at any period of her life. Is it not wonderfully singular that emetics should have the power of almost invariably coaxing the urine to and from the stomach? I think seriously, and feel the most indignant desire to reprobate the imposition; and yet I cannot altogether bring my mind to write gravely on the subject. Half a pint of urine, clear and unsullied, without the slightest possible admixture of any foreign matter, was shown to Mr. Gibbon by the hypocritical mother of the patient, as coming from the stomach under the operation of an emetic! But, away with the emetic, and all thought about it. Even were it admitted as a fact incontrovertibly established, that pure urine could be ejected by vomiting, I deny that it could be produced entirely free from other matter. Some particles of gastric juice and mucus must have escaped with it; and if not these, some particles of saliva. The action of vomiting INVARIABLY increases the action of the vessels of the salivary glands; and it must come home to the recollection of all your readers, that they never retched without evacuating some quantity of the salivary fluid. It is remarkable that, throughout this case of six long months duration, the catheter was never proposed for trial, and never introduced; although at no period did a symptom exist to render its use improper. It is also worthy of remark that, in the pure spirit of piety and truth, two women declared on oath before a magistrate that they saw urine actually vomited from the stomach; though these women had previously asserted before two medical gentle men of this town, that they never witnessed any thing of the kind. I cannot suppose that any man, after a serious perusal of the case at large, will regard it as a fact of urinous vomiting. I enter my protest against it, and shall bear the penalty of want of credence, whatever it may be, with fortitude, but not with submission. I have read of twenty thousand devils dancing a saraband on the point of a needle; and when I shall discern those infernal gentry tripping on the light fantastic toe and mingling in the dance, then, and not till then, shall I believe in the urinary aberra tions of Ann Foulkes. Now, when urine is secreted, and any cause exists to ob struct its natural evacuation, absorption, in some degree, must be the inevitable consequence; and the fluid thus taken up must unavoidably be passed on by the absorbent channels to the blood-vessels. Having once entered the veins, it It must not be forgotten, that Mr. Gibbon strongly and repeat edly urged the introduction of the catheter, which was objected to on other grounds besides the dislike of the patient, 392 commixes commixes with the blood, is diffused throughout it, and becomes subject to the laws of the circulation. I admit, therefore, that urinous particles may and must have their exit from any and from every exhalent surface: indeed, under Ischuria, life could not be maintained without it; and I feel so strongly impressed on the subject, that, whenever a fatal case of lengthened duration shall occur, I will venture to affirm that, on dissection, any collection of a fluid, in any part of the body, would possess both the smell and taste of urine. But, when urine is once absorbed, I deny that, as urine, it can be evacuated. It must pass from every pore with the natural, or rather corrupted, fluid of the parts, in an altered and adulterated condition. From its quantity and unusual retention, it must be expected to preserve both its taste and smell; but as pure urine it cannot be discharged. And, with my view of the subject, it is utterly impossible, under the phenomena of Ischuria, that the stomach, or any other part, should be found to have the urine regularly, uniformly, and systematically, directed to it, and it alone, for weeks and months together. are But what avails all this.-We are told that vomiting of urine can take place for weeks, months, nay even years, together; and facts, "stubborn" and "indisputable,' marshalled and arranged against us, of modern date, and drawn from the records of earlier time. FACTS are indeed stubborn things! and I am well aware that it is an ungracious task to question the veracity of statements, when introduced with specious front and bold assertion, and more especially when extracted from the dead, whose remains we are taught to touch with tenderness and awe. I desire not wantonly to doubt the word of any man; but surely, when I reflect on the writings of some medical authors, I am justly entitled to withhold my credence on matters which appear to me more supernatural than reasonable. In fact, were I called upon at this moment to credit every thing which has been published on medical subjects, I should be compelled almost to believe that a sovereign remedy existed for the cure of every disease. The press has often groaned under its labors to announce the birth of weighty remedies for formidable complaints; but when such helps have been submitted to the test of fair and honest experiment, they have usually been condemned for their imbecility and inertness. Whenever very extraordinary occurrences arise in pathology, the first duty of a medical man is, to doubt; his second duty, tho roughly to investigate; nothing ought to be granted; nothing ought to be published as true, unless incontrovertibly witnessed and substantiated. But it is a lamentable fact, that some some medical characters possess a thirst for novelty which never can be allayed, and an appetite for the marvellous of insatiable voracity; they catch reports and assertions as they fly, and, instead of calmly interposing in the flight, in aid of reason and of truth, are eager only to add a feather to the wing. Since the case of Dr. Senter, taken from the Transactions of the College of Physicians at Philadelphia, seems to be triumphantly brought forward as the most positive and decisive to establish the truth of urinous vomiting, I beg leave to go a little into the consideration of it. It appears that Lucy Foster, the subject of it, labored under ischuria more than three years; that, during the continuance of her disease, her urine was constantly secreted by the kidnies, and regu larly passed to the bladder; but that she was totally incapable of evacuating it by its natural passage, except in two instances when under the influence of fright. She never failed to vomit urine in thirty or thirty-six hours, unless drawn off by the catheter; and to put this beyond a doubt, was often watched at such times as the recurrence of the vomiting was expected. On such occasions, the bladder was discovered to be full, hard, and tender to the touch; and the urine vomited, when compared with the urine drawn off, was found in every respect exactly similar. During the last twenty months of her complaint, she sometimes vomited gravelly matter; such matter also was evacuated with the urine on the use of the catheter-and on comparing several drachms of the gravel from both sources, it was found the same in color and consistence. Other medical men attended this extraordinary case, and among them, Dr. Mason wit nessed the vomiting both of urine and gravel. At one period, no urine was vomited for three days, nor did any pass on the introduction of the catheter; it then was expelled at the umbilicus: and when the disease had continued a length of time, urine passed often by the rectum, latterly sometimes with gravel. At one time the patient was so exhausted by her sufferings as not to be expected to outlive the month, then vomiting more sandy matter than at any other period; and throughout her disease, she labored under continual fever, had great loss of strength, and gradually became much emaciated. Death, at last, put an end to the compli cated machinery of her urinary viscera! I disbelieve entirely the reality of this case. On dissection, no cavity of the body contained a drop of urinous matter, not even the stomach and intestines; in fact, the bare smell of it is not mentioned. Several hydatids, the size of a wallnut, were attached to the Tube Fallopiane, and the óvaria were enlarged to the magnitude of a small hen's egg, containing a quantity of limpid fluid; and yet these parts had not the least smell of urine. The bladder was entirely sound; there was nothing calculous within it, no, not even the stone, of the existence of which Dr. Senter was previously and perfectly satisfied from repeated examinations. At the commencement of her disease, she was five days without passing a drop of urine in any way; this occasioned very great pain and distress, yet the fear of an instrument induced her to withhold a full acknowledgment of her situation from her friends! Ask those to believe this who have suffered the most excruciating tortures from a similar inability. I suspect the girl to have drank her urine. But supposing, merely for the sake of argument, that the urine was actually conveyed to the stomach, either by the bloodvessels and their exhalent terminations, after the regular process of absorption, or by the retrograde action of the absorbents, is it within the bounds of probability, setting impossibility aside, that calculous matter, once deposited in the bladder, should be removed by absorption, whether in a regular or retrograde manner? Would it not rather remain, and become a concrete in its urinary habitation? Dr. Senter has not mentioned how long he sat to watch the recurrence of the vomiting; and as the disease began in June 1785, and the watching, apparently from the relation of the case, was not commenced until the December following, it is probable that the stomach, from being habituated to the stimulus of the urine, was able to retain it a considerable time, and thus the vigilance of the doctor might be eluded, by the brackish draught being swallowed before his arrival. This retention of the urine on the stomach would also account for its being occasionally evacuated by the rectum. On the watch, no notice is taken of the state of the bladder after vomiting; and when Dr. Mason saw the vomiting both of urine and gravel, it is not stated that he had been on guard, or what was the previous and subsequent condition of the urinary viscus. Surely I have now stated enough. But, amid all the wonders of this more than wondrous case, the disappearance of the urinary calculus is not the least remarkable; and Dr. Senter is all amazement in contemplating "by what secret instruments in her extraordinary system" it became decomposed!" "Twas strange, 'twas passing strange!" and I too, like the doctor, should marvel much, did I not feel disposed just to hint that the stone might never have existed. In fine, this case appears to be negligently drawn up, and unaccompanied with that attention to every minute particular particular in all its bearings, which its extraordinary nature ought to have imposed; and the author's remarks upon it prove that medical science, in his hands, must be at least as retrograde as the movements of the absorbent system of Lucy Foster. The author of the paper on Ischuria, in your Number for May, considers the different ways in which the circulation has got rid of urine, carried into it by the absorbents, as constituting the vis medicatrix naturæ; and he sees no difficulty in understanding how it should be so discharged, any more than any other absorbed fluid which has become useless or noxious to the constitution. This he illustrates by calling to the recollection of his readers instances of dropsies being speedily cured by sudden and spontaneous evacuations of large quantities of fluid from the stomach, skin, and intestines; and concludes that nobody can deny that the fluids which the exhalents had in such instances poured out into the sto mach, intestines, and on the skin, were the same which constituted the dropsical swellings thus suddenly disappearing. Whenever the urine finds its way into the blood-vessels, mixing with the vital fluid, and its diffused particles are evacuated at any part with other matters, this should not be stiled the vis medicatrix naturæ; it is a term which ought to be exploded, as it may sometimes lead to the grossest absurdities: for instance, when an aneurism exists, and pointing to the skin, its pressure produces ulceration, and blood is evacuated, the vis medicatrix naturæ, which expression might be employed as scientifically on such an occasion, would cut but a sorry figure indeed. A preternatural discharge of urinous particles under ischuria, and an effusion of blood from an aneurism, are consequences impelled by the irresistible laws of animated nature under disease; and one might as justly be termed the vis medicatrix naturæ as the other; but this would lead to the odd conclusion-that a preserving and a destroying effect is one and the same. As to large evacuations of fluid from the stomach, or other parts, under dropsical affections, being the identical fluid forming the disease, I think it extremely questionable. They may be explained in another, and, to me, more satisfactory manner. It is no uncommon thing for one diseased action to effect the cure of another; and the existence of a dropsy might be followed by a powerful determination to the stomach, the intestines, or the skin, producing sudden and profuse evacuations; and during such operation, the exhalent and absorbent vessels, connected with the dropsical parts, might be brought into a more healthy condition. Besides, it is well known that both vomiting and purging are power ful |