An Account of the Diseases which were most frequent in the British military hospitals in Germany

by Donald Monro

Those who really had the Disorder seemed to have received such an Injury of the Bladder, or Kidneys as required a considerable Space of Time to get the better of; and by reason of the short Time we had them under our Care at the flying Hospital, they seldom received much Benefit. One or two thought they grew better on taking the Bark and Balsam of Peru; at the same Time they bathed Morning and Evening the lower Part of the Abdomen and Perinæum, with Flannels dipped in gentle astringent Liquors, applied cold. Blisters applied to the os sacrum had no Effect.

FOOTNOTES:

[96] A Soldier in the Hospital at Paderborn used to discharge his Water involuntarily, and mixed with Pus, which came from some violent Blows he had received on the Back.

John Pearce, a young Man about eighteen Years of Age, was admitted into St. George’s Hospital, the 10th of April 1759, for a Pain of his Side, and a Complaint of the Bladder. The Account which he gave of his own Case was, that, some Months before, he had received a violent Blow with a Cricket-Bat on the left Side, on the Region of the Kidney; and that ever since he had had a sharp Pain in that Part, and sometimes had a Stoppage of Urine, and at other Times it came away insensibly. His Pulse was rather quick, but low, and he had a feverish Heat. He at first took some cooling Medicines; but on the 20th, being low and faint, he had some of the fœtid Julep. On the 23d he was attacked with a sharp Pain in the Belly and Side, had a Stoppage in making Water, a quick and full Pulse, and most of the Symptoms of the Stone. He was ordered to be blooded immediately, to take the saline Draughts every four Hours; and as he was inclined to be costive, to take as much lenitive Electuary as to procure him a loose Stool; and it was recommended that he should be sounded as soon as the Violence of the Fever was over. On the 25th he continued much in the same Way, and had made some Water, which was intolerably fœtid. Half a Drachm of the dulcified Spirit of Nitre, and five Drops of the tinctura thebaica, were added to each of his Draughts, as the Pain and Difficulty of making Water had increased. On the 26th his Pulse rose, and became very hard and quick; the Pain in his Side, and the Dysuria, became more violent; and about Twelve o’Clock he had a convulsive Fit, resembling that of an Epilepsy; after coming out of the Fit, as the Fever and Pain had increased, he was blooded; the Belly was fomented and embrocated, and he took the oily Draughts four Times a-Day; his Blood immediately threw up a very thick Buff. He remained pretty easy the rest of the Day; but about the same Time next Day, he had another convulsive Fit, and died.

On opening his Body, we found about two or three Pints of a dark-coloured fœtid Water in the Abdomen; on cutting through, and squeezing the right Kidney, there came out a thin purulent Matter every where from its Substance, though it appeared sound; on raising and cutting through the Peritoneum, covering the left Kidney, there was a Discharge of about a Pint of black and very fœtid Water, which had every where surrounded this Kidney; and there were six mortified Spots on its Surface, as large as the End of one’s Finger, with a Depression in each about a Quarter or Half an Inch deep; most of the Substance of this Kidney seemed diseased, and it was full of Suppurations. The Bladder was contracted and thickened, and contained a rough Stone, which weighed three Ounces. The rest of the viscera were sound. This Stone had certainly been in the Bladder long before the young Fellow received the Blow with the Cricket-Bat; but the Injury done the Kidney had probably aggravated the Symptoms.

I do not remember ever to have seen convulsive Fits, such as this young Man had, in acute Diseases, except in one Case of a slow Fever, which came by taking Cold after a Salivation, and which I attended, along with Dr. Pringle. The Gentleman had three Fits exactly of the same kind as this young Man, at twenty-four Hours Distance from one another, and he died of the third.

OF A
Stoppage of Urine.

We formerly mentioned, that in acute Diseases many complained of a Stoppage or Difficulty of making Water; and others had this Complaint from Strictures of the Urethra, or Disorders of the Bladder or Kidneys[97].

Where it depended on Strictures of the Urethra, Bougies introduced into that Passage, and worn for some Time, were of great Service. The Patients were at the same time ordered to live on a cool Diet, and to drink the decoctum Arabicum, or an Infusion of Linseed, or such other mild mucilaginous Liquors; and to take oily Medicines and Opiates occasionally, and gentle Laxatives, to keep the Body open; which Method of Treatment generally gave Relief. Where the Patients were plethoric, or complained of Pain, or the Disorder was attended with a Fever, Bleeding was often necessary.

When the Stoppage of Urine seemed to arise from an Inflammation of the Kidneys or Bladder, or other Diseases of these Parts, we treated it accordingly; and where the Fever was considerable, we made Evacuations, and gave plenty of diluting Liquors, and the cooling saline Medicines, and afterwards those of the soft, mucilaginous, and oily Nature, and mild Diuretics and Opiates.