roid arteries and sloughing of the thyroid gland. Vomiting
of urine is also mentioned by Coley, Domine, Liron, Malago, Zeviani,
and Yeats. Marsden reports a case in which, following secondary papular
syphilis and profuse spontaneous ptyalism, there was vicarious
secretion of the urinary constituents from the skin.

Instances of the anomalous exit of urine caused by congenital
malformation or fistulous connections are mentioned in another chapter.
Black urine is generally caused by the ingestion of pigmented food or
drugs, such as carbolic acid and the anilines. Amatus Lusitanus,
Bartholinus, and the Ephemerides speak of black urine after eating
grapes or damson plums. The Ephemerides speaks of black urine being a
precursor of death, but Piso, Rhodius, and Schenck say it is anomalous
and seldom a sign of death. White urine, commonly known as chyluria, is
frequently seen, and sometimes results from purulent cystitis. Though
containing sediment, the urine looks as if full of milk. A case of this
kind was seen in 1895 at the Jefferson Medical College Hospital,
Philadelphia, in which the chyluria was due to a communication between
the bladder and the thoracic duct.

Ackerman has spoken of metastasis of the tears, and Dixon gives an
instance in which crying was not attended by the visible shedding of
tears. Salomon reports a case of congenital deficiency of tears.
Blood-stained tears were frequently mentioned by the older writers.
Recently Cross has written an article on this subject, and its analogy
is seen in the next chapter under hemorrhages from the eyes through the
lacrimal duct.

The Semen.--The older writers spoke of metastasis of the seminal flow,
the issue being by the skin (perspiration) and other routes. This was
especially supposed to be the case in satyriasis, in which the
preternatural exit was due to superabundance of semen, which could be
recognized by its odor. There is no doubt that some people have a
distinct seminal odor, a fact that will be considered in the section on
"Human Odors."

The Ephemerides, Schurig, and Hoffman report instances of what they
call fetid semen (possibly a complication of urethral disease). Paaw
speaks of black semen in a negro, and the Ephemerides and Schurig
mention instances of dark semen. Blancard records an instance of
preternatural exit of semen by the bowel. Heers mentions a similar
case caused by urethral fistula. Ingham mentions the escape of semen
through the tes