nd butter; no alcoholic drink should be
allowed. If the urine is acid, bicarbonate of soda may be given, or
citrate of soda; if alkaline, urotropine--a derivative of formic
aldehyde--may prove a useful urinary disinfectant. If the straining and
distress are great, a suppository of 1/4 or 1/2 a grain of morphia may
be introduced into the rectum every two or three hours. The bowels must
be kept freely open. If the urine is foul, the bladder should be
frequently washed out by a soft catheter and two or three feet of
india-rubber tubing with a funnel at the other end, weak and abundant
hot lotions of Sanitas or Condy's fluid being used.

_Chronic cystitis_ is the condition left when the acute symptoms have
passed away, but it is liable at any moment to resume the acute
condition. If the cystitis is very intractable, refusing to yield to hot
irrigations, and to washings with nitrate of silver lotion, it may be
advisable to open the bladder from the front, and to explore, treat,
drain and rest it.

In _tuberculous cystitis_ there is added to the symptoms the discovery
of the bacilli of tuberculosis in the urine, and cystoscopic examination
may reveal the presence of tubercles of the mucous membrane or even of
ulceration. The patient is probably losing weight, and he may present
foci of tuberculosis at the back of the testicle, the lung or kidney, or
in a joint or bone, or in a lymphatic gland. _Treatment_ is rebellious
and unpromising. Washings and lotions give but temporary relief, and if
the bladder is opened for rest, and for a more direct treatment, the
germs of suppuration may enter, and, working in conjunction with the
bacilli, may cause great havoc. Koch's tuberculin treatment should
certainly be given a trial. This consists of the injection into the body
of an emulsion of dead tubercle bacilli which have been sterilized by
heat. As a result of this injection the blood sets to work to form an
"opsonin"--a protective material which so modifies the disease-germs as
to render them attractive to the white corpuscles of the patient's blood
(phagocytes), which then seize upon and destroy them. Sir A.E. Wright
has devised a delicate method of examination of the blood (the
calculation of the opsonic index) which tells when the tuberculin
injections should be resorted to and when withheld (see BLOOD).

Stone.

_Calculi and Gravel._--Uric acid is deposited from the urine either as
small crystals resembling cayenne pepper