the proportionate probability of severe infections being met with. The prognosis is practically that of a chronic cystitis depending on an irremediable, but not in itself fatal, cause. Much suffering may often be produced, and, as a consequence, anæmia and debility. Possibly calculus may be formed; possibly grave renal disease may ensue; possibly villous or epitheliomatous growths in the bladder. In the milder degrees of infection, which fortunately are the commonest, the patient seems to be in no way inconvenienced by the parasite, and generally escapes all serious consequences. In any case, mild or severe, there may be attacks of hæmaturia from time to time; as a rule, the quantity of blood lost is insignificant.
Treatment.— Our knowledge of the situations occupied by the parasite indicates the futility of attempting a radical cure by means of poisonous substances, whether introduced by the bladder, by the rectum, or by the stomach. As yet we know of no direct or other means by which the schistosomes can be destroyed. Only harm can result from attempts at a radical cure of endemic hæmaturia on such lines. Our efforts must, therefore, be confined to palliating the effects of the presence of the parasite. Practically, the treatment resolves itself into that of chronic cystitis. The diet should be bland but nutritious; stimulants and spices are to be avoided. Excess of all kinds, violent muscular efforts, cold and other causes of catarrh, must also be guarded against. During exacerbations of hæmaturia, or of cystitis, rest should be enjoined and diluents freely partaken of. Milton has obtained good results from gramme doses of extract of male fern three times a day in schistosomum hsematuria. A recent writer has advocated the use of methylene blue (3 gr. three times a day) in similar circumstances. Adrenalin has some influence in controlling hæmorrhage. Salvarsan has been tried, but was found to be of no use. Pain may demand anodynes. Excessive catarrh of the bladder suggests washing out with weak boric-acid lotion, and the internal administration of urotropine, uva ursi, buchu, perhaps small doses of cubebs, copaiba, or
