C U C. p. ALUMNI JOURNAL 



23 



Urine Specimens 



By JOHN A. STEFFENS 

 N. Y. C. P. '09. 



Honor student of his class, Doctor Steffens immediately upon completion of his 

 post graduate studies became connected with a busy clinical laboratory. His 

 description of some of his experiences are inter esti fig and sojtie rather startling. 



What is a sample? How should a 

 specim-en be taken? These are questions 

 rarely asked, and when asked as rarely 

 answered. 



Sampling of urine depends upon the 

 object to be achieved, namely, the insight 

 into general bodily conditions, the func- 

 tioning of the kidney, the condition of 

 the urinal tract and its bacterial flora. 

 The physician often desires only a re- 

 port on the bacteria present or absent, 

 but most often combines the first three 

 and neglects the latter. 



However, it is best not to isolate ob- 

 jects when a sample is being examined, 

 for a searching examination will often 

 reveal more serious conditions than sus- 

 pected. In one instance a sample sent 

 in for examination for gonococcus 

 showed in addition over four per centum 

 of sugar. In another case a sample 

 marked "cystitis" showed Nieser's cocci 

 in the bladder, which had not been sus- 

 pected. 



Thus, in general, a sample of urine 

 should be the secretion and d-etritus of 

 the urinary tract- from kindey to the 

 mouth of the urethra, unmodified in any 

 way, taken under known conditions of 

 diet, medication, bodily exercise and 

 nervous condition. Since diet, medica- 

 tion, bodily exercise and nervous condi- 

 tions may not be known and as all sam- 

 ples contain more or less foreign matter, 



allowances should be made in the inter- 

 pretation of analyses. Some physicians 

 make too many allowances, others take 

 every result as absolutely representative. 

 In all cases judgment should be exer- 

 cised. 



Some rather rigidly moral males and 

 females receive a shock when ordered to 

 prepare a sample of urine and following 

 the nervous shock, the kidney behaves 

 abnormally, either secreting more copi- 

 ously or causing a retention of urine. 

 Others try to make conditions as favor- 

 able as possible for a clean bill of health 

 by sudden regulation of habits, purging 

 and copious drinking of water. Some 

 people, too, seem to require "spirituous'' 

 consolation. Thus, the nervous state of 

 the patient and resultant acts may com- 

 pletely change the nature of the urinary 

 indications. 



Bodily exercise and excessive sweat- 

 ing, especially when the patient is not 

 used to that state, may create a tempo- 

 rary state of urinary excretion which is 

 abnormal. Diet similarly may falsify a 

 result as in case of a girl who had only 

 recently been hired in a candy shop and 

 showed a few per cent, of sugar due to 

 over indulgence in the sweets. 



Many persons have formed habits of 

 regularly taking certain favorite pills 

 which have usually been recommended to 

 tnem by a friend, and discovery of this 



