Femina, A Work for Every Woman

by John A. Miller

ULCERATION OF THE BLADDER.

This is perhaps seldom a condition by itself, but rather a complication of the preceding disease. The ulcers occupy the place of what were formerly little abscesses, that have broken into the cavity of the organ. Foreign bodies in the bladder by their direct pressure on the delicate tissues of the membrane have been the cause of ulcerations, that gave rise to dangerous hemorrhage. Earthy concretions or stones will naturally form in the bladder, and the end of a gum catheter has also been found in the bladder broken off in the bungling act of drawing off the urine, or, what is more likely, by boring and poking within the cavity of the bladder, with a catheter or bougie, by persons ignorant of pelvic anatomy or in the belief that the bougie was in the cavity of the womb, for the purpose of inducing an abortion.

Ulcerations will always be accompanied with more or less inflammation or visceral catarrh, so that the symptoms will fall under that head which has already been considered.

CATARRH OR SUBACUTE INFLAMMATION.

The mucous membrane of the bladder, like that of the nose, mouth or bronchial tubes, has its natural secretion of healthy mucous. When any of these membranes become irritated or congested from any cause, this natural secretion becomes so increased as to make a perceptible flow of the secretion of mucus, and this is what the term catarrh signifies. Catarrhs always presuppose the existence of inflammation, which in its nature is subdued or mild, so that it has been qualified as subacute, which is intended to convey the idea that the tissue need not be red nor hot and swollen as is always the case in the acute form of inflammation.

Chronic catarrh of the bladder is traceable to any or all the causes that have been enumerated in the acute processes, because every acute inflammation of the bladder may terminate in a chronic form. It occurs at any period of life, but it is most common in elderly subjects; it is always an attendant of ulceration of the bladder or some abnormal growth in the bladder. If the disease is once established and is due to a complication, it is liable to become aggravated or re-established after a brief subsidence by exposure to cold, excesses in diet and drink, or diseases of the vagina, uterus or rectum.

The secretion of catarrh is white and glairy and resembles the discharge of leucorrhœa or whites. When disassociated with acute inflammation of the bladder, it comes on gradually, or in a slow, insidious manner; for this reason the term subacute inflammation is sometimes employed by authors, because there are no fiery symptoms at the onset of the affection.

The urine is always more or less altered in character, because the inflamed mucous membrane predisposes the urine to speedy decomposition. There is frequent and difficult micturition, and the entire region, but in particular the affected organ, is more or less sensitive and sore.

The quantity of mucus which passes off with the urine varies greatly at different periods and in different cases. In the early stages it may entirely escape notice, being so small that if the urine is not saved in a vessel and accumulated for the twenty-four hours the mucus can hardly be detected; thus, the entire quantity of the above period may often not exceed two teaspoonfuls. When the disease becomes more advanced, the quantity of mucus may be equal to the quantity of urine that passes. The secretion is very thick and sticky, and settles to the bottom of the vessel or adheres to its surface. If there is pus mixed with the mucous secretion, it becomes a more serious question, and it may then be inferred that other organs are involved, the conductors of urine from the kidneys to the bladder, for instance, or the kidneys themselves. If the disease is confined to the bladder, the prospects for a cure are very favorable; only when diseases of other organs in the neighborhood are the exciting causes of the malady are the chances for a cure correspondingly limited.