BOOK 4

Ed. Chart. VII. [381.] Ed. Bas. III. (249. 250.)

...choice, but the action of the bladder is involuntary and natural. It has been demonstrated in my commentaries On the Natural Faculties Galen refers here to his earlier work, "De naturalibus facultatibus," which describes how organs function through innate powers. that almost all parts of the body possess an expulsive faculty The biological power to drive out waste. Original: "ἀποκριτικὴν δυνάμιν" / "facultatem expultricem." for waste products. All parts possess this power constantly, but they only use it when they are irritated by the presence of those waste products.

Therefore, when this expulsive power fails, the condition called ischuria The medical term for the inability to pass urine. Original: "ἰσχουρίαν" / "urinae suppressionem." can sometimes occur. However, if you position the patient so that the neck of the bladder is tilted downward and you apply pressure with your hands to the unnatural swelling, the urine will be discharged. If you do these things and no more urine is produced, you must abandon the idea that paralysis A loss of function in the nerves or muscles. Original: "παράλυσιν." is the cause. Instead, you should suspect that the urethra The tube through which urine is discharged. Original: "οὐρήθραν." is blocked.

This is because if the muscle surrounding the urethra is paralyzed, it does not cause a suppression of urine. Rather, it causes the

involuntary emptying of the urine. Therefore, we must next consider in how many ways the passage of the neck of the bladder, which they call the urethra, can become blocked. I believe there are three ways in total. The first is when the tissue of the passage itself rises into an unnatural swelling so large that the passage is closed off by it; or when...