Preparatory and after treatment in operative cases . he latter is taken care of as stated (page533). Cystitis follows vaginal section by the perineal route in a cer-tain number of cases. Ordinarily, acute cystitis with pus, mu-cus and blood in the urine, subsequent to the operation, willsubside under mild treatment without the necessity of local treat-ment. The pain and tenesmus are frequently relieved by the ad-ministration of 3? Kali citrat 4 drachms Tr. hyscyomi 6 drachms Elix. simpl q. s. ad 6 ounces S. Tablespoonful every two to three hours in water. When the more acute symptoms subside,
Preparatory and after treatment in operative cases . he latter is taken care of as stated (page533). Cystitis follows vaginal section by the perineal route in a cer-tain number of cases. Ordinarily, acute cystitis with pus, mu-cus and blood in the urine, subsequent to the operation, willsubside under mild treatment without the necessity of local treat-ment. The pain and tenesmus are frequently relieved by the ad-ministration of 3? Kali citrat 4 drachms Tr. hyscyomi 6 drachms Elix. simpl q. s. ad 6 ounces S. Tablespoonful every two to three hours in water. When the more acute symptoms subside, urotropin in five-grain doses may be given and the anodyne mixture administeredat night. 538 GYNECOLOGICAL OPERATIONS BY PERINEAL ROUTE If pus is persistently present, irrigation of the bladder withboric acid solution may be made once daily. For the purpose a two-way catheter may be used, the upper connection being at-tached to a long rubber tube connected with a funnel. To the lower outlet is attached a rubber tube draining off the fluid. Fig. 336. Fig. 336.—Irrigation of Bladder with Two-way Catheter. (Kelly.) shows the apparatus in use. Care must be exercised not to permitthe funnel to become empty during the manipulations, or air willbe sucked into the bladder by the entering column of water anddistressing tenesmus is provoked. The advantage the methodhas over the use of the irrigator or syringe is that the pressureis easily regulated by the elevation of the funnel, and this should VAGINAL HYSTERECTOMY 539 not be held higher than will provoke a moderately rapid flow ofcleansing fluid into the bladder. By lowering the funnel to be-low the level of the bladder the contents can be siphoned off. The measures related above usually achieve the purpose in afew days. However, in a certain number of cases the symptomspersist, and, indeed, chronic ulcerative cystitis has occurred underthe conditions mentioned.
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