It is of the first importance, therefore, for the physician to make a careful pelvic examination, and to exclude all conditions that might cause irritation of the bladder. Microscopic examination of the urine, by revealing the presence of pus and blood and the epithelial cells of the bladder, is of value in making a diagnosis. The urine for examination should be drawn with the catheter, to prevent contamination from vaginal discharges. Examination of the urine does not, as a rule, enable one to exclude inflammation of the ureters or of the pelves of the kidneys. If there is any doubt, it may be removed by the use of the endoscope, which will reveal the true condition of the bladder-wall. As has already been said, tenderness upon pressure through the vagina on the base of the bladder is of diagnostic value in determining the presence of cystitis. In the mild forms of chronic cystitis--those characterized by local areas of inflammation--examination of the urine may throw no light upon the condition, as the secretion of pus or mucus is very slight. The diagnosis can then be made only by means of the endoscope. It is perhaps advisable in all cases of chronic cystitis to use the endoscope, not only to confirm the diagnosis, but to begin the treatment by making direct local applications. _Treatment._--The treatment of cystitis is general and local. Local treatment should never be used in the acute stages of the disease. Many cases recover completely without any local treatment whatever. In acute cystitis the woman should be put to bed. The irritation of the bladder is much relieved when the intra-vesical pressure is thus diminished. The diet should be carefully regulated, all stimulating ingredients being withdrawn. An exclusive milk diet is the best. Saline laxatives should be administered, and continued to the point of mild purgation. One dram of Rochelle salts every two or three hours, given in half a tumblerful of soda-water, is useful for this purpose. Large quantities of diluent drinks should be given, such as flaxseed tea or Vichy water. If the urine is acid, citrate of potassium may be administered with the diluent drinks, so that from 1 to 2 drams of the salt are taken during the day. Bicarbonate of potassium in similar doses is also useful. When the urine becomes ammoniacal, boracic acid, in doses of 10 grains from three to six times a day, is most useful. Benzoic acid, in doses of 10 grains three or four times a day, is also valuable. A very good method is to make a pint or a quart of flaxseed tea, to dissolve in it the requisite amount of citrate of potassium or of boracic acid (as the urine is acid or alkaline), and to administer this in divided doses during the day. This treatment, with rest in bed, should be continued as long as the vesical pain and tenesmus continue.