FERMENTATION AND .FORMATION OF SEDIMENTS. 411 



the ordinary properties of urinary mucus, and being decomposed 

 with extraordinary rapidity. In the latter case, the mucous mem- 

 brane of the bladder, at most, suffers only indirectly; as, for 

 instance, in affections of the spinal cord, accompanied with paralysis 

 of the extremities and of the bladder; and if the vesical mucous 

 membrane retain its perfect integrity, the mucus secreted from it 

 cannot be thrown off on account of the deficient contractility of 

 the bladder, but adheres to it, and begins to be decomposed to 

 such a degree that it induces alkaline fermentation almost at once 

 in the urine as it drops from the ureters, so that even in incon- 

 tinence of urine, where the fluid had been retained only a short 

 time in the bladder, it is both alkaline and ammoniacal when 

 passed. Catarrh of the mucous membrane of the bladder is, 

 however, only a secondary affection. 



Scherer assumes from these facts, that the vesical mucous mem- 

 brane may also acquire a condition within the bladder by which it 

 predisposes the extractive matter to the formation of acid. This 

 must undoubtedly be admitted to exist in the calculous diathesis, 

 in which an acid urine is secreted with pre-formed crystals of uric 

 acid ; but the assumption of a mucus which is already modified 

 before it leaves the bladder, does not appear to me to afford a satis- 

 factory explanation in those frequent cases of febriie urine in which 

 this secretion, when freshly discharged, exhibits a moderately acid 

 reaction, and contains only urate of soda; for. independently of the 

 circumstance that in those febrile or inflammatory affections in 

 which we can scarcely assume the presence of any derangement of 

 the mucous membrane of the bladder, or the existence of a mucus 

 which has been modified within that organ, it frequently happens 

 that one kind of freshly passed urine does not turn acid very 

 quickly, nor is uric acid immediately separated from it, whilst 

 urine which had been passed only two hours before may exhibit 

 these properties in a very high degree. This phenomenon might 

 be ascribed to the prolonged retention of a more concentrated urine, 

 which might irritate the mucous membrane of the bladder, if the 

 reverse were not occasionally observed, that is to say, if we did not 

 sometimes find that one specimen of urine turns acid very readily 

 and speedily, although another specimen, passed a couple of hours 

 previously, may not exhibit the same properties for a prolonged 

 period. We must here seek for the causes of the more rapid acidi- 

 fication of the urine in the constitution of the fluid secreted by the 

 kidneys, that is to say, in the special condition of individual 

 substances formed by the metamorphosis of matter during its 



