After eight years of extended experience in this country, and a
thorough trial of hot fomentations for inflammatory affections of
the abdomen, I became convinced that the German method of cold-water
compresses gives more relief and is more in the nature of an
_abortive_, hence curative.
I recommend to my patients, instead of the hot-water applications, a
rubber bag, filled with broken pieces of ice, and applied over the
region of the bladder.
The bowels should be freely moved with castor oil or a dose of salts
and senna, or by an enema of warm soapsuds.
The food should be bland and of a fluid nature as nearly as possible,
broths with an egg, milk gruels or bread and milk.
CHRONIC CYSTITIS.
If the acute attack of cystitis in the course of eight or ten days
becomes modified, but convalescence is not established, then it is
quite probable that the disease is drifting into a _chronic_ stage.
The mucus or slime that formerly accompanied the urinary discharge
is now assuming the character of matter or has become muco-purulent.
While this is a very rare symptom of the acute variety of cystitis and
usually of brief duration, in chronic inflammation it is one of the
characteristics of the malady, and often lasts for a long time; the
muco-purulent fluid is occasionally remarkably profuse.
The pus is not always furnished by the free surface of the mucous
membrane, but may be traced to small abscesses, situated in the tissue
between the mucous membrane and the muscular wall of the bladder. The
locality for the formation of these abscesses is principally at the
neck of the organ, although there is no part of the organ that is
entirely exempt from them. Fortunately, the abscesses generally point
inwards or towards the cavity of the bladder, but it not infrequently
happens that they break through and empty into the vagina or even into
the adjacent bowel or abdominal cavity.
The occurrence of pus or suppuration is by itself so grave a process
that it is always accompanied with certain well marked and stereotyped
symptoms, which are cold chills, alternating with flushes of heat,
increase of heat or fever, anxiety and restlessness. The pain now
becomes dull and throbbing in character, and the burning or stinging
is only felt when the patient urinates. When there are abscesses, the
nervous derangement may be so great as to cause the mind to wander in
delirium. Before the appearence of pus in the urine, nothing but a
skillful examination can establish the existence of an abscess.
The treatment for suppuration of the bladder, when limited to
the surface of the mucous membrane, is always curable with
intelligently-directed treatment, which is the same as that for chronic
catarrh of the bladder, to be detailed further on.
ULCERATION OF THE BLADDER.