A Text-book of Diseases of WomenPenrose, Charles B. (Charles Bingham)
Science
A Text-book of Diseases of Women
Penrose, Charles B. (Charles Bingham)
Women -- Diseases
The endoscope reveals the presence of congestion and inflammation of
the mucous membrane.
_Treatment._--In the acute or the painful stage of the disease no
local applications should be made. The external genitals should be
bathed several times a day with hot water, preferably by means of
sitz-baths. Vaginal douches are not indicated unless the vagina be
involved in the inflammation. The vaginal syringe may be the means
of carrying infection higher up in the genital tract. Rest in the
recumbent position, if possible, is desirable. The diet should be
non-stimulating, and large quantities of diluent drinks, such as
flaxseed tea, should be prescribed. The bowels should be kept loose by
saline purgatives.
In the subacute or the chronic stages of the disease boracic acid (gr.
x-xx three or four times a day), salol, oil of sandal-wood, cubebs,
copaiba, and other drugs used for the similar condition in the male are
indicated. After painful micturition has ceased, the physician may make
local applications to the urethra, in case the inflammation does not
subside satisfactorily without them. Such local applications are not
always necessary, and they may do harm unless proper care is exercised
in their administration. Asepsis and gentleness are necessary, and the
applications should never be too strong or irritating.
Frequent douching of the urethra (two or three times a day if possible)
with sterile hot water is often of much benefit. Skene’s reflux
catheter should be used (Fig. 188). The shaft of this instrument is
fluted or grooved to permit the return of the fluid. The catheter
should be introduced as far as the internal meatus; a fountain syringe
should be attached to it, and the urethra should be washed out with a
quart of hot water.
After the irrigation the catheter should be withdrawn and a urethral
injection of nitrate of silver (gr. j or ij to ℥j) should be
administered. The injection may be given by means of a glass pipette
the nozzle of which is large enough to encircle the external meatus.
The nozzle should be placed over, not in, the meatus. The female
urethra will hold about 15 minims of fluid; more than this should
not be injected. As the condition improves the frequency of these
treatments may be diminished.
[Illustration: FIG. 188.--Skene’s reflux catheter.]
If the condition does not yield to such treatment within a few weeks,
application should be made directly to the mucous membrane of the
urethra through the endoscope. The urethral canal should be washed out
as just described, and the endoscope should be introduced as far as the
internal meatus. As it is slowly withdrawn the application should be
made over the whole inner surface of the urethra by a fine applicator
wrapped with cotton. Nitrate of silver (gr. v-x to ℥j) should be
employed.
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