Sidor som bilder
PDF
ePub

disorders. But I indulge in the hope that the present essay may be the commencement of an investigation, to which the results of subses quent researches on the subject will be gradually added. Io the mean time sufficient evidence has already been obtained to shew, that in some establishments, both in this and other countries, a remarkable uniformity prevails in regard to the frequency of the disease, whilst in other instances a great discordancy is observable, and that none of the circumstances commonly suspected to influence this disorder, can satisfactorily account for this variety of results. This naturally leads to the suspicion, that the tendency to form urinary calculi must arise from some general causes, independent upon the peculiarity of food or beverage to which they have been usually ascribed; and since it appears that in hot climates, and especatly between the tropics, there complaints are almost unknown. one is naturally led to connect this cir: cumstance with the great changes in the urine known to arise fron dif ferent conditions in the surtace of the body, and to enquire whether amongst other causes, there may not be some essential connection between the state of the cutaneous, functions, and the greater or less prevalence of this class of disorders.

With respect to those several remedial processes which have been instituted with a view either to dissolve stone when formed, or to prevent the increase of the concreted substance, ihere can, not be a doubt that the question of their efficacy, must greatly depend upon the practicability of any solvent or corrective maiter finding its way to the urinary, organs; and if that be possible, the next object of inquiry will be, What are the constitu, ent ingredients of the particular substance to which our curative attempts are about to be applied ? Now, that alkaline substances are capable of beiog conveyed to the urinary organs, and in parting their specific properties to the secreted Huid, has been as; certained, beyond the possibility of a doubt. Among the late Dr. Whytt's cases, we find the following experiment,

which, as being conducted by an individual who was biinseli the subject of the experiment, and a ipan of unquestionable veracity, it may not be amiss to record.

• The Reverend Dr. Richard Newcomb, pow Lord Bishop of Landaff, while drinking two English quarts of lime water daily, for the cure of a stone in the bladder, poured his urine every morning and evening upon a piece of human calculus weighing 31 grains; by which in the space of four months it was reduced to three pieces weighing in all six grains. Upon one of these pieces, weighing 2,31 grains, he caused to be daily poured for two months, the fresh urine of a person who drank no lime water, at the end of which tiine the piece of calculus was found to weigh, 2,56 grains, having increased in weight a quarter of a grain. This same piece being afterwards steeped in the Bishop's uribe, (who continued to drink lime water as above) from June 24 to July 9, was in these few days quite crumbled into powder.'

One difficulty presents itself in reference to the solvent agency of substances taken into the stomach ; and it has been urged as an objection against the supposition of lithonthriptics possessing any specific virtue. It is this, that wild alkalies, as they are termed, or those alkaline substances which are combined with the carbonic acid, have appeared to mitigate the symptoms of stone with greater facility and effect than the pure or caustic alkalies, whereas it is these last which display their solvent properties upon lithic concretions out of the body, with by far the greatest activity. This objection, however, is satisfactorily met by the statement, that the carbonic acid of the mild alkalies, may, and does, by meeting with the acid of the stomach, becoine expelled or neutralized, and that thus the medicine is brought to precisely the same condition of efficacy as if it had been taken uncarbonated or pure; while it has this advantage when administered in a mild form, that it can be taken in a much larger quantity, and that, moreover, the veutralization of the acid in the first passages, corrects the constitutional tendency to fresh deposits of calcareous matter.

The priuciple then being aclmitted, that alkaline inatter, when taken into the stomach, possesses at the very least some corrective and solvent property, (it being recollected at the same time, that urinary concretions occasionally happen, which are not acted upon by alkalies, but on the contrary, are only solvable in the mineral acids,) it follows of course to be considered, whether, and to what extent, these acid substances are capable of impregnating the urine with their specific influences. 'On this head; we shall extract the following observations of Dr. Marcet.

. With regard to the acids,' says our Author, the question is not so easily resolved. For, as the urine is naturally acid, and especially containing portions of both the muriatic and sulphuric acids, which are those commonly used as medicines, any small increase of either of these acids in the urine, in consequence of their being taken into the stomach, cannot be so readily ascertained. it is how. ever stated by some chemists, and in particular by Mr. Brande, that acids taken into the stomach, are actually capable of being conveyed into the bladder; and this he has more especially endeavoured to ascertain by experient with regard to the carbonic acid. Unfortunately, however, although alkalies do certainly, and acids may possibly, reach the urinary passages, yet experience bas shewn, that the quantity of either, thus conveyed through the circulation, is so gigall, that very little, if any impression, can be made on large pré-existing calculi with whatever freedom or perseverance these inedicines may be used. But there is abundant evidence to prove, that we are able in many instances, to produce an effect sufficient to check the pre

vailing diathesis, and even sometimes to bring on a calculous de- posit, depending upon an opposite state of the system; a change, which I have myself repeatedly witnessed.'

We have been induced to make the above extract, partly for the sake of doing justice to the extreme candour, and unsystem-like freedom, with which the writer admits the limits of me.. dicinal operation, in the way of solvent efficacy; and partly with the view of impressing the necessity of early ascertaining the precise nature of those sabulous concretions, which are passed in a gravelly subject, before any curative plans are adopted, for the purpose of preventing their increase ; since the common alkaline lithontbriptics, migbt, in the place of proving remedial, actually, in some cases, afford afresh pabulum to the disorder. Into the minutiæ of these plans, we do not consider it as our province to enter; but we shall take occasion to make a shortextract from a writer of celebrity, bearing upon the point of discrimination to which we are now adverting. It will be re: collected, that we have remarked, in a former part of the present paper, that the lithic or uric acid calculi, are the most common species of concretions, and that these are soluble in alkaline menstruæ. In this case, alkaline medicines are called for, and will prove more or less efficacious. But in those kinds of calculi wbich are coinposed of earthy bases with phosphorio acid, it will also be recollecteil that the muriatic acid was said to be the agent of solution ; but it may be now proper to add further, that lime and alkalies might not only be thrown away when applied to these concretions, but that the exhibition of these medicipals as just hinted, would in many cases be actually calculated to increase the evil they were intended to lessen, by furnishing that earthy substance in greater quantities, by which the base of the concretion is principally forined. “The

absurdity, (says Dr. Pemberton, the author to whom we have just alluded,) of persevering in a plan of alkaline inedicines to • dissolve a calculus, which is not in the smallest degree acted

upon by an alkali, but on the contrary by an acid, is sufficiently • apparent. I am here alluding to the schcelian and fusible cal• culi; the first sort being soluble in alkalies and not in the mu

riatic acid, the second, soluble in the muriatic acid, and not in the alkalies. The fusible calculus, or rather the fusible sand, • (continues Dr. P.,) as mentioned by Dr. Wollaston, I am in • clined to believe, is much more common than is usually sus

pected, and the benefit (he adds) obtained from an acid solvent • in this species of calculus, I have observed, is much more ra• pid, than could be expected from the usual effects of repeated • solvents in other cases of calculus.'

It is most probable, that in the instances which Dr. Peinberton adduces in support of this assumption, the benefit procured by the mineral acid, was referrible to its action on the first passages, and to its thereby correcting the tendency to sabulous deposite. But we must refrain from going further into practical detail. We sball therefore conclude our remarks, by recommending both to the philosophical inquirer, and to the medical

[ocr errors]

practitioner, an attentive perusal of the work, which has farnished the occasion of these animadversions. Dr. Marcet's style we think adinirable. It combines scientifie precision with graceful ease. The plates, which are by Miltos, from drawings by Thomson, are executed as much to the life, as any graplric illustrations of pathological subjects we have ever seen. This performance of Dr. Marcet, although perhaps containing very little more than had already been advanced in the Philosophical Transactions, and other scattered publications, is an elegant and classical compendium of the present state of chemical, physiological, and medical science, in reference to the particular subject upon wbich it professes to treat.

our notice.

Art. VII. Sermons in the Death of Her Royal HIGHNESS THE

PRINCESS CHARLOTTE.

(Continued from Page 90.) E had intended to resume, at some length, in our last Nuin

ber, our notice of the numerous discourses which have been published on this melancholy occasion. But ere this time, our readers will have made their selections from the list, and laid the volume by in their libraries. We shall now therefore restrict ourselves to a very brief discharge of what we feel to be an invidious task, humbly entreating the authors of any sermons we may omit to notice, to acoept, in apology, the distinct ad mission we hereby make, that their claims are probably not inferior to the claims of such as are more fortunate in attracting

The Sermons we have already adverted to, would have furnished matter for abundant remark. Dr. Chalmers's, in particular, embraces the consideration of some very iinportant, but very irrelevant political subjects, which we may take some future occasion of discussing, but for the present they must be passed by. We confess that we have been much the best pleased with those Sermons, in which the doctrines of the Gospel are made more prominent than the politics of the preacher. A remark of this nature we have made before ; and though it might seem too indiscriminately to bear, in a way not exaetly intendedy upon sermons of a very opposite complexion, we see no reason to retract our opinion, that whatever was adapted to excite the angry feelings of party, or to divert the attention from the personal innprovement of the occasion, was at the best injudicious. In some instances, a much stronger word would not be in applicable.

A sermon by the Rev. C. J. Hoare, vicar of Blandlord, founded on Psalm xxxix, 9, seems entitled, by the good sepse which is mauifested in treating the subject, to be distinguished as one of the best which have proceeded from the clergy. After considering what, in such a season of calamity, " we ought not to do,"

[ocr errors]
[ocr errors]

under which division he judiciously remarks, 'Let us not be

templed too deeply to speculate upon the secret intentions " of our heavenly Father in such a visitation, the Preacher proceeds, in the following reinarks, to state what we ought

not to do.'

• I. Let us, then, begin with acknowledging the imperfection of our own blind and fallible judgment, which had led us to build our hopes so high upon a passing shadow-the semblance, indeed, and but the semblance, of a great and permanent national blessing. It was usquestionably an error, though like many others known only by the event, that we had conceived that one circumstance so essentially ne. cessary to the best interests of this nation, which God has now taught us in more than words not to have been necessary. There is no one, I am sure, amongst us, rash enough, on this or on any occasion, deliberately to confide in the wisdom of his own choice, rather than in the wisdoni of the Divine appointment. For my own part, I most freely confess, that if any one consideration more than another has prevailed to afford relief to my own mind, under the pressure of this heavy disappointment, it has been the single thought, that could I have previously known the will of God respecting the event in question, I should not have dared, even for a moment, to have wished that will reversed ; nor, even as I tendered my own and my country's best advantage, to have“ stayed His hand, or to have said, What dost Thou?" It is my desire, and let it be also yours, to learn from this consideration, more and more to distrust the wisest calculations of all human foresight; to be prepared for every reverse : and with greater confidence to commit all our ways into his hands, whose “ tender mercies are over all His works, and who alone infallibly knows what is best for us.'

• 2. Painful, however, as we doubtless feel this severe act of die Divine Sovereignty i let us next consider, that as our sins have most clearly deserved all there is of chastisement in it, so that our repentance alone, and deep contrition for sin, can avert its worst consequences as a national curse. When the Almighty appears to us in the dispensations of his providence, he will be seen ; when he speaks to us in the thunders of his power, he will be heard. Vain is it when thus admonished, to reply in the language, or the spirit of Pharaoh, “ Who is the Lord, that I should obey his voice?" Vain is it to harden ourselves, like him, against repeated warnings; or, when forced, at length, to mourn almost as if “ there were not an house where there was not one dead,” still, like him, after a little alarm, and a few momentary relentings of conscience, to return to the very same courses which had brought this evil upon us. " Of you, beloved," may 1 have cause, and that on the best grounds, to say, that “ I am persuaded better things, and things that accompany salvation,” God grant that the impression upon your hearts, and upon those of the nation at large, made by this day's ceremony, may be deep, lasting, and effectual; that we may see a positive and rapid advance amongst us all in the fervours of a rational devotion, the convictions of a well-grounded taith, the fruits of an abiding holiness of life; and that these free-will offerings of a nation's grief may be accepted, not as an atonement for

« FöregåendeFortsätt »