Volume 1
A text-book of medicine for students and practitioners / by Adolf v. Strümpell.
- Adolph Strümpell
- Date:
- 1911
Licence: Public Domain Mark
Credit: A text-book of medicine for students and practitioners / by Adolf v. Strümpell. Source: Wellcome Collection.
864/874 page 828
![is best prescribed in powders of 7.5 gr. (gm. 0.5) three to four times daily, or even in solution (5 parts in 150), three tablespoonfuls daily. Helmitol, though very similar, is less effective. Urotropin is the best remedy in every bacteriuria. In addition, salicylic preparations, especially salol, in powders of 8 gr. (gm. 0.5), repeated several times a day, are specially to be recom¬ mended; naphthalin, 1.5 to 5 gr. (gm. 0.1 to 0.3), repeated several times a day, has also been recommended, but it may produce decidedly disagree¬ able symptoms. If there are severe local symptoms, we prescribe warm compresses and poultices to the region of the bladder. In other respects narcotics, especially subcutaneous injections of morphin, are the best remedy when there is severe pain and tenesmus. Morphin, as well as opium and belladonna extract, are also employed to good advantage in the form of suppositories. Finally, the frequent use of protracted warm baths may be greatly recommended. In chronic cystitis all the remedies previously mentioned are also to be considered; but they are usually not sufficient alone, and at any rate they are far less effective than a methodical local treatment. This consists in a regu¬ lar daily washing of the bladder by means of an elastic catheter. A rather long rubber tube is attached to the catheter at one end, and to a funnel at the other, and by raising or lowering this funnel the bladder can be filled or emptied. We allow a moderate amount, say 3 to 7 ounces (100 to 200 c.e.), of the warm fluid to run into the bladder and escape, repeating the process until the wash water is clean. For this, perhaps, we employ either a simple one-half to one-per-cent solution of common salt, or preferably a warm and weak solution of acetate of lead, 1 to 1,000; permanganate of potassium, 1 to 1,000; or a combination of boric and salicylic acids. By treatment of this sort many cases of chronic vesical catarrh may be cured, while the most obstinate may, at any rate, be kept within bounds. In rebellious cases of puru¬ lent cystitis it is advantageous to employ lunar caustic. The bladder is rinsed out, and then about 5 ounces (gm. 150) of a weak solution of nitrate of sil¬ ver, at first 1 to 3,000, later as strong as 1 to 1,000 or 1 to 500, are injected through a catheter. The solution is allowed to remain two or three minutes in the bladder and then withdrawn. What is called the Janet method of irrigating the bladder is also very useful. The fluid is placed in a fountain syringe, and made to enter the bladder from the urethra, by raising the reser¬ voir high enough to give a pressure which overcomes the sphincter of the bladder. The advantage of this method lies in the coincident dilatation and lavage of the posterior portion of the urethra. [An excellent remedy is argyrol. Wash out with a solution 1 to 1,000, then leave an ounce of five- to twenty-per-cent solution in the bladder.] It is very important, in treating chronic catarrh of the bladder, to con¬ sider the possible cause of the condition—for instance, stricture, or vesical calculi, or paralysis of the bladder. In pericystitic suppuration surgical treatment is only rarely possible. We must, therefore, confine ourselves to purely symptomatic procedures.](https://iiif.wellcomecollection.org/image/b3136276x_0001_0864.jp2/full/800%2C/0/default.jpg)
