204 THE SECRETIONS: 



In consequence of the fluctuations, arising from various 

 causes, in the amount of water in healthy urine, Becquerel 1 

 has come to the conclusion that its increase or diminution can- 

 not be referred to the action of disease, except less than twenty- 

 seven or more than fifty-two ounces are secreted in twenty-four 

 hours, the average quantity in health being about forty-four 

 ounces in that period. 



The diseases in which the quantity of water separated by 

 the kidneys is absolutely or relatively increased are diabetes in 

 its different forms, and certain hysterical or nervous disorders in 

 which a perfectly limpid and thin urine is discharged in large 

 quantity : thus Becquerel relates a case of a young chlorotic 

 girl who ordinarily secreted daily about thirty-seven ounces of 

 water by the kidneys, but in whom the amount rose to ninety 

 ounces upon the accession of a severe hysterical attack. 



The amount of water separated by the kidneys is diminished 

 in inflammatory affections, in which Becquerel has seen it fall 

 as low as twelve ounces in twenty-four hours. In these cases 

 the urine is of a very dark colour, of a high specific gravity, 

 and possesses a strong acid reaction. As the quantity of water 

 increases, the solid constituents*relatively, but not always abso- 

 lutely, diminish, as may be found by comparing them with the 

 amount secreted in twenty-four hours in a state of health. 



The quantity of urea was found by Nysten to be increased 

 in inflammatory affections, and my own analyses of the urine 

 during inflammation, on the whole, tend to confirm his state- 

 ment ; for I found it either absolutely or relatively increased, 

 or equal to the quantity separated in a healthy state, or at any 

 rate but slightly diminished. If we remember, however, that in 

 these acute diseases only very small quantities of nitrogenous 

 food are taken, and that the quantity of urea must naturally 

 decrease under such a diet, we may regard it as increased even 

 if it falls below the physiological average. Becquerel also found 

 the amount of urea in acute diseases very little below the phy- 

 siological mean. 



The quantity of urea is diminished in diseases in which there 

 is either an absolute deficiency of blood, or the blood is poor 

 in corpuscles ; thus Becquerel found the urine in chlorosis defi- 

 cient in urea, and I have observed the same to be the case in 

 the latter stages of typhus. 



1 Semeiotique des Urines, &c. p. 19. 



