Gentle exercise is proper; but violent motion is apt to occasion bloody urine. We would therefore advise that it should be taken in moderation. Persons afflicted with gravel often pass a great number of stones after riding on horseback, or in a carriage; but those who have a stone in the bladder are seldom able to bear these kinds of exercise. Where there is a hereditary tendency to this disease, a sedentary life ought never to be indulged. Were people careful, upon the first symptoms of gravel, to observe a proper regimen of diet, and to take sufficient exercise, it might often be carried off, or at least prevented from increasing; but if the same course which occasioned the disease is persisted in, it must be aggravated.
MEDICINE.——In what is called a fit of the gravel, which is commonly occasioned by a stone sticking in the ureter or some part of the urinary passages, the patient must be bled, warm fomentations should likewise be applied to the part affected, emollient clysters administered, and diluting mucilaginous liquors drank, &c. The treatment of this case has been fully pointed out under the articles, inflammation of the kidneys and bladder, to which we refer.
Dr. Whytt advises patients who are subject to frequent fits of gravel in the kidneys, but have no stone in the bladder, to drink every morning, two or three hours before breakfast, an English pint of oyster or cockle-shell lime-water. The Doctor very justly observes, that though this quantity might be too small to have any sensible effect in dissolving a stone in the bladder, yet it may very probably prevent its growth.
When a stone is formed in the bladder, the Doctor recommends Alicant soap, and oyster or cockle-shell lime-water[[124]], to be taken in the following manner: The patient must swallow every day, in any form that is least disagreeable, an ounce of the internal part of Alicant soap, and drink three or four English pints of oyster or cockle shell lime-water. The soap is to be divided into three doses; the largest to be taken fasting in the morning early; the second at noon; and the third at seven in the evening; drinking above each dose a large draught of the lime-water; the remainder of which he may take any time betwixt dinner and supper, instead of other liquors.
The patient should begin with a smaller quantity of the lime-water and soap than that mentioned above; at first an English pint of the former, and three drachms of the latter, may be taken daily. This quantity, however, he may increase by degrees, and ought to persevere in the use of these medicines, especially if he finds any abatement of his complaints, for several months; nay, if the stone be very large, for years. It may likewise be proper for the patient, if he be severely pained, not only to begin with the soap and lime-water in small quantities, but to take the second or third lime-water instead of the first. However, after he has been for some time accustomed to these medicines, he may not only take the first water, but, if he finds he can easily bear it, heighten its dissolving power still more by pouring it a second time on fresh calcined shells.
The caustic alkali, or soap-lees, is the medicine chiefly in vogue at present for the stone. It is of a very acrid nature, and ought therefore to be given in some gelatinous or mucilaginous liquor; as veal-broth, new milk, linseed-tea, a solution of gum-arabic, or a decoction of marsh-mallow roots. The patient must begin with small doses of the lees, as thirty or forty drops, and increase by degrees, as far as the stomach can bear it[[125]].
Though the soap-lees and lime-water are the most powerful medicines which have hitherto been discovered for the stone; yet there are some things of a more simple nature, which in certain cases are found to be beneficial, and therefore deserve a trial. An infusion of the seeds of daucus sylvestris, or wild carrot, sweetened with honey, has been found to give considerable ease in cases where the stomach could not bear any thing of an acrid nature. A decoction of raw coffee berries taken morning and evening, to the quantity of eight or ten ounces, with ten drops of sweet spirit of nitre, has likewise been found very efficacious in bringing away large quantities of earthy matter in flakes. Honey is likewise found to be of considerable service, and may be taken in gruel, or in any other form that is more agreeable.
The only other medicine which we shall mention is the uva ursi. It has been greatly extolled of late both for the gravel and stone. It seems however to be in all respects inferior to the soap and lime-water; but it is less disagreeable, and has frequently, to my knowledge, relieved gravelly complaints. It is generally taken in powder from half a drachm to a whole drachm, two or three times a day. It may however be taken to the quantity of seven or eight drachms a day, with great safety and good effect.
CHAP. XXXIII.
OF INVOLUNTARY DISCHARGES OF BLOOD.
Spontaneous or involuntary discharges of blood, often happen from various parts of the body. These however are so far from being always dangerous, that they often prove salutary. When such discharges are critical, which is frequently the case in fevers, they ought not to be stopped. Nor indeed is it proper at any time to stop them, unless they be so great as to endanger the patient’s life. Most people, afraid of the smallest discharge of blood from any part of the body, fly immediately to the use of styptic and astringent medicines, by which means an inflammation of the brain, or some other fatal disease, is occasioned, which, had the discharge been allowed to go on, might have been prevented.