ANOMALIES IN THE URINARY DISCHARGE These may be either purely functional, or they may be the result of organic disease. In this place we shall speak only of the latter form.
Anuria, which has been already mentioned as a symptom of ne phritis, also occurs congenitally. For instance, in deformities of the dis charging urinary tracts, and in cystic kidneys, Bonfitnn describes such a case which lasted nineteen days.
Pollakiuria is physiological near the end of the first and the beginn ing of the second year, and it is only at the end of this time that the discharge of urine begins to be dependent upon the will. Pollakiuria sometimes appears in older children temporarily after the acute infec tious diseases. It may be a symptom in diabetes mellitus, diabetes insipidus, contracted kidney, and in imitating conditions of the urinary passage.
Retention of urine, the collection of urine in the bladder until it is distended to its utmost capacity, may occur in the first place in all those conditions in which micturition is accompanied with pain, and it may result from deformities and anomalies of structure, congenital strie tures, duplications of the mucous membrane of the urinary tract, calculi, inflammations of the kidney, bladder, prostate, urethra, or prepuce, in pericystitis, congenital hypertrophy of the prostate, foreign bodies and new formations in the urinary organs, prolapse of the vesical mucous membrane, paresis of the bladder from stupor in the infectious diseases, in organic diseases of the brain and spinal cord, ancl fur ther, by mechanical and reflex disturbances or new growths in neighbor ing organs (for example, Bartenstein described a case of retention of urine in a female infant ten months old, which resulted frorn a peri proctitic abscess). Retention of urine may also be imitated in babies,
as in children suffering from serious gastro-intestinal diseases who take but little nourishment and suffer with numerous watery evacuations (Bartenstein). Hag,enbeck-Burkhardt mention the inability of children suffering with tetanus to discharge the urine, owing to spasm of the sphincter resins.. This subsides along with the other symptonis of tetanus.
incontinence of un.ne, the involuntary discharge of the urine, may be the result of affections of the bladder (calculi, cystitis, bacteriuria), and of deformities of the genital apparatus. As causes of incontinence of urine, exeoriations and irritations near the urethra (oxyuris) may be mentioned. Ray goes so far as to maintain that the "enuresis" is in most ca.ses a symptom of co-existing cystitis, or at any rate the result of irritating conditions persisting after the cure of a catarrh of the bladder (phosphaturia, ammoniuria, gravel, CXCCSSiVe secretion of uric acid).
The treatment of these conditions is directed to the cause. Wherc there is a retention, the catheter must be used to relieve the symptoms resulting from the retention and the dangers of the systemic disturbance.