The treatment will vary according to the causes, etc. When from an acrid matter taken in by the mouth, it must be evacuated by a quick emetic; by large draughts of warni mild liquids; or by the proper antidote, if the nature of the poison is known. If symptoms of inflammation are manifest, bleeding, blisters, fomentations, and frequent emollient laxative clysters may be used. But as the affection often arises in putrid diseases, all that can be done in such circumstances is to avoid irritation, and to throw into the stomach as much of mild and of acescent aliments as it can bear. When the disease is a little alleviated, a light infusion of bark, with a few drops of any mineral acid, is borne with ease, and is highly beneficial. See Cullen's First Lines, vol. i. p. 356, etc. ed. 4.

24. Inflammatio vesicae, cystitis, and cystiphlo-gia. This disease is also placed by Dr. Cullen in the order phlegmasia, and denned a febrile affection, attended with pain and tumour of the hypogastric region; frequent and painful micturition, or ischury and tenesmus. He distinguishes two species. 1. Cystitis from internal; and, 2. from external causes.

It is produced by the usual causes of internal inflammation, or from topical irritation; as acrid diuretics, or a calculus.

A pressing and burning pain, with external soreness, is perceived in the region of the bladder above the pubes, and in the perinaeum, soon after a febrile attack. If the neck of the bladder be inflamed, the urine is retained, with frequent stimulus to its evacuation; - if the fundus, there is a continual discharge, with great efforts to throw out a larger quantity, which the patient conceives to be contained in a bladder. Frequent attempts to expel the faeces, with which the rectum appears to the patient to be always loaded, increase the pain very much, particularly when any hard faeces are contained in it. The pulse is frequent, but seldom hard; the extremities cold, with restlessness, sickness, vomiting; sometimes delirium, and other symptoms of irritation.

This disorder, if very violent, usually terminates soon, either in a recovery or death; frequently the latter, generally from a gangrene. So violent an inflammation of the bladder seldom, however, occurs. We have often seen it without considerable danger, chiefly from topical irritation, and once only from catching cold.

This disorder is sometimes relieved by an increased secretion of mucus from the internal membrane, resembling, in appearance, pus, but much lighter, and more uniform; or by a metastasis. When suppuration follows, pus is discharged with the urine, passes externally through the perinaeum, or into the cavity of the abdomen, where it proves fatal. The ulcer in the bladder and perinaeum are difficult of cure.

Inflammation in the external coat of the bladder should be distinguished from that of the internal; and inflammation in any part of the bladder should be distinguished from inflammation in the adjacent parts, as well as from that retention of urine which proceeds from other causes. The distinction is, however, by no means difficult, as, when the external membrane is affected, the pulse is hard, and the external soreness considerable; nor is the great irritation to make water so painful or frequent.

In the cure, bleeding is seldom necessary to any considerable extent; but the bowels should be kept freely open by such laxatives as do not irritate the rectum.

Relaxing medicines, such as the pulvis antimonials and haustus salinus, should be given early, and repeated frequently. Fomentations to the pubes and perinaeum are highly useful; and mild clysters, which act as such, should be frequently injected.

If the urine is retained, decoctions of mucilaginous herbs may be taken; but we should always reflect, that, though we abate the acrimony of the urine in this way, we increase the disease. Such decoctions should not be drunk in too large quantities, and gum arabic kept in the mouth will sheath the inflamed parts without adding to the quantity of urine. If necessary, the catheter must be introduced; though much care is required in the attempt, which often fails.

If, notwithstanding due evacuations, spasmodic Contraction with much pain continues, opiates in considerable doses, such as tinct. opii. gt. xx. every three op four hours may be given, taking care that no accumulations take place in the bowels.

The patient may be placed in the warm bath two or three times in the day. Blisters are sometimes applied to the perinaeum, and with advantage; the plaster should, however, be covered with thin gauze, and re moved as soon as a vesication has taken place. In this way we have often applied them with success. The rubefacients promise greater utility with less inconvenience, but we know not that they have been tried.

If by irregular shivers, and the diminution of pain, a suppuration is suspected, we must wait its progress., and the disease will then become an ulcer of the urinary passages, which must be treated accordingly.

25. Inflammatoria febris. Dr. Cullen places it in the class pyrexia, and order febres; and as a synonym of synocha; defining it heat, greatly increased; a frequent, strong, and hard pulse; high coloured urine; the functions of the sensorium somewhat disturbed. This fever is the continua non putris of Boerhaave; and the febris acuta sanguinea of Hoffman.

When fever is attended with an inflammatory diathesis, or when actual inflammation affects any part during the existence of fever, the patient is said to labour under one of an inflammatory kind; but, according to the different parts in which the inflammation is seated, different denominations are given to the disorder, as we have seen in the preceding articles.

In strong constitutions it is produced by any of the causes of fever; but it has been doubted whether inflammatory fever exists, independent of topical inflammation. There is little doubt but that it is most commonly attendant on topical inflammation, though it certainly exists alone. When we consider the distinctions of fever, we shall find that they have been too curiously subdivided; and that fever is a more simple disorder than pathologists have represented it. At present we shall only remark, that this disease is distinguished by a hard pulse and more considerable heat than usual, generally owing to the strength and tone of the habits it attacks.