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The condition which we describe under this head commonly causes frequent painful urination. Primarily there is usually some agency which mechanically or chemically irritates the bladder, and if the irritation does not subside, inflammation follows owing to the entrance of germs in some manner. The introduction into the bladder of unboiled, and therefore unclean, instruments is a cause; another cause is failure to pass urine for a long period, from a feeling of delicacy in some persons when in unfavorable surroundings. Nervous spasm of the urinary passage from pain, injuries, and surgical operations constitutes another cause. Inflammation may extend from neighboring parts and attack the bladder, as in gonorrhea, and in various inflammations of the sexual organs of women, as in childbed infection. Certain foods, waters, and drinks, as alcohol in large amounts, and drugs, as turpentine or cantharides applied externally or given internally, may lead to irritation of the bladder. Exposure to cold in susceptible persons is frequently a source of cystitis, as well as external blows and injuries. The foregoing causes are apt to bring on sudden or acute attacks of bladder trouble, but often the disease comes on slowly and is continuous or chronic.

This eruption is situated chiefly on the face, but often on the back, shoulders, and chest as well. It is a disorder which is seen mostly in young men and women at about the age of puberty. It consists of conical elevations of the skin, from a pin head to a pea in size, often reddened and tender on pressure, and having a tendency to form matter or pus, as shown by a yellow spot in the center of the pimple. After three to ten days the matter is discharged, but red elevations remain, which later become brown and disappear without scarring, except in rare cases.

Quinsy is a peritonsilitis; that is, it is an inflammatory disease of the tissues in which the tonsil is imbedded, an inflammation around the tonsil. The swelling of these tissues thrusts the tonsil out into the throat; but the tonsil is little affected. Quinsy involves the surrounding structures of the throat, and usually results in abscess. The disease is said to be frequently hereditary, and often occurs in those subject to rheumatism and gout. It is seen more often in spring and autumn and in those living an out of door existence, and having once had quinsy the victim is liable to frequent recurrences of the disease. Quinsy is characterized by much greater pain in the throat and in swallowing than is the case in tonsilitis, and the temperature is often higher sometimes 104° to 105° F. When the throat is inspected, one or both tonsils are seen to be enlarged and crowded into its cavity from the swelling of the neighboring parts. The tonsils may almost block the entrance to the throat. The voice is thick and indistinct, the glands in the side of the neck become swollen, and the neck is sore and stiff in consequence, while the mouth can be only partially opened on account of pain. For the same reason the patient can swallow neither solid nor liquid food, and sits bent forward, with saliva running out of the mouth. The secretion of saliva is increased, but is not swallowed on account of the pain produced by the act. Sleep is also impossible, and altogether a more piteous spectacle of pain and distress is rarely seen. Having reached this stage the inflammation usually goes on to abscess (formation behind or above or below the tonsil), and, after five to ten days from the beginning of the attack, the pus finds its way to the surface of the tonsil, and breaks into the mouth to the inexpressible relief of the patient. This event is followed by quick subsidence of the symptoms. Quinsy is rarely a dangerous disease, yet, occasionally, it leads to so much obstruction in the throat that death from suffocation ensues unless a surgeon opens the throat and inserts a tube. Occasionally the pus from the ruptured abscess enters the larynx and causes suffocation.

Headache is the most frequent symptom. It may be about the eyes, but there is no special characteristic which will positively enable one to know an eye headache from that arising from other sources, although eye strain is probably the most common cause of headache. The headache resulting from eye strain may then be in the forehead, temples, top or the back of the head, or limited to one side. It frequently takes the form of “sick headache”. It is perhaps more apt to appear after any unusual use of the eyes in reading, writing, sewing, riding, shopping, or sight seeing, and going to theaters and picture galleries, but this is not by any means invariably the case, as eye headache may appear without apparent cause.

This refers to an escape of urine from the bladder uncontrolled by the will. It naturally occurs in infants under thirty months, or thereabouts, and in the very old, and in connection with various diseases. It may be due to disease of the brain, as in idiocy or insanity, apoplexy, or unconscious states. Injuries or disorders of the spinal cord, which controls the action of the bladder (subject to the brain), also cause incontinence. Local disorders of the urinary organs are more frequent causes of the trouble, as inflammation of any part of the urinary tract, diabetes, nephritis, stone in the bladder, tumors, and malformations. The involuntary passage of urine may arise from irritability of bladder the most frequent cause or from weakness of the muscles which restrain the escape of urine, or from obstruction to flow of urine from the bladder, with overflow when it becomes distended.

Syphilis is a contagious germ disease affecting the entire system. While commonly acquired through sexual intercourse with a person affected with the disorder, it may be inherited from the parents, one or both. It is often acquired through accidental contact with sources of contagion. Syphilis and tuberculosis are the two great destroyers of health and happiness, but syphilis is the more common.

In this disease there is pain in the muscles, which may be constant, but is more pronounced on movement. Exposure to cold and wet, combined with muscular strain, frequently excite an attack. On the other hand, it often occurs during hot, dry, fine weather. Attacks last usually but a few days, but may be prolonged for weeks. The pain may be dull, as if the muscle had been bruised, but is often very sharp and cramplike. There is, commonly, slight, if any, fever, and no general disturbance of the health. The following are the most common varieties:

Hives is characterized by the sudden appearance of hard round or oval lumps in the skin, from the size of a pea to that of a silver dollar, of a pinkish white color, or white in the center and often surrounded by a red blush. The rash is accompanied by much itching, burning, or tingling, especially at night when the clothes are removed. The peculiarity of this eruption is the suddenness with which the rash appears and disappears; the itching, the whitish or red lumps, the fact that the eruption affects any part of the body and does not run together, are also characteristic. Scratching of the skin often brings out the lumps in a few minutes. The swellings may last a few minutes or hours, and suddenly disappear to reappear in some other place. The whole trouble usually continues only a few days, although at times it becomes a chronic affection.

The pain is more often in the forehead, but may be in the top or back of the head. The headache may last for hours, or “off and on” for days. Dull headache is seen in “biliousness” when the whites of the eyes are slightly tinged with yellow and the tongue coated and yellowish, and perhaps dizziness, disturbances of sight and a feeling of depression are present. Among other signs of headache due to indigestion are: discomfort in the stomach and bowels, constipation, nausea and vomiting, belching of wind, hiccough, and tender or painful eyeballs.

Tonsilitis is a germ disease and is contagious. Exposure to cold and wet and to germ laden air renders persons more liable to attacks. It is more likely to occur in young people, especially those who have already suffered from the disease and whose tonsils are chronically enlarged, and is most prevalent in this country in spring. The disease appears to be often associated with rheumatism. Tonsilitis begins much like grippe , with fever, headache, backache and pain in the limbs, sore throat, and pain in swallowing. On inspecting the throat (with the tongue held down firmly by a spoon handle and the mouth widely open in a good light, preferably sunlight) the tonsils will be seen to be swollen, much reddened, and dotted over with pearl white spots.