Inability to Hold the Urine. Enuresis.
This complaint, generally called incontinence of the urine, is quite common among children. In some cases the child has no ability to hold its water at any time; but generally it is only passed off involuntarily at night while in bed. In adult life it is less frequently met with, except among the old.
Causes. Irritation of the roots of the spinal nerves which go to the bladder, mechanical injuries of the bladder, palsy of the bladder, particularly in old people, debility of the neck of the bladder, a general weakness of the nervous system, worms in the bowels, piles, whites, gravel or stones in the bladder, long prepuce in boys, etc.
Treatment. As a general rule, the change of constitution which occurs at puberty cures this complaint. But as this does not always happen, it is important that parents do everything in their power to break it up early, lest it become an affliction for life.
Children who suffer from this disorder are apt to drink largely. This habit should be restrained. But little drink should be allowed, whatever the desire for it. Care should be taken that the child make water before going to bed, also that it be aroused at a late hour for the same purpose, and that the foot of the bed be elevated so as to draw the urine away from the neck of the bladder.
The skin should be washed all over, every day, with cool or cold water, and vigorously rubbed with a coarse towel. This will cause the excess of fluids to pass off through the skin, and lessen the action of the kidneys.
In some instances children urinate in bed through carelessness, being half conscious of what is occurring, but not caring enough to rouse themselves. In such cases, they are often cured by some decided correction, the impending act of passing water connecting itself in their mind with the correction, and recalling them instantly to full consciousness. Of course this mode of relief should be resorted to with great judgment and caution.
Ergotin in 1 grain dose given two or three times a day or a mixture containing 15 drops of the fluid extract of ergot or 10 drops of the tincture of belladonna given in water, morning and night are the best remedies. When any disturbances of the eyes are complained of, belladonna must be stopped.
If the disorder be caused by irritation of the spinal nerves, cold water douched upon the back, or croton oil rubbed along the spine, or a warm stimulating or irritating plaster upon the lower part of the back, will be required. The electromagnetic machine may do well in some cases.
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