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CHAPTER IX. CURE OF THE ACUTE AFFECTIONS ABOUT THE BLADDER.

ACUTE affections, resembling those of the kidneys, form also in the bladder; namely, inflammations, ulcerations, calculi, and the obstructions from clots, and, along with these, suppression of urine and strangury. But in this part the pain is more acute, and death most speedy; for the bladder is a broad nerve, whereas the kidneys are like a concretion of blood, of the same species as the liver. But, moreover, the sufferings are most dreadful and most lamentable:

for there, by far,

On wretched men most cruel pains inflicts the god of war.

We must, therefore, straightway make an incision in the flanks, and soothe the bladder by means of a fomentation of much oil, with rue and dill. But if grumous blood be the cause of the pains and stoppage of the urine, we are to give oxymel to drink, or a little quantity of lime with honeyedwater for the solution of the clots, and also such other things, both herbs and seeds, as promote the secretion of urine. But if there be danger from hemorrhage, it is to be stopped without delay, more than in the other cases; for the danger from it is not small. We must remedy it by the medicines which stop bleeding. In this case refrigeration of the bladder is beneficial; bathing with rose-oil and wine, and wrapping the parts in cloths made of unwashed wool.1 An epitheme may be formed with dates soaked in wine, with pomegranate or the juice of sumach. But if the patient is averse to the weight of

the epithemes and the great cooling, they must both be given up; for we must not cool greatly a part naturally thin and cold like the bladder. But we are to anoint the parts with oil of must, or acacia, or hypocistis with wine. But we must not use sponges, unless the hemorrhage be very urgent. The food should be farinaceous, of easy digestion, wholesome, diuretic, such as have been described by me under the head of the kidneys; milk, sweet wine, the Theræan and Scybelitic. Medicines should be drunk which are diuretic, fragrant, and diffusible, and other such things. A very excellent thing for the bladder is cicadœ; roasted, in season, as an article of food; and out of season, when dried and triturated with water. Let also a little of the root of nard be boiled up with the cicadœ. The same things may be used for preparing a bath to sit in for relaxation of the bladder.

But, if it be the impaction of calculi which stops the urine, we must push away the calculus and draw off the urine, with the instrument, the catheter, unless there be inflammations; for, in inflammations, neither do the passages well admit the instrument, and in addition they are hurt by the catheter. But if this treatment be inadmissible, and the patient is nearly killed with the sufferings, we must make an incision in the part under the glans penis, and the neck of the bladder, in order to procure an outlet for the stone and the expulsion of the urine. And we must particularly endeavour to cure the part by bringing the wound to cicatrization. But if not, it is better that the patient should have a flux of urine for the remainder of his life, than that he should die most miserably of the pain.

1 This process is very circumstantially described by Oribasius under the name of κατείλησλς Med. Coll.x.18. Dr. Daremberg translates it, l'enroulement avec les bandes.

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