CATARRH OP THE BLADDER CYSTITIS CATARRHALIS. 71 



quite recent and of great intensity that the indications from the dis- 

 ease itself call for local blood-letting, which then is better performed 

 upon the perinaeum than above the symphysis. In most cases of acute 

 catarrhal cystitis, hot poultices upon the abdomen, and general warm 

 baths, suffice to relieve the symptoms and to bring about a favorable 

 termination. Besides this, we must take care that the urine enter the 

 bladder in as dilute a condition as possible ; but, if we strictly forbid 

 the use of all salt and spices, it will be useless to mix oleaginous or 

 mucilaginous materials in the patient's drink. It is best to let the 

 patient drink the artificial or natural mineral waters the Seltzer, 

 Wildunger, Fachinger, or Gailnauer waters, or soda-water, or lime- 

 water, mixed with equal parts of milk. The semina lycopodii have a 

 peculiar reputation as a remedy for vesical catarrh (sem. lycopod. 

 | ss to mel. despumat. jss. f. elect, s. 3 j every two hours), as has 

 also camphor, where the complaint arises from the abuse of cantharides 

 (camphor pulv. gr. vj, emulsion of almonds, vj). The employment 

 of small doses*, of opium in the form of Dover's powder, given at night 

 before bed-time, or in the form of tinctura thebaica, in divided doses, 

 is not only harmless, but a most efficient remedy against pain and 

 vesical tenesmus. The more the pain abates, and the more copious 

 the admixture of mucus and pus in the urine, so much the more ur- 

 gently are the astringents indicated. The astringent most commonly 

 employed is a decoction of the folia uva ursae ( | ss. to vj, a table- 

 spoonful every two hours). The continued use of tannin is still more 

 efficacious : I have obtained some most happy results from it in cases 

 which seemed almost desperate. In the later stages of acute vesical 

 catarrh, and still more in the chronic form of the disease, the balsams 

 and resins, which are of such striking benefit in catarrh of the urethra, 

 also do excellent service. To this class belong the oil of turpentine, 

 tar-water, Peruvian balsam, and, above all, balsam copaiba, which may 

 be given in capsules of gelatine. If these remedies fail, we should 

 have recourse to local treatment. I have repeatedly made injections 

 with lukewarm water, the temperature of which I gradually bring 

 down to 65 F. after the manner recommended by Civiale, and cannot 

 sufficiently praise their efficacy, especially in treatment of women. 

 Astringent injections, among which solutions of nitrate of silver, sul- 

 phate of zinc, and tannic acid, are recommended; should be used witr 

 greater caution ; so too with injections of emulsion of balsam copaiba 

 ( 3 j to j), the efficacy of which is greatly extolled by some phy- 

 sicians. No modification of this treatment is demanded where ulcera- 

 tion of the bladder is detected. Suppurative destruction of the vesical 

 mucous membrane is quite insusceptible of treatment. In excentrio 

 hypertrophy, the bladder mubt be emptied by the catheter regularly 

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