810 THE URINE. 



istic features of endogenous new formation of pus-corpuscles. 

 In subacute cystitis the features are similar. In chronic catarrhal 

 cystitis the flat epithelia of the bladder are usually absent, and 

 only those of the middle and deepest layer (cuboidal and colum- 

 nar) found. In chronic cystitis the pus-corpuscles sometimes 

 contain dark-brown granules of pigment. In the highest degrees 

 of cystitis scarcely any epithelia are present, and only enormous 

 quantities of pus-corpuscles, mostly swelled, hydropic and disin- 

 tegrated, are to be seen. The urine being highly alkaline, the 

 purulent sediment produces a jelly-like, viscid mass, in which, 

 besides crystals of alkaline salts, clusters of micrococci are pres- 

 ent. The presence of blood-corpuscles and shreds of connect- 

 ive tissue, in addition to the other features, indicates ulcerative 

 cystitis. Large quantities of blood may entirely conceal the 

 original inflammatory trouble. 



Villous Tumors of the bladder yield large shreds of tissue, 

 sometimes containing capillary blood-vessels choked with blood. 

 Occasionally fibrinuria temporarily accompanies villous tumors. 

 (Hofmann and Ultzmann). 



Pyelitis may be recognized by the presence of pelvic epithelia 

 and pus-corpuscles. Epithelia from the pelvis of the kidney and 

 blood-corpuscles are found in pelvic haemorrhage. The urine in 

 this affection is distinctly acid and laden with uric acid, which, as 

 the so-called gravel, is observed in the freshly passed urine. 

 Ulcerative pyelitis may be recognized by the additional presence 

 of shreds of connective tissue. The pelvic epithelia being in fatty 

 degeneration, chronic pyelitis may be recognized. 



Haemorrhage from the Mdneys is marked by the presence in the 

 urine of kidney epithelia, red blood-corpuscles, and delicate 

 shreds of connective tissue ; these are all of a yellow hue, from 

 the coloring matter of the blood. 



The diagnosis of catarrhal nephritis may be made when pus- 

 corpuscles and kidney epithelia are voided, the presence of col- 

 umnar epithelia from the straight collecting tubules indicating 

 an invasion of the pyramidal substance. In acute catarrhal 

 nephritis both the kidney epithelia and pus-corpuscles are numer- 

 ous ; albumen may be present in a varying quantity, but not 

 infrequently it is absent during the whole course of the disease. 

 Small numbers of hyaline casts, mainly from the narrow tubules, 

 and red blood-corpuscles, at times accompany the previously 

 named formations. 



In subacute catarrhal nephritis all features may at times be 



