494 



ALBUMIN IN THE URINE. 



pearls. The ammonia is recognizable both from its odor and from the 

 vapor that forms when a rod moistened with hydrochloric acid is held 

 over the urine. 



The capability of decomposing urea is possessed besides by various other 

 bacteria, including the staphylococci and the pulmonary sarcinae, whose germs 

 float everywhere in the air. These organisms produce a soluble ferment that 

 decomposes urea. Miquel describes ten microorganisms that decompose urea 

 and uric acid. 



In consequence of the presence of the ammonia formed in the urine, 

 the latter becomes turbid because substances are precipitated that are 

 no longer capable of being held in solution, namely amorphous tribasic 

 calcium phosphate; acid ammonium urate (Fig. 154, a) in the form of 

 thorn-apple or morning-star spherules; and, finally, the large, clear, 

 coffin-lid shaped crystals of ammonio-magnesium phosphate (6). There 

 are formed, also, volatile fatty acids, principally acetic acid (from the 

 carbohydrates of the urine). In the presence of catarrhal and inflam- 

 matory conditions of the bladder, the fermentative process may take 



place within this viscus. Under 

 such circumstances, however, 

 leukocytes (pus-corpuscles, Fig. 

 1 60), and desquamated epithe- 

 lial cells are admixed in con- 

 siderable amount. When pus is 

 present in large amount, the 

 urine becomes albuminous. 

 Rarely, free gases form in the 

 bladder (pneumaturia), as, for 



FIG. 154. Sediment due to Ammoniacal Urinary Fermen- 

 tation: a, acid ammonium urate; b, ammonio-mag- 

 nesium phosphate. 



FIG. 155. Micrococcus ureae. 



instance, in consequence of the entrance of the bacterium lactis aero- 

 genes (Fig. 126, 2). A bacillus generating hydrogen sulphid (bacterium 

 coli commune) and one generating methylmercaptan, have also been 

 found. 



ALBUMIN IN THE URINE: PROTEINURIA, ALBUMINURIA. 



For the physician, albumin is a most important abnormal constituent of the 

 urine. 



(i) Serum-albumin (whose properties are described on pp. 73 and 458) may 

 appear in the urine in the absence of anatomical alteration in the structure of 

 the kidney, and the condition has been designated by Leube as physiological albu- 

 minuria. Albumin has often been found normally in the urine in minute traces, 

 particularly in consequence of the presence of a considerable amount of albumin 

 in the blood-plasma (as, for instance, when the secretion of milk is suppressed) 

 and after a meal containing an excess of proteid. Albumin is common, also, in 

 the urine of the fetus and the new-born. (2) When the pressure in the distribution 

 of the renal vessels is increased (as, for instance, after a cold bath or after excessive 



