URINE. 203 



presence of blood, the flattened blood-corpuscles may probably 

 be observed. The pus-globules usually appear rather larger than 

 the pus-globules of the lungs, and less granular ; and I have 

 observed that the nucleus can be more frequently recognized 

 with clearness ; the blood-corpuscles also appear tumid. 



The filtered urine always contains albumen, sometimes in 

 such quantity that flocculi separate on the application of heat. If 

 the urine is allowed to stand for some time, and develops car- 

 bonate of ammonia, the pus becomes so viscid as to form a tena- 

 cious jelly. In these cases small quantities of albumen might 

 escape notice on the application of heat, being held in solution by 

 the carbonate of ammonia ; to assure ourselves of the presence of 

 albumen in these cases, we should make use of nitric acid. 



In catarrhus vesicse, in which a considerable quantity of 

 mucus is frequently discharged, and where the urine is either 

 thick and viscid at the time of emission, or very soon becomes so, 

 a small quantity of pus may be easily overlooked. 



URINE IN DISEASE. 



On the general relations of the urine in disease. 



Although I have, in the preceding pages, made many remarks 

 on the general constitution of the urine in disease, I believe it 

 will not be unacceptable to the practical physician if I offer 

 some additional observations on the variations in the composi- 

 tion of this secretion, when it is pathologically changed. 



The quantity of water in urine is always fluctuating, and 

 may vary to a great extent ; this point has been already referred 

 to in our remarks on the physiology of the urine. The urine 

 may exhibit remarkable differences in its external physical 

 characters in persons suffering from the same disease, a 

 circumstance that analysis will enable us to trace to the dif- 

 ferent proportions of water that may be present. Frequent 

 recourse to fluids, and the degree of activity of the process of 

 transpiration must obviously have a very great influence on the 

 amount of the watery portion, and therefore on the amount of 

 the urine itself, and this is a point which the physician should 

 never lose sight of in forming his opinion on the quantity of 

 the discharged urine and on its degree of concentration. It is 

 well known that the morning urine is more concentrated than 

 that which is discharged during the day. 



