244 THE SECRETIONS: 



solid residue. Hence it would appear that this decided decrease 

 of the urea below the physiological average is a characteristic 

 peculiarity of the urine in typhus. I found the maximum pro- 

 portion of uric acid amount to 4'8g, and the minimum to O9~ of 

 the solid residue; and with respect to the fixed salts, the maximum 

 was 13, and the minimum 3'4g of the solid residue. 



With regard to the state of the urine in typhus, and especially 

 in abdominal typhus, Schonlein observes that it is altogether in- 

 constant, that it is sometimes pale, sometimes apparently normal, 

 and sometimes jumentous. In the first stage it is usually of a 

 dark brownish-red colour, tolerably clear in the sthenic form of 

 fever, but darker in the erethismic and very torpid forms. 



A turbidity in the urine, together with other symptoms of a 

 crisis, frequently indicates the transition into the second stage. 



In this nervous stage of the disease the urine is of a dark 

 brown colour, and very acid. A perturbation is observed in the 

 urine on the seventeenth day, (occasionally it occurs on the 

 eleventh or twelfth day), and at the period of the actual crisis, 

 (the fourteenth or twenty-first day,) the urine becomes clearer 

 and more abundant ; sediments also occur, not of a crystalline 

 form, as in the phlogoses, but of a diffuse, flocculent, mucous 

 nature : the urine sometimes becomes as clear as the urina 

 spastica. 



If the typhus disappears prematurely on the fourth or seventh 

 day, we frequently observe, in addition to other acute critical 

 symptoms, a discharge of turbid, and often purulent urine. In 

 the form to which the term f febris nervosa putrida' has been ap- 

 plied, when the decomposition of the blood is particularly striking, 

 we meet with blood in the urine, which becomes very quickly 

 decomposed, and is of a dark brown or blackish colour. Con- 

 valescence after typhus can never be considered as safely esta- 

 blished until the urine becomes perfectly yellow and pale. As 

 long as it remains of a dark brown, or even high colour, there 

 is still danger. The more brown, decomposed, and fetid the 

 urine is during the course of the typhus fever, the more unfa- 

 vorable is the prognosis. 



In petechial typhus during the first stage, the urine is not 

 very highly coloured ; on the seventh day there is frequently a 

 turbidity; during the nervous stage the urine is of a dark brown 



