PATHOLOGY. 
of fifh-poifon, and that it refults from the fudden putre¬ 
faction which follows death produced by caufes of an 
intenfe and fudden operation, and happening to perfons 
in full habit of body. 
z. Emphyfema abdominis, tympany: tenfe, light, and 
equable, intumefcence of the whole body ; diftinCtly refo- 
nant to a ftroke of the hand. 
So few are the cafes on record of this curious diforder, 
that it may reafonably be doubted whether it ever ex- 
ifted ; that is to fay, as a diftinCt and idiopathic difeafe; 
for that it follows, a putrefactive ftate of the abdomen af¬ 
ter enteritis, or operation for hernia, does not admit of 
a doubt. Should a cafe of idiopathic tympanitis occur, 
it might be advifable to tap the abdomen. When arifing 
from putrefaction, it is almoll unneceffary to fay, that 
nothing need be done. 
The Tympanites intejlinalis of authors, like the me- 
teorifmus of Sauvages, is a variety, fometimes only a 
fymptom, of dyfpepfy, worms, hyfteria, or fome other 
difeafe affeCling the inteftinal canal. 
3. Emphyfema uteri, tympany of the womb: light 
tenfe circumfcribed protuberance in the hypogaltrium ; 
obfcurely fonorous; wind occafionally difcharged through 
the mouth of the uterus. This difeafe, about which as 
little is known as of the former fpecies, is, according to 
Parr, to be cured by rendering the mouth of the womb 
pervious. 
Genus III. Paruria, [from wapas, bad, and «pt«, to 
make water.] Morbid fecretion or difcharge of urine. 
Four fpecies. 
i. Paruria inops, deftitution of urine ; without delire 
to make water, or fenfe of fulnefs in any part of the uri¬ 
nary track. Often the refult of renal inflammation or 
paralyfis ; but fometimes a genuine idiopathic affeCtion. 
Dr. Parr relates a cafe, that occurred in his own praCHce, 
in which no urine was apparently fecreted for fix weeks ; 
at the end of which time the difcharge returned fponta- 
neoufly. A very curious cafe may be found in the Phil. 
Tranf. by Mr. Richardfon, of a boy who never fecreted 
urine. 
z. Paruria retentionis, (Ifchuria, Cullen, See. See.) urine 
totally obftruCted in its flow ; with a fenfe of weight or 
uneafinefs in fome part of the urinary track. Four va¬ 
rieties. 
a. Renalis 5 pain and fenfe of weight in the region of 
the kidneys, without any fwelling in the hypogaftrium. 
The retention of urine, when it has its feat in the kid¬ 
neys, is generally caufed by inflammation, either idiopa¬ 
thic, or arifing from a Itone lodged in the gland or ureter, 
or, on the other hand, from fome morbid growth in con¬ 
tiguous parts. The two former cafes are of courfe to be 
relieved by bleeding, and fedatives, as opium. See. The 
latter are nearly hopelefs cafes, and are only to be pal¬ 
liated by the fame means, in fiighter degrees of force. 
This gland, when it fuppurates, or is accompanied by tu- 
berculated accretions of the peritoneum, acquires, on 
fome occafions, an enormous fize ; on others, it is much 
diminilhed. 
. 0 . Ureterica; with pain or fenfe of weight in the re¬ 
gion of the ureters. 
y. Veficalis; with protuberance in the hypogaftrium 5 
frequent defire to make water; pain at the neck of the 
bladder; fometimes at the end of the penis. 
§. Urethralis ; with protuberance in the hypogaftrium; 
frequent defire to make water; and a fenfe of obftruc- 
tion in the urethra, refilling the introduction of a cathe¬ 
ter. 
The treatment of the firft variety confifts merely in 
relieving pain by anodynes, and promoting relaxation 
by warm bathing. In the two latter varieties, we have 
to confider the caufe of the ifchuria, or ltoppage of urine. 
This is chiefly in the bladder : atony of the fibres of the 
fundus, or fpafmodic action of the fibres of the neck of 
Vol. XIX. No. 1307. 
34 3 
this cavity. This contraction is to be overcome by fuch 
means as llimulate the contractile powers of the fundus, 
or dirninilh thofe of the neck ; fo that, on many occa¬ 
fions, diuretics, as turpentine and nitre, remove a flight 
degree of the diforder. Again, the warm bath fometimes 
relaxes the mufcular fibres of the neck, and thus allows 
the evolution of urine5 but, fince each of thefe agents 
mull more or lefs operate upon the antagonift mufcles, it 
may fo happen that they may do no good, as indeed is 
often fufficiently evident. A compoiition of equal parts 
of tinfture of opium and tinCture of muriated iron added 
to ten times their quantity of water, and given every 
half-hour in dofes of a tea-fpoonful, is perhaps the belt 
remedy for ifchuria that is known; but it often fails. 
It then becomes an objeCt to introduce an inftrument. 
The bougie, the filver or the flexible catheter, may be in¬ 
troduced as occafion ferves ; but their introduction can 
feldom be effected, unlefs fome degree of relaxation is 
brought about; for this purpofe free bleeding and the 
warm bath may be had recouri’e to. If the patient faints, 
this favourable opportunity of introducing the inftru¬ 
ment is not to be loft. Much will depend, in the treat¬ 
ment of this complaint, on the ta6l of the furgeon ; the 
introduction of the catheter being an operation only to 
be acquired by experience ; and it is well known that 
fome furgeons have introduced a catheter inftantly, when 
others have failed after long and repeated trials. 
If the introduction of this inftrument is impoflible, it 
then becomes a matter of confultation how long it may 
be fafe to defer a more ferious and infallible operation, 
the punCture of the bladder. No exaCt time can be fpe- 
cified at which the poftponcment of this operation will 
be fajral. Cafes are related in which the fuppreffion has 
continued for weeks; but of courfe no furgeon would 
rely on thefe cafes for practice. As a general rule it may 
be ftated, that, when the bladder is felt diftending the 
belly an inch or two above the umbilicus, if the accu¬ 
mulation has been rapid, and the pain is very excruciat¬ 
ing, the bladder Ihould be punCtured. See Surgery. 
3. Paruria llillatitia, ftrangury. (Dyfuria, Suuv. Cull. 
&c.) Painful and ftillatitious emiflion of urine. Six va¬ 
rieties. 
a. Spafmodica; from fpafmodic conftriCtion of the 
fphinCter, or fome other part of the urinary canal, cate¬ 
nating with fpafmodic aCtion in fome adjoining part. 
The fame means may be ufed as advifedfor the relaxation 
of the bladder in complete obftruCtion. 
/ 3 . Ardens; from fpafmodic conftriCtion excited by the 
external or internal ufe of various ftimulants, as acrid 
foods, or cantharides; accompanied with a fenfe of fcald- 
ing as the urine is difcharged. Copious and mucilagi¬ 
nous drinks are all that are required to allay this irri¬ 
tation. Opium may be occafionally requifite. 
y. Callofa; from a callous thickening of the membrane 
of the urethra : the ftriCture permanent. Buillie, Morb. 
Anat. Fafc. viii. pi. 5. See Striflure, p. 167. 
Mucofa; the urine intermixed with a fecretion of 
acrimonious mucus, of a whitilh or greenilh hue. 
This difeafe may be confidered as an inflammation of the 
mucous membrane of the bladder, fimilar in its nature to 
phlogofis of any other mucous membrane. In fome cafes, 
general bleeding, but often local depletion by means of 
leeches, with copious diluents, having fmall proportions 
of foda diflolved in them, will generally effeCl a cure. 
When conftriCtion of the bladder has been caufed by the 
long Handing of this complaint, a ftate which is marked 
by conllant pain over the region of the bladder, with in¬ 
ability to retain the urine for a long fpace of time, it has 
been propofed by Mr. Jefle Foot to wafti out and diftend 
the bladder with warm folution of uva urfi, introduced by 
means of a fyringe. 
The one or other of thefe varieties is found alfo occa¬ 
fionally, or as a fymptom, in inflammation of the urinary 
organs, feveral fpecies of lithia, and compreflion from 
4 T local 
