OF BLOODY URINE.
This is a discharge of blood from the vessels of the kidneys or bladder, occasioned by their being either enlarged, broken, or eroded. It is more or less dangerous according to the different circumstances which attend it.
When pure blood is voided suddenly without interruption and without pain, it proceeds from the kidneys; but if the blood be in small quantity, of a dark colour, and emitted with heat and pain about the bottom of the belly, it proceeds from the bladder. When bloody urine is occasioned by a rough stone descending from the kidneys to the bladder, which wounds the ureters, it is attended with a sharp pain in the back, and difficulty of making water. If the coats of the bladder are hurt by a stone, and the bloody urine follows, it is attended with the most acute pain, and a previous stoppage of urine.
Bloody urine may likewise be occasioned by falls, blows, the lifting or carrying of heavy burdens, hard riding, or any violent motion. It may also proceed from ulcers of the bladder, from a stone lodged in the kidneys, or from violent purges, or sharp diuretic medicines, especially cantharides.
Bloody urine is always attended with some degree of danger: but it is peculiarly so when mixed with purulent matter, as this shews an ulcer somewhere in the urinary passages. Sometimes this discharge proceeds from excess of blood, in which case it is rather to be considered as a salutary evacuation than a disease. If the discharge however be very great, it may waste the patient’s strength, and occasion an ill habit of body, a dropsy, or a consumption.
The treatment of this disorder must be varied according to the different causes from which it proceeds.
When it is owing to a stone in the bladder, the cure depends upon an operation; a description of which would be foreign to our purpose.
If it be attended with a plethora, and symptoms of inflammation, bleeding will be necessary. The body must likewise be kept open by emollient clysters, or cooling purgative medicines; as cream of tartar, rhubarb, manna, or small doses of lenitive electuary.
When bloody urine proceeds from a dissolved state of the blood, it is commonly the symptom of some malignant disease; as the small-pox, a putrid fever, or the like. In this case the patient’s life depends on the liberal use of the Peruvian bark and acids, as has already been shewn.
When there is reason to suspect an ulcer in the kidneys or bladder, the patient’s diet must be cool, and his drink of a soft, healing, balsamic quality, as decoctions of marsh-mallow roots with liquorice, solutions of gum-arabic, &c. Three ounces of marsh-mallow roots, and half an ounce of liquorice, may be boiled in two English quarts of water to one; two ounces of gum-arabic, and half an ounce of purified nitre, may be dissolved in the strained liquor, and a tea-cupful of it taken four or five times a-day.