Diseases of women : including their pathology, causation, symptoms, diagnosis, and treatment a manual for students and practitioners / by Arthur W. Edis.

  • Edis, Arthur W. (Arthur Wellesley), 1840-1893.
Date:
1882
Catalogue details

Licence: Public Domain Mark

Credit: Diseases of women : including their pathology, causation, symptoms, diagnosis, and treatment a manual for students and practitioners / by Arthur W. Edis. Source: Wellcome Collection.

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    Disease of the nervous centres, as seen in cases of progressive general pai-a]ysis, is often accompanied by incontinence of urine. The use of the ordinary pouch uiinal may here prove of service. Dui'ing the latter part of pregnancy, involuntary micturition, especially on coughing or standing, is not infrequent. A well- adjusted abdominal belt may assist in relieving the pressure. After parturition, even though no unusual delay or difficulty has occurred, involuntary micturition may take place, persisting only for a few days or extending over a period of many weeks. The adminis- tration of strychnia or belladonna in these cases often proves of much service. In patients who have had large families, or who have borne children rapidly, the power of control over the bladder is often weakened and very impeifect. The insertion of an inflated india- rubber ball in the vagina, so as to press upon the urethra, often remedies this defect. Ovarian tumours, by dragging on the bladder and mechanically interfering with the action of the sphincter, occa- sionally produce involuntary micturition or incontinence of urine. Cicatrices of the vagina, the result of parturition, may also produce a similar result. Division of the cicatrices may succeed in removing the difficulty. Dilatation of the urethra, for the purpose of examining or removing foreign substances from the bladder, may cause permanent incontinence of urine. The application of the actual cautery bulb to the site of the sphincter has been recommended in these cases. The use of the nrethi-a as a vagina, where atresia of this latter canal exists, may lead to incontinence of urine. An operation to re- store the patency of the vagina, so as to enable it to fulfil its proper function, is here indicated. Spasm of the ureters from pressure of the gravid uterus has been mentioned as a cause of incontinence of urine. Change of position, with careful regulation of the bowels, may serve to relieve this condition. Cystitis, or inflammation of the mucous coat of the bladder, is not often noticed in the female in the acute form ; but occurs not infrequently as a sub-acute or chronic affection as a result of prolonged retention of ui-ine, or from partial i-etention of urine. Causation.—Cystitis may arise from exposure to cold or wet, from extension of inflammatory mischief to the neck of the bladder, as in cases of urethritis due to gonorrhoea, from direct irritation from calculi, or from morbid growths, as tubercle and cancer; from irritating conditions of the urine, as from cantharides, turpentine, copaiba; but especially when the urine becomes ammoniacal from retention, as occurs after parturition, in the course of puerperal fever, and in para- lysis of the bladder in consequence of spinal injury or disease. The opening of an extra-uterine gestation cyst, or of a pelvic abscess, or of an adherent portion of intestine, or of an ovarian cyst into the bladder, may set up considerable irritation, inducing cystitis. The employment of a foul catheter, in cases where the bladder is already in an irritable condition, may be sufficient to induce an acute attack of cystitis.