Dysuria

“ If the stone is increasing in size, the quantity of sediment also increases, but if the stone is fully formed and confirmed, the amount of sediment decreases daily, and the urine becomes milky both in the kidneys and the bladder. A stone in the bladder occasions very similar symptoms, together with pain in the peritoneum and pubes, dysuria and strangury, and sometimes the appearance of blood and flocculi (trumbos?) in the urine. Patients suffering from vesical calculus are always constipated, and the dysuria may increase to the degree called furia, a condition not without some danger. ”

“ Dysuria is a symptom from which gouty persons often experience much inconvenience and suffering. It is usually associated with extremely acid urine of high density containing crystalline sediments. It may manifest itself only in frequent and painful micturition, or it may be associated with such a degree of vesical tenesmus as to cause retention and necessitate the use of the catheter. ”

“ When neither inflammation, nor a stone, nor any of the afore-mentioned complaints are present, if there is acrimony in the urine, and if the whole habit or the other symptoms indicate bile, the dysuria or strangury is formed by it, and we are to use medicines for altering and diluting it; the juice of ptisan, fishes, baths, and a corresponding diet; avoiding acrid things, wine, baths, anger, and long abstinence from food. ”

“ Dysuria—i.e. difficult urination, strangury—may have several causes. Cantharides, absorbed from a blister, may produce it temporarily. The more continuous states which cause it are—stricture of the urethra, enlargement of the prostate gland, and calculus in the bladder. In stricture, when the patient can pass water, it is apt to be in a twisted stream. Dribbling often occurs when the prostate is enlarged. ”

“ The most grievous symptoms follow the administration of cantharides, for almost from the mouth to the bladder the parts are tormented with a gnawing pain. The taste resembles pitch or cedar rosin, and the patients have inflammation of the right hypochondrium, with dysuria, and frequently they pass blood by urine, and sometimes it is discharged by the intestines, as in dysentery: they fall into deliquium animi, nausea, and vertigo, and at last they become delirious. ”

“ The dysuria is a scalding of the urine in the urethra; this likewise is obviated by timely using the injection, No. XXI. or No. VIII. But when it is actually become troublesome, drink plentifully of diluting 160drinks, such as balm tea, &c. and take a few fever powders which will soon set this to right again; particularly as that is a symptom which generally vanishes, as the disease becomes milder.
Of Shankers. These are little ulcers coming upon the glans, the frænum, and the præpuce of the yard. They are not only troublesome, but sometimes tedious in the cure; the antacrid injection No. ”

“ When an attack such as this ends in suppuration of the tumor a radical cure is effected, but a marginal ulcer of the anus sometimes follows. An unclean and neglectful habit provoking constipation, sexual incontinence, over-indulgence in highly-seasoned food or in stimulating beverages, exposure to cold and wet, and the straining attendant upon dysuria, will provoke an attack. ”

“ Among the most effective methods of treatment must be included bleeding, which always produces some improvement. Dry friction over the kidneys and flanks, hot moist applications, and the application of a sheep-skin to the loins are also of service. Internally, mucilaginous drinks, diuretic decoctions and milk give the best results. The proportion of albumen rapidly diminishes, dysuria becomes less marked, urine is passed in greater quantities, and in from eight to ten days all the alarming symptoms disappear. Bicarbonate of soda may then be given for a fortnight. ”

“ Ralfe observes, in his “Kidney Diseases,” that long-standing disease of the genito-urinary passages must be reckoned as among the chief etiological factors of chronic interstitial nephritis (page 227) . The condition of the kidneys in cases of strictures of long standing is known not to be a reliable one, and any incentive to dysuria or to retention, no matter how slight, is apt to lead, eventually—and that even in very young subjects—to that toxic condition mentioned in a former part of this chapter as one of von Jaksch’s subdivisions of toxæmia, the ammoniæmia of Frerichs ”

“ In this irritation that the prepuce is liable to cause, we have not only to encounter the dangers that its thickenings or indurations may bring on in their train, in the shape of cancer, gangrene, or hypertrophies, but other and no less serious results are liable to follow a herpetic attack, or in consequence of an attack of balanitis or posthitis. The dysuria attending any of these conditions may be the initial move for such a serious complication that life may be brought to a sudden end, even in infancy, to say nothing of the ease with which life is taken off in after years and in old age ”

“ If it is a flatulent spirit which causes the pain, after carminative injections and draughts, dry-cupping by means of large cupping-instruments, heated and fixed along the whole abdomen, often effects a cure. When the intestine is in a state of inflammation, we must bleed from the arm; but if dysuria prevails, we must likewise open the vein in the ankle, and use the remedies already mentioned, except those things which are acrid and powerfully cathartic; and we must rather use soothing injections, cataplasms, fomentations, placing the patient in a hip-bath of oil. ”

“ The condition is usually found in weak, debilitated women. It may occur during childhood.
The prolapse may be caused by dilatation of the urethra and the external meatus or by the traction of a neoplasm of the urethra. It sometimes occurs after labor. It may be produced by continual vesical tenesmus, the result of cystitis, calculus, or a tumor of the bladder.
The symptoms, vesical tenesmus and dysuria, are usually present. Sometimes incontinence of urine occurs. The protruding mucous membrane may become irritated and inflamed, and cause much local pain. It has been known to slough off. ”

“ Among the symptoms which refer to the pelvic organs are—difficulty in walking and standing; pelvic pain, more or less constant; dysmenorrhoea, menorrhagia, sterility, frequent abortion, constipation, painful or difficult defecation, dysuria, polyuria, tenesmus, etc. Among the symptoms which refer to the nervous system are—neuralgia in various parts, paralysis, hysteria, nervous dyspepsia, anæmia, chlorosis, spinal irritation, etc.
The final diagnosis must always depend upon direct examination of the uterus itself. ”

“ Zeit., 1857) found Thlaspi efficacious in the dysuria of old persons, when the passage of the urine is painful and there is at the same time spasmodic retention of it. On giving the medicine, a large quantity of white or red sand is discharged, and the troublesome symptoms disappear. Dr. Joussett (Bull. de la Soc. Hom. de France, 1866) had a case of hæmorrhage, after miscarriage, at three months. He tried Sabina, Secale, Crocus, tampons soaked in chloride of iron, but all in vain. He consulted Dr. Tessier, who recommended him to try Thlaspi, 20 drops of the mother tincture in a draught ”

“ The practice, however, to speak of it in the mildest terms, is founded on erroneous views of the pathology of these diseases; and employed, therefore, as it is by some, on all the occasions in which they meet with them, must be frequently very injurious. For, independently of the injury to be inflicted by it, when given freely in some of the forms of liver disease, there is an effect produced by it on the urine, when given to a person in health, resembling that which arises from the specific excitement of dropsy. Under a salivation, the urine becomes charged with serum. ”

“ In most diseases the quantity of urinary water is diminished, especially in those in which the activity of the circulation is impaired. There are diseases, however, more especially the granular kidney and certain forms of chronic Bright’s disease, in which the quantity of urinary water is considerably increased, notwithstanding the profound anatomical changes that have occurred in the kidney. There are two forms of suppression of the urine: one is obstructive suppression, seen where the ureter is blocked by stone or other morbid process ”

“ Common sense would dictate rest, which always does good; but, as the bladder is weak, the doctor whips up the kidneys with drugs, thus endeavoring to force them to secrete more urine, and thereby the poor, crippled bladder, which is incapable of disposing of even the diminished quantity secreted, is actually made to do more work in a diseased and feeble condition, than it would perform in a sound, strong, and healthy state. The results of this pernicious practice are Bright's disease of the kidneys, cystitis or inflammation of the bladder, and numerous other grave maladies. ”

“ Hyaline casts are the least significant of all the casts, [p. 115] and occur in many slight and transitory conditions. Small numbers are common following ether anesthesia, in fevers, after excessive exercise, and in congestions and irritations of the kidney. They are always present, and are usually stained yellow when the urine contains much bile. While they are found in all organic diseases of the kidney, they [p. 116] are most important in chronic interstitial nephritis. Here they are seldom abundant, but their constant presence is the most reliable urinary sign of the disease. ”

“ Normally a man passes about 1200 cc. of urine in twenty-four hours, a woman somewhat less. When the amount is under 750 cc. we have an oliguria. To consider a polyuria as present the patient should pass more than 3000 cc., as this amount may be considered the upper normal limit. In anuria we have a cessation of renal activity.
The disease in which anuria is most characteristic is cholera. During the stage of evacuation the urinary secretion becomes less and less along with the progressive failure of circulation and, during the algid stage, we have a suppression of urine. ”

“ We may say in general that with the atrophied kidneys the so-called uræmic symptoms—headache, sleeplessness, delirium, convulsions, coma, dyspnoea—are very apt to occur, and that early in the disease. The urine is regularly increased in amount and of low specific gravity, except [p. 90] during the uræmic attacks, when it is diminished; but the uræmic attacks may come on while the patient is passing 30 to 40 ounces of urine of a specific gravity of 1020. Albumen is regularly present only in small amounts, and not constantly, but exceptionally there will be a good deal. ”

“ If at any time he should fail to perform the act of micturition, he ought not to strain, but should quietly wait for a little before making any further effort. Regularity in the times of making water is also of much importance.
Retention of urine may occur in paralysis of the bladder, or in conditions where the patient is suffering from an illness which blunts the nervous sensibility, such as apoplexy, concussion of the brain, or typhoid fever. It is, however, more commonly due to obstruction anterior to the bladder, as in stricture of the urethra or enlargement of the prostate. ”

“ Cure, as it is dangerous to neglect your kidneys for even one day. Bright’s disease, gravel, liver complaint, pains in the back, rheumatism, rheumatic gout, inflammation of bladder, stone in the bladder, uric acid poison, dropsy, eczema, scrofula, blood disease, offensive odour from sweating, so-called ‘female weakness,’ painful periods, too frequent desire to urinate, and painful passing of urine are all caused by diseased kidneys, and can be speedily cured by Warner’s “Safe” Cure, which has been prescribed for twenty-five years.” ”

“ If the urine comes acid, but pus-laden, from the kidney, it will soon assume the contrary reaction in the bladder, and the pus will be changed by the ammonia into so-called muco-pus; the cells supposed to be characteristic of the pelvis of the kidney will, like the pus-cells, be so altered by the same causes, and so intermixed with similar cells from the bladder, that the distinction will be difficult or impossible. The presence of a few hyaline casts is very likely to be noticed, and indicates irritation, or perhaps a more decided implication, of the renal substance. ”

“ The tubules become blocked by the epithelium, and distended with the pent-up urine; this is one cause of the increase in size that the kidneys undergo in certain forms of Bright’s disease. The lesions in the tubules and in the glomeruli are not generally uniform. The interstitial tissue is always affected, and exudation, proliferation and formation of fibrous tissue occur. In the granular and contracted kidney the lesion in the interstitial tissue reaches a high degree of development, little renal secreting tissue being left. ”

“ Diseases of the kidneys are generally very slow in their inception, coming on gradually and manifesting no special symptoms of their presence until they have assumed a formidable character. For this reason they are the more dangerous. Simple derangement of the urinary secretion is no evidence of disease of these organs, as changes in the color, quantity and specific gravity of the urine are often produced by changes of temperature, active or sedentary habits, mental emotion, and sometimes by articles of diet, or drink, as well as by the use of different drugs. ”