Etiology:—Hemorrhage from the bladder may be caused by direct injury, or by laceration in chronic cases, or by a varicosed or hemorrhoidal condition of the veins; also from the presence of foreign growths, tumors or neoplasms, benign or malignant, and from a large calculus in the bladder. It also occurs from vicarious menstruation, and occasionally during the latter stages of pregnancy or during confinement.
Symptomatology:—The, symptoms are those of heat, a sensation of weight in the bladder, perhaps some acute pain, a sudden desire to urinate, and the passage of blood with the urine. When hemorrhage from the bladder wall occurs, the urine is usually passed unmixed with the blood. Occasionally the blood is passed before coagulation; at other times, clots will obstruct the urethra, to be followed by clear urine. In renal hemorrhage the blood is usually disintegrated; the urine is smoky in color, and the urine and blood are well mingled. An examination with a cystoscope will usually confirm the diagnosis, especially if enlarged veins are present in the bladder wall.
Treatment:—Aside from any inflammatory condition that may exist conjointly with the hemorrhage, the treatment should be conducted on the same principle as that for hemorrhage elsewhere; mild but efficient astringents, such as geranium, gallic acid, thuja, hamamelis and ergot, may be selected and will prove satisfactory. I have obtained good results from capsella, rhus aromatic and ergot. If there is a hemorrhoidal condition of the veins of the bladder, I would advise a local application of one part of distilled extract of hamamelis, in four or five parts of water, and the persistent use internally of ten minims each of strong fluid extracts of collinsonia and hamamelis, every two or three hours.