cystitis. <Callout type="important" title="Important">Cystitis due to calculus can only be cured by removing the stone through the perineum.</Callout> Never attempt to crush a stone in the bladder. Urinary antiseptics are indicated, and hexamethylenamine (urotropin) is recommended for its effectiveness. The bladder should be irrigated daily with hot boracic acid solution. Diet should consist principally of milk. Alcohol, condiments, and drugs that irritate the bladder must be prohibited. Catharsis. The bowels must be kept free, and salines are best, or oil enemata may be used. Pain. Hot applications over the pubis can provide relief. Cloths wrung out of hot water, covered with rubber cloth and bandage, or a hot flaxseed poultice, may be applied. In some cases, an ice bag affords greater relief. If local applications fail to give relief, a <Callout type="risk" title="Risk">hypoergic injection of morphin gr. 1/20 and atropin gr. 1/400 should be given into the skin of the abdomen.</Callout> Suppositories may also be used: <Callout type="tip" title="Tip">I^ Extract! opii gr. vj Extract! hyoseyaminae gr. v Olei theobromatis q. s. Misce et fiant suppositoria No. VI. Sig.: Insert 1 at bedtime.</Callout> DISEASES OF THE KIDNEYS AND BLADDER. <Callout type="gear" title="Gear">Silver nitrate solution is effective for irrigation, with Kaufmann's plan being the best practice.</Callout> In chronic cases, silver nitrate 1:2000 should be used initially, followed by a 1:1000 and then 1:500 solution. The time between injections is gradually increased as improvement is noted. When the urine is acid, the following combination may be administered internally: <Callout type="important" title="Important">I^ Potassii acetatis 3 iv Liquoris potassii 3 j Fluidextracti uva ursi 3 iv Tincturse hyoscyaminse 3 iv TinctursB lupulini 3 iv Aquse § i j Syrupi zingiberis q. s. ad § vii j Misce.</Callout> Causal Therapy. Occasionally, malarial infection will cause a severe acute cystitis, and quinin will give prompt relief when other forms of treatment fail. <Callout type="warning" title="Warning">Do not mistake the systolic murmur heard at the apex for mitral disease; cardiac enlargement is absent.</Callout> CHLOEOSIS. Remember that this condition is due to a deficiency of hemoglobin, and is seen in girls at the age of profound sexual changes. There is no loss of subcutaneous fat, but, on the contrary, fat may be increased, due to deficient oxidation. Remember that puffiness of the face and swelling of the ankles may occur, and suggest nephritis, but a blood and urinary examination will disclose the cause. Remember that in some cases the cheeks may have a reddish tint, and on exertion the patient may complain of palpitation and breathlessness, suggesting disease of the heart or lungs. Don't mistake the systolic murmur heard at the apex for mitral disease. Cardiac enlargement is absent. The venous hum heard over the large veins in the neck is heard only in anemia. Remember that a drop of blood allowed to fall on a piece of white blotting paper often shows the anemia by its pale color, due to the reduction of hemoglobin. Remember the capricious appetite in these cases — the craving for unusual foods, especially acids. Hyperacidity of the stomach and attacks of cardialgia, or severe paroxysmal headaches, are quite common in chlorosis. Remember that the microscope shows small, pale-red cells, with but slight, if any, reduction in the number. Remember that in tuberculosis there is a pallor, but with cough; wasting, positive physical signs, rapid pulse; slight fever, recurring about the same time each day, also coexists; while the pallor of chlorosis is yellowish-green, with areas of pigmentation, and the eyes jDeculiarly brilliant, with sky-blue sclera. Teeatmext. Plenty of fresh air and good red beefsteak for chlorosis is an old adage that is hard to improve upon in the treatment. Rest in bed is imperative in the severe cases, and often better results are observed in milder attacks by requiring midday rest of the patient. Exercise should be moderate and carefully regulated. Those forms that are passive to the patient are best, as buggy riding or boating; then, as improvement occurs, horseback riding and walking may be advised. Massage and dry rubs are excellent. Electricity is indicated, and should be used in the severer forms when neurasthenia is a pronounced factor. Diet must be nutritious. Proteids must be allowed liberally. It is best to feed frequently in small quantities. Milk, to which is added cream, raw or slightly cooked meat, and eggs are excellent. Constipation must be overcome. Saline cathartics or iDilulse aloes et f erri 3 to 5 a day may be used. IJ riuidextracti rhamni pursManse aromatici 5 j Fluidextracli glycyrrhizse 3 ij Misce. Sig.: Teaspoonful night and morning with a glass of hot water. Where the constipation is due to atony of the bowels, and it most frequently is, the following is a good combination: IJ Extracti rhamni purshianse 3 j Extracti nucis vomicae gr. vii j Extracti physostigmatis gr. i j Extracti hyoscyaminae gr. v Misce et fiant pilulse No. XXX. Sig.: Pill night and morning. Iron is the only remedy with which to treat chlorosis. The mode of action is unknown. It is best to gradually increase the dose at the beginning and gradually decrease at the close. Of the preparations to be used, those of U. S. P. are unexcelled. The vegetable iron preparations have no advantage, and the same may be said of peptonates. All are agreed that Blaud's mass will probably give best results. B Piltilte ferri carbonatis (Blaud), recently prepared gr. v Fiat pilula No. I. Dentur tales pilulse No. L. Sig.: Pill three or four times daily half an hour before meals. Blaud's pills may be given after meals, with increase of dose; for instance, 1 pill three times daily for the first week, 2 during the second, 3 during the third, 2 during the fourth, and 1 during the fifth. It is well, where there is digestive disturbance, to give the following powder before meals: IJ Betanaphtolis gr. j Bismuthi subnitratis, Sodii bicarbonatis aa gr. iiss Misce et flat pulvere No. I. Dentur tales doses No. XX. Sig.: Powder three times daily before meals. When severe attacks of gastralgia occur, it is usually made worse by iron and interferes with the treatment. Use an exclusive milk diet, hot cloths over the abdomen, and administer either bella- donna or silver nitrate. IJ Argenti nitratis gr. x Kaolini gr. xlv Petrolati q. s. Misce et fiat massa et divide in pilulse No. L. Sig.: Pill before meals three times daily. Other forms of iron may be used: IJ Ferri reducti 3 ss Pulveris glyeyrrhizse 3 ss Extracti gentianse q. s. Misce et fiat massa et divide in pilulse No. XXX. Sig.: Pill three or four times daily. Arsenic is a useful drug in treating anemia, and may be advantageously combined with the iron: IJ Ferri et ammonii citratis § j Liquoris potassii arsenitis 3 v Aquae menthse piperitse .... q. s. ad 5 vj Misce. Sig.: Half a teaspoonful after meals, gradually increasing dose until teaspoonful is taken. 106 DISEASES OF THE BLOOD. Or: B Ferri et quininse citratis gr. 1 Elisiris simplicis § ij Misce. Sig.: Teaspoonful three times daily. It is well to insist on plenty of water with the iron, especially iron in solution.
Key Takeaways
- Cystitis due to calculus can only be cured by removing the stone through the perineum.
- Hexamethylenamine (urotropin) is effective for treating cystitis and should be used in 5-grain doses three or four times a day.
- Iron supplements are crucial for treating chlorosis, with Blaud's mass being recommended.
Practical Tips
- Maintain good hygiene by keeping the bladder irrigated daily with hot boracic acid solution to prevent complications.
- Use caution when administering morphine and atropin as a local injection; it can be risky if not done properly.
- Ensure that diet is nutritious, especially for chlorosis patients, including plenty of milk and iron-rich foods.
Warnings & Risks
Warning
Do not crush bladder stones; this can lead to severe complications.
Warning
Be cautious with arsenic treatment as it can cause serious side effects if not administered correctly.
Modern Application
While the specific treatments and medications mentioned in this chapter are outdated, the principles of maintaining good hygiene, proper diet, and addressing underlying causes still apply. Modern readers should focus on these core concepts while using updated medical knowledge and equipment.
Frequently Asked Questions
Q: What is the best method for treating cystitis due to a stone in the bladder?
Important
The best method for treating cystitis caused by a stone in the bladder is through removal via the perineum. Attempting to crush the stone can lead to severe complications.
Q: How should iron supplements be administered for chlorosis?
Important
Iron supplements, such as Blaud's mass, should be given gradually starting with a small dose and increasing it over time. The recommended dosage is 1 pill three or four times daily half an hour before meals.
Q: What are the key symptoms of chlorosis that one should look for?
Important
Chlorosis can be identified by a pale complexion, puffiness in the face and swelling in the ankles. Other symptoms include red cheeks, palpitations, and breathlessness on exertion.