If it is decided to pass a catheter a three days' course of
urotropin is given, the bowels are well cleared, and the
condition of the heart and vessels is considered. The patient
is confined to his bed and kept warm, the anterior urethra is
washed out, the whole urethra anaesthetised, and a soft or
flexible catheter is then passed with the full antiseptic details
described on p. 278.
If there is less than four ounces of residual urine there is
no need to institute catheter-life; if more than this catheter-
life or operation are the only two alternatives.
2. The ^'painful retention'^ type, — The bladder is half way
to the umbilicus, and passes into distressing cramps every few
minutes, yet no water is passed, and the prostate is large,
soft, and gorged with blood. The retention must be relieved,
and that quickly.
Administer a large dose of opium — either thirty minims of
the tincture by the mouth, or a suppository containing half a
grain of morphia, and put the patient to lie in a hot bath.
This treatment rarely fails to relieve the condition completely,
but if it does fail resort must be had to the catheter with all
the precautions previously mentioned.
