808 THE UEINE. 



little bioplasson, indicated a completely broken-down constitution. He diag- 

 nosed chronic croupous nephritis, and, when I inquired about the prognosis, 

 he said, " The coffin ought to be made for the man." The next day the physi- 

 cian came who had brought the urine for examination, and, when he learned 

 the diagnosis and prognosis, exclaimed, "Why, the man died last night; 

 the coffin is being made for him." 



Among the formations due to the presence of entozoa in the 

 genito-urinary tract deserve to be mentioned : booklets of ecMno- 

 cocci, which, in rare cases, have been observed in the urine, indica- 

 tive of the presence of ruptured sacs of the echinococcus in the 

 kidneys. Further, the ova of the distoma hcematoUum, or Bil- 

 harzia Jmmatobia, which are oval formations with a distinct 

 shell and a short point at one pole. This entozoon lives in the 

 veins of the prostate and the bladder, and by rupture of the 

 vessels into the cavity of the bladder the ova are deposited in 

 the urine. The disease occurs in North Africa only, and more 

 especially in Egypt. I have, however, never seen formations of 

 this kind myself. The trichomonas vaginalis, a ciliated animal- 

 cule living in the mucus of the vagina, is sometimes seen in the 

 urine. In a case that came under my observation, the physician 

 suspected an ascaris lumbricoides in the bladder of a child the 

 worm, as he supposed, having found its way through the urethra. 

 Besides symptoms of acute cystitis, numerous dark brown gran- 

 ules were observed under the microscope, which perhaps might 

 have been the faeces of the worm. Further particulars of the 

 case were not known. 



Diagnosis from Examination of Urine. Here I wish to briefly 

 describe what, from my own observations, I have found to be 

 correct. Whenever larger quantities of pus or blood are mixed 

 with the urine, albumen is also present, and an approximate 

 estimation must be made as to its amount, whether it is equal to 

 that of the pus or blood present, or whether it exceeds the 

 amount of the two latter. Expressions like " false albuminuria," 

 or "pseudo-albuminuria," used for such cases, should be avoided, 

 as no proper significance is attached to these terms. 



TTretJiritis may be diagnosticated in the initial stages by the 

 large amount of flat urethral epithelia ; in later stages the pus- 

 corpuscles are largely predominant, and cuboidal and' columnar 

 epithelia may also be seen. If long mucous cylinders are present, 

 sometimes with knob-like terminations, which arise from the 

 mucous glands of the urethra, the diagnosis gleet is justified. If, 

 besides flat epithelia of the urethra, columnar epithelia, blood- 



