16 METHODS OF ELUCIDATING DISEASE. 



Attention onglit to be given to the discharge of urine, so as 

 to determine whether micturition is frequent and j)fiinful, or 

 executed at lono: intervals with restricted discharo^e. 



Note is to be taken of the total amount of the urine voided 

 during the twenty-four hours, of its colour, consistency, clear- 

 ness, density, odour, chemical reaction, and disposition to form 

 a deposit. It Avill require to be examined also as to excess or 

 deficiency of such natural constituents as urea, and such un- 

 natural ones as albumen. If a sediment exist after being at 

 rest, note is to be made of its manner of formation, its solu- 

 bility or otherwise by heat, nitric or acetic acid, or liquor 

 potassa\ The presence of such formed materials as blood, pus, 

 epithelial cells, or renal casts must be determined by the 

 microscope. 



In addition to noting these physical phenomena, we must 

 observe in what manner the functions of these organs are 

 carried out ; whether there exists a simple difficulty in mictu- 

 rition, ihjsuria, or a more perfect suppression or retention of 

 the fluid, ischuria, both of which conditions point to disease, 

 either of the urinary organs proper, the urine conduits, 

 changes in the secretion itself, or disease of contiguous organs 

 and structures. We have to recollect that as frequent mic- 

 turition indicates an irritable condition of the urine tube, and 

 probably also of the kidneys, so inability to retain the urine 

 points to relaxation of the sphincter vesica? ; and suppression 

 of the secretion to inflammatory and other structural diseases 

 of the kidne3^s, primarily occurring there, or resulting secon- 

 darily and in association with serious textural changes, follow- 

 ing some general or even local disease. That the last condition 

 is of all others the most serious, seeing that unless relieved the 

 poisoning of the blood by unremoved effete and excremen- 

 titious material is sure to terminate fatally. 



AxiMAL Thermometry.— Besides this collecting of informa- 

 tion by observation and questioning of a subjective and objec- 

 tive nature, as indicated in the systematic examination of the 

 different regions and functions of the animal body, there is 

 another source of obtaining certainty in matters of fact, and 

 one which must not be neglected in clinical examination of 

 cases ; that is, attention to the temperature or calorific function 

 of the body. Wc require to remember that a generally diffused 



