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This affection is not generally attended with much pain, but proves exceedingly troublesome and distressing. Sometimes the urine passes off continually in drops, and at others an involuntary discharge of considerable quantities takes place by an irresistible impulse, which it is beyond every effort of volition to control. •
Causes.—Enuresis is generally produced by paralysis of the sphincter of the bladder, irritations from cold or worms; and mechanical causes, such as tumors, enlarged ovaries, diseased, mesenteric glands, and diseases of the rectum. It also occurs frequently during pregnancy, in consequence of pressure of the uterus upon the bladder.
Treatment.—The principal remedies for the removal of this affection are Causticum, Cantharides, Hyoscyamus, Nux-Vomica, Pulsatilla, and Phosphorus.
When it occurs during the night, while asleep, and especially if associated with heat or increased warmth of the genitals, and an itching of the anus. Causticum.
When it is attended with a burning pain and uneasiness in the bladder and urethra, and the urine passes off in drops. Cantharis.
When the discharge is copious and without pain; or when the disease depends upon paralysis. Hyoscyamus.
When caused by paralysis of the bladder, or by sym. pathetic irritation from piles; constipated bowels ani tenderness of the abdomen. Nux- Vomica.
When it depends upon irritation caused by the small pin worms, (which frequently harass children severely.)
1st. Teucrium; 2nd. Belladonna.
When it arises from intestinal irritation of the common round worm. 1st. Cina.; 2nd. Belladonna.
When the involuntary discharge is associated with a mucous diarrhoea; alternate flashes of heat and creeping chills; disturbed sleep, and especially in females. Puls.
For incontinence of urine, with swelling of the scrotum, and bruised pain in the back; or sore pain in the vagina; swelling of the breasts and pain in the limbs. Rhus-tox.
For Enuresis nocturna (more commonly termed wetting the bed) generally, but not altogether confined to children.
Silex, Sepia, Sulphur, Carb-veg.
Administration.—This affection does not require a rapid repetition of remedies; once a day is sufficient.
Diet And Regimen—In conformity with homoeopathic rules, while taking medicines. Those who are troubled with Enuresis at night should avoid drinking much in the evening, and always remember to urinate before retiring.
XXIV. URINARY CALCULI. (Gravel or Stone in the Bladder.)
The term gravel is generally applied to the sand-like concretions or small stones which form in the kidneys and in a few days pass through the ureters to the bladder and frequently occasion severe nephritic symptoms, such as pain, shooting down the back through the pelvis, and in the thighs; numbness of the legs, and a retraction of either testicle; but when the calculous formation has acquired a size, which renders it difficult to pass from the kidney or bladder it is then termed Stone; the existence of which is characterized by the following symptoms.
Frequent inclination to urinate, and severe pain, voiding it drop by drop; sometimes the urine will start in a full natural stream, and suddenly stop by the rolling of the calculi or stone against the orifice of the neck of the bladder; in males severe pain is frequently experienced in the glans penis, which lasts two or three minutes after urinating. The urine is frequently tinctured with blood, and sometimes pure blood is voided in consequence of an abraded surface, or the rupture of a small vessel; it is sometimes turbid, and deposits quantities of slimy sediment in the bottom of the vessel, which is generally mucus thrown off from the inner coat of the bladder; and a very distressing, pressing and bearing down sensation is not only experienced in the bladder, but also acts sympathetically on the rectum, frequently occasioning prolapsus ani.
The physical properties and constituents of urinary calculi vary very much, according to Marcet, Prout, Fourcroy, Vauquelin, Wollaston and others; some are round, smooth and of a polished surface, others are rough, tuberculated and covered with octahedral crystals; some are of a laminated nature, while others are friable and chalky. Their constituents have been given at length by Brande, Henry, and the gentlemen previously mentioned, and are found to consist principally in uric-acid, lithic-acid, ammonia, magnesium, phosphate of lime, oxalate of lime, and other earthy matter forming according to their properties, and varying in color from dark brown to a white, yellow, gray and greenish hue.
Treatment.—For urinary calculi of a white calcareous appearance and irregular form; great desire to urinate; cutting in the region of the bladder and a burning in the urethra, during and after micturation; urine turbid and depositing a sediment. Kali-carb.
When there is a great desire to urinate; a continual urging; urine deposits a yellow or red sediment like sand; itching in the urethra; violent pain in the fore part of the urethra; cutting pains in the bladder and rectum; or a severe pain in the back, with a degree of constriction of the loins and abdomen. Lycopodium.
When the urine deposits a sediment like brick-dust, or a white floculi; smarting and burning in the urethra, with tension over the bladder. Phosphorus.
When there is a painful desire to urinate, voiding drop by drop; reddish urine, depositing a red sediment; or urine tinged with blood; pain in the back or between the hips. Nux- Vomica.
When the urine is tinged with blood, or pure blood is passed; urine of a fetid, acrid smell; burning in the urethra, with violent stitches in the glans. Calc-carb.
When there is difficulty and pain in voiding the urine; the urine mixed with blood, attended with violent pressing and bearing down pains. Rhus-tox.
Administration.—Give the remedy indicated once or twice a day, unless the symptoms are very urgent which would justify a more frequent repetition.
Diet And Regimen.—The diet should be light and unirritating, and the drinks of a mucilaginous character, such as slippery elm, gum arabic, barley and rice water. If there is much irritation, the patient should be kept quiet and in a recumbent posture.
DISEASES AND CONDITIONS PECULIAR
The beauty and extreme delicacy of the female organization, independent of its anatomical and physiological characteristics, are sufficient to indicate that it is subject to a class of diseases and modifications peculiar to itself. How beautifully formed is woman, and how strikingly dissimilar to man in her physical structure. Though inferior in stature, she is eminently superior in point of perfect symmetry, her bones are thinner and more pliant, with their angles less acute, and their articulations better concealed. The chest is more elevated and the thorax shorter, giving her a peculiar delicacy of waist. The pelvis differs in many respects from that of man, it has a greater expansion of the bones; the pubes are more arching and the diameters larger, and she is thus " calculated to subserve one of the most important and interesting functions." The muscular fibre appears to possess a greater degree of sensibility and mobility, the former rendering her more susceptible to moral and physical impressions, and the latter imparting ease and grace to her movements. The nervous system also presents its peculiarities; the nerves are smaller and more delicately formed, and are necessarily endowed with a much greater sensibility, contributing in an eminent degree to impressions which