The pain, the muco-purulent discharge, and the irritability of bladder connected with this malady, may certainly be relieved by local injections of carbonic acid gas - a method of treatment not, perhaps, so often used as it deserves to be. Dr. Johns, Sir James Simpson, Dr. Skinner, and others have reported much improvement in many severe and chronic cases (British Medical Journal, 1858; Medical Times, 1858-59). The gas is disengaged from a carbonate mixed with tartaric acid, and conveyed through a catheter, the bladder being previously washed out if possible. It is desirable to avoid over-distension of the viscus, either by using only a measured quantity (Skinner), or employing a double catheter (Johns). If too much be injected, there may be some burning pain, and afterward drowsiness and sense of exhaustion, but these symptoms are temporary, and are, in most cases, not felt at all, while relief follows very quickly and lasts for a long time, suggesting that the gas is retained in the bladder for several hours before being absorbed: its use is commonly though not always followed by excretion of urine containing much mucus and oxalates.

The gas may be employed in almost all forms of irritability of the bladder, unless acute inflammation be present - if irritation be severe, it may be diluted with air.