17 
(i7|  cent.  ()1  (llssdlvcd  li.ii‘iii(i;^dul)iii  wi.mld  iiinri’ 
prubalily  cunsidi-n-aljly  iiiurr  than  ii  |f.  of  haeiuoj^lol)in,'  wliilo  llic 
urine  conlained  about  y  of  liaeiuoglobiii.  It  is  diffieull  lo  assume 
dial  in  surli  rases  so  larj^e  an  absor|)lKjn  of  dissolved  liaeuio^loliin 
by  the  renal  epillielium  could  take  place,  when  it  is  borne  in  mind 
that  in  experimental  luiemo^lobmaemia  (bable  35,  h'i^es.  J  to  y)  the 
stream  of  haemoj^dobin  is  strongly  in  the  opposite  direction,  even 
when  the  percentage  of  dissolved  haemoglobin  is  considerable  in  the 
lumen  of  the  uriniferous  tuljules  and  is  relatively  slight  in  the  blood 
plasma,  as  in  ILxp.  10,  Table  35  (h'ig.  y).  This  difficulty  appears  to 
be  an  insuperable  one.  It  must,  moreover,  lie  remembered  that  if 
haemogloliinaemia  were  established  as  a  result  of  glomerular 
haemorrhage  an  adilitional  production  of  luiemogiobinuria  would 
thereby  result,  as  in  cx[ierimental  haemoglobinaemia,  so  that  in 
such  a  case  the  eliminat inn  ol  dissolved  haemoglobin  by  the  kidiic)’ 
would  be  a  double  process. 
2.  The  production  of  granular  casts  uiirler  this  ly'pothesis  would 
bill  into  the  lirsl  ol  the  two  [lossible  iiu'thods  relerred  to  on  p.  l.p), 
that  is  to  say  that  we  may  assume  that  the  granules  would  be 
|irecipitated  as  tbe  urine  containing  dissolved  haemoglobin  passed 
along  the  uriniferous  tubules.  Another  ex|)lanat  1011  might,  however, 
be  ollercd,  namely  that  the  red  blood  cells  esca[)ing  from  the 
glomeriih  were  im|)erfecl ly  lakcd  tiiid  that  the  granules  ri'presenled 
red  cell  tlebris  still  remaining.  This  jjoint  is  scarcely  worthy  of 
serious  consideration.  It  may  be  olcserved  that  the  gr.inules  seen 
111  the  urinary  deposit  (h'ig.  3.’)  and  in  the  sections  of  the  kiiiney 
(*' 33^^b  and  53'4)  Tase  ya,  and  also  sometimes  in  the  urinary 
deposit  in  exjjerimenlal  haemoglobinaemia  (h'igs.  22,  J3)  re.icb  as 
much  as  5/^  in  diameter  and  then  present  a  considerable  resemblance 
to  red  blood  cells.  riiey  diller  from  the  latter  in  their  darker  colour 
and  smaller  size  aiul  the  absence  of  the  typical  form  of  red  cells, 
though  the  latter  might  [lerhaps  be  attributed  lo  the  circunisl anci' 
that  ihese  granules  are  densc'ly  packi'd  together.  Nex'ertheless  we 
think  the  last  two  points  and  the  bud  that  every  transition  occurs 
between  Ibe  granules  seen  in  h'ig.  32  and  the  smallest  granules  .seen 
in  I’igs.  2()  and  31,  negative  the  view  that  the  granules  in  h'ig.  3J 
’*■  ll  is  assumeil  that  llie  patit-iit's  lilouil  plasma  measured  1500  c.c.  ' 
