The TREATMENT of this form of pyelitis, so far as it differs from that of the calculous variety, depends largely upon that of the causative cystitis, though not entirely, since if it has once assumed the chronic condition it does not necessarily subside even if the cystitis be cured. The essentials of treatment may be said to be drainage from below and washing from below and from above. The measures for carrying the first of {55} these indications are those which are also required for the causative cystitis, and, being chiefly surgical, a minute description of them does not come within the scope of this article. They may be simply catheterization, dilatation, divulsion or section of a stricture of the urethra, drainage of the bladder through the rectum or through the perineum. It is not out of place, however, even in a strictly medical essay, to point out the extreme importance, not only in the way of treatment, but of prophylaxis, of securing a free exit for the urine. Even that small degree of obstruction or hindrance which leads a person to habitually put a little extra strain upon the bladder in order to expel its contents, especially if it be allowed occasionally to become dilated, may gradually lead to dilatation of the ureters, and thus make an easy passage upward for inflammatory and decomposed urine if such should afterward be formed as a consequence of cystitis by retention. The washing of the bladder from the urethra may be done with a great variety of antiseptics and acids: nitric acid in the proportion of 1 per mille may be used to change the reaction of the urine. Carbolic acid should be carefully used, from the danger of its absorption in poisonous amounts. Boric acid is a safe and quite efficient antiseptic. Washing from above, which is evidently that which alone can directly affect the renal pelvis, must be done with such drugs as can be safely given internally, so that carbolic acid cannot be of much use in this way. Salicylic acid loses a part, but not all, of its antiseptic properties in its passage through the blood and kidneys. Boric acid passes readily into the urine, alters its reaction, and seems to have some antiseptic action. It is unirritating in the stomach, and may be given in doses of 30 centigrammes or 5 grains to the extent of 1 or 2 grammes per diem. Benzoic acid and the benzoate of sodium, ammonium, or lithium have been found to be of value in cystitis, and as they can only reach the bladder by previously passing over the pelvic mucous membrane, they should also have a good effect here. It is obvious that constitutional symptoms arising from cystitis and its consequent nephritis may demand the most attention, and should evidently be of a decidedly supporting character, the details of which have no special reference to the disease, but to the general condition. Quinine may be called for as an antipyretic.