A handbook of diseases of women : including diseases of the bladder and urethra / by F. Winckel ; authorised translation edited by Theophilus Parvin.

Date:
1890
Catalogue details

Licence: Public Domain Mark

Credit: A handbook of diseases of women : including diseases of the bladder and urethra / by F. Winckel ; authorised translation edited by Theophilus Parvin. Source: Wellcome Collection.

Provider: This material has been provided by the Royal College of Physicians of Edinburgh. The original may be consulted at the Royal College of Physicians of Edinburgh.

    761/792 (page 749)
    means of examination, the more readily will cases of so-called primary neuroses of the bladder be recognized as purely secondary, as, for instance, various authors have recently described fissure of the neck of the bladder as a cause of cystospasm. There is, therefore, good reason to be cautious in the diagnosis of primary vesical neuroses, and to make it solely by exclusion. Bladder Cramp: cystospasm, neuralgia of the bladder. Chiefly nervous, very excitable women are attacked with cystospasm : great emotional disturbance, onanism, excessive coition, colds, especially at the menstrual period, sitting on the damp cold ground, as well as getting the feet wet, may be mentioned as causes. If, besides, the indiscriminate imbibition of a variety of drinks, as of several kinds of beer, and of new, acid wines, be accepted as a predisposing cause, the anatomical condition may be due to a chemical action of the renal secretion on the sensory nerves of the mucous membrane of the bladder with consequent hyperemia. The first and most important manifestation of cystospasm is pressure in the region of the bladder, especially at the neck, associated with varying spasmodic pain. If the bladder is full there is moderate tenderness ; the pain is greatest at the begin- ning of micturition, which sometimes is vainly attempted, often anxiously avoided. The urine is at the same time pale, free from albumin, sugar, pus, blood, sand and foreign bodies, often passed in large quantities, often only in drops at short intervals. The passage of a metallic catheter through the urethra and into the neck of the bladder is at times excessively painful. Only when, the urine beiug entirely normal, the urethra healthy, no anomaly of blood supply and texture of the walls of the bladder can be found by touch and sight, and when also, after dilatation of the urethra with specula, to which patients in obstinate cases readily submit, no local visible or palpable anomaly can be detected, only when, after illumination of the anterior wall of the bladder by Rutenberg's mirror, no disease is found, only then can primary spasm of the bladder be properly spoken of. No one of the symptoms described is alone pathog- nomonic. Even if the existence of vaginismus were demonstrated