THE URINE. 799 



number of plastids (connective-tissue corpuscles). Their presence 

 may be due to haemorrhage, and, in this instance, they as a rule 

 have a yellow tint from the coloring matter of the blood. Small 

 shreds of bundles of connective tissue of a yellow color, if pres- 

 ent with large quantities of blood-corpuscles and kidney epithe- 

 lia, but without pus-corpuscles, indicate capillary haemorrhages 

 in the kidney. Large shreds are present whenever an abscess 

 has emptied into the urinary tract, or ulceration has taken place 

 either in the urethra (in strictures), in the bladder, or in the pel- 

 ves of the kidneys. The accompanying epithelia enable us to 

 determine the seat of the ulceration. Ulcers of the vagina, the 

 cervical portion of the uterus, and its mucosa, may be diagnosed 

 by the same means. When a papilloma is developed in the 

 mucosa of the bladder, large shreds of connective tissue, contain- 

 ing blood-vessels in formation or fully developed, are exception- 

 ally voided with the urine. Occasionally these shreds assume the 

 shape of coils. (See Fig. 365.) 



Shreds of connective tissue have a higher refracting power than mucous 

 strings, but less than linen-fibers, and they cannot be mistaken for any of 

 these formations. I have observed a large number of regular linen-fibers 

 voided with the urine in a case in which external urethrotomy had some time 

 previously been performed, and the surgeon had accidentally left a plug of 

 lint in the urethra, which probably had found its way into the bladder. 



Fat-granules and fat-globules are of very common occurrence 

 in urine. The latter may be passed of quite a considerable size, 

 and that such globules are really formed in the kidneys can be 

 proved by direct observation (see page 777, Fig. 354). In many 

 instances, however, fat is extraneous, due to impurity of the ves- 

 sel or to the fat (oil, vaseline) used for lubrication of catheters 

 and sounds, or the finger used for exploration of the female gen- 

 itals. Small fat-granules are invariably found accompanied by 

 albumen, and, after precipitation of the latter by an acid, 

 the bright, glistening granules of fat, clustered together and 

 varying in size, are easily distinguished from the albumen, 

 the granules of which are pale and of a uniform size. The pres- 

 ence of fat-granules indicates fatty degeneration of the kidneys, 

 and more certainly if fatty casts are also found. In this condi- 

 tion often a few red blood-corpuscles and shreds of connective 

 tissue are mixed with the sediment, caused, perhaps, by a certain 

 brittleness of the walls of the capillaries. In chylous urine fat- 

 granules are formed in connection with albumen, without any 

 kidney epithelia or pus-corpuscles. (See Fig. 365.) 



