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be thereby the moft fully and conveniently promoted. See 

 Manure and YARD-Diing. 



URINARIUS Meatus, in Anatomy, the uretlira of the 

 female. See Urethra. 



URINARY Absce.sses, in Surgery, are fo called when an 

 extravafation of urine in the cellular membrane of the fcro- 

 tum, penis, perineum, &c. excites fuppuration in the parts, 

 fo that purulent matter and urine are found mixed together 

 in the tumour. Such an effulion of urine always arifes from a 

 breach of continuity in the bladder or urethra, moft fre- 

 quently in confequence of tlie dillcntion of that vifcus in ob- 

 itinate, protrafled, and improperly treated retentions of 

 urine ; or in confequence of abfcelTes, which form in the 

 <:ourfe of the urethra, and burll into that canal. The 

 making of a faife pafiage in the urethra, by the unll<ilful ufe 

 of bougies and catheters, ami the laceration of this tube by 

 forcible contufions, are alfo common caufes of an extravafa- 

 tion of urine. There is not in tlie whole body any fluid, 

 whofe extravafation produces more lerious mifchief than the 

 urine. If it be not promptly difchargisd, it foon excites a 

 putrid fuppuration in the cellular membrane containing it ; 

 makes this part flough ; caufes mortification of the ikin ; 

 and a gangrenous inflammation of every ftrufture with which 

 it comes into contaft. 



AVhen the opening, by which the urine has efcaped 

 from the bladder, is fituated either in this vifcus or the 

 urethra, there are invariably two principal indications to 

 be fulfilled. The firft is to prevent the further increafe 

 of the extravaiation, by introducing a catheter, drawing 

 off the urine, and defiring the patient to wear the inllru- 

 ment. The fecond indication is to give an outlet to the 

 effufed urine ; fo that the mifchief, likely to refult from its 

 prefence in the cellular membrane, may be leffened as much as 

 poflible. This is efFefted by fuitable incifions, which alfo 

 have the good effeft of tending to hinder the urine from 

 fpreading more extenfively amongll parts, in which it would 

 be furc to produce inflammation, abfcefles, and gangrene. 



The manner of opening fiich collections varies according 

 as the urine may be in one cavity, or widely eftufed in the 

 cellular membrane. In the firft cafe, a fimple incifion, the 

 whole length of the cavity, will fuffice for emptying and 

 healing it. In the fecond, if the extravafation is extenfive, 

 the incifions muft be multiplied. It would be abfurd to 

 fpare the parts ; for all thofe with which the urine has come 

 into contaft feldom efcape mortification. The incifions 

 which are made hardly ever have the effcft of faving them ; 

 but, by accelerating the difcharge of putrid fanies and ftag- 

 nant urine, they prevent the mifchief which would originate 

 from their further lodgment. If thefe incifions, however, 

 were praftifed a few hours after the extravafation, and before 

 fuppuration, the parts might be completely freed from urine 

 and preferved. When the operation is at all delayed, their 

 deftruftion is inevitable. The approach of mortification is 

 indicated by the crepitation under the bifi;oury, reiembling 

 the kind of noife produced by tearing parchment. The 

 extent and depth of the incifions muft be proportioned to 

 ihofe of the abfcefs. When the extravafation occupies the 

 fcrotum, long deep fcanficatiuns fiiould be made in that part, 

 as well as in the ikin of the penis, and in every place where 

 the urine is effufed. 



Praftitioners, unaccuftomed to fee fuch difeafes, would 

 be alarmed at the extent of the fore produced by the repara- 

 tion of the efchars. Sometimes the whole fcrotum, fliin of 

 the penis, and that of the groins, perineum, and upper part 

 of the tliigh, mortify, and the naked tefticles hang by the 

 fpermatic cords in the midft of this enormous ulcer. It is 



hardly conceivable how cicatrization could take place over 

 the expofed tefticles ; but the refources of nature are un- 

 limited. She unitco the tefticles and the cords to the fubja- 

 cent parts ; and, drawing the ftin from the circumference to 

 the centre of the ulcer, fhe covers thefe organs again, and 

 furnifties them with a fort of new fcrotum. This ftate- 

 ment is founded upon numerous cafes, in which nature 

 always followed this courfe. The cicatrization of the ulcer 

 is even more expeditious than might be expedfed, confider- 

 ing its extent. In all this bufinefs, what does art do i If 

 the introduftion of the catheter be excepted, which, indeed, 

 is abfolutely neceflary for the radical cure, her afliftance is very 

 limited, and almoft nothing, in the generality of inftances ; 

 for when the patients are not exhaufted by the tcdioufnefs 

 of the diforder, when they are of a good conttitution, and ' 

 in the prime of hfe, they get well as quickly and certainly, 

 with the aid of a good diet and fimple dreffings, as when 

 they take internal medicines, and ufe a multiplicity of com- 

 pound topical applications. The praftice of Default at the 

 Hotel-Dieu confifted in applying emollient poultices, until 

 the (loughs were detached. The ulcer was then fometinies 

 dreffed with pledgets charged with ftyrax ; but frequently 

 mere dry hnt was ufed, and continued till the cure was com- 

 pleted. If any comphcation occurred in the courfe of the 

 treatment, fuitable remedies were prefcribed for it. Thus 

 when proftration of ftrength, and tendency to floughing 

 exifted, bark, cordials, and anlifeptics were ordered. But 

 in every cafe, the catheter is the eftcntial means of cure ; 

 without it, the treatment is almoft always imperfeft, and the 

 ulcer will not heal without leaving feveral urinary fiftulae. 

 See CEuvres Chirurgicales de Default, par Bichat, torn. iii. 

 p. 277— 287. 



Urinary Calculi. The formation of concretions in the 

 urinary paffages being occafioned by the precipitation and 

 confolidation of particular ingredients in the urine, calculi 

 muft of courfe be liable to occur in any of the cavities to 

 which the urine has accefs. In faft, experience proves that 

 they are frequently met with in the kidneys, ureters, bladder, 

 and nrethra. It is corrimonly believed, that moft of them 

 are originally formed in tlie kidneys, from which organs they 

 afterwards defcend with the urine into the other mentioned 

 parts. We muft however regard, as exceptions to this ob- 

 fervation, the cafes in which calculi are formed round foreign 

 bodies, introduced into the bladder through the urethra, the 

 digeftive organs, or fome accidental wound. In the centre 

 of urinary calcuh, furgeons have often met with bullets, 

 fphnters of bone, bits of wood, pins, &c. Nor is it necef- 

 fary for fuch foreign bodies to be large, in order to produce 

 this effedt : a clot of blood, or a little bit of chaff', if not 

 very foon voided, appears to be capable of caufing a preci- 

 pitation of the urinary ialts. 



That urinary calcuh are in many inftances originally pro- 

 duced in the kidney, we have the moft unequivocal proofs ; 

 firft, from the (evere pain which the paffage of fuch foreign 

 bodies down the ureter always excites ; and, fecondly, fro.ti 

 their being often difcovered in the infundibula and pelvis of 

 that vifcus after death. Tiiis laft faA is well illuftrated in 

 the firft plate of Dr. Marcet's intereftiiig Effay on the Che- 

 mical Hiftory and Medical Treatment of Calculous Difor- 

 ders. The engraving is taken from a preparation in the 

 mufeum of Guy's hoipital. In this inftance, there were feve- 

 ral calculi clofely preffed againft each other ; but, in another 

 example, drawn from a fpecimen in Mr. Abernethy's mu- 

 feum, the renal concretion was compofed of a fingle mafe, 

 which reprefented a complete caft ot the pelvis and part of 

 the infundibula of the kidney. In this form of the difeafe, 



the 



