During the first month urine passed freely through the wounds
made by the entrance and exit of the ball, and was generally
mixed with pus and blood. Fecal matter was frequently discharged
through the posterior wound. Some time during the third week he
passed several small pieces of bone by the rectum. At the end of
the fifth week the wound of exit healed, and for the first time
after his injury urine was discharged through the urethra. The
wound of entrance gradually closed after five months, but opened
again in a few weeks and continued, at varying intervals,
alternately closed and open until September, 1865. At this time,
on sounding the man, it was found that he had stone; this was
removed by lateral operation, and was found to weigh 2 1/4
ounces, having for its nucleus a piece of bone about 1/2 inch
long. Dougherty reports the operation of lithotomy, in which the
calculus removed was formed by incrustations about an iron
bullet.
In cases in which there is a fistula of the bladder the subject
may live for some time, in some cases passing excrement through
the urethra, in others, urine by the anus. These cases seem to
have been of particular interest to the older writers, and we
find the literature of the last century full of examples.
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