70 THE MICROSCOPE. 



matic crystals, the urate of ammonia, rarely uric acid, sometimes the 

 phosphate and the oxalate of lime, and often pus, mucous, and epi- 

 thelium; though this is the rule there are exceptions. I have seen 

 these prismatic phosphates in perfectly clear urine, the crystals being 

 plainly visible to the unaided eye, no other deposit present, no 

 distention or evidence of structural change in the bladder. 



The urine, as in these cases, when alkaline from a volatile al- 

 kali is generally considered pathological, usually the result of some 

 disturbance of the function of the bladder. 



The prismatic phosphates are often found in the urine of per- 

 sons suffering from dyspepsia, catarrh of the bladder, retention of 

 urine from paralysis, or any interference with the nerve supply of 

 the bladder resulting in paralysis with partial or complete loss of 

 function, also in cases of general nervous debility in which the 

 vital powers are much impaired. 



Among the first two hundred cases treated this last year at Dr. 

 Palmer's medical clinics at University Hospital, I noticed twelve in 

 which the prismatic phosphates were found in the urine, or about 

 one case in seventeen. Of these four were diseases of the stomach, 

 (dyspepsia, gastritis,) three general nervous debility, one each 

 epilepsy, psoriasis, eczema, paraplagia, and cystitis. 



The most common cause of the appearance of these crystals in 

 the urine is paralysis of the muscular walls of the bladder followed 

 by retention. 



The bladder not possessing the power to empty itself we have 

 first distention and then if not relieved, decomposition as a conse- 

 quence. The distended wall of the bladder sets up an irritation 

 followed by inflammation in which the mucous lining becomes par- 

 ticularly involved, and if relief is not soon obtained may extend to 

 the ureters and thence to the kidneys. 



The treatment for prismatic phosphates in the urine consists in 

 locating the cause and removing it. If from indigestion improve 

 the action of the stomach, pre.scribe digestants. 



If from debility and lack of tone, tonics, iron, quinine and the 

 mineral acids particularly are valuable. If from debility from con- 

 stipation, blue mass occasionally at night followed in morning by 

 salines. If from retention due to paralysis, tonics, elixir phos. ferri, 

 quinia et strychnia, teach the patient the use of the catheter and 

 have the urine drawn regularly, fre(juent washing out of the bladde 



