Urination

“ It may follow an obstruction from disease, to which is added temporary swelling and nervous contraction of some part of the urinary passage; or it may be due to spasm and closure of the outlet from nervous irritation, as in the cases of injuries and surgical operations in the vicinity of the sexual organs, the rectum, or in other parts of the body. Overdistention of the bladder from failure to pass water for a long time may lead to a condition where urination becomes an impossibility. ”

“ This may be used in con [Pg 118] nection with the other remedies. For painful urination with a distressed feeling in the neck of the bladder, causing a constant disposition to evacuate urine, the Althœa Officinalis is a certain remedy; it acts like a charm. ”

“ 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 ”

“ When urine contains a larger amount of chemical constituents than it can conveniently hold in solution, a certain quantity crystallizes out, and may be deposited in the kidney or in the bladder. If the crystals run together in the kidney the resulting concretion may either remain in that organ or may find its way into the bladder, where it may remain to form the nucleus of a larger vesical calculus, or, especially in the case of females, it may, while still small, escape from the bladder during micturition. ”

“ The urinary apparatus (consisting of the kidneys, ureters, bladder, and urethra) is known to be the principal emunctory for eliminating and voiding the detritus formed by the continual decay of the parts comprising the animal economy. The urine is this detritus in a state of solution. The components of urine are chemically similar to those of calculi, and as the components of the one vary according to the disintegration occurring at the time in the vital alembic, so do those of the other. ”

“ On introducing the catheter sometimes part of the urine will come away and not the whole, which is difficult to explain; but may arise from the weakness of the muscular fibres of the bladder; which are not liable suddenly to contract themselves so far as to exclude the whole of the urine. In some old people, who have experienced a long retention of urine, the bladder never regains the power of completely emptying itself; and many who are beginning to be weak from age can make water a second time, a few minutes after they supposed they had emptied the bladder. ”

“ If she find an obstruction or stoppage of the urine, by reason the womb bears too much on the bladder, let her lift up her abdomen a little with her hand, and try if she receives any benefit; if she finds she does not, it will be necessary to introduce a catheter into her bladder, and thereby draw forth her urine. If the difficulty be from the ill posture of the woman, let her be placed otherwise, in a posture more suitable and convenient for her ”

“ ANd the thinnest part of it is secreted, and the purest part is passed off in the form of urine, but the thickest and most turbid part is condensed and concreted, at first in small quantity, but afterwards in greater; for being rolled about in the urine, whatever is of a thick consistence it assimilates to itself, and thus it increases and becomes indurated. And when such persons make water, the stone forced down by the urine falls into the neck of the bladder and stops the urine, and occasions intense pain ”

“ A large number of cases came under my observation at Brussels and at Antwerp, and many had already died. Persons rarely recover in whom urine has found its way into the general cavity of the abdomen. They generally die of inflammation in from three to six days.
When the bladder is wounded where it is covered by the peritoneum, and the opening or openings do not by some accident permit the urine to flow into the cavity of the abdomen, the patient may be free from immediate danger for a short time, although very anxious and greatly depressed in countenance and manner, and even sick to vomiting. ”

“ Local disorders of the urinary organs are more frequent causes of the trouble, as inflammation of any part of the urinary tract, diabetes, nephritis, stone in the bladder, tumors, and malformations. The involuntary passage of urine may arise from irritability of bladder—the most frequent cause—or from weakness of the muscles which restrain the escape of urine, or from obstruction to flow of urine from the bladder, with overflow when it becomes distended. ”

“ In many cases of disease and irritation in the bladder, attended with frequent desire to make water, and pain after its evacuation, also in disorders of the urinary organs, accompanied with the lithic acid, or phosphatic deposit in the urine, I have seen a very liberal internal use of the water decidedly beneficial; and elderly persons, afflicted with organic changes in these organs, have often acknowledged to me that they live in greater comfort, and are freer from irritation or pain, at Malvern than elsewhere. ”

“ Where the inconvenience thus detailed is present, the quantity of fluids must by degrees be diminished, the general state of health must be studied. Dieting and warm-bathing are two sheet-anchors, if properly applied. All remedies tending to afford strength to the urinary system must be had recourse to; and where the bladder loses any of its retentive power, I entertain the greatest benefit from an injection.
The next form of urinary disturbance of a proximate nature to the one just described, is also where the urine is discharged in large quantities ”

“ If their urine (as is likely) be retained, owing to their delirium, we must foment the lower part of the belly and bladder with warm oil and water, and then, by applying the fingers of the hand to the part, we must try to incite them to make water. We must also anoint the rest of the body with warm oil; and the patients are to be kept in a recumbent posture, for a state of quietude is to be maintained as much as possible; and, if they be rich, they are to be restrained by their servants; but, if not, they are to be bound with ligatures. ”

“ Removal of tonsils and adenoid vegetations might conceivably cure an enuresis which is nocturnal, it cannot account for an incontinence which spreads to the day. We might believe that to distend the bladder by hydrostatic pressure was a cure for incontinence of urine, and that it acted by removing the local cause,—the smallness and contraction of the bladder,—were it not that the loss of control is so apt to spread to the rectum as well. There is no evidence that the urine is peculiarly irritating. ”

“ But in every case disease-germs are the cause of the trouble, and they may be found in the urine. The first effect of inflammation is to render the bladder irritable, so that as soon as a few drops of urine have collected, the individual has intense or uncontrollable desire to micturate. ”

“ To make the spirit of urine by distillation, some took the urine of a healthy man, some that of a wine-drinking boy of twelve years (pp. 81, 82) . This spirit was administered in lung troubles, in dropsy, suppression of the menses, all kinds of fevers, retention of urine, calculus, etc. (p. 85) ; also in eye troubles, strangury, diabetes, podagra, catarrh, melancholia, phrensy, cardialgia, syncope, dysentery, plague, malignant fevers (p. 86) .
The “spirit of urine” was again distilled with vitriol to make an anti-podagric remedy (85) . ”

“ To resume; the patient will content himself, that the only fault in his system is the disordered condition of his urine, and he earnestly seeks for something to touch that particular symptom, forgetting that trifling as he may fancy it, it is not merely owing to the office of the kidneys and bladder, but to the blood itself, whence the urine is formed, and to other circumstances in the economy that influence it. ”

“ The symptoms are, a wearisomeness and languor of the whole frame, a dry and crimpled state of the skin, a sinking, gnawing pain at the pit of the stomach, the bowels are obstinately bound, while a great thirst always prevails. The body wastes to a mere skeleton, the discharge of urine being almost constant, at least every hour, accompanied with a call that must be immediately obeyed: the leading feature in the composition of the urine, in addition to the varied presence of the urea, is the saccharine matter contained therein. ”

“ SYMPTOMS AND DIAGNOSIS.—Patients complain of difficulty in emptying their bladders, the urine coming away in interrupted jets. They are [p. 349] apt to be irregular in their times of urinating, and are liable in consequence at times to have retention and over-distension. Pain and sometimes a slight cystitis are present. Finally, they completely lose the power of urinating and a catheter has to be used. The diagnosis is to be made as in hypertrophy, by a finger in the vagina and a sound in the bladder. ”

“ The urine is pale and in small quantity in the cold fit from deficient secretion of it, and from deficient absorption of its aqueous parts; it is high coloured, and sometimes deposits a sediment, in the hot fit from the greater secretion of it in the kidneys, and the greater absorption of its aqueous and saline part in the bladder. The dryness and scurf on the tongue and nostrils is owing to the increased heat of the air expired from the lungs, and consequent greater evaporation of the aqueous part of the mucus. ”

“ I have known some persons kill themselves by introducing probes into the urinary passages, to remove, as they thought, somewhat that obstructed the discharge of urine, and others bring on a violent inflammation of the bladder, by using strong diuretics, as oil of turpentine, &c. ”

“ With paralysis of the bladder the penis may be pendent out of the sheath, or being retained within it, the urine may dribble constantly into and from that cavity, and the vulva may be soft and flaccid. When the anus is involved, the adjacent part of the rectum usually participates becoming overloaded, the sphincter is soft and lax and allows a constant oozing, and the exposure of the mucosa. The paralytic tail hangs between the thighs, limp and flaccid, and becomes saturated with manure and in females with urine. ”

“ Some patients keep a catheter and "draw" their own urine. Unless the patient takes great care, the bladder and urethra will be irritated and perhaps infected through neglect of cleanliness. Medicines are not very useful in severe cases. Operation is the only reliable cure especially when some urine is always retained. ”

“ Horseback riding, climbing, and all exercises which rub, chafe, or excite the genital organs, should be avoided. Even the clothing should be loose, so that walking will not produce friction or cause any excitement of these organs. The calls of nature should receive prompt attention, and the urine be voided at any time (especially during the night) when there is an inclination. If there be irritation of the bladder and lower bowels, the patient will receive decided benefit from the daily use of an injection of cold water into the bowels. ”

“ Should a person at any time feel symptoms of indigestion, and be afraid of the consequences, a little of his own urine will relieve all unpleasant sensations and expedite digestion, but this can only be resorted to by people of no caste.
933 Monje مونجي.—The leaf and external fibrous covering of a kind of reed like grass, used to make rope. It is equally cold and hot; useful in acne, disorders of blood, diseases of the eyes, and all complaints affecting the urinary bladder, or urethra.
934 Mooser موسر.—Sweet, bitter, heavy; promotes appetite, cures piles and disorders of wind ”

“ Actual retention of urine, that is, urinary secretion passed into the bladder, but retention in the latter viscus by inanition, stricture, or other obstruction, naturally cannot continue any great length of time without mechanically rupturing the vesical walls; but suppression of urine or absolute anuria may last an astonishingly extended period. Of the cases of retention of urine, Fereol mentions that of a man of forty-nine who suffered absolute retention of urine for eight days, caused by the obstruction of a uric acid calculus. ”

“ When the urine is too long retained, it is not only resorbed, or taken up again into the mass of fluids, but by stagnating in the bladder it becomes thicker, the more watery parts flying off first, and the more gross and earthy remaining behind. By the constant tendency which these have to concrete, the formation of stones and gravel in the bladder is promoted. Hence it comes to pass, that indolent and sedentary people are much more liable to these diseases, than persons of a more active life. ”

“ Retention of urine is not always present even in those cases in which the limbs are completely paralysed, as the fibres of one side of the cord are sufficient to maintain the functions of the bladder. The patient may be aware that the bladder is full, although he is unable to empty it. Similarly, sensation in the rectum and anus may be retained although the control of the sphincters is lost. ”

“ This collection takes place in the kidney, the ureters (the vessels that convey the urine to the bladder) , the bladder, and sometimes in the urethra. The stone so formed varies in its composition and size, and is one of the saddest ills that can befall human nature. Hence the importance of watching, and attending to every urinary disturbance, of which gravel forms a prominent feature, the treatment of which has been already stated; but which, as it involves more practised judgment than a non-professional invalid can be supposed to possess, had better be intrusted only to professional hands. ”