Manual of gynecology / by D. Berry Hart and A.H. Freeland Barbour.

  • Hart, D. Berry (David Berry), 1851-1920.
Date:
1897
Catalogue details

Licence: Public Domain Mark

Credit: Manual of gynecology / by D. Berry Hart and A.H. Freeland Barbour. Source: Wellcome Collection.

    717/810 (page 655)
    Of tliese, calculi are the most important. Stone is less common in the female than in the male, as small calculi can pass along the dilatable female urethra; occasionally, therefore, the gynecologist has to remove from the urethra small stones impacted there—usually at the meatus urinarius. The introduction of foreign bodies, which act as nuclei, is more common in the female. Symptoms. These are severe pain in micturition, especially at the close ; alterations in character of urine ; blood in urine. Physical Signs. The stone, when at all large, can be easily detected Diagnosis bimanually; when any doubt exists, the use of the sound or the passage of the finger into the bladder renders the diagnosis easy. Treatment. Measure the stone : if it be less than an inch, it may be extracted through the urethra dilated first by the finger or Simon's specula; if greater than an inch, then dilate the ui-ethra and crush; if very large or hard or if it have a nucleus, extract by vaginal incision. This incision may be stitched up after the operation, or kept open when the bladder has been much irritated; it can afterwards be stitched as in vesico-vaginal fistula. Supra-pubic lithotomy is sometimes required. For other foreign bodies, the urethra can be dilated and the substance grasped by polypus forceps or manipulated out. When large, they may be extracted as in the case of large stones. FUNCTIONAL DISEASES OF BLADDER. By these we understand derangements of the bladder in regard to Functional urination. Either these are due to caiises as yet unascertained, or the o^^°j*g°^ same derangement {e.g., retention) is associated with many lesions. Bladder. The chief functional diseases are— Irritability, Incontinence, Retention. In regard to all of them, we may remark that in no case should the diagnosis of a functional disease of the bladder be made until the practi- tioner is satisfied that there is no organic lesion. Irritahility. In this, frequent micturition associated with a dis- agreeable feeling is present. It may be due to excessive acidity of the urine, but is often a nervous affection. When it is due to excessive acidity give lithia or potash. Ji Lithii Carbonatis gr. v. Fiat pulv. mitte tales vj. Sig. One thrice daily.