[334] _Galen_, De symptom. caus. bk. III. ch. 8., ἴσχονται μὲν γὰρ ἢ ἀδυνατούσης ἐκκρίνειν τῆς κύστεως, ἢ στεγνωθέντος αὐτῆς, τοῦ στομάχου· ταυτὶ μὲν οὖν ἄμφω τὰ νοσήματα τῆς κύστεως ἓν κοινὸν ἔχει σύμπτωμα, τὴν ἰσχουρίαν·—αἱ μὲν οὖν _στεγνώσεις_ τοῦ στομάχου δι᾽ ἔμφραξίν τε καὶ _μύσιν_ ἀποτελοῦνται· καὶ γίνεται ἡ μὲν _ἔμφραξις_ ὑπὸ θρόμβου τε καὶ πύου παχέος καὶ λίθου καὶ πώρου καὶ διὰ _βλάστημά_ τι κατ’ αὐτὸν ἐπιτραφὲν τὸν πόρον ὁποῖα κἀν τοῖς ἄλλοις ἅπασιν ἐκτὸς ὁρᾶται γινόμενα κατά τε τὰ ὦτα καὶ ῥῖνας _αἰδοῖά_ τε καὶ ἕδραν· ἡ δὲ _μύσις_ ἤτοι δι’ ὄγκον ἐπὶ φλεγμοναῖς ἀποτελεῖται καὶ _σκίῤῥοις_ καὶ τοῖς ἄλλοις οἰδήμασιν, ὅσα τε τὸν τράχηλον ἐξαίροντα τῆς κύστεως εἰς τὸν ἐντὸς πόρον ἀποχεῖ τὸν ὄγκον. (For they suffer either because the bladder is unable to secrete or because its orifice is stopped; but both these complaints of the bladder have one symptom in common, viz. retention of urine.... Now the _stoppages_ of the orifice are produced by _blocking_ or by _closing up_; and stoppages are caused by a clot or dense matter or a calculus or chalkstone or some growth that has formed in the actual passage, as is also observed to occur in other, external, organs, the ears, the nostrils, genitals, or fundament; but closure is due either to a tumour following on phlegmonous affections or by indurations or other swellings which dilate the neck of the bladder and discharge the tumour into the internal passage). Comp. _Caelius Aurelianus_ bk. V. ch. 4. [335] _Galen_, De loc. affect. bk. I. ch. 1. (VIII. p. 12.), οὕτω δὲ εἰ καὶ σάρκα τινὰ δι᾽ ἕλκωσιν ἐπιτραφεῖσαν ἡγούμεθα τὸν τράχηλον τῆς κύστεως ἐμφράττειν, ἔκ τε τῶν προηγησαμένων τοῦ ἕλκους σημείων ἔκ τε τοῦ κενωθῆναι τὸ οὖρον ἐπὶ τῷ _καθετηρι_ συλλογιούμεθα· καί ποτε καὶ γενόμενον οἶδα τοιοῦτόν τι πάθημα· διαβαλλομένου γοῦν τοῦ καθετῆρος, ἤλγησεν κατ’ ἐκεῖνο τοῦ πόρου τὸ μέρος, ἔνθα καὶ πρότερον ἐτεκμηράμεθα τὴν ἕλκωσιν εἶναι· _θλασθείσης δὲ τῆς σαρκὸς ὑπὸ τοῦ καθετῆρος_, ἠκολούθησε μὲν μετὰ τὴν τῶν οὔρων ἔκκρισιν αἵματός τέ τι καὶ θρύμματα τῆς σαρκός· ... τὸ δ’ εἴτε πάθος εἶναι λεκτέον τοῦ πόρου τὸ γεγονός, εἶτε αἴτιον ἰσχουρίας ἐν τῷ πόρῳ περιέχεσθαι, τῶν ἀχρήστων εἰς τὴν τέχνην ἐστίν. (Accordingly if we suspect some accretion of tissue, the result of ulceration, to be blocking the neck of the bladder, our diagnosis will depend both on the foregoing signs of the existence of an ulcer and also on the fact of the urine being voided on the introduction of a _catheter_. Sometimes moreover I have noted the following case to occur; on turning the catheter about pain was experienced at the part of the canal where we had previously conjectured the ulceration to be situated, and the tissue being broken down by the catheter, there followed after the evacuation of the urine some blood and particles of tissue.... Whether in this case we ought to describe the mischief as something affecting the urethral canal, or say that the cause is something lying in the same canal, is scientifically unimportant).