258 THE SECRETIONS: 



Scorbutus et Morbus maculosus Werlhofii. (Land-scurvy.) 



In scurvy the urine is ordinarily of a dark, reddish-brown, 

 and sometimes of an almost black colour. Although it is 

 slightly acid as it passes from the bladder, it very soon be- 

 comes alkaline, and develops a strong and disagreeable ammo- 

 niacal odour, According to Schonlein, blood is frequently 

 discharged from the urinary organs, and the urine then assumes 

 a dark reddish-brown colour, in consequence of the presence of 

 ha3matoglobulin ; in this case, it develops hydrosulphate of 

 ammonia, and soon becomes putrid. 



I have examined the urine in three well-marked cases of 

 scurvy occurring in Schb'nlein^s clinical wards ; two were men 

 between thirty and forty years of age, and the third, a woman 

 who had been delivered a few weeks previously. In the men, 

 not only were the gums attacked, and the peculiar scorbutic 

 odour observed in the breath, but the lower extremities were 

 covered with numerous ecchymosed spots and petechia?. The 

 woman had a very cachectic appearance; her face was somewhat 

 swollen; the gums nearly destroyed, livid, and hsemorrhagic ; 

 the teeth loose (one having fallen out the preceding night), 

 and the breath almost unbearable. In its physical characters 

 the urine was very similar in these three cases. At first it 

 was scanty (eight to twelve ounces), and of a deep dark-brown 

 colour, as if bile-pigment or decomposed blood were present, 

 which, however, was not the case. It was devoid of the pecu- 

 liar sweetish odour of typhus-urine, but, after standing a few 

 hours, developed a disagreeable ammoniacal odour. 



The addition of ammonia produced a very slight turbidity ; 

 and, on the addition of chloride of barium to the urine acidu- 

 lated with nitric acid, the precipitated sulphate of baryta was 

 much less than in healthy urine. The addition of ammonia 

 (after the removal of the sulphate of baryta) produced a com- 

 paratively slight precipitate, showing that there was a deficiency 

 of the phosphates. Infusion of galls, basic and neutral acetate 

 of lead, and acetate of copper, produced considerable turbidity, 

 and the urine was similarly affected (but in a much less degree) 

 by bichloride of mercury. In their chemical characters, these 

 three specimens closely resembled each other, and were found 



