246 THE SECRETIONS: 



during which, in one of these cases, the urine continued unin- 

 terruptedly alkaline, was above eight days. 



In another case, in which I followed the variations of the 

 urine through the course of the disease, it became alkaline at 

 noon on the third seventh-day period, but the next day it again 

 became acid, and remained so till death, which soon occurred. 



[Schb'nlein's opinion that the urine in the regular course of 

 typhus is at first dark and very acid, subsequently neutral and 

 even alkaline, and finally again becomes acid at the commence- 

 ment of convalescence, has received further confirmation from 

 the following observations quoted by Simon in his ' Beitrage.' 



In one case the urine became faintly alkaline on the seventh 

 day after admission ; it remained either alkaline or neutral for 

 seven or eight days; and then became faintly acid and gradually 

 clearer, as soon as the patient exhibited symptoms of con- 

 valescence. 



In a second (very severe) case the urine remained acid till 

 the twenty-first day; it then became neutral, and afterwards 

 alkaline, for the space of ten or eleven days, when it returned 

 to its normal reaction. 



In two other cases the urine became alkaline previously to 

 the fourteenth day of the disease ; in one of them the secretion 

 was so thoroughly saturated with carbonate of ammonia, and 

 evolved so disgusting an odour as to be perceptible over the 

 whole ward. This urine deposited a considerable sediment of 

 pus or mucus, mixed with the phosphates of lime and magnesia, 

 and effervesced briskly on the addition of an acid. In one of 

 these cases the urine remained alkaline for fourteen, and in the 

 other, for twenty-one days, before it resumed its acid reaction. 

 Both cases recovered. 



It is worthy of notice, that a deposition of urate of ammonia 

 not unfrequently precedes the occurrence of alkalinity and the 

 appearance of the earthy phosphates, which, as Schonlein re- 

 marks, may be regarded as the precursors of a favorable 

 change. 



During the mild form of typhus recently (1843) prevalent in 

 Berlin, he noticed these changes in several cases, and in fact, 

 when from being alkaline the urine again became acid, and at 



