54 



ORGANIZED SEDIMENTS. 



ORGANIZED SEDIMENTS. 



(A) Sediment of blood: derived from, erythrocytes and leukocytes (Figs. 157, 

 158, 159, 160), occasionally also shreds of tibrin (Figs. 6, 7). 



(B) Pus-corpuscles, in greater or lesser amount in association with catarrhal 

 or inflammatory processes in the urinary passages, entirely resemble the leukocytes 

 (Figs. 6, 7). Marked, persistent admixture of pus is indicative of profound 

 parenchymatous suppuration; numerous mononucleated leukocytes, of disease 

 of the kidneys. Demonstration. If the supernatant fluid be poured off and a bit 

 of potassium hydrate be dissolved in the sediment, the pus is converted into a 

 vitreous, ropy mass, later becoming more consistent (alkali-albuminate) . Mucus 

 treated in this manner is dissolved into a thin fluid admixed with flakes. 



(C) Epithelial cells of varied shape and not always distinguishable as to the 

 source whence they are derived. They are more abundant in the presence of 

 catarrhal conditions in the parts in question. In the urine of women, pavement 

 epithelial cells from the vagina are also present. The spermatozoids likewise are 

 included among epithelial structures. 



(D) Lower forms of organisms. The freshly collected urine from healthy 



FIG. 164.-^, Molds; /, budding-fungi (yeast); d g, 

 bacteria (micrococci and bacilli); a b c, uric acid 

 (after v. Jaksch). 



FIG. 165. Epithelial Tube-casts. 



persons always contains many microorganisms, which, however, have probably 

 been washed away from the urethral mucous membrane. They are principally 

 large or small diplococci. In cases of gonorrhea, gonococci thus gain entrance 

 into the urine. Lower forms of organisms may also appear in the urinary pas- 

 sages, as, for instance, in the bladder, when their germs have been introduced by 

 means of unclean catheters. The following varieties may be distinguished: 



1. Schizomycetes (fission-fungi). In pathological cases bacteria may gain 

 entrance into the urinary tubules and the urine from the blood. Bacterial cul- 

 tures injected artificially into the vessels are in part eliminated through the 

 kidneys. In urine undergoing alkaline fermentation, both micrococci and rod- 

 shaped bacteria or bacilli appear (Fig. 164). The sarcinae are further included 

 among schizomycetes. 



2 . Saccharomycetes (fermentative germs) : (a) The germ of acid fermentation 

 of urine (saccharomyces urinas) : small vesicular cells, arranged partly in groups, 

 partly in rows (Figs. 153, a; Fig. 164, /). (6) Yeast (saccharomyces fermentum, 

 Fig. 140) is present in diabetic urine. 



3. Phycomycetes (molds) appear in putrid urine as mold-formations (Fig. 164, r). 

 They are without significance. 



(E) Of great significance in the diagnosis of certain diseases of the kidney is 

 the occurrence of so-called urinary cylinders, that is, casts of the urinary tubules. 

 If these structures are relatively thick and rather straight, they are probably 



