THE URINE.

Weshall conclude our treatise by a few remarks on diseases of the urine, to which many are subject. Before proceeding to speak of them, it is necessary, for a full understanding of the subject, to state, that the urine is secreted by two bodies calledkidneys, placed one on each side of the back-bone, as is shown in the cut. After being formed, the urine passes through theuretersinto the bladder whence it is voided, as every one knows, occasionally.

1—1. The Lungs.2. The Stomach.3—3. The Kidneys.4—4. The Ureters.5. The Bladder.View larger image

1—1. The Lungs.

2. The Stomach.

3—3. The Kidneys.

4—4. The Ureters.

5. The Bladder.

View larger image

1—1.The Lungs.2.The Stomach.3—3.The Kidneys.4—4.The Ureters.5.The Bladder.

1—1.The Lungs.

2.The Stomach.

3—3.The Kidneys.

4—4.The Ureters.

5.The Bladder.

The following diagram shows the bladder and its muscular coats, and also its neck imbedded in the prostate gland. The bladder is seen distended, and, of course, as detached from the body. The kidneys are also seen—one in its natural state, the other divided to show its inner structure: the kidneys and their ureters are crossed to save space in the sketch.

1.The entire kidney.2.Its cortical, or secreting part.3.The papilla.4.The pelvis.5.The ureter.6.The bladder.7.The detrusor muscle.8.The sphincter muscle.9.Prostate gland.10.Neck of the bladder.View larger image

1.The entire kidney.2.Its cortical, or secreting part.3.The papilla.4.The pelvis.5.The ureter.6.The bladder.7.The detrusor muscle.8.The sphincter muscle.9.Prostate gland.10.Neck of the bladder.

View larger image

1.The entire kidney.2.Its cortical, or secreting part.3.The papilla.4.The pelvis.5.The ureter.6.The bladder.7.The detrusor muscle.8.The sphincter muscle.9.Prostate gland.10.Neck of the bladder.

The bladder and adjacent parts are seen more fully in the diagram at the top of the succeeding page.

1. Corpus cavernosum.2. Bulb of urethra.3. Membranous portion of ditto.4. Prostate gland surrounding urethra.5. Seminal vesicles.6. The two vasa deferentia.7. The ureters.8. The bladder.View larger image

1. Corpus cavernosum.

2. Bulb of urethra.

3. Membranous portion of ditto.

4. Prostate gland surrounding urethra.

5. Seminal vesicles.

6. The two vasa deferentia.

7. The ureters.

8. The bladder.

View larger image

1.Corpus cavernosum.2.Bulb of urethra.3.Membranous portion of ditto.4.Prostate gland surrounding urethra.5.Seminal vesicles.6.The two vasa deferentia.7.The ureters.8.The bladder.

1.Corpus cavernosum.

2.Bulb of urethra.

3.Membranous portion of ditto.

4.Prostate gland surrounding urethra.

5.Seminal vesicles.

6.The two vasa deferentia.

7.The ureters.

8.The bladder.

It is a very common observation with patients, that they never were in better health in their lives than at the moment of consulting their medical adviser, except in the very particular malady, such as an ulcered limb, a teazing cough, a gleety discharge, or an irritable bladder, that they are seeking relief for; “they are quite well,” they say, “in every other respect.” When illness attacks an individual, it does not always announce its arrival by sound of trumpet. It does not always come on like an apoplectic shock: some minor organization is generally the first to indicate disturbance in the healthy economy by even so simple a presage (I will take for example, more especially as the ensuing remarks bear upon the subject) as excretion of disordered urine. To resume; the patient will content himself, that the only fault in his system is the disordered condition of his urine, and he earnestly seeks for something to touch that particular symptom, forgetting that trifling as he may fancy it, it is not merely owing to the office of the kidneys and bladder, but to the blood itself, whence the urine is formed, and to other circumstances in the economy that influence it. Therefore, it is not merely the urine which is at fault, but the state of it is a pretty good indication of the general state of health; and when it becomes vitiated, the urine is generally, unless restored to a healthy condition, a forerunner of some more serious evil. Still there are many variations in the character and quality of the urine, and each depending upon different causes—some upon a disordered state of the fluids of the body, some upon one remote cause or another, deranging the balance of the circulation, and inducing excessiveperspiration, and the like; and certainly not the least important, nor the least influential, exist in the very structures that make (as it were) and receive the urine, namely, the kidneys and bladder. I may observe here, that chymists have detected upward of twenty different substances, animal and saline, in its composition, but in a state of complete solution. Of all these component parts, the most important is an animal product namedurea, which exists in about the proportion of one in thirty to the water containing it, while the other materials taken collectively, water excepted, yield only about double the quantity of the urea: hence, when the urine is disordered, its specific gravity[17]is increased or diminished, as the case may be; according to the abundance of the urea, and the various proportions of the saline ingredients of the urine, so is the urine thick, thin, acid, or alkaline, pale, or what is called high colored. The various conditions of the urine are ascertained by producing chymically certain decompositions, or by suffering the urine to effect its own changes, which, on being suffered to “stand,” sooner or later it will.

Healthy urine is perfectly transparent and of a light amber color; it yields an odor when warm resembling violets. Its taste (for pathologists trust not only to sight and smell) is saltish and offensive. As the urine cools, it throws up what may be said to be a “urinous smell.” As decomposition proceeds, the urine becomes cloudy, thick, with shining floating patches on the surface; and lastly, a thick deposite coats the bottom and sides of the vessel, the whole giving forth at the same time a fetid ammoniacal exhalation, as is perceived on entering public urinals.

The rapidity with which these several mutations occur, affords some criterion of the healthy or disordered state of the excretion we are talking about, and hence the usefulness of examining especially the urine of persons laboring under any disorder of the urinary system and functions connected therewith. A patient will complain, for instance, of irritable bladder. The symptoms of that complaint, as far as pain and frequent desire to micturate exist, very closely resemble those affections known by the name of “Diabetes,” but which is distinguished from the bladder affection in question by the quantity and character of the urine. I purpose herein to enumerate, in as familiar a manner as is possible, the various disordered states of the urine which my experience has rendered me familiar with, and to present the same as heretofore, in the form of cases that have fallen under my notice.

Now, the urinary disorders that I purpose to collect a description of, and exemplify, may be thusenumerated:—

First, where too great a quantity of urine is voided.

Secondly, where too little is discharged; and also, where suppression of it entirely occurs.

Thirdly, those states where the urine deposites a sediment, of which two kinds are mostly prevalent, namely, the Lithates or Acid, and the Earthy or Alkaline.

Fourthly, a brief exposition of the many but less frequent morbid changes of the urine, in which certain salts and substances, not existing in healthy urine, are precipitated or held in solution.

And lastly, to add a few to the number of those already presented herein, of the infirmities of those organs which excrete the fluid under consideration, namely, the kidneys and bladder.

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