Affections of the Urinary System

Symptoms: There is an increased quantity of urine. This is rich in albumen and of low specific gravity. Most patients appear badly nourished and anemic. Dropsy is frequently present, but uremia is very rare. The liver and spleen are usually enlarged from the same cause. A similar waxy infiltration is seen in the walls of the blood-vessels.

Etiology: It seems to be merely part of a general degeneration of the body from chronic pus poisoning and develops in long, standing suppurating processes — cancer, tuberculosis, chronic Bright’s “disease,” suppuration of the bones, etc. It is a terminal stage of a long process of pathological evolution which began with enervation and ran on through toxemia with its repeated crises, finally suppuration, and then waxy degeneration of blood vessels, liver, spleen and kidneys. “Syphilis” is listed among its causes. This should mean drugs.

Prognosis: Taken in time, the disease can be arrested,” says Weger, “though the usual progress is rapidly downward to a fatal ending.” In the early stages its arrest depends on recovery from the suppurative process.

Care of the Patient: In the late stages this is only palliative. In the early stages the care should be directed to removing the causes of the primary pathology — cancer, tuberculosis, etc.

HYDRONEPHROSIS

Definition: A cystic condition or overdistention of the renal pelvis with urine, resulting from mechanical obstruction.

Symptoms: Slight distention produces no symptoms. Large cysts are often painful. In cases where the distention is great, a tumor slowly develops in the region of the affected kidney as the urine accumulates. Sometimes the tumor periodically disappears and reappears (intermittent hydronephrosis). The disappearance of the tumor is associated with the discharge of a large quantity of urine, as the pressure exceeds the obstructive resistance.

Etiology: This condition is sometimes seen in infants as a result of a congenital stricture, twisting or other anomaly of the ureter. In adults it results from obstruction of the ureter by impaction of a stone in the ureter, abdominal tumor compressing the ureter, tumors growing within the ureter, compression of the urethra by an enlarged prostate, or a stricture of ureter or urethra following inflammation. Hydronephrosis is comparatively rare and is usually only on one side. When on but one side it is less annoying and offers less danger than when in both kidneys.

Prognosis: If the cyst is only on one side and of no great size recovery or indefinite prolongation of life are possible. If on both sides a fatal ending as a result of rupture into the peritoneum, secondary pyonephrosis, or uremia, is likely. Unilateral hypdronephrosis may end in death in the first two ways here described.

Care of the Patient: Such conditions as are not spontaneously relieved when the pressure exceeds the obstructive resistance are entirely surgical. These cases require aspiration and surgical drainage. Indeed if there is great degeneration of the kidney or atrophy from pressure, its removal is called for.
If the cyst is unilateral and of no great size, or if it spontaneously empties itself intermittently, it should not be disturbed and care should be directed to improving the general health, normalizing metabolism and taking off as much of the load carried by the kidneys as possible.

Symptoms: In the acute form there is scanty urine which contains small quantities of albumen, a few blood corpuscles and epithelia and a few cysts. Edema and uremia are absent. Passive hyperemia presents scanty, turbid, urine of high specific gravity, small amounts of albumen, a few blood corpuscles, and a few casts, and such other evidences of venous stasis as edema, enlargement of the liver and difficult breathing. Uremia is absent. These conditions frequently evolve into acute and chronic nephritis.

Etiology: Acute hyperemia is attributed to exposure to cold, “infectious diseases,” pregnancy, overdoses of certain drugs, etc. Except for the drugs, no cause resides in these things. Many drugs —turpentine, lead, arsenic, mercury, caffeine, etc. irritate the kidneys and produce this condition. Only toxemic subjects will develop renal hyperemia when exposed to cold. Its development in pregnancy is due to toxemia, not to pregnancy. Passive hyperemia may result from pressure on the renal vein by a tumor, ascites, a pregnant uterus; or, it may occasionally be due to thrombosis or embolism of either the renal veins or ascending vena cava. It is due to mechanical obstruction of the flow of blood away from the kidneys.

Care of the Patient: Weger says: “Like most other acute localized disturbances, whether due to active or passive congestion, regardless of speculative or assumed cause, this derangement is easily overcome by the methods advocated in all acute illnesses. Whether or not this condition is accompanied by transient albuminuria, bladder irritation, and the symptoms peculiar to inflammations of the urinary tract, the treatment should invariably be rest, no food, increased amount of water, and a simple-non-irritating diet for some days following the fast. A sensible diet afterwards will prevent a return.”

Symptoms: Progressive emaciation, cachexia, blood in the urine (often profuse) and the presence of the tumor which spreads from the lumbar region and inconstant pain, are the common symptoms.

Prognosis: Cancer is incurable.

Care of the Patient: See Cancer.

Symptoms: In many cases swelling of the ankles (dropsy) with the changes in the urine may be the only indication that something is wrong. The face is usually pale and the eyelids puffy. There may and may not be pains in the back. Sometimes, though not always, there is headache. The sufferer may continue his regular duties not realizing he is very sick until “suddenly,” he becomes so ill he is forced to go to bed.
In some cases, even where the inflammation in the kidneys is not great, the symptoms are very severe. Chills, fever, nausea, vomiting, pains in the back and head, dizziness and weakness may be great in such cases. There is also increased blood pressure. In other cases convulsions caused by uremia may be the first symptoms. In severe cases dropsy, starting with the face and becoming general, and marked anemia, develop. Symptoms of anemia may develop at any stage in the course of the nephritis.
The urine is scanty, and may be wholly suppressed for a day or two. It is highly colored, cloudy or smoky, and of high specific gravity. Upon examination it is found to contain much blood, pus, casts from the kidneys and large amounts of albumen. As improvement proceeds the amount of urine increases and albumen, blood, pus and anemia and dropsy grow less.

Complications: The most important of the many complications that result from the crippling of kidney function in these cases are broncho-pneumonia, pleuritis, pericarditis or inflammation of some other serous membrane, edema Of the lungs, edema of the larynx and dilatation of the heart.

Etiology: Pregnancy, “infectious diseases” and exposure to cold and wet are listed as causes. This is merely the guess of ignorance. Poisons which are eliminated through the kidneys, such as cantharides, turpentine, etc.,” are also listed as causes. For once we strike firm ground.
To the kidneys are carried most of the poisons that are produced in the body or that get into the body from without, for excretion. Upon the kidney is thrown the greater part of the burden of keeping the bloodstream sweet and clean. Though naturally very resistant to toxins, they have their limitations and are finally broken down by the continued overwork and irritation they are called upon to bear.
All drugs, vaccines, serums, antitoxins, toxoids, gland extracts, etc., are renal irritants and nephritis is a frequent aftermath of serum inoculations. Tobacco, tea, coffee, chocolate, cocoa, alcohol, soda fountain slops, mercury, lead, arsenic and other drugs are all destructive of kidney tissue and aid in producing pathology in these. Because the average person never checks on the amount and variety of poisons he is deliberately introducing into his body, either as “medicines,” or for “pleasure,” and the frequency with which these are introduced, he does not adequately realize how much irritation he regularly subjects his kidneys to. Post-mortem studies, of the kidneys of those who die between the ages of fourteen and eighty years show that practically every kidney has undergone some structural change.
Pus from teeth and tonsils is commonly held responsible for nephritis. The damage a little pus can do is nothing as compared to what the above poisons and the thousands of others given by physicians can do. The wholesale administration of vaccines, serums, and drugs is responsible for the larger share of cases of nephritis.
Sepsis habitually absorbed from the digestive tract is another common cause of pathology in the kidneys. Abstemious livers do not develop nephritis. It is rather a “disease” of “high livers” and gluttons, those whose digestive tracts are constantly full of decomposing food. Protein decomposition is particularly prolific of virulent poisons that reach the kidneys for elimination.
Overeating, frequent eating, eating without relish, eating wrong combinations of food, eating when digestion is impaired or suspended, eating when power to digest is absent — these forms of eating assure gastro-intestinal decomposition and septic infection of the body.
Eating candies, cakes, pies, jellies, jams, sugars, pastries, puddings, and the like, also favors fermentation and putrefaction and leads to intestinal autointoxication.
Perhaps few of the above causes would produce nephritis in those of pure blood and full nerve force. But enervation and toxemia are so nearly universal that the resistance and functioning power of the kidneys are often very low. Enervation and toxemia should be considered as basic or primary causes of nephritis, with the above causes only auxiliary.

Prognosis: Medical authorities tell us that “acute Bright’s disease gets well or kills within a few weeks.” They say that in most cases of acute nephritis the patient makes a complete recovery, but that in some cases, the patient appears to get well, but the condition continues in the sub-acute or chronic form. It is our contention that these conditions result from maltreatment and from a return to wrong living after apparent recovery.

Care of the Patient: Fasting is most important so long as there is any evidence of kidney inflammation as evidenced by dropsy and the urine changes. The patient must be put to bed at the first signs of trouble and the feet must be kept warm. He may be allowed all the water thirst calls for.
After the dropsical effusion in the extremities and the different cavities has been cleared up, fruit juices may be given for a few days — one week. Fruit juices will be all the fluid needed to cause the kidneys to act. If it is water melon season these may be used —as much as desired at a meal, but no other foods with the melons. After a week on juice there may be a gradual return to a normal diet as given in volume II of this series. Sunbaths and mild exercise may now be instituted also.

Symptoms: These are said to develop most insidiously, but this is because we close our eyes to the significance of the “minor” discomforts with which almost everybody suffers from time to time. There is gradual loss of strength, with increasing anemia. Digestive disturbances are common. Thickening of the walls of the arteries, high blood pressure, accentuation of the aortic second sound and hypertrophy of the heart are chief among the vascular symptoms. In late stages heart weakness, edema of the lungs, hydrothorax or uremia may either one cause difficult breathing. Disturbances of circulation or uremia may result in headache, vertigo, or insomnia. Albuminuric retinitis may result in dimness of vision. Dropsy is often absent, or slight and late in developing. Uremia is a very frequent occurrence.

Complications: Albuminuric retinitis, dilatation of the heart, brain hemorrhage resulting from the weakening of the arteries and the increased blood pressure, uremia, inflammation of the serous membranes (often latent), acute pulmonary edema, pneumonia, and bronchitis are the chief complications.

Etiology: It may follow passive congestion of the kidneys, as from a weak heart, or may accompany arteriosclerosis, in which case it is coetaneous with the hardening process. Overeating, indolence, nervous strain, chronic alcoholism and lead poisoning are frequent antecedents. It often develops as a complication of gout and of so-called “infectious diseases.” Its causes are the same as the causes of inflammation and hardening anywhere else in the body — namely, toxemia and its complications.

Prognosis: “The disease is incurable, but may last many years,” say medical authorities who treat the patient with drugs that further impair the kidneys and ignore the cause of the pathology. Dr. Weger says “complete recovery is never known to occur. However, we have found that nature tolerates even so serious a pathology for years in some instances when patients learn to live within certain definite and restricted limitations with reference to diet.” If they do not live within these limitations acute uremia, and apoplexy are imminent possibilities at all times.

Care of the Patient: Weger says: “Remarkable results have been obtained by dietetic treatment alone.” “Such patients,” he says, “must give up all enervating habits, including coffee, tea, sweets, liquor, tobacco, condiments, and all foods that have been a determining factor in causation.” We have always insisted on a preliminary fast in these conditions and, while we don’t think the changes in the kidneys can be removed, we have had gratifying results.

Symptoms: These are also said to develop insidiously and consist of progressive weakness, marked anemia, general dropsy which is often first noted in the face and eyelids on rising in the morning, digestive disturbances, and sooner or later some degree of hypertrophy of the heart and high blood pressure. Symptoms of uremia may develop at any time.
In the large white kidney there is a lessened amount of urine which is usually turbid and of low specific gravity. It is highly albuminous and deficient in urea. In the contracted white kidney the urine is increased in amount, of low specific gravity and contains a smaller percentage of albumen.
The amount of albumen in the urine varies so greatly in all forms of nephritis that one can never judge by this how mild or severe the case is. An acute case may show so much albumen that when the urine is boiled it solidifies. The more chronic cases have less, and the most chronic cases have the least. The worst cases may show so little albumen that only an expert can find it, while, for months, all albumen may be absent. An acute case which recovers may have the maximal amount, while, a chronic case which dies may present only a trace. Urinalysis may, therefore, be a most misleading index to the true condition of those who go to the doctor for a periodic check-up.

Complications: These are numerous and often lead to the diagnosis. Uremia, extensive dropsy, latent inflammation of the serous membranes, pneumonia, dilatation of the heart, albuminuric retinitis, apoplexy, and acute exacerbations of nephritis are the most common.

Etiology: Tilden says: “This disease is no different from acute Bright’s disease, except that the patient has shown a strong resistance, and has also been incorrigible, inasmuch as when better be has been imprudent.” Acute nephritis develops occasionally for a short time —perhaps light crises a few months apart — and, finally, becomes chronic; or chronic nephritis may develop “insidiously” following suppressed fevers, badly treated indigestion, or a general systemic impairment from any cause. Only the profoundly enervated and toxemic develop chronic nephritis.
Only rarely, today, does one find typically healthy kidneys. Most people dying from other causes have been, to a large extent, made less resistant to them by the all too common kidney degeneration. Few people realize what a tremendous tax the conventional mode of living places upon their kidneys.

Prognosis: “Chronic Bright’s disease never gets well, but may persist with very fair health for ten or even twenty to thirty years,” say medical authorities. There is no adynamic biogony that responds so readily or so quickly to proper hygienic and dietetic care as chronic nephritis.

Care of the Patient: When chronic nephritis is regarded as a degeneration resulting from systemic toxemia and the sufferer is cared for with a view of eliminating all sources of toxemia, nephritis is not difficult to remedy. Recovery depends on the amount of functioning tissue left in the kidneys. If there is enough to carry on the essential eliminative function, recovery can occur.
The fear and terror produced in the mind of the patient and members of his or her family by a diagnosis of Bright’s “disease” are the results of the regular failure of the prevailing methods of treatment. These methods of treatment are all based on a study of the nature of the changes in the kidneys and not upon a study of the patient’s habits of living, eating, and drinking and the relation of the kidneys to the nervous system, the digestive and circulatory organs and to body metabolism in general.
Many destructive and degenerative changes occur in the kidneys and elsewhere in all forms of nephritis, but from a practical viewpoint, these changes concern us far less than do their causes. We are not so much interested in the nature of the degenerative changes as we are in the nature of the changes in the daily living habits of the patient, which are essential to the arrest of the degeneration. The really important question is: what habits of living must be avoided in order to prevent these changes from continuing, once they have begun?
The first step in the care of chronic nephritis should be a correction of the whole mode of living. Tobacco, alcohol, soda-fountain slops, tea, coffee, cocoa, chocolate, salt, condiments, spices, etc., should be wholly eschewed. All stimulating practices must be avoided.
Rest — mental, physical and physiological rest — is essential to the elimination of toxemia and restoration of normal nerve force. The fast should last long enough to relieve the kidneys of their toxic burden and remove most of the dropsy from the tissues. The rest may well be prolonged much beyond this stage. After the first symptoms have disappeared moderate exercise may be indulged. Sun baths are valuable but should not be overindulged.
Fruits and vegetables — fresh and raw — should constitute the greater part of the diet after the fast.
Tilden says: “Those who have once had an attack of Bright’s disease, and were fortunate enough to overcome it, should be willing to live moderately and take the proper care of themselves. Many people die of Bright’s disease because they prefer a short and merry life, to a longer one if subjected to what they call restrictions and privations.”

Symptoms: Pain and tenderness in the kidney region are common symptoms. Rough motion aggravates the pain which tends to radiate along the ureter. There is often much irritability of the bladder. The frequent passing of blood, pus and crystals or fine gravel indicates the presence of stone. The presence of stone is not readily detected until it is forced out. The symptoms of nervous irritation that have existed for years are likely to be attributed to other causes. One of our cases which had received a diagnosis of stone after an X-ray, passed eight ounces of pus on the ninth day of a fast. Rapid recovery followed and no stone showed up.

Renal Colic results from the entrance of the stone into the ureter. Small particles are frequently passed with little or no annoyance. The larger ones are extruded with great pain. Renal colic is characterized by intense pain radiating from the kidney downward into the groin, thigh and testicle. The testicle is often retracted. Often there are nausea, vomiting and collapse. The urine usually contains blood and particles of stone after such a crisis.

Complications: Anuria (suppression of the urine) is one of the most serious complications. The stones may obstruct the ureter producing hydronephrosis or pyonephrosis, or where there is complete obstruction, atrophy of the kidney.

Etiology: The gouty diathesis seems to be what is meant when it is said that heredity is a predisposing cause. Sedentary habits also predispose. Its greater frequency in men than in women is probably due to the greater enervation of men.
The stones form by the deposit of uric acid, urates, oxalates, phosphates, etc., around a nucleus, which may be either blood, pus, mucous, or epithelium. Uric acid stones are the most common. They can develop only in chronic pathology of the kidney, hence are one of the many outgrowths of toxemia.

Prognosis: This is good in most cases.

Care of the Patient: Weger says: “Either type (of stone) can be dissolved by fasting and dieting, though in the case of very large stones surgery is needed. * * * The cause and treatment is markedly similar to that of biliary calculi” discussed when treating of affections of the gall bladder.
The pain, which is often extremely agonizing, may last for days and palliatives are usually demanded during the crisis, though some patients prefer to tough it out. Hot applications are the only palliatives we ever permit, and we never encourage the use of these.
Fasting and rest, are all that can benefit during the crisis. After the stone has passed, the mode of living should be reordered to prevent a recurrence.
We do not agree that surgery is always needed in the case of large stones, for we have seen them dissolved and broken up with fasting and orange juice.

Symptoms: There are no symptoms that can be positively identified as that of a floating or dislocated kidney. The slight discomforts that accompany it are caused by gas, indigestion, colitis, etc.

Prognosis: In most instances this condition “cures itself” in time.

Care of the Patient: Follow the instructions given for visceroptosis.

Symptoms: These differ little from those of the kidney. Mild fever may be present and, sometimes, pain in the back.

Etiology: Lowered resistance and toxemia constitute the cause.

Care of the Patient: Weger says: “With proper non-surgical treatment, drainage may be established through the ureter. Considering the anatomical structure ‘and the impossibility of knowing whether the location of the abscess may be favorable to drainage, expectant treatment is attended by greater risk than surgery.”

Symptoms: Intermittent blood In the urine, and the urinary and heart and arterial changes seen in chronic interstitial nephritis, and the occurrence of tumor-like masses in both kidney regions are the usual symptoms.

Etiology: The condition is thought to be usually congenital, though it is usually latent until adult life when, doubtless due to the same causes that produce nephritis, the vast number of cysts of varying sizes in the greatly enlarged kidneys increase in size. The condition is usually bilateral and is thought to depend upon some defect of development.

Care of the Patient: There is nothing to do except adopt and stick to a healthful mode of living.

Symptoms: These are often vague and as these “two” affections are always secondary to pathology elsewhere, are often overshadowed by the symptoms of the primary pathology. Constitutional disturbances that vary greatly in degree are commonly present in acute cases and in the exacerbations that arise in chronic cases. The most common of these are chills, fever (100 to 104 F. or more), sweats, digestive disturbances, and loss of weight and strength. There may also be local pain, or tenderness in the kidney region, frequent urination, and, should pyeonephrosis develop, a smooth rounded tumor. There is pus and blood in the urine. The urine varies in amount. It is usually diminished in acute cases and, unless both kidneys are seriously affected, increased in chronic cases.

Prognosis: This varies. In mild acute cases recovery may always be expected. Chronic cases involving both kidneys may persist for some time before recovery is complete. If obstruction exists and both kidneys are involved in this, the condition is grave.

Care of the Patient: Acute cases should be cared for as directed under acute nephritis. Chronic cases may be cared for as directed under chronic nephritis.
Weger says: “The results obtained in these cases by fasting and proper diet are really noteworthy. Even where both kidneys are alike affected, making surgical removal out of the question (one can not live with less than one kidney) we have had complete cures in less than two months in people past middle age who have been semi-invalids for five to ten years. Where there is a natural drainage outlet from any suppuration we anticipate the most helpful natural cooperation by the forces for healing within the body.”

Symptoms: Pain, usually dull but sometimes sharp, like that of renal colic, in the lumbar region, tenderness on pressure, frequent urination, lack of urination, slight, irregular fever, and more or less cachexia, are the chief symptoms.

Prognosis: Chances of recovery or prolongation of life depend on “complications” and the extent of the systemic involvement.

Care of the Patient: See Tuberculosis.

Symptoms: It may develop in any type of nephritis or as a result of any condition causing complete suppression of the urine. It may develop suddenly and run a rapid course (acute uremia), or it may develop slowly and persist for weeks or months (chronic uremia). The symptoms vary in these two states.

Acute. In this form the most common symptoms are severe headaches intense restlessness and tossing to and fro (jactitation), epileptiform convulsions, muttering (occasionally even maniacal.) delirium, coma, difficult breathing (of the asthmatic or Cheyene-Stokes type) and persistent vomiting sometimes associated with hiccup and diarrhea. Transient blindness may also occur.

Chronic. Dull headache, vertigo, mental and physical fatigue, recurrent nausea, and vomiting (often thought to be “bilious attacks”), continuous dyspepsia, obstinate insomnia, and various mental abnormalities are the leading symptoms of chronic uremia. Not uncommonly hemiplegia or monoplegia, usually transitory, develops. Less frequently, such symptoms as muscular cramps, twitching of the limbs, ringing in the ears, itching of the skin and erythematous eruptions, are seen.
Coated tongue, foul breath (ammoniacal or urinous), usually scanty urine, or if undiminished of low specific gravity, as a rule subnormal temperature, but sometimes elevated (uremic fever), high blood pressure, unless there is advanced degeneration of the heart muscle in which case it may be low, are present.

Latent Uremia: This is uremia resulting from complete suppression of the urine and characterized by insomnia, difficult breathing, digestive disturbances and progressive muscular weakness, but with the absence of convulsions, and mental clearness, at least in most cases, almost to the end.

Complications: Chronic uremia often ends in peritonitis, pleurisy, meningitis, and pericarditis.

Etiology: No known constituent of the urine has thus far been identified as the causative agent and it is hardly probable that uremia is due to only one urinary constituent. The “modus operandi” of its production has not been discovered but the probable cause is overworked kidneys, enervation or faulty metabolic changes.

It is the Hygienic view that uremia represents inflammation of the kidneys. It is often seen in pregnant women at the end of the period of gestation and it is our view that this represents faulty kidney function.
Weak or inflamed kidneys may be able to do their work very well in the absence of overeating, overworking, overstraining, worrying, anxiety, alcoholism, etc., but any of these will certainly overwork the impaired kidneys and bring on uremic headache. Indeed, unless the cause is understood and removed a pronounced uremic poisoning may be brought on at any time in those whose kidneys are impaired.

Prognosis: Uremia is always a grave condition, though recovery is possible even after the most severe symptoms. Unless the obstruction is removed, death occurs about the tenth or eleventh day in latent uremia. Chronic uremia may persist with varying intensity for months, but acute exacerbations may develop at any time.

Care of the Patient: No food but water should be given. The patient should be kept warm, even hot. Afford every opportunity for rest and keep noises and other disturbances away from the sick room. After the symptoms have disappeared teach the patient how to live to avoid future recurrences.

CYSTITIS — Acute

Definition: This is inflammation of the bladder — vesicle catarrh.

Symptoms: The symptoms vary in nature and intensity in the various stages of the condition. Commonly these begin with a sensation of tenderness in the region of the bladder. Frequent pains in the neck of the bladder are felt upon urinating. There arise frequent and continuous desire to urinate and even after urination there may be spasmodic contractions of the bladder denoting great irritation of its lining. In some cases there is a persistent and almost uncontrollable urge to empty the bladder. The pain is due to straining, vesicle tenesmus and the scalding or irritation produced by the urine upon the sensitive membranes. The urine is cloudy and is passed in small quantities.

Etiology: In by far the greater majority of instances cystitis is due to an extension of urethritis, prostatitis or gonorrhea, the latter infection being carried into the bladder by catherization.

Prognosis: Acute cystitis readily heals under proper care.

Care of the Patient: Fasting with all the water desired are essential so long as there is bladder irritation. Rest in bed must he enjoined. If pain and tenesmus are great, immersion of the hips in hot water will afford temporary relief with less cost to the system than drugs exact. After all irritation is gone a diet of fruits and vegetables should be eaten.

CYSTITIS — Chronic

Definition: This is chronic catarrhal inflammation of the lining membrane of the bladder.

Symptoms: Chronic cystitis presents the same symptoms of less intensity as acute cystitis. The condition may go so far as to cause such irritability of the neck of the bladder that urine cannot be voluntarily passed, necessitating the use of a catheter. In severe cases the urine resembles pus and the bladder becomes so distended (saccubated) that some of the urine is retained so long that ammoniacal decomposition occurs, rendering the urine more irritating and increasing the trouble.

Etiology: Chronic cystitis is most common in middle-aged or old men. It may result from repeated acute crises or may result from. enlargement of the prostate gland, or an obstructive condition due to stricture or stone.

Prognosis: This is good in the majority of cases. In some cases where the obstruction is not readily removed, non-surgical cure is not likely.

Care of the Patient: Fasting and rest until there are no longer any pain, irritation or obstruction should begin the care of each case. I have had but one case where this failed to bring quick relief. I was forced to send this case to the surgeon. When all the symptoms have subsided proper attention to habits will prevent recurrence.

Symptoms: The appearance of oxalic acid, uric acid and other crystals in the urine is preceded by a deposit of “brick dust” or white, powdery sediment. Tenderness in the bladder region and sharp stabbing pains immediately after urinating precede the appearance of the stone. In males the pain frequently extends to the head of the penis. Often the urine is tinged with blood, the desire to urinate is frequent and but a small quantity is passed at a time.

Etiology: This is the same as that given for stones in the kidneys and gall bladder. It is preceded by catarrh of the bladder.

Care of the Patient: This is the same as that given for kidney stones.

Symptoms: The chief symptom is an intense desire to urinate which persists after the bladder is empty. Attempts to urinate result in the expulsion of but a few drops and severe burning pain.

Etiology: It is most commonly a part of cystitis and results from the same causes that cause the bladder irritation. It sometimes follows alcoholic sprees.

Care of the Patient: Same as for cystitis

Symptoms: Itching and smarting of the urethra, especially during urination, is the first symptom of urethritis. As the condition develops there is a discharge of mucus, or, should an abscess form, of pus, with increased pain when urinating. The discharge may sometimes be streaked with blood. The condition may be acute or chronic, the symptoms of the two conditions varying only in degree. There is swelling of the mucous membrane resulting in a hardening of the urethra and a narrowing of the passage. There may be an intense burning sensation produced by urination. Indeed non-specific urethritis resembles gonorrhea and it is often difficult to distinguish between them.

Etiology: We are not here dealing with gonorrheal urethritis as we have dealt with this elsewhere. We pause only to say that the difference between simple and septic urethritis is the difference between simple and septic inflammation anywhere else in the body. Simple infection is due to non-toxic irritation; septic infection is due to sepsis which we recognize as the only infecting agent.
We wholly discount the absurd theories that it is due to “inoculation during sexual intercourse from discharge due to inflammation of the womb or other parts of the female organism” or that “it may arise in a similar way from cohabitation during the menstrual discharge.”
Simple, or catarrhal urethritis is due to the same causes that produce catarrh of the nose and throat or of any other part of the body.

Care of the Patient: Fasting to relieve the body of its overload, followed by a healthful mode of living are all that are required.