Licence: In copyright
Credit: Aids to surgery / by Joseph Cunning. Source: Wellcome Collection.
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![stone by the click which is given. By the cystoscope the inside of the bladder can be looked at. The patient must be anaesthetized, the bladder washed out, and 6 ounces of boracic lotion introduced. The instrument must be lubricated with glycerine, not oil. A suprapubic cystotomy is the final resort. Cystitis. All forms of true cystitis are due to bacterial infection, of which the Bacillus coli and staphylococci are the commonest. The organisms are introduced on instru- ments, travel along the mucous membrane of the urethra, as in gonorrhoea, or grow along mucus lying in the urethra, or travel downwards from the kidney. Acute Cystitis is due to—(i) gonorvhcea spreading to the bladder ; (2) the presence of foreign bodies or after operations ; (3) the introduction of sepsis on instruments or mucus, as in paralysis of the bladder from spinal injuries. Cantharides and cold in gouty subjects are said to produce cystitis. Symptoms.—(i) Pain and tenderness over the hypo- gastrium ; (2) frequent and painful micturition, only small amounts being passed (strangury); (3) pyuria. The temperature is raised, and there is tenesmus. The case usually terminates by resolution, though irritability of the bladder may remain. Sepsis may spread to the kidney, and cause fatal toxemia. In some cases retention, distension, and atony occur if the neck of the bladder is chiefly affected. The wall of the bladder may slough in very severe cases. Treat??2e?it.— The. patient must be kept in bed with hot fomentations over the hypogastrium. A fluid diet, with plenty of barley-water, must be ^iven. Alkalies and hyoscyamus, with morphia suppositories, relieve the pain. Urotropin (gr. x. t.d.s.) is the best internal antiseptic. If the urine is very foul, the bladder may be washed out. In sloughing cystitis median perinatal drainage is neces- sary, but these cases are usually fatal. Chronic Cystitis is due to the entry of organisms, but there is always a predis]50sing cause, such as stricture of the urethra or enlarged prostate, causing retention ; cal-](https://iiif.wellcomecollection.org/image/b21510891_0378.jp2/full/800%2C/0/default.jpg)
