HiEMATURIA. 



103 



being at the same time in a state of great congestion, and infiltrated 

 with blood. 



7yeatme?it,—ln plethoric and robust persons, in cases depending 

 on congestion of the liver or spleen, or upon suppressed discharges, 

 and where there are indications of increased or sthenic action, we 

 should have recourse to copious or repeated bloodlettings, according 

 to circumstances. Cvppwg over the hypochondria, purgatives, 

 cathartic enemata, and external derivatives, should be resorted to. 

 In the more active forms, a full dose of calomel, followed in a few 

 hours by a purgative draught, and this by a cathartic enema, so as 

 to procure copious alvine evacuations, should precede the use of 

 astringents. When the hemorrhagic discharge is so copious as to 

 forbid the delay which this practice would occasion, the calomel 

 should be followed in a short time by a full dose of oil of turpentiiie, 

 given on the surface of milk or of some aromatic water, or of this 

 medicine conjoined with castor oil. If this draught be thrown off 

 the stomach, it should be repeated ; and it may be even again pre- 

 ceded by the calomel. Notwithstanding its usual nauseating effect, 

 turpentine is generally retained in hsematemesis, and it allays the 

 vomiting by arresting the hemorrhage. 



Of the astringents, the acetate of lead, in large doses, with opium, 

 or with pyroligneous acid, acetate of morphia, and creasote, is the 

 most efficacious. In the more passive states of the disease, the 

 tonic astringents, as the tincture of the sesquichloride of iron, the oil 

 of turpentine with aromatics, the sulphates and sulphuric acid with 

 opium and infusion of roses, alum in milk-whey, are generally 

 useful. 



During the continuance of the discharge, total abstinence should 

 be enjoined ; but afterwards, mild mucilaginous drinks, and farina- 

 ceous food in small quantity, may be allowed, and the transition to 

 solid and more nutritious diet carefully and gradually conducted. 

 The drink should be cooling and astringent, and appropriate to the 

 state of the digestive organs, especially the liver and spleen. Sub- 

 sequently, change of air, regular exercise on horseback, and the use 

 of deobstruent mineral waters, ought to be recommended. 



HEMATURIA [Hemorrhage from the Urinary Organs). 



Symptoms, — The source of blood voided through the urethra may 

 be either the kidney, ureters, bladder, or urethra. When it proceeds 

 from an affection of the kidneys, it is attended with a sense of heat 

 and pain in the loins, and sometimes with coldness of the extremi- 

 ties, and the blood is intimately mixed with the urine. When the 

 disease is in the ureters, there is a sense of pain and tension in their 

 course ; and coagulated shreds of jihrine, having the shape of the 

 ureters are frequuetly voided. W^hen the hemorrhage is from the 

 bladder, it is usually preceded by heaviness and tension above the 



