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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    allowed to occur, the catheter must be passed regularly at least thrice daily, until the bladder has recovered itself, extreme caution being employed in disinfecting the catheter every time it is used. Should cystitis, however, result, care must be taken to allow only a bland, unirritating diet, mainly composed of milk and farinaceous articles. Soda water and milk, linseed tea, barley water, and other similar demulcent fluids may be given ad libitum. Where pain is urgent, suppositories or small enemas of opium or belladonna at regular short intervals should be administered. Fomentations or poultices to the hypogastrium, or warm sitz-baths, may be resorted to, provided the condition of the uterus does not contra-indicate their employment. Eest in the horizontal position is essential. The application of a few leeches may occasionally be called for. Lithia, soda, or potash water, or citrate or nitrate of potash, freely diluted, combined or not with hyoscyamus, belladonna, or opium, will generally be found of service in the early stage. The bowels must be regulated by saline or other aperients. The patient must not be allowed to return to a nitrogenised diet until all acute inflammatory symptoms have subsided. When the disease has become chronic, and there is more or less tendency for the urine to become ammoniacal and loaded with ])hos- phates and mucus, nitromuriatic acid, with tincture of nux vomica or liquor strychnia^, combined with decoction of pareira, buchu, uva ursi, or triticum repens, will generally prove of most service. The diet must now be more liberal, but unstimulating. Alcohol, in any form, is usually contra-indicated. Opium or other sedative must be given at bedtime, and at other times if deemed requisite. The bladder must be properly emptied every eight hours or so, if necessary by means of a catheter, carefully cleaned and disinfected after use, carbolised oil being employed to lubricate it. If the irrita- bility has subsided, washing out the bladder, daily, by means of a double-current catheter, often proves advantageous. Warm water only should first be tried. The simplest and most eflScacious method of doing this is by means of an iriigator or syphon douche. When the bladder has become accustomed to this, or where injec- tion of water has been fairly tried and failed, various agents have been suggested for injecting into the cavity of the organ, allowing them to remain for some few minutes, or merely injecting and then withdrawing them. Of these, dilute nitric acid (5j-ij ad §vj), car- bolic acid (1 in 48, or 5j ad Jvj), nitrate of silver (gr. xij ad §vj), tincture of iodine (gss ad J^^), or quinine (gr. vj-x ad |vj aquas) are most likely to be of service. A seton introduced just above the symphysis has been highly spoken of as useful in cases of chronic cystitis. In severe and protracted cases, where there is reason to fear that ulceration of the bladder exists, or where internal remedies, washing out the bladder and injection of chemical agents, fail in afiTording relief, Dr. Emmet has suggested the operation of making an opening in the vesico-vaginal septum, through which the urine may escape into the vagina as rapidly as it enters the bladder. In this way absolute rest of the organ is secured, and the inflammation will subside. The