200 
The  deposit  in  the  urine  on  the  first  day  consisted  of  yellowish 
brown  granules,  forming  a  precipitate,  or  arranged  in  masses  or  in 
well  defined  casts  (Fig.  29,  p.  100);  the  individual  granules  reaching 
up  to  4‘5/“  ill  diameter;  unaltered  red  cells  in  small  numbers  (not 
present  in  the  first  .specimen  of  urine);  sejuamous  epithelial  cells-  ' 
and  (in  the  first  specimen  only)  triple  phosphate  crystals.  Siibsp-  I 
quently  the  amount  of  deposit  became  very  small  and  consisted,  even  f 
m  the  last  specimen,  of  red  cells  ;  coarse  granular  casts  surrounded  hy  ' 
renal  tubule  cells  (Fig.  32,  p.  104);  granular  debris;  and  renal  cells,  |' 
isolated  or  in  groups.  j 
The  first,  third,  fourth  and  fifth  specimens  of  urine  gave  (after 
centrifugalisation)  the  following  percentages  of  haemoglobin,  deter-  ' 
mined  by  means  of  a  comparison  spectroscope:  0'4i  per  cent; 
ri  per  cent.  ;  r2  per  cent.  ;  0'8  per  cent.  These  estimations  of  the 
oxyhaernoglobin  actually  present  do  not  represent  the  amounts 
actually  passing  into  the  urine  in  the  kidney,  since  much 
of  the  haemoglobin  had  been  decomposed.  On  comparing  the  I 
chocolate  brown  precipitate  obtained  with  that  yielded  by  boiling  s  J 
mixture  of  blood  and  urine,  it  was  found  that  the  samples  of  urine  If 
were  matched  as  follows:  —  ist,  with  r8  per  cent,  of  haemoglobin; 
3rd,  with  2' 5  per  cent,  of  haemoglobin;  4th,  with  3‘5  per  rent,  of 
haemoglobin  ;  5th,  with  3’5  per  cent,  of  haemoglobin.  The  total  [ 
haemoglobin  lost  by  the  kidneys  on  the  first  day  did  not  therefore  I 
exceed  6-4  +  o'qq  +  075  +  0-42  +  0'52  =  g'od  g.  of  wet  red  blootl  | 
cells.  The  yellow  coloured  urine  subsequently  pas.sed  contained  ]-  to  t 
§  column  of  coagulable  proteid  of  a  slightly  brownish  white  colour,  F 
Post-mortem  examination. — Body  well  nourished.  .Skin  no  longer  ft 
sallow.  Subcutaneous  tissue  oedematous  generally.  i 
Peritoneal  cavity  contained  about  goo  c.cm.  of  clear  yellowish  fluid  I 
Spleen  much  enlarged  :  bin.  long,  qin.  broad,  and  2in.  thick.  Spleen 
smear  showed  ])hagocytosis  of  red  blood  cells,  but  no  malarial 
parasites  or  pigment.  Liver  somewhat  enlarged,  milky  opacity  on 
surface,  some  congestion.  Kidneys  markedly  enlarged,  measuring 
slightly  more  than  sin.  in  length,  3in.  in  breadth,  and  i|-in.  in 
thickness;  capsule  stripped  readily;  corte.x  not  markedly  congested, 
I!  'I 
