REMEDIES.- Nux Vomica at night, and Sulphur in the morning, are recommended, and perhaps facilitate the cure.
86. Incontinence of Urine – Wetting the Bed.
This is a frequent and troublesome affection of children, consisting of partial or complete loss of power to retain the urine. From the age of three, at any rate, a child should have control of the bladder. The most common form is Enuresis nocturna – wetting the bed; in rarer cases the child may have an almost incessant urging to pass water, which, if not responded to, results in a painless, involuntary discharge. If the child be troubled with a cough, the inconvenience is much increased, as during each paroxysm the urine is apt to escape. The affection is most common in children three or four to fourteen or sixteen years of age, and is most frequent at night.
CAUSES.- Apart from general diseases, such as Diabetes, Rheumatism, Epilepsy, inflammation of the spinal cord, or mental deficiency, of which it may be but one manifestation, enuresis may be caused by (a) some lesion in the urinary tract, such as Calculus, Bacilluria or Cystitis (inflammation of the bladder); (b) abnormality of the urine itself, either excessive quantity (due to drinking too much fluid in the evening) or excessive acidity; (c) reflexly through the nervous system by thread- worms, Phimosis, adherent foreskin, adenoids, etc.; (d) some inherent defect in the nervous control of the bladder.
TREATMENT.- Belladonna and CalcareaCarb. are the most useful remedies. Causticum often acts well. Quarter-grain doses of thyroid extract, gradually increased, are useful where there is reason to believe that the thyroid secretion is deficient (dry harsh skin, dull expression, thick lips, chilliness, Constipation).
If there is no reason to suspect thyroid deficiency, and if Belladonna (1x or 3x or higher), CalcareaCarb. and Causticum (in this order) have been tried (along with all accessory measures) without success, then a trial should be made of Belladonna in substantial doses, beginning with five drops of the mother tincture three times a day and rapidly increasing until fifteen to twenty drops are taken four times a day. If the enuresis stops under this dosage it should be continued for three or four weeks and then gradually diminished to the vanishing point.
ACCESSORY MEANS.- Tolle causam (“remove the cause”) is obviously the first injunction to remember. If there is calculus or anything of a surgical nature, it must be surgically removed. If there is Bacilluria (see Section 87), Thread-worms (Section 70), Adenoids (Section 59), they must be treated. Adenoids may have to be removed. Phimosis must be remedied by circumcision.
Excessive acidity of the urine, not a common cause of Enuresis, may be remedied by giving alkalies such as bicarbonate of soda, but is probably relieved equally well be giving the indicated homoeopathic remedy, as well as by limiting the starch in the diet. Fluid should be taken freely (e.g. plain water and bland drinks) in the early part of the day, but none after five o’clock. The mother or nurse should be quite certain that the child fully empties his bladder before getting into bed, as a child very tired or sleepy is apt to shirk this.
If the child is found (as is often the case) to wet during his early sleep, he should be taken up after two hours or even after one hour, and later on again, when the parents retire to rest. A helpful adjunct to treatment is to raise the foot of the bed mine or twelve inches. The child should sleep on a hard mattress, with light clothing, and should not lie on his back; this may be prevented by fixing an empty cotton-reel so that on turning on his back the reel may press into the muscles. At bedtime an occasional warm bath at 90o to 98o Fahr., or a warm sitz bath, is often of great value in this disease, and greatly contributes to the success of the general treatment. Sponging the lower part of the back with hot water at bedtime is said to cure some cases of incontinence in children. Patients should take much open-air exercise, and have ablutions with cold water every morning : this with the subsequent drying should not occupy more than a few minutes.
Corporal punishment will work no cure. The fear of it increases the tendency to urinate in the case of nervous children. It should only be resorted to when incontinence is the result of an indolent habit of neglecting the natural desire.
87. Bacilluria.
DEFINITION.- An infection of the urinary tract with Bacillus coli (rarely with Bacillus proteus).
SYMPTOMS.- There may be Bacilli coli, even in fair abundance, in the urine, without any symptoms. But often there is slight fever, up to 100o, the child is out of sorts, languid, and fretful; no urinary symptoms are complained of, but the water, which is acid, is cloudy and turbid, with a stale “ancient fish- like odour”, and contains pus. If there is actual Cystitis (inflammation of the bladder), there will be great frequency and pain and scalding in passing water. During the course of a simple Bacilluria, there may be sudden exacerbation of symptoms, with sharp rise of temperature to 103o or 104o (accompanied perhaps by rigors or attack of collapse) with pain in the loin (nearly always the right loin). These attacks may come on quite suddenly when the child is in good health, and they are then apt to be very puzzling, because the child does not complain of any symptom that points to the urinary system. Examination of the urine shows the presence of pus and swarms (perhaps a pure culture) of colon bacilli, and a diagnosis is at once made of acute Pyelitis (inflammation of the pelvis of the kidney) due to Bac.coli.
CAUSES.- The fact that girls are much more prone to this infection than boys are suggests strongly that the colon bacilli migrate from the anus to the vulva and so trek up the urinary tract to the kidney. It is possible that intestinal worms (Oxyurides), which undoubtedly migrate to the female vulva, carry colon bacilli with them. Recent opinion inclines, however, strongly to the view that the usual route of infection in cases at any rate of acute Pyelitis, is from the ascending colon to the right kidney, a belief favoured by the fact that there has usually been some intestinal disturbance and perhaps, as a consequence, some injury of the intestinal mucous membrane, before the onset of the Pyelitis. Some have believed that the appendix is the source of trouble and advocate removal of the appendix as part of the treatment.
TREATMENT.- The disease is one that has only lately been recognized, and there are no records of its homoeopathic treatment. The disease, however, readily yields to the simple device of giving an alkali like citrate of potash, which may be combined with bicarbonate of soda, in quantities sufficient to make the urine alkaline. To effect this it may be necessary to give ten or fifteen grains three or four times a day even to infants. Older children will want more. Older children, too, in addition to receiving alkalies, should have milk cut out of their diet. An autogenous vaccine, that is a vaccine made from the patient’s own bacilli, is quite often useful in improving the patient’s general health. If there is any intestinal irregularity, this should be treated (Sections 67-71).
GLOSSARY
Abscess.
A gathering, a collection of pus.
Agglutination.
Adhesion of two surfaces
Alae Nasi.
The cartilaginous sides of the nose.
Anaemia.
Impoverished state of the blood.
Anus.
The orifice of the large bowel.
Arachnoid.
The smooth cobweb-like investment of the brain.
Areolar Tissue.
The tissue which connects the various component parts of the body.
Asthenic.
Want of strength.
Atrophy.
Wasting.
Cachexia.
A bad habit of body.
Caries.
Ulceration of bone or teeth.
Cartilage.
Gristle.
Casein.
The Nitrogenized principle of milk.
Cell-Proliferation.
Cell-bearing.
Cellular Tissue.
Some as Areolar Tissue.
Cerebral.
Relating to the brain.
Chloasma.
Liver Spots.
Chyle.
The milk-like fluid absorbed by the lacteal vessels digested food
Cicatrices. Scars.
Coma.
Torpor; lethargic sleep.
Congenital
From birth.
Congestion.
Undue fulness of the blood-vessels in an organ
Conjunctiva.
The lining membrane of the eyelids and the front part of the
Convalescence
The state of recovery.
Cutaneous.
Belonging to the skin.
Cuticle.
The external layer of skin.
Defluction.
Discharge of excessive secretions.
Depurating.
Cleansing from impurities.
Desquamation.
Scaling of the skin.
Diagnosis.
The distinction of diseases
Diathesis
Constitutional predisposition of disease.
Dorsum Ilii.
The back of the hip bone.
Dyspnoea.
Difficult breathing.
Efflorescence.
The Pulverescence of crystals by the removal of their moisture on exposure of the air.
Effluvia
Exhalation from putrefying substances.
Effusion
The pouring out of fluid.
Emaciation
Wasting
Emphysema.
Infiltration of air into areolar tissues of the lungs or the dilation of the air-cells.
Ephemeral.
Of short duration.
Epithelial Scales
The superficial scales of mucous membrane
Epithelium
The superficial layer of mucous membrane
Erosion.
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."