URINE. 243 



The difference between the urine in typhus and in inflam- 

 matory disorders is sufficiently great to be determined with 

 certainty. In the phlogoses when the fever assumes a synochal 

 character, we observe that the urine, with some few exceptions 

 (as occasionally in cases of injury of the spinal cord, and in dis- 

 eases of the kidneys and bladder,) is of a red colour, acid, usually 

 clear, and only forms sediments of a yellow, red, or brown colour, 

 and consisting of uric acid and the urates, on the occurrence of 

 a crisis; the quantity of the urine is diminished, and the specific 

 gravity increased ; the urea is either absolutely increased, or is 

 equal to, or very little below the physiological average; the 

 quantity of salts is in general diminished, (the sulphates, how- 

 ever, in a much less proportion than the chlorides;) and the quan- 

 tity of extractive matter increased. 



In typhus the quantity of urine is decreased; it varies ex- 

 tremely in colour and reaction ; the red tint of inflammatory 

 urine is, however, very seldom observed, but more commonly a 

 brown or reddish-brown colour; the more the fever assumes the 

 erethismic character or approximates to the synochal form in con- 

 sequence of being complicated with inflammation of the respira- 

 tory organs, the more also does the urine approximate in its 

 physical characters to the inflammatory type; and in proportion 

 to the torpid character of the fever and to the prolapsus virium, 

 does the urine become less dense and acid, and the more readily 

 does it assume the alkaline state. 



The urine may resemble the normal type as far as the specific 

 gravity and the amount of solid constituents are concerned; it 

 is usually, however, less dense, and it frequently happens that 

 the deeply-coloured urine of typhus has a much lower specific 

 gravity than we should have been led, from its tint, to expect. 

 The amount of urea never reaches the physiological mean, and 

 is often far below it ; the uric acid, on the other hand, is often 

 increased, especially on the occurrence of the urinary crisis. 

 The salts, including the sulphates, are very much diminished, so 

 that sometimes hardly a trace of them can be detected. We 

 have seen that in the phlogoses the urea ordinarily attains the 

 physiological average of 39 of the solid residue, and that it 

 sometimes even exceeds it; while in the urine of typhus I found 

 that the maximum proportion of urea amounted to only SI'SJ, 

 the minimum to 22, and the mean of 7 analyses to 26-6 of the 



