Rheumatism of the Urinary Bladder.
—By Prof. Gross.
This man, thirty-nine years of age, complains of pain in the groins and frequent micturition, which attacked him two weeks ago and is increasing. He passes his water, on an average, about twenty times in the twenty-four hours, and is compelled to get up at night sometimes twelve or fifteen times for that purpose. The urine is never bloody, and he voids it in a very small stream with considerable straining, but without any particular pain at the time. He is troubled with some flatulence, constipation and hemorrhoids, but his general health is not much affected, and he says he would sleep well enough at night if it were not for his bladder. He informs us that he has had rheumatism, but not since this trouble commenced.
On passing the sound, we detect no stricture or calculus in the bladder to account for the symptoms; which in all probability are produced by rheumatism or neuralgia, as the bladder is subject to these affections just as any other of the body is. We will, therefore, give him ten grains of Quinine morning and evening for five days, and: Rx Morphiae Sulph., gr. 1/2; Vini Colchici, gtts. xlv. M.; at bedtime, each night.
The Morphia will relieve the irritability of the bladder, and the Quinia and Colchicum will act upon the rheumatism. If this is insufficient to procure for him good rest at night, without which his health can not be restored or maintained, we might give Opium or Morphia suppositories at bedtime, or inject half a drachm of Laudanum, or give Morphia hypodermically, in addition. He shall be kept warm, in the house, and may eat light food but coffee, pastry, and the red meats are interdicted.
One week later.—The patient reports himself as being much improved. He is now compelled to empty his bladder only seven or eight times in the twenty-four hours, and not oftener than four times in the night, instead of every half hour, as before. He has no pain in his side, and no scalding nor tenesmus.
There is marked improvement here, and in a short time he will have fully recovered. A full dose of Morphia or Quinia will frequently accomplish more than a dozen smaller ones, on the principle that when a man is hungry he wants a full meal. We must give medicine to accomplish a certain object, and should always give enough to obtain its full therapeutic effect. We will now give him: Rx Quiniae Sulph., grs. x.; Morphiae Sulph., gr. 1/3; M. which he shall take at night as before; and to modify the urinary secretion, he may take: Rx Infus. Uvae Ursi, f℥ij. Sodae Bicarb., grs. x. M. S. t. d.
He returned three days later, and reported himself comfortable, and almost entirely cured.—Phila. Med. Times.
The Eclectic Medical Journal, Vol. XXXIV, 1874, was edited by John M. Scudder, M.D.