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In six minutes, about one ounce of urine was voided; in twenty minutes six ounces more; and after two hours, a similar quantity.

The first portion became very turbid within ten minutes after it had been voided, and deposited a copious sediment of the phosphates, in consequence of the action of the alkali upon the urine. It slightly restored the blue colour to litmus paper reddened with vinegar: the alkali, therefore, was not merely in sufficient quantity to saturate the uncombined acid in the urine, and consequently to throw down the phosphates; but it was in excess, and the urine was voided alkaline.

The urine voided after twenty minutes, also deposited a cloud of the phosphates; but the transparency of that voided two hours after the alkali had been taken, was not disturbed.

Here, therefore, the effect of the alkali upon the urine was at its maximum, probably in less than a quarter of an hour after it had been taken into the stomach, and in less than two hours the whole of the alkali had passed off.

Experiment 2. On Soda, with Excess of Carbonic Acid.

The same quantity of soda, dissolved in eight ounces of water very highly impregnated with carbonic acid, was taken under the same circumstances as in the former experiment, and the urine was voided at nearly similar in

tervals.

The separation of the phosphates was less distinct, and less rapid. In two hours after the urine had been voided, there was a small deposit, composed principally of phos phate of lime; there was also a distinct pellicle on the surface, consisting of the triple phosphate of ammonia and magnesia. This appearance produced by the escape of the carbonic acid, which had before retained the ammoniaco-magnesian phosphate in solution, and which now occasions its depositions on the surface, is by no means uncommon, even in the urine of healthy persons: in the present instance, it appears to prove, that carbonic acid passes off from the stomach by the kidneys; for, after taking the alkalies in water very highly impregnated with it, the pellicle is uniformly produced, and is also much more abundant and distinct than under any other circum

stances.

In similar experiments with potash, the results were in

all

all cases as similar as could be expected in researches of this nature.

Experiment 3. On Magnesia.

Magnesia was taken under circumstances similar to those of the soda in the former experiment: in the quantity of half a drachm, it produced no sensible effect upon the urine during the whole day. When taken in the dose of a drachm at nine o'clock in the morning, the urine voided at twelve o'clock became slightly turbid: at three o'clock the effect of the magnesia was at its maximum, and a distinct separation of the phosphate took place, partly in the form of a film, which when examined was found to be the triple phosphate of ammonia and magnesia, and partly in the state of a white powder, consisting almost entirely of the triple phosphate and phosphate of lime.

The effect of large doses of magnesia, in producing a white sediment in the urine, is very commonly known, and has been erroneously attributed to the magnesia passing off by the kidneys.

These experiments show that magnesia, even in very large doses, neither produces so rapid an effect upon the urine, nor so copious a separation of the phosphates, as the alkalies; on this its value as a remedy in calculous disorders seems materially to depend.

Experiment 4. On Lime.

Two ounces of lime water, taken in the morning upon an empty stomach, with a cup of milk and water, produced no effect whatever.

A pint of lime water, taken at four intervals of an hour each, produced a slight deposition of the phosphates at the end of the fifth hour. The urine voided at the third hour was not at all affected; at the fifth hour, the effect appeared at its height, but was not nearly so distinct as from small doses of soda, notwithstanding the insoluble compounds which lime might be expected to form with the acids in the urine.

The unpleasant taste of lime water, the quantity in which it requires to be taken, on account of the small proportion of the earth which is held in solution, and the uncertainty of its effect, are circumstances which render it of little use, excepting in some very rare cases, where it has been found to agree particularly well with the stomach,

The effect of carbonate of lime upon the urine was much (No. 139.)

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less distinct than that of lime water; at times it produced no effect, but when taken in very large doses, a slight deposition of the phosphates was produced.

These experiments were repeated upon three different individuals, and there was always an uniformity in their results.

When the medicines were taken some hours after food being received into the stomach, their effects upon the urine were retarded, but not prevented.

The effects of many other substances upon the urine were examined into during this investigation; but they varied so much according to circumstances, that no satisfactory results were produced.

As it is found in the foregoing experiments, that the effects of soda on the urine are modified by the presence of carbonic acid, the following experiment was made, to ascertain whether any sensible effects are produced by that acid on healthy urine.

Twelve ounces of water very highly impregnated with carbonic acid, were taken upon an empty stomach at nine o'clock in the morning. At ten o'clock about eight ounces of urine were voided, which had a natural appearance, but, when compared with urine voided under common circumstances, was found to contain a superabundant quantity of carbonic acid: this gas was copiously given off when the urine was gently heated, or when it was exposed under, the exhausted receiver of an air-pump.

In a patient who had a calculus of large dimensions ex◄ tracted from the bladder, composed entirely of the phosphates, and whose stomach did not admit of the use of stronger acids, carbonic acid was given in water; it was found peculiarly grateful to the stomach, and upon examining the urine during its use, the phosphates were only voided in solution; but when at any time it was left off, they were voided in the form of white sand.

To the Editors of the Medical and Phyfical Journal.

GENTLEMEN,

I Request you will have the goodness to insert the follow

ing Answer to certain Remarks which appeared in No. 131 of the Medical and Physical Journal, upon a Paper of mine

lately

lately inserted, on the subject of Hydrocephalus Internus. The Gentleman, I am sorry to say, with perhaps great submission to his judgment on other subjects, has totally misunderstood every thing respecting the leading principle which I have advanced in the Paper alluded to.

It will only be necessary for me to state to the gentleman, what I have first of all asserted, in my Treatise on Medical Police, &c. lately published, and what I have since published in addition to that in Number 129, alluded to by the gentleman, viz. that I conceive the disease, known by the term hydrocephalus internus, to be an inflammatory af fection of the whole system, and the brain and its membranes as a part of the whole; and that effusion of water into the ventricles of the brain is only a consequence of these inflammatory symptoms having either been entirely neglected, or perhaps, what is worse, ill treated. On this subject I suggested, what I can scarcely believe possible to be misunderstood by one of even very common abilities, or misconceived but by total neglect, that such a state of the system was perhaps most easily ascertained by attention to the state of the pulse. This, I say, I stated to be the disease, and that, the method by which it might almost to a certainty be ascertained, and if early attended to, removed. As concomitant symptoms, though not always present, I stated that the bowels were, in general, very torpid even from the first, and the stools black, or at least brown or green; (this the gentleman has imagined I stated to be the only cause and principal symptom of this widely spreading disease; but attention to the works above alluded to will I think convince him, if he will be convinced, that I meant no such thing) and that later in the disease great torpidity of the whole system was also very common, though not invariably present; and existed in some even to such a pitch that no artificial means could rouse it into any ordinary degree of action, nor could blisters produce any effect on the integuments of the head.

In respect to the prognosis of this disease, I stated, I think very plainly, that our chances of affording relief existed only previous to effusion into the ventricles of the brain; that this state existed always an indefinite number of days, in some even the length of one, two, or three weeks, and that when effusion had once taken place, the disease was in its last stage, and then always irremediable. I therefore agree with the gentleman in conceiving the disease after effusion (the only state previous to my publi

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cation

cation on the subject in which it ever has been described by writers, or deemed to exist by medical practitioners, and from which it has even derived its name) to be irremediable; and in order to prevent that occurrence, our attention, if we expect to be successful, must be directed to the early, consequently to the inflammatory, stage of the disease, when in almost every case it is easily manageable. At this important crisis, I repeat it, our sole object is to reduce inflammatory action. For this purpose, as in every other disease, the bowels, whether torpid or otherwise, must be freely opened, a cap blister put all over the upper part of the head, and, should the inflammatory action be obstinate, general bleeding, the application of leeches to the temples, and the laying open the jugular vein or the temporal artery is absolutely necessary.

Although I am accused by the gentleman of forming as vague theories as any one else, I can assure him that unless theories can lead to a rational train of practice I uniformly abandon them. None are less apt than I am to indulge in visionary speculations, where either the improvement of my profession will suffer by them, or the safety and comfort of the distressed are in any way likely to be lessened. I believe the only theoretical paragraph in my essay on this subject, in my work on Medical Police, is what I shall here subjoin, and it was not without extensive observation and considerable reflection that I ventured to advance it. It bears internal marks of probability.

"Its (hydrocephalus internus) attacking infants in preference to adults might be explained. We know that such is the particular state of the body in children, that the propelling and resisting powers have not acquired that degree of independence of each other, which they possess in after life, so that their diseases are totally different from those of adults; for, from this state of the body, any disease, whereever situated, will, either primarily or ultimately, affect the most delicately organized and tender parts in preference to any other;" thus I conceive it is, that the brain of children is so subject to this disease.

In

The cruelty of this practice the author of the paper in Number 131, deelains against most bitterly. I can assure the gentleman that I have scarcely ever heard any infant even cry from the pain occasioned by such a blister; but, on the contrary, have observed them greatly relieved almost instantly. In short, the sole object of the author of the paper in Number 131 must amount to this;-rather allow the infant to die to a certainty than even occasion to it temporary inconvenience by a blister,

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