Diseases of Kidney and bladder
The kidneys and bladder have various diseases:
Kidney Pain
Severe pain is felt at the location of the kidneys, causing the patient to writhe in pain. There is a frequent urge to urinate, and urine comes intermittently in drops. The pain radiates to the testicles; whichever testicle is painful, the leg and foot on that side will also be painful. The patient experiences nausea and vomiting.
Causes:
Excessive consumption of red meat, rice, pulses, dry foods, and foods that produce flatulence.
Weakness of the Kidneys
The patient experiences severe pain in the legs, thighs, and the area between the shoulders, to the extent that walking becomes difficult. Sleep decreases, the body feels heavy and cold, and urination becomes excessive.
Causes:
Cold and damp weather, excessive use of cold and moist foods.
Inflammation of the Kidneys
At the beginning of the disease, edema appears beneath the eyes and later spreads throughout the body. This occurs because a deficiency of proteins in the blood reduces osmotic pressure, causing plasma to accumulate in the tissues. Blood urea increases, blood pressure becomes high, and urine output decreases.
R.B.C., W.B.C., albumin, and cast cells are found in the urine. Pressing over the shin bone leaves a pit. Pain is present at the kidney region and radiates to the legs. Fever may occur. If pus develops in the kidneys, symptoms similar to tuberculosis become apparent.
Causes:
Urinary retention, kidney stones, injury to the kidney region, diabetes. Generally, streptococcal bacteria cause inflammation, leading to swelling of the kidney capillaries. Their function becomes impaired, allowing R.B.C., W.B.C., and proteins to leak through them.
Kidney Function
Approximately 1700 liters of blood are filtered daily by the human kidneys, producing about one liter of waste material in liquid form, which is excreted as urine. Thus, the kidneys keep human blood free from waste substances, and healthy kidneys ensure that the blood remains free from unnecessary components.
The kidneys have two parts: the outer part is called the cortex and the inner part is called the medulla. Each kidney contains approximately 1.2 million nephrons, which are the basic functional units of the kidney. Together, both kidneys produce two to four liters of urine per day.
The internal structure of the kidneys contains an astonishingly complex filtration system. To the naked eye, a nephron appears like a grain of sand, but under a microscope it resembles a large-headed worm with a twisted tail-like body. The head consists of a cluster of blood vessels, while the tail is a thin tube. The head is covered by a network of capillaries that continuously squeeze fluid from the blood (excluding red blood cells). More than 98% of this filtrate is reabsorbed in the thin tubules. In each kidney, these tubules extend to a combined length of approximately 140 miles. Through a highly selective process, these tubules reclaim amino acids, proteins, glucose, sugars, and minerals required by the body and remove waste products and water at a rate of approximately half a gallon per day.
The water emerging from these tubules collects drop by drop in a basin-like structure of the kidney and then travels through the ureter to the bladder. Every 10 to 30 seconds, wave-like contractions of the ureteric muscles cause this fluid to drip into the bladder.
The kidneys perform two important functions in the body:
Excretory Function
Metabolic Function
1- Excretory Function
The kidneys remove all useless and waste materials from the body through urine. Important substances excreted include:
Uric Acid
Urea
Creatinine
Urates
Phosphates
Phenol
Hippuric Acid
Ammonium Salts
2- Metabolic Function
Maintaining the acid-base balance of the body.
Maintaining water and electrolyte balance in the body.
Endocrine function.
Production of erythropoietin.
Production of renin.
Important Diseases of the Kidneys:
Uric Acid
Urea
Creatinine
Ascites
Urea
Protoplasm, the living substance of cells, is formed from proteins. The chemical structure of proteins contains nitrogen as well as sulfur and phosphorus, and a major portion of the required amounts of these substances is obtained from proteins.
During digestion, proteins break down into proteoses, peptones, polypeptides, and finally amino acids.
Amino acids are absorbed through the intestinal mucosa and enter the bloodstream through the portal vein, after which they are transported to the liver. A portion enters the blood and is utilized by body cells, especially in areas where new cells are formed, such as the bone marrow. Amino acids are also required for the repair of damaged tissues and for the production of glandular secretions and enzymes.
Excess amino acids or proteins are not stored in the body except temporarily in the liver. After passing through metabolic processes, the amino acids not utilized by the body are broken down. This process is called deamination and takes place in the liver. As a result, ammonia is produced, which combines with carbon dioxide to form urea. After being produced in the liver, urea enters the bloodstream, reaches the kidneys, and is excreted from the body through urine.
Urea is a crystalline substance that dissolves in water. Approximately 20 to 30 grams of urea are excreted from the body in urine every 24 hours. Nitrogenous substances are removed from the body through urine, and urea constitutes the largest portion of these substances. The urea excreted in urine is not only derived from amino acid breakdown in the liver but also includes urea produced as a result of cellular activity.
In other words, foods such as meat, eggs, and pulses contain proteins. These proteins are absorbed into the bloodstream and contribute to growth and development. Proteins are compounds found in both animals and plants. They are made of amino acids and are essential for the construction and maintenance of the body. Proteins obtained from animals have a high biological value because they contain essential amino acids. Plant proteins, however, do not contain all amino acids. After absorption of these proteins, a substance called carbomoid remains. This substance is colorless, odorless, and soluble in water. It is considered the waste product of protein metabolism, in other words, urea.
Normally, blood contains 20 to 40 mg of urea per 100 ml. Excess urea is removed from the blood by the kidneys. When the natural filtering mechanism of the kidneys becomes impaired, their ability to perform this function decreases, resulting in an increase of urea in the blood, a condition known as blood urea or uremia.
This is a condition in which the nephrons of the kidneys become swollen, partially destroyed, or completely destroyed, leading to chemical and electrolyte disturbances in the body. If only the urea level is elevated, the condition is called azotemia.
When the blood-filtering units (glomerulosclerosis) become hardened, the blood vessels supplying the kidneys also become hardened. The internal diameter of these vessels narrows and becomes obstructed to such an extent that the kidneys can no longer properly filter the blood. Due to this impairment, blood urea and serum creatinine accumulate in the bloodstream, and the kidneys excrete less than half a liter of urine. This leads to the following symptoms:
Swelling and edema.
Nausea and vomiting after eating or drinking.
Shortness of breath resembling asthma, especially at night. Wheezing occurs due to increased sodium acid phosphate levels.
Very little urine output, with pus, blood, and albumin present in the urine.
A feeling of allergy to water. Itching begins immediately after drinking water. This occurs because phosphate levels rise in the blood and calcium levels decrease.
Headache.
Nervous tension and spasms.
Drowsiness during the day but inability to sleep at night. Even if sleep occurs, slight noise awakens the patient.
Loss of appetite and thirst, along with pain in the stomach region.
Pain in the heart region, rapid heartbeat, and pallor of the face.
Pain in the lower back, kidney region, and legs.
High blood pressure and risk of paralysis.
Muscles become so weak that attempting to raise a hand or foot causes it to drop immediately. Speech becomes slurred.
Enlargement of the kidneys due to persistent inflammation.
If urine output falls below 400 ml in 24 hours, it is referred to as kidney failure.
For this condition, the following laboratory report is obtained:
Renal Function Test
In this report, urea is found above 40 mg/dl and creatinine above 1.2 mg/dl.
Causes of Excess Urea
1. Pre-Renal Causes
Shock due to loss of body fluids or blood.
Blood transfusion reaction.
Severe infection.
Severe cardiac pain.
Poisoning.
Food poisoning.
Transplantation of one body part to another.
Narrowing of the renal artery.
2. Renal Causes
Kidney infections.
Kidney damage due to inflammation.
Kidney damage caused by high blood pressure.
Kidney-damaging medicines such as steroids and improperly prepared metallic compounds.
Failed kidney transplant.
3. Post-Renal Causes
Obstruction caused by a stone in the kidney or ureter.
Obstruction beyond the bladder due to a stone or enlargement of the prostate.
However, the following conditions decrease blood urea:
Reduced liver function.
Excess water in the body.
Excessive administration of intravenous fluids.
Creatinine
This is actually the end product of creatine present in the body's muscles. Approximately one to two percent of muscle creatine is converted into creatinine daily, which is then excreted by the kidneys.
When inflammation causes the kidneys to shrink, they cannot excrete creatinine properly, leading to an increase in its level in the blood. The causes and symptoms are the same as those of elevated urea.
Note:
In all diseases in which urea increases, creatinine also increases. However, unlike urea, creatinine does not increase in old age, reduced food intake, or high fever.
Note:
Diabetic patients whose urine contains ketone bodies may have elevated creatinine levels that are not related to kidney disease.
Renal Calculi (Kidney Stones)
The presence of sand or stones in the kidneys causes burning and pain during urination and discomfort in the kidney region. Similarly, if a stone is present in the bladder, pain is also felt there. Jumping or physical activity increases the pain. If the stone is small, the discomfort is bearable. If it becomes large, the pain can leave the patient exhausted. No position provides relief. Nausea and vomiting are common. The pain radiates from the kidneys to the groin, testicles, and urethra. Fever may also occur. When pain becomes severe, blood may appear in the urine, and sometimes pus is present. Urination becomes frequent and may occasionally stop altogether.
There are three types:
1- This type develops from foods obtained from plants, especially those rich in calcium. If adequate calcium is not present in the stomach and oxalic acid is not properly neutralized, oxalate crystals begin to form.
2- This type develops due to defective protein digestion and consists of uric acid.
3- This type consists of calcium phosphate and develops in people who consume large amounts of eggs, cartilage-containing bones, bone marrow, and broths.
Diabetes
Diabetes is medically known as Diabetes Mellitus. In Greek, "Diabetes" means "to pass through" and "Mellitus" means sugar. In this disease, sugar is excreted through urine instead of becoming part of the body's tissues; therefore, it is called diabetes.
Diabetes develops due to a disorder of the pancreas. First, the anatomy and physiology of the pancreas are described, followed by the nature of its dysfunction.
Pancreas
The pancreas is a very soft gland composed of tissue, approximately six inches long and one inch thick. It is located in the upper posterior part of the abdominal cavity, below the stomach, at the level of the second and third lumbar vertebrae. Its head lies within the loop formed by the first part of the small intestine, while its tail extends toward the spleen.
Ninety-nine percent of the gland consists of small sacs called acini. These sacs produce a secretion known as pancreatic juice. This juice contains various enzymes that aid digestion. The three major types are:
Amylase-Helps digest carbohydrates.
Lipase-Helps digest fats.
Trypsin and Chymotrypsin-Help digest proteins.
This secretion enters the beginning of the small intestine (duodenum) through a duct known as the pancreatic duct.
One percent of the pancreas consists of small clusters containing the following cells:
Alpha Cells – Produce the hormone glucagon.
Beta Cells – Produce the hormone insulin.
Delta Cells – Produce the hormone somatostatin.
Pancreatic Polypeptide Cells (P.P.P.)
Together these hormones fulfill the body's metabolic requirements in a balanced manner.
The pancreas functions both as an exocrine gland and an endocrine gland. As an exocrine gland, its cells surround the pancreatic tubules, and their secretions enter the digestive system through pancreatic ducts.
As an endocrine gland, the hormone-producing cells are called the Islets of Langerhans. These cells are of two main types:
Alpha Cells
Beta Cells
1. Alpha Cells
These cells produce glucagon. When blood sugar falls, glucagon is secreted. It acts on glycogen stored in the liver and rapidly converts it into glucose that can enter the bloodstream.
If glucagon secretion continues for four hours, glucose production in the liver becomes so rapid that all glycogen reserves are depleted. It is established that glucagon mobilizes glucose in the liver.
2. Beta Cells
These cells produce insulin. When blood sugar rises, insulin secretion increases. If beta cells become damaged, they fail to produce insulin, causing blood sugar to rise. This elevated blood sugar is known as diabetes.
Role of Insulin
When food passes from the stomach into the intestines, starchy foods are digested and converted into different sugars, mainly glucose. This glucose is absorbed through the intestinal lining into the bloodstream and is then transported to the liver.
The liver uses some of the glucose for its own needs and supplies the remainder to the muscles for energy. Excess glucose is converted into fat by insulin and stored in fatty tissues. It may accumulate around the intestines, making the abdomen appear enlarged, or in the liver, leading to fatty liver. These fat reserves are used during fasting, exercise, and other situations requiring energy. In diabetic patients, this system becomes disrupted.
Insulin helps glucose enter every cell of the body. Each cell functions like a small engine that uses glucose as fuel to produce heat and energy. Glucose requires insulin in order to enter these cellular engines.
Insulin is also involved in fat and protein metabolism. Dietary fats and oils such as butter and ghee are digested into fatty acids. Insulin converts these fatty acids back into fat and stores them in tissues while preventing their breakdown.
Insulin Deficiency
If insulin becomes deficient or absent, glucose cannot enter the cells and accumulates in the blood. When blood passes through the kidneys, glucose enters the urine and is excreted.
When glucose cannot enter the cells, the cells become starved. To provide nourishment, the body begins breaking down stored fat and protein. This is why diabetic patients experience weakness, fatigue, and weight loss due to muscle protein loss.
If glucose is not being utilized, toxic substances derived from fats accumulate in the body. These toxic substances, called ketones, produce a foul odor in the breath. They also accumulate in blood vessels and cause them to thicken.
3. Delta Cells
The third secretion of the Islets of Langerhans comes from delta cells. It contains only fourteen amino acids and disappears from the bloodstream within two minutes.
This hormone is released when blood glucose, amino acids, fatty acids, or digestive acids increase. It acts locally within the Islets of Langerhans and reduces the secretion of both insulin and glucagon.
This hormone decreases the motility of the stomach, intestines, and gallbladder and helps maintain hormonal balance.
4. P.P.P.
This hormone assists digestion in one way or another.
Diabetes develops when the insulin-producing beta cells of the Islets of Langerhans decrease in number or cease functioning.
The three causes are:
Production of antibodies against beta cells, impairing their function.
Destruction of beta cells by bacterial toxins.
Abnormal degeneration of these cells.
Failure of Insulin Secretion from the Pancreas
1- The insulin-producing part of the Islets of Langerhans is an endocrine gland. It affects and is affected by the nervous system, while other organs are influenced through their relationship with it, such as stimulation in the nerves, breakdown in the glands, and relaxation in the muscles.
When stimulation occurs in the nerves, an excess of glucose and fats in the blood prevents insulin from entering the cells. This is considered true diabetes.
2- If the receptors that receive insulin become reduced in number or ineffective, they impair the ability of insulin to perform its function. The unused insulin remains between the tissues. This occurs due to stimulation in the muscles, degeneration in the nerves, and inactivity in the glands. Because the glands are inactive, they cannot utilize insulin properly, causing blood sugar to rise and eventually appear in both blood and urine.
3- In inflammation of the liver and kidneys, the liver cannot convert dietary sugar into glycogen. Alternatively, due to weakness in the liver's retaining function, glycogen is continuously released into the bloodstream instead of being stored. As a result, blood sugar levels continue to rise. Because of inflammation, the kidneys cannot eliminate it properly, leading to high blood pressure, palpitations, enlargement of the heart due to heat, and symptoms of heart attack.
Symptoms of Cerebral and True Diabetes
Frequent urination, ants gathering around urine, excessive thirst, dryness of the mouth and throat, increased appetite, weight loss, poor digestion, dry and rough skin, reduced body temperature, muscle cramps due to loss of salts in the urine, persistent nervous tension, loss of mental, physical, and sexual strength, pain and burning in the legs, sensation of insects crawling on the skin, delayed wound healing, development of large boils and carbuncles, heaviness in the kidney region, sudden eye diseases, blood pressure often becoming low and occasionally high, severe fatigue, body aches after work, lack of strength to continue working, and sometimes cataracts.
Laboratory Tests for Diabetes
1. Fasting Blood Sugar
This test is performed in the morning before breakfast. In a normal person, fasting blood glucose should not exceed 120 mg per 100 ml.
2. Random Blood Sugar
This test is performed two hours after a meal. Blood glucose should not exceed 120–180 mg per 100 cc.
If both values are above normal limits, diabetes is confirmed.
Causes
Congenital defects, overeating, mental stress, adverse effects of allopathic medicines, and attack by harmful agents.
Gastric Diabetes
Due to stimulation in the muscles, degeneration in the nerves, and inactivity in the glands, gastric diabetes develops. In this condition, insulin is produced but is insufficient to meet the body's needs. As a result, blood glucose levels continue to rise. Since the glands remain inactive, they cannot effectively utilize glucose. Consequently, blood sugar continues to increase and eventually appears in the urine.
Because of this digestive disorder, the tongue and throat become dry, leading to repeated thirst. Gas accumulates in the stomach and sour belching occurs. Excessive flatulence develops in the abdomen, and severe constipation results from dryness. Sleep becomes reduced, and glaucoma may develop. At times, there is pain and acidity in the stomach, and bleeding may occur from the gums or descending colon. Such patients exhibit hemorrhoidal and toxic symptoms and may display psychological and nervous tendencies. Sometimes appetite disappears, and when hunger does occur, it becomes so intense that the body feels exhausted.
Causes
Excessive consumption of cold and dry foods.
Hepatic Diabetes
This is essentially a disease associated with kidney inflammation. In this condition, urine appears yellow and causes burning. There is pricking pain in the body, disturbed sleep, burning in the hands and feet, pain in the head and temples, fatigue, palpitations, and high blood pressure.
Continuous pressure gradually leads to kidney failure, resulting in increased urea in the body and tension in the muscles. Blood pressure becomes elevated because glandular stimulation causes contraction, and the openings of the nephrons become blocked. Glucose does not move toward the liver and remains in circulation up to the kidneys. Thus, sugar remains in the blood and does not appear in the urine.
Causes
Excessive consumption of hot and dry foods.
Hypoglycemia (Low Blood Sugar)
This disease occurs in two forms:
Before meals.
After meals.
1. Hypoglycemia Before Meals
Low blood glucose gradually damages the nervous system. Memory declines, speech becomes slurred, darkness appears before the eyes, and sometimes double vision occurs. In severe cases, seizures and coma may develop.
Laboratory tests generally show blood sugar below 40 mg/dl and serum insulin above eight micro-units per cc.
2. Hypoglycemia After Meals
The patient develops hypoglycemia within one to three hours after eating, and in some cases three to five hours later.
The heart rate increases, sweating occurs, tremors develop, nausea appears, and headaches occur. The patient cannot sleep properly because food passes very rapidly from the stomach into the intestines and is absorbed quickly. Consequently, blood glucose rises sharply. To control it, the pancreas immediately releases excessive insulin, resulting in hypoglycemia.
Causes
Sluggish pituitary gland, obesity, and endocrine gland disorders such as pancreatic tumors, myxedema of the thyroid gland, and kidney failure.
Urinary Retention
There are three types of this disorder.
First Type
In this condition, urine production itself stops. Since no urine accumulates in the bladder, there is no feeling of fullness. The patient feels an intense urge to urinate but nothing comes out. After some time, only a few drops are passed because stimulation occurs in the nerves, degeneration in the glands, and relaxation in the muscles.
When the nerves are overstimulated, blood circulation slows down. Consequently, blood flow to the kidneys decreases, reducing pressure and fullness in the renal arteries. As a result, urine production declines and may be accompanied by burning.
In this condition, medicines that promote urine production should be used rather than medicines that merely expel urine. If urine-expelling medicines are used, the mouth becomes dry, bitterness increases, and urine does not flow. If something that stimulates muscular function is given, urination may begin within minutes and the patient's distress subsides.
Causes
Excessive use of cold and moist foods, and after-effects of allopathic diuretic medicines such as Lasix.
Second Type
In this type, blood continues flowing from the heart to the kidneys and is filtered there. In this condition, stimulation occurs in the muscles, inactivity in the glands, and degeneration in the nerves.
During muscular stimulation, the blood becomes thicker, and due to glandular inactivity, it is not filtered properly. Urinary substances are insufficiently removed. Consequently, sand and stones begin forming in the kidneys and bladder. Pain occurs during urination, irritation develops in the urinary passage, and blood may appear. In severe cases, urination stops altogether.
Causes
Excessive use of cold and dry foods.
Third Type
In this condition, the patient's body feels hot, the taste in the mouth becomes bitter, and there is a sensation of pricking throughout the body. The bladder becomes full of urine, but the outlet remains blocked. The patient feels heaviness over the bladder region.
In this condition, stimulation occurs in the glands, degeneration in the muscles, and relaxation in the nerves. Due to relaxation of the nerves, blood flow toward the glands increases, and urinary excretion is greatly reduced or may stop entirely.
Burning is also experienced because bile production increases and a portion is excreted through this pathway. Excess bile in the kidneys causes inflammation, resulting in burning both during filtration and urination.
Causes
Excessive use of hot and dry foods and medicines, as well as hot weather and climate.
Hematuria (Blood in the Urine)
Sometimes blood appears before urination, after urination, or mixed with urine. Occasionally, pure blood may be passed instead of urine.
If blood appears before urination, it originates from the urethra and may occur even without urination. If only a small amount appears before urination, it originates from the prostate gland.
If blood comes from the kidneys, it resembles the washings of meat in color and is accompanied by pain in the kidney region.
When blood originates from the bladder, it is mixed with urine and appears dark in color.
Sometimes excessive masturbation causes blood to be discharged instead of semen from the seminal vessels.
Causes
Excessive consumption of hot and dry foods, stones in the kidneys or bladder, injury and trauma, ulcers of the kidneys and bladder, gonorrhea, excessive masturbation, excessive menstruation, and similar conditions.
Difficult Urination
Initially there is a frequent urge to urinate, and the urinary stream becomes thin. Sometimes urination stops completely.
Causes
Chronic gonorrhea and excessive use of hot and dry foods.
Dribbling of Urine
In this condition, the urge to urinate occurs repeatedly, but only a few drops are passed. Burning accompanies urination. Concentration becomes difficult. Even after urination, drops seem to continue coming, and the patient feels that the bladder has not emptied completely.
Causes
Excessive use of hot and dry foods and hot climatic conditions.
Enlargement of the Prostate Gland (Prostate Gland)
This condition usually affects elderly individuals. Urine does not pass freely. There is heaviness, burning, and pain in the bladder, rectum, and perineum. The urge to urinate occurs frequently, but only small amounts are passed. Shortly afterward, dribbling begins or the urge returns. A few drops may fall while sitting. Severe pain accompanies urination. Because of the pain, the patient may also be unable to pass stool.
At this stage, ultrasound examination reveals enlargement of the prostate gland. Under normal conditions, it measures approximately 4 cm in length, 3 cm in width, and 2 cm in thickness. It surrounds the urethra and produces a thick, soft secretion. It prevents urine from leaking out automatically and also prevents urination during ejaculation.
Causes
Excessive use of cold and dry foods, old age, and celibacy.
Urinary Incontinence (Frequent Urination)
When the muscle of the bladder becomes weak, urinary incontinence develops. As a result, urine continuously drips drop by drop, or there is a frequent urge to urinate. The quantity of urine is small, and it comes with such urgency that the patient cannot hold it. Consequently, it may be passed involuntarily. This condition worsens during winter when cold winds blow. Repeated urination during the night also disturbs sleep.
Causes
Excessive use of cold and moist foods, true diabetes, weakness of the kidneys, and old age.
Albuminuria (Proteinuria)
Proteins play an important role in the growth and structure of the body. They are the fundamental and essential components of every cell and muscle in the human body. They are necessary for the formation of tissues, ligaments, skin, nails, hair, hormones, enzymes, antibodies, and other structures. However, they do not primarily serve as a source of energy. After metabolism, they are broken down and excreted through the kidneys in the form of urea, while the remainder is converted into glucose and fat.
A blood protein called albumin, along with several other proteins, is normally excreted in the urine of an adult at a rate of up to 150 milligrams in 24 hours. Of this amount, albumin constitutes approximately 10 to 15 milligrams. Albumin is the most important protein produced by the liver. In addition, more than thirty other types of proteins are present.
Kidney diseases or abnormal conditions that damage the glomeruli and tubules increase the excretion of proteins and albumin through the urine. When this excretion exceeds 150 milligrams, the condition is called proteinuria.
If the amount of protein loss exceeds three and a half grams, the resulting deficiency of albumin in the blood causes swelling of the face and feet. This condition is called nephrotic syndrome.
In this disease, structural abnormalities develop in the kidneys. At the onset, the patient may appear healthy. The urine is pale or whitish, passed frequently, and in large quantities. Pain is present in the back of the head and lower back. The body becomes weak and sexual power declines.
As the disease progresses, the patient's complexion becomes pale. Headache develops, breathing becomes rapid, and a persistent cough may begin. Sometimes fainting and convulsions occur. Urine tests reveal the presence of albumin. Fat from the kidneys may be discharged in the urine, resembling egg white.
Causes
Addiction to alcohol, excessive sexual intercourse and masturbation, and inflammation of the kidneys.
Syphilis
The nourishment of the nerves consists of mucus and moisture. When stimulation occurs in the nerves, they also produce moisture and phlegm within the body. Based on these concepts, it is considered that in syphilis there is stimulation of the nerves along with an excess of bodily fluids and phlegm, in which fermentation and putrefaction occur and the condition develops into disease.
Symptoms
Researchers have described three stages of this disease.
First Stage
As soon as the poison of syphilis enters the body, the initial stage begins. This stage may last from three to five weeks, although signs can appear as early as ten days after exposure.
A hard swelling or red pimple develops at the site of infection. Its base becomes hard, and it gradually enlarges, ruptures, and forms an ulcer. Usually only one ulcer is present, and the surrounding area becomes slightly raised.
When the ulcer is pressed, it feels as though a hard mass exists beneath the skin. The ulcer is painless and produces very little discharge.
Five to seven days after the ulcer appears, the lymph nodes in the groin begin to swell. They are hard and tender on pressure but generally painless. They do not soften and do not form pus.
If a small amount of fluid is obtained from the syphilitic sore or swollen gland and examined under a microscope, the spiral-shaped organisms of syphilis can be seen.
Second Stage
It has been explained that during the first stage of syphilis, a swelling or blister appears on the genital organ. This stage usually lasts from ten days to five or six weeks.
If the condition is neglected, the second stage begins and signs of blood poisoning become apparent.
Initially, the patient develops fever, which may be mild or severe, intermittent or continuous. It may resemble malaria or other febrile illnesses.
The patient becomes weak and exhausted. Pain develops in the flesh and bones, particularly in the limbs and joints. Severe headache and insomnia occur, and the skin becomes pale.
The fever and pains of syphilis are often worse at night.
Inflammation and swelling begin in the throat, palate, and tonsils. Subsequently, pink-colored spots appear on the backs of the arms and thighs, indicating the beginning of the second stage.
These eruptions spread throughout the body over two to four weeks and gradually fade within about two months, leaving dark marks behind.
Pus may occasionally develop in these lesions, but there is usually no itching or burning, which is considered a characteristic feature.
At the same time, white patches appear on the lips, tongue, and inside the cheeks. The lymph nodes of the groin and neck enlarge.
Inflammation and swelling occur in the throat, tonsils, and associated tissues. Ulcers may develop in the tonsils. Lesions may also appear around the anus, on the genital organs, between the fingers, and in other moist areas.
Other manifestations include:
Loss of hair.
Brittle and darkened nails.
Wart-like growths.
Pustules and blisters.
Ulcers in various parts of the body.
Pain may also occur in the long bones of the arms and legs.
Because symptoms vary greatly in severity, different forms of skin eruptions may develop after the pink spots fade. These eruptions often appear on the joints, scalp, hands, and feet. Their color is coppery, and scales may form over them.
The entire body may develop lesions resembling psoriasis. Circular scaly patches appear either over the whole body or in selected regions. These lesions usually do not contain fluid.
As the scales fall off, new patches may appear. In some cases, hard nodules form and grow into elevated swellings.
Ulcers may develop in the soft palate, throat, or tonsils. Lesions may appear on the genital organs and around the anus. Hair loss may become severe enough to cause baldness. Some patients develop deafness.
Later, psoriasis-like lesions appear on the palms and soles, and ulcers may develop along the edges of the tongue. Inflammation of the eye structures may also occur.
Sometimes the disease begins with hard eruptions on the skin. When these cluster together and become covered with thick dark crusts, the patient becomes severely disfigured. In other cases, the eruptions resemble smallpox lesions.
Skin diseases caused by syphilis are often difficult to cure and may persist for years.
A distinguishing feature of syphilitic skin diseases is that they tend to be copper-colored, are usually neither itchy nor hot, and are commonly associated with sexual transmission.
The copper coloration is attributed to the spread of the syphilitic poison throughout the blood, causing congestion in the small blood vessels. Pus may occasionally develop within these lesions, but itching and burning remain absent.
Third stage:
There is no fixed time for the appearance of the third stage of syphilis; rather, its appearance depends greatly on the patient’s health and treatment. Therefore, in the third stage of syphilis, in diseases that are treated properly and regularly, the symptoms of the third stage of syphilis do not appear. Even if they do appear, they are very mild. However, in some patients, despite proper treatment, the symptoms of the third stage appear after six or eight months, and in some after many years, and some patients remain healthy for fifteen to twenty years and then the symptoms of the third stage appear. In the second and third stages, from time to time such symptoms appear which warn the patient that the disease of syphilis has not yet gone. These symptoms are called the final symptoms of the second stage, for example:
Inflammation in the different membranes of the eye globe.
Inflammation in the inner layer of the arteries. Due to blockage in a cerebral artery, blood circulation in a specific part of the brain becomes obstructed and its functions are suspended, resulting in paralysis.
A disease called soriasis appears on the soles of the hands and feet and sometimes on the entire body, in which round patches form, and the skin becomes dry and cracks, and flakes keep peeling off from it.
Round ulcers form on the legs etc., which in medical terminology are called rupia and in the terminology of ancient medicine are called liffahat or blisters. These blisters are sometimes separate and sometimes combined, and range from the size of a pea to the size of a pigeon’s or hen’s egg, and are filled with watery fluid. When the blisters burst, the fluid flows out and crusts form over them. A special characteristic of syphilitic liffahat is that the wound grows inwardly. In small children, this disease commonly occurs in the palms and soles due to syphilitic matter.
In short, if proper treatment of the first and second stages is not carried out carefully, then the third stage appears with its terrifying effects, and vital organs are affected. The brain and its nerves, lungs, liver, kidneys, spleen, intestines, and internal organs develop various disorders and hardenings, and the pleasures of life and vitality are turned into hardship and suffering. Sometimes the cornea and other membranes of the eye become fused together, and inflammation occurs in the optic nerve. In the early stages, the bones ache, but in the end, the bones become soft and begin to decay. The palate decays, and sometimes the nasal bridge decays and the nose collapses. Then these conditions become so difficult to treat that the patient begins to count his remaining days.
The effect of this disease also occurs on the particles of blood and the threads of the body’s organs, in such a way that when the poisonous matter enters the patient’s body and the natural defensive forces begin to resist it, hardness and a type of viscous substance is formed in the fibers, glands, and membranes of the body, and the moistures of its temperament gather in every part of the body wherever they find space and continue to develop capacities. This viscous matter exerts pressure sometimes on the body’s fibers and arteries and nerves, and sometimes this viscosity selects any one of these organs. As a result, lumps form in various internal organs under the skin, in muscles, tongue, throat, intestines, brain, spinal cord, nerves of the heart, lungs, liver, spleen, and kidneys, and also in the bones.
Types of syphilis:
Syphilis has two types. In common terms, they are called male and female. In English, they are called soft chancre and hard chancre. According to our research, one is nervous-muscular and the other is nervous-glandular. In Unani medicine, nervous-muscular syphilis is that in which thin phlegm burns and turns into black bile and becomes infected.
And nervous-glandular syphilis is that in which thin phlegm mixes with bile and burns and becomes infected.
In both types, phlegm is involved, which burns and becomes infected.
Male syphilis is nervous-muscular and mostly affects men.
Female syphilis is nervous-glandular and affects men less and women more.
Difference between Male and Female Syphilis:
In female syphilis, symptoms appear at least ten days or up to two weeks after infection. If so, it is female syphilis. In male syphilis, a blister appears within 24 hours of intercourse and turns into an ulcer within 4–5 days.
In female syphilis, after 7–10 days of ulcer formation, swelling appears in the lymph nodes on one or both sides, but no pus forms. In male syphilis, lymph nodes swell immediately and usually quickly form pus.
Although ulcers and swelling occur in both after intercourse with infected women, in female syphilis the blister becomes hard and feels like a gland under pressure and moves slightly when touched. In male syphilis, the lesion appears and heals quickly and is deeper. These points require careful attention.
In female syphilis, the poison spreads in the blood and continues developing internally, so long treatment is required—up to three years in modern times. In male syphilis, the poison does not enter the blood and remains external, but if not treated, it can still damage the genital organ.
Note: In male syphilis, there is less need for mercury compounds because the effect does not reach deep blood vessels, and there are no stages.
Hemorrhoids:
Types of Hemorrhoids:
Basically, hemorrhoids are of two types:
1- Gaseous hemorrhoids
2- Bleeding hemorrhoids
1- Gaseous Hemorrhoids:
These are also called wind hemorrhoids because there is only constipation, no piles are formed, and no bleeding occurs. Gas moves in the abdomen and cannot be expelled easily, and sometimes this gas causes pain in different parts of the body such as abdomen, back, rectum, intestines, shoulders, and head due to pressure.
Cause: Excess use of cold and dry foods.
2- Bleeding Hemorrhoids:
These are of two types:
1- With piles and bleeding, called “Damia”
2- Piles present but no bleeding, called “Amya”
Types of Piles
These piles occur in several forms; some of them are as follows:
1- Grape-like (Angoori): These are shaped like grapes.
2- Fig-like (Teeni): These are shaped like figs.
3- Lentil-like (Tholooli / Masoori): These are like sesame seeds or lentils.
4- Date-like (Tamri / Khajoori): These are like date stones.
5- Mulberry-like (Shahtooti): These are long and soft like mulberries.
Nature of Bleeding Hemorrhoids:
Due to pressure of blood in the final part of the large intestine near the rectum, veins swell. These veins are embedded in the walls of the intestine. Due to pressure they swell outward. The patient feels pain. When he eats spicy and dry foods, dryness increases in the intestines. Stool becomes very hard like clay. When the patient strains, the stool passes over swollen veins, causing tearing and bleeding. These swollen veins are hemorrhoids, inside and outside the rectum in different shapes. Their walls become very thin and pressure increases, causing rupture and bleeding. The patient becomes weak, pale, and dizzy.
Symptoms:
General symptoms include tension, tightness, rapid heartbeat, muscular contraction due to gas, dryness, weakness of brain and nerves, liver and gland sluggishness, excess phlegm, formation of lumps on skin and internal organs, dry mouth and nose, cold, blocked nasal discharge, chest burning, cough, stomach inflammation, kidney and liver pressure, joint pain.
Specific symptoms include pain, burning, itching, heaviness in rectum, constipation, difficulty sitting, bleeding during or after stool, relief after bleeding, worsening with gas blockage.
Thirst:
True thirst is to dilute food in the stomach and help its passage through arteries.
Nervous Thirst (False Thirst):
When nerves are irritated, glands weaken and muscles relax, causing dryness and thirst. Even after drinking water, thirst does not subside. This is called false thirst.
Muscular Thirst:
When muscles are affected, dryness occurs due to acidic substances or excessive exercise.
Excessive Thirst:
Repeated desire to drink water but no satisfaction even after drinking.
Gonorrhea:
It is caused by a bacterium called “Neisseria gonorrhoeae,” through which the Creator of the universe gives lifelong punishment in this world to immoral and shameless men and women who, while violating His command, engage in adultery.
Definition: It is an ulcer of the urethra (naiza) caused by the Neisseria bacterium. During sexual intercourse of shameless men and women, these germs enter the urethra and within two to five days cause irritation and swelling in the inner mucous membrane of the urethra, forming an ulcer. From this ulcer, a foul-smelling white discharge or yellow pus flows. Urination occurs with pain, obstruction, and burning. The mucous membrane becomes constricted, causing narrowing of the urethra.
In women, this bacterium affects the cervix, urethra, and vulva. When the cervix becomes inflamed, they experience pain during urination and discharge of pus. It causes swelling of the uterus, fallopian tubes, and even the entire pelvis.
Nature of Gonorrhea:
Inside the urethra (naiza), there is a membrane made of epithelial (glandular) tissue. This passage remains moist with fluid so that urine or semen can be discharged easily and without burning. When the discharge of this fluid is stopped for any reason, burning occurs in the urethra. This burning develops into urinary irritation or gonorrhea, and when it becomes severe, the gonorrheal substance is produced.
Reality of Gonorrheal Substance:
When the functions of the liver and glands become active, fluids containing bile are discharged into the blood. When bile increases, fermentation begins in the excess bile, and it becomes putrefied. Gradually this poison spreads from head to toe in all glands of the body and chemically mixes with the blood, causing constriction in all of them.
Symptoms: The effects of gonorrheal substance appear within three to ten days, causing itching, pain, and inflammation in the urethra; urine becomes scanty and is passed with burning. Then an ulcer forms there, from which blood comes out and severe pain occurs. Then pus begins to flow, but the patient becomes afraid of urination and sometimes stops it, causing swelling of the genital organ. Sharp pains occur during urination (at that time they feel the thought of modesty). These symptoms are so severe that even touching clothes causes pain. When pus forms, the symptoms decrease. If proper treatment is done and repentance is made, gonorrhea is completely cured. Otherwise, an ulcer forms in the urethra and gradually the effects of the gonorrheal substance spread throughout the body, and the person is forced to live a life of humiliation. There is pain in the back and hips. A feeling of heat in the body occurs. Sleep becomes disturbed.
The urethra becomes narrowed due to ulcers and overgrowth of extra tissue. Urination becomes difficult and sometimes a catheter has to be used.
When its poison spreads into the blood, it also makes it putrid, causing skin eruptions on the body. It also severely affects the glandular membranes of the heart and other organs. When the gonorrheal substance becomes severe, it spreads toward the bladder. It reaches the prostate gland, Cowper’s gland, testicles, seminal vesicles, and epididymis.
In men, when the infection reaches the testes, the sperm becomes dead, making them incapable of producing offspring. In laboratory tests, pus cells in semen increase beyond 4.
Similarly, when the severity of this poison occurs in women, after affecting the urethra, the disease spreads to internal organs. It causes burning in the vagina. Urine comes out in small amounts with burning. Foul-smelling discharge and pus occur. Pain and severe restlessness occur in the back and entire body. Eventually, they suffer from uterine inflammation, inflammation of the uterine adnexa, difficulty in conception, and infertility, with symptoms such as warm hands and feet, bitter taste in the mouth, sleep disturbance, body tingling, and burning in excretory passages. If proper treatment is taken and repentance is made, this disease is completely cured; otherwise, they will live a life of humiliation.
When gonorrheal substance develops in both man and woman, their newborn children suffer from inflammation of the eye membrane, severe eye infection or blindness, and inflammatory effects on the rest of the body.
In short, gonorrhea is such a vile disease from which many other diseases arise, such as severe arthritis, bloody urine, urinary retention, inflammation of the testicles, inflammation of the bladder, impotence, gonorrheal eye infection, blood putrefaction, inflammation of the cervix in women, uterine inflammation, and infertility, etc. But generally, people ignorantly consider gonorrhea a minor disease and do not treat it properly, whereas it is a very harmful and vile disease.
Causes: Immorality, excessive use of hot and dry foods, and hot dry environment and climate.