104 



PRACTICE OF MEDICINE. 



pubes, extending to the perinaeum, groins, and lumbar regions ; the 

 passing of the urine is attended with pain and difficulty ; the blood 

 is little, if at all, combined with the urine. When the hemorrhage 

 is from the urethra, pain is felt in a particular part of the canal, and 

 the blood is red, liquid, and pure, and generally is voided guttatim. 

 When the blood, however, flows back into the bladder, some uncer- 

 tainty as to its origin is produced. 



Hemorrhage of the urinary organs presents little worthy of notice, 

 as regards its 'physical characters^ except when it occurs in the 

 bladder. In this organ, it takes place from isolated points of the 

 mucous membrane, which, as well as its sub-cellular tissue, presents 

 a number of deep red patches, varying from a Une to half an inch 

 in diameter, the larger ones having often a small ash-coloured slough 

 in their centre. These patches consist of blood effused into the 

 mucous and sub-mucous tissues, and are accompanied by venous 

 congestion of those tissues where the effusion has not taken place. 

 This form of hemorrhage is chiefly observed in injuries of the 

 spine ; and appearances perfectly similar sometimes follow the ap- 

 plication of blisters to the chest, abdomen, and other parts of the 

 body. The most frequent cause of hemorrhage from the urinary 

 organs is the presence of the fungoid disease in the prostate, and 

 hence its much greater frequency in the male than in the female. 



Treatment. — The treatment of this affection will, of course, depend 

 on its seat and cause. When the hemorrhage is from the kidney, 

 if the patient be strong, and the pulse full, either general or local de- 

 pletion, with the usual antiphlogistic treatment, is requisite. On the 

 contrary, when the patient is debilitated, as in typhus or scurvy, the 

 urine being generally alkaline, the mineral acids should be given. 

 In ordinary cases, when neither excitement nor depression is present 

 in a marked degree, small doses of copaiba, turpentine, or of the 

 tinct, ferri sesquichhrid.^ the latter of which is the best, are to be 

 administered. The avoiding of all stimulants, and absolute rest, 

 should be insisted on. 



OF DROPSIES. 



If, in man, a large venous trunk be compressed or obliterated, so 

 that the blood no longer circulates through it, whilst at the same time 

 the collateral vessels can relieve but imperfectly the principal vein thus 

 obstructed, an effusion of serum is sure to take place. But if the 

 obstruction exists not merely in the veins of a limb, if it occur in 

 a vessel into which the blood of a much greater number of parts 

 empties itself, then the dropsy will necessarily become more con- 

 siderable. If, for instance, the obstacle to the return of the blood 

 should exist in the abdominal vena cava, the two lower extremities, 

 as also the scrotum, will become filled with serum. If it be the 

 trunk of the vena portse, which is more or less completely oblite- 



