Encyclopaedia Britannica, or, a Dictionary of arts, sciences, and miscellaneous literature : enlarged and improved. Illustrated with nearly six hundred engravings > Volume 13, MAT-MIC

practice.
ipifchefes. The lungs were a little inflamed, and full of fmall
—v tubercles on their furface and in their fubftaxjce: the
heart was large, and a polypus in each ventricle. About
iix ounces of fluid were found in the pericardium : in
the brain nothing preternatural appeared, except about
an ounce of water in each ventricle.
Dr Home feems to have been at a lofs for the re¬
mote caufe of this fuppreflion of urine, which mani-
feftly had its immediate origin from the kidneys having
loft the power of performing their functions. He
thinks the inflammation which appeared in the right
kidney wras fcarce fufEcient to have occafioned the
diftemper, as the other would have fupplied its place :
for which reafon alfo he thinks that the ifchuria wTas
owing to a general aiTedlion of the fyftem ; and that
it was of an arthritic nature, the patient having been
troubled with complaints of that kind for a long time
before.
39S 2. The ifchuria ureteric a is alfo a rare difeafe, unlefs
the obftruilion proceeds from a ftone or clot of blood
flopping up the paflage. Gravel or ftones, indeed, are
very frequently Formed in the kidneys 3 and, by falling
into the ureters, occafion an ifchuria, with violent pain,
and fymptoms more or lefs urgent in proportion to
the ftze and fliape of the ftones. Sometimes it is
attended with eoldnefs of the extremities, naufea,
vomiting, and fpaftic conftridtion of the praecordia,
a difficulty of making vrater, conftipation of the belly,
difficulty of breathing, flupor of the thigh, retraftion
of the tefticle, inquietude, lofs of ftrength, fyncope, and
convullion fits. When the violent pain has continued for
feveral days and nights without intermiffion, and has
brought the patient exceeding low, and the fuppreffion
of urine is complete, with coldnels of the extremities
and convulfions of the tendons, death is at hand. Nor
is it a good fign when the ftone continues long in the
ureter •, for then the appetite decays, a naufea and
retching to vomit fupervene, and the patient is con-
fumed with a hetftic heat. Sometimes the pain is at¬
tended with an inflammation of the ftomach and in-
teftines \ and fometimes the difeafe ends in a dropfy
of the brcaft, or lethargy, which foon carry off the
patient.
The indications of cure are, to exclude the flone as
eafily as poffible, and prevent the breeding of others.
If the patient be of a fanguineous temperament, Sy¬
denham recommends to take away ten ounces of blood
from the affefted fide ; and then to give the patient a
gallon of poffet-drink in which two ounces of marffi-
mallow roots have been boiled, injefting at the fame
time an emollient glyfter. After the pofiet drink has
been vomited up, and the clyfter .returned, give a
pretty large dofe of an opiate. But if the patient be
old or weak, or fubjeft to nervous affeflions, bleeding
may be omitted, efpecially if his urine at the begin¬
ning of the fit be coffee-coloured, and mixed with
gravel ; but as to other things, the cure is the
fame.—Huxham highly recommends an emollient bath
prepared of a decoftion of marfhmallow root, lintfeed,
fenugreek feed, and flowers of chamomile, to which
may be added a fewr white poppy feeds. By the ufe of
this bath he fays he has feen the moft cruel fit of the
gravel fuddenly ended, when neither copious bleeding
nor opiates had the leaft effefl. Mild diuretics are al¬
fo of fervice. Hoffman recommends dulcified fpirit of
453
nitre as proper to relax the fpaftic ftridlure. It is to be lichuria.
taken with fuitable diftilled waters and fyrup of pop-
pies j or in broth, Arith a ferv fpoonfuls of oil of fweet
almonds. Turpentine glyfters are alfo accounted very
ferviceable ; and may be prepared Avith ten ounces of a
decodftion of chamomile, Avith half an ounce of turpen¬
tine diffolved in the yolk of an egg, and about as much
honsy. The fal diureticus, or acetis potajjee, is much
efteemed by fome, Avhen taken along Avith an opiate.
But Avhen the ftone is too big to pals, Arbuthnot re¬
commends a cool and diluent diet to hinder the further
groAVth of it. Whey, infufion of lintfeed, deco&ion of
marihmallows, and gently refolving diuretics, are alfo
proper. To put a ftop to the vomiting, the compound
tincture of benzoin, formerly named balfamum trauma-
ticum, has fometimes been ufed with fuccefs, Avhen al-
moft every other means have failed.
3. The ifchuria veficalis may arife from a ftone in 357
the bladder j and this indeed is the moft common
caufe of it : but there are certain cafes, in Avhich,
though the ufual quantity of urine, or perhaps more,
be palled, the patient dies from the retention of a ftill
greater quantity in the bladder. Of this Dr Home
gives the folloAving inftances. A man of 58 years of
age, of a ftrong fpare habit, and never fubjeft to the
gravel, had, during the winter of 1777, a cough
with expe&oration, which went off in the beginning
of 1778. About the 17th of February 1778 he felt
fome difficulty in palling his urine, and much pain
about the region of the bladder. He continued in
this Avay for ten days, after AA'hich he became eafier on
application of fome medicines. The abdomen then
fwelled, and he had pains in his loins and thighs.
On the 3d of March he Avas admitted into the clinical
Avard : his abdomen Avas then fwelled and tenfe ; and
an evident fluctuation was felt, which fome that touched
him thought was fonorous and produced by wind. A
tumor Avas difeovered between the navel and fpine
of the os ilium on the left fide, which gave him much
pain, efpecially Avhen preffed. This tumor became
more eafily felt after the fwelling of the abdomen de-
creafed, feemed round, and very near as large as the
head of a child. It appeared very much on the left
fide, even Avhen the patient lay on the right, and it then
became dependent. He paffed urine frequently, and
rather more than in health, as it was computed at four
pints a-day. It Avas alA\Tays clear, and of a light co¬
lour. His body had a ftrong difagreeable fmell j his
Ikin was dry, belly bound, and his appetite entirely
gone, fo that he had hardly taken any food for 12 days.
His legs fwelled {lightly for fome days in the evening.
His pulfe was generally regular, fometimes floAver than
natural, and fometimes a little quicker; being once felt
at 64, and another time at 92. He Avas often feized,
efpccially after eating or drinking, AA'itli hiccough ;
AAThich increafed and lafted till his death. On the 20th
day of his difeafe, after fome dofes of fquills, the gene¬
ral fwelling of his abdomen fell, became much fofter,
and more diftinClly difeovered the fwelling of the left
fide. The next day a vomiting came on ; he became
delirious, and died the day following. The body be¬
ing opened, it appeared that the tumor Avhich Avas fo
diftinClly felt on the left fide of the abdomen, Avas
owing to a diftenfion of the bladder AA'ith urine. Its
fundus reached to about the divifion of the aorta into
the
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