as well as external blows and
injuries. The foregoing causes are apt to bring on sudden or acute
attacks of bladder trouble, but often the disease comes on slowly and
is continuous or chronic.

Among the causes of chronic cystitis, in men over fifty, is
obstruction to the outflow of urine from enlargement of the prostate
gland, which blocks the exit from the bladder. In young men, narrowing
of the urethra, a sequel to gonorrhea, may also cause cystitis; also
stone in the bladder or foreign bodies, tumors growing in the bladder,
tuberculosis of the organ. Paralysis of the bladder, which renders the
organ incapable of emptying itself, thus retaining some fermenting
urine, is another cause of bladder inflammation.

=Symptoms.=--The combination of frequency of and pain during
urination, with the appearance of blood or white cloudiness and
sediment in the urine, are evidences of the existence of inflammation
of the bladder. The trouble is aggravated by standing, jolting, or
active exercise. The pain may be felt either at the beginning or end
of urination. There is also generally a feeling of weight and
heaviness low down in the belly, or about the lower part of the bowel.
Blood is not frequently present, but the urine is not clear, if there
is much inflammation, but deposits a white and often slimy sediment
on standing. In chronic inflammation of the bladder the urine often
has a foul odor and smells of ammonia.

=Treatment.=--The treatment of acute cystitis consists in
rest--preferably on the back, with the legs drawn up, in bed. The diet
should be chiefly fluid, as milk and pure water, flaxseed tea, or
mineral waters. Potassium citrate, fifteen grains, and sweet spirit of
nitre, fifteen drops, may be given in water to advantage three times
daily. Hot full baths or sitz baths two or three times a day, and in
women hot vaginal douches (that is, injections into the front
passage), with hot poultices or the hot-water bag over the lower part
of the abdomen, will serve to relieve the suffering. If, however, the
pain and frequency attending urination is considerable, nothing is so
efficient as a suppository containing one-quarter grain each of
morphine sulphate and belladonna extract, which should be introduced
into the bowel and repeated once in three hours if necessary. This
treatment should be employed only under the advice of a physician. In
chronic cystitis, urotropin in five-grain doses dissolved in a glass
of water and