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CYSTITIS IN THE MALEMWCk JotJftyL sulpho-nanide and antibiotic treatment in controlling any tendency for the attacks to recur.Admittedly, new measures in medical practice tend in the beginning to be misused, particularly overused. We have certainly seen this with urethral instrumentation and antiseptic urinary medication. In relation to the former, I had two women patients suffering from frequency, one coming from Bagdad and the other from New York. Each had been having urethral dilatations once a week for several months.There were two other incidents which had a bearing on the same topic. (1) A prominent American urologist recently proclaimed at an important meeting the need to disregard al instrumental urethral treatment in cystitis and frequency cases, and to rely upon the latest medication; he did not relate any experience which would justify this attitude. (2) A prominent American woman, who gave a long history of recurring incidents of urinary infection, was advised by me to have a urethral polypus fulgurated. She said she hoped she would have no antibiotics while in hospital, because she had had them all and they made her very ill. Bacteriological ConsiderationThis can be a big subject, but I shall be brief.Because the physician does not have an opportunity of seeing for himself, the misconception that chronic urinary infection is not usually dependent on a continuing focus of infection somewhere in relation to the urinary tract itself will not easily be discarded.Cystoscopy and urethroscopy have both made it clear that the urine may fail to show signs of infection, while endoscopically these are manifest-in fact, often fitting in with the symptoms. Modern therapy can produce this situation.The return at a later date of another acute attack should warn us of any undue complacency in making a good prognosis on a sterile urine. It is not being too dogmatic to say that there is a solid reason for certainty why attacks recur in some cases, when treatment of urethral lesions is seen to lessen this tendency. Summary Reasons are given for the greater frequency of cystitis in women than in men.An explanation is offered for differences in sex incidences of vegetative posterior urethritis in children.The lull in disturbances of micturition in adolescence and the reappearance of these in early adult life are discussed.Various aetiological groups of ascending cystitis in the male are summarized.Different types of urethroscopes are criticized. Prostatic obstruction is considered. The fundamental principle of treatment is emphasized. REFRENCES

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