220 THE FLUIDS. 



Sugar is, however, normally present in the urine during preg- 

 nancy, and of nursing women ; always in the latter, and in one-half 

 the cases of the former. Its amount varies from 1 to 12 grains in 

 1,000 of urine ; it being more abundant as the rnilk is more 

 abundant and rich. (M. Blot.) 



Albumen may appear in the urine in any case in which there is 

 congestion of the kidney, or a too watery condition of the blood ; 

 its presence being due, doubtless, to a mere transudation, and not to 

 a modified action of the secreting cells. Hence albuminuria is by 

 no means peculiar to Bright's disease, but occurs also in the course 

 of fevers, in renal catarrh, in cases of disease of the heart or lungs, 

 or tumors of the abdomen, and frequently in dropsy. Fat appears 

 in the urine after taking fatty food, though rarely. Isolated fat- 

 globules are sometimes seen in cases of rapid emaciation; also, 

 either free or in the tubular casts, in Bright's disease. Ammonia 

 salts are found in the acid, and especially in the alkaline fermentation 

 of the urine. In acid pathological urine the occurrence of ammonia 

 is not unusual as in typhus, measles, and scarlatina. Ammonia is 

 almost always contained in alkaline urine ; for the alkaline reaction 

 depends either primarily on ammonia formed by the decomposition 

 of urea (especially in vesical catarrh), or upon carbonates of the 

 alkalies, which soon decompose the urea. 



The quantity of urine secreted in twenty-four hours varies ex- 

 tremely, the two most important factors bearing on it being the 

 mechanical conditions for the passage of urine through the kidneys, 

 and the condition of the blood. (Lehmann.) An adult male excretes 

 from 17f ounces to 112J ounces in twenty-four hours; averaging 

 between 38} ounces and 48J ounces. The adult averages 40.13 

 grains to 1,000 grains of his weight; a child, 72.5 grains. The dif- 

 ferent proportions of water account in great part for the variations 

 above mentioned in the quantity of urine; but the solid constituents 

 are also liable to considerable variation, an adult discharging from 

 1J ounces to 2| ounces in twenty-four hours. They are increased 

 by exercise, and diminished by sedentary habits. Moreover, if the 

 blood is poor in albumen and abundant in salts (as in Bright's dis- 

 ease), the solid constituents are diminished. The mineral constitu- 

 ents also vary greatly ; between 108 and 355 grains in twenty-four 

 hours averaging 231.5 grains, or nearly half an ounce. The urine 

 of women is richer in water and poorer in salts than that of men ; 

 and especially during pregnancy. Hence the formation, in the 

 latter condition, of the pellicle improperly called Jciesteine, in the 

 manner already explained (p. 89). 



Origin, Urine is directly eliminated from the blood by the epi- 



