PRODUCTS, ADVENTITIOUS. 



escapes into the urethra in certain cases of 

 paralysis and in habitual spermatorrhoea ; and 

 when the bladder is evacuated shortly after 

 coitus (more especially in persons having stric- 

 ture of the urethra) its contents carry with 

 them a certain quantity of seminal fluid. We 

 doubt that the prostatic secretion alone (the 

 fact has certainly not been proved) leads to 

 distinct albuminuria. Leucorrhceal and cata- 

 menial discharges produce it. 



Fourthly : Albuminuria from a doubtful cause. 

 Cotunnius*, Ouickshankf, ISystenf, Andral, 

 Rayer, Martin- Solon, Becquerel, and we our- 

 selves, have found that the urine may contain 

 a variable quantity of albumen during the pro- 

 gress of acute diseases a fact which is now 

 matter of familiar clinical observation. M. 

 Martin-Solon shows that the impregnation 

 occurs in about yyth of all cases ; ttiis ob- 

 server at one time held that the occurrence 

 was of "critical" signification, an opinion he 

 has since correctly relinquished. In certain 

 chronic diseases, unattended with any organic 

 alteration of the kidneys, the occasional oc- 

 currence of albuminuria has been positively 

 established : in disease of the heart by Dar. 

 wall, Forget ||, and Martin-Solon ; in bron- 

 chitis and disease of the intestines by the 

 latter observer ; in aneurism of the ventral 

 aorta by Dr. Morrison f; in phthisis by 

 Toulmouche##,and by ourselves, temporarily. 

 Of the habitual occurrence of albumen in gouty 

 urine, the evidence is insufficient. Becquerel 

 found it in seven of eighteen cases of acute 

 rheumatism, depending rather upon the acute 

 type, than upon the nature, of the disease. 

 In the exanthemata, albuminuria depends 

 on simple renal congestion (resulting from the 

 inaction of the skin) ; or (especially in scarla- 

 tina) on the supervention of a form of 

 " Bright's disease," characterized by abundant 

 accumulation of epithelium in the tubules. 



The saliva is another secretion which, con- 

 taining albumen in extremely small quantity 

 in the natural state (not more than 1.5 in 1000 

 parts), becomes apparently impregnated with 

 that substance somewhat abundantly in certain 

 morbid conditions. Simon ff found 7.77 per 

 1000 in the fluid discharged in ptyalism. 

 However, the elaborate analyses of Dr. 

 Wright JJ show that this excess of albumen 

 is not a constant phenomenon ; in a case of 

 ptyalism he found the albumen reach only 0.6 

 per 1000, and in three other forms of morbid 

 saliva analyzed by him (fatty, sweet, and 

 bilious), the quantity of albumen equalized 

 the average in the fatty variety only. 



The sweat has been found to contain albu- 



* Op. cit. p. 31. 



t Rollo on Diabetes, p. 444. 



j Recherclies de Chim. et de Phys. Pathologiques, 

 p. 253. 1811. 



Cyclop. Pract. Med. art. Dropsy. 



|| Gazette Me'dicale de Paris, vol. v. p. 609. (two 

 ca^es.) 



f Dub. Med. Journal, No. xxxvi. 1838. 



** Gazette Me'd. de Paris. Fevrier, 1839. 



ft Op. cit. vol. ii. p. 10. 



It Medical Times, or Der Speichel in Physiol. 

 Diagnost. and Therap. Beziehung, 1844. 



93 



men by Anselmino in a case of rheumatic fever. 

 Stark asserts that albumen may be detected 

 in this excretion in " gastric, putrid, and hectic 

 diseases, and also on the approach of death, 

 in consequence of the abnormal solution of 

 the solid constituents." Simon * failed in de- 

 tecting any certain indications of albumen in 

 the sweat of a person in the colliquative stage 

 of phthisis. 



(b.) Albumen retained. That granular par- 

 ticles of protein-basis, retained within the 

 tissues, are some of them albuminous, seems a 

 very admissible proposition. The non- plastic 

 protein-substance infiltrating the kidney in 

 certain forms of Bright's disease, for example, 

 is albuminous rather than fibrinous in all pro- 

 bability. But the difficulty of positively assign- 

 ing their species to protein-compounds, espe- 

 cially under such circumstances, is sufficiently 

 well known. The mechanism of albumen-pre- 

 cipitation within the body must be of different 

 character from that by which it is effected 

 without the frame, at least it is not easy to 

 conceive how the agencies, chemical and phy- 

 sical, which are known to produce precipi- 

 tation of albumen removed from vital influence, 

 can come into play among the tissues. 



Albumen appears in the retained and non- 

 plastic state as an important element in the 

 fluid of dropsies ; to avoid repetition, we defer 

 its consideration under these circumstances to 

 Part II., where dropsical products are ex- 

 amined. 



(B.) Fibrin, (a.) In the secretions. That 

 fibrin should occur in the urine, in association 

 with the other elements of blood, is no more 

 than must be expected in cases of haematuria. 

 But it has of late years been found that fibrin 

 sometimes occurs in solution in that excretion 

 independently of any other constituent of the 

 blood. Thus Nassef " knew a Catholic priest 

 who passed, particularly during the night, a 

 large quantity of whitish urine, that coagulated 

 spontaneously in from ten to fifteen minutes 

 after leaving the bladder, and often indeed 

 coagulated in the bladder itself. The patient 

 experienced no debility. On analysis the 

 urine was found to contain a large quantity of 

 fibrin, but no blood-globules." There were 

 also prismatic crystals of triple phosphate 

 present. Zimmerman^ has particularly fol- 

 lowed up this subject, and affirms he has dis- 

 covered fibrin in the urine in endocarditis, 

 pleuritis, pneumonia, bronchitis, rheumatic 

 ophthalmia, periosteitis of the occiput, and 

 erysipelas of the face. Urate of ammonia or 

 uric acid was sometimes present. The fibrin, 

 he presumes, appeared simply as an excretion, 

 sufficient oxygen not having been taken up to 

 decompose it into its organic forms. Zim- 

 merman holds, that in cases of coagulable 

 urine the coagulation will be found to be due 

 to the presence of fibrin quite as often as of 

 albumen, a proposition which appears to us 

 utterly inadmissible. 



* Op. cit. vol. ii. p. 109. 

 f Brit, and For. Med. Review, vol. xx. p. 75. 

 j Zur Analysis und Synthesis der pseudo-plas- 

 tischen Prozesse ; or, Brit, and For. Rev. loc. cit. 



