Physical Properties of the Urine. 203 



tubules are polyhedral with large nucleus, or columnar. The cells 

 from the male urethra are also largely columnar. In cases, how- 

 ever, in which these cells are passed in large amount because of 

 catarrh of the mucosa all alike tend to assume the globular form 

 with large nucleus so that their true source cannot be certainly 

 stated. It is only from such cells as have become detached with- 

 out change of form that the seat of desquamation can be deter- 

 mined. If an excess of cells approximating to the kidney type 

 are associated with albuminuria and cylindroid casts they become 

 diagnostically significant. Polygonal cells darkly granular with 

 large oval nucleus- and nucleolus suggest kidney inflammation. 

 If the granules are freely soluble in ether there is probably fatty 

 degeneration. If hard, tough and glossy they suggest (but 

 don't prove) amyloid degeneration. 



Pus Cells in Urine. Pus cells, with multiple nuclei revealed 

 by adding dilute acetic acid, may be found in small numbers in 

 apparently healthy urine. When present in large numbers, they 

 usually indicate a catarrhal affection of the mucosa, and especially 

 pyelitis, cystitis, or urethritis. There is always cloudiness, excess 

 of mucin, and in the alkaline herbivorous urine, the liquid may 

 be glairy or stringy. 



Casts of the Uriniferous Tubes. These usually indicate 

 the existence of nephritis, yet they may be present in small num- 

 bers in the urine of healthy individuals under a slight toxic 

 action such as alcohol. 



Unorganised casts of urinary salts or hsem,atoidin found in 

 sucklings appear to have no pathological sig*nificance. Organized 

 casts, on the other hand, usually imply renal troubles, and 

 especially inflammation. As these will be fully described under 

 Bright's disease, it need only be noted here that they may be 

 composed in great part of red globules, leucocytes, epithelium, bac- 

 teria, granules, a hofnogeneous wax-like matter, fat globules, hya- 

 line matter, or urinary salts. The predominance of one or other 

 of these determines the nature of the cast. 



The observations of Mayer, Knoll, Bovida, Von Jaksch and 

 others seem to show that the basis substance of urinary casts 

 differs from all our familiar proteids and must be considered as a 

 distinct nitrogenous compound, a derivative of one of the com- 

 mon proteids. 



