it is only the last few drops of urine that contain blood; sometimes, however, the hæmorrhage is more extensive, and then the entire bulk of the urine may be blood-tinged. Occasionally, clots are passed.
If in a case of moderate infection the urine be passed into a glass and held up to the light, minute flocculi or coiled-up mucoid-looking threads will be seen floating about in the fluid. If it be allowed to stand, the flocculi, and perhaps minute blood-clots, will subside to the bottom of the vessel; these, on being taken up with a pipette and placed under the microscope, will be found to contain, besides blood corpuscles and catarrhal products, large numbers of the characteristic spined ova.
In doubtful cases, where ova are few, the best way to find them is to get the patient to empty the bladder and to catch in a watch-glass the last few drops of urine which can be forced out by straining; these invariably contain ova. A low power of the microscope suffices, and is best for diagnosis.
Endemic hæmaturia lasts for months or years. Recovery is rarely complete. In ordinary cases, provided no reinfection take place, the hæmaturia tends to decrease, although ova may continue for years to be found in the last few drops of urine passed. In severe cases, sooner or later, signs of cystitis supervene and give rise to a great deal of suffering. Not infrequently the ova become the nuclei for stone, and symptoms of urinary calculus are superadded. (Fig. 140.) Sometimes the pathological changes induced by the presence of the parasite in the bladder lead to the development of new growth, in which event the symptoms become more urgent and the hæmaturia perhaps excessive. Hypertrophy, contraction, and even dilatation of the bladder, are not unusual. Besides the bladder symptoms there may be signs of prostatic disease, or of disease of the vesiculæ semi-
