248 THE SECRETIONS: 



line urine is only passed in those cases in which it has re- 

 mained for a very long time in the bladder. I shall now give 

 the facts which he has collected regarding the urine in typhoid 

 fever. He observed the urine in thirty-eight cases of abdominal 

 typhus, eleven of which were very severe, eighteen of ordinary 

 intensity, and nine were mild cases. Purgatives, especially 

 Seidlitz waters, formed the basis of the general treatment. Seven 

 of the eleven severe cases recovered; two, however, subsequently 

 died from tubercular phthisis. Of the four fatal cases, one died 

 on the eighth day, the second at a more advanced period, the 

 third on the fifty-third day, and the fourth from perforation of 

 the intestines. 



In all these cases Becquerel found the urine to deviate con- 

 siderably from the normal type. While the fever was intense, 

 and before the adynamic period was established, the urine was 

 scanty, highly coloured, dense, and charged with uric acid ; it 

 sometimes contained blood, albumen, or mucus in considerable 

 quantity, but seldom pus. In many cases, it exhibited a more 

 marked tendency to decomposition than is observed in other 

 diseases, and the rapidity and facility of this spontaneous 

 decomposition usually corresponded with the severity of the dis- 

 ease. But when, in the progress of the disease, the adynamic 

 period comes on, the quantity of the urine will be diminished 

 in consequence of the intensity of the fever, the colour will 

 be high but the specific gravity low, and at the same time 

 there will be frequent deposits of uric acid either spontaneous 

 or after the addition of an acid, or else the urine will as- 

 sume the ansemic type and be pale, of low specific gravity, and 

 only slightly acid. The urine of this latter form differs widely 

 from that which was passed at an earlier period of the disease, 

 and is diagnostic of the asthenic state and of its degree of in- 

 tensity. But exceptions to this general rule have been observed 

 both by Becquerel and myself; on the one hand, the urine 

 has been slightly coloured, clear, and of low specific gravity in 

 cases of typhoid fever in which the patients were far removed 

 from the asthenic state, and on the other hand the latter state 

 (the asthenic) is not incompatible with turbid, sedimentary 

 urine. 



We must not overlook the circumstance of the urine having 

 possibly remained for a long time in the bladder, in which case 



