Persons who are weak and debilitated bleed much easier than strong, vigorous ones, because the blood may become so thin or poor in fibrin that it greatly loses its property of coagulating. Some diseases bring this particular diathesis about, such as scurvy, also measles, scarlatina or smallpox. Worms have been found to make their way from the rectum into the cavity of the bladder, and caused profuse and even fatal hemorrhage. A violent fall of the body, rupturing an artery in the bladder, severe horseback riding, and venereal excesses, have all caused almost fatal hemorrhages, to which must be added ulceration of the mucous membrane. The most profuse hemorrhage of the bladder that I was ever called upon to witness, followed drinking a strong decoction of wormwood; irritating diuretics, like spirits of turpentine or tincture of cantharides, are also liable to cause bleeding. Hemorrhage is always accompanied with frequent desire to pass urine and spasmodic pains at the neck of the bladder. The blood may also coagulate in the bladder, causing an obstruction. The treatment consists principally in keeping the patient very quiet, and a rubber ice bag should be applied over the region of the bladder; nothing but bland liquid food is advisable, but no hot drinks are permissible. If the urine does not pass, a soft rubber catheter should be employed for the purpose of drawing it off. Hemorrhages of the mucous membrane, whether of the bladder, the bowels or lungs, generally yield to the following mixture:—— NO. VIII. Take: Gallic acid 4 scruples Tr. of digitalis ½ ounce Fluid ex. of ergot 1 ounce Simple syrup ½ ounce Mix, and give a teaspoonful in a little water every four hours; children in proportion. URINARY FISTULA. By this is meant a permanent unnatural opening into the bladder from without, through which urine escapes. The situation of the female bladder, just in front and over the vagina, and also its attachment to a portion of the cervix or neck of the womb, exposes it to injuries, especially from pressure of the child’s head during delivery. By referring to Plate II, it will be seen at a glance how easily an accident can take place from this cause. It was at one time supposed that delivery by forceps was the most fruitful cause of this lesion. That this is likely to happen only where the instrument is in incompetent or bungling hands, there is no reasonable doubt. A thorough acquaintance with the entire subject has proved that there are other causes that are the mainspring of this, sometimes very serious accident.