THE KIDNEYS SECRETION OF URINE. 497 



and others 1 to the conversion of urea in the blood into carbonate of ammonia, 

 and in a case recorded by Spiegelberg not only was the quantity of urea in 

 the urine greatly diminished, but the proportion of this substance in the 

 blood was augmented to three times its normal amount, whilst clear evidence 

 was obtained by Dr. Gscheidleu that the blood contained a considerable 

 excess of ammonia. Experiments on animals in which carbonate of ammonia 

 has been injected into their veins, show that conditions precisely analogous 

 to the urrcmic state can be established, the animals first becoming restless, 

 and then exhibiting both tonic and clonic spasms, and finally passing into a 

 state of deep coma.' 2 



407. In order to form a correct opinion of the state of the Urinary secre- 

 tion in morbid conditions of the system, it is desirable to be acquainted with 

 every leading particular regarding its normal character. Fresh healthy 

 Urine is a perfectly transparent, amber-yellow-colored liquid, exhaling a 

 peculiar but not disagreeable odor, and having a bitterish saline taste. The 

 only morphological elements which it normally contains, are pavement epi- 

 thelium-cells and mucous corpuscles from the lining of the urinary passages ; 

 which, however, are present in healthy urine to only a very small amount. 

 But in certain morbid states of the urine, minute cylindrical bodies are seen 

 in greater or less abundance, which are obviously derived from the tubuli 

 uriniferi ; these are sometimes composed almost exclusively of the epithelial 

 lining of the tubes, of which the cells remain adherent to each other, notwith- 

 standing their detachment from the basement-membrane beneath ; whilst 

 sometimes they are fibrinous moulds of the interior of the tubes, formed by 

 exudation of granular plastic material, and containing blood- or pus-corpus- 

 cles ; whilst in other instances, again, they are perfectly transparent, or 

 hyaline, and are then believed by Dr. Basham to correspond to the viscid 

 mucous exudations poured out from all inflamed mucous surfaces. The first 

 of these forms occurs chiefly in desquamative irritation of the kidneys, the 

 second as a consequence of acute inflammation, and the last in the advanced 

 stages of "Bright's disease," as well as in the gouty and atrophic kidney. 3 

 In all natural conditions of the Human system (even when a vegetable diet 

 is used) the urine possesses a well-marked acid reaction. When it is left to 

 itself for some time, slight nebulae, consisting of mucus, are formed in it ; 

 and these gradually fall to the bottom. Soon afterwards an unpleasant odor 



1 See Spiegelberg, Archives of Gynaecology, 1870, and Hampeln, Dorpat Med. Zeits., 

 Bd. iv, 1873, and Lond. Med. Record, vol. i, 1873, p. 611. 



2 Voit (Henle and Meissner's Herieht, 1867, p. 358) is inclined from his experi- 

 ments to hold that the effects observed in tira'inic poisoning are due to the action of 

 the various secondary compounds and alkaline salts proceeding from the disintegra- 

 tion of the albuminous constituents of the body which are retained in the blood in 

 this disease upon the central parts of the nervous system, no ammonia being generated 

 except on the intestinal mucous membrane (see also G. Johnson, Brit. Med. Jour- 

 nal, vol. i, 1873, p. 19.') ; JMantegazza (Centralblatt, 1870, p. 576), on the other hand, 

 finding that intravenous injection of urea or of urine produces convulsions both in 

 curarized frogs and even in muscles excised from the body, regards the action as 

 peripheric, and not centric. Traube attributes the symptoms of urasmic poisoning to 

 too great fluidity of the blood and over-tension of the systemic vessels, leading to 

 oedema and anaemia of the brain ; but Picot's experiments (Comptes Rendus, July 6th, 

 1874), in which water was injected at considerable pressure, are opposed to this view. 

 Rosenstein (Virchow's Archiv, Bd. Ivi, 1872, p. 383), Oppler, and others contend 

 that the symptoms caused by the injection of ammonia differ essentially from those 

 of ursemic poisoning. Urea ingested by the stomach is eliminated unchanged. See 

 Rabuteau in L'Union Medicale, 1872, No. 142. For an account of the effects of the 

 injection of ammonia into the circulation, see Tibbits, Med. Times and Gazette, 1872, 

 No. 1166. 



3 See, for admirable drawings and descriptions of these, the work on Renal Dropsy, 

 by W. R. Basham, M.D., 1866. 



