A surgical handbook : for the use of students, practitioners, house-surgeons, and dressers / by Francis M. Caird and Charles W. Cathcart.

  • Caird, Francis Mitchell, 1853-1926
Date:
1889
Catalogue details

Licence: Public Domain Mark

Credit: A surgical handbook : for the use of students, practitioners, house-surgeons, and dressers / by Francis M. Caird and Charles W. Cathcart. Source: Wellcome Collection.

Provider: This material has been provided by The University of Leeds Library. The original may be consulted at The University of Leeds Library.

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    renal or hepatic colic ; also in blockage of the ureter by a calculus or by the pressure of a tumour. Complete Suppression of Urine—a condition of the utmost (lant;er—may occur not only in severe forms of Bright's disease, and in the course of any violent fever, but also in the congestions and inflammations of the kidney which are apt to follow even the simplest operations on (he uretiira or bladder, especially when there has l)een long-standing backward pressure in the pelvis of the kidney from obstruction to the outflow of urine, tlue to stricture or enlarged pn^state. Su]jpression may also be caused by an overdose of turpentine, nitric acid, or other irritant, or by the absorption of cantliarides from a large blister. An increased quantity of urine may be due to diabetes insipidus or mellitus ; to the early stage of any degeneration of the kidneys, of which it is sometimes the first symptom ; to the intermediate stage of cirrhotic kidney associated with increased arterial tension ; or to cystic degeneration of the liidney and double hydro-nephrosis. The frequency of micturition should always be noted, as, taken along with other symptoms, it is an important aid in diagnosis. Like tile quantity of urine, the frequency of micturition may be relative, but when there is an increase from the patient's previous habit, or when the frequency is manifestly above the normal, some cause must be looked for. The increase in frequency may be attributed solely to a larger quantity of fluid passed, but besides, its explanation may be sought (1) In the irritating quality of the urine, when highly concentrated, charged with acid, or loaded with sugar. (2) In irritations of the genital organs and perina;um, as in congenital phymosis and adherent prepuce, and occasionally in gonorrhoea and piles. In children from worms in the rectum. (3) In obstruction to the outflow of urine, as in stricture of the urethra and enlargement of the prostate (mostly at night). (4) In irritation of the bladder from cystitis, presence of a calculus or foreign body, tumour or tubercular deposit in the bladder-wall, or cellulitis near the bladder. Also in pressure against the bladder-wall from tumours, misplaced uterus, or pelvic accumulation of fluid—i.e., pus or blood. (5) Irritation of the kidney, as in renal calculus, or tubercular pyelitis. {2) Any Association of Pain with Micturition should also be observed and recorded. Pain before micturition indicates sensitive- ness to stretching of the bladder-wall, generally from cystitis ; dming micturition, some obstruction to the flow, as stricture, also irritating quality of the urine, a highly sensitive urethra as in urethritis, or a caruncle in women ; after micturition, generally some irritation at the neck of the bladder as from a calculus or tubercular deposit there, or from an inflamed prostate. Almost all irritations of the neck of the bladder and in the urethra cause referred pains at the point of the penis, and those in the kidney and ureter often cause similar pains shooting down to the testicle and scrotum in men, and towards the groin in women.