If the patient’s stomach cannot bear the allum in substance, whey may be made of it, and taken in the dose of a tea-cupful three or four times a-day. The allum-whey is prepared by boiling two English quarts of milk over a slow fire, with three drachms of allum, till the curd separates.
Opiates are of service in this disease, even though the patient rests well. They take off spasm and irritation, and at the same time lessen the force of the circulation. Ten or twelve drops of liquid laudanum may be taken in a cup of the patient’s drink three or four times a-day.
The best corroborants which we know, are the Peruvian bark and wine. A drachm of bark may be taken in a glass of red port or claret three times a-day. The medicine will be both more efficacious and less disagreeable, if fifteen or twenty drops of the acid elixir of vitriol be added to each dose. Such as cannot take the bark in substance may use the decoction, mixed with an equal quantity of red wine, and sharpened as above.
There is a disease incident to labouring people in the decline of life, called an INCONTINENCY of urine. But this is very different from a diabetes, as the water passes off involuntarily by drops, and does not exceed the usual quantity. This disease is rather troublesome than dangerous. It is owing to a relaxation of the sphincter of the bladder, and is often the effect of a palsy. Sometimes it proceeds from hurts, or injuries occasioned by blows, bruises, preternatural labours, &c. Sometimes it is the effect of a fever. It may likewise be occasioned by a long use of strong diuretics, or of stimulating medicines injected into the bladder.
This disease may be mitigated by the use of astringent and corroborating medicines, such as have been mentioned above; but we do not remember ever to have seen it cured.
In an incontinency of urine, from whatever cause, a piece of sponge ought to be worn, or a bladder applied in such a manner as to prevent the urine from galling and excoriating the parts.
OF A SUPPRESSION OF URINE.
It has already been observed, that a suppression of urine may proceed from various causes; as an inflammation of the kidneys, or bladder; small stones or gravel lodging in the urinary passages, hard fæces lying in the rectum, pregnancy, a spasm or contraction of the neck of the bladder, clotted blood in the bladder itself, a swelling of the hæmorrhoidal veins, &c.
Some of these cases require the catheter, both to remove the obstructing matter, and to draw off the urine; but as this instrument can only be managed with safety by persons skilled in surgery, we shall say nothing further of its use. A bougee may be used by any cautious hand, and will often succeed better than the catheter.
We would chiefly recommend, in all obstructions of urine, fomentations and evacuants. Bleeding, as far as the patient’s strength will permit, is necessary, especially where there are symptoms of topical inflammation. Bleeding in this case not only abates the fever, by lessening the force of the circulation, but, by relaxing the solids, it takes off the spasm or stricture upon the vessels which occasioned the obstruction.