the lumbar region, and every effort should be made to
train the child to pass water at stated times and regular intervals.
In the adult the cause which produces the over-distension must be
removed if possible; but, as a rule, the patient has to be provided
with a catheter, which he can pass before the bladder has filled to
overflowing. A soft flexible catheter should be given in preference to
a rigid or semi-rigid one. The best form is the red-rubber catheter,
and he should be taught the need of keeping it absolutely clean. In
the case of children incontinence of urine means irritability; in
adults it means overflow.

The condition termed by Sir James Paget _stammering micturition_ is
analogous to speech stammering, and occurs in those who are nervous
and easily put out. It would seem to be due to the sphincter of the
bladder not relaxing synchronously with the contraction of the
detrusor, and is sometimes caused by external irritation, such as
preputial adhesions. Occasionally not a drop of urine can be passed,
or a little passes and then a sudden stoppage occurs; the more the
patient strains the worse he becomes, until at last there is complete
retention of urine. The trouble can sometimes be cured by the removal
of irritating causes, and in these cases, as well as in those in which
no such cause can be discovered, care should be taken to avoid those
difficulties which have given rise to the patient's worst failures. If
at any time he should fail to perform the act of micturition, he ought
not to strain, but should quietly wait for a little before making any
further effort. Regularity in the times of making water is also of
much importance.

_Retention of urine_ may occur in paralysis of the bladder, or in
conditions where the patient is suffering from an illness which blunts
the nervous sensibility, such as apoplexy, concussion of the brain,
or typhoid fever. It is, however, more commonly due to obstruction
anterior to the bladder, as in stricture of the urethra or enlargement
of the prostate. The distended bladder can be felt as a rounded
swelling above the pubes, and perhaps reaching to the level of the
navel. Percussion over it gives a dull note. When the bladder is
distended, it is necessary to evacuate it as soon as possible. If
there is no obstruction to the flow of urine, the retention being due
to atony or paralysis, a soft catheter is p