THE ALBUMINS. 285 



pathological phenomenon. Some writers, it is true, speak of a 

 physiological albumimiria, which may be observed after severe 

 muscular exercise, following cold baths, during pregnancy, etc., 

 and it is even claimed that the elimination of albumin in young 

 persons, which is so commonly observed in neurotic and anaemic 

 individuals, in association with an increased amount of uric acid 

 and oxalic acid, belongs to this order. There is an increasing 

 tendency among pathologists, however, to doubt the physiological 

 character of such forms of albumimiria, and personally I main- 

 tain that every albumimiria of a haBmatogenic type is a pathological 

 phenomenon. We may, in fact, go further, and assume that the 

 appearance of nucleo-albumin also in amounts which can be de- 

 monstrated by ordinary tests is abnormal, as such an occurrence 

 must of necessity be associated with an increased desquamation of 

 epithelial cells, which in itself is evidence of a pathological process. 

 This, however, is hardly the place to enter upon a detailed con- 

 sideration of the various morbid conditions in which albumimiria 

 may occur, and it will suffice to state that any disturbance in the 

 nutrition of the glandular elements of the kidney, from whatever 

 cause, will at once find expression in the appearance of albumin in 

 the urine. The albumins which are then eliminated are the common 

 albumins of the blood, and notably serum-albumin and serum- 

 globulin. Fibrinogen, on the other hand, is usually not found. In 

 cases of haematuria and chyluria, however, its presence may be 

 inferred from the formation of coagula of fibrin. This may occur 

 in the urinary passages already, but more commonly it is observed 

 after the urine has been voided. 



Other albumins besides those which are normally found in the 

 blood are encountered only exceptionally in the urine ; but it may 

 be stated that whenever such substances find their way into the 

 general circulation their elimination at once follows. Formerly 

 it was taught that peptones could thus appear, and for many years 

 various types of peptonuria were described. More recent investiga- 

 tions, however, have shown that the substances in question were in 

 reality no peptones in the sense of Kiihne, but albumoses. Some 

 of these are, no doubt, identical with the common digestive albu- 

 moses, and find their way into the blood, when their further trans- 

 formation into native albumins does not occur in the epithelial 

 cells of the digestive tract. Others again are probably formed in 

 the body proper in diseases which are associated with suppurative 

 processes, and in which the formation of albumoses occurs at the 

 expense of the tissue albumins under the influence of various micro- 

 organisms. Under still other conditions, as in the various non- 

 septic fevers, in phosphorus poisoning, etc., the albumosuria may 

 be the expression of a metabolic abnormality per se, and is possibly 

 dependent upon the action of the various tissue ferments. 



Of special interest, further, is the appearance in the urine of the 

 so-called albumin of Bence Jones, which has been repeatedly ob- 



