HAMATURIA. 153 
Thereafter, and until the inflammation returns, there appearing to persist 
some irritability of the bladder merely, it would scarcely be advisable to drug, 
for it could not do much good. Certainly the stone would not be dissolved 
either by medicines given through the mouth or injected into the bladder. 
Stone can be taken intact from the bladder or crushed and removed in 
minute pieces, but the operations require skilled hands. When the stone is 
small and has lodged in the urethra or neck of the bladder, it can sometimes be 
pushed back; but if not, or it cannot be passed, it becomes necessary to cut 
through at the point of. obstruction and effect removal by way of the incision. 
If to pass a catheter is not possible, and the bladder must burst if not 
otherwise emptied, relief can be promptly effected by means of a small trocar 
and canula. In the female this should be entered on the median line, at the 
so-called brim of the pelvis. In the male the point of entrance should be low 
down and as near the brim as possible, but either on the right or left side of 
the flank. 
HAMATURIA. 
Hematuria or bloody urine may occur in consequence of trouble in the 
bladder or the passage to it, but in most cases it is due to intense acute conges- 
tion of the kidneys. Such attacks may be occasioned by blows or other injuries 
across the loins. They seem due, also, in occasional instances, to simply an 
abnormal sensitiveness of those organs to the influence of cold. As a rule, how- 
ever, they have been found after death to have been caused by stone in the 
bladder or kidneys, or by parasites in the latter, especially the giant strongle, 
which is a most troublesome intruder. 
For a day or more before the urine becomes bloody the victim is generally 
dispirited ; he shivers now and then, and exhibits decided stiffness in getting up 
‘or lying down. His nose is hot, he has some fever, and vomits occasionally. 
His urine is of a port-wine hue; it is voided at frequent intervals, and with 
evident discomfort. 
Attacks caused by traumatic injuries to the kidneys are commonly soon re- 
covered from. When induced by kidney calculi they are also usually transient, 
but recur at intervals. But if due to parasites, the result is, as a rule, soon fatal. 
As regards treatment, about all that can be done is to afford protection 
against exposure to cold and properly nourish with bland and non-irritating foods, 
as milk, boiled rice, thin gruels, and broths. Butter-milk is of special value in 
such cases, and the quantity need not be restricted. When recovery is possible, 
it will occur under good management and nursing without the aid of medicine. 
