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Diseases Bladder

urine, catarrh, chemical, instruments, chronic, symptoms and treatment

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BLADDER, DISEASES OF.—rnder this general heading xvill be described some of the more common affections of the bladder.

Cystitis.--Intlarnmation of the bladder, or vesical catarrh, may vary greatly in its manifestations, and may he due to any one of many cause,:. Retention of urine and injuries, however slight, to the mucous membrane lining the bladder seem to he important factors. Mechanical, infectious, or chemical influences also play a part in the production of the further development of the disease. The most important causes may he sum marised as follows : abrasion of the mucous membrane and infection of the interior of the bladder by instruments introduced for various purposes ; bacteria, which find their way from without on instruments, from within by transmission from the ureters, the pelvis of the kidney, and the large intestine ; foreign bodies, gravel and stones, which have been formed in the bladder or in some portion of the urinary tract higher up ; narrowing of the calibre of the urethra ; obstruction to the regular passage of the urine by enlargement of the prostate, due to advanced years ; acute and chronic gonorrhceas. tuberculosis of the bladder ; chemical irritants, such as acrid remedies used for washing the bladder, and the administration of drugs like cantharides (Spanish fly) ; and, finally, the not generally acknowledged influence of exposure. As regards the last-minted, there is no doubt that a cold aggravates an already existing catarrh of the bladder.

In an acute attack of vesical catarrh the symptoms consist in a frequent desire to urinate, and the passing of urine rendered cloudy by the admix ture of pus and mucus, and occasionally bloody. The blood is usually noticed with the drops of the urine, which is scanty in amount but frequently voided. Fever and a moderate degree of constitutional dis turbance are often present. The greatest annoyance, however, is caused by the constant desire to urinate, which also interferes with proper sleep. The chronic catarrhs are accompanied by fewer general disturbances ; but the local symptoms, the urinary changes, are more marked, and the disagree able odour due to the decomposition of the urine is a source of continual annoyance.

The main indications for treatment must be prescribed by the physician after the exciting causes have been determined. It should be borne in mind, however, that in addition to the necessary medical and instrumental treatment, every case of yesical catarrh demands proper attention on the part of the patient. Rest in bed is to be recommended as a safe Nvav of avoiding cold, and also for the maintenance of uniform bodily warmth. Warm sitz-baths and full baths arc useful, especially where there is difficulty in passing urine. Alcoholic drinks and richly seasoned dishes had best be entirely avoided ; and attention should be given to the daily emptying of the bowels. It is well to abstain from taking natural or artificial mineral waters which contain much carbonic-acid gas. In the presence of chronic catarrhs it is important to avoid the dangers attendant upon self-catheterisa tion by following closely the directions for the cleansing of instruments employed for this purpose. See CATHETERISM.

from the Bladder.—:1 condition which may appear as one of the symptoms of catarrh, of stones (especially after violent exertions), or of tumours or injuries of the bladder, the latter particularly if the hip be frac tured. Before any final decision can be reached in regard to the cause of the bleeding, whether it is derived from the bladder itself or from the upper portion of the urethra, a careful chemical and microscopical examination of the urine is necessary, supplemented, in certain cases, by an examination of the interior of the bladder by the aid of artificial light. \\There severe spas modic cramp in the bladder is present, there is, in all probability, a catarrh; when there is marked pain after urinating, a stone is very likely present ; and when hoemorrhage appears without other known cause, a tumour of the bladder probably exists. In every case of hemorrhage from the bladder, even in that following injury, complete rest must be enjoined until the arrival of the physician ; and where injury has taken place, an ice-bag is to be recommended. Hot-water bags are useful in reducing the pain ; or cloths wrung out of hot water, and on which a drop of turpentine has been placed, may be used.

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