Interstitial cystitis is an affection that is more frequently due to, and associated with, disease in some other part of the urinary tract, than to an acute cystitis becoming chronic. A patient suffering from renal calculus will almost certainly have chronic cystitis, so also will those suffering with obstructions of the urethra, or from vesical calculus. Its most frequent causes then are the following: Chronic retention of urine from obstructive disease of the urethra - in early and middle life this means stricture, in advanced age, hypertrophy of the prostate - ; atony of the bladder, occasionally paralysis, foreign bodies in the bladder, tumors; sometimes abnormal conditions of the urine itself, and lastly it exists as a sequel of the acute malady.
The symptoms are: Micturition increased in frequency, usually with some pain preceding the want to perform it; pain about the pelvis and perinaeum. The urine is cloudy from the presence of an undue quantity of mucus from the lining membrane of the bladder. This is always present in all forms of chronic cystitis; without it there is no inflammation; with mucus in the urine, and the urine retained, it is very sure to become septic. The amount and character of the mucus deposit differ greatly in different cases; thus, while in ordinary examples the quantity is inconsiderable, only producing cloudiness of the urine, in others it is so great as to form a large, dense mass of semi-gelatinous material, giving rise to the term catarrh of the bladder. In treating cases of chronic cystitis we should endeavor to influence the urinary secretion in such a way that the urine, which enters the bladder from the kidneys, shall arrive in a state as little liable to irritate the viscus as possible. It should not be too concentrated, hence dilutent drinks are usually beneficial. The urine may be alkaline when it issues from the bladder from admixture of mucus or from ammonia produced by decomposition of the urea, although it has been secreted with the usual or even with an augmented degree of acidity, and if this be barely neutralized in the manner suggested, the inflamed bladder is less irritated and less inflammatory products are found than would otherwise be the case.
We find considerable crude homoeopathy in the following, taken from "Reynold's System of Medicine," and what is not homoeopathy may be very useful to know, and help us very much in relieving a case of chronic cystitis: "There are numerous infusions and other agents which appear to exert a salutary influence on the urinary tract of mucous membrane when it is inflamed, which shall be briefly mentioned. The infusions of buchu, uva ursi, parsley, breakstone, alchimella, arvensis and common hop, the decoctions of pareira brava, triticum repens, marsh mallow, linseed and pearl barley are all useful, but should be administered in much larger doses than are usually given, of none giving less than ten ounces daily. Sometimes small doses of the balsams, such as sandalwood oil, capaiba, or of compound tincture of benzoin, of benzoic acid, are useful; more commonly they merely derange the stomach and are without value. Counter-irritation is a valuable part of the treatment; the best form perhaps being the application of a hot linseed poultice, the surface of which is sprinkled with flour of mustard, to the sacral, supra-public and perineal regions."
The prime object of this paper is to call attention to chimaphila as a very reliable remedy in chronic cystitis. I have witnessed very remarkable benefit from this drug in two very bad cases of this trouble. A lady about fifty years of age has been a sufferer from renal calculus for about eighteen years; as a consequence she became afflicted with chronic catarrh of the bladder. She became a patient of mine about nine years ago. Her symptoms were as follows: She has at irregular intervals attacks of renal colic, which is evidenced by the fact that particles of calcareous matter pass with the urine afterwards. She has had so many of these attacks, and has tried so much to get relief during the paroxysms of pain, and failed, that she now takes nothing, simply "grins and bears it." I have thought that perhaps her sufferings were greater formerly; that the frequent passing of calculi through the ureters has distended them and made them less sensitive, they have gotten used to it, so to speak.
Her chronic cystitis is always aggravated when she has these attacks; the urine which is always heavily loaded with mucus, and voided frequently and with pain, now becomes bloody, and the pain and urging almost unbearable, the urine deposits a bloody, jelly-like substance. The abdomen in the region of the bladder is always sore and tender. She can hardly ever retain the urine for the space of one hour, therefore is compelled to stay at home all the time. I prescribed many remedies with only slight benefit, until chimaphilaq ten drops in a goblet half full of water were given. She soon experienced marked relief, the urging and the pain on micturition became less and the calls to urinate grew less frequent; the urine slowly became quite normal in character. She took the chimaphila for several months and was so much improved that she discontinued treatment. She has remained comparatively well ever since, with the exception of aggravations following the passage of calculi, and these, it should be said, are not so frequent as formerly. Chimaphila always quickly relieves her distress and clears up the urine.
This case is a sample of several that could be related, but it is unnecessary; they are essentially the same.
Chimaphila, as far as my limited experience goes, is our best remedy for chronic cystitis, and unless there were good reasons for doing otherwise, I would always give it first and stick to it.
Hughes, in his "Pharmacodynamics," says: "Dr. Hale has found it a valuable medicine in cases of dysuria with mucous sediment in the urine; and has cured gleet with it." Dr. Holland relates a good case (British Journal of Homoeopathy), of chronic cystitis in which it proved curative after many medicines had failed. From Journal
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