BLADDER, Irritability of.
This may usually be regarded as the first symptom of a cystitis, and treated accordingly by the removal of the cause and the use of the agents and drugs discussed in the previous article. It must be remembered also that such reflex causes as displacements of the uterus, phimosis, adherent prepuce, threadworms, rectal fissures, ulcer, polypi, and Imnor rhoids may be producing frequency of mieturition. The removal of these will be soon followed by a disappearance of the irritable condition of the bladder. Sexual excess, probably by inducing prostate hyperiesthesia, is a not uncommon cause, and the symptoms rapidly subside as soon as abstinence is insisted upon. An irritating state of the urine may produce considerable frequency in micturit ion , as the writer has very often observed in cases of even mild glycosuria, and in the absence of bladder disease the secretion should always be examined for sugar.
Hyperacid urine is a frequent cause of irritability, and can be relieved by large doses of Bicarbonate of Soda or Potash. Phosphaturia with an alkaline or neutral urine also gives rise to this symptom. Hexamine (io grs.) combined with Acid. Sod. Phosph. (gr. xv.) thrice daily and regulation of the diet gives immediate relief.
A gouty urethritis is also often to be met with which yields to consti tutional treatment. Where the irritability is part of a neurosis, as is commonly the case in patients who suffer from severe insomnia, the treatment of the underlying condition is clearly indicated. In rare intractable cases where the irritability remains even after the removal of the primary exciting cause and the continual tenesmus is wearing down the patient, it may be necessary to open the bladder from the perineum by a small incision in the middle line and establish temporary drainage.