A Compleat TREATISE OF URINES, Shewing the right Method of Urinal Prognostication, Far different From the Common Practice OF Quacks and Mountebanks.
By T. H. Pharmacop, Rustican.
LONDON: Printed for Henry Bonwicke, at the Red Lyon in St. Paul's Church-yard. 1703.
To My very Worthy good Friend, The Reverend Mr. Arthur Heron, Rector of Morton, near Chipping-Ongar in Essex.
KNowing your Ability in Physick, as well as your good and great Character in Divinity, and presuming in the inter-change of your Studies, you had sometimes met with the Subject, I here present you with, I submit it to your impartial Judgment and Censure.
When I came first to reside in these Parts, nothing was more nois'd among the Vulgar (in case of any Illness) than the wonderful Skill some Men had, above others, in Water-judgment, by Ʋrinal Prognostication.
This put me upon the most diligent Search I cou'd make, and having consulted many Books on that Subject, I found no great Satisfaction in the matter; yet sometime after, perusing a small Treatise, intitul'd Tractatus Epistolaris de Ʋrinis, &c. (which proving multum in parvo, more ample, tho' brief, than any I had yet read) I forthwith Translated it, and having added some Collections from other Authors, I subjovn'd some late Observations in my own Practise, all which was design'd, for my own proper use only: but hearing very frequently, of the many grand Impositions, on a better sort of People, than the meer Vulgar, by some bold Quacking Medicasters, I resolv'd to Print the following Discourse, hoping thereby, that passing through many Hands, it might, in some measure, prevent the too much abus'd Credulity of some.
For indeed, too too many have been so long impos'd upon, that their Faith of the matter is grown so great, that they believe those bold Pretenders, by the bare inspection of a little Piss, through a Glass, (Conjurer like) can discover the greatest Secrets in Nature, and unfold the most [Page]difficult and most intricate Cases of all Diseases; Nay, I suppose, by a bare shake of the Urinal, they can, as well fore-tell, what number of Corns a Man has on his Toes, or what number of Teeth, an Old Woman has in her Head.
Yet, I must confess indeed, some guess pretty well at the matter; for, 'tis not long since a good Woman in out Neighbour-hood, carry'd her Daughter to a fam'd Ʋrinal-Conquassator, for his advice; who after a demure View of the Virgin-like Water, and a little handling of the tumefy'd Damsel, told the poor Woman, her Daughter was Liver-grown, that her Liver was doubled, (had two Livers) which was too true indeed; for, the poor Wench was big with Child, and visible to almost every Eye, but the fond doting Mother's. How great a Consternation the poor Woman was in, at so monstrous a Relation, I will not here, trouble you with, to recite.
I shall now add no more, but that I may pre-suppose, that this Pis-pot Discourse will not savour well, in the Nostrils [Page]of every busie Critick; but whether it will, or will not, it's equal to me, if you please favourably to accept and approve of it, which will further ingage my Ambition of being,
THE PREFACE.
THE Ancients in the very Infancy of Physick made strict Enquiries into the Nature of Urines, fetching thence their practical directions; for hence 'twas the great Hippocrates especially took the measures of his Fore-knowledge and Precepts, in passing Judgment on the Sick, and choosing the fittest seasons for Physick. So that 'twas unlawful not to observe that famous, ancient and establish'd Maxim among Physicians, viz. to purge Concocteds, without a right consultation of the Chamber-pot. And this indeed seems most agreeable to the most common reason, that since we cannot throughly re-search the inmost Retirement of a Sick Body, (which is like a Vessel close shut up,) we should take the hints of Judging from the ingested Liquor, which in its passage washes over every part, drawing from most a Tincture, and carrying off some loose Particles with it. For Urines are as certain Indications of the Constitutions and Ill-temperaments of our Bodies, (when a right Judgment is made) as Waters betray the nature of that Mineral, through which they pass.
Wherefore the Contemplation of this, tho' the basest Excrement, is become the Subject of a Science, and hath exercis'd the Wits of the most Renowned [Page]Physicians, both Ancient and Modern; concerning which are many Books extant, compil'd with the greatest diligence, in which are enumerated the various differences of Urines, of their Colours and diversities of consistence. The Contents are exactly describ'd, and for every of these, distinct Precepts of Water judgment are deliver'd, which by some are thought so certain, as if the bare Inspection of Urine, gave intimation of every Disease or affected Part, nay every minute Accident concerning the Sick. But in this the Vulgar are most egregiously cheated, and yet are obstinately wilful to be impos'd upon. For they maintain, none can discover the Disease, nor fore-tell any thing of it, except be consult the Chamber-pot; and unless the Doctor undertakes to Divine by his Urinal, (as 'twere by a Magick Glass) they value him not a rush. But for what in truth concerns the Precepts and Rules upon which the practice of Water-inspection is bottom'd, there are many things found out by diligent Observation, and then confirm'd by sound judgment. Yet because the intimation of Urine is too largely stretch'd by some to particular Cases, very many Ʋncertainties interwoven, and some thing's plainly false, besides what are liable to errour; whosoever therefore, by this Water guide only, confidently descants on the Diseases of the Sick, desereves the name rather of a Juggler, than a fair Practitioner. But this Doctrine of Urines is every where so full of errors; because its Practical Observations are ill made, or not well Methodiz'd. It may be justly suspected, that the Observations are not rightly made, since from one or other particular Case, a general Rule is drawn.
For example: Because some Dropsical Persons make a thin Watery-Urine therefore 'tis Canon'd, that such Urines are the undoubted Symptoms of a Dropsy; when indeed, in some other Affects, the same kind of Urine is made: And sometimes in Dropsies the Urine is thick and of a deep Red.
Again, what is vulgarly most receiv'd, is for the most part uncertain, viz. That Urine upon which there swims a Scum (like that on Water wherein Tartar has been boyl'd doth signifie a Consumption, when this sign is more proper and familiar to Hypochondriacks, than Consumptive Persons, and also very many, without this sign, die of a Consumption.
Besides, what is generally affirm'd is altogether false, that the nature of any Affect is discoverable by Urines; because, sometimes those that are diseased make water like sound Men: and sometimes those who seem to be sufficiently in health, by reason of some accident (perhaps the Food they have eaten) make suspicious Urine, and such as are estranged from a natural state. As to the Method or Doctrine of Urines deliver'd by most, it looks altogether Empirick-like, and not at all rational. For the naked differences of Urines are recited, as they are usually distinguisht in their Colour, Consistence and Contents: Then to every of these kinds are oppos'd Pathological, i. e. Affect describing significations, only collected from more unusual Observations; when in the interim neither the Causes of Phaenomenons or preternatural alterations (as ought to have been) are assign'd, neither is the intimation of Urines apply'd [Page]to the Causes of Diseases, but only to the Disease or its Symptom.
Therefore 'tis very often deceitful and uncertain, by reason the Morbifick Cause and Intimation of the same Urine, may indifferently at the same time, point at divers Diseases and Symptoms medimely.
For Example: Thin and watrish-Urine very often unmediately signifies want of Concoction in the Bowels: Yet by reason of the state of Crudity, oftentimes the Green-sickness in Virgins, sometimes the Dropsy, or white and Phlegmatick Swelling of the whole Body, sometimes the Headach and many other Affects also arise.
The Heads of the Subsequent Discourse, Are
First, THE Anatomy of Urine, what Elements and Paris it consists of, as also its Originals in our Bodies; to wit, by what Concoction and then Separation of some Particles, from others, this Liquor is made.
Secondly, The Inspection of Urines is rightly explain'd, and what Certainty and Rule there is of Urine Prognostication.
Thirdly, and Lastly, A general Description of the Colour, Consistence and Contents of the Urine in most Diseases, and what those Signs Prognosticate.
BOOKS Printed for Henry Bonwicke at the Red Lion in St. Paul's Church yard.
Collections of Acute Diseases: In Five Parts. 1. Of the Small-Pox and Measels. 2. Of the Plague and Pestilential Feavers. 3. Of continual Feavers. 4. Of Agues, a Plurisie, Peripenumonia, Quinsie and the Chole [...]a Morbus. 5. And Lastly, of the Bl [...]dy Flux, Miscarriage of Acute Diseases of Women with Child, a R [...]eumatism, Bleeding at Nose, Apoplexy, Lethargy, and [...]everal other Diseases. in 8o.
A Collection of Chronical Diseases, viz. the Cholick, the Bilious Cholick, Hysterick Diseases, the Gout and the Bloody Ʋrine from the Stone in the Kidneys. in 8o.
The Store-house of Physical Practice, being a general Treatise of the Causes and Signs of all Diseases afflicting Humane Bodies: together with the shortest, plainest, and safest way of curing them, by Method, Medicine and Diet; to which is added for the benefit of Young Practicers, several choise Forms of Medicines used by the London Physitians. 8o.
A general Treatise of the Diseases of Maids, Big-Bellied Women, Child-bed Women and Widows: together with the best Methods of preventing and curing the same.
A plain Introduction to the Art of Physick, containing the Fundamentals, and necessary Preliminaries to Practice, whereby the reading of Practical Authors will be render'd easie and intelligible to the Young Student. To which is added the Materia Medica contracted, &c. 8o.
Promptuarium Praxeos Medicae, seu Methodus medendi, praescriptis celeberrimerum Medicorum Londinensium concinnata. Editio altera auction & emendatior.
These Six by John Pechey, of the College of Physicians in London.
OF URINE.
CHAP. I. Of the Principles and chief Accidents of Urine.
URINE new made, or after putrefaction by long digestion, may be Chymically resolv'd into these Principles. By Distillation, 1st, A small Spirit, like that of Wine diluted with Water, ascends; but in so little a quantity, that 'tis not easily tasted: This is succeeded by a watery Liquor considerable in quantity, intermix'd with some looser particles of Salt, and principally Sulphur: 3dly, A very penetrative Water is exhal'd, commonly call'd Spiritus Urinae, which has but little of the Wine-like Spirit, being generally only a Phlegm very much sharpen'd with Salt; wherefore, as in Vinegar distill'd, it ascends last.
But because the Salt of Urine is volatile, and of Vinegar fluid, therefore the distill'd Liquor impregnated with the particles of this, is very Acid; but what's incorporated with the saline particles of the other, is very sharp and pungitive.
'Tis hence evident, That the Spiritus Urine [Page 2](commonly so call'd) owes its sharpness especially to Salt; because tho' most subtile, it takes not flame; but extinguisheth it, if presented to it.
After Distillation, and the remaining moisture being wholly evaporated, another portion of Salt with a little Earth remains in the bottom of the Matrass, out of which by a stronger heat, a Volatile Salt may be sublim'd, leaving the earthy Dregs behind.
This Anatomy of Urine, plainly shews, That the Principles whereof it consists, are most Water and Salt, a little Sulphur and Earth, and very little Spirit. We may discern the Saltness of Urines by Taste and Touch; in Taste it comes nearest a Nitrous Salt, and proceeds from the salt Particles of what we eat, which by Concoction in the Vessels, is for the most part elaborated into a Volatile Salt, i. e. a Salt and certain Spirit, which by their long and mutual combination are knit together in the closest tye: hence Salt it self otherwise fix'd, is volatiliz'd, and (as 'twere by the Wing of another) becomes not unfit for motion.
From the different Dispositions of our Bodies, Urines contain more or less Salt, and that (according to the Accidents) more volatile or fix'd, and therefore are different in Colour and Consistence.
That there's Sulphur in Urines, their speedy putrefaction and stink sufficiently prove; and it proceeds from the saline-sulphureous Particles of Nourishment.
Of this Sulphur there's less than in Blood, the Horns of Animals, or Soot; (and therefore in the [Page 3]Distillation of Urine, nothing almost Oily or Fat ascends) for while the Blood circulates, the spirituous and sulphureous Bodies which depart from it, for the most part evaporate: In the interim, the saline and watery reliques make up the Urine. Yet Urines always have some Sulphur, but the quantities and proportion are diversly altered, according to the different degrees of Concoction and Crudity; hence proceed the changes of heat and consistence in Urines. That the wine-like Spirits of Urine are but few, 'tis evident from the defect in the Liquor first Distill'd, as also from the sudden putrefaction of Urine; but the intestine motion of the Particles in Urine, conclude some; viz. the separation of Thin from Thick, and the spontaneous division of some parts from others, and the collection of that Hypostasis, or thick substance which generally subsides, at the bottom of Urine; besides, the saline Particles (inasmuch as they become volatile) are closely wedded to the spirituous, and therefore become more brisk in motion and quick of energy. Yet according to the different plenty and prevalency of Spirits in Urines, there are divers modes of those Nubeculae, or Urine-clouds, and also of the Sediments, and the Urines themselves, have a more quick or slow putrefaction. The watry-part in Urine, far exceeds the rest in quantity, as being almost six times more than the other: And by Distillation 'tis not so clearly separated, but that some volatile parts of Salt and Sulphur ascend together with it, which tincture it with an ingrateful sent.
This has its original from a plentiful ingestion of Liquids with Food, which yet of what kind [Page 4]soever they be, lose their proper Qualities, and acquire others, before their change into Urine; for nothing almost sincere of that Liquor we drink, besides moisture, barely remains in the Piss.
The distillation and evaporation of Urine, plainly demonstrate, that there's some portion of Earth, as well as slimy-muddy Dreggs in it; for when all the liquid parts are exhal'd, the Earth, as a Caput mortuum, remains in the bottom in a moderate quantity.
For in the Nutritive Juice, besides the active Principles of Salt, Sulphur and Spirit, is requir'd something solid, whence Bodies have their bulk and magnitude. The Recrements and earthy Dreggs of this, are plentifully dissolv'd in the serous part, making the contents of a more thick consistence; but this is different according to the variable State of Concoction and Crudity.
These are the Principles which make up the Body of Urine, into which, by Chymistry 'tis easily resolvable.
From the combinations and various admixtures of these, the other Accidents of Urine, viz. Quantity, Colour and Consistence, which are sensibly the most observable in it, and from hence the especial Objects of Urine-judgment, do arise; for when almost nothing besides is discernible in Urine, those make the first Phaenomenons, in the right solution of which, the whole Hypothesis of this Science consists.
Wherefore in the next place, I shall Treat of these; and first, concerning the Urines of sound Men, what is their Quantity, Colour, Consistence and Contents; as also I shall endeavour to declare [Page 5]upon what mixture of Elements, what Concoction of the Bowels and Vessels, every one of these depend,
In the next place it shall be shew'd, how far the Urines of sick Persons, differ from the Rule and Standard of those who are sound. And I shall endeavour to assign the proper Causes of their change to each of these Differences; and what I have said hitherto, shall finish the first scope of my Discourse, to wit, the Anatomy of Urine.
CHAP. II. Concerning the Quantity and Colour in Sound Mens Urine.
THE quantity of Urine in Sound Men, ought to be a little less, than the Liquids dayly ingested; for what is potable and moist that is daily taken, is the very matter of which Urines primarily consist. But these (when hunger and thirst urge) are more plentifully requir'd, that they may sufficiently dilute the Mass of Chyle, for its right Fermentation in the Bowels; as also that it may serve for a Vehicle, both to convey it into the Mass of Blood, that the Blood it self may circulate in the Vessels without Stagnation, and to the Nervous Juice, that it may actuate and moisten the Organs of sense and motion. Thus the serous part having almost contributed whatever Spirit or Sulphur it had, gives place to a new Nutritive Humor, and it self then, as [Page 6]unprofitable, is carry'd off from the Blood, by the seclusive help of the Kidneys.
The Nourishing Liquor, which at last is chang'd unto Urine, is different in its own nature; sometimes waterish, sometimes inpregnated with Spirits, sometimes with Salt and Sulphur; and according to the different prevalency of this or that Element in it, many Variations happen: but no liquids wholly and unchanged pass our Bodies, but in diverse parts, undergo their mutations and loose some portion of their quantities, before they be ultimated into Piss. For the Liquor to be turn'd into Urine, being first receiv'd into the Stomach, and staying there till Concocted, is also Impregnated with Salt and Sulphur of its own or other dissolv'd particles, from some more solid nourishment; after this, much of it, together with the Nutritive Juice is mixt with the Blood, with which after long Circulation, and then according to the various temper of the Blood, and its accension in the Heart, it receives a further tincture of Salt and Sulphur; hence some portion of it, is deriv'd into the Brain and Nerves, and there being render'd weak and non-Nutritive 'tis finally again reduc'd into the mass of Blood. After that, the more generous part of the Serum is spent upon the Blood and the Nervous juice, a great part also by Sweat and other Emunctories, the remainder, while the Blood continually passeth the Reins, is there separated from it, either by Percolation, or the Force of some Fermentation, by way of precipitation, passing the Ureters, into the Bladder, whence 'tis ejected.
From the Original and view of this serous [Page 7]part now discrib'd, 'tis evident and that clearly, that the Urine ought to answer the quantity of Liquids ingested in a proportion somewhat less, perhaps about a third, which plainly shews the complextion and strength of the Bowels, whose Office is Concoction, and likewise of the Blood it self, as also in some sort, the temper and distribution of the Succus Nervosus: Moreover it carries with it the signs of the affects of the urinary Passages.
The quantity of the Urine does not always hit this Rule, but sometimes exceeds, sometimes comes short, and for a little time, may consist with a State, not much out of tune; but the long continuance of such different Accidents argues a sickly condition: Concerning these, I shall speak amongst the Phaenomenons of Urine in a crasy Body.
In the next place, I consider the Colour of a sound Urine.
The Urine that is made, after a perfect Concoction in the whole Body, is of a Citron-colour like a Lixivium indifferently boil'd, which without doubt proceeds from the Salt and Sulphur of the Nutritive Juice and Blood, dissolv'd by ebullition in the Serum.
This Colour arises not from Salt only, (as some contend) for any Liquor that is impregnated with Salt (except it be evaporated to a certain thikness) doth not at all grow Yellow: And truly the Salt of Tartar dissolv'd by liquation, yet remains clear.
To what's objected concerning a lixivium of Ashes; I answer, the whole quantity of Sulphur is not [Page 8]spent by burning, but the citron colour arises from some Salt and other adust Sulphureous particles cleaving to the ashes, infus'd and incocted in the Liquor. Nor has sound Urine this tincture from Sulphur only; for Sulphur in a Waterish Menstruum, cannot be dissolv'd without the addition of Salt; neither parts with any of its tincture without such addition: and therefore if you digest Salt of Tartar and common Sulphur together in Water, or boil Antimony in a Salt Menstrum, both liquors, Urine like, grow Yellow from thence; even so the Salt and Sulphureous particles of Nourishment, by digestion in the Stomach and Intestines, and by circulation with the Blood in the Arteries and Veins, being minutely divided and througly incocted with the Serum, make the Urine of a Citron-colour.
The dissolution of Salt and Sulphur in manner aforemention'd, by which Urines become Citroncolour'd, is first begun in the Bowels, afterwards perfected in the other Vessels, much depending upon the Concoction of the Stomach and Intestines.
For here by the help of Heat, and Fermentation, the Nourishments ingested are especially fermented. The tye of mixture being loosed, the Sulphureous and Saline particles minutely broken, are advanc'd into Chyle, and then the Serum, which is the remainder from the concoction and distribution of that Milkie Juice, becomes citron colour'd; as when Salt of Tartar and common Sulphur are dissolv'd together in any Liquor, and some Acid pour'd upon it, it presently turns milkie, and soon after, the contents being separated per Sabsidentiam, the remainder of the Liquor grows yellow like a Lixivium.
But if the Nourishment, through some indisposition of the Stomach, be not rightly digested in the first Concoction, as it often happens in a Pica, Dropsie, and other Distemperatures of the Bowels, the Urine then becomes crude, clear and almost insipid like Fountain Water.
But by reason of the too exalted, or otherwise deprav'd Ferments of the Bowels; as in the Scurvy, Hypocondriack Melancholy, or in a Feaverish constitution, the particles of nourishment being too much dissolv'd in the first Region, the Urines become red and thick.
The Serum, which in the first Concoction, as is said, had got a tincture like Lie, being mixt with the Blood, as long as it circulates with it, is yet further concocted and gets a deeper colour; for tho' the throughly concocted particles of Blood are generally separated into the Vesicula fellis, yet partly their incoction in the Serum enhances 'its tincture. Hence Urine first made after Concoction is most pale; the next made somewhat red; and after long fasting, yet more deep.
Where the Blood is more cold, as in a Cachexia, the colour of Urine is below its just state; but where the Blood is accended and as 'twere boil'd by a Feaverish Heat, 'tis of a high Red.
'Tis worthy observation, that some Urines, and those sound, made after large drinking, are not colour'd, but pale and waterish.
Concerning which, the enquiry is, how the Serum so suddenly passes the Stomach, (contrary to common belief) and running through first the Chylie-passages, then the Veins, Arteries, the Ventricles of the Heart, the turnings and windings [Page 10]of the Reins and Ureters, in so short a space is sent out of the Body; and besides, otherwise than in most other cases, borrows no colour in its passages, but loses its own.
'Tis probable, besides the long circuit of the Nutritive juice, wherein after some stay in the Stomach, it glides down the Intestines, and thence is carry'd through the lacteal-Vessels into new passages, and thence into the Veins; (a circuit not to be run in a trice, therefore) 'tis probable, I say, that there's another more proper passage of the same Nutritive Juice, by which 'tis presently convey'd to the Mass of Blood and perhaps to the Succus Nervosus. Wherefore after long hunger, immediately upon Eating, but especially upon Drinking, we find a sudden refreshment, which cannot be suppos'd to proceed but from Spirits or Vapours; because immediately after such drinking follows pissing, and that sooner than the Mass of Chyle can be thought to be sent out of the Stomach. Therefore it seems not improbable, that forthwith a thinner part of the Nourishing Liquor (that's receiv'd into the Stomach) consisting of some Spirit and espeially Water, is imbib'd by its Membranes, like a Spunge, and thence instill'd into the Mouths of the Veins, and is presently mixt with the Blood in its return to the Heart. For many are of this opinion, that the Chyle in some measure is immediately deriv'd from the Stomach and Intestines, through the branches of the Vena porta into the Mass of Blood. And as the lacteal passages carry it about in a long Circuit, by which 'tis sent into the descending Branch of the Vena cava, so by a nearer way, [Page 11]through these Vessels, may it be carry'd into the ascending branch of the same Vein; for the Blood, being in some measure impoverisht with its Circulation, returning both ways, ought to be refreshed with a new Juice, before it enters the Heart, to enliven the Ferment there.
Now since the far greater part of Blood is carry'd upward, it seems certainly Reasonable, that some part of the Nutritive Juice should as 'twere fewel for a new accension in the Heart) be conveyed into the Blood already spent and grown feeble. Many arguments make for this, which to recite, were too large a digression from my present scope; wherefore I think 'tis in some measure after the manner aforesaid, that we piss such a pale waterish Urine, so soon after drinking.
That Liquor, which from Nourishment is so speedily convey'd into the Mass of Blood, not passing through so many windings, as the membranes of the Bowells, (as if drawn by distillation, the grosser part rejected) in a manner, is only Water and Spirit, whereby it may refresh the Vital Spirits and dilute the Blood. In which task, the spirituous part being spent, the waterish part, being weighty and troublesome by reason of its plenty, is continually sent out by the Kidneys; and since it comes from the Stomach, not as yet embrewed with Salt and Sulphur, nor is not so long circulated with the blood, as to acquire from thence, a lixivious tincture, tis piss'd out thin and clear.
CHAP. III. Concerning the Consistence and Contents of the Urine of the sound.
HItherto have we discours'd of the Quantity and Colour of Urines in sound Bodies; but as to the Contents, there ought to be nothing in sound Urines, besides the Nubecula or Urine-sloud; and what this is, and how it is form'd, in the next place remains to be explain'd.
While the mass of Blood is commixt with serum and the Nutritive humour, 'tis continually circulated in the Vessels; from hence a certain Nutritive Juice, by perpetual digestion is elaborated, which becomes a Nutriment at last, continually supplying the solid Parts. This at first is concocted into a glutinous Humour, not much unlike the white of an Egg; after that, into slender Filaments, which being interwoven in the pores and little spaces of the solid Parts, supply them with an augmentation always of new Substance. And while the Serum, that is mixt with the Blood, washes over all the regions of the Body, it swallows up in it self a superfluous part of this last Nourishment, design'd for the Augmentation of the solid Parts, and carries out with it, that which makes the Urine-cloud. When this appears (because it signifies Concoction and Nutrition in some measure) 'tis accounted a laudable sign; but if no such Phaenomenon be visible, [Page 13]'tis a sign of Crudity, as in a Cachexia and Dyscrasie in Feavers.
It consists of slender Filaments (as aforesaid) and is disperst thro' the whole body of the Urine, and then is gather'd together into one Cloud, Thus; the Filaments are long and somewhat smooth, having some asperities, bramble-like, so that being mov'd to and fro, they easily take hold one of another, and are complicated in themselves; as if we shou'd cast many Hairs into a Vessel full of Water, and there by often shaking, and tossing the Vessel about, the Hairs, which at first Swim on the top, here and there, shortly after Mutually embrace, and knit in one knot. After the same manner, ('tis probable) the Filaments which make up the Nubecula or Urine-cloud, being tost too and fro by the innate heat and Spirits of the Urine, do concur and knit together, till by a mutual complex of each other they Concenter into one little Cloud; and because those Filaments are more compact and firm, than the rest of the Contents of the Urine, by reason of their Gravity, they fall to the bottom. 'Tis highly probable, that such Filaments, in some Persons make up the Urine-cloud; because the Blood in a good State, and consequently disposed for Nourishment, is interwoven with many Fibres or white threads, which any body may discover by phlebotomy, when the Blood is receiv'd into hot Water; therefore 'tis probable that some divided slender parts of those threads, being snatch'd along with the Serum, are the matter of that Wool-like Subsidence in the Urine: Wherefore in a Cachexia, the blood being waterish [Page 14]through Crudities, and unfit for Nourishment, is distitute of those Elaborated small fibrous threads; as likewise in great Dyscrasies, when by an over ebullition of the Blood, the Nutritive Juice is not rightly concocted into such like threads, the Hypostasis or thick Sediment of the Urine is either utterly wanting, or very much confus'd and troubled.
A good and laudable Urine-cloud is white, round and equal, falling towards the bottom; and to this is requir'd, first, that the Nourishment be rightly elaborated, whereby the Filaments may become somewhat smooth, round and firm, like slender threads.
2dly. That the Urine be sufficiently Impregnated with Spirits, which (as 'tis evident in the Fermentation of new Wine) may drive and exagitate the parts to and fro.
3dly. That the Liquor be not too thick, nor its pores prepossess'd with other little bodies, whereby it may happen, that the motion of the Contents may be hindred; wherefore there ought to be an ample space left, to agitate and hurry about such Particles. If the Urine-cloud be red, 'tis a Sign that the last nourishment is render'd adust, and over concocted by too much Heat; therefore such a Sediment for the most part, is in the beginning of Feavers, while the Concoction of the Bowells and Vessels is not wholly preverted. If the Hypostasis be broken and unequal, 'tis a sign, that the Nutriment design'd for the solid Parts, is not rightly and equally concocted, that its particles are not altogether Congenerous, i. e. of the same kind, and of [Page 15]the same Nature, and therefore the Filaments hang not together Uniformly, but as 'twere after a Separate and confus'd manner of Implication; hence some that are more crass, fall to the bottom; others more rare, hang higher. When the substance, of which the Hypostasis is made, doth not altogether fall, but wholly hangs either in the top or middle Region, it happens thus, either because 'tis made of Filaments not perfectly Elaborated, firm and compact, but more thin and Spungy, or because the Liquor is more than ordinary Impregnated with Salt and Sulphur, and therefore like a strong Lixivium, bears up that weighty matter, which otherwise wou'd fall to the bottom.
Some times the Nubecula or Urine-cloud is wholly wanting in sound Bodies, after long Hunger, immoderate Labours or extraordinary Sweats, the matter being either wholly spent in Nutriment; or evaporated by Sweat: And.
In Feavers, because the mixture of the Blood is greatly Deprav'd: in the longing and deprav'd Appetites of Child bearing Women; in a Cachexia or an ill habit of body, and other such like Affects, by reason of the Predominant Crudity.
Concerning the Consistence of sound Urines, not many things worthy observation occur. 'Tis commonly like Middle Ale well purify'd by Fermentation, or a Lixivium indifferently boil'd: viz. The aqueous part of the Urine, ought to contain within its pores and spaces many particles of Salt and Sulphur broke and disolv'd very small, as also a little Earth disjoin'd [Page 16]into the least atomes, and disperst throughout the whole body of the Urine. If the Consistence be thinner, than it ought to be, as 'tis seen in clear and waterish. Urine, 'tis a Sign of Indigestion and Crudity, that the aliment is not fully concocted: but if the Urine be more crass and thick than it ought to be, 'tis a Sign the body of the Liquor is clogg'd with Preternatural Contents; but of these elsewhere, when we treat of the Urines of sick Persons. Hitherto have we spoken of Urine in a sound Body, both as the Excrement and Sign of Concoction rightly perform'd in the Bowells and other Vessels.
We must take the measures of its Quantity from what we drink; its Citron-colour, from Salt and Sulphur dissolv'd and incocted in the Serum. The Hypostasis or Contents depend upon the filaments elaborated in the mass of Blood, for the nourishment of the solid parts. Its Consistance is from Salt and Sulphur, together with some particles of Earth, filling up the pores and spaces of the serous Part. It remains next, that we treat of the Urines of sick Persons, in which likewise the Quantity, Colour, Contents and Consistence, as also some other accidents, offer themselves to our consideration.
CHAP. IIII. Of the Quantity and Colour of the Urines of Sick Persons.
IN a desease or sickly State of Body, the Quantity of Urine frequently answers not the necessary [Page 17]proportion of ingested Liquids; for sometimes there's a Defect, (sometimes an Excess) in the just Measure, when the Urine is far less than the ingested Liquors. The reason of the Defect is, because the serous part Stagnates somewhere in the Body, or is diverted some other way, than that of the Urinary excretion; For 'tis either 1st, lodg'd aabout the Bowels and their cavities, and sometimes also stays longer, than it ought, in the Stomach, by which means 'tis somewhat distended, causing troublesome Spitting: but more frequently it is lodg'd in the hollow of the Paunch, sometimes in the cavity of the Breast or Head, and there usually produces Dropsical Diseases: or 2dly. the serum Stagnates in the Vessels, and thereby augmenting the Mass of Blood and Nervous Liquor, greatly perverts their motion: or 3dly. that waterish Humour is thrown upon the habit of the Body and so creates a swelling of the whole or some parts: or 4thly and lastly 'tis obstructed in the Urinary passages, by a Stone or some Viscous matter creating Pain and Convulsions in those parts, and a Superfluity of serum in the whole Body.
But when the serum is diverted otherways, it often disposes the Sick to frequent and troublesome Sweats, or almost a continual Flux. The Affects therefore which the deficient Quantity of Urine indicates, are Swellings and aqueous collections of some Bowels, also sometimes Rheumatick Pains, sometimes an ill Disposition of the genus nervosum, sometimes an universal Dropsy and phlegmatick Tumours, and sometimes the [Page 18]Stone in the Reins and Bladder; sometimes also the penury of Urine is the effect and sign of some other praeternatural Evacuation, to wit, of Sweat, a Diarrhaea, or some other immoderate Excretion. To describe every cause and mode of the office of the Serum, either as it is in the Body, or as it is excern'd thence, were in a manner to bring over hither, the whole matter of all the Affects; for many and diverse are the Occasions and Circumstances, by reason of which the serum is lodg'd in this or that Part, and by staying in the Body, lessens the quantity of Urine. Notwithstanding, the principal and most frequent cause of this, is not so much the Vice of the Liver, Spleen or Reins, as that of the Blood it self.
Free and plentiful Pissing, as likewise its tarrying in the Body and penurious Excretion, depend especially upon the temper of the Blood and its Accension or Fermentation in the Heart: For, if the Blood be impregnated with active principles, (viz. Spirit, Sulphur and Salt) rightly exalted, and have a lively Ferment in the Vessels, so that the well loosened complex of the Liquor be rightly accended by the Ferment of the Heart, it all in a manner Spiritualizeth, and by its Heat and rapid Motion Transmits it self, without obstruction, through every Part; whatsoever is superfluous and volatile evaporates, and while the Blood that is rarify'd and as 'twere boyling with Heat, passeth the Reins, that which is the serous part, either by reason only, the Kidneys, is as 'twere its Strainer, or having in them [Page 19]some Coagulated matter, is easily separated and as 'twere Precipitated from the rest of the Mass of Blood. Tis the same in a manner with the Mass of Blood, what we observe in Milke; viz. while it grows Hot and almost Boyling, it easily Curds or Coagulates, and its Serum or Whey soon separates by pouring in a little Runnet or any sharp sour Liquor; but if it be Cold, though you pour in stronger Ferments and a considerable quantity of any Acid, scarce any Precipitation follows.
Therefore if the Blood become more Cold and Watery from an ill constitution of Diet, so that being less impregnated with active Particles, its Ebullition is more slow, 'tis accended as 'twere piece-meal in the Heart, and circulates very slowly and with difficulty in the Vessels, and running the course of the pores and passages in the Flesh and Bowels, sticks by degrees, leaving something of it self behind it: whence Obstructions and Tumours every where accrue.
By this means also, the Blood being Feeble and Viscous, is consequently less sit for Precipitation or Percolation, and doth not so readily convey its serous Excrements into the Kidneys, but leaves them every where dispers'd in the whole Body, by reason of the Settlement of some Humour and Difficulty of Circulation. Wherefore in this State, those things which much exagitate the Blood, as Exercise, swift and frequent Motion; or as those things which like Rennet infus'd do precipitate, as Acids and Salt Preparations do, provoke Urine more plentifully.
Sometimes sick Persons Piss very copiously, so that in the space of twenty four hours, they evacuate twice or thrice as much Urine as they have taken Liquids. The cause of which Effect is divers, and the Signification much different. If after the diminution' of its quantity, or suppression of Urine; if in dropsical affects, Rheumatisms or other nervous Passions, or the crisis of Feavers, plenty of Urine naturally, or by the use of Diureticks, freely ensue, for the most part it presages the discontinuance of the Disease and Preternatural Indisposition; or at least, its declension. But if (as I have often observ'd, without these foregoing and premention'd effects) the Urine far exceeds the ingested Liquids, and thence ensue a remarkable Debility, this indeed portends an ill State, an inclination to an Atrophy or Consumption. I have known some Women of a slender thin habit of Body, who sometimes being indispos'd for many days together, were wont to make in great plenty (above what Liquids they took) a thin Watery Urine, without Contents or Urine-cloud, at which time, they complain'd of their strength languishing, difficulty of Breathing, and an inability to Motion.
I suppose in this case, the Blood and Succus Nervosus, by an exalted and fluid Salt, became too acid, and consequently unapt to be in the least dissolv'd in their mixture, and were too much dispos'd to Serosities; for 'tis observable, that whatever Liquids, tho' thick and clammy, if kept till sour, they presently become more thinn and waterish. Further, 'tis manifest, that those [Page 21]accidental overflowings of Urine arise from such a disposition of the Blood and Humours; for the Urine has a Vinegar Smack: and such affects (as aforemention'd) are ordinarily cur'd by Chalybeat Medicines, and not always by common Astringents and Thickners.
Now as to the Colour of the Urine of the Sick, that of sound Persons must be the rule and Standard, by which all the rest ought to be try'd and judg'd.
Since then the Colour of theirs who are Sound, ought to be Citron; the Urine of those that are sick, will either be more Pale than Citron, and so white like common Water; or more deeply tinctur'd, and then generally 'twil be either of a Flame or Saffron-colour, Red, Green or Black. In short, I'le endeavour to appropriate the Causes, from which each of these Alterations proceed, and what Affects or preparations of Diseases they usually indicate.
The Urine is clear like Water, when by reason of the indigestive faculty of the Stomach, the Saline and Sulphureous particles of our Meat are not so well concocted and minutely broke, that they can be volatiliz'd and dissolv'd in the Serum to tincture it so deep, as that after all its windings and passages it can bespeak its Originals.
For Liquids, that are to be chang'd into Urine, by reason they are press'd and driven through secret and very narrow Passages, as 'twere by Distillation, thereby loose their Colour and Consistence which they had when ingested, and imbibe [Page 22]nothing from the Chyle (whose vehicle they are) but what is volatile. Wherefore if by reason of eminent Crudity, Salt and Sulphur and other Contents be not first volatiliz'd in the Bowels, nor after, dissolv'd in the Vessels so far, as to run the same course with the Serum, this at last, in a manner divested of all, is sent out like clear Water. And that such Urines generally want their active Principles, 'tis evident, because they are longest preserv'd from Putrifaction.
Such Urine in Virgins generally signifies a Chlorosis or the Green-Sickness, in most an ill habit of Body or a Dropsie; in some 'tis a sign of great crudity and the want of Concoction; and sometimes also, in those who are subject to the Stone, it Preindicates an approaching Fit, viz. while the Serum in the Kidneys is coagulated by an acid fermenting Juice, its Contents being condens'd into a Tartarous matter, a thin waterish part is only excern'd. They who for a time, (let the Disease be what it will) Piss thin and waterish, have very often these Symptoms; difficult and frequent Breathing after motion, Distension about the region of the Stomach, and as 'twere a Swelling or Puffing up, after Meat. The reason of which wholly depends upon want of Volatilization in the Blood: For, because its Liquor is destitute of active particles rightly exalted, viz. (Spirit, Sulphur and Salt) therefore 'tis not sufficiently accended by the ferment of the Heart, whereby the whole should presently sally and as 'twere break forth into a Flame; but fermenting with difficulty, and apt to Stagnate, or for the most part [Page 23]to settle in the Heart, 'tis much oppress'd by it; wherefore, if the Blood thus dispos'd, be hasten'd thro' the Ventricles of the Heart, by a motion more quick than ordinary, because it has not free Rarefaction, it presently sallies out, in a manner all at once; therefore there is need of a greater Endeavour, and more frequent Agitation of the Lungs to pump it.
Waterish Urines therefore, fore-tell such like Crudities in the Blood; because if they have received, in a manner, no tincture from the Salt and Sulphur, 'tis a sign their particles are less dissolv'd, or less volatiliz'd, in the Mass of Blood.
As to the Distention of the Stomach, of which clear Urines are both an effect and sign; I say, for want of a due Fermentation, the Chyle is not all changed into a volatile white Substance, but (like Bread not fermented) is alter'd and transmuted into a heavy ponderous Mass, which is slowly, and not without a Viscous Phlegme accompanying it, sent from the Stomach, whole reliques being fixt to the foldings and membranes of the Stomach, obstruct all its Pores and Passages, so that nothing can evaporate, and what is more Thin and Spirituous, cannot be carry'd to the Blood forthwith through secret Passages as it ought. Hence plenty of Flatulencies or Windiness is engender'd; which speedily stretches the Stomach, blowing it up beyond its proportion. And since those dreggs, by long residence in the Stomach, abound with a fixt Salt, they sometimes degenerate into an Acid, sometimes into a Vitrioline or other base Heterogeneous matter, whence [Page 24]Violent pains in the Stomach, deprav'd Appetite, violent heat with frequent Thirst, sometimes violent Vomitings and other very grievous Symptoms arise. Some of which, tho' they argue heat, and that in a great degree, lurke and lye hid within: yet those who are thus affected for want of Concoction, often make Crude and Waterish Urine. We have thus now largely treated of clear Urine, because the reasons of the rest, may be had hence, which are Pale and thin without Colour or Consistence, in those who are Sound. For the Phaenomenons of Pale straw-colour'd or other Colours below Citron, arise, and may be explicated after the same manner we have already said of the Water-like, clear Urine, from the greater or less Dissolution and Concoction of Salt and Sulphur in the Serum.
Another kind of Urine, more Pale than Citron, yet remains, not at all Thin but Thick, of a sullied whitish Colour, which is commonly observ'd, Children make, when their Bowels are much troubled with Wormes; the reason of which seems to be, because the matter of which Wormes are ingender'd, is a viscous Phlegm through indigestion of Chyle and want of Volatilization, heapt up in the Bowels, which doth not readily transmit any tincture to the Urine, because the matter is fixt; after that, the same matter putridfying, is exalted and volatiliz'd in a manner, and then partly by Heat and Spirit is form'd into Wormes, and that phlegmatick matter, being unfit for nourishment, 'tis separated from the Blood with the Serum and mixt with the Urine; [Page 25]hence that white Colour and whitish Sediment.
Sometimes in Feavers, especially the Urines of Children grow white; the reason of which is, because the supply of Nutritive Juice coming from the Chyle to the Mass of Blood, is not rightly assimilated, but degenerates into an excrementitious Humour, a part of which being incocted in the Serum, gives it a more thick Consistence and milkie-colour, otherwise than in Feavers of the Adult, where when the Heat is more strong and vigorous, the mixture of such Juice tinctures the Serum with a deep Red.
Sometimes also Urines appear white, from a Gonorrhaea, Flour albus, Ulcers of the Kidneys, Ureters, or Urinary passage, by reason of the commixture of Matter or corrupted Seed. However it be, the white colour of the Urine, is produc'd by its Contents, which falling to the bottom, the Liquor for the most part becomes of a yelowish-pale Colour, like as 'tis seen in the preparation of Lac Sulphuris, where the Milkie substance falling to the bottom, the Liquor swimming above, is commonly of a Citron colour.
Urines whose Colour is more Intense, than Citron, owe not their appearances only to the more than ordinary dissolution of Salt and Sulphur, but in some measure, to the more crass Contents in the Liquor.
The plentiful dissolution of Salt and Sulphur is perform'd in the Vessels containing the very Mass of Blood, and thence is the Tincture deriv'd upon the Serum, and this for the most part, comes to pass two ways.
First, either by reason of a Feaverish Heat, in as much as the Blood boyling in the Vessels, and being more accended in the Heart, is much weakned in its mixture; and therefore the particles of Salt and Sulphur, which are separated by Ebullition, plentifully impregnate the Serum. Or Secondly, without a Feaver, when such like Sulphureous and Saline little Bodies, which were wont to be sent out at other Emunctories, are detain'd; therefore being heapt up, by little and little in the Blood, they are commixt with the Serum: Of which, there are two particular Cases or Modes for either the Excrements of Blood, which especially partake of an adust Sulphur, and ought to be sent forth by the Vesicula Fellis, are retain'd and so mixing with the Serum, tincture it with a yellow: Or the Effluviums which are especially of a Saline nature, and were wont to evaporate by insensible Transpiration are retain'd, and by them is the Urine tinctur'd, like a Lixivium or with a Lye-like colour.
All Persons in the Jaundise have Urine of the frist sort; but that of the latter, is familiar to the Scurvy; for in a Scorhutick Habit, the Saline Particles of Blood fall short of Volatilization, and become fluid, wherefore by reason of fixation, they evaporate less, and being plentifully heap'd up in the Mass of Blood, they greatly prevent its Mixture, and especially impregnate the Serum with Salt.
The Contents which augment the colour of Urine are of two sorts, viz. Either the adust [Page 27]Recrements, which are the reliques of the Blood's Inflammation: Or the Particles of the Nutritive Juice, degenerated into an unknown Matter; of which, in their proper place hereafter: Our present Task is, a particular decyphering every Colour, that is above Citron.
In the first place, The Flame-colour'd Urine appears like the yellowish red Vapours in the Distillation of Spiritus Nitri, and this is very often found in Intermitting Feavers, frequently in Tertians. This Colour arises from a small portion of thin yellow Choler, mix'd with the Serum, while 'tis in motion; for in this Feaver there is a sharp and hot Distemperature of the Blood, which burnes and in a manner torrifies all the Humours, and therefore plentifully produceth Choler.
And tho' this for the most part, is sent out by the Ductus bilarius; notwithstanding, since it abounds in the Vessels, part of it, or (what's equivalent) the adust Particles of Blood and Humours being incocted in the Serum, tincture it with a deep yellowish-red. This Urine is Thin and Shining, because in this Disease, almost a continual Sweat forces out the Excrements of the Nutritive Juice and the more gross part of the Serum, to the circumference of the Body. The Saffron-colour'd Urine, which dies Linnen-cloth with the same colour, is an undoubted Sign of the Jaundise; and 'tis thus tinctur'd from yellow Choler, or Salt and Sulphur adust and plentifully mix'd with the Serum, For that Yellow is necessarily produc'd by the more than [Page 28]ordinary continual motion and over-heat of the Blood: And Nature has design'd the Vesicula Fellis and its passages which are radicated in the Liver, for discharging the Choler from the Mass of Blood. But if this Office of the Ductus Bilarius, in conveying the Gall, be any ways hinder'd, that Humour stagnating in the Blood and plentifully heap't up there, dies the Skin, Blood, and Urine especially, with a yellow Tincture.
A Safftron-colour'd, differs from a Flame-colour'd Urine; because in the last, only some part of the thinner, in the first, a more crass and plentiful part of the Gall is incorporated with the Urine: Farther, in yellow Choler, Sulphur being long circulated with an accompanying Salt, is fully dissolv'd by it, and becomes like Paint, colouring any Subject with a Saffron tincture, like as when common Sulphur and the Oil of Tartar are dissolv'd together.
But that Redness which is in Urine, without the stagnation of Choler, happens after the same manner, as in a Lixivium or Lie of Ashes, where the Particles of Sulphur without any predisposition, from those of Salt, together with them are imbib'd in the Liquor.
In the next place, we will Treat of Red Urines, which are of a different Nature, depend upon different Causes, and many times signify differrent kinds of Affects; the chief of which, and their proper significations we'll briefly describe. First of all, the Liquor grows red of it self, remains in the same Condition, neither is the Colour of any part of it alter'd by Subsidence. Or, [Page 29] 2dly, the deep dye of Urine proceeds especially from what's contain'd in it; and after its residence to the bottom, it becomes Yellowish, or less Red than before. The Affects which such Urines are wont to signify, are especially, Feavers, Scurvy, and a confirm'd Consumption.
Let's consider the Reasons of each. When the Urine which is made Red, continues so. 'Tis either 1st, of an indifferent Consistence and Transparent, and then it owes its Colour to Salt and Sulphur more than ordinarily adust and therefore plentifully incocted in the Serum.
Or, 2dly, Such an Urine is Red, as also Dark and Muddy and besides what particles of Salt and Sulphur it hath, some earthy Particles are emboyl'd in it, which sticking in the Pores and Passages of the Urine, do not all precipitate; because the Liquor of the Urine divested of its fit Spirits, which wou'd separate and precipitate all parts of a different disposition, as it usually happens in Wine that hath lost its Head, or been sower'd by Thunder; in which Case, the Liquor is impregnated with thick and muddy Dreggs, and for want of due Spirits cannot finally clarify and become limpid as before.
Hence such Urine is the worst of signs in Feavers; because it signifies such a confusion of adust matter in the Blood, that ought to be separated, and yet the Vital Spirits cannot bring it under and overcome it. The Urine is sometimes made Red, because of its Contents, which falling to the bottom, the Liquor becomes of another Colour
Now this, as 'tis said above, is two-fold, viz. sometimes thin, which is the matter or remainder of the adust Recrements from the deflagration of the Blood: Sometimes thick, viz. from the degenerate Particles of the Nutritive Juice; both these being torrify'd by the Blood's Ebullition and being separated, are partly sent out by Sweat, and partly mix'd with the Serum, whose Consistence they thicken, and enhance its Colour, to wit, as long as those Contents are held up, being enclos'd in the Pores and Passages of the Liquor, the Colour appears more deep, and the Consistence more thick; but these being fallen to the bottom, the Redness and Thickness of the Liquor are abated: The reason of both which shall be assign'd hereafter, when we assert the Causes of Clearness, Darkness, and other Colours of Urines. Now let's enquire What's the Reason of the difference, that Red Urines are wont to be made [...] Feavers, the Scurvy, Consumptions, and per [...]aps in other Affects.
1st. In Feavers the Liquor of Urines is of a [...]eep Red, through the plentiful dissolution of Salt and Sulphur, whose Particles are plentifully [...]ncocted in the Serum; for while the Blood and Humours are in Ebullition from a Febrifick Cause, [...]y reason of great Heat, highly inflam'd, the little [...]odies of Salt and Sulphur being torrefy'd and [...]dust are more dissolv'd, and by incoction in the S [...]um, tincture it more deeply; as a Lixivium, or Lie of Ashes boyl'd on the Fire, becomes far more red, than if we only proceed by way of In [...]usion.
As likewise in Feavers, the Contents of Urine often advance its Colour, that is, by reason of the Intemperature and Deflagration of the Blood; for then both the degenerate Particles of the Nutritive Juice, as also another matter (like Ashes remaining from the Calcination of Blood) are burnt, as 'twere into a red Calx, which being shut up in the Pores of the Urine, render its Colour higher; and afterwards falling to the bottom, becomes a red Sediment, like Painter's Oaker
2dly, In an inveterate Scurvy, the Urine is often so high colour'd, that 'tis not exceeded in a violent burning Feaver, which (if evaporated or distill'd) yields plenty of Salt with slimy Dreggs, wherefore it seems evident by this Experiment. that this high Colour, owes its original to Salt Principles, as was hinted before; because in Scorbutick Cases, those Salt Particles, which ought to be Volatiliz'd, and sent forth by a constant Transpiration, are fix'd and restrain'd from their usual Motion, and therefore are more plentifully heap'd up in the affected Body. This Salt (afore-said) remaining within, with Sulphur and Earth, is diversly coagulated, and then plentifully resolv'd. And from this different Coagulation and Re-dissolution, follows wonderful Symptoms of this Disease.
Likewise from these Saline Particles, plentifully dissolv'd with some Tartarous Dreggs, and diluted with the Serum, Urines become tinctur'd with adeep and high Red. Besides in this Affect, when inveterate, the course and passages [Page 32]of the Liver and Vesicula Fellis being obstructed and deprav'd, they perform their Office worse, in separating the adust Particles of Blood from the rest of the Mass, which being plentifully loaded with it, and dissolv'd in the Serum, do the more dye it with a Lie-like Tincure. And if those Particles of adust Sulphur, over-ballance those of a fix'd and Scorbutick Salt, the Jaundise is in complication with the Scurvy, and the Urine then dyes Linnen with a Saffron-colour.
But if they be exceeded by the Saline Particles, only a Scorbutick Affect is produc'd, in which the Urine is highly red; but yet will not make yellow Linnen. That 'tis thus, it is highly probable; for, in Dissecting many of those, who had frequently made red Urine and dy'd of the Scurvy, it has has been observ'd, that their Liver or the Vesicu [...] Fellis was greatly in fault: In some, the Liver hath appear'd wholly bloodless and dry'd like a Cow's Udder: In others, the Vesicula Fellis was quite empty: In some obstructed with little Stones: In others again, fill'd with Mothery Dreggs, nor at all bitter: but in all those that were so affected, a separation of the Gall was hinder'd.
3dly, by reason of Salt so dissolv'd, the Urines are sometimes Red in Gouty Diseases for besides the Arthritik Fits (in which such Urine is often made) I have observ'd, in some very painsal Affects, imitating, in a manner, a Feaver, with a deep red Urine, wandring Pains, sometimes raging in this, sometimes in that Part; so [Page 33]that the afficted Patient could scarce stand upon his Feet, or move a Member; troubled also with Watchings and frequent Sweats, and likewise with Thirst, great dryness of the Jaws, the Urine very red, with a plentiful Sediment; yet in the interim, 'twas not evident, that there was any great Ebullition in the Blood, that the Patient was under any great Languor of Spirits, or Head-ach, whereupon I suspected this Affect was especially from the genus Nervosum, chiefly depending upon the Exorbitances of a Saline, rather than a Sulphureous Principle.
4ly, Likewise the Urine is Red in a confirm'd Consumption, especially if a Hectick (as 'tis generally) be join'd with it. The reason of which is, if at any time an Ulcer has seiz'd the Lungs; from thence, a putrid Matter being mix'd with the Blood in it's Circulation, causes almost a continual Ebullition; whereby the Sulphureous and Saline Particles, being more plentifully dissolv'd and incocted in the Serum, render its Liquor Red: Besides, by reason the Blood is thus contaminated, almost all the Nutritive Juice degenerates into Putrefaction, and with those Recrements the Urine being impregnated, grows more Red, and is plentifully stuss d with its Contents. An evidence of which is, that Consumptive Persons are for the most part, hot after Meat, their whole Body being put into a Feaverish-heat, which is succeeded by Nocturnal Sweats. Moreover, there is in the Urines a thick and plentiful Sediment, viz.
The Nutritive Juice being mix'd with the [Page 34]Blood, and not rightly assimilated, causeth an Ebullition in it, and degenerating into some strange Matter, is partly driven through the Skin, partly transmitted by Urine, and partly augments its Colour and Consistence.
Hitherto have we Treated of Red Urines; and every kind of 'em now hinted at, have many Degrees of intension and remission; for as the Causes change in them, so in the Colour and Consistence they are either weaker or stronger.
As for Green or Black Urine, I confess, I never saw any that was either exactly green as Leeks, or black as Ink. But I think, from a very high yellow, with a dark or somewhat Inky mixture, the appearances of greenish or blackish Urine may arise, which Authors usually call green or black Urine.
But those Urines which are thus colour'd, do either constantly remain in the same state for some time, and are signs of the Black-Jaundise, or the Blood affected with some Virulency; or the Urines are occasionally diversly chang'd, and are sometimes of that, and sometimes presently of another Colour; so that I have known Hypocondriacal Persons wont first to make such Urines, and then a little after, like those of sound Persons.
As to the former, when the Jaundise grows very high, so that the adust portion of Sulphur and Salt have a longer continuance in the Mass of Blood, these same by long incoction, acquire a Colour more deep than yellow; viz. at first Greenish, and then afterwards somewhat Black, [Page 35]with which the Serum is in like manner tinctur'd. For if yellow Gall be taken out of the Vesicula Fellis, and put into a Bolt-head, and expos'd to the gentle heat of a warm Bath, it waxes shortly green, and afterwards by continuance will appear almost as black as Ink. Wherefore in the Black-Jaundise, which is only the Yellow, by longer continuance advanc'd into a greater degeneracy, there's nothing more usual than an Inky-Urine.
Further, such Urines sometimes appear in a malignant Feaver and the Plague, as also frequently after the drinking of Poyson, and in these Cases, are commonly a deadly Sign; because they argue the Blood much corrupted, and as 'twere mortify'd, the Spirits being vanquish'd, and the bond of mixture loos'd, just as when a part in our Bodies is Ulcerated, and afterwards perverted into a Gangrene or Mortification, presently the Piss, which before was waterish, white or yellow, becomes black. Wherefore in the aforesaid Affects, when the Urine grows black, the Serum and Blood being wholly vitiated, the outward Skin is likewise darkned with such a Colour.
Urines that are tinctur'd with a greenish, or especially a black Colour, at certain times which often happens to Hypocondriacks) very likely proceed from the Dregs of the Bilis atra, or the black Choler entreasur'd in the Spleen; and then through too plentiful congestion, overflowing at sometimes, mix with the Mass of Blood: For such Matter being often effunded into [Page 36]the Stomachs of some Men, produces greenish or inky Vomits: As likewise in others, the same Matter being suck'd up by the Blood, in its Circulation, may tincture the Urine with such like Colours.
Hitherto have we spoken of the Colours of Urines: Those that are Pale, proceed from too much Crudity; almost all those that are Highcolour'd, arise either from Salt or Sulphur too plentifully dissolv'd, and sometimes, from the adust Recrements throughly incocted in the Serum; or from the more crass Contents of the Urine, whether they be the very Calx and remainder of the Aliment degenerated in Concoction, or the Liquations and mouldrings of the Consumptive Body, or some ill-affected Part thereof; which expressions will be better understood, if we explain the manner, how such-like Dissolutions and Contents may diversly change the Colour of Urine.
The Causes of different Appearances and changeable Colours, as also of Darkness and Transparency in Urines (as in other Liquors) depend wholly on the different immission and emmission of the Rays of Light.
For, if the body of the Liquor be thin, with open Pores and Passages, that the Rays of Light may be easily transmitted, 'tis then Transparent and Clear, like Fountain-water: But if the Pores of the Liquor be stuff'd with Contents, or little Bodies swimming in it, so that the illuminating Rays be refracted and broken in the transmission, at last when they appear according [Page 37]to the different Modes of Refraction and Reflection, in the (as yet) diaphanous Liquor, the Colour will appear either Citron, Saffron, or Red.
But if the spaces of the Pores, be yet more possess'd, so that the Light be not at all transmitted, from thence Darkness will proceed: But then if the Rays once receiv'd, be but little or not at all reflected, the Liquor will appear of a dusky or blackish Colour. But if they be Reflected according to the different modes of Reflection, the appearance will be White, Ashecolour'd, or of another kind; upon this Supposition, that as the Liquor of the Urine is sometimes in a manner, almost devoid of Salt, Sulphur, and other Dissolvables, it easily transmits the Light. Sometimes being moderately, or much stuft'd with such-like Contents, it either distorts the incident Rays in their passage, or wholly imbibes them, or lastly reflects them: So that from hence, 'tis easy to unfold all the Phaenomenons of Colours and Consistence in Urines.
It happens frequently, that the Colour of the same Urine is much chang'd; for that which is made Red, being expos'd to the Air, becomes White or of a Darkish-colour, and then a little time after of a Citron colour; the reason of which appearance seems to be this:
This Urine when made is red, because the Pores of the Liquor are much possess'd with the Contents: Yet as long as those Pores are kept open by Heat, they transmit the Rays of Light in such manner (tho' diversly distorted) that they by way of Reflection, rebound again.
But this Urine, is no sooner expos'd to the cold Air, but the Pores being shut up, the position of Parts are chang'd in the Contents, and therefore the transmission of the Rays of Light is hinder'd, wherefore the Liquor becomes presently dark, and as those Rays are reflected this or that way, the Colour becomes white, dusky, or some other Colour. But at last the Contents, by their weight, falling to the bottom, the Pores being freed, easily transmit the Rays of Light, and do less distort them; wherefore the Colour appears not high, but Citron.
From what has been said concerning the Colour of Urines, it may appear what's the Causes of the different Consistence of Urines: For as the Particles of Salt, Sulphur, or adust Matter, or the Nutritive Juice depriv'd of a right Assimilation, are more or less incocted in the Serum, the Urines become more or less Thick or Thin in their Consistence.
In the next place it remains, we speak of the Preternatural Contents in Urine.
CHAP. V. Concerning the Contents in the Urines of the Sick.
WE acknowledge the Contents to be twofold, in the Urine of the Sick, viz. Either Universal, which proceed from the Mass of [Page 39]Blood and succus Nervosus, and respect the Habit of the whole Body: Or Particular, which are the Excrements and refuse of some Bowel or Part ill-affected; concerning which, by and by.
These of the former kind, which proceed from the Habit of the whole Body, are either Natural, to wit, the Filaments making up the Nubecula or Urine-cloud, as in sound Persons: Or Preternatural, which especially are the Particles of the Nutritive Juice degenerated in Assimilation, making up those more crass Bodies of the Sediments in Urines.
And lastly (in a Feaver) some adust Matter from the Inflammation of the Blood, diluted with the Serum, is added, which augments the blackness of the Contents.
But these, as well Natural as Preternatural Contents of Urines, are very different, as the Blood is more or less disorderly or unduly fermented.
And likewise, as the Aliment in the Bowels and Vessels is diversly concocted; and either the superfluities or refuse of the Chyle, which is made thence, are wash'd off with the Serum: And if the Nutritive Juice sent to the Blood, be not wholly perverted, but a great part chang'd into Nourishment, for the augmentation of the solid parts; then likewise a part of this being mix'd with the Serum, leaves some foot-steps of an Urine-cloud. And if that Preternatural Sediment, which is made up of a degenerate or adust Matter, be yet but little and thin, it doth not, as yet, wholly obliterate the appearance of this, which is Natural.
Hence, in the beginning and declension of Feavers, and sometimes in a Consumption, or in a Cachexia or an ill Habit of Body, the Nubecula, or Urine-cloud is seen, tho' not so perfect. But if the greater part of the Chyle, boiling with the Blood, through its immoderate heat, be perverted into an heterogeneal Matter, which afterwards, as hurtful and unprofitable, is sent out with the Serum, the Urine-cloud forthwith becomes obscure and imperfect: Also besides that, there are many Contents in the Urines which enhance their Colour and Consistence.
Such Urine which has in it a Urine-cloud, tho' imperfect, if it be kept in a hot place, the Nubecula only is visible, and the rest of the Contents, being kept in the Pores of the Urine, while enlarg'd by Heat, become utterly invisible; notwithstanding the same Contents (the little spaces of the Pores being straitned by Cold) are precipitated, and thereupon changing their place and situation, rendet the Urine dark and troubled, obliterating the appearance of the Urinecloud. Such Urines are commonly made in the better state of Feavers, a Catarrh, Cough, want of Transpiration, a Caccchymia (or the abundance of Ill-humours in the Blood) and in most of the higher sort of Dyscrafies, i. e, evil Complexion or Temperature.
But if the Sickness be so far advanc'd, that the Concoction and Nutritive Juice be wholly chang'd into Putrefaction, such like, are plainly visible in the Urine, and that without the appearance of an Urine cloud, and do signify a great [Page 41]diversity in Diseases, as they are precipitated divers ways, and make a Sediment of divers kinds, as there is a sudden, slow, or no Separation at all of Parts, and as the Matter falling is Little or Much; White, Red, or Dusky: I shall briefly run through all the material or chief Observations concerning this Matter.
First, Urine Impregnated with such Contents, sometimes is not precipitated at all, (unless it be after a long time, the body of the Liquor dissolving by Putrefaction) but remains a long time troubled and somewhat dark, the little Bodies floating all over it. The reason of this is, either because these Contents are too deeply incocted in the Serum, so that the Innate Spirits cannot seperate the Pure from the Impure, the Thick from the Thin; as is seen in the Brewing of Beer, in which if too much of the Mealy-part of the Malt be commixt, the Liquor will scarce ever after become Clear: Or likewise the Urine remains troubled, because 'tis utterly destitute of Spirits which might ferment the parts of the Liquor; as 'tis wont to happen in Beer that grows sour by reason of Thunder, or immoderate Heat, and being loaded with muddy Dreggs, is seldom or ever, rightly depurated again. Such like Urine in Feavers, is for the most part, very dangerous: Sometimes also it denotes an irrecoverable Cachexia, and always intimates a very ill Sign.
2dly, It sometimes happens that the Urine is so impregnated with Contents, that they begin to precipitate while it's yet hot. I have often [Page 42]observ'd it thus in a lingring Feaver, where the Heat is more mild and remiss, in which, the Particles of the Thick Nourishment are deprav'd, and being less conquer'd by that Heat, or less incocted in the Serum, do more easily fall from its Pores; like as when common Sulphur is boyl'd in a Lixivium, if it be remov'd from the Fire before a perfect dissolution, the Liquor that is at first clear and red, because of the sudden precapitation of the dissolv'd Contents, forthwith becomes turbid, obscure, and of a whitish colour.
3dly, What usually happens: The Urine being much impregnated with such like Contents, as long as 'tis hot, and sometime after, appears clear and transparent; but when it grows cold by degrees, it waxeth turbid, and (as if some infus'd Coagulum, or curdling Matter had mix'd with all its parts) is precipitated, which notwithstanding, if it be kept at the Fire, or in a hot place, grows clear again. The reason of which, is sufficiently Explain'd before, where we spoke of the Causes of Darkness and Transparency.
4thly, After the Urine expos'd to cold is precipitated in manner aforesaid, it may be observ'd how its Contents fall to the bottom. For sometimes they fall in a short time, and if in the space of two or three Hours the Liquor grows clear, 'tis a Sign the Urine is not stuff'd, nor much impregnated with Salt and Sulphur; hence in the beginning and declension of Feavers, when the Heat is remiss, such Urine is often made. Sometimes, [Page 43]except in the space of many Days, such a subsidence of Contents will not ensue; because the consistence of the Urine is thicker than it ought to be; therefore it cannot let go its Contents out of its embraces so easily, that by their gravity they may find the bottom.
Such Urines are generally made in the state of Feavers, and are the fore-runners of an ill Crisis.
5thly, The Sediments which fall to the bottom, are not less differing; in this place, passing by Corruption and Blood, Sand and Gravel, and certain other deposited parts.
For those that are the products of the whole Body, are for the most part white, dusky or like red Oker.
If the Urine, after it has stood long, be filter'd through Cap-paper, such Contents are retain'd, and may be plainly examin'd. I have often seen white Sediments like Chalk; sometimes red, like Armenian Bole, and without doubt, the matter of all is the same; viz. the Recrements of the Blood after its Inflamation, and the Nutritive Juice deprav'd in Assimilation, which as they are concocted in our Bodies by Heat and diversly perverted, they appear likewise in Urine, under a different Colour and Form. As Antimony mix'd with Nitre, and more or less Calcin'd, produceth a Calx sometimes red, sometimes Saffron-colour'd, sometimes yellow and sometimes dusky.
The like Reason, as it seems, may be render'd concerning the Sediments of Urines, which are, [Page 44]as 'twere the Calx of a Sulphureous and Terrestrial Matter over-burnt by the heat of a Feaver in the Bowels and Vessels.
6thly, Besides such usual Contents in the Ʋ rine of the Sick, I have often observ'd, that after the Ʋrine had stood sometime in a Chamberpot, some Sand-like Matter cleav'd to the sides thereof, and that under a different figure; For sometimes these little Bodies are like Sands with a rough and unequal Surface.
Sometimes they grow together with ridge and furrow like the Chrystals of Nitre, and are splendent and glistring like Ice; sometimes I have seen such-like Chrystals stick to the sides of the Pot, from those who had labour'd under a Dysenteria or Bloody-flux. Sometimes in Urines, when they have stood a while, there appears a Scumm swimming at top, just like Tartar, when boyl'd in Water. That whitish Crust, coagulated in the surface of the Urine, is commonly believ'd to be both Fat and Oily, and is accounted a Liquation or melting away of the solid Parts; those therefore, who make this Urine, are presently pronounc'd Consumptive and very deplorable.
But this Concretion is only Saline, and being expos'd to the Fire, is not at all dissolvable, but is condens'd into a crusty Substance. Moreover, both these and the rest of the Incrustations of Urines, are a kind of Tartar, produc'd in them by a certain coagulation. Such a Concretion wholly depends on the Particles of a fluid and acid Salt, combin'd with those of a fixt or Alkaliz'd Salt.
For, in any Subject, where this commixture of Salts of both kinds doth happen, whether produc'd Naturally, or by Artificial Operation, there ensue diverse kinds of Coagulations and Chrystallizations.
Wherefore such kind of Urine, on which there swims a Tartar-like Scum, or in which, Crystals cleave to the side of the Pot or Urinal, shew that the Blood is degenerated from its Sweet Balsamick Nature (such as is the result of Salt Volatiliz'd) into an Acid and Corrosive Temper, and the fludity and fixation of a Saline Principle: Such Urine, if evaporated, leaves great store of Salt in the bottom of the Vessel. The Affects of which, as 'tis often observable (as I have experienc'd) are spitting of Blood, an Atrophy and an Hypocondriacal Disposition. 'Tis worthy Observation, Whether the Ʋrines of Sick Persons, give a Tincture to the Chamber-pot, or not; for sometimes in Feavers, the Ʋrine is no sooner put into a Glass, but presently it darkens its sides with a whitish-cloud, yet, at another time, 'twill not happen so. I think, the reason of that sully'd dye on the Glass, is, because the Urine is more impregnated with a dissolv'd Sulphur, than its Pores can contain in them. For every Liquor, that is too much impregnated with Sulphur doth the same. As 'tis seen in a Lixivium, in which common Sulphur or Antimony hath been boil'd.
Likewise every Urine, if it stands in a Glass till it putrefies, it tinctures its sides with a Cloudyness, or some crusty Matter, sometimes whitish [Page 46]or red, or sometimes of another Colour. For the Fabrick of the Urine being loos'd by Putrifaction, the Particles being freed from the bond of mixture, are fasten'd and adhere to the Glass.
Now further, in the Urines of Sick Persons, this happens forthwith, because the Sul phar is more plentifully dissolv'd in the Serum, than can be contain'd in the Pores.
Now as for the particular Contents of Urine, those indeed are manifold, and may proceed from divers Places and Parts: Yet very frequently, from Diseases seated about the Kidneys, Bladder, and Urinary Passages; sometimes happening from an Ulcer in the Liver, Spleen, Lungs or other Bowels; or because some Preternatural Humours are heap'd up in those Places and over-flow, through their Superabundancy; hence some extraneous or foreign Matter is transmitted into the Mass of Blood and thence into the Serum; yet this happens but seldom: For when [...]n Impostume is broke within, for the most part, it sends its Matter into the Cavity of the Bowels, from which there are no passages to the Urinary Conduits.
Besides, the Mass of Blood being impregnated with Impurities, Nature doth not presently endeavour to send them out by Urine, but often by Swe [...]t, Expectoration, throwing out of Pimples, Wheals or Tumours, and by other ways of Excretion. 'Tis hence commonly observ'd, that other Contents of Urines (besides what we have spoken of above) are especially sent from [Page 47]the Kidneys, or their Appendages. The chief of which are Sand, Stones, Blood, purulent matter, little pieces of Flesh, small Skins, or mealy Sediments; which for the most part signifie either some great Ulcer, or the Stone, or both together seated beyond the Emulgent Vessels.
'Tis usual with some, to piss little Grains of Sand of a red Colour, in great quantity: Some of those are troubled with the Stone in the Kidnies, and often have those Nephritick Fits: Yet I have known others void Gravel a long time without Pain, or any other grievous Symptom.
All Urines, if they stand long in an earthen glaz'd Vessel, sometimes leave such a Gravel sticking to the sides or bottom, viz. the Volatile-salt of Urine, is coagulated with the six'd-salt of the Metal. So when Sal Armoniacum, mix'd with the silings of Steel, Vitrioline or Sea-salt, is sublim'd, the elevated Flowers grow eminently red.
Wherefore 'tis probable, that such-like Red grains of Sand, are produc'd in the Kidneys; because, the Volatile Salt of Urine, is coagulated with the dregs of some Tartarous matter, left about the Meanders or windings of the Reins, and thereupon is that Sandy matter made, which forthwith, is washt away by the Serum, in its passage; therefore those grains of Sand, which are so often made, are not the piece-meal mouldrings of some greater Stones, (as 'tis Vulgarly believ'd) but the extemporary products of the Blood and Serum, while they pass the Chanels of the Kidneys.
How Stones are produc'd in the Bladder and Reins, is not the enquiry of this place, fully to discuss; yet beyond all peradventure, rather by Coagulation, than Exsiccation or Calefaction.
I have observ'd some Men afflicted with the Stone in the Bladder, who after they had made Water, were wont with much Labour and Grief to [...]void a more than ordinary Viscorus Juice, which was presently condens'd into a Scaly matter; the smell of it was like that of a Lixivium, and it was of the same consistence too, as that evaporated to a Thickness; which Liquor, when it becomes more crass, and is expos'd to the cold, forthwith doth concrete into a Saline Crustiness.
Lesser stones pass the Urinary passages, and are ejected with little or no difficulty; but 'tis better, that those, that are great, rest quietly in their Dens.
The places in which they are usually produc'd, are the crooked Passages and Winding Meanders of the Reins, from whence those that are less, fall into the Bladder, and if they be not ejected from thence, grow very great.
I once saw many, somewhat large Stones, about the sides of the Bladder, betwixt its membranes, shut closely up. These without doubt, while less, were sent from the Reins and detain'd in the passages of the Ureters that creep between the Tunicks of the Bladder, and there by degrees were augmented in bulk. The poor Gentlewoman who was thus troubled, long before her Death, avoided a Membrane thick and [Page 49]large, fill'd with a Sandy Matter, which (as it after appear'd, by Dissection of her Body) was a part of the inner Tunick of her Bladder, fretted and broken asunder by the Stones, that had been shut up there.
'Tis ordinary with those who have the Stone, to emit both Blood and purulent Matter frequently with their Ʋrine; for the fleshy part of the Kidneys, being fretted asunder with a Stone that is greater than ordinary, and being very rough and unequal, the Mouths of the Veins and capillary Vessels are unlock'd, from which, the Blood issuing, tinctures the Ʋrine.
By this means, a Solution of Continuity in the Reins is begun, and an Ʋlcer very frequently follows, whereby Corruption and Matter are mixt with the Serum, and make a plentiful and stinking Sediment in the Ʋrine; after that, a continued Pus proceeds from the Ʋlcer, and large effusions of Blood, very often follow, and the very Flesh of the Kidneys being corroded and eaten away by degrees, is cast out by Urine. I remember formerly, an ancient good Woman, who, for a long time. voided Blood in her Ʋrine, every Day, in great quantity: Moreover she usually emitted, great plenty of pieces of Flesh, as 'twere little Gobbets, and the fistulous ends of corroded Vessels, when she mad [...] Water; so that 'twas suspected, one of her Kidneys was quite destroy'd, by this means. Yet afterwards, by a Decoction of Vulnerary Herbs, made acid with Spirit of Vitriol, this emission of Blood by Urine was stopp'd, and the Woman [Page 50]grew sound and liv'd many Years after.
I have heard of another Gentlewoman, who at first was wont to void both Blood and corrupted Matter, with some little Membranes, for a long time; but after, that Sanguinary Pissing ceasing, she made for many Years, a Waterish Urine, with a plentiful Sediment, White and like purulent Matter, falling to the bottom of the Chamber-pot. Afterwards when that Sediment was wanting, a Feaverish Distemper, with wandering Pains here and there, a Deliquium and Languor of Strength, and other Ill-natur'd Symptomes ensu'd; but when this Patient, was brought into great danger of death, a Tumour rising in her side, about the seat of the left Kidney, being brought to suppuration, a copious eruption of Matter, freed her. Yet the hollow and sinuous Ʋlcer in that place, sweating out a thin Matter, remain'd as long as she Liv'd; which sometimes being heal'd, suddenly broke forth again; after that, in the space of less than two Years, this Illustrious Lady, having labour'd under an Ischuria or a suppression of Ʋrine, for the space of fourteen days, died Apoplectick: her Body being open'd, the left Kidney was utterly gone, and in its place grew a Membranous Substance, cleaving to the Loyns, enfolding the extremities of the Ureters and other Vessels; yet tho' some Foot-steps of the Ureter did remain, 'twas without any Orifice into the cavity of its Passage.
Moreover, an Ichor or serous Matter sweating out of the Orifices of the Emulgent Arteries, [Page 51]was carried into the outward and sinuous Ʋlcer.
The other Kidney was very much obstructed with a gravelly Matter and little Stones. Besides also, about the top of the Ureter, a Stone was fastned, about the bigness of a large Filbert-Nut, and its extremity was adapted for the Passage or Cavity of the Ureter, and so firmly, as 'twere, ramm'd into it, that it exactly shut up its Orifice (as in the Nature of a Stopple) and hinder'd all the passages of the Urine.
A corrupted Matter, not only from the Reins, but also from the Bladder and Urinary Passages, in those who are Ulcerated, is deposited in the Ʋrine: As also sometimes, from the genital Vessels, Glandulae prostatae, and from certain little neighbouring Tubes, corrupted Seed, or some other purulent Matter, is voided with the Ʋrine.
Sometimes also, the Albae Mulrieum fluxiones, and Menstruous Blood mixing with the Urine, produce preternatural Sediments in it, which ought therefore to be diligently examin'd, and accurately distinguished, from the Purulent and Sanguinary Urines afore-mention'd.
In the Urines of sick Persons, white and plentiful Contents, made up of very little bodies, which after Settlement, filling the Liquor, above half way, making it white and darkish, while the rest, in the upper region of the Chamber-pot, is thin and clear; such is called a mealy Sediment; because indeed it resembles Water mixt with Meal; and of this, 'tis doubted, whether [Page 52]it proceeds from the whole Mass of Blood, or from the Urinary Vessels.
'Tis observable, that in the Stone of the Bladder, such Urines are for the most part made, and sometimes also, because a greater Stone possesseth the Reins; for without some Affect in the Kidneys, such a Sediment in the Urine, is never seen; wherefore this, is always accounted an undeniable sign of the Stone; and it seems to depend wholly upon some sort of Juice or curdling Humour heapt about the external parts of the Stone: For where a Stone is fix'd in the Reins or Bladder, there the nutritious Humour is perverted from Assimilation, and degenerates into a more crass filthy Substance (like the Ichor in an Issue, that, by reason of the Pea lodg'd therein, being changed into thick Matter, is more plentifully excerned) and that filthy thick Substance being carried off with the Scrum, makes up this Sediment of the Ʋrine.
CHAP. VI. Of passing Judgment on the Urines of the Sick.
HItherto concerning the Anatomy of Urines, in which their Elementary and Constitutive Principles, together with their chief Accidents: to wit, Colour, Consistence and Contents, as well those that might be in them Naturally and Essentially, as those that are wont Preternaturally to happen to them, by reason of [Page 53]the Body being ill-affected. Hence 'tis not very difficult for any to bring this Hypothesis to Practice, and to pass Judgment upon Ʋrines, by a right Examination of the Urinal; for by what has been said, 'tis manifest, of what Parts the Diseases are discoverable by Inspection of Ʋrine, and what the Ʋrine signifies in every Particular of them. Concerning this Subject, some Authors have sufficiently Treated; wherefore I shall pass over this Matter more briefly.
Although the principal Matter of the Urine, viz. the Serum, doth pass by every Region of the Body, and Circulates together with the Blood through every part, yet it discovers not the State and Diseases of them all, but of those only to which it owes its natural Perfection and Original, or from which it receives some Alteration; wherefore in some sort it discovers the Action and Temper of those Bowels which serve for Concoction: And besides, it hints at the Motion and Temper of the Blood and Humours in the Vessels. But that any should pretend to guess, and pronounce a Pain in the Head, an Ulcer in the Throat, or any other Affect, of another Part (from whence nothing is communicated to the Serum) by the Urinal only, he will rather suggest to us, a Symptom of his Ignorance, than one of the Disease.
The Urines that are brought from sick Persons, sometimes perfectly resemble those of the Sound, and then they give no light to the Disease, or Part affected. But upon inspection, something Negatively may be said, That the Patient [Page 54]is free from a Feaver, and that as to his Stomach and Concoction of Nourishment, they are not very bad: Wherefore except he be inclinable to a Consumption, or labour under an Ʋlcer, or some other Disease of Solution of Continuity: the Affect whatever it be, is not very dangerous or difficult to Cure. But yet, I would not have him say any thing rashly, nor proceed so far, from whence he can have no commendable Retreat: For it has sometimes happen'd in the most grievous Affects, to wit, in a Malignant Feaver, when the Patient lay very dangerously Sick, his strength greatly dejected, the Pulse weak and unequal, an Eruption of Spots, and other very ill Symptoms accruing, that notwithstanding all these Accidents, the Urine has been laudable, like that of Sound Persons, as to the Colour, Consistence and Hypostasis; so that in such a Case the Physician having only a sight of the Urine, will err grosly, as to the Prognostick: Wherefore except other Symptoms coindicate, Credit is scarcely to be given to the single Testimony of the Urine. That sometimes it thus happens in the Plague and Malignant Feavers, proceeds from this Reason, because the Blood is corrupted in those Diseases, many times without any great Ebullition, and as 'twere silently; so that although its Serum be affected with a certain kind of Coagulation, yet because at the same time, the Blood doth not produce any heap of adust Matter, by its intense Inflammation, but is little, or not at all altered from its wonted Crasis or Tenor; hence (I say) the [Page 55] Urine that sometimes cannot carry with it any such adust Recrements, in the most dangerous Affects, becomes a perfect Cheat. Besides, many times in such an Inflammation, when the Ebullition of the Blood is very great, whatever Excrementitious Matter is heap'd together in its Mass, it's presently carry'd to the Brain, and genus Nervosum; wherefore the Serum is usually freed from Preternatural Contents: Therefore except in these Cases, when the Urines are high-colour'd, Turbid, and without any Sediment, there's no reason why the Water-Prophet should much stick in making his Prognostick
As often as the Ʋrines of Sick Persons, are not like those of Sound Men, either something Natural is Deficient, or something Preternatural is Superfluous, or both together may happen. First, Colour, Consistence, Contents, and Quantity may be defective; if the Colour be more remiss, than what it ought to be; if very Pale, it discovers Crudity and want of Spiritualization, viz. because the Nutritive Juice is neither so rightly concocted or exalted in the Bowels and Vessels, that the Salt and Sulphureous Particles in Sublimation together, may follow the distribution of the Serum (as 'twere in Distillation) so far as wholly to cleave to it, and tincture it. Wherefore upon the sight of such an Ʋrine, thou may'st (and that without folly) guess at the following Symptoms; to wit, that there is an Oppression and Heaviness in the Stomach, want of Appetite, hardness of Digestion, Drowsiness, a difficulty of Breathing, frequent Palpitation of [Page 56]the Heart, (in any Exercise more than ordinary) a pale Countenance, swelling of the Feet and Belly, and that there is danger of falling into (if he is not already in) a Cachexia, or else a Dropsie; and if the Person is one of the Fair Sex, that she is, or will be affected with a depravity of Appetite or the Green-sickness. But if in a Feaver, the Colour of Urines be abated without a Crisis, 'tis a sign that the fermentative Matter, or the adust Recrements of the Blood are excluded from its reception, and fix'd somewhere else, which happens for the most part in the Brain; and then such Urines commonly Prognosticate a Delirium; or sometimes, a Pleurisie: In Nephritick Persons, a sudden alteration of the Urine into a pale-colour, and waterish, fore-tells an approaching Fit of the Stone.
A pale and plentiful Urine, often declares a too great dissolution of Salts, by which Serosities are sent from the whole Body, and especially from the Nervous Parts, as 'twere in a certain Inundation. Such an Excretion is sometimes wholesome, as 'twere Critical, when the Superfluities happen only to be sent forth; Sometimes Symptomatical, and brings a great Weakness, because then, the Nutritious Juice and other profitable Humours, are sent out together with it.
If the Consistence be thin, and the Liquor pale, it argues Crudity and want of Spiritualization; or a Disposition to a Nephritick Paroxsym, (as afore-mention'd) or else, it proceeds from too large a potation of Drink. But if the Colour be flaming, 'tis a sign of an Intermitting, Tertian.
If there be no Contents and the Urine pale, 'tis a sign of Inconcoction and a Cachectick Affect of the Body; but if the Colour be Citron, and the Urine of an indifferent Consistence without any Nubecula, or Urine-cloud, you may suspect the sick Person to have accustom'd himself to too much Excercise and hard-labour; or is frequently troubled with Nocturnal Sweats; or paradventure is in a Consumption or inclinable to it. But if the Urine be daily made in a less quantity than is meet, unless there be a more than ordinary plentiful Sweating, 'tis a sign the Blood is not sufficiently discharg'd of lis Serum, and therefore of necessity it becomes more pale and waterish, and at last a Cachectick Disposition, or else an Anasarca, or Dropsy of the whole Body follows. But if it be stop'd suddenly and voided with pain and difficulty, 'tis a sign of some Affect belonging to the Kidneys or Bladder.
2dly, Something Superfluous is sometimes added to the Urine; viz. The Colour is sometimes augmented, when, in the mean time, the Consistence, and Contents are in their due order, and then there's a suspicion of a disposition to a Feaver, or an Hectick begun: Perhaps some evident Cause fore-runneth, as great Heat from Bathing, Drunkenness, or immoderate Exercise, which might over-heat the Blood; or some great Cold was unwarily taken, whereupon ensu'd a closure of the Pores, and consequently want of Transpiration. If the Urine be Saffron-colour'd, and give that dye to Linnen cloth, the Disease is undoubtedly the Jaundise. But if it be of an [Page 58]intense Red without a Feaver, for the most part it argues a Scorbutick or Hypocondriack Affect. Although the Colour and Hypostasis be both as they ought, yet Preternatural Contents are often lodg'd in the Urine; therefore, when it grows cold, 'tis turbid, and leaves a Sediment, sometimes White, and then there's a suspicion that the Blood is fill'd with many Impurities; as likewise the Stomach is loaded with an Excrementitious Matter, or troubled with Worms. Sometimes the Sediment is Red, which commonly happers by reason that Transpiration is hinder'd and o [...]structed; to which a Feaver, if not a Consumption, may owe its original. Although the Urine be in a Natural State, yet sometimes more than ordinary thick Contents are in it, which argues, that some Parts about the Urinary Passages, are either Ulcerated, or suffer some other way; whence purulent Matter, Fluxus albus, contaminated Seed, or such like, are mix'd in the Urine. You may therefore easily discover by asking the Patient, How he is in this or that Place, which is the Place affected; and so you may be ascertain'd of the Nature of the Affect, by recollecting what Disease the Sediment of such Urines will shew.
When Urine has stood for some time, and a white and plentiful Sediment appears in it, 'tis not easy at the first sight to discover whence it proceeds, whether from the whole Mass of Blood, or from some particular Bowel appropriated to the Preparation of the Serum or Sperma. For, the Impurities of the Blood succus Nervosus, [Page 59]falling to the bottom of the Chamber-pot in a mealy appearance, are often wont to make the Physician suspect a Fluor albus or a Gonorrhaea. Likewise the Contents of the Ʋrine, which proceed from the Urinary Parts, are to slight in a manner the same with those which are emitted from the Spermatick Vessels; among these Doubts, least the Water-Prophet from a rash Confidence, not only tell Uncertainties for Realities, but Falsities for undeniable Truths, thus may he search the difference of such like Ʋrines: If the Contents be universal, and their intimations applicable to the whole Mass of Blood, for the most part, presently after making of water (except sometimes by chance, in a Critical evacuation of Urine) these (because they are of a more thin substance) are utterly invisible: afterwards, when the Urine proves cold and begins to separate, the Contents descend slowly to the bottom, and after they have settled in the Chamber-pot, being heated again, their appearance totally re-vanish. But if those White Sediments owe their Originals to some particular Spring, they Thicken and make the Ʋrine very Turbid tho' newly made; and are presently precipitated to the bottom, and do not at all disappear by Heat, if warm'd again. Now to find out, to what particular Vessel such Contents are to be ascrib'd, tis easy to discover by other Circumstances.
3dly, The Ʋrine is sometimes wholly alter'd from its natural State; the Colour and Contents which ought to be in it, are deficient, and other [Page 60]Accidents are deposited in their room; and then 'tis a sign the whole Body is distemper'd, and the Concoction is deprav'd in the Bowels and Vessels. Then may you say, the sick Person is in a Feaver; and also by asking Questions, you may learn, and forthwith pronounce, That he is troubled with Thirst, great Heat, want of Appetite, Watchings, and other Symptoms deducible from hence by consequence.
It sometimes happens, that the Ʋrine falls short of its natural State, yet doth not at all indicate the Affect of which the Patient complains, and it either shews the Causes of the Disease, or the consent of another Part with the affected Part. As if any one should complain of a violent Headach, or Trembling of the Heart, and should make a waterish Ʋrine, this doth not denote the very Affects, but only the Crudity of the Stomach, as also an Obstruction of the Spleen and neighbouring Bowels, which may be the Cause of those Affects. I say in this Case, the primary Indications in the Method of Cure, are to be taken from the Ʋrine; viz. We must use neither Cephalick not Cardiack Remedies, but either Emetick, Cathartick, or De-oppilative Medicines, and especially Chalybeats. Sometimes the Ʋrine is vitiated, yet its Indication utterly disagreeth with the Affects of which the sick Person complains. For Example, If any in a Coma, or a Lethargy, make Red Ʋrine fill'd with Preternatural Contents, its Inspection excellently suggests Coindications; to wit, that we use not Remedies too hot; but temperate. The principal [Page 61]use of Water-Judgment, is, in observing the State and Progress of every Disease, as also the Critical Alterations towards Health or Death. For in Chronical Affects, where the Physician sees the Ʋrine every Day, he may know, from hence, by what degrees the Disease or Sickness is every Day augmented; what time Purgatives or Alteratives will be most fit, and what other Medicaments will be most suitable: Hence may he observe, Whether Nature prevails over the Disease; or no; and hence may the most certain Prognosticks be made, of the hope or danger of Recovery; viz. how the Signs of Concoction or Crudity appear in Ʋrines: Hence in Acute Diseases may the state and height of a Feaver be best fore-seen; at what time the Crisis, and with what Success it may be hop'd for; when seasonable to Evacuate, and when to give Restoratives and Cordials.
Physicians ought to observe, with as much assurance, and diligence, the Phaenomenons of Urines, for the fit Season and most proper Method of administring Physick, as Mariners their Sea-compass, to steer their Course by. Let this which is already deliver'd, concerning Urine-judgment suffice, which is not a Collection from the empty Traditions of Mountebancks, but consonant to right Reason and Truth. I know besides, that Quacks and other bold Pretenders, almost every where scatter innumerable Rules and false Preceps of Water-prophesy, insomuch that if they look but on the Urinal, they pretend, as if they could divine whether it be a Man or Woman [Page 62]that is sick; how long the Patient has been ill; what Disease, he is sick of; whether the Disease, will end in Life or Death; whether the Party, be Amorous or Sad; whether a Woman, be with Child or no; and if with Child, fore-tell whether Boy or Girle, and many other ridiculous Stories. In which, by using these empty Conjectures, and by their Confidence, they impose on Credulous Minds; or, what's more frequent with them, make private and subtle Inquiry other ways, into the State of the matter; and then falsly ascribe that Knowledge to the Inspection of Urine.
CHAP. VII. Concerning the examination of Urines and the different manner of Trial.
THO' commonly the Trial and Inspection of Urine be but simple; viz. most Quacks and Mountebanks, immediately after they have put the Water into a Glass, shake it and then forthwith pass their Judgment: Yet the matter seems a little more intricate, to those who hartily design the Well-fare and Health of the Sick. And concerning this Water-Inspection, there are some observable Circumstances, which if omitted, nothing certain, or that may be indeed a Directory in Practice, can be learnt from the Urinal. Moreover in some Affects, besides Inspection [Page 63]of the Glass, there are other Methods of Trial, by which what is hidden and in the dark in relation to Urines, is made manifest; whence some, who endeavour'd a more accurate Water-judgement, have successfully brought in fashion, the Evaporation and artificial Precipitation of Urines.
Wherefore we will briefly speak of the right manner of Urine-inspection, and in some Cases, bow they may differently be resolv'd into their first Principles.
When the Urine of the Sick Person is offer'd to the Physician, if it has stood sometime before in the Glass, and if the Liquor be Transparent, the Nubecula form'd, and if the rest of the Contents fall to the bottom, there's nothing further wanting, but that forthwith the Prognostick be pronounced. But if the Water be newly pour'd out into the Ʋrinal, or be before troubled by shaking together, you must stay till the confus'd parts be again separated, and recover their due places of Settlement. But if the Liquor being fill'd with Contents, its Pores being shut up with cold, become Turbid and Muddy, let the Glass be kept in a hot place till the Urine clear again, and afterwards let it be plac'd for some time near the Fire, so long till the preternatural Contents, to wit, either the Thinner be re-imbib'd by the Pores, when enlarged by Heat, or the more Thick fall to the bottom: And if the Filaments which make the Urine-cloud (if there be any) be collected together in the Middle Region or a little beneath, then from hence 'twill appear, [Page 64]what's the Nature of, and what kind of predominancy the Disease has; and likewise in Feavers, the degree of Heat and Effervency, the Concoction of the nutritive Juice, or its Depravation, as also the heaping up of Adust Matter in the Blood, and its Separation begun or wholly frustrated, will also be somewhat more manifest by intimation from the Urine: Wherefore after this manner, must you proceed, when Urine is brought from far, whole Particles being greatly troubled by such shaking, except they be kept sometime in a hot Place, will not easily recover their right Position. But if you Visit the Patient often at his own House, 'twill be convenient that the Ʋrine newly made be put into an Urinal and plac'd near some Heat, and while it leisurely grows hot, every Part without any Perturbation will be dispos'd of, after the best manner of Settlement.
After that Urine is thus nakedly, and as 'twere without its Vail presented to the sight, the next Caution is, least that some of its Phaenomenons only accidentally contracted, and not properly belonging to it, impose upon the Physician, which is wont to happen sometimes through divers Alterations, proceeding from the Food that's eaten, of which this especially consists; and then the Colour and Scent are variously changed beyond Nature and the Physician's expectation. For indeed, there's an Error sufficiently common, when the Urine, by Ruburb, Saffron or the Seed of L [...]vender-Cotton and other things of the like Tincture▪ ingested by the Mouth, growing yellow, [Page 65]and giving that dye to Linnen, is thence believ'd to be an undoubted sign of the Jaundice, Sometimes we likewise suppose, tho' falsely, that the Ʋrine shews a Feaverish Distemper when highly tinctur'd wirh a deep Red, by the broth of Pease, or a decoction of Madder, or other Liquids of the like nature.
It often happens, that the high Colour of Ʋ rine, by a thin small Liquor copiously drank, is abated; and by a stronger Drink and more hot Nourishment, is rais'd; which accidental Causes, except a Physician know, he is necessitated to pass a false Judgment upon the bare sight of Ʋrine.
When therefore, without any manifest Cause the Colour of Ʋrines is chang'd, the manner of Diet must be inquired into, so that when the Alteration proceeds from what's ingested, it may not rashly be ascrib'd to the Disease. A Question may be rais'd here, Why since most things taken in at the Mouth, before they be transmuted into Urine, wholly lose their innate Colours; there are yet some others, which being eaten, bequeath such a lasting Tincture to the Serum, that they run through the Windings of all the passages without any alteration?
The reason of which, is solely this: Some mixt Bodies have Particles of immutability of Colour, which make up their composition so subtile and exceeding volatile that these Bodies ingested, tho' in a 1ittle quantity, colour the whole mass of Chyle, and then the Nutritive Juice, that's convey'd to the Blood, ascends colour'd, and its vehicle, to wit, [Page 66]the serous Part, is sent out always Tinctur'd.
'Tis obvious to every one, who sometimes smells his own, to know what Scent, sound Urines have: viz. because when newly made, the Sulphureous, and Saline Particles are closely bound together in the Liquor, and then 'tis not very ingrate. But when it has stood sometime, so that from the solution of the mixture, the Sulphur edg'd with Salt begins to exhale, it has a very noisom stinking Scent. Besides we may observe, that Ʋrines new made sometimes smell sweet like Violets; and sometimes smell very strong and stinkingly.
The first, depends neither upon a sound nor unsound State of the Body; but is only produc'd by those things that are ingested. Turpentine, Nutmegs and some other Aromaticks, tho' of a different Nature or Operation, taken inwardly give a sweet scent equally alike to the Ʋrine; whereof this seems to be the reason: In such like Bodies, very many Particles of a purer Sulphur (that is, more Spirituous) have the Predominancy in the mixture, and tho' blended with the Serum, cannot be contain'd in it, but forthwith when the Urine is made, break their bond of mixture, and those alone, not accompany'd with other stinking Particles of the Ʋrine, sally forth, and thereupon diffuse a Scent sufficiently grateful, which tho' it be the result of different Ingestibles yet always smells Violet-like; because all those Sulphureous Particles are freed in Digestion from other adjuncts of the same concrete Body, neither are they infected with others from the Urine.
As for a very ingrate stinking Urine, that, sometimes proceeds from an Ʋlcer about the Kidneys, Bladder, or Urinary Passages: Sometimes it likewise proceeds from a more than ordinary hot Distemperature of the Reins, or the whole Body; for when Sulphur is too deeply incocted in the Serum, its Particles being edg'd with those of Salt (because less closely combin'd) do forthwith exhale, and very offensively smite the Organs of Smelling. Besides, Urine sometimes has its graveolent or stinking Scent, from what's eaten; for Garlicky Sparrowgrass, the Balsom of Sulphur, Syder, Rhenish-Wine and many other Ingestibles cause a stinking Urine. If the reason of these be requir'd, I answer, Those things that cause a stinking Scent in Urine, likewise provoke it in a more plentiful manner; wherefore it appears and is hence demonstrable, that the Assumption or taking of such things, precipitates the Blood, and abundantly hastens the emission of the Serum, and when that, after this manner, is abruptly dis-united from the Mass of Blood, the compage of the Liquor is render'd loose, neither are the parts exactly mix'd, wherefore the compage of the Urine before 'tis sent out of the Body, being thus loos'd and dissolv'd, as soon as it is made, the more crass and Sulphureous Particles (which are link'd together with Salt) do presently exhale or breath forth, and so diffuse a very ill S [...]ent: For, the Urine that is thus alter'd by what is taken inwardly, seems very like a Lixivium, in which Antimony, or common Sulphur is boyl'd, and an Acid afterwards [Page 68]instill'd; for in this Decoction, as also in such an Urine, the compage of the Liquor being destroy'd, the Sulphureous little Bodies break forth and attaque the Organs of Sensation with a noisome Savour.
But if any curious Searcher of Urines, will go beyond the Trial of Sight and Smell, he may readily by several Operations, resolve them into their several Parts, and at 'twere Anatomize them to the Life; and thence deduce Physical Directions of great Consequence.
For, in some Chronical Diseases, where the ill Contemperaments of the Blood are exactly to be search'd, that the Proportion and Temperature of the Salt and Sulphur in it, may be rightly found out, 'twill be convenient sometimes to evaporate or distil the Urine;, as also something may be learn'd by precipitating or separating them by Putrifaction. I knew an honest Woman grievously afflicted with a perfect Lepra or scaly Deformity of her Skin, who usually every Day scrap'd off a great quantity of Bran-like or Scaly Matter; her Ʋrine being evaporated, left behind it a crusty Salt Sediment, very much like that Excrement of the Skin, sticking to the sides of the Vessel. Formerly I evaporated the Ʋrine of a Gentlewoman, who was greatly afflicted with Convulsive Motions, and distension of the Muscles; the quantity of the Saline and Tartarous Matter that remain'd in the bottom, did exceed the half of all the Liquor in weight. By these means it appears, we may easily find out the proportion of a Saline Principle in the Blood and [Page 69]Humours. Now whether that Salt is volatiliz'd or fix'd above measure, the Distillation of the Urine, will manifest. For if the Spirit (so call'd) be plentifully exhaled from the Urine, and if the Salt also ascends in the Glass-Alembick, 'tis a visible sign of Volatilization; but if the contrary, it argues the fixation of the Salt. As the Evaporation and Distillation of Urine shews the power of a Saline Principle, so the Precipitation and Putrefaction discover the Sulphur and more crass Contents of Urines, as 'twere in Weight and Measure.
As to the First, tho' the Urine be a Salt Liquor, and full of Contents, yet because its Saline Particles, are not (as 'tis usual in other Menstruums) either wholly in a state of Fixation or Fluidity, but for the most part Volatile, therefore 'tis not presently precipitated by the pouring in of any thing that's Salt; the Spirit of Vitriol and other Acids do nothing; the Salt of Tartar makes a little perturbation; but the Dissolution of Allom in it (because it very much binds its spaces) presently and that very much troubles the whole Liquor, forcing all the Contents of the Liquor or Ʋrine out of their places, and renders them visible; whereupon by this means, without the tedious process of settling, you may know how much Sulphureous and terrene Matter the Mass of Blood, as its Dregs, imparts to the Serum. The putrefaction of Ʋrines is wont to exhibit every Particle of every kind, yet more distinct, and as 'twere separately rang'd. For if the Ʋrine stand in a Glass unmov'd for many [Page 70]Days, 'tis much alter'd in Colour, Scent and Consistence; for the Colour is more intense and high, the Smell ingrate and very stinking, the Consistence more thick, and very often it acquires in its surface a dark, and sometimes a blackish-blew colour; as also a thick and plentiful Sediment in the bottom of the Vessel, and often a sandy Crust on the sides, or a whitish or Ash-colour'd Tartar.
By such Phaenomenons, since Urines putrify sooner or later, and thereupon are more or less alter'd from their former State, we may guess, what is the proportion of Salt or Sulphur, and which predominates: Likewise a true Judgment may hence be made, concerning the quantity of the Terrene or Earthy Matter.
CHAP. VIII. Urocritica, or the General Signs of Urines in most Diseases; and what those Signs Prognosticate.
WHen Judgment is to be pass'd on Urine, it must not be shook together, (as Quacks generally do) but if it be far brought, or much confus'd any other way, let it forthwith be put into a thin clear Urinal, plac'd in the Sun, or the clearest Light you can, and then permit it to subside for the space of one at least, if not two or three Hours, that its Separation may be [Page 71]rightly made, and then every part will distinctly appear to view. In the next place, you must diligently examine the Colour, Consistence, and Contents of the Urine; whence you may fairly pronounce a true and perfect Ʋrocriterium, or Judgment upon the Ʋrine.
Wherefore that you may the more readily Descant upon this Matter, I shall now describe the most general Colours, Consistence, and Contents of the Ʋrines in most Diseases, according to the several Assertions of some Authors, hereafter mention'd, and which for the most part, I have by my own Observation found very true. And if any examine this Matter accurately and rightly, as it ought, he will undoubtedly find great Satisfaction therein; but according to the common Practise, from an immediate Coagitation or bare Inspection, very little or nothing of the Disease can be discover'd; and consequently, nothing certain can be pronounc'd: Yet after a diligent Examination of every distinct part of the Ʋrine, it may then be well shook together, or warm'd upon a Fire, if any desire to know what Colour it had when newly made.
And where the Patient is Visited every Day, 'tis necessary that the Physician should consult the Chamber-pot, as soon as the Ʋrine is first made (if conveniently it may be) before any Separation is begun, that by observing the Colour and Consistence when new made, and well remembring the Experiments made by the Urinal, he may (from frequent Practise) guess in a great measure, while the Ʋrine is hot, at some of the [Page 72]Contents, and what kind of Hypostasis or Sediment will happen after a just separation of the Ʋrine.
I shall now submit the following Observations, to the Impartial Judgment and Censure of every Honest and Ingenious Practitioner.
Thin Urine like clear Water.If the Urine appears Thin and White like clear Water, it shews the Defect of the Digestive Faculty, Obstructions, a Cachexia, an oppression at Stomach, want of Appetite, the Green-sickness, or else a Dropsy. Such Thin and Watery Urines in an obstinate Disease, are very pernicious; because such Urines are Signs of an extream Crudity: For either these Urines do shew the Cholerick Matter to be carry'd up into the Head, whence arises Phrensy and Madness; which is confirm'd by Hippocrates Aph. 72. Sect. 4. where he says, If the Urine appears White and perspicuous, it is dangerous; especially if it come from such as are in a Phrensy. Or they signify very great Crudities, which portend either Death or a long Disease; for Nature requires a long time to expel that extream Crudity. That these Thin, White, Clear and Watry Ʋrines are always bad, is also confirm'd in Cap. XLIII Lib. 1. Petri Poterii de febribus. Pag. 665. De Urinis— Ʋrina quae alba funditur (inquit) atque pellucida, mali est Ominis, atque potissimum in Phreneticis. Aquosae malae sunt Ʋrinae, ob debilitatem coctricis facultatis. Tenues verò & albae, valdè malae. In Intermitting Feavers, or gentle and diuturnal, a Thin Ʋrine denotes great Obstructions of [Page 73]the Spleen, Liver, Mesentery, and other like Parts, through which the Ʋrine being strain'd, becomes so Thin and Watry.
That Ʋrine which comes from the Body thick, muddy and troubled, but becomes afterwards of it self clear and limpid, is good: For it portends the Victory of Nature, separating things heterogeneous, and expelling that which is injurious to her; and that so much the more, if after the separation, the thicker part settle in the bottom, white, smooth, and equal.
Thick Muddy Ʋrine without separation.A Thick Muddy Urine, which so remains, that being put to the Fire will not clear up, is a very evil and bad Sign. For such Urine; saith Galen, in Aph. 70. Sect. 1. If the Strength of the Body be great, shews that the Disease will be of long continuance; but if the Strength be much diminish'd, it portends the Death of the Patient: For it is caus'd by a multitude of thick and crude Humours, with which, much Wind being mix'd, the Urine is thereby agitated and troubled; so that if the Strength be much Wasted, there is great danger lest it be Suffocated by the Super-abundance of such Humours; but if there be any considerable Strength remaining, much time is requir'd to discuss those Humours. This thick and turbid Urine, continuing so without separation for some Days, is a very dangerous Sign in a Feaver.
When the Urine is highly tinctur'd with a deep and intense Red,Red Ʋrine 'tis a certain indication of a Feaverish Distemperature: For it shews an extraordinary heat and inflaming disposition in [Page 74]the Liver, or Stomach, or Midriff, by which no Concoction, but rather an adustion or scorching of the Humours is caused. It this high Colour'd Red-Urine be voided thin (as commonly it is, from a great Scorching and adustion) and if it so continues for some time, 'tis a very evil sign. For if the Body be weak, it portends Death; but if the Body be in any reasonable strength, it signifies a prolongation of the Disease or a diversion of the Humour into the lower parts.
Tho' Red Urine be the common sign of Feavers in general, yet it also indicates a Consumption; for in a Phthisis pulmonalis, from the Hectick heat, 'tis very frequently emitted Red. If the Urine be of a Reddish Brown without a Feaver, Redish Brown. it shews a Scorbutick or Hypocondriack Affect; especially the latter, if it has a Tartarous Scum swimming upon it;Scum like Tartar. which is also sometimes seen in the Urine of Consumptive Persons, and of those who are troubled with Spitting of Blood.
Flame-Colour.As the Flame-colour'd, or Yellowish Red shining Urine is commonly made in intermitting Feavers, especially Tertians; so likewise the Saffron colour'd Urine which dyes Linnen-cloth of the same Colour,Saffron Colour. is Vulgarly known to be an undoubted sign of the Yellow Jaundise, as is thus confirm'd in the Processus integri Dris. Sydenham pag. 57. de Jectero. Urina crocea et pannum immersum eodem colore inficiens, morbum (Icterum) indigitat.
Sometimes, but not common, in the black [Page 75] Jaundice, a very Black Urine is voided;Black Ʋrine and if such appear in an acute Disease, 'tis very dangerous.
For it signifies an extraordinary Scorching up of the Humours, causing them to degenerate into deep Melancholy, which produces deadly affections,
And if these Black Urines are also thin, they are so much the worse, because they signify a greater crudity; hence Hipocr. in 1 Epid. says, that Thin Black Urine, and made in a little quantity, which appear'd at the beginning of burning Feavers was one of the signs by which they were wont to portend certain Death: but whether they come forth in a great or small quantity, these black and thin Urines (in acute Diseases) are always mortal: as also those, which appearing at first black, turn afterwards into thin and watry, i. e. clear and transparent.
Lastly, worst of all are the black Urines with a black-Sediment, of which Galen. Black Sediment 1. de Cris. Cap. 12. Thus discourses; ‘'Worst of all is that Urine which is totally black, so that I have seen no Man escape that ever made such Water: yet it is less pernicious, if the sediment be only black; and still less dangerous, if only that which is in the middle be black, and much less it is to be fear'd, if the Cloud appears only of that colour.'’ And thus another Author, Urinae Nigrae, à calore adurente malae censentur. And again, Viris & Mulieribus, Urinae nigrae, pessimae sunt; Pueris verò, aquosae.
White GravelIf white Gravel doth issue forthwith the Urine, it doth signify that the Patient hath or shall have the Stone ingender'd in the Bladder, and there is pain about those parts.
Mealy Ʋrine. Red Sand or small Stones.If the Urine appears mealy, or hath large Red or Yellow Sand or small Stones at the bottom, 'tis an undoubted sign of the Stone in the Kidneys or Bladder; and is attended (if in the Kidneys) with great pain in the small of the Back, a certain obscure itching at the Kidneys, and the sense of a weight or heaviness at the Loins, a sharp and pricking pain, in moving or bending the Body, a Numbness of the Thigh of the same side, by reason of the compression (caused by the Stone) of the Nerves, descending out of the Vertebrae of the Loins, into the Thigh. But when the Stone is in the Bladder, the Fundament and whole Perineum is pressed (as it were) with a heavy weight, especially if the Stone be of any bigness, a troublesome and pricking pain runs to the very end of the Yard, and there is a continual itching of that part, with a frequent and needless desire to make Water, the Urine coming away drop by drop, with a most grievous tormenting pain. The cause of so great torment is the frequent striving of the Bladder to expell the Stone, wholly contrary to the Nature thereof, whereto by Sympathy, the expulsive Faculty of the Guts, and all other parts of the Belly, come as it were for supply.
Sediments like whites of Eggs.The Sediment of the Urine is gross and Viscid, and sometimes like the whites of Eggs.
Black Gravel.Sometimes black Gravel subsides in the Urine, which is produc'd chiefly of a Melancholy Humour superabounding.
☞ Note, that if the Gravel (of what kind soever) come away, and the Patient find no ease, 'tis a certain indication that the Stone is confirm'd: But if the pain goes off, after the Gravel is voided, 'tis a sign that the Stone is broken and Mouldreth away.
Note also, if the Urine be very pale and waterish, (in the Stone) it shews an approaching Fit. That the Urine is first clear, thin, and voided in a small quantity, or sometimes Bloody, (in the Stone) is confirm'd in the Praxis Barbettiana pag. 201 Thus, Urina primum clara, tenuis & pauca, cruentavi; posteà vero aliquid fundum petit, & tandem arenulae aut lapilli excernuntur, in dolore Nephritico: But 'tis said also in the same place, In Colicis vero, Urinae ab initio crassiores excernuntur, fiuntque.
Those who labour under the Cholick make a very thick Water in the beginning (by which a Cholick and a Nephritick pain are distinguished) and so continues during the Paroxysm.
This Consistence of Ʋrine (in the Cholick) when 'tis first made i. e. in the beginning of the Cholick Fit, is also confirm'd in the Processus integri Dris. Sydenham pag. 49. In Colica (inquit) Urinae ab initio crassiores existunt.
Bloody Ʋrine.Bloody Pissing, is a voiding of Blood together with the Urine, arising from the heaping up of the same in the Bladder, and when the Urine thus mixt is expelled, it doth [Page 78]not shine, but hath the Colour of Water, in which the Flesh of Beasts new kill'd is wash'd. If the Blood proceeds from the Kidneys, 'tis plentifully and exquisitely mix'd with the whole Urine, that being as 'twere diluted with it, 'tis Thin, Ruddy, Liquid and settles without clotting together, It arises either from the Anastomosis (or opening of the Veins) of some Vessel in them, and then 'tis plentifully made and high-colour'd: Or from the Corrosion of a Vessel, and then the Blood is voided in a lesser quantity, especially at the beginning: Or by a Diapedesis, (i. e. an Eruption of the Blood, from the thinness of the Vessels) and then the Urine is highly dy'd with a Red-colour; and is thus also sometimes, by a Wound of the Ureters from Stones passing through them.
If any one Piss Blood on a sudden, it is a Sign there is some Vein of the Kidneys broken: Namely, if mere and pure Blood, and without any External Cause. This is intimated by Hippocrates, C [...]o [...]s of Blood. Aph. 78. Sect. 4. And Aph. 80. of the same Sect. If any Piss Blood, or Clots of Blood, and. make his Water by Drops, having Pain about the Hypogastrium, Perinaeum or Pecten, then the places about the Bladder are Diseas'd: Namely, all the parts belonging to the Bladder and not the Bladder only.
The Signs of an Ulcer of the Kidneys are purulent Matter,Pu [...]ulert Matter. howsoever mix'd with the Urine, never evacuated by it self, but always flowing forth with the Urine and residing at the bottom of the Chamber-pot, with a [Page 79]sanious and red Sediment,Small Fibres of Flesh. fleshy and as it were bloody Fibres (which Fibres are part of the Reins, or Kidneys, and are a manifest Sign of their being Ulcerated) swimming up and down in the Ʋrine, the smell of the Filth is not so great as that which flows from the Ulcerated Bladder; because the Kidneys being of a fleshy substance, do far better ripen and digest the purulent Matter, than the Bladder, which is Nervous and Bloodless. This or the Ulcerated Kidneys; and the next, of the Ulceration of the Bladder, you may Read in Parey's Surgery, page 407.
The Signs of an Ulcer in the Bladder are, a deep Pain in the Share-bones, the great stench of the Matter flowing therefrom,White Skins. white and thin Skins swimming up and down in the Water. But when the Ulcer possesseth the Neck (and not the bottom) of the Bladder, the Pain is more gentle, neither doth it trouble before the Patient come to make Water, but in the very making thereof, and a little while after.
If bloody purulent Matter flow forth with the Urine, Bloody purulent Matter. it may rather proceed from an Exulceration of the Glandulae prostatae, or some other neighbouring Vessels, than from the Bladder: because that purulent Matter, is never seen mix'd with the Urine, (in Ulcers of the Bladder) as is usual in an Ulcer of the upper Parts, because 'tis pour'd forth not together with Urine, but immediately after it.
☞ Note, it hath sometimes happened that a filthy Matter has been discharg'd with the Urine, [Page 80]from an Ulcer in the Lungs, or from the Liver, (or it may proceed from the breaking of an Impostume in some other parts) in as much as those parts do Transmit matter through the Veins to the Bladder. But this is dstinguish'd from the Situation of the pain; if from the Lungs, the pain is in the Breast: If from the Liver the pain is only in the right side.
And if it be from an Ulcer in the Kidnies, there is great Pain in the Loyns and small of the Back: But if from the Bladder a very intense pain is about the Share, as is afore-mentioned.
If filthy Matter be voided with the Urine, of a very stinking or strong smell, that purulent Matter and stink are almost infallible signs of an Exulceration of the Bladder: Ex Ʋrinis magis exitio saesunt faetidae, quod magnam putredinem denotent. And where a thick Urine comes forth with certain branny Scales, [...]cales [...]ike Bra [...] the Bladder of such Persons is Scabby. By thick (Urine, is here meant, well concocted, which is a peculiar Symptom that the things then contained in the Urine, proceed from the Reins or Bladder.
Tr [...]c [...]iasts [...] P [...] fi [...]g [...] H [...] [...] Trichiasis or Pissing of Hairs is, when with the Urine, a mucous Matter is voided like to Hairs, which sometimes seem to equal the length of one or two Hands breadth. The cause of them, is a thick and viscous Flegm, dryed and knit together in the Veins by heat, which in its long passage through the narrow Veins of the Kidneys and Ureters, is extended to so great a length. See concerning [Page 81]this, The Idea of Practical Physick: Book 10. pag. 61. Also Horstius his fifth Section. Epistol. Medic. And Hippocrates in his Aph. 76. Sect. 4. saith, That Water which hath in it small fleshy Fibres, as it were certain Hairs, proceeds from the Reins.
Bubbles.When Bubbles do swim on the top of Urine, they proceed from windy Matter included in some viscous Humidity, and signifie great Crudity and Indigestion in many Parts of the Body, where the Humours are chiefly multiply'd and heap'd together.
Resident Bubbles do signify great Flatulencies in the Body, or do indicate some Indisposition of long continuance: But Bubbles not resident, which break quickly, signifie a present Debility or great weakness of Body.
And it Bubbles cleave to the Urinal, 'tis a Sign of a Cacochymia or the abundance of Ill-humours in the Blood.
If a green Circle appears in Urine, Green and Black Circles. it intimates a burning Heat in the Stomach. And this Colour (in a Feaver) doth indicate some disorder in the Head, proceeding from Choler. If a black Circle be visible in the Urine, 'tis a Sign that Death is approaching.
If a Woman with Child,Lead-colour. void her Urine of a Lead-colour, 'tis an undoubted Sign that the Child is Dead within her. This Leaden-colour'd Urine, as also that which hath as 'twere, a dark Sky fleeting above; also Urine black and thick, and little in quantity, are generally mortal Signs, in whatsoever Diseases they appear.
Urines that are Oily,O [...]ly- [...]rine. wherein do swim little fat things like Cobwebs, are extremely bad; forasmuch as they shew a mighty Heat that melts the Fat about the Kidneys, and in the whole Body. Now how you may know, whether this Colliquation proceeds from the Reins or from the whole Body, Hippocrates teaches, Aph. 35. Sect. 7. in these Words; Those who have a close Fat or Oilyness swimming en the top of their Urine, have an acute Evil in their Reins. By an acute Evil, he means a hot Distemper, which causes (from its Colliquative Force) as it were little heaps of Fat in the Urine; for as there is a great quantity of Fat heap'd up about the Reins, and as from thence, there is a short and quick way for the emission of the Urine, therefore that which is melted, sticks not much by the way. And if the Fat be voided in little Lumps,Little Lumps of Fat, or sometime [...] [...]ke Cobwebs. it proceeds from an acute Evil in the Reins; but if not in Lumps, but like Cobwebs, it shews a Consumption of the Fat through the whole Body. These Oily Fat Urines (saith Hippocrates) are commonly Signs that Death is near at hand. That these fat Urines, in which there is an appearance like Cobwebs swimming at top, are always very evil and dangerous, is also confirm'd by another Author, in these Words; Pingues Urinae, telis aranearum similes, valdè periculosae & sunt damnandae.
If the Urine hath no brackish, but a sweetish-taste,Urite of an Honey-taste. like Water dulcify'd with Honey, 'tis acknowledg'd an undoubted [Page 83]Sign of a Diabetes, a Disease, wherein immediately after one hath drank, the Urine is presently made in great plenty, by the dissolution of the retentive Faculty of the Reins, and the depravation or immoderation of the attractive Faculty, proceeding ordinarily from a too much exalted, or too acid Ferment of the Reins, and from an Inflammation of the Liver and other Parts, but especially of the Kidneys and Bladder. The Loins in this Disease are molested with a pricking and biting Pain, and there is a continual and unquenchable Thirst: And altho' this Disease proceeds from a hot Distemper, yet the Urine is not colour'd Red, Troubled or Thick; but thin and like Water, by reason the Matter thereof makes very small stay in the Stomach, Liver and Vena cava, being presently drawn away by the heat of the Kidneys or Bladder.
Those Sediments in Urines that appear like course Meal are evil,Sediments like course Meal. those that appear like Scales are worse, but those that seem like Bran are worst of all. Hip, 2. Prog.
These kind of Settlements, according to Galen, 1 of Crit. Chap. 12. are caus'd by an immense Heat, melting and burning the Fat, and the very substance of the Flesh. But when this burning Heat preys upon the solid Parts, first it assails the more soft and newly substantiated Fat, afterwards the more solid; and when all the Fat is melted and consum'd, then it falls upon the more tender and newly compacted Flesh; after that, upon the more solid Flesh; and lastly, upon the [Page 84]most solid Parts themselves, By the new Fat thus melted by the extream heat of the Feaver, are caus'd (as is already mention'd) Oily Urines. Sediments like course Meal But the more solid Fat being melted, as also from the Flesh raggedly dissolv'd, and likewise from thick Blood parch'd, are caus'd those Sediments resembling course Meal.
From the solid Parts unequally dissolv'd, proceed those Sediments,Sediments like Scales of Fish, or like Bran. which are like Scales of Fish, as also those resembling Bran, when the heat is more intense; whence it plainly appears, that the Scaly Sediments are worse than the Mealy ones, and the Branny Sediments worse than the Scaly, as is testify'd by Galen.
And thus confirm'd by another Author; Subsidentiae in Urinis, speciem crassioris farinae referentes, malae sunt; iis verò pejores sunt squamosae; at omnum pessimae sunt furfuraceae.
How pernicious those Sediments are, will appear by the judgment of Galen, of that resembling course Meal,Sediments like course Meal. which, as is already declar'd, is not so bad as the rest. in Com. in Aph. 31. Sect. 7. he thus writes; such Urines are sometimes mortal, as also is said in the Prognost. And many dye in a short time of Sickness, but whoever of them escape▪ they have a long illness, the Disposition requiring a great Concoction, where such Water [...]s m [...]de. Hippocrates confirms this, in the following Aphorism; Sediments in Urines, made [Page 85]in the time of Agues, like unto course Wheatmeal, do signifie, that the Sickness shall continue long. For, they shew a kind of gross thick humor, which cannot be dissolv'd or voided in a short space.
It is therefore manifest by these examples, that whoever they be, that void Ʋrine like to a thicker sort of Meal, if they may be saved, yet it is long, before they escape: But whoever they are, that are thus mortally affected, they perish immediately.
Thin Sediment.A Thin Sediment, in the begining of a Disease, which in the progress of the Malady, thickens daily by Degrees, is good. For, it shews that Nature endeavour'd a Concoction at the beginning, and doth daily labour to bring its work to perfection.
Thick Sediment.A Thick Sediment, caused by thick and crude humors is very bad; for, as those thick and crude humours are very hard to be o'recome by Nature, therefore they do threaten much danger, especially if the strength of the Body be decay'd; but if there be any strength of Nature, they do only signifie a prolongation of the Disease.
These crude and thick humors settling at the bottom of the Chamber-pot, may deceive a young Practitioner, who may perhaps think them to be a good and true Settlement; and therefore they are to be exactly distinguish'd.
And First, those crude and thick humours usually appear at the beginning of a Disease, but the good and true Settlement never till the declination [Page 86]thereof. And it happens, that after the beginning of the Disease, that thick and crude Humour being attenuated, there appears no more settlement in the bottom, but only in the place thereof, a Cloud or Matter hanging in the middle or the Urine, which as the Concoction proceeds falls down daily from the upper part of the Chamber-pot, to the lower part; which is the true sign of Concoction, when the Cloud changes into that Matter, (which hangs in the middle of the Pot) called Enaeorema, and that Eraeorema into the Sediment: but on the contrary, when the Sediment changes into the Enaeorema or Cloud, that Settlement is not laudable, but a crude and thick humour which was afterwards attenuated by Concoction.
Secondly, This crude Humour doth not stick close together, neither is it altogether smooth and equal: but the laudable Sediment is smooth, equal and moderately thick. Lastly, This crude Humour is heavier and resides altogether to the bottom of the Chamber-pot; but a good Sediment doth not close, but rather rests in the bottom, being a little raised from it, and as it were gathered into a kind of Globe, which the crude Humour doth not do, but remains a little more diffused and scattered.
Urines in malignant and Pestilent Feavers in Substance, Colour and Contents like the Urine of found People, are pernicious. For Hippocrates saith, Urines concocted suddenly and without reason for it, are evil; and whatever appears contained in the Urine, not Concocted according to Nature, is worse.
I will close all in the Words of the ever honoured and never to be forgotten Prince of Physicians, the great Hippocrates:
Coctio ex superioribus securitatem Salutis, & celeritatem Criseos demonstrat.
Si verò intermiserit, atque interdum mingatur sine Sedimento, & aliqando habeat Sedimentum album, laeve & aequale, morbum diuturnum, & minùs securum ostendit.
Iterum idem in Coacis praenotionibus scribit. Urina bonum Sedimentum habens, quod derepente evanescit, laborem, mutationemque significat.Item: Si Urina fuerit subrubra, & Sedimentum subrubrum, ac laeve, diuturnior haec quidem est, quàm prior, valdè tamen salubris.
Qui in Ʋrinis celeritèr Sedimentum habent, celeritèr judicantur. Ex iisdem Coacis praenot.
Celeriter, id est, intra paucos dies; nam Urina derepentè cocta, mala judicata fuit.
From hence it appears, That Ʋrine is best which hath its Sediment White, Smooth, and Even, and doth also continue so all the while, till perfect Judgment be made of the Disease. This well concocted Matter, is a sign of a speedy Crisis and perfect Recovery:
But if it do intermit, and that sometimes the Water be made without any Sediment, it portends that the Disease will be longer and less safe. Again, that Urine which hath a good Sediment, if it suddenly disappear, it fore-tells a [Page 88]great change, and that the Distemper will prove dangerous. Also if the Urine be somewhat Red with a Sediment of the same Colour and Smooth, such indeed, is more continual than the former, yet greatly profitable and very healthful; i. e. it shews the Disease will be of long continuance, but free from danger. Those which have a Sediment in their Urines, within a few Days after their Illness, have Judgment soon made on the Diseases; for Ʋrines concocted suddenly are judged very had.
In a Word, as a good sound Ʋrine ought to be of a middling Substance, that is, neither too Thick nor too Thin, of a Citron-colour, or a little inclining to Red; and those other differences that come nearest to this, are to be accounted best: So likewise those Ʋrines, which in any degree, appear contrary, either in Substance or Colour, are to be adjudg'd naught; of both which, a right Prognostication may be made, by an Accurate Uroscopia or diligent Inspection of the Urine.