Dr. Willis's practice of physick being the whole works of that renowned and famous physician wherein most of the diseases belonging to the body of man are treated of, with excellent methods and receipts for the cure of the same : fitted to the meanest capacity by an index for the explaining of all the hard and unusual words and terms of art derived from the Greek, Latine, or other languages for the benefit of the English reader : with forty copper plates.

CHAP. VII. Of the Examination and various ways of proving of Urines.

ALthough the business of the Examination and Inspection of Urines seems commonly only a simple thing (viz. the Medicasters and Quacks for the most part behold the Urine sent in a Glass, shake it a little, and presently give Judgment) yet to those who honestly endeavour the recovery of the sick, the matter seems a little more intricate, and they use to observe se∣veral circumstances concerning Judgment by Urine; which being omitted, nothing indeed can be cer∣tainly or directly learnt in the Medicinal Practice from the Urinal. Moreover, in some diseases, besides the mere inspection of the Glass, there are other ways of tryal to be had, by which, what lies hid in the Urines, and out of sight, may be made clear: from whence some not unprofitably taking care of the separation of Urine more accurately, have used to evaporate, distill, putrifie, and precipitate them. Wherefore we shall speak briefly of the right manner of inspecting Urine, and in some cases of the Ana∣lysis or separation variously to be instituted.

When the Urine of the Patient is offered to the Physician, if it hath first stood for some time in the Glass, and if the liquor be clear, the Hypostasis is as it were gathered into a little cloud, and if the rest of the contents sink down to the bottom, there is nothing more wanting, but that forthwith a progno∣stick sentence may be given. But if the Urine be newly poured into the Urinal, or be troubled by a former shaking, you must stay till the confused parts be separated, and the settlement have acquired its due place. If the Liquor be full of contents, and the Pores straitned, it becomes troubled and dark, and the Glass must be put in a warm place, till the Urine grow clear again, and then let it be placed for some time near the fire, that whilst the preternatural or more thin contents are absorpt by the Pores dilated by the heat, the more thick may fall down to the bottom, and the filaments or little rags ma∣king the Hypostasis, (if there be any) may be gathered together below, or in the middle region; for so will appear what is the power of Nature, and what of the Disease: Also in Fevers, the degree of heat and effervescency, the concoction or depravation of the nutritious Juyce, also the congestion or hea∣ping together of the adust matter in the blood, and its separation begun, or wholly frustrated, may somewhat appear by the signification taken from Urines; wherefore you ought to proceed after this man∣ner, when the urine is brought from far, to wit, whose Particles are disturbed by much shaking, unless it be kept for some time in a warm place, they will not easily get again their due place of position. But if you often visit any Patient that keeps his bed, it will be convenient, that the urine newly made, and put into an Urinal, be placed near a Stove, where, whilst it grows moderately hot, the several parts may, after the best manner, be disposed to a settlement without any trouble or disturbance.

Afterwards the Urine thus naked, and as it were disrobed from any covering, is offered to the sight, the next caution will be, lest any of its Phaenomena or appearances being accidentally contracted, and not properly belonging to it, may impose upon the Physician; which indeed sometimes happens, by rea∣son of alterations caused in them by food taken, and which chiefly consist in the colour and smell of Urines, being variously changed besides Nature, and the expectation of the Physician.

For it is an errour commonly committed, when the Urine being yellow, and tinging the linen by the taking of Rhubarb, Saffron, Sanders, and the like, undoubtedly to believe it a sign of the Jaundice; also the urine being imbued with blackness by the taking of Cassia, to attribute it to the melanch•…•…ck Tumor or black Bile; also when the urine is deep colour'd by taking of Pulse-broth, or a Decoction of Madder, or other drinks, we falsly suppose it to indicate a feverish intemperance. It often hap∣pens from the drinking plentifully thin liquor, the urine is lessened of its high colour beyond expecta∣tion,

and heightned by the drinking of strong drink or hotter things: unless the Physician •…•…ake notice of these kinds of mutations, he will give but a false Judgment concerning Urines by looking on them. When therefore the colour is changed in the Urin•…•…s without any manifest cause, the manner of living must be inquired into, if that the alt•…•…ation proceeds from what is ea•…•…n or drunk, that it may not be wrongfully ascribed to the disease. A question will her•…•… arise, why forasmuch as mo•…•… things taken in at the mouth, before they go into urine, wholly los•…•… all th•…•…ir colour; which being eaten; so pertina•…•…∣ously impress a tincture to the Serum, that they pass untouched through all the •…•…rait turnings and windings of the passages? The reason or cause of which consists chiefly in this, that some mixtures have the constitutive parts of their colour or dye very subtil, and those highly volatile; wherefore these be∣ing taken only in a small quantity, dye the whole mass of the Chyle with their colour; and from thence the nutricious Juyce conveyed to the blood, ascends coloured, and its vehicle, viz. the serous Latex, is sent away still dyed or tinctured.

What the odour of Urines of sound people may be, is obvious to every one that can smell, viz. whilst it is fresh made, it is not very ungrateful, by reason of the sulphureous and saline Particles bound up in the substance of the liquor; when it hath stood so long, that the Sulphur begins to exhale, sharpned with the Salt, the mixture being loosned, it putrifies and stinks grievously. Besides we may observe, that sometimes there arises from urines fresh made, a sweet odour like Violets, and sometimes they of∣fend the nose with a very ungrateful stink. The former doth not depend either on an healthful or un∣healthful condition of the body, but is produced only from things taken: Turpentine, Nutmeg, and other Gumms and Spices taken in at the mouth, though of a diverse nature and operation, impart a like suavity or sweetness to the urine. The reason of this seems to be, because in these kind of mixtures very many particles of the purer Sulphur (that is imbued with Spirits) are eminent; which, for that they are volatile, being confused with the Serum, are not contained in the bond of the mixture; where∣fore the urine being made, these alone leap out, and not accompanied with others of the stinking urine, and so diffuse a grateful odour; which, although it proceeds from divers kind of things eaten, yet re∣mains still after the same manner like Violets, for that in all, those sulphureous Particles are set •…•…ee by digestion from the others joyned with them in the same concr•…•…te, nor are infe•…•…ed by different ones from the urine. But as to what respects the stinking urine, that sometimes proceeds from an Ulcer about the Reins, Bladder, or urinary passages; sometimes also it is raised from a too hot intemperance of the Reins, or of the whole Body; for when the Sulphur is deeply boiled in the Serum, its particles being sharpned by the Salines, (for that they are less closely shut up) do presently evaporate, and grievously affect the sense of smelling; but besides, sometimes urines contract a stink from things eaten. For the Balsam of Sulphur, Garlick, Asparagus, Cider, Rhenish Wine, and many other things taken at the mouth, do cause a strong smell in the urine. If the reason of this be demanded, we say that such things which impart a stink to the urine, also p•…•…ovoke it in a more plentiful quantity: wherefore it seems that these sort of things being taken, fuse the blood, and greatly hasten the precipitation of the Serum; and when by this means the serous Juyce is pulled away as it were abruptly from the blood, the frame of the liquor is made lax, nor are its parts exactly •…•…xed, nor contained in an equal bond of disposition: wherefore when this urine is made from the body, its frame or substance being b•…•…fore loosned, the par∣ticles of the more gross Sulphur (that is combined with Salt) presently breathe out, and so diffuse a stinking smell. For urine thus altered by things taken, seems very like to Lye, wherein Antimony o•…•… common Sulphur is boiled, and is afterwards instilled into some acid thing, because in this Decoction, as also in such ruine, the frame of the liquor being unlocked, the little sulphur•…•…ous bodies leap out, and affect the sensory with a stinking smell.

If that any one more curious in the search of Urines, shall seek further than the examination of the sight and smell, he may easily, by a divers manual operation, resolve them into parts, and as it were dissect them to the life, and thence draw Medicinal directions of no small moment; for that in many Chronical diseases where the Dyscrasies of the blood are more exactly to be sought into, that the pro∣portion and temperature of Salt and Sulphur may be truly found in it, it is sometimes convenient to eva∣porate urines, or to distil them, something also is to be learned from them, being precipitated, or loos∣ned by putrefaction. I knew an honest Woman greatly afflicted with a scaly filthiness of the skin, which she was wont to scratch off in great plenty, as it were a branny matter. Her urine being evaporated in a little Skillet, left sticking to the sides of the Vessel, a crusty and salt sediment, like the excrement o•…•… her skin. Not long since I evaporated the urine of a Gentleman, grievously subject to convulsive mo∣tions and painful stretchings out of the Muscles, in the bottom of which there remained a quantity of sal•…•… and tartarous matter, exceeding the weight of half the liquor. By this means it will be an easie thing to find the proportion of the saline Principle in the blood and humours: but whether this Salt be volatile, or becomes fixed beyond measure, the distillation of the urine will presently shew; For if the Spirit (•…•…o called) be copiously drawn out of the urine, and that besides the Salt ascends into the Alembeck, it is a sign of volatilization: but the contrary to this argues the fixity of the Salt.

As the evaporation and distillation of the Urine shew the power of the saline Principle, so the preci∣pitation, putrefaction, and Sulphur lay open the thicker contents of the Urine, as it were in weight and measure. As to the former, although the liquor of the urine be salt, and often big with contents, yet for as much as its saline Particles are not (as it is wont to be in most Me•…•…struums) either wholly in a state of

fixity, or of flux, but for the most part volatile, therefore it is not easily nor presently by any salt in∣fusion subject to putrefaction; the Spirit of Vitriol and other acetous things effect nothing: the Salt of Tartar stirs up a little peturbation. But the so•…•…ution of Alu•…•…, for that it greatly constrains into a little space, presently disturbs the whole liquor extreamly, and delivers all the contents of the urines, as they were thrust out of their dens, to be seen openl•…•… by the eyes. Wherefore by this means, without any long stay for settlement you may 〈◊〉〈◊〉 k•…•…w how much of •…•…ulphureous a•…•…d earthy 〈◊〉〈◊〉 is depo∣sed 〈1 line〉〈1 line〉

The putrefaction of Urines is w•…•…nt to exhibi•…•… 〈◊〉〈◊〉 se•…•…l 〈◊〉〈◊〉 of 〈◊〉〈◊〉 kin•…•…, •…•…et mor•…•… distinct, and disposed as it were by themselves; for if the urine be left to stand unmoved for many days in the Glass, the colour, odour, and consistency will be very much altered; for the colour will be deeper, the smell ungrateful, and •…•…ighly stinking; the co•…•…sistency thicker, and will have on the superficies a downi∣ness or 〈3 lines〉〈3 lines〉 or less altered from their formet state, it may be conjectured what the proportion of Salt or Sulphur may be, whether of them exceeds the other: also no unfaithful Judgment of the quality and plenty of the earthy matter or the contents may be take•…•… from hen•…•…e.

And thus, Sir, at length you have the Doc•…•…e or Method of Separation of Urine, such as our un∣skilfulness hath rendred it: I desire you would be pleased not only to pardon the errours and barrenness of this Discourse, bu•…•… al•…•…o to 〈◊〉〈◊〉 it in other things, •…•…cause at first writ b•…•… your 〈◊〉〈◊〉, and then by your command and request made pub•…•…. Where•…•… pray take care of this ch•…•… hardly brought forth and almost an abortive, and as it were exposed a•…•…d deservedly laid at your door without por∣tion. Farewel.