Acute Inflammation of the Bladder. Cystitis.
THIS disease affects the lining membrane of the bladder, sometimes its muscular substance. It may attack the upper portion, the middle, or the neck of this organ. It runs a rapid course.
Symptoms. Burning, piercing, and throbbing pain in the region of the bladder. The pain extends to the perineum, and in some cases, to the testicles and thighs, and is much increased by pressure. The perineum, the space between the fundament and testicles, feels sore to the touch. The desire to pass urine is incessant, but the effort to do so is mainly ineffectual. The water passes off drop by drop, with great pain, or is entirely stopped, causing enlargement of the bladder, and great distress. Mucus from the inflamed lining of the bladder passes off with the water. Nausea, vomiting, and great anxiety are common. The bowels are bound, and when the disease is on the side next the lower bowel, there is a desire to empty the bowels; and if the inflammation be in the neck, there is great pain in the perineum, and frequently an entire retention of the water. The pulse is full, hard, and frequent, the skin hot and dry, the thirst urgent, and the patient restless and dejected.
Causes. This disease may be produced by taking cantharides and turpentine; by irritating substances forced into the bladder with a syringe, or by pushing bougies or catheters into it; by gravestones in the bladder; by retained urine; by external injuries; by gonorrhea; and by cold applied to the feet, or to the lower portion of the abdomen.
Treatment. If the urine be retained, it is of the utmost importance that it be early drawn off with the catheter, lest a distention of the bladder bring on mortification. Great care is required not to produce irritation by any roughness in introducing the instrument.
Poultices should be applied upon the lower part of the bowels and perineum. Cold compresses will often do as well. The bowels must be opened with Epsom salts. Injections of warm water, with a few drops of tincture of arnica leaves, will act finely as a local bath, the water being retained as long as possible.
The tincture of veratrum viride will be required in five to ten drop doses, or the compound tincture of Virginia snakeroot, to induce perspiration. Ex. jaborandi may sometimes be used for the same purpose.
Drinks must be taken very sparingly. A small amount of cold infusion of slippery elm bark, or marshmallow and peach leaves, or cleavers. This mucilaginous drink must be the beginning and the end of the diet during the active stage of the disease. Alkalis are exceedingly useful in allaying the pain and smarting of urination, perhaps the best remedy being liquid potass. citratis, in tablespoonful doses every two hours. Suppositories of opium and belladonna in one fourth grain doses by the rectum every two to four hours allay the frequent urination and pain and quiet the spasm of the neck of the bladder.
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