INFLAMMATION OF THE BLADDER 569 



INFLAMMATION OF THE BLADDER 



Is an extremely painful affection caused by retention of urine, injuries, 

 the presence of calculi, irritation of abnormal virine, by extension from the 

 kidneys, and occasionally from foreign bodies whose presence it is most 

 difficult to account for in such a situation. 



I'he Symptoms are much the same as nephritis, but examination per 

 rectum may discover the bladder to be full and unable to contract upon 

 its contents, the muscular coats being paralyzed. Frequent attempts at 

 micturation with constantly protruded penis, arched back, anxious 

 countenance, high temperature, quick and irritable pulse. 



Treatment. — The same generally as for nephritis (see page 567), but by 

 the use of the catheter something may be done to relieve the pain, and by 

 forcibly syringing up the urethral passage a mixture of exti'act of belladonna 

 and glycerine diluted with warm water. Belladonna is the one active drug 

 for which the claim can be made that it has a special soothing effect upon 

 the urinary apparatus, where opium for various reasons is inadmissible. 

 Demulcent drinks, as linseed tea and barley-water, should be given freely. 



Fig. 100. Urinary Calculi. Fia. 101. 



Retention of urine may be due either to inflammation of the neck of 

 the bladder, occasioning a spasmodic closure of that part, or there may be 

 spasm unattended by inflammation and due to the irritation of some offend- 

 ing substance, such as a calculus. 



The Treatment in either case must be directed to the spasmodic constric- 

 tion, which is generally under the control of large doses of opium and 

 camphor, that is, from one drachm to two drachms of each, repeated every 

 five or six hours. If the symptoms are urgent, bleeding may also be resorted 

 to, and when the bladder is felt to be greatly distended, no time should be 

 lost in evacuating it by means of the catheter, Avhich operation, however, 

 should only be entrusted to a regular practitioner accustomed to its use. 



Calculi in the bladder are formed of several earthy salts, and pi'esent 

 various forms and appearances, which may be comprised under four divisions. 

 1st. The mulberry calculus, so named from its resemblance to a mulberry, 

 possessing generally a nucleus (see Fig. 100). 2nd. A very soft kind resemb- 

 ling fuller's-earth in appearance, and being chiefly composed of phosphate of 



