that