The gouty and rheumatic bladder is so very rare that a detailed description is hardly necessary. But it might be well to remind the reader that if she is of a gouty or rheumatic disposition and has also bladder trouble, it may be due to the bladder being compromised or influenced by gout or rheumatism. In that case, appropriate treatment directed to the rheumatic diathesis will also cure the bladder. PARALYSIS. The female bladder becomes paralyzed from various causes; some of these are located in the organ itself, while others are due to disease of the brain or spinal cord. An obstruction to the flow of urine through the urethra causes the bladder to become overdistended with urine and induces paralysis. A prolonged pressure from the child’s head during delivery is oftener the cause of transient paralysis than any other. It happens that lying-in women cannot pass their urine for several days after confinement. Violence from without, as a blow or a kick, may have a similar effect. This results from the pressure to which the bladder was subjected. Operations on the rectum, vagina, or any of the pelvic organs, are frequently followed by a partial or complete paralysis. In all these cases, there is only one precaution to observe, and that is to draw off the urine at regular intervals so as to avoid an enormous accumulation of fluid. The paralysis becomes dangerous and obstinate to treatment, in proportion as the bladder becomes abnormally distended, and the length of time that the muscular tissues are under the excessive strain. In those cases where the paralysis is due to spinal or brain disease, there is little prospect of a cure. In other cases, as for instance after confinement or an operation on the rectum for piles or fistula, it generally passes off in a few days. Great care and cleanliness must be exercised in using the catheter, so that the bladder is not infected from filth or virus from another patient. A catheter that has been employed on a patient who had her urine drawn off while she suffered from purulent catarrh or puerperal fever, will inoculate a healthy person with the same disease, and in this manner diseases are often communicated. The bladder is exceedingly liable to infection. HEMORRHAGE. A discharge of blood from the bladder is not of frequent occurrence, but it occurs often enough to make it noteworthy, and women should at least know that there is such a thing. It oftener takes place in men than in women, as a symptom of some grave or serious disease, or it may be only a trivial disorder. Hemorrhage of the mucous membrane takes place very readily, owing to the delicacy of the tissues and the great vascularity of the submucous layer, and there is a much greater tendency to hemorrhage in some persons than in others.