1292 



URINE. 



ally neutral. Its specific gravity is nearly 

 always lower than that of health. The uric 

 acid is usually in very small proportion, and 

 sometimes altogether absent. This is not, 

 however, always the case ; and I have some- 

 times seen the lithic acid in excess existing 

 as a deposit. Simon believes albumen not 

 unfrequently present in diseases quite uncon- 

 nected with affections of the kidneys. His 

 facts, however, are not satisfactorily stated, 

 and I believe him to have been greatly mis- 

 taken in this opinion. In connection with 

 the morbus Brightii, we have to notice two 

 substances which, according to Heller, are 

 often present as deposits in that disease, viz. 

 uroglaucin and urrhodin. These are colour- 

 ing matters, derived by oxidation from uro- 

 xanthin, or a yellow colouring matter of urine, 

 which exists only in small proportion in 

 healthy urine, but which is greatly increased 

 in Bright's disease. The deposits observed 

 in the morbus Brightii consist of the casts 

 of the urinary tubules of the kidney epi- 

 thelium of two kinds, viz. spheroidal and 

 pavement epithelium. ( Vide woodcut of urin- 

 ary deposits, fig. 799.) 



CYSTITIS. 



The urine in this disease is alkaline, the 

 alkalinity increasing rapidly after the urine is 

 voided, owing to the formation of carbonate 

 of ammonia. Mucus and pus are present in 

 quantity. Albumen can always be detected 

 in solution when the pus corpuscles are pre- 

 sent in the deposit. As cure is effecting, 

 this albumen is found to decrease in propor- 

 tion as the pus corpucles disappear. 



TYPHUS. 



In typhus the urine shows no great va- 

 riation from the normal standard, so far as 

 specific gravity and amount of solid consti- 

 tuents is concerned. The urea is generally 

 in deficient proportion, the uric acid in- 

 creased. The salts are much diminished. 

 During the progress of typhus, the urine very 

 generally becomes alkaline. Becquerel and 

 Andral have made many experiments on the 

 state of the urine both in typhus and typhoid 

 fevers. They both have met with a large 

 number of cases in which it was precipitable 

 by nitric acid ; this is quite in accordance with 

 my own observations ; the precipitate, how- 

 ever, is lithic acid, and not albumen. 



Scherer found, like former observers, that 

 the salts were much decreased in the urine 

 of typhus, and that there was always an excess 

 of uric acid. 



The following analyses are worthy of note. 

 They were made by Scherer at the 9th, 12th, 

 and 15th day of a slow nervous fever, which 

 occurred in the person of a woman aged thirty- 

 eight years. 



9th Day. 



Water 945-48 



Urea 8-60 



Uric acid - 0'60 



Alcoholic extractive - - 27-50 

 Watery ditto - 7*40 



Albumen .... 1-80 

 Fixed salts soluble in water - 6*20 

 Earthy phosphates - 2'30 



12th Day. 



Water 951'26 



Urea 10-40 



Uric acid - 0'70 



Alcoholic extractive - - 21 '80 



Watery ditto - - - 7 '90 



Albumen - - - - TOO 



Fixed salts soluble in water - 5'30 



Earthy phosphates - T20 



15th Day. 



Water - 959-29 



Urea 11-40 



Uric acid - 0*80 



Alcoholic extract - 15*70 



Watery ditto - 6'20 



Albumen and mucus - - 90 



Fixed salts soluble in water - 4*50 



Earthy phosphates - - 0'60 



It will be observed that, as the disease pro- 

 gressed, the urea increased, while the ex- 

 tractive matters diminished. The " salts so- 

 luble in water" also diminished in quantity. 



INTERMITTENT FEVER. 



L'Heritier has made analyses of the urine 

 in this disease, and has drawn up the follow- 

 ing table, which represents its composition in 

 the different stages, as deduced from a mean 

 obtained from twelve cases. 



Notwithstanding the variations from the 

 natural standard shown by the above table, 

 it often happens that the urine in agues differs 

 but little from that of health in every stage of 

 the disease. 



CHOLERA. 



In this disease the urine is often altogether 

 suppressed. When it can be collected in any 

 quantity, its specific gravity is generally below 

 the natural standard, and it has only a feeble 

 acid reaction. Albumen is very often to be 

 found it it. The urea is below the standard 

 of health. Vogel states that the urine, in a 

 case of this disease which he examined, was 

 entirely wanting in the salts of lime and mag- 

 nesia, and that the chloride of sodium was 

 deficient. The sulphates, however, were in 

 larger proportion than in health. Albumen 

 and biliary colouring matter could be detected 

 by the appropriate tests. 



