506 SEDIMENTS IN THE URINE. 



Tube-casts of leukocytes are observed in connection with suppurative pro- 

 cesses in the urinary tubules (Fig. 167). U rates arranged in the shape of tube- 

 casts are without significance (Fig. 168); as well as cylindroids, formed of mucus, 

 with which short strands of mucus arising in the ureter, the bladder, the prostate, 

 the uterus, and the vagina, may be confounded. 



UNORGANIZED SEDIMENTS. 



The unorganized sediments, in part crystalline, in part amorphous, have already 

 received consideration in the discussion of the individual constituents of the 



SCHEMATIC RESUME FOR THE RECOGNITION OF ALL OF 

 THE SEDIMENTS IN THE URINE. 



I. In acid urine there may be found 



i. An amorphous crumbling sediment, 



(a) Which is soluble in the heat and is again precipitated in the cold, and 

 which, on addition of a drop of acetic acid to the microscopic preparation, forms 

 crystals of uric acid, which often has a reddish color (brick-dust powder) . 



This sediment consists of sodium or potassium biurate (Fig. 153). 



(6) The sediment is not dissolved by heat, but on addition of acetic acid, 

 and without effervescence. This is probably tribasic calcium phosphate. 



(c) Highly refracting granules, occurring occasionally and soluble in ether. 



$ 



FIG. 172. a, Finely granular calcium carbonate; b and c, crystalline neutral calcium phosphate. 



are fat-globules. Fat occurs in the urine particularly in conjunction with the 

 presence of a round-worm (filaria sanguinis hominis) in the blood (only in for- 

 eigners or travelers) ; further, occasionally together with sugar in the urine, in 

 tuberculous patients; in cases of phosphorus-poisoning, of yellow fever, of pyemia; 

 after protracted suppuration; and, finally, after injections of fat or milk into the 

 circulation. Fatty degeneration in some portion of the urinary apparatus, ad- 

 mixture of pus from old abscesses, and severe injuries to bones, should further 

 be taken into consideration. In this connection, attention should be given also 

 to cholesterin and lecithin. Rarely, the amount of fat in the urine may be so 

 marked as to give rise to a creamy appearance chyluria. 



2 . A sediment consisting of crystals : 



(a) Uric acid (Fig. 148 and Fig. 153 whetstone-shaped crystals). 



(6) Calcium oxalate (Fig. 153, Fig. 162, B} envelop-shaped crystals, insolu- 

 ble on addition of acetic acid. 



(c) Cystin extremely rare (Fig. 162, A). 



(d) Leucin and tyrosin of great rarity (Fig. 163). 

 II. In alkaline urine there may be present: 



1. The sediment is wholly amorphous and crumbling; it consists of tribasic 

 calcium phosphate. It is soluble on addition of acids without effervescence. 



2. The sediment is crystalline, or, at least, of characteristic form. 



