URINE. 



ture prefents an appearance as if filled with a firm tough 

 lymph. Sometimes the part is two or three times as large 

 as natural, and J. L. Petit once faw it as large as the fid. 

 In feme inftances, only a part of it is fcirrhous ; in others, 

 the whole of it is thus affefted. The hardened gland can be 

 felt in the reftum, and the examination does not give much 

 pain. 



A retention of urine is an ordinary fymptom of a fcirrhua 

 of the proftate ; the catheter is alfo here neceffary, and the 

 introdudtion of it is often attended with greater difficulty 

 than in otlier afFeftions of this gland. As the induration of 

 the part does not allow it to yield, fmall catheters are better 

 than thofe of large fize. It alfo frequently happens, that 

 confiderable force muft be iifed ; and as this cannot^be done 

 with elaftic catheters, a filver catheter, of the fize ufed for 

 children, was recommended by Default. The moderns fome- 

 times employ a conical filver catheter, as we have already 

 noticed. Sometimes, however, no inflrument can be intro- 

 duced unlefs it be rotated, in doing which it is effential to 

 recoUeft that the urethra in thefe cafes makes a very fudden 

 turn upward before it terminates in the bladder. 



After the filver catheter has been worn three or four days, 

 the canal is ufually freer, fo that one made of elaftic gum 

 will now admit of being palled. This lafl. mull in general 

 be continually employed for four or five weeks, and in the 

 mean while attempts ihould be made to check the difeafe in 

 the proftate by the exhibition of mercurials, conium, &c. 

 Suppofitories of hemlock have alfo been particularly recom- 

 mended. Some of Mr. Hunter's remarks on this complaint 

 will be found in the article Prostate GlatuI, Difeafe of. 



17. Retention of Urine brought on by Stridures This is 



another cafe, which we deem neceffar-y to notice in this work. 

 The common nature, moft frequent fituation, and different 

 methods of treating ftriftures in the urethra, have been al- 

 ready explained. (See Urethra, 5'/r/i?arfj q/". ) Perfons 

 who have been long fubjeft to ftriftures in the urethra, but 

 who are ftill able to void their urine in a fmall ftream, are 

 liable, from accidental caufes, to have a complete retention, 

 and are incapable of expelling the contents of the bladder. 

 This arifes in fome cafes from the diameter of the urethra 

 being ftill further diminifhed by attacks of inflammation, but 

 more frequently from the fpafmodic ftate of the urethra and 

 mufcles of the perineum. The fame effeft may be produced 

 by fuch patients retaining their urine too long after the firft 

 defire to void it is experienced. It happens not unfrequently, 

 that the permanent ftrifture may be of fuch a nature, as not 

 to admit of the introduftion of any inftrument into the 

 bladder, even under the moft favourable circumftances. A 

 fpafmodic ftate of the urethra, as Mr. Earle has further ob- 

 ferved, would not facilitate fuch attempts. Other cafes 

 again occur, in which perhaps an inftrument can be pafFed, 

 when the urethra is in a more tranquil ftate, but where it 

 would be highly injudicious, and often imprafticable to in- 

 troduce fuch inftrunients under circumftances of irritation, 

 by which attempts the fpafm would be increafed, and the 

 patient rendered liable to returns of retention, even were 

 we to fucceed in the firft inftance. 



In all fuch cafes, it is, as Mr. Earle remark?, highly de- 

 firable to overcome the retention by other means than the in- 

 troduftion of inftruments. For this purpofe purgatives, 

 general and local bleeding, warm-baths, the tinftura opii, 

 and tinftura fern muriatis, are commonly reforted to. With 

 refpeft to purgatives, their aftion neceffarily requires more 

 time than, from the urgency of the fymptoms, is frequently 

 admiffible. The other remedies arc highly ufeful, and will 

 frequently fulfil every indication. Sometimes, however, 

 they are unavailing, and we are compelled to refort to ope- 



rations for relieving the diftended bladder. Mr. Earle then 

 proceeds to recommend the ufe of tobacco in the form of an 

 enema, either of fmoke or the decoftion, which he found, in 

 fome cafes which are detailed, a powerful and expeditious 

 means of relieving the retention of urine, when other more 

 common remedies had failed. See Medico-Chir. Tranf. 

 vol. vi. p. 84, &c. 



18. Retention of Urine produced by foreign Bodies in the 

 Urethra. — Moft of the foreign bodies, occalionally met with 

 in the bladder, may caufe a retention of urine, when they 

 are lodged and ftopped in the urethra. Thus, calculi, 

 bougies, &c. fixed in this canal, may become obftacles to 

 the tranfmilFion of the urine through it. The means which 

 have been recommended for promoting the removal of fuch 

 extraneous fubftances are numerous. Some advife oily in- 

 jeftions to be thrown into the urethra, in order to make its 

 iurface 'more flippery, while others think it better to dilate 

 the canal as much as poftible with catgut bougies. The 

 ancients propdfed the trial of fuftion. But, fays Default, 

 thefe and other fimilar means are ineffeftual, when the foreign 

 body is clofely embraced by the urethra. In this cafe, he 

 obferves, if the extraneous fubftance cannot be puftied for- 

 ward with the fingers applied externally, an endeavour may 

 be made to extraft it with the forceps, invented for the pur- 

 pofe by Mr. Hunter, and which are contained in a cannula. 

 When, however, the foreign body is too large to be got 

 out in this manner, it muft be extrafted by an incifion. The 

 wound of the operation will afterwards be found to heal up 

 very well, if care be taken to keep an elaftic catheter in the 

 urethra, in order to prevent the urine from coming into con- 

 taft with the cut part. There has lately been publiftied a 

 cafe of calculus in the urethra, attended with dyfury, where 

 almoft inftantaneous relief was obtained from the exhibition 

 of an enema of tobacco. The patient foon felt a ftrong de- 

 fire to void his urine, and " upon making the attempt, a 

 large calculus came rolling along the urethra, with complete 

 rehef of all his complaints." See Edinb. Med. and Surg. 

 Journal, vol. xii. p. 373. 



Urine, SvppreJJion of, in Animals, a difeafe arifing from 

 the want of making water in c»nfequence of fome afteftion 

 of the pai'ts concerned in pafling it. The complaint is 

 caufed, according to lome, either by inflammation obftruft- 

 ing the funftions of the kidneys, or by the ureters being 

 obitrufted by ftones, fmall gravel, or other fuch foreign 

 matters, or when affefted with any numbnefs, or other de- 

 feft, that may difable them in their office of feparating the 

 urine from the blood. In this laft cafe, the bladder is, for 

 the moft part, empty, fo that the animals make no motions 

 to pafs urine, but ftand in the ftraddling manner, as in other 

 diforders of the urinary paftages, when the bladder is full or 

 the urethra inflamed ; this is particularly the cafe in the horfe 

 kind of animals ; and if they continue a few days in this 

 condition, without the fecretion of urine, their bodies are 

 liable to fwell to a very great degree, and they, in this fort 

 of animals, often break out univerfally in blotches and die, 

 unlefs fpeedy relief be afforded. Where the difeafe is caufed 

 by ftrangury, it is commonly attended with a partial, if not 

 a complete fuppreflion of urine, but in general without much 

 appearance of fever, though there arc figns of uneafinefs 

 and irritation with lofs of appetite. The diforder may be 

 produced from different other caufes, as from whatever has 

 a tendency to affedl the parts about the neck of the bladder, 

 fuch as certain articles of food, blows, a fpafmodic ftate of 

 the mufcles inducing contraftion in them, and fome others. 



In the cure of the difeafe, it will firft moftly be neceffary, 

 in cafes where there is a tendency to indammation, to take 

 away a few pints of blood in proportioii to the ftate of the 



affeftion 



