URINE. 



1289 



Urine in disease may not only show a 

 tendency to deposit matters of an insoluble 

 character in the form of urinary deposits or 

 calculi, but it may also contain in solution an 

 excess or deficiency of any one or more of its 

 normal constituents. There may likewise be 

 present in solution matters altogether foreign 

 to the healthy constitution of the fluid. The 

 urine in disease may then, so far as its dis- 

 solved matters are concerned, be considered 

 in two points of view, viz. 1. Excess or defi- 

 ciency of ilbrmal constituents ; 2. Presence 

 of matters not existing in healthy urine. 



I shall proceed to notice the state of the 

 urine in those forms of disease in which it 

 has received attention, and shall quote from 

 the work of Franz Simon, who not only 

 laboured long and well on the subject, but 

 collected much valuable information relating 

 to it. Before doing this, however, I must 

 notice the ingenious attempt made by Bec- 

 querel to classify all diseased conditions of 

 urine under four heads, viz. 1. Febrile, urine ; 

 2. Anaemic urine ; 3. Alkaline urine ; 4. Urine 

 but slightly varying from the conditions of 

 health. 



I will shortly notice the principal cha- 

 racters of these four varieties. 



1. Febrile urine. a. Febrile urine, strictly 

 speaking. The proportion of water passed 

 in the twenty-four hours less than in health. 

 Solid matters slightly diminished in propor- 

 tion. Urea and inorganic salts deficient. 

 Uric acid increased in proportion. Colour 

 high. Specific gravity above the normal 

 standard. Often turbid from lithates. Some- 

 times contain albumen. 



This latter statement of Becquerel's must 

 be received with some reservation. Thus I 

 have several times known a deposit produced 

 in urine in adynamic forms of fever on the 

 addition of nitric acid, which proved, on ex- 

 amination, to be lithic acid and not albumen. 



The following are the conditions in which, 

 according to Becquerel, the urine assumes 

 the febrile character ; viz., in chronic and acute 

 inflammations; in diseases of the liver, heart, 

 and lungs ; in haemorrhages, and in organic 

 degenerations of organs resulting from fever 

 or long functional derangement. 



ft. Febrile urine, ivith debility. The pro- 



portion of water diminished. Specific gravity 

 less than in o. Solid matters also less in the 

 twenty-four hours. Uric acid in normal 

 proportion. All other constituents absolutely 

 but not relatively diminished. This urine is 

 then less concentrated than that of health. It 

 is deeply coloured, often turbid from deposit 

 of uric acid. It occurs in adynamic fevers. 



7. Febrile urine containing the natural pro- 

 portion of water. Urea and fixed salts dimi- 

 nished in proportion. Uric acid and other 

 organic matters normal. Specific gravity low. 

 Colour deep. No sediment. 



2. Anaemic urine. a. True anaemic urine. 

 Watef in the twenty-four hours nearly normal. 

 Solids discharged much less than in health. 

 Urea, uric acid, and fixed salts diminished. 

 Other organic matters decreased in slighter 

 degree than the above. Specific gravity low. 

 Colour light. No sediment. 



. Concentrated anaemic urine. Water in 

 twenty-four hours diminished, although the 

 solids are then relatively increased, still they 

 are absolutely diminished. Urea, uric acid, 

 and fixed salts especially diminished. Other 

 organic matters less so. Urine of livid or 

 greenish tint. 



3. Alkaline urine. Distinguished by alkaline 

 reaction on test paper. Odour ammoniacal : 

 occurs in acute and chronic nephritis, diseases 

 of the bladder with secretion of pus, and in 

 certain cerebral diseases; occasionally in the 

 " morbus Brightii." 



4. Urine nearly normal. Nearly that of 

 health. Occurs in mild disorders unaccom- 

 panied by fever. 



With respect to this classification of Bec- 

 querel, it may be observed that the heads of 

 arrangement by no means embrace all the 

 forms of diseased urine met with in practice, 

 an end, indeed, which will scarcely be com- 

 passed by any attempts of the kind. There 

 appears no advantage in making such clas- 

 sifications ; and indeed much evil must result 

 from the necessary endeavour which will be 

 made in such a table to place diseases under 

 headings which either imperfectly or incor- 

 rectly express their real character. The table, 

 however, is of some value, as showing the 

 general results obtained in fevers and in 

 anaemia ; but further than this the student 

 need not regard it. 



The following introductory remarks by Franz 

 Simon are extremely valuable, and will well 

 repay the reader for the trouble taken in their 

 careful perusal. I transcribe them from Dr. 

 Day's translation for the Sydenham Society: 



" In inflammatory affections, and in those 

 diseases which are accompanied by that form 

 of fever which is termed sthenic or synochal, 

 the urine differs greatly in its properties from 

 normal urine. In speaking of the probable 

 cause of the changed constitution of the blood 

 in the phlogoses, I showed that it is not to be 

 referred to the diseased organ, but to the re- 

 action which manifests itself throughout the 

 vascular system. If the change in the con* 

 stitution of the blood bears an accurate and 

 inseparable relation to the fever, there can be 



