Retention of Urine.
This disorder is often confounded with suppression of the urine, but it is different in every respect. In suppression, the urine is ]:lot formed by the kidneys; in retention, it is formed, and, in some cases, poured into the bladder, but is retained on account of some inability to pass it.
lschuria. This is one of the forms of retention. In this complaint, the urine has passed from the kidneys to the bladder, but from some cause, generally palsy of the muscles of the bladder, it cannot be passed off. In this case, there is no pain, but the stream of water flows off with slower and slower pace, the patient having to make tiresome efforts with the abdominal muscles to get the bladder emptied. As the quantity discharged diminishes, the desire to urinate grows more urgent. Pressure just above the pubes gives pain, and the bladder feels under the hand like a large, hard tumor.
Dysuria. In this form of the complaint, the water is passed to some extent, but with pain and heat along the water pipe. This is generally caused by some inflammation along the urethra.
Strangury. In this the water is only passed drop by drop, and with great burning, scalding, and tenesmus in the neck of the bladder. When there is considerable inflammation, the skin becomes hot,,the pulse hard and quick, and the tongue covered with a white fur.
Causes. These several forms ' of the complaint are caused by palsy of the bladder, gonorrhea, inflammation in the neck of the bladder or the water pipe, mechanical injuries of the bladder in childbearing or otherwise, by tumors pressing upon it, by irritation from gravel or stone within its cavity, by stricture or partial closing up of the urethra, by disease of the prostate gland, by taking spirits of turpentine or cantharides, or by the absorption of this latter article when used as a blister.
Treatment. It is obviously necessary in this complaint, that treatment, in order to be of any avail, should be prompt; for when the retention is complete, the bladder will burst in from two to five days, and cause the death of the patient.
The treatment must vary according to the cause of the retention.
If it be caused by palsy of the bladder, the common flexible catheter must be used daily until the muscular fibers recover their lost power. When much irritation is caused by introducing it, it is better not to withdraw it, but to close its external orifice with a small plug, which the patient can remove as often as necessary to let off the urine. To remove the paralysis, the electromagnetic machine is worth a trial, the current being passed through the bladder. At the same time let the patient take strychnia (86), (86), (83), (95). Cantharides, in the form of tincture, or in connection with strychnia (291), is often used.
If the retention is caused by inflammation of the neck of the bladder, heat should be applied to the perineum, and three or four drops of croton oil may be rubbed on just above the pubes to bring out an eruption. Warm fomentations will also be serviceable, and warm hipbaths. Cooling diuretics, as infusions of marshmallow, cleavers, pumpkinseeds, buchu, sweet spirits of nitre, etc , must not be omitted.
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