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Chronic imflammation of the bladder is practically always due to microörganisms, the one most often encountered being the bacillus coli communis, which exists normally in such abundance in the intestinal canal. The gonococcus, the tubercle bacillus, the typhoid bacillus, the various pyogenic bacteria, etc., are also frequently found. It should never be forgotten that it is not a calculus, an enlarged prostate. a tumor, or a quantity of residual urine which is the direct cause of an inflammation, but the bacteria which have in some manner gained entrance to the bladder in presence of these conditions. Even a cancer does not produce inflammatory symptoms until infection has taken place. I had recently under my care an old gentleman with vesical carcinoma, whose urine remained free from pus for a considerable time after the growth began. It is possible for germs to enter the bladder through the kidneys, the urethra, and
FREEMAN L. THE TREATMENT OF CHRONIC INFLAMMATION OF THE BLADDER, WITH REPORTS OF TWO CASES OF CONGENITAL DIVERTICULA.. JAMA. 1896;XXVII(15):804–807. doi:10.1001/jama.1896.02430930024002f