Urinary Diseases



MEDICINES.- Among those used, the following are probably the most successful- Ac.-Phosphorus, Nux V., Ac.-Oxal., Lycopodium, Cann., Berb O Gelsemium, Aconite, Cantharis, Nat.-Carb., Podoph., Mercurius, Ocim., Can. During an attack of renal colic Morphia will almost certainly be needed.

When a Stone becomes dislodged, and is passing from the kidney down the ureter towards the bladder, or from the bladder through the urethra, the pain is extreme; the membrane of the canals is liable to be lacerated, and Inflammation and suppuration may supervene; or Irritability, Spasms, or Incontinence may trouble the patient for a long time.

To prescribe for a patient with Stone in his bladder such remedies as Cann., Belladonna, Nux V., or Phosphorus-Ac., to remove the pain and frequently of micturition; Vichy water to correct the altered urine; or Hamamelis, or Vichy water to correct the altered urine; or Hamamelis, or Cantharis, to arrest the haemorrhage, is useless, except to afford temporary relief; it would be wasting precious time and throwing away the opportunity of cure which an operation offers.

All cases in which there is even room for a suspicion of Calculus should be at once placed under the care of a professional Homoeopath.

181.- Enlargement of the Prostate.

This vague but convenient term refers to an affection met with in men after middle life, of which the most prominent symptom is an irritability of the bladder and a progressive incapacity to empty it. The prostate gland undergoes a considerable increase in size, and by pressing on the neck of the bladder forms an obstruction to the outflow of urine from that organ, so that the latter cannot be completely emptied.

Enlargement of the prostate is compatible with vigorous health and an absence of symptoms for a period which may range from months to years. The earliest symptom is that the patient has to rise from bed to make water, especially during the early morning hours. He notices that the urine is slow in coming, that the stream is less forcible, and that urine escapes after he thinks the act completed; he is inclined to strain in passing water, although this hinders rather than helps the flow. The repeated straining may induce piles and prolapse of the anus.

At any time the enlarged prostate may become congested from alcoholic or sexual excess, or from exposure to cold, especially if the patient has allowed his bladder to become full, for example on a railway journey, and he then finds himself unable to pass water; in other words there is acute retention.

TREATMENT.- To improve the muscular tone of the bladder and to train it to empty itself, the patient should, after passing water in the normal way, wait a minute or two and then try again. This should be practised as frequently as possible till only a very small quantity can be squeezed out (Say half an ounce). When this point has been reached, twice or thrice daily may suffice. When the symptoms are entirely due to the mechanical obstruction at the neck of the bladder, and the health and vitality of the patient are unimpaired, a radical operation for removal of the prostate is indicated.

The complications of enlarged prostate are retention of urine, cystitis, stone in the bladder and haemorrhage. Haemorrhage resulting from congestion of the enlarged prostate is often beneficial, but if it persist recourse should be had to hot baths, and appropriate medicine. If these measure fail a full- sized catheter may require to be passed and tied in for a few days, or the bladder tapped.

The operation of removing the prostate is as a rule a remarkably successful one in relieving the patient of his symptoms, and improving his general health.

Of drugs one of the following may prove useful- Apis., Baryta.-C., Calcarea, Clem., Conium, Digit., Lycopodium, Nux Vom., Phosphorus, Pulsatilla, Selenium, Sepia, Sulphur, Thuja., Ferrum Pic.

182.- Irritability of the Bladder and Spasm of the Bladder – Strangury -Difficulty in Passing Water.

These conditions are usually consequent on some diseases of the urinary organs- Cystitis, Calculus, Gonorrhoea, etc.; or are associated with Gout., Hysteria or other conditions.

SYMPTOMS.- Frequent desire to urinate; the fluid is forcibly or spasmodically ejected in small quantities; and its passage is attended by burning, aching, or spasmodic pain (strangury); the pain is confined to the bladder, or extends to the end of the penis, round the pelvis, or down the thighs. The urine may or may not be unnatural; but when the diseases has become chronic, mucus or pus is passed with it (Catarrh of the bladder). In children, irritability of the bladder is sometimes caused by worms.

A person in health passes water on a average about five or six times a day, and has not to rise generally in the night for this purpose; but when there is any degree of inflammatory action of the bladder, the inflamed mucous membrane cannot bear much distension, so that five or six ounces of urine, or even less, excite a desire to urinate, although under healthy conditions the bladder contains without inconvenience fifteen or sixteen ounces.

EPITOME OF TREATMENT.- Nux V. (Spasm); Ferrum (simple irritability during the day); Belladonna (irritability in children and hysteric females); Apis. (Strangury); Aconite (Strangury from cold); Cantharis (with or after inflammation of the pats); Lycopodium (with much red sediment or gravel).

ACCESSORY MEANS.- Mucilaginous drinks, the tepid hip-bath, etc. It is important to recollect that Strangury is not a substantive disease, but a symptoms resulting from various causes, the removal of which is necessary before the bladder can regain its healthy sensibility and tone.

183.- Incontinence of Urine-Wetting the Bed.

This is not a disease per se, but a symptom dependent upon one or more of various causes, and may consist of partial or entire loss of power to retain the urine in the bladder. The patient may have an almost constant urging to pass water, which, if not immediately responded to, results in an involuntary discharge, but there is no pain or Spasm as in Strangury. If the patient be troubled with a cough, the inconvenience is much increased, as during each paroxysm the urine escapes. When the loss of voluntary power is more complete, the urine continues to dribble away as fast as secreted. The constant excoriates the parts causing soreness when moving about; at the same time an offensive urinous odour is exhaled from the person, which renders the condition most distressing.

The majority of the patients are young-from three or four up to fourteen or sixteen years of age-and the symptom is most troublesome at night.

CAUSES.- Reflex action, from many and diverse causes. Consequently, successful treatment can only be adopted after a careful investigation of the cases. Paralysis of the bladder is but an infrequent cause. It may result from injuries, Tumours, syphilitic disease of the spine, or constitutional causes. In children the most frequent causes are irritation of the bladder from worms in the rectum; too large a quantity of warm fluids, especially if taken towards evening; improper food or drink, causing acid urine, which irritates the mucous coats of the bladder, etc.

DIAGNOSIS.- One or two points may be determined by an inquiry as to whether the incontinence is most troublesome in the daytime or at night. Stone in the bladder does not cause much disturbance at night; but in the daytime, when moving about, it occasions frequent calls to micturate. On the other hand an enlarged prostate is most troublesome at night, when frequent calls to pass water are made. If this symptom occurs in a patient about sixty years of age, who has only recently had urinary troubles, and these are greatest at night, an enlarged prostate gland is the most probable cause. Lastly, in obscure cases, diseases of the brain, spinal cord, kidneys, bladder, or rectum, should be examined for; and the possibility of masturbation, or the existence of obvious causes of irritation about the external genitals, should not be forgotten. Among the latter we may especially Congenital Phimosis, which, in consequence of the hindrance it offers to strict cleanliness, allows the secretions to accumulate around the gland and become a source of irritation. In these cases circumcision is the remedy, and is generally effective.

Dribbling of urine in adult life usually denotes overflow of a distended bladder.

TREATMENT.- The chief remedies are-Belladonna, Gelsemium (in the aged); Causticum, Cantharis, Nux V., Ac.-Phosphorus, (with alkaline urine, and in hysterical females); Podoph., Calcarea carb., Ac.-Nit., Opi., Lycopodium, Ac.-Benz. (high-coloured and strong-smelling urine); Cin. or Spigelia (from worms); Ferrum, Silicea (diurnal); Scilla (profuse discharge); Aconite, Cantharis, or Chamomilla (in children, with uneasiness in micturating).

Gelsemium.- Relaxed or paralytic condition of the sphincter of the bladder, leading to involuntary urination night and day.

ACCESSORY MEANS.- As incontinence of urine is generally the result of disease, corporal punishment cannot correct the annoyance, but only medical and general treatment, which must be entirely regulated by the cause. The bladder should be trained to retain water during the day. All salt, sharp and sour article of food, malt-liquors, spirits, tea and coffee, should be avoided. Meat may be eaten in moderate quantities, but only a small quantity of fruit, and no flatulent food. Noting hot should be taken in the after part of the day. Simple Water, milk-and-water, and cocoa, are the most suitable beverages. Cold soft water or mucilaginous drinks in moderation tend to diminish the acrid properties of the urine. The mother or nurse should be quite certain that the child empties his bladder before getting into bed, as the child when sleepy or tired is apt to avoid this. Until the cause is removed, the patient the patient should be taken up an hour and a half after he has gone to sleep, and if this is not sufficient, at regular hours throughout the night. Regular habits as to micturition should be encouraged during the day. Children who wet their beds ought to sleep on hard mattresses, with light clothing, and not be permitted to lie on the back; this may be prevented by fixing an empty cotton reel so as to press on the muscles as soon as the patient lies on the back. Patients should take much open-air exercise, and have shower baths or ablutions with cold water every morning; the whole process, including drying with a large towel or sheet, should not occupy more than a few minutes.

Edward Harris Ruddock
Ruddock, E. H. (Edward Harris), 1822-1875. M.D.
LICENTIATE OF THE ROYAL COLLEGE OF PHYSICIANS; MEMBER OF THE ROYAL COLLEGE OF SURGEONS; LICENTIATE IN MIDWIFERY, LONDON AND EDINBURGH, ETC. PHYSICIAN TO THE READING AND BERKSHIRE HOMOEOPATHIC DISPENSARY.

Author of "The Stepping Stone to Homeopathy and Health,"
"Manual of Homoeopathic Treatment". Editor of "The Homoeopathic World."