Femina, A Work for Every Woman

by John A. Miller

The neighboring organs begin to sympathize with the advanced state of the inflammation at this stage; cutting pains are felt in the rectum, while darts of pain shoot from the bladder towards the groins and ovaries.

Owing to the spasmodic action of the urethra, the bladder is never completely emptied so that the urine gradually accumulates in abnormal proportions; the retained urea rapidly decomposes into ammonia and the urine becomes very hot and irritating, thus greatly augmenting the suffering. Under these circumstances, the bladder may become greatly distended and feel as a sensitive globular tumor above the pubis. The retention of the urine may be complete, owing to a partial paralysis of the bladder and now complicated with spasmodic stricture. Nausea and vomiting are rarely absent in this stage, the tongue becomes coated and dry, while the expression is anxious and the fever very high.

In the commencement of the disease there is some difference in the symptoms of inflammation of the bladder which arises from the nature and seat of the inflammatory process.

If the neck of the bladder is mainly affected, the spasmodic desire to urinate is more pronounced, and the pain is felt low down in the vagina and anus, while the symptoms are higher up in the rectum, with constant inclination to go to stool, if the base or posterior wall of the organ is principally involved.

Acute cystitis runs its course in six or eight days; under favorable circumstances and appropriate treatment all painful symptoms will in that time have subsided, and the patient will have entered upon a course of permanent recovery.

If through a constitutional habit, or through neglect or improper treatment, the disease is not curbed, the result will be quite different; the inflammation may pass into a suppurative stage or assume the chronic form.

The treatment in the acute stage will resolve itself into two different measures of relief; these are first to subdue the spasmodic pain and nervous excitement, and secondly, to quiet the local irritation. The pain is best controlled by morphine powders, one-fourth of a grain each, given every four hours. Warm teas of German chamomile or flaxseed, so as to dilute the urine, may be freely given. Hot vaginal injections of borax water have a remarkably soothing influence; the hot sitz-bath is another useful adjuvant. It has been customary in this country and England, to apply hot water compresses or hot poultices over the hypogastrium, which is that part of the lower abdomen corresponding to the region of a distended bladder.

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.