THE URINE 



399 



losis. The menstrual period of women must be kept in mind in the examination 

 of urine sediments. 



Epithelial Cells. For morphology of cells from different locations see illustration. 

 It is almost impossible to state positively the origin in the genito-urinary tract of 

 certain cells. Very trustworthy evidence however is finding of epithelial cells on 

 casts or the so-called compound granule cells (fatty degenerated renal epithelium). 

 Sheets of more or less small round or caudate epithelial cells are rather significant of 

 pyelitis. Vaginal epithelium resembles that gotten from scraping the buccal 

 mucosa. 



Bladder epithelium resembles vaginal but is of smaller size, and ureteral is like 

 that of the pelvis of the kidney but smaller. Cells from the region of the prostate 

 are very refractile with a distinct nucleus and are oval rather than round. 



FIG. 109. Fatty and waxy casts, a, Fatty casts; b, waxy casts. (Greene.') 



Casts. Of casts we have (i) hyaline, narrow and homogenous. 

 They do not prove nephritis. (2) Epithelial casts. Usually indicative 

 of nephritis but very slight inflammatory processes can cause them. 

 (3) Blood casts. (4) Granular casts. If coarse granules rather sig- 

 nificant of chronic nephritis. Finely granular casts do not seem to 

 have any more significance than hyaline ones. As a matter of fact 

 under dark ground illumination hyaline casts show a granular structure. 

 (5) Waxy casts are highly refractile, show fissuring of margins and were 

 formerly considered of serious prognostic import (chronic nephritis), 



