I 



CHRONIC CYSTITIS. 513 



male animals this latter form of cystitis is characterised by frequent 

 spasmodic contractions of the accelerator urinae. In acute cystitis, on 

 the contrary, the contractions are temporary only and of no import- 

 ance. Lastly, in female animals cystitis due to calculus formation 

 is quite exceptional, owing to the large diameter and shortness of the 

 urethra. 



When nephritis and cystitis co-exist certain signs indicate the fact. 



Prognosis. The prognosis varies, according to the acuteness of the 

 disease and the character of the urine and epithelial debris, which afford 

 valuable information. 



Treatment. The treatment should be directed towards relieving the 

 vesical and pelvic pain and modifying the local conditions. 



Hot fomentations to the loins and flanks relieve pain. The adminis- 

 tration of bicarbonate of soda and of cold drinks, such as barley-water, 

 decoctions of couch-grass and pellitory, mucilage, etc., are of service. 

 These materials are readily taken by the patients, and have a soothing 

 effect. Camphor also produces good results, but benzoate of soda is 

 most useful on account of the disinfectant action produced within the 

 bladder, as a consequence of the benzoic acid being separately eliminated 

 by the kidney. Eepeated washing out of the bladder with antiseptic 

 solutions has been recommended, but is open to criticism. Such treat- 

 ment is difficult in male animals, owing to the special formation of 

 the glans penis and urethra, and in female animals it is by no means 

 easy. In all cases of acute cystitis, in fact, the passage of the catheter 

 is painful, and as a metal, gutta-percha or hard rubber sound is used, 

 the mere contact of the tip of the instrument injures the diseased 

 mucous membrane, makes it bleed, and gives rise to danger of auto- 

 inoculation, with the possibility of serious results. 



Those who recommend this method of treatment can never have 

 followed closely the development of a grave case of acute cystitis, and if 

 the practice is at all permissible, only a soft catheter should be used. 



In chronic cystitis, on the other hand, washing out the bladder might 

 be useful. 



CHRONIC CYSTITIS. 



Chronic inflammation of the bladder is still rarer than acute cystitis. 

 It usually attacks females as a consequence of acute inflammation, though 

 the condition may be chronic from the first, in which case the early 

 stages are commonly overlooked. 



Symptoms. The chief functions of the body do not appear to be dis- 

 turbed, although the urine seems abnormal. Micturition is difficult, slow, 

 and somewhat painful, and is followed by long-continued tenesmus. 



The urine appears whitish, purulent, slimy, or of a deeper tint, 



D.C. L L 



