After bleeding, fomentations must be used. These may either consist of warm water alone, or of decoctions of mild vegetables; as mallows, camomile-flowers, &c. Cloths dipped in these may either be applied to the part affected, or a large bladder filled with the decoction may be kept continually upon it. Some put the herbs themselves into a flannel bag, and apply them to the part, which is far from being a bad method. These continue longer warm than cloths dipped in the decoction, and at the same time keep the part equally moist.
In all obstructions of urine, the body ought to be kept open. This is not however to be attempted by strong purgatives, but by emollient clysters, or gentle infusions of senna and manna. Clysters in this case not only open the body, but answer the purpose of an internal fomentation, and greatly assist in removing the spasms of the bladder and parts adjacent.
The food must be light, and taken in small quantities. The drink may be weak broth, or decoctions and infusions of mucilaginous vegetables, as marsh-mallow roots, lime-tree buds, &c. A tea-spoonful of the sweet spirits of nitre, or a drachm of Castile soap, may be frequently put into the patient’s drink; and, if there be no inflammation, he may drink small gin-punch.
Persons subject to a suppression of urine ought to live very temperate. Their diet should be light, and their liquor diluting. They should avoid all acids and austere wines, should take sufficient exercise, lie hard, and avoid study and sedentary occupations.
OF THE GRAVEL AND STONE.
When small stones are lodged in the kidneys, or discharged along with the urine, the patient is said to be afflicted with the gravel. If one of these stones happens to make a lodgment in the bladder for some time, it accumulates fresh matter, and at length becomes too large to pass off with the urine. In this case the patient is said to have the stone.
CAUSES.——The stone and gravel may be occasioned by high living; the use of strong astringent wines; a sedentary life; lying too hot, soft, or too much on the back; the constant use of water impregnated with earthy or stony particles; aliments of an astringent or windy nature, &c. It may likewise proceed from an hereditary disposition. Persons in the decline of life, and those who have been much afflicted with the gout or rheumatism, are most liable to it.
SYMPTOMS.——Small stones or gravel in the kidneys occasion pain in the loins; sickness; vomiting; and sometimes bloody urine. When the stone descends into the ureter, and is too large to pass along with ease, all the above symptoms are increased; the pain extends towards the bladder; the thigh and leg of the affected side are benumbed; the testicles are drawn upwards, and the urine is obstructed.
A stone in the bladder is known from a pain, at the time, as well as before and after making water; from the urine coming away by drops, or stopping suddenly when it was running in a full stream; by a violent pain in the neck of the bladder upon motion, especially on horseback, or in a carriage on a rough road; from a white, thick, copious, stinking, mucous sediment in the urine; from an itching in the top of the penis; from bloody urine; from an inclination to go to stool during the discharge of urine; from the patient’s passing his urine more easily when lying than in an erect posture; from a kind of convulsive motion occasioned by the sharp pain in discharging the last drops of the urine; and lastly, from sounding or searching with the catheter.
REGIMEN.——Persons afflicted with the gravel or stone should avoid aliments of a windy or heating nature, as salt meats, sour fruits, &c. Their diet ought chiefly to consist of such things as tend to promote the secretion of urine, and to keep the body open. Artichokes, asparagus, spinnage, lettuce, parsley, succory, purslane, turnips, potatoes, carrots, and radishes, may be safely eaten. Onions, leeks, and celery are, in this case, reckoned medicinal. The most proper drinks are whey, butter-milk, milk and water, barley-water; decoctions or infusions of the roots of marsh-mallows, parsley, liquorice, or of other mild mucilaginous vegetables, as linseed, lime-tree buds or leaves, &c. If the patient has been accustomed to generous liquors, he may drink small gin-punch.