Suppression and retention of urine although frequently producing similar symptoms are entirely unlike.
In suppression of urine there is no secretion of urine, the secreting function of the kidneys being for the time either partially, or entirely destroyed. This variety is attended with considerable danger, the brain being exceedingly liable to become diseased, and if the suppression be total, serious cerebral difficulty generally sets in, in the form of delirium, succeeded by coma and effusion. In these cases the saliva, sweat, and water effused on the brain, have a urinous smell and taste.
The suppression may arise from inflammation of the kidneys, when it is attended with febrile symptoms, nausea, vomiting pain in the region of the kidneys, tenderness of the abdomen to the touch, frequent desire to urinate, but if any is secreted, it passes in small quantities, and is accompanied with severe pain; or it may be occasioned by the presence of gravel or calculi in the kidneys, giving rise by their irritation to inflammation, when the symptoms are similar to those described above. Sometimes it may depend on paralysis of the kidneys, when there may be no desire to urinate, an absence of pain and febrile symptoms, but the unpleasant cerebral symptoms set in none the less rapidly.
In retention of urine, the urine is secreted as usual, but from some cause, such as the presence of stone in the bladder, inflammation or stricture of the urethra, paralysis of the bladder, enlargement of the prostrate gland or the presence of tumors, it is prevented from passing out. The symptoms of course are exceedingly varied according to the cause of the disease. There is distension of the bladder, which can be distinctly felt, elevated above the pubis, - and by this symptom alone the difficulty may be distinguished from suppression of urine, - pain in the region of the bladder, and constant but ineffectual desire to urinate, attended with severe pain, except in cases of paralysis, where there is an absence of febrile symptoms and pain. This difficulty seldom exists alone, but generally in connection with some other disease. If not relieved, the bladder may become so distended as to be ruptured, discharging the urine into the bowels, causing gangrene, and resulting in death.
The use of the catheter may be frequently required, but as this should be used by the practiced hand of the physician, it will be unnecessary to speak of it here. The cause of the disease should be ascertained as nearly as possible; whether the result of stricture, of inflammation, of mechanical injury, of paralysis or gravel.
External application, such as, warm baths, poultices, warm cloths, or if much heat is present, cold water will be found not only in this complaint, but in Cystitis and Nephritis, valuable auxiliaries. See also wet-bandage. The prominent remedies are: Canth., Cann., Aeon., Bell., Rhus, Nux-v., Terebinth, Ars., Asparagus, Arnica.
Where it is occasioned by mechanical injury, or the irritation of calculi, Arnica is the proper remedy.
When the result of paralysis, Nux-v., Arsenic, Terebinth.
The treatment as a general thing should commence with Camphor or Aconite. These remedies will often produce entire relief. If however after four or five doses have been given no relief has been obtained select another remedy.
Opium is of great benefit in. the aged.
Camphor two or three drops given every half hour will be of great benefit, especially in children.
Three drops, or twelve globules, in a tumbler of water, a tablespoonful at a dose; or a powder, or six globules on the tongue. In severe cases a dose may be given every half hour, increasing the intervals as relief is obtained, to two or three hours.