Diagnosis, Treatment. 979 



whether the albumen is derived from the kidneys (albuminuria 

 vera) or from the urinary passages or from the near-by genitalia 

 (albuminuria spuria). If the urinary sediment contains no 

 organic form elements, and if the presence of dissolved blood 

 coloring matter may be excluded, if further the organic sediment 

 consists exclusively of form elements which are derived from 

 the kidneys it can only be a question of renal albuminuria. On 

 the other hand, in the presence of copious organic sediment a 

 small quantity of albumen (less than 1%) speaks against renal 

 albuminuria. If the urine contains, in addition to pus cells, 

 also epithelia from the urinary passages or, in addition to red 

 blood corpuscles, comparatively much (several per cent of) 

 albumen, the indications point not only to a spurious albu- 

 minuria, but it may be inferred that the urine contains albumen 

 on leaving the kidneys. (In the presence of pus cells, at least 

 50,000 pus cells in a cubic centiineter of urine correspond to 

 an albumen content of 1:1000 [Goldberg].) 



Significance of Albuminuria. The importance of albumin- 

 uria lies in the fact that a portion of the albuminous substances 

 which circulate in the tissue fluids of the body leave it unused, 

 which necessarily leads to disturbances in nutrition. Accord- 

 ingly a persistent albuminuria leads of itself to a gradual weak- 

 ening of the organism. In a given case the amount of albumen 

 present and the duration of the albuminuria are of importance, 

 aside from the basic disease. 



Treatment. As albuminuria is only a symptom of several 

 different diseases, the treatment must be adapted to the under- 

 lying pathological condition. 



Literature. Fettick, Z. f. Tm., 1899. III. 329 (Lit.). — Goldberg, Cbl. f. 

 med. Wissenseh., 1893. 36. — Henn, Die Albuminurie, etc. Diss. Giessen 1909 (Lit.). 

 — Bievel, D. t. W., 1901. 151. — Senator, Albuminurie, 1882. 



2. Hematuria. 



Etiology. Blood or red blood corpuscles may become mixed 

 with the urine either in the kidneys already or only in the 

 urinary passages, and they may also get into the urine from 

 the contiguous genital organs. Hematuria presupposes some 

 disease of the blood vessels in the kidneys or in the urinary pas- 

 sages, which makes it possible for the red blood cells to extrava- 

 sate by diapedesis or by rhexis. Thus renal hemorrhage may 

 occur in consequence of certain forms of acute, less often of 

 chronic renal inflammation, after injury to the kidney, in severe 

 blood stasis, after rupture of the renal artery if this shows 

 an aneurismal dilatation (Liebetanz, Voltz, Hackbarth), also 

 in acute infectious diseases (purpura, anthrax, swine plague, 

 hog cholera, etc.), and likewise in hemophilia and m cachectic 



