NEURALGIAS OF ME FEMALE URETHRA.
They were formerly con sidered independent affections more frequently than is really the case, perhaps because the pain and spasm occasioned by catheterization was referred to the nerves in default of a more exact diagnosis. Ohlshausen believes that both Scanzoni and I confounded the angular bending of the urethra caused by the descent of the pregnant uterus with spasm of the organ. This may be the case. But it is hardly to be doubted that the female urethral mucous membrane does occasionally show hyper sensibility without demonstrable organic disease; and also that after very careful introduction of the catheter, and, 8,s Scanzoni has observed, after cohabitation in the newly-married, the urethra does sometimes become the seat of a painful spasmodic contraction. So also certain states of the urine may affect the urethral mucous membrane and. cause spasm, exactly as it occasionally does in men after drinking sour wines or beers, or an exposure to cold. But, of course, local irritations will always remain the most important cause of such hypertesthesias. A most thorough local examination, if necessary with dilatation and palpation and inspection of the urethral mucous membrane, must be undertaken. The diagnosis of a pure neurosis should not be lightly made.
Neuralgia can only be diagnosticated when none of the affections which we have previously described as causing abnormal sensations and sins modic contractions of the organ are present. Locally we can use luke warm or warm sitz-baths, vaginal injections of hot water, suppositories of cocao butter with extr. belladonna3 (gr. iv. i) or ext. hyoscyam. (gr. x— i), or morphine, (gr. ii— i). Besides this, bougies with extr. opii or morphine may be placed in the urethra, or rectal injections of linseed tea ( 5 ii with 10 to 20 drops of tra. thebaica) given to relieve the pain. A solution of chloral (1 to 50) has been used per rectum for the same purpose.
If the urine irritates very much, mucilaginous drinks or camomile or orange blossom teas may be drank. It is useful also to give hourly tea spoonful doses containing extr. hyoscyam gr. j. or extr. opii gr. it to I in emulsio amygdalina. Lupulin, with or without opium, 3 to 4i gra. taken several times a day, and the tincture of cannabis indica 10 to 15 drops F.S. are to be recommended. The new local anmsthetic cocain ought to do good service in these eases; it should be applied to the mucous membrane with a brush.