72 DISEASES OF THE BLADDER. 



every eight or twelve hours, and an elastic bandage should be fitted 

 to the abdomen. In concentric hypertrophy, on the other hand, the 

 patient must be charged to retain his water as long as possible, in 

 order gradually to dilate the bladder. It has also been proposed to 

 introduce an elastic catheter, closed by a cork, into the bladder, by which 

 the 'irine may be evacuated every two or three hours. 



CHAPTER II. 



CROFPOUS AND DIPHTHERITIC CYSTITIS. 



CROFPOUS and diphtheritic cystitis scarcely ever occur, excepting 

 in cases of severe infectious disease in septicaemia, typhus, small-pox, 

 and scarlatina and are accompanied by similar inflammation of other 

 mucous membranes. Far more rarely it arises after the abuse of can- 

 tharides, after difficult labor, or in consequence of very intense irrita- 

 tion of the bladder from decomposed urine. In this form of inflam- 

 mation a coagulating exudation of variable thickness and consistence 

 is formed, a portion of it infiltrating the tissues of the mucous mem- 

 brane, while another portion lies upon its free surface. The process 

 rarely extends over the entire surface of the bladder. More usually it 

 is confined to detached streaks and spots of a rounded form. After 

 separation of the diptheritic slough, there remain losses of substance 

 in the mucous membrane. The disease can only be recognized when 

 whitish membranous coagula are discharged with the urine, with 

 symptoms of severe tenesmus. In the croupous cystitis which some- 

 times follows the abuse of cantharides, or difficult forceps deliveries, we 

 occasionally see large tenacious false membranes discharged with the 

 urine. The treatment of croupous and diphtheritic cystitis should be 

 similar to what we have already advised in cases of violent and acute 

 catarrhal cystitis. 



CHAPTER III. 



PERICTSTITIS. 



BESIDES the inflammation induced by perforation of the bladder, 

 and by abscesses and suppuration of its walls, another and independent 

 inflammation, which we call pericystitis, sometimes involves the connec- 

 tive tissue which surrounds this organ, and connects it with the adja- 

 cent parts. It is of far less frequent occurrence than the inflammation 

 which takes place about the rectum, and is hardly ever observed 

 excepting as an accompaniment of infectious disease, typhus, the acute 

 exanthemata and septicaemia. As a still greater rarity, it arises idio- 



