URETHRITIS AND NEURALGIA OF THE URETHRA.
INFLAMMATION of the canal by which the urine is conducted and
discharged from the bladder is termed urethritis.
There is no organ of the female anatomy that is oftener the seat of
local inflammation.
The acute and chronic inflammations that affect the male urethra, also
affect that of the female, only perhaps to a more limited extent, owing
to the comparative smaller mucous surface of the tube, it being only
from an inch to an inch and a half in length.
Inflammation is oftener confined to this portion of the urinary
apparatus than is generally supposed, because any derangements of these
parts is at once attributed to the bladder, and it is an actual fact
that many women have doctored uselessly for years, for the one, when
it was the other that was diseased. Symptoms of urethral inflammations
are so very similar to inflammations of the bladder that the points of
distinction are easily overlooked.
The trouble begins with frequent desire to void urine and a continual
bearing down or straining sensation, which may be accompanied with
a sense of heat suggesting to the minds of the most chaste and pure
women, sexual desire, which the gratification of that indulgence does
not relieve nor satiate, but, on the contrary, the sexual passion
becomes only exaggerated. It is only the strongest force of character
and Christian fortitude that keep some of these unfortunate women
in the path of rectitude and virtue, and it is only the scientific
specialist who can appreciate the real cause. In many instances
women, truly noble in character, have fallen from their high estate,
because uncontrollable impulses swept them into the maelstrom of
licentiousness, which might have been averted, if they had known of
whom to seek proper advice.
This irritation is often innocently and ignorantly acquired in early
girlhood by fingering the parts, or practicing masturbation, which
sets up an inflammatory condition of the urethra that becomes chronic,
and in time may entail the terrible consequences to which I have
already alluded. For that reason mothers should not be over-delicate;
they should not only keep a watchful eye on their children when in
seclusion, but should make it their holy duty to gradually initiate
their children into a knowledge of physiology and of the diseases that
may result from any violation of youthful virtue.
Why is it that many children who have been reared in an atmosphere of
sanctity, children who have enjoyed from their earliest recollection
moral and spiritual administration, have fallen into vice and
depravity? The reader should stop to answer this question for herself,
while I too will answer it for her.
It is because moral teachers overlook the fact that human beings are
dual; that we are all animal, however spiritual, and that the functions
of the animal nature must be understood in order that the spiritual
nature can control them.
A false delicacy has entirely neglected this part of the education of
our children, which I stamp as the height of stupidity and hypocrisy.
Among other causes of this malady is hot and acrid urine, or gravelly
discharges from the bladder, cutting and irritating the mucous membrane
in its passage; abrasions of this nature often lay the foundation for
ulcers. When the urine is in that condition, it is probably due to a
complication of diseases of the bladder, the kidneys and the liver. A
chemical and microscopical examination of the urine will be the only
means of settling these questions.
The urethra often takes on the inflammations of the neighboring tissue
or organs; disease of the vulva or of the vagina will spread itself to
the urinary canal. I have seen cases in which the whole trouble was
traceable to a catarrh of the neck of the womb.
Gonorrhœal infection of the vagina will in the great majority of cases
extend itself to the urethra as well as to the cavity of the womb and
neighboring organs.
If treatment in these complicated cases is to be successful, it must be
directed to the disease in all of its strongholds; this, of course, can
only be done under the direction of a skillful specialist.
There is a predisposition on the part of the mucous surfaces to become
infected by eruptions of the eruptive fevers, and the urethra is
particularly liable to this invasion. Children who have had the measles
and scarlet fever will often be troubled with frequent and smarting
micturition and after convalescence from all the other symptoms of the
respective fevers, they are still more or less annoyed for weeks or
months with a urethritis. I have had cases of this nature that dated
back years. If the early treatment is neglected and the case becomes
chronic, it generally spreads to the bladder, which also becomes
similarly affected.
Smallpox pustules are apt to break out in the urethra during the acute
stage of the disease, and excite a very itching and painful urethritis.
Dysentery in children may give rise to the disease. In adults I have
noticed the affection in connection with typhoid fever, but this
generally passes off with convalescence. Hemorrhoids or piles give
rise to urethral inflammation which does not yield to treatment, but
subsides at once after the removal of the piles. The application of a
Spanish-fly blister to any part of the body may also cause a stranguary
or a urethritis.
Mothers may become uneasy, as to the cause of the muco-purulent
discharge from the urethra of their little girls. I have known them to
entertain suspicion of some specific infection being introduced into
the genitals, in some mysterious manner; a little inquiry into the
history of every case, dispels these absurd delusions, and it will be
found that pinworms have caused the inflammation. In adults, however,
the subject should be made the object of particular inquiry. During
delivery, the passage of the child’s head exerts great pressure on
the urethra, so that it may be crushed or torn across. Women may be
troubled with derangement from this cause for a long time, or for their
whole lives, if the real cause of their ailment is not recognized.
Displacements of the womb in different directions, principally when it
is tipped backwards so that its neck impinges on the urethra or neck of
the bladder, compresses the canal, so that its caliber is diminished,
and a painful obstruction and retention of urine ensue.
Papillated growths and mucous polypoids that were so small that they
were hidden from external sight, but readily detected by scientific
methods of examination of the urethra, by means of the urethral
specula, were the exciting causes of some cases that came under my
treatment. The unfortunate victims were under the impression that their
kidneys or their bladders were diseased. The numerous quack medicines
advertised for the cure of these maladies were copiously consumed,
doing, of course, more mischief than good. The removal of the growths
in each instance at once put a stop to any further inconvenience.
In pregnancy, after the third month, the womb rises out of the pelvis,
so as to accommodate its increasing size. This naturally drags the
bladder upwards, and so stretches the urethra that it becomes sore and
extremely irritable. To relieve this distress until the parts have
accommodated themselves to their new relations, the Femina vaginal
capsules are of the greatest value, and without the slightest ill
effect arising from their use. Vaginal irrigations of hot water are
also of decided benefit, especially before using a capsule.
Mix. A teaspoonful to be given to an adult every four hours till
relieved.
The symptoms of inflammation of the urethra are always very pronounced,
because the mucous membrane of the urethra is the most sensitive
part of the bladder. In the healthy state the coloring of the lining
membrane is of a pale red; when inflamed or catarrhal, it assumes a
dark red, or a cherry color. The membrane is also considerably swelled
and puffed, and feels hot to the touch, and imparts a burning sensation
to the patient. The muco-purulent secretion excoriates or chafes the
skin, so that the parts look angry and red in the neighborhood; this is
oftener observed in children. The characteristic symptom of frequently
urinating is never absent, while very little is passed at a time, yet
the straining to pass water continues, after the last drop is voided.
The treatment is cleanliness to begin with. In grown people, the
entire vulva and vagina must be rinsed out with a warm borax solution,
in the proportion of one teaspoonful of the powdered borax dissolved
in a quart of water. In little children the same object, that of
cleanliness, is to be accomplished with a small ear syringe.
After the external parts and the vagina are thoroughly cleansed, then,
by means of a hard rubber syringe, No. 1, three or four syringefuls
of clean borax water are injected into the urethra for the purpose of
cleaning that too. To relieve the straining and frequent desire to
micturate, which is accompanied with more or less pain, I give:—
NO. V.
Take: Fluid ex. of gelseminum 1 dram
Sweet spirits of nitre 7 drams
Mix. A teaspoonful in a wineglassful of water three or four times a day
for an adult; children in proportion.
The patient must confine herself to a bland liquid diet, principally of
milk, raw eggs beaten up in bouillon or broth. Vegetables may be eaten,
but they are not to be seasoned with anything but salt; and alcoholic
liquors, wine or beer must also be suspended for the time being.
NEURALGIA OF THE URETHRA.
The female urethra is sometimes the seat of simple neuralgia, by which
is meant a painful condition in which there is no apparent disease or
inflammation of the tissues.
This pain assumes often a spasmodic character; that there is a cause
for this is certain, but it is as a rule remote from the sensation
which attracts attention. It is often found to be the symptom of
some of the diseases to which I have already referred. These are
ulcerations, displacements, or inflammation and congestion of the
neighboring organs. Abnormal growths or tissues will often be painfully
reflected on the nerves of the urethra. I remember a case of internal
hemorrhoids, which was never suspected by the patient because there
were no painful symptoms pointing to the rectum, but in which the
urethra was very painful in its entire extent. The suffering from this
urethral neuralgia had lasted for years, but disappeared at once,
on the removal of the piles. I have called attention to a catarrhal
inflammation of the urethra, from stretching occasioned by the
ascending womb after the third month of pregnancy; there is a similar
pathological process after the seventh month of gestation, when the
pregnant womb begins to descend again into the pelvic cavity, and this
is particularly marked in the pregnancy with the first child, when the
pain is often very severe.
If in a first pregnancy there is no abnormal disproportion between the
dimensions of the child’s head and the maternal pelvis, or if there
be no abnormal position of the child, then there is an obstetric rule
that the womb, or rather the child’s head, begins to descend into the
pelvis after the seventh month of gestation, so that it can accommodate
or conform itself to the maternal parts. This occasions a drag on the
urethra downwards and backwards, which is painfully annoying, and there
is a constant inclination to pass water.
There are two mechanical methods of relieving this distressing symptom;
one is to obtain as much rest as possible in the recumbent position,
and the other is to wear an abdominal supporter or bandage around the
lower abdominal region, so as to take the weight off the urethra. The
internal medication consists of an occasional dose of a mild laxative
medicine.
In the newly married, the urethra becomes sometimes the seat of a
painful spasmodic contraction; this is due to a tense hymen, which
should be slightly nicked with a pair of scissors. Exposures to colds
will also cause neuralgia. Fresh beer and sour wine make the urine
irritating, and also occasion painful symptoms.
A thorough examination of the mucous membrane of the urethra which does
not reveal any inflammatory condition or abnormal growth, establishes
its neuralgic character. The next step will naturally be to make such
a careful examination of all the surrounding tissues and organs, for
the purpose of ferreting out the real cause. When the cause is removed
or cured, it will also relieve the urethral pain. In the absence of a
clear comprehension of the true nature of the malady, the treatment
must be palliative. The sitz-bath is always one of the most palliative
measures for all sorts of pelvic pains and aches. Vaginal injections of
hot water, not too hot, from 105 degrees to 108 degrees, are another
sort of general panacea,—the quantity of fluid should be large, from
half to one gallon, in which a teaspoonful of pulverized borax has been
dissolved. If the pain is very severe, then a Femina vaginal capsule
should be used every night before retiring, and immediately after
having used the vaginal irrigation. The bed should always be previously
warmed with a hot bottle, unless it is very warm weather.
If the urine is irritating, a cupful of buchu tea three or four times
a day, or German chamomile tea, should be drunk between meals. If
these measures do not give relief, then consult an honest, competent
physician, in whose integrity you can rely.