314 



THE SECRETIONS: 



It continued, however, transparent, and did not form sedi- 

 ments till the crisis. 



A servant girl in our hospital, aged about 20 or more years, 

 presented a case of inflammatory icterus. The skin was of a 

 brown-yellow colour, the tinge on the face and breast being 

 particularly dark : the pulse was feverish, especially towards 

 the evening ; the mental faculties disturbed and delirium during 

 the night. 



The urine was of a brown, almost a blood-red colour, (thin 

 strata appearing of a deep saffron tint,) it had a powerful acid 

 reaction, and deposited a very abundant brownish-yellow sedi- 

 ment, which consisted partly of crystallized uric acid coloured 

 by biliphaein, and partly of urate of ammonia coloured in a 

 similar manner. The specific gravity of this urine was 1020. 

 It contained : 



Water 



Solid constituents 



Urea 



Uric acid with biliphaein 



Alcohol-extract 



Spirit-extract 



Water-extract, mucus, and bile-p gment 



Biliary resin 



Biliverdin . 



Earthy phosphates 



Chloride of sodium and lactate of soda 



Alkaline sulphates and phosphates with ) 

 traces of chloride of sodium . $ 



Analysis 147- 



954-50 



45-50 



12-34 



2-90 



4-35 



5-29 



5-14 



1-45 



1-08 



3-14 



2-61 



3-90' 



This analysis presents several points worthy of consideration. 

 The urea is much below the normal average, amounting to only 

 27g instead of 39 of the solid residue. The uric acid is much 

 increased, for it amounts to 6-3g, whereas the normal average 

 is only l'5g; it must, however, be remembered that the uric 

 acid from a very considerable sediment of urate of ammonia 

 has been included, and that a certain amount of bile-pigment 

 was associated with it. The fixed salts are below the normal 

 average, amounting to only 19g, the earthy phosphates on the 

 other hand amount to 4'9. 



1 The biliary resin and biliverdin were taken up by anhydrous alcohol with the urea 

 and alcohol-extract. On evaporating the alcohol and adding water, the biliary resin 

 and biliverdin were precipitated; this latter was separated from the resin by diges- 

 tion in a weak solution of ammonia, which on evaporation left the green colouring 

 matter. 



