UEINE CONTAINING ALBUMEN. 719 



the kidneys, from congestion and inflammation of the renal 

 capillaries, from alteration and contamination of the blood 

 supplied to these structures, and from some other conditions. 



The gravity of the condition of the discharge of urine con- 

 taining albumen must of course always be subject to modifica- 

 tions depending upon the cause which appears to operate in 

 determining those conditions favourable to this state. A 

 temporary appearance of this material, due to some obvious 

 irritation itiducing hypen^mia and probably active transudation 

 of blood, being a somewhat different condition to a continued 

 albuminous discharge, directly the result of textural change 

 in the renal secreting structures. In addition it ought not to 

 be forgotten that in recoveries from many active inflamma- 

 tory affections, and from some common and specific fevers, 

 the existence of albumen in the urine is probably less con- 

 nected with kidney disease than, as we have said, haemal 

 contamination. We are aware that in all these states con- 

 siderable changes take place in the colloid elements of the 

 blood, and that materials held in solution in the serum tend 

 to be eliminated by the kidneys, while at such times a 

 special aptitude on the part of the blood-fluid to pass through 

 the containing vessels is not an uncommon feature. 



h. Urine containing Bile Compounds. — The existence in 

 peculiar states of the system of certain bile compounds, acids, 

 or simple colouring matter is generally admitted to be 

 ordinarily evidenced by the more or less yellow or yellowish- 

 green colour imparted to the secretion. The presence of 

 these biliary matters in urine is generally held to be 

 established by the employment of a little nitric acid, which, 

 when dropped on a white porcelain surface thinly covered by 

 urine, or added to a little of the secretion in a test-tube to 

 which heat is afterwards applied, is followed by an iridescent 

 play of colours. 



The clinical importance of this abnormal constituent is 

 chiefly in relation to the disease known as jaundice. As to 

 the manner of its access to the urinary secretion, its mode 

 of production in relation to either the blood or the urine, 

 or its significance in connection with hepatic disease, and the 

 relation of these to jaundice, there is still much uncertainty. 

 In a general sense, however, the existence of bile compounds 



