warm hip bath may be preferred. The patient may also be advised, in attacks caused by irritant medicines or new wine or beer, to drink large quantities of water. In twenty or thirty minutes the water will have entered the bladder, and the irritating substance, being held in solution by the water, will be expelled from the viscus. Any substance which will cause a relaxation of the muscles will also be beneficial. For this purpose the inhalation of chloroform has been advised. If the attack is not very severe a very few inhalations will be required, just enough to decrease the sensibility to the pain; but in severe cases it may be necessary to carry it to the extent of producing complete anesthesia. The remedies that may be required in the treatment of this disease will be found among those most capable of exciting spasms in other parts of the system. Among these Nux vomica probably holds the first rank. It is especially useful in cases caused by sexual excesses, or by the undue use of stimulants.

Hyoscyamus may also be thought_of, and will, no doubt, be found a very valuable remedy, although clinical experience with it is very meagre.

Pulsatilla will also be found useful, especially in females, more particularly dur ing pregnancy, or in affections of the

uterus.

Sarsaparilla has also been mentioned, especially when the attack has been caused by the presence of stone in the bladder.

Clinical experience in regard to the use of any of our remedies is very scanty, for the reason that a pure, uncomplicated neurosis of the bladder is a very rare affection; but the remedies that have been used with good effect, in addition to those already mentioned, are Canth., Bell., Berberis, Colo., Cann. sat., Camphor, Colch., Dulc., Lyc., Phos. acid, Sepia, Terebinth, etc. Enuresis. W. F. Edmundson, H. M., Oct., 1876.)

In the treatment of this complaint we must at once direct our efforts to the removal of the exciting cause, the enuresis being but a consequence or secondary pathological condition, carefully noting all the symptoms, both subjective and objective, subjecting the patient to careful physical examination, having them exercise care in regimen and diet, and endeavoring by all means to restore and build up their general health. Among the numerous remedies used in this complaint we mention the following as the most prominent: Sulphur, Puls., Lycop., Bell., Calc. carb., Sepia, Staphisagria, Canth., Nux vom.,

Cicuta virosa, Causticum, Strychnine, Uranium nitr., Magnesia phos., Phos. acid., Hyoscyamus, Squilla, Ignatia, Cina. Symptomatic Indications: Aconite. This great antiphlogistic is indicated when the skin is dry and hot; great thirst; unrest; nervous excitement; fear and anxiety; pain in the region of the bladder; retention of urine, with stitches in the kidneys; frequent and violent urging to urinate, with scanty emissions of red, turbid urine.

Angustura. Tenesmus of the bladder, followed by profuse emission of white urine; tenesmus after micturition. One is obliged frequently to urinate, although but a few dark-yellow drops are emitted each time, causing a burning pain; orange-colored urine, soon becoming turbid Anantherum.

Frequent emission of urine, which is turbid, or soon becoming so; sensation of numbness and obstruction in the kidneys; sensation as if the kidneys and bladder were always full and swollen. Pressure and burning pains in the bladder, with urging to urinate every minute; the bladder cannot hold the smallest quantity of urine. Difficult, painful, intermittent urination; it stops, and begins again the next moment. Fullness and distension of the bladder, with inability to urinate; urine turbid, thick, and full of mucus, as in catarrh of the bladder; retention of urine, with retraction of the urethral canal; urine brownish, or yellowish, and bloody; very frequent urging to urinate, with burning urine, which is discharged in drops; urine with yellowish, grayish, or dark sediment; incontinence of urine, with involuntary urination when walking, and even at night in bed during sleep, as if caused by paralysis of the neck of the bladder; tenesmus vesica, with ischuria.

Apis. Burning in the urethra before and after micturition; disagreeable sensation in the bladder, with a bearing-down in the region of the sphincter and frequent desire to urinate; incontinence of urine, with great irritation of the parts, worse at night and when coughing; almost incessant desire to pass urine; urine high colored; and more frequent emissions of small quantities; straw colored urine, with brickdust sediment.

Asparagus. Urging to urinate; burning in the urethra; frequent urinating, with fine stitches in the orifice of the urethra; urine scanty and cloudy; a little straw-colored urine is passed, which becomes turbid immediately after being passed, and is full of motes; after urinating, burning in the urethra, with sensation as if there was some urine yet to pass.

Arnica. This remedy will often be indicated in affections of the bladder arising from mechanical injury, when retention of urine is present, with tenesmus of the neck of of the bladder, with ineffectual efforts to urinate; urging, the urine dropping out involuntarily; brown urine, with brick-red sediment; one has to stand a great while before the urine is emitted; urine strongly acid; specific gravity increased.

Arsenicum a. Retention of urine, as if the bladder was paralyzed; scanty urine passing with difficulty; burning in the urethra during micturition; tenesmus and strangury; great desire to urinate, but does not pass any urine; urinates more frequently than usual. Involuntary emission of urine in the night when sleeping; ischuria; urine copious and burning hot. Greenish darkbrown urine, turbid when emitting it; urine profuse and dark brown; hæmaturia; much sediment in the urine. Belladonna. Difficult micturition, the urine being passed guttatim, with frequent urging; the urine is yellow and turbid, sometimes depositing a reddish sediment; constant dribbling of urine; sharp stitches low down in the abdomen in the direction of the perineum; pains come on suddenly, and cease in the same way; feeling in the back as if it would break; enuresis, with profuse perspiration; paralysis of the sphincter vesicæ.

Berberis v.

Violent stitching pains in the bladder, extending from the kidneys into the urethra, with urging to urinate; frequently recurring crampy pain in the bladder; cutting constrictive pain in the bladder, when full or empty; burning in the urethra; burning pain in the female urethra during and after micturition; stitching pain in the female urethra, beginning in the bladder; violent stitches in the bladder, which compel one to urinate; burning pain in the bladder. Urine darkyellow, red, becoming turbid; copious mucous sediment, mixed with a whitish gray, and later a reddish mealy sediment. Greenish urine, depositing mucus. Blood

red urine, which soon becomes turbid, and deposits a thick mucus and bright red mealy sediment, slowly becoming clear but retaining its blood-red color; pains in the loins and kidneys frequently accompany the morbid urine, but not always; movement brings on or increases the urinary troubles.

Benzoic Acid. Vesical catarrh; irritability of the bladder; nocturnal enuresis in children; too frequent desire to evacuate the bladder; the urine normal in appearance; decrease of the quantity of urine; urine

aromatic; urine of a very repulsive color, of a changeable color, brownish, cloudy, of an alkaline reaction; dark, reddish-brown urine, of greater specific gravity than normal urine, with an acid reaction. Indicated when the urine contains an excess of uric acid. The patient is pale, languid, with a feeling of weakness in the loins. Fleeting pains in the region of the bladder; a granular mucus, mixed with phosphates, in the sediment of the urine.

Calcarea carb. Pain in the bladder, and cutting on urinating; burning in the urethra before and after urinating; fine tickling stitches through the urethra; much sour-smelling urine passed at night; trickling of urine after micturition; involuntary passage of urine on every motion during menstruation; nocturnal enuresis; urine very dark colored, without sediment; the urine has a pungent odor, is clear and pale; offensive dark-brown urine, with a whitish sediment; the urine soon becomes turbid and deposits a whitish flaky sediment; a fatty pellicle forms on the surface.

Camphora. Diminished power of the bladder. Retention of urine, with urging to urinate; tenesmus of the neck of the bladder. Painful urination; burning urine; strangury; the urine passes in a thin stream, as if the urethra were contracted; yellowish green, turbid urine, of a musty odor; brown urine; red urine; the urine on standing becomes very turbid and thick, of a whitish green color, without deposit of sediment; urine contains mucus, without sediment; urine with white or red sediment; urine increased, of a dark brown color; urine profuse, colorless, frequent; urine scanty.

Cannabis indica. Inflammation of the bladder; burning, scalding, stinging pain before, during, and after urination; urging to urinate, with much straining: copious discharge of clear, bright-colored urine; the urine passes freely at times, then again in small quantities, with burning and biting; the urine dribbles out after the stream ceases; aching in the kidneys; thick, red urine.

Cannabis sativa. Enuresis; paralysis of the bladder; drawing pain in the region of the kidneys, extending into the inguinal glands, with anxious nauseous sensation in the pit of the stomach; burning while urinating, but especially afterward; urging to urinate, with pressive pain; stitches along the urethra when not urinating; white turbid urine; urine red and turbid; urine full of fibres, as of mucus, with pus.

Cantharides. Inflammation of the uropoietic organs; pains in the region of the kidneys and urging to urinate; burning, tenesmus, and violent pains in the bladder; ardor urinæ; urine scalds, and is passed drop by drop, with extreme pain; hot, acrid, and bloody urine; urine dark-colored, turbid, and scanty; urine loaded with mucus and sediment; cloudy urine, like mealy water, with white sediment.

Capsicum. Spasmodic contraction with cutting pains in the neck of the bladder; burning, biting pain in the urethra after urinating; scanty, light-colored urine. Carbo veg. Pressing pain in the bladder; contraction of the urethra every morning; frequent urging to urinate; copious emission of light yellow urine; the urine has a strong odor; dark-colored urine; dark-red urine, as if it were mixed with blood; the urine deposits a red sediment.

Causticum. Frequent, difficult, and painful micturition; involuntary emissions of urine when coughing; nocturnal enuresis ; smarting pain in the urethra while urinating; light-colored urine, with flocculent sediment.

Chimaphila umbellata. Chronic catarrh of the bladder; scanty urine, containing a large quantity of muco-purulent sediment; urine thick, ropy, of brick color, and copious bloody sediment; dysaria; inability to pass the urine without standing with the feet wide apart and the body inclined forward.

Cicuta virosa. Involuntary emission of urine. Frequent desire to urinate; the urine is expelled with great force. Copious mic

turition.

interruption; the urine is thick, white, and turbid, or as clear as water, with frequent calls to pass it; burning sensation when urinating; pressure in the neck of the bladder with stitches, worse when walking, better when sitting; burning in the urethra. Copaiva bal.

Excessive irritation of the bladder. Inflammation of the urinary organs; swelling and dilatation of the orifice of the urethra, with pulsative pain throughout the penis. Constant, ineffectual desire to urinate; the urine is emitted in drops; foaming urine, greenish, turbid, with the odor of violets.

Digitalis p. Inflammation of the neck of the bladder; pressure on the bladder, with the sensation as if it were too full, continuing after micturition. Continual desire to urinate, only a few drops being passed at each effort; the urine is dark-brown, hot, and burning when emitted. The urine is more easily retained in the recumbent posture; alternate emission of large and small quantities of colorless urine; contractive pain in the bladder during micturition.

Dulcamara. Paralysis of the bladder, with involuntary discharge of urine; catarrh of the bladder; thickening of the coats of the bladder; retention of urine; strangury; painful micturition; urine turbid and white; reddish, burning urine; mucous sediment in the urine.

Erigeron. Vesical catarrh, with pain and irritation; dysuria in children; they have frequent desire, and cry when urinating; the urine is profuse, and of a very strong odor; the external parts are inflamed and swollen.

Gelseminum s.

Enuresis from paralysis of the sphincter, in children at night; profuse urination; urging, with scanty emission, and tenesmus of the bladder; spasm of the bladder, with alternate dysuria and enuresis.

Graphites. Micturition is preceded by a cutting pressing from the kidneys; anxious pressure in the bladder, with sudden desire. to urinate, but scanty emission; nightly desire to urinate; nocturnal enuresis; frequent micturition; the urine has a sourish smell; the urine becomes very turbid, and deposits a reddish sediment.

Hepar sul. cal. Nocturnal enuresis; weakness of the bladder; the urine is passed slowly, without force, dropping perpendicularly from the urethra; the urine is flocculent and turbid; dark-yellow urine, burning while passing; brown-red urine,

the last drops are mixed with blood; sharp, burning urine, which corrodes the internal surface of the prepuce; the orifice of the urethra is red and inflamed; discharge of mucus from the urethra.

Hedeoma p. Suppression of urine; tenesmus; painful urination; cutting, burning pains in the urethra; scanty emission of urine, with frequent and urgent desire; urine very dark, like black tea.

Hydrastis c. Chronic cystitis; catarrh of the bladder, with thick, ropy mucous sediment in the urine; decomposed smell of the urine.

Hyoscyamus n. Enuresis; Paralysis of the bladder; retention of urine, with pressure in the bladder; frequent micturition, with scanty discharges.

Ignatia a. Irresistible desire to urinate; painful pressure, with a scraping sensation in the neck of the bladder, especially when walking; turbid urine; frequent emission of watery urine.

Jodium. Nocturnal urination; retention of urine; increased secretion of thick urine, with dark sediment; urine dark; turbid; milky; with a variegated cuticle on its surface; ammoniacal smell of the urine. Kali bich. Frequent discharges of watery urine of strong odor; painful drawing from the perineum toward the urethra; urine with white film and deposit of mucous sediment.

Lachesis. Urinate; copious emission of foaming urine; yellow-colored urine; copious brown-red urine; urine with red or brickdust sediment turbid and dark urine, with a sediment of brown sand, and a severe cutting during micturition. Sensation as if a ball were rolling in the bladder. Laurocerasus. Retention of urine; pale-yellow urine, scanty, acrid, depositing a thick, reddish sediment; burning in the urethra, and pressing after urinating. Lycopodium c. Involuntary micturition; stitches in the bladder; frequent emission of large quantities of pale urine; frequent micturition at night, with rare and scanty emissions of urine during the day; urine dark, with diminished discharge; red, sandy sediment in the urine; painless hæmorrhage from the bladder; itching in the urethra during and after micturition; greasy pellicle floats on the urine.

Magnesia phos. Nocturnal enuresis, caused by nervous irritation; spasmodic retention of urine.

Mercurius vivus. The quantity of urine passed is larger than that of the fluid drank; burn

ing in the urethra between the acts of micturition; inability to retain the urine; frequent and violent desire to urinate, with scanty emission in a feeble stream; scanty red urine; urine turbid and fetid; darkred urine, as if mixed with blood; the urine is very turbid, and deposits a sediment; pieces of white filaments are emitted after the urine; the urine looks as if it contained pus or mucus, and has a sour smell. Natrum mur. Involuntary micturition when walking, coughing, and laughing; desire to urinate day and night; stitches in the bladder during micturition, with a smarting, burning sensation in the urethra; pale urine, with brickdust sediment; discharge of mucus from the urethra; dark, coffeecolored urine.

Nitrate of Uranium. Sore feeling in the pubic region; increased frequency of micturition; profuse nocturnal urination, strawcolored and fetid; burning in the urethra, with very acrid urine; desire to urinate again immediately after voiding urine. Nitric acid. Enuresis; nightly desire to urinate, with cutting pain in the abdomen; scanty, turbid, badly-smelling urine; fetid urine; smarting burning pain in the urethra while urinating; cramp-like, contractive pain from the kidneys toward the bladder; discharge of bloody mucus, or of pus from the urethra; The urine is cold when emitted.

Nux vomica. Retention of urine; strangury; painful, ineffectual desire to urinate; painful emission of thick urine; discharge of pale urine, followed by passage of thick, viscid, whitish, purulent mucus from the bladder; reddish urine, with brickdust sediment; burning and lacerating pain in the neck of the bladder during micturition; hæmatorrhoea.

Opium. Atony of the urinary bladder; retention of urine from a weakened condition of the contractile power of the bladder dark-colored urine, which deposits a brickdust sediment; lemon-colored urine, depositing much sediment.

Pareira brava. Violent pains in the bladder; pain in the thighs, extending down into the feet; strangury, with paroxysms of violent pain; the urine can only be voided while the patient is on the knees, with the head pressing against the floor; the paroxysms more usually occur in the morning from 3 to 6 o'clock; the urine has a strong ammoniacal smell, and contains a thick, viscid, white mucus. Phosphorus. Involuntary emission of urine; urine with a sediment of white flocculi ;

smarting and burning in the urethra, with frequent desire to urinate; tension over the region of the bladder; acrid, offensivesmelling urine; brown urine, with red, sandy sediment; hæmaturia.

Phosphoric acid. Enuresis, with cutting, burning pain in the urethra, and cramppain in the region of the kidneys; spasmodic constriction of the bladder; profuse discharge of watery urine, in which immediately forms a white cloud; milky urine, with bloody, jelly-like lumps; burning in the urethra while urinating.

Phytolacca d. Copious nocturnal micturition; violent urging to urinate, urine excessive in quantity, or scanty; dark-red urine, which leaves a stain on the urinal of a mahogany color, which adheres very closely; the urine deposits a chalk-like sediment; pain in the bladder before and during micturition; albuminous urine, with increased specific gravity; frequent and painful inclination to urinate.

Plumbum. Paralysis of the bladder; tenes

mus of the neck of the bladder; ischuria; difficult emission of urine; the urine is mixed with blood; copious red or yellow urine.

Populus t. Catarrh of the bladder; vesical

and urethral irritation; scalding of the urine; painful micturition.

Pulsatilla. Vesical catarrh; incontinence of urine; enuresis nocturna; frequent desire to urinate, with a drawing sensation in the abdomen; spasmodic pain in the neck of the bladder after micturition, extending to the pelvis and thighs; involuntary discharge of urine when coughing; the urine is discharged in drops when sitting or walking; burning in the urethra while. urinating; hæmaturia; scanty red-brown urine, with brick-colored sediment; bloody or mucous deposit.

Rhus tox. Tenesmus vesica, with emissions of only a few drops of blood-red urine. Diminished secretion of urine. Incontinence of urine. Urine hot, white, and muddy, or pale, with white sediment. Dark urine, soon becoming turbid.

Ruta g. Nocturnal enuresis. Continual pressure on the bladder, as if always full; the desire to urinate continues after micturition; involuntary discharge of urine at night in bed, and while walking during the day. Frequent urging, with emission of green urine.

Sarsaparilla. Pain and cramps in the bladder, with urging and burning; urine pale and copious; frequent urging to urinate, with scanty but painless discharge; urine

clear and red. Severe strangury, with discharge of white, acrid, turbid matter, with mucus; painful retention of urine; urine frequently voided; does not become turbid, but deposits a cloud; frequent and copious discharge of pale urine, which becomes turbid on standing, like clay-water; urine either too frequent, copious, and pale, or scanty, slimy, flaky, clayey, or sandy; irridescent pellicle on the urine. Santonin. Chronic cystitis; incontinence of urine; nocturnal enuresis; dysuria; suddenly waking with urging to urinate, only a few drops of urine being passed each time; the urine has a peculiar green or orange-green color.

Sepia. Nocturnal enuresis, especially during the first sleep; constant desire to urinate, with painful bearing down in the pelvis in the morning; burning in the bladder and urethra; pressure on the bladder in the evening, with burning after urinating; urine turbid, with red sandy sediment and a cuticle on the surface; urine has an offensive smell, and deposits a white sediment. Squilla m. Tenesmus of the bladder after micturition; frequent calls to urinate, especially at night, with scanty emission, or profuse discharge of pale urine; sanguinolent urine, with a deposit of red sediment. Stannum. Painless retention of urine; the

urging to urinate is absent, as in atony of the bladder.

Staphisagria. Profuse discharge of pale urine, with urging; frequent desire to uri nate, with emission of a small quantity of dark-colored urine; burning in the urethra during and after urinating; urging after micturition; as if the bladder had not been emptied.

Strychnia. Atony of the bladder; retention of urine or incontinence, when these conditions depend on impaired power of the detrusor muscle of the bladder, from overdistension.

Sulphur. Nocturnal enuresis ; violent desire to urinate at night; copious micturition. after midnight; stitches in the bladder; cutting pain in the urethra while passing urine; the urine is sometimes clear, and sometimes contains a thick sediment; rose-colored urine; fetid urine, a greasy film forming on the surface. Terebinthina. Strangury; dysuria; violent dragging and cutting pain in the bladder; burning in the bladder; urine scanty and red, or bloody urine; difficult micturition; the urine has the odor of violets, with deposit of mucus, or a thick muddy sediment. Thuja o. Frequent urging to urinate, with profuse emission; the urine looks like water