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THE LIBRARY
OF
THE UNIVERSITY
OF CALIFORNIA
PRESENTED BY
PROF. CHARLES A. KOFOID AND
MRS. PRUDENCE W. KOFOID
Wap ae eee
Sas
Ss
THE
SYDENHAM SOCIETY
INSTITUTED
MDCCCXLIII
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———
LONDON
M DCCCXLVI.
ANIMAL CHEMISTRY
WITH REFERENCE TO THE
—, ~
PHYSIOLOGY AND PATHOLOGY OF MAN
y
—, i Se, ai
—
BY
DR. J. FRANZ SIMON
FELLOW OF THE SOCIETY FOR THE ADVANCEMENT OF PHYSIOLOGICAL CHEMISTRY AT BERDIN
ETC, ETC.
TRANSLATED AND EDITED BY
GEORGE E. DAY, M.A. & L.M. Canras.
LICENTIATE OF THE ROYAL COLLEGE OF PHYSICIANS.
IN TWO VOLUMES
VOL. II.
LONDON
PRINTED FOR THE SYDENHAM SOCIETY
MDCCCXLVI.
} Said
“= ahi fie
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‘PRINTED BY
TABLE OF CONTENTS.
CHAPTER III.
THE SECRETIONS OF THE CHILOPOIETIC VISCERA AND THE THEORY
OF DIGESTION.
Saliva
Morbid saliva
Saliva of animals
Pancreatic fluid
Bile ‘
Morbid bile . :
Bile of animals ;
On the action of the bile in the process of dlgestics
Gastric juice
Morbid gastric juice
Intestinal fluid
The process of digestion
Diseased digestion
CHAPTER IV.
MILK.
General physico-chemical characters of the milk
Special chemistry of the milk
Milk before delivery
Milk immediately after delivery faaaateiel
Ordinary human milk
The effect of temperament on the milk .
The changes in the milk dependent on nutrition
Il,
42
Ad
47
49
50
54
ib.
vi CONTENTS.
Page
Changes in the milk corresponding with the age of the infant. : 56
Diseased milk . ; ; ; : ; : 57
Colostrum of animals : 61
Milk of animals . ° : . peer. : : ib.
Diseased milk of animals : . ; ; P 67
CHAPTER V.
SECRETIONS OF THE MUCOUS MEMBRANES.
Mucus , ‘ 2 es 70
Morbid mucus ¢ : ; 3 ’ ‘ 72
Purulent mucus . : : : : at - 83
Pus . é ‘ ; ‘ ; inn
Ichor . BS ‘ : ‘ é : : 96
On the formation of mucus and pus on mucous membranes, and on the .
deteetion of pus in mucus. ; i : j 97
CHAPTER VI.
SECRETIONS OF THE EXTERNAL SKIN.
Sweat (sudor) : : : : : ‘ 101
Morbid sweat ; ; ; tay 45a ; d 106
Sweat of animals ‘ ; : : as Z Tit:
Fat. s : : ; uk, ‘ 112
CHAPTER VII.
THE URINE.
Healthy urine ; : : : Sere 113
Qualitative facto of urine ; ; ; , : 115
Quantitative analysis of urine ‘ ;: ‘ 5 4 134
A shorter method of separating the most important constituents of the urine 141
Composition of healthy urine é i “ : : 143,
Physiological relations of the urine. ‘ ? ; i 147
Pathological changes in the urine . : : 170
Qualitative and quantitative analysis of urine modified by disease : é ye
CONTENTS.
On the general relations of the urine in disease
urine in the phlogoses
pericarditis
phlebitis uterina
meningitis
encephalitis
delirium tremens .
myelitis
bronchitis
pneumonia
pleuritis
pleuropneumonia
empyema
emphysema |
angina tonsillaris .
gastritis
enteritis and dysentery
hepatitis
peritonitis
nephritis acuta
Pa arthritica
pe albuminosa seu morbus Brightii
cystitis .
metritis
typhus .
febris intermittens
scorbutus et morbus maculosus Werlhofii
chlorosis
hemorrhagia cerebralis
hemoptysis .
heematemesis
hematuria . :
catarrh
measles
cholera
rheumatism
gout.
erysipelas
scarlatina
279
viii CONTENTS.
On urine in yariola and varicella x = : ;
ac scrofulosis
. rachitis
me osteomalacia
a phthisis pulmonalis
Ss diabetes mellitus . ; ; ¥ ¢
” ” insipidus
* dropsy .
os jaundice
me hysteria : . : ' .
marasmus senilis
“ carcinoma ‘ A . “
wt syphilis
ei urticaria tuberculosa
a herpes zoster
> pompholix
Fatin urine . | ‘ ; ; ; ‘ ‘
Milk in urine
Excess of hippuric acid in urine
Urostealith in urine
Semen in urine
Urine of peculiar colour
Urine during pregnancy, at the period of ditivecs, and after bien
On the passage of medicinal and other substances into the urine -
Urine of animals
CHAPTER VIII.
THE SECRETIONS OF THE LACHRYMAL, MEIBOMIAN, AND CERUMINOUS
GLANDS.
The tears
The gummy secretion of the eyes
Cerumen . : 2 ; ‘ 5
CHAPTER IX.
SECRETIONS AND FLUIDS OF THE GENERATIVE ORGANS.
Semen -
Prostatic fluid
Liquor amnii ‘ ‘ ‘ . eee
Fluid of the allantois. ‘ 5 ; ‘ ‘
Vernix caseosa
282
283
284
286
ib.
289
304
308
313
316
317
ib.
319
320
ib.
322
323
"ib.
324 .
326
327
ib.
329
336
342
353
ib.
354
356
359
ib.
363
364
CONTENTS. te
CHAPTER X.
THE INTESTINAL EXCRETIONS.
Page
Meconium . ‘ ; ae : ¢ } 367
Feces of infants ; ‘ j F ‘ ‘ 369
¥ adults : ‘ ; ¥ ; ; 370
» during disease ; tae, : : ‘ ; 376
», in diabetes j Z i ; ‘ : 377
» dysentery ‘ ;: , ‘ : . 380
» enteritis ; ‘ 4 E a ; 381
» abdominal typhus : i : ‘ ‘ ib.
» diarrhoea ; : ; ; d ‘ 382
» Cholera : i : ‘ ‘ : ib.
» enterophthisis : ; ; . ‘ ‘ 384
»» jaundice ; 5 ‘ : ; ‘ ib.
‘Calomel-stools .. : E ; : : ; 386
Vomitus (matters discharged by vomiting) . ; ; <7 eee
CHAPTER XI.
THE COMPONENT PARTS OF THE ANIMAL BODY. —
The bones : ; : , , P ‘ 396
Bones of the lower animals oR ; . : , 402
Morbid bones ; ; on : : : : 406
The teeth . ; é ; 3 ; ; 413
Cartilage ; ; ; , 2 es
Synovia : : ‘ ‘ ; ; : 416
Cellular tissue, tendons, ligaments, skin, and hair ‘ ; ; ib.
Crystalline lens and fluids of the eye ‘ ; : : 419
The arteries and veins - ‘ ‘ es : ; 421
The muscles . i ; ‘ ; ; ; 422
The brain, spinal cord, and nerves . S : ; ‘ 425
Fat ‘ ; ; — ; ‘ : 427
The glands . ° . ‘ : ; ecco
Otolithes . : ; ‘ ; ‘ : = 429
x CONTENTS.
CHAPTER XII.
SOLID MORBID PRODUCTS.
Concretions, their qualitative analysis
Vesical and renal calculi
Calculi of uric acid
He urate of ammonia
re uric (xanthic) oxide
a cystin
ws protein-compounds
" oxalate of lime
i neutral phosphate of lime
e carbonate of lime
is urostealith
On the laminz of vesical and renal calculi, and on their quantitative analysis
Urinary gravel
Urinary calculi of animals
Intestinal concretions in man
s in animals
Gall-stones in man
i in animals
Salivary calculi and tartar
Various concretions Bouts eee
Tubercle : ; i met "
Scrofulous matter : -
Scirrhus j :
Incrustations on the surface of the body
CHAPTER XIII.
FLUID PRODUCTS OF DISEASE.
Fluid contained in hydatids
; ovarian and other cysts
”
Fluid of pemphigus
ammoniaco-magnesian phosphate and phosphate of lime
Page
430
437
440
442
444
445
446
ib.
448
449
450
452
453
459
461
464
466
469
471
473
474
478
480
481
482
CONTENTS.
Fluid of hygroma ; °
» hydrocephalus
» ascites
Thoracic effusions .
Subcutaneous serum in Bright’s disease
Fluid of hydrocele
Fluid effusions found in the body after death
APPENDIX I.
Ultimate cs ons of protein
‘i tritoxide of protein
Pa binoxide of protein
” erythroprotid
a leucin
” protid
- albumen of the blood
” albumen of eggs
eS or fibrin
ns casein
Hes crystallin
% globulin
” pepsin
ie chondrin
‘i glutin
i glycicoll or gelatin sugar
es hematin
s cholic acid
re urea
Sar uric acid
ee hippuric acid
>" uric oxide
% cystin
vs glycerin
= stearic and margaric acids
+ lactic acid
xi
Page
A489
490
ib.
493
494
495
497
503
ib
ib.
504
ib,
ib;
ib.
ib,
505
ib.
ib.
ib.
ib.
ib.
ib.
ib.
ib.
506
ib.
ib.
ib.
ib.
507
ib.
ib.
ib.
xii CONTENTS.
APPENDIX II.
ADDITIONS TO VOLUME I.
Page
Blood in thoracic inflammation . ~~. . 509
» intermittent fever . ; ; zs ; 510
» certain diseases of the eye ; ; : p ib.
» serofula : ; ; hea 5 i
» Bright’s disease ; A ; ri ‘ 514
Menstrual fluid . ‘ y ; : ; 516
ADDITIONS TO VOLUME Il.
Saliva ; : . : ; i j 518
Morbid saliva ; : 3 : : ‘ -——_ ib.
Fluid of ranula ; : Pe
Bile . , : : : ; «Sens ib.
Morbid bile ; : ; ‘ 5 ; 520
Use of the bile. 3 ; i d i j ib. .
Gastric juice ; j : . ‘ ‘ ib.
Vicarious secretion of milk 2 P : 521
Dumas’ experiments on the influence of food on the milk of the bitch ‘ ib.
Colouring matter of urine (uroxanthin, uroglaucin, and urrhodin) é 522
Quantitative determination of urea. ee : ie
Urine in Bright’s disease ‘ é y : : 528
Liquor amnii . : : : 4 ; : 541
CHEMISTRY OF MAN.
PPP DLE
CHAPTER III.
THE SECRETIONS OF THE CHYLOPOIETIC VISCERA, AND THE
THEORY OF DIGESTION.
The Saliva.
THE saliva is a peculiar fluid, secreted by the parotid, sub-
maxillary, and sublingual glands, and conveyed from them by
certain ducts into the cavity of the mouth, where it becomes
mixed with the buccal mucus. It may, however, be obtained
in a state of purity by collecting it as it flows from one of the
ducts. The following observations respecting the secretion
of the saliva were made by Mitscherlich,' on a person with a
salivary fistula, in whom the saliva could be collected directly
from Steno’s duct. He found that there was no flow of saliva
while the muscles of mastication and of the tongue were in a
state of perfect repose, and all nervous excitement avoided.
He likewise observed that, during the acts of eating and drink-
ing, (especially at the commencement,) the secretion was
abundant, being proportionate to the stimulating nature of the
food and to the degree it was masticated. From two to three
ounces of saliva were collected from one of the parotid glands
in the course of twenty-four hours. It is usually supposed that
about ten or twelve ounces of saliva are secreted daily, but accu-
rate observations are still required on this subject.
Human saliva is a rather opalescent, viscid, colourless fluid ;
1 Rust’s Magaz. vol. 40.
Il. 1
a THE SECRETIONS :
when collected and allowed to rest in a cylindrical glass, it is
observed to yield a deposit of epithelium-scales and mucus-
corpuscles, while the supernatant fluid remains clear. When
perfectly normal, its reaction is alkaline; it is devoid of taste
and odour, and, when observed under the microscope, is seen
to contain peculiar corpuscles, which differ very slightly in their
form from tumid mucus-corpuscles. The appearance presented
by human saliva taken from the mouth, when examined under
the microscope, is depicted in fig. 13. I have always observed
the cells (a) in the saliva; they appear to consist of swollen sali-
vary corpuscles. The salivary corpuscles are represented in (8) ;
(c) represents epithelium-scales ; and (d) fat-vesicles. Mem-
branous shreds are sometimes observed, apparently fragments
of injured epithelium-scales.
The amount of solid residue in the saliva is very small;
it is composed of fat, ptyalin, water-extract, spirit-extract, a
little albumen, certain salts, and a trace of sulphocyanogen.
The presence of the last constituent was first noticed by
Treviranus ; it has since been detected by Gmelin and Tiede-
mann, and other chemists.!
The salts of human saliva are, according to Mitscherlich,
chloride of calcium, lactates of soda and potash, soda either
free or combined with mucus, phosphate of lime, and silica:
according to Gmelin and Tiedemann, they consist of alkaline
carbonates, phosphates, muriates, and traces of sulphates, toge-
1 The occurrence of this substance in the saliva is equally interesting in a physiolo-
gical and chemical point of view; and it would be very desirable to establish its pre-
sence in an unquestionable manner by experiments on a large quantity of saliva.
Gmelin and Tiedemann (Die Verdauung nach Versuchen, vol. i, p. 9) formed an alcoholic
extract of saliva, and distilled the residue, after mixing it with phosphoric acid. The
fluid obtained by this distillation reddened litmus paper, after some days evolved an
odour of prussic acid, yielded a deep yellow-red colour on the addition of perchlo-
ride of iron, and precipitates on the addition of nitrate of silver and nitrate of
peroxide of mercury. On the addition of sulphate of iron and sulphate of copper toa
portion of the distilled fluid, a white precipitate was thrown down, which communi-
cated a red colour to an acid solution of perchloride of iron, The clear chlorine-
solution, obtained by mixing chlorate of potash, hydrochloric acid, and chloride of
barium, was rendered turbid when digested with a portion of the distilled fluid, and
there was a gradual deposition of sulphate of baryta, the sulphuric acid being obtained
at the expense of the hydrosulphocyanic acid. Gmelin and Tiedemann observed the
reaction indicating the presence of sulphocyanogen in the saliva of the sheep, and
I have noticed it in the saliva of the horse.
SALIVA. 3
ther with the phosphates and carbonates of lime and magnesia.
According to Hiinefeld, ammoniacal salts are also present. On
evaporating the saliva, we obtain a brown residue, which evolves
a rather agreeable odour, resembling that of toasted bread.
In certain pathological states the saliva contains other sub-
stances besides those already enumerated: thus, in one case of
morbid saliva I detected free acetic acid, and in another I found
a considerable quantity of a substance resembling casein.
The albumen contained in the saliva is indicated by the |
turbidity produced on the application of heat; and after the
_ removal of the coagulated albumen by filtration, the presence
of the various extractive matters may be shown by the precipi-
tates thrown down by acetate of lead, bichloride of mercury,
and tannin; the casein may be indicated by the addition of
acetic acid; ptyalin, and probably casein, by the addition of
alcohol to clear and somewhat concentrated saliva; and sulpho-
cyanogen, by the redness produced on the addition of perchlo-
ride of iron.
With a view to separate the constituents of the saliva I eva-
porated a known quantity to dryness, and thus determined the
water. I then treated the residue with ether, for the purpose
of extracting the fat; and with water, in order to take up the
ptyalin, extractive matters, and salts. The insoluble residue
that had resisted the action of ether and water, consisted of
albumen and mucus. Another portion of the saliva was de-
canted from its precipitate, evaporated to a small residue, and
the ptyalin, with a trace of extractive matter, precipitated by
alcohol. When the saliva contains a caseous matter, (which
I have observed in large quantity in the saliva of the horse,)
the precipitate of ptyalin and casein produced by the alcohol
must be dissolved in water, and the casein then thrown down
by the careful addition of acetic acid. In this case, a portion
of the casein precipitated by the alcohol usually remains un-
dissolved by the water. I have detected free acetic acid in the
saliva discharged during salivation. In order to determine its
quantity, the saliva must be accurately neutralized by a solu-
tion of carbonate of potash of known strength ; from the amount
of the alkaline solution required, the quantity of acetic acid
can be calculated. If, in addition to acetic acid, free lactic acid
is likewise present, the residue of the saliva, after evaporation,
4 THE SECRETIONS:
when dissolved in water, will still indicate an acid reaction,
because lactic acid differs from acetic acid in not being vola-
tilized at the ordinary temperature used for evaporating animal
fluids. In order to determine the amount of free soda in the
saliva, the dried residue must be extracted with alcohol; the
free soda (which is left in the residue) must be saturated with
acetic acid, the resulting acetate of soda extracted with alcohol,
evaporated, and, by incineration, reduced to carbonate of soda.
An analysis of my own saliva yielded the following results.
It contained, in 1000 parts:
Analysis 58,
Water ‘ : . - . 991-225
Solid constituents ; ; é 8°775 |
Fat containing cholesterin : ‘ 525
Ptyalin with extractive matter . ‘ 4°375
Extractive matter and salts . ‘ 2°450
Albumen, mucus, and cells : ; 1:400
Berzelius! found, in 1000 bats of human saliva :
Water 4 ; - 992°9 ——
Ptyalin ; ‘ ‘ : 2°9
Mucus : 14
Extract of flesh with alkaline lactis ‘ ‘9
Chloride of sodium : : 7
Soda ‘ . ; ; 2
According to the analyses of Tiedemann and Gmelin, 1000
parts of human saliva contain from 9 to 11:4, or even 11°9 of
solid constituents, consisting in 100 parts, of phosphorized fat,
extract of flesh, chloride of potassium, lactate of potash, and
sulphocyanide of potassium, 31'25 ;—animal matter with traces
of alkaline sulphates and chlorides, 1:25 ;—ptyalin, with alkaline
phosphates, chloride of sodium, and traces of alkaline sulphates,
20-00 ;—mucus and a little albumen, with alkaline phosphates
and carbonates, 40°00. This solid residue yielded on incine-
ration 21:99 of inorganic constituents, 17°8 of which were
soluble, and 4:1 insoluble in water. Mitscherlich found that
1000 parts of human saliva yielded from 14-7 to 16°3 of solid
residue, of which 348 were insoluble both in water and in alcohol,
42° soluble in water but not in alcohol of ‘800, and 242 soluble
in water and in alcohol. These proportions varied, however,
in different analyses. :
' Thierchemie, p. 219.
SALIVA. ; 5
The inorganic constituents in 1000 parts of saliva are, accord-
ing to Mitscherlich, chloride of calcium, 1:8; lactate of potash,
"95; lactate of soda, ‘24; soda, probably combined with mucus,
1:64; phosphate of lime, :17; silica, °15.
[According to Dr. Wright, pure saliva is a limpid fluid, having
a faint blue tinge, and a slight degree of viscidity. It is per-
fectly uniform in consistence, and unobscured by frothiness or
flocculi. It possesses a faint sickly odour sui generis, due to
its constituent, ptyalin: this odour is strengthened by heat and
by most acids, but alkalies diminish and destroy it.
The saliva even of healthy people varies considerably in its
specific gravity. It is always denser after a meal than during
fasting ; and generally denser in an evening than in a morning.
But the converse is usually the rule with dyspeptics. Dr. Wright
found that animal (especially fatty) diet, and alcoholic stimulants,
have a tendency to thicken the saliva; oysters, and vegetable
diet, he says, produce an opposite effect. He states, as the
result of many trials and observations, that healthy saliva is
mostly of a sp. gr. of 1007-9. When above 1010:0 or below
1003-0, the secretion may be considered to be morbid. Healthy
saliva, he affirms, is either alkaline or neutral, generally the
former. If saliva be heated, it not uncommonly acquires an
acidity in a few minutes, but this chiefly happens to neutral saliva.
Dr. Wright believes in the existence of the principle called
ptyalin, though he separates it from saliva by a new process.
This process is “ to pass saliva through ordinary filtering paper,
and, after filtration shall have been completed, to exhaust the
residue with sulphuric ether; the ethereal solution contains
a fatty acid and ptyalin.! It is to be allowed to evaporate
spontaneously, and the residue left by evaporation is to be placed
upon a filter and acted upon by distilled water, which dissolves
the ptyalin and leaves the fatty acid. If the aqueous solution
be carefully evaporated to dryness, the “ salivary matter will be
obtained in a pure state.” “Ptyalin,” he says, “as thus pre-
pared, is a yellowish-white, adhesive, and nearly solid matter,
neither acid nor alkaline, readily soluble in ether, alcohol, and
' A reference to vol. i, p. 24, will show that Wright’s ptyalin differs in several
respects from the ptyalin described by Simon. In truth, little is known regarding
this constituent.
oS THE SECRETIONS:
essential oils, but more sparingly soluble in water. It alone
possesses the characteristic odour of saliva; it is unaffected by
galvanism and by most of the reagents which coagulate albumen.
It is abundantly precipitated by sub-acetate of lead and nitrate
of silver; feebly so by acetate and nitrate of lead, and tincture
of galls; uninfluenced by bichloride of mercury and strong
acids; the latter considerably heighten its proper odour and
impair its solubility, whilst alkalies render it more soluble, and
give it the smell of mucus. Moderate heat and oxygen gas
also increase its odour, but a more intense heat or cold dimi-
nishes or entirely destroys it. At a suitable temperature,
ptyalin may be preserved for any length of time without risk
of decomposition. The salivary fluid from which ptyalin has
been removed, possesses a sickly mucous smell, decomposes
much sooner than ordinary saliva, and, in the process of decay,
invariably evolves ammonia. Ifthe fluid be heated, the mucous
smell will be increased until the evaporation shall have been
continued nearly to dryness, when a slight salivary odour may
be recognized, due to a portion of ptyalin being liberated from
the mucus with which it was previously in combination.”
Dr. Wright says that sulphocyanogen is an invariable consti-
tuent of healthy human saliva. He advises that it be sought
for in the alcoholic extract of the residue left by the careful
evaporation of the fluid, as the mucus, unless removed, offers
considerable impediment to the action of reagents. The sulpho-
cyanogen occurs in combination with potassium, the salt consti-
tuting generally from ‘051 to :098 of the secretion. ‘The
proportion,” he says, “is temporarily augmented by local sti-
mulation of the salivary glands, as by smoking, chewing siala-
gogues, &c. It is also increased by the internal use of prussic
acid and salts of cyanogen, and remarkably so by the use of
sulphur.”
Pure saliva absorbs a variable quantity of oxygen. Dr.
Wright says, “I have known the quantity absorbed to exceed
21 times the bulk of the saliva; but I once met with an instance
in which the healthy secretion did not absorb more than half
its volume of oxygen. The difference is generally dependent
upon the carbonic acid gas naturally contained in the saliva,
the proportion of which gas to the secretion varies from one
eighth to one twelfth in volume, though, in some particular
i fork eee tip : eo a Ae Ve ep cs
7 a , q Sd aol Ce ral eee oe a e-
; bas aoe ae
SALIVA. 7
cases, it is much more abundant.” He says that saliva, in its
healthy state, contains also oxygen gas, which it can be made
to evolve on the application of heat. This in some measure
aids its digestive powers; for he found that saliva which had
been exposed for some hours to an atmosphere of oxygen, con-
verted a much greater quantity of starch into gum and sugar
than other saliva which had not been so exposed. This state-
ment, founded upon a great number of comparative experiments
was made by Dr. Wright long before the apparently less correct
observation of Liebig, that the saliva collects “bubbles of air”
to assist the digestive function. In pure saliva there are no
“bubbles of air ;” the absorbed gases are carbonic acid and
oxygen, the latter only contributing to the digestive properties
of the fluid. As the result of numerous analyses, the process
of which Dr. Wright has fully detailed, he gives the following
as the constituents of the healthy secretion :1
Water . ; ; 2 9881
Ptyalin ; : ; 18
Fatty acid y ; . 5
Chlorides of sodium and potassium. 1°4
Albumen with soda : : >
Phosphate of lime "6
Albuminate of soda ; aS 8
Lactates of potash and soda ; “3
Sulphocyanide of potassium “9:
Soda ‘ : : 5
Mucus, with ptyalin , : 2°6
L’Heretier has recorded the mean of ten analyses of the
saliva of healthy persons, collected while fasting :
Water ‘ : : 986°5
Organic matter ; ; 12°6
Inorganic matter : . 9
The salivary matter, or ptyalin, formed 2°5 of the 12°6 parts
of organic matters.
In children, the amount of water is generally increased. As
a mean of four analyses, he found :
' Der Speichel in physiologischer, diagnostischer, und therapeutischer Beziehung,
p. 28, Wien, 1844. Dr. Wright’s investigations first appeared in the Lancet.
8 THE SECRETIONS :
Water . x . 996°0
' Organic matter ‘ : 3°5
Inorganic matter ‘ ° 5
The ptyalin amounted to only 1-1.
He was unable to detect any difference between the saliva
of man and woman.
Enderlin has made numerous analyses of the ash left after
the incineration of the saliva, and has always found it to have
the same constituents. He considers that its alkaline reaction
is due to the tribasic phosphate of soda (8NaO, PO.) which
retains the mucus and protein-compounds in solution. Enderlin
observes that, independently of conclusions deduced from the
ash, he has sought unsuccessfully, in a direct manner, for lac-
tates in the saliva. On incinerating salivary mucus obtained
by washing that constituent from a filter, the residue is found
to consist of phosphate of lime, with traces of chloride of sodium
and phosphate. of soda, the same composition as the tartar that
collects on the teeth.
A quantitative analysis of the ash from a large amount of
saliva obtained from different persons, yielded the following
results :
A. Constituents soluble in water.
Tribasic phosphate of soda (3 NaO, PO,) : 28°122 .
Chlorides of sodium and potassium 61-930 92-387
Sulphate of soda . ‘ ; 2°315
B. Constituents insoluble in water.
Teenie of lime ’ ; ;
i magnesia ; : . 5509 ]
yi peroxide of iron
Very little is known with certainty regarding the part taken
by the saliva in the process of digestion. Spallanzani fancied
that he had observed that food inclosed in tubes pierced with
numerous apertures, and moistened by the saliva, was more
rapidly digested than when simply moistened with water.
Berzelius, however, found that the saliva exerts no greater
solvent power than pure water, and Miiller confirms his state-
ment. Himefeld, on the other hand, believes that the object
of the saliva is to destroy the tenacity of the food, and he
— Py (ST
or WERT rats LT ts
DSR oy peta Leah Ses:
MORBID SALIVA. 9
thinks that it has the power of reducing fibrin to the condition
of a viscid fluid.
[The services which the saliva performs in the animal eco-
nomy are classified by Dr. Wright as follow:
Active.—1. To stimulate the stomach and excite it to acti-
vity by contact. 2. To aid the digestion of food by a specific
action upon the food itself. 3. To neutralize any undue acidity
in the stomach by supplying a proportionate alkali.
Passive.—1. To assist the sense of taste. 2. To favour the
expression of the voice. 3. To clear the mucous membrane of
the mouth, and to moderate thirst.
Mialhe! has recently announced the discovery of an active
principle in the saliva analogous in its physical and chemical
characters to diastase. Jt is solid, white or greyish-white,
amorphous, insoluble in alcohol, but soluble in water and spirit.
The directions for obtaining it are the following: Filter saliva
and treat it with five or six times its weight of absolute alcohol,
adding it as long as any precipitate occurs. This animal dias-
tase is insoluble, and falls in white flocks, which must be col-
lected on a filter and dried. It forms about °22 of the whole
saliva. |
Leuchs? was the first who observed that saliva converts boiled
starch into sugar.
Morbid Saliva.
The saliva becomes affected in various morbid conditions of
the system, but the nature of the changes that it undergoes
has not hitherto been sufficiently studied. Morbid saliva
sometimes contains a free acid; this is most commonly lactic
acid, but, in some cases, acetic acid is likewise present. The
acid reaction may be at once detected by test paper; while
normal saliva communicates a blue tint to red litmus paper,
this, on the contrary, reddens blue paper. I have frequently
seen the saliva acid in acute rheumatism, and in cases of sali-
' Lancette Francaise, 1845, April.
* Kastner’s Archiv. 1831.
10 THE SECRETIONS:
vation. According to Donné,’ the saliva has an acid reaction
in all cases of irritation and inflammation of the stomach, in
pleuritis, encephalitis, intermittent fevers, acute rheumatism,
uterine affections, and amenorrhea. Brugnatelli? detected
oxalic acid in the saliva of a phthisical patient. The secretion
of saliva is sometimes increased to an extraordinary degree,
- constituting salivation ; in such cases, the chemical characters
of the saliva are also more or less affected. In a specimen of
saliva forwarded to me for examination, which was obtained
from a patient who had just terminated a course of mercury of
some weeks’ duration, I observed an acid reaction arising from
the presence of free acetic acid. It was very viscid, of a yellow
colour, and possessed a sickly, disagreeable, acid smell. It
contained no mercury. After evaporation to dryness, all the
acid reaction had disappeared: thus showing that it contained
no free lactic acid. This saliva contained a very large quantity
of semifluid fat, a considerable amount of albumen, and traces
of caseous matter. Under the microscope, an immense num-
ber of fat-vesicles were seen, some epithelium-cells, and a very
few partially-destroyed saliva-corpuscles. 1000 parts of this
saliva were composed of :
Analysis 59.
Water : ; ; 974°12
Solid Feet SiH f : ; 25°88
Yellow viscid fat ‘ 6°94
Ptyalin with extractive matter and traces of casein 3°60
Alcohol-extract with salts : : 7°57
Albumen ; 3 ; yh of
The salts consisted of a largely preponderating amount of
the chlorides of sodium and potassium, associated with the
lactates of soda and potash, and with a small quantity of the
earthy phosphates. On contrasting this saliva with the normal
fluid, we are struck with its large amount of solid constituents,
arising not from any increase of the ptyalin, but of the fat, the
extractive matters, the albumen, and the salts.
[L’Heretier gives the mean of three analyses of this secretion
during mercurial ptyalism. He found:
* Arch. Génér. de Méd. 1835, May.
* Stark. Allgemeine Pathologie, p. 1074.
MORBID SALIVA. 11
Water ; ‘ 970°0 in place of 986°5
Organic matters - 28°6 12°6
Inorganic matters ‘ 1-1 £9
The mean amount of ptyalin was 2°6, or very nearly the
normal quantity. He attributes the large amount of organic
matter to the increased quantity of mucus secreted by the
buccal membrane.
Dr. Wright also found that the saliva of mercurial ptyalism
contained an unusual amount of mucus. It consisted of:
Water ; : ‘ : 988°7
Ptyalin : ; : : 1-9
~ Fatty acid ; ; 4 . *4
Albumen with soda, and \ 6
Albuminate of soda
Mucus with a trace of ptyalin > ‘ 3°8
Lactates : ee
Phosphates . ;
; Soda . 2°4
Muriates tine
Hydrosulphocyanates
He could not detect the slightest trace of mercury in it. |
Gmelin! has examined saliva discharged in consequence of
salivation produced by mercurial inunction. In one case it
was brown and turbid, and contained a large quantity of fat
but not much albumen; in another instance it presented a
yellow tint; it contained a large quantity of yellow fat, and
when heated, gave no perceptible indication of coagulation, In
both cases, but most decidedly in the latter, indications of mer-
cury were obtained.?, Thomson’ found the saliva resulting
1 Pogg. Ann. 41, p. 438.
? Gmelin employed Smithson’s method for the detection of the mercury. A large
quantity of saliva was treated with nitric acid, and evaporated; the residue was di-
gested with nitric acid and dissolved in water; and, after the removal of fat by filtra-
tion, a stream of sulphuretted hydrogen was passed through it. The precipitate
obtained by this process contains sulphuret of mercury; it must be collected, digested
in nitro-muriatic acid, evaporated, dissolved in dilute hydrochloric acid, and a bit of
gold-leaf enveloped in tin-foil, or encircled by iron wire, suspended in the fluid. The
gold is tarnished if mercury is present. No tin-foil should be used that has not been
itself tested for mercury. In place of the gold-leaf I have employed the blade of a
knife with advantage.
* Annals of Philosophy, vol. vi, p. 397.
12 THE SECRETIONS :
from the administration of mercury, turbid ; it deposited flocculi
of coagulated albumen. It was not precipitable by tannic
acid, had a specific gravity of 1003-8, and contained, coagulated
albumen, 2°57; mucus, 3°67; chloride of sodium, ‘9; water,
992-8. Bostock analysed the saliva of a man who was secreting
about two quarts daily in consequence of mercurial salivation.
It was of a clear brown colour, neutral, viscid, but not stringy,
and barely transparent. It became clear, however, after the
deposition of the minute flocculi suspended in it; the appli-
cation of heat, and also the addition of corrosive sublimate,
gave indications of the presence of albumen. It yielded 2° of
dried residue. After the discontinuance of the mercury, the
saliva was found to be less transparent; it reddened litmus
paper, contained more albumen, and more solid constituents
generally. Vogel! analysed the saliva of a man with sponta-
neous salivation; it contained 991-2 parts of water; 4-4 of
ptyalin, osmazome, fat, and albumen; and 4°4 of salts of soda,
potash, and lime; hence, in respect to the amount of solid
constituents and ptyalin, this saliva did not differ very much
from the normal standard. Mitscherlich also found that,
in the salivary flow excited by nervous irritation, the amount
of the solid constituents was not increased, that the ptyalin and
sulphocyanogen were even below the normal standard, while,
on the other hand, the extractive matters were somewhat in-
creased. A similar observation has been made by Guibourt.
I examined the saliva of a patient suffering from an inflam-
matory affection of the pancreas. It was discharged from the
mouth in large quantity; it was a clear, viscid fluid, mixed
with mucus, alkaline in its reaction, and exhibiting, under the
microscope, mucus-corpuscles, numerous oil-vesicles, epithelium- —
cells, and membranous shreds: its specific gravity was 1005 ;
and 1000 parts yielded only ten of solid residue, which, in addi-
tion to mucus, and a very small quantity of albumen, consisted
principally of an extractive matter which developed an aromatic
odour on the application of heat, of fat, certain salts, and a
little ptyalin.
' Lehrbuch der Physiologie, von R. Wagner, p. 212.
ye
rie
28 Fae rie OO
MORBID SALIVA, 13
[L’Heretier observes that, in chlorosis, the amount of water
increases in proportion to the progress of the disorder. An
analysis of the saliva in this disease is given in page 299 of his
Pathological Chemistry.
In dropsy, with albuminous urine, the saliva contained :
Water ‘ i ‘ 985-9
Organic matter ’ ‘ 13°6
Inorganic matter ‘ ‘ 5
In most inflammatory affections, the amount of water is
‘diminished. The following numbers express the mean results
of six analyses in cases of inflammatory fever, pneumonia, and
erysipelas :
Water x 3 ‘ 968°9 ©
Organic matters ; ; 30:0
Inorganic matters ‘ > 11
The mean amount of ptyalin was 3°6; the ordinary amount,
according to L’Heretier, being 2°5.
The three following forms of morbid saliva have been ana-
lysed by Dr. Wright :
Fatty saliva.
albuminate of soda
Water : : F 987°4
Ptyalin ‘ i ; : 7
Adventitious fatty matter and fatty acid ‘ 3°9
Albumen with soda, and \ 15
albuminate of soda
Sulphocyanide of potassium ‘. ‘ a trace
Mucus : ‘. = : 2°4
Lactates ‘ Potash
Muriates ‘ i Soda . } 1:8
Phosphates Lime
Sweet saliva.
Water ‘ : : : 986°9
: Ptyalin . : F 3
Fatty acid : : ; ‘ ‘2
Muco-saccharine matter , ‘ . 5°6
Albumen with soda, and \ 4
14 THE SECRETIONS:
Snlphocyanogen ; : : a trace
Mucus with a trace of aie : : 2°6
Lactates / Potash
Muriates ; } Soda . } 19
Phosphates Lime .
Bilious saliva.
Water ; ; : : 986°7
Ptyalin ° ; 3)
Fatty matter and fatty sal. ; ; 13
Biliary matter. ; ‘ ‘ 3°2
Cholesterin A : : s “4
Albumen with soda, and \ 1-9
albuminate of soda
Mucus ‘ : " > 16
Carbonates A Potash
Muriates i Soda . ; 2:3 ]
Phosphates Lime .
Saliva of animals.
I have analysed the saliva of a horse suffering from ozzena.
Professor Hertwig kindly assisted me in exposing Steno’s
duct; and, in the course of eight hours, (during which
time the horse was feeding,) about five ounces of saliva were
collected from the opened duct. The fluid was viscid, of a
faintly yellow colour, devoid of odour, alkaline in its reaction,
and possessed a specific gravity of 1006. (Schultz? collected in
a similar manner 55 ounces 7 drachms of saliva from a horse
in the course of twenty-four hours.) After some time, the
saliva deposited a white sediment, consisting of irregular mem-
branous shreds and saliva-corpuscles. On the application of
heat it became turbid. A copious precipitate was thrown down
on the addition of acetic, dilute sulphuric, or lactic acid; and
on evaporation it became covered with a film of coagulated
casein. Perchloride of iron produced a vivid red colour, and a
slight precipitate. It contained a larger amount of solid con-
stituents than human saliva, and a very considerable quantity
of casein, part of which coagulated on evaporation, and part
was thrown down by acetic acid; in this manner it was sepa-
! De Alimentor. concoctione. Berol. 1834.
aed aa
SALIVA OF THE SHEEP. . 15
rated from the ptyalin. 1000 parts of this saliva were com-
posed of :
Analysis 60.
Water ‘ a ‘ 982-000
Solid constituents ; : é 18-000
Fat containing cholesterin é . 120
Ptyalin with extractive matters . / 4°442
Casein ‘ 4 : 5°422
Albumen ‘ 5 ‘ ‘601
Extractive matters and salts : ; 7°178
Saliva of the dog.
The saliva of a healthy dog was collected by exposing Steno’s
duct, and examined by Gmelin and Tiedemann. It was rather
turbid, of a pale yellowish-white colour, thick, capable of being
drawn out in threads like albumen, alkaline in its reaction,
and 1000 parts left, on evaporation, a solid residue of 25-8,
consisting of a little extractive matter soluble in alcohol, an
average quantity of ptyalin, mucus, a very large amount of chlo-
ride of sodium, together with alkaline carbonates, acetates, sul-
phates, and phosphates, and a little phosphate and carbonate
of lime. -
Saliva of the sheep.
Gmelin and Tiedemann succeeded in collecting between three
and four ounces of saliva in the course of fifteen hours from
the stenonian duct of a sheep. It was of a reddish tint, in
consequence of being mixed with a little blood, perfectly fluid,
faintly alkaline, and of a slightly saline taste. 1000 parts of
the saliva contained :
Water : 989-0
Extract of flesh, an organic shatter with which chloride of
sodium crystallized in octohedra, chloride of sodium, and a
little sulphocyanide of sodium . I'l
A little ptyalin, with a good deal of phosphate pce Sivhcuadn
of soda, and chloride of sodium ‘ 8-2
Mucus or albumen, with a little phosphate and iadeacate of
potash
Gr
16 THE SECRETIONS: |
The Pancreatic Fluid.
The most accurate analysis of the pancreatic juice is that of
Tiedemann and Gmelin.’ Earlier observers, as, for instance,
De la Boé, De Graf, and others, had shown that it is an acid,
clear, rather viscid fluid, possessed of a saline or acid-saline taste.
Wepfer, Pechlin, and Brunner, on the other hand, had described
it as turbid, of a whitish colour, not acid, but having a saltish
taste, somewhat like the lymph. Mayer? described the pan-
creatic juice of a cat as transparent, viscid, decidedly alkaline,
and containing albumen, chloride of sodium, and a peculiar
animal matter. Magendie found it alkaline and albuminous
in a dog, and in birds it contained so large an amount of albu-
men as to coagulate on the application of heat.
Tiedemann and Gmelin cut down upon the pancreatic duct
of a strong well-fed dog, and, in the course of four hours, col-
lected about 155 grains of the fluid secretion. The portion
that was first collected was turbid, and somewhat red, probably
in consequence of the presence of a little blood. This was
placed aside. The subsequent portion had a blueish-white tint ;
could be drawn out in threads like dilute albumen, had a faintly
saline taste, and an alkaline reaction. 1000 parts left 87 of
solid residue. The red portion first collected has a faintly acid
reaction. The principal constituents were extractive matters,
chloride of sodium, albumen, and a sort of modified casein.
The pancreatic juice of a sheep was found by Gmelin and
Tiedemann to be clear, slightly acid, and of a faintly saline
taste. 1000 parts left 36 of solid residue, consisting of the
same ingredients as in the dog. In this instance, also, the
portion that escaped during the latter part of the experiment
was alkaline, and was richer in solid constituents than the
fluid that escaped earlier; it contained 51-9 of solid constitu-
ents in 1000 parts. |
The following is the result of their analyses :
In the dog. In the sheep,
Water ft é - 917°2 963°5
Extractive matters and salts soluble in alcohol 36°8 15°5
Caseous matter and soda-salts soluble in water 15°3 2°8
Albumen and salts ‘ - $ 35°5 22°4
' Op. cit. vol. i. p. 25. * Deutsch. Arch. fiir die Physiologie, vol. iii, p. 170.
1S, hg NRE ryt =
BILE. 17
The alcohol-extract of the pancreatic juice of the dog yielded
a very singular reaction. On the addition of a little solution
of chlorine to the dissolved alcohol-extract, a vivid rose-red tint
was produced, and, in the course of twelve hours, there was a
precipitation of delicate violet-coloured flocculi. The colour
was immediately destroyed by the addition of an excess of
chlorine. An attempt to isolate this colouring matter proved
unsuccessful.
Leuret and Lassaigne have analysed the pancreatic juice of
a horse, and the result of their investigation is, that it is almost
identical in its composition with human saliva. This statement
is so much at variance with the results obtained by Tiedemann
and Gmelin, that we must conclude that Leuret and Lassaigne
were not sufficiently careful in their investigation.
We are still unable to state with any degree of certainty
what part the pancreatic fluid performs in the process of
digestion. There can be no doubt that when the pancreas is
diseased, the pancreatic fluid must be also affected, but we are
perfectly in the dark as to the nature of those changes.
The Bile.
Bilin and urea can hardly be regarded as simultaneous pro-
ducts of the metamorphic action of the blood ; for while I have
detected small quantities of urea in the blood of a healthy calf,
I have never been able to recognize the least trace of bilin or
of bile-pigment. Hence, while urea is produced not only in
the kidneys but in other parts of the system, bilin seems to be
produced and secreted only in the liver.
The bile is a very complicated fluid. According to the latest
researches of Berzelius, it contains bilin ; cholepyrrhin (or bili-
phein); biliverdin ; mucus; cholesterin ; oleate, margarate, and
stearate of soda; chloride of sodium; sulphate, phosphate, and
lactate of soda; and phosphate of lime.
Gmelin and Tiedemann, as well as Frommherz, mention casein
and ptyalin, and the carbonates and sulphates of soda and lime,
among the constituents of the bile.
A perfect analysis of bile would be a subject of extreme
labour and. difficulty, and we must, therefore, confine our atten-
tion to its most important constituents. Let us suppose that
II, 2
18 THE SECRETIONS :
it was required to ascertain the amount of bilin, bilifellinic acid,
and cholesterin, in a specimen of bile; the fluid must be first
evaporated to dryness, and the amount of water thus estimated ;
the residue must be repeatedly extracted with ether, the ethe-
real solution evaporated to dryness, and its residue, consisting
of cholesterin and fluid fat, thoroughly washed with cold and
not too strong alcohol, which dissolves the greater portion of
the fluid fat. It must then be digested with hot alcohol of
0-83; and as this solution cools, the cholesterin separates in
crystals. After the removal of the fat, the residue is treated
with anhydrous alcohol, which takes up bilin, bilifellinic acid,
and biliverdin. The filtered alcoholic solution is then treated
with a solution of chloride of barium, as long as a dark green
precipitate falls ; and afterwards with baryta water, guitatim, as
long as it causes any turbidity; it is then filtered, the excess
of baryta thrown down by a stream of carbonic acid, the car-
bonate of baryta removed by filtration, and the solution evapo-
rated to perfect dryness. The residue is dissolved in anhydrous
alcohol, all the bases are thrown down from the alcoholic solu-
tion by sulphuric acid dissolved in strong spirit, and then, after
filtration, the solution is mixed with moist, pure carbonate of
lead, and the greater part of the alcohol distilled. The fluid
remaining in the retort is removed by filtration from the mso-
juble portion, the lead removed by sulphuretted hydrogen, and
the fluid evaporated. The residue, after being extracted with
ether, leaves pure bilin mixed with a certain amount of fellinic
and cholinic acids, which must be separated with oxide of lead.
We then obtain pure bilin and bilifellinic acid combimed with
oxide of lead.
An accurate quantitative determination of the most important
ingredients of the bile, although difficult, is by no means im-
practicable. It is, however, very uncertain whether the result
of the analysis would afford any insight into the true character
of that changeable secretion. From the latest researches of
Berzelius, it appears that the bilin is so unstable a compound,
that it is hardly possible to obtain bile in the condition in which
it is secreted by the liver, or as it exists in the gall-bladder:
for when bile is left to itself, and much more when it is acted
on by heat and other more or less energetic agents, the bilin
undergoes a series of metamorphoses by which fellinic, cholinic,
ot oe &-. ? ae
i AS Blas teed ee Loy
BILE. 19
and very probably also cholanic and fellanic acids are produced.
The biliary secretion, as it exists in the liver, may be regarded
as pure bilin mixed with biliverdin and fats; the bilin probably
commences its metamorphoses in the gall-bladder, and conti-
nues them in its passage onwards into the intestinal canal. If
fellinic and cholinic acids are formed in the gall-bladder, then
the presence of the two bilifellinic acids in fresh bile may be at
once assumed, since they are only to be regarded as combina-
tions of the former with different proportions of bilin. It is
not by any means probable that cholic acid exists in fresh bile,
and the presence of dyslysin and taurin may be positively
denied ; consequently, the biliary resin, the mixture of fellinic
and cholinic acids and dyslysin does not pre-exist in the bile.
Berzelius and Thénard have made quantitative analyses of
healthy human bile: they found, in 1000 parts :
Berzelius. Thénard.
Water x ‘ ; 907-4 Water. ‘ : 909-0
Bilin, fellinic acid, &c. ; 80°0 Yellow and very bitter resin $7°3
Mucus dissolved in a free alkali 3°0 Brown pigment and mucus 1°8—9-°0
Free alkali and the ordinary salts 9°6 Albumen , ‘ 38°2
Soda holding the resin in
solution < 3 51
_ Salts of potash and soda, and
peroxide of iron o% 4°]
According to Gmelin and Tiedemann, human bile contains
biliary sugar, brown pigment, a little biliary resin, cholesterin,
ptyalin, mucus, oleic acid, and salts.
[In the year 1837, Demarcay announced that the bile con-
sisted essentially of an organic acid combined with soda. He
termed this acid choleic, and obtained it in the following man-
ner: Bile from which the mucus had been precipitated by
alcohol was evaporated on the water-bath, and ten parts of the
dried residue were dissolved in 100 of water, to which ten of
hydrochloric acid had been added. Allowing evaporation at a
moderate temperature to proceed, it was observed that a dark
green oil collected on the surface, while, at the same time, the
fluid became turbid. On removing the oil, and allowing the fluid
to rest for some time, it gradually became clear, with the precipi-
tation of a green deposit. This dark green bitter precipitate is
20 THE SECRETIONS:
Demarecay’s choleic acid, and is regarded by him as constituting
nine tenths of the solid constituents of the bile. It is still
mixed with margaric acid, cholesterin, pigment, &c. After the
removal of these impurities, it is described by Demargay as a
yellow, spongy, pulverulent matter, which rapidly absorbs oxygen
from the atmosphere ; very bitter, slightly soluble in ether,
soluble in water, and very soluble in alcohol. Its solutions
have an acid reaction, decompose carbonates, and form a pecu-
liar class of salts with bases from which the choleic acid may
be removed by acetic acid. Its composition is represented by
the formula C,,H,,NO,,. The choleate of soda obtained by
adding an alcoholic solution of soda to an alcoholic solution of
choleic acid till there is an alkaline reaction, and then passing
a current of carbonic acid through it to remove the excess of
soda, possesses all the characters of bile; it yields, on evapo-
ration, a brown resinous mass, and is soluble in water and in
alcohol. 5
When choleic acid is boiled with hydrochloric acid, it yields
ammonia, taurin,' and choloidic acid ; the latter being insoluble,
is deposited. (Compare this with page 46, vol. I.) | Choloidic acid
is solid, fusible, of a yellow colour, and bitter taste, insoluble in
water, and soluble in alcohol. It combines with bases, neutra-
lizing them, and forming salts which are soluble in alcohol.
It contains no nitrogen, and its formula is C,,H.,,O.,.
Dr. Kemp has communicated some experiments relative to
the bile, tending to show that it is principally composed of a
mere simple solution of a salt of soda, the acid of which differs
from the choleic acid of Demarcay in several respects ; he terms
it bilic acid. Liebig has published a memoir based on Kemp’s
experiments, in which he arrives at very similar conclusions,
but regards bilic acid as identical with the choleic acid of
Demargay and the bilifellinic acid of Berzelius.
Theyer and Schlosser have subsequently published an account
of some new researches on the bile which were made in the
Giessen laboratory, and confirm the accuracy of Liebig’s pre-
vious conclusions.
In a recent essay on the bile, by Platner,? it is shown that
1 It has been recently asserted by Redtenbacher that taurin contains 262 of sulphur,
Hence the formula C,H, NO,, (see vol. I. p. 47) fails to represent its true com-
position. 2 Muller’s Archiv, No. 2, 1844.
BILE. 21
the bilic acid and acid bilate of soda may be procured in a
crystalline state. In a subsequent communication by the
same chemist, after correcting certain errors in his first paper,
he proceeds to show that two distinct substances are met with
in perfectly fresh bile: ‘I have been able,” he observes, ‘to
cause bile, which was evaporated in a water-bath, and freed
from mucus and the greater part of its salts by repeated solu-
tion in alcohol, to crystallize immediately. For this purpose
nothing further is necessary than to add ether repeatedly to
as strong an alcoholic solution of the bile as possible, and then
to set it aside in a cool place. The principal and most impor-
tant constituent of the bile then crystallizes, in the same manner
as in my former experiments; but }—1of the bile used does not
crystallize, but remains as a yellowish-brown syrup. I have
not been able to succeed in separating this in any manner from
the crystals; consequently, I can say nothing more concerning
its nature. It is, however, evidently a different substance from
the principal constituent of the bile, possibly a product of its
decomposition. The decomposition of the bile begins even in
the organism, and it is impossible to examine fresh bile which
is not partly decomposed. The brown liquid appears to consist
principally of biliary colouring matter. I must, however, re-
mark that the crystals have also a slightly yellow tint. The
principal constituent of bile is a compound of soda with a
peculiar organic body, and this compound may be immediately
procured from the bile without its undergoing any important
alteration. Liebig called this compound bilate of soda; I have
denominated it choline-soda. It does not appear to me suffi-
ciently proved that the principal organic constituent of bile is
positively an acid. It is possible that, like albumen, it may
combine with acids as well as with bases. The most recent
examinations of the bile by Berzelius would then be partly true.
Further experiments must decide this. These, however, are
peculiarly difficult, because, in separating the bile from soda,
an acid body may undoubtedly be formed. From the above
observation, it is further evident that the formula advanced by
Liebig for bilic acid must be incorrect; for Kemp, Theyer, and
Schlosser have not analysed the essential biliary ingredient in
a perfectly pure state, but have always at the same time in-
cluded the brown syrup. |
22 THE SECRETIONS :
Morbid Bile.
Our knowledge of the changes that the bile undergoes in
disease is still very superficial.
In persons suffering from dropsy, the bile is stated by Forget
to be thinner, and, in persons with diseased liver, thicker, than
in the normal state. I examined the contents of the gall-
bladder of the woman with icterus, referred to in vol. I, p. 329.
I only obtained a small quantity of viscid, dirty yellow fluid,
from which alcohol precipitated mucus and albumen. The
portion soluble in alcohol yielded, after evaporation, a small
quantity of a viscid substance with a sweet rather than a bitter
taste. Bizio! has analysed a remarkable specimen of bile taken
from the gall-bladder of a man who died in a jaundiced con-
dition. It was a fluid of a dark-red colour, thick, of a nauseous
but not bitter taste, with an odour of putrid fish, and holding
in suspension red and black particles. It contained fatty oil,
3°972; stearin, 8°613; green resin, 2:030; a yellow, non-nitro-
genous, hard substance, soluble in alkalies, in cold hydrochloric
acid, and in alcohol, 1°937; erythrogen, 4°157; dissolved he-
matin, 3:148; a gummy-saccharine extract with colouring
matter, 1:978; soluble albumen, 7°282; fibrin, 11°348; phos-
phate of soda, 1-340; chloride of sodium, 0-984; phosphate of
lime, 1:320; peroxide of iron, 0°532; water, 51:232.
[Scherer? analysed the bile of a man who died in a state of
icterus. It was a thick fluid of a blackish green colour, and
exhibited under the microscope a large number of pigment-cells.
It contained in 1000 parts :
Water ; < 5 859°6
Solid constituents é 140°4
Bilin . “ ; 48°6
Bilifellinic acid Z ; 30°5
Fat é ; i 8-6
Bile- pigment d ‘ 44°3
Salts 5 ‘ , 8:0
Not a trace of cholesterin could bé discovered in this bile,
' Brugnatelli Giorn. di Fisica, vol. xv, p. 455.
? Untersuchungen, &c. p. 103.
MORBID BILE. — 23
which Scherer regards as singular, although, according to
Berzelius, it amounts to only °00012 of healthy bile (in the ox),
a quantity easily overlooked. The bile-pigment? in healthy bile
is imponderable ; its amount in this case, as well as that of the
solid constituents generally, is enormous. |
Chevallier? found that the bile of a man with scirrhous pan-
creas, who died jaundiced, was of a pale greenish yellow colour,
evolved a putrid odour, had an alkaline reaction, and a faint,
slightly saline taste: it contained a yellow, semi-crystalline fat,
green resinous matter, ptyalin, osmazome, soluble albumen,
hydrosulphate of ammonia, and phosphate, sulphate, and hydro-
chlorate of soda. Chevallier found that the bile of a woman
who died from pulmonary phthisis was of a brownish yellow
colour, and yielded 2° of dried residue, of which 0:83 was biliary
sugar. According to Chevreul, the bile in cases of phthisis
contains very little fat. The bile of a woman who died from
the effects of syphilis is described by Chevallier as of a dark
green colour; it yielded 20— 308 of dried residue, of which
one third, or 0:94, was biliary sugar, with resinous and yellow
matter.
Pheebus? found that, in persons who died from cholera, the
gall-bladder was usually tolerably full, (sometimes to an excess,)
and that the bile was rather dark-coloured. According to
Hermann, the bile in cholera contains an excess of resin.
In cases of fatty degeneration of the liver, there is, accord-
ing to Thénard, a diminution of the biliary resin, and the bile
appears as a mere albuminous fluid, and by the time that the
liver contains five sixths of its weight of fat, the bile loses all
its original characters.
Lehmann‘ states that the bile of a dropsical boy developed
a large amount of hydrosulphate of ammonia, a circumstance
which, in other cases, did not occur even when the bile had been
kept for some days.
1 [Scherer has recently investigated the composition and properties of biliary co-
louring matter. A notice of his researches may be found in my Report on the Pro-
gress of Chemistry in “ The Half-yearly Abstract of the Medical Sciences,’ vol. i, 1845.]
? Journ. de Chim. Méd., vol. ii, p. 461.
3 Cholera Archiv, vol. i, p. 399.
4 Summarium, vol. xii. 1839.
24 THE SECRETIONS:
Bile of Animals.
The bile of animals has been examined by Berzelius, Gmelin,
Thénard, myself and other chemists.
[According to the latest observations of Berzelius, filtered
ox-gall, when evaporated to dryness at a temperature of 266°,
gives off 928°38 parts of water, and leaves 71°62 of solid residue,
consisting of—
Mucus 2 s 2°310
Extractive matter insite in sete with dicate sulphates
and phosphates : : 4°334
Chloride of sodium, lactate of soda, bats stron matter
soluble in alcohol i = : . 15-000
Bilin and cholepyrrhin Fo ; : 50-000
Cholesterin “ $ ; : ; 001
According to Enderlin,! the following salts occur in _ the
bile of the ox:
Choleate (or bilate) of soda,
Tribasic phosphate of soda,
Alkaline sulphates,
Chlorides of sodium and potassium,
Phosphate of lime, .
Phosphate of magnesia,
Phosphate of peroxide of iron, and occasionally
Sulphate of lime.
The bile of the ox and of the swine Ling likewise been analysed
by Thénard, and the bile of the dog by Gmelin, but the de-
scriptions are of so vague a character as to be of little or no use.
The same objection applies to their examination of the bile of
various birds. |
In the bile of the Python bivittatus Berzelius found bilin (as in
the mammalia), a small quantity of bilifellinic acid, bile-pigment
the same as in other classes of animals, a little crystalline
biliary matter precipitable by carbonate of potash, similar to
that which occurs in the bile of fishes, ptyalin or a substance
resembling it, a peculiar animal matter soluble only in boiling
water, fatty acids, and the ordinary salts. The bile of the Coluber
' Annalen der Chemie und Pharmacie, 1844.
BILE OF ANIMALS. 25
natriz is described by Gmelin as of a grass-green colour, trans-
parent, perfectly fluid, and passing through the ordinary change
of colour (blue, red, and yellow) on the addition of nitric acid.
The bile of the Rana esculenta and R. temporaria is very fluid,
of a pale green colour, and yields the ordinary series of tests with
nitric acid. The bile of the water-frog leaves a somewhat
crystalline residue on evaporation; the bile of the grass-frog
has a sweetish taste, and is less bitter than fish-bile.
The bile of the Cyprinus leuciscus is described by Gmelin as
green, transparent, and fluid, communicating a sweet and after-
wards a very bitter taste to the gustatory organs, neutral in its
reaction, affected, as to its colour, by nitric acid like other bile,
and coagulating immediately on the addition of potash imto a
greenish white granular mass, becoming covered, on evaporation,
with an almost colourless crystalline film, and yielding 14°38 of
a dark green, transparent, crystalline residue.
The bile of the Cyprinus barbus is similar to that of C. leuciscus
in its physical characters, and yields 19°3° of a dark green
crystalline residue.
The solid residue of the bile of the Salmo fario and Esox lucius
is stated to be non-crystalline.
On the Action of the Bile in the process of Digestion,
We are as ignorant of the action of the bile on the che-
mical changes that the food undergoes in the intestinal canal
and in the process of chylification, as of the exact influence of
the saliva or of the pancreatic juice. Experiments, with the
view of deciding this point, have been instituted by Brodie and
by Tiedemann and Gmelin, and the conclusions to which they
lead are, that the bile does not exert any material influence upon
digestion and chylification. Assuming that these experiments
were correctly performed, the bile must be regarded as a mere
excretion, whose removal from the organism is as necessary for
the preservation of the normal constitution of the blood as the
removal of carbonic acid, urea, &c.
Tiedemann and Gmelin state as the results of their observa-
tions on animals, in which the flow of bile into the intestine was
prevented: Ist, that digestion (as had been stated by Brodie)
proceeds just as perfectly as when the supply of bile is not
26 THE SECRETIONS:
hindered ; 2d, that the contents of the small intestine, czecum,
and large intestine, after the application of a ligature to the
ductus communis choledochus, do not differ inany essential degree
from their ordinary state ; and 3d, that the bile plays no essential
part in the formation of chyle.
Notwithstanding these general conclusions, they found that
the chyle of dogs, in whom the ductus communis choled. was
tied, was perfectly clear, whilst in the natural state it is white
and turbid in consequence of the fat held in suspension, a diffe-
rence not to be passed over as altogether unimportant. Another
undeniable effect of the bile in chylification consists in the neu-
tralization of the free acid of the chyme by the alkali that is as-
sociated in so unstable a manner with the biliary secretion, in
consequence of which the bilin gradually begins to undergo
certain changes, but whether of the same nature as in the labo-
ratory of the chemist it is impossible to decide.
[That the bile is not merely an excrementitious fluid, in-
tended to remove effete matter from the blood, but that it
is a secretion essential to the animal economy, was rendered
almost certain by the experiments of Berzelius, Theyer, and
Schlosser, which showed that the human feces contained much
too small a quantity of a substance resembling bile to justify
the idea that it is evacuated in this manner. A further proof
that the bile is absorbed and not excreted is afforded by an
examination, made by Enderlin, of the ash yielded by the con-
tents of the different portions of the intestinal canal of a hare.
He found that the ash from the contents of the duodenum alone
effervesced on the addition of an acid, thus showing that the
choleate of soda (which yields the carbonate on incineration,)
is absorbed before reaching the jejunum. Schwann has re- —
cently established this opinion beyond a doubt, by a series of well-
devised experiments on dogs. He tied the ductus communis cho-
ledochus, and at the same time formed a fistulous opening in the
gall-bladder, by which the bile escaped externally. His most
important conclusions are, Ist, That when the bile does not get
into the bowel, its absence is generally perceptible in dogs,
about the third day, by a marked diminution in weight; and,
2dly, That unless the channel for the conveyance of bile to the
duodenum is re-established, symptoms of deficient nutrition,
GASTRIC JUICE. 27
wasting, debility, &c., ensue, and death is the ultimate conse-
quence. |
If the bilin becomes decomposed in the intestinal canal into
various constituents, through the influence of the acid chyme,
then a wide field of investigation is open to us respecting the
function of the biliary secretion in relation to chylification.
No explanation has yet been afforded of the discrepancy in the
amount of albumen contained in the chyme absorbed by the
intestinal villi, and in the chyle discharged by the absorbents,
(even without passing through the mesenteric glands.) May
it not happen that a constituent of the bile acts on some
hitherto ill-defined protein-compound of the chyme, and con-
verts it into the form known as uncoagulated albumen ?
ON THE GASTRIC JUICE, DIGESTION, AND THE CHYME,
Gastric Juice.
The gastric juice has been examined by numerous chemists,
in consequence of the importance attributed to it in the process
of digestion. There have been found in it free acids, a con-
siderable amount of salts, and certain indefinite animal sub-
stances, which were known at the period to which we refer as
osmazome or salivary matter. Experiments on artificial diges-
tion have thrown much light on the nature of the gastric juice.
Eberle’ proved that an artificially-formed gastric juice does not
thoroughly dissolve food, unless a small quantity of gastric
mucus, or a portion of the mucous membrane of the stomach
be added to it. On the strength of this discovery, Miller and
Schwann? instituted a series of experiments, from which Schwann
was led to conclude that the gastric juice contains a peculiar
substance, which, cooperating with an acid, possesses the pro-
perty of rapidly dissolving substances insoluble in mere water,
or in a mixture of extractive matters, salts, and a little acid, as
for instance, fibrin, coagulated albumen or casein. To this
1 Physiologie der Verdauung. Wiirzburg, 1834.
2 Ueber die kiinstliche Verdauung des geronnenen Eiweisses, Miiller’s Archiv,
1836,
28 THE SECRETIONS :
somewhat problematic substance he gave the name of pepsin:
Wassmann! and Pappenheim? have endeavoured to isolate it.
(See Vol. I, p. 224.)
Prout? has shown that the free acid of the gastric juice is
muriatic-acid. Gmelin and Tiedemann‘ have found it associated
with acetic acid, and in the gastric juice of horses, with butyric
acid: there is no doubt that lactic acid is likewise contained in
it. From the researches of the latter chemists, which are the
most perfect that we possess on the subject, it appears that in
addition to the free acids, the gastric juice contains mucus, and
occasionally (in horses) a very small quantity of albumen, ex-
tractive and salivary matter, and that the ash consists of alkaline
muriates and sulphates, a little phosphate and sulphate of lime,
chloride of calcium, magnesia, and peroxide of iron.
The gastric juice collected from the empty stomach, although
mixed with mucus, was tolerably clear; it was neutral, of a
yellow colour, a saline taste, and on evaporation left only 2° of
solid constituents. Gastric juice obtained by irritating the
stomach with pebbles was acid, viscid, and of a pale brown
colour. Hiinefeld does not believe that there is any free hy-
drochloric acid in gastric juice.
Berzelius analysed gastric juice collected by Beaumont from
a young man with a fistulous opening into the stomach. It
had been kept for five months before Berzelius received it, and
was therefore totally unfit for the purpose of analysis. In that
condition it was clear, yellow, devoid of odour, reddened litmus
paper in a decided manner, and left a solid residue of 1°2699,
consisting principally of crystals of chloride of sodium, in the
interstices of which was a brown extractive matter, which, on
exposure to the air, resolved itself into a dark brown thick
syrup. Its quantity was too small to admit of its being accu-
rately examined, but it was proved to contain lime and a proto-
salt of iron. Beaumont describes human gastric juice as a
clear, inodorous, saline, and very acid fluid, which effervesces on
the addition of alkalies. Dunglison detected in it free hydro-
chloric acid, an animal substance soluble in cold but not in
' De Digestione nonnulla. Diss. inaug. Berol. 1839.
? Zur Kenntniss der Verdauung. Breslau, 1839.
5 Philos. Transactions, 1824, p. 45.
* Die Verdauung nach Versuchen, p. 150.
GASTRIC JUICE. 29
hot water, and acetic, phosphoric, and hydrochloric acids, in com-
bination with potash, soda, lime, and magnesia.
The gastric juice of a horse, collected by irritating its empty
stomach with pebbles, was found by Gmelin to contain :
Water "i A x 984-00
Solid residue ; : 16°00
Organic constituents ! 10°52
Salts soluble in water ; 5°02
Salts insoluble in water . 0°46
[Braconnot has examined the gastric juice collected by means
of sponges from the stomachs of dogs, but his results are not
very definitely given. |
Hence it appears that the principal constituents of the acid
gastric juice are pepsin ; a substance not yet carefully examined,
but bearing a close resemblance to extract of flesh; an unex-
amined substance resembling salivary matter; free acids, es-
pecially muriatic acid; mucus; sometimes a little albumen;
salts, especially alkaline chlorides, muriate of ammonia, (according
to Hinefeld,) and a small quantity of earthy salts.
[M. Blondlot has recently published a treatise on Digestion,'
detailing very numerous experiments made upon dogs, in
which fistulous openings into the stomach were maintained for
upwards of two years. ‘The gastric juice was obtained in very
large quantities. Submitted to distillation, the fluid passing
over did not exhibit the slightest acid reaction, whilst the re-
sidue in the retort was always strongly acid. Hence he con-
cludes that the acid of the gastric fluid is neither hydrochloric
nor acetic acid, since both these are volatile. The gastric fluid
of other animals gave the same result on being distilled.
When chalk or any other carbonate of lime was added, no
effervescence ensued, proving the acid not to be the lactic.
M. Blondlot concludes that the acid reaction of healthy
gastric juice is owing to the presence of superphosphate or
biphosphate of lime. He adds—Ist. That there is no other
acid fluid which can remain acid, and fail to decompose car-
bonate oflime. 2d. That sulphuric acid, added to gastric juice,
' Traité analytique de la Digestion. Paris, 1843.
30 THE SECRETIONS:
precipitates an abundance of sulphate of lime, and oxalic acid
precipitates oxalate of lime. 3d. Potass, soda, ammonia, and
lime water, produce abundant precipitates of neutral phosphate
of lime. 4th. That the calcined ash of gastric juice is not deli-
quescent, dissolves without effervescence in hydrochloric acid,
forming chloride of calcium; it therefore contains neutral
phosphate of lime, the excess of acid being driven off in the
calcination.
M. Blondlot believes that the digestive property of gastric
juice depends, not on its obvious chemical constitution, but
upon a peculiar organic principle. If exposed to a temperature |
of 104° to 122° F., or higher, it loses entirely and irrevocably
its digestive powers, although to all appearance, and even as to
its composition, as made known by analysis, it remains un-
changed. With the exclusion of the air, gastric juice may be
kept for two years without loss of its activity; but with the
free access of air, it putrefies in five or six days, although the
chyme which it forms from nitrogenous organic substances may
be preserved for two or three months without change. The
precipitation of all the lime it contains does not affect its ac-
tivity, nor are its chlorides indispensable, but whatever acts
upon its organic constituents, (heat, strong alcohol, or strong
acids,) or which removes them, (such as animal charcoal, chlorine,
tannic acid, or acetate of lead,) destroys all its digestive properties.
M. Blondlot also shows—a. That coagulated albumen resists
the action of the gastric juice only from its compact form.
When coagulated in very small particles, as the white of an egg
beaten into a froth and poured into boiling water, it is digested
as quickly as soft fibrin. 6. That the action of the stomach
in coagulating milk is not due to its digestive principle solely,
but to its acid, which acts like lactic acid. c. That the effect of the
gastric fluid upon bones, whether entire or not, is to disintegrate
them slowly, beginning at the surface, and to reduce the
earthy matter into a fine chalky powder, but without dissolving
or decomposing it. The earthy matter not being dissolved,
proves that no hydrochloric acid has acted upon it; it is all
discharged with the feces.
Since the work of M. Blondlot was published, two other
French chemists, MM. C. Bernard and C. Barreswil,' have made
1 Journal de Pharmacie, Jan. 1845.
GASTRIC JUICE. 31
an experimental investigation into the properties of the gastric
juice. They start with the assumption that this fluid owes its
digestive properties to the union of two principles: Ist, an acid ;
2d, a peculiar organic matter destructible by heat. What is
the nature of the acid? ‘The principal fact which has been
adduced to prove that the acid reaction is owing to the presence
of biphosphate of lime is, that it may be treated with carbonate
of lime without effervescence. Our experiments show that this
arises from the dilution of the acid, which allows the carbonic
acid to be dissolved as it is formed. When, therefore, the
gastric juice is concentrated, it causes a considerable effer-
vescence with chalk. Moreover, gastric juice dissolves neutral
phosphate of lime, whilst this salt is entirely insoluble ina solu-
tion of the biphosphate. On distilling gastric juice, the first
distillate exhibits no acid reaction. If a mere trace of acetic
acid or acetate of soda is added previous to distillation, it gives
an acid reaction ; the normal acid is not therefore acetic. This
also appeared, at first sight, to prove it could not be hydro-
chloric acid; but on distilling water rendered slightly acid by
hydrochloric acid, nothing passes over at first but pure water,
the acid not distilling until the end of the operation. On dis-
tilling gastric juice a neutral limpid liquor passes over, which
is not precipitated with nitrate of silver; when about four
fifths has distilled over, the distillate is perceptibly acid,
nevertheless, it does not render a solution of nitrate of silver
turbid ; but at the end, and when only a few drops of the gas-
tric juice remain in the retort, an acid liquid passes over which
precipitates salts of silver ; this is, doubtless, hydrochloric acid.
Does this acid exist free in gastric juice, or has a chloride been
decomposed in this operation? When the least trace of oxalic
acid is added to gastric juice which we know contains lime, a
turbidity is produced from the formation of an insoluble oxalate
of lime ; but if to water acidified with 2000ths of its amount of
hydrochloric acid, and containing chloride of lime, the same re-
agent be added, no turbidity ensues. This clearly proves that
hydrochloric acid exists as a chloride in the gastric juice, and
not in a free state.
When concentrated by evaporation, gastric juice is strongly
acid, effervescing with chalk, and not loosing its acid reaction
in the presence of an excess of the chalk. This proves the pre-
32 THE SECRETIONS:
sence of phosphoric acid. On saturating the acid with lime and
oxide of zinc, and filtering the solution, the neutral filtrate
contains both zinc and lime, therefore phosphoric acid is not
the only free acid in the juice. What is the acid combined
with the zinc and lime in the filtered solution? It is one
which, as we have seen, passes over at the end of the distillation,
and does not precipitate salts of silver. These characters be-
long to lactic acid. On distilling water slightly acidulated with
lactic acid, a small quantity of chloride of sodium being added,
we obtain a fluid analogous to gastric juice; first, pure water
passes over, then an acid which does not precipitate salts of
silver, and the last drops carry over hydrochloric acid. So that
it is evident that the presence of hydrochloric acid in the last
product of distillation of the gastric juice is owing to the de-
composition of the chlorides by lactic acid.”
Hydrochloric acid cannot exist in a free state in the presence
of a lactate, a phosphate, or an acetate. ‘ We have observed,”
say the authors, ‘‘in the acid of the gastric juice all the cha-
racters of lactic acid, as pointed out by M. Pelouze; both give
soluble salts of lime, barytes, zinc, and copper, a double salt of
copper and lime, deeper in colourthan the simplesalt, and a salt of
lime soluble in alcohol, precipitated by ether.” From the above
facts, MM. Bernard and Barreswil conclude that the acid re-
action of the gastric juice is not owing to biphosphate of lime,
but arises from a free acid, which is not hydrochloric or
acetic acid. They have always found lactic acid, with a minute
proportion of phosphoric acid, the latter being a product of the
reaction of the lactic acid on the phosphates present. In
their opinion, lactic acid is a constant production of the ©
stomach. They do not mean to say that the digestive powers
of the gastric juice are owing to lactic acid; on the contrary, —
they think if an acid reaction be indispensable, other acids may
supply its place, because among the various salts constantly in-
troduced into the stomach with the food, some will have their
acid replaced by the free lactic of the stomach, and the new
acid liberated may supply the place of the normal acid.
In a more recent memoir they enter more fully into the
nature of the active organic matter, on the presence of which
“they believe the digestive power of the gastric juice to depend.
It is precipitated and destroyed at a temperature of 190°. One
GASTRIC JUICE. 33
of the most remarkable of its properties is that its digestive
powers vary according to the medium in which it is contained.
In the gastric juice, which is acid, it dissolves nitrogenous mat-
ters, such as fibrin, gluten, and albumen ; but exerts no action on
baked starch; but if the gastric juice is rendered alkaline by
the addition of a little carbonate of soda, it rapidly dissolves the
starch, and no longer possesses the power of acting on the
nitrogenous matters. As these physiological properties are
exactly those of saliva and the pancreatic fluid, it became an in-
teresting point to ascertain if a change in the reaction of these
fluids would cause a corresponding variation in their solvent
power. ‘This was found to be the case; on acidulating these
naturally alkaline fluids, their ordinary mode of action was in-
verted, and they were enabled to dissolve nitrogenous matters,
while their capability of dissolving starch was lost. From nu-
merous and varied experiments they believe that one and the
same organic principle (the agent of digestion) exists in the
gastric juice, the pancreatic fluid, and the saliva, and that its
physiological action varies according to the acid or alkaline
nature of the fluid in which it occurs. .
M. Melsens' has also examined the gastric juice, and denies
the accuracy of Blondlot’s conclusions. |
The fluid secretion in the crops of birds is stated by Gmelin
and Tiedemann to have an acid reaction; and the fluid in the
glandular stomach, even when empty, contains free acids, es-
pecially muriatic and acetic acids.
Brugnatelli observed that Iceland spar inclosed in tubes is
decidedly attacked after remaining for some time in the stomachs
of hens and turkeys; and Treviranus noticed that a porcelain
basin, in which the chyme of hens had been digested, was cor-
roded, from which he concluded that fluoric acid was present.
Tiedemann and Gmelin did not succeed in detecting fluoric
acid in the gastric juice of ducks, although they carefully sought
for it.
Morbid Gastric Juice.
It is well known that the gastric juice sometimes assumes
anomalous characters, but important as such modifications are
' Journal de Pharmacie, Jan. 1845.
Il. 3
34 THE SECRETIONS:
to practical medicine, little is known with certainty in relation
to their true causes, and still less respecting the peculiar influ-
ences that morbid gastric juice exercises on chymification and
chylification. The question naturally suggests itself, whether
morbid changes in the gastric juice may not be the origin of
many of the diseases of early childhood. Such changes may
originate purely from internal causes (nervous influences,) or
from a complication of the above with external influences,
such as diet, &c.
The only modifications respecting which we can speak with
any degree of certainty are the following: Ist, There may be a
considerable excess of free acid; 2dly, There may be a diminution
of free acid; and 3dly, The gastric juice may become posi-
tively alkaline. In all probability, with these there are associ-
ated other changes in the composition of the fluid, producing
an injurious effect on the process of digestion; but on this sub-
ject we are unable to speak with certainty.
The increased acidity of the gastric juice usually arises from
an excess of those acids which exist in it in a normal state,
namely, muriatic, acetic, and lactic acid. When there is a
tendency to the formation of an excess of acid in the gastric
juice, it appears to be developed from the food. Muriatie acid
is principally developed from animal food; acetic and lactic
acids from vegetable and especially saccharine food, such as acid
bread, beer, and wine ; and the fatty acids from an excessive use
of fatty matters. An excessive acidity of the gastric juice is
frequently observed in cases of gastritis serosa, and of scrofula
and rickets associated with disease of the spleen. In gout, po-
dagra, and nettlerash, the gastric juice contains, according to
Stark’, phosphoric and uric acids; the presence of the latter
acid must however be regarded as very problematical.
The cases in which the gastric juice exhibits a positively al-
kaline reaction are comparatively rare. This deviation from the
normal condition arises chiefly from the use of salted or putrid
food and drink containing basic salts, from prolonged fasting,
and especially from care and anxiety (Stark.)
The experiments of Purkinje and Pappenheim show that
when the gastric juice is mixed with bile, its digestive powers
are diminished. |
' Allgem. Pathologie, p. 848.
CHYME. 35
Our knowledge of the uses of the gastric juice in the process
of digestion, is much clearer than that of the other fluids already
described, as the saliva, pancreatic juice, and bile. We know
that alimentary matters insoluble in mere water are readily dis-
solved by the pepsin of the gastric juice combined with a little
free dilute acid, and that some of these substances become
chemically changed during the process of solution.
The intestinal fluid.
The small intestines, when empty and not irritated, secrete
an almost neutral, very viscid fluid, but during digestion, or
when irritated, the secretion becomes decidedly acid. We
cannot examine this fluid in a state of purity, but it is most
probable that in its constitution it is similar to the gastric juice,
and that it possesses the property of acting on those substances
which have escaped the solvent power of that fluid. According
to Tiedemann and Gmelin it contains a large quantity of albu-
men ; this is, however, most likely due to the pancreatic fluid
which becomes mixed with it. It must also be more or less
mixed with the biliary secretion.
On the process of Digestion, and the Chyme.
By the process of digestion we understand the solution and
the modifications that the food undergoes in the stomach and
adjoining portion of the intestinal canal, together with the ab-
sorption and metamorphosis of the nutrient fluid (chyme) con-
tained in the reduced pulpy mass of the food, till it becomes
perfect chyle.
The subject of digestion has attracted much attention for the
last seventy years, but unfortunately the results that have been
obtained are by no means proportionate to the time and labour
involved in the experiments instituted in relation to this de-
partment of physiology.
The discovery and isolation of pepsin forms a new epoch in
the chemical history of digestion. It is now in our power to
institute experiments on artificial digestion with every prospect
of success ; we can examine the new products that are developed,
and we shall be thus led to the true understanding of the for-
36 THE SECRETIONS:
mation of chyle, which as we know is always tolerably con-
stant in its composition, although evolved from the most di-
verse species of nutriment.
Previously to commencing such researches, it would be’ re-
quisite to study and examine the pepsin obtained from different
classes of animals; for it is very possible, as Berzelius suggests,
that it may be a mixture of various substances, differing in dif-
ferent classes of animals. On this account, various simple natural
substances, after the addition of a due quantity of acid (which must
be determined experimentally,) should be artificially digested
with the different sorts of pepsin, and the products, both soluble
and insoluble, carefully analysed. Such terms as osmazome,
salivary matter, &c. must be rejected. The researches, of
Berzelius and myself have opened the way for an exact and
separate determination of the extractive matters and ptyalin.
We should then be enabled to see what real connexion there is
between the substances resembling extract of flesh which are
produced in artificial digestion, and those that are actually
obtained from flesh itself.
Our knowledge of the changes that the different elements of
_food undergo in the process of digestion is at present very
limited ; it is confined to the following leading points.
1. Albumen is dissolved and chemically changed. This ob-
servation was made by Eberle, and has been confirmed by
Miller, Schwann!, and others. The digested albumen no longer
coagulates at the boiling point ; it is stated to have been changed
into osmazome and salivary matter, (a vague statement requiring
further proof,) and according to Schwann, into a third albumi-
nous principle, which is thrown down by carbonate of soda, and
in that condition is insoluble in water and spirit, soluble in
muriatic and acetic acids, and not precipitable by acetate of lead —
or alcohol, but copiously by nitric acid and bichloride of mer-
cury, and partially by ferrocyanide of potassium and toma:
acid.
2. Coagulated casein is partially converted by artificial di-
gestion into albumen ; soluble casein becomes coagulated when
submitted to the aetion of a solution of sugar of milk and
pepsin, but not when acted on by the pepsin alone.
3. Fibrin is rapidly dissolved, and, from the experiments of
1 Miiller’s Archiv, 1836, p. 68.
CHYME. 37
Tiedemann and Gmelin, appears to be partially converted into
albumen.
4, Glutin becomes so changed by artificial digestion, that it
loses its property of gelatinizing, and can no longer be precipitated
by chlorine.
5. Sugar of milk, when submitted for a sufficient time to the
action of pepsin, becomes completely converted into lactie acid.
This fact has been established by Fremy and myself.
6. Starch is partially converted into sugar. (Tiedemann and
Gmelin.)
7. The fluid found in the stomach of a horse, fed with oats,
contained butyric acid, a resin, a substance resembling extract
of flesh, salivary matter, and albumen.
From recent experiments on digestion, we know that alimen-
tary substances are dissolved as rapidly in an artificial digestive
fluid, consisting of pepsin and properly diluted muriatic acid, as
they are in the gastric juice itself. Hence we are justified in ©
the conclusion that pepsin, the free acid, and a suitable tempe-
rature, are the principal agents in gastric digestion, and that
the motions of the stomach are chiefly with the view of pro-
moting the due admixture of the food with the secreted fluid,
and of propelling it towards the pylorus, through which it must
pass in order to enter the duodenum. It is impossible to state
with certainty whether the pepsin and free acids dissolve and
modify the food through a catalytic influence, or-whether they
enter into any chemical combination with it, the products of
these combinations being the dissolved and changed matter.
If, however, the conversion of sugar of milk into lactic acid is
explained by the catalytic action of the pepsin, we may fairly
conclude that the pepsin exerts a similar influence on other
substances, if no facts to the contrary present themselves.
Hinefeld is imclined to attribute considerable influence in di-
gestion to the ammoniacal salts of the gastric juice, in conse-
quence of having observed that under certain conditions fibrin
is readily soluble in the muriate or lactate of ammonia, especially
when free lactic acid is also present.
The various articles of food are dissolved in the process of
_ digestion with different degrees of facility. Those which ap-
proximate most closely to the constituents of the chyle, obvi-
ously require the least modification, as, for instance, the fluid
38 THE SECRETIONS:
albumen and yelk of egg, fibrin, boiled albumen, muscular
flesh, casein, and the protein-compounds generally. Certain
substances are not at all digestible, as, for instance, woody fibre,
husks of fruit, horn, hair, &c. We always observe a relation —
between the degree of the changes requisite for the assimilation
of different sorts of nutriment, and the complexity of the di-
gestive apparatus. Hence, in the carnivora, the intestinal canal
is much shorter and simpler than in the herbivora,
In the ruminantia, the first two stomachs do not secrete an
acid, true gastric juice, such as occurs in the stomachs of men
and carnivora, but a thin yellow saline fluid containmg enough
alkaline carbonates to produce a marked effervescence on the
addition of anacid. Their nutriment (grass, hay, &c.,) after being
chewed and mixed with saliva, is first received into these sto-
machs, where it is soaked in the alkaline fluid, which dissolves
and takes up vegetable albumen and glutin. The fiuid gra-
dually passes onwards into the third stomach, while the
insoluble portion returns to the mouth for a second mastica-
tion. The fluid obtained by pressure from the contents of
the first stomach (the paunch) contains, according to Tiede-
mann and Gmelin, carbonic acid and sulphuretted hydro-
gen, albumen in combination with soda, carbonate of ammo-
nia, and certain animal matters, one of which is volatile and
assumes a red tint on the addition of muriatic acid. In addi-
tion to carbonic acid and sulphuretted hydrogen gases, the first
two stomachs occasionally develop (especially after the use of
fresh clover) an extraordinary quantity of carburetted hydrogen.
The third stomach secretes an acid fiuid, and in the fourth sto-
mach the acidity is much more marked, the substances dissolved
by the alkali being first precipitated and then redissolved in
the excess of acid. Finally chyme is produced, said to be ana-
logous to that which is formed in the stomachs of men and
carnivora.
In birds the food is first moistened in the crop with a faintly
acid fluid ; from thence it passes into the proventriculus, where it
meets with a peculiar and. very acid fluid, and it finally reaches
the muscular stomach, which effects its thorough trituration.
On leaving the stomach the food enters the small intestine,
where it becomes mixed with the pancreatic juice and the bile.
Here it commences to be absorbed by the intestinal villi; more-
CHYME. 39
over, it is here mixed with the intestinal secretion, and it is
probable that the digestion, not entirely accomplished in the
stomach, is here perfected.
There are many points connected with the process of digestion
which have not been hitherto explained. We may especially
instance the conversion of chyme into chyle. It is very diffi-
cult to understand the source of the large quantity of albumen
found in the chyle, even before it has passed the mesenteric
glands, and just after its absorption by the intestinal villi.
An experiment made by Tiedemann and Gmelin on the
chyme and the chyle of a horse fed with oats, will place the
difference clearly before the reader.
a denotes the fluid expressed from the thick, pulpy, acid
contents of the stomach. It was of a brownish yellow colour,
turbid, became darker on exposure to the air, and much more
turbid on boiling, and on the addition of bichloride of mercury.
6 is the brownish yellow fluid from the duodenum. c is the
brownish yellow fluid obtained from the central portion of the
small intestine, mixed with mucous flocculi and with a tough al-
buminous substance, apparently resembling salivary matter.
d is the brownish yellow fluid from the lower part of the small
intestine. eis chyle from the absorbents before its entrance
into the mesenteric glands. f is chyle from the absorbents
after its passage through them: and g is chyle from the thoracic
duct.
We shall omit the amount of water in these various fluids,
and merely compare the composition of their solid residue.
1000 parts of solid residue contained :
a. b. « d. e. fe g-
1. Resinous matter, with an
acid soluble in ether . 156 079 025 O15
2. Resinous matter soluble in
anhydrous alcohol, alco-
hol-extract, and salts so-
luble in spirit J . 61°56 44°61 67°25 77:60 67°50 42°24 30°44
3. Spirit-extract, probably
gummy mattersand salts 25°26 10°80 5°08 }r20
4. Insoluble brown matter . 0°66 9°14
5. Brown nitrogenous mat-
ter, soluble only in water 16°32 12:44 7:40 250 2:17 311
¢- Albumen, oxydised extrac-
tive nfatter, and phos-
phate of lime ‘ . 11:00 7:11 5:03 3:10 27:56 .49°82 63°98
40 THE SECRETIONS :
The numbers in 2, under 4, ¢, and d, refer only to the extrac-
tive matters and salts soluble im alcohol, while those under e,
J, and g refer not merely to them but also to the fat, the re-
lative proportions of which may be seen in the analyses 4, 5, and
6, of the chyle, in p. 357, vol. 1. The numbers in 6, under e, f,
and g, indicate the amount of pure albumen in the chyle, whilst —
under J, c, and d extractive matter and phosphate of lime are
included. It is to the two lines 2 and 6 of the above table that
I wish especially to direct attention. The chyme 8, ¢, and d
differs from the chyle, by a deficiency of fat in the former, and
by an excess of albumen in the latter. If the fat is really con-
tained in the chyme, which we cannot doubt that it is, in what
state of combination can it occur so as to escape detection ?
Does the chyme contain fatty acids, combined with the alkalies
(soaps), and the chyle, ordinary fat? The chyme contains an
extraordinarily large amount of substances soluble in alcohol,
whose place in the chyle seems to be supplied by albumen ;
may we not endeavour to clear up this difficulty by supposing
that some still unknown proteim-compound, soluble in alcohol,
has been converted into albumen? If the chyme contains so
small a quantity of pre-existing protein-compounds, as the above
analyses 6, c, d teach us, we must assume that their extraordi-
nary increase in the chyle of the absorbents and of the tho-
racic duct, must be at least in part due to the influence of the
lymphatic glands and vessels, and therefore either directly or
indirectly to the blood. But, in opposition to this view, we
may remark that it is impossible to conceive that the blood can
impart that identical quality to the chyle which renders that
fluid the means of supplying nutriment to the blood, and of
imparting to it the carboniferous and nitrogenous materials
requisite to supply the place of those that have been removed
from the body in consequence of waste of tissue. _ If, however,
we bear in mind that the mesenteric veins absorb a fluid from
the chyme different from that which is taken up by the lym-
phatics, we may then perhaps account for the discrepancy
between the chemical composition of the chyme and the chyle,
by the assumption of a ‘ vis electiva’ residing in the absorbent
vessels of these two systems; for the lymphatics absorb and
carry off a fluid abounding in protein and nitrogenous com-
pounds, while the venous system takes up an excess of the
DISEASED DIGESTION. 4]
compounds of carbon and hydrogen; and since the absorbents
of the lymphatic system in the small intestines must have taken
up a very albuminous chyle, the chyme examined by Gmelin
may on that account have been poor in coagulable albumen,
and in the same manner the gradual decrease of the albumen
in the chyle, as the large intestine was approached, would be
accounted for.
Diseased digestion.
It is by no means rare to meet with an excessive formation
of acid both in the stomach and the intestines, especially in
children. Acid eructations, a sour smell from the mouth, and
frequent green stools, afford indications of a morbid digestion
which, doubtless, originates in too acid a condition of the gastric
and intestinal fluids, and on the consequent rapid production
of lactic and acetic acids from vegetables and milk. I have
observed that the feeces of a child at the breast, suffering from
improper digestion, consisted of a large quantity of coagulated
casein, and a very acid, greenish, whey-like fluid, with nume-
rous oil-vesicles on its surface. The fat was isolated and con-
tained a large amount of the fatty acids.
A copious secretion of gas is a frequent consequence of dis-
eased digestion. This gas is not a mere mixture of carbonic
acid and nitrogen with a little hydrogen (the ordinary gases)
but also contains a considerable amount of sulphuretted hydro-
gen, and, in all probability, phosphoretted hydrogen and car-
buretted hydrogen.
There can be no doubt that there are anomalies in the pro-
cess of chylification, in consequence of which an unsuitable
chyle is prepared and conveyed to the blood, modified both in
its quality and its quantity ; but with respect to the particulars
of these anomalies we are still perfectly in the dark.
CHAPTER IV.
MILK.
Tne milk is a white, fatty, and rather thick fluid, which is
secreted by the female breasts during pregnancy and after
delivery. A metastatic or vicarious secretion of milk from
the skin, the navel, the groin, the stomach, the intestines, the
mucous surface of the genital organs, or the axilla, is by no
means rare: it has also been observed in the breasts of men.
General physico-chemical characters of the milk.
Perfectly fresh milk has always a decidedly alkaline reaction,
and it retains this property for a longer or shorter time: the
milk of women retains its alkaline reaction longer than that of
cows; and the milk of healthy women longer than that of in-
valids.
On examining the milk under the microscope we perceive a
great number of fat-vesicles of very different sizes swimming in
_a clear fluid, and occasionally epithelium-cells. From repeated
comparisons I have found that the fat-vesicles in the milk of
woman are generally rather larger than those in the milk of
the cow. In addition to these fat-vesicles, we observe, under
certain circumstances, other microscopic objects, of which I shall
treat subsequently. The fat-vesicles have, as Raspail declared,
a solid envelope, a point which has been confirmed beyond dis-
pute by Henle and myself. Raspail considers that it is com-
posed of coagulated albumen ; it is, however, more than probable
that it consists of coagulated casein. Henle! has shown that
this capsule may be dissolved by acetic acid, and that butter
then issues from it; it is probable, however, that this fluid fat
becomes inclosed in a new envelope, for Ascherson? has observed
! Froriep’s Notizen, 1839, No. 449.
? Ueber die Hautdriisen der Frésche und iiber die Bedeutung der Fettstoffe,
Miiller’s Archiv. 1840.
CHARACTERS OF MILK. 43
that a membrane immediately forms around every drop of fat
that is brought in contact with a solution of albumen; and I
have found that fat shaken with a caseous substance (crystallin)
in a state of solution, causes a partial coagulation by the for-
mation of such membranes or capsules. I have shown that
when woman’s milk is evaporated, and the residue reduced to a
fine powder, and extracted with ether (which takes up the butter),
there are left the capsules of the fat-vesicles, which, when mixed
with water, and placed on the object-stage, may be observed
with the microscope.
Milk is materially affected by a large number of substances,
especially by those that precipitate its casein. The addition of
any of these substances causes it to coagulate, that is to say,
the casein becomes insoluble and incloses the butter, and thus
produces the separation of awhey-like fiuid from the caseous mass.
A precipitation of this nature is brought about by alcohol which,
at the same time, takes up a very small quantity of fat: when
milk is shaken with ether, no precipitation of casein ensues,
but the milk becomes rather clearer and the ether is found to
contain fat, but only a small portion of all that is contained in
the milk. When milk is left to itself for a considerable time,
it coagulates, in consequence of the conversion of a portion of
its sugar into lactic acid: this change often takes place very
rapidly in cow’s milk, and generally more quickly than in
woman’s milk. If the milk is allowed to remain still longer
exposed to an ordinary temperature, the surface becomes covered
with peculiar forms of mould, and, under certain conditions
which are not accurately known, particular species of infusoria
are developed. These infusoria are the cause of a blue or yellow
colouring matter, which is especially distributed over the sur-
face, a phenomenon that has long been observed, and which
has recently been carefully investigated by Fuchs.
Rennet likewise precipitates the casein apparently by a cata-
lytic action on the sugar of milk, by which it is converted into
lactic acid ; hence the precipitation is hindered by the addition
of an alkali, and, as Herberger has observed, does not occur in
milk which abounds in alkaline salts.
The solid constituents of the milk vary from about 9 to 358 ;
the specific gravity usually lies between 1028 and 1042.
44 THE SECRETIONS:
SPECIAL CHEMISTRY OF THE MILK.
Constituents of the Milk, and methods of separating them.
The following substances are contained in a state of solution
in healthy milk: casein, fat (including olein, stearin, butyrin,
caproin, and caprin), sugar of milk, extractive matters, and
salts. The salts are the chlorides of sodium and potassium ;
lactates of potash, soda, probably of ammonia, of lime, and
magnesia; phosphates of potash, soda, lime, and magnesia ; and
traces of phosphate of peroxide of iron.
The plans that were formerly proposed for the analysis of
milk could not give satisfactory results. For instance, the
fatty portion which collects on the surface (the cream) was
analysed separately from the poorer fluid beneath it; by this
means, then, were obtained accurate estimates of the two sepa-
rate portions, but not of the milk collectively. |
The course adopted by the French chemists, was to evaporate
the milk, to take up the butter with alcohol, or a mixture of -
alcohol and ether, and then to wash out the sugar from the
residue ; if we reflect, however, that the dried casein of cow’s
milk is always slightly soluble, and that of woman’s milk is
freely soluble in water, the source of error in this system be-
comes at once obvious. By the adoption of this incorrect
method, Payen fixed the amount of casein at 0°232, while the
mean of seventeen analyses performed by myself yielded 3°48,
or more than fourteen times as much.
The following is the method that I adopt :! a known quan-
tity of milk is evaporated to dryness, and the residue weighed;
by this means we determine the amount of water. A weighed
portion of the dried and finely-powdered residue is thrice ex-
tracted with five or six times its volume of boiling sulphuric
ether, in order to remove the fat. After the removal of the
fat, the residue is placed in a porcelain basin, is again pulverized,
and digested with a little warm water. The pulp which is thus
formed is treated with an additional quantity of boiling water,
in which it is partially soluble if the analysis is being conducted
' Die Frauenmilch nach ihrem chemischen und physiologischen Verhalten, p. 27.
CONSTITUENTS OF MILK. 45
with cow’s milk ; it dissolves entirely, with the exception of an
inconsiderable quantity of coagulated casein, if woman’s milk
is used. The solution is then evaporated at a gentle tempera-
ture to the consistence of a thin syrup, and is treated with ten
or twelve times its volume of alcohol of 0°85, which precipitates
the casein. As the casein may retain a little sugar, it is expe-
dient to digest it once or oftener with a little water, and to treat
the dilute pulp with spirit; the casein that remains must be
thoroughly dried and weighed. The spirituous solution con-
tains the sugar, and the greater part of the extractive matter,
from which the sugar cannot be easily separated. A partial
separation may be effected in this way: we may dissolve the
impure sugar in a little water; on the addition of strong alcohol,
the sugar with a very little extractive matter, is precipitated,
while the alcoholic solution contains extractive matters and a
little sugar. On evaporating this solution to the consistence
of a syrup, and adding strong alcohol to it while still hot, some
more sugar separates on cooling.
I usually estimate the salts by incinerating a weighed por-
tion of the dried residue of the milk; and, in some cases, I
have separated the soluble from the insoluble salts.
This analysis of milk does not yield, as Berzelius' justly
observes, any very accurate results, since casein is slightly soluble
in alcohol ; although strong cold alcohol takes up only a very
small portion, dilute hot alcohol dissolves a considerable quan-
tity. The determination of the sugar and of the extractive
matters by the course that I have indicated is still more imac-
curate. Berzelius proposes to precipitate the casein (and the
butter) by rennet; but it must be observed that, by this means,
we do not obtain results of greater accuracy, since a portion of
the casein always remains in solution in the whey. ‘This
amounts to a considerable quantity in woman’s milk, but is
comparatively slight in the milk of the cow,” and has always to
be obtained by means of alcohol from the evaporated solution.
In order to precipitate the casein thoroughly by rennet, it
would be requisite to supersaturate the free alkali of the milk
by acetic or lactic acid; we should then obtain the casein in a
state of combination with these acids; in fact, casein precipi-
! Thierchemie, p. 698. 2 Die Frauenmilch, &c. p. 33.
46 THE SECRETIONS:
tated by rennet from non-acidulated milk does in reality exist
in this condition.
If we precipitate the casein of cow’s milk by sulphuric acid,
and decompose the sulphate by carbonate of lime or baryta, we
shall obtain soluble compounds of casein with lime or baryta.
The casein of woman’s milk is very imperfectly precipitated by
sulphuric acid.
If albumen is present in milk, which is sometimes the case,
it must be determined by a separate experiment. The milk
must be boiled, and the coagulum must be collected and ex-
tracted with boiling spirit, in order to remove the sugar and
fat ; it must then be dried, and its weight estimated. The
amount of albumen obtained in this manner is deducted from
the amount of casein obtained by the method which has been —
described, and which must sisi include both the casein and
albumen.
[Haidlen! has recently proposed a new method for analysing
milk. It consists in coagulating the milk by gypsum, by which
means the error in the determination of the casein that resulted
from all former methods, is avoided.
When milk is stirred with about one fourth of its weight of
finely-pulverized gypsum, and heated to 212°, it is entirely
coagulated ; and if the whole is then evaporated to dryness,
a brittle mass is obtained, which is easily reducible to powder.
From this powder the butter may be extracted by ether; the
sugar of milk and soluble salts may be removed by hot alcohol
of 0°85; while the caseate and sulphate of lime, and insoluble
salts, remain undissolved. The alcoholic solution scarcely ex-
hibits any perceptible opacity on the addition of chloride of
barium, showing that no error in the result is occasioned by
any of the gypsum being taken up by the alcohol. |
About 100 grains of gypsum and four times its weight of
milk answer very well. The soluble salts extracted from the
milk by the alcohol may easily be determined by incineration ;
and since their amount is to that of the insoluble salts in the
average proportion of 5 to 7, the amount of the latter may at
least be found approximately, and the ascertained weight of
' Simon’s Beitrage, p. 358.
MILK BEFORE DELIVERY. 47
the sugar and casein corrected accordingly. But if it be required
to determine the salts with perfect accuracy, it is best to inci-
nerate a weighed quantity of milk, and to analyse the residue.
The analyses of Clemm,! which will be presently noticed,
were made in the following manner: One portion of milk was
used for the determination of the water and of the solid residue,
and afterwards (by incineration) of the fixed salts. Another
portion was evaporated nearly to dryness, and treated with one
or two drops of acetic acid to coagulate the casein and render
it insoluble. It was then treated with ether, in order to remove
the fat, and with water in order to take up the sugar of milk,
extractive matters, and salts. The residue was regarded as
casein. |
Healthy Milk.
1. Milk before delivery.
The mammary glands secrete a milky fluid during pregnancy
which, at first, differs considerably from normal milk, but, as
the period of delivery approaches, gradually approximates to it
in its characters. In the first stage of its secretion, albumen
preponderates, and sugar is almost entirely absent ; the albumen
gradually gives place to casein, and, at the same time, sugar
and fat are more abundantly formed. There are no means of
obtaining any very accurate information respecting the fluid
secreted in the breasts of women previous to childbirth,? but
experiments have been made by Lassaigne and myself on this
secretion in animals.
I analysed the milk of an ass pregnant for the first time, and
within about fourteen days of her full period of gestation.
The fluid was transparent, scarcely opalescent, tenacious, and
viscid ; it had an alkaline reaction. The microscope revealed
a few fat-corpuscles, some granular bodies, composed of accu-
mulated minute fat-vesicles and mucus-corpuscles.
It did not become more gelatinous or stringy on the addition
of caustic ammonia; when heated, a considerable quantity of
1 The investigations of Clemm are contained in the article “ Milch” by Scherer,
in Wagner’s Handworterbuch der Physiologie, vol. 2, 1845.
2 [Clemm found that the fluid obtained from the breasts of a woman shortly before
delivery contained 5:4782 of solid constituents. ]
48 THE SECRETIONS:
albumen coagulated. The presence of casein was shown, and
its amount determined, by the addition of acetic acid, by
boiling the fluid till it evaporated to the consistence of an
extract, and by then extracting it with boiling spirit. The
casein differed from the ordinary casein of cow’s milk, in being
soluble to a very considerable extent in boiling spirit ; it par-
tially separated from the clear hot solution on cooling: it
seemed rather to resemble the casein of the crystalline lens.
After the removal of the fat, by means of ether, it was almost
perfectly soluble in water; on the application of heat, the
surface of the solution became covered with an irregular film,
and the addition of a little dilute acid was followed by a very
copious precipitate.
The analysis of this milky fluid yielded, in 1000 parts :
Analysis 61.
Water ; ; : 3 ; 737°00
Solid constituents : ; ; ; 263°00
Fat 3 P ; : : 7°98
Casein ; ‘ ‘ ; ; 28-93
Albumen J ‘ - ‘ . 198°34
Extractive matters, traces of sugar and casein, chloride of
sodium, and lactate of soda x , ‘ 18°41
The milk of the same ass was examined eight days after-
wards ; it was less thick and sticky, and rather whiter than
before. It more closely resembled true milk in its smell, and
it had a mild, faintly sweet taste. It contained, in 1000 parts:
Analysis 62.
Water | ; ; e ? yee 814-0
Solid constituents ; , 4 ; 186°0
Fat ; , ; ‘ ; 8°5
Casein é ‘ d ; 25-0
Albumen 6 ; ? . ‘ 123°9
Extractive matter, with a little sugar, salts ; s 28°6
The change in the constitution of the fluid was very striking ;
the solid constituents collectively, and especially the albumen,
were diminished, while the fat, casein, and sugar, had relatively
mereased. In the first analysis, the casein formed only one
ninth of the solid residue; in the second, it amounted to one
seventh.
Lassaigne has observed similar proportions in the fluid
secreted by the mammary glands of cows previous to calving.
Forty-one days before calving, it contained albumen in place
COLOSTRUM. 49
of casein, had an alkaline reaction, a specific gravity of 1063,
and, when allowed to stand, deposited a large quantity of cream,
from which a very soft sort of butter was obtained. The fluid
retained these properties till ten days before calving; it then
acquired a milder taste, but still contained albumen in place
of casein. If Lassaigne had been acquainted with my method
of separating casein from albumen by means of boiling spirit,
he would, doubtless, have found casein, as I did, in the asses’
milk. It was not till five days after calving, that the fluid
resembled ordinary milk; it then had a specific gravity of
1035, and contained casein instead of albumen.
2. Milk immediately after delivery.
The lacteal secretion immediately after delivery differs from
the ordinary milk produced after the milk-fever, and has re-
ceived the name of colostrum. In woman I found the colostrum
thicker than true milk.! It had a dirty light yellow colour, an
alkaline reaction, no peculiar odour, but a remarkably sweet
taste.
[Clemm states that the alkaline reaction very soon disap-
pears. He has found the colostrum become acid in the course
of three hours. | .
According to other observers, it resembles a thin solution of
soap and water (Joannide”), with drops of oil on its surface.
On examining the colostrum with the microscope, a very large
number of fat-globules are seen, some of which are larger than
those that occur in ordinary milk, and these are frequently
observed clinging to one another; besides these, there are gra-
nulated, yellow, roundish corpuscles, larger than the milk-cor-
puscles, which appear to be composed of very minute fat-vesicles;
they seem to be peculiar to the colostrum, and were first observed
by Donné,? who states that they occur in woman’s milk till the
twentieth day, when the milk loses all the characters of colos- |
* Die Frauenmilch, &c. p. 51.
? Physiolog. Mammar. Mulieb. Specim. Halle, 1801.
3 Du Lait, et en particulier de celui de nourrices, etc. Paris, 1837, p. 19.
II,
50 THE SECRETIONS :
trum; I have never succeeded in detecting them after the eighth
or tenth day.
[According to the observations of d’Outrepont,! the granu-
lated corpuscles usually disappear on the third day.]
The following analysis represents the composition of 1000
parts of the colostrum of a woman. The other analysis repre-
sents the average composition of healthy milk, deduced from
many observations, and is given in order that the reader may
contrast the composition of the colostrum with that of the
normal secretion.
8 Analysis 63. Healthy milk of the
Colostrum, same individual.
Water ure us J 828°0 887°6
Solid constituents : g 172-0 112°4
Fat ; ‘ ns 50°0 25°3
Casein . ed: ‘ 40°0 34°3
Sugar of milk : : 70:0 48-2
Ash z ; : 31 23
Of the fixed salts, 1:2 were soluble, and 1°8 insoluble in water.
The chemical differences between the colostrum and the milk
are at once obvious; the former is much the richer of the two
in solid constituents, especially in butter and sugar of milk.
The absolute quantity of casein is also greater, but the ratio of
the casein to the solid constituents is less than in ordinary
milk. The salts are also increased; the aperient property of
the colostrum is probably due to the Jeetinned quantity of aed
and sugar of milk.
3. Of ordinary milk.
The ordinary milk of the human female is a white or blueish
fluid, and of a sweeter taste than cow’s milk. It usually ex-
hibits nothing but the milk-globules under the microscope. It
has always an alkaline reaction, which it retains for five or six
days before it becomes acid. Its specific gravity varies from
1030 to 1034; the average of a large number of analyses yielded
the number 1032. On evaporation, it becomes covered, like
every other sort of milk, with a film of coagulated casein; and
when the evaporation has been sufficiently prolonged, it yields
' [Neue Zeitschrift fiir Geburtskunde, vol. 10, pp. i—7 a}
HEALTHY HUMAN MILK, 51
a brownish extract-like residue which, when dried, is perfectly
soluble in water, (with the exception of a little albumen,) and
forms a milky fluid. Everything that precipitates casein, coa-
gulates milk; the mucous membrane of the stomach of an infant
a few days old, that has recently died, seems, from my obser-
vations, to coagulate woman’s milk more perfectly than the
mucous membrane of the stomach of the calf.! The solid con-
stituents fluctuate between 8°60 and 13°862. I shall now give
- some analyses of milk: Ist, the average of fourteen analyses
-
made at different periods with the milk of the same woman ;
2d, the analysis of the milk of a woman aged 36 years; 3d, the
analysis of the milk of a nurse aged 20 years; 4th, the maxima,
and, 5th, the minima, of numerous analyses.
An. 64. An. 65.
i 2, 3. 4. 5.
Water . ‘ Y . 883°6 894:0 898°0 9140 861°4
Solid constituents “ . 1164 1060 102°0 1386 86:0
Butter a ~ 25S SSE. 263° 640 8-0
Casein A : ett SMB VE Sa OS BSD: 452. 996
Sugar of milk and extractive matters 482 40°5 360 624 39:2
Fixed salts ; ; ‘: 23 1°8 27 16
The maximum table gives the highest amount of each indi-
vidual constituent, and the minimum the lowest that occurred
in the whole series of analyses.
[Clemm has recently published the following analyses :
The 4thday The 9th The 12th
after delivery. ditto. ditto.
Water : : ; . 879°848 885°818 905°809
Solid constituents 2 : « 120°152 114°182 94°191
Butter . F R - 42°968 35°316 33°454
Casein . i 3 AN 35 55 | 36°912 29-111
Sugar of milk and extractive matters . 41°135 42-979 31°537
Salts x : ; : 2°095 1691 1939
Two analyses of healthy human milk have been made by
L’Heretier.2 He found:
1. 2.
Water : ; ; . 867°8 870°6
Solid constituents ; ‘ a ohoee 129°4
Butter. : : s- £2°5 52°0
Casein. : : ae a: 9°5
Sugar of milk : ; . 74:0 63°4
Salts : : ; : 4:0 4°5
' Die Frauenmilch, &c. p. 29. ? Traité de Chimie Pathologique, p. 627.
52 THE SECRETIONS :
Haidlen,' by the method already noticed, found that 1000
parts of woman’s milk contained :
iS 2.
Butter ‘ ret K ; ; 13 34
Casein and insoluble salts . ; 27 31
Sugar of milk and soluble salts x , 32 43
In the second analysis, the milk was extremely rich in solid
constituents. |
Meggenhofen? has also analysed woman’s milk; but, from
the method which he pursued, we can place no reliance on the
determination of the individual constituents. The dried resi-
due was extracted with alcohol of 0°83, and afterwards with
water, as long as any additional matter was taken up. It is
evident that fat, some of the sugar, and perhaps even traces of
casein must be contained in the alcohol-extract; the water-—
extract contains the rest of the sugar, some extractive matter,
and a great part of the casein. According to Meggenhofen,
the solid constituents in woman’s milk vary from 10 to 12-565,
and the salts from 1:2 to 2°4%. These numbers correspond
very closely with my results.
The analyses gave in 1000 parts:
Water : - : . 827°5 883°5 789°3:
Solid constituents . ; 1725 1165 210-7
Fat with sugar and iadibrSitrect : 91:3 88-1 171°2
Sugar and casein . ‘ 11°4 12°9 8°8
Coagulated casein . ‘ ’ ; 24°1 14:7 28°38
Payen? has likewise analysed woman’s milk, but his results, —
especially regarding the amount of casein, differ so very much
from those of other chemists that they can only be explained
on the assumption that there was an error in the plan of his
analysis. The following numbers represent the mean of three
analyses; water, 857:7; solid constituents, 142°3; butter,
51:5; casein, 2°2; residue of evaporated whey, 78:0.
' Annalen der Chemie und Pharmacie, vol. 45, No. 3.
* Dissert. inaug. sistens indigationem lact. mul. chemic. auct. Meggenhofen.
Frankf. a. M. 1826. |
3 Journal de Chim. méd. vol. iv, p. 118.
HEALTHY HUMAN MILK. 53
The salts of woman’s milk appear, according to my own ob-
servations, and those of Meggenhofen, to range at about from
; to } per cent. of the fluid; of these, usually about 2 are insoluble,
and } soluble in water: the former consist of phosphate and
carbonate of lime, with a little magnesia, and a very small
quantity of (phosphate of ?) peroxide of iron ; the latter, of chlo-
rides of sodium and potassium, with a little chloride of calcium,
-carbonate of soda, (corresponding with the lactate in the milk,)
and a little sulphate of potash, the acid of which does not pre-
exist in the milk, but is produced during incineration. Pfaff
and Schwartz' found a larger proportion of salts in woman’s
milk, namely, 0:44072; they were composed of phosphate of
lime, 0°25; phosphate of magnesia, 0°05; phosphate of iron,
0:0007 ; phosphate of soda, 0°04; chloride of potassium, 0:07 ;
and soda originating from lactate of soda, 0°03. Carbonate of
lime, sulphate of potash, and chloride of sodium are not noticed,
although all other observers concur in finding them in the milk.
Chevallier and O. Henri have instituted some researches on
the milk ; they precipitated the casein by acetic acid, evaporated.
the fluid portion, and determined the salts by the incineration
of the residue. They estimated the part that was consumed as
sugar of milk, and removed the fat from the precipitated casein
by means of ether. By this process they obtained much too
small a quantity of casein from woman’s milk, (since this con-
stituent is only imperfectly precipitated by acetic acid,) and too
large a quantity of sugar, which was thus made to include all
the destructible constituents, with the exception of the casein
and fat. In the other sorts of milk, the precipitation of the
casein by acetic acid is also imperfect. The following is the
result of their analysis of woman’s milk :
Water Ea é : 879°8
Solid constituents : : 120-2
Butter . ; x rs Na
Dried casein : 15:2
Sugar of milk ; : 65°0
Salts ; 3 ; 4°5
‘! Dissert. inaug. sistens nova experimenta circa lact. princip. constit. Kiel, 1833.
54 THE SECRETIONS:
On the effect of temperament on the milk.
[It has been long believed that the milk of fair women is
inferior in its properties to the milk of brunettes. As far as I
am aware, the only analyses bearing on this point are those of
L’Heretier. He selected two females of equal age, and made
them submit to the same diet and mode of life. The following
are the results of his analyses :
A Blonde, aged 22. A Brunette, aged 22.
te FE 1. be
Water " - 892°0 881°5 853°3 853°0
Solid constituents - 108-0 118-5 146°7 147°0
Butter. - . 855 40°5 54:8 56°3
Casein : : 10°0 9°5 16°2 17°0
Sugar of milk ; 58°5 64:0 71:2 70:0
Salts ; : 4:0 4:5 4°5 4°5
He appears to have selected the analyses that presented the
most marked contrast; for he observes, that if he had taken
the mean of all his analyses, the difference between the amount
of the solid constituents in the two cases would have been less
marked, the average ratio being 120 : 134.
L’Heretier has likewise investigated the changes produced
in the milk by a prolonged sojourn in the breast. The two fol-
lowing analyses illustrate the effect thus produced. The milk
in each analysis was afforded by the same woman: in the first
case it had remained in the breasts for forty hours; in the
second, it was obtained after the infant had been sucka for
some little time. |
1. 2.
Water Z - ; 901-1 858°0
Solid residue ; ; 98°9 142°0
Butter : ; ; 34:0 36°5
Casein ; ‘; : 1°9 13°0
Sugar of milk ‘ ‘ 58°5 780
Salts is A i 4°5 4°5 ]
On the changes in the milk dependent on nutrition.
That the character of the food exerts an influence on the
quality and quantity of the milk, is a fact that has been long
known, although the nature of the changes could not be cor-
MODIFICATIONS OF MILK. 55
rectly determined. I analysed the milk of a very poor woman
fifteen times at regular intervals during the course of half a
year, commencing with the second day after delivery. It so
happened that she was suddenly deprived of the means of ob-
taining even the most ordinary necessaries of life. The milk
secreted at this period, (the 11th of November,) was sufficiently
abundant in quantity, but was very poor in solid constituents,
containing only 8°62. Some days afterwards (the 18th of
November) she was placed upon a full and nutritious meat diet.
The milk, in consequence, was secreted so copiously as to run
spontaneously from the breasts: it left 11:92 of solid consti-
tuents. Her circumstances again became very bad, and she
was frequently in a state of the utmost destitution: on the
Ist of December, while in this condition, the milk again be-
came very thin, and left only 9°82 of solid constituents. I con-
cluded my researches on the milk of this woman, by an exa-
mination on the 4th of January, after she had been supplied
for two days with a nutritious meat diet: the milk was then
very rich in solid constituents, and left a residue of 12-62.
The following are the results of my examinations on these
four occasions; below them is the average of the fourteen
analyses to which I have already referred :
Solid Sugar and
Water. constituents. Butter. Casein. extractive matter.
1. Milk on Nov. llth . 914:0 86°0 8:0 35°5 39°5
2. Ditto Noy.18th : 8806 119-4 34:0 -37°5 45°4
3. Ditto Dec. Ist - 920°0 98:0 8:0 39°0 49-0
4. Ditto Jan. 4th . 873°6 126°4 37°0 40°0 46°0
5. Average of 14 analyses 883°6 116°4 25°3 38°3 48°2
It is evident from these analyses, that however much the
nutriment of the mother may vary, no great influence is thereby
exerted on the relative quantities of casei and sugar. The
changes consist in a greater or less degree of saturation, in the
rich yellowish white or the blueish colour, in the quantity of
the milk, and in its amount of solid constituents ; with the ex-
ception of the variation in quantity, all the other changes are
dependent on an increase or diminution of the butter; the
former occurs under the use of a copious and nutritious diet,
the latter when the food is poor and scanty. Donné’s' proposal
' Du Lait, etc. p. 54.
56 THE SECRETIONS:
for determining the goodness of the milk by a microscopic ex-
amination, is founded on incorrect principles; he assumes that
the increase of the butter and of the other constituents is
simultaneous ; an assumption that the above analyses show to
be inconsistent with facts.
Changes in the milk, corresponding with the age of the infant.
It seems probable that certain changes will be observed in
the milk when the progress of development of the child indicates
the necessity for other food. The question is one of consider-
able physiological interest, and in order to elucidate it I made
analyses of the milk of a woman during a period of nearly six
months, commencing with the second day after delivery, and
repeating my observations at intervals of eight or ten days.
The results would doubtless be more decisive if the expe-
rimentalist were able to exclude all disturbing influences: but
in almost all cases the exercise of a strict control over the
method of living and the nature of the food of the mother, is just
as impossible as the exclusion of exciting moral forces.
The fourteen analyses (the colostrum being excluded) gave
the following results : ;
Specific Solid ; Fixed
Analyses gravity. Water. constituents. Casein. Sugar. Butter. salts.
66 3ist Aug. 1031°6 873-2 126°8 212. 624 346 0°84
67 7th Sept. 1030°0 883°8 116°2 196 576 314 1:66
68 8th Sept. 1030°0 899-0 101-0 257 (523 180 2:00
69 14th Sept. 1030°0 883°6 116°4 220 520 264 1:78
70 = 27th Oct. 1034°0 898:2 101°8 430 450 140 2:74
71 3d Noy. 1032°0 886-0 114:0 45°2 . 392. 274 2°87
72 ~=11th Nov. 1034°5 914-0 86°0 35°33 39°5 80 2°40
73 =: 18th Nov. 1033°0 880°6 119°4 37:0 45:4 34:0 2°50
74 25th Nov. 1033°4. 890°4 109°6 38:5 «475 = =619°0 2°70
75 Ist Dec. 1032°0 902-0 98-0 39°0 49-0 8-0 2°08
76 8th Dec, 1033°0 890-0 110°0 410 43:0 22:0 2°76
77. ~—-: 16th Dec. 10344 8910 = 109°0 42°0 44:0 20:0 2°68
78 =3ilst Dec. 1034°0 861°4 138°6 310 52:0 540 2°35
79 4th Jan. 1032°0 873°6 126°4 400 460 37:0 . 2°70
A glance at the three columns of casein, sugar, and butter,
will show that, with few exceptions, Ist, the quantity of casein
is at its minimum at the commencement; it then rises consi-
derably, and ultimately attains a nearly fixed proportion ; that,
MODIFICATIONS OF MILK. 57
2d, the quantity of sugar is at its maximum at the commence-
ment, and subsequently diminishes; and that, 3d, the butter
is a very variable constituent of the milk.
The variations observed in the columns of the sugar and of
the casein arise in all probability from those disturbances of
the mode of living, and of the tranquillity of the mind, which
produce a decided influence on the composition of the milk,
and over which the experimentalist can exert no control.
Milk changed by disease.
There are certain morbid states of the system which produce
such an influence on the milk that the infant cannot partake
of it without detriment to its health. It is a well-known fact
that the milk of women who are exposed to violent mental agi-
tation, to passion, grief, &c. will occasionally produce very serious
effects (and sometimes even instantaneous death,) on the in-
fant: and some physiologists and physicians are of opinion that
chronic diseases may be transmitted by the milk from the
mother to the child.
When we read the statements of trustworthy authors re-
garding the instantaneously fatal effect produced by the milk
on the infant, on the occurrence of a sudden shock affecting
the mind of the mother, we cannot deny that some chemical
change is produced through the nervous influence on the milk,
although we cannot determine the nature of that change. In
many cases the milk, possibly, acts only as a conducting fluid, and
thus conveys the nervous shock from the mother to the child.
Certain morbid changes in the milk which are dependent on
the formation of mammary abscess, may be easily recognised by
the microscope, which will then reveal the -presence of pus- or
mucus-corpuscles. Thus in cow’s milk which was drawn from
a teat affected with vaccinia, I found a considerable quantity
of mucus- or pus-corpuscles, while in the milk drawn from an-
other teat of the same udder there were none.
When a mammary abscess opens internally, the milk always
contains pus-corpuscles, and frequently also blood-corpuscles,
if blood has escaped with the pus. Donné! has frequently made
' Du Lait, etc. p. 40.
58 THE SECRETIONS :
microscopic examinations of the milk of women with swelled
breasts ; it resembles, in some measure, the colostrum. In the
milk of a cow affected with vaccinia, I found a number of cor-
puscles, which were very like the yellow granulated colostrum-
corpuscles.
I have had an opportunity of examining the milk of a re-
cently-delivered woman, who was in a state of considerable
fever in consequence of a violent fit of passion: her child, after -
partaking of her milk, was seized with vomiting, diarrhoea, and
convulsions. The breasts were swollen, tense, and painful ; the
milk had an alkaline reaction, and apparently possessed the
qualities of the ordinary secretion ; it had, however, a different
and not very easily described animal odour. When boiled it
exhibited no albumen, but after evaporation to a certain point
it coagulated, and had a marked acid reaction. Another por-
tion that was set aside, coagulated after some hours, and had
an acid reaction, a circumstance I have never observed in healthy
human milk, which will remain undecomposed for five or six
days. After twenty hours it developed so large an amount of
sulphuretted hydrogen, that a slip of paper which had been
moistened in a solution of lead, and was then placed in the flask,
in a short time became brown. ‘The casein, sugar, and butter,
did not seem to have undergone any change, either qualitative
or quantitative. In fact there appeared to be little difference be-
tween it and the milk that was secreted twenty-four hours
before, and six days later, as may be seen by a comparison of
analyses 67, 68, and 69: analysis 68 merely exhibits a smaller
proportion of solid constituents, which is principally due to the
decrease of butter. The differences observable in this milk
were undoubtedly connected with the bad effects which it pro-
duced ‘on the infant.
The case was altogether different with the milk of a woman
who contracted syphilis after the birth of her first child, and
who, in consequence of defective or improper medical treatment,
carried the remains of the disease about her for years. The
children which she bore while in this condition, and which
were begotten by her husband who also had some suspicious
sores on the feet, did well for the first half year, they then
became highly scrofulous, and died in a state of marasmus:
_ the first child was perfectly healthy. The milk, when she was
MODIFICATIONS OF MILK. 59
suckling her sixth child, which was a year and half old, and in
a dreadfully scrofulous state, exhibited no deviation from the
healthy secretion: it appeared rich, tasted and smelled like
healthy milk, and had an alkaline reaction, which it retained
for the space of six days. Its constituents, casein, sugar, and.
butter, appeared normal, and there was no peculiarity in their
quantitative admixture. (See analysis 64, p.51.) Hence, although
the woman was suffering from a malignant chronic disease, no
morbid change was observable in the milk.
Donné’ has frequently submitted the milk of syphilitic women
to microscopic examination, but never observed any deviations
from the normal appearance.
Meggenhofen? found that the milk of a syphilitic woman
reddened tincture of litmus, and that it was coagulated by
protonitrate of mercury, basic acetate of lead, and infusion of
galls, but not by hydrochloric or acetic acid, protochloride of
tin, neutral acetate of lead, or alcohol of 0:83.
Herberger? has analysed a specimen of diseased human milk ;
he found it composed of, water, 895; solid constituents, 105 ;
casein, 18°3; sugar, 26:9; butter, 23°3; chlorides of potassium
and sodium, lactate and phosphate of potash, and an imorganic
substance, insoluble in oil of turpentine, 41°6 ; organic matter
soluble in oil of turpentine, 1:6. The latter substance was a
yellow extract soluble in water and alcohol. The solution re-
duced the salts of gold, silver, and platinum, yielded no ammonia
by dry distillation, and was not precipitated by tannic acid.
Deyeux* examined the milk of a woman who was liable to
frequent nervous attacks: he found that simultaneously with
these seizures, the milk became transparent and viscid, like
albumen, and did not reassume its normal condition for some
time. :
Other changes in the milk.
Certain substances which are not included in the ordinary
constituents of the milk are sometimes detected in it, after having
been taken into the system, either as food or medicine. It is
' Op. cit. p. 52. ? Dissert. inaug. etc. p. 16.
* Journal fiir prakt. Chemie, vol. vi, p. 284.
* Crell’s Chemische Annalen. vol. i, p. 369.
60 THE SECRETIONS :
not to be expected that all the substances which enter the cir-
culating fluid and are separated by the kidneys, should be
found in the milk, since the absorbents appear to exert a sort
of selective power, and would thus reject those substances which
occur in the blood, but which would produce an injurious effect
on the tender frame of the infant, if they entered into the milk.
I have sought in vain for ferrocyanide of potassium in the
milk of women who were suckling, and to whom I have given
it in doses of six drachms. This salt is known to enter very
readily into the circulation, and is found after a very short in-
terval in the urine. After the lapse of two days I gave the
same woman twenty-three grains of iodide of potassium, but I
could detect no trace of this salt in the milk. Lastly, I at-
tempted in vain to detect sulphate.of magnesia in the milk of
a woman who was suckling, and to whom I had administered
it in a sufficient dose to act as a laxative.
For the particulars of these experiments I must refer to my
essay ‘On the Milk of Woman, in its Chemical and Physio-
logical Relations. From these observations I think that I
am justified in the conclusion that energetic substances,
which are foreign to normal milk, either do not enter into
that secretion at all, or if they do, they undergo modifi-
cations, which render them more compatible with the organism.
Although I could not detect the sulphuric acid of the sulphate
of magnesia in the milk, it is very probable that the magnesia
entered the milk as a lactate, while the sulphuric acid was car-
ried off by the urine as a sulphate.
Peligot, however, has detected iodide of potassium in asses’
milk ; and Herberger in the milk of woman. [I have on several
occasions observed the ordinary indication of iodine on the ad-
dition of xyloidin, or of starch and a drop or two of nitric acid
to the urine of infants at the breast during the period of the
mother taking three grains of hydriodate of potash thrice a
day—a convincing proof that the salt has entered the milk.]
Mercurial medicines used by women who are suckling have
never been traced in the milk, [although their effects on the
infant are undoubted. |
COLOSTRUM OF ANIMALS. 61
OF THE MILK OF ANIMALS.
Colostrum of animals.
In the colostrum of the cow Chevallier and Henri found:
water, 803°8 ; casein, 170°7 ; and butter, 26:0. They describe it
as a dark yellow, thick, viscid fluid, sometimes marked with fine
streaks of blood; it has an alkaline reaction, contains little
butter, (as shown by the analysis,) coagulates on heating, and
in all probability contains a mixture of albumen and casein, in
the same manner as I observed in the mammary secretion of
the ass a short time before delivery.
Boussingault and Le Bel’ found in the colostrum of a cow
the day after calving: water, 784°0 ; casein with albumen, 151-0;
butter, 26:0; sugar, 36:0; and earthy salts, 3:0. | (I shall pre-
sently describe a specimen of cow’s milk resembling colostrum,
which was analysed by me.)
_ In the colostrum of the ass Chevallier and Henri found :
water, 828°4; casein, 123°0; butter, 5°6; and sugar, 43-0 ;—
and in the colostrum of the goat: water, 641:0; casein, 275-0;
butter, 52°0; and sugar, 32-0.
_ The 170°7 parts of casein found by Chevallier and Henri
in the colostrum of the cow, consisted of 150°7 of a substance
coagulable at a boiling heat, which they termed colostrum-casein,
and of 20 of a substance remaining in the whey, to which they
applied the name of matiére muqueuse.
The 123 parts of casein in the colostrum of the ass con-
sisted of 116 of the former, and 7 of the latter substance ; and
in the colostrum of the goat they were in the proportion of
245:30. These numbers approximate very closely to the pro-
portional amount of casein and albumen in asses’ milk, pre-
viously to delivery. (See page 48.)
1. Cow’s milk.
Cow’s milk is a rich white fluid of an agreeable, somewhat
sweetish taste, and of a peculiar odour; when allowed to stand,
1 Anal. de Chim. et de Phys. May 1839.
62 THE SECRETIONS :.
the fatty portion (cream) collects on the surface ; when boiled,
it becomes covered with a film of coagulated casem. My own
observations and those of others show that, when fresh, it has
always an alkaline reaction. D’Arcet and Petit have, however,
found it to be acid. This discrepancy may probably be explained
by the circumstance of the speedy conversion of the sugar into
lactic acid, which is sometimes noticed in cow’s milk. The
state of acidity is hastened by a heightened temperature, and
is most rapidly induced by being brought in contact with rennet.
The specific gravity of cow’s milk varies from 1030 to 1035.
We possess several analyses of cow’s milk; it has been exa-
mined by Herberger and myself by the method I have pre-
viously explained, and our results approximate closely. The
third of my analyses (No. 82) represents the milk a short time
after calving, while it still retained the character of colostrum.
Boussingault and Le Bel have also analysed normal milk with
the view of ascertaining the influence of various sorts of fodder
on its composition ; by the adoption of the French method to
which I have already alluded, they obtained too little casein
and too much sugar. I shall give the mean of twelve of their
analyses :
F. Simon. Herberger. 3 Ae bie
a =
le - ee 3 FH 5 3 s
An.80. 81. 82, 1. 2. se 63 23
Qs Os
Water “ ; 857°0 861-0 823°0 853°0 8620 868 8740 870-2
Solid constituents . 143°0 139°0 177°0 147:0 1380 132 1260 129°8
Butter ‘ 400 380 55:0 389 375 36 390 313
Casein § . 720 680 67:0 698 670 56 340 448
aati grep } 28-0 290 51:0 31° vice 330. 407
Fixed salts i 6°2 61 13:0 70 7°2 6:0
Earthy salts ° 2:2
[Haidlen found, in the milk of a cow: water, 878; solid
residue, 127; butter, 830; casein and insoluble salts, 51 ; sugar
and soluble salts, 46. He has carefully studied the salts of
the milk, and is of opinion that the carbonate of soda that
occurs in the ash does not originate from a lactate in the fresh
milk, but exists there combined with casein. The salts are
combinations of phosphoric acid with lime, magnesia, and per-
ASSES’ MILK. 63
oxide of iron; chlorides of sodium and potassium, and soda in
combination, with casein.
The following numbers represent the amount of the various
salts found in 1000 parts of milk: the per centage of each con-
stituent is added in order to show the slight variation to which
the different salts are liable, in relation to the mass of the ash.
i Per centage. 2. Percentage.
Phosphate of lime : ; 2°31 47°1 3°44 50°7
Phosphate of magnesia . , 0°42 8°6 0°64 9°5
Phosphate of peroxide of iron . 0:07 14 0°07 1-0
Chloride of potassium rasa be” 29°4 1°83 27°71
Chloride of sodium . ; 0°24 4°9 0°34 5°0
Soda ; ; : ; 0°42 8°6 0°45 6°7
490 100-0 6-77 1000 |
Berzelius! found, in skimmed milk: water, 928°75; casein,
with butter, 26:00; sugar, 35°00; alcohol-extract, with lactic
acid and salts, 6:00; chloride of potassium, 1°70; alkaline
_ phosphates, 0°25 ; phosphates of lime and magnesia, with traces
of iron, 2°30. The cream consisted of: water, 920; butter,
45 ; casein, 35.
Pfaff and Schwartz? estimate the fixed salts at 0°37429,
scarcely more than half the quantity obtained by Herberger
and myself. They contained phosphate of lime, 0°1805 ; phos-
phate of magnesia, 0°0170; phosphate of iron, 0:°0032; phos-
phate of soda, 0°0225; chloride of potassium, -0°1350; and
lactate of soda, 0°0115.
A comparison of my analyses of cow’s milk with those of
woman’s milk will show that the former contains the larger
amount of solid constituents, especially of casein, while the
latter contains the greater quantity of sugar.
2. Asses’ milk:
Asses’ milk is a tolerably rich white fluid, with a sweeter
taste than cow’s milk, and occasionally having an acid reaction.
- Its specific gravity fluctuates between 1035 and 1023. I found
! Thierchemie, p. 701.
? Diss. inaug. sist. nova experim. circ. lact. princip. constit. Kiel, 1833.
64 THE SECRETIONS:
the milk of an ass, about a year after foaling, to be com-
posed of :
; Analysis 83.
Water : : : ‘ 907-00
Butter, with some lactic acid . . : 12°10
Casein : “ 16°74
Sugar, with scisakiiee: matter nd alkaline aie . 62°31
The following is the mean of several analyses of asses’ milk
made by Peligot ;' his numbers approximate pretty — to
mine :
Water i é . Z é 904-7
Butter s ‘ : ; ¥ 12°9
Casein ‘ i 19°5
Sugar, extractive srintbee: and nits ; : 62°9
Chevallier and Henri found in 1000 parts of asses’ milk :
Water J , 4 916°3
Solid constituents ‘ : ‘ 83°5
Butter : . Z a i |
Casein i ; J < 18-2
Sugar Z ; ‘ - ‘ 60°8
Salts i = ’ e 3°4
Asses’ milk contains a smaller amount of solid constituents,
especially of casein and butter, than cow’s milk ; it also differs
from it in its great abundance of sugar and extractive matter,
in which peculiarity it resembles woman’s milk.
3. Mare’s milk. fae)»
Mare’s milk is very rich in solid constituents; it has a spe-
cific gravity of 1034°6—1045-0; it contains little butter, but a
large amount of sugar. Stipriaan, and Luiscius and Bondt ob-
tained from it 0°88 of cream, 1-628 of casein, and 8°752 of sugar.
I obtained a yellow, viscid, saltish, and nearly inodorous fluid
from the teats of a mare expected to foal shortly : it coagulated
on heating, exhibited a few fat-vesicles and granular corpuscles
under the microscope, and acetic acid separated a small quan-
tity of casein. It contained 5% of solid constituents, of which
only 0°15° was butter. The solid constituents consisted for the
most part of albumen, mixed with a little casein, butter, and
extractive matter.
’ Annal. de Chimie et de Physique, Aéut 1836, p. 432.
GOAT’S MILK. 65
4. Goat’s milk.
Goat’s milk is a very rich white fluid, of specific gravity
1036, with a peculiar disagreeable odour arising from the hircic
acid which is present in the butter. Its solid constituents are
as abundant as those of cow’s milk, and it contains in 1000 parts :
Chevallier Stip., Luisc.,
and Henri. Clemm. Boysson. John. Payen. and Bondt,
Water ‘ . 868-0 865°175 892°8 849°3 855°0 744°4
Butter ; - a2 42-507 29°9 11:7 40°8 45°6
Casein : - 402 60°321 52°9 105°4 45°2 91-2
Sugar : - 528 : 20°7 23°4 43°8
Salts : . 5°8 hg
Residue of whey 58°6
Cream 75°0
[An analysis of the mammary secretion of a he-goat has
been recently made by Schlossberger.' The animal was four
years old, and had. given undoubted proof of his generative
powers. The fluid obtained by repeatedly milking the animal,
had the colour, consistence, and taste of milk, and was perfectly
devoid of any unpleasant odour. Under the microscope, the
globules appeared numerous, and a considerable amount of
cream separated after standing for some time. The milk was
analysed according to Haidlen’s method, and found to contain :
Water. ‘ ‘ 3 : 850°9
Butter. ‘ , ‘ ; 26°5
Casein (with salts insoluble in alcohol) - . . 96°6
Sugar (with salts soluble in alcohol) . é 26:0
The milk left 7822 of ash, of which ‘325 were soluble, and
‘457 insoluble in water. This case is interesting in reference
to the theory of secretion ; it seems to show that the secretion
of milk is independent of any peculiar condition of the blood
incident to pregnancy, but that it depends far more upon the
development of the secreting organ. |
1 Annalen der Chemie und Pharmacie, 1844.
Le |
Il.
66 THE SECRETIONS :
5. EHwe’s milk.
Ewe’s milk is an extremely rich, thick, white fluid, with an
agreeable smell and taste, and having a specific gravity of 1035
to 1041. Stipriaan, Luiscius, and Bondt found in 1000 parts:
Water 3 t : , 632°0
Solid constituents . ; j 368°0
Butter . ‘ 5 F 58-0
Casein . ; ‘ 153°0
Sugar . : : : 42°0
Cream . ; - 115°0
We cannot help thinking that in this, as well as in the pre-
vious analysis by the same chemists, the amount of solid con-
stituents, and especially of the casein, is higher than is likely
to be correct. Chevallier and Henri found in 1000 parts:
Water é ‘ ‘ 856°2 ee
Butter 4 ' P ; 42:0 “
Casein . é : : 45-0
Sugar ‘ ; F ‘ 50:0
Salts 4 ; ; ‘ 6°8
6. Bitches’ milk.
I have made two analyses of the milk of a bitch of the bull-
dog breed. The milk was drawn from one of the teats that
was not used by the pup: it was very thick, (whereas the milk
from the teats which the pup was in the habit of sucking was
very thin,) had a disagreeable animal odour, and a rather saltish,
mawkish, but not sweet taste. A period of ten days elapsed
between the two analyses. :
Anal, 84. Anal. 85.
Water Z ; : 657°4 682°0
Solid constituents £ 5 342°6 318°0
Butter . ; , 162-0 133°0
Casein é : é 174:0 146-0
Extractive matter and traces of sugar 29-0 30°0
Fixed salts é : 15°0 14'8
This milk is distinguished from every other kind of milk that
I have examined, by the immense amount of its solid consti-
tuents, and by the nearly total absence of sugar.
DISEASED MILK. — 67
[Clemm examined the milk of a bitch. Its specific gravity
was 1033; and 1000 parts yielded 274689 of solid constituents,
consisting, for the most part, of casein and, butter, but still
giving undoubted indications of the presence of a very small
quantity of sugar. The bitch was fed entirely on flesh.]
On diseased milk in animals.
The changes produced by disease have been especially studied
in cow’s milk. The milk may contain mucus, pus, and blood,
under similar conditions to those which we have noticed in
woman’s milk. (See page 57.) These substances are easily
detected by the microscope.
Through the kindness of Dr. Bremer, I obtained some milk
from the udder of a cow affected with vaccinia, and indeed
one portion of the milk was taken from a teat covered with
the eruption, while the rest was drawn from a healthy teat.
The two specimens differed both chemically and physically : the
milk from the diseased teat was strongly alkaline, had a slightly
saline taste, and exhibited under the microscope a number of
mucus- and pus-corpuscles. It became gelatinous on the addi-
tion of a spirituous solution of caustic ammonia; it yielded a
precipitate of mucus- or pus-corpuscles on standing, while the
upper portion became clear; and it coagulated on heating, in
consequence of the presence of albumen.
The milk from the healthy teat had a mild acid reaction,
tasted like ordinary milk, contained no pus- or mucus-corpuscles,
but a larger proportion of fat-vesicles than the diseased milk.
These analyses gave :
Analysis 86. Analysis 87.
Milk from the Milk from the
: healthy teat. diseased teat.
Water - . : 912°10 935°40
Solid constituents : ; ; 87°90 64°60
Butter P 3 é é 19°58 12°05
Casein ‘ ‘ - ‘ 40°62
Casein, with pus or mucus, and albumen ‘ 31°40
Sugar, with alcohol-extract, lactates, and 29-36
chloride of sodium j : :
Extractive matter, with chloride of sodium, 16°18
lactate of soda, and a little sugar
Water-extract : : ‘ 0°32
Salts soluble in water . ‘ ; 3°87 6°42
Salts insoluble in water ; 3 3°20 2°42
68 | THE SECRETIONS:
The great increase of the soluble salts, especially of the free
alkali, the presence of albumen, and the almost total absence
of sugar, are the points most worthy of notice in the morbid
specimen.
Herberger' has analysed the milk of cows suffering from the
grease, and found it materially affected. In the first stage of
the disease he found that the milk only coagulated imperfectly
on the addition of rennet, in consequence of the increased
quantity of alkaline salts; moreover (and probably for the same
reason) the fat-vesiclesw ere not distinct, as they usually are, but
merged into each other. In the second stage, only a few fat-
vesicles were observable, the coagulation by rennet was very
imperfect, and the milk, which was thick and viscid, had an
unpleasant putrid smell and taste. In both stages the sugar
and casein were below their normal proportions, but the amount
of salts was increased ; the presence of carbonate of ammonia
(an ingredient never before observed in the milk) was detected.
His analyses gave the following results :
In the first stage. In the second stage. Healthy milk.
ee 2. ‘a 2.
Water ‘ ‘ 869°0 872°4 87471 879°3 857°5
Solid constituents 131-0 127°6 125°4 120°7 142°5
Fat ? : 39°0 38°5 38-2 37°9 38°2
Casein . 4 52°4 51°0 50°0 49-0 68°4
Sugar . ‘ 22°8 21-0 21°0 19°0 28°8
Fixed salts. 16°8 17°1 16°6 13°9 71
Specific gravity 1033°6 1033-0 103371 =—1029-1 1033°7
The most striking changes in the diseased milk are the dimi-
nution of the solid constituents, especially of the casein and
sugar, and the extraordinary increase of the salts. Hence the
modifications of the fluid in this instance closely resemble those
in my analyses in the preceding page.
Donné found that the milk of the cow during “la maladie
aphtheuse,” resembled colostrum. It was less fluid and homo-
geneous in its mixture than ordinary milk ; it became viscid on
the addition of ammonia, and, besides the ordinary milk-cor-
puscles, the microscope revealed mucus-granules and tubercular
(mulberry-form) corpuscles. 2
' Pharm. Centralblat. Jahrg. 1840, p. 138.
OTHER CHANGES IN MILK. 69
Of other changes in the milk.
The passage of various substances into the milk has been
more frequently observed in animals than in the human species.
Peligot detected iodide of potassium, and chloride of sodium in
the milk of the ass, after internal administration. The salts
of iron, zinc, and bismuth, are also said to enter it in minute
quantities.
The sulphates of soda and potash, sulphuret of potassium,
and the mercurial salts have never been met with in the milk.
The smell, taste, and colour of vegetable substances are taken
up by it.
The milk is sometimes observed to become blue on its sur-
face after standing for 24 to 48 hours, and the tint gradually
diffuses itself through the whole fluid: the milk has also been
observed to turn yellow in a similar manner. Fuchs! has care-
- fully investigated this phenomenon, and has detected in milk
of this nature a peculiar infusorium, to which he has applied
the name vibrio cyanogenus ; it is not of a blue colour itself,
but it appears to have the power of gradually changing the
milk to this tint. When removed from the milk, and placed
in an infusion of marsh-mallows, these animalcules increase in
size, and communicate a faint blue tinge to the fluid; in this
way they may be preserved for a long time. Closely allied to
this animalcule is the vibrio xanthogenus ; they are sometimes
found together in milk, and Fuchs had also an opportunity of
observing them in milk which had become yellow, a much more
rare change than the former.
‘ Beitrage zur naheren Kenntniss der gesunden und fehlerhaften Milch der
Hausthiere. Magazin fiir die gesammte Thierheilkunde, Jahrg 7, Stiick 2.
CHAPTER V.
SECRETION OF THE MUCOUS MEMBRANE.
Mucus.
Aut the internal parts of the animal body which are connected
by direct continuity with the external surface, are covered by
a soft velvety and highly vascular coat—the mucous membrane,
which in its turn is protected by a delicate layer of epithelium.’
The mucous surfaces, especially when they are in a state of
irritation, secrete a viscid, stringy, and often tough fluid ; occa-
sionally it is clear and colourless, but most commonly it is
turbid, of a faint yellow or grayish white colour, and is frequently
of sufficient consistence to separate in gelatinous globular masses,
or tough flocculi.
Of normal mucus.
The transition from healthy to diseased mucus is so inde-
finitely characterized, that it is almost impossible to draw a
strict line of demarcation between them, and the same remark
is equally applicable to the further change of the diseased se-
cretion into pus: hence it is not very easy to form a distinct
conception of what normal mucus really is.
Henle states that in the same manner as the outer surface of
the external skin is continually peeling off and giving place to
? According to Henle the epithelium consists of one or more layers of cells which,
from the peculiarity of their form, are arranged in three groups: Ist, Pavement
epithelium [the scaly epithelium of Bowman], fig. 14 a, which occurs in the mouth,
in the intestinal canal as far as the pylorus, in the vagina, &c.: 2d, Cylinder epithe-
lium, [the prismatic of Bowman, the columnar of Todd,] fig. 14 b, having a conical
form, and arranged perpendicularly to the basement membrane; this form occurs in
the portion of the intestinal canal below the pylorus, in the gall-bladder, and in the
male genito-urinary apparatus: and 3d, The ciliated epithelium, fig. 14, which re-
sembles the cylinder epithelium in form, and has its free edges armed with cilia.
This occurs in the respiratory organs, in the uterus, and fallopian tubes.
Bs
MUCUS. 71
the layer beneath it, so there is also a continuous desquamation
or separation of the epithelium of the mucous surfaces, which
sometimes occurs in men, who are in other respects healthy,
to such an extent that thick clots of mucus are expectorated in
the morning ; which, on being examined with the microscope,
contain merely epithelium-cells. This, which is formed by a
mere act of separation from the uppermost layer of epithelium,
is regarded by Henle as normal mucus: he gives it the name,
however, of epithelium, and restricts the term mucus to the
morbid secretion of the mucous surfaces in which mucus-cor-
puscles (of which I shall speak presently) are found. I have
always found these corpuscles in the secretion from the nasal
and pulmonary mucous membrane of perfectly healthy persons:
they are mixed in a small quantity with the epithelium-cells, and
become increased when the mucous membrane is irritated.
Physical character of mucus.
Normal mucus, when fresh and recently secreted, is denser
than water, and when mixed with that fluid it gradually sinks
to the bottom of the vessel, unless it should be hindered from
doing so by extraneous causes.
Dried mucus sinks very rapidly: normal mucus from the
lungs or nostrils usually floats on water for a considerable
period ; in fact it was regarded as characteristic_of mucus to
float on water, in contradistinction to pus, which always sinks.
A more careful investigation enables us to trace the floating
of the mucus to two causes: first to the number of air-bubbles
that are entangled in it, (after the removal of which it sinks) ;
and, secondly, to the proportionally small amount of solid con-
stituents in the secretion. The insolubility of fluid mucus in
water is the cause of the long retention of the air-bubbles.
When mucus contains pus, the proportion of solid consti-
tuents increases, the fluid portion diminishes, and its place is
supplied by albumen. Water rapidly permeates mucus in this
state, the air-bubbles escape, and it speedily falls to the bottom
in consequence of its specific gravity. Mucus from the bladder
or from the intestines does not swim on water in consequence
of the absence of air-bubbles.
When some fresh, fluid, transparent, nasal, or bronchial mucus
72 THE SECRETIONS:
is examined under the microscope, it is found to consist of a
liquid in which minute rounded or prolonged corpuscles of a
granular appearance (mucus-corpuscles) are inclosed, which do
not exhibit any independent motion, in consequence of the thick
viscid nature of the fluid in which they are suspended; but when
the fluid is stirred they are seen to move with it. In addition
to the mucus-corpuscles, some epithelium-cells are also observed,
and a finely-granulated substance which pervades the whole
fluid, and can only be seen with a good light. Nasal mucus,
from my own observations, is represented in fig. 15 ; @@ mucus-
corpuscles, 6 6 epithelium cells; cc the faintly a
substance.
' According to Henle, the diameter of the mucus-corpuscles
varies from 0:003 to 0:007 of a line: according to Vogel, from
0-004 of a line: Gruby’ considers them from 2 to 4 times the
size of the blood-corpuscles. They are prolonged, oval, or
round, and when observed in fresh mucus have a clear well-
defined contour, a pale gray colour, a granular appearance, and ©
sometimes give faint indications of one or more nuclei. After
remaining for some time in water, the mucus-corpuscles become
more or less swollen, paler, and more transparent ; the granular
appearance on the external capsule disappears, and one or more
nuclei may be observed in the interior of the cell. The external
capsule frequently becomes so colourless as to render its de-
tection difficult.
The epithelium-cells appear under the microscope in the form
of elliptic dises ; according to Gruby, the axis major varies from
0:013 to 0°0333 of a line, and the axis minor from 0-010 to
0-016 of a line: the surface is frequently irregular, wrinkled,
or plicated. We sometimes find them swollen and vesicular,
and sometimes, but more rarely, almost circular or elliptic. The
nucleus is of the same prolonged form as the mucus-corpuscle;
it is granular and rather darker coloured. If mucus is fre-
quently observed, the transition of mucus-corpuscles into epithe-
lium-cells may easily be seen. We have attempted to illus-
trate this progressive change in d, e, f, fig. 15.
' Observationes Microscopice ad Morphologiam Pathologicam. Vindobone, p. 15.
MUCUS: 73
Chemical character of mucus.
The action of chemical reagents on the epithelium cells and
- mucus-corpuscles may easily be observed under the microscope.
The former are not affected by the addition of water or of
dilute acids; they disappear, however, under the influence of
caustic alkalies or concentrated acids. According to Gruby,
solutions of the ordinary earthy, and metallic salts effect no
change on the epithelium cells. The mucus-corpuscles are
very differently acted on. Dilute acetic, oxalic, and tartaric
acids speedily deprive the capsules of the mucus-corpuscles of
their granular appearance. The corpuscles themselves become
round and transparent; the nuclei become apparent, the cap-
Sules at length disappear, and the nuclei frequently divide into
several granular bodies, so that in place of the mucus-corpus-
cles previously visible, there are at last only two, three, or
more rounded granules to be seen.
Dilute mineral acids do not produce these changes in the
capsule of the mucus-corpuscle, which remains unchanged, as
shown by the observations of Giiterbock, Vogel, Gruby, and
myself. Dilute, as well as concentrated solutions of the alkalies
and their carbonates render the capsules clearer, and ultimately
dissolve them. The free fixed alkalies produce these changes
more rapidly than their carbonates; free ammonia much less
rapidly than free potash.
The liquid portion of the mucus always exhibits a decidedly
alkaline reaction: when examined under the microscope it ap-
pears like a clear fluid, in which, with a very good light, a faint
granular appearance is perceptible. On the addition of a little
water, a decided coagulation may be observed, and an extremely
fine granular precipitate is formed. Acetic, and indeed any
weak acid produces a.similar effect, but the precipitate is more
copious, and forms a grayish granular film, sufficiently strong
to admit of traction. The free alkalies and their carbonates do
not precipitate this fluid.
It is clear from the preceding observations that mucus is
composed of two distinct parts, the cells and the fluid. The
viscidity of the secretion evidently pertains to the latter, and
‘the ingredient that gives rise to this property must be contained
74 THE SECRETIONS:
in it in a state of solution, as is obvious from microscopic ex-
amination. There can, I conceive, be no doubt that the prin-
cipal constituent of the fluid, mucin,’ is held in solution by
means of an alkali, since water (by taking up the alkali) is
sufficient to precipitate it, and the effect is produced in a much
higher degree by the addition of a free acid. |
When mucus is allowed to remain in contact with water,
a slight quantity of the mucin always dissolves, probably through
the aid of a free alkali; hence it is that the water in which the
sputa, during catarrhal affections, are allowed to float, always
become slightly turbid on the addition of acetic acid.
In addition to the mucin, the fiuid portion of the mucus also
contains a small quantity of extractive matters and salts, (espe-
cially lactate of soda and chloride of sodium,) and either no
albumen, or at any rate a mere trace. The contents of the
mucus-corpuscles are not accurately known; in all probability
they contain a fluid in addition to their nuclei. The fat that
occurs in mucus is probably contained in the corpuscles, for no
fat-vesicles are generally observed in fresh mucus, but after the
solution of the corpuscles by the addition of acetic acid, a few
fat-vesicles make their appearance ; indeed in some of my obser-
vations, the nuclei of the mucus-corpuscles, have seemed to lose
their dark granular appearance, and, after a time, to become
clear and like minute fat-vesicles. The nuclei of mucus-cor-
puscles do not appear to undergo this change invariably ; there
are probably different stages of development, and on the as-
sumption that the nuclei of the least-developed corpuscles are
composed of fat, the relative increase of fat will clearly corre-
spond with the amount of mucus that is secreted.
1 [Simon observed the great similarity between mucin and pyin; the researches
of Eichholtz seem to show that these substances are identical. The substance de-
scribed by Eichholtz as pyin differs from the protein-compounds in being precipitated
from an alkaline solution by an aqueous solution of iodine and by distilled water. A
considerable excess of water dissolves a slight portion of it. Dilute mineral acids, when
carefully added, precipitate it, but when in slight excess, immediately redissolve it;
moreover, ferrocyanide of potassium causes no precipitate in a clear acid solution, but
a turbidity is produced by the same substances that throw it down from its alkaline
solutions. Acetic, tartaric, and oxalic acids precipitate, but do not redissolve it, and
a solution of alum, gradually added, produces a precipitate insoluble in an excess of the
test. On evaporating an alkaline solution of mucin on the water-bath, it becomes
covered with a film of coagulated mucin which is difficult of solution in water. ]
MUCUS. 75
It follows, from the preceding observations, that mucus con-
tains the following constituents: mucus-corpuscles, epithelium
cells, mucin, small quantities of extractive matters and fat,
chlorides of sodium and potassium, alkaline lactates, a little
carbonate of soda and phosphate of lime, and sometimes a
minute quantity of albumen. In order to separate these con-
stituents I adopt the following course.
A known weight of mucus must be washed with distilled
water and evaporated to dryness on the water-bath. The re-
sidue must be finely triturated and repeatedly extracted with
boiling ether in order to remove the fat ; it must then be boiled
in spirit of 0-91 as long as any additional matter is dissolved.
The spirituous solution must be evaporated to a small syrupy
residue, and alcohol of 0°85 added, in order to precipitate any
dissolved mucin, caseous matter, water-extract, and pyin: the
alcoholic solution, containing the alcohol-extract and lactates,
is also to be evaporated. The portion undissolved by boiling
spirit of 0-91, consists of mucin with cells, and traces of albu-
men, if the previous qualitative investigation has shown that
this substance is present.
In order to determine the salts, a portion of the dried re-
sidue must be submitted to incineration. It is difficult to ob-
tain a white ash in consequence of the fusion of the salts, The
chlorides may be extracted with spirit; the residue must be
then treated with acetic acid, in order to convert the carbonates,
which have arisen from the incineration of the alkaline lactates,
into acetates, which may be extracted with alcohol. Anything
that still remains, is composed of phosphates and perhaps sul-
phates, in very minute quantity, together with traces of iron
and silica. :
I have analysed mucus both from the nose and lungs, during
pulmonary catarrh, but as I cannot regard these cases as illus-
trations of normal mucus, I shall defer their consideration for
the present. From an analysis of nasal mucus made by
Berzelius, it appears that there are in 1000 parts:
Watet. : : ‘ i 9337
Mucin ‘ : ‘ . ‘ 53°3
Alcohol-extract and alkaline lactates : , 3°0
Chlorides of sodium and potassium 3 : 5°6
Water-extract with traces of albumen and phosphates 3°5
Soda, combined with mucus. j : 3°9
76 THE SECRETIONS:
Consequently Berzelius found no fat, but he detected traces
of albumen. :
The foregoing remarks refer especially to the mucus of the
nostrils and lungs, but as the physico-chemical properties of all
sorts of mucus are not quite the same, I shall briefly commu-
nicate my own observations and those of Berzelius on the
different varieties of mucus.
1. Nasal mucus.
Nasal mucus generally occurs as a gelatinous or fibrous, and
nearly transparent mass ; after complete evaporation it remains
in the basin as a yellow, and tolerably transparent coating. It
contains epithelium cells and a few mucus-corpuscles, is not
soluble in water, but if it remains in contact with that fluid for
a considerable time it yields some mucin, in consequence of
which the addition of acetic acid to the water produces a
very slight turbidity. When water containing mucus is sub-
mitted to filtration, the latter remains on the filter and gra-
dually solidifies. Berzelius has observed that it may be dried
and again diffused through water repeatedly, without changing
its properties ; it ultimately, however, becomes opaque, yellow,
and apparently purulent. When boiled with water it does not
shrivel and harden, but only slightly contracts, and may be
diffused by shaking. On cooling, it again becomes tenacious
and viscid. By dry distillation of evaporated mucus we obtain
carbonate of ammonia and Dippel’s oil. Mucus dissolves in
dilute sulphuric acid; in the concentrated acid it becomes dark
‘coloured and is decomposed. Dilute nitric acid causes a su-
perficial coagulation ; acetic acid induces a degree of contrac-
tion, and the mucus does not dissolve in it at a boiling heat.
On the addition of caustic alkalies, it, at first, becomes tough
and thick, but subsequently dissolves into a thin fiuid.
2. Bronchial and pulmonary mucus.
These are very similar to nasal mucus. They separate into
clear and gelatinous, or else into gray or yellowish flocculi,
which remain suspended in water for some time, but ultimately
sink to the bottom.
MUCUS. 77
[Nasse! has analysed pulmonary mucus expectorated in the
morning bya healthy man. Analysis No. 1 refers to the mucus
itself, and No. 2 to the solid residue.
1. 2.
Water ‘ , : 955-520
Solid constituents : i 44°480
Mucin, with a little albumen : 23°754 53°405
Water-extract 3 ‘ 8°006 18-000
Alcohol-extract ; ; 1810 4:070
Fat : ; ; 2°887 2°490
Chloride of sodium. ; 5°825 13°095
Sulphate of soda ‘ ‘ 0-400 0°880
Carbonate of soda é ; 0-198 0°465
Phosphate of soda ‘ 0-080 0-180
Phosphate of potash, with traces ‘of iron 0°974 2°190
Carbonate of potash . ; - 0°291 0°655
Silica, and sulphate of potash. 0°255 0°570 ]
3. Mucus from the intestinal canal.
When evacuated with watery motions after the administra-
tion of a purgative, I found it occurring in yellow gelatinous
masses, which, on being examined with the microscope, were ob-
served to contain a large quantity of mucus-corpuscles. Berzelius
found that the mucus discharged with the feces becomes hard
and black on drying; if it is then placed in water it becomes
softer, and if the water contains any free alkali it again becomes
viscid. It is thoroughly soluble in caustic potash, and it may
be precipitated from its alkaline solution by the addition of any
acid. According to Gmelin,? the mucus from the small in-
testines of dogs and horses appears, after being washed in cold
water, in the form of white shreds or flocculi. Dilute acids
increase its coagulation, but concentrated acetic acid dissolves
the greater part. It also dissolves in the alkalies, from which
it may be precipitated by an acid.
4. Mucus from the gall-bladder.
When bile is submitted to filtration a certain quantity of mucus
which is suspended in the bile is detained on the filter, while
another portion chemically combined with an alkali passes
through in a state of solution, and may be precipitated by
1 Journal fiir praktische Chemie, vol. 9, p. 59.
? Handbuch der theoretischen Chemie, vol. ii, p. 1118.
78 THE SECRETIONS :
an acid: the latter has, however, lost the characteristic vis-
cidity of mucus. If the acid be removed by means of an alkaline
carbonate, the mass does not become viscid; if, however, in-
stead of a carbonate, a caustic alkali is employed, the viscidity
is restored. If the mucus of the gall-bladder is precipitated
by alcohol, the viscidity disappears, it is restored, however, by
being washed in water. When dried, it becomes transparent
and yellow; on the addition of water it swells, and is rendered
opaque but not viscid. :
5. Mucus from the urinary bladder.
Vesical mucus is always present in the urine, but only in
very small quantity in the normal secretion. In recently dis-
charged urine it cannot be detected with the naked eye, but
after the fluid has stood for some time, there are formed light,
often hardly perceptible nebule of smking mucus, in which the
microscope reveals mucus-corpuscles and epithelium-cells. On
filtration the mucus remains on the paper in the form of co-
lourless flocculi ; it contracts and ultimately forms a glistening
varnish-like coating, which does not resume its former appear-
ance on being moistened with water.
According to Berzelius it is insoluble in sulphuric acid, but
the greater part of it dissolves in acetic and hydrochloric acids :
ferrocyanide of potassium throws down a precipitate from these
solutions.1 .
Morbid Mucus.
It is well known that any irritation will increase the secretion
of mucus in an extraordinary degree; this is seen in the
secretion of the mucous membrane of the nostrils and lungs
during a common cold or catarrh. The mucus is then mate-
rially changed ; at the commencement of the attack it is gene-
1 [We have at present analyses of only three varieties of mucus, viz. the mucus of
the oviduct of frogs, the mucus of the cesophagus of the peculiar species of swallows
which build edible nests, and the mucus of the gall-bladder. The results differ so
much that either animal mucus is a variable mixture of heterogeneous substances, or
that different substances at present bear the name of mucus in common. ‘The ana-
lyses are quoted in Mulder’s Chemistry of Vegetable and Animal ee p- 240,
English translation. }
MUCUS. 79
rally thinner than usual; but, towards the termination, it be-
comes thicker ; the epithelium-cells diminish, while the mucus-
corpuscles increase in number ; the reaction continues alkaline;
in fact, in most cases it is more strongly so than in the normal
state; the fat is increased, and always contains cholesterin ;
_ and at the same time there is an excess of albumen.
Gruby found that mucus secreted by the nasal mucous mem-
brane during a state of irritation of that surface, was white, of
the consistence of the white of eggs, and had a saline taste.
When examined with the microscope, there were only a few
epithelium-cells and mucus-corpuscles to be seen.
I have analysed nasal mucus which accumulated in the upper
part of the nose of a man aged thirty years; it generally came
away in the form of thick, tough, yellow lumps, about the size
of an ordinary bean, or, if it had only been retained in the nos-
tril for a shorter period, it was obtained as an extremely copious,
tough, yellow fluid; it was invariably discharged from only one
nostril. This mucus was devoid of odour, had an alkaline
reaction, and being moistened with water, (in which it sank,) it
exhibited an extraordinarily large quantity of epithelium-cells,
and a few mucus-corpuscles, connected by a pretty thick mem-
brane of coagulated mucin. When the mucus was gently
dried and pressed between the fingers, they presented the same
glistening appearance as if they had been pressing fat ; no fat
could, however, be distinctly recognised by the microscope in
consequence of the dense strata of membrane and mucus-cor-
puscles. In 1000 parts of this mucus there were contained :
Analysis 88.
Water ‘ F ; ; : 880°0
Solid constituents : : ‘ ‘ 120-0
Fat, containing cholesterin : ; 6:0
Caseous matter, with pyin or mucin in ‘solution : 13°2
Extractive matters, with lactates and chloride of sodium . 12°0
Albumen, cells, and coagulated mucin : <2 84:0
Gruby found that the mucus secreted during catarrhal
affections (slight inflammation) of the mucous membrane of
the nose, conjunctiva, fauces, larynx, bronchi, ureters, vagina,
and intestinal canal is thicker than the mucus secreted during
mere irritation of those membranes; it was thick, tough,
lubricous, of a yellowish white colour, and, as it gradually
dried, it formed a grayish-yellow elastic mass. It sank in water,
80 THE SECRETIONS :
unless air-bubbles were entangled in it, and exhibited no change
for a considerable time, but ultimately became whiter. With
the aid of the microscope, Gruby observed, Ist, a white amor- —
phous mass, not acted on by water (coagulated mucin,) and 2d,
round yellowish-white globules, whose number seemed in a
direct ratio with the intensity of the yellow colour of the mucus.
These cells which were observed in the mucus of the larynx,
had eight times the diameter of the blood-corpuscles, were inti-
mately connected with the amorphous white mass, and consisted
of a very delicate transparent capsule that was easily ruptured,
of an inner round cell with a nucleus twice as large as a blood-
corpuscle, and very many small vesicles one sixth the diameter
of the blood-corpuscles, some of which were transparent and
some opaque. The large vesicles sometimes contained two inner
central cells.
I have also frequently observed these large cells (which
strongly resemble the full primary cells described and figured
by Henle,') in the gray or yellow-streaked gelatinous mucous
flocculi which are expectorated during a slight catarrh of the
trachea and bronchi, as well as in the thick, tough, yellow
nasal mucus that is secreted during a cold. I have repre-
sented this bronchial mucus in fig. 16, in which aa represent
the large cells. Other observers have detected these cells in tu-
bercular matter ; it is clear, however, that they occur in diseased
mucus, and are not to be regarded as diagnostic of tubercle.
Gruby found that the mucus in ophthalmoblennorrhea, and
in the uterine and vaginal discharges of some women after their
confinement, is of a deep yellow colour, thready and opaque ;
it sinks in water and forms flocculi, which, on being stirred, dis-
colour the fluid ; but after remaining in the water for some time,
they lose their power of communicating their colour to a fresh
supply of clear water. This mucus, when dried, forms a yellow,
transparent, brittle mass, which continues to burn when lighted.
Under the microscope, a white amorphous mass, insoluble in
water, 1s observed, together with a large number of yellow
vesicles of the form and nature of those. previously described,
some with, and others without a central cell. These vesicles swell
in water, the capsule bursts, the inclosed molecules escape, and
Ueber Schleim und Eiterbildung u. s. w. fig. 14.
~ MUCUS. 81
either become scattered or else accumulate round the unchanged.
internal cell, and often exhibit for some time the phenomena of
molecular motion. Only a few epithelium-cells are observable;
those that are present are full, round, and often closely resemble
the large mucus-vesicles. I have likewise observed these
epithelium-celis, which I regard as characteristic of a lower
stage of development, in nasal mucus. (See fig. 14, d, e, f.)
The mucus secreted in chronic blennorrheea of the vagina and
bladder is, according to Gruby, of a yellowish white colour, and
slightly thready. It quickly renders water turbid, and deposits
white flocks at the bottom of the vessel: in other respects it
resembles the former varieties of mucus. Under the micro-
scope we observe a small number of yellowish white vesicles,
some with a capsule, granular contents, and a central cell,
some with merely a capsule and a central cell, and some that
are composed of an aggregation of granules, without any cap-
sule whatever.
Gruby found that the lochial discharge,’ a short time after
delivery, is of the colour of blood, is possessed of an animal
odour, is only slightly thready, and when dried leaves a red
pulverisable mass ; it consists of hzematoglobulin, fibrin, (pro-
bably also albumen,) and vaginal mucus: under the microscope
we observe an amorphous thready mass, blood-corpuscles, mu-
cus-vesicles with capsules and aggregated granular molecules,
and finally epithelium-cells. Very shortly before delivery we
can observe nothing in the vaginal mucus beyond the true
mucus-corpuscles (fig. 14, a,) and epithelium-cells; but very
soon after delivery the large mucus-vesicles, with granular con-
tents (molecular granules) and delicate capsules, make their
appearance. Fig. 16, a, exhibits these cells, and is copied from
the plate in Gruby’s work. On the second day after delivery
vesicles with a central cell (fig. 16, 5) are visible, the mucus
becomes less dense, the blood-corpuscles diminish, and the large
mucus-vesicles increase in number. On the third day the red-
dish lochial discharge contains yellow vesicles with granular
contents and central cells. On the fourth day the discharge is
considerably less red, and contains white stringy flocculi. On
the fifth day the mucus contains grayish white, viscid flocculi,
' Scherer’s observations on this subject have been already given : see Vol. I, p. 338:
II. 6
82 THE SECRETIONS :
together with white vesicles, eight or ten times the size of blood-
corpuscles, which contain only a few, and, in some cases, no gra-
nular molecules; these are represented in fig. 16,c,d. Between the
sixth and tenth days the lochial discharge becomeswhite, and con-
tains white round vesicles, with finely granular contents, but de-
void of a central cell, or the larger molecules. (Fig. 16, e, f, g.)
Gruby has shown that the mucus discharged by stool at the
commencement of dysentery is clear and stringy, and scarcely
different from the mucus secreted in simple diarrhoea, but as
the disease becomes more severe, there is a secretion of thick
red mucus, consisting of blood- and mucus-corpuscles, resem-
bling the ordinary secretion of inflamed mucous membranes.
I have observed that the mucus secreted during inflam-
matory affections of the mucous membrane of the respiratory
organs is thick, rounded in form, of a white or pale yellow
colour, and floats on water. These clots of mucus remain un-
broken for a considerable time, but ultimately break up, and
sink to the bottom: they then spread out into long tough fibres,
which, when observed with the naked eye, have an uniform non-
granular appearance: they possess a certain degree of con-
sistency, and feel slippery, in consequence of the mucin which
connects the mucus-corpuscles ; they are consequently not very
easily fixed and broken up by pressure against the sides of the
vessel with a glass rod. When examined with the microscope,
the white masses of mucus are found to consist of a large num-
ber of mucus-corpuscles, and a few epithelium-scales, connected.
by a delicate granular membrane of coagulated mucin: the yel-
low clots contain, in proportion to the intensity of their colour,
a greater or smaller quantity of the large cells with granular
contents, (fig. 16, aa,) in some of which a central cell is visible,
while in others no cell can be seen. ‘The fluid in which the
thick clots of mucus are swimming is slightly clouded by acetic
acid, but rendered very turbid by nitric acid: on the applica-
tion of heat, it becomes white and opalescent ; and infusion of
galls, and basic acetate of lead yield tolerably copious flocculent
precipitates ; there is, consequently, a greater quantity of dis-
solved mucin and albumen present than the water would have
extracted from healthy mucus. A quantitative analysis of these
floating clots, after being well washed in distilled water, gave
the following results.
MUCUS. 83
The numbers are calculated for 1000 parts :
Analysis 89.
Water 2 941°75
Solid sinstidrannte 3 i i 58°25
Fat with traces of cholesterin 5°01
Spirit-extract, with lactates and chloride of sodium 11-09
Alcohol-extract ‘ 6°95
Cells, mucin, and a little ‘albumen : 34°80
In a case of severe bronchitis that recently occurred in
Schénlein’s clinical wards, the patient expectorated purulent
mucus, which, when placed in water, assumed a delicate arbo-
rescent form, the ultimate fibrils floating on the water when the
slightest motion was communicated to the vessel. When placed
in acetic acid, it swelled and became converted into a trans-
parent jelly, and after long digestion almost entirely dissolved;
the solution being precipitable by ferrocyanide of potassium.
Under the microscope the fibrils resembled coagulated fibrin,
and there can be no doubt that plastic lymph was exuded as a
consequence of the bronchitis, and expectorated in a coagu-
lated form. [Observations on the sputa in bronchitis and
pneumonia may be found in Scherer’s ‘ Untersuchungen,’
pp- 93-97. |
Gruby states that the sputa expectorated during the ordi-
nary inflammatory affections of the mucous membrane of the
respiratory organs, are, at the commencement of a catarrh,
white, transparent, and mixed with gray flocculi ; under the mi-
croscope they. are seen to contain a few round vesicles with
granular contents, and numerous epithelium-cells, swimming in
a transparent fluid. As the catarrh gets worse, the gray floc-
‘culi increase, and become more of a yellow colour, and the
amount of transparent mucus decreases; the coloured flocculi
contain numerous cells with granular contents (molecular gra-
nules) and a central cell, which are all connected together by
very tough mucus. As the inflammation decreases the amount
of this globular sputa diminishes, and it assumes a whiter colour.
Purulent Mucus.
If the mucous membranes or the tissues immediately beneath
them pass into a state of suppuration, pus becomes mixed with
the secreted mucus: in this manner the mucus of the lungs,
bladder, intestinal canal, generative organs, &c. may contain
84 THE SECRETIONS:
pus. When tubercles form in the lungs, they produce, like
any other foreign body, a degree of irritation in the surrounding
tissue, and an increased secretion of mucus is the result. Gruby’s
observation that the mucus discharged during irritation of the
mucous membrane, dependent on the deposition of tubercle,
does not differ from the mucus produced during catarrhal
affections, is confirmed by Hetterschig! and other observers ;
the secretion of mucus at the commencement of a catarrh is,
however, more abundant than that which is produced by the
irritation of existing tubercles.
The quantity of expectoration increases with the more ex-
tended deposition of tubercle, until softening commences; the
tubercular matter is then expectorated, and, in consequence of
the inflammation that occurs, pus is secreted by the walls of the
cavity thus produced, and in this manner gets mixed with the
sputa. |
The purulent expectoration of persons with tubercular phthisis
is easily distinguished by the experienced practitioner from
healthy sputa,? and with tolerable certainty from diseased mucus,
nor can there be any doubt regarding its nature while tuber-
cular matter is being discharged from a vomica, but the tran-
sition from diseased into healthy purulent mucus is so slight and
imperceptible, that it is hardly possible to detect the first traces
of pus that are mingled with the mucus; for although, as I
Shall presently show, their general physical and chemical rela-
tions are perfectly sufficient to distinguish pure pus from pure
mucus, we have no means of determining with certainty the
presence of a little pus in mucus, or the presence of a little
‘mucus in pus.
Purulent mucus from the lungs contains much less mucin
than normal or diseased mucus,? and consequently the mucous
clots have not the toughness, lubricity, and consistence ob-
served in mucus, unmixed with pus: in fact they have a de-
cided tendency to dissolve. Purulent mucus sinks more
quickly in water than the normal secretion, partly im conse-
' De Inflammatione ejusque exitu diverso. Trajecti a. R. 1841, p. 176.
* [Dr. Wright’s papers on Expectoration (recently published. in the Medical Times)
may be consulted with advantage. ] i
3 [This ‘is perfectly consistent with the observation of Eichholtz, that the pyin (or
mucin) varies inversely with the pus-corpuscles. ]
MUCUS. 85
quence of the fewer air-bubbles that are inclosed, (on account |
of slighter tenacity of the fluid medium of communication, and
the comparative facility with which they escape,) and partly in
consequence of the greater amount of albumen in the fluid, and
its higher specific gravity. If the secretion is composed of
nearly equal parts of mucus and pus, it sinks rapidly to the
bottom, and forms small definite tough clots: the masses may
easily be broken up by means of a glass rod, and can often be
separated by mere shaking: they have not so uniform an ap-
pearance as the healthy or morbid clots of mucus which float
on water, but to the naked eye they appear finely granulated
or gritty, since, in consequence'of the deficiency of the con-
necting medium—the mucin, the cells of the secretion are not
so closely associated.
When there is only a small amount of pus in the globular
sputa during phthisis, it separates from the mucus on being
placed in water ; the pus at once sinks, and while the mucus is
still floating on the surface we may observe long dependent
viscid fibres, at the extremities of which white or yellowish gra-
nular particles of pus may be noticed.
Phthisical sputa deposit a whitish granular sediment at the
_ bottom of the vessel, while masses of mucus are still floating on
the surface of the water. A microscopic examination of the
sediment shows that it consists of cells, which closely resemble
mucus-cells, especially when they have been in the. water for
any time: since, however, the cells of purulent sputa come in
contact with the water more readily in consequence of the
smaller quantity of the connecting medium, mucin, they swell
and become larger than the mucus-corpuscles, after they have
been for only a short time in water: the capsules become
transparent and vesicular, the granular appearance vanishes, and
one, two, three, or even more nuclei with internal nucleoli, be-
come visible: the capsules of many of the cells burst, and the
nuclei swim about in a state of freedom, in the same manner as
we observe in mucus that has been long under water. Gmelin’s Chemie, vol. 2, p. 1395.
94 THE SECRETIONS :
On the fifth, sixth, eighth, and ninth days after the com-
mencement of the eruption the pustules contained a thick
yellow fluid, which had a slightly alkaline reaction, and con-
tained numerous yellow pus-corpuscles, the capsules of which
readily burst.
Tremoliere describes the contents of a well-conditioned pus-
tule as yellow, turbid, and with an oily appearance. The smell
and taste of this fluid were unpleasant, its specific gravity was
1031, and it consisted, according to his statement, of fibrin,
mucus, chloride of sodium, sulphate of potash, and phosphate of
lime. Gruby found that the fluid in the pustule on the seventh
day was transparent; it contained white, nearly spherical vesicles,
which appeared wrinkled on one side.
Vogel has made some important observations regarding the
modifying influence of tissue, constitution, &c., on the nature of
pus.
Pus from the cellular tissue is usually the purest, pus from
mucous or serous surfaces being too thin and fluid, and con-
taining in one case an admixture of mucus, in the other of
serosity. Pus from the liver is pultaceous, thick, and of a
brownish red colour. On allowing it to stand for some time,
a dense, thick, and reddish matter separates from the white
pus. Pus from the kidneys is usually rather fluid, of a whitish-
yellow colour, and saltish. Pus from the urinary bladder may
be either fluid or tough, and varies in colour from a yellow toa
dirty brown-red tint; it frequently also has an ammoniacal
odour. Pus from the bones is blackish, or white with black
specks ; it has an odour and taste of phosphorus. Syphilitic
pus is of a yellow or yellowish-green colour ; it possesses a nau-
seous smell, and a sweet but sickly taste. Scrofulous pus is
caseous, very fluid, grumous, and sometimes resembles coagu-
lated milk ; according to Gendrin, it contains more soda and
chloride of sodium than ordinary pus; according to Preuss, it
contains casein, like tubercular matter. Rheumatic and
arthritic pus are very similar; for the most part very fluid, irri-
tative, and corrosive. I have examined the dried residue
of the liquor puris of an arthritic person ; it was of a grayish-
yellow colour, contained no membranous shreds, could be easily
pulverised, and exhibited no appearance of crystals when exa-
mined under the microscope. -On heating it with nitric acid, I
PUS. 95
obtained, after the evaporation of the acid, and more strikingly
on the addition of ammonia, a brilliant purple colour, indicating
the presence of uric acid beyond a doubt. On triturating this
substance with water I obtained a pulpy mass, which, when exa-
mined under the microscope, was found to contain numerous
epithelium-cells and pus-corpuscles, but no crystals of uric acid.
Alcohol extracted 5:46 of fat, consisting chiefly of margaric and
oleic acids, with a little cholesterin; boiling water took up 52°69,
of which a little fat, extractive matters, with hydrochlorate of
ammonia and lactate of soda, were soluble in anhydrous alco-
hol; and chloride of sodium, extractive matter, and albuminate
of soda in spirit. The remainder was washed with cold water,
(which extracted very little,) and was then dissolved in a faintly
alkaline solution. On the addition of hydrochloric acid to this
alkaline solution, crystals of uric acid were deposited, and some
albumen thrown down from the albuminate of soda: the acid
solution then contained hydrochlorate of ammonia and chloride
of sodium. The portion insoluble in water yielded on incinera-
tion 5° of ash, consisting of earthy phosphates, with a little
peroxide of iron and carbonate of soda; the dried residue of the
liquor puris yielded, however, 102 of ash, composed of carbonate
of soda, a little phosphate of soda, carbonate and phosphate of
lime, a little chloride of sodium, and traces of peroxide of iron.
It contained in 100 parts:
Analysis 91.
Portion insoluble in water . : : P 47°4
Fat ‘ ° ‘ A ‘ ‘ 5°4
Alcohol-extract, with hydrochlorate of ammonia and lactate
of soda ‘ ‘ : ; ; 49
Spirit-extract, with chloride of sodium and albuminate of
soda ; : . ‘ ; 17°5
Uric acid and albumen, combined with ammonia and soda _ . 17°2
The amount of the individual salts was not determined.
I have received, through the kindness of Dr. Piutti, of El-
gersburg, two small flasks filled with a white fluid discharged
from an abscess on the foot of a gouty patient, who had been
trying the water-cure. On standing, the fluid threw down a
copious white sediment, the supernatant liquid portion having a
reddish tint. When shaken, innumerable crystals might be ob-
served with the naked eye, which, under the microscope, ex-
hibited an acicular form; a few pus-corpuscles were also present.
96 THE SECRETIONS:
The crystals, after being carefully washed, so as to remove all
extraneous matter, formed, when dry, a white powder, and when
incinerated on platinum foil, left a white fused ash, consisting
of carbonate of soda. The white crystalline mass, when warmed
with nitric acid, yielded the deep purple tint indicative of uric
acid. On digesting a portion with dilute hydrochloric acid,
a large number of rhombic tablets of uric acid appeared on
cooling. The hydrochloric acid solution yielded, on gentle
evaporation, crystals of chloride of sodium. Hence the white
acicular crystals consisted of urate of soda. The red super-
natant fluid contained a few corpuscles, a large quantity of albu-
men, and some hematoglobulin.
Scorbutic pus is thin, ichor-like, of a bad odour, often mixed
with blood, and soon becomes putrid. Cancerous pus possesses
a very peculiarly fetid odour, and appears very frequently to
contain sulphuretted hydrogen and ammonia.
Pus sometimes contains infusoria; thus R. Wagner’ has ob-
‘served minute ciliated animalcules, in some slight degree
resembling pus-corpuscles, in pus taken from cancer of the lip;
they appeared to be the colpoda cucullus. Valentin has also
observed infusoria in the purulent fluid of carcinoma. Donne?
has observed the vibrio lineola in the pus from chancres and
gonorrhea: he found other forms of infusoria in the pus from
syphilitic vaginitis ; they were twice the size of the blood-cor-
puscles, with a round or elliptic body, considerably prolonged
anteriorly ; he proposes for this animalcule the name of ¢rico-
monas vaginalis.
Ichor.
When pus begins to undergo decay, or is secreted from ma-
lignant or carcinomatous growths, or when mortification comes
on in consequence of the depressed state of the vital powers, it
becomes thin and discoloured, (being often of a brown or reddish
tint,) and emits a fetid odour: it is then termed ichor. Ichor
frequently contains no pus-corpuscles, or only a very few, and
those partially broken : it is of a blood-red colour, but does not
always contain blood-corpuscles, the red colour being apparently
due to their solution in the putrid and decomposed fluid. From
' Valentin’s Repertorium, p. 119.
3 Recherches microsc. sur la nat. du Mucus, ete. Paris, 1837.
PUS. 97
the odour we may infer the presence of hydrosulphate of am-
monia. Vogel examined some ichorous pus from a sore in the
foot of a rheumatic patient ; he found perfectly normal pus-cor-
puscles in it, and it only differed from normal pus in its greater
fluidity.
Pus of animals.
I have analysed pus from a lymphatic gland in a horse. There
were contained in 1000 parts :
Analysis 92.
Water ‘ ; : ‘ R 976°00
Solid constituents 4 ‘ ; ; 24:00
Fat, containing cholesterin . ; = 1°68
Water-extract and caseous matter ; 1:26
Spirit-extract, with lactates, and chloride of sodium ‘ 2°94
Albumen, cells, — and np ae of lime, and
traces of iron : 17°64
Gobel! has analysed pus from the uterus of a mare ; it was a
thick fluid, of a whitish-yellow colour, opaque, of specific gravity
1079, and had a faint animal odour: it was neutral, and coagu-
lated on the application of heat. It contained, water, 913°3 ;
albumen, 7°2; gelatinous non-coagulable animal matter, 9°4;
chloride of sodium, lactate and sulphate of potash, phosphates
of lime and magnesia, protoxide of iron, and silica, 5°3. Dumas
analysed pus from the frontal sinus of a mule: it reddened lit-
mus paper, formed an emulsion with cold water, and when heated
to 158°, yielded a granular coagulum. It contained, 17-9° of
solid constituents, of which 16:5 were albumen; the Ferivaitidae
consisted of extractive matter, free lactic acid, phosphates and
sulphates.
On the formation of mucus and pus on mucous membranes, and
: on the detection of pus in mucus.
It seems to be now almost generally admitted that the dis-
tinctions between pus and mucus are to be sought for, not in the
morphological character or chemical relations of their respective
corpuscles, but rather in the chemical peculiarities of the fluid
portions of these secretions.
It has been already shown that the fluid of mucus contains a
large quantity of dissolved mucin, while no albumen, or, at the
most, a mere trace, is present: on the other hand, the fluid of
’ Schweigger’s Journal, vol. 34, p. 407.
Il. 7
93 THE SECRETIONS:
pus is rich in albumen, and contains only a very small quantity
of dissolved mucin. Hence, if it were proved that normal mucus
never contains albumen, we might conclude that all mucus
which gave indications of the presence of that substance was
purulent. We should then also arrive at the conclusion that
most persons, on the slightest irritation of the mucous mem-
brane, secrete purulent mucus. In this manner we should have
to agree with Vogel that normal mucus contains only epithe-
lium, and that any secretion of mucus-corpuscles indicates an
admixture of pus.
To the physician the detection of traces of pus in mucus is
a point of little importance ; it is of much more consequence to
be able to decide from the sputa whether suppuration of the
parenchyma of the lungs or of other tissues has actually com-
menced. The point is one of very great difficulty, in conse-
quence, as has been previously observed, of the imperceptible
changes that mucus undergoes in its transition from the normal
secretion into pus.
My own observations, as well as those of others, lead me to
concur in the view that Henle! has developed in his essay on
the Secretion of Pus and Mucus, in which he distinctly and in-
geniously points out the analogous phenomena between mucous
membranes and the external skin. The mucous membranes are
covered with several layers of epithelium, and in the ordinary
course of secretion, the more recent and inferior layer of cells
projects against the superior and older cells which constitute the
existing epithelium. The inferior cells themselves gradually
become epithelium, and, in their turn, are thrust out and
supplanted by still deeper cells. As the fiuid portion of the
mucus is secreted at the same time, it evidently cannot be re-
garded as the cytoblastema of these cells, but must be looked
upon as effete, and no longer essential to the formation of mu-
cus-corpuscles; the albumen for their nutrition having been ex-
tracted from it during the progress of their development towards
actual epithelium, and only mucin (the product of their meta-
morphosis) left in its stead.
As the secretion is increased by irritation of the mucous mem-
brane, it follows either that such epithelium as is thrown off in
the normal state is then not formed at all, or else that it is
1 Hufeland’s Journal, May 1836.
PUS. 99
only secreted imperfectly, and consequently we meet with
cells in every state of development under these circumstances.
These changes in the epithelium lead to corresponding variations
in the fluid portion of the mucus, for if a normal stratum of
epithelium is no longer formed, that is to say, if the deeper
layers throw off the superior cells before they have arrived at
maturity, the changes impressed on the fluid must be different
from those which it would undergo during the ordinary secre-
tion of healthy mucus. It is impossible that all the nutritious
matter of this fluid can be consumed by these immature cells,
and we consequently find in it, under these circumstances, a
greater or less quantity of albumen and fat, two substances which
universally yield a cytoblastema forthe higher development of cells.
If an increased secretion of mucus takes place on a mucous
membrane which possesses only a single layer of epithelium,
(either the cylinder or the ciliated variety,) the mucus-corpuscles
appear immediately after the epithelium has scaled off. The
transition of the mucus-corpuscles into epithelium-cells is not
observed so well in this instance, as when there is a profuse
secretion from a surface possessing several layers. These
transitions and various stages of development lead us to the con-
clusion that the mucus-corpuscles represent the first stage of
formation of the epithelium-cells, into which they would ulti-
mately have been converted if they had not been thrown off too
early, and, further, that the different forms of epithelium-cells
are in their primary state identical with one another.
The same elements are likewise recognised, according to
Henle, in other tissues, in the ganglia of nerves, in the brain,
in the contents of the Graafian vesicle around the ovum, in the
parenchyma of the liver, and in the blood-formative glands, (the
spleen, thymus, and thyroid.) These cells occur also in the
blood, where I have termed them chyle-corpuscles ; they proba-
bly represent the blood-corpuscle in a preparatory stage of de-
velopment.
If we suppose the secretion of mucus to be still further in-
creased, the mucous membrane will produce only these primary
cells, which cannot be distinguished from pus-cells, with which,
in fact, they are identical. Whether the secreted fluid is to
be regarded as pus, mucus, or purulent mucus, depends on the
quality of the liquid that is secreted with the cells. If it con-
100 THE SECRETIONS.
tains much mucin, the fluid must be regarded as mucus ; if there
is no mucin in it, or only a small quantity, but on the other
hand much fat and albumen, it must be regarded as pus ; while
if all three are contained in the fluid, it must be regarded as
purulent mucus. In a very diseased state of the mucous mem-
brane the fluid may even contain fibrin, and thus resemble plastic
lymph. Henle! has observed this in one instance. We may
consequently observe the various stages of transition from plastic
lymph to the normal fluid of mucus (containing mucin, but
no albumen), in the same manner as we can trace the epithe-
lium-cells gradually downwards till they assume the form of
primary cells.
The following conclusions are all that we are entitled to de-
duce from the previous observations :
(1.) Pure mucus floats on water for a considerable time if
air-bubbles are entangled in it; pure pus sinks rapidly to the
bottom ; purulent mucus swims if it contain air-bubbles, but
allows the pus to deposit itself; the deposit frequently takes
place in the form of pendent fibres. If pure mucus contain
no air-bubbles it sinks. 7
(2.) Pure mucus, lying in water, appears as a homogeneous,
streaked, vesicular, viscid, and tenacious mass, of a white or
whitish-yellow colour, and yielding readily to pressure. Pure
pus forms a stratum at the bottom of water, of a white or
greenish-yellow colour, and sometimes tinged with blood; by
agitation it is diffused through the water, and in a short time |
again sinks to the bottom. Purulent mucus forms streaked,
vesicular, often discoloured masses, or mucous sediments ; they
are easily diffused through water, and have a granular, non-
homogeneous appearance.
(3.) Pure mucus imparts no albumen or mucin to water;
mucus which is mixed with much saliva does, however, render
water a little albuminous; pure pus communicates a large
amount of albumen to water, and purulent mucus imparts a
quantity of albumen proportionate to the amount of pus.
None of what have been termed the “ pus tests” are calcu-
lated, in my opinion, to detect minute quantities of pus in mu-
cus, and no test is requisite to distinguish pure mucus from
pure pus, or to recognise a large quantity of pus in mucus.
' Hufeland’s Journal, 1836, p. 21.
101
CHAPTER VI.
SECRETION OF THE EXTERNAL SKIN.
Sweat. (Sudor.)
THE sudoriparous glands continuously secrete a very consi-
derable amount of watery fluid, which, in consequence of the ex-
tent of surface over which these glands are distributed, usually
passes off directly in the shape of vapour, leaving behind, how-
ever, on the skin, its various solid constituents, mixed with the
secretion of the sebaceous glands. It is only under the influ-
ence of active exercise, high external temperature, or certain
forms of disease, that the secretion is elaborated in such quan-
tity as to stand in drops on the skin, instead of being carried
off as insensible vapour ; it is then termed sweat. ;
Attempts have been made by Sanctorius, Dodart and Reil,
and more recently by Lavoisier and Seguin, to determine the
quantity of fluid which escapes from the skin within a certain
time, in the form of vapour. Seguin found that, on an average,
18 grains of fluid were discharged in a minute by the skin
and lungs ; the former exhaling 11 and the latter 7 grains. The
minimum exhalation from both sources amounted to 11 grains;
the maximum, in a state of rest, to 82 grains in a minute.
From these data the maximum of matter lost by the body
through the skin and lungs in 24 hours, would amount to 5
pounds, and the minimum to 1 pound, 11 ounces, and 4 drachms.
Taking the average of 11 grains in the minute, the whole quan-
tity would amount to 29 ounces of fluid.
The amount of solid constituents carried off with the fluid,
is comparatively very small, and does not exceed 7 or 8 scruples
in the 24 hours: all the rest is mere water, with some carbonic
acid, and perhaps some nitrogen.
The solid constituents of the sweat consist of a mixture of
salts and extractive matters, of which the latter preponderate ;
the principal ingredient of the salts is chloride of sodium.
102 THE SECRETIONS:
I have on several occasions collected and analysed the sweat
of persons in the vapour-bath ; it is, however, always mixed with
more or less water condensed on the body from the vapour of
the bath. The sweat collected in this manner from the arms
and face was a turbid, rather dirty-looking fluid, which, after
standing for some time, deposited gray floccules, recognizable
under the microscope as epithelium-scales, for the most part
broken and in fragments. The filtered sweat had in one in-
stance a specific gravity of 1003, in another of 1004; it was
slightly acid, which appears to be the ordinary reaction of nor-
mal sweat; in the course of 24 hours it became neutral, and on
holding over it a rod moistened with hydrochloric acid, a slight
cloud was observed.
On evaporation of my own sweat, as well as that of another
healthy man, the peculiar smell of the axilla was observed, and
an odour of ammonia developed; the presence of this sub-
stance was also indicated by the test to which we have just re-
ferred. On evaporation to dryness, the odour of extractive
matter became perceptible. On triturating a portion of the
residue with free potash, ammonia was developed ; on the addi-
tion of sulphuric acid to another part, sulphurous acid was
first given off, and afterwards a marked odour of acetic acid.
In one instance the odour of butyric acid was so clearly asso-
ciated with that of acetic acid, as to leave no doubt of its
presence.
On boiling the dried residue of sweat with ether, a small
quantity of fat is taken up, which may be isolated by evaporating
the ether, and possesses the peculiar odour of sweat. Alcohol,
on being then added to the residue, becomes of a pale yellow
colour, and is rather strongly precipitated by tannic acid and
acetate of lead,—indications of the presence of alcohol-extract.
On evaporation of the alcohol, chloride of sodium crystallizes in
cubes, and in addition to these cubes, which constitute the
greater part of the salts, and many of which have octohedral
surfaces, there are also long prisms, plates, and fern-like crystal-
line clusters of hydrochlorate of ammonia; the latter, especially, _
is very abundant in sweat that has stood for some time. On
treating a portion of the residue of the salts with sulphuric acid,
there is extricated in the first place some hydrochloric acid in a
state of vapour, and subsequently a decided odour of acetic acid.
SWEAT. 103
If a portion of the residue is incinerated, the ash effervesces on
the addition of hydrochloric acid. On dissolving out the
chlorides with alcohol, and adding bichloride of platinum, we
obtain a slight yellow precipitate. The residue is soluble in
water, with the exception of some gray flocculi, and on the ad-
dition of tannic acid this aqueous solution yields a precipitate,
which shows that the sweat contains-water-extract. The solu-
tion also contains a small quantity of lime, but hardly a trace
of phosphoric acid, and only once, in several trials, was there a
faint indication of sulphuric acid. When the whole residue of
the sweat was incinerated, the amount of phosphate of lime was
_ much larger, and a considerable quantity of sulphuric acid, as
well as traces of peroxide of iron, were always perceptible.
It is true that these are superficial and merely qualitative in-
vestigations ; they are, however, sufficient to establish the ex-
istence, in normal sweat, of
1. Substances soluble in ether: traces of fat, sometimes in-
cluding butyric acid.
2. Substances soluble in alcohol : alcohol-extract, free lactic
or acetic acid, chloride of sodium, lactates and acetates of pot-
ash and soda, lactate or hydrochlorate of ammonia.
3. Substances soluble in water: water-extract, phosphate of
lime, and occasionally an alkaline sulphate.
4. Substances insoluble in water: desquamated epithelium,
and (after the removal of the free lactic acid by-alcohol) phos-
phate of lime, with a little peroxide of iron.
The results of the investigations of other chemists coincide
generally with these conclusions of mine. Berzelius infers
from his analyses of sweat that collected in drops on the fore-
head, that it contains in solution the same substances which
occur in a dissolved condition in the acid fluid of muscu-
lar flesh, together with an excess of chloride of sodium. The
most comprehensive analyses of sweat have been made by Ansel-
mino.! He inclosed the naked arm in a glass cylinder, and
collected the sweat that had exhaled during several experiments:
in the course of five or six hours a table-spoonful had condensed.
A portion was heated with sulphuric acid, evaporated, and
1 Tiedemann’s Zeitschrift, vol. 2, p. 321.
104 THE SECRETIONS :
caustic potash added to the residue; by this means the pre-
sence of ammonia was established beyond a doubt. On digesting
another portion with oxide of lead, and moistening the dried
mass with sulphuric acid, vapours of acetic acid were developed.
A third portion, which was treated with lime water, became
turbid, in consequence of the presence of carbonic acid. For
the purpose of determining the solid constituents, Anselmino
made use of sweat that had been collected by clean sponges from
the vapour-bath ; it was turbid, and had a strong though by no
means a constant odour. After the distillation of a portion of
the filtered liquid in the steam-bath, acetate of ammonia was
found in the fluid that had collected in the receiver. A very
small amount of solid residue (from 0°5 to 1:25) was left after
evaporation of the sweat. Anselmino extracted the solid resi-
due with alcohol of ‘833, evaporated the alcoholic solution
to dryness, and then, by means of anhydrous alcohol, extracted |
from the saline residue an acid, extract-like matter, similar to
the alcohol-extract of flesh, and containing free acetic acid,
acetate of potash, and animal matter precipitable by tannic
acid. Berzelius conceives the free acid of this extract (like the
free acid in extract of flesh,) to be lactic acid. Now I will not
assert that the sweat always contains free acetic acid, but I cer-
tainly have observed cases in which the odour clearly showed
that the free acid was principally the acetic; lactic acid may,
however, still be always present. The occurrence of acetic acid
in sweat is placed beyond a doubt by my experiments. The
matters which are undissolved by anhydrous alcohol are princi-
pally chlorides of sodium and potassium, and spirit-extract ; the
latter is not precipitated by chlorine, protochloride of tin, or
bichloride of mercury. In this investigation Anselmino seems
to have overlooked, as Berzelius remarks, the hydrochlorate and
lactate of ammonia. All that is insoluble in alcohol may be
dissolved in lukewarm water, with the exception of a gray mat-
ter; this aqueous solution contains sulphates and an animal
matter precipitable by tannic acid, and perchloride of tin, (water-
extract.) The gray insoluble matter leaves on incineration a
considerable amount of phosphate, pueiare with a little car-
bonate of lime.
Anselmino has consequently ened at results which entirely
correspond with my own, excepting only that I could not in every
SWEAT. 105
case detect the presence of sulphates in fresh sweat, although
I always found them in the incinerated residue ; from this cir-
cumstance I am led to infer that some of the constituents of
sweat contain sulphur.
In 100 parts of the solid residue of sweat Anselmino found :
Substances insoluble in water and alcohol, chiefly salts of lime . 2:0
Water-extract and sulphates P ‘ . 21:0
Spirit-extract, with chlorides of sodium and si a ‘ 48-0
Alcohol-extract, acetic acid, and acetates (lactates) . : 29°0
These figures must be regarded merely as approximative. In
1000 parts of sweat there are contained, according to Anselmino:
; Water ‘ . . 995-000 987-500
Epidermis and salts of haw ’ ‘ "100 250
Water-extract and sulphates ‘ ‘ 1050 2°625
Spirit-extract, chlorides of sodium and potassium 2°400 6°000
Alcohol-extract, acetates, lactates, and free acetic
acid : ; ‘ : 1450 3°625
From 100 parts of dried residue of sweat Anselmino obtained
22°9 of fixed salts, consisting of carbonates, sulphates, and phos-
phates of soda and (in small quantity) of potash, chloride of
sodium, phosphate and carbonate of lime, and traces of per-
oxide of iron.
The peculiar odour of sweat from different parts-of the body
is dependent in a great measure on the secretion of the seba-
ceous glands in those parts: thus it is well known that the sweat
from the feet of many persons has a very penetrating odour,
that the sweat from the axilla gives off a peculiar ammoniacal
smell, and that the sweat of the external organs of generation
contains and smells faintly of butyric acid.
The gases which are given off by the skin are, according to
Collard de Martigny,' carbonic acid and nitrogen ; they are not
exhaled in constant, but in varying proportions, and generally
in the greatest quantity after meals and after violent exertion.
Collard has observed that an excess of carbonic acid is exhaled
after the use of vegetable food, and an excess of nitrogen after
a nitrogenous diet. Since these gases are contained in a state
' Magendie’s Journal, vol. 10, p. 162.
106 THE SECRETIONS:
of solution in the blood, (see vol. I, p. 135,) it may readily be
conceived that they will exhale at those pomts where the blood
in its passage through the capillaries comes in the most inti-
mate contact with the external atmosphere; at least it seems a
simpler view to regard it as a mere physical process than as a
disintegration of animal matter by the secreting organs. In
fact, the cutaneous exhalation must be regarded, as Edwards
has observed, in the light of a partly physical, partly organic
process. The product of physical exhalation is pure water and
. gas; the product of organic exhalation contains animal consti-
tuents, which must be regarded as secretions of cells.
The amount of exhaled matter is liable to great variations : it
is increased by a dry and light atmosphere; and is lessened
by a moist, vapoury, dense, and calm atmosphere. During and
immediately after meals the exhalation is at its minimum;
it attains its maximum during the actual period of digestion.
The cutaneous exhalation is in antagonism with the urinary
secretion and the pulmonary exhalation, so that an excessive
secretion of urine diminishes the action of the skin, and,
conversely, the renal functions are less energetic when the skin
exhales freely.
On Morbid Sweat.
Our knowledge of the chemistry of normal sweat is very im-
perfect ; but our information respecting the changes which this
secretion undergoes in disease is still more deficient. Our
ignorance may be explained, and in some measure excused, by
the extreme difficulty of obtaining, in a state of purity and un-
adulteration, a sufficient quantity of the secretion for the pur-
pose of forming a successful chemical analysis.
Dr. Piutti, of Elgersburg, has had the kindness to present
me with some sweat which he obtained from persons during
the use of the water-cure, and also with a manuscript communi-
cation containing some analyses of sweat instituted by himself,
which I shall at once proceed to enumerate.
The manner in which he conducted his analyses is not stated.
We observe the absence of salts of lime in these analyses, and
Piutti states that he could find no traces of phosphate or ben-
zoate of lime, the former of which has indisputably been de-
SWEAT. 107
tected by other chemists. Since the phosphate of lime doubt-
less pertains to the epidermis, we may conclude that Piutti
removed all the desquamated cuticle before he commenced his
analyses. All mention of sulphuric acid, and of potash, is
likewise omitted. I have already stated that I only once
detected traces of sulphuric acid in fresh sweat, although I
always found a considerable quantity of it in the incinerated
ash. Piutti has made three analyses of the sweat collected
from invalids. They gave the following results :
1. , 3.
Water : : : 995°5 993-0 994°6
Chloride of sodium ‘ 30 4:0 3°3
Phosphate of ammonia . ‘ az) 8 11
Acetate of ammonia tre ‘ 5 6 5
Hydrosulphate of ammonia ; trace trace
Extractive matters : ; D 1°6 5
The first analysis was made with the sweat of a man aged 36
years, who during twelve years had suffered from atonic gout, and
had been trying the water-cure for ten weeks. The specific gra-
vity of the sweat was 1003°5. The sweat in the second analysis
was taken from a woman aged 54 years, who for six years had
suffered from gout, and who had been under the water-cure for
twelve weeks: its specific gravity was 1004, In the third case
it was collected from a girl .22 years of age, suffering from para-
lysis of the lower extremities, but in other respects blooming
and healthy. The animal matter in this case was of a greenish
colour when isolated ; it was soluble in ether, but not in alcohol.
The specific gravity was 1003.
The sweat that was forwarded to me by Dr. Piutti, and
which was inclosed in ounce-bottles with ground stoppers, was
in a state of decomposition when I received it, and therefore
was not in a proper condition for an accurate qualitative ana-
lysis. It smelt strongly of hydrosulphate of ammonia, espe-
cially a specimen collected from a man who had had psoriasis
diffusa for seventeen years. The gray deposit which was found
in every bottle consisted of desquamated epidermis. The sweat,
to which I have just referred, had a penetrating odour of sul-
1 Berzelius, however, is of opinion that a portion of phosphate of lime appertains
to the sweat itself, and that it is held in solution by a free acid.
108 THE SECRETIONS:
phuretted hydrogen, which continued during evaporation, and
ultimately merged into a nauseous animal smell. Its specific
gravity was comparatively high, being 1008 ; and it yielded 9-9
of solid constituents, which, after being exposed to the influence
of a red heat, were found to consist of a large proportion of
chloride of sodium, carbonate of soda, a little phosphate of lime,
and a fair amount of sulphuric acid.
The statements which we possess from other sources, regarding
the morbid changes of the sweat, are very loose and inconclusive ;
in fact we have no accurate observations on the subject.
1. The quantity of the sweat is sometimes increased in an
: extraordinary degree. 7
Thus critical sweats are usually very abundant, continuous,
and watery, in intermittent fevers, in rheumatic affections, and
in colliquative disorders. :
2. The quality of the sweat is changed.
a. The sweat may be distinguished by a peculiar odour.
The sweat of persons with the itch is said to have a mouldy
odour, while that of syphilitic patients is said to smell sweet.
The sweat of rheumatic and gouty persons has an acid smell,
while in putrid fever and scurvy, it has a putrid odour; in
jaundice it is said to resemble musk in its smell. In Stark’s
‘General Pathology,’ (p. 1126,) we find it stated that the odour
of the sweat in scrofula resembles that of sour beer, while in
intermittent fever it smells like fresh-baked brown bread. The
determination of odours is, however, very subjective, and (with ~
a few exceptions) it is more than probable that different ob-
servers would detect different resemblances.
6. Some of the normal constituents may be abnormally in-
creased.
Ist. The free acid of the sweat may be increased. Lactic
acid, which is the ordinary free acid, is usually increased in
cases of rheumatism and gout; the sweat in these diseases has
a strong acid reaction. When there is also an acid odour,
acetic acid is present. Prout has found free acetic acid in the
SWEAT. 109
sweat of a person suffering from hectic fever. | After an attack
of acute rheumatism, the joints of the feet remained swelled,
for which potash-baths were ordered. These baths, in the
course of three weeks, brought on an attack of eczema, extending
as high as the knee. The sweat from the feet had then a de-
cided odour of acetic acid, which became more strongly developed
when they were sharply rubbed. Anselmino' found free acetic
acid in the sweat of women during their confinement; and, ac-
cording to Stark, the quantity of free lactic acid is increased
in the sweat during scrofula, rachitis, and certain cutaneous
eruptions.
2d. The ammonia of the sweat may be increased. Anselmino
found a larger proportion of (free?) ammonia in the sweat after
an attack of gout than in any other case. Berend? states that
the sweat in putrid and typhus fever is ammoniacal; and in
nervous diseases (?), according to Nauche,? it becomes alkaline.
All sweat with a putrid odour probably contains free ammonia.
3d. The salts may beincreased. Prout* observed that in the
case of a man with dropsy the skin became covered with a white
saline crust of chloride of sodium, after an abundant perspira-
tion. Anselmino found in the sweat, after a severe attack of
gout, more salts than usual. In cases of gouty and urinary
concretions, the quantity of phosphate of lime appears to be in-
creased. ;
c. Abnormal constituents may be present in the sweat.
1st. Albumen has been observed by Anselmino in a critical
sweat, which broke out in large quantity one evening over the
whole body in a case of febris rheumatica, with severe pains in
the joints; on the following day it had disappeared. Stark
asserts that albumen may be found in the sweat in gastric,
putrid, and hectic diseases, and also on the approach of death,
in consequence of the abnormal solution of the solid constituents.
I failed in detecting any certain indications of albumen in
sweat collected (by means of linen washed with distilled water)
from the breast of a person in the colliquative stage of tubercular
phthisis.
! Tiedemann’s Zeitschrift, vol. 2, p. 223. 2 Vorlesungen iiber Semiotik, p. 388.
3 Stark, p. 1127. 4 London Med. Gaz. vol. 15, Oct. 1834.
110 THE SECRETIONS:
2d. Blood or its constituents. Voigtel! observed an instance
of bloody sweat from under the arm of a young man; it ap-
peared after any violent exertion. In scurvy, putrid fever,
and typhus icterodes, bloody sweat has likewise been observed.
3d. Uric acid is stated to have been found in the sweat of
arthritic persons (Stark). Wolff? found that the sweat which
had hardened on the forehead into a solid white substance, (in
a patient with stone in the bladder,) contained uric acid. Urate
of soda is likewise stated to have been found in the sweat of
persons suffering from gout or stone.
4th. Bilin and biliphein have been found in the sweat of
persons with jaundice, and sometimes in such large quantity as
to colour the linen yellow, and to communicate a bitter taste
to the perspiration. According to Berend, the sweat in febris
putrida biliosa likewise contains bile-pigment.
5th. Red colouring matter of the urine (uroerythrin) was found
by Landerer? in sweat from the axilla of a fever patient. A
blue colouring matter, doubtless allied to cyanurin, has occa-
sionally been observed in the sweat. Dr. Bleifuss* has seen blue
sweat from the foot of a patient with disease of the abdomen.
Michel has likewise observed it in an hysterical woman and in
a hypochondriacal man ; it was most marked on the right side
of the body. Billard® observed a blue sweat on the upper part
of the body of a girl.
6th. Fat is stated to occur in colliquative hectic sweats.
d. Substances altogether foreign to the animal organism may
be conveyed, through the process of digestion, into the blood,
and thus occur in the sweat.
Landerer® has observed in his own person that after taking
large doses of quinine, the sweat assumed the bitter taste of the
drug. The following substances enter into, and have been de-
tected in the sweat: sulphur, mercury, iodine, iodide of po-
tassium, assafcetida, garlic, saffron, olive oil, rhubarb, indigo,
prussian blue, and copper. (Stark, General Pathology, p. 1127;
’ Stark, p. 1131. * Diss. sing. casum calculositatis. Tub. 1817.
® Buchner’s Repert. 2d series, vol. 5, p. 234.
4 Wirtemberg. Med. Correspond. Blatt. 1835, No. 26.
5 Froriep’s Notiz. 32. ® Buchner’s Repert. 16, p. 238.
SWEAT. 111
Baumgartner, Elements of Physiology and Therapeutics,
p- 486.)
Many of these statements, regarding the changes undergone
by the sweat in disease, are fully confirmed; some must, however,
still be regarded as doubtful.
Sweat of animals.
Anselmino has analysed the sweat of the horse, the only
animal of whose sweat we have any accurate knowledge. He
used for his analysis the scaly matter that falls from horses
during the process of currying, in the form of a white powder,
and consisting of dried sweat mixed with a considerable amount
of dirt and epithelium. It contained, Ist, a substance with
an acid reaction, soluble in anhydrous alcohol, alcohol-extract,
together with an alkaline lactate or acetate ; 2d, an extract-like
matter, soluble in alcohol of ‘833 and possessing an odour like
that of the horse, together with chloride of sodium; 3d, an
extractive matter soluble in, and communicating a brown colour
to water, and precipitable by infusion of galls, together with
chloride of sodium and sulphates. The portion still undissolved
evidently consisted of epithelium. Anselmino regarded it as
coagulated albumen ; doubtless it was in it that the phosphate
of lime and magnesia occurred, which were recognised in the
ash of the sweat. The ash consisted of sulphates of potash and
soda, chlorides of sodium and potassium, a large proportion of
the phosphates of lime and magnesia, with traces of iron, but
no alkaline carbonates or phosphates. Anselmino seems to
have overlooked the ammonia-salts, for itis only by the presence
of hydrochlorate of ammonia that we can explain how it is
that the ash contains no alkaline carbonate, while the alcohol-
extract contains either lactate or acetate of potash. The pre-
sence of acetic acid was established by a separate experiment.
Fourcroy and Vauquelin sometimes found small quantities of
urea in horses’ sweat, but Anselmino could never detect it.
112 THE SECRETIONS.
Fat.
The minute sebaceous glands (folliculi sebacei) which are
distributed over the whole surface of the body, secrete a peculiar
fat, which renders the skin supple and flexible, and hinders it
from being permeated by water. The composition of this fat
varies in different parts of the body, as is clear from the variety
of smell which it evolves in the axilla, on the generative organs,
on the scalp, and on the feet of many persons. It is usually
of a pale yellow colour, not viscid, and insoluble in water, with
which, when it is rubbed, it forms an emulsion. It contains
relatively only a small amount of true fat, and is associated
with several other animal matters, (as, for instance, albumen
and extractive matter,) and a considerable amount of inorganic
salts. Esenbeck has made an analysis of the fat collected in an
enlarged sebaceous gland. It did not coagulate on boiling, and
was precipitated by acids, corrosive sublimate, and tannin. It
contained in 100 parts:
Stearin ; : : 24:2
Extractive matter, with s some olein . ‘ 12°6
Salivary matter : ; ; : 11°6
Albumen with casein (?) 5 ; : 24°2
Phosphate of lime ; : : ‘ 20:0
Carbonate of lime , : ; ; 21
Carbonate of magnesia : 1:6
Traces of acetate of soda, chloride of sodkieen,. and loss . 37
113
CHAPTER VII.
THE URINE.
THE urine is an extremely complex fluid, but the relative
proportions of its different constituents are not very variable.
The following are the ordinary constituents of healthy human
urine: urea; uric acid; [hippuric acid]; extractive matters,
embracing alcohol-extract, spirit-extract, and water-extract,
with their respective constituents; mucus; brown colouring
matter of the urine (hemaphezin) ; red colouring matter of the
urine (uroerythrin) ; carbonic, lactic, hydrochloric, sulphuric,
phosphoric, silicic, and hydrofluoric acids;'’ ,soda; potash ;
ammonia; lime; magnesia; and peroxide of iron.
Recently discharged urine ordinarily possesses the mean tem-
perature of the body; it is of an amber yellow colour, perfectly
transparent, has a well-marked acid reaction, and exhales a
peculiar but not disagreeable odour, which it loses on cooling.
Its specific gravity fluctuates from 1005 to 1030, the average
being about 1012°5. It has a saline and disagreeably bitter
taste ; it undergoes no apparent change upon being heated to
the boiling point, and its behaviour towards reagents is depen-
dent upon that of its various constituents, although modified by
the very dilute state in which they occur. Acids, with the
exception of the oxalic, which produces a turbidity, throw down
no precipitates ; the free alkalies, on the contrary, throw down
the phosphate of lime; the salts of baryta, silver, and lead,
cause precipitates ; so also does tannin, but in a less degree.
_ When urine is left to itself for some time, slight nebule, con-
sisting of mucus, are formed in it, which gradually descend to
the bottom. Soon after the appearance of this phenomenon,
an unpleasant odour is developed; instead of an acid, an alkaline
1 [In addition to these constituents, two new acids, to which no names have been
yet assigned, have been described by Pettinkofer and Heintz. ]
II. . 8
114 THE SECRETIONS :
reaction is observed, and carbonate of ammonia is formed,
which causes more or less turbidity by precipitating the am-
moniaco-magnesian phosphate, and phosphate of lime. A
portion of these salts, associated with mucus, forms a greasy
whitish scum, in which, by means of the microscope, beautiful
crystals of ammoniaco-magnesian phosphate may be seen, mixed
with an amorphous mass of phosphate of lime and decomposed
mucus. On treating the urine in this state with hydrochloric
acid, it effervesces, in consequence of the presence of carbonate
of ammonia. If the urine is allowed to stand for a still longer
period, the smell becomes more disagreeable ; cubic, and four-
and six-sided prismatic crystals, composed of chloride of sodium,
hydrochlorate of ammonia, and phosphate of soda and ammonia,
are produced in consequence of the concentration produced by
the spontaneous evaporation, and the urine ultimately becomes
covered with a sort of mould, which is usually of a blue or
blueish-gray colour.
We have no certain knowledge regarding the manner in
which the acids and bases combine to form salts in fresh healthy
urine. We may fairly conclude that the chloride of sodium
preexists in it; the sulphuric acid is generally supposed to be
united with potash, phosphoric acid with lime and magnesia,
and ‘if (as is generally the case) more phosphoric acid be present
than is required for the saturation of these earths, the excess
combines with soda; and if there be not sufficient soda present
to effect the saturation of the acid, the ammonia combines with
it, forming the biphosphate of ammonia. The lactic acid of the
urine is partly free, and partly combined with ammonia, potash,
and soda. Hydrochlorate of ammonia is also supposed to pre-
exist in the urme. Carbonic acid, when it occurs in the urine,
is held in solution and in a free state. Uric! acid is supposed
by Berzelius to exist in a free state in solution in the urine,
although warm urine usually holds a larger quantity of uric acid
in solution than an equal quantity of water at the same tempe-
rature could retain. There is, however, this point in favour
of his view, that the uric acid, which separates spontaneously
from the urme on cooling, contains mere traces of ammonia
1 [It is stated in volume I, page 54, that the formula for hydrated uric acid is
C,,.N,H,0,+HO. From various analyses of urates by Bensch (Liebig’s Annalen,
vol. 54, p. 189), there is reason to believe that the true formula is C,N,HO,-=-HO.]
URINE. 115
and soda, and he conceives that, in all probability, the uric acid
is held in solution through the agency of some of the other con-
stituents of the urine.
[Liebig’ has shown that uric acid possesses the property of
combining with a portion of the soda of the alkaline phosphate
of soda, and acquires in the combination a higher degree of
solubility than it possesses in its uncombined state, at the ordi-
nary temperature of the body. By this reaction there are
produced a urate of soda and an acid phosphate of soda. |
Prout, on the contrary, is of opinion that the uric acid is held
in solution in the urine in the state of urate of ammonia, a
combination which probably always occurs in healthy urine, and
which is often found in large quantity in the urine of diseased
persons, giving rise to the formation of sediments. The real
state of the case may be, that normal urine contains both free
uric acid and urate of ammonia.
Qualitative analysis of healthy urine.
The qualitative analysis of healthy urine seldom presents any
_ great difficulty. Many of its constituents may be detected with
ease, unless, as is sometimes the case, they exist in very minute
quantity. Others, as for instance, the extractive matters, can
only be detected with any degree of certainty by isolating them,
in the same manner as is done in quantitative analysis.
The analysis of the urine is something like that of mineral
waters ; some of the constituents may be at once recognised by
the addition of a test, while we can only be assured of the pre-
sence of others, by separating them in a distinct and _ iso-
lated state. :
The specific gravity of the urine is most accurately deter-
mined by the ordinary 1000-grain glass bottle. An areometer
will give the result with less trouble, but, at the same time,
with less accuracy.
Becquerel? has published a table for the purpose of enabling
us to calculate the amount of the solid constituents in a known
weight of urine, from the observed specific gravity, [but it has
1 Lancet, June 1844. 2 Séméiotique des Urines, p. 17. -
116 THE SECRETIONS:
been proved to give results on which no dependance can be
placed.?]
1. Urea. This constituent seldom occurs so abundantly
in the urine, as to be immediately detectible by the addition
of any reagent. A portion of urine is usually evaporated in
the water-bath to the consistence of a syrup, anhydrous al-
cohol is added, and the alcoholic solution is filtered, and eva-
porated on the water-bath nearly to dryness; some drops of water,
and subsequently of nitric acid are added, upon which crystals
of stellar and foliated shapes very speedily develop themselves.
Upon leaving the alcoholic extract to spontaneous evapora-
tion, long acicular crystals of urea will be formed ; on examining
some of them under the microscope, they will be found to pre-
sent the appearance of four-sided prisms, as shown in figure 20,
If, (which however is not often the case,) the urea should be
present in very small quantity, and no crystals are formed for
some time after the addition of nitric acid, it only requires a
microscopic examination to ascertain whether the crystals are
those of nitrate of urea: if they are, they will occur in the
forms indicated in fig. 21. If, instead of nitric, oxalic acid has
been used for the detection of the urea, we obtain the forms
represented in fig. 22. z
2. Uric acid. It is but seldom that the uric acid exists in —
such large amount, as to be precipitated in the form of a fine
crystalline red sediment when the urine cools. When, how-
ever, this is the case, the crystals, under the microscope, exhibit
the rhomboid form shown in fig. 23. Another method of
proving that the sediment consists of uric acid, is to place some
of it in a porcelain capsule moistened with nitric acid, and
to apply heat till the acid evaporates. A purple-red colour then
appears, which is characteristic of uric acid: this colour becomes
more intense on -the approximation of a rod dipped in ammonia.
If no crystalline sediment is deposited as the urine cools, two
or three drachms of hydrochloric acid must be added to six or
eight ounces of urine, and the mixture must be allowed to
' [On the specific gravity of the urine in health and disease, especially in diabetes
and granular degeneration of the kidneys. By George E. Day. Lancet, June 15> —
1844. ] .
URINE. 117
stand, covered, for twenty-four to forty-eight hours. A red or
reddish-brown sediment of uric acid then separates, consisting
of crystals of the forms represented in fig. 23a, and 230.
2*, [Hippuric acid is regarded by Liebig! as an invariable
constituent of ordinary human urine. “ All the urine taken
in this country from individuals living upon a mixed animal
and vegetable diet, contains hippuric as well as uric acid, and
about the same proportion of both acids. Hippuric acid may
be obtained in the following manner, even from proportionally
small amounts of fresh urine :—Fresh urine is evaporated in a
water-bath to the consistence of a syrup; it is then mixed with
some hydrochloric acid, and agitated with its own volume of
ether, which latter substance dissolves the hippuric acid. It
usually happens that the mixture does not separate spontane-
ously, but that the ether remains inclosed by the fluid, like
froth ; the separation of the ether takes place immediately upon
adding to the mixture, after having allowed it to stand at rest
for an hour, one twentieth part of its volume of alcohol. In
this case the froth disappears, and the fluid separates into two
layers ; the upper layer contains the hippuric acid in solution;
but besides it also contains urea, owing to the addition of the
alcohol. This upper layer is carefully removed by means of a
pipette or syphon, and agitated with small portions of water ;
the water removes the alcohol and the urea, whilst the hippuric
acid remains in solution in the ether. By evaporating the
ethereal solution the hippuric acid is obtained in crystals. The
crystals produced are usually of a yellowish or brown colour,
arising from the presence of a resinous substance, which may be
easily and completely removed by means of charred blood.?
1 Lancet, June 1844.
2 [The following is asimple method of obtaining pure crystals of hippuric acid
from human urine. Evaporate the urine till there is a copious deposition of salts.
Add strong alcohol, and place the mixture in a stoppered bottle. With the aid of a
gentle heat, (for instance, by placing the bottle in warm water), we ensure the solu-
’ tion of the urea, the lactates (if any are present) and the hippurates in the alcohol,
whilst the urates remain with the insoluble constituents. When the supernatant
fluid is perfectly clear, it must be decanted, evaporated very nearly to dryness, and
redissolved in hot water. Ifa stream of chlorine be passed through the aqueous
solution, the urea is destroyed; and by gradual concentration, and the addition of a
little free mineral acid, we obtain crystals of hippuric acid. ]
.
118 THE SECRETIONS:
_ “In its pure state the hippuric acid produced from human urine
presents the same long, shining, transparent, four-sided ob-
liquely-truncated prisms, by which the hippuric acid produced
from the urine of animals is so easily detected and distinguished
from benzoic acid. (See fig. 23.) The hippuric acid of human
urine is not volatile at the subliming temperature of benzoic
acid; at a higher temperature it undergoes fusion, forming a
brown-red liquid, and yielding upon dry distillation the same
products which common hippuric acid forms under the same
circumstances, viz., a red-coloured oil smelling like tonka-beans,
ammonia, benzoic acid, and a copious residue of carbon. It
dissolves in nitric acid at a high temperature, and yields, upon
cooling, crystals of benzoic acid, owing to the decomposition
which it undergoes.
“From 0-499 of hippuric acid produced from urine, 10791
of carbonic acid and 0°2317 of water were obtained. This gives
for 100 parts— i
Found. Calculated.
Carbon . , ; 59°47 ‘ : 60°89
Hydrogen F : 5°15 . ‘ 4°45
This analysis corresponds sufficiently with the calculated results
to remove all doubt as to the nature of the acid ; it will be per-
ceived that it contains 10 less carbon than benzoic acid.’ |
3. Extractive matters. The exhibition of the divisions of ex-
tractive matter, namely, the water-extract, the spirit-extract,
and the alcohol-extract, can only be effected by evaporating the
urine, and treating it with alcohol, as we shall presently show
in speaking of the quantitative analysis of this fluid. Little
has yet been done in this department of chemistry, but the
presence of the extractive matters can generally be easily re-
cognized by the addition of certain tests: for instance, acetate of
copper, chloride of tin, perchloride of iron, and sulphate of prot-
oxide of iron, throw down precipitates from freshly-passed urine; °
and bichloride of mercury, nitrate of tin, and tannic acid, cause
a degree of turbidity. There is, however, no certain proof, al-
though there is every probability that normal urine in all cases
behaves in this way with the above tests. The extractive mat-
URINE. 119
ters which I formerly separated from the urine were not precipi-
tated by the salts of iron, while, on the contrary, its perchloride
throws down a copious precipitate in a specimen of urine, which
I am now analysing.
Berzelius states, that after urine has been neutralized by an
alkali, precipitates are induced by the salts of zinc, tin, and
mercury: I find that fresh urine, with a strong acid reaction,
becomes clouded or deposits a sediment upon the addition of
these salts.
4. Mucus. Mucus in the urine is readily detected by the
microscope. We take up with a spoon a portion of the sepa-
rated nebulous matter, and on placing it on the object-glass we -
can easily recognize the mucus-granules, and frequently a few
epithelium-scales.
5. Hemaphein. It is this constituent which gives to healthy
urine its amber or brownish-yellow colour. The variations in
the tints of the urine are dependent upon the quantity of this
colouring matter.
[Scharling! has recently examined the brown organic matter
which gives the colour to inspissated urine, and seems also to
be the source of its peculiar odour. By treating urine con-
centrated by the application of a freezing mixture, with ether,
and evaporating, he obtained a brown fusible resinous mass,
which he calls oxide of omichmyle, and supposes to contain a
radical, omichmyle, the composition of which is still unknown.
It has a strong odour of castoreum, and when heated smells
like urine. It dissolves in alcohol, forming a solution that
reddens litmus. It burns with a clear flame, leaving scarcely
any ash. |
6. Uroerythrin. This red colouring matter exists only in
very small quantity in healthy urine, and cannot be easily de-
tected by tests. It is always associated with uric acid, and
seems to increase and decrease in the same proportion as that
constituent. It is precipitated with the uric acid and urate of
’ Ann. der Chemie und Pharmacie, vol. 42, p. 265.
120 THE SECRETIONS:
ammonia, to the former of which it appears to enact the part
of a mild base, imparting to it a more or less deep red colour,
This constituent can therefore be detected by the addition of
hydrochloric acid to the urine, in the manner already described
in speaking of uric acid. In some few diseased states, we find
a gray or yellow precipitate of uric acid, as if this constituent
was present in large quantity, while the uroerythrin was defi-
cient: on the addition, however, of hydrochloric acid, dark
coloured uric acid is soon precipitated.
7. Carbonic acid is probably a constituent of healthy urine,
existing in a state of solution: in order to detect it, fresh urme
must be warmed in a retort, the neck of which rests a few lines
under the surface of lime-water. The presence of carbonic
acid renders the lime-water turbid. In order to guard against
the production of carbonate of ammonia, we must take care
that the urine is not submitted to too powerful a heat, and
that the distillation is not carried too far. 7
[The following method is far less liable to give erroneous re-
sults. It is founded on the principle that one gas passed through
a solution of another will displace it, so that hydrogen or ni-
trogen will liberate carbonic acid and dissolve in its place. A
series of Wolfe’s bottles must be arranged, so that hydrogen
gas evolved in the ordinary manner from the first shall pass
through a strong solution of caustic potash to free it from any
carbonic acid that may be mixed with it, and then through an-
other bottle containing lime-water, in order to certify its purity;
in the next bottle through thé urime to displace the gas dis-
solved in it, and, finally, through lime-water a second time, to
show if the displaced gas were carbonic acid or contained it. |
8. Lactic acid is always present in the urine, imparting to
it an acid reaction. It may be presumed that the carbonates
which are left upon the incineration of the solid residue of the
urine correspond to the lactates, because lactates with fixed
bases are transformed into carbonates by incineration, and
because the other salts which occur in the urine, the sulphates,
phosphates, and hydrochlorates, are not similarly changed. It
may, however, happen that no carbonic acid is found in the
URINE. 121
ash, although there has been a large proportion of lactic acid
in the urine ; for if the urine contained only free lactic acid, or
lactate of ammonia, or even the lactates of soda and potash, at
the same time with phosphate of ammonia or chloride of ammo-
nium, the ash might be devoid of carbonic acid, in consequence
of the liberated phosphoric or hydrochloric acid uniting with
the base.'
In this case the lactic acid would have to be determined
analytically. The alcohol-extract of the urine contains both
free lactic acid and alkaline lactates ; after dissolving it in ab-
solute alcohol, precipitating the bases by sulphuric acid, filtering,
evaporating the alcohol, dissolving the residue in water, and
digesting the acid solution with oxide of zinc, we obtain a lac-
tate of zinc, which may be decomposed by free baryta. This is
certainly a very tedious proceeding for the mere qualitative de-
termination of lactic acid, and need never be adopted: since,
as far as I am aware, the ash (more especially the ash of the
spirit-extract,) always contains carbonates, and as the presence
of lactic acid in healthy urine has been sufficiently proved by
- Berzelius.
[It is well known that Liebig denies the existence of lactic
acid and the lactates in the urine ; and as the subject has re-
cently attracted much attention, I have thought it advisable to
state the grounds upon which that chemist has arrived at his
conclusions. “ Lactic acid,” he observes, “is a non-nitrogenous
substance. Nothing has hitherto been observed tending to show
that it may be produced from the elements of a nitrogenous
substance, by the decomposition of such a substance and the
transposition of its elements. In every instance where the for-
mation of lactic acid has been observed, the result of careful
examination has proved the presence of a non-nitrogenous sub-
stance of an identical, or, at least, similar composition with
that acid.
1 [It has been recently shown by Dr. Golding Bird that an alkaline acetate (and
the observation applies equally to a lactate) may exist in a solution of phosphate of
soda in considerable quantity, and yet yield no carbonate by ignition. The reaction
is explained by the equation :
NaO, C, H, O,4-HO, 2 NaO, PO,=3 NaO, PO,+CO,, HO+C, H, 0.
(Lond. and Edin. Phil. Mag., June 1845.)]
122 THE SECRETIONS:
“These observations would seem to render the formation of
lactic acid in the body of the herbivorous and graminivorous
animals, which take starch and sugar in their food (substances
from which lactic acid may be formed), not merely possible,
but in many cases highly probable; and yet, strange to say,
chemists have hitherto attempted in vain to detect lactic acid in
the urine of the cow and of the horse. The urine of the cow
or horse has no acid reaction ; on the contrary, its reaction is
strongly alkaline ; it contains carbonated, hippurated, or ben-
zoated alkali, or alkalies combined with mineral acids, but no
trace of any /actate.
“Tn contrast with this, the urine of man, and of carnivorous
animals, manifests, when in a healthy state, a strongly acid re-
action. Now, it is precisely in analyses of the blood and urine
of man, and of carnivorous animals, that we find lactates men-
tioned as constant constituents ; not because they have in reality
been detected in these fluids—for no one has as yet succeeded
in producing lactic acid therefrom—but because, upon examin-
ing the aqueous and alcoholic extracts of blood and urine, some
non-crystalline matters have been found which sometimes mani-
fested an acid reaction, and upon incineration left a carbonated
alkali as a residue, thus presenting a remote similarity in deport-
ment to the alkaline lactates.
“ From what substance could lactic acid be formed in the
body of carnivorous animals? With the exception of fat, they
partake of no non-nitrogenous matter in food, no substance, in
fact, so far as we know, capable of producing lactic acid. Car-
nivorous animals partake of no sugar, no starch, no gum, no
mucus; there is a total absence of the non-nitrogenous sub-
stances which form so large a part of the aliments of herbivorous
and graminivorous animals.
“ The assumption, @ priori, that neither the blood nor any
other fluid in the body of carnivorous animals can possibly con-
tain any lactic acid, has been positively established by the ex-
periments of Enderlin, (Annalen der Chemie und Pharmacie,
vols. 49 and 50.) Finally, Pelouze has proved that the experi-
ments of Henry, who pretended he had detected lactate of urea
in urine, are erroneous, and by no means to be relied upon.
“ Consequently, as our knowledge of this subject stands at
present, the acid reaction of urine cannot proceed from lactic
URINE. 123
acid. And although processes of transposition take place in
the healthy animal body, rendering insoluble substances soluble
in the stomach and bowels, yet these processes are of a different
kind from that process of putrefaction of casein in milk which
causes the formation of lactic acid.
“ Direct experiments prove that fresh urine, of a strongly
acid reaction, and taken from various healthy individuals, when
cautiously neutralized with baryta water, does not retain in so-
lution the least detectible trace of baryta. Now, as lactate of
baryta is readily soluble in water, the urine would certainly, and
of necessity, contain baryta, if its acid reaction were really owing
to the presence of lactic acid. Upon the addition of the very
first drop of the baryta water to urine an extremely copious pre-
cipitate is formed; this precipitate contains urate and phosphate
of baryta and of lime, but no detectible trace of baryta is found,
even although only just so much baryta water is added as to
leave the urine still possessing a feebly acid reaction.
“ Carbonate of magnesia and calcined magnesia act upon
urine in precisely the same manner. If either of these sub-
stances be mixed with water, so as to form a milky fluid, and be
then added to urine with an acid reaction, the acid reaction
will immediately cease, and a very considerable white precipi-
tate be formed. The fluid now manifests a feebly alkaline re-
action, and contains a trace of magnesia in solution. It is a
remarkable circumstance that magnesia withdraws the phos-
phoric acid from the urine so completely, that a mixture of per-
chloride of iron and acetate of potash no longer indicates a trace
of phosphoric acid in the urine which has thus been treated with
magnesia.
“ Had lactic acid been the solvent of the lime and magnesia
present in the urme, one would have expected that a corre-
sponding amount of baryta, or of magnesia, would have taken
its place upon its separation. But, as I have already observed,
not a trace of baryta is found in solution when that substance
has been employed for neutralizing the acid, and only a slight
trace of magnesia when it has been used for the same purpose.
“ But as urine contains a certain amount of alkaline phos-
phates, i. e. phosphate of soda and phosphate of potash, and as
baryta and magnesia form, with phosphoric acid, insoluble
124 THE SECRETIONS :
salts, it might have been supposed that the neutral lactates
formed upon the neutralization of the urine with the two bases
had been decomposed, together with the phosphates of soda and
potash contained in the urine, and transposed themselves anew,
with these substances, into phosphate of baryta or of magnesia,
and into neutral lactate of potash or soda. In this case neither
baryta nor magnesia could remain in solution. This cireum-
stance, therefore, renders these experiments indecisive, and
leaves the question as to the presence or absence of lactic acid
in urine dependent upon more direct experiments,
“ T employed putrid urine in my attempts to detect lactic
acid, because lactic acid is not destroyed by putrefaction, and it
must, therefore, of necessity be present in putrid urine if it
really forms a constituent of fresh urine ; and because if lactic
acid can at all be formed by the putrefaction of urine, from
matters containing previously no lactic acid, the question whether
lactic acid is to be reckoned among the constituents of normal
urine is at once practically decided; or, more correctly speak-
ing, the problem is proved to be impossible of solution, since
we possess no means of positively determining which urine may
be considered of a normal constitution, and, on the contrary,
which is, to this extent, abnormal.
« As matters at present stand, therefore, with regard to this
subject, it was immaterial whether the presence of lactic acid
was detected in fresh or in putrid urine ; if it was found to exist
in the latter, this fact must be considered as a confirmation of
Berzelius’ examination of fresh urine ; whilst its absence from
putrid urine would justify us positively in asserting that it does
not form a constituent of fresh urine ; and, moreover, that urine
contains no substance giving origin, my means of putrefaction,
to the formation of lactic acid.
“« T have come to the latter conclusion. I have found it im-
possible to detect the presence of lactic acid in putrid urine ;
and if we examine somewhat more closely and minutely the
experiments made by Berzelius, and from which he inferred the
presence of lactic acid in urine, we find that not one of them
amounts to a positive proof that lactic acid really forms a con-
stituent of fresh urine.
* The experiments which I made for the purpose of ascer-
URINE. 125
taining the presence of lactic acid in putrid urine are the
following :
“ Putrid urine was first evaporated over an open fire, and
afterwards to dryness in a water-bath ; the residue was treated
with a mixture of alcohol and sulphuric acid, which caused the
solution of phosphoric acid, hydrochloric acid, and of lactic acid
also, if this latter substance were really present. The fluid ob-
tained was saturated with oxide of lead, and then filtered off
from the phosphate, sulphate, and chloride of lead formed ; the
lead contained in solution in the filtrate was separated by means
of sulphuretted hydrogen. The solution thus freed from lead,
and which ought to have contained the lactic acid had there
been any present, was evaporated in a water-bath, and the re-
sidue treated with alcohol: a quantity of common salt remained.
In order to remove the soda from the alcoholic solution, efflo-
resced oxalic acid was dissolved in the latter, at a high tempe-
rature, and the oxalate of soda formed was separated from the
fluid by filtration; the fluid was then saturated with oxide of
lead, which again gave rise to the formation and separation of
chloride of lead. The solution was, by means of sulphuretted
hydrogen, again freed from the lead which had. dissolved, then
concentrated in the water-bath, and basic acetate of lead added.
in excess ; a copious white precipitate was formed, from which
the fluid was filtered off. This fluid must contain the lactic
acid if any had been present in the urine; the lead which this
fluid held in solution was precipitated by means of sulphuretted
hydrogen, the fluid filtered off from the precipitate, concen-
trated in the water-bath, and boiled with hydrate of baryta:
a quantity of ammonia was expelled by this operation. After
the decomposition of the ammoniacal salt the new-formed salt
of baryta was cautiously decomposed, by means of sulphate of
zine, and every possible means was applied to obtain from this
fluid crystals of lactate of zinc, but without success ; no trace
could be discovered.
« The white precipitate obtained by means of the basic acetate
of lead contained hydrochloric acid, and a brown resinous sub-
stance, which, upon combustion, comported itself like an ani-
mal substance.
“ In other experiments the putrid urine was boiled until all
the carbonate of ammonia it contained was completely expelled ;
126 THE SECRETIONS:
then, with addition of hydrate of lime to destroy the remaining
salts of ammonia, evaporated to dryness, and the residue treated
with cold water, which must have dissolved lactate of lime had
any lactic acid been present in the urime. The aqueous extract
was evaporated to dryness, and the residue again treated with
alcohol ; the fluid obtained contained a copious amount of lime
combined with an organic acid ; the lime was then removed by
the addition of oxalic acid, and the excess of oxalic acid by
the addition of oxide of lead; the minute trace of dissolved
oxide of lead was removed by means of charred blood. The
fluid obtained was very acid; it contaimed hydrochloric acid,
which was removed by the addition of oxide of silver; a por-
tion of the fluid filtered off from the hydrochlorate of silver
was saturated with oxide of zinc, and left to crystallize, but no
lactate of zinc was obtained; the fluid settled into a dark-
coloured resinous mass. Another portion of this acid fluid was
evaporated in the water-bath ; a quantity of acetic acid was ex-
pelled during the evaporation, and there remained at last only
a very minute amount of a resinous matter, which upon calcina-
tion emitted a very fetid odour.
“ All the other experiments, which I made in order to detect
lactic acid in putrid urine, and a detailed description of which
would be as tedious as useless, gave the same negative result.
These experiments were usually made upon quantities of from
forty to fifty pounds of urine, so that even a very minute
amount of lactic acid, if really present in the urine, could not
have escaped detection. All these experiments indicated the
presence of an organic acid, but after the removal of all the
inorganic acids and bases contained in the urine, this acid
turned out to be a mixture of acetic acid with a brown resinous
substance rich in nitrogen.
“The presence of acetic acid in putrid urine does not warrant
us to infer that this acid is present also in fresh urine ; on the
contrary, the experiments made with regard to this matter
prove that fresh urine contains no acetic acid. I have treated
it exactly in the same manner as putrid urine, and have, by,
distillation with oxalic acid, obtained a fluid of a strongly resi-
nous odour, but not possessing any acid reaction. When em-
ploying sulphuric acid and hydrochloric acid the distillate was
acid, but the acid reaction proceeded from hydrochloric acid.”
URINE. 127
In the analyses of Lehmann, to which we shall presently re-
fer, the lactic acid is determined quantitatively in a large
number of cases. The following independent investigations of
Heintz and Pettinkofer are important, as offering a clue to the
real nature of the crystals assumed by Lehmann and other
chemists, to consist of lactate of zinc.
In the observations of Liebig, quoted above, it is assumed
that as lactic acid is not destroyed by putrefaction, it cannot be
altered in putrefied urine. Heintz conceived that during the
putrefaction of the urine certain causes might prevail to cause
the destruction of the lactic acid, and in order to determine the
point he instituted the following experiment.
* About fifty pounds of fresh urine, obtained from several
young healthy men, were first evaporated over a free fire, and
then in the water-bath ; the extract obtained exhausted with
alcohol, to which a sufficient quantity of dilute sulphuric acid
had been added, The acid solution was saturated with oxide
of lead, the precipitate filtered, the liquid much evaporated, and
the urea contained in this concentrated solution precipitated
with pure oxalic acid. A considerable quantity of oxalate of |
urea was obtained, which, after washing with water and re-
crystallization, separated in perfectly white, large crystals. The
liquid, separated by pressure from the urea, from which it was
now almost free, was evaporated to dryness, extracted with
alcohol, and effloresced oxalic acid added to the solution to re-
move the soda. The oxalate of soda was separated by filtration,
the filtered solution saturated with oxide of lead, and then pre-
cipitated with basic acetate of lead. The lead was removed
from the filtered liquid by sulphuretted hydrogen; the filtered
solution was concentrated over the water-bath, and boiled with
hydrate of baryta, when a considerable disengagement of am-
monia resulted. The salt of baryta obtained in solution was de-
composed with sulphate of zinc, in such a manner that only a
slight excess of this latter remained in the solution. It was
then evaporated to a small volume, when some delicate micro-
scopic crystals separated, which were at first taken for lactate
of zinc, but on examination under the microscope they soon
proved to be distinct. The lactate of zinc, for instance, forms
needles with acute dihedral summits, while the crystals of the
zinc salt obtained from the urine have truncated terminal sur-
128 THE SECRETIONS:
faces. To ascertain more precisely the nature of the acid
combined with the oxide of zinc in this salt, the crystals were
separated as carefully as possible from the mother-ley, pressed
between blotting-paper, dissolved in a large quantity of boiling
water, in which they were but sparingly soluble, and allowed to
crystallize by cooling. The mother-ley afforded more crystals
on further evaporation. They were again separated from ad-
hering liquid by pressure.
“The zine salt thus obtained had a faint greenish-yellow tint,
and was therefore probably not quite pure, although its solution
was perfectly colourless. The acid was isolated from this salt
by means of sulphuretted hydrogen; after separation of the
sulphuret the solution was entirely free from zinc. The liquid,
which had a strong acid reaction, was freed by boiling from the
excess of sulphuretted hydrogen, and evaporated on the water-
bath. When it had become sufficiently concentrated, the acid
separated in prismatic crystals, which appeared to form quadri-
lateral rectangular columns and tables. It is easily soluble in
water, and separates in crystals on evaporation; the solution has -
a strong acid taste, and reddens litmus-paper. It likewise dis-
solves in alcohol, but not quite so easily as in water; ether
dissolves scarcely a trace of it. Heated on platinum foil it melts,
becomes brown, and leaves behind a coal, which is difficult of
combustion, but which disappears entirely by stronger heat.
“From the mode of preparation it is evident that the acid
forms with oxide of zinc a very sparingly-soluble salt, which
separates in microscopic crystals. When the acid is supersatu-
rated with ammonia, and the solution evaporated on the water-
bath, so much ammonia escapes that it again becomes acid ; if
it be evaporated to dryness, so that all the ammonia that could
escape at this temperature is expelled, and caustic potash be
added to the mass, a considerable quantity of ammonia is
given off ; therefore it appears that this acid, like many organic
acids, forms acid salts. The ammonia-salt obtained in this
manner is somewhat more difficult of solution in water than the
acid itself. When the acid is accurately neutralized with pot-
ash, it forms an easily-soluble salt, the solution of which affords
no precipitate with sulphate of copper. The oxide of copper is
not thrown down from this mixture by an excess of potash, but
the colour of the solution becomes somewhat darker. Acetate
URINE. 129
of lead produces a slight turbidity, most probably arising from a
small quantity of some impurity. No precipitate is obtained
with nitrate of silver, and the mixture, after having been ren-
dered ammoniacal, is not altered by boiling. 4°45 15°29
Chloride of ammonium j é 1:50
Phosphate of lime and magnesia : : 1-00
Silicic acid ° . 0°03)
I have made two analyses of the urine of a healthy man,
aged 33 years, of a decidedly sanguineous temperament, whose
digestion and nutrition were not very good. 1000 parts
contained :
Analysis 93. Analysis 94.
Specific gravity F - 1011 1012
Water 3 . - 963°20 956°00
Solid residue ‘ - 36°80 44:00
Urea F ‘i - 12°46 14'578
Uric acid 0°52 0-710
Alcohol-extract, with free
lactic acid J 5°10) . 4:800 Ext. mat. &
Suisit-dktract 2-60 Extractive matter 5590 amm.-salts.
, Water-extract and vesical — mates tin
mucus ° 1:00 { ~ 2°550
Lactate of ammonia . 1:03
Chloride of ammonium . 0°41)
Chloride of sodium Ss 5°20) 27°280
Sulphate of potash ‘ 3°00 ot
Phosphate of soda : 2°41 : 2°330 ;
Phosphates of lime and 0°58 . ict 0°654 { cacti
magnesia ; |
Silicic acid ‘ . a trace J a trace J)
_ | Thierchemie, p. 458.
2 This includes the lactate (carbonate) of soda and a little sulphate of potash.
144 THE SECRETIONS:
I have analysed the urine of the same man upon three other
occasions under the following circumstances. A represents
urine passed upon rising in the morning, after having drunk
several glasses of water the previous evening. After drinking
coffee and a glass of water, such violent exercise was taken for
two hours, that the pulse rose to above 100, with occasional
intermissions ; the urine B was then voided. Half an hour af-
terwards the urine C was discharged. In all three cases the
urine was clear, B being the most slightly tinged. They all
had an acid reaction, that of C being the strongest, and of B
the weakest. The analyses, in which, however, all the prox-
imate constituents were not determined, gave the following
results :
Analysis 95. Analysis 96. Anal, 97,
A. B. C.
Specific gravity : ‘ - 1010 1008 1014
Water : ; : 972-600 981-000 957-600
Solid residue ‘ < ; 27°400 19-000 =—--42400
Urea : 8-402 7°568 15257
Uric acid, extractive matter, ammonia-
salts, and chlorine compounds . 13960 8°618 19-140
Phosphate of soda ‘ - 1-850 1°250 2-750
Sulphate of potash ‘ 4 2°790 2-200 5°000
Phosphates of lime and magnesia . 0°479 0°264 0°656
C. G. Lehmann has likewise made some very minute analyses
of the healthy urine of a young well-fed man, [himself in fact. ]
These analyses approximate closely in their results to those of
Berzelius. They were made with the collected urine of the
past twenty-four hours. The concentration of the fluid may
be explained by the circumstance of the young man by whom
the urine was passed, taking only a very little drink, as is the
usual habit with persons of the sanguineo-bilious temperament.
1, 2. 3.
Water ; ; , - 937°682 934-002 932°019
Solid residue ‘ : - 62°318 65998 - 67:981
Urea ‘ ° ‘ - 931°450 32°914 32°909
Uric acid. - ; ; 1-021 1-073 1-098
Lactic acid . 2 j 1-496 1°551 1°513
Water-extract ‘ A 5 0-621 0°591 0°632
Spirit- and alcohol-extract - 10°059 9°871 10°872
Lactates 1-897 1-066 1-732
Chlorides of sodium and ammonium _—3-646 ~ 3602) 4 3712) 5
Alkaline sulphates ; ; 7314 (38 7:289 |= 732142
Phosphate of soda : 3°765 (6 3°666 (5 3°989 (>
Phosphates of lime and magnesia ee: ite Bax rTs7y 1-108) ™
Mucus 5 5 é : 0-112 0-101 0-110
URINE. 145
Christison! published an analysis of healthy urine, in which,
however, he did not enter into very minute details. The
specific gravity was 1029. In 1000 parts, he found 67:7 of
solid residue, of which 55:2 were composed of urea, extractive
matters, and lactates, 11:1 of alkaline chlorides, sulphates and
phosphates, 1-0 of earthy phosphates, and 0:4 of mucus. Hence
100 parts of the solid residue contain about 40 urea, 16 fixed
salts, 39 extractive matters and ammonia-salts, and 1°5 earthy
phosphates. :
' _Dumenil made an analysis of urine in 1826. He found the
specific gravity of the mixed urine of several healthy persons
to be 1016.
In 1000 parts there were 31'8 of solid residue, which con-
sisted of 13:2 parts of urea not quite free from alcohol-extract,
0:08 of uric acid, 2°09 of extractive matter, 0°6 of earthy phos-
phates, 1-03 of phosphate of soda, 0°55 of phosphate of ammonia,
2°69 of sulphate of potash, 8-03 of chloride of sodium, 2°69 of
sulphate of potash, 8:03 of chloride of sodium, 1:16 of chloride
of ammonium, 0°18 of phosphate of lime, peroxide of iron, and
sulphate of lime, and 0°39 of mucus.
[In addition to these analyses we may mention those of
Becquerel, Marchand, and myself. Becquerel obtained the
following results :
Mean composition
of urine of Ditto of General
4 healthy men. 4 healthy women. mean.
Specific gravity , ‘ 1018°9 1015-12 1017-01
Water ‘ ‘ F 968°815 975°052 971°935
Solid constituents ; 31°185 24°948 28-066
Urea : : 3 ~ 13°838 10°366 12°102
Uric acid 3 a 0°391 0°406 0°398
Fixed salts ’ : 7°695 6°143 26°919
Organic matters ; , 9-261 8-033 8°647
\
1 Edin. Med. and Surg. Journal, vol. 33.
2 [These salts consisted of :
Chlorine F ; 3 0°502
Sulphuric acid P ; 0°855
Phosphoric acid . ‘ 0°317
Potash : ‘ 7 1°300
Soda, lime, and magnesia ‘ 3°944 ]
Il. 10
146 THE SECRETIONS :
Marchand’s! analyses correspond very closely with those of
Lehmann. He cites the two following analyses as representing
the composition of the healthy secretion :
Water : : : 933°199 938°856
Solid constituents ; : 66°801 61°144
Urea : : ; 32°675 30°321
Urie acid d ; ‘ 1:065 1:00T
Lactic acid . A ‘ 1°521 1°362
Extractive matters : 4 11°151 10°553
Mucus : ; *283 201
Sulphate of potash : ‘ 3°587 3°201
Sulphate of soda ; : 3°213 3°011
Phosphate of soda ; : 3°056 2°998
Biphosphate of ammonia : 1-552 1231
Chloride of sodium "5 ; 4218 4:001
Chloride of ammonium 1°652 1°231
Phosphates of lime and magnesia 1-210 1-001
Lactates ; 1618 1°032
The following table gives the mean result of six analyses of
the morning urine of a healthy man, instituted by myself,? Bin:
Specific gravity 4 * - 1022°5
Water ; ‘ i - 961°00
Solid constituents ; z . 39°00
Urea ; ‘ é ‘ 16°60
Uric acid 3 4 ; *61
Fixed salts 5 : 9°27
Organic matter and loss : -- A
The apparent discrepancies in the composition of healthy
urine, as shown in the analyses that have been quoted, depend
for the most part on the fluctuating amount of water. If we
calculate the proximate constituents of the urine in relation to
an equal amount of solid residue, we shall find these dif-
ferences exhibited in a much less striking manner, although to
a certain degree they still exist.
100 parts of the solid residue of the urine contain—
? Lehrbuch der physiologischen Chemie, p, 292. * Lancet, Feb. 1844.
147
URINE.
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On the physiological relation of the urine.
position of the
g on the influence of
the food, upon the com
[The following observations of Liebi
the salts contained in
urine are well worthy of consideration.
148 THE SECRETIONS :
“ The alkaline reaction of the lymph, chyle, and blood of
man, and of the carnivorous animals, cannot be owing to the
presence of a free alkali; for the nutriment of man, and of the
carnivorous as well as the graminivorous animals, contains no
free alkali, nor any salt formed of an alkaline base and an acid
which might be destroyed in the organism, by the vital pro-
cess, and thus cause the alkaline base to be liberated. The
blood must contain the same salts as exist in the aliments. With
the exception of common salt, nothing is added during the di-
gestion of the aliments. We have seen that this substance
undergoes decomposition in the upper part of the digestive ap-
paratus, being resolved into free soda and free hydrochloric
acid ; but we have also seen that the liberated soda rejoins the
hydrochloric acid during the preparation of the chyme, and
previous to the transformation of the latter into chyle ;! that is,
when the acid has performed its function, namely, the solution
of the aliments; the salt formed by this combination, that is,
common salt, has neither an acid nor an alkaline reaction.
The salts with an alkaline reaction contained in meat, flour,
or grain, are alkaline phosphates. Hence it is obvious that the
alkaline reaction of the chyle, lymph, and blood of animals feed-
ing upon animal and vegetable substances, can only be derived
from their alkaline phosphates.
“The bibasic phosphates of soda and of potash are, in many
respects, highly remarkable salts ; although of a tolerably strong
alkaline reaction, yet they exercise no destructive action upon
the skin or upon organic formations; they possess all the pro-
perties of the free alkalies without being such; thus, for in-
stance, they absorb a large amount of carbonic acid, and this
in such a manner that acids produce effervescence in a satu-
rated solution.of this kind, just as they would in alkaline car-
bonates ; they dissolve coagulated casein, as well as coagulated
albumen, into clear fluids, with the greatest facility, just as
caustic or carbonated alkalies do. But of still greater im-
portance in relation to the secretion of urine is their deport-
ment towards hippuric and uric acids. Hippuric acid dis-
solves with the greatest facility in water to which common —
phosphate of soda has been added ; uric acid possesses the same
' Liebig’s Animal Chemistry, 2d edit. p. 112.
URINE. 149
property at a high temperature ; the phosphate of soda, in this
process, loses its alkaline reaction completely upon the addition
of uric and hippuric acids, and assumes an acid reaction.
The acid nature of the urine of man, and of the carnivorous
and graminivorous animals, is thus explained in a very simple
manner.
“There are but two principal channels through which the
salts entering the organism with the aliments can effect their
exit from the body ; viz., they must either be carried off in the
feces or in the urine. The most simple experiments show that
soluble salts are carried off by the feeces only when the amount
of salt contained in the fluids in the intestines is larger than
that contained in the blood; if the amount of salt in these
fluids is equal or inferior to that of the blood, the soluble salts
are reabsorbed by the absorbing vessels of the intestinal tube,
and enter the circulation, and are then removed from the body
by the urinary organs and channels. If the amount of salt
contained in the intestinal tube is larger than that contained
in the blood, the salts exercise a purgative action.
“ Tf, after previous evacuation of the rectum, a weak solution
of common salt (one part of salt to sixty parts of water) be
taken by means of a clyster, no second evacuation will take
place ; the fluid is absorbed, and all the salt is found in the
urine. This experiment yields the most convincing results if
ferrocyanide of potassium is substituted for common salt; in
this case, the first urine excreted after the injection of the saline
solution, and frequently even after so short a time as fifteen
minutes, contains so large an amount of ferrocyanide of potas-
sium as to yield, upon the addition of persalts of iron, a copious
precipitate of Prussian blue.
“The influence which salts in general exercise upon the se-
cretion of urine is, in the highest degree, worthy of attention.
It is a well-known fact that a very speedy emission of urine
takes place, in healthy individuals, after drinking fresh pump-
water. If ten glasses of water, of from six to eight ounces
each, containing no more than 1-500th of its amount in salts,
be drank at short intervals, an emission of urine of the usual
colour will, after the lapse of about ten minutes, follow the
second glass, and from eight to nine evacuations of urine will
generally occur in the course of an hour and a half. The
150 THE SECRETIONS :
urine, in this experiment, emitted in the last evacuation, will
be clear and colourless, like pump-water, and the amount of
salts it contains is little more than is contained in pump-water.
There are individuals who are capable of thus imbibing from
six to eight quarts of water consecutively without any in-
convenience.
“ But the case is quite different with water possessing an
amount of salts equal to that of the blood; if even as little as
1-100th part of common salt be added to pump-water, and from
three to four glasses drunk, no evacuation of urine will take
place, even two hours after drimking. It is almost impossible
to drink more than three glasses of this saline water, for it
weighs heavily on the stomach, as if the absorbent vessels had
no power of taking it up. This obviously arises from the fluid
within the channels of circulation, i. e. the blood, and the fluid
without these vessels, i. e. the saline water, not exercising any
physical action upon one another, i. e. not intermixing by
endosmose or exosmose.
“Water containing a larger amount of salts than the blood,
such as common sea-water, for instance, and even the weaker
kinds of saline mineral waters, exercise again a different action
from that of pump-water mixed with 1-100th of common salt ;
not only no emission of urine takes place after the imbibition
of such saline water, but water exudes from the circulating
vessels into the intestinal tube, and, together with the saline
solution, is carried off through the rectum; purgation takes
place, attended with much thirst, if the saline solution be in
some measure concentrated.
Considering that a certain amount of salts is absolutely ne-
cessary to constitute normal blood, we may deduce from these
observations and experiments (which any one may easily imi-
tate and verify upon his own person) that the physical condition
of the tissues or of the blood-vessels opposes an obstacle to any
increase or decrease of the amount of salts in the blood; and
thus that the blood cannot become richer or poorer in salts
beyond a certain limit.
Fluids containing a larger amount of salts than the blood,
remain unabsorbed, and leave the organism through the rectum ;
fluids containing a smaller amount of salts than the blood enter
URINE. 151
into the circulation, absorb, and remove from the organism,
through the urinary channels, all the soluble salts and other
substances which do not belong to the constitution of the blood;
so that, finally, only those substances remain in the organism
which exist in chemical combination with the constituents of
the blood, and which, therefore, are incapable of being secreted
by the healthy kidneys.
“JT have convinced myself, by careful and minute examina-
tions, that urine emitted after drinking a copious amount of
water, invariably contains a somewhat larger amount of salts
than the water which has been drunk; whilst the amount of
phosphates contained in the last emitted portions of the urine
is extremely minute, and no longer detectible by the ordinary
tests. It is therefore obvious that all the salts, without excep-
tion, contained in the urine, are to be considered as accidental
constituents of the blood, which are excreted and removed from
the organism precisely because they no longer form a part of the
normal constitution of the blood. The phosphates emitted with
the urine were, previously, constituents of substances which have
been decomposed in the vital processes, or they existed as con-
stituents of the blood, but upon its transformation into living
tissues they were not admitted into their composition, not being
required for their constitution. :
“Now, among the products of the vital processes, which,
together with the soluble phosphates, are removed from the or-
ganism through the urinary organs and channels, there are two
organic acids, namely, wric acid and hippuric acid, both possess-
ing the property of combining with the soda or potash of the
alkaline phosphates, and acquiring in the combination a higher
degree of solubility than they possess, per se, at.the common
temperature of the body. It is obvious that by the accession
of these two acids, and by their action upon the phosphates
of soda, an urate and hippurate of soda must be formed
on the one hand, and an acid phosphate of soda on the
other ; and that, consequently, the urine must acquire an acid
reaction.
But the presence of these two acids in the urine is not the
only cause of its acid nature; there exists another cause which
tends powerfully to maintain and increase it.
“ According to the preceding remarks we ought to find in
152 THE SECRETIONS:
the urine all the soluble salts of the food, as well as a small
amount of the phosphate of lime, which is soluble to a certain
extent in acid fluids, together with magnesia. The amount of .
these latter substances will be in proportion to their solubility
in acid phosphate of soda. The other insoluble salts of the ali-
ments we ought to find in the feeces. In other words, assuming
that the materials composing the aliments become converted
into oxygen compounds, that is, are burnt in the organism, we
ought to find in the urine, all the soluble salts of their ashes,
and in the feces, all the insoluble salts. Now, upon comparing
the constitution of the ashes of the blood or of the aliments,
(or, rather, the salts contained therein,) with those of the urine,
we find that there exists a striking difference between their re-
spective amount of sulphates.
“ According to the analyses of the ashes of the grains of
wheat and rye (Ann. der Chemie, vol. 46, p. 79), the urine of
an individual feeding exclusively upon bread, ought not to con-
tain a trace of a sulphate, whilst the urine of an animal fed
upon peas or beans ought to contain sulphates together with
phosphates in the proportion of 9 of the former to 60 of the
latter. Finally, as flesh contains no soluble alkaline sulphate
(broth does not yield any precipitate of sulphate of baryta when
tested with salts of baryta), the urine of carnivorous animals
ought to be equally free from soluble sulphates. We find, on
the contrary, that the urine of man, according to the most
correct analyses, contains a far larger proportion of sulphates
than the aliments partaken of; nay, even that the amount of
the sulphuric acid evolved from the system must, in many cases,
be equal or superior to that of the phosphoric acid contained in
the aliments. According to the analyses of human urine made
by Berzelius and Lehmann, the amount of the sulphates present
in urine is nearly double that of all the soluble phosphates to-
gether. Hieronymi found the amount of sulphate of potash
contained in the urine of the tiger, the lion, and the leopard,
compared with that of the phosphates, to be as 1to 71. Itcan
be distinctly and positively proved that these salts have not been
partaken of in such proportions. But we now know the origin
of the greatest portion of the sulphuric acid contained in the
urine ; this acid has entered the organism with the food, not
in the form of a sulphate, but as sulphur.
URINE. 153
*‘ Glutin!, vegetable casein, flesh, albumen, fibrin, and the
cartilages and bones, contain sulphur in a form quite different
from the oxygen-compounds of this substance. This sulphur
is separated as sulphuretted hydrogen during the putrefaction
of these substances; it combines with the alkalies, which act
powerfully upon these animal substances, and may be obtained
from such combinations in the form of sulphuretted gi
by means of stronger acids.
“Now, we know, from the experiments from Wohler, that
the soluble sulphurets become oxidized in the organism; and
that thus, for instance, sulphuret of potassium becomes converted
into sulphate of potash ; and it is therefore unquestionable that
the sulphur of the constituents of the blood, derived from the
aliments, or, what comes to the same point, the sulphur of the
transformed tissues becomes finally converted into sulphuric
acid by the oxygen absorbed in the process of respiration, and
thus that in the urine it must appear in the form of sulphates ;
and from this cause the original amount of these salts contained
in the aliments become increased. The alkaline base which we
find in the urine, in combination with this sulphuric acid, is sup-
plied by the soluble alkaline phosphates; and the latter, in conse-
quence of the loss of part of this base, are converted into acid salts.
“It follows, from all we have hitherto stated, that the acid
nature of the urine of carnivorous animals, as well as that of
man, depends upon the nature of the bases partaken of in the
aliments, and upon the particular form of their combinations.
In the flesh, blood, and other parts of animals, as well as in the
grains of the cereal and leguminous plants, there exists no free
alkali. The alkali which these substances contain is invariably
combined with phosphoric acid: the acids formed in the or-
ganism by the vital process, namely, sulphuric acid, hippuric
acid, and uric acid, share the alkali amongst them, and this, of
course, must give rise to the liberation of a certain amount of
phosphoric acid, or what comes to the same point, to the for-
mation of a certain amount of acid phosphates of soda, lime,
and magnesia. The proportional amount of the liberated phos-
phoric acid varies with the temperature ; at a higher tempera-
‘ Dietrich (in the laboratory of Giessen) has examined glutin with regard to its
amount of sulphur ; he found wheat-gluten to contain from 0-033 per cent. to 0°035
per cent. of sulphur, exactly the same proportion as is contained in albumen or fibrin.
154 THE SECRETIONS :
ture the phosphate of soda dissolves a larger amount of uric
acid and hippuric acid than at a lower temperature,——at 100°
more than at 60°. It is owing to this, that urme, upon re-
frigeration, sometimes deposits uric acid, or urate of soda in a
crystalline state, which, of course, can only take place by the
uric acid, at a lower temperature, restoring to the phosphoric
acid the soda or potash which, at a higher temperature, it had
withdrawn from it. At the common temperature phosphoric
acid decomposes urate of soda, whilst, at a higher temperature,
uric acid decomposes phosphate of soda. When urine, con-
taining uric acid and manifesting an acid reaction, forms no
sediment upon cooling, it shows that the amount of the phos-
phoric acid and that of the uric acid exactly balance each other
with regard to their affinity forsoda. Had there been present
a larger proportion of uric acid, this would have separated upon
cooling ; whilst, on the other hand, the presence of a prepon-
derating proportion of phosphoric acid would likewise have
caused the precipitation of uric acid, because the affinity of the
former for soda would then exceed that of the latter: This
explains the circumstance that urine, in certain states, when,
from some cause or other, its amount of sulphuric, hippuric, or
other acid, becomes increased, precipitates a larger proportion
of uric acid than urine in its normal state. The solubility of
uric acid in urine must decrease in proportion as the amount
of the other acids present in the urine increases, because those
acids share the soda with the uric acid; and, of course, the
larger the amount of soda which combines with these other
acids the less comes to the share of the uric acid. It is like-
wise owing to this, that uric acid is very frequently precipitated
from urine upon the addition of mineral or other acids, and
that urime of a turbid whey-like appearance, from the presence
of uric acid, frequently manifests a far more strongly acid re-
action than normal urine.
“Now, bearing in mind that the use of alkaline citrate, of
neutral tartrate of potash, bi-tartrate of potash, acetates of
potash and soda, and tartarized soda, renders the urine alka-
line by creating in it an amount of carbonated alkali; and
that, likewise, after the eating of fruit, such as cherries,
strawberries, &c., the urine is of an alkaline nature, inasmuch
as these fruits contain alkalies combined with vegetable acids,
URINE. 155
it is obvious that the acid reaction of healthy urine is purely
accidental, and that urine of an alkaline or neutral reaction
cannot be considered as a symptom of a diseased condition of
the body. All the vegetable aliments, without exception,
tubers, roots, and leaves, potatoes, turnips, greens, &c., contain
alkalies in combination with vegetable acids: potatoes, for in-
stance, contain alkaline citrates; turnips, alkaline racemates
and oxalates, &c. All these plants yield, upon incineration,
more or less strongly alkaline ashes, the bases of which were
contained in the living plants, as salts of vegetable acids.
“It is obvious that by adding these vegetables to a meat
diet, to bread and to other aliments prepared from flour, the
nature of the urine must become thoroughly altered ; for the
alkalies which these vegetables contain in combination with
organic acids, enter the urine, in the form of carbonated alka-
lies, and neutralize the acids, of whatever kind, which may
be present. When partaken of in a certain proportion, they
render the urine neutral ; when partaken of in a larger pro-
portion they impart to it an alkaline reaction.
“The urine of all animals feeding upon vegetables, such as
grass, herbs, roots, &c., has an alkaline reaction. The urine of
the horse, of the cow, of the sheep, of the camel, of the rabbit,
of the guinea-pig, of the ass, &c., is alkaline; it contains
alkaline carbonates, and acids produce in it a lively effervescence.
“The acid, neutral, or alkaline reaction of urine of healthy
individuals does not depend upon any difference in the pro-
cesses of digestion, respiration, or secretion, in the various
classes of animals, but upon the constitution of the aliments,
and upon the alkaline bases which enter the organism through
the medium of these aliments. If the amount of these bases
is sufficiently large to neutralize the acids formed in the or-
ganism, or supplied by the aliments, the urine is neutral ; whilst
it manifests an alkaline reaction when the amount of alkaline
bases thus supplied to the organism is more than sufficient to
neutralize the acids; but in all these cases the urine accords
with the nature of the aliments taken.
“The inorganic bases and acids contained in the urine were,
with the exception of sulphuric acid, which joins them in the
organism, constituents of the aliments. The amount of imor-
ganic bases and acids emitted through the urine in twenty-four
156 THE SECRETIONS:
hours must, in adult individuals, be equal to that of these bases
and acids supplied to the organism, during the same period,
through the medium of aliments.”!
Our knowledge respecting the influence of diet on the com-
position of the urine has been much increased by the admirable
researches of Lehmann,” instituted on himself. The whole of
the urine passed in twenty-four hours was always collected, the
absolute weight and specific gravity determined, as well as the
amount of solid residue. The investigation was commenced in
October, and the amount of drink was only just sufficient to allay
thirst. During thirteen successive days, on which he lived on >
his ordinary mixed diet, the following observations were made:
Amount of urine Solid residue Whole amount of
in 24 hours. Spec. grav. per mille. solid residue, in grammes.
1088 grammes ® 101774 58°432 63°5718
‘898 1022-2 65-998 59-2662
927 1025°1 67°842 62°8895 |
1022 : 1024°7 66°744 68°2124
712 1029-2 79°923 56°9052
1361 1020-2 65-008 78°4759
900 1019-2 62-318 56°0862
940 1022°5 66°423 62°4376
1100 1019-1 61°984 68-1824
939 1029°4 80°878 75°9434
1448 1016°7 56°264 81°4702
1088 1025°2 67°981 73°9633
1328 1015°6 55°932 74°2777
A perfect analysis of the urine was made on three of these
days, the results of which are recorded in p, 144.
The amount of urea was determined on the Ist, 2d, 4th, 6th,
7th, 8th, 11th, and 12th days. The results are given in the
following table :
Solid residue Urea Urea Daily amount
in 1000 parts in 1000 parts in 100 parts of urea,
of urine. of urine. of solid residue. in grammes,
58°430 26°72 » 45°74 39°077
65-988 32°91 49°87 29°556
66°744 28°22 43°79 29-869
65-008 29°25 | 44°99 35°306
62°318 31°45 50°46 28°301
66°423 29°50 44-4] 27°728
56°264 23°72 — 42°15 34°339
67-981 32°91 : 48°41 35°804
' Lancet, June 1844. ? Journal fur praktische Chemie, 1842.3.
’ The gramme = 15°4 grains troy.
URINE. 157
From these data it appears that, during his ordinary mixed
diet, the urea amounted on an average to 46°23° of the solid
residue, and that the average amount of urea excreted in twenty-
four hours was 32°498 grammes, or about 500 grains.
The amount of uric acid was determined on the 2d, 6th, 7th,
8th, 11th, and 12th days. The following results were obtained :
Uric acid Urie acid Daily amount
in 1000 parts in 100 parts of uric acid,
of urine. of solid residue, in grammes.
1-073 1°626 0°967
1°124 1:729 | 1°357
1:021 1638 0°919
1-097 1-651 1031
1131 2-001 1°630
1098 1615 1195
From these numbers it appears that 1000 parts of urine con-
tain, on an average, 1:089 of uric acid; and that 100 parts of
solid residue contain 1°71 of uric acid; likewise, that the daily
amount of excreted uric acid is 1:183 gram., or about 18°3 grains.
Hence the daily amount of urea is to that of uric acid as 27:1.
The mean amount of free lactic acid, (or, at least, the sub-
stance regarded by Lehmann as lactic acid,) in 1000 parts of
urine was 1°525; and in 100 parts of solid residue, 2°325. The
mean daily amount was 1:534 gram., or 23°6 grains. —
The mean amount of combined lactic acid in 1000 parts of
urine was 1°160 ; and in 100 parts of solid residue, 1:703. The
mean daily amount was 1°173 gram., or 18 grains.
Having thus determined a standard of comparison, he pro-
ceeded to notice the effect of a purely animal diet on the urine.
He lived for twelve days on a purely animal diet, and for four
of these days entirely on eggs, during which period he consumed
128, or 32 a day. From an analysis of the eggs it appeared
that he took daily 189°7 grammes of dry albumen, free from
ash, and 157-48 grammes of fat; and from Scherer’s analyses
it appears that this albumen contained 104°335 grammes of
carbon, and 30°16 grammes of nitrogen ; while the fat contained
124-41 grammes of carbon. Hence the whole amount of carbon
was 228°75 grammes, a little within the amount given off in the
course of twenty-four hours, according to Liebig. The obser-
vations were conducted for twelve successive days in July, and
yielded the following results :
158 THE SECRETIONS :
Absolute weight Solid residue Whole amount
of urine in 24 hours, Spec. grav. in of solid residue,
in grammes. 1000 parts. in grammes.
921 1029-2 80°87 79°34
1240 1021-9 66°12 81-99
998 1030°7 84°23 84:06
1075 1027°8 77°72 83°55
1184 ’ 1026°4 72°30 85°61
1384 1018°7 59°21 82°09
1113 1028°5 78°15 86°99
1092 1028-9 79°04 86°23
979 1033°8 90°68 88°78
1211 1026°3 72°38 87°85
1346 1024°3 66°73 89°84
1127 1029°0 78°38 88°38
If we compare the mean of these numbers with the mean
of the former corresponding table, we have :
During a mixed diet. | During animal diet.
The absolute weight of the urine in =
24 hours ; : : 1057°8 grammes (1202°5 grammes
Specific gravity . é 1022°0 1027°1
Amount of solid residue in 1000 parts of
urine 5 ‘ 65°82 75°48
Sum of the solid pele ; 67°82 grammes 87°44 grammes
Hence it appears that, during a purely animal diet, the
amount of solid constituents is increased, while at the same
time the amount of water is augmented by no less than 125
grammes, notwithstanding these experiments were made in
June, and those with a mixed diet in October.
From the above data it appears that the solid matters dis-
charged by the urine during an animal diet amount to about
one fourth of the amount of dry nutriment.
The following are the principal changes in the urime induced
by use of a strictly animal diet. It becomes pale, of a straw
colour, limpid, and similar in appearance to the urine of the
carnivora. On the addition of nitric acid, crystals of nitrate
of urea were immediately produced. Uric acid was gradually
deposited in large crystals. The reaction of the urine was always
decidedly acid. ‘Two analyses instituted with the urine passed
on the 28th and 30th of July, (the 9th and 11th days of the
experiment,) gave the following results :
URINE. 159
July 28th. July 30th.
Water ak . ; ‘ 909-32 933°27
Solid residue : ; ‘ 96°68 66°73
Uréa : : x 53°79 41°65
Uric acid ; i 4 1°41 118
Free lactic acid A : 2°28 1°64
Lactates ‘ 1°67 1°02
Extractive matter soluble i in water } 0°82 0°61
Extractive matter soluble in aleohol . 4°50 3°24
Mucus : 0:09 0-11
Chlorides of sodium and ammoniém 3 5°37 3°46
Sulphates ; : ; 11°51 7°08
Phosphate of soda ‘ : 5°52 4:04
Earthy phosphates ; ; 3°72 2°70
The six following observations were made regarding the
amount of uréa :
Urea in 1000 parts Urea in 100 parts Urea secreted in
of urine. of solid residue, 24 hours, in grammes.
July 23d { the expen) bas: 71 58°815 49-134
27th : 46°67 59°043 50°913
28th : . 53°79 59°320 52°034
29th : . 46°19 63°811 56:095
30th : - 41°65 62°413 54°071
31st ‘ - 50°36 64°382 56°887
From these numbers it appears that, during a purely animal
diet, there is a mean daily increase of 20°7 grammes in the
amount of urea. During a mixed diet, the relation of the urea
to the other solid constituents = 100: 116, while onan animal
diet it = 100:63. The uric acid was estimated on the last
four days of the experiment :
Urie acid Uric acid Daily amount
in 1000 parts in 100 parts of uric acid,
of urine. of solid residue. in grammes.
28th July ‘ : 1°41 1°554 1371
29th : : 1:20 1°630 1°432
30th " “ 118 1°764 1°565
31st R ; 137 1:749 1546
Hence, while the mean daily amount of uric acid during a
mixed diet is 1:183 grammes, the amount is increased during
an egg-diet by ‘295 of a gramme, an increase not sufficiently
large to entitle us to suppose that a purely animal diet favours
the formation of uric acid in the healthy organism. During
a mixed diet, the proportion of uric acid to the other solid con-
160 THE SECRETIONS:
stituents = 1:58°5, during an animal diet it = 1 :59-7;
i.e. there is a relative diminution. The proportion of uric acid
to urea during a mixed diet = 1: 27-0, during an animal diet
it = 1: 32:7; consequently the uric acid is not by any means
increased in the same proportion as the urea; and, indeed, it
can hardly be regarded as produced from the protein-compounds
in the same manner as the urea probably is.
The mean amount of free lactic acid excreted daily (as de-
duced from four analyses) was 2°167 grammes.
The earthy phosphates were determined daily from the 27th
till the 31st of July, when the experiments were discontinued.
The following are the results obtained :
In 1000 parts In 100 parts Daily amount,
of urine, in grammes. of solid residue. in grammes.
3°09 3°913 3°374
3°72 4:102 3°642
2°99 4°134 3°632
2°70 4°046 3°635 ae
3°13 3°994 3°530
Consequently, during a purely animal diet, 3-562 grammes of
earthy phosphates are, on an average, discharged daily by the
urine; while, during a mixed diet, the average quantity is only
1:13 grammes. If we estimate the amount of earthy phos-
‘phates in the albumen at 2°, the whole quantity consumed daily
with 189°7 grammes of albumen, amounts to 3°794 grammes ;
consequently, much the greater part (namely, 3°562 grammes)
is carried off by the urine, while the remaining -232 of a
gramme is removed with the excrements, perspiration, &c.
During a mixed diet, a much larger amount of earthy phos-
phates was consumed without there being a corresponding in-
crease in the urine, the greater part being removed by the
intestinal canal. Generally speaking, the amount of excreted
earthy phosphates exceeds the amount consumed, the excess,
doubtless, arising from the oxidation of the phosphorus con-
tained in the protein-compounds during the metamorphosis of
the tissues. This view is confirmed by the preceding observa-
tions; for, during the egg-diet, the phosphorized fat contained
in the oil of the yelk is conveyed into the fluids of the body,
and, by the oxidation of its phosphorus, in addition to the
phosphorus of the protein-compounds, the phosphoric acid of
URINE. ‘ 161
the phosphate of lime is generated, while only a portion of the
earthy phosphates of the food is conveyed into the blood. Lime
occurs in the blood in considerable quantity, being conveyed
there by the water taken as drink, and combining readily with
the free phosphoric acid. Moreover, a further confirmation of
this view is afforded by the fact of the increased excretion of
phosphate of soda. During a mixed diet, the daily average is
3°673 grammes, while, during a purely animal diet, it amounts
to about 5:217 grammes.
Lehmann next proceeded to investigate the effects of a
strictly vegetable diet. The urine was examined daily from the
12th to the 23d of August ; it was of a yellowish-brown rather
than a yellow colour ; tt had a faint odour, and a decidedly acid
reaction, which did not disappear for six or eight days. The
morning urine was of a dark brown colour, and rapidly depo-
sited a mucous sediment, after which there was a gradual sepa-
ration of bright red crystals of uric acid. The following table
contains the daily amount of urine and of its solid constituents,
and the specific gravity :
Absolute weight Solid residue Daily amount
of urine in 24 hours, Spec. grav. in of solid residue,
in grammes, 1000 parts. in grammes.
980 1028-9 ' 67°60 66°25
765 103671 82°76 63°31
1059 1020°1 55°85 59°14
978 1025°7 60°13 58°81
1212 1016°4 50°01 60°61
817 1032°3 . 75°68 61°83
916 1026°8 63°09 57°79
720 1034-2 80°76 58°15
796 1029-8 70°90 56°44
931 1023°8 58°09 54°08
811 1028°6 67°01 56°35
892 1027°9 65°08 58°05
By taking the mean of these numbers we are enabled to
construct the following table :
On- On On
mixed diet. animal food. vegetable food.
Amount of urine in 24 hours . 1057°8 gr. 1202°5 gr. 909 gr.
Specific gravity . - 1022-0 10271 1027°5
Solid residue in 1000 parts of
urine : . - 65°82 75°48 66°41
Solid constituents in 24 hours. 67°82 gr. 87°44 gr. 59°23 gr.
II. 11
162 THE SECRETIONS :
The amount of urea was ascertained daily from the 17th to
the 23d of August :
Urea in 1000 parts Urea in 100 parts Daily amount of urea,
of urine. of solid residue. in grammes.
28°87 38°145 23°585
26°00 41°211 23°815
30°68 37°988 22-089
28°31 40°078 22-618
22°42 38°607 20°880
25°52 33°093 21°467
25°69 39°478 22°917
ad
Hence, on an average, the urea amounted to 39°086% of the
solid residue, and 22-481 grammes were daily excreted. The
effect of diet on the urea may be seen by the following table:
In 100 parts of Daily amount,
solid residue, in grammes,
Urea during a mixed diet , ‘ 46°230 32°498
” an animal diet a? ‘ 61°297 53°198
» avegetable diet . . 89-086 22-481
Consequently, during a vegetable diet, there is both an ab-
solute and a relative diminution of urea.
The uric acid was determined on five occasions :
Urie acid in 1000 parts Urie acid in 100 parts Daily amount of uric acid,
of urine. of solid residue. in grammes,
1°40 1°836 1°135
1°23 1:947 1°125
117 1°652 933
1:01 1:743 "942
"89 1489 969
Consequently, the average daily amount (from these five
analyses) was 1:021 grammes; and, on comparing this with the
previous data, we have:
In 100 parts of Daily amount,
solid residue. in grammes.
Uric acid during a mixed diet . : 1-710 1183
Pe an animal diet . é 1°674 1478.
ma a vegetable diet j 1-737 1021
Hence the uric acid is scarcely affected by the diet.
From three analyses it appeared that 1:189 grammes of free,
and 1:371 grammes of combined lactic acid were daily excreted
during a vegetable diet; and, associating these with the pre-
vious numbers, we have:
_ URINE. 163
During | During During
a mixed diet. an animal diet. a vegetable diet.
Free lactic acid : 1°462 2°167 1-189 grammes
Combined lactic acid . 1-162 ? 1°371
Hence there is not any very appreciable effect produced on
the amount of the lactic acid. The phosphates and sulphates
were much the same as during a mixed diet.
The three following perfect analyses of the urine were insti-
tuted :
Aug. 20th ‘ Aug. 2lst. Aug. 23d.
(the 9th day of the experiment.)
Water i j ‘ 929°10 941°91 934°92
Solid residue : ‘ 70°90 58:09 65°08
Urea ‘ ; 23°o1 22°42 25°69
Uric acid : ‘i 1t7 1-01 0°89
Lactic acid 4 1°55 1:01 1°35
Lactates . A : 2°39 1°89 2°06
Extractive matter solublein water 3:80 3°07 3°71
8 » alcohol 17°84 13°78 15°77
Mucus ° é Ae 10 10
Chlorides of sodium and ammonium 3°80 3°07 3°71
Sulphates i ‘ 7°16 7°14 7:23
Phosphate of soda F 3°54 3°68 3°74
Earthy phosphates ; 1:22 1:09 Ill
The following table shows how much the extractive matters
are influenced by diet :
Extractive matters
in 100 parts Extractive matters
of solid residue. discharged daily,
During a mixed diet 3 16°637 10-489 grammes
» ananimal diet . ; 5°818 5196
yy a vegetable diet . 29°482 16°499
Lehmann concluded his experiments with some observations
on the influence of a strictly non-nitrogenous diet on the urine.
These are the least satisfactory of the series, because the general
health becomes so rapidly injured as to affect the results. His
daily food consisted of about 400 grammes of starch, sugar, or
gum, and 125 grammes of almond oil. The urine passed after
this diet had been continued for twenty-four hours had a brownish
red colour, a slightly acid reaction, and became alkaline in
twenty-four to thirty-six hours. The following analyses were
made in the month of June, on the 2d and 3d day from the
commencement of this course of diet :
164 THE SECRETIONS:
1, 2.
Water ; a : - 953°98 965°11
Solid constituents ‘ : zi 46°02 34°89
Urea ea : : : 18°92 11°08
Uric acid : : *89 54
Lactic acid and lactates ; $ 4°89 511
Extractive matter soluble in water ‘ 2°80 271i
me alcohol ; 8°32 8°78
Mucus a ; ‘ll “4
Chlorides of sodium and ammonium A 2°74 1:14
Sulphates : : ; 3°25 2°98
Phosphate of soda. ‘ ; 3°01 2°48
Earthy phosphates . 1:00 “91
On the second day 977 grammes, i eesti on the third 1113
grammes of urine were discharged, so that the whole amount
was calculated as follows:
; On the 2d day. On the 3d day.
Solid constituents ‘ ‘ 44-524 grammes 38°836 grammes
Urea é ; ‘ 18-484 12°332
Uricacid . z ‘ "869 *601
Lactates . ; . 4°865 5687
Extractive matters . ; 10°864 12°844
In conclusion, the following table gives the mean daily
amount of the various solid constituents during these different
systems of diet :
Mixed diet. Animal diet. Vegetable diet. Non-nitrogenous diet.
Solid constituents . 67°82 87°44 59°24 41°68 grammes
Urea 4 . 38260 53°20 22°48 15°41
Uric acid Rees i 1°48 1-02 “73
Lactic acid and lactates 2°72 2°17 2°68 5°82
Extractive matters . 10°49 5°20 16°50 11°85
Lehmann’ has likewise examined the effect of severe bodily
exercise on the urine, and has found that the urea, lactic acid,
phosphates, and sulphates are increased, while the uric acid and
extractive matters are diminished. The following are the mean
results obtained from the frequent examination of the daily
urine during a pedestrian tour :
In 24 hours. In 1000 parts.
Water ‘ : : 900:006 grammes 916°707
Solid constituents ; é 82°594 83°293
Urea A ; 45°314 45°697
Uric acid - . “642 "647
Lactic acid é ‘ 3°140 3166 °*
Extractive matters . é‘ 8°455 8:526
Alkaline phosphates ‘ 4:598 4°636
Alkaline sulphates : 15°047 15°174
Earthy phosphates . j 1105 1114 14
' Wagner’s Handworterbuch der Physiologie: Art. Harn. vol. 2, p. 21.
URINE. 165
The admirable researches of Lecanu’ show that the urine of
the same person, analysed at different times, gives nearly uni-
form results.
The urine of persons of different ages and sexes exhibits
deviations both in the relative and absolute proportion of its
constituents, while in persons of similar ages and sexes, the
variations are very trifling.
The quantity of urine discharged by different persons,
in the course of the twenty-four hours, varies considerably,
even although the circumstances under which the obser-
vations are made are apparently similar. In 16 individuals of
different ages and sex, with different but sufficient food, the
quantity varied from 18 to 78 ounces.
The mean specific gravity of the urine of different persons
varies. The highest specific gravity was 1030, the lowest 1016.
It was most frequently between 1020 and 1030. The urine
of men in the prime of life was more concentrated than that of
old men, women, or children.
The quantity of urea amounts, according to Berzelius and
Lehmann, to nearly one half of the solid constituents ; accord-
ing to my observations, to a little more than a third. It follows,
from the experiments of Lehmann, which have just been stated,
that these proportions are dependent on the nature of the food;
it is certain, however, that they are also dependent on the
powers of assimilation, for we know that some persons thrive
upon a very frugal, and barely sufficient diet; while others appear
half-starved, although taking an abundance of nutritious food.
According to Lecanu, the quantity of urea which different
individuals, living under different circumstances, secrete during
the same period, differs greatly; it approximates, however, in
proportion to the similarity of the circumstances.
In the course of twelve days there was secreted by—
A man aged 20 years, 334 grammes of urea
22
334
38 310
43 351
53 364
A woman aged 28 205
16 210
A child aged 8 171
8 168
1 Journal de Pharmacie, vol. 35, 1839.
166 THE SECRETIONS:
The quantity of urea is greatest i in men in the prime of life ;
it is greater in women than in old men, or children. It
amounts in—
Mean. Maximum, Minimum.
Men ; ‘ : 432 509 357 grains
Women : 3 294 436 553
Old men J > 125 189 60
Children aged 8 : ; 207 253 161
i 4 ; ‘ 69 82 57
The quantity of urea excreted bythe same individual in twenty-
four hours, is always nearly the same; and if instead of twenty
four hours, we compare it for a longer period, the deviation
will be still less marked.
The quantity of uric acid excreted in twenty-four hours by
persons of different age and sex, and living under different cir-
cumstances, is as variable as the quantity of urea. It fluctuated
between 1°38, and 24°25 grains. A comparison of the quan-
tities of uric acid excreted during a longer period by persons
of the same age, sex, &c. will show that they nearly coincide.
In twelve days there were excreted by—
A man aged 20 years, 11°945 grammes of uric acid
22 11:967
38 13°434
In eight days there were excreted by—
A girl aged 19 years, 3°778 grammes of uric acid
A woman aged 43 3°619
The quantity of uric acid excreted by the same person during
the same period (a period of some days for instance) is always
nearly constant. This observation is confirmed by the analyses
of Lehmann, and myself.
The amount of fixed salts, (earthy phosphates, chloride of
sodium, alkaline sulphates and phosphates,) excreted in twenty-
four hours, varies considerably with age and sex. It fluctuated
(in Lecanu’s analyses) between 378 and 75 grains. There was
apparently no uniformity in the amount of these salts in the
urine of the same person during different equal periods. For
instance, in a man aged 20, the amount of fixed salts in the urine
of twenty-four hours, was determined four times. It varied
from 348 to 224 grains.
In men, in the prime of life, the amount of fixed salts is
higher than in aged persons, children, or women.
URINE. 167
They occur, according to Lecanu, in the following proportions:
Mean. Maximum. Minimum.
InMen . ‘ 4 260 378 153 grains
Women ; : 222 302 166
Children of about 8 years. 135 168 152
Old men ; ; 124 151 94
Lecanu found the earthy phosphates in the urine of twenty-
four hours vary in different persons from 30°3 grains to rather
less than half a grain.
The amount of earthy phosphates, excreted in twenty-four
hours by the same person, is not always uniform; it appears
to have no direct connexion with either age or sex.
In accordance with Guibourt and Rayer, Lecanu found
these salts in smaller quantity in the urine of old men than
in that of children. From the analyses made by Lecanu,
Lehmann, and myself, it appears that the variations in the
amount of the earthy phosphates, both absolutely and relatively,
are less than those of the other constituents of the urine.
A considerable difference was observed by Lecanu in the
amount of chloride of sodium excreted by different persons.
In his analyses the quantity excreted in twenty-four hours fluc-
tuated between 116 grains and a quarter of a grain. Moreover,
the quantity excreted by the same person in twenty-four hours
is by no meaus constant. In four observations, each made on
the urine of twenty-four hours, of a man aged 20, the maximum
was 116, and the minimum 67 grains: in six similar obser-
vations on the urine of a man aged 35 years, the maximum
was 82, and the minimum 29 grains. Lecanu found the quan-
tity of chloride of sodium very small in the urine of women and
old men. !
It is clear that the excretion of a salt taken with most of
our articles of food, must be entirely dependent on the quantity
consumed, and must therefore vary very considerably. The
urine, generally speaking, is deficient in salts during disease:
our analyses show that the deficiency occurs at the expense of
the chloride of sodium; the sulphates and phosphates taking
only a small part in it. I have analysed urine in typhus which
contained a mere trace of chloride of sodium.
Lecanu observed differences similar to those we have just
168 THE SECRETIONS:
noticed in the alkaline sulphates and phosphates. The quan-
tities excreted in twenty-four hours not only varied in different
persons, but also in the same persons at different times. From
my analyses, and those of Lehmann, it appears probable that
a connexion subsists between the quantity of urea and of the
sulphates, and possibly of the phosphates likewise ; that is to
say, the sulphates always increase with the urea, and vice versd.
I incline, therefore, to the opinion of Berzelius, that at least a
portion of the sulphates and phosphates owe their origin to the
oxidation of sulphur and phosphorus, previously associated with
protein which has become changed during the active metamor-
phosis of the blood. We do not, however, mean, in making
this statement, to deny that the salts are also supplied to the
blood by the food, and again separated by the kidneys.
The five following results, of much importance in physiology,
have been deduced from the admirable researches of Lecanu:
1. The quantity of urea excreted by the same person during
equal periods is constant. :
2. The same is the case with respect to the uric acid.
3. The quantities of urea and uric acid excreted by different
persons during equal periods are variable.
4, The varying amounts of urea excreted during equal
periods by different persons, bear a relation to age and sex.
5. The amount of fixed salts varies in different persons without
reference to age or sex. It also varies in the same person
during equal periods.
An observation simultaneously made by Lehmann! and
myself,? appears to me of high physiological import. We
have ascertained that the amount of the urea, as well as of the |
sulphates, is increased by strong bodily exercise. I produced
this state by taking such violent exercise for two hours that the
pulse continued for some time above 100.
Further confirmation of the above observation is certainly
desirable.
If, however, we might assume it as a general fact, it would
be an additional argument in favour of my view regarding the
formation of urea; for it would then become still clearer that
the urea is not formed during the change which occurs in the
1 See page 164. ? See page 144.
URINE. 169
blood as a consequence of peripheral nutrition, but that it is
formed during those processes which are dependent on the
respiratory and circulatory functions, in which we must seek for
the greater part of the carbonic acid which is exhaled, and for
the principal source of animal heat. I refer to the active meta-
morphosis of the blood, or to the mutual action excited by the
blood-corpuscles, the plasma, and the oxygen held in solution
in the blood, on each other.
[I am indebted to the kindness of Dr. Percy for the following
analyses, which, to a certain amount, corroborate Simon’s views.
The urine of a man, aged 30 years, training for a pedestrian
match, was examined on two occasions: on the first, a quarter
of an hour after running a mile in five minutes and a few
seconds ; on the second, after running three races of one mile
each on the same day.
In both cases the urine was of a pale straw colour; it depo-
sited a slight mucous cloud on the first occasion, and was rather
more turbid on the second. It was acid, and its specific gravity
was 1019. It contained in 1000 parts: |
1, 2.
Water ‘ ea. : ° 956-00 950°80
Solid constituents : 2 3 44:00 49°20
Urea js . : : 14°01 20°42 ©
Uric acid ‘ ‘ ‘ 1:58 64
Salts soluble in water : ‘ 11:16 7°88
Salts insoluble in water ? R 1:10 1:48
Although the soluble salts are not increased as in the
cases of Lehmann and Simon, the augmentation of urea is very
striking. |
To sum up once more: the urine is most abundant in urea,
uric acid, and the most important salts, in men in the prime of
life ; it is less rich in these constituents in women; while the
minimum occurs in old men and children. The nature of the
food exerts an influence upon the composition of the urine:
the amount of urea is increased by an excess of nitrogenous
food, and diminished after living on food deficient in nitrogen.
Upon a diminution of the quantity of food, the urine becomes
deficient in nitrogen, as has been shown by my own experi-
170 THE SECRETIONS :
ments! and those of Lehmann, but the separation of nitrogenous
compounds, as for instance urea, through the urine, occurs
even when no food is taken. The urine is most abundant in |
urea and sulphates after active bodily exercise, in consequence,
doubtless, of increased vascular excitement. The quantity of
urine discharged in twenty-four hours, amounts on an average to
about 45 ounces. It is more abundant in the prime of life than in
old age or childhood, and in the male than in the female sex.
ON PATHOLOGICAL CHANGES IN THE URINE.
During disease the urine may undergo numerous modifica-
tions, both in its physical characters and its chemical constitution.
The chemical changes may be reduced to one of the following
forms.
1. One or more of the normal constituents of the urine ex-
isting in larger quantity than in healthy urine.
2. One or more of the normal constituents existing in less
quantity than in healthy urine.
3. A normal constituent absent.
4. The presence of substances that do not exist in normal
urine.
Qualitative and quantitative analyses of urine modified by disease.
In tracing the changes which the urine undergoes in dis-
ease, the simple addition of certain tests is sometimes all that
is sufficient, while in other cases it is requisite to institute a
quantitative analysis. I shall now proceed to describe these
changes in accordance with the above scheme.
INCREASE, DECREASE, OR ABSENCE OF THE NORMAL CONSTI-
TUENTS OF THE URINE.
1, Increase or diminution of the solid constituents generally.
I have already observed that the proportion of the solid con-
stituents to the water is so very variable, is so dependent upon
the vicarious action of the skin and lungs, and upon the quan-
' Brande’s Archiv, xxii, p, 25.
URINE. 171
tity of fluid that has been taken into the system, that it is im-
possible (without taking other facts into consideration) to de-
termine from the urine alone, whether a mere increase or de-
crease of the solid constituents is due to diseased action. Pale
urine, more or less like water, may be fairly considered deficient
in solid matters, while a deep brown colour is indicative of an
abundance of these constituents.
The specific gravity,! and still more the determination of the
solid constituents in the manner which has been already de-
scribed, will give the required information. The colour of the
urine is sometimes deceptive, especially the fiery red that occurs
during fevers. Urine of this sort is frequently found to be
poorer in solid constituents, and its specific gravity lower than
we should have anticipated from its colour: it is usually, how-
ever, more abundant in uric acid than normal urine.
2. Increase or decrease of free lactic acid.
With a little practice we may form a rough estimate of the
increase of free acid, by observing the colour which the urine
imparts to blue litmus paper. If neither the blue nor the red
litmus paper is affected the urine is neutral.
3. Increase, decrease, or absence of urea.
In the course of my analyses, I have found that the quantity
of urea may vary from 0°3° to 2°4° in fresh urine; I have ob-
served, however, at the same time, that these statements are
very deceptive, if the amount of solid residue is not at the same
time given. It is only by comparing it with the solid residue
that we can judge whether the urea has increased or decreased
in an extraordinary manner. In healthy urine the urea may
probably fluctuate from } to } of the weight of the solid con-
stituents. Further experience is wanted to show whether an in-
crease or decrease of this constituent (apart from other changes)
implies a diseased state of the urine.
Urine has been known to yield crystals of nitrate of urea,
1 The common urinometer is sufficiently accurate for ordinary cases.
172 -THE SECRETIONS :
a short time after the addition of nitric acid, without being
first concentrated by evaporation. Indeed Lehmann observed
that his morning urine, after living exclusively for five days on
animal food, contained so much urea, as to stiffen immediately
upon the addition of nitric acid. This might arise either from —
an absolute increase of urea, or from a relative increase, cor-
responding with an augmentation of the solid constituents
generally.
An entire absence of urea has been observed in cases of
diabetes insipidus, in which the urine is distinguished by an
extreme deficiency of solid constituents: such statements should, —
however, be received with caution. Willis! instances such
cases ; he is, however, inclined to believe that it is always present
in very small quantity. In order, therefore, to offer a decided
opinion regarding either the absolute pathological increase or
decrease of urea, it is requisite to estimate its weight, and the
ratio of its weight to that of the solid constituents generally.
The method of determining the urea is described at page 136.
If the quantity of urea is so small as to render the crystallization
of its nitrate imperceptible to the naked eye, the microscope
must be used in the manner described when treating of the
Blood, in Vol. I, page 182.
4. Increase, decrease, or absence of uric acid and the urates.
The variation in the quantity of uric acid in diseases has
long been known, but it has not yet been determined with
certainty whether this is in all cases an absolute, or whether in
some cases it is merely a relative increase dependent upon the
increased amount of solid constituents generally. The point
must be determined by the quantitative analysis of uric acid,
and its ratio to the solid constituents generally.
a. Increase of uric acid. Urine, containing an excessive quan-
tity of uric acid, exhibits in most cases a very high colour, and
has an acid reaction. Its specific gravity is frequently lower
than would have been supposed from the intense colour.
1 Urinary Diseases and their Treatment. By Robert Willis, m.p. p. 12.
URINE. 173
If this urine is allowed to stand for some hours, there are
deposited, partly at the bottom, and partly on the sides of the
vessel, (and they are not unfrequently observed on the surface,)
small crystals perceptible to the naked eye, whose form, under
the microscope, usually appears as delineated in fig. 23a, some-
times as in fig. 23. Vigla! states, that in addition to the crys-
tallized uric acid, a portion separates as an amorphous powder.
It is only rarely that I have observed uric acid deposited in this
amorphous form: the amorphous sediment of a yellow or red-
dish colour, which frequently occurs in large quantity in acid
urine, may be shown to consist of urate of ammonia, by its ready
solubility when the urine is warmed. Rayer, in his work on
Diseases of the Kidneys, describes the crystalline form of uric
‘acid, which is represented in fig. 23c.
As a further evidence that these crystals are composed of uric
acid, they may be tested with nitric acid in the manner explained
in page 116.
A brown or reddish-brown sediment is sometimes observed
to be deposited in dark reddish-brown urine, which does not
disappear either upon the application of heat or the addition of
hydrochloric acid, and in fact in the latter case is rather in-
creased. Under the microscope it exhibits the described forms
of uric acid. We also observe, although more rarely, that dark
urine will deposit a dense gray or yellow granular sediment,
which is shown, by the application of heat, by the addition of
hydrochloric acid, and by the microscope, to consist also of uric
acid coloured by a peculiarly small quantity of uroerythrin.
If the amount of uric acid is to be determined quantita-
tively in these instances, we must have regard not merely to
the uric acid which is deposited, but also to that which remains
in solution. The amount of the whole urine is determined as
accurately as possible, the sedimentary uric acid collected on a
weighed filter, washed with distilled water, dried, and weighed.
Any uric acid that adheres to the glass, and cannot be removed.
by a feather or a glass rod, or by washing out the glass with
water, must be treated with some warm solution of potash, until
it is dissolved.
1 Etude microscopique de l’urine, eclarée par l’analyse chymique. (L’Expérience,
vol, 1, p. 193.)
174 THE SECRETIONS :
The alkaline solution must be filtered, and the uric acid
precipitated by hydrochloric acid, collected on a filter, dried,
and its weight ascertained. We thus estimate the ratio of the
separated uric acid to the whole fluid and to the solid residue,
if indeed this element has been determined from a weighed
quantity of the urine. A certain quantity of the urine is
treated with hydrochloric acid in the manner indicated in page
137, allowed to rest for twenty-four to forty-eight hours, and the
precipitated uric acid collected on a filter and weighed. We thus
obtain the amount of uric acid held in solution, and its ratio
both to the whole amount of urine, and to the solid residue.
b. Increase of urate of ammonia. Urate of ammonia, which,
as we have already mentioned in page 115, is probably an inva-
riable constituent of urine, is occasionally excreted to a very
large amount during the exacerbations of fever, arthritic attacks
and various other diseases. It is the most common form of
urinary deposit, but seldom occurs alone; it is frequently mixed
with uric acid, sometimes with urate of soda or of lime, and
occasionally, but not often, with earthy phosphates. Urine
depositing urate of ammonia is generally of dark colour, is
seldom clear, and usually exhibits an acid reaction; it is, how-
ever, occasionally neutral or even alkaline. It is only in the
latter case that earthy phosphates can be present, as they are
never precipitated in urine with a marked acid reaction. The
colour of urate-of-ammonia sediments varies from a yellowish
to a brick-red tint. The red sediments frequently contain free
uric acid, and sometimes urate of soda: nearly white sediments
of urate of ammonia have occasionally been observed. Urate
of ammonia seems to preponderate in the yellow and yellowish-
red sediments, and free uric acid in those of a more purple-red
colour.
All these sediments may contain more or less mucus,
1. If the sediment consists of urate of ammonia alone, it
may be at once recognized by its perfect solution when the
fluid is raised to incipient ebullition. To determine this point,
the clear fluid is poured from the sediment, some of which is
placed in a test tube and heated over the flame of a spirit-lamp:
the fluid first becomes transparent on the surface, and gradually
URINE. 175
clears throughout its whole extent: on being allowed to cool it
again becomes turbid, and deposits the sediment afresh. Ifa
portion of the sediment, after being washed, is rubbed with
caustic lime, a perceptible odour of ammonia is developed: and
if a few drops of nitric acid are poured over it in a porcelain
basin, and gentle heat applied, the purple colour, indicating the
presence of uric acid, appears. On heating a little of it on
platinum foil, it burns away without a residue.
2. If uric acid is mixed with the urate of ammonia, the sedi-
ment sinks rapidly to the bottom, as a dense granular powder,
after the fluid has been cleared by the application of heat. If
hydrochloric acid is added, after the urate of ammonia has been
dissolved by heat, the precipitate on cooling consists of uric acid
alone.
3. If earthy phosphates are mixed with the urate of am-
monia, the urine is either neutral or alkaline, and is only
partially cleared by heat. The turbidity which remains, pro-
duced. by the earthy phosphates in suspension, disappears imme-
diately upon the addition of hydrochloric acid. Free uric acid
is precipitated on cooling.
4. If mucus or pus is mixed with the urate of ammonia the
fluid becomes only partially cleared on warming, neither does it
become perfectly clear on the addition of hydrochloric acid, since
mucus and pus are not dissolved by that agent. If there should
be so large a proportion of mucus and earthy phosphates mixed
with the urate of ammonia, that the solution of the latter salt
on the application of heat produces no perceptible effect, it
will only be necessary to filter the heated urine, and to allow it ©
to cool. The separation of urate of ammonia on cooling renders
it turbid, and crystals of uric acid may be obtained on the
addition of hydrochloric acid.
5. If urine containing urate of ammonia is albuminous, it is
necessary to be very cautious in the application of heat as a test.
On gently warming the tube, the urate of ammonia dissolves
before the albumen begins to coagulate. If the fluid which
has thus become clear is exposed to a stronger heat, it becomes
cloudy, the turbidity commencing in the upper, hottest stratum
of fluid, and gradually extending itself.
Urate of ammonia is recognized under the microscope as an
176 THE SECRETIONS :
amorphous mass, in which large, well-defined globules, some-
times united two and two, are often observed. Fig. 28a and
6 exhibit these forms. It is obvious from a comparison of fig.
28 a, and fig. 26, that the urate of ammonia, in consequence
of its form, may easily be mistaken for phosphate of lime. The
following points enable us to distinguish them. Phosphate of
lime occurs as a sediment only in neutral and alkaline, never
in acid urine. Phosphate of lime when examined under the
microscope disappears instantaneously on the addition of a
little hydrochloric acid, which usually develops numerous air-
bubbles. The sediment of urate of ammonia does not disappear
so rapidly under similar treatment, and in a short time, fre-
quently only a few minutes, its place is occupied by rhombic
crystals of uric acid, as shown in fig. 28 ¢.
The quantitative determination of urate of ammonia pre-
sents no difficulty when no other constituent is present in the
sediment. The weight of the urine and the amount of solid-re-
sidue are accurately determined : the sediment is collected in
a filter of known weight, washed with a little ice-cold water,
dried, and weighed. The ratios of the amount of. sediment to
that of the whole urine, and to that of the solid residue are thus
obtained. In order to separate the urate of ammonia from uric
acid, earthy phosphates, or mucus, with which it may be mixed,
the sediment must be collected, and the quantity of urine
from which it was deposited, carefully ascertained. The sedi-
ment must then be placed in a test-tube with a little of the
urine, and gradually raised to the boiling point (if we are pre-
viously assured that no albumen is present): it must then be
filtered, and the residue washed with a little hot water, while the
clear fluid that passes through the filter must be artificially
cooled, and the urate of ammonia allowed to separate. It
must be collected on a filter, dried, weighed, and its ratio de-
termined in reference to the urine, and to the solid residue.
The determination of the urate of ammonia as uric acid, from
which the amount of the salt might be calculated would, per-
haps, give safer results, since uric acid is less soluble than urate
of ammonia.
The fluid which, by the application of heat, has taken up the
urate of ammonia from the mixed sediment, must be concen-
trated by evaporation, and treated while still warm with hydro-
URINE. 177
chlorie acid. Upon cooling, the uric acid will separate and must
be collected.
ce. Increase of urate of soda. Lam not certain whether urate
of soda exists in normal urine. I shall, however, proceed to
state in what manner its presence may be recognized in certain
pathological conditions. Deposits of urate of soda alone are
not often to be met with; this substance is, however, frequently
associated with uric-acid and urate-of-ammonia sediments.
Urate of soda is detected chemically in the same manner as
urate of ammonia; like that salt it dissolves on the application
of heat; and when warmed on a porcelain capsule with a little
nitric acid, it develops the same purple colour. It differs, how-
ever, from that salt, in not developing an odour of ammonia
when rubbed with caustic potash, and in leaving a white ad-
hesive residue, when heated on platinum foil. This residue
when moistened with water, colours red litmus paper blue, and
froths when treated with hydrochloric acid,— (carbonate of soda.)
It may be distinguished in the same manner as the urate of
ammonia from uric acid, earthy phosphates, mucus, or pus.
Under the microscope it presents the form of globules, min-
gled with small prisms arranged in stellar groups: at least it is
in this form that I have always seen it when obtained artificially;
and I have detected such globules, only of g more opaque
appearance, in certain urinary sediments. ‘These. forms are
exhibited in fig.29a@ and 6. Certain forms described by Vigla
and Quevenne are given in fig. 29c¢. This peculiar crystalline
arrangement is sufficiently characteristic to enable the urate of
soda to be detected when mixed with urate of ammonia, or other
sedimentary matters, either crystalline or amorphous.
For a quantitative analysis of a sediment consisting of pure
unmixed urate of soda we must proceed in exactly the same
manner as for urate of ammonia. If, however, it is mixed with
uric acid, earthy phosphates, or mucus, the same method must
be adopted as for urate of ammonia under similar circumstances,
If urate of ammonia is mixed with urate of soda, they are both
held in solution when the urine is warmed, and are thus sepa-
rated from the other constituents of the sediment.
The solution is then slightly concentrated by evaporation, and
afterwards thoroughly cooled. The alkaline urates separate them-
II. 12
178 THE SECRETIONS:
selves, are collected on a filter, dried, and weighed. If the filter
with its contents is then incinerated in a platinum crucible, the
urate of soda will leave carbonate of soda, which must be con-
verted into a sulphate, and determined in that form. From the
sulphate of soda we can reckon the urate, and by deducting the
latter from the whole amount of alkaline urates, we obtain the
amount of urate of ammonia.
d. Decrease of uric acid, A relative and an absolute decrease
of uric acid has frequently been observed. In diabetes mellitus
I have sometimes been unable to obtain any trace of it, while
in other cases I have found it. If the method described in
page 116 fails in yielding any traces of uric acid we are not jus-
tified in assuming its entire absence. In doubtful cases we
must evaporate a large quantity of urine, and treat the residue
with alcohol. The portion of the residue which is insoluble in
alcohol must be dissolved in acidulated water, and there is then
an insoluble residue left, consisting of mucus, silica, and uric
acid (if this constituent be present.) If the nitric-acid test be
then carefully applied, we may convince ourselves with certainty
whether there is an entire absence of uric acid.
5. Increase or diminution of the extractive matters and
. ammonia-compounds.
An increase or diminution in the quantity of the extractive
matters,! of the chloride of ammonium, and lactate of ammonia,
1 [At the meeting of the German Association of Natural Philosophers, held at
Nuremberg last September, a paper was read by Scherer, on the extractive matters of
the urine. The following are the principal facts he has ascertained. The greater —
portion of the extractive matters is merely a pigment analogous to those of the blood
and bile. It may be thrown down from the urine by acetate of lead, and by treating
the precipitate with alcohol and hydrochloric acid, it may be obtained in a state of
purity. In healthy individuals it yields from 62 to 63 per cent. of carbon, and from
6°2 to 6°4 of hydrogen. In fevers, when there is rapid waste of tissue, and the fune-
tions of the lungs and liver are inactive, the carbon may amount to 66 or 67, and the
hydrogen to 7:2 per cent. An increase in the quantity of extractive or colouring
matter may be detected by boiling urine in a test-tube, and adding alittle hydrochloric
acid to it. Urine containing an excess of this colouring matter becomes of a dark
colour, and on cooling deposits a brownish, blackish, or frequently an indigo-blue
sediment, freely soluble in alcohol. Scherer believes that this colouring matter is
formed from the hematin of arterial blood, and that the amount of carbon contained
URINE. 179
in pathological conditions of the urine can only be ascertained
by the analytical proceedings described in pages 118 and 137.
6. Increase or diminution of the fixed salts.
The qualitative and quantitative variations occurring in the
mixture of the fixed salts of the urine in disease are deserving
of much attention. Some of these changes may be recognized
without difficulty.
a. Increase or diminution of the earthy phosphates.
There are certain diseased states of the system in which the
earthy phosphates are absolutely increased to a very marked
degree ; there are others, again, in which they decrease in an
extraordinary manner, or even altogether disappear.
a. It is no very rare occurrence for the free acid of the urine
to become neutralized by the formation of ammonia, and the
urine thus becoming neutral or even alkaline, the earthy phos-
phates are precipitated. Urine in which these events occur
is most commonly light-coloured ; sometimes, however, dark.
Blue litmus paper is not at all reddened by it, in fact red litmus
is usually rendered slightly blue, and in some cases a powerful
alkaline reaction is manifested. Generally speaking, the urine is
clear and slightly acid at the period of its emission, but in a
very short time it undergoes the change we have stated; a
change which also occurs in normal urine, but not till after the
lapse of several days. It becomes turbid, a film is formed on
the surface in which minute crystals may be frequently detected
‘with the naked eye. A sediment shortly begins to form, and
at the same time the inner surface of the glass which contains
the urine becomes covered with a stratum of salts; at least I
have observed this to occur in several instances. Sediments of
this kind are sometimes scanty, sometimes very copious. I
have seen a case in which the sediment, which consisted almost
in this pigment varies inversely with the degree of oxidation of the blood; that its
formation is analogous to the formation of uric acid and urea; that the carbon and
hydrogen contained in it do not increase in an equal ratio ; and that, finally, a long-
continued secretion of urine, rich in this colouring matter, usually induces anemia
and emaciation. (Med. Times, Oct. 11, 1845.) ]
180 THE SECRETIONS:
entirely of earthy phosphates, occupied, when it had entirely
settled, one third of the volume of the fluid. I received from
a physician of this city, a portion of dried urinary sediment
which consisted almost entirely of pure earthy phosphates.
This fragment bore evident traces of the form of the glass in
which the urine had been kept, and it was of the extraordinary
thickness of nearly an inch and a half. Earthy-phosphate sedi-
ments are seldom perfectly pure; their colour is white, gray,
yellow, or reddish. White and gray sediments consist princi-
pally of earthy phosphates and mucus; yellow and reddish sedi-
ments contain a greater or less admixture with urates.
That the sediment is composed of earthy phosphates we are
assured by the following chemical facts. The urine from which
it is precipitated is neutral, or more commonly alkaline; the
sediment does not dissolve on the application of heat, like the
urates; it is, however, readily dissolved by the addition of an
acid (hydrochloric, nitric, or acetic,) to the urine; a property
which is not enjoyed by sediments of the urates, of mucus, or
of pus. If the sediment contain so large a proportion of urates
and mucus that the addition of an acid does not produce any
obvious degree of clearing, the acidulated urine must be gently
warmed and filtered from the insoluble constituents. Upon the
addition of free ammonia to the clear, filtered fluid, the earthy
phosphates will be precipitated.
The nature of the sediments may be still more quickly ascer-
tained by the microscope. If the sediment consists of earthy
phosphates, we observe the beautiful crystals of ammoniaco-
magnesian phosphate depicted in fig. 27, and also amorphous”
masses of phosphate of lime, fig. 26. Upon the addition of a
minute quantity of free acid to the objects on the field of the
microscope the crystals and amorphous masses immediately dis-
appear, and at the same time numerous air-bubbles are liberated.
If the earthy phosphates have been dissolved by a little acidu-
lated water from the urates and mucus or pus, with which they
were associated, and are then precipitated from the filtered
solution by free ammonia, the precipitate exhibits other forms
under the microscope.
I have represented these forms, which seem to vary according
to circumstances, in fig. 30. Fig. 30a exhibits the different
forms under which the ammoniaco-magnesian phosphate is pre-
URINE. 181
cipitated, in which the predominating character is the forked
arrangement of the crystals. Fig. 30 6 exhibits the forms in
which the phosphate of lime appears.
The quantitative determination of earthy-phosphate sedi-
ments presents no difficulty, if other constituents are not also
present. The method of proceeding is exactly the same as for
the quantitative determination of the urate-of-ammonia sediment
in page 176. Its amount must be determined in reference to the
whole quantity of urine, and to the amount of solid residue.
In order to separate the earthy phosphates from urates, and
mucus or pus, the sediment must be collected, washed with
a weak solution of ammonia, the earthy phosphates taken up
by water acidulated with hydrochloric acid, precipitated from
the filtered solution by free ammonia, collected on a filter, dried,
and weighed. Upon submitting the dried precipitate to a strong
heat the ammonia is given off, and the weight proportionally
diminished. The ratio of the earthy phosphates to the solid
residue of the urine enables us to determine whether an increase
in this particular class of constituents has occurred. If the re-
lative quantities of phosphate of lime and ammoniaco-magnesian
phosphate are required, the separation must be conducted on the
principles described in page 139.
3. Diminution of the earthy phosphates. There can be no
doubt that in certain diseases the earthy phosphates are much
diminished, and that occasionally they altogether disappear. If
the amount of earthy phosphates in the urine should be so slight
that, upon the addition of free ammonia no precipitate is ob-
served, it will be necessary, in order to be assured of the entire
absence of this constituent, to evaporate a large quantity of
urine, to incinerate the solid residue, to dissolve the ash in
water containing a little nitric acid, and then to add ammonia.
If no precipitate is formed after the fluid has been warmed and
allowed to rest for some hours, the absence of earthy phosphates
may be considered as proved.
b. Increase or diminution of the chloride of sodium and of the
jixed alkaline sulphates and phosphates.
The quantity of fixed alkaline salts almost always decreases
182 THE SECRETIONS:
during disease, principally in consequence of the diminution of
the chloride of sodium, which, however, is by no means one of
the most important of the saline constituents, and whose weight
may be determined in the manner described in page 140. It
is different, however, with the alkaline phosphates and sulphates,
which (more especially the sulphate of potash,) appear to fluc-
tuate considerably in disease.
We may readily be convinced of the presence or of the total
absence of the aforesaid salts in urine which has become modi-
fied by disease, by the application of certain tests, or by the
methods which have been enumerated in page 130, under
9, 10, and 11; indeed the practised experimenter will be
able to judge from the specific gravity whether there is any
decided increase or diminution in the amount of the fixed alka-
line salts.
As, however, it is of importance to know the exact amount
of the alkaline sulphates and phosphates in certain diseases, we
must adopt the method described in page 140, and determine
the relation of these salts to the solid residue.
7. Increase of mucus.
In catarrhal affections of the bladder the amount of mucus
in the urine is often very much increased. The urine in these
cases is acid or neutral, but frequently exhibits a strong ten-
dency to become ammoniacal in a short time. The colour is
usually unaffected, and seldom higher than ordinary. If there
is a very large proportion of mucus in the urine, a diffuse sedi-
ment of a viscid consistence, and of a white, yellowish, or dirty
yellow colour, will separate itself.
If the urine exhibits a strong tendency to the formation of
ammonia,the mucus will become very tough, and almost thready.
The supernatant fluid is somewhat turbid, but heat induces no
coagulation unless albumen be present.
The mucus may be recognized under the microscope by the
peculiar mucus-granules, which are usually rather larger and
less granular than those from the mucous membrane of the
lungs or nose. |
I have represented the mucus of the bladder, as it occurs in
certain pathological states, in fig. 31 @.
URINE. 183
Mucus frequently accompanies sediments of the urates and
earthy phosphates, and its presence in these cases may be de-
tected by the microscope. When mucus is separated in large
quantity, (as in vesical catarrh,) carbonate of ammonia is soon
formed, and we always find numerous crystals of ammoniaco-
magnesian phosphate.
The quantitative estimation of the mucus must be effected in
the manner described in page 135. The ratio of its weight to
that of the solid constituents must be determined.
In order to ascertain the quantity of mucus in a sediment of
urates and earthy phosphates, the sediment must be collected,
the urates dissolved in hot water, and the earthy phosphates
then taken up by acidulated water. The mucus will remain on
the filter, and must be dried and weighed.
The method of conducting the quantitative analysis of diseased
urine is precisely the same as for the healthy secretion, provided
the changes are only dependent upon an increase or diminution
of one or more of the normal constituents: indeed it may be
still more simplified by omitting the exact determination of
the lactic acid, the lactates, the chloride of ammonium, and the
extractive matters.
The proportions of water and of solid residue must be de-
termined, in the manner already described, from a weighed
quantity of filtered urine. The residue, after being dried over
sulphuric acid, must be moistened with a little warm water,
and then thoroughly extracted with anhydrous alcohol. The
undissolved portion must be dried, weighed, and incinerated.
The extractive matters and uric acid are consumed, and there
remain the earthy phosphates, the alkaline sulphates and phos-
phates, and the chloride of sodium, which must be separated.
and determined.
The anhydrous alcoholic solution must be gently evaporated,
dried over sulphuric acid, weighed, and dissolved in a little
water. The urea must be then precipitated as a nitrate, which
must be separated and dried in the ordinary manner, weighed,
Sean THE SECRETIONS:
and the weight of urea calculated from it. By subtracting the
weight of urea from that of the whole of the alcohol-extract, we
obtain as a residue the lactates, chloride of ammonium, alcohol-
extract, and lactic acid, if any should be present.
The uric acid must be determined from a separate portion of
urine. Ifany sediment occurs in the urine, it must be separated,
and its weight ascertained in relation to the weight of the urine.
After having ascertained its general nature, its various consti-
tuents must be determined by the methods already given. _
If the morbid urine contains substances which do not occur
in the healthy secretion, this method will even then often hold
good, since the abnormal ingredients are sought for by inde-
pendent processes. In many cases, however, a change is requisite;
and I shall proceed to notice the various cases that may occur.
1. Qualitative and quantitative determination of substances
which do not occur in normal urine.
Albumen is frequently present in the urine of persons suf-
fering from disease, and indeed I once found it ‘in the urine of
a healthy vigorous young man, aged twenty-six years. If there
is a considerable amount of albumen, nitric acid or bichloride of
mercury will cause a precipitate, and the urine will become
turbid on the application of heat, and deposit flocculi of coagu-
lated albumen. Urine of this sort is usually pale and slightly
turbid from containing mucus in suspension: its colour may,
however, be high, as in the phlogoses; it may have an acid,
neutral, or alkaline reaction, a high or a low specific gravity.
When the quantity of albumen is very small, the application of
heat is the most efficient test, and the most minute quantity of
albumen may be readily detected by observing the uppermost
part of the column of the fluid as it is being gently heated in
a test-tube. When the temperature is sufficiently elevated, the
coagulation begins to occur in the form of small white nebule,
which are dispersed by the rising of large bubbles, and the general
turbidity of the whole fluid is often so slight that unless the de-
velopment of these nebule has been observed at the commence-
ment of the process, it becomes a matter of difficulty to decide
upon the presence of albumen. It is only in cases in which
URINE. 185
the urine has a decidedly alkaline reaction that nitric acid is
preferable for the detection of small quantities of albumen,
as in these instances the albumen is held in solution by the free
alkali.
A turbidity may occur on the application of heat from the
precipitation of earthy phosphates, or possibly of carbonate of
lime, when no albumen is present; but in this case it is directly
removed on the addition of nitric acid: similarly, nitric acid
may throw down a deposit of uric acid, which may be mistaken
for albumen, but in this case no precipitate is caused by the
application of heat. Dr. G. O. Rees has observed, that after
the use of cubebs or balsam of copaiva, the urine is rendered
turbid by nitric acid, although it contains no albumen ; it is,
however, not affected by heat. Hence, if there should be a
tendency to the deposition of phosphates, a precipitate might
ensue both on heating, and on the addition of nitric acid, and
yet no albumen be present. I have confirmed the accuracy of
the above observation ; the precipitate consists of minute oil-
vesicles readily soluble in alcohol, and possessing an odour of
balsam of copaiva.
The quantitative analysis of albumen is best effected by
boiling the urine, collecting the albumen on a filter, washing,
drying, and weighing it, and ascertaining its weight in relation
to that of the urine which was boiled, and to the solid residue.
The portion of urime from which the albumen has been separated
by boiling, may also be used for the determination of the other
solid constituents and of the urea, if the quantity of albumen
is not very large, and if the coagulated albumen is carefully
washed. If the proportion of albumen is so large as to cause
the urine to gelatinize on being heated, which, however, is very
seldom the case, it may be feared that the coagulated albumen
will entangle many other substances ; in that case, the amount
of solid constituents may be determined from a fresh quan-
tity of urine, about 500—600 grains ; the coagulated albumen
must be treated several times with hot water before it is
dried. When the quantity of albumen is very small, as for in-
stance when the urine becomes only slightly turbid on heating,
its amount cannot be determined with accuracy. It is then
contained in the water-extract, and it is sufficient to state that
the urine contains traces of albumen. If the amount of albu-
186 THE SECRETIONS:
men is very considerable, certain changes must be made in the
method of determining the other constituents. The albumen
itself must be always separated by boiling.
In determining the urea we must see whether, when the
albumen is very abundant, the greater quantity of it cannot be
precipitated by alcohol. The albumen thus separated must be
washed with alcohol. If we were to attempt to determine the
urea in very albuminous urine in the manner described in page
136, there would be reason to apprehend that the albumen pre-
cipitated by the application of heat would entangle too large an
amount of urea.
The determination of the uric acid is usually regarded as
very uncertain in strongly albuminous urine. I have, however,
convinced myself that this constituent may be separated from
very albuminous urine by the careful addition of extremely di-
luted hydrochloric acid, [or acetic acid may be used, which —
precipitates uric acid without affecting the albumen.| It-must
also be observed that urine which is very rich in albumen always
contains only mere traces of uric acid, and a very small pro-
portion of urea.
In the determination of the water-extract, it must be borne
in mind that albumen is present in it. As its quantity is
known, it must be subtracted from the combustible portion of
the water-extract.
The spirit-extract is obtained from the portion of urime pre-
cipitated by alcohol, where it occurs in a state of solution,
This solution must be filtered, evaporated, and all substances
insoluble in anhydrous alcohol precipitated by the addition of
that reagent. These are spirit-extract with chloride of sodium,
and a certain quantity of albumen which remains insoluble on
the addition of water. The watery solution of the spirit-ex-
tract and of the salts must be filtered, again evaporated, weighed,
and then treated in the manner described in page 137.
If we wish to avail ourselves of the alcoholic solution which
remains after the precipitation of the spirit-extract by anhydrous
alcohol, for the estimation of urea, we must take another por-
tion of urine for the determination of the alcohol-extract and
ammonia-compounds, and proceed in the same manner as for
the determination of the urea.
In the determination of the fixed salts it must be remembered
URINE. 187
that the earthy phosphates are increased by the phosphate of
lime associated with the albumen, and as this generally amounts
to 6 or 7 per cent., a corresponding amount must be deducted
from the earthy phosphates. In other respects the method de-
scribed in page 140 must be adopted.
[The following method for determining the amount of albu-
men has been recently proposed by Heller,! and offers several
advantages.
A small quantity of the urme (from 20 to 10 grains) must
be carefully weighed, and its solid residue accurately determined.
In this way we estimate the per centage of solid residue,
Another portion must be rapidly heated to incipient ebullition
in a small narrow-mouthed flask. The mouth must be then
closed, in order to prevent the escape of vapour, and the liquid
when cold strained through a moderately fine linen cloth. The
strained fluid is thus obtained perfectly clear, the albumen re-
maining on the linen as a snow-white magma. By treating a
small quantity with nitric acid, we may be certain that the
albumen is completely separated. The amount of the solid
residue yielded by the strained fluid is determined, and the
per centage calculated. The difference gives the per centage
of albumen. If extreme accuracy is required, the flask with
its contents may be weighed both before and after ebullition,
and a correction made for the escaped vapour. In _case the
fluid should be alkaline, it must be previously acidulated with
acetic acid. |
2. Constituents of the blood with the exception of fibrin.
Bloody urine is not of very unfrequent occurrence; it is
distinguished by a more or less marked blood-red colour, some-
times being of a brown-red, and on other occasions even of a
brownish black tint. No certain conclusions regarding the
presence of blood can, however, be deduced from the colour
alone. I have seen urine in colour strongly resembling bloody
urine which contained not a trace of hematoglobulin. Various
resemblances to the colour of blood may be induced by mix-
tures of considerable quantities of hemaphzin, of uroerythrin,
Archiv fir phys. und patholog. Chemie und Mikroskopie, vol. 1, p. 192.
188 THE SECRETIONS:
and of biliphzin. The presence or absence of the constituents
of the blood may, however, be easily determined by the micro-
scope, and by certain tests. If undissolved blood-corpuscles
remain in the urine, as is frequently the case, they sink to the
bottom and form a dark brown-red sediment, in which their
forms may be recognized by the microscope. The dark-red
supernatant fluid coagulates on the application of heat, m the
same manner as ordinary albuminous urine; the coagulated
matter, however, in this case is not white, but of a dirty brown
colour. Similar appearances are produced by the addition of
nitric acid. If the blood-corpuscles are perfectly dissolved in
the urine, as I have sometimes observed to be the case, the
microscope affords us no assistance. The application of heat,
and the addition of nitric acid will, however, be sufficient to
convince us directly of the presence of albumen and hemato-
globulin.
The quantitative determination of blood in urine, and the
changes which must be made, in consequence of the presence
of a considerable quantity of that fluid, in the determination
of the normal constituents are precisely similar to those already
described in speaking of albuminous urine. It must be ob-
served that the ash becomes reddened by the peroxide of iron
which occurs in the hematin; and the fixed alkaline salts, as
well as the earthy phosphates, are increased by the fixed salts
of the blood, which usually amount to about 8 per cent.
3. The constituents of the blood generally.
Fibrin has been found associated with the other constituents
of the blood which we have described as occasionally occurring
in the urme.!_ Urine of this sort resembles blood in appear-
ance; assumes, on being allowed to rest, a gelatinous consis-
tence ; trembles on the movement of the vessel; and, finally,
separates into two portions, a clot, and thin fluid serum.
On examining, under the microscope, a little of the fiuid
obtained by pressing a portion of the clot, blood-corpuscles are
‘ [Fibrin has been detected occurring in a state of solution in urine, independ-
ently of the other constituents of the blood. Zimmerman describes seven cases of
this nature, some of which are noticed at length in a future part of this chapter,
(Zur Analysis und Synthesis der pseudoplastischen Prozesse. Berlin, 1844, p. 129.)]
URINE. 189
observed: and upon kneading the clot in water we obtain fibrin,
which may be washed perfectly pure. Under these circum-
stances there is no difficulty in ascertaining the presence of
blood. If the blood has coagulated in the bladder, the urine
will be of a blood or brown-red colour, or even of a brownish-
black, and will contain gelatinous flocculent coagula of fibrin,
which, after remaining for some time in the urine may acquire
a degree of transparency by the solution of their colouring
matter.
It is only necessary, in these cases, to make sure that the
coagula are not composed of mucus, a point which can be readily
settled by the microscope, under which coagula of fibrin, upon
compression between thin glass plates, present an amorphous
granular appearance, while in the mucus-flocculi we recognize
the well-known mucus-granules.
The quantitative determination of the constituents of the
blood must be conducted in the manner described in 2. A
method perfectly similar to the one which I have given for the
analysis of blood may, however, be adopted, and in order to
determine the urea in a certain quantity of bloody urine, the
protein-compounds must be precipitated with alcohol, in the
same manner as in albuminous urine.
4, Urine may contain fat either as an independent extra-
neous constituent, or associated with albumen, or with casein
and the other constituents of milk. To distinguish these three
morbid forms of urine we may term them, for brevity, fatty
urine, chylous urine (Prout), and milky urine. In addition to
these forms, urine containing blood always contains, of course,
a relatively corresponding quantity of fat.
Fatty urine. We occasionally observe that the urine of
persons labouring under consumptive disorders becomes covered
over with a glistening film. It would be precipitate to consider
this, without further investigation, as a fatty coat, since I have
observed a similar appearance on the surface of urine which had
been standing for some time, and was just becoming ammoniacal.
The microscope will immediately disclose the nature of the film :
if it is composed of fat, we observe, on the microscopic exa-
mination of a small portion, an immense number of fat-globules ;
190 THE SECRETIONS:
in the other case, we observe an amorphous granular matter.
Cases have however occurred in which the urine has contained
so large a quantity of fat that the oil-vesicles could be observed
even with the naked eye, and formed a perfect stratum on the
surface ;—-such cases have been recorded by Elliotson and
Bachetoni.!
The microscope is always sufficient for the recognition of fat
in urine. If a quantitative determination of the fat is required,
a weighed portion of urine must be evaporated and the residue
repeatedly extracted with ether. The ether must then be eva-
porated, and the fat separated from the urea, and other con-
stituents which may have been also taken up by means of water.
This separation should be effected in a small porcelain basin,
in which the fat must be heated till all aqueous moisture is dis-
sipated, and then weighed. If the amount of solid residue is
known either by this, or a separate experiment, the proportion
of fat to the urime, and to the solid residue, can be at once
obtained. ‘The residue, after the separation of the fat, will
serve for the determination of other constituents, as urea or
extractive matters; it must however be remembered that the
water in which the fat was washed, contains some little urea.
Chylous urine. Chylous urine contains both fat and albu-
men; it is usually turbid, curdy, sometimes even resembling
milk in point of colour. Under the microscope it exhibits
numerous fat-vesicles. On the addition of a small quantity of
acetic, or dilute sulphuric or hydrochloric acid, no coagulation
occurs, even when gentle heat is applied; but on the addition
of nitric acid a white precipitate is observed. Upon the ap-
plication of heat to chylous urine, the albumen coagulates in
flocculi. The methods of determining the amount of albumen
and fat have been already given.
5. Casein.
Casein has never yet, so far as I know, been observed as a
single extraneous constituent of the urine, as albumen some-
times seems to occur, but has always been found in combination
with fat, and, in all probability, also with sugar, forming milky
urine.
} Urinary Diseases and their Treatment. By Robert Willis, m.p. p. 166.
URINE. 191
Milky urine is always turbid, of a yellowish-white colour,
sometimes like milk, and when examined under the microscope,
exhibits a quantity of fat-vesicles. Upon the application of heat to
urine of this nature, coagulation will take place if a considerable
amount of lactic acid is present, and then only a moderate tem-
perature (86° to 104° F.) is sufficient. If it does not coagulate
at this temperature, neither will it do so at the boiling point,
as I have proved in an experimental mixture of milk with urine.
If, however, albumen should also be present, the urine will
coagulate on being boiled. On the addition of a few drops of
acetic, or dilute sulphuric or hydrochloric acid to a little of this
urine, flocculi of coagulated casein will be formed if a moderate
heat is applied. In order to determine the quantity of casein
we must add a little acetic acid to a weighed portion of mode-
rately warmed urine, and allow it to digest till the white flocculi
of acetate of casein have separated themselves, and the urinary
fluid has become clear.
The flocculi must be collected, washed, dried, and weighed.
This is most readily effected on a light filter of known weight,
which must be deducted, in order to give the true weight of
the casein. The fat becomes entangled in the precipitated
acetate of casein, and the filtered fluid exhibits only a few scat-
tered fat-vesicles swimming in it. The fat may be separated,
and its amount determined, either from the dried residue of
the urine, or from the dried casein, by extraction with ether.
The casein must be determined from a separate portion of
urine ; after this constituent has been separated the urine may
be evaporated, and the urea and water-extract determined from
the residue.
6. Brown pigment of the bile. (Biliphein.)
It is no uncommon occurrence to find the urine tinged with
this substance; in icterus it is always present. Urine of this
sort is of a saffron, dark yellow, or yellowish-brown colour,
and its sediment, if it contains one, is usually of a yellow
or brown colour also. We cannot, however, always decide
upon the presence of biliphzin from the colour of the urine,
since hemaphein (the peculiar colouring matter of the urine)
is capable of producing a similar tint. It is a peculiarity
192 THE SECRETIONS:
of urine coloured dark by biliphzin, that it exhibits in thin
layers a characteristic saffron yellow colour. The presence of
biliphzin may be at once detected with certainty by the addi-.
tion of nitric acid, by which the well-known transitions in
colour, from green to violet, red, and yellow are produced.
It is only when there is a considerable quantity of biliphein
present that these transitions can be distinctly observed, and
the best method of proceeding is to pour a layer of urine care-
fully over nitric acid, and to continue the mixture of the two
fluids gradually.
When the quantity of biliphein is very small, the only
changes that we are certain to observe on the addition of the
nitric acid, are the transition of the yellow colour of the urine
into green, which usually reverts to a yellow, without the
intermediate colours being observed. Hydrochloric acid con-
verts the yellow or brown colour of the urine into green, but
does not develop the other tints. ——
An exact quantitative determination of the biliphzein in urine
appears, with our present resources, hardly practicable, for its
amount is usually very minute, and, like the animal colouring
matters generally, it possesses the property of combining very
intimately with other constituents. Thus we find uric acid,
when it occurs as a sediment in icteric urine, mucus, the ex-
tractive matters, &c. always tinged yellow by bilipheimn. We
must therefore be content, in our estimation of the amount of
the biliphein, to draw our inferences from the intensity of the
colour of the urine, and from the degree of change that it
undergoes on the addition of nitric acid.
7. Bilin and bilifellinic acid.
The quantity of bile in urine is occasionally so large as to
communicate to that fluid a decidedly bitter taste: in these cases
biliphzein is always present. Whenever biliphzin occurs in
urine, we are justified in suspecting the presence of bilin and
bilifellinic acid, although they are not always found.
When the taste of the urine does not decidedly indicate the
presence of bilin and of the acids of the bile, we must, in order
to be assured of their existence, evaporate the urine, extract the
residue with anhydrous alcohol, and then expel the alcohol by
URINE. 193
evaporation ; the residue will contain bilin and bilifellinic acid,
in addition to urea, alcoholic-extract, and the IRE ; their
presence may be recognized by the taste.
[The best method of ascertaining the presence of _bilin (or
choleic acid) is one recently published by Pettinkofer.! A
small quantity of the urine or other fluid, supposed to. contain
bile, must be poured into a test-tube and treated with about
two thirds of its volume of sulphuric acid, added by drops.
Considerable heat is evolved, and the mixture must be kept below
144°, otherwise the bilin will be decomposed. A few drops of
a solution of cane-sugar (five parts of water to one of sugar) are ~
added, and the mixture shaken. If bilin be present, a violet-
red colour will appear, the distinctness of which will vary with
the amount of bilin. The following precautions must be at-
tended to :—Ist, the temperature must not exceed 144°, other-
wise the colour, although formed, will\be again destroyed:
2dly, the quantity of sugar must not be too large, lest sul-
phurous acid should be formed, and the solution become of a
dark brown colour: 3dly, the sulphuric acid must be free from
sulphurous acid: 4thly, if albumen be present, it is advisable
to coagulate and remove it before applying the test, since it —
gives origin (when present in a large quantity) to a tint some-
what resembling that produced by bilin: 5thly, a great excess
of chlorides produces a brownish-red colour.
In liquids where the bile is in very small quantity, as in the
urine and other secretions, it is often necessary to make a
spirituous extract, to evaporate this nearly to dryness on the
water-bath, and to transfer the moist residue into a watch-
glass. When quite cold, sulphuric acid and a very small quan-
tity of syrup are added, so that the temperature of the solution ~
remains low. In the course of a few minutes, if the most
minute trace of bile is present, the colour is produced. In em-
ploying this test grape-sugar, or any substance convertible into
grape-sugar, may be substituted for cane-sugar.
The nature of this reaction is unknown ; it was at first con-
sidered that the peculiar violet tint might be dependent on the
decomposition of the bile-pigment, but it was found to occur,
1 Liebig’s und Wohler’s Annalen, vol. 52, part 1.
II. 13
194 THE SECRETIONS:
even in a more marked degree, with decolorized bile, and with
pure bilin.
Another test has been recently proposed by Schwertfeger.
He recommends that the urine should be treated with basic
acetate of lead. When bile is present the precipitate is yellow.
On treating this precipitate with alcohol containing some sul-
phuric acid, we obtain a green solution, to which (as has been
suggested by Dr. Griffith) Pettinkofer’s test may be applied with
advantage. |
For the purpose of forming a quantitative analysis of the
bilin in the urime, we must evaporate a weighed portion, pre-
cipitate the water-extract and the salts insoluble im alcohol
with spirit of 0°85, evaporate the spirituous solution, and extract
the residue with anhydrous alcohol. The alcohol of this last
solution is expelled, the residue dissolved in a little water, and
some hydrochloric acid added; it is then allowed to digest ill
the resinous matter of the bile has separated itself, which must
be washed, dried, and weighed. The presence of bile offers no
impediment to the determination of the urea, for which purpose,
however, a different portion of urine must be used.
When icteric urme contains a sediment, it is usually of a
yellow or brown colour, and in addition to the ordinary con-
stituents of urinary deposits, it contains biliphein. The sedi-
ment, in these cases, must be separated, and extracted with
alcohol. This alcoholic solution must be united with the spi-
rituous solution of the residue of the urine, from which the bilin
was determined. The sediment must be analysed according to
the rules already laid down for the separation of uric acid, the
urates, and earthy phosphates.
8. Sugar.
In diabetes mellitus the urine frequently contains a large
' quantity of grape or diabetic sugar, while the urea is at the same
time either absolutely or relatively diminished. When the quan-
tity of sugar is considerable its presence can be detected without
difficulty. The urine must be evaporated, ‘and the syrupy residue
treated with alcohol of 0°83. The alcoholic solution must
then be evaporated till a yellow and very sweet syrup is left.
Trommer, of Berlin, has discovered that the smallest quantity
URINE. 195
of grape-sugar may be detected in a fluid by the addition of a
solution of sulphate of copper and of caustic potash.’ On heating
the mixture we do not obtain a black precipitate of oxide of
copper, but the fluid becomes turbid, and a more or less consi-
derable yellow, or yellowish-brown precipitate of reduced sub-
oxide of copper is thrown down. According to the statements
of Trommer, this method is particularly applicable to the de-
tection of very minute quantities of diabetic sugar in urine; but
since the ammonia-salts, the urea, and nitrogenous extractive
matters, when heated with caustic potash, develope free ammonia,
which impedes the action of the test, it is better to proceed in
the following manner. The urine must be evaporated and the
syrupy residue treated with anhydrous alcohol. Dry carbonate
of potash must be added to this solution, and the mixture well
shaken. The carbonate of potash dissolves and forms a layer
beneath the alcohol. Upon the addition of some dissolved sul-
phate of copper, and the application of heat, there is produced
in the lower portion of the fluid, a yellow or yellowish-brown
turbidity, if sugar is present. Trommer states that this method.
is equally applicable for the detection of sugar in the blood.
The quantitative determination of sugar in urine is not very
easy: I proceed in the following manner. A weighed quantity
of urine is evaporated on the water-bath to the consistence of
a thin syrup, and the residue treated with alcohol of 0°85,
which precipitates the mucus, the salts insoluble in.spirit, the
water-extract, uric acid, &. The spirituous solution is then
evaporated to the consistence of a thick syrup, and anhydrous
alcohol added, which precipitates the greater part of the sugar
in the form of a yellowish-white magma. On pouring off the
supernatant yellow alcohol, and repeatedly treating the magma
with anhydrous alcohol, it gradually assumes a tough pasty
form : it must then be warmed for some time on the water-bath,
until all the alcohol is expelled, and be subsequently placed
under a receiver over sulphuric acid, to dry. ther is then
added to the alcohol, in about the proportion of one volume of
the former to two of the latter, by which an additional quantity
of sugar is precipitated, whose weight must be determined
1 See Vol. I, p.68. Additional observations on the application of this test will be
found in the remarks on the urine in diabetes.
~~
196 THE SECRETIONS:
separately. The substances now remaining in solution in the
etherealized alcohol are urea and alcohol-extract. The fluid
must be evaporated or distilled, and the urea determined from
the residue by nitric acid. The sugar separated in this manner
is not perfectly pure; it still contains chloride of sodium, extrac-
tive matters, and, in most cases, a small quantity of urea.
From the portion precipitated from the urine (after it has been
reduced to a thin syrup) by alcohol of 0°85, and which consists
of water-extract, earthy phosphates, uric acid, and mucus, the
water-extract may be taken up by water, and determined after
evaporation. The earthy phosphates may be taken up by water
slightly acidulated with hydrochloric acid, from which they may
be precipitated by ammonia: uric acid and a little mucus remain.
The uric acid should be determined from a separate quantity of
urine, according to the method described in page 137, for by this
process we frequently obtain mere traces of it, and sometimes
no indication whatever of its presence. The determination of
the fixed salts in diabetic urine is of importance. Hunefeld has
observed that diabetic urine frequently contains more chloride
of sodium than the healthy fluid, a circumstance probably arising
from the diet which is most commonly observed during the dis-
ease in question. In order to determine the fixed salts, a portion
of urine must be evaporated, and the residue incinerated. The
perfect incineration of the residue is a matter of some difficulty:
it may be facilitated by moistening the carbonaceous residue
with nitric acid, and then submitting it to a red heat; or nitric
acid may be added to the syrup at once, in which case a very
large amount of carbon is burnt off immediately upon the resi-
due being submitted toa red heat. The salts must be determined
by the method described in page 139.
The exact determination of the solid residue of diabetic urme
presents certain difficulties. A very small quantity of urine
(from about 150 to 230 grains) should be evaporated in the
water-bath, and the residue spread over the evaporating basin,
which should then be placed under a receiver over sulphuric
acid, for the perfect removal of the water. The quantities of
sugar, urea, uric acid, &e. must be brought into relation with
the amount of solid residue as well as with the whole quantity
of urine.
Diabetic urine may also contain a tasteless species of sugar,
URINE. 197
which, according to Bouchardat,! corresponds exactly in its be-
haviour towards yeast, and in its solubility in spirit, with sweet
sugar, and may be separated in the same manner.
I have had one opportunity of examining diabetic urine,
containing a slightly sweet sugar which was soluble in spirit,
and also a considerable amount of insipid matter which was
precipitated by alcohol, and appeared to resemble gum mixed
with water-extract and mucus. I could not separate it from
the water-extract, which is usually very scanty in diabetic urine.
9. Carbonate of ammonia.
In some diseases, especially in affections of the brain and
nervous system, and of the bladder and kidneys, the urine pos-
sesses the property of becoming quickly alkaline; indeed I have
observed instances in which it was alkaline at the period of its
being passed. In these cases it has a very disagreeable, am-
moniacal odour, and changes red litmus paper to a bright blue.
In colour it may be either light or very dark ; it ordinarily
forms, in the course of a short time, a sediment of a grayish-
white, and occasionally of a yellow or red colour, consisting
of earthy phosphates. A certain test for the presence of car-
bonate of ammonia is afforded by holding a glass rod moist-
ened in non-fuming hydrochloric acid over the urine; its
existence is indicated by the formation of dense white vapours.
On the addition of nitric acid to the filtered urine, numerous
bubbles of carbonic acid gas are briskly developed. After a
little practice the odour will be a sufficient indication of a
very minute quantity of carbonate of ammonia. The quan-
titative analysis of this substance is seldom undertaken, but
without doubt it is of importance, especially for the purpose
of ascertaining whether an increase in the quantity of carbonate
of ammonia necessarily involves a decrease in the amount of urea.
I have satisfied myself that in diseases of the spinal cord,
when the urine often contains much carbonate of ammonia, it
is formed at the expense of the urea. In four experiments,
instituted with this object, I found scarcely a trace of urea in
the urine,
An approximation to the amount of carbonate of ammonia
1 [Bouchardat now regards this tasteless sugar as a compound of the ordinary
diabetic sugar with salts. ]
198 THE SECRETIONS:
may be made in the following manner. Dilute hydrochloric
acid of known strength must be added guttatim to a weighed
quantity of gently warmed urine, till, from being alkaline, the
fluid becomes slightly acid. This point being attained, the
warmth is continued for some time in order to make sure that
the acid reaction is not due to the carbonic acid that has been
liberated. The amount of carbonate of ammonia is then esti-
mated from the quantity of hydrochloric acid which has been used.
10. Oxalate of lime.
Oxalate of lime not unfrequently gives rise to urinary caleuli.
A compound resisting a solvent power of the moderate acidity
of the urime cannot, of course, occur in it in a state of solution :
it has, however, been detected several times in urinary sediments,
for whicli reason I refer to it here. Prout and H. Brett’ have
observed these sediments. The latter writer states that the
urine was very high-coloured, and that the sediment was of a
brownish tint. He ascertained its nature by its ready solubility
in dilute nitric acid without any indication being afforded of the
presence of uric acid, by its becoming white on incineration, by
the ash then dissolving in hydrochloric acid with considerable
effervescence, and by oxalate of ammonia producing an imme-
diate precipitate, while no marked effects followed the addition
of ammonia in excess: by these characters the oxalate of lime
was thoroughly and satisfactorily made out. I once found ox-
alate of lime in the urine of a man with induration of the
pancreas and suffering from great acidity of the stomach. The
urine was neutral, or all but alkaline, and contained the minute
prismatic crystals represented in fig. 36d. They were insoluble
in acetic, but dissolved in hydrochloric acid ; and a further in-
vestigation left no doubt of their real nature. After some days
the urine became remarkably acid, and deposited a sediment
devoid of oxalate, but containing carbonate of lime.
[I have already mentioned that oxalate of lime is a much
more common ingredient of urinary sediments than was formerly
supposed. (See Vol. I, p. 85.) In order to detect it, place
urine, passed a few hours after a full meal, in a large test-
1 Urinary Diseases and their Treatment. By Robert Willis, m.p. p. 118.
URINE. 199
tube, and allow it to stand for some hours. Decant the upper
6-7ths, pour a portion of the remainder into a watch-glass, and
gently warm it over a lamp; in a few seconds the heat will have
dissolved any urate of ammonia that may be present, and will
(by rendering the fluid specifically lighter) induce the deposition
of the crystals of oxalate of lime. Having allowed the urine to
repose for a minute or two, remove the greater portion of the
fluid with a pipette, and replace it by distilled water. A white
powder, often of a glistening appearance, will now become
visible, and this, under a microscope furnished with a half-inch
object-glass, will be found to consist of crystals of oxalate of lime
in beautifully-formed transparent octohedra, with sharply-defined
edges and angles. (Fig. 36a.) This process is the most satis-
factory, and, after a little experience, can be performed in a few
minutes. But even this may be avoided by placing a drop of
the lowermost stratum of the urine on a plate of glass, placing
over it a fragment of thin glass or mica, and then submitting
it to the microscope; the crystals diffused through the fluid
becoming very beautifully distinct. In this way, however, it is
obvious that very much fewer are submitted to examination than
by the former process. This salt never (or scarcely ever) subsides
to form a distinct deposit; remaining for days diffused through
the fluid, even when present in so large a quantity that each drop
of the urine, when placed under the microscope, is found loaded.
with the crystals. A large quantity of the oxalate, when present,
may escape the eye, in consequence of its refractive power ap-
proaching that of the urine; for whenever we meet with a
specimen in which the salt has partially subsided, and replace
the decanted urine by distilled water, the crystals often become
readily perceptible to the unaided eye, resembling so many
glistening points in the fluid.
The crystals of the oxalate, when collected in a watch-glass
in the manner above directed, are unaltered by boiling either
in acetic acid or solution of potash. In nitric acid they readily
dissolve without effervescing, and the act of solution can be
observed with the microscope. When the oxalate is allowed to
dry on a plate of glass, and then examined, each crystal re-
sembles two concentric cubes with their angles and_ sides
opposed; the inner transparent and the outer black, so that
each resembles a translucent cube set in a black frame. (Fig.
200 THE SECRETIONS :
36 6.) This is best observed under a half-inch object-glass ; as
with a higher power this appearance is lost.
In a very few cases the oxalate is met with in very remarkable
crystals, shaped like dumb-bells, or rather like two kidneys with
their concavities opposed, and sometimes so closely approxi-
mating as to appear circular, the surfaces being finely striated.
(Fig. 36 c.)
The greatest possible variation in the size of these crystals
is met with not only in different specimens of urine, but often
in the very same portion. Ina single drop of urine octohedra
of oxalate of lime may be frequently observed mixed with others
four or six times their size. Dr. Golding Bird has given the
following measurements of some of his preserved Kae
-
inch.
Length of a side of the largest octohedra ; 4 . ah
ss smallest ditto ; rs ; 3650
Long diameter of large ‘ dumb-bell”’ crystals F - ses
Short diameter of ditto . “whe
Long diameter of the smallest “ dumb-bells” ; - ws
Short diameter of ditto ; A P !
In the urine of the horse they are much larger, often bemg
1-150th of an inch long.
Many specimens of oxalic urine give a precipitate with salts
of lime, insoluble in acetic acid, and consisting of oxalate of
lime. This is often dependent on the presence of oxalate of
ammonia, and delicate acicular crystals of this salt may be occa-
sionally noticed, during spontaneous evaporation, on the border
of the capsule.
Lehmann states that he has very frequently met with oxa-
late of lime in healthy urine, and that it often occurs in
large quantity in cases of tuberculosis, arthritis, and especially
of osteomalacia or softening of the bones. He has likewise
met with it in endocarditis and other acute diseases. He
states that the crystals are neither octohedra nor cubes, but
four-sided double pyramids, which in their projection under
the microscope appear as very minute cubes, or as somewhat
larger octohedra. He further believes that a portion of the oxa-
late of lime is held in solution by lactic acid, and advises that
if the urine be very acid, it should be neutralized, boiled, and —
allowed to cool slowly, before looking for the crystals.
URINE. 201
For further information on this subject I must refer to the ©
excellent little work by Dr. Golding Bird on ‘ Urinary Deposits,’
from which the above observations are chiefly taken. |
11. Carbonate of lime.
[Carbonate of lime is a rare ingredient of urinary deposits.
Dr. Griffith’ describes it as consisting “of nuclei which were
almost colourless, and studded with minute acicular crystals all
over their surfaces.”
It is occasionally met with in the alkaline urine common in
cases of paraplegia following injury to the spine. In the majority
of cases it forms an amorphous deposit mixed with prisms of
ammoniaco-magnesian phosphate. More rarely it is met with
regularly crystallized, in compound spherical crystals, apparently
built up of an infinite number of close-packed needles, radiating
from a common centre. The outline of these masses is irregular,
and their periphery is often apparently serrated. (Fig. 30*c.)
The carbonate of lime is normally present in the urine of many
of the graminivora, especially of the horse. The dense deposit
which forms in the urine of this animal consists of a mixture of
carbonate and oxalate of lime. ‘The former series form large
spherical crystals like glass beads, which, when immersed in
balsam, present the radiated acicular structure above described.
(Fig. 830* ab.) Very beautiful evidence of structure is exhibited
in these crystals of carbonate of lime when examined by polarized
light; a series of coloured rings traversed by a black cross being
visible. |
12. Cystin.
[Cystin, when present in the urine, forms a nearly white or
pale fawn-coloured pulverulent deposit, resembling the pale
variety of urate of ammonia.” It appears to be merely diffused
through the urine whilst in the bladder, as at the moment of
emission the secretion is always turbid, and very soon deposits
a copious sediment. On applying heat to the urine, the deposit
undergoes no change, which serves to distinguish it from urate
1 Med. Gaz., March 1844.
2 It is, however, always crystallized, a few regular six-sided lamin being often
seen, but the great mass consisting of numerous superposed plates, so that the com-
pound crystals thus produced appear multangular, as if sharply crenate at the margin,
(fig. 324.) They thus resemble little white rosettes, when viewed by reflected light.
202 THE SECRETIONS :
of ammonia; its insolubility in strong acetic acid prevents it
from being mistaken for earthy phosphates. The best cha-
racter of cystin is its ready solubility in ammonia, mere agita-
tion of some of the deposit with liquor ammonie being sufficient
to dissolve it, and a few drops of the solution evaporated on a
slip of glass leaving six-sided tables of cystin. (See fig. 32 a.)
A certain portion of cystin exists in a state of solution in the
urine, as the addition of acetic acid always precipitates a small
quantity. Urine containing cystin usually develops a peculiar
odour resembling that of the sweet-briar, and often exhibits a
peculiar greenish tint. (See Urinary Deposits, p. 111.) ]
13. Pus.
Pus is not easily detected in the urine, especially when a
small quantity is mixed with a much larger amount of mucus.
I must refer to what has been already stated in page 100 re-
garding the distinctions between pus and mucus; it must at
the same time be remembered that the mucus of the bladder
differs in its properties from the bronchial mucus, and is less
easily distinguished by the naked eye from pus. Urine con-
taining pus may have an acid, neutral, or (and that not un-
commonly) an alkaline reaction; at least it exhibits m most
cases a strong tendency to the development of ammonia, The
colour and amount of solid constituents are subject, according
to Willis, to great variations, There is only one property of
purulent urine that can be considered specific, and that is the
invariable presence of albumen; too much stress must not,
however, be laid upon this point, since urine is frequently albu-
minous without containing a single particle of pus, and we may
very easily mistake albuminous urine containg mucus for puru-
lent urine. In order to detect the presence of pus with the
greatest degree of certainty, the urine should be analysed as
soon as it is discharged; it is then turbid, and very soon de-
posits a sediment, which, on the least motion of the glass, mixes
with the fluid, and is again as quickly deposited. It forms an
uniform substratum of a yellow, pale yellow-green, or yellowish-
white colour, in which the presence of blood may also some-
times be recognized. On examining the sediment with the
microscope, we find that it consists of pus-globules (fig. 17),
which, by inclining the stage of the microscope, may be readily
caused to move; and if the colour should lead us to infer the
—~—
URINE. . 203
presence of blood, the flattened blood-corpuscles may probably
be observed. The pus-globules usually appear rather larger than
the pus-globules of the lungs, and less granular; and I have
observed that the nucleus can be more frequently recognized
with clearness ; the blood-corpuscles also appear tumid.
The filtered urime always contains albumen, sometimes in
such quantity that flocculi separate on the application of heat. If
the urine is allowed to stand for some time, and develops car-
bonate of ammonia, the pus becomes so viscid as to form a tena-
cious jelly. In these cases small quantities of albumen might
escape notice on the application of heat, being held in solution by
the carbonate of ammonia ; to assure ourselves of the presence of
albumen in these cases, we should make use of nitric acid.
In catarrhus vesice, in which a considerable quantity of
mucus is frequently discharged, and where the urine is either
thick and viscid at the time of emission, or very soon becomes so,
a small quantity of pus may be easily overlooked.
URINE IN DISEASE.
On the general relations of the urine in disease.
Although I have, in the preceding pages, made many remarks
on the general constitution of the urine in disease, I believe it
will not be unacceptable to the practical physician if I offer
some additional observations on the variations in the composi-
tion of this secretion, when it is pathologically changed.
The quantity of water in urine is always fluctuating, and
may vary toa great extent ; this poimt has been already referred
to in our remarks on the physiology of the ure. The urine
may exhibit remarkable differences in its external physical
characters in persons suffering from the same disease,—a
circumstance that analysis will enable us to trace to the dif-
ferent proportions of water that may be present. Frequent
recourse to fluids, and the degree of activity of the process of
transpiration must obviously have a very great influence on the
amount of the watery portion, and therefore on the amount of
the urine itself, and this is a point which the physician should
never lose sight of in forming his opinion on the quantity of
the discharged urine and on its degree of concentration. Itis
well known that the morning ‘urine is more concentrated than
that which is discharged during the day.
204 THE SECRETIONS:
In consequence of the fluctuations, arising from various
causes, in the amount of water in healthy urine, Becquerel?
has come to the conclusion that its increase or diminution can-
not be referred to the action of disease, except less than twenty-
seven or more than fifty-two ounces are secreted in twenty-four
hours, the average quantity in health being about forty-four
ounces in that period.
The diseases in which the quantity of water separated by
the kidneys is absolutely or relatively increased are diabetes in
its different forms, and certain hysterical or nervous disorders in
which a perfectly liimpid and thin urime is discharged in large
quantity: thus Becquerel relates a case of a young chlorotic
girl who ordinarily secreted daily about thirty-seven ounces of
water by the kidneys, but in whom the amount rose to ninety
ounces upon the accession of a severe hysterical attack.
The amount of water separated by the kidneys is diminished
in inflammatory affections, in which Becquerel has seen it fall
as low as twelve ounces in twenty-four hours. In these cases
the urine is of a very dark colour, of a high specific gravity,
and possesses a strong acid reaction. Asthe quantity of water
increases, the solid constituents relatively, but not always abso-
lutely, diminish, as may be found by comparing them with the
amount secreted in twenty-four hours in a state of health.
The quantity of urea was found by Nysten to be increased
in inflammatory affections, and my own analyses of the urine
during inflammation, on the whole, tend to confirm his state-
ment; for I found it either absolutely or relatively increased,
or equal to the quantity separated in a healthy state, or at any
rate but slightly diminished. If we remember, however, that in
these acute diseases only very small quantities of nitrogenous
food are taken, and that the quantity of urea must naturally
decrease under such a diet, we may regard it as increased even
if it falls below the physiological average. Becquerel also found
the amount of urea in acute diseases very little below the phy-
siological mean.
The quantity of urea is diminished in diseases in which there
is either an absolute deficiency of blood, or the blood is poor
in corpuscles ; thus Becquerel found the urine in chlorosis defi-
cient in urea, and I have observed the same to be the case in
the latter stages of typhus.
' Séméiotique des Urines, &c. p. 19.
URINE. 205
The relative proportion of uric acid varies much in dif-
ferent diseases. We may conclude from the observations which
have been made that the amount is increased by disturbances
in the circulating system, as in the paroxysms of fever, in in-
flammations, &c. The following pathological conditions lead,
according to Becquerel, to an increased quantity of uric acid :
fever; great general functional disturbances, such as arise from
oppressive dyspnoea in pulmonary emphysema or cardiac dis-
ease, acute pain, convulsions, delirium, &c. especially when
attended with fever; and diseases of the liver, as hepatitis, cancer,
or cirrhosis. The amount of uric acid is diminished in those
cases in which there is a deficiency of blood, or where the blood is
poor in corpuscles. Becquerel found this to occur in cases of
chlorosis and anemia, and in persons in whom the vital juices
seemed dried up. The amount of the salts in the urime fluctuates
extremely during disease. Generally speaking, we may assume
that the quantity of salts decreases in most pathological states
of the system; the cases in which the salts increase during
disease being very rare. Becquerel states that in those diseases
in which the amount of urea is only slightly diminished, the
proportion of salts is not materially affected; but that in those
cases in which the urea suffers a considerable reduction, the
same takes place with regard tothe salts. Analyses of inflam-
matory urine are, however, opposed to this statement, since
in these cases the urea sometimes exceeds the normal amount,
while the salts are decreased in an extraordinary manner. It
is to be regretted that Becquerel has not undertaken an exact
quantitative separation of the different salts, as the increase or
decrease of the fixed salts collectively is a circumstance of much
less importance than the varying relative proportions of the
individual compounds.
ON THE CONSTITUTION OF THE URINE IN DIFFERENT DISEASES.!
Urine in the Phlogoses.
In inflammatory affections, and in those diseases which are
accompanied by that form of fever which is termed sthenic
1 Becquerel has attempted to classify every form of morbid urine under one of the
206 THE SECRETIONS :
or synochal, the urine differs greatly in its properties from
normal urine. In speaking of the probable cause of the
changed constitution of the blood in the phlogoses, (see Vol. I,
four following heads: 1st, Febrile urine; 2d, Aneemic urine; 3d, Alkaline urine;
4th, Urine differing but slightly from the normal standard.
Ist. Febrile urine presents three distinct varieties :
a. Febrile urine, in the strict sense of the word, is passed by persons suffering
from fever, or with severe functional disorders. This urine is characterized by a con-
siderable diminution in the quantity of the water discharged by the kidneys in twenty-
four hours, and by aslight diminution in the amount of the solid constituents, the urea
and inorganic salts being below the daily healthy avcrage, while the uric acid is in-
creased. It is of higher specific gravity than normal urine, its colour is deeper and
redder, it is frequently turbid, and often contains a small quantity of albumen.
Becquerel gives the following analysis as a type of this form of urine: I place his
analysis of healthy urine by its side, in order to render the differences in the two
fluids the more striking :
True febrile urine. | Healthy urine (Becquerel.)
Quantity of urine in twenty-four hours 23 ounces 45 ounces
Specific gravity ‘ j 1021°8 10170
Water : ; , 964-0 972-0
Solid constituents . F 36:0 28:0
Urea yp ; - 13°2 12°1
Uric acid 4 15 0°4
Other organic matters 3 14°7 8°6
Fixed salts : ; 71 6°9
The urine is stated to assume the true febrile character in severe functional
derangements, in chronic and acute inflammations, in general hyperasthenia, in dis-
eases of the liver, the heart, and the lungs; in hemorrhages during their continuance,
and in such organic degenerations of the different organs as result pales fever or
functional derangement.
8. Febrile urine, accompanied with great debility. In this variety of urine the
water is likewise diminished. The specific gravity of the urine and the amount of
solid constituents are considerably less than in the former case. With the exception
of the uric acid, which remains normal, all the other constituents are absolutely,
although not relatively, diminished.
The following analysis is given by Becquerel as a type of this variety of urine:
Quantity of urine in twenty-four hours é ‘ 21 ounces
Specific gravity é g é - 10147
Water : : ‘ ; -, 9740
Solid constituents ‘ ‘ . 26°0
Urea . ; . ‘ ‘ 7°3
Uric acid ; 4 ‘ 0°8
Other organic matters : ‘ . 10°5
Fixed salts ‘ é ° 4:2
This form of urine is less concentrated than the normal secretion, is deeply coloured,
and often turbid from the spontaneous deposition of uric acid. It occurs in those
cases of fever in which there is great prostration and debility arising either from the
URINE. 207
_p. 284,) I showed that it is not to be referred to the diseased
organ, but to the reaction which manifests itself through-
out the vascular system. If the change in the constitution of
disease itself or from very energetic treatment, rg as free venesections or repeated
purgations.
y- Febrile urine in which the quantity of water is not affected. In this variety
the daily amount of water is not less than in health; the urea and fixed salts are
diminished ; the uric acid and other organic matters are normal. The composition
is illustrated by the following analysis :
Quantity of urine in twenty-four hours ° ; 45 ounces
Specific gravity . : : - 10105
Water : ; : 2 . 982°8
Solid constituents . ‘ x ; 172
Urea 3 4 \ ‘ ‘ 6°8
Uric acid ; V ; 0°3
Other organic matters 3 A - 7°5
Fixed salts 3 2°6
The specific gravity is low, although the elit is anal deep. It does not deposit
any sediment, and even, after the addition of an acid, there is often no precipitation
of uric acid.
2dly. Anzmic urine. This form of urine usually occurs in anemia, chlorosis, &c.
It is divided by Becquerel into the two following varieties :
a. True anemic urine. The amount of water discharged by the kidneys in twenty-
four hours is almost normal, while the solid constituents are considerably less than
in healthy urine; the urea, uric acid, and fixed salts being much diminished, and the
other organic matters decreased in a slighter degree. Its specific gravity is low, it is
not deeply coloured, and it deposits no sediment. Its constitution is well represented
in the following analysis :
Quantity of urine in twenty-four hours ; ; 38 ounces
Specific gravity . R : - 1010°3
Water : ‘. ‘ ; - 9828
Solid constituents : : 2 : 17°2
Urea . ‘ : ‘ , 6°51
Uric acid 2 a ; ‘ 0°25
Other organic matters : : . 6°23
Fixed salts ; : \ 4:20
B. Concentrated anemic urine. In this form “ urine the water discharged in
twenty-four hours is much diminished, and the amount of solid constituents, although
rélatively increased, is absolutely diminished also. The urea, uric acid, and fixed
salts are the most diminished ; the other organic matters less so. This urine is of a
green or livid tint, and is never red or yellow.
3dly. Alkaline urine. This variety is distinguished by its alkaline reaction on test-
paper and by its ammoniacal odour. (When the urine has become alkaline by the use of
bicarbonate of soda there is no ammoniacal odour developed.) It has been observed
by Becquerel in acute and chronic nephritis, in diseases of the bladder accompanied
with purulent secretion, in certain diseases of the brain, and sometimes in Bright’s
disease.
4thly. Urine not differing from the normal type occurs in slight non-febrile affec-
tions.
208 THE SECRETIONS:
the blood bears an accurate and inseparable relation to the fever,
there can be no doubt that the change in the constitution of
the urine must be in relation to the same cause, for the urine
is separated from the blood, and was previously an integral con-
stituent of it; and because, further, every alteration in the con-
stitution of the blood must mvolve corresponding changes in
the secretions and excretions, and more especially in the urine.
Since like effects follow lke causes, and since in inflammatory
affections the vascular system similarly participates in the dis-
turbance, we may assume @ priori that similar changes will
occur in the urine,—a point confirmed by experience.
The urine discharged during inflammations is usually termed
febrile urine. There is no objection to this term, since the cause
of the change in the urine must be sought for in the fever: I
shall, however, not introduce the term ‘ febrile urine’ here, since
it is more than probable that the changes in the composition
of the urine vary according as the character of the fever is
synochal or torpid. My analyses show, in fact, that the rela-
tive proportions of urea in fevers of a torpid and of a synochal
character are different; and although the analyses are not yet
sufficiently numerous to establish the difference with certainty,
it still appears to me to be a point of sufficient importance to
demand attention, and one that should be carefully worked out.
In order to take a correct view of the composition of the
urine, we must bear in mind the composition of the blood, the
reaction of the vascular system, and the diet, since the mixture
of the proximate constituents is dependent upon these circum-
stances.
The following are the general characteristics of the urine in
inflammatory affections: The urine is darker than usual, and is
of a yellow, brown, or reddish-brown tint ; it has an acid reac-
tion, and is generally of a high specific gravity. With respect
to its most important constituents, the urea is either absolutely
increased, or is at the ordinary physiological average, or may
be a little below it; the uric acid is always absolutely increased,
and so are the extractive matters, especially the alcohol-extract. —
The salts are always absolutely diminished, especially the chlo-
ride of sodium ; the sulphates, on the other hand, either ap-
proximate to the physiological average, or are not far below it.
Assuming, as the mean of numerous analyses, that the urea
~ URINE. 209
constitutes 392 of the solid residue of normal urine, I have found
it as high as 46°8 in inflammatory affections. (In abdominal
typhus, with a quick small pulse, I have seen it as low as 22.)
The physiological average of uric acid may be placed at 1°52 of
the solid residue ; in the phlogoses I have observed it amount
to nearly 3°, and Becquerel even found it rise as high as 5°92.
The quantity of extractive matter &c., which in normal urine
amounts to 23°59 of the solid residue, rises in inflammations to
43°. The fixed salts, which, in healthy urine, constitute about
25° of the solid residue, diminish here to 12%. The sulphate of
potash, which, in healthy urine, forms about 102 of the solid
residue, I found to vary in inflammation between 72 and 98.
The composition of the urine becomes changed if much blood
is abstracted during the progress of the inflammation. It be-
comes clearer, specifically lighter, and the amount of urea
decreases absolutely and relatively.
At the height of the inflammation, or (perhaps it would be
better to say) at the time when the fever puts on the synochal
type most strongly, the urine is usually clear and deeply coloured;
it subsequently forms a sediment of a yellow or red colour,
composed of uric acid and urates.
Pericarditis.
1 have had an opportunity of examining the urine in peri-
carditis. A man aged 36 years entered the hospital with the
symptoms of very acute pericarditis; the pulse was 108, very
full and hard. The urine obtained for analysis was clear, of a
deep fiery-red colour, had an acid reaction, a specific gravity of
1023°5, and, on being heated, gave indications of the presence
of albumen.
The chemical analysis gave :
; Analysis 98.
Water ; . ‘ . ; 937°50
Solid residue . : ; Fie ; 62°50
Urea ; ; ; : : 29°30
Uric acid - ‘ ; : F 1°50
Extractive matters . é - 22°70
Earthy phosphates ; é ‘ ‘ 0°55
Sulphate of potash é . , ‘ 4°89 4
Phosphate of soda a . 0°56
Chloride of sodium and carbonate of soda . ‘ 1°40
A strict antiphlogistic regimen with bloodletting was ordered.
The blood taken at the first venesection exhibited, after coagu-
II, 14
210 THE SECRETIONS :
lation, an inflammatory crust three fourths of an inch thick.
At the fourth bleeding, when five pounds of blood had been
abstracted, the inflammatory crust was one fourth of an inch
thick, and the clot very firm. The urine now discharged (about
thirty-six hours after the first bleeding) could hardly be consi-
dered darker than in health: it had an acid reaction, was devoid
of albumen, and had a specific gravity of 1018. It was composed
of the following constituents :
Analysis 99.
Water ‘ ‘ ‘ ‘ 960°10
Solid residue ; ; ; ; 39°90
Urea = : 5 s 17°50
Uric acid m : : 0-99
Extractive matters 7 é 15°10
Fixed salts . ‘ : 3°65
If we calculate the ratios of these constituents in relation to
100 parts of solid residue, and compare the numbers with the
normal average, we shall detect in the first analysis the elements
of a true inflammatory urine: the urea considerably exceeds
the physiological average, the fixed salts collectively are dimi-
nished, while the sulphates are only a little below the normal
standard, and the uric acid and extractive matters are increased.
We see, at the same time, the effect produced upon the consti-
tution of the urine by decided venesection.
100 parts of solid residue :
In Analysis 98.. In Analysis 99. In Normal Urine.
Urea ‘ ; 46°8 43°8 39°0
Uric acid . : ; 2°4 2°5 15
Extractive matters . , 36°2 37°8 23°5
Fixed salts ‘ 4 12°0. 89 - 25°8
Sulphate of potash. . 78 10°3
[Zimmermann' found fibrin in the urine of a patient with
“endocarditis of the right ventricle at the period of the com-
mencement of hypertrophy.” The urine was very variable in
its characters, sometimes normal, sometimes sedimentary, and
sometimes coagulable. In the latter case it was pale, and ic |
became alkaline. ]
Phlebitis uterina.
I have had several opportunities of examining the urine in
phlebitis uterma. In one instance occurring in our hospital I
found it of a dark colour, an acid reaction, and depositing a
' Zur Analysis und Synthesis der pseudoplastischen Prozesse, p. 129.
URINE. — 211
slight sediment of urate of ammonia and uric acid. In another
case (that of a woman aged 380), I likewise found it dark-
coloured, but it had a slightly alkaline reaction with a disa-
greeable ammoniacal odour. It deposited a dirty yellow sedi-
ment, which appeared to the naked eye to be purulent, but
which was shown by the microscope to consist of an immense
number of mucus-granules, of a few crystals of ammoniaco-
magnesian phosphate, and of an amorphous precipitate of phos-
phate of lime and urate of ammonia. The clear urine developed
some carbonic acid on the addition of nitric acid, and became
turbid, from which the presence of albumen was inferred.
Meningitis.
In the acute form of meningitis the urine assumes the in-
flammatory type. Schodnlein describes it as being of a dark-red
colour, very like brown beer. The secretion is usually scanty,
(frequently only from eight to nine ounces in twenty-four hours,)
it has a strong acid reaction, and the specific gravity and con-
sequently the amount of solid residue is high. In four cases
of meningitis observed by Becquerel, the mean specific gravity
was 10252; sediments of uric acid sometimes occurred sponta-
neously, and were sometimes induced by the addition of nitric
acid. In two of the cases he observed albumen. Schonlein
observes that at the crisis towards recovery the urine is secreted
more abundantly, and sometimes deposits purulent sediments.
Encephalitis.
The urine in encephalitis appears to be much the same as in
meningitis. It sometimes deposits a sediment, and contains a
small quantity of albumen. Becquerel found the specific gra-
vity to be 1020°2.
[Considerable attention has recently been paid to the urine
in the different forms of insanity. The most characteristic fea-
ture seems to be the excess of ammonia excreted as carbonate,
urate, hydrochlorate, or ammoniaco-magnesian phosphate. The
reader may consult Erlenmeyer,’ Heinrich,? and Sutherland and
Rigby,? on this subject. ]
! Observationes physiolog.-patholog. in morotrophio Sigburgensi institut. de urina
maniacorum.
2 Ueber die Wichtigkeit mikroskopischer und chemischer Untersuchungen fiir die
Psychiatrik, mit besondrer Riicksicht auf Harnsemiotik. (Hiaser’s Archiv, vol. 7, 2.)
3 Med. Gaz., June 1845.
212 THE SECRETIONS :
Delirium tremens.
In delirium tremens the urine has more or less of the inflam-
matory type ; sometimes, however, it resembles normal urine in
its colour and reaction. In a man aged 40, who had a very
severe attack, Becquerel found the urine acid for the first five
days, with a mean specific gravity of 1017-2. It deposited a
sediment either spontaneously or on the addition of nitric acid.
In another man aged 40, who was also in the third stage of
phthisis, and died three days afterwards, the urine possessed the
characters of inflammation ; it had a specific gravity of 1021°8,
and deposited a sediment.
Myelitis.
In inflammation of the spinal cord the urine in many cases
is much the same as in inflammation of the brain; it is red,
acid, and sometimes thick and sedimentary. Becquerel, how-
ever, has observed cases of affections of the spinal cord in which
the urine was not much removed from the normal type. In
two persons aged 32 and 50 years respectively, who were suf-
fering from a slight degree of paralysis of the lower extremities,
the urine did not differ materially from the healthy secretion,
although it varied on different days; it had an acid reaction,
and contained a little more mucus than healthy urime.
In inflammatory affections of the brain, and still more in
those of the spinal cord, especially in chronic cases, the kidneys
and bladder sympathise in a high degree; the latter is some-
times paralysed. The character of the urine then changes ina
very peculiar manner ; it loses its acid reaction, and its colour
becomes clearer; at the period of its excretion it is either slightly
acid or neutral, and in a very short time it becomes alkaline, in
consequence of the formation of carbonate of ammonia.
When first discharged, the urine is clear, generally of a bright
yellow colour, and possesses rather an unpleasant odour. If
allowed to stand, a glistening pellicle often forms very quickly
on the surface, consisting partly of crystals of ammoniaco-mag-
nesian phosphate, and partly of amorphous phosphate of lime,
as may be seen by the microscope. The presence of ammonia
may also be recognized at once by the odour, and by test-paper.
After a time, the urine becomes turbid, and deposits a sediment
~
URINE. 213
of earthy phosphates and mucus, which sometimes assumes a
purulent appearance, and becomes tough and viscid in proportion
to the quantity of mucus which is present. The odour is then
strongly ammoniacal, and often stinking and putrescent; and
on the addition of hydrochloric acid to the urine, a well-marked
effervescence is produced by the liberation of carbonic acid.
Cases have however been observed in which the urine was am-
moniacal at the period of its emission from the bladder. A man
aged about 40 years was brought into our hospital with a severe
cerebral affection ; he soon sank into a,state of deep coma, and
the urine was emitted involuntarily. On collecting the urine
in a bottle, it had an unpleasant ammoniacal odour, an alkaline
reaction, and soon deposited a sediment of mucus and earthy
phosphates. Upon the addition of nitric acid after filtration,
brisk effervescence took place, and the urine became turbid, in
consequence of the presence of a slight quantity of albumen.
Becquerel observed much the same in,four cases of chronic
affection of the spinal cord, in which the functions of the bladder
were impaired. The urine was discharged involuntarily, was
of a dirty-yellow pale colour, of the ordinary specific gravity,
and soon became alkaline; in those cases in which the urine
was clearer, the specific gravity was lighter. The urine always
contained a considerable quantity of mucus, muco-pus, or true
pus, some albumen, ammoniaco-magnesian phosphate, phosphate
of lime, and carbonate of lime.
In a former part of this work, attention has been directed to
a peculiar arrangement which the elements of urea assume,
when an aqueous solution of that substance is allowed to stand
for a considerable period, or when it is treated with strong acids
or alkalies. 1 atom of urea takes up 2 atoms of water, and
becomes carbonate of ammonia, for
1 Atom of Urea . ‘ H,N,:.. C0, 0,
+ 2 Atoms of Water ‘ . H, 0,
2 Atoms of Carb. Ammon. i H, N, + C, O, = 2 (NH,, CO,)
We have sufficient reason to justify the assumption that an
arrangement of the elements of urea which occurs in pure water
will also occur under certain circumstances in the kidneys or in
the bladder, if the nervous activity, which has a very marked
effect on the composition of the animal fluids, is changed, and
if the urine contains mucus or muco-pus, which facilitate the
214 THE SECRETIONS:
new arrangement of the atoms in the same manner as yeast
resolves sugar into alcohol and carbonic acid.
Inflammatory affections of the brain and spinal cord are not
the only diseases in which carbonate of ammonia is formed in
the urine: I shall subsequently show that alkaline urine is fre-
quently observed in diseases of the kidneys and the bladder, and
in nervous fevers.
In inflammation of the respiratory organs the urine generally
exhibits the inflammatory type in a high degree, varying, how-
ever, with the development, extent, and intensity of the dis-
ease.
Bronchitis.
In bronchitis, if the attack is severe, and accompanied with
much.synochal fever, the urine is scanty, of a dark-red colour,
strongly acid, and of a high specific gravity.
Becquerel observed an appreciable amount of albumen in the
urine in such cases. The urime deposited a sediment, and had
a mean specific gravity of 1025°2. During convalescence, the
urine either returns to the normal state, or assumes the anzemie
type (of Becquerel), i. e., it is pale, of low specific gravity, and
deficient in solid constituents, especially in urea. In milder
forms of acute bronchitis Becquerel found the urime highly co-
loured, sometimes sedimentary, and of a mean specific gravity
of 1024°3. In the mildest forms, the urine scarcely deviates
from the normal state.
Pneumonia.
In pneumonia the urine is subject to considerable variations
dependent upon the extent of the disease, and the degree of in-
flammation. In severe inflammations, the urine is very dark,
of high specific gravity, and frequently sedimentary, especially
at critical periods and during the fever; Becquerel, however,
once found that the urine deposited a sediment on the day when
the fever ceased. An appreciable amount of albumen is by
no means rare, ‘The urine remains acid during the whole
period of inflammation, and Becquerel found the same to be the
case during the period of convalescence also. The mucus is
URINE. 215
increased during the febrile period, and this is observable in a
more marked degree in women than in men. :
Andral' has communicated some observations regarding the
urinary sediments in pneumonia. Out of thirty-three cases, in
twelve the urine remained perfectly clear throughout the whole
course of the disease, and was not rendered turbid either by
nitric acid or by heat; of these cases in six even the colour
was not affected, and two sank under the disease. In nine
of the thirty-three cases the urine was alternately clear and
turbid or sedimentary. The sediments were for the most part
spontaneous, and composed of amorphous uric acid. In one
of these nine cases the urine contained albumen. The sedi-
ments occurred, as might be expected, in the different cases,
at different periods and under different modifications. In one
the urine was clear and of a reddish brown colour till the tenth
day, and then formed for the first and only time a grayish white
precipitate. In another case, the urine, which was of a brown-
red colour, did not become turbid till the ninth day, when,
as well as on the two following days, it formed a brick-red sedi-
ment. It then became clear, and remained so. In a third
case, the urine, which was deep-coloured, deposited a grayish-red
sediment on the seventh day, and then became clear and amber-
coloured. In the other twelve cases that remain from tlhe
thirty-three, the urine was always turbid or sedimentary, either
spontaneously or on the addition of a few drops of nitric acid,
from the period of admission to the termination of the disease.
Three of these twelve cases terminated fatally, and in these the
urine remained turbid to the last. In the nine other cases the
urine returned to its transparent state at the cessation of the
disease.
Becquerel has arrived at the following results respecting the
constitution of the ure in pneumonia.
In a case of acute pneumonia at the period of the crisis, the.
quantity of urine passed in twenty-four hours was 26 ounces,
its specific gravity 1015-1, and its amount of solid residue 24°9 ©
in 1000. The patient was depressed, his pulse 96, and the
urine, as well as the skin, had a bilious tinge.
In a second case, in which there was intense fever, and the
pulse was 120, 22 ounces of dark red urine of specific gravity
' Becquerel, Le Séméiotique des Urines, p. 332.
216 THE SECRETIONS :
1021°8 were passed in twenty-four hours: there were 86 parts
of solid residue in 1000 of urine. In a third case in which the
patient had been much depressed by venesection and large doses
of tartarized antimony, and where the pulse was 104, there
were 30 ounces of dark-yellow, turbid, acid urine, of specific
gravity 1015-9, and containing 26°3 of solid residue in 1000
parts, emitted in twenty-four hours.
Becquerel has made one complete analysis of the urine m a
case of pneumonia in which the pulse was 100. He found
The quantity of urine in twenty-four hours : : 36 ounces
Specific gravity : ‘ ‘ é - 1011-7
Water . ‘ ; ; eM . 980-6
Solid residue ; " ; ‘ ; 19°4
Urea . . a ‘ , ‘ 73
Uric acid : ; : ; : 0-4
Fixed salts ‘ d ‘ . y 2°7
Extractive matters . eas : . 8°8
I have made two analyses of urine passed in pneumonia.
Analysis 100 represents the urine of a man aged 35 years; it
was of a fiery-red colour, clear, and strongly acid; the pulse
was full, 108 in the minute.
Analysis 101 represents the urine of a man aged 40 years;
it was of a dark yellow colour, had an acid reaction, and con-
tained a considerable quantity of mucus. In both cases there
was a good deal of albumen.
Analysis 100. Analysis 10},
Specific gravity : ‘ ‘ 1017-0 1020-0
Water ; ‘ . ‘ 959-60 947-90
Solid residue 3 z é 40°40 52°10
Urea A ; ; 15°79 19°35
Uric acid . 0°71 1°50
Alcohol-extract with lnctic acid and ammonia-salts 9°34 9°65
Spirit-extract _ ‘ ; ‘ 110 3°18
Water-extract , > Fe 5°64. =: 6°40
Albumen. A ; ‘ 1°47 0°50
Earthy phosphates P : : 0°42 0°56
Sulphate of potash. 3°70
Phosphate of soda, chloride of sodium and carbo- 3.98 loos 6°74
nate ofsoda . :
If we calculate the amount of the more important consti-
tuents in relation to 100 parts of solid residue in these three
analyses, we shall find that they exhibit very close approxi-
mations to each other, and on contrasting them with the nor-
mal standard, it will appear that the urea is a little diminished,
URINE. 217
that the uric acid is increased, that the salts are diminished,
and that the extractive matters, especially the aleohol-extract
are increased in the urine of pneumonia.
100 parts of solid residue of 100 parts of solid residue of
pneumonic urine contain : normal urine contain :
Becquerel. Simon.
Caen.
Urea. ‘ 37°6 39:0 37:2 39:0
Uric acid : 2°0 1:7, 28 1:5
Fixed salts ; 14:0 18:3 14:0 25°8
Extractive matters 45°4 40:0 37:0 23°5
Sulphate of potash 9-0 10°3
According to Schoénlein, the crisis in pneumonia shows itself
in the urine by the secretion.becoming turbid and sedimentary ;
after ten or twelve hours a crystalline micaceous deposit-forms, —
above which the urine becomes clear.
The following instance is strongly confirmatory of Schénlein’s
opinion. In a case of pneumonia that recently occurred in his
own wards, the urine, during the height of the inflammatory
stage, was dark, very acid, and deposited no sediment; at the
period of resolution it became paler and neutral; one morning
I found it yellow, neutral, and with a sedimeut of white crystals
visible even to the naked eye. The microscope at once revealed
the beautiful shapes assumed by the ammoniaco-magnesian
phosphate. I was much struck with the singular relations of
the urine itself. It was perfectly neutral; and any acid, even
dilute acetic, threw down a white precipitate, which led to the
supposition that a caseous matter was present; I soon, however,
found that this was not the case, for on treating a portion with .
hydrochloric acid and allowing it to stand for some time, very
beautiful, nearly colourless crystals of uric acid were deposited.
Alcohol threw down a tolerably copious white precipitate,
which was collected on a filter and washed with more alcohol.
A portion of this precipitate was taken up by warm water, and
left as a residue after evaporation ; it was entirely consumed
when heated on platinum foil ; rubbed with caustic potash, it
developed ammonia ; warmed with nitric acid, it gave indications
of the presence of a large amount of uric acid. The portion
insoluble in warm water was readily soluble in hydrochloric acid,
from which it could be again precipitated by ammonia, and on
examining this precipitate under the microscope, I found that
218 THE SECRETIONS:
it was composed of ammoniaco-magnesian phosphate. Hence
it follows that the white precipitate which I at first mistook
for casein, consisted of uric acid combined with ammonia, which
existed dissolved in the urine to an unprecedented amount.
Heller’ has recorded a singular case in which the urine emitted
an odour of hydrosulphate of ammonia, and deposited a sedi-
ment of urate of soda, during this disease.
The patient was a boy aged 14 years, with pneumonia of the
right lung. The peculiar odour of the urine was first observed
on the tenth day of the disease. The secretion on that day
was copious, of a light-yellow colour, very turbid, and deposited
an abundant clay-colour sediment. This sediment when ex-
amined under the microscope was ‘found to consist of clear and
beautifully defined large globules studded with numerous spines,
mixed with smaller star-like objects of the same form. (See
fig. 29 a.) There were also a few epithelium-scales and mucus-
corpuscles. The urine had a strongly alkaline reaction: its
specific gravity was 1018.
Heller noticed the following reactions :
1. Acetate of lead produced at once a very dark brown colour,
and, finally, a~blackish-brown precipitate of sulphuret of lead.
2. Perchloride of iron (which seems to be the best test for
sulphuretted hydrogen in urine, since pure sulphuret of iron is
thrown down, while the precipitate, caused by the former test,
contains the chloride, &c.) rendered the secretion almost black.
3. Nitrate of silver showed that the chlorides were in great
€XCess.
4. Nitrate of baryta indicated an abundance of sulphates.
5. Ammonia showed that the earthy phosphates were normal,
6. Nitric acid and heat indicated the existence of traces of
albumen.
The urine contained in 1000 parts:
Water and hydrosulphate of ammonia ‘ ; ; 951-98
Solid constituents. : : 7 é 48°02
Urea. i . , ; é 12°21
Free uric acid : ‘ : 7 no trace
Albumen A . ; traces
Urate of soda (in the sediment) : 1:80
Extractive matters, with a large amount of hydrochlorate and
carbonate of ammonia . ; ; é 27°40
Fixed salts 4 ‘. : F j 6°61
' Archiv fiir physiolog. und patholog. Chemie, vol. 1, 24.
URINE. 219
As the fixed salts contained a mere trace of chloride of so-
dium, and nitrate of silver added to the urine showed that the
chlorides were in excess, it is clear that nearly all the chlorine
must be referred to the hydrochlorate of ammonia. That the
sediment consisted of urate of soda was proved chemically as
well as microscopically. The uric acid was determined by the
ordinary test; and the soda by incinerating a portion in a
platinum spoon, dissolving the white residue in dilute sulphuric
acid, evaporating, and obtaining crystals of sulphate of soda.
On the following day, (the eleventh,) the odour remained
nearly unchanged, but acetate of lead and perchloride of iron
showed that the amount of hydrochlorate of ammonia was
diminished. There was a small flocculent sediment composed
of urate of ammonia, mucus, and fragments of epithelium, but
entirely free from urate of soda. The urine now contained a
normal amount of uric acid, and about as much albumen as on
the preceding day.
On the twelfth day the peculiar odour was very faint, and on
the thirteenth it altogether vanished. The urine was still alkaline,
but gradually resumed its normal characters.
There was nothing in the treatment to account for the pro-
duction of the sulphuretted hydrogen, and it can hardly be
ascribed to the decomposition of the small quantity of albumen
in the urine.
Zimmermann once detected fibrin in the urine ofa patient
with pneumonia on the third day. The secretion was of a fiery
red colour, but deposited no sediment. |
Pleuritis.
In pleuritis the urine comports itself much the same way as
in pneumonia. It exhibits, especially at the height of the in-
flammation, all the signs of inflammatory urine, and sometimes
contains albumen.
In order to form a correct opinion regarding the urine in
this disease, it is of especial importance to pay attention to the
various circumstances that may modify the nature of the secre-
tion, as for instance whether the disease is simple or compli-
cated, acute or chronic, whether there is much or little fever,
to what extent the inflammation has proceeded, and whether
there is any effusion. Becquerel observed several instances of
220 THE SECRETIONS:
pleuritis associated with pulmonary phthisis, and in fifteen
out of seventeen cases observed by him, there was considerable
effusion. In a man aged 36 years, with acute pleuritis, deli-
rium, and certain typhoid symptoms, and whose pulse was 112
in the minute, the urine was of an orange-red colour, and on
the addition of a drop of nitric acid, deposited a sediment of
uric acid ; it also contained a little albumen. The quantity of
urine in twenty-four hours was 17 ounces, the specific gravity
1021, and in 1000 parts there were thirty-four of solid residue.
In a man aged 23 years, who had sub-acute pleuritis, whose skin
was slightly jaundiced, in whom there was slight anasarca of the
lower extremities, (it being a case in which peritonitis was also
suspected,) and who was much weakened by the free application
of leeches, the urine was of a deep orange-colour and clear ;
on the addition of nitric acid it deposited an abundant sediment.
In the course of twenty-four hours there were 26 ounces of
urine passed, of specific gravity 1014°2.
1000 parts of urine contained :
Water : é . i 976°5
Solid residue . ; : ‘ 23°5
Urea E é ieee |
Uric acid ‘ “ : j 0-6
Fixed salts . ; ‘ , 6°4
Organic matters é ; ‘ 10:2
Becquerel attributes the small amount of urea in this case
to the debilitated state of the patient.
He found the mean specific gravity of the urine in seventeen
cases of pleuritis to be 1021-8; in those cases im which there was
a spontaneous sediment, it was 1024°8; and in those in which a
sediment was produced by the addition of nitric acid, it was
1022°7. _ Albumen was present in three out of the seventeen
cases. The amount of mucus was frequently increased, espe-
cially in the urine of women, but pus could never be detected.
Urine, which before the crisis is‘ of a reddish colour, at that
period deposits copious sediments.
{Zimmermann observed fibrin in the urine of a patient with
pleuritis, from the third to the fifth day. The urine was of a
dark yellow colour, and very frothy. |
Pleuropneumonia.
‘IT have had an opportunity of observing a case in which urine
of a very peculiar nature was emitted during pleuropneumonia.
=~
URINE. 221
The urine of a man of about 30 years of age, who was re-
covering from an attack of pleuropneumonia, and whose renal
secretion had always previously been rather dark-coloured, be-
came lighter and neutral. It was found one morning of a citron
colour, and had deposited a white crystalline sediment, which,
when observed under the microscope, was found to consist of
beautifully-formed crystals of ammoniaco-magnesian phosphate,
recognizable even by the naked eye, perfectly free from any
mixture with phosphate of lime, urates, or mucus. The urine,
which was filtered off, had a slight alkaline reaction, but did not
become turbid on heating: the addition, however, of any acid,
even acetic, produced a copious white turbidity, which did not
disappear on the addition of an excess of the acid, but slowly
vanished on the application of heat. In the acid urime thus
cleared by heat ferrocyanide of potassium produced no effect.
On evaporating the urine a sediment was deposited, and on
mixing the residue with alcohol, a large quantity of a white
substance was precipitated, which did not dissolve in water, and
consisted of phosphate of magnesia, urate of ammonia, and a
little extractive matter. Since the precipitate induced by the
addition of acids to the urine gradually crystallized, and ex-
hibited all the properties of uric acid, it is clear that the turbidity
and precipitate had been caused by the decomposition of an
urate which must have been present in a state of solution, to a
very large amount. The urine had a specific gravity of 1022.
1000 parts were composed of :
In 100 parts of
Analysis 102. of solid residue.
Water. ‘ é ‘ 951°10
Solid constituents . 4 48°90
Urea P , . 20°80 42°0
Uric acid! ‘ : : 1°48 30
Extractive matters : 13°50
Ammoniaco-magnesian phosphate and 10-20
other fixed salts
On the following day the alt et of the urine were en-
tirely changed. The colour certainly was the same, but it no
longer had an alkaline reaction, nor did it form a crystalline
sediment, nor was any turbidity induced by the addition of an
acid. Free ammonia alone produced a slight cloudiness.
In a case of peripneumonia that recently occurred in Schonlein’s
1 The uric acid existed in the urine as urate of ammonia.
229 THE SECRETIONS :
wards, the urine at the period of resolution exhibited precisely
the same characters as in the above case, and as in the case of
pneumonia noticed in page 217. There was a beautiful crys-
talline sediment of ammoniaco-magnesian phosphate, and any
acid threw down a copious precipitate.
Cases such as these suggest two important questions, one of
which may be readily answered by a series of careful observa-
tions: viz. whether these peculiar phenomena in the urine are
connected with the process of resolution after inflammation of
the respiratory organs ?—and if so, what is the nature of the
connexion ?
The solution of the former question would afford material
service in the prognosis of these affections. The phenomena
persisted for three or four days, and in both cases recovery took
place.
There was a man in Schonlein’s wards with very extensive
and intense peripneumonia, whose urine presented all the ap-
pearances of a saccharine fluid in which fermentation had been
induced by yeast. It had a yellowish, turbid appearance, and
its surface was covered by a thick layer of foam, in which nu-
merous air-bubbles were developing themselves. Gas was like-
wise developed in the fluid itself, and in the amorphous yellow
sediment that had been spontaneonsly deposited. The frothy
covering and the sediment were composed of an amorphous
matter, numerous crystals of ammoniaco-magnesian phosphate,
and mucus-corpuscles. On treating the sediment with a free
acid, the crystals and a portion of the amorphous matter (con-
sisting of phosphate of lime) were dissolved: the remainder was
insoluble, and resembled coagulated albumen in its behaviour
towards reagents. The urine contained no trace of sugar, but
a considerable amount of carbonate of ammonia.
On evaporating some of the filtered urine to which hydro-
chloric acid had been added, there remained a large quantity of
hydrochlorate of ammonia. Very little urea was present, the
greater part having been converted into carbonate of ammonia
through the influence of the proteim-compound. Vesical mucus
exerts a similar action, and consequently in catarrh of the
bladder the urine rapidly gives off a very disagreeable odour,
and the amount of urea diminishes in proportion as the car-
bonate of ammonia increases.
URINE. 223
Martin Solon! states, that in twenty-four cases of pleuropneu-
monia, he found albumen in twenty-two; it was especially
observed at the period of the crisis.
Empyema.
It was known to the ancient physicians that effusions of pus
into the thoracic cavity are, under certain circumstances and
peculiar treatment, carried away by the kidneys.
Schonlein has observed several such instances, and I have
had several opportunities, in the clinical wards of our hospital, of
seeing cases of pleuritis with empyema, in which, after a proper
course of treatment, turbid urine was discharged for some days.
This urine contained albumen, and deposited a sediment, which,
under the microscope and in its general physical relations
resembled pus, or (in one case,) mucus mixed with pus.
The urine, which after some time became clear above the
sediment, was of a dark colour, only slightly acid, and soon
became alkaline. The symptoms of empyema gradually dis-
appeared, in proportion as the urine continued to form purulent
sediments.
Emphysema.
Becquerel has examined the urine in eight cases of pulmo-
nary emphysema. When the emphysema produces violent
dyspnea, frequent cough and much general disturbance, the
urine assumes the inflammatory type. Becquerel made one
analysis of urine of this nature; it was of a dark brown colour,
had an acid reaction, but deposited no sediment. Its specific
gravity was 1016°8. It consisted of—
In 100 parts of solid residue.
Water ; 3 j 972°3
Solid residue : : 27°7
Urea : ; ; 13°0 47°0
Uric acid . 5 , 0°4 1°4
Fixed salts : al 4°3 15°5
Organic matters : : 10°0 36°71
' Urinary Diseases and their Treatment. By Robert Willis, m.p. p. 157.
224 THE SECRETIONS:
In a man aged 60 years, who had emphysema with bronchitis,
the urine deposited a sediment, and had the high specific
gravity of 1025-6. After he had taken purgatives for seven con-
secutive days, the urine became very aqueous and the specific
gravity was only 1009:2. In two other cases in which emphy-
sema was combined with cough and dyspneea, the specific gravity
was 1025°2 and 10222.
Angina tonsillaris.
In angina tonsillaris, when associated with synochal fever,
the urie presents the inflammatory type. Becquerel ob-
served a case in which the urine possessed the characteristics
of inflammation in a high degree. It was red, and had the
high specific gravity of 1029°7. In another case, which was
combined with violent fever, the urine was dark-coloured, and
had a specific gravity of 1023-9. In neither of these instances was
there any sediment; but in the second case, on the seventeenth
day, an abscess which had formed in one of the tonsils opened
into the mouth, and on that day alone there was a spontaneous
sediment of uric acid, and the specific gravity rose to 1025-2.
In three other cases, in which the fever was not so high, the
specific gravity remained lower.
Gastritis,
Becquerel has made some observations on the urine during
gastritis, especially the chronic form.
Of three cases, two got worse, and merged into the acute
form. The other case was unaccompanied by fever, and the
urine did not appear to differ materially from the normal type.
Of the two cases, one was that of a woman who was free from
fever at the period of her admission into the hospital. The
urine was pale and the specific gravity low. Continued fever
subsequently came on, and assumed a typhoid character. The
urine immediately became denser, darker in colour, and turbid
(urina jumentosa). After some time the patient returned to
her former state, and the urine again became clear. In the
third case, that of a man aged 35 years, chronic gastritis sud-
denly merged into the subacute form; he had frequent bilious
URINE. 225
vomiting and fever. The urine retained the inflammatory type
until the condition of the patient improved. In a case of very
acute gastritis with green watery vomiting, I found the urine
scanty, of an extremely dark-red colour, acid, and forming a dull
yellow sediment of urate of ammonia and uric acid: in fact,
exhibiting all the characteristics of the urine of inflammation.
Enteritis and Dysentery.
In a severe case of enteritis, with obstinate constipation,
violent pain on pressure, green acid vomitings, and wiry pulse,
only a small quantity of urine was excreted. It was of a fiery-
red colour, acid, and, after some time, threw down a copious
reddish sediment of urie acid and urate of ammonia.
Becquerel has observed the urine in enteritis and dysentery:
when the diarrhea is only trifling, and unaccompanied by fever,
there is hardly any deviation in the urine from the normal state.
If, however, severe diarrhoea and fever are present, the urine
may assume the inflammatory type. In a case of simple en-
teritis with diarrhoea the urine was at first very turbid, of specific
gravity 1023-1, and deposited a sediment of uric acid: it was
afterwards normal, and finally became anemic, the specific gra-
vity fallimg to 1010-0. In another case it was invariably
high-coloured and very concentrated, its specific gravity being
1024°3 ; in this instance there was a daily sediment.
In eight cases of mild enteritis and diarrhoea, Becquerel only
on one occasion detected a small quantity of albumen.
In two cases of a more chronic form of diarrhcea in persons
who had long suffered from disease and from insufficient food, the
_ urine was very light-coloured, and of low specific gravity, 1011°7.
According to Schdnlein, in purely inflammatory diarrhea,
the urine is of a fiery-red colour, causes scalding in the urethra,
and forms, at the crisis, a crystalline sediment of uric acid.
In catarrhal diarrhoea, the urine is rather dark, and becomes
more so in the evening: at the crisis, a mucous sediment is
deposited.
In bilious dysentery the urine is of a dark-red colour, tending to
a brown; during the crisis it yields a fawn-coloured precipitate.
Finally, in typhous dysentery, the urine is dark, turbid, and
fetid. During the crisis it forms no precipitate, but becomes
clear and loses its smell.
II, 15
226 THE SECRETIONS:
Hepatitis.
Very different opinions have been expressed regarding the
constitution of the urine in hepatitis.
Rose! asserts that, in several cases of acute and chronic
- hepatitis, he found the urea entirely absent. In the acute forms
the urine was dark, in the chronic it was clear. It possessed no
urinous smell, and the specific gravity was lower than that of
healthy urine. Henry? found the urine, in a case of chronic in-
flammation of the liver, to be devoid of smell and colour, and of
a specific gravity of only 1003. The extract obtained by evapo-
ration gave no indications of urea on the addition of nitric acid.
Rose puts the question, which can only be answered by farther
analysis, whether the deficiency of urea arises from the actual in-
flammation of the liver, or from the dyspepsia that accompanies
it. According to Coindet,? the urine, in inflammation of the
liver, instead of urea, contains a substance resembling bilin.
The analyses made by Becquerel and myself of the urine in
hepatitis do not correspond with these statements. I analysed
the urine of a man aged 36 years, who was suffering from acute
hepatitis. The urine was scanty, had an acid reaction, was of a
dark reddish-brown colour, and deposited a copious red sediment
of urate of ammonia and uric acid. On the addition of nitric acid
the brown colour of the urine changed into a decided green. It
likewise became turbid on the application of heat, so that it
contained both biliphzin and a little albumen.
A quantitative analysis gave :
Analysis 103.
Water ‘ ‘ ‘ , : 939-70
Solid constituents ‘ ; P e 60°30
Urea 3 : ; ; ; 22°50
Uric acid. ‘ i . ‘ 1:70
Alcohol-extract : : . 9°70
Water- and spirit-extracts and albumen ‘ 6°30
Earthy phosphates ‘ : ‘ : 0°84
Sulphate of potash ; ; . ; 5°30
Phosphate of soda : : : 3°13 ;
Chloride of sodium and carbonate of soda. ; 9°50
The urate of ammonia was not estimated in that form, but ;
was reduced to uric acid by the addition of hydrochloric acid,
' Thomson’s Annals of Philosophy, vol. 5, p. 423. 2 Ib. vol. 6, p. 392.
3 Stark’s Allg. Pathologie, p. 1152,
URINE. gay
and weighed as such. The carbonate of soda associated with the
chloride of sodium, arose from the reduction of the lactates.
Becquerel analysed the urine of a man (A) aged 33 years,
who was attacked with icterus accompanied with fever and diar-
rhea, after being in a violent rage. He was soon reduced to
a state of great debility. The urine was very bilious, depo-
sited a yellow sediment of uric acid, and had a specific gravity
of 1013-0.
The urine of a woman (B) who had a chronic affection of
the heart, and was attacked with acute hepatitis without very
well-marked icterus, was of a deep yellow colour, but not tinged
by bile. It deposited a spontaneous sediment, and had a specific
gravity of 1018-9.
The composition of the urine in these two cases was as follows:
A. B.
Water . a ‘ 978°50 968°90
Solid constituents . ; 21°50 31°10
Urea ‘ P : 6°15 13°10
Uric acid ; j 1°14 - 1:57
Fixed salts ¢ F 5°15 4°31
Organic matters . ‘ 8°01 11°88
Ix, we calculate the relative proportions of the various con-
stituents in relation to one hundred parts of solid residue in these
analyses, and compare them with the corresponding numbers in
healthy urine, we find the proportions much the same as we have
already found in pneumonia, except that in Beequerel’s first
case in which there was great debility accompanied with typhoid.
symptoms, the urea is very much diminished, whilst, in his second
case, it is very much increased ; in my case the salts were present
to a large amount.
100 parts of the solid residue of 100 parts of the solid residue
the urine in hepatitis contained of healthy urine contained.
Becquerel. Simon.
1, 2.
Urea é 29°6.. 42:2 37°5 39°0
Uric acid ' 5:4 5°6 2°8 sig
Fixed salts . 24:0 13°9 31°3 25°38
Extractive matters, &c. 41:1 38:2 26°6 23°5
Sulphates : 9°0 10°3
Pao
- Schénlein states that the urine in hepatitis is of a dark-red
colour, approaching a brown, that it usually contains biliphein,
and that at the crisis a rose-coloured precipitate is formed.
228 THE SECRETIONS:
[Herzog' has recorded the case of a woman aged 44 years,
in whom the principal symptoms were pain in the left lobe of
the liver, and vomiting. The urine was of a saffron colour, but
contained none of the ingredients of the bile. Its specific gra-
vity was 1035-7, and 1000 parts yielded 68-84 of solid residue,
55°15° of which were urea. |
Peritonitis.
I have had one opportunity of analysing the urine in peri-
tonitis puerperalis. It was passed by a woman aged 29 years,
was of an acid reaction, and somewhat turbid, but not particu-
larly dark: when examined with the microscope it was found
to contain mucus-corpuscles, membranous shreds and other
fragments, which could only be taken for epithelium composed
of many regularly-formed, large, and elongated cells. On the
application of heat the presence of a small quantity of albumen —
was detected. The specific gravity was 1020-0. The urine was
composed of—
Analysis 104.
Water : “ ‘ 2 951°80
Solid constituents . ¥ ; 48°20
Urea ; z j : 20°10
Uric acid é ; + : 0°83
Extractive matters ;, é é 16°36
Fixed salts * : c : 9°20
By calculating the various constituents in relation to 100
parts of solid residue, we at once see that this urine is of a
decidedly inflammatory type.
We obtain:
Urea 5 ‘ ‘ ‘ 42-7
Uric acid ‘ ; ‘ ; 1°7
Fixed salts : $ ; 19°1
Extractive matters : ‘ 36°71
The urea even exceeds the physiological average, the salts
are diminished, and the extractive matters increased.
[Scherer? analysed the urine in three cases of febris puer-
peralis. The urine was usually of a fiery-red colour, sometimes
neutral, and often alkaline (or at least it rapidly became
so ;) it deposited a mixed sediment of pus, mucus, and urate of
ammonia.
1 Buchner’s Repert. 1844. * Untersuchungen, &c. p. 72.
URINE. 229
Two analyses gave the following results :
‘i 2.
Water . : a 956°63 960°24
‘Solid residue P 5 46°37 39°76
Urea . ' i‘ 10°00 12°42
Urate of ammonia 5 2°04 0°84
Alcohol-extract . : 12°54 9°34
Water-extract . 3 8°40 10°23
Soluble salts ; 5 6°69 6°34
Earthy phosphates ‘ 0-80 0°62
Albumen and mucus é 2°60 Mucusalone 0°54
In the third case the urine resembled butter-milk, and was
loaded with urate of ammonia; it contained :
Water v i 2 937°00
Solid residue . J ‘ 63°00
Urea . : ‘ é 6°70
Urate of ammonia ‘ F ‘ 3°20
Alcohol-extract 3 3 A 19°02
Water-extract " ; 27°20
Salts : ‘ 3 ‘ 6°31
Bouchardat’ has published an analysis of milky urine passed
by a woman with this disease. It contained no traces of sugar
of milk or casein, the appearance being due to a large amount
of urate of ammonia. It.is moreover remarkable for the large
quantity of fat and of albumen. It contained :
Water . * . ‘ 940°9
. Solid constituents é : = 59°1
Urea ; : ‘ . 12°4
Uric acid . . P - 15
Albumen and mucus . * ‘ 29-2
Fat : 2°5
Alcohol-extract with lactates, Re. ° 5°3
Alkaline sulphates. 2°7
Phosphate of soda, and biphosphate of ammonia 4:2
Alkaline chlorides 0°8
Earthy phosphates. z 0°5
It must be observed that this urine was clear on emission,
and only became turbid on cooling. |
Nysten2 analysed the urine of a person aged 23 years, suf-
fermg from peritonitis. He found it of a dark-red colour,
perfectly transparent, of the ordinary odour of urine, and of an
acid reaction. An albuminous pellicle formed on the surface
during evaporation, and the whole finally coagulated into a trem-
bling gelatinous mass. Nysten states that this urine contained
thrice the quantity of urea that “ urina sanguinis” contains. The
' Journ. de Connaiss. Méd. Aott 1843, 2 Recherches, &c. p. 240. 1811.
230 THE SECRETIONS:
numbers which he gives do not, however, make out so large
a ratio. I1 calculate from the figures quoted in Meckel’s
Archiv,’ that Nysten’s “urina sanguinis” contains 40 parts of
solid residue, of which 12 are urea, in 1000 of urine, whilst on the
other hand, in 1000 parts of his inflammatory urine there are
76 of solid residue, of which 22 are urea. The urine in the latter
case was evidently much more concentrated than in the former,
but the ratio of the urea to 100 parts of solid residue is the
same in both, and coincides with my own analysis and those
of Becquerel. It amounted to 30 parts of urea in 100 of solid
residue.
Nephritis.
In nephritis acuta the urine is, according to Schdnlein, of
a dark red or claret colour, and contains hematin; according
to Rayer the secretion is very scanty, especially when both
kidneys are diseased: it contains a certain quantity of blood
or albumen, and has an acid, a neutral, or even an alkaline re-
action ; it occasionally contains pus, as when an abscess com-
municates with the pelvis of the kidney, or when the nephritis
is accompanied by inflammation of the mucous membrane of
the urimary passages.
Becquerel analysed the urine in five cases of acute nephritis,
and in none of them was blood present. The urine of a man
who had acute nephritis possessed the properties of inflam-
matory urine, but contained neither pus, mucus, nor albumen,
and deposited no sediment. In two cases accompanied with
hectic fever, the urine assumed the inflammatory type, but
contained no pus, and only, in one of the cases, a little albu-
men. In a woman who had, at the same time, disease of the
heart, chronic gastritis, and incipient cirrhosis of the liver, the
urie was highly inflammatory; it was acid, formed a copious
uric-acid sediment, and contained some mucus and albumen. ~
In a woman aged 23 years, who had an anemic appearance, and
was suffering from slight polydipsia, and in whom the symp-
toms of acute nephritis showed themselves by violent pain in
the right kidney, by continual vomiting for above ten days, by
great anxiety and some fever, Becquerel observed that the
1 Vol. 2; p. 648.
URINE. 231
urine remained quite unaffected ; it was pale, clear, of low spe-
cific gravity, and very abundant. Willis directs attention to
the sediment in simple nephritis, which distinguishes the dis-
ease from arthritic attacks; it usually consists of an amor-
phous powder of phosphate of lime with crystals of ammoniaco-
magnesian phosphate, (if the urine is neutral or alkaline,) or of
urates. If any crystals of uric acid are present, they are only
in small quantity. In speaking of the urinary crisis at the
commencement of recovery, Schdnlein observes that the urine
is secreted copiously and forms a creamy, and often a brown
sediment, which afterwards separates itself into flocculent mucus;
this mucous sediment will often go on for some weeks,
In nephritis arthritica the urine possesses very peculiar pro-
perties : Sch6nlein describes it as being of a fiery-red colour, very
acid, and soon after emission depositing glistening red crystals
of uric acid. In one instance Schénlein found that the sediment
occupied half the volume of the urine. Sometimes the sediment
is of a yellow colour, and occasionally there is gravel, mixed with
mucus and blood. According to Willis, the urine in arthritic
nephritis contains crystals of uric acid, even at the moment of
its emission.
If the disease terminates in convalescence, Schdnlein ob-
- serves, that either copious sediments of a sandy micaceous
appearance present themselves, or gravel of varying size is dis-
charged with the urine,
In nephritis albuminosa, or Bright’s granular degeneration
of the kidneys, the urine differs materially from the normal
type in always containing albumen; in other points, as for
instance colour and composition, it may also be changed, or
may more or less resemble normal urine.
During the first stage of the disease, hematuria sometimes
occurs; I have witnessed a case of this sort in our hospital, and
have analysed the urine, which was of a blood-red colour and
contained blood-corpuscles but no fibrin. I subsequently ana-
lysed the blood of this patient. (See Analysis 37, Vol. I, p. 322.)
The urine was neutral, and when allowed to stand, formed a
sediment which was shown Py the microscope to consist of
blood-corpuscles.
232 THE SECRETIONS:
On the application of heat, there was a considerable coagu-
lation of albumen, which was tinged brown by hematin.
The specific gravity was 1017°0.
The analysis gave:
Analysis 105.
Water " 5 ; § . 948°14
Solid residue . : . ; . 51°88
Urea : * ‘ ‘ 5 7°63
Albumen \ 2 ; 5 % 15°00
Globulin 3 E 1-00 %
Heematin, extractive matter with salts, and hematoglobulin 23°80
I have in several cases made qualitative examinations of the
urine in Bright’s granular degeneration of the kidneys, and have
always found it albuminous, usually pale, and of an acid or
neutral reaction. The amount of albumer varies exceedingly.
Rayer,! who has long and accurately studied this disease,
asserts that, in the acute form of the disorder, the urine is at
first discharged scantily, that it is coloured red or brown by
the presence of blood, that it has an acid reaction, and has —
usually a higher specific gravity than normal urine; when al-
lowed to stand, fibrous-looking red flocculi of blood, (fibrin ?)
are precipitated which, when examined under the microscope,
appear to consist of blood-corpuscles and mucus-granules mixed
with epithelium. After some days the urine becomes of a citron-
yellow colour, but upon the recurrence of the paroxysms the
blood-red tint reappears, and disappears during the remissions.
The amount of albumen discharged in twenty-four hours often
fluctuates considerably. The amount of the other constituents, —
with the exception of the urea, does not seem to vary so much
from the normal standard in the course of twenty-four hours in
acute nephritis albuminosa as in the chronic form of the disease :
the amount of urea is often only slightly decreased, and that of
uric acid hardly at all, and consequently the specific gravity is
not much affected.
In the chronic form of the disease, Rayer usually found the
urine rather acid at the period of its discharge, but sometimes —
neutral or alkaline; it was always pale, often turbid, and at times
had a curdy appearance from the presence of small white floceuli
swimming in it, which, under the microscope, appeared as mi- —
! Maladies des Reins.
URINE. 233
nute whitish lamelle, (epithelium ?) frequently mixed with an
amorphous mucous substance. Sometimes the turbidity arose
from the presence of fat.
Rayer states that the amount of albumen is larger in chronic
than in acute albuminous nephritis, while, on the contrary,
the amorphous urates and the phosphates are diminished in
the former affection. In the chronic form of this renal affec-
tion, before the commencement of dropsy, the ratio of the
quantity of urine to the drink which has been taken, hardly
differs at all from the normal proportion. This state may con-
tinue for several months, during which period the presence of
albumen affords us a certain means of diagnosis.
Becquerel found the urine anemic in the majority of his
cases, (in sixteen out of twenty-two.) After the separation of
the albumen, it appeared clear, pale, and of a greenish colour.
Its specific gravity varied from 1006°3 to 1014°7. The mean
specific gravity was 1011°3; sediments were not often observed,
and the reaction was alkaline. The amount of urine differed
very little from the normal quantity, and the relative proportions
of the most important normal constituents to each other did not
seem to be altered, but the urine was usually deficient in the
amount of solid constituents.
In those cases in which Bright’s disease was accompanied by
other inflammatory attacks, by cardiac affections, by cirrhosis
of the liver, or by pulmonary emphysema, Becquerel found the
urine to possess the inflammatory type: it was of a dark colour,
high specific gravity, an acid reaction, and not unfrequently
deposited a sediment. Out of twenty-two cases of Bright’s
disease, Becquerel observed four in which the urine corresponded -
with the above description, and had a mean specific gravity of
1023°5. In two cases the urine was alkaline throughout the
whole course of the disease, and deposited sediments composed
of the phosphates of lime and magnesia, and carbonate of lime.
The urine also contained in these cases a very large quantity of
carbonic acid, which was combined with various bases (but chiefly
with ammonia); the urea was at the same time considerably
diminished, having yielded the elements for the formation of
carbonate of ammonia. (See page 213.) =
In some cases Becquerel found that the urine hardly differed
“at all in its physical characters from the normal type. He ob-
234 THE SECRETIONS :
tained the following results from seven analyses. They are
calculated for 1000 parts :
- 2. 3. 4, Be 6. 7.
Specific gravity . 101693 1010°0 1007°5 1008-4 1005°4 10126 1010°0
Amount of urine in F F } ; : :
ys ugg poe 28-0 35:2 62:0 780 1060 253
Water . i ; 965°0 981°5 987°5 986°3 989-1 975°5 981°5
Solid constituents . 35:0 18°5 12°5 13°7 10°9 24°5 18°5
Urea 2 : 11°6 6°3 6°3 18 3°8 75 5°9
Uric acid . 3 0°3 0°6 0°3 0°2 0:2 0°4 0°4
Albumen . 5 11°9 2°5 01 3°4 2°6 59
Fixed salts . 6°6 41 2° 2°9 1:7 4:9 3°7
Extractive matter 4°6 4:8 3°2 55 2°5 57 4°7
The urine in the Ist analysis was taken from a person suf-
fering from Bright’s disease without any complication. There
was a little fever present. It-was of a greenish yellow colour,
very acid, and contained a little mucus. In the 2d analysis
the urine belonged to a patient in whom the disease had as-
sumed a chronic form; it was greenish, clear, and acid. In
the 3d analysis the ure was taken from a person in a state of
convalescence, and who afterwards recovered. The 4th analysis
represents the urine of a man aged 35 years who was suffering
from polydipsia, with cedema of the feet, and ascites. The urine
was clear, alkaline, formed a diffuse, whitish sediment, and
effervesced briskly on the addition of acids. The man from
whom the urine of analysis 5 was obtained, had tubercles im
the lungs and Bright’s disease in the first stage. There was
infiltration of the feet, and slight ascites; the urine was
acid, pale, clear, and very abundant. The urine in the 6th
analysis was taken from a man who also had tubercles in the
lungs and Bright’s disease in the first stage: there was no
infiltration or dropsy : the urine was bloody and very acid.
If we compare these analyses of morbid urine with that of
the healthy renal secretion, (the composition! of which is water
971-9, solid constituents 28:1, urea 12-1, uric acid 0°4, fixed
salts 6°9, extractive matters 8°6,) we shall find that, with the
exception of analysis 1, the solid constituents are less than im
healthy urine, that the urea, with a single exception, only
amounts to 1-3d or less of the solid constituents, whereas,
according to Becquerel, it constitutes nearly one half in healthy
! It must be remembered that this is Becquerel’s analysis of normal urine. See p. 145.
URINE. 235
urine, that the quantities of fixed salts, and also of extractive
matters, are likewise less than in the normal secretion ; that, on
the other hand, the morbid urine contains albumen, which is
altogether absent in a state of health.
My own analyses give a similar result, at least as far as the
urea is concerned. I have recently analysed the urine of a young
man 21 years of age, suffering from Bright’s disease, which was
remarkable for the large quantity of albumen it contained. He
had been attacked with anasarca and ascites, and the urinary
secretion was diminished to about 12 ounces in twenty-four
hours ; the urine was of a dark-yellow colour, had an acid reac-
tion, and formed a whitish mucous sediment, which, when
examined under the microscope, appeared to consist, at least
for the most part, of long, articulated tubes, similar to those of
the conferve, which were in part filled with a dark granular
matter; there were, moreover, many globules filled with the same
matter, which resembled Gluge’s inflammatory globule; there
were also mucus- or pus-granules, and in one instance a slight
quantity of very beautifully-crystallized yellow uric acid. I have
since examined the sediment in various cases of this disease,
and find that this appearance is by no means uncommon. ‘To
the naked eye sediments of this nature resemble a little mucus,
but on carefully pouring off the urine and examining the deposit
under the microscope we observe :
Ist. Mucus-corpuscles of the ordinary size, more or less
granular, and decidedly nucleated. Fig. 31, a. a.
2dly. Pavement epithelium, from the mucous membrane of
the bladder. Fig. 31, 0.0.
3dly. Blood-corpuscles. Fig. 31, c.c.
4thly. Round dark vesicles apparently filled with granular
matter, and varying in diameter from 0006 to ‘0009 of a French
inch. They strongly resemble Gluge’s inflammatory globule.
Fig. 31, d. d.
5thly. Tubes composed of an amorphous matter, resembling
coagulated albumen. Fig. 31, e.e. That these tubes have in
most cases an actual*capsule and are cylindrical may be seen
by inclining the stage, when they will rotate in the fluid in
which they are floating. In some the capsule appears to be
absent, and we can then see an amorphous, finely granular
mass, adhering in a cylindrical form. Some of these tubes are
236 THE SECRETIONS :
full, others empty ; the former contain a granula? matter, darker
at some points than others, and containing cells and vesicles,
similar to mucus-corpuscles. The diameter of these tubes vary
from ‘0011 to :0006 of a French inch.
I have satisfied myself, beyond a doubt, that they are derived
from the epithelium investing the tubes of Bellini. Whether
they are present as a consequence of Bright’s disease, or whe-
ther they occur in other renal affections, must be decided by —
further observations: my present experience leads me to believe
that they are cotemporaneous with a certain amount of albumen
in the urine, but that blood-corpuscles need not necessarily be
present with them. [These tubes occasionally present the
twisted appearance represented in fig. 31, f, copied from Scherer.
The diagnostic value of this form of sediment is uncertain ;
Schoénlein regards it as an undoubted sign of Bright’s disease ;
Scherer! has, however, observed it ‘during the period of des-
quamation succeeding scarlatina ; the same observation has been
made of Lehmann, and I have myself observed it in various
cases associated with a congested or irritated condition of the
kidneys. |
On the fifth day from the commencement of treatment,”
the urine was much diminished in quantity; it amounted to
only from 2 to 2} ounces in twenty-four hours, was of a dark-
brown colour, continued to exhibit an acid reaction, and depo-
sited a very copious sediment in relation to the small quantity
of fluid. The quantity of albumen was so great that per-
fect coagulation took place on boiling some of the urme m
a test-tube; the tube could be inverted without any fluid
escaping. On the seventh day the amount of urine increased,
and it subsequently became still more abundant ; its properties
remained much the same till the eleventh day, after which the
albumen decreased to such an extent that on boiling a portion
of the urme, only about half its volume became coagulated.
The first occasion on which the urine was analysed, was when
the secretion was reduced to a few ounces ; the second occasion
was on the day when it again became more abundant. In
the latter case the solid constituents were much more abun-
1 Untersuchungen, &c., p. 57.
ibe
URINE. 237
dant, although the urine was clearer, and as much as 12 ounces
was passed in the twenty-four hours.
The following are the results of the quantitative analyses :
Analysis 106. Analysis 107.
Specific gravity ; 2 1014°0 1022-0
Water ; - * 966°10 933°50
Solid constituents ; x 33°90 66°50
Urea : ; p 4°77 10°10
Uric acid i é ‘ 0°40 0°60
Fixed salts . ‘ . 8°04 10°00
Extractive matters fi ‘ 2°40
Albumen ‘ ‘ F 18°00 33°60
If we bring the quantities of urea and of albumen in these
analyses in relation to 100 parts of solid constituents, we shall
see that in both cases they occur in nearly equal ratios: for in
the first we have 14° urea, and 54° albumen ; and in the second
15° urea, and 512 albumen. The amount of urea is very much
diminished ; if we brought it in relation with the solid consti-
tuents exclusive of the albumen, it would even then be below
the normal average, and would amount to only 308.
The observations of Bright, Christison, and others, on the
properties of the urine in this disease, correspond in general
with the account which we have given.
[Some excellent cases of Bright’s disease with chemical ex-
aminations of the urine, are given in the work of Scherer, to |
which we have already referred.
Dr. Percy has published a case of Bright’s disease, and given
an analysis of the urine. Its specific gravity was 1020.
In 1000 parts there were contained :
Water : z . ; . 946°82
Solid constituents 53°18
Urea = 3 . > 7°68
Uric acid and indeterminate animal matter . 17°52
Fixed soluble salts . : ; ae
Earthy phosphates ‘ ‘ : é
Albumen a 22°64
Schlossberger has recently published a case in which, as the
disease progressed, cerebral symptoms with maniacal paroxysms
and perfect unconsciousness supervened, the paroxysms usually
lasting for about twelve hours. The urine excreted before
one of the paroxysms, and likewise that excreted during the
first hour after the same paroxysm was submitted to analysis.
BE
238 THE SECRETIONS:
The urine, in both cases, was of a pale-yellow colour, faintly
acid, somewhat turbid, and deposited a sediment of epithelium
mixed with the tubes already described ; in the course of eight
hours there was also a considerable deposit of uric acid. The
specific gravity of the former urme was 1011°6, and the secre-
tion contained in 1000 parts :
Before the After the
paroxysm. paroxysm.
Water 3 ; : ; 942°0 931°3
Solid residue ; F 58-0 68°7
Urea ‘ 3 7°6 4°5
Uric acid with mucus a ‘ 2°6 5-2
Alcohol-extract with salts . 19°5 20°5
Water-extract with earthy phosphates 10°1 21°9
Albumen ; : ; 17°9 17-0
In the second specimen there was a very large quantity of
mucus. |
With respect to the analysis of very albuminous urine I must
again refer to page 184, and I would expressly remark that the
urine must be treated with absolute alcohol for the determi-
nation of the albumen and the urea, since we obtain inaccurate —
results in attempting to determine the urea from the evaporated
solid residue. For the determination of the uric acid we must
employ hydrochloric acid pretty freely diluted with water; it
must be added carefully, in order not to precipitate any albu-
men. When blood occurs in the urine, we must adopt a pre-
“cisely similar course.
Albuminous urine has now been so frequently observed in
numerous diseased states of the organism independent of Bright’s
disease, that the idea has long been abandoned that granular
degeneration of the kidneys always occurs when we have albumi-
nous urine: the presence of albumen in the urine is, however, in
no case a favorable symptom, and invariably indicates serious dis-
ease: I once, however, found a considerable quantity of albumen
in the urine of a blooming and apparently quite healthy young
man, and the only cause to which its presence could be assigned
was that he had suffered from intermittent fever six years pre-
viously. There are various conditions under which this con-
stituent may be present. During a catarrho-rheumatic affection
I once observed a little albumen in my morning urine, but in
the urine secreted in the middle of the same day not a trace
URINE. 239
could be detected. I noticed the following case of albuminuria
in Schénlein’s wards. A man suffering from pneumonia passed
very turbid urine till the period of incipient resolution ; it had
a very acid reaction, and after several hours’ rest deposited no
sediment. The turbidity arose from urate of ammonia in sus-
pension, it disappeared on the application of heat, and again
became apparent as the urine cooled. The urine presented
this jumentous appearance for six days; on the seventh there
was a slight flocculent amorphous deposit of urate of ammonia.
On gently warming the urine the sediment perfectly dissolved,
but at a boiling heat it became turbid from the separation of a
considerable amount of albumen. On the following day the
urine was very turbid in consequence of the presence of urate
of ammonia, the amount of albumen remaining much the same.
From that date the urine became clear, but remained albu-
~ minous till convalescence was established, the albumen gradually
disappearing as the health improved. During the whole of this
period the patient complained of no pain in the region of the
kidney, even on strong pressure; neither was there any depo-
sition of mucus.
A man treated antiphlogistically for a severe attack of arti- —
cular rheumatism passed, for a considerable time, urine of a dark
colour and very acid reaction, which, however, threw down no
sediment. During the period of convalescence, when the
swelling and pain had diminished, the urine became less acid,
without any appearance of a sediment; the sweat, however, was
still extremely acid, and one morning the urime contained a
very considerable amount of albumen.
This abnormal constituent occurred in the whole of the
urine excreted that day; on the morrow it was nearly gone,
and on the third day had quite disappeared. No renal irri-
tation could be detected, neither was any sediment ob-
served.
The urine of a young man with all the signs of general
dropsy contained a considerable amount of albumen, and de-
posited a light mucous sediment contaiming a considerable
number of colourless blood-corpuscles (recognizable by their
discoid form), numerous exudation-globules, mucus-corpuscles,
and a few of the tubes described in page 235. The urine had
the pale, green, opalescent appearance indicative of the presence
240 THE SECRETIONS:
of albumen, and did not contain a trace of hematin, which
must consequently have been perfectly separated from the blood-
corpuscles before leaving the kidneys. The patient complained
of no pain (even on pressure) in the lumbar region.
I received a specimen of urine from Dr. Broun, which had
been passed by a patient who for a long time had suffered from
considerable cedematous infiltration of the extremities. It gave
no indication of albumen, neither did it contain any of the
peculiar sediment which seems especially associated with renal
irritation.
That in certain forms of dropsy the urime is albuminous,
while in others not a trace of albumen can be detected, has
been thoroughly demonstrated. In hydrothorax, and in dropsy
dependent on disease of the heart or the liver, there is generally
no albumen, whereas, if the dropsy arise from disease of the
kidney, albumen is generally present. In Bright’s disease, as far
as my personal observations extend, it is always found, although
the opposite opinion is held by Graves.’
Cystitis.
Two deviations from the normal-condition are frequently
observed in the urine in cases of cystitis; these are, its rapid
tendency to alkalinity, in consequence of the formation of car-
bonate of ammonia, so that it is sometimes alkaline even at the
period of emission ; and the large amount of mucus or muco-
pus. In the first stage of the disease the urine is, however, red,
possesses all the characters of genuine inflammatory urine, and
usually contains only a little mucus.
In cystitis acuta the urine was observed by Schénlein to be
of a dark-red colour, and frequently to contain hematoglobulin.
When the inflammation was caused by vesical calculi the urine
had a pale greenish colour. 3
In a case of inflammation of the bladder, which was brought
on by the use of stimulating injections, Becquerel found that
the urine at first possessed the characters of the inflammatory
type, but these in part disappeared in consequence of the quan-
tity of the fluids drunk by the patient ; it was acid, of average
1 Dublin Journal, No. 60.
URINE. . 241
specific gravity, and deposited, after some time, a stratum of
transparent mucus.
In another case in which the inflammation had been brought
on in a similar way, the urine was alkaline, had a specific gra-
vity of 1022°6, deposited a thick layer of purulent mucus,
contained albumen and some fat which was removable by ether,
and exhibited pus-corpuscles under the microscope.
In a third case of acute cystitis, which speedily came to a
fatal termination, Becquerel found the urine, at the period of
its discharge, turbid, thick, and viscid. On allowing it to stand
for some time, there was formed a layer which occupied nearly
the lower half of the vessel, and consisted of almost pure and
white pus: the fluid above the sediment was pale, clear, and
alkaline.
As the disease terminates i in convalescence copious sediments
are deposited, or, if a sediment had been formed during the
height of the disease, it is now more abundant.
In arthritic cases the sediment is, according to Schénlein, of
a crystalline micaceous appearance; in non-arthritic cases (and
in the latter stage, in arthritic cases also,) very bulky mucous
sediments occur, which are often tough and fibrous, from the
action of carbonate of ammonia. Sediments of this latter form
frequently continue for a long time, so as to constitute genuine
catarrhus vesicze. Schénlein states, that in cystitis erysipelacea
the urine is of a dark reddish-brown colour, mixed with fibrous,
flocculent, or bran-like mucus.
Metritis.
In acute metritis the urine possesses all the characters of
the inflammatory type. Becquerel found it acid, of a reddish
colour, of average specific gravity (1018-O—1021:0), and some-
times containing albumen. A sediment of uric acid was always
thrown down either spontaneously or by the addition of nitric
acid : during convalescence it became paler and less dense, and
ceased to deposit sediments. The leucorrhcea which accompa-
nies metritis, or appears towards the period of convalescence,
renders the urine turbid and cloudy. ;
In chronic metritis, and in uterine congestion, the urine is
much the same, except that the inflammatory signs are less
II. 16
242 THE SECRETIONS:
marked: In these cases, especially in chronic metritis, it is
frequently mixed with the leucorrhceal uterine discharge.
[In a case of endometritis' and pericarditis with purulent
exudation, occurring thirteen days after delivery, the urine was
passed in very small quantity, evolved a disagreeable odour,
was turbid, and deposited a rather copious sediment. The
sediment consisted for the most part of pus, mixed with a few
blood-corpuscles, epithelium-scales, and fat-vesicles. ,
The reaction of the urine was acid; its specific gravity 1020.
It appeared on analysis that the urea was much diminished,
that there were only traces of uric acid, that there was a little
albumen, no bile-pigment, and scarcely any trace of chlorides.
The sulphates were slightly, and the earthy-phosphates much
increased. |
Urine in typhus.
We formerly had occasion to remark that less was known of
the actual condition of the blood in typhus than in inflam-
matory diseases; the same observation is equally true with regard
to the urine. Very little light has yet been thrown upon the
varying nature of the urine in this disease: sometimes we find it
of a brown colour, acid, and of high specific gravity, in fact, like
inflammatory urine ; sometimes it is clear like the urine after
copious drinking; on other occasions it does not appear to differ
from normal urine: it varies between an acid, an alkaline, and
a neutral reaction. It is to. be presumed that these changes in
the relative constitution of the urine correspond with certain
reactions: in the organism; the connexion, however, is not
always very clear, even to the observant physician. This much
is, however, certain, that in the first stage of the disease a
dark, specifically dense, acid urine is often excreted, and that
in proportion as the fever assumes a torpid character, and the
vital powers become depressed, the urine becomes clearer, loses
its acidity, becomes neutral, and in a very short time (often after
one to two hours) alkaline, containing carbonate of ammonia.
Sometimes a yellowish eng turbid, fetid, and alkaline urime
is excreted.
1 Heller’s Archiv, vol. 1, p. 23.
URINE. 243
The difference between the urine in typhus and in inflam-
matory disorders is sufficiently great to be determined with
certainty. In the phlogoses when the fever assumes a synochal
character, we observe that the urine, with some few exceptions
(as occasionally in cases of injury of the spinal cord, and in dis-
eases of the kidneys and bladder,) is of a red colour, acid, usually
clear, and only forms sediments of a yellow, red, or brown colour,
and consisting of uric acid and the urates, on the occurrence of
a crisis; the quantity of the urine is diminished, and the specific
gravity increased ; the urea is either absolutely increased, or is
equal to, or very little below the physiological average; the
quantity of salts is in general diminished, (the sulphates, how-
ever, in a much less proportion than the chlorides;) and the quan-
tity of extractive matter increased.
In typhus the quantity of urine is decreased; it varies ex-
tremely in colour and reaction; the red tint of inflammatory
urine is, however, very seldom observed, but more commonly a
brown or reddish-brown colour; the more the fever assumes the
erethismic character or approximates to the synochal form in con-
sequence of being complicated with inflammation of the respira-
tory organs, the more also does the urine approximate in its
physical characters to the inflammatory type; and in proportion
to the torpid character of the fever and to the prolapsus virium,
does the urine become less dense and acid, and the more readily
does it assume the alkaline state.
The urine may resemble the normal type as far as the specific
gravity and the amount of solid constituents are concerned ; it
is usually, however, less dense, and it frequently happens that
the deeply-coloured urine of typhus has a much lower specific
gravity than we should have been led, from its tint, to expect.
The amount of urea never reaches the physiological mean, and
is often far below it; the uric acid, on the other hand, is often
increased, especially on the occurrence of the urinary crisis.
The salts, including the sulphates, are very much diminished, so
that sometimes hardly a trace of them can be detected. We
have seen that in the phlogoses the urea ordinarily attains the
physiological average of 392% of the solid residue, and that it
sometimes even exceeds it; while in the urine of typhus I found
that the: maximum proportion of urea amounted to only 31°8;,
the minimum to 225, and the mean of 7 analyses to 26°63 of the
244 THE SECRETIONS :
solid residue. Hence it would appear that this decided decrease
of the urea below the physiological average is a characteristic
peculiarity of the urine in typhus. I found the maximum pro-
portion of uric acid amount to 4°89, and the minimum to 0°92 of
the solid residue; and with respect to the fixed salts, the maximum
was 132°, and the minimum 3°4° of the solid residue.
With regard to the state of the urine in typhus, and especially
in abdominal typhus, Schénlein observes that it is altogether in-
constant, that it is sometimes pale, sometimes apparently normal,
and sometimes jumentous. In the first stage it is usually of a
dark brownish-red colour, tolerably clear in the sthenic form of
fever, but darker in the erethismic and very torpid forms.
A turbidity in the urine, together with other symptoms of a
crisis, frequently indicates the transition into the second stage.
In this nervous stage of the disease the urine is of a dark
brown colour, and very acid.. A perturbation is observed in the
urine on the seventeenth day, (occasionally it occurs on the
eleventh or twelfth day), and at the period of. the actual crisis,
(the fourteenth or twenty-first day,) the urine becomes clearer
and more abundant; sediments also occur, not of a crystalline
form, as in the phlogoses, but of a diffuse, flocculent, mucous
nature: the urine sometimes becomes as clear as the urina
spastica.
If the typhus disappears fremantuely 0 on the fourth or ee
day, we frequently observe, in addition to other acute critical
symptoms, a discharge of turbid, and often purulent urine. In
the form to which the term ‘ febris nervosa putrida’ has been ap-
plied, when the decomposition of the blood is particularly striking,
we meet with blood in the urine, which becomes very quickly
decomposed, and is of a dark brown or blackish colour. Con-
valescence after typhus can never be considered as safely esta-
blished until the urine becomes perfectly yellow and pale. As
long as it remains of a dark brown, or even high colour, there
is still danger. The more brown, decomposed, and fetid the
urine is during the course of the typhus fever, the more unfa-
vorable is the prognosis.
In petechial typhus during the first stage, the urine is not
very highly coloured ; on the seventh day there is frequently a
turbidity; during the nervous stage the urine is of a dark brown
URINE. 245
colour; and at the ee of the crisis, sediments are also
Miciited:
Willis! remarks, that the state of the urine in typhoid fevers,
especially in regard to its acid or alkaline reaction, may be
studied with advantage, as affording an indication of the progress
of the disease. During the early stage it is acid; as the disease
advances, it becomes neutral, and then alkaline ; as the disease
decreases it again becomes neutral, and ‘ultimately acid. The
return to the acid state is always a good symptom, and will
sometimes enable us to offer a favorable prognosis.
The observations made by Pelletan in Bouillaud’s clinique,
perfectly coincide with the above statements ; he observes that,
during the first days of typhus, the urine is of a dirty yellow
colour, and transparent ; during the whole of the first stage it
is always more or less acid, and the darkest kind, which has an
odour like gingerbread, is usually the most acid. At a later
period it changes, resembles turbid whey or putrid broth, and
is usually neutral ; it is also sometimes found of a dark colour,
with an odour like cow-dung. At a still later period, it is turbid,
putrid, and smells rather ammoniacal, assuming at the same time
a corresponding reaction. If the disease takes a favorable turn
from this period, the urine goes through the same changes in a
reversed order.
The observations which I have made in Schénlein’ s clinical
ward correspond entirely with those already communicated.
In two men aged between 20 and 30 years, who had very
severe attacks, I observed that the urine became alkaline to-
wards the seventeenth and twenty-fourth days of the disease :
it was then discharged in greater quantity than before, and was
clearer; it was pale, somewhat turbid, and soon deposited a dirty
or a bright-red sediment composed of earthy phosphates, urate
of ammonia, and mucus. Test-paper and a rod moistened in
hydrochloric acid, afforded indications of ammonia, and by the
addition of an acid the presence of carbonic acid, but not of al-
bumen, was demonstrated. Both men recovered, but convales-
cence, especially in one of them, was very slow. The urine then
became gradually clear, yellow, and acid, as before: the period
' Urinary Diseases and their Treatment, p. 128.
246 THE SECRETIONS:
during which, in one of these cases, the urine continued unin-
terruptedly alkaline, was above eight days.
In another case, in which I followed the variations of the
urine through the course of the disease, it became alkaline at
noon on the third seventh-day period, but the next day it again
became acid, and remained so till death, which soon occurred.
[Schénlein’ s opinion that the urine in the regular course of
typhus is at first dark and very acid, subsequently neutral. and.
even alkaline, and finally again becomes acid at the commence-
ment of convalescence, has received further confirmation from
the following observations quoted by Simon in his ‘ Beitrage.’
In one case the urine became faintly alkaline on the seventh
day after admission ; it remained either alkaline or neutral for
seven or eight days; and then became faintly acid and gradually
clearer, as soon as the patient exhibited symptoms ¢ con-
valescence.
In a second (very severe) case the urine remained acid till
the twenty-first day; it then became neutral, and afterwards
alkaline, for the space of ten or eleven days, when it returned
to its normal reaction.
In two other cases the urine became alkaline previously to
the fourteenth day of the disease ; in one of them the secretion
was so thoroughly saturated with carbonate of ammonia, and
evolved so disgusting an odour as to be perceptible over the
whole ward. ‘This urine deposited a considerable sediment of
pus or mucus, mixed with the phosphates of lime and magnesia,
and effervesced briskly on the addition of an acid. In one of
these cases the urine rémained alkaline for fourteen, and in the
other, for twenty-one days, before it resumed its acid reaction.
Both cases recovered.
It is worthy of notice, that a deposition of urate of ammonia
not unfrequently precedes the occurrence of alkalinity and the
appearance of the earthy phosphates, which, as Schénlein re-
marks, may be regarded as the precursors of a favorable
change.
During the mild form of typhus recently (1843) prevalent in
Berlin, he noticed these changes in several cases, and in fact,
when from being alkaline the urine again became acid, and at
URINE. 247
the same time clear and abundant, there was scarcely any risk
in giving a favorable prognosis. |
In some cases in which the patients recovered, the dark urine
did not become alkaline quickly enough to be perceived during
the hospital-visit, but by the evening it would deposit a con-
siderable dirty viscid sediment composed of earthy phosphates
and mucus, and would have a well-marked alkaline reaction:
subsequently it retained its acidity for a longer period, until
at length it resumed its normal condition. On the other
hand, I observed one case in which the urine was dark, had an
acid reaction, and only became slightly alkaline for a short time
before death ; it continued throughout of this dark colour, was
turbid, and threw down a mucous sediment. In another case
the urine, which was of a dark, muddy colour, remained acid
till death. 7
Lastly, I will refer to two cases of typhus in girls, where the
urine continued of a dark colour, and exhibited an acid reac-
tion, throughout the course of the disease, which lasted from
three to four weeks. During convalescence it became turbid, and
deposited an imperfect sediment; although it did not entirely
lose its acid reaction, it now became sooner ammoniacal than
before. Ps: 240 20m
In a child the urine was clear and almost amber-coloured ;
it became, however, quickly alkaline, and deposited a viscid,
white sediment of earthy-phosphates. Dark acid urine I
have frequently found to be slightly albuminous. From these
observations, as well as from those of Willis, Pelletan, and
others, we arrive at the conclusion that in a regular and
favorable case of typhus the urine loses its acid and assumes an
alkaline reaction; that it then again becomes gradually acid,
although not perhaps in the exact reverse proportion, and that
it does not necessarily reassume the dirty-brown colour which it
possessed during the first period: consequently the transition of
the urine in typhus from the acid to the alkaline condition need
not be so much dreaded as has been generally supposed.
I cannot positively assert that the urine in typhus is alkaline
at the moment of its emission from the bladder. Becquerel
expresses himself opposed to the idea; he considers that alka-
248 THE SECRETIONS :
line urine is only passed in those cases in which it has re-
mained for a very long time in the bladder. I shall now give
the facts which he has collected regarding the urine in typhoid
fever. He observed the urine in thirty-eight cases of abdominal
typhus, eleven of which were very severe, eighteen of ordinary
intensity, and nine were mild cases. Purgatives, especially
Seidlitz waters, formed the basis of the general treatment. Seven
of the eleven severe cases recovered; two, however, subsequently
died from tubercular phthisis. Of the four fatal cases, one died
on the eighth day, the second at a more advanced period, the
third on the fifty-third day, and the fourth from perio of
the intestines.
In all these cases Becquerel found the urine to deviate con-
siderably from the normal type. While the fever was intense,
and before the adynamic period was established, the urme was
scanty, highly coloured, dense, and charged with uric acid; it
sometimes contained blood, albumen, or mucus in considerable
quantity, but seldom pus. In many cases, it exhibited a more
marked tendency to decomposition than is observed in other
diseases, and the rapidity and facility of this spontaneous
decomposition usually corresponded with the severity of the dis-
ease. But when, in the progress of the disease, the adynamic
period comes on, the quantity of the urine will be diminished
im consequence of the intensity of the fever, the colour will
be high but the specific gravity low, and at the same time
there will be frequent deposits of uric acid either spontaneous
or after the addition of an acid, or: else the urine will as-
sume the anzmic type and be pale, of low specific gravity, and
only slightly acid. The urine of this latter form differs widely
from that which was passed at an earlier period of the disease,
and is diagnostic of the asthenic state and of its degree of in-
tensity... But exceptions to this general rule have been observed
both by Becquerel and myself; on the one hand, the urine
has been slightly coloured, clear, and of low specific gravity in
cases of typhoid fever in which the patients were far removed
from the asthenic state, and on the other hand the latter state
(the asthenic) is not incompatible with turbid, sedimentary
urine.
We must not overlook the circumstance of the urine having
possibly remained for a long time in the bladder, in which case
URINE. 249
it may undergo decomposition there, and by its irritative action
on the vesical mucous membrane produce an excessive secretion
of mucus or even pus.
Becquerel found that the density of the urine, except in those
cases in which there was great prostration of strength, was above
that of normal urine, and amounted on an average to 1023°5.
This, as I have already observed, is opposed to my own obser-
vations. The mean specific gravity of the urine which threw -
down a spontaneous sediment was, according to Becquerel,
10247. The colour of the urine increased with the concentra-
tion. The colour of the spontaneous sediments in some cases
resembled the brick-dust tint of the sedimentum latericium ;
the precipitates thrown down by acids were usually of a yellowish
or gray colour.
In the thirty-eight cases of typhus abaerved by Becquerel,
pus occurred in the urine of only one individual, and in this
case the secretion was alkaline; in all the others it was acid. In
avery extensive series of observations made by Andral the urine
was found to have an acid reaction, except in the following cases,
viz. when pus was present, when the urine had remained for a
long time in the bladder, when the patient had taken a great
quantity of alkaline fluids, or, lastly, when the secretion was
not examined for some hours after its discharge. |
The precipitate which Becquerel observed in the urine of
typhus, whether thrown down spontaneously or after the addi-
tion of an acid, consisted of amorphous or crystalline uric
acid ; the latter was only seen twice, once after the addition of
a little nitric acid, and in the other instance forming a portion
of a spontaneous sediment. These spontaneous deposits were
usually of.a gray or reddish colour.
The important questions, whether urinary sediments i in typhus
occur at any fixed epochs of the disease ?—-whether there is any
connexion between their appearance and a favorable result ?—
and whether their presence is prognostic of such a result ?—are
answered by Becquerel in the negative.
From a table communicated by Becquerel it appears that
some persons died in whom the urine deposited a sediment
either spontaneously or on the addition of an acid, almost un-
interruptedly from the fifth or seventh day ; while others, under
similar circumstances, recovered: im a case, in which the
250 THE SECRETIONS:
urine threw down a sediment spontaneously on the third day
of the fever, and after the addition of an acid on the eleventh,
twelfth, and thirteenth days, death occurred on the fifteenth
day; in other cases, in which sediments appeared at intervals,
convalescence took place. Out of twenty-seven observations, a
sediment first occurred in one case on the third day of the dis-
ease (death); in one case on the fifth day (death); in one on the
sixth (recovery) ; in three on the seventh (two deaths, one re-
covery) ; in one on the eighth (recovery) ; in four on the ninth
(recovery); in five on the tenth (recovery); in four on the
eleventh (recovery) ; in three on the twelfth (recovery) : in four
cases the sediment first appeared after the twelfth day (recovery).
Amongst Becquerel’s thirty-eight cases, he only found blood
in the urine in two cases: in one the patient was: dangerously
ill, and a small quantity of blood was found in the urine every
morning ; in the other, the patient was recovering from fever
when he was attacked with small-pox. Albumen was found in
eight cases, in which neither pus nor blood was present. Of
these eight cases, four had the fever very severely, three mode-
rately, and one slightly. Of the severe cases, two terminated
in death; in one of these albumen was only found during the
last eight days; in the other it occurred first on the twenty-
fourth or twenty-fifth day, and subsequently from the thirty-
first to the thirty-eighth day, when death took place. In the
other cases the albumen only appeared at intervals.
Andral examined the urine in forty-one cases of abdominal
typhus, of which seven died. They were all treated by copi-
ous bloodletting. In eleven out of the thirty-four who re-
covered the urine did not differ in appearance from the normal
type, and nitric acid threw down no precipitate. In the other
twenty-three cases, the urine was generally deeply coloured,
(of a reddish tinge,) and became turbid either spontaneously
or after the addition of nitric acid. In some cases it remained
turbid throughout the whole course of the disease; in others
it presented no turbidity at first, even after the addition of
nitric acid ; but as the febrile symptoms attained their greatest
height, it became clouded, and as they disappeared, it gradually
regained its original appearance. In other cases the appearances
of the urine possessed no regularity, and it was clear and turbid
or sedimentary by turns.
URINE. 251
The urine during the convalescence of the thirty-four cases,
was usually pale and transparent; but in some it remained
turbid or sedimentary for a considerable time after the termina-
tion of the fever. Albumen was only observed in one instance.
In these thirty-four cases the urine was acid during the whole
course of the disease, and remained so during convalescence,
except in two cases, in which it was invariably strongly alkaline,
light, watery, pale, and transparent; the persons from whom
the urine, in these cases, was derived, were very weak, and in
a state of well-marked anemia, having had the fever very se-
verely, and having been repeatedly bled. The urine in these
cases did not appear to have been retained in the bladder
longer than usual. After several days, it became neutral; it
then became gradually more deeply coloured, and ultimately
regained its acid reaction.
_ With respect to the seven fatal cases, the urine in one re-
tained its normal appearance; in four it assumed from the com-
mencement till death a deep colour, and became turbid from
an excess of uric acid which deposited itself; and in all the seven
was invariably acid.
I shall now communicate the results of my own analyses of
the urine in typhus, which enter more into minutiz.
I have made several analyses of the urine in abdominal ty-
phus, but have only determined with accuracy the most impor-
tant of the constituents.
The urine in analysis 108 was taken from a man aged 30
years, who had been dangerously ill for three weeks; delirium,
subsultus tendinum, pulse frequent and small; the urine was
moderately dark, turbid without a sediment, and strongly acid.
He died two days afterwards. It is worthy of remark that the
urine had on one occasion, about eight days before death, an
alkaline reaction; it returned to its acid condition the fol-
lowing day. Analysis 109 represents the urine of a typhus
patient, who was lying in a state of deep coma; it was pale,
and had an acid reaction. Analysis 110 represents the urine
of the same patient three days afterwards, when he was in a
state of great general debility ; it was pale, transparent, and
slightly acid, but after some time became alkaline, and de-
posited a sediment of earthy phosphates. The patient subse-
252 THE SECRETIONS:
quently recovered after a tedious convalescence. Analysis 11]
represents the urine of a typhus patient on the eighteenth day
of the disease; it was dark, tolerably clear, threw down no
sediment, and had an acid reaction. The urine in analysis 112
belonged to a person who had been suffering from typhus for
some weeks; delirium, subsultus tendinum, stupor, rapid and
very small pulse ; it was brown, turbid, of an unpleasant odour
(like the urine of horses), slightly alkaline, and deposited in
a short time a very copious, flocculent, reddish sediment of
urate of ammonia. Analysis 113 represents the urine of a
girl suffering severely from typhus, who lay in a state of great
prostration and coma, and afterwards died; it was of a dark brown
colour, slightly alkaline, rather turbid, and without a sediment ;
a deposit of earthy phosphates was, however, subsequently
formed. Analysis 114 represents the urine of a girl who had
had typhus for four weeks: coma, subsultus tendinum, pulse 120
and small. It was rather dark, was turbid, and had an alka-
line reaction and ammoniacal odour. The urine in analysis 115
was taken from the same girl two days afterwards: her general
condition much as before, pulse 112, urine neutral, of a yellowish-
brown colour and rather turbid. Analysis 116represents the urime
of a girl aged 20 years, in whom the fever was less severe than
in the previous case: there were symptoms of bronchitis, pulse as
high as 108, urine of a yellowish-brown colour, and slightly acid.
The urine in analysis 117 was passed by a man aged 380 years,
who had been ill fourteen days. Coma; pulse 108, and small.
Anal. 108. Anal. 109. Anal. 110. Anal. 111. Anal. 112,
Specific gravity é - 1016:00 1010°00 1009°00 1017-00 1016-00
Water . ; . 960700 971°00 975°00 950°00 953-50
Solid constituents . ‘ 40°00 29-00 25°00 50°00 46°50
Urea : ; ‘ 9°47 7°30 6°70 —- 10°50
Uricacid . , ; 1:10 0°62 0°40 os 1°50
Earthy phosphates ts a trace trace — trace
Sulphate of potash : — trace trace _— —
Sum of fixed salts ; 2°50 1-00 1-00 6°50. 5°20
Anal. 113, Anal. 114, Anal. 115. Anal. 116. Anal. 117.
Specific gravity . - 1015°00 1016:00 101350 1018°00 1026-00
Water j ; - 958°40 952°80 956°830 941°50 930-00
Solid constituents. : 41°60 47°20 43°20 58°50 70°00
Urea ; ; : 9°30 13°20 12°60 18°60 22°50
Uric acid . ; ‘ 0°40 1°50 2°10 0°92 1:47
Earthy phosphates - —_ — trace — 0-90
Sulphate of potash : —- — 0°64 Fim Pe
Sum of fixed salts , —_ — 2°76 2°80 2°90
URINE. 253
If we calculate the ratios of these constituents to 100 parts
of solid residue, and compare them with the average ratios in
normal urine, we shall arrive at the results noticed in page 343,
viz. that in the urine in typhus the urea falls below the physio-
logical average, the uric acid is increased, and the fixed salts
are much diminished.
In 100 parts of the solid residue of the urine in ‘phos 100 parts of the solid
there are contained : residue of normal
urine contain
Analyses
e ~
108. 109. 110. 112, = 113. 114. 115. TR TEs
Urea 236 25:0 268-226 22:0 287 312 318 323 39-0
Uric . . : ; s oars : : :
acid | 27 21 16 32 09 32 48 216 21 15
Fixed] 4, ‘ ; " , : ‘zy e
aia} Oe Os 46 a 8 a ee 25:8
[Scherer! has made several analyses of the urine in typhus,
which differ in some points from those of Simon. He observes
that, in many cases, the urine is tolerably abundant in lactic
acid and extractive matters, and continues so throughout the
case, whether it terminate fatally or not. In a few cases the
urine was alkaline, and this generally occurred when the fever
assumed a very low or putrid form, or when the contents of
the bladder had not been discharged for some time; and that
not unfrequently, after being acid, it became alkaline, and then
again acid. In the most severe cases it usually contained a
little albumen. :
The urea was never increased except in those cases in
which the secretion was much diminished, and was often much
below the normal standard. As a general rule, the fixed salts
were considerably diminished, and the ammonia-salts increased.
There was always an excess of uric acid, which usually sepa-
rated, after standing, in the form of small red crystals, on the
sides of the vessel; this was especially observed when there was
much pulmonary congestion. No critical phenomena indicated
the commencement of reconvalescence. Scherer has published
the following analyses :
1. A woman aged 38 years, with slow nervous fever. The
urine on the ninth day contained, in 1000 parts :—
' Untersuchungen, &c. p. 65.
254 THE SECRETIONS :
Water eo n m . 945°48
Solid constituents > F 3 54°52
Urea : ; ‘ 8°60
Uric acid . 0°60
Alcohol. extract with lactic acid and lactates 27°50
Water-extract ‘ 7°40
Albumen . tii : 1°80
Fixed salts soluble in water : > 6:20
Earthy phosphates . : . 2°30
On the 12th day of the disease it contained :
Water - x c ; 951°26
Solid constituents : q : 48°74
Urea . - P . 10°40
Uric acid . 0°70
Alcohol-extract with lactic acid and lactates 21°80
Water-extract with ammonia-salts . 7°90
Albumen. . o5.
Fixed salts soluble in water : . 5°30
Earthy phosphates. . , 1:20
On the 15th day it contained : es
Water Z a 5 ; 959-29
Solid constituents ; ; F 40°71
Urea ‘ 4 : ; 11°40
Uric acid . a 0°80
Alcohol-extract with lactic acid and lactates 15°70
Water-extract 4 ; ; 6°20
Albumen and mucus ; ‘ 0°90
Fixed salts soluble in water é i 4:50
Earthy phosphates . ‘ ° 0°60
Convalescence occurred very slowly, without any critical
phenomena. ‘The urea gradually increased and the extractive
matters diminished.
2. A man aged 66 years, of a muscular frame and good con-
stitution, but of intemperate habits. The disease developed
itself with great rapidity. The urine contained :
On the 4th day. On the 6th day.
Water ; " ; ‘ 939-30 934-60
Solid constituents 3 é . 60°70 65°40
Urea > ‘ : : 22°84 34°52
Uric acid 1:70 1-62 —
Alcohol-extract with lactic acid and lactates 20°73 20°20
Water-extract ‘ ; 7°20 8°51
Fixed salts soluble in water . - 4-02 ‘ oa
Earthy phosphates : 7 0°72 1-02
3. In a case of typhoid fever of a very putrid character, the
URINE. 255
urine was of ared colour and an acid reaction. It contained in
1000 parts :
+
Water a a ‘ 4 983°5 965°3
Solid constituents . 4 : 16°5 34°7
Urea j : F 3 i2 5°3
Uric acid . ‘ m ; 0:
Alcohol-extract, with lactic acid and lactates 6°
Water-extract and ammonia-salts 5 6°
Fixed salts soluble in water . ‘ :
Earthy phosphates : 0°
0:
on @nm ow
Albumen and mucus
The specific gravity in these cases was 1007 and 1011.
Analysis 2 was made after the patient had taken phosphoric
acid for some days, and the septic tendency had diminished. ]
Urine in intermittent fevers.
The urine varies considerably in its physico-chemical relations
in this class of fevers. An abundant lateritious sediment at
the period of the crisis was formerly regarded as an acknowledged
characteristic ; recent investigations have, however, shown that
this is by no means an invariable occurrence.
Schénlein observes on this point that he feels bound to con-
tradict the old physicians—that the lateritious sediment in the
urine discharged at the termination of the paroxysm is a signum
pathognomonicum of intermittents, and that it may serve for the
purpose of distinguishing masked intermittents from similar
forms of disease,—because the urinary crisis exhibits itself in
various forms, and in many epidemics is either altogether absent,
or only forms the exception and not the rule. For instance,
when the whole tendency of the disease is directed towards the
skin, the crisis is uniformly exhibited through that medium,
and an urinary crisis is either altogether absent or only occurs
subsequently, during the non-febrile state; so that while a
perfectly clear urme is discharged at the termination of thie
paroxysm, the sediment which has been noticed occurs on the
following day.
Becquerel examined the urine in fourteen cases of intermit-
tent fever, ten of which were of the tertian, two of the quartan,
and two of the quotidian type. During the intermission the
urine resembled the normal secretion, and the resemblance was
256 THE SECRETIONS :
closer in proportion to the shortness of the paroxysm and the
length of the intermission: the average specific gravity was
1018-9. In many of the cases, the urine during the paroxysm
assumed the inflammatory type, that is to say, it was scanty in
quantity, highly coloured, and very acid, with or without sedi-
ments (either spontaneous or produced bynitric acid), and having
a mean specific gravity of 1023°5.
In other cases, in which the febrile paroxysms had been re-
curring for a length of time, the appearance of the urine changed
with the prolongation of the disease; it became paler and less
acid, and its specific gravity fell to 10147.
The changes produced in the urine by the prolongation of
the disease was very striking in the case of a man aged 49 years,
who was attacked with a quartan fever during convalescence
from acute articular rheumatism. As long as the first disease
lasted the urine was inflammatory, but, on the accession of the
second, it became paler, less dense, contained a good deal of
mucus, and finally became alkaline; the return of the paroxysm
did not produce any change in the character of the urine, which
remained the same until the recovery of the patient.
In a young chlorotic girl who was attacked with quotidian
fever, Becquerel found that the urine was pale, as is the case
with chlorotic persons, and was rendered turbid by a large
quantity of mucus equally during the intermissions and the
paroxysms; but, at the same time, the acidity and density
(1021-8—1023°1) were more considerable than is usually the
case in chlorosis; and, on cooling, a copious white a of
uric acid was thrown down.
Becquerel frequently observed turbidity or anweale (either
spontaneous or by the addition of an acid) towards the close
of intermittent fever, but not earlier. During the paroxysms
themselves, the urine was observed to present several modifi-
cations. In the majority of cases it seemed to undergo no ~
change during the three stages, that is to say, the urine
passed towards the end of the cold stage closely resembled
that which was passed during the other stages; sometimes in
the cold stage it was deeply coloured, acid, and of rather high
specific gravity, and it would retain these characters in the
hot stage; sometimes it would be slightly coloured, faintly
acid, and of low specific gravity (1013°4) in the cold stage,
URINE. 257-
and would be darker, more acid, and of higher specific gravity
(1021-°8) in the hot stage.
Becquerel occasionally observed sediments in the urine at
the termination of the paroxysm, but they were by no means
of constant occurrence: Andral observed the same. He only
noticed them in those cases in which the fever was intense and
prolonged, and terminated in a very abundant perspiration, or
when it was complicated with functional derangements, or with
congestion of certain organs.
The sediment formed in intermittent fevers is always com-
posed of uric acid and urate of ammonia, in most cases combined
with red colouring matter (uroerythrin).
A very perfect crisis by the skin and kidneys is said to indi-
cate an erethismic type of fever; an imperfect and slight one,
occurring through only one of the secreting organs, a synochal
type; and a colliquative crisis, a fever of a torpid character.
In a young man aged 23 years, who was treated in our hos-
pital for quartan fever, the urine, at the end of the paroxysm,
always threw down a copious, yellowish-red sediment. During
the intermission it was secreted more copiously, was clear, of
an amber-yellow colour, contained a few mucous flocculi, and
had a slight acid reaction. :
[The following table, drawn up by L’Heretier,! represents
the mean composition of the urine in the different stages of
this disease, as deduced from the analyses of the urinary secre-
tion of twelve patients :
: Cold stage. Hot stage. Sweating stage.
Specific gravity . -. 1017°330 1020°304 1022°820
Water. ‘ ‘ 967°520 964-680 961°845
Solid constituents . s, . $2:480 35°320 38°155
Urea. ; ‘ 9°845 9°015 7°624
Uric acid é : 0-660 0-980 1-029
Salts and organic matter. 21°975 25°325 29°502
In all these cases the physical characters of the secretion
were affected by the disease; in six other cases the urine re-«
mained apparently normal. | .
1 Traité de Chimie patholog. p. 528.
II, 17
258 THE SECRETIONS :
Scorbutus et Morbus maculosus Werlhofii. (Land-scurvy.)
In scurvy the urine is ordinarily of a dark, reddish-brown,
and sometimes of an almost black colour. Although it is
slightly acid as it passes from the bladder, it very soon be-
comes alkaline, and develops a strong and disagreeable ammo-
niacal odour. According to Schonlein, blood is frequently
discharged from the urinary organs, and the urine then assumes
a dark reddish-brown colour, in consequence of the presence of
hematoglobulin; in this case, it develops hydrosulphate of
ammonia, and soon becomes -putrid.
I have examined the urine in three well-marked cases of
scurvy occurring in Schonlein’s clinical wards; two were men
between thirty and forty years of age, and the third, a woman
who had been delivered a few weeks previously. In the men,
not only were the gums attacked, and the peculiar scorbutic
odour observed in the breath, but the lower extremities were
covered with numerous ecchymosed spots and petechie. The
woman had a very cachectic appearance; her face was somewhat
swollen; the gums nearly destroyed, livid, and hemorrhagic ;
the teeth loose (one having fallen out the preceding night),
and the breath almost unbearable. In its physical characters
the urine was very similar in these three cases. At first it
was scanty (eight to twelve ounces), and of a deep dark-brown
colour, as if bile-pigment or decomposed blood were present,
which, however, was not the case. It was devoid of the pecu-
liar sweetish odour of typhus-urine, but, after standing a few
hours, developed a disagreeable ammoniacal odour.
The addition of ammonia produced a very slight turbidity ;
and, on the addition of chloride of barium to the urine acidu-
lated with nitric acid, the precipitated sulphate of baryta was
much Jess than in healthy urme. The addition of ammonia
(after the removal of the sulphate of baryta) produced a com-
paratively slight precipitate, showing that there was a deficiency
of the phosphates. Infusion of galls, basic and neutral acetate
of lead, and acetate of copper, produced considerable turbidity,
and the urie was similarly affected (but.in a much less degree)
by bichloride of mercury. In their chemical characters, these
three specimens closely resembled each other, and were found
URINE. 259
to approximate to the urine in typhus. The amount of urea
was much less than in normal urine, not exceeding 25—-302
of the solid residue. The fixed salts were diminished in the
urine of the men, forming 14-182 of the solid residue, while
in the woman they amounted to 27%, a little above the normal
average (25%). The uric acid was slightly above the healthy
standard in all the cases, ranging from 1—39 of the solid re-
sidue. The men rapidly improved under proper treatment ;
the urine became more abundant and clearer, and, in the course
of six days, was apparently normal. The woman recovered
more slowly.
In a girl aged 20 years treated in Schénlein’s clinical wards
for morbus maculosus Werlhofii, I found the urine, during
a period of a fortnight, of a dark brown colour, of a dis-
agreeable ammoniacal odour, and with an alkaline reaction.
It deposited a viscid sediment of earthy phosphates, urate of
ammonia, and mucus. The addition of nitric acid indicated
the presence of a small quantity of bile-pigment. Blood (of
which the composition is given in Vol. I, page 316) issued from
the mouth, exuding from red patches situated above the uvula.
The odour of the breath was putrid. During her recovery, the
urine returned to its original state.
[The urine in this disease has likewise been analysed by
Heller and Martin.
The two following cases are recorded by Heller :1
1. A girl aged 19 years, marked over the whole body, was
admitted into the clinical ward of Professor Lippich.
The urine was of an intensely yellowish-brown colour, rather
turbid, and deposited flocks of mucus. The odour, at first ordi-
nary, rapidly became ammoniacal ; and the same tendency was
observed throughout the course of the disease. Reaction faintly
acid. Specific gravity 1021. The urine contained in 1000 parts:
Water = : : - : 949°28
Solid constituents ‘ ‘ ‘ ; 50°72
Urea : " A - ‘ 16°21
Uric acid P ‘ ; ‘ F 1°27
Extractive matters with much hydrochlorate of ammonia 23°24
Fixed salts : : : z 9°80
' Archiv fiir physiologischen und pathologischen Chemie, vol. 1, p. 12.
260 THE SECRETIONS:
The fixed salts consisted almost entirely of earthy phosphates
and sulphate of potash, there being a mere trace of chloride of
sodium. No albumen was present.
2. In a youth aged 16 years, the urine, during the progress
of the disease, was of a brownish-yellow colour and turbid ;
and when an improvement manifested itself, the secretion
became of a lighter tint, and clearer. A sediment of ammo-
niaco-magnesian phosphate and urate of ammonia was depo-
sited during the disease, but gradually disappeared during con-
valescence. The urine had a faintly acid reaction, but, not-
withstanding, evolved a putrid odour, and very rapidly became
alkaline. The specific gravity was at first 1017, and subse-
quently varied from that number to 1012. Traces of albumen
could always be detected till symptoms of convalescence ap-
peared. In its chemical characters it resembled the preceding
case. The hydrochlorate of ammonia was much increased,
while the chloride of sodium was diminished to a mere trace.
The uric acid was much increased, amounting to 2 in 1000
parts. The urine remained abnormal for six days, and then
appeared to have resumed its ordinary character.
Heller observes that the augmentation of the ammonia (in
the form of hydrochlorate) and of the uric acid, together with
the diminution of the chloride of sodium,—characters seem-
ingly associated with this disease,—indicate that the blood must
be in a state of dissolution.
In Martin’s' case, the secretion was very scanty, about one
or two ounces being passed at a time, and the daily amount
being from twelve to twenty ounces. In its physical characters
it resembled the urine described in the preceding cases.
On evaporating the urine, and allowing the solid residue to —
remain for some hours at a temperature of 212°, there was re-
marked on the surface of the brown, and (for the most part)
saline mass, a copious, reticulated, dendritic efflorescence which,
when examined with a lens, was found to consist of long, traps-
parent, four-sided needles, with double-sided sharp extremities.
They were proved to be neither hydrochlorates, sulphates, or
phosphates, and were presumed to be crystals of hippuric acid.
Three analyses were instituted.
’ Neue med.-chir. Zeit. 1845.
URINE. 261
ie 2. 3.
Specific gravity ‘ a ‘ 1013°40 = 1021°26 =1010°31
Water : ‘ ‘ : 984°42 973°74 985°730
Solid constituents ‘ ‘ : 15°58 26°26 14°270
Urea ; 6°43 6:07 5°430
Green colouring matter (thrown down by : H .
hydrochloric acid in place of uric acid) ikl wie 006
Extractive matters with ammonia-salts, &c. 2°34 2°25 0°650
Fixed salts soluble in water . : 6°30 17:00 7°794
ee insoluble in water é 0°42 0°84 0°390
Analysis 1 was made on Oct. 22d, before the administration
of any remedies. The urine was faintly acid. The soluble
salts consisted for the most part of chloride of sodium. Analysis 2
was made on the 3d of November with the mixed urine of the
preceding twenty-four hours. It had a strong ammoniacal
odour, but was perfectly neutral. The patient had taken sul-
phuric acid, iron, and other tonics, in the interval, without any
obvious improvement, and traces of iron were found with the
earthy phosphates. Analysis 3 was made with the morning
urine passed on the 25th of November. The same treatment
had been pursued with very decided benefit. The urine was
clear, slightly yellow, and devoid of the unpleasant odour it
previously evolved. Its reaction was faintly acid, and it con-
tained traces of iron.
The green colouring matter is probably a compound of uric
acid and biliphein. A compound of this nature has been ob-
served and described by Heller."]
Chlorosis.
The urine of chlorotic persons is usually pale, of low specific
gravity, and of a mildly acid reaction: in these respects it re-
sembles the urine of persons who have lost a considerable quan-
tity of blood, or the form of urine termed nervous, which we
sometimes observe in hysterical attacks. |
Becquerel applies the term anemic to this form of urine, and,
as in the majority of cases in which it occurs, there is either
an absolute deficiency of blood or a scarcity of the truly vital por-
tion—the blood-corpuscles, no objection can be raised to such
a designation. - The urine in chlorosis has, however, other dis-
! Archiv fiir phys. und pathol. Chemie, vol. 1, p. 99.
262 THE SECRETIONS :
tinctive properties, as has been clearly shown by the researches
of Becquerel; for it is very poor in urea, and in that respect
resembles the urine in typhus, while it differs from the latter
in containing only a small quantity of uric acid, and a large -
amount of fixed salts.
I may perhaps be allowed to refer once more to the intimate
connexion subsisting between the action of the metamorphosis
of the blood-corpuscles (or of their development and vitality) on
the one hand, and on the production of urea on the other.
The proportion of the urea to the solid constituents of the
urine in inflammatory diseases, in those forms of typhus which
assume a torpid character, and lastly in chlorosis, affords us
sufficient illustration of this connexion.
In the form of typhus to which we have alluded, as well as
in chlorosis and anemia, the urea is diminished; but, as we
have already remarked, in that case the uric acid, which is a
product peculiar to febrile action, is increased, and the salts
(partly in consequence of the diet) are diminished; while in
chlorosis, in which a nutritious nitrogenous diet is allowed, the
diminution of the urea plainly indicates that the seat of the
disease must be sought for in the production of the blood-cor-
puscles.
I shall now give Becquerel’s account of the chemico-physical
relations of the urine in chlorosis.
The quantity of urine emitted in twenty-four hours amounts
to about 34 ounces. It is pale and of a greenish tint, and
only becomes dark when the urine is very concentrated: the
acid reaction is weak ; uric-acid sediments are seldom formed ;
when they do occur, they are of a white or gray colour. If, as
is not unfrequently the case, leucorrhca is associated with
chlorosis, the urine is more or less turbid in consequence of the
mixture of the morbid product with it; in these cases a little
albumen is generally observed. |
The quantitative analyses which Becquerel made of the urine
of chlorotic persons gave the following results :
Anal.l, Anal. 2. Anal. 2.
Quantity of urine in 24 hours ; 41°3 ounces 50°8 ounces 27:5 ounces
Specific gravity ; - 1011°3 1012°6 1016°8
URINE. 263
1000 parts contained :
Water : ‘ 981°28 979°21 972-28
Solid residue ‘ ‘ 18°72 20°79 27°72
Urea . ‘ ‘ 6°03 ~ 7°38 6°83
Uric acid : ‘ 0-08 0°26 0°23
Fixed salts ‘ 4°80 8°05 8°45
Extractive matters d 7°79 5°14 11°16
If we calculate the amount of urea, uric acid, and fixed salts
in these analyses in relation to 100 parts of solid residue, and
compare the results with the physiological average which
Becquerel has given, the proportions to which I have already
alluded will plainly appear, that is to say, there is an absolute
anda relative diminution of urea and of uric acid, and an in-
crease of the fixed salts: 100 parts of solid residue contain :
Anal. 1, Anal. 2. Anal. 3. Normal Urine.
Urea ‘ ‘ 32°0 33°0 24°0 42°0
Uric acid . 3 0°4 1:2 0°38 1°4
Fixed salts ‘ ‘ 26°0 38°0 30°0 24:0
The urine may exhibit some differences in its chemico-
physiological properties if other diseases are associated with
chlorosis, or if the latter is not very fully developed. The persons
from whom the urine in analyses 1 and 2 was taken were slightly
feverish. In analysis 3, the chlorosis was combined with pul-
monary emphysema. In analysis 4, there was some affection
of the nervous system.
With the exception of a considerable diminution in the
quantity of urine discharged’ in twenty-four hours in analyses 1
and 3, and the increase of uric acid in analysis 2, there are no
particular deviations in the relative proportions of the solid con-
stituents from the statement that we have previously made ; for
the urea is both absolutely and relatively diminished, and the
salts occur in a higher proportion than in normal urine.
2 3 4.
1. ‘ .
Quantity of urine passed a 23°3 oz. 24°5 oz. 17°8 oz. 38°5 oz.
24 hours, in ounces é
Specific gravity 2 1014°2 1017°6 1016°8 1016°8
1000 parts contained:
Water : . 976°43 970°89 972°28 972:28
Solid constituents < Goose 29°11 27°72 27°72
Urea ‘ 8°37 7°81 8°64 6°95
Uric acid . . 0:20 0°81 — 0-22
Fixed salts : 4°74 0°09 8°36 8°89
Extractive matters . 10°34 11°47 10°24 12°10
264 THE SECRETIONS:
Becquerel has made some interesting remarks on the influ-
ence of ferruginous preparations on the urine in chlorosis.
In the majority of cases the iron is partially carried off by
the urine ; sometimes, without any apparent reason, it is absent
from urine in which it is found on the preceding and suc-
ceeding days. The quantity of iron thus carried off in the
urine of the same individual is subject to great variations ;
sometimes it can only be detected after the incineration of a
portion of evaporated urine, while, on other occasions, the simple
addition of a test is sufficient to indicate its presence. The iron
begins to pass off by the urine from the commencement of the
administration of the medicine, and it occurs in all the urine
that is emitted; so that there is no necessity for the system
to be saturated with it before any portion can pass off by the
kidneys; as the assimilation of the iron is a very slow process,
large doses merely derange the digestive organs without bemg.
of more service than smaller doses.
[Herberger! analysed the urine of the chlorotic girl referred
to in Vol. I, p. 3138, and his analyses indicate the simultaneous
diminution of the blood-corpuscles and urea. The urine was
analysed on three occasions before the use of iron, and twice
afterwards.
Urine before the use of iron.
1. 2. 3.
Specific gravity . - 1010 1009 1012
Quantity in 24 hours . ‘ 32 02. 42 02. 35 02.
Water f A : 975°43 978-21 971:98
Solid constituents . ; 24:57 21:79 28°02
Urea é § : 7°04 7°00 7°12
Uric acid 3 é i: APIS 0:21 0°19
Extractive matters . £% 10°48 9-00 13°99
Fixed salts : = 6°80 5°50 6°62
Urine after the use of iron.
| ‘2 2.
Water z j : - 940°16 938-70
Solid constituents é é 59°84 61°30
Urea ‘ : ; ; 26°84 27°36
Uric acid ; 4 é 0°94 0°96
Extractive matters. aie : 18°62 16°28
Fixed salts ‘ é ~~ 13832 15°71
? Buchner’s Repertorium; vol. 29.
URINE. 265
Traces of iron were detected both in the sweat and urine
during the period of treatment. ]
Donné states that normal urine always contains a certain
quantity of iron which disappears during chlorosis, and only
reappears after the use of ferruginous preparations. This state-
ment is contradicted by Bécquerel, who has never been able to
discover iron in the incinerated residue of normal urine,
although ferrocyanide of potassium would evolve a blueish shade,
—an effect which this test sometimes has on chlorotic urine.
[L’Heretier! gives the mean of eight analyses of the urine
in uncomplicated chlorosis :
In 24 hours.
Quantity of urine 3 ‘ ; 1000 38 oz.
Specific gravity ; ; : 10119 . —
Water ° : ‘ : 983°1 18372 grains
Solid constituents. F , 16°9 316
Urea . : ‘ : 6°6 123
Uric acid : ‘ ; 0:2 5
Fixed salts ; : : 4°] 77
Organic matter : ° 6:0 lll
I am indebted to the kindness of Dr. Golding Bird for the
following cases :
1. A girl aged 18 years, of anzemic appearance, and who had
suffered from anasarca for six months, passed 30 ounces of acid
urine of specific gravity 1024, in twenty-four hours.
The water amounted to : ° 12690 grains.
The solids. ; : : 750
Urea . : : : 162
Uric acid 3 ‘ : 9
She then commenced taking ferri sulph. gr. ij, ter die. In
the course of a week the urine was again examined ; it amounted
to 20 ounces, had a specific gravity of 1029, and deposited urate
of ammonia.
The water amounted to : : 8392 grains.
The solids . . . : . 608
Urea ‘: : ; ; 137
Uric acid é ae : 20
1 Traité de Chim. patholog. p. 551.
266 THE SECRETIONS :
The anzemia was now disappearing. At the end of the second
week the amount of urine was 30 ounces, and the specific
gravity 1023.
The water amounted to : : 12690 grains.
The solids . ; ; 720
Urea F ; 5 : 242
Uric acid . : - a 5
2. The urine of a girl aged 15 years, of chlorotic appear-
ance but menstruating regularly, amounted to 25 ounces, and
had a specific gravity of 1020.
The water amounted to ‘ , ; 10637 grains
The solids ‘ ’ ; : 519
Urea ; ‘ : . 231°25
Uric acid ° ; : ; 25°00
The amount of uric acid in this case is very remarkable. ]
Hemorrhages.
The properties of the urine in hemorrhages are entirely de-
pendent, during the period of the discharge and for some short
time afterwards, upon the degree in which the vascular system
participates in the general disturbance. In many cases, as for
instance, in cerebral and pulmonary hemorrhages, we find that
the quantity of urine is diminished, its colour becomes deepened,
its acidity and its specific gravity increased,—that is to say, it en-
tirely resembles inflammatory urine. When there is hemorrhage
from the kidneys, uterus, or any portion of the generative sys-
tem, the urine will naturally contain blood, either in a state of
solution or undissolved. If the hemorrhage is succeeded by a
state of anzemia and great prostration of strength, the urme then
becomes pale, of slight acidity, and of low specific gravity, as in
chlorosis. |
Becquerel made three examinations of the urine in cerebral
hemorrhage, and in two of these cases he found it analogous
in its physical relations to the urine of inflammation: in the
third case, in which the patient had imperfect hemiplegia of the
right side, but in other respects seemed well, the urine could
hardly be considered abnormal. 7
In one of the first two cases, the urine was taken from a
man aged 43 years, who was affected with perfect paralysis of
;
URINE. 267
the left side, and died on the fifteenth day from the seizure.
It exhibited in a high degree, both in its physical properties
and in its chemical constitution, the characters of inflammatory
urine. The quantity was diminished ; the specific gravity, the
urea, and uric acid exceeded the physiological average.
Quantity of urine in 24 hours, in ounces > ‘ 25°7
Specific gravity ‘ ‘ ‘ - 1023°1
Water : : 4 ; : 960°40
Solid residue . ; ; : 39°60.
Urea i ‘ : ; ; 17:10
Uric acid . z i ‘ F 0°65
Fixed salts . ‘ ‘ ; * 10:00
Extractive matter , : ; ; 11°80
In 100 parts of solid constituents there are 43-0 of urea, and
1°6 of uric acid.
The urine of a man aged 31 years, who was treated in
Schénlein’s clinical wards fora severe attack of pulmonary hemor-
rhage, was of a dark red colour, very acid, and exhibited the other
symptoms of the inflammatory type, from the period of admis-
sion to the eleventh day. On two occasions I found its specific
gravity to be 1023 and 1022. On the eleventh morning the
urine was rather turbid, and on the twelfth it became jumen-
tous from the urate of ammonia which was suspended in it; it
still had a strong acid reaction, but did not form any sediment ;
on the next day, the sediment was very considerable. The
pulse was quick and feverish till the urine began to deposit
sediments ; subsequently, the vascular excitement almost en-
tirely disappeared, and the urine became clear and pale, and
contained only a few mucous flocculi.
In a girl aged 20 years, with severe hematemesis, who had
brought up nearly a quart of coagulated blood, the urine which
was passed almost immediately after the attack scarcely differed
from the normal secretion; but, on the following day, it was
pale, and scarcely acid, and it continued in this state for several
days.
In hematuria the urine contains blood, either in a coagulated
state or devoid of fibrin; in the latter case, the blood-corpuscles
may be either perfectly dissolved or not; and when they are
found floating in the urine, they form, after a short time, a red
sediment. More minute observations on this subject have been
given in page 187.
268 THE SECRETIONS:
Rayer has published a very interesting communication on
an endemic hematuria that occurred in the Isle of France.
Children of very tender age discharged blood with the urine;
he relates for instance, the case of a boy, who from his seventh
year lost nearly an ounce of blood daily: uric-acid gravel was
combined with the hematuria.
A man aged 21 years, from the Isle of France, who was
under Rayer’s care, had had hematuria from his youth, The
urine which he passed in Rayer’s presence formed, in the course
of seven hours, a cream-like layer on the surface; two distinct
strata were afterwards formed, the upper being of a yellowish-
white colour, and the lower red: the latter contained two clots
of coagulated matter, one was the ordinary blood-clot, the other
was white and loose. The upper milky stratum contained much
albumen and fat (chylous urine), the lower one contained blood.
No casein was present. It is worthy of remark that the hema-
turia never came on till about noon, the urine passed in the
earlier hours being always clear.
Rayer and Orfila also observed a similar case of bloody and
milky urine in a Brazilian. The disease commenced with a
discharge of milky urine, the hematuria coming on a year after-
wards.
Catarrhs.
In simple catarrh the state of the urine corresponds with the
degree of vascular reaction.
If the catarrh terminates without any perceptible fever, the
urine scarcely deviates at all from the normal state : if the fever
is accompanied by much excitement, the urine, according to
Schonlem, becomes rather red, and forms a mucous sediment.
At the commencement of convalescence from a feverish catarrh
the urinary crisis shows itself by a mucous sediment.
In influenza the urine assumes a reddish tint, and assumes
more or less of the inflammatory type in proportion to the —
synochal character of the fever. Schénlein states that the
nature of the urinary crisis at the approach of convalescence is
dependent on the character of the fever : in erethismic fever the
sediment is mucous, in synochal fever it is earthy, and in gastric
fever it is of a yellowish-gray colour.
. URINE. 269
In measles, which are considered by Schénlein as the most
highly-developed form of catarrhal disease occurring in the
northern hemisphere, the urine changes with the varying stages
of the disorder. In most cases it more or less resembles the
inflammatory type, it is red (as in inflammatory measles), acid, and
sometimes jumentous (as in gastric measles), or deposits a mucous
sediment during the course of the morning (as in catarrhal mea-
sles). Becquerel states, as the result of his observations, that
the urine is generally inflammatory at the commencement of
the febrile period. It becomes very dark and of high specific
gravity, and frequently deposits a sediment of uric acid: a
small quantity of albumen was found in a few of the cases.
During the eruptive period the character of the urine changes ;
if the eruption is slight, and there is not much fever, it resumes
the normal type; if the contrary is the case, the urine retains
the inflammatory appearance. Becquerel did not meet with any
case in which the urine was turbid or sedimentary towards the
close of the eruptive stage.
During the period of desquamation and of convalescence, the
urime either returns at once to the normal state, or continues
turbid and sedimentary for some time, or becomes pale, clear,
and anzemic. :
In three cases anasarca came on during convalescence, but
the urine did not contain albumen.
During the catarrhal affection of the mucous membrane of
the stomach, or the status gastricus (as it has been called), which
when more fully established, becomes gastric fever, the urine
is generally more or less turbid, and earthy sediments appear
as symptoms of a crisis.
Becquerel found that the urine in “lembarras gastrique”
was often of a deep colour, and sedimentary, as in the phlo-
goses: sometimes, however, it hardly differed from the normal
secretion. Out of twelve cases, the urine in two scarcely differed
at all from the normal type, in the other ten it approximated
more or less in its characters to the urine of inflammation: the
deepness of the colour appeared to be always in relation to the
intensity of the disorder, and to the presence of some degree of
270 THE SECRETIONS:
fever. In the twelve cases, with two exceptions, the urine was
constantly acid. In one of the exceptions the urine was alka-
line, and contained numerous crystals of ammoniaco-magnesian
phosphate. In six cases sediments of uric acid were formed
either spontaneously, or on the addition of an acid: in two
in which the symptoms were very intense, a little albumen
was present, but in each case it lasted only one day. The mean
specific gravity of the urine was 1021°4; the highest, and in this
case a sediment was deposited, was 1025: 2.
In gastric fever the urine is frequently turbid and jumentous:
it usually contains urate of ammonia in suspension, and has an
acid reaction. An earthy flocculent sediment occurs as a urinary
crisis at the commencement of convalescence, the supernatant
fluid being clear. (Schénlein.)
In mucous fever the urine is red and fiery, if the fever (which
at the commencement assumes the intermittent type, and which
only at a later period becomes continuous,) takes on a synochal
character.
It is not unfrequently limpid and clear, as in hysterical cases,
and forms, especially if the affection has extended to the genito-
urinary mucous membrane, a mucous sediment. In those cases
in which the urine is limpid, it assumes the normal colour during
the progress to convalescence, and sediments are deposited which
gradually become thicker, and pass from a mucous to an earthy-
purulent character. (Schonlein).
The urine in bilious fever is usually impregnated with bile-
pigment; it is of a more or less brownish colour, and when a
thin layer is seen it appears of a citron-yellow tint: it differs,
however, with the degree of vascular excitement; if the fever
has a synochal character the urine is dark and of a fiery-red
colour, if the fever is erethismic, which is frequently the case,
it is of a dark yellow or yellowish-brown zolour, and in torpid
fever it is more or less brown, and not unfrequently mixed with
blood. The presence of bile-pigment may always be recog-
nized by the change of colour which succeeds the addition of
nitric acid.
URINE. 271
Cholera.
In sporadic cholera, as well as in the Asiatic form of the
disease, the urinary secretion is very scanty, and sometimes
altogether suppressed. Any urine that is discharged is usually
of a dark colour, and has a feeble acid reaction, but its specific
gravity is below the healthy average.
In a case which I observed in our hospital, where the symptoms
were exhibited with great severity in a woman 36 years of age,
there were frequent evacuations by stool, but only about one
ounce and a half of dark acid urine, with a specific gravity of
1011-0, in the course of twenty-four hours. I only determined
the amount of solid constituents collectively, and of the urea.
In 1000 parts I found :
Analysis 118.
Water 5 : 3 4 975°90
Solid constituents ; ‘ : 24°10
Urea : . ; ‘ 7°10
The urea in this case amounts to rather more than 292 of
the solid residue, which is considerahly below the normal pro-
portion. At the approach of convalescence the urine was
discharged more copiously, but it continued to be deeply co-
loured: it was only after some days that it became pale and
anemic. I never observed any sediment.
[The urine of a man aged 30 years, attacked with sporadic
cholera, was analysed by Heller.’ There was excessive diar-
rhea and vomiting, and the patient died on the fourth day.
During the first forty-eight hours of his illness only one ounce
of urine was discharged; it had a deep golden-yellow colour,
and deposited earthy phosphates although strongly acid. Its
specific gravity was 1018. It contained in 1000 parts:
Water and free carbonic acid ‘I . 955°67
Solid constituents i , : ‘ 44°33
Urea A ° é . : 10°50
Uric acid ‘ . ‘ : ; 0°10
Extractive matter, with a large quantity of a peculiar sub-
stance apparently originating from the bile . 27°32
Fixed salts : : ; ; 6°41 |
' Archiv fiir phys. und pathol. Chemie, vol. 1, p. 15.
ae
me
279 THE SECRETIONS:
We are unfortunately not possessed of any trustworthy in-
formation respecting the urine in Asiatic cholera. R. Herrmann!
has communicated the following remarks. _
As no opportunity occurred for obtaining urine passed during
the more urgent stages of the disease, that which was first dis-
charged by a patient who was just getting over a severe attack
was analysed: it was yellowish, turbid, deposited no sediment,
had a neutral reaction, and by the application of appropriate
tests, the presence of phosphates, hydrochlorates, and ammonia-
compounds was indicated ; on the addition of nitric acid, crystals
of nitrate of urea were obtained ; but only small quantities of
all those substances were present. Its specific gravity was very
low, being only 1006.
Wittstock? has likewise instituted some researches on the
urine which was passed immediately after an attack of cholera.
It had a specific gravity of 1008-5, was neutral, of a pale yellow
colour, but not perfectly transparent in consequence of micro-
scopic crystals (consisting, in all probability, of ammoniaco-
magnesian phosphate,) held in suspension. The sides of the
glass were also covered with minute glittering crystals, which
were supposed by Wittstock to consist of uric acid, but which,
in all probability, were composed of ammoniaco-magnesian
phosphate also.3
An interesting investigation regarding the urine in cholera
has also been made by Vogel. The urine was passed after the
most violent symptoms had abated: it was-of a deep brownish-
yellow colour, was rather turbid, deposited no sediment, had a
specific gravity of 1008-0, and indicated a strong acid reaction.
The salts of lime and magnesia were entirely wanting, and the
quantity of chloride of sodium was very minute, while on the
other hand the sulphates were found in a larger proportion than
in normal urine.
The existence of bile-pigment and of albumen was proved by
' Poggendorff’s Annalen, vol. 22, p. 176. 2 Cholera Archiv, vol. 1, p. 428
3 It is by no means probable that urine, with so low a specific gravity, and espe_
cially when it is alkaline or neutral, should throw down a precipitate of uric acid; a
sediment of urate of ammonia would be much more probable. The neutral state of
the urine would favour the separation of crystals of ammoniaco-magnesian phosphate,
as suggested in the text.
URINE. 273
the addition of nitric acid to the urine. Urea, uric acid, mucus,
and a good deal of phosphoric and lactic acid were present. Sub-
sequently the albumen and bile-pigment disappeared, and the
earthy phosphates returned.
In vesical catarrh the urine is generally very pale, and always
contains a greater or less amount of mucus. The feeble acid
reaction which it possesses at the period of its emission is fre-
quently lost in a very short time, and it becomes neutral or
valkaline, and a quantity of the earthy phosphates, (especially of
crystals of ammoniaco-magnesian phosphate,') becomes mixed
with the mucus. The quantity of mucus which is separated is
sometimes very bulky.
Schonlein remarks that we may possibly be able to -deter-
mine the seat and the extent of the blennorrhcea from the
quality and the amount of mucus. Mucus secreted from the
mucous membrane of the bladder forms an uniform mass, and
is tenacious and thready, while that secreted by the mucous
membrane of the ureters and of the pelvis of the kidney is, on
the contrary, flocculent: if the tenacious and the flocculent forms
of mucus are both found at one and the same time, we are jus-
tified in assuming that the bladder, ureters, and pelvis are simul-
taneously affected. Willis,” in speaking of cystorrhea, states that
in acute vesical catarrh accompanied by inflammatory fever, the
urine is scanty and highly coloured, and precipitates a much
greater quantity of tenacious mucus than usual ; also that in the
earlier stages of the disease it is sometimes ammoniacal, but
more frequently when the disease has continued for a long time.
In chronic vesical catarrh the urine is flocculent when it is
passed ; the flocculi increase with the advances of the disease,
and collecting at the bottom, form a tenacious mass which
may be drawn out into threads; this mass sometimes assumes
the.consistence of bird-lime, and exhibits spots of blood.
As the disease advances still further, we often find a fourth
or even a third part of the urine to consist of mucus, so that
six to eight or even ten ounces are daily thrown off. Willis
' [It is worthy of observation that beautiful crystals of ammoniaco-magnesian
phosphate may be occasionally found in urine with a decidedly acid reaction. }
? Urinary Diseases and their Treatment, p. 399.
II. ; 18
274 THE SECRETIONS:
inquires whether this secretion is always composed of actual -
mucus, or whether pus in a modified form is not always present.
In the urine of a man who was being treated for catarrhus
vesicee in our hospital, I found a very bulky sediment composed
of mucus and earthy phosphates: the quantity of ammoniaco.
magnesian phosphate was also very considerable.
The urine upon becoming clear above the sediment, was of
a faint yellow colour, and contained much carbonate of ammonia;
it constantly had an alkaline reaction. The sediment for a pe-
riod of eight days assumed a faint grayish-blue colour; when
washed (for the purpose of separating the urine from it as com-
pletely as possible,) and dried, it was treated with anhydrous
alcohol, which took up the blue colouring matter, and on evapo-
ration left it as a beautiful blue substance insoluble in water,
but dissolving in ether with a reddish tint ; I can only compare
it to Braconnot’s cyanourin. 7
Rheumatism.
We have already seen that the blood in rheumatism perfectly
corresponds with the blood in the true inflammations; hence we
are led to infer that the urme will also present the inflammatory
type—an inference confirmed by experiment.
The urine in acute rheumatism, (when the reaction is accom-
panied by synochal fever,) exhibits in a high degree those cha-
racters of inflammatory urine which I have already so often
described. The colour is sometimes deep purple-red, like claret,
its acid reaction is very strongly developed, and very bulky,
fawn-coloured or lateritious sediments consisting for the most
part of urate of ammonia, but occasionally of crystallized uric
acid, are deposited. The extent to which these properties of
the urine are exhibited depends upon the violence, and the more
or less synochal character of the fever.
Vauquelin and Henry found free phosphoric acid, and the
latter also free acetic acid, in the urine.
In chronic rheumatism without fever, the characters of inflam-
matory urine may be altogether absent, and instead of the
earthy sediments we shall have merely a cloudiness and tur-
bidity, as I have observed in my own case. The urine which I
have passed during the night has frequently remained perfectly
URINE. 275
clear, while that discharged in the course of the day often
formed only slight deposits. As the urine in rheumatism often
throws down sediments even at the height of the disease, the
deposits which are formed can only be regarded as significant
of a true crisis when the supernatant urine is perfectly clear.
Eisenmann! remarks that the properties of the urine may un-
dergo a change if the disease continues for a long time; for
instance, if it should take a hypodynamic character, the urine,
instead of being acid, will assume an alkaline reaction, and will
give off a fetid ammoniacal odour. |
When the disease takes on the hypodynamic type, without
_having previously exhibited a hyperdynamic character, the urine
instead of being red, is then, according to Stork’s observations,
pale, frequently thick, turbid, and fetid.
Becquerel has made quantitative analyses of the urine in
several cases of rheumatism. He found the relative proportions
of the solid constituents the same as in inflammation—a fact
that had been previously observed by Henry? who found a
large amount of urea in his own urine during rheumatic fever.
The urine of a man aged 30 years (Anal. 1), who had been
bled for acute rheumatism, was very deeply coloured, and on
the addition of a little nitric acid threw down a copious sedi-
ment. It also threw down a spontaneous sediment of a reddish
colour after standing for two hours. The specific gravity was
1017-2. The urine of the same man was analysed another day,
(Anal. 2). It was of a very dark colour, almost like blood,
and had a specific gravity of 1018-0. The urine in the third
analysis was taken from a man aged 38 years, whose pulse
was 104 in the minute. It was of yellowish-red colour, and
threw down a sediment of uric acid on the addition of a few
drops of nitric acid. 7
1. 2. 3.
Water . i ; 971°80 970°20 981°10
Solid constituents . ‘ 28°20 29°80 18°90
Urea : . 12°20 9:00 8:00 ©
Uric acid ; 1°70 1°04 0°50
Fixed salts : ; ‘ 5°59 2°34
Extractive matter : 14°70 8-00
' Die Krankheitsfamilie Rheuma, p. 51. 2 Journ. de Pharm. 15, p. 228.
276 THE SECRETIONS:
If we calculate the amount of urea and of uric acid in pro-
portion to 100 parts of solid residue, we obtain 43° urea and
6° uric acid in the first, but only 312 urea, and 3°52 urie acid in
the second analysis; so that in the first analysis the physio-
logical average is exceeded, while in the second it is not reached,
_ at least as far as the urea is concerned.
In the third analysis the numbers approximate closely to the
physiological average, viz. 42° urea and 2°62 uric acid.
In eighteen cases of rheumatism, in which the renal secretion
was examined by Becquerel, it always assumed to a greater or
less degree the characters of inflammatory urine during the con-
tinuance of the fever: the very deep colour was general, as also
the acid reaction, except in one case, in which for a single day
an alkaline reaction was observed. The mean specific gravity
was 1022-6: in those cases which threw down a’ spontaneous
sediment it was 1025-2. In twelve out of the eighteen cases,
a spontaneous sediment was thrown down during the febrile
period : these sediments usually alternated with dark but clear
urine, or with urine that was precipitable by nitric acid.
Albumen was detected in seven of the eighteen cases. During
the period of convalescence the urine was anemic, or returned
to its normal state.
[The following analysis of the urine of a man aged 22 years,
suffermg from acute rheumatism, was made by Dr. Baumert.’
The urine submitted to analysis was passed on the fourteenth
day of the disease. It was of a deep yellowish brown colour
but perfectly clear. In the course of twenty-four hours it de-
posited a copious sediment of urate of ammonia, but did not
become alkaline.
It presented the normal degree of acidity, and its specific
gravity was 1028°3. It contained in 1000 parts:
Water ‘ ‘ ‘ - 928°68
Solid constituents ; : ; 71°32
Urea 3 . ; : 18°65
Uric acid : 0°86
Extractive matter with a large quantity 37-61
of hydrochlorate of ammonia .
Fixed salts . ee ; 14:20
' Archiv fiir phys. und patholog. Chemie, vol. 1, p. 45.
URINE. 277
The fixed salts contained no trace of chloride of sodium,
the normal amount of earthy phosphates, a slight excess of
alkaline phosphates, and an augmentation of the sulphates.
Hippuric acid was sought for without success.
Oxalate of lime is of frequent occurrence in cases of acute
rheumatism. |
In chronic rheumatism, if the pains are not very acute, and
the night’s rest is not disturbed, the urine retains its normal
properties. Out of thirty-seven cases observed by Becquerel,
the urine remained unaffected in twenty, while in seventeen it
assumed the inflammatory type, and in nine of these threw down
a spontaneous sediment.
Gout.
I have made four analyses of the urine in two cases of gout,
with the view of determining the effect of benzoic acid on that
secretion :
Before After Before After
administration. ditto. administration. ditto.
Anal. 119. Anal. 120. Anal. 121. Anak 122.
Water ‘ ‘ 976°73 ~ 978°84 965°25 962°43
Solid constituents ‘ 2s'27 21°16 34°75 37°57
Urea ; . 7°02 6°10 9°23 10°00
Uric acid. ; 0°50 0°48 0°58 0°60
Earthy phosphates ; 0°35 — 0°28 —
Sulphate of potash ‘ 2°67 —_ 2°08 —
Phosphate of soda . 1:60 a= 4°53 —
Hippuric acid : — 0°65 — 0°69
If we determine the per centage of the urea and uric acid in
relation to the solid residue, we find in the first case, that be- -
fore the use of benzoic acid the urea amounted to 30°162 and
the uric acid to 2°14°, and afterwards they amounted to 28°21
and 2:22 respectively. In the second case the urea and uric
acid amounted to 26:562 and 1°66° before the use of the acid,
and 26°612 and 1:59° afterwards.
These analyses are insufficient to show that benzoic acid exerts
any influence on the amount of urea or uric acid. The clinical
experiments of Froriep and others indicate, however, that it is
a valuable remedy in various forms of arthritis.
Froriep! has published a notice of twenty cases of gout and
' Simon’s Beitrage, p. 294.
Sie eee
278 THE SECRETIONS :
chronic rheumatism in which he administered benzoic acid.
During the first twenty-four hours the symptoms are always
aggravated, but they usually subside on the second day.
The Exanthemata.
In all the acute exanthemata the urine very frequently pre-
sents, as Schonlein remarks, a peculiar character, which is due, in
many cases, to an admixture of bile-pigment: it has a dark-
brown colour, and resembles badly-fermented beer in appear-
ance. At the commencement of the crisis the urine becomes
clearer, and forms a pulverulent sediment consisting of uric
acid*(and perhaps urate of ammonia).
In the fever which accompanies erysipelas, and is usually of
an erethismic or synochal character, the urine is frequently
loaded ~with bile-pigment, and is of a reddish-brown or red
colour. At the urinary crisis, fawn-coloured precipitates are
deposited, and the ure becomes clear. (Schoénlein.)
Becquerel has examined the urine in several cases of erysipelas.
When the erysipelas is accompanied by fever, as is most com-
monly the case, the urine assumes the inflammatory type.
Becquerel made two quantitative analyses of the urine of a man
aged 39 years, who had erysipelas of the face, and a good deal
of fever (pulse 112).
The urine of the first analysis was of a deep yellowish-red
colour, and clear; its specific gravity was 1021-0.
The urine of the second analysis was so deeply coloured as
to appear almost black ; it threw down a reddish sediment of
uric acid, and had a specific gravity of 1023°1.
The first analysis was made on the fourth, and the second
on the sixth day from the commencement of the disease.
These analyses gave :
Anal, 1. Anal. 2,
Quantity of urine passed in 24 hours, in ounces : 27°0 , 308: 23
Water ; ; : ; ‘ 965°5 961°9
Solid constituents . : : g 34°5 38°1
Urea. ‘ ; ; ; 12°5 12°7
Uric acid 5 ‘ 4 : 1:2 13
Fixed salts ‘ j ge é ns 8-2
Extractive matter Z . 3 — 15°9
In a woman aged 45 years, with erysipelas of the face,
SX.
URINE. 279
whose pulse was 104 and full, the urine was very scanty, of a
dark-brown colour, strongly acid, threw down a yellow sediment
spontaneously, and had a specific gravity of 1023-1.
It contained :
Water. : : 961-7
Solid constituents , : : 38°3
Urea 7 ; : - Ri:7
Uric acid : i f 1:3
Fixed salts i Z 9-2
Extractive matters : ‘ 1-7
In five cases in which the morning urine was daily examined
with care, the characters of inflammation were present in a very
high degree: the specific gravity varied from 1021 to 1025. In
four of these cases the urine threw down a reddish sediment,
and in two a little albumen was occasionally present.
In scarlatina, the urine at the commencement, while there is
considerable fever, is of a deep dark-red colour, and possesses
all the properties of inflammatory urine.
In children the urine is always less coloured than in adults,
and its colour in this disease is proportionally less dark.
It almost always has an acid reaction, and only exhibits a
tendency to become rapidly ammoniacal, when the disease is
associated with a nervous or septic condition of the system.
Any sediments that may be formed consist, for the most part,
of urate of ammonia and uric acid mixed with a greater or less
quantity of mucus: blood-corpuscles are occasionally noticed.
When the urine is ammoniacal, viscid whitish sediments of the
earthy phosphates are deposited, and if there is much gastric
disturbance the urine becomes jumentous. Albumen is com-
monly but not always found in the urine during the period of
desquamation. - Dropsy may even supervene without the urine
becoming albuminous: it is sometimes preceded by the occur-
rence of hematuria.
Becquerel found that the urine during the febrile period was
generally very high coloured, and, if severe angina was present,
was very acid, and was either turbid, or became so on the
addition of an acid: it frequently also formed a gray or lateri-
tious sediment, and the presence of a small quantity of albumen
280 THE SECRETIONS :
was by no means rare. Becquerel only observed blood in the
urine in the single case of a child five and half years old, who
was attacked with anasarca. In a girl whose nervous system
was very much deranged during the period of the febrile in-
vasion, the urine was very deeply coloured, turbid, and deposited
on the sides of the vessel a copious precipitate of a bright red
colour. The sediment disappeared when the eruption was fully
established. Blood was frequently observed in the urme when
there were symptoms of impending dissolution during the ner-
vous form of scarlatina; the quantity was sometimes very consi-
derable, and the corpuscles could be readily detected by the
‘microscope. The appearance of blood in this state must be
distinguished from that in which it arises from a renal affection
(Bright’s disease) in which Becquerel has frequently observed it,
and where, in the fatal cases, the existence of Bright’s disease
was proved. ‘The amount of albumen in the urine is, in these
cases, constant and larger than is frequently found in inflam-
matory diseases, without the occurrence of any simultaneous
dropsical symptoms.' During the period of desquamation symp-
toms of dropsy frequently supervene, and the urine often contains
albumen, in larger amount and more continuously than is usually
the case in inflammations.
The observations regarding the presence of albumen during
the period of desquamation after scarlatina are so contradictory
that it has become a matter of very great interest to settle these
conflicting statements by further researches. We have dropsical
symptoms with albuminuria, dropsical symptoms without albu-
minuria, and albuminuria without dropsical symptoms. Solon
found albumen in the urine in twenty-two out of twenty-three
cases of scarlatina, On the other hand, Philipp? observed, in
Berlin where scarlatina was recently very prevalent, and ana-
sarca could not be warded off, at least sixty cases in which the
urine was tested both with heat and nitric acid, and no trace of
albumen could be detected.
In two cases of scarlatina that were being treated in Romberg’s
1 When the urine contains no blood-corpuscles visible by the microscope, dissolved
hematoglobulin may be present, which can be estimated in the manner described in
p. 187.
* Casper’s Wochenschrift, 1840 ; No, 35.
URINE. 281
clinical ward for children, and in which there were no drop-
sical symptoms, I could find no albumen. In the case of a man
aged 20 years, which occurred in Schénlein’s clinical wards, the
urine was very albuminous during the period of desquamation,
and continued so for four days without the occurrence of
dropsy ; in another man, in whose urine I found no albumen,
there were also no dropsical symptoms.
In a boy aged 5 years, who was suffering from septic scar-
latina just then at its acme, (putrid odour from the mouth and
nose, and disturbance of the cerebral faculties,) the urine was
of a dark-yellow colour, had an alkaline reaction, a very dis-
agreeable ammoniacal odour, and threw down a dirty white
sediment of earthy phosphates, urate of ammonia, and urate of
soda;—the latter occurring in the form of opaque globules.
The specific gravity was 1022, and about 16 ounces were dis-
charged in the course of twenty-four hours. There were contained
in 1000 parts :
Analysis 123.
Water . ‘ ‘ ‘ 943°60
Solid constituents ‘ . = 56°40
Urea 3 . ‘ 4 19°35
Uric acid . 3 : 1°69
The uric acid was combined with ammonia and soda. I ex-
amined the urine of the same boy afterwards, and found that
it possessed precisely similar characters: it was of a straw-
colour, had an alkaline reaction, and an ammoniacal odour ;
the sediment was more copious than on the former occasion,
and there were considerably more of the large opaque globules,
which I consider to be urate of soda. During the period of des-
quamation I found a greater number of mucus-corpuscles in the
sediment than is usual, but nitric acid gave no indication of
albumen. The urine above the sediment remained turbid in
consequence of holding in suspension a very large quantity of
epithelium, which was swimming about, partly in single scales,
and partly in fragments of 8-12 scales connected with each
other, and all of which were acted on by some chemical agent,
probably by the carbonate of ammonia in the urine.
This sediment should always be sought for with as much
care as albumen. It is an indication of the desquamation of
282 THE SECRETIONS:
the mucous membrane, and is frequently a precursor of the
desquamation of the cuticle. The tubes described as occurring
in Bright’s disease are occasionally found in this form of
sediment.
In variola and varicella the urine changes with the various
stages of the disease, and with the nature of the fever which
is present. 1
Urine of a synochal character is, however, often met with,
especially during the first stage of the disease, when the fever
has a synochal type. : |
Becquerel examined the urine of eleven persons with variola,
and of ten with varicella. In a case of varicella in which the
early symptoms (les prodromes) were extremely severe, the urme
was passed in very small quantity, of a deep red colour, and a
specific gravity of 1022-7. puke.
In a case of varicella in which the early symptoms were
scarcely perceptible, the urine remained normal. Schénleimn
states that in the first stage of this disease the urine is often as
limpid as in hysteria. During the eruptive stage, the state of
the urine depends upon the intensity of the fever which accom-
panies the appearance of the exanthema.
In five out of the eleven cases of variola observed by Becquerel
the symptoms accompanying the eruption were very severe;
the urinary secretion was diminished, and amounted on
an average to only 23°5 ounces in twenty-four hours. The
specific gravity had not, however, increased so much as might
have been supposed, being only 1020°6. It frequently threw
down uric-acid precipitates, either spontaneously, or on the ad-
dition of nitric acid, and im one case a little albumen was ob-
served. :
M. Solon found the urine coagulable in five out of eleven
cases of variola. When the inflammatory symptoms, during
the eruption, are slight, the urine hardly differs from the normal
state. During the suppurative stage of variola, Becquerel ob-
served that the urine retained the synochal character as long as’
the febrile symptoms continued, in all the eleven cases. In
three of these cases which terminated fatally, it continued in
this state to the last.
URINE. 283
During the period of desquamation the urine is either normal
or anemic. Becquerel states that although the urine during
desquamation after variola resembles, in its chemical constitu-
tion, the urine during desquamation after varicella, it differs in
respect to colour, the former being of a greenish, the latter of
a yellowish tint. According to Schénlein, in the first stage of
variola it is of a reddish brown tint; on the third or fourth
day a sweat of a peculiar and strong odour is observed, and the
urine contains a turbid, apparently purulent, mucous sediment,
of an unpleasant odour.
During the period of suppuration sediments, and frequently
purulent mucus, are thrown down.
In the nervous form of variola the urine is even more
changeable, being sometimes spastic, and sometimes dark. In
the putrid form the urine appears decomposed, ammoniacal, and
not unfrequently of a dark red colour from the presence of
heematin. |
Scrofulosis.
The urine of children with the scrofulous diathesis differs
considerably in the majority of cases from the normal secretion.
It is usually pale, but if there is much vascular excitement
it becomes more or less deeply coloured ; its specific gravity is
lower than in a state of health, and in many cases it is much
more acid than the urine of children is generally observed to
be; it has, however, been found neutral.! I have found the
urine of rickety children only slightly acid, and once, after it
had been passed some hours, it had an alkaline reaction. There
are differences of opinion with regard to the nature of the free
acid ; some state that it is phosphoric acid, others hydrochloric
acid, while others, again, are of opinion that it is lactic acid.
The urea and uric acid are frequently found to exist in a di-
minished proportion ; on the other hand, the salts, especially
the phosphates, are increased; moreover, we not unfrequently
find in the urine of scrofulous children an acid which is foreign
to the normal organism, viz. oxalic acid.
According to Schénlein, the principal chemical changes in
the urine of scrofulous persons consist in the diminution of the
1 Stark Allg. Patholog. p. 1147.
284 THE SECRETIONS:
nitrogenous constituents,—the urea and uric acid, and in the
appearance of the non-nitrogenous oxalic acid, and occasionally
but more rarely of benzoic acid. The acids are frequently so
abundant that the urine, upon cooling, deposits copious sedi-
ments of the oxalates, and these sediments sometimes form
renal and vesical calculi within the organism itself. The fre-
quent occurrence of oxalate-of-lime or mulberry calculi in chil-
dren is well known; indeed, Prout is of opinion that half the
stone-cases occur hefore the full age of puberty.
Becquerel has examined the urine in many cases of scrofula,
in some of which it showed itself in the form of caries, ne-
crosis, &c. ; while in others it appeared in suppuration of the
glands. A number of these children were in an anemic state,
while others were apparently in good condition; in the former
cases the urine was anzmic, in the latter it was normal. The
specific gravity varied from 1010 to 1022. The lowest specific
gravity occurred in the anemic cases. The colour was lighter
than that of normal urine, and was frequently of a greenish
tinge; the degree of acidity varied extremely, the urine fre-
quently becoming alkaline after a very short time. No uric-
acid sediments were observed, either spontaneous, or after the
addition of an acid. When febrile symptoms were combined
with those of scrofula, the urea approximated to the inflamma-
tory type; its specific gravity became higher, (the average of
twelve cases being 1026,) the colour deeper, it had a very acid
reaction, and threw down a sediment of uric acid.
In scrofulosis of the osseous tissue or rachitis the urine varies
very much in its composition from the normal type. These
deviations principally consist in the diminution of urea and of ©
uric acid, and in the increase of the salts. The colour of the
urine is generally either pale, or else it differs but little from
the normal appearance; the free acid sometimes increases to
an extraordinary degree, and some (Fourcroy) maintain that it
is free phosphoric acid. The phosphates exceed the physiolo-
gical average, and moreover a considerable sediment of oxalate
of lime is byno meansrare. This extraordinary and morbidly-
increased capacity of the kidneys for the removal from the blood
of those salts which are so essential for the structure of the
osseous tissue, and the consequent tendency to the formation
of calculi in rachitic children, is regarded by Walther as a
URINE. 285
vicarious act of the kidneys in connexion with the formation of
bone.
The urine of a child aged 5 years, who was being treated. for
rachitis in Romberg’s clinical ward for children, was sent: to
me for analysis. It was of a pale yellow colour, turbid, and neu-
tral; its specific gravity was 1011. As the determination of the
salts was the principal object that I had in view, it was allowed
to stand for two days before the analysis was undertaken; hence
the determination of the urea may not have been perfectly ac-
curate. The urine in the other analyses was passed by chil-
dren aged 3 and 4 years respectively. It was much about the
same colour as, or perhaps rather darker than in the first case,
was slightly acid, and the specific gravity varied from 1015 to
1020.
The proportion of the most important constituents was found
as follows :
Anal. 124, Anal. 125. Anal, 126. Anal. 127.
Water ‘ ‘ - 978-40 968-50 964-90 962°80
Solid constituents. ‘ 21°60 31°60 35°10 37°20
Urea. F ‘ 3°50 6°70 6°17 7°36
Uric acid ‘ : =) 0°26 0°35 0°26
Fixed salts ‘ : 8°53 8:60 14:71 16°70
Phosphate of soda ‘ /2°82 4:0] 4°27 3°74
Sulphate of potash : 1°90 1°80 1°31 ' 1°80
Earthy phosphates ‘ 0°48 0°52 0°58 —
On calculating the ratios of these constituents to 100 parts
of solid residue, and comparing them with those that occur
in healthy urine, we find that the quantity of urea has con-
siderably decreased, while that of the salts is increased. In
analyses 124, 126, 127, the increase of the fixed salts is very
considerable, especially of the phosphate of soda and earthy
phosphates. In analysis 125 this increased ratio is less striking.
100 parts of solid residue contain :
Anal. 124. Anal. 125. Anal.126. Anal. 127. Normal Urine.
Urea F ‘ 16°1 21:2 17°6 19°8 39°0
Uric acid é ; — 0°8 Pos OY 15
Fixed salts. =e 39°4 27°3 41°8 44°8 25:0
Phosphate of soda ‘ 13°0 12°7 12°1 10°0 10°0
Earthy phosphates ; 2-2 1-6 1°6 — 15
Sulphate of potash > 8°7 5°7 3°8 4°8 8:0
1 The uric acid was not determined.
%
286 THE SECKETIONS :
In order, however, to arrive at a correct conclusion from these
figures we must bear in mind that the urme of children natu-
rally contains a less proportion of urea and of salts than the
urine of adults.
In osteomalacia the urine is much the same as in rachitis ;
it is very acid, and often contains an excessive amount of earthy
phosphates.
[Marchand! analysed the urine of a child with osteomalacia
three days before its death. The fluid was invariably acid, and
contained in 1000 parts :
Water ve : . 9382
Solid constituents é 3 a 61:8
Urea i ¥ ‘ . 27°3
Uric acid ; ; : 0-9
Lactic acid and lactates é 5 14-2 *, =
Phosphates of lime and magnesia ; 57
Other substances, and loss ‘ ; 13°7
The earthy phosphates in this instance are five or six times
as abundant asin health. In one of the cases recorded by
Mr. Solly,? there was found in the urine between three and
four times the amount of phosphate of lime that occurs in the
healthy secretion. |
Tubercular pulmonary phthisis.
In tubercular phthisis the urine varies in accordance with
the progress of the disease and the degree of fever which is
present. I have observed in the majority of cases that after
the febrile symptoms have become continuous the urine has
assumed the inflammatory type; that is to say, it is not so
deeply coloured as at the height of acute inflammation, but is’
of a yellowish brown colour, has a tolerably acid reaction, and
is above, or at any rate attains the ordinary specific gravity. _
In the early stages of the disease I have not found the urine
to differ much either in colour, density, or acidity from the
normal secretion. I have only observed that form of urine to
' Lehrbuch der physiolog. Chemie, p. 338.
? Transactions of the Medico-Chirurg. Society, p. 448, 1844.
URINE. 287
which the term anemic has been applied when considerable
hemoptysis has occurred in the second or third stage. After
hemoptysis the urine is generally turbid, and for the first day
or two throws down slight sediments of urate of ammonia; it
afterwards becomes pale and clear, and continues acid, gradually
returning to its normal state. When the febrile symptoms be-
come continuous and the colliquative stage has fairly commenced,
I have found the urine approximate in its composition to the
urine of inflammation.
Becquerel has examined the urine in a great number of
phthisical cases, When the disease is progressing beyond the
first stage, the urine is often of higher specific gravity, darker,
and secreted in less quantity than usual,—a symptom that the
tubercles are extending, and that a state of continuous fever is
supervening. The subsequent phenomena of the morning
sweats and colliquative diarrhoea further contribute to the con-
centration of the urine. When, however, a state of decided
asthenia has been brought on by these extraordinary drains
upon the system, it rapidly assumes opposite properties, and
becomes anemic. Thus the urine of a woman, in whom
the tubercles ‘were beginning to soften, and who had at the
same time certain symptoms of disease of the heart, was found
by Becquerel to amount to 20 ounces in twenty-four hours.
It was of a deep yellow colour, threw down a sediment of uric
acid, had a specific gravity of 1022-2, and 1000 parts contained
36:5 of solid residue. |
In a woman in the third stage of phthisis with great pros-
tration of strength, the urine, three days before her death, was
of a deep colour, acid, and threw down a spontaneous sediment.
The specific gravity was 10147, and 16-2 ounces were discharged
in twenty-four hours. 1000 parts contained :
Water : 3 975°95
Solid constituents ‘ : 24:05
Urea : : ; 9-00
Uric acid 5 - ~ 1°25
In another precisely similar case the urine, three days before
death, was of a deep colour, acid, and threw down a sediment
spontaneously. The specific gravity was 10147, and there were
only 7°2 ounces passed in twenty-four hours.
288 _ THE SECRETIONS:
1000 parts contained 24°25 of solid residue, of which 9-01
was urea, and 2:2 uric acid. In the first of these cases the
urea amounted to 37:42 of the solid residue, and the uric acid
to 5:12; in the second the urea amounted to 37-22, and the uric
acid to 9°,—proportions which, as far as the amount of urea is
concerned, approximate to those of inflammatory urine.
An analysis of the urine of a man aged 30 years, who was in
the colliquative stage of tubercular phthisis, gave very similar -
results, except as regards the specific gravity.
The urine was brown and turbid, had a very acid reaction,
and deposited a purulent-looking yellow sediment of urate om
ammonia. The specific gravity was 1026-6.
1000 parts contained :-
Analysis 128.
Water 2 ; : 935°92
Solid constituents ; : 64:08
Urea ; A 3 23-90
Uric acid. é : 2°40
Fixed salts . i : 10°85
Of these 10°85 parts of fixed salts 1:3 were earthy phos-
phates, and the sulphates formed only a small part. The urea
amounted to 37:32, and the uric acid to 3°72 of -the solid con-
stituents, the urea being as nearly as possible the same as in
Becquerel’s analyses.
The increase of uric acid is of great interest; it is particularly
striking in Becquerel’s analyses: other observers have noticed
this fact in adults sufferimg from tubercular phthisis, and
Schonlein, moreover, has directed attention to it.
[I am indebted to Dr. Golding Bird for the following case.
A man aged 24 years, in the early stage of phthisis, (tubercular
depositions but no cavities,) passed in the course of twenty-four
hours, forty-five ounces of urine of specific gravity 1020.
The water amounted to . ‘ - 19125 grains.
The solids : ; : i 936
Urea ; : - . 328°5
Uric acid. : ; 3 4°5 ]
In renal and vesical phthisis the urine contains a ereaies or
less quantity of pus.
It is usually pale, turbid, and very quickly takes on an alka-
line odour, especially in phthisis vesice, in which, even on
URINE. 7 289
emission, it is ammoniacal, and of an unpleasant odour. . The
pus is sometimes mingled with blood. That the clear filtered
urine always contains albumen may be shown by the addition
of nitric acid, or by the application of heat.
The urine immediately on its discharge is turbid, but on being
allowed to rest, the pus separates in a clearly-defined layer at
the bottom ; on shaking, it easily mixes again with the urine,
and if that fluid have an alkaline reaction the pus becomes
tough and fibrous. Pus-corpuscles may be detected by the
microscope, and if the urine has an alkaline reaction they will
be mixed with crystals of the ammoniaco-magnesian phosphate
and with an amorphous precipitate of phosphate of lime.
In order to determine with certainty whether a uriary sedi-
ment consists of mucus or of pus, urine which has been just
discharged should be examined: the rapid descent of the pus-
corpuscles from urine which is turbid at the period of its dis-
charge, and the formation of a sediment which is frequently
discoloured, or mixed with blood, together with the presence of
a considerable amount of albumen in the urine, leave no doubt
respecting the diagnosis. (See page 202.)
Diabetes mellitus.
In diabetes mellitus it is well known that the urine undergoes
a very peculiar change ; it contains a certain quantity of sugar
which, in its ultimate constitution is perfectly identical with
grape-sugar, and in consequence of which the urine possesses
the property of deflecting the polarized ray to the right. Dia-
betic urine differs moreover in its physical relations from the
normal secretion ; it is paler, has a turbid wheyish appearance
with a greenish dings, and a higher specific gravity,—according
to Willis, from 1025 to 1055.
Henry drew up a table for the determination of the solid
constituents of diabetic urme by the mere application of the
urinometer. ‘The results, as far as my experience goes, come
sufficiently near to the truth to give fair approximate values ‘to
the solid residue from the specific gravity. G. O. Rees recom-
mends the table, having confirmed it by his own experiments ;
I have somewhat extended its limits, and shall give it here.
II. 19
290 THE SECRETIONS:
Spec. grav. Solid residue Spec. grav. Solid residue
at 60°. in 1000 parts. at 60°. in 1000 parts.
1005 11°7 1028 69°1
1006 14:2 1029 71°5
1007 16°7 1030 73°9
1008 19°2 1031 76°4
1009 21:7 1032 78°8
1010 24°2 1033 81:4
1011 26°7 1034 83°9
1012 29°2 1035 86°4
1013. 31:7 1036 88°8
1014 34°2 1037 91°3
1015 36°7 1038 93°8
1016 39°2 1039 96°3
1017 41°7 1040 98°7
1018 442 1041 - 101°2
1019 46°7 1042 103°7
1020 49°2 1043 106°2
1021 51°6 1044 108°7
1022 54°1 1045 111-1
1023 56°7 1046 113°6
1024 59°1 1047 11671
1025 61°6 1048 118°7
1026 64:0 1049 121°2
1027 66°5 1050 123°6
[In my paper! on the specific gravity of the urine in health
and disease (founded on 200 observations), I have shown that
Christison’s formula, A x 2°33, gives more correct results than
the above table. A indicates the excess of the specific gravity
over 1000. Thus, supposing it is desired to ascertain the
amount of solid matter in 1000 parts of urine whose specific
gravity is 1035, A is here represented by 35, and 35 x 2°33=81°55,
the required number. |
According to Schénlein there is no sugar in the urine in the
first stages of the disease, but albumen; and as the albumen
subsequently disappears the formation of sugar in the urine
commences. |
The quantity of ure increases in an extraordinary degree.
P. Frank mentions a case in which fifty-two pounds were dis-
charged during twenty-four hours. According to Bouchardat,
*
! Lancet, June 15, 1844.
URINE. | 291
the average quantity discharged in the course of the day
amounts to from ten to seventeen pounds.
Opinions regarding the composition of the urine are very
contradictory, and sufficient analyses have not yet been insti-
tuted to enable us to regard any one view as positively correct.
Some assert that as the sugar increases in the urine the urea
and uric acid decrease, while others maintain that although the
absolute quantity of urea in a given amount of urine is actually
diminished, yet that on account of the large quantity of urine
discharged, the amount of urea is not less than, and in fact
exceeds the normal average.
Thus M‘Gregor shows that the urine of twenty-four hours in
one case of diabetes contained 1013 grains of urea; in_another
case he found 945 grains, in a third 810 grains, and in a fourth
512 grains, whereas, according to the same authority, the quan-
tity excreted by a healthy person in twenty-four hours does not
exceed from 362 to 428 grains. Kane also found in diabetic
urine as large a proportion of urea as in the normal secretion.
My own analyses certainly tend to show that the ratio of urea
to the solid residue is always much less than in health, and
that this ratio is diminished in proportion to the increase in the
quantity of the sugar; bearing in mind, however, the increased
secretion of urine, it is very possible that in some cases the urea
is not absolutely diminished: the apparent connexion between
the urea and the sugar may then be simply explained by the
mere increase of the sugar, which, by increasing the solid residue,
causes a relative diminution of the urea.' The same is probably
the case with respect to the uric acid ; when no crystals of uric
acid are separated after the addition of free hydrochloric or
nitric acid to diabetic urine, the cause may lie in the proportion
1 Tn connexion with this subject, we may refer to the experiments of Henry. On
mixing the residue of six quarts of diabetic urine with the residue of one quart of
healthy urine, and adding nitric acid, only a small quantity of nitrate of urea was
obtained after the mixture had stood for twenty-four hours; and on mixing the re-
sidue of eight quarts of diabetic urine with that of one quart of healthy urine, and
treating it in a similar manner, not a crystal of nitrate of urea could be observed after
it had stood for forty-eight hours. Hence it is indispensably requisite that the sugar
should be first removed (as completely as possible) before we attempt to determine
the urea.
292 THE SECRETIONS :
of water being so large as to retain the uric acid in solution.
I have frequently observed this to be the case, for on the ad-
dition of free hydrochloric acid to the urine no uric acid has
been separated, when upon treating that portion of the residue
of the urine which is insoluble in alcohol with nitric acid, I have
always obtained the red colour which is characteristic of uric
acid. Becquerel, however, has observed a spontaneous sediment
of uric acid thrown by diabetic urine. |
[In this country a sediment of uric acid is by no means
rare ; I have observed it in at least six cases, usually in the form
of bright yellow lancet-shaped crystals. |
I have observed cases in which I have convinced myself that
the absolute quantity of urea was diminished.
A man aged 52 years, treated for diabetes mellitus in our
hospital did not pass more than from two to two and a half
quarts of urine in the twenty-four hours. In its external ap-
pearance it was perfectly normal ; it contaimed, however, 8°63 of
sugar, and only 0°026° of urea, so that while a healthy man
excretes about an ounce of urea in the twenty-four hours, in
this case there were only thirteen grains excreted in an equal
time. In another man who was being treated by Dr. Lehwess,
and who indulged freely in sugared drinks, the quantity of urine
in twenty-four hours amounted to between four and five quarts,
and contained mere traces of urea. The urine was very pale
and turbid, its specific gravity was only 1018, and it contained
42° of solid residue, 3°9 of which were sugar. After the dis-
continuance of the sugar, and the adoption of a proper diet,
the specific gravity became lower and the urine contained as
much urea as constituted a fifth part of the solid residue: the
sugar had also decreased to one half its original amount. —
Subsequently the sugar almost entirely disappeared from the
urine ; the urea, on the other hand, had increased to such an
extent as to constitute a third part of the solid residue.
Bostock is of opinion that diabetes mellitus is not unfre-
quently preceded by a diseased condition, (in fact a kind of
diabetes,) during which a large quantity of urine very rich in
URINE. 293
urea is excreted. As the diabetes becomes developed the urea
gradually diminishes as the sugar increases.
Willis! states that the urine is occasionally rather turbid on
emission, and has then been found to contain a quantity of
albuminous matter in the caseous form.
According to Schénlein the urine during the early stage of
diabetes contains albumen, and in proportion to its increase the
urea diminishes: in the second stage the albumen disappears
either totally or partially, and sugar takes its place. I have
only detected albumen in two cases of diabetic urine, viz., in
the case to which I have already referred, in which I analysed
the urine at a time when the patient took a good deal of sugar
in his drink ; in this case, however, the disease had made consi-
derable progress: and in the urine of a girl a few days before
her death ; in this instance it existed in considerable quantity,
amounting to 0:22 of the urine, or 3°72 of the solid residue.
Brett? found casein and butter in a case of diabetic urine.
Diabetic urine sometimes contains an insipid species of sugar,
which, however, according to Bouchardat,*? corresponds in all
other properties with the ordinary sweet diabetic sugar, pos-
sessing the capability of fermenting, and being convertible by
acids into sweet sugar. I have had only one opportunity of
observing sugar of this nature. |
A girl with diabetes mellitus discharged an abundant quan-
tity of very saccharine urine, and the sugar which was obtained
from it had all the properties of grape-sugar. Subsequently
the strength of the patient, which had been long giving way,
decreased to such an alarming extent as to cause apprehensions
of her speedy dissolution. Two days before her death the urine
was again sent to me for examination; and I was not a little
surprised to find in it a perfectly tasteless sugar soluble in hot
spirit, and mixed with a considerable quantity of a gummy
matter insoluble in spirit which, on the application of heat,
emitted a peculiar odour not unlike that of burned paper.
The salts in diabetic urine are stated by Gueudeville, Bostock,
' Urinary Diseases and their Treatment, p. 200.
* London Medical Gazette, July, 1836.
* Revue Médicale, 1839.
294 THE SECRETIONS :
and Henry, to be diminished, while they retain their normal
proportion to each other. I have found the amount of earthy
phosphates not much below the normal average.
Lehmann! was the first who directed attention to the
occurrence of hippuric acid in diabetic urime: it has since
been detected by Ambrosiani, Miller, and very recently by
myself. I obtained it in the same manner as Lehmann did,
from the etherial solution of the dried residue: after evapora-
tion there remained a slight brownish-yellow residue, in which,
with the help of the microscope, I observed heaps of long
acicular crystals. The residue was warmed with a few drops of _
a weak solution of potash, which neutralized the acid reaction, —
and the solution was then filtered. On the addition of a solu-
tion of perchloride of iron a cinnamon-yellow precipitate was
obtained, which on being warmed contracted itself into red
floeculi. wis
On allowing diabetic urine to stand for a considerable time
a sediment forms which consists for the most part of fermenta-
tion-globules. If the urine above this sediment is allowed to
remain for some time longer at a suitable temperature, it begins
to undergo fermentation. I have frequently observed the fer-
mentation-globules, and have represented them in fig. 35.
I have made several minute analyses of the urine in diabetes
mellitus. The three following analyses were made with the
urine of a man aged 50, to whose case reference has been pre-
viously made. The first analysis was made at a time when the
patient indulged freely in sugared drinks. The urine then
contained a mere trace of urea. After the patient had been
properly dieted for some time, I obtained the urme for the
second analysis, which in its results differs very little from the
first. Eight days from this time I again analysed it, and found
that the sugar had almost entirely disappeared.
About three months afterwards I received some more of his —
urine for analysis; it was then very rich in sugar, while urea
was present to only a very small amount. Albumen was only
detected in the urine of the first analysis. Uric acid was always
present, but only in very small quantity. :
1 Journ. fiir prakt. Chem. vol. 6, p. 114.
ae
URINE, 295
Anal. 129. Anal. 130. Anal. 131.
Specific gravity : ‘ . 1018-00 1016:00 1007:00
Water. 4 Pais . 957°00 960°00 982-00
Solid constituents . ; ; 43°00 40°00 18°00
Urea . ° : ; traces 7°99 4°63
Uric acid x ; a traces a trace a trace
Sugar ; 39°80 25°00 a trace
Extractive matter and salta” i 2°10 6°50 8°60
Earthy phosphates ‘ , 0°52 0°80 1:00
Albumen was present.
The urine of the first two analyses was of a pale-yellow co-
Jour, and slightly acid ; in the third case it was as clear as water,
and produced. no change on test paper.
The two following analyses were made with the urine of a
girl aged 20 years, who was being treated for diabetes mellitus
in Prof. Wolff’s clinical wards.
The first analysis was made eight weeks before the second ;
I made an analysis of the blood at the same time. (See Analysis
42, Vol. I, page 327.)
The second analysis was made two days before death; it re-
vealed the fact that the diabetes sapidus had changed into dia-
betes insipidus ; moreover, at this period, the urine contained a
considerable quantity of albumen.
Analysis 132. Analysis 133.
Specific gravity : j ‘ 1032-00 1021-00
Water : j . i 921-85 947-20
Solid constituents. : r 78°15 52°80
Urea. ee ‘ ‘ 0°54 1°47
Sweet sugar : : : 72°00 —
Insipid sugar ‘ F : — 27°61
Extractive matter and salts ; 4°20 2°80
Earthy SRT RY : : 0°92 0°40
Albumen ; : — 2°00
Gummy matter . — 17°30
Analysis 1384 was made otk the urine of a man aged 52 years,
who was being treated in Schonlein’s clinical wards for diabetes.
The urine was not passed in very large quantity, but it con-
tained a remarkably large proportion of sugar. The composi-
tion of the blood, which also contained sugar, is given in
Analysis 41, Vol. I, page 327,
Analysis 134.
Specific gravity : : z 1036-00
Water ‘ j ‘ : 909°60
Solid constituents : P . 90°40
Urea : : : ; 0°26
Uric acid : ; j a trace
Sugar : 3 ; 86°30
Extractive matter and salts . : 2°10
Earthy phosphates’. ; ‘ 150
296 THE SECRETIONS:
I have recently had an opportunity of making a careful ex-
amination of the excretions of a diabetic patient. He was a man
aged 40 years, who had suffered from intense thirst and had
observed a great increase in the amount of his urine for the pre-
_ceding ten months. At the period of his admission into the
hospital, the colour of his urine was normal, and an acid reac-
tion always observed, which, however, became more decided
some time after emission: in the course of ten or twelve hours
it usually became turbid, and deposited a light viscid sediment
consisting of amorphous urate of ammonia and mucus-corpuscles;
on two occasions (during the use of a very animal diet) crystals
of uric acid were noticed in the sediment. During the period
of my investigations I never detected albumen in the urine.
The specific gravity varied from 1039 to 1030. It was highest
at the commencement of the treatment.
On admission the daily amount of urine averaged nearly five
quarts, but while under treatment it was reduced to three quarts.
The daily amount of sugar gradually diminished to one third,
but was never so thoroughly reduced as to afford hopes of a
permanent cure. ‘The daily excretion of urea was at first much
diminished, but subsequently reached the healthy average.
Uric acid was always present, but not in so considerable a quan-
tity as would have been found in the urine of healthy persons
living on a similar diet. The amount of fixed salts varied con-
siderably, but was always larger than in a state of health.
After the use of the ordinary hospital diet for a few days, he
was placed on a very nitrogenous diet, consisting of beef-tea, eggs,
meat, milk, and white bread. Subsequently coffee was substituted
for the milk, and the amount of bread diminished. And still later
gluten-bread containing only one-half the amount of starch, but
three times the amount of nitrogenous matter, was given in its
place.
During his last three weeks he consumed daily, one pound
of gluten-bread, two of beef from which a quart of beef-tea
had been made, besides a quarter of a pound of ordinary boiled
beef, three or four ounces of roast veal, six eggs, and two quarts
of coffee prepared from an ounce of the beans. Although this
quantity was (according to his own statement) sufficient to
satisfy his hunger, he was occasionally detected in appropriating
the farinaceous diet of other patients. With regard to medical
treatment, opium and its various compounds were first given ;
FE
URINE. 297
hewas then treated with astringents, the nitrogenous diet being at
the same time increased, and the saccharine and farimaceous mat-
ters diminished. After this course had been pursued for some
time without any decided benefit, he took daily two ounces of
cod-liver oil, and after this had been continued for twelve days, -
he took, additionally, four grains of iodide of iron. Finally,
(these medicines being continued) the gluten bread was or-
dered, and the milk and white bread stopped. Under this
treatment the daily amount of sugar fell from twelve ounces to
seven and three-quarters ; it subsequently, however, rose to nine
ounces and one drachm. The urea, which on his admission
amounted to only three drachms in twenty-four hours, was now
increased to one ounce and three drachms, and the uric acid
rose from a mere trace to twelve grains.
During this course of treatment the digestion seemed good,
the thirst diminished, and he occasionally perspired consider-
ably ; he had become, however, very emaciated. The saliva was
slightly alkaline, and I examined it for sugar unsuccessfully.
Sugar was, however, detected in the perspiration. The an-
alysis of his feeces will be found in Chapter X.
In the determination of the sugar and urea there are certain
difficulties which I shall briefly notice. On treating diabetic
urine evaporated to the thickness of a syrup with warm spirit,
the mucus, uric acid or urates, and earthy phosphates are pre-
cipitated. On evaporating the filtered spirituous solution to
the consistence of a thin syrup, and adding anhydrous alcohol,
- an insoluble semifluid mass separates, which, when repeatedly
treated with anhydrous alcohol, becomes finally thick and tough.
On dissolving this saccharine mass in warm spirit, and again
precipitating it by anhydrous alcohol, it will still be found to
contain a certain amount of urea; in fact, I have detected urea
after the operation has thrice been effected, and I find that
sugar can only be obtained free from urea by allowing it to
crystallize spontaneously from its spirituous solution. In con-
sequence of the difficulty of separating these substances, I pro-
ceed in the following manner: the solid residue of the urine
is first accurately determined ; a weighed portion of urine is
then evaporated, mixed with spirit, and the solution filtered.
The filtered solution is evaporated to the consistence of a syrup,
and, when cold, mixed with a sufficient quantity of concentrated
298 THE SECRETIONS:
nitric acid to allow of a few drops remaining on the surface of
the crystalline mass. It must then be submitted to a low tem-
perature, and the crystals placed on blotting paper and com-
pressed till they cease to communicate moisture. The fixed
‘salts must be determined from a separate portion of urine. If
we deduct from the known quantity of solid residue the portion
insoluble in spirit (from which the uric acid is determined), the
urea, and the fixed salts, we obtain, as the difference, sugar and
alcohol-extract which appears to decrease in diabetic urme in ~
proportion as the sugar increases. The following are the special
results of my analyses of the urine of this man.
No. 135 represents the analysis of the urine before the com-
mencement of the animal diet ; No. 186, shortly after its com-
mencement; No. 137, during the same diet, shortly before the
use of the cod-liver oil; No. 138, after the oil had been taken
for eight days; No. 139, after the iodide of iron had been used
for eight days; No. 140, after the gluten-bread had been tried
for eight days; No. 141, two days subsequently to the preceding
analysis, there being a considerable increase in the secretion.
In twenty-four hours there were discharged :
Anal. 135. Anal. 136. Anal. 137.
43 quarts 3 quarts 4 quarts
Specific gravity . . 1037-1 1038-9 1029-7
Solid constituents . ; 14°5 oz. 9°9 oz. 10°0 oz.
we lg aoe gap } 12'5 ,, 7-5 ,, 85 ,,
Urea , ; ; 3 drachms 5 drachms 7 drachms-
Uric acid | ‘ ‘ -— 5 grains 8 grains
Fixed salts ; a — 6 drachms
Anal. 138. Anal. 139. Anal, 140. Anal. 141.
4 quarts 4 quarts 34 quarts 45 quarts
Specific gravity . - 1030-2 1030°4 1032°37 1032°97
Solid constituents 4 10°5 oz. 10°5 oz. 10°2 oz. 12°5 oz.
Sugar and extractive
Mm a ‘| 8°9 ,, 7°25 5, 8h 4 9°6 5,
Urea as ; ‘ 7°8 drs. 10°0 drs. ~ BY 54 L°Si55
Uric acid : : 10 grs. —_ 5 grs. 15 grs. .
Fixed salts. : 6 drs. 8 drs. 6°8 drs 1 oz. 9 grs.
The composition of the urine appears from my observations
to undergo a rapid modification as soon as there are decided
indications of convalescence. The sugar decreases to a very
>
‘URINE. | 299
great extent, and is replaced by albumen, a substance of fre-
quent occurrence at the commencement of the disease, and
apparently alternating with the sugar.
When the sugar is no longer perceptible to the taste (either
in the urine or in the spirit-extract), it can always be readily
detected by Trommer’s test. I usually take a test-tube of
about seven inches in length, fill three fourths of an inch of it
with urine, and heat it with zss or Dij of carbonate of potash ;
I add five or six times the volume of spirit of ‘845, and again boil;
a few drops of a solution of sulphate of copper are then added,
and heat again applied. If much sugar is present, the reduction
of the oxide of copper to a state of sub-oxide occurs very
quickly in the lower stratum of solution of carbonate of potash,
and the fluid becomes of a yellow, red, or copper colour ; if the
quantity of sugar is very small, the reduction still takes place,
but much more gradually. If, however, no sugar is present,
the solution of potash remains of a blue or blueish-green colour.
I have recently analysed a specimen of diabetic urine con-
taining only a very small amount of sugar, although previously
that constituent had been present in large quantity. A short
time previously to the last analysis, no sugar could be detected,
but albumen was present. The urine passed at different periods
of the day was analysed separately. The quantity of urine
passed between noon and evening contained most sugar, and
was most abundant; that passed during the night contained the
least. The three analyses gave the following results :
Anal. 142. Anal. 143. Anal. 144,
Urine from Urine during Urine from
Noon the early Morning
till Evening. Night. to Noon,
Quantity of urine : : 34°3 02. 6 02. 10°7 oz.
Specific gravity . é - 102602 1024°38 1027°76
In 1000 one there were contained :
Water - 943°00 946°43 934°47
Solid counties G : 57°00 53°57 65°53
Urea : - : 14°12 17°50 16°21
Uric acid - ‘ 0°34 0°80 ~ 0°50
Chloride of sodium, with a little
carbonate and ‘sulphate of 11:27 8°60 10°50
soda
Alkaline sulphates and phosphates 5°80 4°65 5°70
Earthy phosphates. 1:20 0°80 0°90
Extractive matters, with am-
24°51 21:94 32°18
monia-salts and traces of
sugar ; :
%
300 THE SECRETIONS:
The whole amount of the different constituents discharged in
twenty-four hours was as follows :
Solid constituents : : . 30z
Urea : ‘ 365 gers.
Uric acid , . ‘ . 11-2 grs.
Fixed salts. ‘ F ; 425 grs.
Extractive matters ; ‘ - loz. 139 grs.
(The followimg analysis of diabetic urine has been made by
Dr. Reich.! The particulars of the case are not recorded :
Water ; i - 907-88
Solid constituents : ~ 98-12
Urea ; ; : 8°27
Hippuric acid ‘ ‘ 0-04
Sugar ° : ‘ 56°00
Water-extract ‘ : 5°60
Alcohol-extract : ; 16°36
Mucus re . : 0°54
Albumen 4 : ; 0°58 j
Chloride of potassium . 3 0°30 Se
Chloride of sodium ; J 0-84
Chloride of ammonium : 0°66
Sulphate of potash : . 0°26
Phosphate of soda a ‘ 2°15
Phosphate of lime : , 0°46
Silica g 0°86
The hippuric acid was determined by evaporating the urine
to one eighth of its volume and treating it with hydrochloric
acid, when that constituent was thrown down as a white deposit.
An instance in which diabetic urine occurred in a state of
extraordinary concentration has been observed by Bouchardat.
Its composition is given below. The three other analyses were _
made by Dr. Percy; the cases are fully recorded in the London
Medical Gazette for 1844. :
Bouchardat. Percy.
en ee
ITEEE =
Spec. grav. 1042-00 1035-00 10°39
Water : ; 837°58 894-50 918°30 898-90
Solid constituents 162-42 105-50 81°70 101-10
Urea ast ; 8°27 12°16 30°32 2°39
Uric acid : —_— 0°16 0°26 not isolated
Sugar ; ‘ 134-42 40°12 17°15 79°10
Extractive matters and salts 20°34 06 32°59 19°52
Earthy phosphates . 0°38 aS 1°30 0-09 ]
Lehmann? has made two minute analyses of diabetic urine ;
he found neither albumen, urea, nor uric acid in it, but a
' Simon’s Beitrage, p. 545. * De diabetica urina. Dissert. inaug.
URINE? 301
considerable amount of hippuric acid. The urine of a man
aged 18 years had a specific gravity of 1029-5, was pale, when
fresh, had a milky smell, and subsequently became acid. The
solid constituents amounted to 62°05, of which 58°15 were sugar.
Ether took up 0°187, which was chiefly hippuric acid. . The
urine of a man aged 38 years was turbid, of a straw colour,
contained neither albumen, urea, or uric acid, had a specific
gravity of 1028°5, and contained 56°24 of solid constituents, of
which 50:9 were sugar. There were also found 0°31 of hippuric
acid, 0°169 of salts soluble in alcohol, 0°21 of water-extract,
0:39 of salts soluble in water, 0°31 of salts insoluble in water,
and 0°23 of mucus.
An interesting case of diabetes in a girl aged 8 years was
observed by Cantin.! The urine which she discharged was of a
blue colour, and impregnated with sugar. The colouring matter
appeared to possess the properties of Prussian blue.
Diabetic urine has been observed in children as well as in
adults, and during the period of puberty.
The female sex is not exempt from this disease.
It is impossible in the present state of our knowledge on this
subject to state with certainty in what part of the system the
’ sugar is formed, which is produced and excreted in such ex-
traordinary quantity. It is either directly formed in the chy-
lopoietic system or it is produced in the peripheral vascular
system, or it is generated by a morbid action of the cells of the
kidney, or finally its origin may be due to a combination of
these agencies.
To decide this point satisfactorily, (and for the science of
medicine it is most important that it should be decided,) the
following points should first be established by experiments: on a
sound and certain basis :
(1.) Is the correspondence of the absolute diminution of the
urea with the absolute increase of the sugar, an invariable rule?
(2.) May not the nitrogen be removed from the system in
some other way, probably in the form of ammonia-compounds ?
(3.) Do the other secretions undergo a change, especially the
bile?
(4.) Does the air which is exhaled from the lungs differ in
its composition from that which is expired by healthy persons?
' Journ. de Chim. Méd, vol. 9, p. 104.
302 THE SECRETIONS:
(5.) Do the kidneys, liver, or lungs undergo any change ?
and if so, what is their nature?
If the connexion between the appearance of the sugar and
the diminution of the urea is constant, that is to say, if, without
exception, the urea invariably decreases in the same ratio as the
sugar increases, then we must assume with Berzelius, that in
place of the metamorphosis of the protein-compounds into urea
which occurs as a normal process, these compounds are in this
case, from certain causes which are unknown to us, transformed
into sugar, ammonia, and perhaps into nitrogenous extractive
matters. This hypothesis is, however, opposed by the facts
which were observed by M‘Gregor: in his cases the daily
secretion of urea equalled, and in fact exceeded the healthy
average.
It has been established by the researches of Rollo, Bouchardat,
myself, and others, that the blood really contains sugar. It
exists, however, in an extremely minute quantity, and my own
observation confirms the remark of Bouchardat, that it is most
abundant a short time after meals: the blood of a girl in whom
the disease had made considerable progress, when taken before
a meal, exhibited a mere trace of sugar. Hence we are led to
infer that the formation of sugar occurs in the chylopoietic viscera
alone, or there and in the blood simultaneously.
From experiments made by M‘Gregor,' he infers that the
sugar is formed in the stomach alone. After having con-
vinced himself of the existence of sugar in diabetic blood
by having induced fermentation, he sought for, and found it in
the matters vomited both by a healthy man and a diabetic pa-
tient, three hours after dinner. Upon treating the healthy man
and the diabetic patient with an initiatory course of emetics
- and purgatives, and then for three days feeding them with no-
thing but beef and water, no sugar was found in the matter
vomited by the healthy man, whilst there was still sugar in the
other case. M‘Gregor also found sugar in the feces of diabetic
patients: no sugar was, however, found in the sweat. It is
well known that persons with this disease do not readily per-
spire ; on the contrary the skin becomes dry, rough, and peels
' London Med. Gaz., May 1837.
URINE. 303
off. Willis! relates a case of diabetes that fell under his own
observation, in which the furfuraceous exfoliation of the cuticle
had a decidedly sweet taste.
From pathological anatomy we learn that the kidneys in
death from diabetes are very frequently softened, and according
to Meyer (who refers the formation of sugar to the kidneys),
even disorganized, their blood-vessels much enlarged, and the
substance of the papille and the tubuli very permeable; the
kidneys have also been found inflamed, atrophied, suppurating,
and containing caleuli. The condition in which the liver has
been found is also various: the bile is, however, usually very far
from being in a normal condition ; it is of a pale yellow colour,
very fluid, and, instead of being alkaline, has usually an acid
reaction, The veins which form the portal system are over-
loaded, and the mesenteric vessels are generally congested.
As the disease becomes further developed the lungs participate
in the general disturbance, for, according to Willis, pulmonary
phthisis is the immediate cause of death in two thirds of the
cases of diabetes. Traces of morbid action have also been found
in the nervous system.
It is of great importance in reference to the etiology of dia-
betes mellitus to ascertain whether the changes which are
revealed to us by the prosecution of the morbid anatomy of the
disease, are consequences of the disease itself, or whether they
had a previous existence in those blood-metamorphosing organs,
the kidneys, liver, and lungs, and whether the formation of the
sugar is due to them.
The questions which I have already suggested are of much
importance in elucidating these points.
Taking into consideration all that is known of the origin of
diabetes mellitus, it appears very probable that the sugar is
formed not in any single organ, but that it is produced by a
diseased condition of the whole system, and we are almost led
to adopt the opinion expressed by P. Frank, that a specific in-
fluence is exercised upon the nerves of the fauces by a sponta-
neously-generated virus diabeticum, which occasions an insatiable
Urinary Diseases and their Treatment, p. 205.
ee
304 THE SECRETIONS:
desire for drink, and at the same time exerts a peculiar influence
upon the nerves of the lymphatic system, exciting them to
extraordinary activity.
This activity of the lymphatic system, when associated with
an excessive absorption from all the secreting surfaces of the
body causes the premature elimination of raw and unassimilated
chyle, which, not being adequate to the formation of blood,
must be again removed from it. When we consider what an
extraordinary quantity of sugar is carried off, even in those pa-
tients who are restricted to animal food, we cannot doubt that
the sugar is formed from the protein-compounds,’ and in all pro-
bability, future and more accurate analyses of the urine, the bile,
and the expired air, will enable us to understand in what manner
the nitrogen is removed from the system, a point upon which
we are at present in the dark. For although we can well con-
ceive the possibility of the proteim-compounds being, under
peculiar circumstances, resolved into sugar of grapes, and cer-
tain nitrogenous compounds similar to protein itself, yet these
latter must be capable of being detected.
Periodic symptoms have been occasionally observed in diabetes
mellitus.
A physician in Berlin has a patient who, at certain times of
the year, had periodical attacks of diabetes mellitus, which after
continuing for some time, and with the application of proper
diet, would disappear: although the amount of sugar which was
excreted during these attacks was by no means inconsiderable,
the patient did not exhibit that meagerness which usually suc-
ceeds a prolonged continuance of the disease ; on the contrary;
he became corpulent, and complained of no disturbance of his
general health.
*
Diabetes insipidus.
Under the term “diabetes insipidus” are included seve-
ral diseased states, in which the urinary secretion is very
much increased, but where the urine contains no sugar, either
sweet or insipid, which is capable of fermentation.. Willis
' [Budge’s views on this subject may be seen in my Report on the recent progress «
of Animal Chemistry, in vol. 2 of Ranking’s Half-yearly Abstract.]
URINE. 305
treats of these different states under the heads Hydruria,
Anazoturia, and Azoturia.
Hydruria, which is also known as_ diuresis, polyuresis,
and polydipsia, seems to be capable of continuing sometimes
for several years, without being accompanied by any ‘other
morbid symptoms than a frequent desire to micturate, and an
insatiable thirst. Willis mentions several cases of the kind :
amongst others, that of an artisan 55 years of age, who from
his sixteenth year had upon an average drunk nearly two pails-
ful daily, and who, during the same period, passed on an
average thirty-four pounds of urine and one of feces. The
urine was scarcely denser than pure water and contained no
sugar.
A similar case is recorded of a woman aged 40 years, who
from her infancy experienced constant thirst, and an enormous
secretion of urine. She enjoyed good health, and was the mother
of several children.
Becquerel observed a case of polydipsia or hydruria in a
servant girl aged 23 years. After recovering from an attack of
acute nephritis she lapsed into a state of anzmia, for which fer-
ruginous medicines were exhibited, but without success. 0°20
Fat : ; : . 0°12
Extractive matters, much cee :
. 12°14
of ammonia, &c. . :
Fixed salts > : > 14°44
consisting of :
Earthy phosphates . ‘ ; 2°60
Chloride of sodium . ° A 5°40
Sulphate of potash . ° 0°08
Phosphate and carbonate of soda, &c . 6°36
From these analyses we may conclude that in herpes zoster
the chief peculiarities of the urine are:
1, A marked increase of the chlorides and phosphates, and
a corresponding diminution of the sulphates.
2. An excess of hydrochlorate of ammonia.
8. A large amount of fat.
4. A diminution in the amount of uric acid. An increase
only occurs when the disease is accompanied with fever.
The presence of oxalate of lime may always be suspected in
these cases.
The urine in a case of pompholix has also been analysed by
Heller. The patient was a woman aged 40 years; the attack
was very severe and proved fatal. The urine deposited a light
cloudy sediment consisting principally of mucus, but also con-
taining fat-globules, urate of ammonia, and a few epithelium-
scales. It was acid, and its specific gravity was 1017°5.
It contained in 1000 parts :
Water . : . 955°80
Solid constituents . 2 44°20
Urea ; ‘ 24°63
Uric acid " 0°58
Extractive matters ‘ 11°79
Fixed salts . ‘ 7°20
Of the fixed salts the earthy phosphates were normal, the
‘sulphates much increased, and the chloride of sodium propor-
‘tionally diminished. The urea is considerably above the norms
average. |
URINE. 323
ON SOME OTHER MODIFICATIONS OF THE URINE INDUCED
BY DISEASE.
Fat in urine.
There are certain morbid conditions in which fat is excreted
in a free state with the urine, which, at the same time, is
neither chylous nor milky, nor contains any large amount of
albumen or casein. Urine of this sort most commonly occurs
in those diseases in which there is a very rapid loss of substance
and force. I have on several occasions detected fat in the urine
of phthisical persons, and on two occasions I have found it
during tabes. I have already (see page 190) explained in what
manner the presence of fat may be detected with certainty; I
would here add a word of caution, that the presence of fat from
extraneous sources, as improperly cleaned glasses, &c. must be
carefully guarded against.
Such cases as that which is related by Bachetoni,’ in which
a noble young lady is reported to have discharged two ounces
of olive oil with the urine on different occasions, must at least
_be regarded as mysterious; Elliotson? also witnessed the daily
discharge of about one third of an ounce of oil with the urine
of a woman suffering from biliary calculi.
[A case of fatty urine has been recently described by Dr.
Golding Bird (Urinary Deposits, page 263.) An analysis of
this form of urine has likewise been given in page 229 of this
Volume. |
Milk in urine.
In speaking of diabetes I adverted to chylous urine, and said
a few words regarding milky urine. It appears from an essay
of Rayer, in which he enters fully into the subject, that this
form of morbid urine is extremely rare; but that the term
‘milky urine’ has frequently been applied incorrectly to the
! Comment. Bonon. Pars I, ad ann. 1787.
2 On the discharge of fatty matters from the alimentary and urinary passages.
(Medico-Chirurg. Transactions, vol. 18, p. 80.)
324 THE SECRETIONS:
fiuid simply from its having a turbid or emulsive appearance,
while there has been no trace of casein, but the fat has been
suspended by means of albumen.
The only recorded case of actual milky urine containing
casein and fat are one by Canubio, of a woman who was suck-
ling ; one by Alibert, of a healthy young widow; and, lastly, a
case by Graves.
Excess of hippuric acid in urine.
[There are certain conditions of the system in which an excess
of hippuric acid occurs in the urine, independently of those
cases in which benzoic or cinnamic acid is taken either in the
food or as medicine.
The following case is recorded by Bouchenlaks 1
A lady aged 53 years, suffering from lassitude, dry skin and
tongue, occasional pain in the region of the liver, loss of appe-
tite, and great thirst, passed a large quantity of limpid urme
possessing an odour of whey. Its specific gravity varied from
1006 to 1008; it slightly reddened litmus paper, and contained
in 1000 parts :
Water . ; - 986°00
Solid constituents . : 14°00
Urea . ‘ 3 1°56
Hippuric acid . . 2°23
Lactate of soda . ‘ 2°96
Albumen ‘ ‘ 1°47
Mucus ee 0:20
Chloride of sodium ; 2°75
Phosphate of soda ‘ 0°97
Alkaline sulphates : 1°44
’ Earthy phosphates : 0°42
Dr. Garrod? has narrated the case of a man suffering from
pain in the loins and symptoms of atonic dyspepsia, with flabby,
white, furred tongue, who excreted a considerable amount of hip-
puric acid,
When examining the urine for the purpose of ascertainil
the proportion of uric acid by the-addition of a small quantity
of hydrochloric acid, he found the tube filled with crystals of
hippuric acid, and on these large crystals smaller ones of uric
1 Annuaire de Thérapeutique, 1842, p. 285. 2 Lancet, Nov. 16, 1844.
“eA
URINE. 325
acid were deposited. For several days he found as much as
half a drachm in six ounces of urine, or about 10 of hip-
puric acid in 1000 parts. It afterwards gradually diminished,
requiring considerable evaporation before crystals were depo-
sited, and ultimately disappeared. The patient had previously
suffered from voicing an excess of urea, and his urine had con-
tained a deposit of ammoniaco-magnesian phosphate.
Dr. Pettinkoffer' has also published an analysis of urine con-
taining an excess of hippuric acid. The patient was a girl aged
13 years, suffering from chorea. The urine was limpid and
acid on emission, but soon became alkaline and deposited crystals
of ammoniaco-magnesian phosphate. After pouring nitric acid
on the evaporated alcoholic extract with a view of determining
the amount of urea, Dr. Pettinkoffer was surprised to find that
instead of the usual crystalline plates of nitrate of urea, brownish
yellow needles made their appearance. Under the microscope
the needles were found to be six-sided prisms, in some places
intermingled with plates of nitrate of urea. The urine evi-
dently contained a large amount of hippuric acid in combination
with potash or soda, from which the nitric acid separated it.
When the alcoholic extract of the urine was evaporated, mixed
with hydrochloric acid, and allowed to stand, four-sided pris-
matic crystals of hippuric acid were deposited.
1000 parts of urine contained 40-668 of solid residue, of
which 31°251 were soluble in spirit, and consisted of hippurates,
urea, extractive matters, and chlorides; while the remaining
9°417 were composed of urates, phosphates, and sulphates, to-
gether with mucus and water-extract.
The solid residue yielded, on incineration, 10°599 of fixed
salts. :
On the following day, 1000 parts of urine yielded 49-825 of
solid residue and 12°985 of ash, consisting of :
Carbonates of lime and magnesia F 1153 : ;
isd phioiighates 8 0-713 \ 1866 insoluble in water.
Carbonate of soda. ‘ ‘ 3°996
Chlorides of sodium and potassium ; 6181
Phosphate of soda. ‘ ; 0°128
Sulphate of lime ‘ : ‘ 0°814
1 Liebig’s und Wohler’s Annalen, vol. 50, No. 1.
326 THE SECRETIONS:
If we consider that the alkaline carbonate in the ash corre-
sponds with the hippurate in the urine, then 1000 parts of urine
must have contained 12°886 of anhydrous hippuric acid, and
100 parts of solid residue 25:8 of the same constituent. During
this period the only food taken by the girl was bread, apples,
and water; she, however, gradually resumed her ordinary diet,
and the excess of hippuric simultaneously disappeared. |
Urostealith in urine.
[ Heller’ has recently announced the discovery of a new con-
stituent of urinary calculi, to which he has given the name
urostealith. It is soluble in carbonate of soda; and when that
remedy is administered, urostealith in a state of solution is found
im the urine.
The patient was a man of tolerably good constitution, aged
24 years ; he complained of pain in the region of the right kid-
ney, and difficulty in micturition, occasionally passing small
elastic soft concretions. These were examined by Heller, and
found to be perfectly soluble in alkalies, with which they formed
a soap.
Analysis of the urine before the administration of carbonate
of soda.—25th Feb. The urine had a light yellow, whey-
like appearance, no odour, and deposited a sediment of ammo-
niaco-magnesian phosphate. Fat-globules were detected under
the microscope. The reaction was neutral ; the specific gravity
1017°5. It contained in 1000 parts:
Water ’ 4 . > - 965-800
Solid constituents 3 3 : : 34°200
Urea s é ‘ ‘ . 12°631
Fat é 0°320
Extractive matters with much hydrochlorate of ammonia 87569
Fixed salts ‘ a, ‘ 12-680
consisting of :
Earthy phosphates Pe “ ‘ 2°040
Chloride of sodium 5 : oe 12-680
Sulphate of potash . 2°296
Basic phosphate of soda and peroxide of i iron ° 8-181
Moreover, every 1000 parts of urine threw down 0-62 of
pure ammoniaco-magnesian phosphate. Not a trace of uri¢
acid could be detected.
' Archiv fiir phys. und patholog. Chemie, vol. 2, p. 1.
URINE. 327
28th Feb. The day after the carbonate of soda had been |
given, the urine was neutral, of a pale yellow colour, and had
a specific gravity of 1006. Fragments of urostealith were de-
tected in the sediment, mixed with ammoniaco-magnesian
phosphate. . No uric acid was present.
By the 2d of March the calculus of urostealith was almost
entirely dissolved. The reaction of the urine was neutral; the
addition of ammonia produced a reddish brown tint; (this is
regarded by Heller as a test for urostealith ;) uric acid was still
absent. The specific gravity was 1020. The urine contained
in 1000 parts :
Water " “ . s - 959°90
Solid constituents ¥ . : 40°10
Urea P ‘ ‘ ‘ : 11-20
Fat and urostealith . ‘ é j 3°40
Extractive matters and hydrochlorate of ammonia . 8°29
Fixed salts he ‘ : : 17°21
No sediment was deposited. In order to obtain the uro-
stealith, a large quantity of urine was evaporated, and sulphuric
acid added in order to decompose the soap. The urostealith was
taken up by boiling ether, which, on evaporation, yielded a
violet tint. For further information on the chemical charac-
ters of this substance I must refer to Chapter x11. |
Semen in urine.
It may sometimes be of importance to ascertain whether the
urine contains any seminal fluid. This point can be best set-
tled by the microscope. We find mucous floccules in the urine ;
and if semen is present, the spermatozoa will be detected
amongst them. ‘They are represented in fig. 33.
Urine of peculiar colours.
Some cases have been recorded in which the colour of the
urine has deviated extremely from the normal type. A case
is related by Janus Plaucus, in which a dark blue sediment
was precipitated from the urine of a man 60 years of age, a
short time before his death. He had formerly suffered from
398 THE SECRETIONS:
dysuria and vesical calculus, and subsequently from typhus
fever. ;
Marcet, Prout, Braconnot, Babington, Garnier, Spangeberg,
and others, have observed blue and black urine. I have re-
lated a case in which the urine deposited a blue sediment, in
page 274.
I have made an examination of the urine passed by a man
at Grafenberg, who had spent many years in the East Indies,
and returned to Europe for the benefit of his health. It had
a strong ammoniacal odour, was of a clear blue colour, and de-
posited a somewhat copious dark blue sediment, which ap-
peared, from a microscopic examination, to consist of very fine
amorphous matter (on which the blue colour was dependent)
and a few crystals of ammoniaco-magnesian phosphate. On
treating a portion of the washed and dried sediment with caustic
potash the colour did not disappear; hence it was not de-
pendent on the presence of iodide of starch or prussian blue.
Dilute organic acids and hydrochloric acid neither dissolved it
nor destroyed its colour; but on digesting it in nitric acid, the
tint changed from blue to yellow. Digested in concentrated
sulphuric acid, it dissolved, forming a solution of an indigo
colour. On warming a portion of the sediment on platinum
foil, it first evolved an urinous odour, and subsequently vola-
tiliized, going off in deep violet-coloured vapour. The most
convincing proof that the blue tint was due to indigo, was that
on warming a portion of the sediment with dilute alcohol to
which grape sugar and potash had been added, the fluid lost
its blue tint, and assumed a yellowish red colour, which, on
shaking, was converted into an intense blood-red, and then
rapidly into a green. On allowing it ‘to rest the green tint
disappeared, and the fluid assumed a yellowish-red colour. All
these phenomena led to the conclusion that the colouring mat-
ter was indigo. Ihave since heard that specimens of the same
urine were sent to Bouchardat, Liebig, and Prout, who coin-
cide in the opinion that the pigment was not indigo, but a dis-
tinct organic compound. No indigo, or indeed medicine of
any sort had been recently taken by the patient.
Dulk! has observed and analysed black urine passed by a per-
‘son suffering from derangement of the liver and portal system.
‘Archiv der Pharmacie, vol. 18, p. 159.
URINE. 329
[Dr. v. Velsen'. has published the case of a man aged 84
years, with chronic cystitis, who passed very fetid urine of a
deep violet colour, after the use of lime-water mixed with warm
milk. After the omission of the draught for a few days, the
peculiar colour disappeared. |
Urine during pregnancy, at the period of delivery, and after
, delivery.
Since Nauche’s announcement (a few years ago) of the dis-
covery of a peculiar substance to which he gave the name of
kystein, in the urine of pregnant women, the renal secretion
during this state has been carefully examined by numerous
chemists.
Nauche describes kystein as a white mass that, after the
urine has stood for some time, separates, partly rising to the
surface, where it forms a somewhat tough pilous membrane
interspersed with glistening crystals, and partly sinks to the
bottom, forming a creamy precipitate. Nauche regards kystein
as an indubitable sign of pregnancy. It is also considered a
certain test by Eguiser ; he states that it appears after the urine
has stood two to six days, depositing itself as a white opaque
body, and then rising to the surface and producing a film like
the solid fat that settles on cold broth. From an extensive
series of observations, Dt. Kane concludes that kystem does
not appear sooner than thirty hours, or later than eight days ;
that on its first appearance it forms a scarcely perceptible
membrane, which gradually becomes firmer and thicker, and
after a time, breaks up, the fragments sinking to the bottom ;
that a kystein-like membrane may also appear in the urine of
persons with phthisis, arthritis, metastatic abscesses, vesical
catarrh, &c. but that it differs from true kystein, both in the
manner of its formation and of its destruction ; it appears later
than the true kystein, but, having once appeared, develops it-
self more rapidly and possesses less tenacity. The urine is
neutral or ammoniacal on the appearance of the kystein, which,
under the microscope, appears as an amorphous matter cor-
sisting of minute opaque corpuscles, intermingled with crystals
' Casper’s Wochenschrift, 1844, No. 18.
330 THE SECRETIONS :
of ammoniaco-magnesian phosphate. Dr. Kane convinced
himself that the occurrence of kystein was independent of the
presence of albumen ; he likewise ascertained that it occurs not
only during pregnancy but also during the period of lactation,
especially when the secretion of milk is at all checked. He
concludes with the observation that “when pregnancy is pos-
sible, the exhibition of a clearly-defined kystein-pellicle is one
of the least equivocal proofs of that condition, and that when,
in a case of suspected pregnancy, this pellicle is not found, if
the female be healthy, the probabilities are as twenty to one
that the prognosis is incorrect.”' It appears from a review of
Kane’s cases, that the kystein most commonly appears on the
third day; in one case, however, it could not be observed till
the eighth day after the urme had been passed; and in some
cases it appeared during the first twenty-four hours.
During the first weeks of pregnancy, Kane only rarely ob-
served it; it was most commonly noticed during the seventh,
eighth, and ninth months, and up to the period of delivery.
In eighty-five cases of pregnancy it was absent eleven times,
and was present in thirty-two out of ninety-four cases examined
during lactation.
I have examined the urine during the second, third, fourth,
fifth, and sixth months of pregnancy, but have not invariably
detected kystein. In the cases in which it was formed, as in
the second, fifth, and sixth months of pregnancy, the urine on
emission was clear, yellow, faintly acid, and not affected either
by nitric or acetic acid, or by heat. Usually, in about twenty-
four hours, the whole urine became slightly turbid, the acid
reaction disappeared, a white viscid sediment was deposited,
and soon afterwards the surface of the fluid became covered
with a pellicle at first extremely delicate, but after from twelve
to twenty-four hours becoming tough, thick, opaque, and with a
glistening appearance in consequence of the light reflected from
numerous minute crystals of ammoniaco-magnesian phosphate
with which it was studded. On examining this pellicle in its early
state under the microscope, it appeared (when magnified 300
times) to consist of an amorphous matter composed of minute,
opaque points, such as are presented by sediments of phosphate
of lime or urate of ammonia, except that in the latter the in-
1 American Journal of Med. Science, July 1842.
URINE. 331
dividual particles are usually darker, more clearly defined, and
larger than in kystein. The whole field of vision was likewise
bestrewed with numerous vibriones in active motion, and crystals
of ammoniaco-magnesian phosphate. When the pellicle became
thicker, precisely similar phenomena were observed, but the
vibriones were supplanted by a considerable number of monads ;
on the addition of acetic acid the crystals disappeared, while
the amorphous matter remained unaffected. On digesting the
pellicle in acetic acid, and adding ferrocyanide of potassium to
the filtered solution, a comparatively slight turbidity ensued,
but on macerating the pellicle in a dilute solution of pot-
ash, acidulating the filtered solution with acetic acid, heating,
and adding ferrocyanide of potassium after a second filtration,
a more decided turbidity was observed. From these experi-
ments I concluded that a protein-compound was present. The
_ white sediment, that occurred after the urine had stood for some
days, possessed a disagreeable, pungent, caseous odour: under
the microscope it presented the same appearance as the pellicle.
After repeatedly washing a portion of the sediment with water,
and then heating it with alcohol and a little sulphuric acid,
it developed a disagreeable fruit-like odour, reminding me of
butyric ether. [We shall presently show that the accuracy of
this observation has been thoroughly established by Lehmann. |
It results from the above observations, that kysteim is not a
new and distinct substance, but a protein-compound, whose
formation is undoubtedly and closely connected with the lacteal
secretion. From the observations of Kane and myself, it seems
to follow that pregnancy may exist without the occurrence of
kystein in the urine ; if, however, there is a probability or pos-
sibility of pregnancy, and kystein is found in the urime, then
the probability is reduced almost to a certainty. We are un-
able to draw any positive inferences respecting the stage of
pregnancy from the appearance of the kystein.
A deposit of caseous matter and earthy phosphates was fre-
quently observed by Golding Bird in the advanced stages of
pregnancy. The sediment is probably similar to Nauche’s
kystein.
Every urine left to itself forms a pellicle, more or less re-
sembling that of kystein. If formed soon after the urine is
discharged, it consists of earthy phosphates, which, from the
332 THE SECRETIONS:
urine being alkaline, are, for the most part precipitated, but
hkewise form a delicate film on the surface. When this -is the
case, the pellicle is very thin and readily sinks to the bottom.
Under the microscope crystals of ammoniaco-magnesian phos-
phate, and an amorphous matter very similar to kystein, but
consisting of phosphate of lime, are observed: this likewise
differs from kystein in being soluble in free acids. A pellicle
of fat on the surface of urine may sometimes be mistaken for
kystein: films of this nature are very thin and usually irides-
cent, and the microscope reveals the presence of numerous
fat-globules.
The membrane formed on the surface of urine six or eight
days after emission, usually consists of a species of mould ; under
the microscope there may be seen innumerable filaments matted
together, and interspersed with sporules.
I once observed a pellicle on the surface of a man’s urine
three days after emission, which both in chemical and micro-
scopical characters presented the closest analogy to kystein.!
(Lehmann? frequently examined the urine of a pregnant
woman from the second to the seventh month. It was of a
dirty yellow colour, and more inclined to froth than usual; it
generally became turbid in from two to six hours ; but the morn-
ing urine, after standing for thirty-six or forty-eight hours, was
always covered with a grayish-white film, which often, in two
or three days, sank and mixed with the sediment that formed
when the turbidity appeared, but sometimes was a longer period
before it broke up. By means of ether he could always re-
move from this film a considerable quantity of viscid fat, which
formed a soap with potash, and then, on the addition of sul-
phuric acid, developed a well-marked odour of butyric acid.
‘On treating a large quantity of this urine with sulphuric acid,
and distilling, he obtained, after treating the distillate with
baryta water, brilliant crystals of butyrate of baryta. The
substance taken up by ether, when gently evaporated with nitric
acid and exposed to the vapour of ammonia, was not in the
least reddened ; with concentrated hydrochloric acid, on the
' [A similar appearance has been observed by Prout in the urine of a delicate
child, fed chiefly on milk. (On Stomach and Renal Diseases, 4th edit. p. 555, note.) ]
? Lehrbuch der physiologischen Chemie, vol. 1, p. 252.
URINE. 333
other hand, it assumed a blue tint; dissolved in potash, boiled,
and treated with hydrochloric acid, it developed sulphuretted
hydrogen ; it dissolved tolerably freely in acetic acid, from
which it was precipitated by ferrocyanide of potassium. These
reactions left no doubt of its being a protein-compound. The
portion of the film insoluble in potash consisted chiefly of phos-
phate of magnesia, [ammoniaco-magnesian phosphate ?] with
a little phosphate of lime. Hence Lehmann concludes that the
kystein of Nauche is not a new and distinct substance, but a
mixture of butyraceous fat, phosphate of magnesia, and a pro-
tein-compound very similar to casein. He likewise mentions
that, in examining the urine of a woman who was not suckling,
and was kept on very low and sparing diet, on the third, fourth,
sixth, and ninth days after delivery, he found a large quantity
of butyric acid taken up by ether from the solid residue; and
on dissolving the ethereal extract in water, adding sulphuric
acid, and distilling, he obtained a further quantity. The urine
in this case was always rather turbid, of a dirty yellow colour,
very acid, and contained a very small amount of uric acid.
Moller! relates two cases in which the urine of women who
were not pregnant was covered with a film exactly resembling
kystein : im one case there was considerable hypertrophy of the
uterus ; in the other, no affection of the generative organs could
be detected. The film of kystein consists, according to his
observations, of fat, earthy phosphates, and a caseous matter,
which differs, however, from the casein of milk in being held
in solution by a free acid. When the urine becomes neutral
or alkaline, the caseous matter ceases to be held in solution,
and separates askystein. Everything checking the decomposi-
tion of the urine hinders the formation of the pellicle, and if the
recent secretion is treated with a free acid (mineral or organic) ;
no separation of kystein takes place even if ammonia be added
to saturation, or decomposition allowed to proceed to any
extent.
In a case of decided pregnancy, no kystein was formed during
the period of a severe cold, attended with a copious deposition
of urates ; but when the urine became natural, the kystein re-
appeared. He twice detected cholesterin in kystein.
' Casper’s Wochenschr. Jan. 11-18, 1845.
334 THE SECRETIONS :
Kleybolte! has examined the urine in ten cases of pregnancy,
and invariably found kystein on the fifth day. The morning
secretion was used, and, after being slightly covered to protect
it from dust, was allowed to stand, at an ordinary temperature,
for ten days. The followmg appearances were observed in the
tenth week of pregnancy: urine peculiarly yellow, with a green-
ish tint. 2d day, mucous sediment; 3d day, no change; 4th
day, turbidity ascending from the bottom; 5th day, white
points and leaflets on the surface, turbidity ascending from all
parts of the bottom, and the sediment almost gone; 6th day,
kystein distinctly observed on the surface, like lumps of fat on
the surface of cold broth; 7th day, no change. From the 8th
to the 10th day, the kystein disappears, the turbidity again de-
scends, and the sediment noticed on the 2d day is reproduced.
The nine remaining cases are in most respects similar to the
above. .
A few observations on kystein have been recently published
by Audouard,? but contain nothing of importance, except that
in six specimens of urine passed by young women suffering
from amenorrheea, he found kystein in five.3]
I shall now give a short abstract of Becquerel’s researches.
During pregnancy, the general state of the system is liable to
great variations, and the urine presents differences of corre-
sponding importance. If good health is enjoyed during preg-
nancy, the urine remains normal ; if, however, anything should
happen to excite the vascular system, it readily changes, be-
coming dark-coloured, acid, sedimentary, and diminished in
quantity. During the latter stages of pregnancy the urine
often assumes the anzmic type, that is to say, it becomes pale,
contains only a small amount of solid residue, and the spe-
cific gravity does not exceed 1011. The observations which
were communicated by Donné in a letter addressed to the
Academy of Sciences, dated May 24, 1841, in reference to the
urine in pregnancy containing less free acid, and less of the
phosphate and sulphate of lime than normal urime, were not
! Casper’s Wochenschrift, April 26,1845. * Journal de Chimie Méd. May 1845.
$ Many other communications have recently been published on this subject, which —
I do not deem necessary to notice, as they are, for the most part, simply confirmatory
of the above observations.
URINE. | 335
confirmed by Becquerel. Neither could ra Rt observe
kystein.
After delivery, mucus, tinged with bieed; is mixed with the
urine; this is succeeded by the discharge which is known as
the aed During the period that intervenes between deli-
very and the commencement of the milk-fever, the urine either
assumes the inflammatory type, and is scanty, high-coloured,
acid, and dense, as, for instance, in those cases in which the
labour has been very difficult and painful, and the vascular
system is much excited; or it takes on the anemic form, as in
those cases in which the labour is followed by great debility
and prostration.
Becquerel gives two analyses: one was made with the urine
of a woman aged 33 years, who, the previous evening, had been
delivered of a dead child; pulse 96, strong; urine of a deep
red colour, acid, and sedimentary; the sediment was mixed
with sanguineous mucus, and there was a little albumen in the
urine. |
The second analysis was made with the urine of a woman
aged 22 years, who had been delivered forty-eight hours pre-
viously of a seven months dead child. Pulse 92, rather weak ;
urine wasvery red, and held in suspension a cloud of sanguineous
mucus and a considerable quantity of albumen.
1. 2.
Quantity of urine in 24 hours in ounces © 30 26°5
Specific gravity ‘ ‘ ta 1012°6 1018°0
1000 parts contained :
Water. epee r : 979°5 970-2
Solid constituents . ‘ : 20°5 29°8
Urea . Pr F : 6°5 78
Uric acid ; ‘ é 0°5 0°5
Fixed salts : ’ 4°6 7°4
Extractive matters i 4 9°5 10°6
Albumen F . 2 — 3°3
We see from the ratio of the urea and also of the uric acid
to the solid residue, that the urine in neither of these cases
can be regarded as inflammatory, but that it rather approxi-
mates to the anemic type. In the first analysis the urea
amounts to only 312 and the uric acid to 2:4 of the solid re-
sidue ; in the second analysis, the former amounts to 27 and
the latter to 28.
; oe aia 3
336 THE SECRETIONS :
In most of the cases in which Becquerel examined the morn-
ing urine of women who had recently been delivered, he found
it anemic; the specific gravity varied from 1006 to 1014, the
average aie 1011.
As the milk-fever comes on, the chemical composition of the
urine appears to undergo some modification, at least we are led
to infer so from an analysis of Becquerel. It was secreted in
diminished quantity, contained a larger proportion of urea and
uric acid, was darker, and deposited a sediment. —
He examined the urine of a woman aged 22 years, four days
after delivery, while suffering from the milk-fever. It was of
a saffron-yellow colour, deposited a sediment on the addition
of nitric acid, and also spontaneously, after the lapse of some
hours. In the course of twenty-four hours there were 15°5
ounces excreted. The specific gravity was 1031-5.
1000 parts contained :
Water ; ‘ : .¢ :oae2
Solid constituents . ‘ ¢ ‘4 51°8
Urea ; ; ‘ : 18°7
Uric acid . facie Ps ; 2°7
Fixed salts . 3 4 11°3
Extractive matter ‘ ; j 18°3
Albumen . ; : : 0°7
Here the urea amounts to 36%, and the uric acid to no less
than 52 of the solid residue.
On the passage of medicinal and other substances into the urine.
[All substances incapable of assimilation that enter the cir-
culation are removed by the kidneys, either in the state in
which they entered the organism, or in a modified condition.
Inorganic, non-metallic bodies. Iodine appears rapidly in
the urime in combination with ammonium, (Lehmann,) sodium,
and potassium. Bromine has been detected by Glover and —
Heller, and chlorine by Orfila.
Iodide of potassium, the alkaline borates, silicates, chlorates, —
and carbonates, as also chloride of barium, ferridcyanide of —
potassium, and sulphocyanide of potassium, were found by ~
‘Wohler’ in the urine ; the ferrideyanide was, however, converted —
into ferrocyanide in the system.
' Tiedemann’s Zeitschr. fiir Physiol. vol. 1, p. 305. -
Tet ae aA eae Te REIT 8
URINE. 337
Sulphur has been found (after administration) in the urine
by Wohler and Orfila; and after the use of liver of sulphur,
free sulphur, and an excess of sulphate of potash were found
in the urine. In four experiments made by Laveran and
Millon, sulphur neither appeared in the urime, nor was the
quantity of sulphates increased.
Metallic substances. Arsenic and antimony may be readily
detected in the urine, and have been observed by many che-
mists. The detection of mercury is by no means easy; it has
been sought for in vain by Lehmann, L’Heretier, and Rees,
but has been found by Buchner, Cantu, Jourda, Venables,
Orfila, Gisterlen,! and Audouard.2 Iron is almost always present
in the urine during its administration as aremedy. Nickel was
found by Wohler in the urine of a dog to whom he had given
half a drachm of tartrate of nickel and potash. Gold, silver,
tin, lead, and bismuth, were found in the urine of dogs to.
whom Orfila had given large doses of the soluble salts of those
metals. Copper and manganese have been detected in the
urine by Kramer. 7
Inorganic acids. Orfila has detected nitric, hydrochloric,
and sulphuric acids in the urine. As nitric acid is not a con-
stituent of normal urine, there was no ambiguity in this ex-
periment. In dogs poisoned with dilute hydrochloric or sul-
phuric acid, about six times as much chloride of silver and
sulphate of baryta were obtained as are found in ordinary
urine. In none of these cases was the urine more acid than
usual, the acids having formed neutral salts by combining with
the alkalies of the blood.
Organic acids and their salts. It appears from the inves-
tigations of Wohler, that many of the organic acids, adminis-
tered in a free state, enter the urine in a state of combination ;
as, for instance, oxalic, citric, malic, tartaric, succinic, and gallic
acids.
To the above list Orfila has added acetic acid, and con-
firmed Wohler’s statement regarding oxalic acid.
According to Pereira meconic acid may be occasionally
detected in the urine of animals poisoned with opium.
L’Expérience, Aug. 1844. ? Journal de Chim. Méd. 9, p. 137.
3 Giornale dell’ Instituto Lombardo.
* Elements of Materia Medica, Ist ed. vol. 2, p. 1299.
II. * 22
338 THE SECRETIONS:
One of the most important of Wohler’s discoveries is, that
the neutral vegetable salts become modified in their passage
through the system, and are found in the urine as carbonates.
A few hours after the use of these salts, the urine becomes
alkaline, is frequently turbid from the deposition of phosphates,
and effervesces briskly on the addition of an acid.' If the dose
is very large, oxalate of lime may frequently be detected,
Similar results follow from the use of alkaline lactates ; Lehmann
found, that two hours after taking two drachms of lactate of
soda, alkaline urine was excreted. That this change is effected
after the salt has entered the blood, and not in the intestinal
canal, is proved by an experiment performed by Mr. J. Goodsir,
at my request. A drachm of acetate of potash was dissolved
in an ounce and a half of water, and injected into the femoral
vein of a dog, whose urine had been previously ascertained to
be acid. The urine passed about an hour after the operation
was alkaline. A similar experiment has been since made by
Lehmann, who injected a drachm of lactate of potash into the
jugular vein of a dog, and found the urine alkaline an hour
afterwards. The process is one of simple combustion: each
atom of acetic acid (of the acetate of soda) combines with eight
of oxygen, and yields four atoms of carbonic acid and three of
water, or C, H, O, + 80 = 4CO, + 3 HO, and each atom
of lactic acid combines of twelve of oxygen, forming six of
carbonic acid and four of water, or C, H,O, + 120 = 6CO,-
+ 5 HO.
In a series of 268 experiments instituted by Millon and
Laveran, with the tartrate of potash and soda, (Sode potassio-
tartras. Ph. L.) they found the urine more for less alkaline in
175, acid in 87, and neutral in 6 cases. This apparent dis-
crepancy was doubtless dependent on the degree of concen-
tration of the saline solution. (See page 149.)
We have already mentioned that benzoic and cinnamic acids ©
are converted in the organism into hippuric acid, and then ex-
creted by the kidneys.
Vegetable bases. Quinine, when administered in large doses,
has been noticed in the urine by Piorry, Landerer, and others.
1 Some excellent observations on the physiological action of these salts will be found
in Dr. Pereira’s Treatise on Food and Diet, p. 29.
URINE. 339
The best test for its presence is the iodated iodide of potassium,
consisting of four parts of iodide of potassium, one of iodine,
and ten of water. The precipitate afforded by this reagent
with disulphate of quinine is very insoluble in water, not
affected by an excess of the test, and readily soluble in alcohol.
It is of a yellowish-brown colour, and forms a turbidity or sedi-
ment, according to the amount of the alkaloid in the urine.
When the quantity is very small there is merely an olive tint
produced on the addition of the test. The disulphate of quinine
may be reobtained from the sediment in a state of purity by
a simple chemical process.!
Morphia is stated to have been once detected by Barruel in
the urine of a person under the influence of a poisonous dose
of laudanum, and it was likewise discovered by Orfila, in the
urine of dogs. None of the other alkaloids have yet been de-
tected in the urine.
Indifferent organic substances. According to Wohler, most
colouring matters and many odorous principles passed unchanged.
or slightly modified into the urine. In the former class we
may place indigo, gamboge, rhubarb, red beet-root, madder,
logwood, mulberries, black cherries, &c. ; in the latter, valerian,
asafcetida, garlic, castoreum, saffron, turpentine, &c.
Alcohol is placed by Wohler amongst the substances that
do not enter the urine, and Liebig has recently affirmed that
it has never been found in that secretion. It has, however,
been detected by Percy in the urine of a dog, into whose sto-
mach four ounces of spirit of ‘85 had been injected, and in the
urine of a man in a state of intoxication who had taken about
a bottle of whiskey. In both cases he obtained, by careful
distillation, an inflammable fluid that dissolved camphor.2
In order to ascertain whether alcohol, taken in moderate
quantity would enter the urine, my friend Dr. Wright instituted
the following experiment on a man whose ureters opened ex-
ternally. Three ounces of whiskey were administered, and the
urine collected by applying a test-tube to each ureter. The
tubes were corked and replaced every two minutes, for the
space of half an hour.
! Journal de Pharmacie, Sept. 1843.
? On the presence of Alcohol in the Brain, 1839, p. 104.
340 THE SECRETIONS:
The following table represents the amount of fluid in the tubes. |
ist two minutes ; : 3 a drachm.
2d % " : 2 drachms.
3d* s . : 5 drachms.
4th A : > 1 drachm.
5th* os : Sf 6 drachms.
Our i ; 2 drachms.
7th 5) : ; 4 a drachm.
8th 3 : A 3 a drachm.
9th + . : 3 drachms.
10th* ss. : ; 6 drachms.
llth ey ‘ : 4 drachms.
12th ‘5 > : 8 drachms.
oun? t, ¥ : 7 drachms.
M4th*. ,, . : 6 drachms.
15th* ‘ : ‘ 4 drachms.
The contents of the tubes were analysed separately, according
to Dr. Percy’s method, * and in those marked with an asterisk
the presence of spirit was distinctly recognized.
In another experiment upon the same individual, in which
two ounces of whiskey diluted with three times its volume of
water were administered, no trace of the spirit could be obtained.”
Lehmann has sought in vain for salicin, phloridzin, caffein,
theobromin, asparagin, and amygdalin.
As the modifications that these substances undergo in the
organism are of extreme interest, let us see what are the most
probable changes that can take place. We select salicin, by
way of illustration, as a substance whose chemistry is pretty
well established.
Is salicin converted in the organism into sugar and saliretin 73
—a change that occurs on digesting salicin in dilute acids: or is it
converted into salicylous acid and water?*——as occurs on treating
salicin with bichromate of potash and sulphuric acid. Or, in-
stead of salicylous acid, is hydrated benzoic acid (which is
. Op. cit. p. 8.
2 These experiments were originally recorded in my Heresies Prize Essay on the
Chemistry of the Urine in Health and Disease; 1842.
3 This change is illustrated by the equation—
Salicin. Sugar. . Saliretin.
C4 Hyg On = Cy Hy, O14 + Cyo Hy, Og
Salicin. Oxygen. Salicylousacids Waters
Symbolically—C,, H., O.. + O = 3C,, He O, + 11HO.
URINE. 34]
isomeric with it) produced,! and the benzoic acid then converted
in the ordinary manner into hippuric acid? Or does the salicin
yield salicylous acid which appears to be isomorphous with,
and convertible into oxide of omichmyle?? Or, finally, does
the salicin undergo the same changes as when oxidized by
fusion with caustic potash, and become converted into salicylic,
oxalic, and carbonic acids, and water ?3 In sixteen experiments
made by Lehmann with salicin in doses of 20 or 80 grains, he
never detected saliretin, but always salicylous acid, which was
taken up by ether with the oxide of omichmyle, and yielded
the characteristic violet tint on the addition of nitrate of iron;
in most of the experiments there was also a small quantity of
hippuric acid, and of oxalate of lime. Similar experiments
have been made by Laveran and Millon.
After taking phloridzin, Lehmann also found hippuric acid
and oxalate of lime in the urine. After taking a scruple of
thein at bedtime, no trace of it could be found in the morning
urine, but the urea was considerably increased, amounting to
_ 58°1952 of the solid residue. He did not remark any un-
pleasant symptoms, but two of his pupils, after a similar dose
(obtained from coffee) experienced great excitement of the
nervous and vascular systems generally, and especially of the
generative organs. ‘This is perfectly in unison with Mulder’s5
statement, that it produced abortion in pregnant rabbits. |
Salicylous acid. | Hydrated benzoic acid.
1 Symbolically—C,, H,;O0, == HO, C,, H, 0,.
? It appears from the researches of Scharling that the oxide of omichmyle belongs
to a series having a compound radical analogous to that of oil of spirza, or salicylous
acid; at least he found that chloromichmyle is isomeric with chloride of salicyl or chlo-
rosalicylic acid, C,, H; O,, Cl. Oxide of omichmyle does not produce a violet colour
with nitrate of iron in the same manner as salicylous and salicylic acids ; moreover,
salicylous acid and salicin do not enter the urine as oxide of omichmyle, but as sali-
cylous acid, as has been found by Lehmann in eight experiments. Scharling hints
at the existence of a widely-diffused radical, which, in the vegetable kingdom, in
warm climates, is the starting point of the benzoyl and cinnamyl series; in cold
climates, of the salicyl compounds; and, in the animal kingdom, presents itself as
omichmyle.
3 These changes may be thus explained symbolically :
Salicin. Oxygen. Salicylic acid. Oxalic acid. Carbonic acid. Water.
Co Hy On. + 290 = 2C,, He Og + 60,0, + 200, + 17HO.
* Lehrbuch der Physiolog. Chemie, vol. 1, p. 97.
5 Natuur en Scheikundig Archief, 1839, p. 458.
342 THE SECRETIONS:
Urine of Animals.
The chemistry of the urine of animals is still in a very defi-
cient state. I shall here give the little that is known on the
subject.
The urine of carnivorous animals is, at the period of its dis-
charge, acid, but speedily becomes alkaline, in consequence of
the formation of ammonia. This observation of Hieronymi’s
is confirmed by Hiimefeld, who found that the urine of the bear
retained its acid reaction for a considerable period. Vauquelin
found a large proportion of urea, but no uric acid in the urine
of beasts of prey. Hiinefeld also missed the uric acid, but it
was detected by Hieronymi. Hieronymi carefully analysed
the urine of the lion, the tiger, and the leopard, and its compo-
sition appeared much the same in these three animals. The spe-
cific gravity of the urine of each animal varied between 1059
and 1076. It was clear, of a bright yellow colour, had a
pungent disagreeable odour, an acid reaction, and a nauseous
bitter taste ; after standing for a short time, it became alkaline.
On collecting and evaporating the urine, there was a coagula-
tion of some white flocculent matter; and as the concentration
increased, the greater part of the urea began to separate in a
crystalline form. The mixed urine of these three animals gave
the following result :
Water ‘ : ; é - 846-00
Solid constituents . - 154:00
Urea, alcohol-extract, and free lactic sia «> -dB2-20
Uric acid . , P é , 0°22
Vesical mucus ; ‘ > ; 5°10
Sulphate of potash . 1:22
Chloride of ammonium, and a little dlietie of sodium 116
Earthy phosphates . ‘ 1°76
Phosphates of soda and potash — ° ; 8:02
Phosphate of ammonia ‘ ‘ : 1-02
Lactate of potash. ; : é 3°30
The urine of herbivorous animals likewise contains a large —
quantity of urea, but no uric acid,’ there being in its place hip- —
puric acid. The urine of the horse was analysed by Foureroy
and Vauquelin: they describe it as of a yellow colour, often
A [Traces of uric acid have been occasionally detected by Fownes and other chemists’
in the urine of the graminivora. See Vol. I, p. 53.]
URINE, 343
turbid, of an unpleasant smell, and a saltish bitter taste. When
allowed to rest, a quantity of the carbonates of lime and mag-
nesia was deposited ; it had an alkaline reaction, frothed on
the addition of an acid, and had a specific gravity of from 1030
to 1050. 1000 parts contained :
Water . ‘ : 940°0
Solid constituents . é ; 60°0
Urea . ; z 70
Hippurate of soda ‘ ; 24:0(?!)
Chloride of potassium ‘ : 9-0
Carbonate of soda > ‘ 9°0
- Carbonate of lime ; i 11:0
This analysis probably requires further confirmation. I
found a larger amount of urea in the urine of a horse suf-
fering from ozna; for from 1000 parts I obtained 50 of urea;
and after the horse had fasted for four days, I still found
24°1. In the urine of another horse, the solid constituents
amounted to 10°79 of the urine, and the urea to 5-062, or about
one half of the solid residue.
From my own observations, I should say that the urine of
horses is generally of a straw colour, is at first acid, but soon
becomes ammoniacal, and then emits the peculiar penetrating
odour which is doubtless caused by the formation of a volatile
fatty acid, although I was unable to isolate it. The urine,
after it has become alkaline, is often so tenacious and viscid
that it can be drawn up in long threads. The microscopic
examination of the urine of the horse exhibits a great number
of rounded corpuscles, from the size of mucus-corpuscles to
four times that size, which burst upon pressure of the glass
slips between which the fluid is examined. Fourcroy and
Vauquelin, after evaporating the urine of the horse, separating
the urea as a nitrate, and neutralizing the acid by an alkali,
found a small quantity of reddish fat, which volatilises over the
water-bath, and is considered to be the cause of the smell and
colour of the urine.
[The urine of the horse has been recently analysed by
Von Bibra’ and Boussingault.
In two analyses of the urine of the same horse, made at dif-
ferent periods, Von Bibra found :
' Annalen der Chemie und Pharmacie, 1845, No. 1.
%
THE SECRETIONS :
1. 2.
Water i - 885°09 912°84
Solid constituents 114°91 87°16
Urea é 12°44 8°36
Hippuric acid . 12°60 1°23
Water-extract . 21°32 19°25
Alcohol-extract : 25°50 18°26
Mucus ; ; 0°05 0°06
Salts soluble in water ‘ ‘ 23°40 40-00
Salts insoluble in water . js 18°80
On two occasions the individual salts were determined, and >
1.
it was found that in 100 parts of the saline residue there were :
2.
Carbonate of lime 12°50 31°00
Carbonate of magnesia 9°46 13°07
Carbonate of potash 46°09 40°33
Carbonate of soda 10°33
Sulphate of potash ‘ 13°04 9°02
Chloride of sodium ” 6°94 5°60
Silica ; d 0°55
Loss. .. ie aie
Traces of iron were always observed, but he could never ascer-
tain the presence of fluorine. The mean specific gravity resulting
from numerous observations was 1045. The horses, in these
cases, were used for agricultural purposes, and fed on hay and
oats. ‘The prevailing opinion that, by excessive work, the hip-
puric is replaced by benzoic acid, is stated by Von Bibra to be
incorrect. Benzoic acid was scarcely ever observed, and, when
present, was only recognizable under the microscope. The
hippuric acid varied in different analyses from 15 to 5 or even ~
less in 1000 parts of urme. The secretion was always alka- —
line, and in a few minutes deposited a sediment, consisting (as
seen under the microscope) of compact vesicles. The deposit
consisted of the carbonates of lime and magnesia, with an or-
ganic compound that could not be removed by the most careful
washing. In three analyses there were found :
Carbonate of lime » 809 87°2 87°5
Carbonate of magnesia 12°1 75 8-2
Organic matter ; 7:0 53 4°3
er RT
1000 = 1000 =~ 1000 |
Boussingault’ has likewise analysed the urine of a horse —
feeding on trefoil and vetches. It was very alkaline, had a
specific gravity of 1037-3, and contained in 1000 parts: .
' Annal. de Chimie et de Physique, Septembre, 1845.
URINE. 345
Water and indeterminate matters. » 910°76
Urea , : . . 31-00
Hippurate of adit R ‘ : 4°74
Lactate of potash . ‘ A ‘ 11:28
Lactate of soda : ° : . 8°81
Bicarbonate of potash ‘ ‘ ‘ 15°50
Carbonate of lime . . ‘ , 10°82
Carbonate of magnesia , . . 4°16
Sulphate of potash . ‘ ‘ 1:18
Chloride of sodium : ‘ ‘ 0°74
Silica ‘ ; ‘ “ : 101
Phosphates ‘ , : + absent.
As several chemists have noticed, amongst the constituents
of the urine of the herbivora, ared oil on which the colour and
odour of the secretion are dependent, Boussingault endeavoured
to isolate it. He distilled upwards of 26 gallons at a single ex-
periment, but did not obtain a trace of the oil, a colourless
fluid passing over which evolved the peculiar odour of horses’
urine: hence he concluded that the odorous principle is a volatile
acid. ‘The only means by which anything like a red oil can be
obtained consists in carrying on the distillation to dryness, in
which case an oily substance is obtained, analogous to, if not
identical with some of the products of a of the
alkaline hippurates. |
Horses are not unfrequently subject to a disease which cor-
responds with diabetes insipidus, or hyperdiuresis, in man: it
has also been observed in sheep and cattle.
The following analysis of the urine of cattle was made by
Sprengel: 1000 parts contained :
Water : ; - 926°24
Solid constituents é j 73°76
Urea ; ‘ a ‘ 40°00
Albumen . : ; ‘ 0°10
Mucus - : : : 1:90
Benzoic acid ; : . 0°90
Lactic acid ‘ j x 5°16
Carbonic acid é ‘ ; 2°50
Potash. > : . 6°64
Soda . ; ‘ j 5°54
Silica ‘ ; : 0°36
Alumina . " ‘ : 0°04
Oxide of manganese . : : 0°01
Lime F A : : 0°65
Magnesia , ; é , 0°36
Chlorine . . ‘ * 2°72
Sulphuric acid : : . 4°05
Phosphorus . : é 0°70
This analysis requires further confirmation.
346 THE SECRETIONS:
The urine of cattle, just after it is passed, is clear and acid ;
it soon, however, deposits crystals of the carbonates of lime and
magnesia. It contains hippurate of soda, and a larger propor-
tion of urea than is found in human urine.
[The urine of oxen employed for agricultural purposes was
analysed by Von Bibra. The specific gravity varied from 1040
to 1032. The urine was of a dark yellow colour, perfectly
clear, and of a peculiar odour.
The following analyses were made with the urine of the same
animal at different times :
i. 2.
Water % “ . . 912°01 923-11
Solid constituents . : 87:99 76°89
Urea . 3 ; 19°76 10°21
Hippuric acid . . 5°55 12-00
Mucus . ‘ 0°07 0:06
Alcohol-extract . ? 14°21 10:20
Water-extract ; _ 22°48 16°43
Soluble salts “ a 24°42 25°77
Insoluble salts E 4 1:50 2°22
The saline residue contained:
Carbonate of lime ; : ; 1:07
Carbonate of magnesia . j : 6°93
Carbonate of potash j . See fe
Sulphate of potash , : - 13°30
Chloride of sodium ‘ ‘ P 0°30
Silica A ; ; ’ 0°35
Traces of iron, and loss Z ; 0°77
100-00
Although these salts are liable to considerable quantitative
variations, (for instance, Von Bibra, in two analyses, found
14°22 and 16% of chloride of sodium,) yet, as a general rule,
the urine of oxen contains more alkaline and less earthy
carbonates than the urine of horses.
The urea and hippuric acid varied extremely in different
analyses. The food of the oxen consisted of fresh clover and
a little hay. e
Boussingault found that the urine of a cow feeding on after-
math and potatoes, effervesced briskly on the addition of an
acid, and deposited numerous crystals of hippuric acid. Its
specific gravity was 1040, and it contained in 1000 parts:
URINE. 347
Water and indeterminate matters. ~ 921:32
Urea ‘ A . is 18°48
Hippurate of pabial ; ; . 16°51
Lactate of potash R : : 17°16
Bicarbonate of potash ; ; ; 16°12
Carbonate of magnesia ein Sstten : 4°74
Carbonate of lime : : ; 0°55
Sulphate of potash ‘ ‘ ; 3°60
Chloride of sodium : ‘ : 1°52
Silica ; ‘ ; ‘ ° traces
Phosphoric acid . : : . absent ]
Vogel found the urine of the rhinoceros turbid, and having
an odour like that of crushed ants. It grew darker after ex-
posure to the air, and became covered with a film of carbonate
of lime; it effervesced on the addition of acids. As it cleared,
it deposited a yellow sediment composed of earthy phosphates
with a little peroxide of iron and silica, which amounted to 2°72
of the weight of the urine. It then remained of a dark yellow
colour, and formed, on evaporation, a new sediment of car-
bonates of lime and magnesia, which were previously held in
solution as bicarbonates. On evaporating the urine to two
thirds of its volume, and then treating it with hydrochloric
acid, a precipitation of hippuric acid took place, amounting to
0-452 of the weight of the urine. The urine also contained
urea and the ordinary salts.
Vogel found the urine of the elephant turbid from the presence
of carbonates of lime and magnesia in suspension ; it contained
a larger amount of urea than the urine of the rhinoceros,
but, on the other hand, was devoid of hippuric acid. Brandes,
however, detected the latter constituent, partly combined with
an alkali and partly with urea.
In the urine of the camel, Chevreul found a large quantity
of urea, but no uric acid; it contained, however, chloride of
sodium, hippurate of soda, carbonate of soda, sulphate of potash
together with a little sulphate of soda, carbonate of ammonia,
and a trace of peroxide of iron: no phosphates were found in
it. On mixing it with sulphuric, nitric, or hydrochloric acid,
the urine became red,—a property due to its containing a vola-
tile oil, to which, moreover, it owes its odour.
The urine of the pig has been analysed by Lassaigne. He
describes it as being of a pale yellow colour, clear and trans-
348 THE SECRETIONS :
parent, and containing urea, sulphates of potash and soda, chlo-
rides of potassium, sodium, and ammonium, and traces of car-
bonate and sulphate of lime. Van Setten’ has communicated
a special analysis of the urine of a pig. It was yellow, almost
imodorous, and had a specific gravity of 1003.
There were contained in 1000 parts:
Water : 5 « 990-028
Solid constituents ; ‘ 9°972
Urea : : ‘ é 0°750
Uric acid. ; : : 07195
Water-extract ; ; 1:708
Alcohol-extract : / : 1:105
Resinous matter ; ; : 0°425
Albumen and mucus . a F 0°721
Lactic acid . ‘ : é 0°490
Stearin ‘ F > ‘ 0:092
Sugar ; f ; 0°375
Phosphate of soda 1:376
Sulphate of potash, chlorides of sodium & potassium 2-075
Sulphates of lime and magnesia . 0°425
Sulphate of ammonia . ‘ " 0°196
Chloride of ammonium > ~ 0:010
[The urine taken from the bladders of pigs immediately
after they were killed is described by Von Bibra as clear, nearly
devoid of odour, alkaline, and having a specific gravity of 1012
to 1010. In two cases in which he analysed it he found in
1000 parts :
1. gee“
Water ; ; . 981-96 982-57
Solid constituents , % 18-04 17°43
Urea Pe 3 a-7s)- 2°97
Alechol-extract ‘ ‘s 3°87 3°99
Water-extract ‘ . 1:42 1-12
Mucus : é 5 0°05 0°07
Soluble salts . ‘i ‘ 9-09 8-04
Insoluble salts * a 0-88 0°80
The salts in the first of these analyses consisted of :
Chloride of sodium and a little chloride of potassium 53:1
Sulphate of soda . 5 J ‘ 7°0
Carbonate of potash ‘ r ree Ys |
Phosphate of soda os,
Phosphates of lime and magnesia, with traces of
silica and iron * 8°8
100-0
1 Natuur en Scheidekundig Archiv, Deel 2.
URINE. 349
In both the above analyses he searched in vain for hippuric
or benzoic acid in three ounces of the fluid.
In two other analyses he obtained microscopic crystals of
hippuric acid on the evaporation of the ethereal solution. He
never detected even a trace of uric acid, which, considering the
mixed nature of the food of these animals, is extraordinary.
Boussingault analysed the urine of a pig feeding on potatoes
and water slightly impregnated with salt. The urine was
alkaline, very limpid, and of an extremely pale yellow colour.
Its specific gravity was 1013-6.
It contained in 1000 parts :
Water and indeterminate organic matter 979°14
Urea é ‘ : 4:90
Bicarbonate of potash. ‘ ; 10°74
Carbonate of magnesia . ' , 0°87
Carbonate of lime ‘ : ‘ traces
Sulphate of potash ° : , 1:98
Phosphate of potash ; ; ; 1:02
Chloride of sodium . . - 1:28
Alkaline lactates . . undetermined
Hippuric acid! ‘ . ‘ absent
Silica ; ; . . 0°07
The urine of the goat has been analysed by Von Bibra. The
animals from whom the fluid was obtained were confined in a
stable and poorly fed, getting sour hay, &c. The urine was
clear, of a peculiar but pungent odour, and alkaline. The spe-
cific gravity was generally 1008 or 1009. In two instances it
contained in 1000 parts:
1. .
Water . : » 980-07 983-99
Solid residue , ‘ ; 19°93 16°01
Urea : : : 3°78 0°76
Hippuric acid : > 1°25 0°88
Alcohol-extract ; > 4°54 4°66
Water-extract ; 5 1:00 0°56
Mucus j : 0°06 0°05
Soluble salts = ‘ 8°50 8°70
Insoluble salts id . 0°80 0°40
1 Thinking that the absence of hippuric acid might be dependent on the diet,
Boussingault mixed green trefoil with the potatoes: the result was, however, still
the same.
350 THE SECRETIONS:
The ash consisted of:
Carbonate of magnesia with a little carbonate oflime 7°3
Sulphate of soda . . . « 25°0
Chloride of sodium ; : i ee
Carbonate of soda with a little carbonate of potash 53°0
100°0
Here we remark, as in the urine of oxen, a considerable excess
of the alkaline carbonates over the alkaline earths. The hip-
puric acid seemed very variable, sometimes equalling the urea
in amount. |
Vauquelin analysed the urine of the beaver. He found in
it the bicarbonates of lime and magnesia, and hippurate of
soda, but no phosphates or uric acid. He also detected the un-
decomposed colouring matter of the bark of the willow (the
ordinary food of the beaver) in the urine; for he found that a
piece of cloth which had been previously saturated with alum,
took up the same colour from soaking in the urine as from lying
in a decoction of the aforesaid bark.
The urine of rabbits and guinea-pigs is much the same: it
has an alkaline reaction, froths on the addition of an acid, and,
when exposed to the air, throws down a sediment of carbonate
of lime: it contains urea and the salts which are generally met
with in the urine of the herbivora.
[The urine of the hare has been examined on two occasions
by Von Bibra. The first analysis was made in December. By
external pressure on the region of the bladder he was enabled
to collect about three pints from seven or eight hares. This
was divided into two portions, one of which was evaporated and —
incinerated, the other tested for hippuric acid, which was found
to be present in small quantity, forming 0°0072 of the urine.
The ash contained :
Chloride of sodium with a little chloride of potassium 7:12
Sulphate of soda . : : - 16°82
Carbonate of soda ‘ : : 9°84
Phosphate of soda ee oe « , $905
Phosphates of lime and magnesia ; - 1317
100-00
URINE. 351
The urine was turbid and alkaline, depositing a white sedi-
ment of minute globules, much smaller than those occurring
in the urine of the horse, and consisting, for the most part, of
phosphate of magnesia. The urine similarly obtained in the
month of June had a faint alkaline reaction, and, in the course
of six hours, crystals of ammoniaco-magnesian phosphate were
observed on the surface. Its specific gravity was 1050, and it
contained in 1000 parts:
Water . y > - 912°86
Solid constituents . ; : 87°14
Urea . ‘ x 8°54
Hippuric acid . ; microscopic crystals
Alcohol-extract . é : 9°58
Water-extract g ; i 32°68
Soluble salts J ‘ 5 23°70
Insoluble salts . Z 5 12°64
The ash consisted of :
Chloride of sodium with a little chloride of potassium 22°49
Sulphate of soda 4 ‘ ‘ 29°97
Carbonate of soda - ee ‘ 8°73
Phosphate of soda ° ‘ : 4°39
Phosphate of lime . é ; 12°00
Phosphate of magnesia. : : 22°42
100°00
The difference in the amount of earthy phosphates in these
analyses is easily accounted for when we consider the different
nature of the food in winter and summer.
Von Bibra obtained a minute quantity of a substance closely
allied to humic acid in most of his analyses of the urine of the
herbivora. |
The urine of birds, which is discharged from the cloaca as
a white pulpy mass and soon hardens when exposed to the air,
is remarkable for the large quantity of urate of ammonia which
it contains. The urine of birds of prey contains urea, and a
peculiar green colouring matter which is not found in the urine
of graminivorous birds.
Vauquelin and Fourcroy found that, in the ostrich, the uric
acid amounted to one sixtieth of the weight of the urine; there
were also present sulphates of potash and lime, chloride of
ammonium, an oily substance, a peculiar animal matter, and
probably acetic acid. The urine of the parrot is, according to
J. Davy, very similar to that of serpents.
Be
352 THE SECRETIONS:
The urine of serpents is excreted as a white, pultaceous,
earthy mass, which soon stiffens when exposed to the air. It
is composed, for the most part, of uric acid in combination
with potash, soda, and ammonia, together with a little phosphate
of lime. It contains no urea, since, upon digesting it in alco-
hol, a yellow extractive matter is taken up, in which no crystals
of urea can be detected.
On the other hand, Berzelius directs our attention to the
circumstance that Cap and Henry have obtained urea from that
source, after having saturated the uric acid with hydrated
baryta.
[For an analysis of the urine of the rattle-snake, see Vol. I,
p. 53, note. |
The urine of the bull-frog (rana taurina) consists, according
to J. Davy, of a fluid of specific gravity of 1003, which con-
tains urea, chloride of sodium, and a little phosphate of lime in
solution. The urine of bufo fuscus had a specific gravity of 1008 ;
it contained a larger proportion of urea than the urine of the
frog, together with chloride of sodium and phosphate of lime.
In the urine of testudo nigra, which was examined by Magnus
and J. Miller, there was no uric acid; on the other hand, there
was 0°12 of urea, with a brown colouring matter which was
soluble in water, spirit, potash, and hydrochloric acid.
[The urine of a land-tortoise (testudo tubulata), which had
been kept without food for some months, has been recently
examined by Marchand.’ It had a faintly acid reaction, and
resembled pus in appearance. He collected 1337 grains, con-
sisting of ;
Or in 1000 parts;
Water ; A , 1271 950°64
Solid constituents ‘ : 66 49°36
Urea ‘ ; : 8°5 6°40
Uric acid. : ‘ 23°0 17°25
Hippuric acid ° ‘ none
Salts and indeterminate organic matter 34°5 25°70 ]
A small quantity of brown liquid fat, with a strong urinous
odour, was taken up by ether. ]
* Erdmann und Marchand’s Journ, 1845, iv, 4,
353
CHAPTER VIII.
THE SECRETIONS OF THE LACHRYMAL, MEIBOMIAN, AND
CERUMINOUS GLANDS.
The Tears.
Tue glandule lachrymales are two conglomerate acinous
glands which secrete a limpid fluid, containing a very small
proportion of solid constituents, and forming the tears. ~ They.
are for the purpose of preserving the cornea of the eye in a
state of moisture, and their secretion is much increased by in-
tense feelings either of joy or grief.
The tears have not yet been subjected to an accurate analysis,
partly perhaps from the subject being one of little interest in
a scientific point, and partly from the difficulty of obtaining a
sufficient quantity.
When examined under the microscope, the tears exhibit a
small quantity of pavement epithelium and a few mucus-cor-
puscles swimming in a clear fluid. They have a slightly saline
taste, (much like that of the perspiration that exudes from the
forehead,) and change red litmus-paper to a pale blue.
The only chemical examination of the tears that can be de-
pended on is that of Fourcroy and Vauquelin, who assert that
they resemble in their constitution the aqueous humour of the
eye. The solid constituents amount to only 19, and consist prin-
cipally of chloride of sodium and of a yellow extractive matter
which is not perfectly soluble in water: it is not improbable
that the insoluble portion arises from the fatty-mucous secretion
of the meibomian glands. The mucus also into which, accord-
ing to those chemists, the extractive matter of the tears is con-
verted previously to its being perfectly dried, may be, as Ber-
zelius conjectures, the secretion of the meibomian glands. With
regard to this latter secretion,—the gummy secretion of the
eyes, we know even less than of the tears: it seems to consist
principally of a mucous matter and of fat.
II. 23
354 THE SECRETIONS:
Cerumen.
The glandule ceruminose, which are situated in the external
skin of the meatus auditorius externus, secrete the ear-wax
(cerumen), a peculiar salve-like matter, which is thrown out as a
yellowish milk.
If a small portion of ear-wax is pressed between two slips of
glass and observed under the microscope, we shall find a quan-
tity of variously-grouped lamellz lying in a tolerably homoge-
neous yellow mass. In these lamellz, the practised observer
will easily recognize pavement epithelium. On mixing the ear-
wax with water, which may be readily done, a sort of yellowish
milk is obtained, in which, with the microscope, we may observe
colourless fat-vesicles, epithelium-scales, and sometimes rhombic
crystals, very like cholesterin. The yellow colour of the cerumen
does not belong to the fat, but to the matter which is soluble
in water. Berzelius has made the following observations on the
cerumen. Ether takes up fat from the mass which swells in it,
and becomes as soft as goose-grease ; it has not an acid reaction,
consists of stearin and olein, and contains a substance which,
after saponification, gives off a strong smell of sweat. The
fatty acids which are liberated on the addition of hydrochloric
acid melt at 104°. After the fat has been removed, alcohol
takes up a yellow substance from the ear-wax, which, on eva-
poration of the alcohol, is left as a glossy matter, perfectly
soluble in water, and of a very bitter taste. It may be en-
tirely thrown down from its aqueous solution by the neutral
acetate of lead and by chloride of tin; on the other hand,
nitrate of silver does not even render it turbid; hence there
can be no chlorides present. Upon incinerating this mass,
there remains an ash, which consists of the carbonates of pot-
ash and lime. The portion not dissolved by alcohol yields to
water a small amount of yellowish matter, which is very similar
to the soluble matter obtained in a similar manner from the other
fluids of the animal body, and has a piquant taste; but it is
distinguished by the circumstance that neither lime-water, basic
acetate of lead, bichloride of mercury, nor tannic acid preci-
pitate it. :
The portion of the ear-wax which is insoluble in ether,
CERUMEN. 355
alcohol, and water, is, next to the fat, the largest: acetic acid
causes it to swell, and only takes up a very small portion of an
albuminous matter. The residue (consisting evidently of nothing
but epithelium-cells) is partly soluble in free potash, from which
it cannot be again precipitated by acetic acid; ferrocyanide
of potassium causes no precipitate in the acid solution, but
infusion of galls a very copious one. Another portion of the
residue, when heated with a concentrated solution of potash,
enters into combinations which are not soluble in that fluid,
but which are soluble in water, similar to what is observed in
the urine.
This investigation shows that the ear-wax is an emulsive com-
pound, which contains a soft fat, albumen, a peculiar extractive
bitter matter, epithelium-scales, lactate of lime, and an alkaline
lactate, but no chlorides and no phosphates soluble in water.
356
CHAPTER IX.
SECRETIONS AND FLUIDS OF THE GENERATIVE ORGANS.
1. Secretions of the male generative organs.
SEMEN.
Tue seminal fluid which is formed in the testicles and is
conveyed along the vas deferens, is a thick, whitish, glutinous
mass possessing a peculiar odour, and when examined under
the microscope is found to be composed of a clear fluid, in
which an immense number of minute caudate molecules, the
spermatozoa, appear to be moving about at will. (Fig. 33.) In
addition to the spermatozoa, seminal granules are likewise to be
seen, which, according to Wagner, are rounded, fine granular
corpuscles of ,1; — 4, of a line in diameter, and a few epithe-
lium-scales.
The spermatozoa occur in the semen of nearly all animals:
they are elliptic in man, but assume various forms in different
classes of animals,
The chemical analysis of the semen, although not an uninter-
esting subject, seems little calculated to throw any light upon the
remarkable process that is recognized in the term impregnation.
We cannot even form any conjecture regarding the connexion
and the reciprocal effect that must take place between the
fructifymg semen and the ovum which is to be fructified ; and
although we cannot doubt that there are certain chemical pro-
cesses going on, since the act of impregnation is succeeded by —
a change not only of form but of matter, we have as yet but
little prospect of investigating the subject successfully, in con-
sequence of the insufficiency of our resources.
The seminal fluid at the period of emission is somewhat
turbid, and is mixed with the mucous secretion of the prostate,
from which it cannot be separated. It has not always the same
SEMEN. 357
consistence, and the longer it remains in the vesiculz seminales,
the more consistent it becomes.
The investigations of Vauquelin, Jordan, and John have
elicited the following results, which, however, do not sufficiently
explain its chemical relations. When the seminal fluid has
been allowed to rest for some time, it becomes clear, more
fluid, transparent, and almost entirely soluble in water; if, on
the contrary, it is at once dropped into water it sinks, and
instead of perfectly dissolving, it coagulates in threads, in the
same manner as if it had been treated with alcohol. This
coagulated matter is readily soluble in acetic acid, and the
solution gives a copious precipitate on the addition of ferro-
cyanide of potassium.
On allowing the coagulum to remain in water, it gradually
dissolves therein, leaving a residue of a few flocculi. The so-
lution, if rapidly evaporated, gives off the peculiar odour of
‘semen, and leaves a clear glossy residue, which is opaque in
water, and only partially dissolves in that fluid. From the
portion which is insoluble in water, alcohol takes up extractive
matter; and the portion insoluble in alcohol dissolves in boiling
water, leaving a mucous residue : the solution is precipitable by
acetate of lead, chloride of tin, bichloride of mercury, nitrate
of silver, and infusion of galls.
In semen which had stood for some time, Vauquelin found
four-sided prisms arranged in stellar groups, and terminating in
long four-sided pyramids, which Berzelius considers to have
been ammoniaco-magnesian phosphate. Ifthe semen is allowed
to evaporate it becomes covered with a film, in which white
points may be observed, which are supposed by Vauquelin
to be composed, as well as the before-mentioned prisms, of
phosphate of lime. When the whole of the water has been
removed by evaporation, there remains a yellow, transparent,
elastic mass, which amounts to 102 of the weight of the semen.
Vauquelin, moreover, states that fresh semen is soluble in
all acids, from which it cannot be precipitated by alkalies, and
conversely, that it is soluble in the alkalies, from which it is
not precipitable by acids: chlorine-water, however, coagulates it
to such a degree as to render it insoluble in water or acids. If
the semen at the moment of emission is allowed to fall into
alcohol, and to remain in it for some time, it coagulates tho-
358 THE SECRETIONS:
roughly, becomes opalescent, and resembles a long thread: it
is now incapacitated from returning to a state of solution like
fresh semen, but remains, on being dried, fibrous, snow-white,
and opaque. It gradually softens in water, but even at the
boiling point only a very small portion dissolves in that fluid ;
it swells, however, like mucus. If the water in which it has
been boiled is evaporated, a white matter remains, which is
partly soluble in cold, partly in boiling water, and the solution
is freely precipitable by tannic acid. That portion of the semen,
after coagulation by alcohol, which is not soluble in boiling
water, will also resist the action of dilute solution of potash at
a moderate temperature; it will, however, dissolve on being
heated with a concentrated solution of caustic potash, and it
cannot be again precipitated from this solution by acetic acid.
With concentrated sulphuric acid it forms a yellow fluid, with-
out the application of heat; on the addition of water it is pre-
cipitated with a white colour, and the precipitate is not soluble
in an excess of water.
With acetic acid the coagulum becomes gelatinous and trans-
parent ; on being diluted and warmed it dissolves, but does not
form a perfectly clear fluid: this is only rendered turbid by fer-
rocyanide of potassium, is not precipitated by bichloride of
mercury or carbonate of ammonia, but by tannic acid is thrown
down in light floccules, which continue for a long time in
suspension.
From these researches Berzelius concludes that the semen
contains a peculiar matter which may be obtained in two sepa-
rate states depending upon whether it be projected into water
or alcohol. When coagulated by alcohol it has an external re-
semblance to fibrin, and, moreover, like that substance, it can
be precipitated from its acetic-acid solution by ferrocyanide of
potassium : on the other hand, it differs from it in its solubility
in nitric acid, and in its power of resisting the soluble action of
a cold solution of potash.
On heating the residue of the semen it becomes yellow,
emits an odour of burnt horn, gives off a considerable quantity
of ammonia, and leaves a carbonaceous mass which is not ©
easy of incineration, and contains carbonate of soda, chloride
of sodium, and phosphates of lime and magnesia. Vauquelin
assigns the following composition to the seminal fluid.
SEMEN. 359
In 100 parts there are—
Peculiar extractive matter - P 6
Phosphate of lime . ° P 3
Soda ‘ s ‘ . 1
Water : ; ; . 90
According to John, the seminal fluid contains a substance
resembling mucus, with small quantities of a peculiar form of al-
bumen, of a substance slightly soluble in ether, of soda, phosphate
of lime, chloride of sodium, sulphur, and a volatile odorous
principle.
The prostatic fluid which mixes with the semen of the male,
at the moment of emission, has never yet been procured in
sufficient quantity for analysis: it forms an almost clear fluid,
which may be drawn out in threads.
2. Secretions of the female generative organs.
LIQUOR AMNII.
The liquor amnii surrounds the foetus: at the period of de-
livery the membranes which contain it give way, and it escapes
externally. Although it has been submitted to numerous ana-
lyses, its nature, even now, is not clearly understood. Human
liquor amnii is turbid, and holds in suspension flocculi of caseous
matter, arising from the vernix caseosa with which the foetus
is covered. Its specific gravity is 1005, and it contains from
1-22 to 1°62 of solid constituents; but according to Fromherz and
Gugert, as much as 3°, It has avery decided alkaline reaction,
but the indications of this reaction disappear when the test paper
is dried ; it is consequently dependent on free ammonia.
Alcohol took up extractive matter from the residue of the
liquor amnii, and there remained, according to Fromherz and
Gugert, a quantity of albumen, salivary matter (ptyalin), and
casein.
When evaporated to the consistence of a syrup, and treated.
with hydrochloric acid, acid flocculi separated themselves, which
were recognized, after a careful analysis, as benzoic acid.
Berzelius, however, supposes that it might have been hippuric
acid. After the fluid had been filtered, and the above matter
removed, nitric acid was added and the mixture submitted
he
360 THE SECRETIONS:
to the action of cold. Verrucose crystals then separated them-
selves, which were assumed to be composed of nitrate of urea,
without being further analysed.
The salts of the liquor amnii are described as consisting of
chloride of sodium in large quantity, phosphate, sulphate, and
carbonate of soda, sulphate of lime, and a small amount of
potash-salts.
The analyses of Voigt, which were made with the liquor amnii
of women who had died in various stages of pregnancy, give
discordant results, probably as Berzelius supposes from the cir-
cumstance of the fluid at the full time being different from
what it was in the early stages of pregnancy. The liquor amnu
at the fourth month was not turbid, had an insipid taste, a
specific gravity of 1018°2, a neutral reaction, frothed upon
being shaken, coagulated on boiling, was precipitated by bi-
chloride of mercury and tannic acid, and less copiously by
perchloride of iron and acetate of lead. After coagulation by
boiling, the fluid which had been cleared by filtration, was
strongly precipitable by nitric acid, while it was very little
affected by chloride of barium, lime-water, ammonia, or oxalate
of ammonia. Perchloride of iron, and chloride of platinum,
produced no effect upon it.
The liquor amnii at the sixth month was turbid, yellowish,
viscid, had a specific gravity of 10092; when heated to the
boiling point gave a mucous coagulum which could not be se-
parated by filtration, and its behaviour towards reagents was
the same as in the former case. As to casein, ptyalin, urea,
benzoic and hippuric acids, Voigt was as unable to find them
as carbonate of ammonia or sulphuret of ammonium, and he
conceives that at least some of these substances may arise from
the fetal urine which becomes mixed with the liquor amnii
previous to delivery. Voigt’s view of the composition of the
liquor amnii is as follows :
At the 4th month. At the 6th month.
Water ‘ ‘ - 979°45 990°29
Aleohol-extract and lactate of soda 3°69 0°34
Albumen ; ‘ 10°77 6°67
Chloride of sodium ; Ee 2°40
Sulphate and phosphate of lime. 0°14 0°30
LIQUOR AMNII. 361
[Four specimens of liquor amnii examined by Dr. Rees', ex-
tracted from four individuals in the 74 month of pregnancy,
contained the same constituents. The specific gravity varied
from 1008°6 t01007. They were alkaline, contained urea, and the
same salts as occur in the blood. One specimen contained :
Water ; é ; : : - 984°98
Solid constituents ; E k : ‘ 15°02
Albumen with traces of fatty matter , ‘ : 1°80
; Salts. ’ x 2°80 ‘
Extract soluble in water Organic matter, chiefly albumen 3°22 6-02
Salts 7 é 2°80
Do. soluble in water and alcohol 4 Organic matter, chiefly 7:20
lactic acid and urea 4°4
The caseous matter floating in the liquid contained cho-
lesterin. i
The liquor amnii at the full time has been recently analysed
by Mack,? who obtained two specimens for examination from
Dr. Mikschik. The fluid in both cases was perfectly pure, the
membranes being ruptured as they projected from the external
organs.
The quantity of the fluid in the first case amounted to a little
more than an ounce and a half; it was turbid, with white flocculi
of vernix caseosa in suspension; it had a sickly odour, and a
faintly saline taste. Under the microscope there were seen
isolated mucus-corpuscles, with pavement and ciliated epithelium.
The specific gravity was 1006'3, and the reaction faintly alkaline.
The fluid coagulated slightly on heating, and became covered
with a thin membrane during evaporation.
The amount of fluid obtained in the second instance was
slightly above two ounces ; the specific gravity was 1004°7 ; the
reaction alkaline; and the other physical characters the same
as in the former case. In 1000 parts there were contained :
1. 2.
Water é j 985°147 988°123
Solid constituents ‘ 14°853 11877
Fat F ‘ 1°250 0°132
Alcohol-extract ; 5°251 4°752
Water-extract : 4°651 4°352
Matter insoluble in water 3°701 2°641
Sulphate of lime . 1:722 1°672
Chloride of sodium and : 9°333 : 9-236 fixed salts.
carbonate of soda 7611 7-564
1 Phil. Mag. (3d series) vol. 13, p. 395.
2 Heller’s Archiv fir physiol. und pathol. Chemie und Mikroskopie, vol. 2, p. 218.
362 THE SECRETIONS:
Urea and hippuric acid were carefully, but unsuccessfully, —
sought for in both specimens; neither could carbonate or hy-
drosulphate of ammonia be detected.
It is suggested by Mack that the discrepancies in the results
obtained by other chemists may be owing to their having ex-
amined the fluid mixed with blood, mucus, or urine. Two years
ago he analysed a specimen (under the superintendence of Dr.
Ragsky) which contained much blood and mucus. The fluid
was of a dirty yellow colour, and deposited a sediment. Under
the microscope there were seen blood- and mucus-corpuscles,
with epithelium-cells. The specific gravity was 1011°2.
In 1000 parts there were contained :
Water . . - 984131
Solid constituents - 15°869
Fat . 4 0°4984
Alcohol-extract ‘ 0°8529
Water-extract . 4:0998
Substances insoluble in water 10°4177 ]
Several analyses have been made of the liquor amnii of
animals. A very remarkable observation on this subject was
made by Prout. The liquor amnii of a cow in an early stage
of pregnancy was of a yellow colour, and opaque in consequence
of holding a large quantity of glittering particles in suspension ;
its taste was like that of fresh whey, it smelt like fresh milk, and
was neutral to test paper. Upon heating it to the boiling point it
coagulated; coagulation was, however, prevented by the addition
of acetic acid: with chloride of barium it gave a copious pre@i-
pitate. The fluid which had been boiled gave, after filtration and
evaporation, crystallizable sugar of milk, from which alcohol took —
up a yellow extractive matter with some lactates. Berzelius
remarks that the presence of sugar of milk in the liquor amnii
at an early period, is of the greatest physiological interest, since
it doubtless contributes to the nutrition of the foetus. Prout
gives the following as the composition of 100 parts of this
fluid :
Water ‘ ‘ p ;. 97°70
Albumen i ss ‘ ‘ 0°26
Alcohol-extract and lactates o ‘ 1°66
Water-extract, salts, and sugar of milk ‘ 0°38
In the liquor amnii of a mare which Voigt examined, he also
aa
FLUID OF THE ALLANTOIS. 363
found no urea. It had a specifie gravity of 1005:1, and left
a solid residue of 1:452, half of which was soluble in alcohol :
the portion which was not soluble in it consisted of albumen,
chloride of sodium, and sulphate of lime.
In the liquor amnii of a cow, which was viscid, very thick,
of a yellow colour, and had a saltish taste and an alkaline reac-
tion, Lassaigne found albumen, mucus, a yellow matter analo-
gous to bile, chlorides of sodium and potassium, carbonate of
soda, and phosphate of lime: no extractive matters are enu-
merated amongst the constituents. The flocculi which are
suspended in the liquor amnii of the cow are said by this che-
mist to be composed of albumen with 0°27 of their weight of
oxalate of lime.
I have already treated of vaginal mucus, menstrual blood,
and the secretion of the mammary glands ; it still remains for
me to offer a few remarks on the fluid of the allantois. The
allantois with its inclosed fluid is absent in the human em-
bryo: it is found, however, in many animals. It is situated
above the amnion, and it is between these two membranes that
the urine of the foetus collects, being conveyed there by the
urachus from the urinary bladder, and constituting the fluid of
the allantois. |
It has several times been the object of chemical. investiga-
tion; it is clear, of a brown-yellow colour, of a bitter and saltish
taste, and reddens litmus paper. Its specific gravity, according
to Dzondi, fluctuates between 1003 and 1029. On evapora-
tion flocculi are precipitated, which consist of albumen and
phosphate of lime. The residue left after evaporation is very
slightly soluble in alcohol, which takes up a yellowish-brown
acid extractive matter, and white nacreous crystals which retain
their form upon mixing the residue obtained by evaporation with
water, and constitute allantom, which was first termed by
Vauquelin, amniotic acid, and by Lassaigne, allantoic acid.
The substances remaining in the watery solution, are chloride
of sodium, alkaline lactates, a salt of ammonia, and extractive
matters. From the portion insoluble in alcohol, water takes up
sulphate and phosphate of soda, phosphates of lime and mag-
nesia, and a brown extractive matter which is copiously precipi-
tated by infusion of galls. Whether the fiuid of the allantois
364 THE SECRETIONS :
contains urea as well as allantoin is a point not yet ascer-
tained.’
In speaking of the liquor amnii we mentioned that the
floccules which are seen swimming in it are derived from the
peculiar caseous matter, the vernix caseosa, which invests the
foetus. I shall avail myself of this opportunity of offering
a few remarks upon this substance. Upon examining this ca-
seous investment with the microscope, I found, especially when
it had been previously diluted with water, a very large quantity
of pavement epithelium, numerous fat-vesicles, and some but
not a great many crystals, which in part resembled cholesterin,
and in part distinctly assumed the form of ammoniaco-magne-
sian phosphate.
Upon examining the vernix caseosa by the microscope, with-
out previously diluting it with water, indications of a large
number of crystals presented themselves; they disappeared,
however, on the addition of water, and I concluded that this
peculiar appearance was caused by epithelium-cells.
According to Fromherz and Gugert the vernix caseosa con-
sists of a mixture of fat resembling cholesterin with coagulated
albumen. Microscopic investigation at once shows that what
was considered by these observers as albumen, was at any rate
for the most part epithelium, and that a considerable quantity
of fluid fat must be present besides cholesterin. They also
state that ether takes up from the vernix caseosa a fat which
crystallizes in glittering leaves, which does not admit of sapo-
nification, and does not melt in boiling water. Cold water
takes up a little of the portion which is insoluble in ether, and
boiling water takes up a yellowish substance with an alkaline
reaction, which they regarded as ptyalin, but which Berzelius
conceives to be most likely albuminate of soda. The residue
is evidently epithelium, since it is insoluble in a cold, but
soluble in a boiling solution of potash.
[The most recent observations on the vernix caseosa are those
of Dr. Davy.” He states “that its specific gravity (after the
air that is entangled in it is removed) is 1003-9. It is very
! See vol. I, p 57. 2 Medico-chir. Trans. 1844, p. 193.
ens tid
ope H rit
OATS oe ae 1 a >
» ae ayant
, E ; eer a
PEN ER ene Te eae ape ne et ji bd? d
VERNIX CASEOSA. 365
retentive of water. It required ten hours’ exposure over the
steam-bath, to expel from eight grains the whole of the water
belonging to it, when it was reduced to 1:77 grain. A spe-
cimen of great purity taken from a healthy infant immediately
after birth was found to consist of :
Water . : a 77°87
Olein . ’ “ 5°75
Margarin ch . 3°13
Epithelium-scales . ‘ 13°25
100-00
“ A portion of the same was incinerated: it burned with a
bright flame and left a very small quantity of white ash,
hardly 3th of a grain, although 40 grains was the quantity con-
sumed, weighed before drying. This ash, in a drop of dilute
muriatic acid, dissolved, emitting a distinct smell of sulphuretted
hydrogen ; and the solution was clouded by adding a little am-
monia, indicating the presence of a minute portion of phosphate
of lime and sulphur—the latter in union probably with lime or
potash.” | }
366
CHAPTER X.
THE INTESTINAL EXCRETIONS.
Tuat portion of the food which is not taken up by the absor-
bents which are everywhere distributed between the stomach
and the large intestine is again discharged from the system as
feeces.
The feeces must materially vary with the species of food that
is taken, and with the energy of the digestive powers. When we
see that many men are kept in a better and more desirable con-
dition on a very small quantity of food, than others who take
a larger amount of nutritious aliment, we must necessarily
conclude that in the former case everything which could possibly
serve for nutrition was extracted and suitably employed, while
in the latter we must suppose that only a small portion of
nutritive matter was taken up from the large quantity of food,
and that the greater portion was discharged with the feces.
In accordance with what I briefly stated respecting the fluid
secretions of the chylopoietic viscera in relation to the process
of digestion, it follows that after food has been taken the feeces
must contain (]) that portion of the food which has not been
absorbed, and (2) the addition which is received in the form of
secretion from the intestinal canal and its appendages, between
the mouth and the anus. These consequently are, those sub-
stances which are altogether insoluble in the digestive fluids,
as for instance, vegetable fibre; those which, although capable
of digestion, have from various causes not been digested, as for
instance, the flesh of old animals, sinews, ligaments, fat, &c. ;
the bile, more or less modified, together with biliphzin and
cholesterin, the mucus of the intestinal canal, and a consi-
derable amount of salts, amongst which ammoniaco-magnesian
phosphate is especially distinguished by its well-defined crystals.
The feeces of adults are, however, different from those of the
RP ee eee eee
, a a poe ee?
we eee
Lk . x
et en A eR od:
ia
Se) Gee ee ee ee he, eee ee Pe oe
ie
ailre Tis
FACES. , 367
foetus and the infant at the breast, as the following analyses
will show.
I have made an analysis of the feces of the fcetus,—the
meconium; it constituted a thick, glutinous greenish-black
mass, had a sweetish insipid odour, and a corresponding taste :
when examined with the microscope, after being diluted with
water, a very large number of epithelium-cells and numerous
rhombic plates, resembling crystallized cholesterin could be
seen, besides a green-coloured amorphous mass which was pre-
sent in considerable quantity.
A small number of minute rounded corpuscles, which upon
floating about, allowed me to recognize their flattened shape,
appeared to be discoloured blood-corpuscles.
Ether took up, from the dried meconium, a firm white fat,
—cholesterin ; alcohol took up some extractive matter with
bilifellinic acid; spirit took up a substance reacting exactly lke
casein, together with some bilifellinic acid ; finally, alcohol aci-
dulated with sulphuric acid took up some green bile-pigment.
There remained cells, mucus, and probably albumen.
100 parts of the dried meconium contained :
Analysis 149.
Cholesterin ; 16:00
Extractive matter and bilifellinic acid e 14:00
Casein ‘ : ‘ 34°00
Bilifellinic acid and bilin ‘ : 6°00
Biliverdin with bilifellinic acid . ‘ 4°00
Cells, mucus, albumen ‘ ; 26°00
The ash of meconium consists, according to Payen, of an
alkaline carbonate, and phosphate of lime.
[Dr. Davy! has recently examined the meconium both micro-
scopically and chemically. “ It may be advantageously examined.
by the microscope, either mixed with water or in a saturated
solution of common salt, or merely compressed between two
plates of glass. Using either method, its appearance is much
the same,—it exhibits a confused mixture of globules, plates,
and molecules.
«The globules, about 1-3000th of an inch in diameter, are very
' Medico-Chirurg. Trans. 1844, p. 189.
368 _ THE EXCRETIONS :
abundant, and form the principal mass of the whole. Judging
from their form and size, their insolubility in water and alcohol,
they may be inferred to consist chiefly of mucus.
“ The plates, which are tolerably abundant, are of two kinds:
one kind is of irregular form, somewhat granular, varying in
size from about 1-2000th to 1-1000th of an inch in diameter,
insoluble in water, alcohol, whether hot or cold, and the dilute
acids and alkalies after the manner of epithelium-scales, which
we believe them to be. The other kind are of a regular form,
chiefly rhomboidal, of great thinness and perfect transparency,
insoluble in water and acids and cold alcohol, but readily so-
luble in hot ;—properties sufficiently indi¢ative of cholesterin.
“The molecules vary in size from 1-8000th to 1-20,000th of
an inch in diameter ;—and, as they are insoluble in water, and
in most part soluble in an alkaline ley, they may be considered
as consisting chiefly of fatty matter. They constitute a very
small part of the whole.
“ Besides these ingredients admitting of being distinguished
by the microscope, to which the meconium owes its thick con-
. sistency and viscid nature, there is another portion, the soluble
part, with which they are imbued, and from which the mass
derives its colour and taste, and probably its power of resisting
putrefaction, and which seems identical with the colouring and
sapid matter of bile, being soluble in water and alcohol.’
“The specific gravity of meconium, deprived of air, exceeds
that of water. It sinks in a saturated solution of common
salt of the specific gravity of 1148.
“This mixture of meconium and brine affords, after standmg
for some time, a kind of mechanical analysis or separation of
its ingredients. The mucus-globules and epithelium-scales,
dyed of a dark green by the colouring matter, find their place
of rest at the bottom, whilst in the supernatant fluid, slightly
turbid, and of a bright greenish-yellow hue, numerous plates of
cholesterin, and a smaller number of fatty globules and mole-
cules are found suspended.”
! This property of meconium is remarkable. After more than three months a
portion put by in a bottle containing a good deal of air, closed to prevent the drying
of the substance, was found unaltered in colour, and presenting the same appearance
under the microscope as when first examined ; the only perceptible difference was
that its upper surface was covered with a mould or mucor, like that of cheese, formed
of connected globules, each about 1-5000th of an inch in diameter.
Sr abs
Od Araki SRA ee os OS cd TURE rik ko,
ort ey a
FACES. 369
Every specimen examined by Dr. Davy, (some voided just |
after birth, others taken from the intestines of still-born chil-
dren,) was very similar, composed chiefly of mucus-globules and
epithelium-scales, and of biliary matter containing, besides the
colouring and sapid matter of the bile, a small portion of cho-
lesterin, of margarin, and olein, with a little free acid, probably
the carbonic, judging from the absence of a precipitate on the
addition of nitrate of silver, and from the circumstance that
the redness imparted to litmus paper was removed by heat.
A specimen obtained from a healthy child immediately after
birth, contained :
Water , : j 727
Mucus and epithelium- at ‘ ‘ 23°6
Cholesterin and margarin P 0-7
Colouring and sapid matter of bile, aid olein . 3°0
100-0
A portion of the same meconium was incinerated. It burned,
after becoming semifluid, with a bright flame, and left -699 of
reddish ash, chiefly peroxide of iron and magnesia, with a trace
of phosphate of lime and chloride of sodium: the magnesia
seemed to be the predominant ingredient and uncombined. |
I have likewise analysed the feces of an infant six days old,
nourished on its mother’s milk. They were pultaceous, of a
yellow colour, had a strong acid odour, and both smelled
and tasted like sour milk. When the mass was diluted with
water, I could observe through the microscope an extraordinary
number of fat-vesicles; there were no epithelium-cells, but I
found an amorphous consistent matter resembling coagulated
albumen or casein. The proportion of fat was so large that on
evaporation the whole mass became fluid. Ether took up this
fat, which appeared to be more solid than butter, but contained
no cholesterin, since it was perfectly saponifiable. After
the removal of the fat, the feeces did not yield any extractive
matter to alcohol, but gave’ biliverdin to alcohol acidulated with
sulphuric acid. On extracting this colouring matter with ether,
a considerable quantity of green fat was taken up.
II. 24:
370 THE EXCRETIONS:
100 parts of the dried fecal mass contained :
Analysis 150.
Fat ‘ 5 - 52°00
Bile-pigment with fat . - 16°00
Coagulated casein with mucus . 18°00
Moisture and loss ° - 14:00
No accurate analysis of the excrements of the healthy adult
has been made, that I am aware of, since 1804, when Berzelius
investigated the subject : I shall therefore give his results. The
excrements mix very gradually with water, which they render —
mucous and turbid, and which is a long time clearing itself :
on decanting the mixture, there remains a grayish-brown re-
sidue consisting of insoluble vegetable matter, through which
a thick grayish-green fluid permeates, depositing a copious
sediment when placed in a corked bottle.
The thinner supernatant portion can only be filtered with
difficulty. If the fluid is very concentrated, and is at the same
time clear, it will soon be observed to become dark, a change
of colour apparently due to the action of the atmosphere.
When this fiuid is evaporated, crystals of ammoniaco-magne-
sian phosphate gradually form on the surface; as they were not
previously apparent we may conclude that the ammonia is sub-
sequently produced. On extracting with alcohol the residue left
after the evaporation of the water, a substance of a reddish- a
brown colour is taken up, while a grayish-brown matter (A) ~
remains undissolved.
The alcoholic solution yields on evaporation a residue which — 1
forms a resinous precipitate with sulphuric acid, consisting of
bilifellinie acid with an excess of bilin, which may be separated a
by oxide of lead into bilifellinate of lead and bilin.
On distilling the mixture with sulphuric acid we obtain a
fluid which yields traces of hydrochloric but not of acetic acid:
on saturating the sulphuric acid in the residue with baryta,
after the separation of the biliary resin, and then evaporating,
and treating the dry mass with alcohol, an extractive matter of e:
a reddish-brown tint is taken up, which is apparently the cause
of the change of colour to which we have already alluded m
the concentrated aqueous solution of the feces. This sub- :
stance is soluble in alcohol and in water, is almost entirely
precipitated by the salts of tin, lead, and silver, and on the addi- i
sid aca ga
Pe ae ee ae en ee
sa A A ae Sahih
Laas asi
= ¥ ‘ a ian EF
ee, et, Bee ce ee, ee
a ae Tog het .
I a ha os a Nae
Pee ae, Teen aes
FACES. 371
tion of an acid a bright red deposit is formed. On adding a
little tannic acid it is precipitated in the form of a red powder,
and by an excess of that reagent, in greyish-brown flocculi.
The substance (A) which is soluble in water but not in al-
cohol, consists of albumen coloured brown by bile, containing,
mixed with it, alkaline sulphates and phosphates, and phosphate
of lime.
That portion of the feeces which is insoluble in water, and
remains floating on its surface, consists of a mixture of intes-
tinal mucus and of the substances precipitated by the bile: it
is very viscid, clogs up the pores of filtering paper, and dries
upon it as a glistening, brittle, and elastic coating; on being
again placed in water it softens, and, especially if any free alkali
is present, becomes viscid as before.
This mass is perfectly soluble in caustic potash, and may
be again thrown down by the addition of an acid; the fluid
then gives off an odour of bile. Ether and alcohol take up fat
and biliary resin, and yield greenish extracts. The ethereal
solution becomes turbid on the addition of alcohol in conse-
quence of the precipitation of fat; the residue left after eva-
poration melts in boiling water, leaves spots of fat on filtering
paper, and dissolves in caustic potash; hence it contains no
cholesterin. The portion left after the aforesaid extractions
with ether and alcohol, imparts to water a peculiar yellow
matter, which soon changes to a darker tint after exposure
to the air; it is devoid of odour or taste, and rapidly becomes
putrid. It is at first insoluble in alcohol, but it becomes soluble
as decay commences ; moreover when fresh it is hardly rendered
turbid by the addition of infusion of galls, but is strongly precipi-
tated by that reagent after the commencement of putrefaction.
If this substance, when quite fresh, is mixed with the solution
of fat and biliary resin which we have just described, we observe
a grayish-green precipitate which deposits itself as slowly as the
precipitate from which these substances were originally obtained.
Hence, as Berzelius remarks, we may conclude that the excre-
ments contain an insoluble combination of the constituents of
the bile, with other materials which have been added to it in
the course of the digestive process.
The analysis of human feces, sufficiently consistent to form
&
372 - ‘THE EXCRETIONS:
consistent masses, yielded to Berzelius the following results in
1000 parts :
Water | Z ; ; ‘ 733°0
Solid dhigcanata’ 3 : ; : 267°0
Bile eo . i é 9:0
Albumen r ‘ . J 9-0
Peculiar extractive matter % ; ‘ 27°0
Salts ‘ ; ; 12°0
Insoluble residue of food : , 70°0
Substances added in the intestinal canal, as much, biliary
resin, fat, a peculiar animal matter, &c. ‘ é 140°0
The salts in this analysis were determined by a separate
experiment: three ounces of fresh excrement were repeatedly
extracted with water, and the residue obtained by evaporation
was incinerated.
The ash was composed of :
Carbonate (lactate) of soda ; ‘ 3°5
Chloride of sodium ; : : 4:0
Sulphate of soda . ‘ ‘ 2:0
Phosphate of magnesia. ; : 2°0
Phosphate of lime ‘ é ‘ 4-0
15°5
We observe that there is a considerable proportion of phos-
phate of magnesia, and a much larger of phosphate of lime;
the former constituting 13°32 and the latter 26°62 of the salts.
The comparatively large amount of phosphate of magnesia may _
be partly accounted for by the use of coarse bread, which con-
tains a considerable quantity of this salt. 2
From dried excrements Berzelius obtained 15-0° of fixed
salts, of which 10° were earthy phosphates with a trace of _
sulphate of lime, 0°88 carbonate of soda, an equal quantity
of sulphate of soda with sulphate of potash and phosphate
of soda, and 1-69 silica originating from vegetable matters. — a
Nothing is said regarding the chlorides ; they were probably _
not determined. i.
[Enderlin has instituted numerous observations on human S
feeces, chiefly in reference to the salts.
A. Fresh excrements of a yellowish-brown colour, a pulpy
appearance, and an alkaline reaction, were dried and incinerated.
FACES. 373
The resulting ash was white, alkaline, effervesced on the addition
of an acid, and contained :
Tribasic phosphate of soda (a little).
Chloride of sodium.
Alkaline sulphates.
Phosphates of lime and magnesia (in abundance),
Carbonate and sulphate of lime.
Phosphate of iron (a trace).
s. Another portion of the same excrement was extracted
with water, and the brown, alkaline solution evaporated on the
water-bath.
During the process of evaporation there was formed on the
surface a tenacious, yellowish-brown film, which, when removed,
was speedily replaced.
a. One half of the evaporated aqueous extract was incine-
rated. The ash was very alkaline, effervesced briskly on the
addition of an acid, and contained :
Alkaline carbonates. Alkaline sulphates.
Alkaline phosphates. Chloride of sodium and earthy phosphates.
b. The other half of the evaporated aqueous extract was treated
with alcohol, which assumed a tint varying from a red to a -
green, and had an alkaline reaction. On evaporating the al-
coholic solution, an alkaline ash was obtained, consisting, for
the most part, of tribasic phosphate of soda and chloride of
sodium.
The membrane and other matters not taken up by alcohol,
yielded a neutral ash consisting of phosphates of lime and
magnesia, with traces of chloride of sodium and alkaline phos-
phates. |
c. The portion of excrement not taken up by water, yielded
a neutral ash consisting of :
Phosphates of lime and magnesia,
Sulphate of lime.
Traces of chloride of sodium and alkaline phosphates.
With a solution of baryta, the alcoholic solution yielded a
very bulky, yellowish-green precipitate; and, on the addition
of basic acetate of lead, there was a considerable sediment so-
luble in acetic acid, decolorization of the fluid, &c.; hence un-
changed choleate of soda was present. The occurrence of this
constituent was, however, by no means invariable ; and, gene-
374 THE EXCRETIONS:
rally speaking, choleate of soda (or bile) may be expected to be
absent when the feces have remained for some time in the
large intestine, and there has been full opportunity for re-
sorption.
It follows that the carbonate of lime is a product of the
double decomposition that occurs between the sulphate of lime
and the carbonate of soda resulting from the incinerated cho-
leate of soda, or bile.
The formation of the membrane during evaporation indicates
the presence of a certain amount of albumen.
In 100 parts of the ash yielded by the excrement of another
individual, there were contained: —
Chloride of sodium and alkaline sulphates 1°367 ;
} soluble in water.
Bibasic phosphate of soda ‘ . _2°633
Phosphates of lime and magnesia . 80°372
Phosphate of iron . F - .,2°090 |. P :
Sulphate of lime. soe pale
Silica. ‘ - . 7940
98-932
From the absence of carbonate of lime in this imstance, it
may be concluded that no choleate of soda or bile was present. -
The excrement was very firm and solid.
I am indebted to the kindness. of Dr. Percy for the follow-
ing analyses of the feces.
1..The individual, who was about thirty years of age, had
taken the ordinary diet of this country, and appeared to be in
the enjoyment of perfect health.
In 100 parts of dried residue there were contained :
Substances soluble in ether (brownish yellow fat) 5 11°95
-" in alcohol of-'830 ¢ : 10°74
9 in water (brown resinoid matter) ‘ 11°61
Organic matter insoluble in the above menstrua , 49°33
Salts soluble in water ‘ ; ; ; 4°76
Salts insoluble in water : : ; ; 11°61
An ultimate analysis of the feces in this case was also insti-
tuted. “I may here premise,” says Dr. Percy, “ that I have
invariably used chromate of lead as the oxidising body, and
have occasionally sheathed the combustion tube with thin sheet
copper, in order to enable me to attain a high degree of heat
EE oe oe PAR EROS,
Pe ee ee eS eT Ce aL ee See
ee pen ee — i a he Ae
sal
Ae iia tle
an Ce ore oe
fe a ta rie ie it ae a : aa 2 ee a iT : he ; Pre
PME nd Eta garste ans Ayr Nee tenet aitPe ea ta
Ti OSL 4
a |
es Rome eae ee
FACES. 379
towards the close of the combustion, a precaution essentially ne-
cessary in the analysis of these matters, as the last trace of carbon
cannot, without this precaution, be completely burned. In
corroboration of this statement I may mention that the perfect
incineration of feeces at a red heat requires a considerable time.
The matter was prepared for analysis by first drying over the
water-bath, and then either in an oven at the temperature of
212° or some degrees above, or in the salt-water bath and by a
current of air desiccated by chloride of calcium. I was extremely
particular in respect to the drying, and, generally, in a second
analysis, employed matter which had been subjected to the
drying process for a much longer time than in the first, so that
the correctness of the proportion of hydrogen should be satis-
factorily tested.
Ist Analysis: 7°41 grs. gave—of water 4:43 or of hydrogen 6°648, of CO, 12°55
or of C 4671898.
2d Analysis: 7°24 grs. gave—of water 4°44 or of hydrogen 6°81, of CO, 12-28
or of C 46°23$.
Incineration : 50°13 grs. gave—of ash 8°21, or 16°37$.
Nitrogen—not yet determined.
_ Taking the mean, we have:
Ose ooate te SSO :
H . . ° 6°72
1 .
Neo at does
Wie gs. 4-3. 1632
“ These results are very nearly the same as those obtained
by Dr. Playfair,! at Giessen. His analysis gives C 45-24,
H 6:88, N & 0 34°73, ash 13°15. These facts are worthy of
attention, as they seem to show that, under ordinary circum-
stances of health, the composition of the feces is more uniform
than we might @ priori have anticipated. The first analysis,
it will be borne in mind, was of the feces of a man in this
country; the second, of a soldier at Giessen.
«2. A man undergoing the curious and rigorous discipline
of training for prize-fighting. This individual, it will not be
doubted, was in the possession of the most perfect health. [He
had been in training for about a week. Age, 22; height, 5ft. 6in.;
weight, 8: stones. I request particular attention to the diet. He
breakfasted at 9 a.m., and took one pound of mutton weighed
before cooking. He dined at 1 p.m., took the same quantity of
1 Liebig’s Animal Chemistry, 2d edition, p. 285.
Me
396 THE EXCRETIONS :
mutton, and about two ounces of bread. He had the same quan-
tity of mutton for supper at 8 p.m. At each meal he drank halfa
pint of ale, and no other liquid during the day ; nor, it must be
remembered, had he any other vegetable matter besides the small
quantity of bread mentioned. He walked seventeen miles daily.
Ist Analysis: 5°35 grs. gave—of HO 3°43 or H 7:12§, of CO, 9°73 or C 49°608.
2d Analysis: 5°74 grs. gave—of HO 3-62 or H 7-018, of CO, 10°52 or C 49.985.
The difference between these two analyses, in respect to the
carbon, is greater than should be allowed, but I had not time
to make a third analysis.
Incineration: 31°42 grs. gave—of ash 4°56, or 14-518.
Mean—C 5 ; . 49°79
H . : iy: ges
N&O : . 28°64 rr
Ash . : ; oe.
“T should observe that, in drying this specimen, towards the __
end of the process a small quantity of liquid condensed on the
surface of the tube communicating with the vessel of water,
which was clear and colourless, had a peculiar and extremely
offensive odour, and which powerfully reddened litmus. 1 had
not sufficient leisure to examine it more minutely at the time.””]
The feces during disease.
In certain pathological conditions, the feeces frequently un-
dergo very important modifications. These changes cannot be
due to any peculiarities in the ingesta; they must originate in
an alienated mixture or separation of the secretions of the
chylopoietic viscera. This irregularity may lead to imperfect
chymification, in which case matters will be carried off with the
feeces, which, if they had been properly digested, would have _
entered the vascular system ; or, in consequence of the changed _
process of secretion, substances which are normal secretions
may be separated in too large a quantity, as, for instance,
water; or substances which ought to be present, are entirely
! I strongly suspected the matter to be butyric ‘acid, and my suspicion has since
been much strengthened by my examination of a specimen of pure butyric acid which
Thad an opportunity of seeing in London, at the Pharmaceutical Society. Besides,
Dr. Erwin Waidele, whom I had the pleasure of meeting at Professor Graham’s, __
informed me that Dr. Ragsky of Vienna has discovered this acid in the feces.
FASCES. 377
absent, as, for instance, bile; or, lastly, substances which are
altogether foreign to the normal secretions, are mixed with the
feeces, as albumen, blood, &c.
In the case of diabetes alluded to in p. 296, I carefully ex-
amined the feces. They contained no sugar, and were chiefly
remarkable for their large amount of solid fat. Two or three
pultaceous stools, averaging collectively 18-5 ounces, were passed
daily. They gave off a very disagreeable odour, and were of a
grayish clay colour.
Alcohol digested with this fecal matter became coloured
brown, and extracted a large quantity of fat, extractive matter,
and a little bilin. On treating the portion insoluble in alcohol
with water, a small amount of water-extract, almost devoid of
taste, was taken up. The insoluble residue yielded, on incine-
ration, an odour of burned horn or glue, and contained a large
amount of nitrogen.’ A quantitative analysis showed that the
18°5 ounces of fecal matter contained :
Analysis 15].
Whole quantity. In 100 parts.
oz. grains.
Water . : . > 12 312
Solid constituents ‘ ‘ ; 5 408
’ Fat 2 0 34°0
Bilin and extractive matter ‘soluble in :
alcohol é ‘ x O66 2°0
Water-extract 0 56 2°0
Alkaline salts 0 182 6°5
Carbonate of lime . 0 70 +364 2°5
Earthy phosphates and peroxide of iron 0 112 4:0
Insoluble nitrogenous matters 2 359 470
I have attempted, in accordance with the plan laid down in
the appendix to Liebig’s ‘ Animal Chemistry,’ to compare the
amount of carbon, nitrogen, and hydrogen in the food and in
the excretions.
The ingesta consisted of :
8 oz. of dry gluten bread.
11:5 ,, dry meat.
2 yp ary egg.
2 4 cod-liver oil.
23°5 ounces.
! [This is entirely opposed to the experience of Lehmann, who states that the feces
of diabetic patients frequently yield a mere trace of nitrogen. Lehrbuch der physio-
logischen Chemie, 1842, p. 312.] .
378 THE EXCRETIONS:
There were discharged :
By the urine. From the bowels.
8°8 oz. of sugar. 2 oz._of fat.
1°3 oz. of urea. 2°5 oz. of nitrogenous insoluble feecal
15 grains of uric acid. matter & protein-compounds.
100 grains of extractive matter & bilin.
p Tae ae A
Pisa. a
15. ounces.
There is then an excess of 8! oz. of food.
In the food there are contained ; In the excretions there are contained :
12 oz. of carbon. 6°6 oz. of carbon.
1 oz. 6 drms. of hydrogen. 1 oz. of hydrogen.
2°5 oz. of nitrogen. 410 grains of nitrogen.
700 grains of fixed salts. 710 grains of fixed salts.
Hence there are carried off, by respiration and transpiration,
5*5 ounces of carbon, 0°75 of hydrogen, and 1°62 of nitrogen.
This quantity of carbon and hydrogen is much less than is
generally supposed to be carried off by the lungs; and with —
respect to the nitrogen, although we may assume that some is
carried off by the skin, the disproportion is still very great. An
accurate examination of the expired air might throw much light ~
on this obscure and remarkable morbid process. :
[I am indebted to Dr. Percy for the following analyses of —
diabetic feeces : a
1. “ Feces of a boy aged 7 years. It was found impossible
in this case to enforce a rigid system of animal diet, so that
we may regard these feces as the feces of diabetes uncheclal a
or modified by treatment. They were hard, and not of the |
natural consistence of health. .
Ist Analysis: 5°44 grs. gave—of HO 3°35 or H 6°838, of CO, 8°76 or C 43°94.
2d Analysis: 4°72 grs. gave—of HO 3-01 or H 7-092, of CO, 7°58 or C 43°798. —
Incineration: 30°76 grs. gave—of ash 6°18, or 20-099.
Mean—C ‘ é . 43°86
H . 6 - 6°96
N&O - . 29°09 _—
Ash . = . 20°09
The proportion of saline matter is here much greater than rc
usual, and, doubtless, depended upon constipation. :
The fat taken up by ether amounted to 16-162 of the hess
feces. ;
FECES. — 379
2. “The feces of a man (Flint) aged 48 years, who was labouring
under diabetes of long standing. He.was restricted principally -
to animal food, a small quantity of bread only being allowed.
Consistence moderate. This analysis was executed under my
own supervision by my former pupil, Mr. Stallard.
Ist Analysis: 8°22 grs. gave—of HO 5:61 or H 7:588, of CO, 16°43 or C 54:519.
2d Analysis: 8°57 grs. gave—of HO 5°84 or H 7°572, of CO, 17-03 or C 54:202.
The nitrogen was determined by Wills’s method.
Nitrogen : 6°29 grs. gave—of metallic platinum 5°33 grs., which corresponds to
12-018 of nitrogen.
Incineration: 61°01 grs. gave of ash 5°71, or 9°368.
Mean—C j ‘ . 54°35)
Re tino OO
Bes oS FES e600
Ro ae eee
Ash . , . 936)
Proximate Analysis :
Substances soluble in ether ° <4 : 22:00)
pe alcohol . : 11°13
* water . . ‘ 12°02 . 100-00
Organic matter, insoluble in these menstrua ‘ é 45°49
Ash. ‘ . . ‘ ‘ 9°36 |
3. “Feces of the same individual some weeks afterwards,
while taking about three ounces of fat bacon daily, in addition
to his usual animal diet. It was evident after drying, that
these feeces abounded in fat from their appearance on the ap-
plication of heat. It was impossible to reduce them per se
to fine powder.
Ist Analysis: 5°06 grs. gave—of HO 4:22 or H 9°22, of CO, 11°20 or C 60°36.
2d Analysis: 6°28 grs. gave—of HO 5:25 or H 9°28§, of CO, 13°89 or C 60°32.
Incineration: 55°93 grs. gave—of ash 7°40, or 13°235.
Mean—C ‘ ‘ - 60°34
H - a F 9°25
coc ae
Ash . ; eS Ree
Ether took up a quantity of fat amounting to 51°552 of the
dried feces.
4. “ Feces of the same individual a few weeks afterwards,
while restricted to an animal diet of the lean of meat: as far
as it was practicable all fat was removed.
380 THE EXCRETIONS:
Ist Analysis: 7-06 grs. gave—of HO 5°05 or H 7°959, CO, 13°72 or C 53-008.
2d Analysis: 6°62 grs. gave—of HO 4°77 or H 8-00§, CO, 12°93 or C 53-27$.
Incineration : 16°81 grs. gave—of ash 2°96, or 17-608.
Mean—C ; : . 53°09
H ; 4 it te |
N&O : . 21°34 ee
Ash . : » 3760
5. “ Feeces of a man (Roberts)' between 30 and 40 years,
labouring under diabetes of some standing. Diet, exclusively
animal, with the exception of a small quantity of bread.
Ist Analysis: 4°53 grs. gave—HO 3°07 or H 7°538, CO, 7°64 or C 45°99$.
2d Analysis: 5°33 grs. gave—HO 3°67 or. H 7°658, CO, 8°92 or C 45°64.
Incineration : 50°84 grs. gave—of ash 10°77, or 21°188.
Mean—C % yi . 45°81
H ‘i ; ‘ 7°59
SAO Cc cee
Ash . s 2118
6. “ Feces of the same individual, some weeks afterwards,
while on a mixed diet. At this time also he was much emaciated
a Vie oe ee
FO aes Eee
and exhausted, in consequence probably of having been obliged ~
to work, and to subsist on a mixed diet.
Ist Analysis: 5°13 grs. gave—of HO 3°36 or H 7:28%, CO, 8°63 or C 45°888.
2d Analysis: 4°86 grs. gave—of HO 3-18 or H 7-272, CO, 8°21 or C 46-078.
Incineration : 32°31 grs. gave—of ash 7°14, or 22°10.
Mean—C : ; . 45°97
Wee gs
N&O . . 2466 ¢ 100°00 |
Mae Jo eons
In dysentery the stools are thin, contain flocculent mucus,
and are either almost colourless or milky, (dysenter. catarrh.)
or they are coloured red by blood (dysenter. inflammat.). Ac- i
cording to Schénlein they possess a peculiar smell quite cha-
racteristic of the disease.
On examining the white or slightly coloured mucous fluid —
under the microscope, we observe numerous mucus-corpuscles
floating about in it: the red, sanguineous discharges also con-
tain an extraordinary number of mucus-corpuscles, numerous
blood-corpuscles, but no (or very few) epithelium-scales.
We sometimes find pseudo-membranous portions of exuded
plastic lymph mixed with the stools, especially in the most in-
flammatory forms of the disease.
' Roberts’s case has been published in the Medical Gazette. He has since died,
and the sequel will shortly appear, together with the cases of the child a gece
diabetes, and of the other patient Flint, “
~~
he ad
\. 2 a
FACES. 381
In typhous diarrhcea the motions are frequently very bulky,
of a chocolate colour, frothy, mixed with black dissolved blood,
and not giving off the peculiar odour of dysenteric evacuations,
but rather a cadaverous smell. In bilious diarrhea the bile-
pigment is mixed with the fluid motions, which are less copious
than in the former case.
In enteritis mucosa the stools, especially those which are
discharged during the night, are thin, and, in addition to the
mucus and fecal matters coloured yellow by bile-pigment,
contain a peculiar flocculent mass, like exuded lymph, which,
on more accurate examination; seems to consist of purulent and
fatty matter. Blood is likewise sometimes found in these stools.
In abdominal typhus the stools are very characteristic; in
the first stage they do not differ very much from the normal
state ; they are sometimes very firm, sometimes very thin and
watery. In a more advanced stage of the disease, they sepa-
rate when shaken in a glass vessel into two strata; the lower
one forms a slightly yellow flocculent mass, while the upper
one is composed of a cloudy, whey-like fluid. On examining
the flocculent material under the microscope, I found that it
was composed, for the most part, of small lumps of mucus or
pus, of an amorphous yellow matter—probably coagulated al-
bumen with bile-pigment, of a comparatively small quantity of
epithelium, and sometimes of extremely numerous and beau-
tifully formed crystals of ammoniaco-magnesian phosphate,
such as are depicted in fig. 27: sometimes we find, as also in
phthisis intestinalis, small white masses about the size of a
millet, or half as large as a hempseed; they are easily triturated
and then have a greasy appearance ; when examined under the
microscope they appear to be composed of cells similar to pri-
mary cells or what are called the globules of inflammation. The
contents of these spherical cells, which are inclosed in a very
delicate membrane, are coarsely granulated and escape on the
least pressure.
In some of the larger parent cells, I found smaller cells with
nuclei. I dried a portion of the flocculent precipitate ; on in-
cinerating the residue I obtained 32% of salts, of which nearly
one half, namely, 14°6 were earthy phosphates.
The whey-like fluid which is above the sediment, is usually
tolerably rich in albumen. It coagulates, or at any rate be-
comes turbid on the application of heat or nitric acid. In
382 THE EXCRETIONS:
most cases it has a strong alkaline reaction, and contains a
large amount of carbonate of ammonia, which frequently in-
terferes with the action of heat on the albumen.
In some cases I observed that a beautiful rose-red tint was
produced by the addition of nitric acid, of which I shall speak
more fully in my observations on the stools in cholera. Typhous
stools are sometimes tinged with blood.
In melena blackish pitchy blood is mixed with the feces,
which sometimes consist entirely of that substance. I have
previously described the peculiarities of the blood. (See Vol. I,
p: 317.)
In catarrhus intestinor. the intestinal mucous membrane
acts very much the same as the mucous membrane of the re-
spiratory organs in pulmonary catarrh. The secretion is at
first checked, then very much increased, and, finally, after
secreting thick and tough mucus, returns to its normal con-
dition.
In simple diarrhoea a thin muco-aqueous yellow, or yellowish-
brown discharge follows the evacuation of the true feces.
In bilious diarrhoea the stools are also liquid, but they are
generally of a greenish colour, and possess so strong an acid
reaction as to produce excoriation of the anus.
In dysenteric diarrhea a large quantity of gray or greenish
mucus tinged with blood, is discharged. In diarrhcea lactan-
tium, masses are discharged which are not unlike chopped eggs:
they have a strong acid odour, and exert a corroding effect on —
the vicinity of the anus.
In Asiatic cholera it is well known that an extraordinary —
quantity of watery fluid is discharged by the intestines.
Dulk found that the evacuations in cholera had an alkaline —
reaction, that they contained albumen, and that they were en- —
tirely devoid of the ordinary odour of feces.
_ Hermann,’ on the contrary, found that they had an acid
reaction, and resembled the vomited matter, in which he de-
tected free acetic acid. The ordinary reaction of the stools in
cholera is, however, alkaline, and this was observed in a very
severe case of sporadic cholera that fell under my own observation.
According to Vogel’s observations, the stools in this disease
resemble turbid whey : the fluid has a powerful alkaline reaction,
and effervesces on the addition of an acid. On distilling a por-
' Poggend. Annalen, vol. 22, p. 161. ks
FECES; 383
tion of the fluid he obtained in the receiver a liquid with an
alkaline reaction, and having a fishy odour. On the addition
of nitric acid this liquid assumed a beautiful red tint, which it
retained during evaporation. The fluid, when concentrated, had
an intense red colour, but was devoid of odour, which only be-
came again apparent on neutralizing the free acid by an alkali.
The portion that remains in the retort after the distillation
of the fluid contains traces of albumen, some intestinal mucus,
the ordinary salts of the animal fluids, and a large amount of
carbonate of soda.
Wittstock’s researches respecting the fecal discharges in
cholera, coincide in most points with those of Vogel: he ob-
served the beautiful rose-red tint that was produced by the ad-
dition of nitric acid, and he ascribed it to the presence of an
urate; it is however known, that the formation of purpurate
of ammonia or murexid from uric acid, requires a greater de-
gree of concentration of the reacting substances, and a height-
ened temperature.
The feces of a woman who had a very severe attack of
sporadic cholera, (whose blood and urine I likewise analysed,)
formed a turbid and colourless fluid, which had a strong
alkaline reaction, and effervesced on the addition of acids,
giving off carbonic acid and sulphuretted hydrogen, which, in
all probability, arose from carbonate of ammonia and.-sulphuret
of ammonium (hydrosulphate of ammonia).
When allowed to stand for some time it formed a sediment,
which consisted, for the most part, of mucus-corpuscles, with
some crystals of ammoniaco-magnesian phosphate. No epi-
thelium cells were observed. On treating the fluid with nitric
acid, effervescence took place, and flocculi of coagulated albumen
separated themselves ; moreover, the fluid in a short time be-
came of a rose-red colour,—a phenomenon that was induced
more rapidly by gentle warmth: when strongly heated for some
time the colour entirely disappeared.’
The quantitative analysis of the feecal discharge in this case
gave the following results, calculated for 1000 parts :—
' [In an examination of the feces in cholera, instituted by Heller, (Archiv i, p. 18,)
a similar reaction was observed. The exact nature of the change that the bile-pigment
undergoes in such cases is not clearly understood. ]
384 THE EXCRETIONS:
Analysis 152.
Water ‘ , : ; 980-00
Solid constituents ; ; 20°00
Fat . ‘ : 3 0°08
Extractive matter . . ‘ 4°80
Albumen and mucus : 0°52
Chloride of sodium, lactate and acetate of 13°40
soda, and alkaline phosphates le
Phosphates of lime and magnesia ; 0°60
This analysis bears out the result of the investigation of the —
blood, given in Vol. I., page 326.
Landerer! has analysed the fecal evacuations of a child suf-
fering from diarrhea infantilis. It was a yellowfluid, with an acid
and bitter taste, and its specific gravity was 1038°2. Landerer
found in it: carbonate of lime 1°50; phosphate of lime 2-00;
chloride of calcium 1°50; chloride of magnesium 2°45; chloride
of sodium 2°43; sulphate of lime 1:50; sulphate of magnesia 0°80;
bilin, butyric acid, and extractive matter 3°00; spirit-extract 1-00;
free lactic and hydrochloric acids 1-00.
In enterophthisis, the feecal evacuations likewise separate into
two strata: the lower is flocculent, and when examined under the
microscope is seen to consist of mucus- or pus-corpuscles min-
gled with remnants of food, or with an amorphous mass tinged
with pigment. Sometimes we find, in the deposit from these
evacuations, small white or yellow masses, which consist of
cells, and can be easily crushed (such as I have already de-
scribed in speaking of the evacuations in typhus), and mixed
with them there are numerous fat-vesicles. A little blood is
not unfrequently observed in these stools; they then have a
chocolate or dark blood-red tint. The supernatant fluid is
turbid, and of a yellow, brown, or bloody tint ; it always con-
tains a considerable amount of albumen.
In icterus the feces are generally devoid of all the consti-
tuents of the bile: they are consequently of a white or grayish
white colour; they are usually very firm, and deficient im
moisture.
[I am indebted to Dr. Percy for the following ultimate
analysis of the feces in jaundice. |
' Journal f. prakt. Chemie, 1841, vol. 17, p. 62.
: FACES. 385
A young woman affected with jaundice in a mild form, de-
pending probably on functional derangement of the liver. The
feces were brown, and not clay-coloured, as in severe jaundice.
Ist Analysis—5°59 grs. gave of HO 3°66 or H 7°273, CO, 9°69 or C 51°425.
2d Analysis—5-12 grs. gave of HO 3°37 or H 7°312, CO, 9°69 or C 51°61.
Incineration—28°18 grs. gave of ash 3°41 grs., or 127102.
Mean—C ‘ ‘ of ee
H ‘ , “ice eee ie
N&O 5 ju ee ee |
oo aie ; ¢) aa
A physician of this city sent me a white, roundish, easily
compressible mass, resembling caseous matter, which had been
evacuated after an ordinary motion, by a lady who was suffering
from bilious sensations. When observed under the microscope,
this substance, which emitted a rather disagreeable odour, was
found to be composed of an extraordinary quantity of fat
' The following table shows, at a glance, the results of the preceding ultimate
analyses :
oF leai/ss8 | 82 r88 188 | 83 | 8 7
&&s ea a = '3 = 2 = 2 3 a &
ge} 48 |)SR | *a | "a | *a | 2a [ea | sa
— =6
i 2. 3. 4. 5. 6. 7. 8. 9.
C . . | 46:20] 49°79] 43°86 ]| 54°35] 60°34] 53-09] 45°81] 45-97]) 51-51
H . .| 672| 7:06] 6-96|| 7:57| 9-25] 7:97]] 7°59] 7-27|| 7:29
N&O . | 30°71] 28°64] 29-09 || 28-72] 17-18] 21°34 || 25:42] 24-66|| 29-10
Ash . | 16°37| 14°51] 20-09]| 9°36] 13-23] 17-60]| 21:18] 22-10|| 12-10
100-00 |100-00 |100-00 ||100-00 |100-00 |100-00 ||100-00 |100-00 |/100-00
TABLE of ComposITIOoN, exclusive of AsH.
1. 2. 3. 4, 5. 6. (fe 8. 9.
C > . | 55°24| 58°24] 54°88 || 59°96] 69°53} 64:43 |} 58°11} 59°01 || 58°60
:: os -| 8°03} 825) 8°70|} 835] 10°66) 9°67 9°62} 9°33); 8°29
N&O . | 36°73] 33°51] 36°42 || 31-69] 19-81] 25°90|| 32°27} 31°66 || 33°11
100-00 {100-00 |100-00 ||100-00 |100-00 {100-00 |/100-00 |100-00 ||100-00
II. 25
&
386 THE EXCRETIONS: .
arranged in a structureless, albuminoid mass; no tissues or cells
were detected. The mass, when heated, gave off a very strong
odour of butyric and acetic acids ; it melted and burned with a
clear flame. Alcohol extracted a very large amount of fat, con-
sisting of margarin, ole, and butyrin, with their acids, which
partially separated on cooling. In the separated flocculi I
detected, with the aid of the microscope, crystals of margaric
acid, but none of cholesterin. After the evaporation of the
alcohol, water dissolved some butyric and acetic acids from the
residue.
The portion insoluble in alcohol was digested for a consi-
derable time in dilute acetic acid, and was precipitated from this
solution by ferrocyanide of potassium.
Water did not extract any matter that was precipitable by
the last-named reagent.
_ On incineration a considerable amount of ash was left which
had an acid reaction, did not effervesce with acids, and con-
sisted almost entirely of earthy phosphates: it contained no
sulphates.
Calomel stools.
In certain morbid conditions of the system calomel is fre-
quently given in considerable quantity: its administration is
succeeded hy numerous, very green, bilious stools. I endea-
voured to determine by an experiment whether the bile and its
pigment is the actual cause of the colour of these evacuations.
The fifth stool that was passed after the administration of a
large dose of calomel, was made the subject of the analysis. It
was fluid, perfectly green, had no fecal odour, exhibited a mild ;
acid reaction, and showed, under the microscope, a great number —
of mucus-corpuscles and epithelium-cells. On evaporation it
gave off an odour resembling that of saliva or extractive matter
under similar circumstances. Ether extracted from the solid —
residue a considerable amount of fat which had an acid reac-
tion, contained cholesterin, and was coloured with biliverdin. —
All other substances which were separated from it by water and :
alcohol were more or less coloured by bile-pigment.
Bilin with bilifellinic acid and biliverdin were found in large —
quantity ; by digestion with sulphuric acid the bilin became —
entirely converted into biliary resin. From a quantitative
FACES. 387
analysis it appeared that 100 parts of the solid residue of this
evacuation were composed of :
Analysis 153.
Green fat containing cholesterin 10-0
Salivary matter soluble only in water, and slightly ciediaitathd by
tannic acid and acetate of lead 24°3
Bilin with bilifellinic acid and biliverdin, collectively pees in
anhydrous alcohol : 4 ‘ : p 21°4
Extractive matter soluble in spirit ; é . 11-0
Albumen, mucus, and epithelium-scales ; : 1771
Salts A ‘ 2 : ; 12°9
100-0
Various attempts that I made (by Smithson’s method) to
detect mercury in calomel-stools proved unsuccessful.
[Dr. Golding Bird has published an analysis of the green
evacuations so frequently observed in children. The specimen
examined by him “ was passed by a hydrocephalic infant whilst
under the influence of mercury, and presented the following
characters. It was a dirty-green turbid fluid which, by repose
in a glass vessel, separated into three very distinct portions ;—
1, a supernatant fluid, of oil-like consistence, presenting a
brilliant emerald-green colour; 2, a dense stratum of mucus,
coagulated albumen, and epithelial debris, mixed with red par-
ticles of blood ; 3, a deposit, occupying the lower part of the
vessel, of large crystals of ammoniaco-magnesian phosphate, in
fine prisms of an apple-green colour.
The supernatant emerald-green fluid was decanted for
examination.
A. It was faintly alkaline, possessed a broth-like odour, and
a density of 1020.
B: The addition of a few drops of nitric acid did not alter
the colour, even after ebullition. A larger quantity of the acid
being added whilst the mixture was boiling, converted the
emerald-green colour into a pinkish-yellow; the green colour
was not restored by the subsequent addition of an alkali.
c. Acetic acid scarcely affected the green fluid, producing
no apparent coagulation of mucus.
p. A solution of acetate of lead threw down a copious
grayish-green, tenacious precipitate, leaving the supernatant
fluid colourless.
358 THE EXCRETIONS:
E. Bichloride of mercury produced a light-green precipitate,
leaving the supernatant fluid pale, but not decolorizing it.
It was analysed i in the following manner :
1. 1000 grains of the green fluid left, by caret evapora-
tion, a deep olive-green, highly deliquescent extract, weighing
100 grains.
2. This extract, on being immersed in alcohol of ‘837 formed
a mass like birdlime, which could not be mixed with the spirit.
Even after long boiling, it appeared hardly to diminish in bulk.
The clear tincture being decanted left, however, an extract
weighing 30 grains. This residue possessed the yellowish-
green colour of faded leaves, an odour -of fresh broth and a
sweet sub-astringent taste, with a very slight admixture of
bitterness.
3. The alcoholic-xtract being carefully incinerated, left 5-5
grains of ash, consisting chiefly of chloride of sodium mixed
with mere traces of tribasic phosphate of soda (8NaO, PO,).
It was alkaline, but did not effervesce with acids.
4, The portion left undissolved by boiling alcohol yielded to
water 13 grains of nearly tasteless matter which, by incinera-
tion, left a powerfully alkaline ash weighing 1°75 grains, not
effervescing with acids, and consisting nearly exclusively of
alkaline tribasic phosphate of soda.
5. The residue insoluble both in water and alcohol weighed
57 grains, and consisted almost entirely of coagulated albumen,
dry mucus, and modified blood. It left by incineration one
grain only of ash, consisting almost wholly of black-red peroxide
of iron.
The following is a view of the results of the examination :
Organic Z A 24°50
Inorganic ; : 5°50
Organic ; , 11°25
Alcoholic extract {
Aqueous extract {
Inorganic ; ‘ 1°75
Organic , : 56°00
Insoluble matter thoriestiie 1-00
Water and volatile matter A . 900-00
1000-00
The organic portion of the alcoholic extract consisted chiefly
Pe
* Sa apes . P
Soh Sac a be A eo
FACES. 389
of fatty matter, cholesterim, and a green substance probably
identical with biliverdin ; with these were traces of bile barely
sufficient to communicate a bitter taste to the extract, and in
too small a quantity to leave any carbonate of soda in the
residue of incineration. The aqueous extract consisted chiefly
of ptyalin and the extractive matters comprehended under the
general term of “ extrait de viande,” by Berzelius. The com-
position of the fluid part of the green evacuation may therefore
be thus expressed :
Water , ; ~ 900-00
Biliverdin, alcoholic rebie fat, dibieatéuin: ‘with traces of bile . 24°50
Ptyalin, @queous extract coloured by biliverdin ; aks See
Mucus, coagulated albumen, and hematin . . — 56°00
Chloride of sodium, with traces of tribasic phosphate of soda F 5°50
Tribasic phosphate of soda ‘ : ‘ ; 1°75
Peroxide of iron ; ‘ : é ; 1:00
1000-00
Professor Kersten of Freiberg has recently published a paper
on the cause of the green evacuations observed after a course
of the Marienbad waters for fifteen or twenty days.
The occurrence of these evacuations is regarded as critical
and highly favorable. Kersten denies that the tint is in any
degree dependent on the presence of bile, and ascribes it to the
formation of green sulphuret of iron.
In the paper referred to he first shows that on the addition
of very dilute hydrochloric acid to an evacuation of this nature
diluted with thrice its weight of water, there is a development
of sulphuretted hydrogen, indicating the presence of a metallic
sulphuret ; moreover, on the addition of ferrocyanide of potas-
sium to the filtered acid solution a bright blue precipitate is
observed, which becomes darker after exposure to the air, indi-
cating the existence of protoxide of iron. This experiment
shows that the green pigment is destroyed or decomposed by
dilute hydrochloric acid, and further, that it is a compound-of
_ sulphur and iron. He accounts for the presence of the sul-
phuret of iron in this way. The sulphate of soda present in
the water is reduced in the stomach to a sulphuret of sodium
by the deoxidising power of the organic matters with which it
is in contact, aided by a temperature favorable to such a change.
390 THE EXCRETIONS :
The bicarbonate of iron in the water is decomposed at the tem-
perature of the stomach, and the iron precipitated either as a
protoxide or as a hydrated peroxide, and immediately redis-
solved by the free acid of the gastric juice. This reacts on the
sulphuret of sodium, and sulphuret of iron is the result.
Since the publication of Kersten’s paper, a very similar view
has been propounded by Dr. Bley, namely, that the green eva-
cuations observed after the use of calomel are dependent not on
the presence of bile, but of sulphuret of mercury. Unfor- —
tunately for this theory the mercury cannot be detected by ana-
lysis, and Pettinkofer’s test reveals the presence of bile.
Dr. Frankl has published a paper containing various argu-
ments in opposition to Kersten’s views, and criticising his
conclusions.
Berzelius, on the other hand, writes thus: “ It never entered
my mind to suspect that this coloration arose from sulphuret
of iron, but I always believed that it might be attributed to the
black oxide of iron. It is, however, quite natural that as sul-
phuretted hydrogen is usually produced during the progress of
digestion, the oxide of iron present in the intestinal canal should
be reduced to a sulphuret, no matter whether sulphates have
been given or not.”
Berzelius renders Kersten’s view more general, observing
“that every chalybeate water, whether it contain sulphates or
not, produces a similar appearance in the evacuations.” On
this Kersten remarks: that “the coloration may be most
intense when sulphates are present, because by their decompo-
sition during digestion an excess of sulphuretted hydrogen will
be generated.”
Vomitus. (Matters discharged by vomiting.)
It is well known that the fluid which is found in the stomach,
and which is a mixture of gastric juice, saliva, and remnants of
food, becomes much changed in its properties in certain morbid
conditions of the system. I need scarcely refer to the excess
of free acid, and to the presence of bile in certain conditions of
the stomach. On the occurrence of the latter of these states
we usually observe a separation, or peeling off, of the upper
oe), a
VOMITUS. 391
stratum of epithelium-scales from the tract of mucous membrane
between the pharynx and the stomach, and this condition is
recognized by the gastric furred tongue.'
This fur or coating has been analysed by Denis: he found
that one half consisted of phosphate and carbonate of lime, the
other half of mucus.
In gastrodynia, even when there is no food in the stomach,
the gastric juice is secreted in such an acid condition as to set
the teeth on edge. This is chiefly caused by free hydrochloric
acid, but concentrated lactic and acetic acids will produce the
same effect.
In gastritis, colonitis, enteritis, and peritonitis, a grass-green
liquid is often brought up; it is frequently mixed with green or
white floceuli, and on other occasions is quite clear; it almost
always has an acid reaction, and usually contains a considerable
amount of fat.
I analysed a fluid of this sort that was vomited during peri-
tonitis: it had a greenish, viscid appearance, and contained —
whitish flocculi that presented an amorphous character under
the microscope. It did not affect blue or red litmus paper ;
on the addition of nitric acid there was a separation of white
floceuli, and the fluid became first of a pale blue and subse-
quently of a reddish tint. On the application of heat some
globules of oil separated themselves, and a small quantity of
albumen became coagulated; it contained 2°92 of solid consti-
tuents, from which ether took up a yellow liquid fat that was
imperfectly soluble in cold, but dissolved easily in hot alcohol ;
it contained a little cholesterin, and gave off a smell like that
of a fatty acid.
Alcohol took up extractive matter and bilifellinic acid, which
latter could be separated by means of sulphuric acid; dilute
alcohol took up spirit-extract with a little bilifellinic acid. A
considerable amount of the portion that was insoluble in spirit
dissolved in water, and was again precipitated by alcohol, tannic
' On examining the thick coating of the tongue in cases of abdominal typhus, I
‘have found that it is composed of matted epithelium-scales over which minute
sporules are scattered. The sordes from the teeth exhibited similar characters.
392 THE EXCRETIONS:
acid, and acetate of lead. The precipitate thrown down by
alcohol was soluble in an excess of water, which was rendered
turbid by the addition of acetic acid, and yielded a copious
precipitate on the subsequent addition of ferrocyanide of Paes
sium.
As the ash, after incineration, consisted of carbonate of soda,
I regarded the substance insoluble in alcohol as an albuminate
of soda. 7
The quantitative analysis of this “vomitus ezruginosus seu
herbaceus” yielded the following proportions in 1000 parts :
Analysis 154.
Water F ; ‘ ; ‘ 971:0
Solid residue . ‘ : : : 29-0
Fat ‘ 4:3
Bilifellinic acid, alcohol- extract, and bile- pigment ; 15
Spirit-extract with a little bilifellinic acid . ‘ 11-4
Albuminate of soda ‘ ‘ 5°4
Mucus and albumen . ‘ : ‘ 5°8
[Heller' analysed a brilliant green fluid vomited by a young
woman aged 20 years, suffering from peritonitis.
In quantity it amounted to about three ounces; it was
slightly turbid, and threw down an inconsiderable sediment
which was viscid, more of a yellowish tint than the supernatant
fluid, and consisted of epithelium-cells and mucus-corpuscles.
The fiuid had an acid reaction, but contained neither free
hydrochloric nor acetic acid. Its specific gravity was 1006.
On the addition of nitric acid it first became blue, and after-
wards of a beautiful carmine red. It contained no albumen.
In 1000 parts there were contained :
Water ; ‘ ‘ ‘ : 990°50
Solid constituents 2 : p ; 9°50
Fat ; j ; ; ‘ 0°24
Water-extract 2 F ‘ ‘ 1°30
Biliverdin with a little biliphzin and a trace of 5:38
alcohol-extract ; ‘ ‘
Fixed salts * ‘ - j 3°75
The salts consisted for the most part of the chlorides of :
sodium and calcium, associated with less quantities of phosphate
of soda, sulphate of potash, and earthy phosphates. Urea and
uric acid were sought for without success.
' Archiv, vol. 1, p. 226.
i
-VOMITUS. 393
The green colour seems undoubtedly due to the presence of
biliverdin, which is probably formed in the stomach by the
action of the acid solution of hydrochlorate of lime on the bili-
phein. Hence the occurrence of green vomiting need not be
regarded as indicative of any peculiar morbid change.
A brief notice of a green fluid vomited during an attack of
sporadic cholera, may be found in vol. 1, p. 18, of Heller’s
Archiv. | :
Vomitus with urinary constituents.
It is stated that in those cases in which the formation and
excretion of the urine are impeded its constituents are discharged
with vomited matters.
Nysten* and Barruel had an opportunity of analysing a
vomited fluid which contained urea, uric acid, and the ordinary
urinary salts.
[Dr. Halliday Douglas has reported a case in which urea was
detected in the vomited fluid. London and Edinburgh Monthly
Journal of Medical Science, vol. 1, p. 410. ]
Vomitus in carcinoma.
In carcinoma of the stomach a fluid is vomited which de-
posits masses of chocolate or coffee-coloured flocks on the bottom
of the vessel, while others are observed on the surface of the
fluid. On examining a few of them under the microscope we
observe a considerable quantity of large rounded cells with yellow
granular contents, and also avery great number of fat-vesicles,
some larger and others smaller than the cells. Remnants of
food, and especially undigested starch-granules, are likewise .
frequently observed. The latter may be easily mistaken for
fat-vesicles, but moderately strong compression causes their
envelopes to break, and on the addition of a solution of iodine
they assume a blue colour. By this test all ambiguity is
avoided.
[Dr. George Wilson has published a notice of the chemical
and microscopical characters of the fluid ejected in pyrosis—
' Journ. de Chem. Med. 1820, Ser. III, p. 257.
394 THE EXCRETIONS: -
the ordinary water-brash. The most remarkable of these is
the appearance of a microscopic cryptogamic plant (sarcina
ventriculi), and of acetic, lactic, and carbonic acids in the
liquid. The first case in which these were found, occurred
to Mr. Goodsir, and was published by him in the ‘ Edin-
burgh Medical and Surgical Journal’ for April 1842. Since
that period a case has occurred in the practice of Mr. Ben-
jamin Bell of Edinburgh, who allowed Mr. Goodsir and
Dr. Wilson to examine the fiuid ejected by his patient, in which
the same organism and acids were discovered; and Mr. Busk,
of the Dreadnought hospital ship, Greenwich, has published the
history of three cases where the sarcina presented itself, but no
analysis was made of the fluids in which it appeared.
On examining the fluid with the microscope, the sarcina is
found to present the following characters.1_ In every instance
the organisms presented themselves in the form of square or
slightly oblong transparent plates, of a pale yellow or brown
colour, and varying in size from the 800th to the 1000th of
an inch. They were made up of cells, the walls of which ap-
peared rigid, and could be perceived passing from one flat sur-
face to another as dissepiments. These dissepiments, as well
as the transparent spaces, were, from compression of contiguity,
rectilinear, and all the angles right angles; but the bounding ~
cells bulged somewhat irregularly on the edges of the organism, ~
by reason of the freedom from pressure, These circumstances —
gave the whole organism the appearance of a woolpack, or of a —
soft bundle bound with cord, crossing it four times at right ©
angles, and at equal distances. From these very striking pe- —
culiarities of form, Mr. Goodsir has proposed for it the generic
mame of SARCINA.?
On examining the ejected fluid in the case recorded by Mr. :
Goodsir, it was found to possess the following characters. It —
was thick and viscid; on standing, it deposited a large quantity —
of ropy matter mixed with portions of undigested food, and, —
when filtered through paper, had a pale brownish yellow colour, —
and was quite transparent. It still contained much animal —
1 The reader is referred to the ‘Edinburgh Medical and Surgical Journal’ for —
April 1842, for a more minute description of the sarcina, and a detailed account of —
the chemical analysis of the liquid containing it.
2 Sarcina, a pack or woolpack.
—"< ae i ‘i ¥ = “
NETS Bh Pe
VOMITUS. 395
matter in solution, becoming opaque and flocculent when boiled,
and giving a very copious precipitate with infusion of galls.
It also precipitated nitrate of silver densely, and, when evapo-
rated to dryness and exposed to a full red heat in a platmum
crucible, left an ash containing much chloride of sodium. It
reddened litmus powerfully, and effervesced sharply with alkaline
carbonates. It continued strongly acid after being twice dis-
tilled, and did not precipitate nitrate of silver, but retained the
sour smell, which could now be recognized as identical with
that of vinegar. On neutralizing the twice distilled fluid with
lime-water, and evaporating to dryness, a salt was obtained,
which, on being decomposed in a tube-retort with sulphuric
acid, yielded a volatile odorous acid, readily identified by seve-
ral tests with the acetic.
It was found by several trials, that, on an average, an ounce
of the liquid neutralized 0:4 grain of carbonate of potash; a
quart (32 oz.) would therefore neutralize 12°8 grains, which cor-
respond to 9 grains of the hydrated (crystallizable) acetic acid,
C,H,O,+HO. The liquid remaining in the retort continued
to redden litmus powerfully after all the acetic acid had been
distilled from it. This was traced in part to the presence of a
small quantity of free hydrochloric acid; but it was chiefly
owing to the existence in the liquid of a considerable proportion
of lactic acid. The most remarkable feature of this case, in a
chemical point of view, was the large quantity of acetic acid.
found; the quantity of liquid ejected at once by the patient
often amounted to more than two quarts, which would contain
18 grains of acetic acid. In Mr. Bell’s case the chemical cha-
racters of the liquid were very similar. An additional point
was, however, ascertained, namely, the presence of free carbonic
acid in the liquid. |
396
CHAPTER XI.
THE COMPONENT PARTS OF THE ANIMAL BODY.’
The Bones.
THE bones are the least destructible of all the parts of the
organism. Under favorable circumstances they remain as un-
changed as mere inorganic matter, and the amount of cartilage
has been found unaltered in bones three thousand years old.’
The external surface of bone is surrounded by a membrane
richly endowed with nerves and vessels—the periosteum, which,
as well as the cartilaginous portion, can be converted, by boil-
ing, into gelatin. The interior of the cylindrical bones is lined
in a similar manner: the flat and short thick bones are, how-
ever, filled in the interior with delicate lamelle arranged so as
to present a cellular appearance: in the flat bones, this is
termed the diploe. Ifa bone is suspended in dilute hydrochlorie
acid at a low temperature, all the earthy matter becomes gra-
dually dissolved and the mere cartilage remains, retaining the
precise form of the original bone. It is supple, transparent,
and soft, but on drying it becomes of a darker colour, hard,
and somewhat contracted. When boiled it becomes rapidly
converted into gelatin, leaving the fibrous tissue and the vessels
of the bone unacted on. These vessels may be exhibited by
leaving the bone in dilute hydrochloric acid till about one half
of the earthy matter is dissolved: it must then be washed with
' This has been observed in the bones of human and animal mummies discovered
in Egyptian sepulchres. Apjohn and Stokes found in the bones of an extinct gigantic
elk, 48°87 of ordinary cartilage, combined with 43-45 of the phosphates of lime and
magnesia with fluoride of calcium, and 9°14 of carbonate of lime, &c. In the teeth
of an Egyptian mummy, Lassaigne found 299 of organic matter; and in the teeth of
a fossil bear, 14 of cartilage and 70 of phosphate of lime. Gimbernat prepared an
edible jelly from the bones of the Ohio mammoth.
BONES. 397
cold water, and afterwards kept for twenty-four hours in water,
nearly at the boiling point. The cartilage, from which the
earthy matter has been removed, is thus dissolved, and num-
berless minute vessels may be seen issuing from the undecom-
posed portion of bone, presenting a beautiful white velvety
appearance, which is injured by the least motion, If the bone
when immersed in dilute hydrochloric acid is exposed to heat,
the chemical action is facilitated, and the bone develops car-
bonic acid and separates into fibrous lamelle, divisible in a
longitudinal direction, which, if they are sufficiently thin, possess
the property of polarizing light in the same manner as mica.
When bone is submitted to thorough incineration, all the
organic portion is destroyed, and there remains nothing but
the earthy matter mixed with certain salts which have been
formed during the process of incineration, such as alkaline
sulphates and carbonates, and with free lime formed by the
expulsion of the carbonic acid from carbonate of lime.
The carbonate of lime in bone is just the sarhe as the natural
carbonate of lime; the phosphate, on the other hand, consists
of 8CaO + 3 PO., according toBerzelius! ; and 3 CaO + PO,,
according to Mitscherlich. In addition to these salts we find
small quantities of phosphate of magnesia and fluoride of cal-
cium,” and traces of the peroxides of iron and manganese.
[An elaborate treatise on the Chemistry of Bone has been
recently published by Von Bibra. We extract the following
analyses :—
1 [Berzelius repeated the analysis of the salt last year, and found that its compo-
sition is rightly expressed. (Ocefversigt af Kongl. Vat. Akad. Forhandlingar, 1844,
No. 6; or Liebig’s und Wohler’s Annalen, Feb. 1845.]
2 [The presence of fluoride of calcium in bone has been denied by Rees (Phil.
Mag. Jan. 1840.) The researches of Daubeny and Middleton (Memoirs and Proceed-
ings of the Chemical Society of London, vol. 2, pp. 97 and 134) not only demonstrate
its almost constant occurrence both in recent and fossil bones, but point out that
ordinary water is the vehicle by which it is conveyed into the system. “ With regard
to the statements of Rees,” observes Von Bibra, “I put them to the proof, and found,
as was to be expected, that they were altogether incorrect. I used in these experi-
ments the human femur, humerus, and teeth. On treating large quantities of bone-
earth with sulphuric acid, I have obtained corrosions on glass sufficiently deep to be
felt with the finger-nail.” (Chemische Untersuchungen iiber die Knochen und
Zahne, p. 103, Schweinfurt, 1844.) ]
&,
398 ANIMAL BODY :
Male Foetus at the 6—7th month. z
aa a
es ee Femur. Tibia. Humetus, q
phate of lime with barely recogniza a!
traces of fluoride of calcium ‘} 53°46 pa-46 53°15 F %
Earthy carbonates : : . 3°06 3:10 3°05 2
Phosphate of magnesia. , ° 2°10 2°00 1-96 a
gee : ; : ? 1:00 1-07 102 "4
Cartilage : ; : ; 40°38 40°37 40°82
Fat ‘ ‘ ; ; : a trace a trace a trace .
100-00 100-00 10000
Female Feetus at the 7th month. 7
c vagal a \ :
Ulna. Radius. Scapula. Clavicula. 4
Phosphate of lime with very little 4
ee ra 3 57638767 TB 5695
Carbonate of lime . : ; 5°86 5°89 5°99 oa oe
Phosphate of magnesia ‘ é 1:10 0-99 1°12 1:07
Salts : ; ‘ : 0°60 0°67 0-62 0-73:
Cartilage . ;" ; : 34°78 34:08 34°32 34°54 |
Fat ‘ : ; ‘ 0°63 0°50 0°82 0°96
Child aged 2 months. —
Tibia. Ulna,
Phosphate of lime with a little fluoride of calcium : . 57°54 56°35 _
Carbonate of lime ‘ ‘ ‘ ‘ ‘ . 6°02 6°07
Phosphate of magnesia ‘ ‘ : ‘ - 103 100°°3
Salts. . . : - 073 Ts %
Cartilage ‘ : ‘ ; ; ; - 33°86 34:92
ee : ; ¢ = . 082 10194
Child aged 9 months. is
Femur. Humerus. Tibia. Radius. Ulna. Costa. Seapula.
Phosphate of lime with a r
little fluoride of calcium } 48-11 50°15 48°55 45°38 48°06 42°32 42°61
Carbonate of lime . 612 G13 579 514 620 5:00 508
Phosphate of magnesia . 0°97 1:00 1:00 0°93 101 0°89 0:92
Salts. . 123° 1300 «241070 1-24 109) 0
Cartilage = - 41°71 39°53 41:50 45°65 41:70 48°55 48°36
ee . 186 189° 192 183 179 215 193
ie
2
' The “salts” in the analyses of Von Bibra are the salts soluble in water.
BONES.
399
A child aged 5 years. A girl’ aged 19 years.
Femur. Tibia. Femur. Humerus,
Phosphate of lime with a little fluoride
aha ‘| 5996 5974 05478 54°84
Carbonate of lime é 5°91 6°00 10°90 10°82
Phosphate of magnesia 1:24 1°34 1°34 1:26
Salts * : ; 0°69 0°63 0°83 0°79
Cartilage . ‘ ‘ a: Sa 31°34 31°15 81°37
Fat é 0°92 0°95 1:00 0°92
A woman aged 25 years.
ct >
Femur. Tibia. Fibula. Humerus. Ulna. Radius, Metacarpus.
Phosphate of lime with ;
a little fluoride oth rae 57°18 57°39 58°03 57°52 57°38 57°77
calcium <
Carbonate of lime 8°92 893 8:92 9°04 8-97 8°95 8°92
Phosphate of magnesia 1:70 1:70 163 159 171 1°72 1°58
Salts ; 060 O61 0°60 0°59 0°67 0°63 0°61
Cartilage 29°54 29°58 29°49 29°66 29°14 29°43 29°23
a. ¢ . 182 2:00 1:97 1:09 199 1°89 1°89
es %,
Os oc- Os inno-
Clavicula. cipitis. Costa. Sternum. Seapula. Vertebre. minatum.
Phosphate of lime with ;
a little fluoride | 56°35 57°66 52°91 4263 54°76 44:28 49°72
calcium ‘
Carbonate of lime 8°88 875 8°66 7°19 8°58 8:00 8:08
Phosphate of magnesia 169 169 140 Ili 153 = 1°44 1°57
Salts 0°59 063 0°60 0°50 0°51 0°53 0°60
Cartilage = 30°66 29°87 33°06 46°57 32°90 43°44 38°26
Fat... ‘ 183 1:40 2°37 2°00 P93-* 231 1:77
A man 25 or 30 years of age.
c een ea are 4
Femur. Tibia. Humerus. Ulna. Os occipitis. Costa.
oo ogee ant 59°63 58:95 59°87 59:30 58-43 55°66
Carbonate of lime 7°33 7°08 7°76 7°35 8°00 6°64
Phosphate of magnesia 1°32 1°30 1:09 1:35 1:40 1:07
Salts ‘ : 0°69 0°70 0°72 0°73 0°90 0°62
Cartilage 29°70 30°42. 29°28 29°98 29°92 33°97
Fat 1°33 1°55 1:28 1°29 1:35 2°04
1 This girl died from phlebitis thirteen days after the operation of amputation of
the upper arm for caries of the elbow-joint.
%
400 ANIMAL BODY:
Femur of a man aged 58 years.
cating ae
irs i:
Compact substance. Spongy substance.
Phosphate of lime with fluoride of \
; 58°23 42°82
calcium ; ‘
Carbonate of lime ? . ; 8°35 19°37
Phosphate of magnesia. ° ; 1-03 1:00
Salts ‘ k ; ; 0°92 0°99
Cartilage ‘ 4 ; m 31°47 35°82
Femur of a woman' Femur of a woman
aged 62 years. aged 78 years.
Phosphate of lime with a little \ 63-17 57-36
fluoride of calcium A
Carbonate of lime . : : 4°46 7°48
Phosphate of magnesia : ‘ 1-29 1:10
Salts . ; ; wine 0°90. 0°97
Cartilage . ‘ . 28°03 32°16
Fat , S ; " 2°15 0°93
These are the most recent, and probably the most accurate
of any of the analyses of human bone yet published. We
may omit, from absolute superfluity of matter, the researches
of Schreyer, Rees, Thilenius, Sebastian, Davy, Frerichs, and
Stark, which refer merely to the estimation of the organic and
inorganic matters, and shall take a brief survey of the more
perfect analyses of bone.
Berzelius found in human bone:
Phosphate of lime . , ‘ 51°04
Fluoride of calcium ‘ " ; 2°00
Carbonate of lime ‘ - 5 11°30
Phosphate of magnesia ; 1°16
Soda, with a little chloride of odin = 1:20
Cartilage .- : ‘ ; 32°17
Vessels > Se 113
Dr. Thomson found? in the human femur:
2. 2.
Phosphate of lime . ‘ 43°67 51°12
Carbonate of lime ; . 14:00 9°77
Magnesia ‘ , : 0°49 0°63
Soda ‘ . . 2°00 0°59
Potash ‘ ‘ “ 0°06 a trace
Cartilage ‘ s : 39°12 35°93
' A cretin. The bones had been underground for four years.
? Animal Chemistry, p. 245.
BONES.
401
The four following analyses were made by Valentin :—1 re-
presents the cortical portion of the tibia of a man aged 38 years;
and 2, the medullary portion of the same bone; 3 represents
the external condyle of the left femur of a girl; and 4, the head
of the left tibia of the same individual.
l. 2.
Basic phosphate of lime - 52°930 49°019
Carbonate of lime i 7 7°666 7°760
Phosphate of magnesia é 0°254 1°542
Chloride of sodium. : 0-911 0°441
Carbonate of soda ; ; 0-204 0:076
Cartilage, vessels, &c. . . 38°020 41:160
3.
37°012
5°038
0°874
0°645
1°331
55°180
4.
41°774
77109
0°874
1-677
48°560
Marchand found in the compact substance of the femur of
a man aged 30 years:
Basic phosphate of lime
Fluoride of calcium .
Carbonate of lime
Phosphate of magnesia
Soda :
Chloride of sodium ‘ :
Cartilage insoluble in hydrochloric acid .
Cartilage soluble in hydrochloric acid
Vessels ; . .
Peroxides of iron and manganese, and loss
52°26
1:00
10°21
1°05
0°92
0:25
27°23
5°02
1-01
1°05,
The most recent analyses of human bones, with the exception
of those by Von Bibra, are those of Lehmann.
Bones of a man aged 40 years who committed suicide.
ae
cr
Humerus. Radius. Ulna. Femur,
Fibula.
Phosphate of lime and
Masride of calcitun 56°61 53°25 53°98 58°93 52:99
Carbonate of lime : 9°20 9°76 9°51 9°28 9°33
Phosphate of magnesia . 1-08 1-06 1:07 1:09 1:06
Chloride of sodium ; 0°37 0°36 0°40 0°40 0°37
Soda . : 1°35 1°36 0-98 1:04 1:07
Organic matter : 3152 33°76 33:23 28°61 34:14
From the bones of a man aged 44 years he obtained :
Femur. Tibia.
Phosphate of lime and fluoride of calcium ~ 52°67 52°93
Carbonate of lime ‘ ‘ - 10°03 9°88
Phosphate of magnesia : i F 0°93 0°91
Soda ; : i 3 1:07 1°09
Chloride of sodium ; : ore 0°34 0°31
Organic matter. : : . 3415 33°94
II. 26
~
Tibia.
53°12
9°35
1:07
0°39
0°99
34°10
Fibula.
52-04
10°13
0°89
1-12
0°39
34°51 |
A402 ANIMAL BODY :
BONES OF THE LOWER ANIMALS.!
Mammalia.
[ EpEenTATA. Common armadillo.
Pasi a Be.
the throat. the abdomen. the tail.
Phosphate of lime with a little fluoride
} 53°45 50°92 55°43
of calcium ;
Carbonate of lime : 6°73 6°63 6:99
Phosphate of magnesia 1:30 1°23 1:07
Salts 0°89. 0°95 0°92
Cartilage 34°63 36°77 32°81 —
Fat 3°00 3°50 2°78
GLIRES.
Squirrel (old). Mouse. Rat. Hare.
Ce Femur and tibia
Femur. Humerus. together. Femur, Femur.
Phosphate of lime with a : 4 ; : G
little fluoride of iia | oF adios wicca wedi eo
Carbonate of lime - 1045 # 10°50 9-62 6°72 9°07
Phosphate of magnesia . 1°36 1°32 1°10 1-91 0°99
Salts aie ‘ 0°90 0°91 0°83 0°91 0:82
Cartilage ; - waghe SiZi 36°84 28°98 29°60
Fat . A 0°80 0°79 1:30 1:10 1:07
RUMINANTIA.
Sheep aged 4 years. He-goat. Bulli aged 4 years.
Femur. Osoccip. - Femur. Tibia. Os occip.
Phosphate of lime with a be
little fluoride of calcium 55°94 47°07 54°07 54°03 52°51
Carbonate of lime 12°18 9:09 12-71 11-99 11-14
Phosphate of magnesia 1:00 1°59 142 1°44 1:05
Salts 0°50 1°02 0°30 §60°70 0°50
Cartilage 29°68 39°58 29°09 29°92 32:80 —
Fat 0°70 1°65 1°91
Bony plates from the region of.
“192 2°00
—
! The whole of these analyses, with two exceptions, were made by Von Bibra,
as
BONES. 403
PACHYDERMATA.
Horse! (foetus of Castrated horse Mare
about 3 months.) aged 6 years. aged 14 years.
Humerus and tibia. Femur. Humerus. Femur.
Phosphate of lime with a
little fluoride of calcium } we? 54°37 aoe nave
Carbonate of lime : 1°83 12°00 12:07 11°28
Phosphate of magnesia. 1-40 Leas ae 1:50
Salts ; ? a trace 0-70 = O71 0°40
Cartilage ‘ : 36°26 27°99 29°70 27:98
Fat ‘ — 3°11 2°91 4°21
Wild-boar.
Costa.” Metatarsus.” Femur.
Phosphate of lime with a 58°88
little fluoride of calcium baie aoSus
Carbonate of lime ; 6°32 9°05 9°02
Phosphate of magnesia. 1:94 "69 117
Salts ‘ ‘ 1:22 1:78 0:92
Cartilage 28°00
‘het } 47°30 34°16 pee
CETACEA. PINNIPEDIA.
Dolphin. Common seal.
ene - A 5
Costa. § Vertebre. Os occipitis. Maxilla inf.
Phosphate of lime bcs
, ; 8° 54°11
little fluoride of calcium aaa aie ald
Carbonate of lime . 9-99 937-52 7°23 7°20
Phosphate of magnesia. 110 0:98 . 118 0°93
Salts ; e724 SO 1-24 1°43 1°22
Cartilage ; : 30°46 33°97 30°11 35°24
Fat ‘ 3 — — 1:28 1°30
' Von Bibra likewise analysed separately the compact and spongy substance of the
femur of a horse aged 12 years, and obtained the following results :
Compact Spongy
substance, substance.
Phosphate of lime with a little fluoride of calcium 54°65 41°14
Carbonate of lime ; : ae ied ee 18:93
Phosphate of magnesia AR ; . 148 1-32
Salts P ‘ ‘ . 0°86 0°94
Cartilage ‘ F ; ~ 327 37:67
? These analyses were made by Valentin.
404
FALCULATA.
ANIMAL BODY:
Cat aged 6 years. Wolf.
fo pata zs, %
Humerus. Verteb. Os occip. Femur. Humerus. Costa. Verteb.
Phosphate of lime with
a little fluoride of cal- } 59°30 48°01 51°70 57°87 55°36 51°76 48°72
cium ;
Carbonate of lime 10°69 84% 10:13 11:09 11°76 10:90 10-03
Phosphate of magnesia 1:70 = 0°97 107 +113 #£+1:07 +100 0°88
Salts ‘ 0°40 0°39 037 1:02 099 090 091
Cartilage . 27°21 40°79 35°83 27:44 29°51 33°78 37°53
Fat 0°70 1:40 0°90 1°45 131. =1°66°: 195
VOLITANTIA. Common bat.
Femur. Humerus.
Phosphate of lime with a little fluoride of calcium 57°45 56°90
Carbonate of lime 4°77 6°00
Phosphate of magnesia — 1:03 1:00 —
Salts ¢ 0°75 0°80
Cartilage ; 34:20 34:27
Fat 1:80 1:03
POLLICATA.
Cebus Capucinus (Capuchin ape).
Poms; Humerus. Vertebre. Costa. Scapula. Os ili.
Phosphate of lime with
a little fluoride of cal- } 54°33 51°87 50°43 «95154 = 50°24 46°63
cium ar" .
Carbonate of lime 7°99 7°33 6°92 7°00 7°31 6°03
Phosphate of magnesia 1°58 1:72 1°33 115 1-20 1:07
Salts 0°89 0°93 0°92 0°87 0°91 0-90
Cartilage 34°01 37°18 39°04. 38°37 =39°33. 44°16
Fat 1:20 0°97 1°36 1:07 1°01 121
BIRDS.
; Thrush. Sparrow 6 days old. Sparrow (aged).
— Femur, tibia, & humerus
Femur. Humerus. together. Femur, Humerus.
Phosphate of lime with
a little fluoride of ca} 58°64 62°65 39°78 59°46 60°04
clum-=..- .
Carbonate of lime 5:07 «605 3°62 8:88 9-97
Phosphate of magnesia 0°83 0°90 0°40 1:03 1:09
Salts 0°77 0°84 0°30 0°90 0°90
Cartilage 33°43 =.28°02 55°80 27:20 26°14
Fat 1°26 1°54 0°10 2°53 1:86
BONES.
Rana esculenta.
REPTILES.
Salamandra
terrestris.
Mixed bones. Femur.
Phosphate of lime with
a little fluoride of cal- } 53°89 59°48
cium P
Carbonate of lime . 2°46 2°25
Phosphate of magnesia 1-07 0°99
Salts of soda é 0°82 1:78
Cartilage . d 38°64 30°19
Fat . : 3°12 5°31
FISHES.
Eel. Pike.
Vertebre. Vertebre. Vertebre.
Phosphate of lime with a
little fluoride of calcium ander
Carbonate of lime : 3°64
Sulphate of lime : 1:09
Phosphate of magnesia. 0°78
Sulphate of soda : 0°83
Carbonate of soda & we et
ride of sodium :
Cartilage ; : 36°99
Fat ; ; 23°55
38°70
14°30
0°81
0°97
32°72
12°50
Tibia.
59°73
2°24
0°97
1-90
29°16
6°00
Salmon.
36°64
101
0°70
0°83
21°80
38°82
405
Coluber Anguis
natrix. fragilis.
Vertebree. Vertebre.
59°41 47°52
7°82 6°92
1:00 111
0°73 0°90
24°93 36°18
6°11 7°37
Cod.
Vertebre. Os occip.
57°65 61°15
4°81 5°20
2°30 2°62
100 =—-:1-03
31°90 27°89
2°34 2°11
We have selected these individual cases from 143 analyses
of the bones of mammalia (independently of man) ; 151 of birds,
31 of reptiles, and 23 of fishes. ]
406
[ Rachitis.
several chemists.
ANIMAL BODY:
Morbid Bones.
The bones in this disease have been analysed by
* Lehmann examined the tibie of three rachitic children.
He found :
Phosphate of lime
Carbonate of lime
Phosphate of magnesia
Chloride of sodium
Soda.
Cartilage
Fat
: Bs 2. 3.
32:04 26-94-2813
4-01 4:88 3°75
0-98 081 0:87
0-21 0:27 0°28
0:54 081 0-73
54:14. 60-14. 58°77
5°84 6-22 6-94
Ragsky found in the scapula and humerus of a rachitic child:
Phosphates of lime and magnesia 15°60
Carbonate of lime 2°66
Soluble salts 0°62
Cartilage, vessels, and fat 81°12
In the ulna of a child aged 5—6 years, Von Bibra found:
Phosphate of lime with a little fluoride of calcium 47°83
Carbonate of lime 7°42
Phosphate of magnesia 1:23
Salts : 1°82
Cartilage 35°61
Fat 6:09
Osteomalacia. Several analyses of bone in this disease are
on record.
Vertebra. Vertebra. Costa.
(Bostock). (Prosch.) (Prosch.)
Phosphate of lime 13°60 13°25 33°66
Phosphate of magnesia . 0°82 — —
Carbonate of lime 113 5°95 * 4:60
Sulphate of lime and phosphate of soda 4:70 0°90 0°40
Cartilage , 79°75 74°64 49°77
Fat _ 5°26 11°63
An analysis by Bogner of the bones of a man aged 32 years,
who died from osteomalacia, yielded the following results :
Scapula. Radius.
Phosphate of lime 26°92 28°11
Carbonate of lime 0°98. 1:07
Phosphate of magnesia 5°40. 6°35
Cartilage and vessels 65°85 63°42
Soda, iron, and loss 0°85 1°05
Femur.
23°50
0°97
5°07
69°77
0°69
Patella.
23°23
0°94
5°03
70°60
0°64
tin"
MORBID BONES. 407
Ragsky has analysed bone in this disease. He found in arib :
Phosphates of lime and magnesia ; 17°48
Carbonate of lime and salts ; ‘ 6°32
Cartilage, vessels, and fat : ‘ 76°20
After the removal of the fat, Lehmann found :
1. 2 3.
Phosphate of lime . 36863 31-718 35871
Other salts. . 4968 7913 5684
Cartilage . 58169 60369 58445
and in two other cases of osteomalacia occurring in persons
aged about 40 years, the same chemist found :
I. 2.
Femur. Costa. Femur. —Costa.
Phosphate of lime : - 1756 21°02 _ 18°83 19°14
Carbonate of lime ee 3°04 3°27 3°83 4:08
Phosphate of magnesia ‘ 0°23 0°44 0°54 0°60
Soluble salts : ‘ 0°37 0°63 0°43 0°41
Cartilage ; . . 48°33 50°48 4154 42°43
Fat : : - 29°18 23°13 34:15 32°65
The three following analyses of bone in this disease were
made by Von Bibra: => eS
Tibia of a woman Femurofawoman Femur of a man
aged 75 years. 83 years. aged 60 years.
Phosphate of lime with a
little fluoride of calcium f °°"? so19 a oa
Carbonate of lime : 4:94 6°37 . 7°49
Phosphate of magnesia . 2°01 1-20 1:22
Salts é . 0°31 1°37 1:35
Cartilage : . 29°17 30°99 32°54
Fat ‘ ‘ 8°56 13°28 4°15
Marchand found the bones of the child whose case is noticed
in p. 286 of this Volume, composed in the following manner :
Vertebra. Radius. ‘Femur. Sternum.
Phosphate of lime . : - 1256 15:11 14°78 21:35
Phosphate of magnesia ‘ F 0°92 0°78 0°80 0°72
Carbonate of lime. ‘ : 3°20 3°15 3°00 3°70
Sulphate of lime
Sulphate of Saf
wraorins of calcium, chloride of ot 1-00 198 100 2-01
iron, and loss . .
Cartilage . : ‘ . 7522. 71:26. 72:00 61°20
Fat : . ‘ ‘ 6°12 7°50 7°20 9°34
The cartilage yielded neither glutin nor chondrin.
098 100 102 °& 1°68
408 ANIMAL BODY:
Arthritis. Marchand analysed the upper part of the femur,
and the bones of the fore-arm of a person with abundant to-
phaceous deposits in the knee- and elbow-jomts. He found
in these bones:
Femur. Radius & ulna.
Phosphate of lime ; A + eos 43°18
Carbonate of lime : ; - 8°24 8°50
Phosphate of magnesia. ; ; 1-01 0°99
Animal matter ; ; +: (4632 45°96
Fluoride of calcium, soda, chloride of ety ta 2-3} 137
and loss
Lehmann analysed the bones of three persons with chronic
gout ; their ages varied from 40 to 50 years. He found:
1. 2, 3.
Phosphate of lime . - 95°16 35°83 37°22
Carbonate of lime . ; 8°41 9°82 8-99
Phosphate of magnesia os 105 - FI
Soluble salts é " 2°93 2°03 1°82
Cartilage : ‘ . 38°14 38°26 40°03 |
Fat : ? , ae 13°37 9°15
Caries. Valentin has analysed carious bones, and likewise
an osteophyte incrustation surrounding the carious tibia of a
man aged 38 years. ;
Tibia ofaman Vertebra of a man
aged 38 years. aged 20 years.
Phosphate of lime A : 34°383 33°914
Carbonate of lime 2 é 6°636 7°602
Phosphate of magnesia ; 1-182 0°389
Chloride of sodium 3°157
Carbonate of soda } as ca 0118
Organic constituents. . 55°880 54°830
External condyle Head of tibia
of the femur of a girl. of the same individual.
Phosphate of lime ; 39°393 45°451
Carbonate of lime ; 4°620 5°683
Phosphate of magnesia. 0520 1180
Chloride of sodium ; 0°424 1°620
Carbonate of soda ; 0-647 0-446
Organic constituents : 54396 45°620
MORBID BONES.
409
In the osteophyte incrustation there were contained :
Phosphate of lime
Carbonate of lime
Phosphate of magnesia
Chloride of sodium
Carbonate of soda
Organic matters
29°424
4-201
0°317
5556
1°117
59°370
Von Bibra has also made several analyses of carious bones.
Phosphate of lime with a little
fluoride of calcium
Carbonate of lime .
Phosphate of magnesia
Salts .
Cartilage
Fat
Phosphate of lime with a little oe
of calcium
Carbonate of lime
Phosphate of magnesia
Salts. =
Cartilage
Fat >
Bones of the hand of a man.
J Its upper 3
Metacarpal bone. articulating portion. Phalanx.
} 49°77 31:36 49°36
7°24 4:07 8:08
111 0°83 0°98
0°30 0°30 0°40
37°97 59°36 37°47
3°61 4:08. 3°71
Femur of a man.
eee lg a
Diwwanesi portion. Mass of the sitar,
51°53 54:98
5°44 5°97
3°43 3°70
0°91 0°89
35°69 31°44
3°00 3°02
Palate bone of a woman aged 40 years, with inveterate syphilis.
Phosphate of lime with fluoride of calcium
Carbonate of lime
Phosphate of magnesia
Salts
Cartilage
Fat
Phosphate of lime with Sach
of calcium
Carbonate of lime
Phosphate of magnesia
Salts
Cartilage
Fat
(The portion submitted to analysis was thrown
off during her lifetime, and weighed 16-5 grains.)
45°14
5°03
We, 2°40
0°82
42°34
4:27
Tibia of aman Tarsus of aman
aged 25 years. aged 40-50 years.
47°79 39°22
6°44 6°87
1°30 0°50
2°00 2°10
28°57 29°23
13°60 22°09
410
fluoride of calcium
Carbonate of lime
Phosphate of magnesia
Salts
Cartilage
Fat
Phosphate of lime, ap |
Necrosis.
Phosphate of lime, with fluoride of calcium
Carbonate of lime
Phosphate of magnesia
Salts
Cartilage .
Fat
This small amount of organic matter is not characteristic of
necrotic bone, for in two minute portions thrown off after frac-
tures Von Bibra found :
ANIMAL BODY:
Nasal bone of a girt
aged 15 years. aged 40 years.
44°05
45°77
3°77 3°45
1°45 1°02
1:10 1:70
38°62 41°42
9°29 8°36
The following analysis was made by Von Bibra:
Phalanx of a man
aged 40-50 years.
72°63
4:03
1-93
0°61
19°58
1-22
Lumbar vertebra! of a woman |.
1. 2.
Organic matter 37°87 31°58
Inorganic matter 60°77 67°33
Fat 1°36 1:09
Osteoporosis. Ragsky has analysed a specimen of osteopo- |
rosis growing on the cranium of an aged person. It yielded
gelatin when boiled. It contained:
Phosphates of lime and magnesia 55°80
Carbonate of lime and salts 5°59
Cartilage, vessels, and fat 38°61
4
i
Ki
5
ta
os
B
! In the cavity of this bone, produced by the caries, there was a thick, reddish a
yellow matter, like inspissated pus.
Albuminous matter
Aleohol-extract and lactates .
Water-extract
Shreds of cartilage
Fat ‘
Fixed salts
The latter contained i in 100 parts :
19°7
0°9
2°4
51°0 ~
7:2
18°8 containing 903 of phosphate of lime.
ie
It consisted of 81:3 parts of water and volatile ’
matter, and 18-7 of solid constituents.
MORBID BONES. 41]
Sclerosis. Ragsky has analysed bone in several cases of
this affection.
Simple sclerosis of the cranium of a madman.
Phosphate of lime with fluoride of calcium 54°10
Carbonate of lime ; ‘ ‘ 10°45
Phosphate of magnesia ; ‘ 1:00
Soluble salts ; , J 1:04
Cartilage and vessels. ‘ : 33°41
Sclerosis consecutive on osteoporosis.
(The bone not specified.)
Phosphates of lime and magnesia : 48°20
Carbonate of lime : : : 7°45
Soluble salts . : : 0°25
Cartilage, fat, and vessels ¢ ieee Set
Sclerosis more highly developed.
Phosphates of lime and magnesia , 50°29
Carbonate of lime and soluble salts : 7°20
Cartilage and vessels. : , 42°51
Sclerosis in the highest degree.
Phosphates of lime and magnesia ; 55°52
Carbonate of lime : ‘ ‘ 5°95
Soluble salts . ° : 0°26
Cartilage and vessels. ‘ ; 38°27
Sclerosis of the femur.
Phosphates of lime and magnesia : 53°21
Carbonate of lime ‘ : : 8°30
Cartilage and vessels. : ° 38°49
Syphilitic sclerosis, highly developed.
Phosphates of lime and magnesia of 87°20
Carbonate of lime ‘ : : 6°50
Cartilage and vessels.” : ‘ 36°30
Ezostosis. Lassaigne has analysed an exostosis, the thick-
ened bone to which it was attached, and a healthy portion of
the same bone.
Thickened bone. Healthy bone. Exostosis.
Phosphate of lime . . 36°3 41°6 > SOG
Carbonate of lime . ‘ 6°5 8°2 14:0
Soluble salts ‘ . 14:2 8°6 10°0
Organic matter . é 43:0 416 46:0
Von Bibra has analysed an exostosis on the humerus of a
412 ANIMAL BODY:
dog. In the second analysis the cempean of the healthy
radius and ulna are represented.
1. 2.
Exostosis. Radius and ulna.
Phosphate of lime with fluoride
of calcium ‘ ‘I 47°99 60°95
Carbonate of lime . : 1°00 2°84
Phosphate of magnesia : 1°55 1°39
Salts ‘ : : 0°91 0°93
Cartilage . é : 45°74 32°88
Fat : : a 2°81 101
We observe in both these cases that the exostosis contains a
larger amount of organic matter than healthy bone. ]
I have analysed a remarkable osteoid tumour that formed
on the knee of a leucophlegmatic boy aged 14 years, who was
suffering from oedema. ‘The tumour was ten inches long and
twenty-five broad, and could be hardly half spanned with both
hands. The limb was amputated and the tumour examined.
I analysed separately three portions of the tumour, one hard
and bony, a second softer, and a third perfectly soft. On ex-
posing them to heat on an oil-bath, the first became white and
earthy, while the other portions assumed a horny appearance.
Ether took up a dirty yellow, non-phosphorized fat.
The three specimens yielded on analysis :
Anal. 155. Anal. 156. Anal. 157.
Phosphate of lime j .. 35°85 8-00 9-20
Carbonate of lime : ; 2°70 0°62 0°64
Phosphate of magnesia ? ; 0°58 0°21 —
Soluble salts ; é ; 0°52
Chloride of sodium ‘ " 0°26 sisi: doin
FR . é ; 1°16 3°61 3°21
Cartilage and vessels ‘ . 98°91 87°04 86°20
The proportions of the fixed salts to each other in these cases,
and as they occur in normal bone, are exhibited in the maieedie
table:
l. 2 3. Healthy bone.
Phosphate of lime ; Tee gf 86°5 86°9 79°4
Phosphate of magnesia . ‘ 15 1°9 — 17
Carbonate of lime s ; 68 6°6 6°0 16°9
Soluble salts. ; 9 NT 1-4
Chloride of sodium ae } be ee 0-4:
The most striking peculiarity is the relative diminution of
the carbonate of limé.
TEETH. ae
[Callus has been analysed by Lassaigne and Von Bibra.
Lassaigne examined the outer and inner portions of a mass
of callus. He found:
External portion. Internal portion.
Phosphate of lime . ; ‘ 33°3 32°5
Carbonate of lime . 4 : 5°7 6°2
Soluble salts ; : 11:3 12°8
Animal matter ‘4 : : 50°0 48°5
The following analyses were made by Von Bibra :
. Callus from the Callus from the
tibia of a hare. rib of a horse.
Phosphate of lime with fluoride of ee
ee f 3262 43:9
Carbonate of lime : : 1°01 5°69
Phosphate of magnesia. ‘ 1°13 1°20
Salts 7 : i 1°79 0°74
Cartilage ; . : 61°41 46°97
Fat ‘ : : 2°04 1°50
Hence callus does not contain so large an amount of earthy
salts as true bone. |
The Teeth.
The teeth, like the bones, consist of phosphate and carbonate
of lime, fluoride of calcium and cartilage. The bony matter of
the tooth is covered superiorly with enamel, while the fangs
are coated with cement or cortical matter, which likewise over-
lays the enamel of the crown. Of the three constituents of
tooth, enamel, bone (dentine), and cortical substance, the last
is the poorest in inorganic matter. Lassaigne found therein :
Organic matter ‘ : : 42°18
Phosphate of lime : ; ‘ 53°84
Carbonate of lime : : : 3°98
‘The osseous portion (dentine) hardly differs from true bone.
Berzelius found therein :
Cartilage and vessels : - 28°0
Phosphate of lime with fluoride of calcium . 643
Carbonate of lime ; ; oe
Phosphate of magnesia. F oe
Soda, with chloride of sodium 5 SS af
414 ANIMAL BODY:
Pepys found :
Cartilage ; : : si. 2B
Phosphate of lime ; ; . 580
Carbonate of lime : : , 4:0
Water and loss fl : ct. ore
From analyses made by Lassaigne of human teeth at dif-
ferent ages, it appears that the phosphate of lime gradually
increases, and that there is a corresponding diminution of the
carbonate.
Organic Phosphate Carbonate
matter. of lime. of lime.
Tooth of a child one day old ; 35°00 51:00 14:00
» Of achild aged 6 years . ‘ 28°57 60°01 11°42
» Of an adult man . ‘ 29°00 61-00 10:00
» Ofamanaged 8l years . . ; 33°00 66-00 1-00
In the enamel of human teeth, Berzelius found :
Phosphate of lime with fluoride of calcium - 88°5
Carbonate of lime 4 é oe BD
Phosphate of magnesia. P vi eS
Membrane, alkali, and water . ae
So that this substance seems almost destitute of organic
combination. —
[Von Bibra has made the following analyses of human teeth :
Molar tooth of Molar tooth of
a woman aged 25 years. an adult male,
Enamel. Osseous portion. Enamel. Osseous portion. —
Phosphate of lime with a :
little fluoride of calcium 81°65 67°54 solic 66:72
Carbonate of lime j 8°88. se FSF 4°37 3°36
Phosphate of magnesia. 2°55 2°49 1:34 1:08
Salts ; : 0-97 1-00 0-88 0°83
Cartilage io é 5°97 20°42 3°39 27°61
Fat ‘ ‘ a trace 0°58 0°20 0°40
For a series of analyses of the teeth of the lower animals —
I must refer the reader to the original work, (Chemische
Untersuchungen iiber die Knochen und Zahne des Menschen —
und der Wirbelthiere,) which may- be regarded as a pea
monograph on the subject of which it treats.]
tes oT - raches r
Pa POE ae Tie eae ae
ae
CARTILAGE. 415
Cartilage.
The cartilages are invested with a peculiar membrane, the
perichondrium ; they are not so hard as bone, but are more
elastic and supple. They are usually divided into two classes,
the true and the fibrous cartilages. In addition to their re-
spective microscopic appearances, they present well-marked che-
mical differences. The true cartilages dissolve almost entirely
in water, and yield chondrin (see Introduction, p. 25). If,
however, the boiling is interrupted before the solution is per-
fectly effected, it will be found that the cells have remained
almost unchanged, and that only the basic substance has been
dissolved. Even when true cartilage is perfectly dissolved the
solution is somewhat turbid, owing, probably, to a partial change
in the cells. Fibrous cartilage, in which the cells form the
preponderating mass when continuously boiled for forty-eight
hours, yields only a small quantity of extract, which exhibits
all the ordinary reactions of chondrin, but does not gelatinize.
The inorganic constituents of cartilage form only a small portion
of their mass; Fromherz and Gugert! found in the costal car-
tilage of a man aged 20 years, 3°402°2 of fixed salts, associated
in the following proportions :
Carbonate of soda : : 35°1
Sulphate of soda : : 24°2
Chloride of sodium ; ; 8-2
Phosphate of soda ‘ ‘ 0°9
Sulphate of potash S : 12
Carbonate of lime ; ‘ 18°3
Phosphate of lime Beng é 4°]
Phosphate of magnesia. ; 6°9
Peroxide of iron and loss ; 0°9
In the corresponding cartilage of a woman aged 63 years,
the same salts were observed, but to a smaller amount: there
was also a larger amount of phosphate than of carbonate of lime.
[The following analyses of cartilage are extracted from Von
Bibra’s work :—
1 Schweiger’s Journal, vol. 50, p. 187.
416 ANIMAL BODY:
Costal cartilage of a child Ditto of a child
aged 6 months. aged 3 years.
100 parts yielded
a
¢ a)
2-24 of the following ash: 3-00 of the following ash:
Phosphate of lime ; ‘ 20°86 21°33
Sulphate of lime : . , 50°68 48°68
Phosphate of magnesia. ‘ 9°88 8:88
Sulphate of soda , . 9°21 10°93
Phosphate of soda 3°00
Carbonate of soda } , ; aased —
Chloride of sodium : 9°37 7°18
Costal cartilage of a girl Ditto of a woman Ditto of a man
aged 19 years. aged 25 years. aged 40 years.
100 parts yielded
c \
7°29 of the followingash: 3*92o0f the following ash: 6:1 of the following ash:
Phosphate of lime . 5°36 6°33 13°09
Sulphate of lime - 92°41 87°32 79°03
Phosphate of magnesia 0°99 4:10 3°78
Sulphate of soda «Ss 1°24 0°95 1:22
Phosphate of soda . a trace a trace 0°93
Chloride of sodium . a trace 1:30 1°95
Carbonate of soda . — a trace a trace
Carbonate of lime . — — a trace |
Synovia.
The synovial fluid is viscid, transparent, of a yellow or reddish
colour, faintly saline, and resembles in its odour the serum
of the blood. A specimen of this fluid, analysed by John,
contained :
Water : : g ‘ 92°80
Albumen é ‘ ‘ > 6°40
Extractive matter, with muriate and carbonate of } 0-60
soda 3 ‘
Phosphate of lime . ’ ‘ 0°15
Cellular Tissue, Tendons, Ligaments, Skin, Hair.
These may be classified together as tissues that yield gelatin.
They are distinguished more by their microscopical than their
chemical characters, and we may refer to Henle for an excellent
account of their minute structure. The elements of cellular or
combining tissue (Bindegewebe) in whatever part of the body
it occurs are long, fine, hyaline fibrille or cylinders, varying in
diameter from ‘0003 to ‘0008 of a line, and lying in close ap-
TENDONS, LIGAMENTS, SKIN. 417
position. They are firm and elastic, are not changed by cold
water, nor dissolved by acetic acid; the latter reagent renders
them gelatinous and tough, but takes up no protein-compound.
The organs containing this tissue diminish when boiled, become
harder and more rigid, but ultimately soften and dissolve into
gelatin, forming a solution that stiffens on cooling. Alcohol,
ether, and oil exert no action on cellular tissue, even when aided
by heat.
_ Tendons swell on being boiled, become yellow, aiid are gra-
dually converted into gelatin. The solution is turbid in con-
sequence of the flocculent appearance presented by minute
vessels in suspension. In concentrated acetic acid they swell,
become transparent and gelatinous, and in this state readily
dissolve in hot water, from which neither an alkali nor ferro-
cyanide of potassium throws down any precipitate.
Ligaments consist partly of cellular and partly of elastic
tissue, and these two structures present both chemical and
physiological differences. True elastic tissue is not changed by
acetic acid, is not converted by boiling into gelatin, but with
the aid of heat dissolves readily in dilute mineral acids, from
which it is not precipitated by ferrocyanide of potassium. As
illustrations of the true elastic tissue we may refer to the liga-
menta flava between the vertebre and the ligamentum nuche
im the ruminants.
The evtis, or true skin, is a contractile cellular tissue con-
vertible, by boiling, into gelatin. It is permeated by a fluid, and
contains also cellular tissue and vessels. Wienholt has endea-
voured to determine their relative proportions; he obtained:
Cutaneous tissue ee cellular tissue and vessels) . 32°53
Water « 57°50
in which were tieiskeed : '
Albumen : ; ‘ . ‘ 1°54
Alcohol-extract . - x ‘ * 0°83
Water-extract ‘ ; ; : 7°60
The skins of different nals require boiling for different lengths
of time in order to be converted into gelatin, and the change
is effected more rapidly in young than in old animals.
The conversion of the cutis into gelatin is much facilitated
by the action of dilute alkalies or acids; it then takes place at
an ordinary temperature. The skin combines with basic sul-
phate of iron, and with bichloride of mercury, when immersed in
II, 27
418 ANIMAL BODY,
solutions of those salts, and it then resists putrefaction. It
likewise combines with tannin, forming a substance insoluble
in water, and no longer tending to putrefaction (leather).
The epidermis is affected by strong mineral acids: concen-
trated sulphuric acid dissolves it, as also do the caustic alkalies.
Many metallic salts combine with and colour it. The ter-
chloride of gold communicates a purple, nitrate of the protoxide
of mercury a reddish brown, and nitrate of silver a black colour :
the volatile oxide of chrome (?) exerts a similar effect, and
even the alkaline sulphurets communicate a brown or black
colour to it. |
[The hair has recently been examined by Scherer and Van
Laer.1 By treating the hair with spirit, ether, and water,
there were removed margarin and margaric acid, olein, a brown
matter soluble in water, chlorides of sodium and potassium,
and lactate of ammonia.
By ultimate analysis there were then obtained :
Scherer. Van Laer.
r sree: ~ pee tea
1. 2. 3. 4, 1. 2.
Carbon . . 51°529 50652 50622 49-935 50-12 50°65
Hydrogen . 6687 6:766> 6613 . 6-631 6:33. 6°36
Oxygen 21:03 20°81
Sulphur . 23848 24643 24829 25°498 499 500
Nitrogen - 17:963 17:963 17:963 17:963 17°52 (17°14
No. 1 was hair of the beard; 2, of the head of a fair
person ; 3, was brown hair; and 4, black hair from a Mexican,
The ash in 1 amounted to 0°72°; in 2, to 0°82; and in 4,
to 2:08. .
According to Van Laer, the inorganic constituents in 100
parts are:
Colour. Ash. Soluble portion. Peroxide of iron. Insoluble portion.
Brown hair ‘ 0°54 0°17 0°058 0-312
” . 1°10 6°51 0°395 0°200
” . 0°32 _ — sag
Black hair ‘ 1:02 0°29 0°214 0°516
” . 115 —_ — Sas
Red hair - 1°30 0°93 0:170 0-200
is . 0°54 0-27 0°275 —
” . 1°85 —_ : —_ ice
Gray hair : 1:00 0°24 0°232 0°528
A . 0°75 a5 soe sa
’ Scheik. Onderzoeck, 2° St. p. 75.
THE EYE. 419
The soluble portion consisted of chloride of sodium, sulphate
of lime, and sulphate of magnesia; the insoluble constituents
were phosphate of lime and silica.
From Van Laer’s investigations it appears that the hair con-
sists essentially of :
1. A connecting medium consisting of a tissue yielding ge-
latin and represented by the formula C,, H,, N, O, ;—and
2. Of bisulphuret of protein, C,, H,, N, O,, §,,.
The large amount of sulphur in hair (averaging 5°) is the
cause of its colour being affected by various metallic salts.
As there is no constant difference in the results obtained by
the analysis of hair of various tints, it is to be presumed that
the colour is dependent on peculiar arrangements of the ul-
timate particles.
Hair further contains about 0:4° of peroxide of iron, which
is supposed by Van Laer to be chemically combined with the
protein. |
Crystalline Lens and Fluids of the Eye.
The crystalline lens is insoluble in boiling water, spirit, and
acids; it does not even communicate any turbidity to them ;
hence it consists neither of cellular nor elastic tissue, but is a
distinct substance, approximating possibly towards horny tissue.
The membrana Demoursii, the third layer of the cornea, pos-
sesses similar properties, while the true horny layer which lies
between the external layer of epithelium and the membrana
Demoursii appears to be fibrous, and is converted by boiling
into chondrin. The crystalline lens itself possesses a peculiar
and very regular fibrous arrangement. Chevenix found the
specific gravity of the human lens to be 1079, and that of the
sheep 1180. I have observed that the crystallme lens in young
animals is softer, and less resisting than at a more advanced
age. :
With respect to the chemical composition of the lens, I
find that, in addition to albumen, it contains a substance
closely resembling casein, to which I apply the term crys-
tallin. I reduce the lens to a pulpy mass, stir it with water,
and then heat the mixture to the boiling point: the albumen co-
agulates, while the crystallin does not coagulate, but is entangled
420 ANIMAL BODY.
in the albumen. In order to separate them I evaporate to
dryness, pulverize the white residue, and boil it, first with ether
in order to separate fat, and then with spirit of °915 as long as
anything continues to be taken up. The albumen rapidly sinks
from the hot, clear, spirituous solution, and the supernatant fluid
which must be decanted from the sediment, soon begins to be-
come turbid from the separation of numerous flocculi of erys-
tallin. I evaporate to a slight residue, and then precipitate the
crystallin by strong alcohol, in which it is only slightly soluble.
The lactates and chloride of sodium remain dissolved in the
alcohol. In this manner I analysed the crystalline lens of the
ox and the horse.
Anal. 158. Anal, 159.
Crystalline lens of ox. Ditto of horse.
Water é ; ; ; 65°762 60-000
Albumen. ; ; . 23290 25°531
Crystallin ‘ . ; ‘ 10°480 14:200 ©
Fat ‘ ‘ 0°045 *0°142
Extractive matter with chloride of
sodium and lactates . 1 0°495 wtih
Berzelius has not separated the albumen and crystallin ; m
other respects his analysis approximates to mine, as far as the
amount of the protein-compounds is concerned.
He found it composed of :
Water s f 58:0
Proteis bouipodiad , ‘ 35°9
Alcohol-extract with salts . é 2°4
Water-extract with traces of salts ( 13
Cell-membrane . ; 2°4
It has been shown by Wurzer aiid Lassaigne, that when the ©
lens is opaque (in cases of cataract) it contains an excess of
phosphate of lime. This may be the cause of the opacity, or it
may be due to the coagulation of the protein-compounds by the
presence of a free acid. Wurzer determined the composition
of an opaque lens from a bear. It contained (after the removal —
of the water) :
Phosphate of lime ; ; - 689
Carbonate of lime ‘ ‘ 96 8°59 10°19 12°18 14°82
Phosphorus é - 080 165 1:0 1-00 0°85 |
According to Vauquelin, the medulla oblongata and the spinal
cord contain the same constituents as the brain, but a larger pro-
portion of fats and a less amount of albumen, extractive matter,
and water.
[L’Heretier found that the spinal cord of an adult was
composed of : :
; Water ‘ ; ; 71:05
Albumen H ; ; 7°30
Fat ; : : 8°25
Osmazome . : ‘ 11:50
Phosphorus. : ‘ 1-90
The nerves, according to the same chemist, contain more
albumen, less solid and more soft fat than the brain. |
On boiling the nerves in alcohol a fluid fat exudes which sinks
to the bottom of the vessel: on boiling them with water they
swell but do not dissolve. The albumen of the medullary portion
dissolves in a weak solution of potash, the fat swims on the sur-
face, and the neurilemma remains. On treating the nerves with
acetic acid the medullary portion is expressed by the contraction
of the tubes, which are themselves unacted on.
Fat.
The fat contained in the fat-cells is a mixture of margarin
and olein in man and the carnivora, of stearin and olein in the
ruminantia. Human fat usually occurs in a fiuid or semifluid
state, consisting of a solution of margarin in olein, from which
the margarin separates on cooling into microscopic stellar
groups.
The Glands.
Our knowledge of the chemistry of the glands is very defec-
tive, and in all probability the analysis of these organs will
never throw much light on the process of secretion in conse-
quence of the utter impossibility of separating the nerves, ves-
428 ANIMAL BODY:
sels, and cellular substance. Fromherz and Gugert attempted
to analyse human liver. ee found in 100 parts :
Water . ; 61:79
Solid residue . . 38°21
The insoluble parenchyma formed 28°728, and the portion
soluble in water and alcohol 71:282 of the solid residue: 100
parts of dried liver contained 2°634 of salts, consisting of chlo-
ride of sodium, phosphate and a little carbonate of lime, phos-
phate of potash, and traces of peroxide of iron.
In the liver of the ox Braconnot found water 55°50, soluble
matter 25°56, walls of vessels and membrane 18°94.
In certain morbid conditions of the system the liver becomes
much affected. Its amount of fat is so extraordinarily increased
in certain cases as to conceal the true structure, for the fat, as
Rokitansky observes, not only occupies the place of the true
glandular tissue, but all the tissues are permeated and the vas-
cular substance perfectly overwhelmed. This morbid condition
has been very frequently observed associated with pulmonary
phthisis, and is a consequence of too luxurious a life, and the abuse
of spirituous drinks. Fromherz and Gugert analysed a liver of
this nature. It weighed twelve pounds, and had a soft caseous
appearance. Its true organization appeared entirely destroyed.
It contained a non-saponifiable fat with a small quantity of unco-
agulated albumen, a little extractive matter, casein, salivary
matter, a few shreds of vessels, chloride of sodium, and phosphate
of lime: they found no cholesterin, fatty acids, or bilifellinic acid.
[A fatty liver analysed ne Frerich,' yielded :
Water ‘ : . 73°09
Solid constituents : ‘ - 26°91
Fat containing phosphorus ‘ - 17°26
Albumen . 5 ‘ 3°67
Vessels and hepatic cells ‘ ; 4-00
Water-extract ‘ ; ; 0°48
Alcohol-extract - 6 ‘ 1°50
A. waxy liver (a variety of the above) yielded:
Water : ‘ ; - 80°20
Solid constituents : . 19°80
Fat containing phosphorus, and sania 2°20
Albumen . ‘ 3°50
Vessels and hepatic cells : ‘ 3°60
Water-extract : : , 7°00
Alcohol-extract ‘ ws ‘ 4:50
' Schmidt’s Jahrbiicher, vol. 48, p. 148.
OTOLITHES. 429
The two following analyses have been made by Boudet :
Fatty liver. Healthy liver.
* Water ; . 55°15 76°39
Solid constituents : 44°85 23°61
Animal matter dried at 212° 13°32 21-00
Saponifiable fat ; 30°20 1°60
Cholesterin é 1:33 0-17 |
The thyroid gland has been analysed by Fromherz and
Gugert, and the thymus by Morin.
The kidneys have been submitted to analysis by Berzelius.
From two experiments he concludes that the kidneys are made
up of a congeries of minute vessels, and that the tubes contain
a very albuminous acid fluid, in which there is no dissolved
fibrin, and in which not a trace of urea can be detected.
[According to Boudet, the parenchyma of the lungs, freed
as much as possible from blood and extraneous substances, is
formed of the following chemical elements :—1st, a substance
susceptible of transformation into gelatin by ebullition in water,
(cellular tissue ;) 2d, a substance soluble in cold water, pre-
cipitated by nitric acid, coagulated by heat, containing albumen
and hematin ; 3d, a substance analogous to casein ; 4th, fibrin ;
5th, free oleic and margaric acids; 6th, oleate and margarate
of soda; 7th, cerebric acid; 8th, lactic acid; 9th, cholesterin
amounting to ‘05° of the weight of the lungs dried at 212°;
10th, the water amounting to 82°. The ash contained a con-
siderable quantity of chloride of sodium and sulphate of soda,
a small quantity of phosphate and carbonate of lime, and traces
of silica and peroxide of iron. |
Otolithes.
The membranous labyrinth of the ear contains a rather
viscid fluid, which, however, never occurs in sufficient quantity
to admit of chemical examination. In this fluid there are found
minute six- or eight-sided crystals (otolithes), which, however,
are generally soworn at the angles and borders that the crystalline
form can be no longer recognized. They appear to consist for
the most part of the carbonates of lime and magnesia combined
with animal matters, and not unfrequently with phosphates.
4130
CHAPTER XII.
SOLID MORBID PRODUCTS.
Concretions.
THESE morbid products are of frequent occurrence. They
are found in various organs, especially in those through which
fluid glandular secretions are discharged. They then consist
for the most part of the most insoluble constituents of that fluid,
although they occasionally contain substances foreign alike to
the secretion and to the whole organism, and produced by a
depraved formative process. Concretions are, however, also met
with in other situations, as the brain, the cavities of the heart,
the arteries, &c.
The substances ordinarily entering into the composition of
concretions are by no means numerous. Some concretions are
formed of one constituent alone, while others have a mixed
composition. The following substances must be viewed as true
formative constituents, not as mere accidental admixtures: uric
acid with its salts, uric oxide (xanthic oxide), cystin, hippurate
of ammonia, basic and neutral phosphate of lime, ammoniaco-
magnesian phosphate, oxalate of lime, carbonate of lime, car-
bonate of magnesia, fibrin, cholesterin, and biliphzin: the
accidental components are mucus of the urinary and gall-
bladders, albumen, hematoglobulin, bilifellinic acid, fat, extrae-
tive matters, chloride of sodium, and lactate of soda.
The principal object in the analysis of concretions is to de-
termine the nature of the leading constituents, and this may be
easily effected even by persons little skilled in chemical mani-
pulation. Medico-Chirurg. Transactions, vol. 10.
® Naturwissenschaftliche Abhandlungen. Tibing. 1826.
7 Journal de Pharmacie, 1838, p. 463.
® London and Edinburgh Philosophical Magazine, 1838,
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458
%
MORBID PRODUCTS.
I now proceed to give one or two analyses of human calculi
as illustrations of their general character.
I analysed the remarkable calculus alluded to in pp. 439 and
449, I examined, Ist, the external layer ; 2d, the mner, tuber-
‘ culated nucleus; and 3d, the minute round nucleolus. I have
likewise analysed (4th) a calculus of uric acid.
i Anal.J60. An.161. An. 162. An. 163.
E Cortex. Nucleus. Nucleolus. Uric acid caleulus.
Water . 24°5 10-0 3°7 3°0
Solid residue ; . tue 90-0 96°3 97°0
Earthy phosphates . . 70°5 11 —_ —_—
Oxalate of lime — 76°1 — —_
Urie acid _— —_— 91-2 92°8
Alkaline urates 1-0 0°5 13 3°2
Animal matter 3°5 12°8 3°5 —
Fat and extractive matter atrace a trace — 1:0
The animal matter in the cortex contained a little silica and
peroxide of iron; and in the nucleus, a large quantity of dark
brown colouring matter.
Uric acid calculi contain :
According to
r Fer af
Taylor. Joss. Laugier. Von Bibra.
1 2 ‘a
Uric acid 60°0 70:0 10:0 84°69 96°10 :
Urate of ammonia —_ — 40-0 ” 9-03 a
Urate of lime — 10°3 — — —_ a
Phosphate of lime 10°0 — - -—
Ammoniaco-magnesian phosphate 20-0 — oo 1:12 —
Phosphate of ammonia —_ —- 5°0 —_— —_
Oxalate of lime ‘ , —_ — 15°0 0°95 —
Ammoniacal matter and water 10°0 19°0 20°0 1:80 1:60
A substance soluble in ether — 0°5 — 0°81 0°50
. gy alcohol — —_ = -- 0-41
Calculi in which the earthy phosphates and carbonates pre-_
dominate have been analysed by Fromherz and Lindberson:
Fromherz,
Carbonate of lime 91°0
Phosphate of lime 3°0
Albumen and fat 4:0
Lindberson.
Urate of soda ,
Basic phosphate of lime
Ammoniaco-magnesian phosphate 38°
Carbonate of lime 31
Carbonate of magnesia
Albumen
GRAVEL. 459
[Calculi in which oxalate of lime predominates have been
analysed by Scharling :
1. 2.
Oxalate of lime ot ‘ 37 63°5
Phosphate. of lime ‘ ‘ — 6°2
Ammoniaco-magnesian phosphate. 39 _
bteagial : ; ‘ 10 30-3
Organic matters d : 13
See also analysis 161, and the above analysis of Laugier. |
Cystic calculi have been analysed by Taylor and Bley:
. Taylor. Bley.
Cystin . : : j 10:0 6°2 —
Ammoniaco-magnesian phosphate é 10-0 36°6 75°0
Phosphate of lime . : 38°0 —_ 7:0
Carbonate of magnesia : ) — 571 —
Uric acid : ‘ ‘ —_ ~- 18°0
Animal matter and loss , . 42°0 — =
Both the calculi analysed by Bley were taken from the
bladder of the same man; the first weighed 1:75, and the
second 2 grains. :
URINARY GRAVEL.
Gravel has naturally the same composition as calculi; uric
acid is, however, the most frequent constituent. In form,
gravel is round-or angular, not unfrequently crystalline ; its
colour is most commonly red, but sometimes pale yellow, gray,
or brown. ‘The rules already given for the analysis of calculi
apply equally to gravel. After having ascertained by the blow-
pipe whether the gravel is perfectly destroyed by heat, or
whether it leaves an ash that burns white, we then proceed in
accordance with the directions given in p.431. Uric-acid gravel
is frequently crystalline, and red or purple, but occasionally
of a bright yellow colour, or white. The urine from which it
separates is concentrated, highly coloured, and has usually a
strong acid reaction.
White gravel is usually composed of phosphate of lime with
ammoniaco-magnesian phosphate, and occasionally of oxalate
of lime. The ammoniaco-magnesian phosphate crystallizes in
beautifully regular prisms, (often of considerable size,) as de-
460 . MORBID PRODUCTS.
picted in fig. 25, and the oxalate in minute globules, or in
octohedra, as represented in fig. 36. Phosphate of lime and
ammoniaco-magnesian phosphate almost always occur together;
oxalate of lime sometimes occurs by itself, and sometimes alter-
nates with the earthy phosphates. Gravel consisting principally
of the earthy phosphates is sometimes mixed with urate of
ammonia, which latter readily dissolves when heated in water.
I have alluded to the analysis of this kind of gravel in my
remarks on urinary sediments in p. 181. The urme in which
this white earthy gravel is formed, is either neutral or alkaline, —
- never acid.
Magendie describes a species of gravel containing hairs,
(gravelle pileuse), consisting of phosphate of lime, ammoniaco-
magnesian phosphate, and a little uric acid. It is possible
that the hair may have been introduced from without, and
thus be a mere accidental constituent. When cystin occurs
as gravel, it almost always assumes the regular crystalline form _
that is so characteristic of that substance. Cystic gravel is of
a yellow colour, and appears crystalline even to the naked eye.
Lecanu! analysed Segala’s collection of 110 specimens of
gravel. Seventy-nine of them (passed by 20 patients) con-
sisted of uric acid with traces of ammonia and organic matter,
which, however, in five cases were found only in the cortex, —
the nucleus consisting of pure uric acid. One minute caleulus —
passed at the same time with others of pure uric, hada nucleus ~
of oxalate of lime, and a thick cortex of uric acid. Five calculi E
from different patients, consisted of oxalate of lime without —
earthy phosphates, but with some uric acid} nine from different
patients consisted of oxalate of lime and earthy phosphates;
three from two patients consisted of phosphate of lime and —
ammoniaco-magnesian phosphate, without uric acid; four from
the same paticht consisted only of earthy phosphates; four
from two patients consisted of ammoniaco-magnesian phosphate,
without any appreciable traces of lime; three from two patients,
of cystin. A calculus, the size of a pea, discharged with uric
acid gravel from a man aged 62 years, was soft and white,
soluble in water and alcohol, fusible, when heated evolving an
odour of burned sugar, and containing a brown nucleus, formed
' Journal de Pharmacie, Sept. 1838.
URINARY CALCULI OF ANIMALS. 461
apparently of a grain of corn. No cases of carbonate of lime
were observed in this collection.
[Schlossberger has recently directed attention to the fre-
quent: occurrence of gravel (urate of ammonia) in the tubuli
uriniferi of new-born children. He found it in 18 out of 49
cases. |
Preputial and urethral calculi have been analysed by Romer:
fifty-one concretions of this sort, weighing in all 158 grains,
were removed from a child with natural phymosis. They con-
sisted of uric acid, associated with phosphate of lime and some
connecting animal matter.
URINARY CALCULI OF ANIMALS.
-Calculi are by no means uncommon amongst the lower
animals, and it has been stated that rats are especially liable to
this form of disease. . Generally speaking the constituents are
much the same as in man, except that no uric acid occurs in
the calculi of the herbivora, which consist for the most part of
earthy phosphates and carbonates.
In awild eat, Fourcroy and Vauquelin found a renal calculus
of phosphate of lime. The vesical calculi of dogs consist for
the most part of phosphate of lime and ammoniaco-magnesian
phosphate, with a little animal matter. (Marcet, Brande,
Wollaston, and Prevost.) Brande found 30 parts of ammoniaco-
magnesian phosphate, 64 of phosphate of lime, and 6 of animal.
matter. lLassaigne found 53 parts of oxalate of lime, 13 of
phosphate of lime, and 39 of animal matter: in another calculus
he found 972 of cystin. Two urinary concretions from these
animals, examined by myself, were white and somewhat crys-
talline ; they consisted principally of phosphate of lime with
a little carbonate of lime. Im a renal calculus from a dog,
Lassaigne found 58:0 parts of uric acid, 30°8 of urate of am-
monia, 1*] of oxalate of lime, and 10:1 of phosphate of lime.
Calculi from rats consist, according to Marcet, of ammoniaco-
magnesian phosphate and phosphate of lime; according to
Fourcroy, of oxalate of time; and, according to Morand, of
phosphate, carbonate, and oxalate of lime. Vesical calculi of
t
ee
462 MORBID PRODUCTS.
hares consist, according to Marcet and Brande, of phosphate
and carbonate of lime. Vesical calculi of swine consist chiefly
of carbonate and phosphate of lime, and ammoniaco-magnesian
phosphate; according to Yellowly also, of oxalate of lime. The
renal calculi of horses consist of carbonate and phosphate of
lime in very variable proportions; Gurlt found 92-08 of the
former, and 0°92 of the latter; while Brande found 22° of the
former, and 76° of the latter: their vesical calculi are com-
posed, according to Brande and Marcet, of the same consti-
tuents: a specimen, analysed by Buchholz, likewise contained
ammoniaco-magnesian phosphate, silica, sulphate of lime, and
carbonate of magnesia: a calculus, analysed by Wackenroder,
contained 72°47 parts of carbonate of lime, 3°52 of carbonate
of magnesia, 3°25 of sulphate of lime, 1:91 of phosphate of
lime, 17:10 of mucus, and 1:40 of water. Vesical and_renal
calculi of oxen consist, according to Rapp, Brande, and Gmelin,
‘
m
&
of carbonate of lime. A calculus, analysed by Wurzer, con- —
tained 81:4 parts of carbonate of lime, 6:2 of phosphate of
lime, 4°3 of carbonate of magnesia, ‘009 of peroxide of iron,
and °001 of peroxide of manganese. The same chemist found
in a calculus taken from the urethra of an ox, 60 parts of
carbonate and phosphate of lime, 38°2 of silica, and 1°8 of
peroxide of iron. In a very hard concretion taken from the
urethra of an ox, I found a large proportion of carbonate of
lime, mixed with a little phosphate of lime and silica.
Re Gh rr Vie Seals NE eal Mee LC ab cend | e el o fat Se Ree
pe
uw 2 ee
[The following analyses have lately been made by Von Bibra:
Calculi from ureter Calculus from bladder
of a horse. of swine.
Ln go ae
x: 2. 3.
Carbonate of lime > , 87°63 78°81 — _
Carbonate of magnesia : == 9°31 ante >
Ammoniaco-magnesian phosphate 6°61 93°27 90°41
Phosphate of lime 3 3 — -— 2°10 6°31
Sulphate of lime ‘ : 1°64 _ — <—
Phosphate of magnesia —- 0°90 _— _ %
Organic matter taken up by isdtash 0:20 — 0°10 0-201
” ” ; alcohol — : 0°30 sn Vans ‘> 2 Sit <- Rek Shy i te . A,
i
a
=
ae
=
re:
Ss
%
INTESTINAL CONCRETIONS. . 467
cart-horse ; it was round, perfectly smooth, of a grayish-yellow
colour, weighed about 123 ounces, was 3 inches and 7 lines in
diameter, 11 inches in circumference, and consisted of 3 strata
which were deposited round a fragment of granite. All three
laminze were composed of ammoniaco-magnesian phosphate
with a little of the alkaline phosphates, but without any phos-
phate of lime. The second lamina had a radiating structure,
and between the rays woody fibres might be detected. The
central portion, about the size of a walnut, presented the
appearance of a brown urinary calculus ; the outer layer closely
resembled common jasper. Au analysis yielded :
Analysis 164,
Ammoniaco-magnesian phosphate ‘ 8111
Phosphates of potash and soda. i 1°50
Sand ‘ j : : 0°60
Vegetable fibre : ‘ j 0°58
Alcohol-extract j : ; 0°50
Water-extract : : ‘ 0°50
Water and loss : : 3 15°19
I have analysed some of the concretions in the museum of
the Berlin Veterinary College. Some small, flat, reniform,
grayish brown concretions from the colon of a horse con-
sisted chiefly of pure ammoniaco-magnesian phosphate aggre-
gated around very minute nuclei of metallic lead.._A flat,
grayish brown concretion, of the size of a pigeon’s egg, taken
from the colon of a horse, contained, in addition, some phos-
phate of lime; the nucleus was a fragment of brick. The
external layer of a gastric concretion from a horse, weighing
8 pounds, consisted principally of ammoniaco-magnesian phos-
phate combined with some phosphate of lime, and the external
- layer of a large calculus found in the intestines had a perfectly
similar composition. Some small, triangular, smooth and white
concretions fromthe stomach of a Dutch mastiff, when frac-
tured, presented a beautiful, white, sparkling, crystalline cha-
racter, and were composed of the same Constituents; the
quantity of phosphate of lime was, however, very small. The
external layer of an intestinal concretion from an ass exhibited
white and chalky lamelle, with little firmness. It consisted
of carbonate of lime, with a small admixture of phosphate of
lime. |
Carbonate of lime, such as I observed in the concretion
468 MORBID PRODUCTS.
from the urethra of an ox, and in the above mentioned intes-
tinal concretion from an ass, has been very rarely observed ;
Pearson detected it in a gastric calculus from an ape; Kinast in
a similar concretion from a cow; Pearson and John in the in-
testinal concretion of a horse; and Vauquelin and Fourcroy in
bezoars. Uric acid was observed by Fourcroy in the intestinal
concretion of a horse.
Concretions formed of agglomerated hairs are often observed
especially in cows. They are usually brown and polished, but
not hard.
[Several analyses of intestinal concretions have been recently
published by Von Bibra.’ We give the two following as illus-
trations of their composition :
Concretion from
intestines of horse.
Ammoniaco-magnesian phosphate yey ae
Phosphate of lime . d : 1:18
Matters taken up by alcohol and ethier ‘ ; 0°43
mm potash : § ‘ 0°36
Chloride of sodium ‘ Sh ‘ 0°63
Phosphate of soda . ‘ i 0°31
Water, vegetable fibre, traces of iron, and eed ; 3°99
Concretion from stomach
of a miller’s horse,
Ammoniaco-magnesian phosphate - ‘ 93°02
Phosphate of lime ; a ‘ : 1-01
Matter taken up by alcohol . ; ‘ 0°41
by potash : : ; 0°33
Sand ; : : : . 0°40
Chloride of sodium and traces of phosphate of soda . 0°51
Water, traces of iron, vegetable fibre, and loss ; 4°32
The occurrence of phosphate of soda is remarkable, as that
salt does not occur in the gastric juice. |
Peculiar concretions are found in the intestinal canal of an
herbivorous animal inhabiting Persia and Thibet. They are
termed bezoar stones; they are round or oval; in colour they are
dark green, brown, or black ; they are polished on the surface, —
and consist internally of concentric lamine. Some are soluble,
others insoluble in alcohol, but all dissolve in caustic potash.
The researches hitherto made with these concretions throw very
little light on their real composition. They are usually green
’ Simon’s Beitrage, pp. 404 12.
GALL-STONES. 469
in the interior, do not fuse on being heated, and give off atiot
disagreeable odour. Hot water extracts a yellow matter ;
caustic potash dissolves them rapidly, forming a grayish brown
solution, from which a dull green precipitate is thrown down on
the addition of an acid.
This precipitate dissolves in nitric acid, producing a red tint,
which rapidly changes to a yellow. Berzelius is of opinion
_ that the principal mass of bezoar consists of biliary fat and
resin, mixed with other fatty matter, and held together by
intestinal mucus.’
Gall-stones in Man.
Biliary concretions are of very common occurrence in the
human subject. They consist principally of cholesterin with a
small amount of other fats, bilifellinic acid or biliary resin
mixed with some bile-pigment, and mucus. In analysing a
gall-stone, we first reduce it to a fine powder, which is a matter
of no difficulty, and heat it on the water-bath in order to
expel all moisture. The powder is then extracted with water,
which takes up bilin with bilifellinic acid, and probably a little
extractive matter ; these are obtained by evaporating the water.
The portion not taken up by water must be again dried and
treated with hot, pure ether, which extracts the fat. We eva-
porate the ether, and dissolve the residue in hot alcohol, from
which cholesterin crystallizes on cooling; after the removal of
the cholesterin the evaporated alcohol yields the other fats as
_ fatty acids. The residue insoluble in ether is now extracted
with boiling anhydrous alcohol, which dissolves the biliary resin.
On evaporating the alcoholic solution and treating the residue
with cold alcohol, we obtain a solution of biliary resin (fellinic
and cholinic acids, and dyslysin.)
The portion unacted on by alcohol may still contain bili-
phzein and biliary mucus ; the former is soluble in carbonate of
ammonia, the latter in a solution of potash.
Human gall-stones vary from the size of a hemp-seed to that
of a pigeon’s egg; they are round, or, if several occur together,
angular and flat-sided, each facette lying in close apposition
with that of the adjacent calculus. Their surface is smooth,
1 [For further information on this subject the reader is referred to a paper by
Guibourt, in vol. 16 of the ‘Comptes Rendus,’ and to observations ‘ on a new organic
acid in benzoar stones,’ by Lipowitz, in Simon’s Beitrage, p. 462.1]
470 ~MORBID PRODUCTS.
their colour brown or yellow. Internally they present a de-
cidedly crystallme character, they are white or yellow, and
often contain a minute cavity in the centre, of a darker colour
than the rest of the concretion, and presenting an incrusted
appearance. ee
Witting! found in a human gall-stone cholesterin 50; resin
and colouring matter msoluble in ether 35; carbonate of lime
8, water 5.
The following analyses of human gall-stones were made by
Glaube and Brande:
Brande.
Glaube. Chee 2. 3.
Cholesterin : 56. . $125 6976 Sige
Biliary resin. j , 8 3°12 5°66 3°83
Bile-pigment . ; 15 938 11°38 7°57
Albumen with mucus and sats extract- é oe
able by water : : } Ba ae i ac.
Coagulated albumen j 9 — — —
Biliary mucus. ; 12 6°25 13°20 —_
In addition to the: ordinary constituents Von Bibra? found
1:52 of aluminawith iron, and 1°42 of carbonate of lime im a biliary
Gillet ; and Witting, as I hive already observed, detected a
considerable amount of the latter constituent in a concretion of —
this nature. An extraordinary quantity of this earth was found —
by Bally and Henry in a gall-stone; it consisted of carbonate —
of lime with traces of carbonate of magnesia 72°70, phosphate —
of lime 13°51, mucus, with a little peroxide of iron and bile-
pigment, 10°81.
[Schmidt and Wackenroder have recently published analyses —
of human biliary calculi, consisting principally of colourmg —
matter. Archiv der Pharmacie, vol. 41, p. 291.]
Berzelius mentions another kind of gall-stone, consisting 2
principally of carbon ; at least it is insoluble in water, alcohol —
and ether, acid and athe fluids ; when heated to redness in
a retort, undergoes no alteration, but when burned in oxygen, —
after giving off slight traces of smoke, takes fire, and burns —
= Shy eats i Sy ah Be ‘
TOS alas TU a ais eta einer ae Sa area Sar as
without flame or residue, with the formation of carbonic-acid gas. Ee
I have recently examined a biliary calculus found in the ~
gall-bladder of an officer who died from cerebral and spinal —
irritation, and incipient softening of the nervous tissue: mM
1 Archiv der Pharm. vol. 25, p. 292. ? Journ. fur prakt. Chemie, vol. 12, ps 3lies
BILIARY CONCRETIONS. 471
contradistinction to the general rule, it contained mere traces
of cholesterin, and was principally composed of biliary resin,
and modified colouring matter.
[ Bertazzi! has recently announced the discovery of copper
as a constant ingredient of gall-stones. He analysed fourteen
of these concretions sent to him by Polli, and found it in every
instance. The amount of copper seemed to stand in a direct
ratio to the amount of bile-pigment in the calculus. Thus,
on incinerating an almost black spongy-looking concretion, so
large a quantity of copper was present in the ash, that an iron
eylinder, nearly a line in diameter and four inches long, after im-
mersion for a few seconds in a dilute acid solution of the residue,
was entirely coated. When, on the other hand, merely the
nucleus or the external layer contained pigment, the indications
of the presence of copper were comparatively slight, and he is
of opinion that perfectly white concretions are entirely devoid
of this constituent. With the view of ascertaining whether
copper could be detected in the bile, Bertazzi analysed the
fluid collected from the gall-bladders of ten persons. He could
not, however, detect any indications of the metal.
The above statement respecting the presence of copper in
biliary calculi has been subsequently confirmed by Heller.?]
Biliary Concretions in Animals.
Biliary concretions are very common in cattle: Gurlt never
observed them in horses, and only once detected a calculus of
this nature in a dog. The biliary concretions of cattle differ
considerably from those of man ; they consist for the most part
of biliary pigment and resin, with a little cholesterin. In
analysing the biliary concretions of oxen we must pursue the
method already described, but at the same time we must not over-
look the circumstance that an independent (lithofellinic) acid has
been noticed by Gobel as occurring in them, which is not found -
in human biliary calculi. It is soluble in boiling alcohol and
crystallizes on cooling; on heating it fuses, becomes decom-
posed and burns. It is insoluble in acetic and hydrochloric
' Polli’s Annali di Chimica. Milan. Juglio 1845, p. 32.
* Archiv fiir physiolog. und patholog. Chemie, vol. 2, p. 228.
472 MORBID PRODUCTS.
acids, but dissolves in caustic potash, with which it forms a
soap that develops an odour resembling amber. It separates
from this soap in a crystalline form on the addition of an acid,
These crystals are of a rhombic-prism form, dissolve in alcohol
and ether but not in water, fuse at a high temperature, and
combine with alkalies to form soaps, which are slightly soluble
in water, but dissolve readily in alcohol and ether. This
acid has also been observed by Wohler, and I have lke-
wise detected a substance in the biliary calculi of cattle,
which, as far as I have yet been able to analyse it, seems to be
identical with lithofellinic acid. It is probable that lithofellinic
acid is of more frequent occurrence than has hitherto been
supposed ; it ought, therefore, to be sought for in all biliary
calculi, more especially in those of cattle.
The biliary calculi of cattle vary from the size of a pea to
that of a pigeon’ s egg; they may be easily pulverized, the
powder varying in colour from a dull green to a clear brown,
and possessing a decidedly bitter taste. On boiling the pul-
verized calculus with alcohol, the alcohol becomes coloured
yellow or green, and leaves on evaporation a small quantity of
biliary resin and cholesterm. The powder, after extraction
with alcohol, yields to caustic ammonia or to its carbonate, a
certain amount of its colouring matter, but not so much as is
taken up by an even very dilute solution of caustic potash.
The alkaline solution is of a yellowish brown tint, but soon
changes into a green. On the addition of hydrochloric acid to
the alkaline solution the colouring matter is precipitated in the
form of gray flocculi which dissolve readily in alcohol, leaving
in an insoluble state the mucus that had been dissolved by the
potash.
Schiibler and Michel’ analysed a concretion found in a cystic
tumour in the liver of 4 man. It was of a red colour, and was
composed of 25 parts of yellow, slightly saponifiable fat soluble
in ether, and of 75 parts of red colouring matter. This colourmg
matter presented several remarkable characters, and Berzelius—
regards it as a morbid form of the ordinary bile-pigment.
' Journal fir prakt. Chemie, vol. 8, p. 378.
SALIVARY CALCULI. 473
Salivary Calculi, Tartar, &c.
In man salivary calculi are of rare occurrence, but the forma-
tion of tartar on the teeth is continually observed: it consists
of earthy phosphates, epithelium-scales, a little ptyalin, and fat,
and when examined under the microscope there are seen
abundance of pavement epithelium and mucus-corpuscles with
fat-vesicles, and, in addition to these, numerous long acicular
bodies and infusoria of the genera Vibrio and Monas.
According to Berzelius tartar is composed of earthy phos-
phates 79-0, salivary mucus 12°5, ptyalin 1:0, animal matter
soluble in hydrochloric acid 7:5.
Vauquelin and Laugier obtained similar results, ae
66 parts of phosphate of lime with a little magnesia, 9 of car-
bonate of lime, 13 of salivary mucus, and 5 of animal matter
soluble in hydrochloric acid.
Poggiale’ analysed a salivary calculus taken from a man; it
was hard, round, tuberculated, of a yellow colour, and easily
pulverized. It contained a large amount (94°¢) of phosphate
of lime, with a little mucus and animal matter.
Wurzer’ analysed a calculus from the maxillary gland of a
man; it weighed three grains, was oval, of a grayish white
colour, and consisted principally of carbonate of lime and earthy
phosphates, with traces of iron and manganese.
Salivary calculi are of frequent occurrence in the ass aud
the horse, and are occasionally found in the dog. They consist
for the most part of earthy carbonates mixed with a small
amount of earthy phosphates and animal matters.
The following analyses will give an idea of their composition :
From an ass. Froma horse. From a horse.
Caventon. Lassaigne. Henry.
Carbonate of lime : : 91°6 84 85°52
Carbonate of magnesia . : — — 7°56
Phosphate of lime ‘ ° 4°8 3 4°40
Animal matter soluble in water. 3°6 9 2°42
Water ‘ é Fe — 3 —_
Similar concretions occur in many other parts of the organism.
I shall notice a few instances.
' Journal de Pharmacie, 1839, p. 337. ? Archiv der Pharmacie, vol. 14, p. 254.
474 : MORBID PRODUCTS.
Wurzer analysed a concretion formed in one of the tonsils:
externally it was of a grayish white colour, marked with rose-
red spots, and verrucose ; internally it presented no appearance
of lamelle, although it contained an oval nucleus. It consisted
of phosphate of lime 63°8, carbonate of lime 16°7, animal
matter 13°3, ptyalin, with chlorides of sodium and potassium,
7-1, iron and traces of manganese, 0-1. Daniel has described a
hard and dense tumour, containing, however, traces of fibrous
tissue, that occurred in the anterior wall of the uterus of a
single woman aged 72 years. It contained 35% of animal matter
and water, 56° of phosphates of lime and magnesia, 5° of car-
bonate of lime, and 4° of chloride of sodium and other salts. An
earthy deposit in the uterus, analysed by Wiggers, contained
46°8° of earthy phosphates and carbonates, and 46°18 of fibrin,
with a little fat. Poggiale has examined the muscular tissue of a
man in whom ossification of the muscles had proceeded to such
a length as almost entirely to prevent any voluntary motion.
A portion of the ossified gastrocnemius contained 582 of organic
matter, 32-099 of phosphate of lime, 1:25 of phosphate of mag-
nesia, and 8°662 of carbonate of lime.
Concretions in the brain are very rare. I obtained a con-
cretion of this nature that had formed in the cerebellum;
it was about the size of a nut, of an irregular angular form,
very solid, and both internally and externally resembled a por-
tion of bone. ‘The whole concretion was enveloped in a fine
coriaceous capsule; it consisted principally of phosphate and
carbonate of lime, with a little cholesterm. A similar con-
cretion analysed by John consisted of 75 parts of the phos-
phates of lime and magnesia, and 25 of animal matter; another,
examined by Morin, was composed of cholesterin, coagulated
albumen, and earthy phosphates. In a concretion taken from-
the brain of a horse Lassaigne found 58 parts of cholesterin,
39°5 of coagulated albumen and cellular matter, and 2°5 of
earthy phosphates.
[Scherer found in the gritty matter contained in the pineal
gland : , | :
Organic matter x: : : 22°460
Phosphate of lime : ; P ; 60°321
Carbonate of lime ‘ , 17-219 |
VARIOUS CONCRETIONS. 475
A concretion from the eye of a blind man contained, ac-
cording to Wurzer, 47:9 parts of phosphate of lime, 9°5 of the
carbonates of lime and magnesia, 20°3 of mucus, 0°9 of peroxide
of iron, and 11°9 of clear fat resembling butter. A nasal concre-
tion occurring in a woman aged 57 years was found by Brandes!
to consist of 79°6 of phosphate of lime, 6°4 of carbonate of lime,
and 14 of chloride of sodium, animal matter, and water. It
consisted of five portions, weighing altogether 210 grains. It
varied externally from a grayish white to a yellowish green
colour, and its internal surface was gray and finely granular.
A nasal concretion analysed by Regnard consisted princi-
pally of carbonate of lime, with a little phosphate of lime and
animal matter. A specimen analysed by Geiger consisted
almost entirely of earthy phosphates and carbonates, while an-
other examined by Herberger, yielded 46% of dried nasal
mucus. A calculus of this nature weighing 81 grains, ana-
lysed by Rémer, contained 90 parts of phosphate of lime, 5 of
carbonate of lime, and 5 of animal matter with traces of car-
bonate of soda.”
Concretions formed in the lungs consist also principally of
the earthy phosphates and carbonates. A pulmonary concre-
tion analysed by Sgarzi, contained carbonate and phosphate of
lime, carbonate of magnesia, cholesterin, fat, mucus, albumen,
peroxide of iron, and silica. A concretion of this nature, that
had been expectorated, was analysed by Brandes; it contained
the above mentioned salts, cemented with mucus and albumen.
On examining the lings of the boy with the osteoid tumour,
noticed in p. 412, there was found in them an oval, solid en-
cysted concretion, of the size of a hazel nut. Being anxious
to ascertain whether it was allied to the osteoid tumour in its
composition, I analysed it and found in 100 parts:
: Anal, 165.
Organic matter x s 38°89 In 100 parts of fixed salts.
Fixed salts. ‘ ; 61°11
Earthy phosphates . : 53°33 87°20
Carbonate of lime. 3 7°04 11°50
Soluble salts ‘ ; 0°37 0°65
! Archiv der Pharmacie, vol. ]1, p. 157.
* [Much additional matter on the chemistry of nasal concretions may be found in
a paper by Demarquay, in the ‘ Archives gén. de Médecine,’ Juin 1845,]
476 MORBID PRODUCTS.
Hence this concretion, in relation to the proportions of its
salts, differs only in this respect from the osteoid tumour—that
it contains a larger amount of carbonate of lime and a smaller
quantity of soluble salts.
[A concretion found in one of the bronchi of a man who died
from phthisis was analysed by Scherer. It had a knotty, white
appearance, and was invested with a delicate membrane. It
contained in 100 parts :
Organic matter . ; : . 20°10
Phosphate of lime . ‘ a ; 69°92
Carbonate of lime . ‘ 9-09
Chloride of sodium, sulphate sail cbnieshaie of soda 0°89
A hard concretion of the size of a pea, attached to the pleura,
was analysed by Schierenberg, and found to contain :
Organic matter ; ; : 36°967
Phosphate of lime . : ‘ 55°924
Carbonate of lime . ; : 7°109 ]
A concretion in the pericardium, analysed by Petroz and
Robinet, consisted of 65°3 parts of basic phosphate of lime, 6°5 of
carbonate of magnesia, 4°0 of sulphate of soda, with a little sul-
phate of lime, and 24°3 of organic matter. Concretions in the
mesenteric glands have been analysed by Wild: they contained
56-61 of phosphate of lime, 28 of carbonate of lime, and 26-28%
of cellular membrane and fat. In a calcareous deposition on the
peritoneum, Bley! found 34 parts of carbonate of lime, 27-66
of carbonate of magnesia, 10°32 of phosphate of lime, and 12-4
of albumen, mucus, and fat. A concretion from the prostate
gland, examined by Lassaigne, contained 845° of phosphate of
lime, with traces of carbonate of lime and animal matter.
I examined an incrustation occurring in the aorta of an old
man who died from phthisis pulmonalis; it consisted principally
of carbonate of lime and earthy phosphates.
[The ossified arterial membrane in the case of marasmus
senilis, mentioned in p. 317 yielded, after careful preparation :
1 Archiv de Pharmacie, vol. 20, p. 212.
GOUTY CONCRETIONS. 477
Organic matter ‘ . , 7°292
Phosphate of lime P ; 63°636
Phosphate of magnesia ‘ . 10-909
Carbonate of lime . ; - 18181 |
Gouty concretions, which frequently form on the joints of
the hands and feet, consist of urate of soda, with a little of the
urates of potash and lime, chloride of sodium, and ordinary
animal matter. Wollaston was the first to describe their com-
position correctly. The two following analyses will illustrate
their composition :
Laugier." Wurzer.
Uric acid ; é : 16°7 20:0
Soda . ‘ ‘ : 16°7 20:0
Lime . j ‘ : 8°3 10°0
Chloride of sodium ; F 16°7 18-0
Chloride of potassium - é _ 2:2
Animal matter. : ‘ 16°7 19°5
Water : ; : x ee 10°3
Some gouty concretions, about the size of a pea, were ana-
lysed by Pauquy and Bor, and found to consist of urate of
soda, urate of lime, and an albuminous substance, but no
chlorides. |
[In page 408 there is an analysis of bone in a case of arthritis,
by Marchand. The same chemist analysed a gouty concretion
on the lower articulation of the femur. It contained:
Urate of soda ‘ F ‘ 34°20
Urate of lime : , ‘ 2°12
Carbonate of ammonia j ‘i 7°86
Chloride of sodium ‘ P 14:12
Water . : 3 ‘ 6°80
Animal matter . . ‘ 32°53
Lehmann analysed a tophaceous concretion that formed on
the metacarpus of a man only 22 years old, but who had suf-
fered from well-marked gout. It was, on its removal, soft
and tough, white internally, and reddish-brown on its external
surface. When dried, it formed a white chalky mass. Under
the microscope there were seen innumerable foursided prisms
1 The loss in this analysis amounts to 16-6,
t
478 MORBID PRODUCTS.
arranged in stellar groups; these consisted of urate of soda. 4
The concretion, when dried, was found to contain :
Urate of soda : i «$212
Urate of lime a a ; A 1:25
Chloride of sodium ; ’ : 9°84
Phosphate of lime d ‘ : 4°32
Cellular tissue ; 4 . 28°49
Water and loss 4 Ws Op ; 3°88
A concretion of this nature, analysed by L’Heretier, yielded :
Urates of ammonia, soda, and lime . ; 49
Phosphate of lime ; ; ; 42
Organic matter and water , ; 9
Tubercle.
Chemical analysis has hitherto thrown very little light on —
the nature of tubercle, or on the mode of its formation. A
tubercular mass, analysed by .Preus, contained 19°5 of solid
constituents and 80°5 of water. The solid constituents were —
composed of a substance resembling casein in its relations to-
wards acetic acid and heat, a fat containing cholesterin, and a
very small quantity of salts.
In an analysis which I instituted of a mass of tubercle from a
horse, I detected a little of the caseous matter noticed by
Preus. The tubercular matter was deposited in masses from —
the size of a nut to that of a pigeon’s egg; it varied from a —
yellow to a flesh colour, and its consistence was such as to —
admit of its ready division by the knife, Internally it was —
green and resembled coagulated casein. , It was composed of:
‘ Analysis 166.
Water 2 ; j 84°27
Fat containing chualdsterin ge 1-40
Spirit-extract with salts ; ; 1°52
Caseous matter with water-extract 4 1:14
Water-extract and salts p ? 3°80
Insoluble constituents . ; 5 4:44
[The following ultimate analyses of tubercle, by Scherer, —
are highly important in tending to throw light on the che- —
mistry of its formation. -
Crude pulmonary tubercle yielded little fat or extractive
matter, showing that the morbid process was not far advanced.
TUBERCLE. 479
An ultimate analysis, after the most careful removal of foreign
constituents gave :
Carbon ; . 53°888
Hydrogen : : 7°112 | which corresponds with the
Nitrogen . ~ 17°237 formula C,, H,, Ng 0,5
Oxygen. : ~ 2h°767
Hence tubercle may be regarded as protein’ (C,, H,, N, O,,),
from which five atoms of carbon, one of hydrogen, and one of
oxygen have been removed.
A mass of tubercle deposited in the liver, when examined
under the microscope, was found to contain round, irregular,
nucleated cells larger than pus-corpuscles, and numerous in-
terspersed granules.
In 1000 parts there were contained :
Water . ; : : : 826°04
Solid residue ; 173°96
Fat taken up by ether, consisting of olein ind
margarin ; , 18°63
Alcohol-extract . i 21°75
Water-extract with very slight traces of pyin. 8°34
Insoluble organic residue . ; 120°34
Fixed salts : : . 4°90
This insoluble portion contained :
Carbon ‘ . §4°554 a
Hydrogen ; . 7°121 | which corresponds with the
Nitrogen ‘ . 16928, formula C,, H,, Ng 0,,
Oxygen : ~~» 21:397
Hence it may be supposed to be dunived from protein that
has lost three atoms of carbon and one of oxygen.
In tubercular masses found in the abdominal cavity, resem-
Sang coagulated albumen, there were found :
Water ; i s . 893°82
Solid residue : : . 106718
Fat a 25°40
Casein and ‘alcohol-extract j : 12°39
Pyin and water-extract ; . 6°19
Salts ‘. : ‘ 7°43
Crude tubercular matter : 54°55
which yielded in — inaiyoal:
2. 3.
Carbon : : 55° 299 55°069 55°137 -
Hydrogen . ‘ 7098 7°004 6°944
Nitrogen. : 16°698 16534 16-476
Oxygen ; : 20°905 21°393 21°443
| This is Liebig’s formula.
480 MORBID PRODUCTS.
These analyses correspond with the formula C,, H,, N, O,,;
hence tubercle in this case may be regarded as protein from
which two atoms of carbon and one of oxygen have been re-
moved.
In this instance, the surface of the liver was coated with
a layer of plastic exudation a line and a half thick. This
was separated and analysed in the same manner as the tuber-
cular matter. It contained :
Water ; ; ; - 73162
Solid constituents , ° - 268°38
Fat ° ° , . 15:47
Water-extract with pyin and casein ‘ 4°32
Spirit-extract ° ‘ : 6°23
Salts ; ‘ ; " 5°40
Insoluble organic residue ; - 237°96
Containing—Carbon ‘ : 55°190
Hydrogen . . 7186
Nitrogen ; . 16-602
Oxygen ‘ ; 21-022
This substance is consequently identical in its ultimate com-
position with the tubercular matter found in the abdomen.
Tubercular matter from the brain yielded, after purification :
Carbon ; . 54410
Hydrogen ‘ ; 7°147 | which corresponds with the
Nitrogen ; . 16°366{ formula C,, H,, N, Oj,
Oxygen ‘ - 22°077
That is to say, two atoms of carbon less, and one atom of
hydrogen more than occurs in protein.
If in this and the preceding analyses the formule for the
morbid deposits are calculated in relation to C,,, their connexion
with the formula for protein will be more obvious to the eye.
‘We shall have: © ;
2 At. of tubercular matter from the lungs = 2Pr+NH,+2HO+H
2 At. of tubercular matter from the liver = 2Pr+NH, +H
2 At. of tubercular matter from the abdomen == 2Pr + NH, .
4 At. of cerebral tubercle 4Pr+JNH, + 4HO+3H
Scherer has adopted a similar course of research with other
morbid products.
A scrofulous mass found in the abdomen of a child who died
from general scrofula, was, after extraction with water, alcohol,
- -MORBID TISSUES. 481
and ether, submitted to — analysis. Independently of
salts, it yielded :
Carbon ; 54°125
Hydrogen ; : 7:281 | which corresponds with the
Nitrogen sat . 15°892 ( formula C,, Hj, Ng 01.
Oxygen : - + 22°702
Hence the scrofulous matter may be regarded as formed from
protein by the removal of two atoms of carbon and oxygen,
and the addition of two of hydrogen, or making the amount of
carbon the same in the scrofulous mass and the protein, we have :
_ 1 At. scrofulous matter . = Pr + HO + 2H. ‘.
Carcinoma uteri and scirrhus testiculi were examined by
Scherer in a similar manner.
L’Heretier has made the three following proximate analyses
of scirrhus :
Of breast. Of uterus. Of dorsal region.
Water — ‘ : ~ 5 29°75 21°15 24°80
Albumen : é s: 28:10 29°85 21:70
Fibrin. . ‘ . 18°80 15°20 27°15
Gelatin : eS — 817
Fat é : : : 2°00 oa 8°05
Phosphorized fat . ; : — 6°00 —
Peroxide of iron . . i 115 1°25 traces
Yellow pigment . ‘ 2 — 7°00 —_
Salts. " F . 12°60 9°55 10°13 ]
A fatty tumour analysed by Nees von Esenbeck’ contained
23:0 of solid fat, 12°0 of extract of flesh, 11-0 of gum-like animal
matter, 23-0 of albumen, 19-0 of phosphate of lime, 2-0 of car-
bonate of lime, and 1:5 of carbonate of magnesia. It is not
stated whether this solid fat contained cholesterin ; in all pro-
bability it did, as this fat is of frequent occurrence in fatty
tumours. In a fatty tumour examined by J. Miiller there
were acicular crystals mixed with a gray substance which was
deposited in vesicles and dissolved in boiling water, from which
it was not precipitated by acids or the ordinary metallic salts.
The crystals were insoluble in acids, water, or alcohol, but dis-
solved in ether; hence they probably consisted of cholesterin.
’ Kastner’s Archiv, vol. 12, p. 460.
il, 31
482 MORBID PRODUCTS.
Another fatty tumour contained some casein precipitable from
the aqueous solution by acetic acid.
Incrustations on the surface of the body.
Sore surfaces from which the epidermis has been removed
are covered by a fluid which usually consists, according to Ber-
zelius, of serum. This fluid dries up and protects the exposed
surface from the atmospheric influence. My own investigations
lead me to believe that this fluid differs materially from serum,
that it contains a much larger quantity of albuminate of soda,
and that its solid residue consists, for the most part, not of
coagulated albumen, but of epithelium- and pus-cells.! Lassaigne
has analysed the crusts of small-pox; they contained 63—70 —
parts of coagulated, and 15—14 of uncoagulated albumen,
2—1 of fat, 18—11 of extract of flesh, and 2—2°5 of salts.
Wackenroder found uncoagulated albumen in the crusts of
tinea capitis.
I have analysed the crusts which formed on sores on the
body of a man with a severe attack of icterus. They appeared
as yellow or whitish-yellow scales, or as large shreds of skin,
and were very difficult to pulverize. When rubbed with water
they swelled, and ultimately formed an emulsive sort of fluid,
which did not clear on standing, and in which a very large
number of epithelium-scales were suspended. The filtered fluid
coagulated very slowly on the application of heat, but became
covered with a film during evaporation. It had a faintly alka-
line reaction, and was rendered slightly turbid by the addition
of an acid, but again became clear on the addition of an excess
of the test. It was strongly precipitated by ferrocyanide of
potassium, infusion of galls, and bichloride of mercury. On
heating the residue, after evaporation with water, it was found
to be almost insoluble; alcohol took up some extractive matter
with a very little chloride of sodium.
The residue yielded an ash which slightly effervesced on the —
addition of nitric acid, and contained mere traces of the earthy
phosphates and chlorides, but a considerable amount of phos-
1 [In connexion with this subject a paper ‘ On Pyinn, and its importance in the —
Human Organism,’ by Eichholtz, in Rust’s Mag. fiir die gesammte Heilkunde, vol. bes
p- 140, may be consulted with advantage. }
INCRUSTATIONS. 483
phate of soda. The portion insoluble in water appeared, when
examined under the microscope, to consist of epithelium-cells,
for the most part more or less injured. Alcohol took up from
these scales a little yellow fat which partly separated on cooling :
this portion consisted of margaric acid and margarin, while
oleic acid remained in solution. The ash left by the direct in-
cineration of the scales contained scarcely appreciable traces of
sulphates or chlorides, a little carbonate and a large amount of
phosphate of soda, earthy phosphates, and a trace of iron.
Hence these scales contained the ordinary fats and fatty acids, a
little uncoagulated albumen, a large quantity of albuminate of
soda, some extract of flesh, and a considerable amount of salts,
in which the phosphate of soda and earthy phosphates predo-
minated. No bilin could be detected, and only a trace of bile-
pigment.
I have recently examined the scales of a person with
ichthyosis. They were of a gray or black colour ; when placed
in water they softened, and on then placing a section under the
microscope I found that the abnormal structure was formed of
compressed epithelium-scales.
On incineration the scales left an ash containing carbonate
and phosphate of lime, and peroxide of iron ; the latter was in
such abundance as to communicate a yellow colour to the ash.
The ash yielded by the incineration of the ordinary thickened
skin on the hands and feet is perfectly white, and contains a
mere trace of peroxide of iron.
484
CHAPTER XIII.
FLUID PRODUCTS OF DISEASE.
Hypatips are round vesicles filled with fluid, sometimes but
not always containing a minute animal (echinococcus) ; these
vesicles occur most commonly in the brain and liver. Gobel
analysed hydatids from the liver of a goat; the echinococcus
was present in large numbers; the fluid contaimed im the
vesicles was clear, yellow, neutral, gave off an unpleasant odour
during evaporation, and blackened a silver spatula with which
it was stirred. It yielded 1:54 of solid residue consisting of
‘04 albumen, 0°24 mucus, and 1:26 salts, namely, carbonate of
soda, chloride of sodium, sulphate of potash, and phosphate of
lime. The vesiele itself was imsoluble in water and alcohol,
yielded a little fat to ether, swelled in acetic acid without dis-
solving, but dissolved in a solution of caustic potash, from
which it could be precipitated by the addition of acetic acid.
Collard de Martigny has likewise analysed hydatids. The
fluid contained in them was faintly yellow, and somewhat turbid
from the presence of flocculi of albumen, which soon settled to
the bottom. Boiling produced a marked turbidity in conse-
quence of the coagulation of albumen. It contained water
96°5, albumen 2-9, and salts, for the most part chloride of
sodium, 0°6.
The membrane enclosing the fluid was divisible into five
laminz, was insoluble in ether, alcohol, and boiling water, but
dissolved, even without the aid of heat, in sulphuric, hydro-
chloric, and nitric acids, from which it was not precipitated on
neutralization with a free alkali; it was not dissolved by acetic
acid, and was rendered leathery by infusion of galls.
[Scherer has analysed the fluid contained in hydatids of the
kidney. It was of a brownish yellow colour, threw down a
FLUID PRODUCTS OF DISEASE. 485
light, floceulent, brown deposit, and evolved an ammoniacal
odour. |
In 1000 parts there were contained :
Water . ; : . 934°762
Solid constituents ‘ ij i 65-238
Albumen é ‘ 3 157960 | Protein-compounds
Albuminate of soda . 5 : 10°044 26°006
Alcohol-extract with lactates & ammonia-salis 22°312
Water-extract - : ‘ 3°797 ber ern meers
- Fat ; ; f : Es 2°042
Inorganic salts , : , 10°615
. Uric acid : . mar 0°413
Not a trace of urea could be found; it had probably been
converted into carbonate of ammonia. |
Cysts may either be filled with a solid matter, as for instance,
fat (in which case they form the fatty tumours of which we
have already spoken), or they may contain a fluid.
Collard de Martigny analysed the fluid contents of a cystic :
tumour situated between the rectum and the uterus. The fluid
was of the consistence of a syrup, of a dirty yellow colour,
viscid, and of a sickly odour. When evaporated at a tempera-
ture of 104°, it left a brown residue amounting to 12°8°, which
softened in water without dissolving, and on heating gave off
an odour of burned horn. On the addition of alcohol to the
fluid a thick, elastic, yellow mass was precipitated ; which
dissolved in water and was again thrown down on adding a
dilute acid, but was soluble in an excess of the reagent. The
alkalies, sulphate of iron, and nitrate of silver, exerted no in-
fluence on this solution, but a yellow precipitate was thrown
down by nitrate of the protoxide of mercury, tincture of iodine,
tannin, and bichloride of platinum. From these imperfect data
it is impossible to form any conclusion regarding the true nature
of the fluid.
I made an analysis of a thick chocolate-coloured, alkaline
fiuid, obtained by puncture in a case of ovarian dropsy. Under
the microscope there were a considerable number of pus-cor-
puscles, and a few coloured blood-corpuscles visible. It con-
486 FLUID PRODUCTS
tained so much albumen that on heating it coagulated, forming
thick brown flocculi. The colouring matter is doubtless to be
attributed to the presence of hematoglobulin : the fat abounded
in cholesterin,
It contained :
Analysis 167.
Specific gravity. : . 1030
Water . i ‘ ‘ : 925°00
Solid constituents : : i Bas 75°00
Fat containing cholesterin : : 1710
Albumen . : ‘ : 56°77
Alcohol-extract
Spirit-extract 4°50
Water-extract Z
Carbonate of soda, phosphate of lime, 8:89 ‘
chloride of sodium and lactate of soda ™
Albuminate of soda ‘ a : 7°50
[Scherer has made several analyses of the contents of ovarian
cysts. .
1. A thick, viscid fluid of this nature, obtained from a woman
aged 40 years, had an alkaline reaction, a specific gravity of
1022, and when allowed to stand, deposited a sediment com-
posed of granules, inflammatory globules, and minute nucleated
cells.
In 1000 parts there were
Water a « 952°2
Solid constituents i ie
Protein-compounas
thrown down Ae 33°6
alcohol .
Extractive matters. 9-1
.q f consisting chiefly (nearly
ree! ° ; es { 4: sie of chloride of sodium.
On a subsequent occasion (about. two months afterwards)
the fluid contained :
Water z ra Sg - 940°90
Solid constituents . ‘ 59-10
Albumen precipitable by boing, after the addition ;
of acetic acid 42°62
Extractive matters 5 ; z 12°03
Inorganic constituents 3 . ; 5°58
OF DISEASE.
2. In another instance a fluid was obtained containing :
Water vs
Solid constituents .
Mucin with exudation-cells
Albumen coagulated by ere
Albuminate of soda
Fat é
Alcohol-extract
Water-extract
Fixed salts
867-57
132°43
27°65
55°70
30°26
4:70
3°52
2°35
7°81
487
The mucin and exudation-cells were precipitated from the
fluid by acetic acid; they were then boiled with alcohol in
order to remove any adherent fat, and submitted to ultimate
analysis
They yielded :
Carbon 55°443
Hydrogen 7114
Nitrogen 18°305 |
Oxygen 19°138
A little more nitrogen and
hydrogen, and rather less
oxygen than protein.
In the following analyses, 1 and 2 represent the composition
of the contents of two other cysts in the same ovary, 3 repre-
sents the fluid in another case:
:
Water 903°11
Solid constituents 96°89
Albumen 40°38
Albuminate of soda 36°50
Fat < a 3°40
Extractive matters 6°07
Salts 8°54
2. 3.
839:904 799-85
160-096 200-15
150534 75.95,
— 3°13
1-456 14:50
8-006 10°43 |
_ Valentin has analysed a tumour (meliceris) containing a fluid
of the consistence of honey, of a dirty yellow colour, devoid
of odour, and leaving on evaporation, 11:3° of solid residue,
which consisted of, in 100 parts :
Coagulated albumen
Olein and oleate of soda
Cholesterin
Stearin
Uncoagulated albumen with a, little potash :
Lime / ; :
Magnesia
52°49
28°50
312
1-96
9°17
1-88
0-92
488 FLUID PRODUCTS
[The contents of a strumous cyst analysed by Scherer
contained :
Water mn ‘ F 920°54
Solid constituents si 79°46
Albumen with a little blood f 61°23
Extractive matters : F 8°71 ) Transformed matters
Fat (chiefly ry : 1-80 10°51
Salts 3 7°72 ]
Fluid of pemphigus. I have examined the faintly yellow
fluid occurring in the bulle of pemphigus. It had an acid
reaction, and deposited a sediment of corpuscles resembling
mucus- or pus-corpuscles in form, and in which a nucleus was
very apparent, Its specific gravity was 1018. On evaporation
it developed an acid odour similar to that which is observed
on evaporating the saliva in cases of ptyalism and due to the
presence of a little acetic acid. When submitted to a high
temperature it deposited a quantity of very white albumen ;
the acid reaction was then more powerful than before, but
after evaporation to dryness it disappeared, for the alcohol with
which the residue was extracted had scarcely a perceptibly acid
reaction. It was composed of :
Analysis 168. —
Water $ ; ‘ é 940°0
Solid constituents ; , bts 60:0
Fat containing cholesterin ? : 2°6
Albumen with earthy phosphates : 48-0
Extractive matter soluble in alcohol, with
lactate of soda and ehlorides of sodium 6°5
and potassium é
A substance resembling ptyalin, soluble in 19
water .
Free acetic acid and mucus-corpuscles . imponderable
Five years afterwards I examined the fluid from the same
patient during a fresh attack. In its physical characters it
was much as before. ee.
It contained in 1000 parts :
Analysis 169. :
Water : : : . 9598
Solid constituents ; 4 ‘ 40°2
Albumen with en ee ; 28°1
* Fat = ‘ 3°0
Alcohol-extract ee ; : 3°0
Fixed salts : : ; " 4°5
The fluid was strongly acid from the presence of acetic acid ;
no indications of urea were detected.
OF DISEASE. — 489
[Girardin has recently made an analysis of the fluid in cer-
tain vesicles on the abdomen.
In 1000 parts there were contained :
Water A é ; . 939°500
Solid constituents : F i 60°500
Albumen ‘ - 3 49-200
Cholesterin i P a 6°475
Alcohol-extract : 1-075
Phosphates of soda and lime, and dae 3-750 ]
of sodium
Fluid of hygroma. I have examined the fluid of an hygroma
situated on the lower jaw of a horse. The fluid was almost
clear and transparent, but so extremely viscid that it could
be drawn out into long threads. Its reaction was alkaline.
Under the microscope a few very large mucus-corpuscles, three
or four times the ordinary size, could be observed, occurring
as round granular vesicles, in which, in consequence of the
opacity of the investing membrane, the nucleus could not ‘be
detected. }
The fluid did not mix with water, but a separation of white
flocculi took place ; white gelatinous flocculi were likewise pre-
cipitated by alcohol. Ebullition rendered the fluid opaque, but
did not altogether coagulate it.
The gelatinous mass precipitated by alcohol was boiled in
spirit of 848 and then warmed with water, in which it swelled
and became viscid without dissolving. On the addition of
acetic or hydrochloric acid to the swollen mass it coagulated
immediately into opaque fibrils. It was perfectly soluble in a
dilute solution of caustic potash with the aid of heat, and again
precipitable by acetic acid, without being soluble in an excess
of the reagent. Hydrochloric acid threw down a substance
which was immediately redissolved, and a peculiar odour of
sulphuretted hydrogen was evolved, just as when we add. hydro-
chloric acid to an alkaline solution in which horn-shavings
have been digested.
The hydrochloric-acid solution was scarcely rendered at all
turbid by ferrocyanide of potassium, but was strongly precipi-
tated by tannin. From these experiments it appeared that the
substance under examination was mucin. Alcohol took up a
very small quantity of chloride of sodium and lactate of soda
490 FLUID PRODUCTS
from this fluid. The mucin left, on incineration, an ash of
phosphate of lime.
Dropsical fluids. The fluids that collect in different parts of
the body, especially im the cavities of the abdomen and thorax,
and in the subcutaneous cellular tissue, in a certain class of
disorders (dropsies), have been frequently submitted to chemical
analysis. Fluids of this nature are usually of a faint yellow colour,
and more or less turbid; flocculi of coagulated fibrin are some-
times present, and occasionally, after acute inflammatory attacks,
they contain so large an amount of that constituent as to assume
a gelatinous consistence.. Their specific gravity varies from 1010
to 1020 or higher; their reaction is alkaline, and they some-
times contain so small a quantity of albumen as only to be
rendered slightly turbid by heating, while in other cases the
amount is so large that the whole fluid becomes coagulated ;
the quantity of salts, especially of chloride of sodium, is fre-
quently also considerable. If the kidneys are affected, urea is
generally present. ‘The fat usually contains cholesterin.
The following analyses of the fluid found in the brain in
cases of hydrocephalus approximate closely in their results :
Marchand.
‘ eee molinge 3+
Berzelius. Mulder. ls z ;
Water é : - 988°30 989°997 986°54 989°93 —
Solid constituents , é 11°70 10:003 ~~ «=«+13'46 ©1007 ©
Albumen . ; : 1°66 0°549 163 sbOeae
Fat ? ‘ ; — 0°070 0°05 0°33!
Alcohol-extract with lactate of soda © 2°32 2°538° 2°10 4
Water-extract % : 0°26 — oils — 3
Chlorides of sodium and potassium 7°09 6°553 7°87 528 |
Earthy phosphates. A 0°09 0°090 0°10
Sulphate of soda : : —- 07146). > 0-11 0°23
_ Carbonate of soda gee ae — 0°057 :
Soda : ‘ : 0°28 tis. aa edie
Marcet obtained similar results in his analyses of dropsical
fluids. 3 :
_ Marchand found an extraordinarily large amount of urea in
the fluid, removed by tapping, from a woman with ascites.
>
Eee
! Of this, 0°21 was cholesterin. |
OF DISEASE. 491
There were contained in 1000 parts :
Water : ; : - 952:2
Solid constituents. : ; : 47°8
Albumen ; ; 23°8
Urea at - - : 4°2
Chloride of sodium | 81
Carbonate of soda 4 21
Phosphate and traces of sulphate of soda ‘ 0°6
A viscid substance } 8°9
[Several analyses of the fluid of ascites have been recently
made, some of which we shall insert in a condensed form. The
two following were made by Scherer :
1. A whitish turbid fluid removed from the abdomen by
paracentesis, in a case of dropsy dependent on abscesses pro-
ceeding to chronic suppuration, yielded in 1000 parts :
Water . ; ° é - 986°71
Solid residue : : ; 13°29
Minute granules and soluble ‘albanien . Sot 3°61
Extractive matters “ 2 . 1:80
Salts | ; F ee ‘ 7°90 .
The fluid evolved no odour, and was neutral.
2. The fluid obtained by tapping a patient with dropsy from
‘steatoma hepatis, carcinoma ventriculi, et perienteritis chronica,’
was examined on two occasions :
1. 2.
Water . . : y= $B2-99 960°49°
Solid constituents . é $ 47°01 39°51
Fibrin . : ; 0°32 —
Albumen ; ‘ 11°88 —
Albuminate of soda Z j 22-70 29°73
Extractive matters : P ‘ La02 zis
ree: : : ‘ 1°26 1°63
Salts ; ; 7°22 5°94
Urea was sought for in analysis 1, but without success.
Heller analysed the dropsical effusion in the case of ascites
noticed in p. 311.
The fluid hada milky appearance, was neutral, devoid of
odour, and its specific gravity was 1007.
Nitric acid and heat scarcely affected it, but an enormous
precipitate was thrown down by nitrate of silver.
492 FLUID PRODUCTS .
In 1000 parts there were contained :
Water : : . . sf 950-00
Solid constituents . = 50°00
Extractive matters and sees of sibisain 2 5°97
Fat - : 0°84
Fixed salts ( almost exclusively chloride of sodium\ 44-00
Not a trace of urea or of bilespiemneat could be detected.
The fat was perfectly saponifiable and contained no cholesterin.
In addition to the enormous amount of chloride of sodium in
the effusion, it was abundant in the urine (see page 312), and
the sweat was so saturated with it that it crystallized in minute
glittering particles on the skin.
In a case of Bright’s disease, in which the walls of the
abdomen were punctured, a fluid with an alkaline reaction
and specific gravity 1007°5 was obtained. It was analysed by
Heller, and found to contain :
Water ; 7 ; . 980°640
Solid constituents ‘5 A é 19-360
Albumen : 8 3 8-121
Free fat ; § 3 ‘ 0:220
A soda-soap : ‘ ans 0°392
Extractive matters . j ‘ 2-546
Fixed salts z = ; 8-080
It yielded no indications of urea, bile-pigment, or cho-
lesterin.
Percy found in a fluid of this nature :
Water ; : qe ; 952-0
Solid constituents ; € é 48°0
Albumen . , gates 38°0
Indeterminate organic matter . ; 3°2
Salts 76 |
I made an analysis of the dropsical fluid obtained by
puncturing the abdomen of a young man in whom the sub-
sequent autopsy revealed suppuration of both kidneys. Urea —
was present in this fluid, which was of a faintly yellow —
colour, strongly alkaline, and threw down flocculi of albnaey
on boiling.
OF DISEASE. 493
It contained :
Analysis 170.
Specific gravity ; P et See
Water : : j je 978°0
Solid constituents ; : . 12-0
Fat containing cholesterin ‘ ; 1:0
Albumen . ; ‘ E $ 8-4
Alcohol-extract ‘ ‘ ‘ 0°3
Spirit-extract s ‘ een: 17
Carbonate of soda and phosphate of lime 1:2
Chloride of sodium and lactate of soda. 6°8
Urea ; 3 4 I*2
Thoracic effusions. I have analysed the fluid obtained from
the cavity of the pleura by paracentesis thoracis. It was of
a yellow colour, devoid of odour, and consisted of two portions,
viz., a thin liquid portion and a gelatinous clot floating on it.
The fluid had a strongly alkaline reaction, a specific gravity
of 1022-4, and showed, under the microscope, a few primary
cells of the size of pus- or mucus-corpuscles. The coagulum™
was slight in its consistence, and when examined microscopi-
cally was found to exhibit the structure of coagulated fibrin,
with a few enclosed primary cells; when washed with water
the fibrin was left perfectly white.
In 1000 parts there were contained :
Anal, 171.
Water ; ; ; - 934°72
Solid constituents . * 63°28
Fibrin . 3 x : 1°02
Fat F : : = 1°05
Alcohol-extract with salts SR . 1:35
Spirit-extract with salts ; : 10°64
Albuminate of soda . ; 17°86
Albumen é 3 : 31-00
Fixed salts ; ; ; 9°50
The fluid, both in its physical and chemical characters, closely
resembled lymph.
[The following analyses of similar fluids have been made by
Scherer. In 1 and 2 the fluid was taken at an interval of
eight days from the same person. In 3, it should be observed,
that the fluid was not analysed till a fortnight after the
operation.
494 FLUID PRODUCTS
25 -# 3.
Water. . : = ae 936°06 928-0
Solid constituents . . 64°48 63°94 72:0
Fibrin. ‘ 0°62 0°60 —_—
Albuminate of coda ; 49°77 52°78 —
Albumen ; — — 52°0
Fat’ * .. , 2°14 1°35 2°4
Alcohol-extract . ‘ 1°84 161 5'2
Water-extract . i 1°62 23
Salts - ° 7°93 7°40 10°2 ]
I once analysed the fluid obtained from incisions in the
lower extremities of a man with Bright’s disease. It contained
a very appreciable amount of urea, and a considerable quantity
of albumen, with much chloride of sodium.
I give the results of this analysis :
Analysis 172. ste
Specific gravity . es aie’ : ~ 1012
Water ; ; é . 5) 976°0
Solid constituents é ; - 24:0
Fat containing cholesterin : ; 0°5
Albumen
7
Alcohol-extract with urea 2
Spirit-extract : ; : 1
Water-extract ; |
Carbonate of soda and phosphate of lime 1
Chloride of sodium and lactate of soda 8
{Heller has recently published an elaborate essay on the
chemistry of the fluids in Bright’s disease, including several
analyses of the subcutaneous serum. His analyses of the blood —
and urine will be found in Appendix IT.
a, The subcutaneous serum from the body of a man who —
died from Bright’s disease was of a pale yellow colour, alka-
line, and had a specific gravity of 1011. It contained only a
very small quantity of albumen, but a large amount of fixed a
salts, viz. 10-1 in 1000 parts of the fluid.
6. Several ounces of fiuid were obtained by incisions in the
leg of a man aged 40 years, with general edema. The liquid —
was clear and almost as colourless as water, there being merely
a very faint tint of yellow. On cooling there was formed at~
a tai ie ak eee ee i alle Py
the bottom of the vessel a very light and delicate clot, which —
was slightly pink from the presence of a few blood-corpuscles;
OF DISEASE. — 495
the serum was then entirely colourless, had an alkaline reaction
and a specific gravity of 1010.
In 1000 parts there were ;
Clot p . ; : 18°78
Serum a ‘ ij «(2 9@P23
And there were contained in the fluid :
Water ; F : s 986-800
Solid constituents ; ‘ : 13°200
Fibrin. 0°134
Extractive matter, an imponderable quan 4-226
tity of albumen, and urea
Fixed salts : ‘ > 8°840
c. The serous fluid obtained in another case, by incisions in
the leg, was turbid, of a dirty yellow colour, and deposited a
flocculent sediment, consisting for the most part of epithelium-
scales, with a little pus and a few crystals of ammoniaco-mag-
nesian phosphate. ‘The reaction was strongly alkaline, and
the specific gravity 1010.
There were contained in 1000 parts :
Water j ‘ : . “97520
Solid constituents : S j 24°80
Albumen . 5:42
_ Extractive matters, salts, free and saponified :
3°76
fat, and urea : S
Fixed salts ‘ ‘ P 15°62
We shall revert to this subject, in relation to the composition
of the blood and urine, in the Appendix. |
_I have analysed the fluid obtained from a hydrocele ; it was
remarkable for the large amount of cholesterin contained in it;
it was of a yellow colour, devoid of odour, alkaline, and sparkled
when shaken, in consequence of the numberless crystals of
cholesterin suspended in it. The amount of solid constituents
was larger than I have ever observed in any other serous fluid
of a similar nature. The amount of salts, composed principally
of chloride of sodium, is also very remarkable.
This fluid contained :
496 FLUID PRODUCTS
Analysis 173.
Water : ‘ ; . 860-00
Solid coosithnnate tat . 140°00
Cholesterin with a little margarin ‘ad oleic adi : 8°40
Albumen ; 5 48°30
Albuminate of soda with extractive matter : : 6°88
Extractive matter soluble in alcohol i 2°30
Chlorides of sodium and calcium, a little sulphate and 79:52
traces of phosphate of lime
Phosphate of lime with traces of peroxide of i iron : 0:70
[Heller has recently published an essay on the fluid of
hydrocele, founded on three analyses :
1. Nearly ten ounces of fluid were removed from a man
aged 65 years, who had laboured under hydrocele for seven
years.
The fluid was of a dark-brown colour, alkaline, and of |
specific gravity 1021.
It contained a large amount of bile-pigment but no chole-
sterin, and after standing deposited a sediment.
In 1000 parts there were contained : |
Water ; : : . wae
Solid constituents * ; ; 80°8
Albumen. , ; ‘. 58°0
Free fat * ig 1°6
A soda-soap, bilipheein, heematoglobulin, 13-9
dissolved hematin, and extractive matters
Fixed salts : ; 73
2. About three ounces were obtained from a man aged 30
years. The fluid was of a clear yellow colour, strongly alkaline, —
and had a specific gravity of 1020. 3
It contained in 1000 parts:
Water j ; ‘ ; _ « 934°00
Solid constituents . : Ki ; 66°00
Albumen ‘ 52°81
Fixed salts, chiefly chloride of sodium ‘ 7°68
Fat, but no cholesterin ‘é g 0°14
Water-exttatt j j 117
A soda-soap, biliary resin and pigment, urea, uric 4°20
acid, and alcohol-extract .
3. One ounce was taken from a man aged 50 years. It
OF DISEASE. 497
was clear, of a dark yellow colour, alkaline, and had a specific
gravity of 1020.
It contained in 1000 parts :
Water. ; ; 906°36
Solid constituents . ‘ , P 93°64
Albumen ; : ; 60-00
Fat containing cholesterin . : 0°23
Extractive matters, biliphein, and a soda-soap : 24°04
Fixed salts, chiefly chloride of sodium ’ 9°37
A specimen examined by Percy contained in 1000 parts :
Water F be é : . -y 9294
Solid constituents ‘ d : Z 72°6
Albumen ‘ ; ; 59°2
Fat taken up by ether ; : . a trace
Alcohol-extract ; . 3 ; 1:2
Water-extract " : Te
Chloride of sodium with traces of chloride of potassium 6°0
Soda and lime, with eS can a and carbonic
acids : @ 4:0 |
A matter obtained from the scrotum in another case of
hydrocele was of a brown colour, hardly fluid, but rather of a
pulpy consistence. Under the microscope! it was found to con-
tain an immense number of crystals of cholesterin, numerous
blood- and pus-corpuscles, and a yellow substance resembling
coagulated albumen. On heating, it coagulated like blood ; it
yielded a large amount of cholesterin to ether, and of hemato-
globulin to hot spirit.
[The following analyses by Scherer, of fluid effusions found
in the body after death, are worthy of notice.
1. The fluid found in the abdominal cavity after death
from scirrhous degeneration of the chylopoietic viscera, con-
tained :—
1 [According to Heller, on making a microscopic examination of the fluid of
hydrocele, we may expect to find: 1, blood-corpuscles ; 2, fragments of epithelium ;
3, coagula of albumen or fibrin; 4, fat; 5, cholesterin; 6, globules of inflammation ;
7, pus; and 8, occasionally spermatozoa. ]
II, S2
498 FLUID PRODUCTS
Water ; j : j . 963-39
Solid constituents . : : : 36°61
Albumen ; 12°82
Albuminate of soda and heematiti ; d 7°13
Alcohol-extract . ; : ; 3°98
Water-extract : 2 3°72
Fat ‘ § y : ‘ 0°34
Salts. 8°58
The fluid was slightly bloody, and on sana deposited a
yellow sediment.
2. Ina case of metroperitonitis and bronchopneumonia there
was found in the abdomen a reddish-yellow fluid which de-
veloped a little sulphuretted hydrogen, had a well-marked acid
reaction from the presence of free lactic acid, and coagulated
perfectly on heating. The fluid separated from the coagulum
by filtration had an acid reaction, was of a yellow colour, and
contained much extractive matter in solution. On warming it
with carbonate of zinc, filtermg, and evaporating, crystals of
lactate of zinc were readily obtained.
In 1000 parts there were contained :
Water ; ; . 909°83
Solid residue . ; . 90°17
Cells : ; - ~12°95 ; ;
Albumen. 86°00 } Protein wale
A substance resembling pyin ; 8°96
Fat and alcohol-extract . 14°105 | Transformed tissues
Free lactic acid ‘ 1°05 33°41
Ammonia salts and water-exttact : 9°30
Fixed salts. ‘ : 8°88
The exudation in the pleural sac was of a blood-red colour,
although no blood-corpuscles could be detected by the micro-
scope. It was strongly acid.
In 1000 parts there were contained :
Water . ‘ . 936°718
Solid residue .~ ; . 63°282
Albumen ‘ . 81°746
Fat and extractive matter . 25°503)] Transformed tissues
Free lactic acid ; ‘ 1°610 27°113
Fixed salts . s “ 7110
3. In another case of metroperitonitis the fluid in the abdo-
minal cavity was of a yellowish-gray colour, neutral, and
coagulated freely on heating.
OF DISEASE.
In 1000 parts there were contained :
499
Water ; : . 909°79
Solid constituents ; 3 St
Albumen 2 é . 48°17
Alcohol-extract é 14°16
Fat . j E 1:97 | Transformed tissues
Water-extract i 6°80 32°83
A substance thrown down by acetic acid 9-90
Fixed salts 5 . ij 9:00
4. In a similar case, the abdominal exudation separated ina
short time into a purulent deposit, and a reddish-yellow super-
natant fluid. The microscope revealed the presence of cells,
organisms resembling minute algze, granules, and nuclei.
The
exudation had a faintly acid reaction and developed a consider-
able quantity of sulphuretted hydrogen,
In 1000 parts there were contained :
Water ; ; - 902°70
Solid constituents . é s $9730
Pus- and exudation- corpuscles ‘ 13°81 :
Albumen precipitable by water F 1298 Scat Sema ag
Albumen coagulated by boiling = - 23°84
A substance thrown down by acetic :
s . 12°41
acid and not soluble in an excess .
Alcohol-extract 3 ° 14°96 cree nae tigsue
Water-extract 2 ‘ 5°36
Fat ; : 6°20
Fixed salts ; 5 3 8°83
5. A similar fluid in a case of ‘ metritis septica’ was strongly
acid, and contained in 1000 parts :
Water j ; . 90574
Solid constituents . «, 94°26
Pus- and exudation-cells . 14°67] Protein-compounds
Coagulable albumen. . 32°46 47°14
Fat ; ; “4 2]
Lactic acid. 0 |
A substance precipitable by acetic acid 10. Ps >
Alcohol-extract oo BZOO I
Water-extract : ; 7°45 J
Fixed salts . : F 9°38
Metamorphosed tissue
6. The abdominal exudation in a case of metroperitonitis
and endometritis differed from the preceding fluids in not depo-
siting a purulent sediment, but after standing for a considerable
time remained turbid and of a yellowish-red colour.
Under
500 FLUID PRODUCTS OF DISEASE.
the microscope there were seen free granules and nuclei, to-
gether with exudation globules filled with granular contents. It
was strongly alkaline.
In 1000 parts there were contained :
Water ‘ 5 ; | 966°10-
Solid constituents : ; ‘ 33°90
Albuminate of soda ; § ¢ 18°72
Fat ; 5 5 J 1°35
Extractive matters ; : 6°12
ea : ’ ; 8°73
7. In a case of ‘ perimetritis, metritis, and endometritis,’
the microscopic characters of the fluid were similar to those in
the preceding case. The exudation was neutral. When boiled
it coagulated and deposited flocculi; the filtered liquid was
rendered turbid by acetic acid, and the turbidity did not dis-
appear on the addition of an excess of the test. The fluid
was, however, rendered clear by the addition of hydrochloric —
acid. These reactions show that the precipitated substance
was not casein, but pyin.
In 1000 parts there were contained”
Water : . 941°27
Solid Staats ‘ . - SBF3
Albumen : . - 25°21 Unchanged protein
Pyin ; ‘ , 4°37
Fat ; : 2°32 Metamorphosed tissue
Alcohol- extract ; ; =F 27°17
Water-extract ‘ ; 8°11
Fixed salts~ . : : 7°93
8. We shall conclude this series of cases with a notice of the |
analysis of the fluid found in the peritoneum of a boy aged
8 years, who died from perienteritis. The exudation deposited
a sediment similar to those described as forming in the pre- —
ceding cases of puerperal fever; it was neutral and coagulated
on boiling. |
It contained in 1000 parts :
Water 2 : ee - . 980-00
Solid constituents : = z 20°00
Albumen . é f ; 6°49
Pyin : 3 , : 2°45
Extractive matters . ; x 4°74
Salts ; - ; 4 6°32 ]
VAY Sse
Be Fh ee Oy ee
VOOS9 1 ee oe
Note l.
Carbon
Hydrogen
Nitrogen
Oxygen
APPENDIX I.
54°99 55°44
6°87 6°95
15°66 - 16°05
22°48 21°56
Ultimate composition of protein. (Mulder.)
Vegetable albumen. Fibrin. Albumen. Atoms. Calculated.
55°30 40 55°29
6°94 31 7°00
16°02 5 16°01
21°74 12 21°70
Liebig’s formula C,, Hz, Ng O,, is founded on a series of analyses by Scherer, and
gives C 55°742, H 6°827, N 16°143, O 21-228.
Nore2. Ultimate composition of tritoxide of protein. (Mulder.)
Carbon
Hydrogen
Nitrogen
_ Oxygen
1. 9, 3.
5147 51°69 51°38
660 664 6:78
15°37. 15°09 15-01
26°56 26°58 26°82
4. Atoms. Calculated,
51°48 40 81°45
6°56 32 6°72
— 5 14:90
oer 16 26°93
1 was prepared from chlorite of protein, of which the chlorine had been removed
by ammonia; 2, by boiling fibrin in water; 3, by boiling albumen in water; and 4,
from an inflammatory crust.
Nore 3. Ultimate composition of binoxide of protein.
Carbon
Hydrogen
Nitrogen
Oxygen
1. 2.
3. Atoms. Calculated.
53°69 »=53°64 53°44 40 53°36
6°90 6°88 -°
15°63 = 15°85
7°04 ol 6°75
14°51] 5 15°45
23°71 23°64 25°01 14 24°44
1 was obtained by boiling fibrin in water; it then remains behind insoluble; 2,
is the albuminose of Bouchardat (Comptes Rendus, 20 Juin 1842). Von Baumhauer,
in Scheikund. Onderzoek. Deel 1, p. 568; 3 was obtained from hair (see Vol. I, p. 11.)
These analyses were made in Mulder’s laboratory. —
504
Note 4.
Carbon
Hydrogen
Nitrogen
Oxygen
Norte 5.
Carbon
Hydrogen
Nitrogen
Oxygen
Nore 6.
Carbon
Hydrogen
Nitrogen
Oxygen
APPENDIX.
56°63
5°93
10°23
27°21
Atoms.
13
8
1
5
Calculated.
56°12
5°64
10-00
28°24
Ultimate composition of leucin. (Mulder.)
I. os =
55°64 55°53
’ 9°30 9°32
10°51 10°51
' 24°55 24°74
Atoms.
12
12
zag |
4
Calculated.
55°79
9°11
10°77
24°33
Ultimate composition of protid. (Mulder.)
fe 59°20
6°62
10°56
23°62
Atoms.
13
Calculated.
59°04
Ultimate composition of erythroprotid. (Mulder.)
/
OE Spee ee a ae oe ee ae aie ae
Sai then Be
Nore 7. Ultimate composition of albumen of the blood. (Mulder.) E:
In a few instances (see Vol. I, pp. 1—3, 181, and Vol. II, pp. 8, 424, &c.) I find -
that I have doubled the equivalent of phosphorus.
Carbon
Hydrogen
Nitrogen
Oxygen
Phosphorus °
Sulphur
Calculated. —
” Atoms.
54°84 400 54°70
; : 7°09 310 6°92
3 3 15°83 50 15°84
; E 21°23 120 21°47
0°33 1 0°35
0°68 2 0°72
the formula, instead of being 10 Pr + S,P, would become 10 Pr + S.P,.
Albumen of eggs differs from the above in containing only half the amount of 3
sulphur, Mulder’s analysis gave:
Carbon
Hydrogen
Nitrogen
Oxygen
Phosphorus
Sulphur
: ; , 54°48
cae ge
15°70
22-00
0°43
0°38
Atoms,
400
310
50
120
I
1
Calculated, —
54°90
6°95
15°89
21°55
0°35
0°36
Adopting this notation in p. 16,
5 ‘
Wee ‘ ‘ .
CO, Re RE Sod EPR ey et
APPENDIX. 505
Nore 8. Ultimate composition of fibrin from ox-blood. (Mulder.)
Atoms, Calculated.
Carbon 54°56 400 54°90
Hydrogen 6:90 310 6°95
Nitrogen 15°72 50 15°89
Oxygen 22°13 120 21°55
Phosphorus 0°33 1 0°35
Sulphur 0°36 1 0°36
Hence, in its composition, it is identical with the albumen of eggs.
Nore 9, Ultimate composition of casein from cows’ mitk.
(Mulder.)
Atoms. Calculated.
Carbon 54°96 400 55°10
Hydrogen 715 310 6°97
Nitrogen 15°80 50 15°95
Oxygen 21°73 120 21°62
Sulphur 0°36 1 0°36
Nore 10. Ultimate composition of crystallin from the eye.
(Mulder.)
Carbon 55°39
Hydrogen 6°94
Nitrogen 16°51 hence it closely resembles casein.
Oxygen 20°91
Sulphur 0°25
Note 11. Ultimate composition of globulin,
The analysis referred to in the text was published by Mulder in the ‘ Bulletin’
for 1839. In his recent work on the ‘Chemistry of Animal and Vegetable Physiology,’
he states that, although a protein-compound, its real composition is not yet known.
Nore 12. Ultimate composition of pepsin. (Vogel.)
Carbon : ; ; 57°718
Hydrogen : : ‘ 5°666
Nitrogen : ; : 21°088
Oxygen : : ‘ 16°064
506 | APPENDIX.
Nore 13. Ultimate composition of chondrin. (Scherer.)
Cartilage of the ribs of a calf. Cornea. Atoms. Calculated,
coe
Carbon ; 49°496 50°895 49°522 48 50°745
Hydrogen : 7°133 6°962 7°097 40 6°904
Nitrogen ‘ 14908 14908 14°399 6 14°692
Oxygen : 28°463 27°235 28°982 20 27°659
Mulder obtained from costal cartilage :
Atoms. Calculated.
Carbon : : 49°96 320 49°93
Hydrogen ; ; 6°63 260 6°61
Nitrogen ; ; 14°44 40 14:47
Oxygen : : 28°59 140 28°58
Sulphur 4 : 0°38 1 0°41
Nore 14. Ultimate composition of glutin. (Mulder.)
Glutin from hartshorn. Glutin from isinglass. Atoms. Calculated.
—_
1. 2.
Carbon : 50°05 50°05 50°76 13 50°37
Hydrogen . 6°48 6°64 6°64 10 6°33
Nitrogen. 18°35 18°39 18°31 2 17°95
Oxygen. 25°12 24°92 24°29 5 25°35
Nore 15. Ultimate composition of glycicoll or gelatin sugar.
(Mulder.)
Atoms. Calculated.
Carbon . ‘ . 34°27 8 34°39
Hydrogen : : 6°51 9 6°32
Nitrogen ‘ Piet | ae 19-92
Oxygen : . 39°38 7 39°37
Nore 16. Ultimate composition of hematin, (Mulder.)
1. 2: 3. Atoms. Caleulated.
Carbon. 66°49 66°20 65°73 44 65°84.
Hydrogen _—_-530 5°44. 5:28 22 5°37
Nitrogen 10°54 10°46 10°57 3 10°40
Oxygen. 11‘01 11°15 11:97 ~ 6 11°75
Iron : 6°66 6°75 6°45 1 6°64
1 and 2 were prepared from arterial and 3 from venous ox-blood.
APPENDIX. ° 507
Nore 17. Ultimate composition of cholic acid. (Dumas.)
Atoms. Calculated.
Carbon . : : 68°5 42 ——- 68°8
Hydrogen : : 9°7 36 9°6
Oxygen . ; , 21°8 10 21°6
Nore 18. Ultimate composition of urea.
Prout. Liebig and Wohler. Atoms. Calculated.
Carbon : 19°99 20°02 2 20°198
Hydrogen i 6°65 6°71 4 6°595
Nitrogen ; 46°65 46°73 2 46°782
Oxygen : 26°63 26°54 2 26°425
Nore 19. Ultimate composition of uric acid.
Prout. Mitscherlich. Liebigand Woéhler. Atoms. Calculated.
Carbon . 39°875 35°82 36°082 5 36°00
Hydrogen 2°225 2°38 2°441 2 2°36
Nitrogen 31°125 34°60 33°361 2 33°37
Oxygen . 26°775 27°20 28°126 3 28°27
Nore 20. Ultimate composition of hippuric acid.
The hydrated acid contains :
Mitscherlich, Liebig. Dumas. Atoms, Calculated.
Carbon ‘ 60°63 60°742 60°5 18 60°9
Hydrogen : 4°98 4°959 4Q. 9 4:9
Nitrogen : 7°90 7816 7 1 7°8
Oxygen. ; 26°49 26°483 26°9 6 26°4
Nore 21. Ultimate composition of uric oxide.
(Liebig and Wohler.)
Atoms. Calculated.
Carbon ; ; 39°28 5 39°86
Hydrogen : : 2°95 2 2°60
Nitrogen : : 36°35 2 36°72
Oxygen : ; 21°42 2 20°82
heres
508 APPENDIX.
Nore 22. Ultimate composition of cystin.
Prout. Thaulow. Atoms. — Calculated.
Carbon 3 4 29°875 30°01 6 30°31
Hydrogen . : 5°125 5°10 6 4°94
Nitrogen . : 11°850 11°60 1 11°70
Oxygen } 53°150 28°38 4 26°47
Sulphur 25°51 2 26°48
Nore 23. Ultimate composition of glycerin. (Pelouze.)
Hydrated. Atoms. Anhydrous. Atoms.
Carbon ; \ 39°59 6 43°84 6
Hydrogen . A 8°61 8 8°35 7
Oxygen ‘ ; 51°80 6 47°84 5
Note 24, Ultimate composition of stearic acid. (Redtenbacher.)
Atoms, Caleulated.
Carbon é ; 76°71 68 76°76
Hydrogen é ; 12°86 68 12°90
Oxygen ets . 10°46 7 10°34
Ultimate composition of margaric acid. (Redtenbacher.)
Atoms, Caleulated.
Carbon : : 75°64 34 75°64
Hydrogen - > ; 12°86 35 12°71
Oxygen ; : 11°50 + 11°65
The former contains two, and the latter one atom of water.
Nore 25. Ultimate composition of lactic acid,
Lactic acid has been analysed by several chemists, who have all arrived at nearly
the same results. ;
Hydrated. Atoms. Anhydrous. . Atoms.
Carbon ; ; 40°46 6 44-92 6
Hydrogen. . 6°61 6 6°55 5
Oxygen ‘ 52°93 6 48°53 5
Norr.—In vol. i, p. 222, it was inadvertently stated that hippuric acid is non-
nitrogenous, The object of the author is to show that, compared with uric acid, it
contains very little nitrogen.
APPENDIX II.
ADDITIONS TO VOLUME I.
Pace 300. Blood in thoracic inflammation. Zimmermann!
has communicated several observations respecting the blood in
inflammatory affections of the respiratory organs. The fol-
lowing are the results of his analyses, conducted according to
the method of Andral and Gavarret :
Water. Fibrin. Blood-corpuscles. Res. of serum.
1. 7900 3-0 127-0 80°0
784:0 4-0 - 126-0 860
796-0 6:0 119-0 79:0
810-0 7-0 106-0 77:0
"1805-0 5:0 103°5 85°5
4. 8060 9°6 109-9 74:5
7740 4-0 142°0 80-0
5. 17810 40 137°0 78-0
7860 4:0 1315 78°5
6 796-0 3-0 128-0 73:0
7. 7940 3-0 123°5 79°5
8. 792°0 3-0 120-0 890
9 800-0 4:0 119°5 765
10. 800-0 40 . 1080 88-0
11,7. £ 798.0 7-0 116-0 79-0
815°0 8-0 100°5 76°5
12. 806°0 35 100°5 90:0
If we compare the mean of these analyses with the average
deduced by Andral and Gavarret from 58 analyses of the blood
in similar cases, we have: |
Zimmermann 7962 °° «4°75 118-10 80°85 ©
Andral - 799°0 7°30 114°10 81-00
1 Zur Analysis und Synthesis der pseudoplastichen Prozesse, pp. 1841-99,
510 APPENDIX.
The leading difference in these averages occurs in the fibrin.
Zimmermann suggests that probably Andral and Gavarret used
only buffed blood.
Pacer 302. Blood in intermittent fever In four cases in
which the blood of persons residing in malarious districts, who
were suffering from intermittent fever, was analysed by Cozzi,
the fibrin occurred in its normal quantity, but the fat and
albumen were diminished. In three of these cases there was
a great excess of cholesterin, and scarcely any phosphates ; in
the remaining case (No. 3) these salts were abundant, while no
cholesterin was found.
The following are the results of Cozzi’s analyses:
1. 2. 3. 4,
Water and salts . 737°67 705°49 732°45 809°17—
Fibrin . ; 2°20 2°06 2°29 1:96
font ; 15 21 13 16
Albumen ‘ 48°71 56°61 47°59 53°10
Blood-corpuscles . 211°27 235°63 217°54 135°61
The blood in (1) was taken from a soldier with severe inter-
mittent fever, accompanied with considerable enlargement of
the spleen and liver.
The blood in (2) was taken from a man with a quartan
fever, whose spleen and liver were much enlarged, and the
latter the seat of excruciating pain.
The blood in (3) was taken from an artilleryman, who for
five years had been stationed in a malarious district. It was a
case of intermittent fever, with slight enlargement of the liver,
but extraordinary hypertrophy of the spleen.
The blood in (4) was taken from a man with angina tonsil-
laris, who had suffered from fever for a long time: spleen en-
larged and very painful.
In addition to the excess of cholesterin in the majority of
these cases, bile-pigment was observed in the blood. The con-
nexion between the occurrence of these constituents and the
deranged state of the portal system is sufficiently obvious.
Pace 804. Blood in certain diseases of the eye. Zimniene
mann has published the following analyses of the blood in
APPENDIX. 511
a peculiar form of endemic ophthalmia recently prevalent at
Berlin.
1. In a case of ophthalmia of two days’ standing, accom-
panied with much chemosis, the specific gravity of the blood
was 1051. The specific gravity of the serum was 1027, and
of the clot 1086.
In 1000 parts there were :
Water . ; : 798:0
Solid constituents : ; é 202°0
Fibrin. ; : ; 2-0
Blood-corpuscles_ . ; i 1175
Solid residue of serum ; é 82°5
The serum was of a blueish-red colour and opaque.
2. The blood drawn from a patient on the third day of the
ophthalmia had a specific gravity of 1052.. The specific gravity
of the serum was 1028 and of the clot 1090.
In 1000 parts there were :
Water F : ; ‘ 795°0
Solid residue ; F , 205°0
Fibrin. ; ‘ ; 2:0
Blood-corpuscles . ; ‘ 115°1
Solid residue of serum ; ‘ - 87°9
3. A patient on the second day of the disease yielded blood
of specific gravity 1055. The specific gravity of the serum was
1030, and of the clot 1092.
In 1000 parts there were contained :
s
Water ae = F ‘ 790
Solid residue . E ‘ 210
Fibrin ‘ ; ‘ ° 2
Blood-corpuscles. i : 115
Solid residue of serum , ; 93
4, In a similar case the blood had a specific gravity of 1054,
The specific gravity of the serum was 1035, and of the clot
1088.
In 1000 parts there were contained :—
ail ake
512 APPENDIX.
Water . ; : ; 794
Solid constituents ; M : 206
Fibrin S ; > ; 3
Blood-corpuscles . ; 4 105.
Solid residue of serum ie 9
5. A soldier with conjunctivitis and sclerotitis of the right
eye. The specific gravity of the blood was 1052. The specific —
gravity of the serum was 1030, and of the clot 1084.
In 1000 parts there were contained :
Water i : ; : 795°0
Solid constituents ‘ ; : 205°0
Fibrin. : : , 2°5
Blood-corpuscles_. ; , 104:0
Solid residue of serum ‘ ‘ 98°5
6. In a case of conjunctivitis of both eyes without fever, the
E
specific gravity of the blood was 1055. The specific gravity —
of the serum was 1036, and of the clot 1088.
In 1000 parts there were contained :
Water : : é 7860
Solid constituents F ; : 214°0
Fibrin . que ; : 2-0
Blood-corpuscles_ . ; 3 113°5
Solid residue of serum ‘ : 98°5
7. In a case of ophthalmia of the left eye, the specific
gravity of the blood was 1055. The specific gravity of the —
serum was 1031, and of the clot 1090.
In 1000 parts of blood there were contained :
Water .. : 5 d 790°0
Solid constituents : : ‘ 210-0
Fibrin. ; wen a 2:0
Blood-corpuscles_ . 5 : 114°7
Solid residue of serum : : 93°3
Three days having elapsed, venesection was again ordered. Z
The specific gravity of the blood was then 1050°8. The spe- —
cific gravity of the serum was 1027°7, and of the clot 1078.
In 1000 parts there were contained :
Water ; 5 = ; 802-0
Solid constituents ‘ " ‘ 198-0
Fibrin. ; 5 j 2°0
Blood-corpuscles. ; i 116-2
Solid residue of serum ‘ ; 89°8
APPENDIX. 513
8. The blood of a soldier on the third day of the disease had
a specific gravity of 1052. The specific gravity of the serum
was 1031, and of the clot 1080.
In 1000 parts there were contained :
Water ; , ‘ A 796°0
Solid constituents . Pe . 2940
Fibrin . 5 ; E 2°5
Blood-corpuscles : . 106°7
Solid residue of serum * is 93°8
Four days afterwards the specific gravity was 1050°5. The
specific gravity of the serum was 1028, and of the clot
1078.
In 1000 parts there were contained :
Water 4 3 ‘ ; 800
Solid constituents : ‘ 200
Fibrin. -<* ‘é : 2
Blood-corpuscles é eae |.
* Solid residue of serum : ‘ 90
After an interval of ten days he was again bled. The
specific gravity was 1050. The specific gravity of the serum
was 1027, and of the clot 1078.
In 1000 parts there were contained :
Water : ; : 804°0
Solid constituents . , : 196°0
Fibrin . 4 : me 3°5
Blood-corpuscles : , 97-0
Solid residue of serum ; ; 95°5
A glance at the leading characters of the blood in these eight
cases, will show, that in these patients it was in a state of
hypinosis.
Pace 809. Blood in scrofula. _ The blood in this form of
disease has been analysed by Mr. Nicholson.!
The analyses were conducted on Andral and Gavarret’s
method :—
1 Northern Journal of Medicine, Nov. 1845.
II. 33
514 APPENDIX.
Water. Fibrin. Blood-corpuscles. Resid. of serum.
1. 8165 3°0 101-0 795
2. 820°2 2°8 98-0 79°0
3. 820°5 2°4 98-0 79°71
4. 821:0 3°0 97-0 79-0
5. 823°0 2°5 96°5 78:0
6. 839°0 2°3 80°0 78°7
7. 843°0 2°0 79°0 79:0
8. 839-0 2:0 79°0 80:0
9. 855°3 12 63°5 80-0
10. 855°2 18 64:0 79:0
ll. 854°3 17 65:5 78°5
12. 855°0 2:0 64:0 79-0
The blood-corpuscles were few, light coloured, and irregular,
and there was sometimes an appearance as if their circumfer- —
ence was notched and divided. .
Pacs 325. Blood in Bright’s disease. In a case of albu-
minuria, in which the dropsy was only of a fortnight’s standing,
the blood was analysed by Dr. Ayres.’ There was a firm buffy
coat on the blood, a quarter of an inch in thickness.
The coagulum itself was very firm, and so bulky as almost to
fill the glass.
There were contained in 1000 parts :
Water ; : ¢ - 465°022
Solid constituents ; - 234-978
Fibrin and tritoxite of of protein . 11°450
Bee oe : : a trace
Albumen - ; ; 65°875
Hematoglobulin . : - 138°185
Albuminate of soda and salts ‘ 13°940
Osmazome _ ; 5 1°510
No urea could be detected in this blood, the leading cha-
racters of which were a great increase of sas and a diminu-
tion of the water and fat.
The following analyses have been recently published by
Heller.”
1 Lancet, Aug. 2, 1845.
2 Archiv fiir Physiologische und Pathologische Chemie und Mikroskopie, vol. ii,
p- 173.
APPENDIX. _ 515
lst Case.—A man of tolerably robust appearance, aged
38 years. The disease was somewhat advanced, and there was
considerable cedema. The blood was analysed on two occa-
sions. On the first occasion it was taken by cupping from
the region of the kidney. It was very fiuid but of the normal
colour. The clot was small and presented no peculiarity. The
serum was slightly coloured. Under the microscope the blood-
corpuscles appeared large and swollen. The blood was tested
for urea, and found to contain a considerable quantity.
Five ounces were subsequently removed by venesection. The
colour of the blood on this occasion was rather dark, and the
coagulation was perfect. The clot was of a bright red colour
on the surface, but otherwise dark, and there was no buffy coat.
The serum was very pale and opalescent, and its specific gravity
was only 1022, It contained no bile-pigment, and its reaction
was strongly alkaline.
In 1000 parts were contained :
Water . 805°39
Solid oénatinabintis . 19461
- Fibrin $ i 3°52
Albumen P : 51°45
Fixed salts P 6°70 F ‘ :
Pataki: vabibten ; 8-15 Solid residue of serum 68°15
Urea ; 1°85
Hamatoglobulin . 122°94
2d Case-—A woman, aged about 30 years, with the disease
in an early stage. There was slight cedema of the feet and
face, accompanied with pain in the region of the kidneys. Four
ounces of blood taken from the arm presented no physical pe-
culiarities. The specific gravity of the serum was only 1018,
or 10° lighter than normal serum. ‘The clot was to the serum
in the ratio of 544°75 : 455-25.
In 1000 parts of blood there were contained :
Water eo - 816°04
Solid sibnatatinatite : . 183°96
Fibrin ; 2°66
ger ee aap . little extractive Tc e Se Solid r es id c éf een
Urea : ee 1:74
Hmatoglobulin : . 12457
_Heller’s general conclusions respecting the blood in Bright’s
disease are that the specific gravity and the amount of solid
516 APPENDIX.
constituents are diminished, and that the diminution is dependent
alone on the decrease of the albumen, which, for the most part,
is found in the urine, but to a less degree also in the dropsical |
effusions. The appearance of the blood is normal, and in its —
coagulation it presents no peculiarity. The serum is pale, of
low specific gravity (as may be shown by the common urino-
meter), and contains no bile-pigment.
The fibrin and blood-corpuscles occur in the ordinary quan-
tity. The solid residue of the serum is much diminished in
consequence of the great decrease of the albumen. Urea is
abundant in the blood; in the first analysis it amounted to
1°85 in 1000 parts: reckoning the whole amount of blood in
the body at thirty pounds, this would contain about an ounce
of urea. The presence of urea in the blood must not, how-
ever, be regarded as peculiar to Bright’s disease, since it has
been found in a large quantity in cholera, ischuria, and other
diseases associated with suppression of urine.
The fixed salts present no remarkable deviation from the
normal standard, but are usually slightly below the healthy
average.
Pace 838. Menstrual fluid. Since the publication of the
first volume, an analysis of this secretion has been made by
Dr. Letheby.’ The menses were retained by an imperforate
hymen, which, when cut into, permitted the escape of about
forty ounces of a thick and almost black fluid, having the ap-
pearance of treacle. When examined under the microscope,
with a power of 300, it was found to be quite free from fibrin,
but numerous corpuscles were observed floating in it. The
greater number of them were altered blood-corpuscles, but there
were also noticed the exudation or inflammatory globules (of
Gerber and Gluge), lymph-corpuscles, mucus-corpuscles, epithe-
lium-scales, and minute granules resembling mere dots.
The fluid had an alkaline reaction, and was perfectly miscible
with water; when heated a little below 212°, it HS a firm
coagulum.
It was analysed in ssevedanss with Simon’s directions, and
was found to contain :—
' Lancet, Aug. 2, 1845.
APPENDIX. | 517
Water : ; : f , . 857-4
Solid Constituents. ? ; ; «2 4426
Fat ‘ ‘ ; ‘ : : 53
Albumen : < ’ : : 69°4
Globulin : ; : : ; 49°]
Heematin rs 4 ; ? ‘ 2°9
Salts ‘ : fc ; 8-0
Extractive matters 6°7
Another analysis was formed with the view of Se
the quantity of mucus, blood-corpuscles, and soluble albumen,
and gave the following results :
Water . ‘ 857°4
Solid matters AMEE in cold water, oe consisting
of mucous, lymph, and exudation globules with 22°6
epithelium
Solid matters soluble in cold water, and inisitslthe of oJ 53-8
saponified fats and blood-corpuscles
Albumen ‘ ‘ 52-7
Salts . : : ; , 70
These must be taken as the constituents of the fluid. It
can, however, hardly be regarded as the normal menstrual se-
cretion ; from the length of time in which it remained in the |
vagina it became mixed with an excess of mucus, and, acting
as an irritant, produced the inflammatory sages that were
observed in it.
518 APPENDIX.
ADDITIONS TO VOLUME Ii.
Pacr 9. Saliva. Lassaigne has instituted a series of
experiments in reference to the animal diastase of Mialhe.
The results of these experiments are as follows :
a. Human saliva, and that of the horse, at the temperature
of 103°, exert no solvent power on starch, which remains quite
unaltered in its physical and chemical properties. :
6. At a higher temperature (158° to 167°) maintained for —
three hours and a half, horse’s saliva acts on starch exactly as
water does; that is to say, the granules become tumid and dis-
tended, without being changed into either dextrine or glucose.
c. Human saliva obtained from the mouth has no action on
starch at the temperature of the body ; but converts it rapidly
into dextrine at a temperature between 158° and 167°, and
subsequently converts the dextrine into glucose.
d. During the digestion of raw amylaceous substances, the
saliva, being at the temperature of the animal body, cannot
exert the influence attributed to it by Mialhe; it can merely,
as most of the older and modern shitologiete. maintain, con-
tribute to moisten the alimentary bolus, and dissolve such of
its principles as are soluble in water.
Pace 12. Morbid saliva. Scherer has analysed the Saliva
of a girl aged 15 years, suffering from a scorbutic affection of
the mouth. There was copious ptyalism, the saliva amounting
to about 40 ounces in twenty-four hours. The secretion was
very liquid, fetid, and alkaline. The specific gravity was 1004.
In 1000 parts there were contained :
Water ‘ ; 988-8
Solid constituents ; : 11-2
A caseous-like substance precipitable Hid 6-5
acetic acid :
Fat taken up by ether ‘ ° 0°6
Extractive matter and ptyalin® . : 18
Carbonate of soda _. : : 1-2
Chloride of sodium . : : 0-7
Phosphate of lime 04
APPENDIX. | 519
On examining with the microscope the fluid immediately after
its discharge, there were found in it a large number of infusoria,
and a peculiar confervoid-like vegetation.
Pace 15. Fluid of ranula. Dr. Gorup-Besanez' has pub-
lished an elaborate paper on this subject, in which, after dis-
cussing at considerable length the question whether the tumour
constituting ranula arises from an obstruction of Wharton’s
duct, and contains retained and modified saliva, or whether it
is a species of ordinary cystic tumour, he arrives at the latter
conclusion. In 100 parts of fluid he found :
Water .. ; . * 95°029
Solid constituents 3 4971
Alcohol-extract, traces of fat, al dada h
1-062
of sodium 3 j
Water-extract (gluten ?) : : -0°923
Albuminate of soda 2 4 2°986
The microscope detected in the fluid some blood-corpuscles
and globules which were at least twice as large as the corpus-
cles of mucus or saliva, and resembled Gluge’s inflammatory
globules.
Hence the liquid differed entirely, both chemically and mi-
croscopically, from saliva.
Pace 19. The bile. Frerichs*® has recently analysed bile
both in health and disease. He gives the following as the
physical characters of healthy human bile.
In colour it is always deep brown, but, when seen in thin
layers, it has a brownish yellow tint. It is very fluid, being
viscid only in new-born infants. . The specific gravity varies
from 1032 to 1040. On examining with the microscope bile
from the gall-bladder, with which, of course, a certain amount
of mucus is mixed, there are observed :—1. Transparent or
grayish round vesicles, about 1-700th of a line in diameter.
They disappear on the addition of alcohol or ether, and are
removed by filtration. 2. Conical yellow bodies, about 1-140th
of a line in length, and about 1-300th or 1-400th of a line in
breadth, apparently devoid of nuclei; these are epithelium-cells
from the gall-bladder. 3. Here and there irregular dark granules,
' Heller’s Archiv fiir Phys. und Patholog. Chemie und Mikroskopie, vol. ii, p. 22.
? Hannov. Annal. | and 2, 1845.
520 APPENDIX.
which disappear on the addition of a solution of potash, appa-
rently pigment-cells. 4. Occasionally minute crystals of cho-
lesterin, occurring as colourless rhombic tablets. The chemical
characters are shown in the two following analyses. The bile
in these cases was obtained from healthy men, killed by severe
accidents :
1. 2.
Water i : : 86°00 85°92
Solid constituents ; : 14:00 14°08
Bilate of soda : : 10°22 9°14
Cholesterin , inh ONG 0°26
Margarin and olein . : 0°32 0°92
Mucus . ‘ 4 2°66 2°98
Chloride of sodium . : 0°25 0°20
Tribasic phosphate of soda A 020 ~ 0°25
Basic phosphate of lime : ;
s magnesia 0°18 0°28
Sulphate of lime ; . 0°02 0°04
Peroxide of iron : : traces _— traces
Pace 23. Morbid bile. Frerichs has published the two
following analyses of morbid bile:
Bile in Bile in
pneumonia. chronic meningitis.
Water ‘ . 94°60 95°98 -
Solid constituents ; 5°40 4°02
Bilate of soda ‘ 4:16 2°63
Fat ° ae 0°42 0°20
Mucus and salts - 1:00 1:21
Pace 27. For further information on the uses of the bile
we must refer the reader to the recent work of Platner, ‘ Ueber
die Natur und den Nutzen der Galle, Heidelberg, 1845. A
summary of his views on this subject is given in Miller’s Archiv,
No. 4, 1845.
Pace 29. Gastric juice. Dr. R.D. Thompson has published
an account of a series of experiments made with the view to.
determine the acid or acids occurring in the gastric juice. In
order to prevent complication of the phenomena, the animals
were fed on vegetable food alone. His experiments tend to
show that no free hydrochloric acid is present in the stomach
of animals living on vegetable food, but that the free acid is
the lactic. A little acetic acid was also generally present. 2286
Butter . i " . 7°32
Casein a ‘ e _ er ae
Extractive matter ; ; 2 3°39
Soluble salts A ; 0°45
Insoluble salts : : 5 0°57
Not a trace of sugar could be detected in the latter specimen.
His other analyses are merely confirmatory of the same fact.
Dumas believes that the milk-globules are surrounded by a
caseous investment; he found that if milk be shaken with pure
ether, the two liquids which are at first mixed, separate on
standing, and the milk preserves its ordinary appearance,
whilst the ether dissolves scarcely anything. If, however, acetic
acid is added to the milk, and the mixture is boiled, the whole
of the butter may be removed by subsequent agitation with
ether, and the milk ceases to be opalescent.
Pace 119. Colouring matters of urine. Heller has re-
cently published some observations on certain new colouring
matters in the urine. He believes that there exists a yellow
pigment (uroxanthin) which occurs in solution in very small
proportion in healthy urme, but is much increased in certain
forms of disease. It possesses the property of being converted
by oxidation (either spontaneously or artificially) into two other
pigments, one of which is of a ruby-red tint, (urrhodin,) while
the other is of the colour of ultramarine, (uroglaucin.)
These are both insoluble in the urine, and being deposited,
form a purple or violet-coloured sediment.
That uroxanthim and its products are derived from urea
seems probable, from the circumstance that uroglaucin and
urrhodin occur in diseases different in most of their characters,
but similar in one—the presence of an excess of urea in the
blood: thus they are found in Bright’s disease, in cholera, and in
suppression of urine. Further, when these products occur in
considerable quantity, (especially when the blue sediment is
spontaneously formed,) there is always much carbonate of am-
monia, and very little urea (perhaps mere traces) in the urine,
as is often the case in Bright’s disease. Finally, Heller has
APPENDIX. 523
observed the blue tint developed by nitrate of urea artificially
prepared and kept moist, and has likewise produced it by
adding nitric acid to an old solution of urea partially converted
into carbonate of ammonia.
The existence of a large quantity of uroxanthin in urine
is indicated :
1. By the clear light-yellow colour of the urine when that
secretion is acid, as in cholera, and sometimes in Bright’s
disease.
2. By the presence of the products of its oxidation, uro-
glaucin and urrhodin, which either of themselves form a violet-
coloured sediment, or communicate that tint to a sediment
already formed.
On allowing urine abounding in uroxanthin to stand for
some time, it is observed that after the formation of the
sediment has ceased, the fluid from the surface downwards
assumes a violet tint, and this change of colour takes place with
a rapidity proportional to the amount of carbonate of ammonia
produced by the decomposition of urea.
Hence, on keeping such urine ina high cylindrical glass,
three distinct strata are observed ; lowermost, a violet sediment;
in the middle, yellow and nearly clear urine; and superiorly,
a violet or purple turbid layer.
On shaking the glass, the whole urine assumes a_bluish-
green tint, because the urrhodin, formed principally at the
surface, becomes converted, by agitation with a full supply of
atmospheric air, into uroglaucin which, mixing with the central
yellow layer of urine develops a green tint. The uroglaucin
thus formed ultimately settles as a blue powder on the sides
and at the bottom of the vessel. Hence there is obviously no
fixed proportion between the quantities of uroglaucin and
urrhodin.
3. If much uroxanthin is present, the crystals of uric acid
(separated either spontaneously or by the addition of an acid)
have a beautiful blue or amethyst tint.
4. Lastly, if much uroxanthin is present, it may be recog-
nized by the addition of concentrated nitric acid, (ten drops to
half an ounce of urine,) which at once communicates a brilliant
violet colour to the fluid: if a smaller amount is present, the
change of colour is developed more slowly.
524 APPENDIX.
The nitric acid oxydises the uroxanthin, and converts it into
uroglaucin and urrhodin. Sulphuric and hydrochloric acids act
similarly, but with less activity. If albumen is present in
urine treated in this manner, it is either precipitated blue at
once, or assumes that tint gradually, according to the amount
of uroxanthin. This is constantly noticed in Bright’s disease
on treating urine abounding in uroxanthin with an acid, and
allowing it to stand for a couple of days; uroglaucin separates
in dark blue crystalline groups, visible to the naked eye, partly
on the surface and partly at the bottom of the vessel. On
taking a drop from the surface and examining it under the
microscope, uroglaucin is seen in the form represented in
Plate iui, fig. 37. :
To separate the two products of oxidation of uroxanthin, we
collect on a filter the sediment thrown down by nitric acid, and
agitate it with cold spirit of ‘830, which takes up the urrhodin,
(as also does ether ;) the residue is boiled for some time with
spirit of the same strength, until the fluid becomes somewhat
concentrated ; we thus get a bright blue solution of uroglaucin.
To exhibit these substances in normal urine, the fluid must
be so far evaporated as just to remain liquid. On adding
concentrated nitric acid to the cold residue, a crystalline magma
of nitrate of urea is at once formed ; on adding to this a few more
drops of nitric acid (and sometimes even this is unnecessary) it
assumes a violet tint. If the crystalline mass is allowed to
stand for some time, and is then dissolved in the smallest
possible quantity of distilled water, after being left at rest for
some time, it deposits a sediment in which urrhodin and
uroglaucin may be detected either by the microscope or by ex-
traction with cold and then with boiling spirit.
The action of nitrate of silver on uroxanthin is very singular.
On precipitating the chlorine by an excess of nitrate of silver,
from urine acidulated with nitric acid, and then carefully neu-
tralizing the filtered liquid by ammonia, there is not only a
pale yellow precipitate of phosphate of silver, but the fluid as-
sumes a brown tint, and in a short time there is likewise a
brown sediment.
Heller has not yet succeeded in isolating uroxanthin.
Uroglaucin associated with urrhodin, occurs in urinary se-
diments in Bright’s disease, and im cases in which urine,
APPENDIX. 525
abundant in uroxanthin, has become alkaline in the bladder.
Heller has noticed it in these sediments forming groups of
delicate prisms. (See Plate iii, figs. 37 and 38a.) It like-
wise assumes this form when urine, abounding in uroxanthin,
is treated with nitric, sulphuric, or hydrochloric acid. In this
case it is principally found on the surface of the fluid.
When allowed to crystallize from its cold spirituous solution,
it forms groups which appear nearly black, but are blue and
transparent at the edges. (See Plate iii, fig. 38 a, 6.)
Urrhodin appears to be a less oxydised product of uroxanthin
than uroglaucin, and usually occurs in much larger quantity.
It is most commonly observed in cases in which the urine is
alkaline before emission, in consequence of containing much
vesical mucus, and its development in such cases is hastened
by the addition of nitric acid. The method of isolating it has
been already described. Heller has never succeeded in ob-
taining it from its spirituous solution in a crystalline form. It
occurs in granules, which, under the microscope, appear of a
beautiful rose-colour. It is resinous in its nature, and burns
with a clear flame.
Heller concludes his paper (of which the above is but a brief
abstract) with a notice of some experiments on uroerythrin, the
ordinary pigment of inflammatory urine.
On treating uric-acid crystals obtained from healthy urine
with cold alcohol, the pigment formed a carmine solution, and
the uric acid remained comparatively devoid of colour, being
of a yellowish-brown tint from the brown pigment of the urine.
The spirituous carmine solution on exposure to the air gra-
dually became purple, and had all-the properties of uroglaucin,
previous to which it appeared to be identical with urrhodin.
On treating the red sediment common in inflammatory af-
fections and tinged with uroerythrin, with hot and cold
alcohol and ether, the red pigment remained unaffected, unless
a little acid was added. ‘The difference of solubility in the
above menstrua is thereforé sufficient to separate uroerythrin
from urrhodin. ;
Heller’s theory of the production of uroglaucin and urrhodin
affords a satisfactory explanation of the occurrence of the blue
sediments noticed in pp. 274, 327, and 329.
Pace 137. Quantitative determination of urea. Two papers
526 APPENDIX.
on this subject have appeared almost simultaneously during the
last three months—one by Ragsky, the other by Heintz.
With regard to the quantitative determination of urea,
Ragsky! observes there is this great objection to its separation
either as a nitrate or oxalate, that both those salts are per-
ceptibly soluble, which prevents on the one hand their com-
plete precipitation, and on the other hand their perfect wash-
ing, on which latter account they retain a certain amount of
extractive matter. No other compound of urea being known,
adapted for its quantitative determination, Ragsky endeavoured
to apply the products of its decomposition to this purpose.
After several experiments made to this effect, with chlorine
and with nitrous acid, he found that concentrated sulphuric
acid answers the purpose best. For this purpose, a mixture
of one part of urea, with from three to four parts of concen-
trated sulphuric acid is introduced into a flask, and exposed to
the heat of a sand-bath, which must not exceed 572° to avoid
loss of ammonia. ‘The decomposition of urea commences at
383° and the evolution of carbonic-acid gas is very lively at
392°. In this process one equivalent of urea assumes the
elements of two equivalents of water, and transposing with the
latter is converted into two equivalents of carbonic acid which
escape as gas, and two equivalents of ammonia which remain
in combination with the sulphuric acid.
C,N,H,0, + 2 HO + 2 (S0,, HO) = 2 (NH, 0, SO,) + 2 CO,.
He determined, in this manner, accurately-weighed portions
of pure urea dried at 212 degrees, and determined the ammo-
nia subsequently in the form of ammonio-chloride of plati-
num. ‘The following numbers will show how approximately
urea may be determined in this way.
1. 0:2612 grammes of urea.yielded 1:9323 grammes of
ammonio-chloride of platinum corresponding to 0°2598
grammes of urea.”
2. 0'3139 grammes of urea yielded 2°3175 grammes of
ammonio-chloride of ay corresponding to 03116
grammes of urea.
1 Liebig and Wohler’s Annalen, Oct. 1845. —
? The English reader will see the accuracy of the result more clearly by reducing
the grammes to grains. From 4°022 grains used in the experiment, 4‘001 were re-
covered,
APPENDIX. 527
3. 0:2716 grammes of urea yielded 2:0400 grammes of
ammonio-chloride of platinum, corresponding to 0:2743
grammes of urea. ,
To ascertain how far the presence of extraneous matters
might interfere with the accuracy of the results, sugar was
mixed with the urea, but the results were unaffected. The
next point was to ascertain whether the extractive matter
would yield ammonia under these conditions. For this pur-
pose Ragsky precipitated 120 grammes (nearly 4 ounces) of
fresh and healthy urina sanguinis, with acetate of lead, after
having previously separated the uric acid by means of some
hydrochloric acid. The precipitate was mixed with water,
decomposed by sulphuretted hydrogen, and the yellow fluid
thus produced evaporated to a syrup, and charred with sul-
phuric acid. The charred mass was subsequently extracted
with water, the solution evaporated, and finally treated with
alcohol and bichloride of platinum. This process gave no indi-
cation of the presence of ammonia. Having thus ascertained.
that the extractive matters, which are normally present in
urine, exercise no adverse influence on the quantitative deter-
mination of urea by means of sulphuric acid and bichloride of
platinum, he next proceeded to determine by this method the
amount of urea present in divers samples of urine, in order to
compare the results with those obtained by the ordinary me-
thods. He found, after several experiments, that 7 grammes
(a little more than five drachms) of urine required about 3°5
grammes (or half the weight) of concentrated sulphuric acid.
If less of the acid be taken the charred mass will readily dry
up, and some loss of ammonia will be incurred in consequence.
The mixture of urine and sulphuric acid is kept in a moderate
state of ebullition, there is a great evaporation of water, and the
fluid turns black. The temperature rises higher and higher,
until at about 392° there ensues evolution of carbonic acid gas
in small bubbles. The cessation of the disengagement of gas
indicates that the urea present in the analysed urine is com-
pletely decomposed. The black residue is then thoroughly ex-
tracted with water and the solution filtered. The clear and
urine-yellow filtrate is finally evaporated in the water-bath, and
the sulphate of ammonia treated with alcohol and. bichloride
of platinum.
Since urine contains salts of potash and ammonia, which
528 APPENDIX.
will of course likewise precipitate upon the addition of bichlo-
ride of platinum, it is necessary to determine the exact pro-
portion in which these salts are present in the urine under
examination. For this purpose a separate weighed portion of
urine is precipitated with bichloride of platinum, and the
amouut of precipitate substracted from the former.
Two samples of urine of 7 grammes each, treated accord-
ing to this method, yielded 0:202 grammes of urea, or 2°88,
and 0°199 grammes of urea or 2°842. Fourteen grammes of
the same urine was treated according to the ordinary plan; they
_ yielded 0°617 grammes of nitrate of urea, or 2°159 of urea.
The extractive matters of the urme yielded no ammonia.
These experiments prove that the method of determining
urea in the form of ammonio-bichloride of platinum yields
much more accurate results than the plan usually adopted ; it
may, therefore, in many cases be advantageously employed,
with this precaution, that all substances likely to interfere with
the accuracy of the process (as uric and hippuric acids, albu-
men, &c.) be previously removed. It might be advisable in
certain cases to separate the urea in the first place by means
of oxalic acid, and then to decompose the oxalate with sul-
phuric acid.
The following table may save trouble in calculation.
atom of ammonio-chloride of platinum corresponds to 0°134498 of urea.
” ” ” ” 0°268996 ,,
0°403494 ,,
” ” ” ”
1
2
3
4° ” ” ” 0°537992 ,,
5 ” ” ” ” 0°672490 ”
6 ” ” ” 0°806988 _,,
7 cP) ” ” ” 07941484 ,,
8 ” ”? ” ” 1:075984 ”
9 ” ” ” ” 1°210482 ”
The author concludes his paper by an acknowledgment of |
the kind assistance of Liebig.
In principle the method adopted by Heintz! is so similar to
the above, that it is unnecessary to enter into the details.
Both writers agree respecting the inaccuracy of the ordinary
method.
Pace 238. Urine in Bright’s disease. In Heller’s memoir
already referred to, we find the following sin ht of the urie
in this disease.
' Poggendorff’s Annalen, No. 7, 1845.
APPENDIX. 529
a. In the case noticed in p. 515, of the man aged 388
years, the urinary secretion was much diminished. The urine
was turbid, of a dark yellow colour, very acid, of specific gravity
1017, and deposited a slight, finely flocculent sediment con-
sisting of albuminous fungi, pavement epithelium, the peculiar
cylindrical forms observed in Bright’s disease, mucus-corpus-
cles, and a tolerably large number of blood-corpuscles.
On the addition of nitric acid, albumen with a violet tint
was precipitated ; hence the urine contained a large amount
of uroxanthin.}
In 1000 parts there were contained :
Water : j é 948-0
Solid constituents . ; 52:0
Urea ; : ‘ 61
Uric acid ‘ : : no trace
Fixed salts. 5 ‘ 3°6
Extractive matters and uroxanthin 23°9
Albumen with some hzmatoglobulin 18°4
The greater part of the salts consisted of sulphate of potash;
only slight quantities of chloride of sodium and phosphate of
soda were present, and after the removal of the albumen not a
trace of earthy phosphates could be detected.
No hippuric acid could be obtained from the urine, and as
uric acid was likewise absent, the acidity (which in this case
was very marked) could not be dependent on these acids.
Heller concludes from various observations that the acid re-
action is dependent on the presence of the uroxanthin.
A week afterwards the urine was again analysed. The se-
eretion was still diminished, was very turbid, of a pale reddish
colour, and formed a flocculent reddish sediment. The specific
gravity was 1010, the reaction acid, and the composition of the
fluid nearly the same as when previously examined.
At the expiration of another week, and just before the
patient’s death, the secretion continued diminished, and the
urine rapidly became putrid. The specific gravity was 1011,
urea was present in very small quantity, and the sediment
contained much pus; in other points the urine remained the
same as before. 3 |
b. The patient was a man aged 40 years, with considerable
oedema of the whole body.
' See page 522.
Il. 34
530 APPENDIX.
The urinary secretion was much diminished. It was ex-
amined on several occasions, principally in reference to the
salts.
The urine was of a pale yellow colour, acid, and of specific
gravity 1018. There was a slight deposit, consisting of colour-
less uric-acid crystals, much pavement epithelium, cylinders,
albuminous fungi, and a few mucus-corpuscles. The urme
contained a large quantity of albumen, very little urea, and
only traces of uric acid. The salts amounted to 7-4 in 1000
parts, and contained an excess of sulphates with a diminution
of chloride of sodium.
On the following day the organic constituents were similar ;
the sediment, however, contained in addition some granular
cells (the inflammatory globules of Gluge).
The urine was subsequently analysed some days afterwards.
It presented the same appearance as before, and the deposit
was similar. The reaction was acid, and the specific fil
1017. | ;
In 1000 parts there were contained :— ,
Water y ; : : 958°0
Solid constituents . 6 ; 42°0
Fixed salts . 7 é 9°4
c. A middle-aged woman with considerable cedema.
The urine was diminished in quantity, was of a dull yellow
colour, turbid, faintly acid, and of specific gravity 1017. It
deposited a sediment consisting of numerous epithelium scales
and cylinders, albuminous fungi, and a few uric-acid crystals.
The urine contained a large amount of albumen, which when
precipitated by nitric acid had a faintly violet tint, indicating
the presence of uroxanthin. The urea, uric acid, and salts
were much diminished ; the latter amounting to no more than
3 in 1000 parts of urine. Of the various constituents of the
saline residue the chloride of sodium was the most diminished.
d. The urine of a patient with considerable cedema, was
analysed. It was of a faint yellow colour, turbid, acid, with a
specific gravity of 1006, and deposited a slight sediment of
pavement epithelium, cylinders, mucus-corpuscles, albuminous
fungi, and afew crystals of uric acid.
APPENDIX. 531
In 1000 parts there were contained :
Water : : : 985°2
Solid constituents : : 14°8
Organic matter : ‘ 13°6
Fixed salts ‘ ‘ 1°2 containing hardly a
trace of chloride of sodium.
e. A patient aged 28 years, who first exhibited symptoms
of Bright’s disease while in the hospital, in consequence of a
broken arm from a fall. The spinal cord likewise appeared
somewhat injured by the accident.
The urine was much diminished in quantity, scarcely amount-
ing to twelve ounces in the twenty-four hours; it-was of a
bluish green (or very deep bottle-green) colour, ean and de-
posited after a short time a flocculent light-blue sediment.
After standing for a longer period, a dark blue sediment was
gradually thrown down, while the supernatant fluid was yellow.
The surface of the urime was covered with a stiff film of
‘uroglaucin, which presented a beautiful copper-like brilliancy
when the light fell on it. With refracted light it appeared of
a dark-blue colour, and arranged in stellar groups. The sedi-
ment, when examined under the microscope, was found to
consist of a great quantity of albuminous fungi and minute
crystals of ammoniaco-magnesian phosphate, together with
groups of uroglaucin, more or less crystalline in structure,
and of a magnificent blue colour: a peculiar modification of
payement epithelium was likewise observed,—oval or nearly
circular, with large nuclei and nucleolar corpuscles, frequently
arranged in groups; and lastly, cylinders with a little pus.
The reaction of the urime was strongly alkaline, and its
specific gravity 1018.
On the addition of nitric net the urine became of a clear
blue colour, and albumen with a violet tint was precipitated,
which on standing became of a darker blue, while the super-
natant fluid assumed a yellowish hyacinthine colour. -
Alcohol slowly added, so as to form a layer on the surface,
took up an azure colouring matter. On thoroughly mixing
the alcohol with the urine, albumen with a beautiful blue tint
was precipitated, while the fluid remained of a hyacinthine
colour.
Ammonia communicated a brown colour to the urine.
532 APPENDIX.
On the addition of a salt of silver to the acidulated urine
there was no precipitation of chloride of silver, but when
added to neutralized urine a coffee-coloured tint was developed,
indicative of uroxanthin.
On the addition of a salt of baryta there was a slight violet-
colour precipitate of sulphate of baryta.
On evaporating the urine there was left a residue of a dark-
blue colour, and bright blue spots were observed on the edges
of the capsule. It was washed with water, in order to sepa-
rate the urea, and then extracted with cold spirit of 0-830,
which dissolved the urrhodin, and formed a carmine solution.
On boiling the residue with spirit, a solution of uroglaucin
was obtained, which, on cooling, formed beautiful ultramarine-
blue crystals. |
The amount of urea was very small, ee hiss was no uric
acid or chloride of sodium; on the other hand, there was
a large quantity of carloads of ammonia, and a moderate
amount of albumen. ‘The earthy phosphates, phosphate of
soda, and sulphate of potash were present in very diminished
quantities. _Uroglaucin and urrhodin were present to a —
amount. 7
The urine eee on the Gtichvinss morning (amounting to a
little above two ounces) was submitted to analysis. It was of
a bottle-green colour, turbid, and deposited a sediment which,
when examined under the microscope, was found to contain
crystals of uroglaucin, and indeed all the constituents noticed
the preceding day. a sinotig
The urine was strongly adkalitig emitting an urmous ammo-
niacal odour. The specific gravity was 1013, and the reactions,
with nitric acid, alcohol, &c., the same as before. There was,
however, a larger amount of albumen. Uroglaucin and urrho-
din were likewise present in abundance. |
The urine contained in 1000 parts :
Water on ay . 971-20
Solid Peet a ‘4 : : 28°80
Urea i wih 5 : 3°81
Urie acid % 5 : . J no trace
Fixed salts " eli F : 3°80
Uroglaucin, urrhodin, uroxanthin, extractive 14°30
matters, and carbonate of animonia
Albumen ; j ; ; 9°89
APPENDIX. 533
Chloride of sodium was altogether absent ; the other salts were
diminished in nearly similar proportions.
Death occurred the same evening, about six o’clock. _ Shortly
before that event, nearly two ounces of urine were removed by
the catheter. The secretion had lost its previous colour, and
was of a deep citron-yellow tint ; it was turbid, and deposited
a perfectly white sediment, composed of all the previous ingre-
dients with the exception of uroglaucin. It was acid, and re-
mained so for twenty-four hours, although exposed during part
of that time to the sun’s rays. Its specific gravity was 1012.
From the examination of the urine it seems clear that the
uroglaucin and urrhodin are products of oxidation of the peculiar
yellow pigment—uroxanthin. For the ‘ native’ urine was in-
tensely yellow, and did not contain, either in solution or in the
sediment, a trace of either uroglaucin or urrhodin. On the addi-
tion of nitric acid there was a white precipitate of albumen,
which gradually assumed a violet tint, and after standing for
some time became of a deep blue colour. On the addition of
this acid the urine became first of a carmine tint, then of a
violet colour, and ultimately of a rich blue; and during these
changes it deposited uroglaucin presenting the appearance of
bright powdered ultramarine, but under the microscope exhi-
biting a crystalline form. On the surface of this urine there
was formed the same coppery film that was noticed on the
blue urine, and the microscope detected crystals of uroglaucin
in it. Cold spirit, when added to the sediment, took up ur-
rhodin, assuming a brilliant carmine tint.
Hence it seems to follow that the acid urine, which was of
a pure yellow colour, contained uroxanthin, and that this uro-
xanthin, under the oxydizing influence of nitric acid, yielded
uroglaucin and urrhodin in the same manner that it had spon-
taneously done in the case of the bluish-green specimens. _T'o
confirm this opinion a portion of the yellow urie was ex-
posed for a length of time to the action of the atmosphere. The
same products were slowly developed which had been rapidly
produced by nitric acid. The same red metallic film was
produced, the same blue tint gradually developed, and, subse-
quently, the same blue sediment yielding uroglaucin and ur-
rhodin, while the supernatant fluid became pale.
534 APPENDIX.
The urine contained albumen, an extremely small quantity
of urea, and not a trace of either uric or hippuric acid. Hence
the acid reaction could not depend (as Liebig supposes) on those
acids, and Heller believes that “the acid reaction of this urme,
and, indeed, of the urine in Bright’s disease generally, (where
uroxanthin is always present in large quantity,) and most pro-
bably of the normal secretion, (at least in part,) is dependent
on uroxanthin, which comports itself as an acid, being precipi-
table by metallic salts.”
The body was examined two days after death. A small
quantity of ure, amounting to hardly a drachm, was found in
the bladder. It had much the same properties as the urme
removed by the catheter before death: it had the same acid
reaction, and the same yellow colour. It deposited a copious sedi-
ment, consisting for the most part of pavement epithelium, and
the characteristic cylinders ; it likewise contained mucus-corpus-
cles and oil-globules. The urine contained uroxanthin, but
not a trace of uroglaucin or urrhodin, which were, however,
subsequently obtained, both by nitric acid and by exposure to
the atmosphere.
J. A man under the care of Dr. Seibert. The disease was
of considerable standmg, and had assumed a chronic form.
There was much cedema of the feet, extending to the body,
and the secretion of urine was diminished. The urime was of
a pale wine-yellow colour, turbid, and threw down a slight
deposit consisting of pavement epithelium, cylinders, mucus-
corpuscles, and crystals of ammoniaco-magnesian phosphate.
_ It was faintly alkaline and rapidly developed ammonia; its
specific gravity was 1014. Nitric and hydrochloric acids com-
municated a reddish violet tint to it. After a time albumen
. with a violet tint was precipitated ; hence the urine contained
_ uroxanthin.
- In 1000 parts there were contained :
Water ; ; te é é 969°25
Solid constituents ‘ ; ; é 30°75
Urea te : 7 Lies "et 2°50
Uric acid ee gee: as ‘ 0°60
Albumen ; : ; ‘ 6°25
Extractive matters, uroxanthin, and carbonate of ammonia 17°70
Fixed salts . ir 5 . 3°50
The fixed salts consisted for the most part of phosphate of
APPENDIX. 535.
soda ; they contained mere traces of chloride of sodium, and a
very small amount of earthy phosphates and sulphates.
g. A woman aged 30 years, an analysis of whose blood is
given in p. 515.
The urine, on the day on which venesection was performed,
was tolerably copious, but had been scanty for some days pre-
viously. It was of a faint clay-yellow colour, and threw down
a flocculent precipitate consisting of pavement epithelium, very
long cylinders, mucus- and pus-corpuscles for the most part
containing two distinct nuclei, albuminous fungi, a few fat-
globules.and blood-corpuscles, and a very few minute crystals
of uric acid. The reaction of the urine was strongly acid, and
its specific gravity 1017. After the removal of the albumen
the specific gravity fell to 1013 ; there was consequently a con-
siderable quantity of albumen present, and with it a propor-
tionate amount of uroxanthin.
The urea was much diminished.
The uric acid was increased, which is always the case in the
early stages, and as long as the disease retains the acute form.
The phosphate of soda and sulphates were apparently un-
affected ; there were mere traces of earthy phosphates, and
chloride ‘of sodium was almost entirely absent.
The urine likewise contained hematin in solution, which
communicated a brown tint to the fluid, and especially to the
albumen on drying.
‘On the following day the urine and its sediment presented
similar characters. The specific gravity was 1012, and after
the removal of the albumen 1010.
In 1000 parts there were contained :
Water . : ; . > 978°74
Solid constituents : P sae at 26°26
Urea ‘ : : ; 6°48
Uric acid ‘ : 0°70
Albumen . “sca : ; 6°03
Fixed salts : 5°05
Extractive and colouring matter 8°00
h. A man aged 20 years, who had been for a long time
under the care of Dr. Bittner. The disease had assumed the
chronic form, and there was great general cedema.
The urine was turbid, of a very pale yellow colour, and de-
536 APPENDIX.
posited a trifling sediment, composed for the most part of al-
buminous fungi, cylinders, and pavement epithelium with a
few mucus-corpuscles.
The urine was faintly acid, but in the course of thirtyaaix
hours became alkaline. The specific gravity was 1009. It
did not contain much albumen, and only a very little uroxan-
thin. In 1000 parts there were contained : E
Water b : : . : Ss
Solid constituents ; gee ; 21°5
Urea i ( E ‘ 2°5
Uric acid . ; rs . traces
Aibumen . ; 4°6
Extractive and colouring matters ; 9°4
Fixed salts i z ; 5:0
On a further examination of the salts it was found that the
chloride of sodium was extremely diminished.
The urine was examined on two separate occasions, some
days later, in relation to the solid constituents generally and to
the albumen. There were found:
1. 2.
Water ‘ : - 978°6 978°2
Solid constituents é ; 21°4 21°7
Albumen . : s 4°5 4°5
Hence in ines! eoaphoks it had remained constant.
Some weeks later, and very shortly before the patient’ s
death, the urine was again examined. It was red from the pre-
sence of blood, had a putrid odour, and deposited a sediment,
which, in addition to the ordinary constituents, contained nume-
rous blood- and mucus-corpuscles, undoubted pus-globules, and
a little uric acid. The reaction was acid, and the specific gra-
vity 1010. A considerable amount of uroxanthin was present.
In 1000 parts there were contained :
Water ; a ; «+ 976°23..
Solid constituents ; ; 4 23°77
Urea : J ‘ , 1-76
Uric acid ; 0°24
Albumen with a little heematoglobulin s 8°75
Extractive and colouring matters : 8°54
Fixed salts é ; : 4°48
The chloride of sodium was much diminished.
Hence we see that blood occurs in the urine, not only in
APPENDIX. 537
the early stages but likewise towards the close of the disease.
In the former case it arises from congestion, in the latter it is
a consequence of incipient dissolution.
i. A woman aged 40 years, with much cedema, under the
care of Dr. Sterz. |
The urine, in this case, was very remarkable for its ex-
tremely high specific gravity, dependent on an enormous
amount of albumen. The secretion was very much diminished.
The urine was of a clay-yellow colour, turbid, and formed a
tolerably abundant sediment, containing numerous cylinders
and mucus-corpuscles, together with urate of ammonia. There
were also a few granular cells (Gluge’s inflammatory globules)
and numerous albuminous fungi. —
The reaction of the urine was acid. Nitric acid caused a
dense coagulation of albumen, which rapidly assumed a violet
tint ; hence a tolerably large amount of uroxanthin was like-
wise present. The specific gravity was 1047.
In 1000 parts there were contained :
Water ; 3 : é 860
Solid constituents ; : : 140
Albumen .. : ; : 57
The urine retained these characters for a considerable time,
always holding hematin in solution. It subsequently became
less dense, as the disease assumed a chronic character.
‘k. A girl aged ten years: cedema general and well-marked.
The urine was very pale, and of a dirty clay-yellow colour ; a little
fluid fat separated on the surface. There wasa very slight de-
posit of epithelium and albuminous fungi. Reaction faintly
acid ; specific gravity 1005.. A small quantity of albumen was
present, which, on being precipitated by nitric acid, rapidly
assumed a violet tint ; on the addition of hydrochloric acid the
urine was rendered turbid, and likewise became of a violet
colour ; a relatively increased quantity of uric acid was thus
ee pariieed, and the crystals were of a beautiful deep blue tint.
Hence, notwithstanding the low specific gravity, the urine con-
tained a large amount of uroxanthin. Of urea there were only
traces, and the salts were diminished to an extreme degree ; the
phosphate of soda—the principal ingredient—being far below
the average, the sulphates and chloride of sodium very trifling,
538 APPENDIX.
while there was a mere trace of earthy phosphates. The sub-
sequent dissection confirmed the accuracy of the diagnosis.
J. An aged man, under the care of Dr. Folwaczny. The
urine was extremely turbid, of a dark clay colour, and formed
a sediment without itself becoming clear. The sediment was
composed of albuminous fungi, numerous cylinders, pavement
epithelium, and urate of ammonia. It was upon the presence
of the last ingredient that the turbidity was dependent, for on
the application of a gentle warmth the fluid became clear. The
reaction was strongly acid, and the specific gravity 1029. After
the removal of the albumen the specific gravity was only 1017.
Hence a large quantity of that constituent was present. On the
addition of nitric acid, albumen with a deep violet tint was
precipitated ; consequently there was much uroxanthin in the
urine. The urea was far below the average ; the uric-acid-and
urate of ammonia were abundant. ‘The salts collectively were
much diminished, but most especially the chloride of sodium.
The subsequent dissection proved the accuracy of the diag-
nosis.
From these and five additional cases Heller draws the fol-
lowing conclusions. |
He divides the disease into three stages, in all of which the
urine presents separate and distinctive characters.
The first is the congestive stage, during which the urine is
red from dissolved blood or hematin, but at the same time is
acid unless neutralized by the presence of very much blood.
In the second—the chronic stage—the urine is pale and of
a clay-yellow colour, and frequently resembling whey.
In the stage of dissolution which (frequently but not imvari-
ably) shortly precedes death, the urine is ammoniacal, developes
a putrid odour, and is again bloody. At this stage the drop-
sical effusions give off an odour resembling that of rotten
eggs. |
In all three stages the urine is (with occasional exceptions)
diminished.. The largest amount is passed during the chronic
stage, when the oedema frequently diminishes for a short time.
During the first and last stages, the daily amount of urime
seldom. exceeds a few ounces, and blood is often present.
The following are the physical characters of the urime. In
the first stage it is red and turbid, forming either a red or
APPENDIX. 539:
white sediment, according as blood-corpuscles are or are not
present. The urine is acid, neutral, or slightly alkaline, and
has a low specific gravity.
In the second stage the urine is of a clay-yellow colour and
turbid, forming a brown sediment; subsequently the fluid be-
comes of a paler colour, of very low specific gravity, and deposits
a white flocculent sediment ; and at this period it exhibits a
greater tendency to putrefaction than before.
In the third stage the urine is of a dark red colour, and
contains more or less blood; it also deposits a red or reddish-
brown sediment containing numerous blood-corpuscles. It is
either ammoniacal on emission, or rapidly becomes so, and its
specific gravity is higher than in the other stages.
The occurrence of blood in the first and third stages is de-
pendent on totally different causes. |
In the congestive stage the constituents of the blood enter
the urine by the law of endosmosis, and it is not so much
actual blood as serum reddened by hzematin in solution that
passes over ; in the last stages, however, the capillaries are ac-
tually corroded by the morbid process, and then the blood-
corpuscles likewise find their way freely into the urine.e Hence
in the latter stage the sediment is always of a reddish-brown
tint, while in the former it is often white.
The microscopic appearances are divided by Heller into—
1, those of constant occurrence, and 2, those occasionally
present. .
The constant constituents are:
_1. Pavement-epithelium, which is always present, and fre-
quently in the congestive stage forms a copious white sediment.
2. Epithelium from the tubes of Beilini, which usually forms
only a slight portion of the sediment in the early stages, al-
though sometimes present in large quantity from the com-
mencement of the disease.
3. Albuminous fungi occurring as a clear dotted granular
matter in all fluids containing albumen. When they are very
abundant the urine developes a mouldy odour.
4. Mucus-corpuscles.
5. Granular cells (globules of inflammation) are always to
be found during the congestive stage.
6. Fat-globules, especially in the chronic form of the disease.
540 APPENDIX.
The occasional constituents are :
1. Crystals of uric acid, even when there is a deficiency of
that constituent in the urine.
2. Urate of ammonia, generally in the early stages.
3. Pus-corpuscles, usually in the latter stages.
4. Blue crystals of uroglaucin, usnally after the urine has
stood for some time.
5. Ammoniaco-magnesian phosphate, when the urine con-
tains carbonate of ammonia.
The specific gravity of the urine in this disease is variable ;
its limits in Heller’s cases were 1006 and 1048.
The reaction is usually acid, often strongly so. In some of
the cases in which the acidity was most marked, the urine con-
tained neither uric nor hippuric acid.
Albumen (according to Heller) is always present ; the quan-
tity is, however, very variable, and is smallest in children.
Uroxanthin is always present in large quantity.
The urea exists in diminished quantity.
The uric acid is at first increased, but subsequently dimi-
nishes, and almost disappears.
The salts collectively are much diminished, the diminution
corresponding with the progress of the disease. The earthy
phosphates and chloride of sodium can sometimes hardly be
detected. :
We are now enabled to compare the composition of the
blood, urine, and dropsical effusions in this form of disease.
From a general view of the preceding analyses, (see pp. 494,
515,) it appears that these fluids are a state of antagonism.
The water which is retained in the system in consequence of
the partial suppression of urine, does not remain in the blood,
but collects in the form of dropsical effusions.
The albumen, which generally occurs in large quantity in
the urine, is taken from the blood, which in the way loses a
large quantity of this constituent. 7
This is the way in which most of the albumen is removed,
for the subcutaneous dropsical effusions contain very small
quantities of it.
When, however, dropsy occurs independently of disease of
the kidneys, albumen in large quantity is found in the effusions.
APPENDIX. | 541
The inorganic salts, which are diminished (or are almost ab-
sent) in the urine, do not remain in the blood, but enter the
dropsical fluids, where they are often found in an extraordinary
quantity. 2
Finally, the urea which is much diminished in the urine,
occurs in large quantity in the blood, and in smaller quantity
in the dropsical fluids.
Pace 862. Liquor amnii. The following analyses of the
liquor amnii of women ought to have been mentioned. They
were made by Colberg.!
1. 2.
Water x ; 2 980-0 977°0
Solid constituents . ‘4 j 20°0 23°0
Albumen : » ‘ 9-0 12°0
Urea. . j 0°5 —
Alcohol-extract and lactates i 2°0 3:0
Fat . 4 3 i 2°0 3°0
Chloride of sodium 4 i 4°0 4°0
Phosphate of lime : : 0-2 _
' Neue Zeitung fur Geburtskunde, 14. 1. 1843.
Fig.
Fig.
542.
EXPLANATION OF PLATE II.
13. Saliva.
13* 4. Colostrum. B. B. Healthy milk.
14. Epithelium.
15. Nasal mucus.
16. Bronchial mucus, with the corpuscles seen in other forms of
- mucus.
17. Pus from the lungs.
18. Tubercle.
19. Peculiar forms occurring in tubercle.
20. Pure urea from urine. -
21. Nitrate of urea from urine.
22. Oxalate of urea from urine.
23. Various forms of uric-acid crystals.
23* Various forms of. hippuric acid.
24. A. and B. Chloride of sodium as it crystallizes from urine. »
EXPLANATION OF PLATE III.
25. Phosphate of ammonia and soda from evaporated urine.
26. Phosphate of lime from an urinary sediment. [The folia-
ceous bodies are most probably urates.] .
27. Ammoniaco-magnesian phosphate from an urinary sediment.
28. Various forms of urate of ammonia from urinary sediments.
29. Various forms of urate of soda from urinary sediments.
30. 4. and B. Various forms in which an acid solution of the
earthy phosphates is precipitated by ammonia.
30* Carbonate of lime.
31. The sediment occurring in Bright’s disease.
32. Cystin.
33. Seminal animalcules and granules.
34. Cholesterin.
35. The torula (the fermentation-globules) in diabetic urine.
36. Oxalate of lime in various forms.
37 and 38. Uroglaucin.
HAdlard se.
0.
ots
¢
¥
IND EX.
Acetic acid, i, 85; in fluid ejected from the
stomach, ii, 395; in urine during
rheumatism, ii, 274; its effects on
the blood-corpuscles, i, 109; its
presence in putrid urine, ii, 126.
Acid, acetic, i, 85.
allantoic, i, 56.
alloxanic, i, 60.
amniotic, ii, 363.
benzoic, its effects in gout, ii, 277.
bilic, ii, 20.
bilicholinic, i, 48.
bilifellinic, i, 48.
butyric, i, 75 ; in kystein, ii, 331, 332 ;
in the feces, ii, 376.
capric, i, 75, 80.
caproic, i, 75, 79.
capryllic, i, 75, 80.
carbonic, in urine, ii, 120.
cerebric, i, 71, 81.
chloroproteic, i, 9.
choleic, ii, 19 ; Pettinkofer’s test for,
ii, 193.
cholic, i, 48.
ultimate composition of, ii, 507.
cholinic, i, 47.
choloidiec, ii, 20.
cyanoxalic, i, 56.
dialuric, i, 60.
fellinic, i, 47.
hippuric, i, 61 ; a constituent of healthy
urine, ii, 117; in diabetic urine, ii,
294; in excess in urine, ii, 323 ; to
detect in an animal fluid, i, 94; its
ultimate composition, ii, 507.
humic, in urine of herbivora, ii, 351.
hydrochloric, i, 2; in urine, ii, 130.
hydrochloro-proteic, i, 8.
hydrocyanic, its effects on the blood,
i, 108.
hydrofluoric, i, 2.
lactic, i, 84; Enderlin’s observations
on its non-existence in the animal
fluids, i, 181, no¢e; in fluid in the
abdomen, ii, 498; in urine, ii, 120;
to detect in an animal fluid, i, 95;
ultimate composition of, ii, 508.
lithofellinic, ii, 471.
margaric, i, 71; ultimate composition
of, ii, 508.
mesoxalic, i, 60.
mucic, i, 66, note.
mycomelinic, i, 60.
oleic, i; 74.
Acid, oleophosphoric, i, 81.
oxalic, i, 84; in saliva, ii, 10.
oxaluric, i, 58.
parabanic, ib.
phosphoric, in urine, ii, 130; determi-
nation of, ii, 140.
purpuric, i, 59.
rosacic, i, 45.
salycilous, ii, 341.
salycilic, ib.
sebacic, i, 74.
silicic, in urine, ii, 131.
stearic, i, 71; ultimate composition of,
ii, 508.
sulpho-bi-proteic, i, 8.
sulpho-proteic, ib.
sulphuric, in urine, ii, 130; determi-
nation of, ii, 140.
thionurie, i, 60.
uramilic, ib. ;
uric, i, 53; Bensch’s formula for, ii,
114 note; its origin, i, 149; quali-
tative determination of, ii, 116;
quantitative determination of, ii,
136; to detect in an animal fluid, i,
94 ; concretions of, ii, 431; ultimate
composition of, ii, 507. -
urobenzoic, i, 61.
urous, i, 62.
vaccinic, i, 75, 80.
xanthoproteic, i, 8.
Acidity of the urine, causes of, ii, 157.
Acids, fatty, i, 71.
inorganic, their passage into the urine,
ii, 337.
organic, their passage into theurine, ib.
Active metamorphosis of the blood, i, 152.
Age, difference of blood according to, i, 237.
Air, amount of, inspired, i, 124; atmosphe-
ric, its composition, i, 123; in swim-
ming-bladder of fishes, i, 138; its
amount in water, i, 137.
Albumen, i, 15; its estimation in urine, ii,
184, its estimation in blood, i, 178 ;
vegetable, i, 5; ultimate composition
of, ii, 504.
Albuminate of soda, to detect in an animal
fluid, i, 94.
Albuminose, ii, 503,
Albuminous urine, cases in which it occurs,
ii, 238 ; how to analyse, ii, 184.
Alcohol-extract, i, 31; of blood, i, 36; of
milk, i, 39; of urine, i, 37; to de-
tect in an animal fluid, i, 97.
544
Alcohol, its effects on the blood-corpuscles,
i, 109; its occasional passage into
the urine, ii, 339.
Alkaline reaction of the blood due to the
presence of tribasic phosphate of
soda, i, 182 note; of the lymph,
chyle, and blood, cause of, ii, 148.
Alkaline urine, ii, 207. nofe.
sulphates, i, 3.
Allantoic acid, i, 56. -
Allantoin, i, 55, ii, 363; to detect in an
animal fluid, i, 94.
Allantois, fluid of the, ii, 363.
ALLEN and Prpys’s experiments on re-
spiration, i, 125.
Alloxan, i, 57.
Alloxanic acid, i, 60.
Alloxantin, i, 60.
Alumina, i, 4; in a gall-stone, ii, 470.
Amniotic acid, ii, 363.
Ammoniacal salts, i. 4.
Ammonia in urine, ii, 132; its effect on the
blood-corpuscles, i, 109; urate of,
i, 55.
Ammoniaco-magnesian phosphate, i, 2; its
occurrence in decomposed urine, ~
ii, 133;
li, 433.
Ameeba rotatoria in blood of fishes, i, 350.
Amphibia, blood-corpuscles of, i, 104.
Amygdalitis, blood in, i, 268.
Anzemia, blood i in, i, 308.
Anzemic urine, ii, 207, note.
Analysis, microscopic, of an animal fluid,
i, 71; physical, i, 90; qualitative,
i, 93
Anasarca, urine in, ii, 312.
Anazoturia, ii, 306. «- :
ANCELL on the blood in hydremia, i, 308;
on the blood in- yellow fever, i,
320; on vomited blood, i, 318; on
the production of animal heat, i,
xii, preface.
ANDRAL on urinary sediments in pneu;
monia, ii, 215; on the urme in
typhus, ii, 250.
ANDRAL and GAVARRET, on the differences
in pneumonic blood during repeated
venesections, i, 260; experiments
on respiration, i, 128.
on the blood in acute rheumatism, i,
274 ; in angina tonsillaris, i, 268 ;
in cerebral congestion, i, 304; in
chlorosis, i, 310; in chronic rheu-
matism, i, 276; in erysipelas, i,
277; in febris continua, i, 295; in
febris intermittens, i, 301: in he-
morrhagia cerebralis, i, 302; in in-
flammation of the bladder, i, 273;
in morbus Brightii, i, 321; in peri-
tonitis, i, 270; in phthisis tubercu-
test for, in concretions,
INDEX.
losa, i, 279; in pleuritis, i, 267 ; it
pneumonia, i, 259; in rubeola, i
300; in scarlatina, ib.; in typhu
fever,-i, 289; in variola, i, 299
their method of analysing blood, i
240.
ANDRAL, GAVARRET, and DELAFOND 01
the blood of domestic animals it
health and disease, i, 340.
Angina tonsillaris, blood in, i, 268; urin
in, ii, 224.
Animalcules in blood; i, 335, 350; in
milk, ii, 69; in pus, ii, 96.
Animal diet, its effects on the urine, ii
57.
Animal fluids, general method of a
i, 90.
Animal heat, i, 142.
Animal sugars, i, 65.
Animals, arterial and venous blood of dif
ferent, i, 196; bile of, ii, 24 ; blood
corpuscles of, i, 103; blood of, i
339; milk of, ii, 61 ; respiration of
i, 136; temperature of, i, 142 ; urin
of, ii, 342.
ANSELMINO on the composition of the
sweat, ii, 103.
Antimony, its passage into the urine, ii
337. gigi
Aorta, blood of, compared with blood o;
the renal veins, i, 213; compare
with portal blood, i, 201.
Arsenic, i, 4; its passage into the urine, ii
337
Arterial blood, cause of its bright colour, i
193, note.
Arterial and venous blood, comparative
analyses of, i, 194; distinctive cha
racters of, i, 192.
Arteries, ii, 421.
ASCHERSON on a peculiar form of blood.
corpuscle, i i, 105.
Ascites, urine in, ii, 309.
Ass, chyle of, i, 356; lymph v i, 352
blood of} i, 349; colostrum of, i 5, 61
milk of, ii, 63.
Atmospheric air, composition of, i, 123.
AUDOUARD on kystein, i ii, 334.
Ayres on the blood in Bright’s disease, i
502; onthe urine in Bright’s disease
ii, 520.
Baarp on the blood in plague, i, 320.
BaRRUvEL on the detection of morphia in
urine, ii, 339.
BarsE on the existence of copper and leac
in the human body, i, 4 nofZe.
BAuMERT on the urine in rheumatism, ii
276.
Bases, vegetable, their passage into urine
li, 338.
INDEX.
Beaver, urine of, ii, 350.
BrecavuEret and Ropier, their analyses of
healthy venous blood, i, 233.
on the blood in bronchitis, i, 258; in
chlorosis,i,312; in fever, continued,
i, 297; puerperal,i, 282; typhoid,
i, 294—in icterus, i, 331—in inflam-
mation generally, i, 251; in pericar-
ditis, i, 255; in peritonitis, i, 272;
in phlegmasiaalba,i, 254; in phthisis
pulmonalis, i, 281; in pleuritis, i,
267 ; in pneumonia, i, 263; during
pregnancy, i, 336; in rheumatism,
i, 276.
on the influence of sex on the blood,
i, 235; of venesection on the blood,
i, 248.
BecQuEREL on the amount of urine ex-
creted in a state of health, ii, 204 ;
his analyses of healthy urine, ii, 145;
his classification of morbid urines,
ii, 200, note; on the specific gravity
of urine as a means of ascertaining
the amount of solid constituents, ii,
115.
on the urine in angina tonsillaris, ii,
224; in bronchitis, ii, 214; in can-
cer, ii, 318 ; in cerebral hemorrhage,
li, 266; in chlorosis, ii, 262; in
cystitis, ii, 240; in delirium tremens,
ii, 212; after delivery, ii, 335; in
diseases of spinal cord, ii, 213;
in dropsy, ii, 310; in dysentery, ii,
225; in emphysema, ii, 223; in en-
teritis, ii, 225 ; in erysipelas, ii, 278;
in gastritis, ii, 224; in hepatitis,
ii, 227; in intermittent fever, ii,
255; in meningitis, ii, 211; in ne-
phritis acuta, ii, 230, no¢e; in n. albu-
minosa, ii, 233; in phthisis pulmo-
nalis, ii, 287; in pleuritis, ii, 220;
in pneumonia, ii, 215; during preg-
nancy, ii, 334; in rheumatism, ii,
275; in scarlatina, ii, 279; in scro-
fula, ii, 284; in typhus, ii, 245; in
variola and varicella, ii, 282.
Benson, his formula for uric acid, ii, 114,
note.
Benzoate of ammonia, test for, ii, 431.
Benzoic acid, its effects on gout, ii, 277.
BERNARD and BarreEswit on the gastric
. Juice, ii, 30.
BERTAZZ1, his analysis of milky blood, i,
333; on the occurrence of copper
in gall-stones, ii, 471.
Bezoar-stones, ii, 468.
Berze ius on the analysis of blood, i, 167;
on the bile, ii, 17, 24; on the com-
position of bone, ii, 400; onthe feces,
li, 372; their black discoloration
from the use of iron, ii, 390; on
the gastric juice, ii, 28; on the nasal
If.
545
mucus, ii, 75; on the saliva, ii, 4; on
the urine, ii, 143; on the precipitates
thrown down from urine by certain
metallic salts, ii, 119; on the state
inwhich uric acid exists in the urine,
ii, 114.
BrprA, his analyses of human bones, ii, 397;
of cartilage, ii, 416; of pus, ii, 91;
of teeth, ii, 414; on intestinal con-
cretions in horses, ii, 468; on the
urine of goat, ii, 349; of hare, ii,
350 ; of oxen, ii, 346; of pig, ii, 348;
on urinary calculi in animals, ii, 462.
Bile, ii, 17; analysis of human, by Berze-
lius and Thenard,ii, 19; by Frerichs,
ii, 519; formed from the blood-cor-
puscles, i, 211; in icterus, ii, 21 ; in
meningitis, ii, 520; in phthisis, ii,
24; in pneumonia, ii, 520; in scir-
rhous pancreas, ii, 24 ; in syphilis, ii,
23.
its action in digestion, ii, 25 ; its func-
tions, ii, 26.
methods of detecting in blood, i, 187 ;
in urine, ii, 192.
of animals, ii, 24; of coluber natrix,
ib.; of cyprinus leuciscus and c. bar-
bus, ii, 25; of ox, ii, 24; of rana
esculenta, and r. temporaria, ii, 25 ;
of python bivittatus, ii, 24.
Bile-pigment, i, 43; in blood, i, 329; in
urine, ii, 191.
Biliary colouring matter, ScHERER’s re-
searches on, ii, 23, note 1.
' concretions in man, ii, 469 ; in animals,
ii, 471.
resin, i, 48; test for, ii, 432.
Bilic acid, ii, 20.
Bilious fever, urine in, ii, 270.
Bilicholinic acid, i, 48.
Bilifellinic acid, i, 48 ; in urine, 2, 192.
Bilifulvin, i, 44.
Bilin, i, 45; its effects on blood-corpuscles,
i, 106, 108, 111; its origin, i, 149,
161; tests for, i, 96; ii, 192; in
urine, ii, 192.
Biliverdin, i, 44; to detect in animal fluid,
i, 96; iri urine, li, 314.
Biliphein, i, 43 ; in pneumonic blood, i,
266; in urine, ii, 191; test for, i,
187, note; ii, 432.
Binoxide of protein, i, 11.
Brrp on calomel stools in children, ii, 387 ;
on the composition of pus, ii, 91 ;
on oxalate of lime and its frequent
occurrence in urinary sediments, i,
85; ii, 200.
on the urine in azoturia, ii, 307;
in chlorosis, ii, 265 ; in marasmus,
ii, 317; in phthisis, ii, 288; in
polydipsia, ii, 306; during preg-
nancy, li, 331.
35
546
INDEX.
Birds, blood-corpuscles of, i, 103; process
of digestion in, ii, 38; temperature
of, i, 142 ; urine of, ii, 351.
BLANDIN on pus in blood, i, 333.
BLonpDLoT on the gastric juice, ii, 29.
Blood, i, 100; alkaline reaction of, i, 182,
note.
analysis of, i, 167; of coagulated, i, 242.
analysis, microscopic, of, i, 102; ¢che-
mistry, special, of, i, 166; consti-
tuents, proximate, of, ib.; extractive
matters of, i, 35.
general chemical relations of, i, 107;
physical characters of,i, 101; phy-
siological relations of, i, 191; meta-
morphosis of,i, 139, 152; in nutri-
tion, i, 147 ; pathological chemistry
of, i, 239 ; specific gravity of, i, 101;
temperature of, i, 102, 142.
affected by age, i, 236; constitution,
ib.; inflammation, i, 251; sex, i,
234; temperament, i, 236; vene-
section, i, 248.
arterial and venous, characters of, i,
192; before and after delivery, its
difference, i, 342 ; of the capillaries,
i, 217; of the hepatic vein, i, 208;
of the placenta, i, 238 ; of the portal
vein, i, 201; during pregnancy, i,
336; of the renal veins, i, 213; of
the umbilical arteries, i, 238; of
young compared with that of old
animals, i, 238.
changes of, during the circulation, i i,
198, 218; in the liver, i, 212; in
the lungs, i, 191; colour of, i, 101 ;
forces that circulate the, i, 122; for-
mation of the, i, 118; nervous sys-
tem, its influence on the, i, 200.
animalcules in the, i; bile-pigment in
the, i, 329; cercaria in the, i, 350;
fat in the, i, 332 ; polystoma sangui-
culum in the, i, 335; pus in the, i,
333; sugar in the, i, 327.
in disease, i, 239; in albuminuria, i,
321, ii, 514; in amygdalitis, i, 268 ;
in anzemia, i, 308 ; in angina tonsil-
laris, i, 268; in Bright’s disease, i,
321; ii, 514; in bronchitis, i, 255;
in carditis, i, 254; in carcinoma, i,
284, 309 ; in cerebral congestion, i,
302; in chlorosis, i, 310; in cholera,
i, 325; in convulsions, i, 282 ; in
cystitis, i, 273; in diabetes, i i, 327;
in eclampsia, i, 282; in erysipelas,
i, 277; in fever, continued, i i, 295—
intermittent, i, 301, ii, 510 ;—puer-
peral, i, 282— typhoid, i, 288—yel-
low, i, 319; in hematamesis, i; in
hematuria, i, 318; in hepatitis, i,
268; in hydremia, i, 308; in icterus,
i, 329; in inflammations generall
i, 251; in inflammation of the th
racic viscera, ii, 509; in land-scury
i, 316; in lienitis, i, 268 ; in measle
i, 300; in melzena, i, 317 ; in metre
peritonitis,i,272; in metrophlebiti
i, 252; in morbus Brightii, i, 32]
ii, 514; in morbus maculosus Wer
hofii, i, 316; in nephritis, i, 273; ‘
ophthalmia, ii, 510; in pericarditi
i, 235; in peritonitis, i, 269; |
phlegmasia alba, i, 253; in phthis
tuberculosa, i, 279; in plague,
319; in pleuritis, i, 266; in pne
monia, i, 258 ; in pneumonia bilios
i, 264; in purpura heemorrhagica,
319; in rheumatism, i, 2783.3
rubeola, i, 300; in searlatina,
300; in scrofula, i, 309, ii, 513; |
scurvy, i, 315; in thoracic inflamm
tion, ii, 509 ; in typhus abdominali
i, 288; in typhus petechialis putt
dus, i, 319; in variola, i, 298. ©
Blood, animalcules in the, i, 335, 530.
of animals, i, 339; of ape, i, 349; |
bufo variabilis, i, 348; of calf,
340, 349; of carp, i, 348; of cat,
346, 349 ; of dog, i, 342, 346, 34¢
of duck, i, 349; of eel, i, 350; of ee
pout, ib.; of frog, ib.; of goat, i, 34
346, 349; of guinea-pig, i, 349;
hen, ib.; of heron, ib.; of horse,
339, 341, 346, 349; of lamb,
342; of land-tortoise, i,350; of o
i, 340, 341, 346 ; of pigeon, i, 351
of rabbit, i, 346, 349; of raven,
349; of sheep, i, 341,346, 349; |
" swine, i, 341, 346; of tench, i, 34{
of trout, i, 350.
Blood-corpuscles, general chemical rel
tions of, i, 107; formation of,
153; of man, various measuremen
of, i, 103; of various animals, ib
of irregular form, i, 105; effects
various reagents on, i, 104; er
ployed in the secretion of bile,
21il;
and fibrin, their antagonism, 1, 24
metamorphosis of, i, 159,
Blood-corpuscles, nuclei of, i, 138; chen
cal relations of, i, 112.
Bloody urine, its character, ii, 187.
Boa-constrictor, urine of, i, 53, note.
Bones, i ii, 396; carious, ii, 408; in arth
tis, ib.; in osteomalacia, ii, 401
in rachitis, ib.; necrotic, ii, 410.
of armadillo, squirrel, mouse, rabb
hare, sheep, goat, bull, horse, de
phin, common seal, cat, wolf, be
ape, birds, reptiles, and fishes, |
402.
INDEX.
Bostock on bone in osteomalacia, ii, 406;
on the saliva in ptyalism, ii, 12.
Bovucuarpart on the blood in diabetes, i,
327; on diabetic urine, ii, 300; on
an insipid diabetic sugar, ii, 197,
293; on a case of milky urine, ii,
229; on urine containing an excess
of hippuric acid, ii, 324.
Bovuper on the fat in the blood, i, 188; on
the composition of healthy and fatty
liver, ii, 429; of the lungs, ib.
BovussINGAULt on the urine of the cow,
ii, 346; of the horse, ii, 344; ofthe
pig, ii, 349.
Brain, composition of, ii, 425; concretions
in the, ii, 474.
fats, i, 81.
Briacut’s disease, blood in, i, 321, ii, 514;
urinary sediment in, ii, 235, 539;
urine in, ii, 231, 528.
Bromine, its passage into the urine, ii, 336.
Bronchitis, blood in, i, 255; urine in, ii,
219.
BRUNNER and VALENTIN’s experiments
on respiration, i, 130.
Buffy coat of blood, i, 250; its nature, i,
13, note.
Bufo variabilis, blood of, i, 348.
Bull-frog, urine of, ii, 352.
Burpacs on the forces that circulate the
blood, i, 122.
BusHMAN on worms in the blood, i, 335.
Busxk on the blood in scurvy, i, 315.
Butter, i, 75.
Butyric acid, i, 75; in kystein, ii, 331, 332 ;
in feeces, ii, 376.
Butyrin, i, 78.
Calculi, salivary, ii, 473.
urinary, ii, 437.
of animals, ii, 451.
Calf, blood of, i, 340, 349.
€allus, ii, 413.
Calomel stools, ii, 386.
Camel, urine of, ii, 347.
Cancer, L’Heretier’s analyses of, ii, 481.
CANTIN on a case of diabetes, ii, 301.
Car and Henry on urea in the urine of
serpents, li, 352.
Capillaries, blood of, i, 217.
Capric acid, i, 75, 80.
Caproic acid, i, 75, 79.
Capryllic acid, i, 75, 80.
Carbonate of ammonia in urine, ii, 197,311.
Carbonate of lime, i, 2; in urine, ii, 200;
microscopic character of, ib.
of magnesia, i, 3.
of soda, ib.
Carbonic acid, formation in the blood, i,
132.
expired, quantity of, i, 128; how
affected by disease, i, 127; causes
affecting the amount expired, i, 130.
547
Carbonic acid, method of detecting in urine,
ii, 120.
Carcinoma, blood in, i, 309; urine in, ii, 317.
medullare colli uteri, blood in, i, 284.
Carditis, blood in, i, 254.
Carp, blood of, i, 348.
Cartilage, ii, 415.
Casein, i, 19; ultimate composition of, ii,
: 505 ; vegetable, i, 6 ; to detect in an
animal fluid, i, 93; in urine, ii,
190, 324.
Cat, blood of, i, 346, 349; chyle of, i, 357.
Catarrh, urine in, ii, 268
CaTTranEI on the non-existence of copper
in the bodies of new-born children,
i, 4, note.
Cattle, urine of, ii, 345.
CaveENtTovu on the blood in chronic pleu-
ritis, i, 267.
Cells, nutrition of, i, 148; functions of, i,
140
Cellular tissue, ii, 416.
Cephalot, i, 81.
- Cerain, i, 70.
Cercaria in blood, i, 350.
Cerebral congestion, blood in, 1, 302.
Cerebric acid, i, 71, 81.
Cerebrot, i, 81, 83.
Cerumen, ii, 354.
Cetyl, oxide of, i, 70.
CHEVALLIER and Henry on the composi-
tion of the milk, ii, 53; on the com-
position of morbid bile, ii, 23.
CHEVREUL on the urine of the camel, ii,
347.
Cut1AJE on the polystoma sanguiculum in
the blood, i, 335.
CHILDREN, on an intestinal concretion in,
ii, 465.
Chlorate of potash, its effects on the blood,
i, 108
Chloride of ammonium in urine, determi-
nation of, ii, 138.
of calcium, i, 3.
of iron, ib.
of potassium, ib.
of sodium, i, 2: amount excreted, ii,
167; in urine, increase or decrease
of, ii, 182; the forms in which it
crystallizes from urine, ii, 131.
Chlorides of sodium and potassium in urine,
determination of, ii, 140.
Chlorine in urine, determination of, ii, 140.
Chlorohzmatin, i, 43.
Chloromichmyle, ii, 341, note.
Chloroproteic acid, i, 9.
Chlorosis, on a peculiar form of, i, 315;
blood in, i, 310; saliva in, ii, 12;
urine in, ii, 261.
Cholemia, i, 329.
Choleic acid, i, 48, ii, 20; PerrinKo¥FER’s
test for, ii, 793.
548
Cholepyrrhin, i, 43.
Cholera, blood in, i, 325; faeces in, ii, 382 ;
urine in, ii, 271.
Cholesterin, i, 82; its estimation in the
blood, i, 88.
in blood, its increase with age, i, 237 ;
test for, ii, 432. ‘
in urine, ii, 313, 333.
Cholic acid, i, 48, ii, 505.
Choline-soda, ii, 21.
Cholinic acid, i, 47.
Choloidic acid, ii, 20.
CHOoMEL On the blood in typhoid fever, i,
293.
Chondrin, i, 25; ultimate composition of,
ii, 506.
CurisTIson on the blood in Bright’s dis-
ease, i, 321; on healthy urine, ii,
145; formula for determining the
solid constituents in diabetic urine,
ii, 290.
Chyle, i, 354 ; of dogs, i, 358 ; of horses, i,
354.
influence of diet on, i, 358; formed
from chyme, ii, 39.
Chylous urine, ii, 190.
Chyme, its conversion into chyle, ii, 39.
Circulating fluids, the, i, 100.
CxiemmM on milk, ii, 47, 51.
Clot, inferences to be drawn from the size
and appearance of, i, 292, note.
Coagulated blood, analysis of,i, 190.
Coagulation, acceleration of, i, 117; re-
tardation or prevention of, i, 115.
CoaTHuPE on the development of carbonic
acid at different periods of the day,
i, 127,
Co1npET on the urine in inflammation of
the liver, ii, 226.
CoLBere on the liquor amnii, ii, 541.
Colostrum, ii, 49; of women, composition
of, ii, 50; of animals, ii, 61.
CoLLarp DE Martieny on bile in the
blood in icterus, i, 329.
Colour of the blood in the lower animals,
i, 101.
Colouring matters, their passage into the
urine, ii, 339.
Colouring matters of the bile, blood, and
urine i, 39.
Colours of arterial and venous blood, causes
of, i, 192, note.
Comparison of the blood of the mother and
foetus, i, 237.
Composition of venous blood, i, 227.
Coneine, its effect on the blood, i, 108.
Constitution, differences of blood depen-
dent on, i, 236.
Continued fever, blood in, i, 295.
Convulsions, blood in, i, 282.
Copaiva, its effect on the urine, ii, 185.
Copper, i, 4; in gall-stones, ii, 471.
INDEX.
Cow, colostrum of, ii, 61.
Cozzi on the blood in intermittent feve
ii, 510. .
Cruorin, i, 170.
Crystalline lens, ii, 419.
Crystallin, ultimate composition of, i
505.
Cubebs, their effect on the urine, ii, 185.
Cutis, ii, 417.
Cyanoxalic acid, i, 56.
Cyanurin, i, 45. .
Cysts, analyses of their contents, ii, 485.
Cystic oxide, i, 64.
Cystin, i, 64; a test for, ii, 431; in caleul
ii, 445; in urine, ii, 201; ultimat
composition of, ii, 508.
Cystitis, blood in, i, 273; urine in, ii, 24
329
Davy on the composition of meconiur
li, 367 ; on intestinal concretions, i
466 ; on the urine of the bull frog, i
352 ; on the vernix caseosa, ii, 364
Day, his analysis of healthy urine, ii, 14¢
on the specific gravity of the urin
ii, 116.
DELARIVE onthe blood in hematuria,i,3 1!
Delirium tremens, urine in, ii, 212.
Demarcay on the bile, ii, 19.
Dents, his method of analysing blood,
169; on the blood of the capillarie
i, 217; on venous blood, i, 230;
the influence of age on the blood,
237 ; on the blood in icterus, i, 33¢
on the menstrual fluid, i, 337.
Dentine, ii, 413.
DEVERGIE on the presence of copper |
the human body, i, 4
Deviations in the constitution of morbi
blood, i, 246.
DeryeEvux on diseased milk, ii, 59.
Diabetes mellitus, amount of carbonic ac:
expired in, i, 127; pathology of,
303; occasionally periodic, ii, 30:
blood in, i, 327; feces in, ii, 337
sweat in, i, 66, note, ii, 297; uri
in, ii, 289.
chylosus, urine in, ii, 308.
insipidus, urine in, ii, 304.
Diabetic sugar, i, 66.
Dialuric acid, i, 60.
Diastase in saliva, ii, 9.
Diet, its influence on the urine, ii, 156.
Dierricu, his analysis of gluten, ii, li
note.
Digestion, artificial, ii, 27, 37; process ¢
li, 35; diseased, ii, 41.
Diseased blood, i, 239.
Diuresis, ii, 305.
Diuretic action of salts explained, ii, 149.
Dog, blood of, i, 342, 346, 349; chyle ¢
i, 358 ; gastric juice of, ii, 29; mil
of, ii, 66, 521; saliva of, ii, 15.
INDEX:
Donné on ammonia as a test for pus in
blood, i, 334 ; on animalcules in pus,
ii, 96;.on the colostrum, ii, 49; on
the milk in syphilis, ii, 59 ; on saliva,
ii, 10; on iron in normal urine, ii,
265; on the urine in pregnancy, ii,
334.
Dropsical fluids, ii, 490.
Dropsy, urine in, ii, 308 ; saliva in, ii, 13.
Dvusois on the blood in scrofula, i, 309.
Duck, blood of, i, 349.
Dov x on black urine, ii, 328.
Dutone and Desprerz’s experiments on
respiration, i, 125. :
Dvumas’s experiment on respiration, i, 129 ;
on the milk of the carnivora, ii, 521.
Dumas and Prevost on the blood of va-
rious animals, i, 349.
_ Dumentt, his analysis of healthy urine,
ii, 145
Duneuison on the gastric juice, ii, 28.
Dysentery, urine in, ii, 225.
Dyslysin, i, 47.
Earthy phosphates in urine, determination
of, ii, 139 ; increase or decrease of, ii,
; 79 ; microscopical characters of, ii,
80.
Ear-wax, ii, 354.
Eclampsia, blood in, i, 282.
Eel, blood of, i, 350.
Eel-pout, blood of, i, 350.
Eguiser on kystein, ii, 329.
ErcHHotrz on pyin, ii, 74 note.
EIsENMANN on the urine in rheumatism,
ii, 275.
Electricity, its effect on the coagulation of
a the blood, i, 116.
Eleencephol, i, 81.
Elephant, urine of, ii, 347.
Emphysema, urine in, ii, 223.
Empyema, urine in, ii, 223.
Enamel of teeth, ii,.414.
Encephalitis, urine in, ii, 211.
ENDERLIN on the ash of human blood,
i, 234; on the ash of the blood of
various animals, i, 348 ; on the non-
existence of lactic acid in the ani-
mal fluids, i, 181, note; on the pre-
sence of bile in the blood, i, 188,
note ; on the salts in the bile of the
Ox, li, 24; on the ash of saliva, ii, 8 ;
on the feces, ii, 372.
‘Endocarditis, urine in, ii, 210.
-Endometritis, urine in, ii, 242.
Enteritis, urine in, ii, 225.
Epidermis, ii, 418. .
‘Epithelium, various forms of, ii, 70, note.
-ERLENMEYeER on the urine in insanity,
ii, 211.
Erysipelas, blood in, i, 277; urine in, ii, 278.
Erythroprotid, i, 13 ; ultimate composition
of, ii, 502.
949
Ether, its effect on the blood, i, 110.
Exanthemata, urine in the, ii, 270.
Excretions, intestinal, ii, 366.
Exercise, its effect on the urine, ii, 164,
168.
Expectoration, purulent, ii, 84.
Exostosis, ii, 410.
Extractive matters, i, 30; of blood, i, 35;
their estimation, i, 181; of urine, i,
30, 37, ii, 118,178, note.
Exudations, various, analyses of, ii, 497.
Eye, fluids of the, ii, 421.
Feces, ii, 366; of an infant, ii, 369; of
adults, ii, 370; ultimate analyses of,
ii, 385.
during disease, ii, 376; green, in chil-
dren, ii, 387; in abdominal typhus,
ii, 381; in catarrh, intest., ii, 382;
in cholera, ib.; in diarrhcea infan-
tilis, ii, 384; in diabetes, ii, 377;
in dysentery, ii, 380; in enteritis
mucosa, ii, 381; in entero-phthisis,
ii, 384; in icterus, ii, 384; in me-
lena, ii, 382; in typhous diarrhea,
ii, 381.
Fat, ii, 112; human, i, 82; in the blood,
i, 332; in urine, ii, 323.
Fats, i, 69; method of separating from
blood, i, 188; the non-saponifiable,
i, 82; true, i, 70.
and fatty acids, to detect in an animal
fluid, i, 95.
Fatty acids, i, 71.
bases, i, 70.
urine, ii, 189.
matter discharged by the bowels, ii,
465.
Febrile urine, ii, 206, note, 208.
Febris intermittens, blood in, i, 301, ii,
510.
continua, blood in, i, 295.
puerperalis, blood in,i, 282 ; urine in,
ii, 228.
Fellinic acid, i, 47.
Fermentation, test for sugar, i, 69.
' globules, ii, 294.
Fever, Mulder’s theory of, ii, 12 nofe.
Fibrin, i, 18 ; formation of, i, 157; its esti-
mation in blood, i, 177.
in urine, ii, 188, 210, 219, 220.
ultimate composition of, ii, 505.
Fibrin and blood-corpuscles, their antago-
nism, i, 247.
Freurer on the analysis of blood, i, 190.
Fishes, blood of, i, 348 ; blood-corpuscles
of, i, 104; respiration of, i, 137;
temperature of, i, 143.
Fixed ‘salts in urine, determination of, ii,
139; amount excreted, ii, 166.
Flesh, analyses of, ii, 422.
Fluid of ascites, ii, 490; of hydrocele, ii,
495; of hydrocephalus, ii, 490; of
550
subcutaneous effusions, ii, 493; of
thoracic effusions, ii, 492.
Fluoride of calcium, i, 2.
in urine, ii, 131.
a constituent of bone, ii, 397, note.
Frericus on the bile, ii, 519; on the
composition of fatty and waxy liver,
ii, 428.
Gall-stones, ii, 469; manganese in, i, 4.
GARROD on urine containing an excess of
hippuric acid, ii, 324.
Gases in the blood, experiments relating
to, i, 133.
evolved by the skin, ii, 105.
various, their effects on the tlood,
i, 123.
Gastric fever, urine in, ii, 270.
Gastric juice, ii, 27 ; morbid, ii, 33.
Gastritis, urine in, ii, 224.
Geppines on the blood in hydremia, i,
309.
Gelatin, i, 25.
sugar of, i, 27; its ultimate compo-
sition, ii, 506.
Glands, composition of, ii, 427.
Globulin, i, 22; its estimation in blood,
i, 179.
Glutin, i, 26; origin of, i, 28; ultimate
composition of, ii, 506
Glycerin, i, 70; ultimate composition of,
ii, 508.
Glyceryl, i, 70.
Glycicoll, i, 27; its ultimate composition,
ii, 506.
GMELIN, his analysis of human lymph, i,
351; on the detection of mercury in
salivayii, 11; on the urine in cramp
in the stomach, ii, 316.
GMELIN and TiEDEMANN on the pancreatic
fluid of the dog and sheep, ii, 16;
on the saliva of the Sheep, ii, 15;
on the gastric juice, ii, 28.
Goat, blood of, i, 341, 346, 349; urine of,
li, 349.
GooDFELLOowW, his case of animalculz in the
blood, i, 335.
Goopstr, his discovery of the sarcina, ii,
394
Goose, blood of, i, 346.
Gout, urine in, ii, 277.
Gravel, urinary, ii, 459.
Graves on the presence of carbonate of
ammonia in urine, ii, 311; on the
urine in Bright’s disease, ii, 240.
GRIFFITH on a urinary sediment containing
carbonate of lime, i ii, 201."
GruBy on morbid mucus, ii, 79.
Grusy and DELAFOND on vias in
blood of the dog, i, 350.
Guinea-pig, blood of, i, 349; urine of, ii,
350
GULLIVER an pus in blood, i, 333.
INDEX.
GiirERBocK on the composition of pus, 4
ii, 89. q
Heemacyanin, i, 43.
Hemaphzin, i, 42; origin of, i, 159.
in urine, ii, 119
-its estimation in blood, i, 180. :
Hematemesis, blood discharged i in, i, 318. :
Heematin, i, 39; metamorphoses of, 159;
general chemical relations of, i, 112.
its estimation of blood, i, 180; ulti--
mate composition of, ii, 506. -
Hematuria, urine in, ii, 267 ; blood in, i,
318. 7
Hemorrhagia cerebralis, blood in, i, 302. —
Hemorrhages, blood in, i, 317; urine in,
ii, 226. :
HarpuEN on the analysis of milk, i ii, 46.
on the composition of woman’s milk,
ii, 52.
Hair, ii, 418 ; a source of binoxide of pro-—
tein, i i, 11; in concretions, ii, 432. —
Hare, urine of, ii, “350. 4
Healthy blood in relation to 0 physiology, i,
"191. :
Heat, animal, i, 142.
HEInricu on the urine in insanity, 4 i
211.
HEINTz on a new constituent in urine, i
127. 3
HELLER on biliphzein in blood, i, 266; on
the determination of albumen, ii,
187. 3
on the blood in Bright’s disease, i,
514; in sporadic cholera, i, 326; im
convulsions, i, 283; in febris puerpe-
ralis, i, 282 ; in peritonitis, i, 271 ;in
metroperitonitis, i, 272; in erysi-
pelas, i, 279 ; in pneumonia, i, 263;
in pneumonia biliosa, i, 265. s
on the fluid of hydrocele, 2, ee. ; on
the subcutaneous serum in Bri;
disease, i ii, 494,
on the urine in ascites, ii, 311;
Bright’s disease, i ii, 528 ; in cholera
ii, 271; in herpes zoster, ii, 320
in morbus maculosus Werlhofii, i
259; in pneumonia, li, 218;
pompholix, ii, 322; in syphilis, i
319.
on urostealith, ii, 326, 452.
on the composition of a green vo mit
fluid, ii, 392.
HeLmHonrz on the consumption of tissu
during muscular action, ii, 424, E
Hen, blood of, i, 349. a
Henry, his table for diabetic urine, i
289; on the urine in rheumati
ii, 275; in chronic inflammation ¢
the liver, i ii, 226.
Henry and Souserran on the blood i |
diabetes, i i, 328. aan
Hepatic vein, blood of, i, 208. |
INDEX.
Hepatitis, blood in, i, 268; milky serum
: in, i, 333; urine in, ii, 226.
HERBERGER on diseased milk, ii, 59; on
the blood in chlorosis, i, 313; on
the urine in chlorosis, ii, 264.
HERING’s analyses of the blood of the
bullock, sheep, and horse, i, 196;
experiments on the velocity of the
circulation, i, 223.
Heron, blood of, i, 349.
_ Herpes zoster, urine in, ii, 320.
HerRMAN on the urine in cholera, ii, 272.
HeERz06 on the urine in hepatitis, ii, 228.
Heterochymeusis, i, 321.
Hewson on the functions of the spleen, i,
119.
HieRoNyYMI on the urine of carnivora, ii,
342.
Hippuric acid, i, 61.
a constituent of healthy urine, ii, 107.
of diabetic urine, ii, 294.
in excess in urine, ii, 324.
to detect in an animal fluid, i, 94.
ultimate composition of, ii, 507.
HorrMann on dried pneumonic blood, i,
264.
Horse, blood of, i, 339, 341, 346, 349;
gastric juice of, ii, 29; saliva of, ii,
14; urine of, ii, 342.
_ Humic acid in urine of herbivora, ii, 351.
Humour, vitreous, of the eye, ii, 421;
aqueous, of the eye, ii, 421.
Humso.upt and Proven¢at, their experi-
ments on the respiration of fishes, i,
137.
HuNEFELD, on a test for sugar, i, 67;
on the composition of the blood-
corpuscle, i, 113.
on a peculiar form occasionally pre-
sented by blood-corpuscles, i, 106.
on the urine of carnivora, ii, 342.
Hybernation, i, 145.
Hydatids, ii, 484.
Hydrzemia, blood in, i, 308.
Hydrocele, fluid of, ii, 495.
Hydrochloric acid, i, 2; in urine, ii, 130.
Hydrochloro-proteic acid, i, 8.
Hydrocyanic acid, its effect on the blood,
i, 108.
Hydrofluoric acid, i, 2.
in urine, ii, 131,
Hydrosulphate of ammonia in urine, ii, 218.
Hydrothorax, urine in, ii, 308.
Hydruria, ii, 305.
Hygroma, fluid of, ii, 489.
Hyperinosis, i, 250.
causes of, i, 284.
Hypinosis, i, 287; causes of, i, 304.
ae hres characters of the blood in, i,
287.
‘chemical characters of the blood in,
i, 287
551
Hysteria, urine in, ii, 316.
Ichor, ii, 96.
Ichthyosis, composition of scales of, ii,
483
Icterus, bile in, ii, 23; blood in, i, 329;
urine in, ii, 313.
Incineration, its effect in increasing the
sulphates ‘and phosphates in ana-
lyses of urine, ii, 141.
Incrustations on the surface of the body,
ii, 482.
Indigo in urine, ii, 326.
Inflammation, its effects on the blood, i,
251; Muxper’s theory of, i, 12,
note.
Inflammation thoracic, blood in, ii, 507.
Inflammatory affections, saliva in, ii, 13.
Influenza, urine in, ii, 268.
Insanity, urine in, ii, 211.
Insects, respiration of, i, 138.
Inorganic acids, their passage into the
urine, ii, 337.
Intermittent fevers, urine in, ii, 255.
Intestinal concretions, ii, 464.
in animals, ii, 466.
Intestinal fluid, ii, 34.
Iodine, its passage into the urine, ii. 336 ;
to estimate, ii. 319.
Iron, i, 3; its effect on the blood in chlo-
rosis, i, 312; its effect onthe urine
in chlorosis, ii, 264 ; its passage into
the urine, ii. 337.
peroxide of, presence in urine, ii, 134.
J GER on intestinal concretions, ii, 464.
Jaundice,. blood in, i, 329; urine in, ii,
313.
JENNINGS on the blood in chlorosis, i, 310,
314; in continued fever, i, 297; in
typhoid fever, i, 293.
KANE on kystein, ii, 329.
Kei, his experiments on the circulation in
the kidney, i, 256.
Kemp on the bile, ii, 20.
KERSTEN on green evacuations, li, 389.
Kidneys, composition of, ii, 429 ; functions
of, i, 215.
KLEYBOLTE on kystein, ii, 334.
Kreatin, i, 32, 35.
Kystein, ii, 329; its uncertainty as a test
for pregnancy, ii, 333, 334.
LacuezeE on the blood in the plague, i,
320.
Tachrymal glands, secretion of, ii, 353.
Lactate of ammonia in urine, determination
of, ii, 138.
Lactic acid, i, 84; to detect in an animal
fluid, i, 95, 96.
in fluid in the abdomen, ii, 498.
Enderlin’s observations on its non-
existence in animal fluids, i, 181,
note.
a solvent of oxalate of lime, ii, 20 0.
552
Lactic acid in urine, ii, 120; increase or
decrease of in urine, ii, 170.
ultimate composition of, ii, 508.
vy. LAER on the hair, ii, 401; on binoxide
of protein, i, 11.
LAGRANGE and HassENFRATZz on the for-
mation of carbonic acid in the blood,
i, 132..
Lambs, blood of, i, 342.
LANDERER on the feces in diarrhea in-
fantilis, ii, 384.
Land-scurvy, blood in, i, 316; urine in, ii,
258.
Land-tortoise, blood of, i, 350; urine of,
ii, 352.
Lassatenz, his analysis of lymph, i, 352 ;
on the milk before delivery, i li, 48;
on the urine of pigs, ii, 347.
Laver on the blood in nephritis. i, 273;
on turbid serum in pleuritis, i,
267.
LAVERAN and MiILuLon on : ion passage of
medicines into the urine, ii, 337.
Lead, i, 4
Lrecanv, his analysis of milky blood, i,
333 ; venous blood, i, 229.
on the blood in carditis, i, 254; in
chlorosis, i, 314; in diabetes, i, 328;
in icterus, i, 330; in scarlatina, i,
301; in typhoid fever, i, 292.
on the effect of temperament on the
blood, i, 236; his experiments on
hematin, i, 39, nofe; on the fats
in the serum of blood, i, 189; his
method of analysing blood, i, 169;
on amount of solid constituents in
the blood in cholera, i, 326.
his observations on the urine, ii, 165 ;
on gravel, ii, 460.
Lzrson on the fallacy of the polarizing
test for sugar, i, 64, note.
LEHMANN, his analyses of healthy urine,
ii, 144; of diabetic urine, ii, 301 ; of
human bones, ii, 401 ; of tophaceous
concretions, ii, 477.
his experiments on the effect of diet
on the urine, ii, 156; on the effect
of exercise on the urine, ii, 164; on
the passage of various substances
into the urine, ii, 340.
on oxalate of lime in urine, ii, 200.
on the presence of hippuric acid in
diabetic urine, ii, 294; on the urine
during pregnancy, ii, 332.
on the presence of sulphur in bilin,
i, 46.
Lens, crystalline, ii, 419.
LENZBERG and MorrTuHier on the blood
in carcinoma uteri, i, 284.
Leopard, urine of, ii, 342.
Levcus on the action of saliva on starch,
li, 9.
INDEX.
Leucin, i, 13; ultimate composition of, —
ii, 504. :
Levret and Lassaiene onthe pancreatic _
fluid of the horse, ii, 17.
L’HERETIER on the composition of the
brain, ii, 427; of lymph,i, 351; of
woman’s milk, ii, 51. :
on the changes produced in the milk
by a prolonged sojourn in the breast,
ii, 54; on the effect of temperament =
on the milk, ii, 54.
on the saliva, ii, 7 ; in chlorosis, ii, 13 ;
in mercurial ptyalism, ii, 11.
on the urine in chlorosis, ii, 265; in
intermittent fever, ii, 257; in poly- —
dipsia, ii, 306. ;
LiesIe on the bile, ii, 20.
on the influence of the salts of the
food on the urine, ii, 147; on the 3
non-existence of lactic acid andl lac-
tates in urine, ii, 121; on the pre-
sence of ammonia in urine, ii, 132;
on the presence of hippuric acid in
the urine, ii, 117; on uric acid,
ii, 115; his views on the absorp- a
tion of oxygen by the blood, i, yi ‘_
note.
Lienitis, blood in, i, 268.
Ligaments, ii, 417.
Lime, carbonate of, i, 2; its occurrence in
urine, ii, 201 ; test for, ii, 434.
oxalate of, its occurrence in urine, ii,
198 ; test for, ii, 433. :
phosphate of, i, 1; ii, 397; test for,
ii, 432.
urate of, characters of,i, 51; test for,
li, 434.
Lime in urine, ii, 133; its determination,
ii, 139
Lion, urine of, ii, 342.
Liquor amnii, ii, 359, 541. =,
sanguinis, general chemical ‘relation an
of, i, 114. =
Liver, composition of healthy, ii, 4283 ig F i
of fatty, ii, 428;
function of, i, 211.
Lochial discharge, i, 338 ; ii, 81.
Lymph, i, 350; a dilute serum, i, 3533
chemical characters of, i, 350 ; mo-
tion of in absorbents, i i, 358.
Lungs, analysis of, ii, 429.
Mac Grecor on the amount of carbonic
acid expired in disease, i, 127; ob-
of waxy, ib.; a
servations on diabetic urine, ii; =
291.
MacLaGan on intestinal concretions, — 4
ii, 466.
Mack on the composition of the liquor a ;
_. amnii, ii, 361.
Magnesia in urine, ii, 133; determination
of, ii, 139.
urate of, i, 55; test for, ii. 435.
INDEX.
MAGNus’s experiments on gases in the
blood, i, 134; on the urine of tes-
tudo nigra, ii, 352.
MAtcorm on the amount of carbonic acid
expired in typhus fever, i, 127.
Manganese, i, 3.
Marasmus senilis, urine in, ii, 317.
Marcuanp, his analysis of healthy urine,
ii, 146 ; of the urine in osteomalacia,
ii, 286; of a land tortoise, ii, 352.
on the composition of nitrate of urine,
li, 136, note.
on the salts of the blood, i, 234; ona
gouty concretion, ii, 477 ; on the
presence of urea in healthy blood, i,
183; on the presence of urea in the
blood in cholera, i, 325.
Marcuarp and CoLzere, their analysis
of lymph, i, 350.
Margaric acid, i, 71; ultimate composition
of, ii, 508.
Margarin, i, 73.
Margary] and its oxides, i, 71.
Mart nN on the urine in morbus maculosus
Werlhofii, ii, 260.
Martin Soton on the urine in peripneu-
monia, ii, 223.
MAYER on cercaria in blood, i, 350.
Measles, amount of carbonic acid expired
in, i, 127.
blood in, i, 300.
urine in, ii, 268. ;
Meconic acid, its passage into the urine,
ii, 337.
Meconium, ii, 367.
Medicines, their passage into the urine,
ii, 336.
MEGGENHOFER on the composition of
woman’s milk, ii, 52; on the milk
in syphilis, ii, 59.
Meibomian glands, secretion of, ii, 353.
Melzna, blood discharged in, i, 317,
Melanurin, i, 45.
Meliceris, analysis of, iiy487.
Melitzemia, i, 327.
MELseEns on the gastric juice, ii, 33.
Meningitis, urine in, ii, 210.
Menstrual fluid, i, 336; ii, 516.
Mercurial ptyalism, composition of saliva
in, li, 11.
Mercury in saliva, ii, 11; in the urine, ii,
337.
Mesoxalic acid, i, 60.
Metals, their passage into the urine,
ii, 337.
Metamorphic actions, i, 165.
Metamorphosis of the blood, i, 139; in
nutrition, i, 147.
Metritis, urine in, ii, 241.
Metroperitonitis, blood in, i, 272.
993
Metrophlebitis puerperalis, blood in, i, 252.
MIALBE on a new principle in saliva, ii, 9.
Microscopic analysis of a fluid, i, 91.
Milk, ii, 42 ; before delivery. ii, 47 ; imme-
’ diately after delivery, ii,49; changed
by disease, ii, 57; changes in, cor-
responding with the age of the in-
fant, ii, 56.
containing infusoria, ii, 69.
ordinary healthy, ii, 50.
physico-chemical character of, ii, 42.
special chemistry of, ii, 44.
method of analysing, ii, 44.
effect of nutrition on the, ii, 54.
effect of temperament on the, ii, 54.
sugar of, i, 65.
extractive matter of, i, 38.
of animals, ii, 61.
of ass, ii, 63; of bitch, ii, 66, 521; of
cow, ii, 61; of ewe, ii, 66; of goat,
ii, 65; of mare, ii, 64.
medicines, their passage-into the, ii,
59.
Milk in urine, ii, 323.
Milky urine, ii, 191.
Mineral constituents of the animal body, i, 1.
MirscHer.icu on the saliva, ii, 4.
Monads in kystein, ii, 331.
Mo6LteER on the urine during pregnancy,
ii, 33.
Moorze’s test for sugar, i, 68.
Morbus Brightii, blood in,i, 321; ii, 514;
cutaneous serum in, ii, 496; urine
in, ii, 231, 528.
Morbus maculosus Werlhofii, blood in, i,
316; urine in, ii, 258.
Morphia, its passage into urine, ii, 339.
Mucic acid, i, 66, note.
Mucin, ii, 74, 486; to detect in an animal
fluid, i, 94.
Mucus, ii, 70; bronchial and pulmonary,
ii, 76.
from gall-bladder, ii, 77; from intes-
tinal canal, ii, 77; from urinary
bladder, ii, 78; nasal, ii, 76; in
urine, how determined, ii, 135 ;
purulent, ii, 83.
formation of, ii, 97.
Mucus-corpuscles, ii, 72.
Mutper, his discovery of protein, i, 5; on
_ the action of thein on the economy,
ii, 341; on the difference of colour
in arterial and venous blood, i, 193,
note.
Mu tpepr’s views on the absorption of oxy-
gen by the blood, i, 155, note.
MiLteR on lymph, i, 350; on the action
of various tests on the blood-cor-
puscles, i, 107 ; on the formation of
the blood, i, 121.
554
Murexan, i, 59.
Murexid, i, 59.
Muscle, ii, 422.
Muscular tissue of man, ii, 423, note ; of ox,
calf, swine, roe, pigeon, chicken,
carp and trout, ii, 423.
ossified, analysis of, ii, 474.
Mycomelinic acid, i, 60.
Myelitis, urine in, ii, 213.
Nasse’s analyses of the blood of the calf,
dog, goat, goose, hen, horse, ox,
rabbit, sheep, and swine, 346.
analysis of chyle of cat, i, 357; of
healthy venous blood, i, 232.
on the buffy coat in pleuritic blood, i,
266.
on the composition of lymph, i, 350,
352.
on the composition of pulmonary
mucus, ii, 77.
on the diseased blood of horses, i, 347.
‘of sheep, i, 347.
serum of pus compared with that of
blood, ii, 92.
Navcueg, his discovery of kystein, ii, 329.
Nephritis albuminosa, blood in, i, 273; ii,
512; urine in, ii, 230, 528.
Nerves, composition of, ii, 427.
NicHotson on the blood in secrofula, ii,
513.
Nitrogen, expiration of, i, 135.
Nitrogenous constituents of the human
body, i, 5.
Nitrate of urea, i, 52; its composition aCe '
cording to Marchand, ii, 136, note.
Non-nitrogenous constituents of the human
body, i, 65.
diet, its effects on the urine, ii, 163.
Nuclei of blood-corpuscles, to separate, i,
104; their general chemical rela-
tions of, i, 112.
Nutrition, metamorphosis of blood in, i,
147
NystTEn, his observations on the amount of
urine in inflammatory affections, ii,
229 ;on the urine in ascites, ii, 311;
in peritonitis, ii, 229.
Objections to the. author’s views on the
modifications of blood, i, 220.
Odorous principles, their passage into the
urine, ii, 339.
Oil, olive, its effect on the blood-corpuscles,
, GE
Oleic acid, i, 74.
Olein, i, 74.
Oleophosphoric acid, i, 81.
Omichmyle, ii, 119, 341.
Ophthalmia, blood in, ii, 510.
ORFILA on arsenic in healthy bone, i, 4;
on bile in the blood in icterus, i,
INDEX.
329; on a case of hematuria, ii,
268; on the detection of morphia
in urine, ii, 339; on the passage of
various substances into the urine,
ii, 337.
Organic “ES their passage into urine, ii,
337. :
constituents of the animal body, i, 5
O’SHAUGHNEssy on the presence of urea
in the blood in cholera, i, 326.
Osteoid tumour, ii, 412.
Osteomalacia, urine in, ii, 286.
Osteoporosis, ii, 410.
Ostrich, urine of, ii, 351.
Otolithes, ii, 249.
Ovarian dropsy, urine in, ii, 313; cysts,
analyses of their contents, ii, 485.
Ox, bile of the, ii, 24; blood of the, i, 340,
341; urine of the, ii, 346.
Oxalate of ammonia in urine, ii, 200.
Oxalate of lime, microscopical character of,
i, 85, ii, 199; in caleuli, ii, 446;
in urine, ii, 198; test for, ii, 4333
Bird on, ii, 200; Lehmann_on, ii,
200.
Oxalic acid, i, 85; in saliva, ii, 10.
Oxaluric acid, i, 58.
Oxyprotein, i, 9.
Pancreas, saliva in disease of, ii, 2.
Pancreatic fluid, ii, 16; in disease i a; 17.
Parameecium loricatum seu costatum in
blood of frogs, i, 350.
Parabanic acid, i, 58.
Parrot, urine of, ii, 351.
PayeEn, his error in the analysis of milk,
ii, 44; on the composition of wo-
man’s milk, ii, 52.
PELLETAN on the urine in typhus, ii, 245.
PreLouzeE and Getts on the best method
of obtaining butyric acid from sugar,
i, 78.
Pemphigus, fluid of, ii, 488.
Pepsin, i, 22; its ultimate compouliaall
ii, 503.
Pepys on the composition of the teeth, —
ii, 414.
Percy on the detection of alcohol in urine,
ii, 339.
on the effect of exercise on the urine,
ii, 169.
on diabetic urine, ii, 300.
on the urine in Bright’s disease, ii, —
237.
on urine in carcinoma of the liver, ii,
318.
on the feces in health, ii, 374; in
diabetes, ii, 378; in jaundice, ii, —
492; of —
384.
on the fiuid of ascites, ii,
hydrocele, ii, 497.
ee ee mee Vande To
INDEX.
Pericarditis, blood in, ii, 209; urine in,
i, 255
Peripneumonia, urine in, ii, 221.
Peritonitis, blood in, i, 269; urine in,
i, 228.
Perspiration containing sugar in diabetes,
: i, 66, note; ii, 297.
PETTINKOFER, his test for bile, ii, 193; on
a new constituent in urine, ii, 129;
on urine containing an excess of
hippuric acid, ii, 324.
Purtrpp on the urine in scarlatina, ii, 280.
Phlebitis uterina, urine in, ii, 210.
Phlegmasia alba, blood in, i, 253.
Phlogoses, urine in the, ii, 205.
Phloridzin, its effect on the urine, ii, 341.
Phosphate, ammoniaco-magnesian, ii, 433;
of lime, its microscopic appearance,
ii, 133.
of lime (basic), test for, ii, 433.
of magnesia and ammonia, i, 2.
of lime (neutral), test for, 2, 432.
Phosphate of soda (tribasic), the cause of
the alkalinity of the blood, i, 182,
note. :
Phosphate of soda, i i, 3.
Phosphoric acid in urine, ii, 130; its de-
termination, ii, 140.
Phthisis tuberculosa, blood in, i, 279 ; urine
in, ii, 286.
Physiology of healthy blood, i, 191; of
healthy urine, ii, 147.
Physical analysis of a fluid, i, 90.
Piarhemia, i, 332.
Pig, urine of, ii, 347.
Pigeon, blood of, i, 350.
Pineal gland, gritty matter in, ii, 474.
Piurtt on morbid sweat, ii, 106.
Placental blood, i, 238.
Plague, blood in, i, 319.
Plasma, genuine chemical relations of the,
i, 114.
PLATNER on the bile, ii, 20.
PLayFarr on the feces in health, ii, 375.
Plethora, Becquerel and Rodier on the blood
in, 306, note.
Pleuritis, blood i in, i, 266 ; urine in, ii, at
Pleuropneumonia, urine in, ii, 220.
Pneumonia, blood in, i, 258, 264; urine in,
ii, 214.
Polyuresis, i li, 305.
Polydipsia, ii, 305.
Pompholix, urine in, ii, 322.
Porphyra hemorrhagica, blood in, i, 316.
Portal blood, solid constituents of, i,
204; compared with arterial, i,
201, 203.
Potash in urine, ii, 132.
bibasic. phosphate of, its a
ii, 148.
555
Potash, chlorate of, its effects on the blood,
i, 108
urate of, i, 54; test for, ii, 434.
Pregnancy, blood during, i, 335; urine
during, ii, 329.
PrEvuS the composition of tubercle, ii,
478.
Prostatic fluid, ii, 359.
Protein, i, 5; ultimate composition of, ii,
503.
compounds, to detect in an animal
fluid, i, 93; diagnosis of, i, 15.
metamorphoses of sulphuric acid and
protein, i, 7; of hydrochloric acid
and protein,i, 8; of nitric acid and
protein, i, 8; of chlorine and pro-
—_ i, 9; of potash and protein,
1,13.
binoxide of, i, 11; ultimate composi-
tion of, ii, 503.
tritoxide of, i, 9 ; ultimate composition
of, ii, 503.
oxides, their effect on the colour of
arterial blood, 193, note.
Protid, i, 14; ultimate composition of,
li, 504
Prout on the composition of the liquor
amnii, ii, 362 ; on the development
of carbonic acid from the lungs at
different periods of the day, i, 127 ;
on the gastric juice, ii, 28; on the
state in which uric acid exists in
urine, ii, 115.
Proximate oe general principles of,
i, 8
Ptyalin, i, 24; to detect in an animal fluid,
i, 98; Wright’s method of deter-
mining, ii, 5.
Purgative action of salts explained, ii, 149.
Purpura hemorrhagica, blood in, i, 319.
Purpurate of ammonia, i, 59.
Purpuric acid, i, 59.
Pus, ii, 86; containing infusoria ii, 96.
formation of, ii, 97.
in the blood, i, 333; in urine, ii, 202;
in mucus, ii, 97.
uric acid in, ii, 98.
from the bladder, ii, 92, 94; from the
cellular tissue, ii, 94; from the
bones, ib.; from the liver, ib.;
from pustules in smallpox, ii, 93;
from synovial membrane of the
knee, ii, 92; from syphilitic bubo,
ii, 93.
arthritic, ii, 94; ‘scorbutic, ii, 96;
scrofulous, ii, 94.
Pyin, i, 12, 29, ii, 74; to detect in animal
fluids, i, 94, 98.
Pyohzemia, i, 333.
Pyrosis, analysis of the fluid of, ii, 393.
556
Quinine, its passage into the urine, ii, 339;
sulphate of, its effect on the blood-
corpuscles, i, 106.
Rabbit, blood of, i, 346, 349; urine of,
ii, 350.
Rachitis, urine in, ii, 284.
Ragsky on the composition of diseased
bone, ii, 406; on the determina-
tion of urea by a new method, ii,
523.
Rarny on the presence of urea in the blood
in cholera, i, 325.
Rattlesnake, urine of, i, 53, note.
Raven, blood of, i, 349.
RayYER on a peculiar form of uric acid,
ii, 173; on urine in nephritis acuta,
ii, 230; on urine in Bright’s dis-
ease, ii, 232; onan endemic hema-
turia in the Isle of France, ii,
268.
ReEs on the blood in diabetes, i, 328; on
the chyle, i, 356; on the lymph, i,
352; on the liquor amnii, ii, 361;
on the action of cubebs and co-
paiva on the urine, ii, 185.
ReicH on diabetic urine, ii, 300. .
REIcHERT on the forces that circulate the
blood, i, 122; on the formation of
the blood-corpuscles, i, 122.
Renal veins, blood of, compared with blood
of aorta, i, 213.
Renal phthisis, urine in, ii, 288.
Resin, biliary, i, 48, ii, 432.
Respiration of the foetus i i, 136; of worms,
i, 139; of insects, i, 138 ; of fishes,
i, 137.
the process of, i, 123.
Rheumatism, blood in, i, 273; urine in, ii,
274.
Rhinoceros, urine of, ii, 347.
Rinpskopr on the blood in pneumonia,
i, 262; in rheumatism, i, 276; in
erysipelas, i, 279.
on the menstrual fluid, i, 337.
RocHLEDER, his experiments on casein, i,
21
Rotto on the blood in diabetes, i, 327.
Rosacic acid, i, 45.
Ross on the urine in hepatitis, ii, 226.
RosstGNoL on the sources of copper in the
animal body, i, 4 nofe.
Rovtrer on the blood in purpura hemor-
rhagica, i i, 319.
Rubeola, blood in, i, 300.
Ruminantia, process of digestion i in, ii, 38.
Sal microscopicum, i, 3, ii, 131.
Salicin, its changes in the organism, ii,
340
Saliva, ii, {; daily amount of, ib.; compo-
sition of, ii, 3.
INDEX.
Saliva in chlorosis, ii, 12 ; in dropsy, ii, 13;
in inflammatory affections, ib..
mode of analysis of, ii, 3.
of animals, ii, 14; of dog, ii, 15; of
horse, ii, 14; of sheep, ii, 15.
use of in digestion, ii, 8.
Saliva, acid, ii, 10; bilious, ii, 14; fatty,
ii, 13; morbid, ii, 9; sweet, ii, 13. ~
Salts in the blood, their functions, i, 151;
their estimation, i, 181.
how calculated from their proximate
elements, ii, 140; their diuretic ac-
tion explained, ii, 149 ; their purga-
tive action explained, ib.
in urine, the amount excreted, ii, 166 ;
their amount affected by disease, i ii,
205.
vegetable, their passage into the urine,
ii, 338.
Salycilie acid, ii, 341.
Salycilous acid, its occurrence in the urine
after taking salicin, ii, 341.
SANSON on a yellow colouring matter in
the blood, i, 43. é
Sarcina ventriculi, ii, 394.
Scarlatina, blood in, i, 300; urine in, a
279.
SCHARLING, experiments on expired air,
i, 129; researches on the urine, ii,
119; on omichmyle, ii, 341, nofe.
ScHERER on the bile in a case of icterus,
ii, 22; on the analysis of tubercle,
ii, 478.
on the blood in bronchitis, i, 257;
in typhoid fever, i, 295; in pneu-
monia biliosa, i, 264 ; in metroperi-
tonitis, i, 272.
on the difference of colour in arterial
and venous blood, i, 192, note.
on the hair, ii, 418.
on the lochial discharge, i, 338.
on the urine in anasarca, ii, 312; in
Bright’s disease, ii, 236 ; in febris
puerperalis, ii, 228; in icterus, ii,
315; in marasmus senilis, i li, 317;
in typhus, ii, 253; in urticaria
tuberculosa, ii, 320. ;
on the extractive matters of urine, ii,
178, note.
Schlerosis, ii, 410.
ScHLOSSBERGER on the mammary secre- -
tion of a he-goat, ii, 65; experi-
ments to determine the ammonia
in urine, ii, 132; on the urine in —
Bright’s disease, ii, 237; on the
composition of the flesh of various
animals, ii, 423; on gravel in new-
born children, ii, 461.
Scumitz on polystoma-like animalcules
in the blood of the horse, i, 350.
INDEX.
SCHONLEIN on the diagnosis of blenorrhcea
from the examination of the urine,
ii, 273; on the blood discharged in
hzematemesis, i, 318; on the blood
in erysipelas, i, 278.
on the urine in cystitis, ii, 240; in dia-
betes, ii, 290; in hepatitis, ii, 227;
in hydrothorax, ii, 308; in inflam-
matory diarrhoea, ii, 225; in influ-
enza, ii, 268; in jaundice, ii, 313;
in nephritis, ii, 230; in pneumo-
nia, ii, 207 ; in scrofula, ii, 283; in
typhus, ii, 244; in variola, ii, 283.
ScHULTz on the action of various tests on
the blood-corpuscles, i, 107; on
the blood-corpuscles of a sala-
mander suffocated in carbonic-acid
gas, i, 106; on the capsule of the
blood-corpuscle, i, 105; on the
forces that circulate the blood, i,
122; on the formation of blood-
corpuscles, i, 120; on portal blood,
i, 202.
Scuuttz and HENLE on the development
of blood-corpuscles, i, 154.
ScHWERTFEGER, his test for bile, ii, 194.
Scorbutus, blood in, i, 315; urine in, ii,
258.
Scrofula, blood in, i, 309, ii, 511; urine
in, ii, 283.
Scrofulous matter, analysis of, ii, 478.
Scurvy, blood in, i, 315; urine in, ii, 258.
Sebacid acid, i, 74.
Secretions of the male generative organs,
ii, 356; of the female generative
organs, ii, 359.
Sediment in Bright’s disease, ii, 235; of
urate of ammonia, ii, 174.
Semen, ii, 356.
Serolin, i, 83.
Serpents, urine of, ii, 352.
Serum, milky, cases of, i, 268, 271, 273,
323, 332.
yv. SETTEN on urine of the pig, ii, 348.
Sex, difference of blood in, i, 234.
Sheep, blood of, i, 341, 346, 349; morbid
blood of, i, 344, 347; saliva of, ii,
15.
Silica, i, 4; test for, ii, 435.
Silicie acid in urine, ii, 131.
Ston, his case of milky blood, i, 333.
Skin, true, ii, 417.
disease, urine in, ii, 320.
disease, amount of carbonic acid ex-
pired in, i, 127.
Smallpox, amount of carbonic acid expired
in, i, 127.
Soda, bibasic phosphate of, its properties,
ii, 148.
Soda, in urine, ii, 131.
urate of, i, 55 ; test for, ii, 434.
557
Solid constituents of urine, increase or di-
~ minution of, ii, 170.
So.xy on the urine in osteomalacia, ii, 286.
Soton on the urine in peripneumonia, ii,
223 ; on the urine in variola, ii, 282;
on the presence of albumen in the
urine in scarlatina, ii, 280.
Spanzemia, chemical characters of the blood
in, i, 306 ; physical characters of the
blood in, ib.
Specific gravity of blood, i, 101; of urine,
ii, 165; how determined, ii, 135.
Spermatozoa, ii, 356; in urine, ii, 325.
Spinal cord, composition of, ii, 427.
Spirit, explanation of term in contradis-
tinction to alcohol, i, 21, nofe.
Spirit-extract, i, 31; of blood, i, 36; of
milk, i, 38 ; of urine, i,37, ii, 137. ~
to detect in an animal fluid, i, 97.
Spleen, Hewson’s views of the functions of,
i, 119.
SPRENGEL on the urine of cattle, ii, 345.
Sputa in bronchitis, ii, 82; in phthisis, ii,
84, 88.
Stearaconot, i, 81.
Stearic acid, i, 71; ultimate composition
of, ii, 508.
Stearin, i, 73.
Subrubrin, i, 43.
Sudor, ii, 101,
Suet, i, 82.
Sugar, its formation in diabetes, ii, 302;
to detect in an animal fluid, i, 97;
methods of detecting in blood, i,
185; in the blood, i, 327, 185; in
the blood in diabetes, i, 302; tests
for, i, 67 ; yields butyric acid, i, 78.
of gelatin, i, 27.
of milk, i, 65; of milk in the liquor
amnii, ii, 362.
in urine, ii, 194, 297 ; diabetic, i, 66.
Sugars, animal, i, 65.
Sulpho-bi-proteic acid, i, 8.
Sulpho-cyanogen a constituent of saliva,
ii, 26
Sulpho-proteic acid, i, 8.
Sulphuric acid, its formation from trans-
formed tissues, ii, 153; in urine, ii,
130, 140.
SUTHERLAND and Riesy on the urine in
insanity, ii, 211.
Sweat, ii, 101; of animals, ii, 111.
sugar in the, i, 66, nofe.
morbid, ii, 106.
Swine, blood of, i, 341, 346; urine of, ii,
348.
Synovia, ii, 416.
Syphilis, milk in, ii, 59 ; urine in, ii, 319.
Taurin, i, 47; on the occurrence of sulphur
in, ii, 20, note.
Tears, the, ii, 353.
558
Teeth, ii, 413.
Temperament, differences of blood in, i, 236.
Temperature of the blood, i, 102.
Temperature of different animals, i, 142.
Tench, blood of, i, 348.
Tendons, ii, 417.
Testicle, analysis of milky fluid from, i,
65 note.
Testudo nigra, urine of, ii, 352.
tubulata, urine of, ii, 352.
Thein, its effects on the urine, ii, 341.
THENARD on the composition of the bile,
ii, 19
THEYER and ScutossER on the bile, ii,
20.
Thionuric acid, i, 60.
THomson on the saliva in mercurial pty-
alism, ii, 12.
TIEDEMANN and GMELIN on blood in
icterus, i, 331; on the comparison
of chyle and chyme, ii, 39; on the
saliva, ii, 4; on chyle, i, 357; on
lymph, i, 350; their table of the
temperature of birds, i, 142.
TIEDEMANN and Rupo.peui, table of the
temperature of animals, i, 142.
Tiger, urine of, ii, 342.
Tissues, formation of, from cells, i, 140.
Torula, the, i, 69.
TRAIL on milky serum, i, 269, 332.
Tritoxide of protein, i, 9.
TROMMER, his test for sugar, i, 68, ii, 195,
299; applied to the blood, i, 187.
Trout, blood of, i, 350.
Tubercles, ii, 4783 peculiar corpuscles in,
li, 89.
Tubercular phthisis, blood in, i, 279; urine
in, ii, 286.
Typhus, urine in, ii, 242.
Typhus abdominalis, blood in, i, 288.
Typhus petechialis putridus, blood in, i,319.
Umbilical arteries, blood of, i, 238.
Ureemia, i, 320,
Uramil, i, 60.
Uramilic acid, i, 60.
Urate of ammonia, i, 55 ; increased quantity
of, in urine, li, 174; miscroscopic
test for, ii, 176; occurrence in cal-
culi, ii, 431; occurrence in intes-
tinal concretions, ii, 464, 465;
resembling cystin in form, i, 64,
note.
Urate of lime, i, 55; test for, ii, 434.
magnesia, i, 55; test for, ii, 435.
potash; i, 54; test for, ii, 434.
soda, i, 55; in urine, ii, 177 ; micro-
scopical character of, ii, 177; test
for, ii, 434.
Urea, i, 49; amount excreted, ii, 165;
amount in healthy urine, ii, 165 ;
amount modified by disease, ii, 174,
INDEX.
204 ;its conversionin the system into
carbonate of ammonia, ii, 213.
its presence in healthy blood, i, 182 ; its
presence in the blood in Bright’s dis-
ease, i, 322; its presence in the
blood in cholera, i, 325; fallacies
to be guarded against in searching
for it in blood, i, 185; its action
on the blood-corpuscles, i, 108 ; its
qualitative determination in animal
fluids generally, i i, 96, 99—in blood,
i, 182—in urine, ii, 116.
its quantitative determination in urine,
ii, 135—by Ragsky’ s method, ii, 523
—in diabetes, i li, 297.
its effect in modifying the crystalliza-
tion of certain salts, i, 53.
its origin, i, 149, 160; obtained from
uric acid, i, 56; ultimate composi-
tion of, ii, 507.
Urea, hydrochlorate of, i, 53.
Urea, nitrate of, its composition according
to Marchand, ii, 136, note.
Urea, oxalate of, i, 52. a
Urea, sulphate of, i, 52.
Uric acid, i, 53; amount excreted, ii, 166: af-
fected by disease, ii, 205; Bensch’s
formula for, ii, 114,no¢e; origin of, i,
149, 160 ; microscopic characters of,
ii, 173 ; qualitative determination in
an animal fluid, i, 194—1in urine, ii,
116.
_ quantitative determination in urine, ii,
136; increased quantity in urine,
ii, 172; diminished quantity in
urine, ii, 178 ; its occurrence in uri-
nary calculi, ii, 440—test for, ii,
431; ultimate compositionof, ii, 507.
Uric oxide, i, 62; calculi of, ii, 444; test
for, ii, 431; ultimate composition
of, ii, 507.
Uril, i, 56.
Urinary calculi, ii, 437; gravel, ii, 459.
Urine, ii, 113; composition of healthy,
ii, 145 ; extractive matters of, i, 37;
water-extract of, ib.; spirit-extract
of, ib. ; alcohol-extract of, ib. zs
pathological changes in, ii, 170.
physiological relation of, ii, 147.
qualitative analysis of, ii, 115; quan-
titative analysis of, ii, 134, 141;
quantity discharged in twenty-four
hours, ii, 165; specific gravity of, ii,
115, 165; tabular view of analyses
of, ii, 147.
in disease, to analyse, ii, 170, 183.
Urine, alkaline, ii, 207, note; anzemic, ib. ;
bloody, ii, 187 ; blue, ii, 328 ; black,
ib. ; chylous, ii, 190 ; fatty, ii, 189;
febrile, ii, 206, note, 208 ; milky, ii,
191, 229.
INDEX.
Urine containing carbonate of ammonia,
ii, 197; carbonate of lime, ii, 201;
cystin, ii, 201 ; hippuric acid in excess,
ii, 324; indigo, ii, 326; pus, ii, 202;
semen, ii, 325; sugar, ii, 194.
Urine during pregnancy, ii, 329.
Urine of peculiar colour, ii, 325.
Urine in disease, ii, 203; in angina tonsil-
laris, ii, 224; in ascites, ii, 309; in
bilious fever, ii, 270; in Bright’s dis-
ease, ii, 231 ; in bronchitis, ii, 214; in
carcinoma, ii, 317; in catarrh, ii,
268; in chlorosis, ii, 261; in cho-
lera, ii, 271; in consumption, pul-
monary, ii, 286; in cystitis, ii,
240; in delirium tremens, ii, 212;
in diabetes insipidus, ii, 304; in dia-
betes mellitus, ii, 289; in dropsy, ii,
308; in dysentery, ii, 225; in em-
physema, ii, 223; in empyema, ii,
223; in encephalitis, ii, 211; in en-
docarditis, ii, 210; in enteritis, ii,
225; in erysipelas, ii, 278; in fever,
bilious, ii, 270—gastric, ib.—intermit-
tent, ii, 255—mucous, ii, 270—puerpe-
ral, ii, 228—typhoid, ii, 242; in gas-
tritis, ii, 224 ; in hemorrhages, ii, 266 ;
in hepatitis, ib.; in herpes zoster, ii,
320; in hydrothorax, ii, 308 ; in hys-
teria, ii, 316; in icterus, ii, 313; in
inflammatory affections, ii, 208 ; in in-
fluenza, ii, 268; in insanity, ii, 211;
in intermittent fever, ii, 255 ; in jaun-
dice, ii, 313; in land-scurvy, ii, 258 ;
in marasmus senilis,ii,317; in measles,
ii, 268 ; in meningitis, ii, 211; in me-
tritis, ii, 241; in morbus maculosus
-Werlhofii, ii, 258 ; in mucous fever, ii,
270; in myelitis, ii, 213; in nephritis
-acuta, ii, 230—albumiinosa, ii, 231;
in osteomalacia, ii, 286; in pericar-
ditis, ii, 209; in peripneumonia, ii,
221; in phlebitis uterina, ii, 210;
in phlogoses, ii, 205; in phthisis tu-
berculosa, ii, 286 ; in pleuritis, ii, 219 ;
in pleuropneumonia, ii, 220 ; in pneu-
monia, ii, 214; in pompholix, ii, 322;
in rachitis, ii, 286; in renal phthisis,
- it, 288 ; in rheumatism, ii, 274 ; inru-
beola, ii, 268 ; in scarlatina, ii, 279 ; in
scrofulosis, ii, 283; in scurvy, ii, 258 ;
in skin diseases, ii, 320 ; in syphilis, ii,
319; in typhus, ii, 242; in urticaria
tuberculosa, ii, 320; in varicella, ii,
282 ; in variola, ii, 282; in vesical ca-
tarrh,ii, 273; in vesical phthisis, ii, 288.
Urine of animals, ii, 342; of beaver, ii,
350; of birds, ii, 351 ; of boa constric--
tor, i, 53, note ; of bull-frog, ii, 252;
559
of camel, ii, 347 ; of cattle, ii, 345; of -
elephant, ii, 347; of goat, ii, 349; of
guinea-pig, ii, 350; of hare, ii, 350;
of horse, ii, 342; of ostrich, ii, 351;
of parrot, ii, 351; of pig; ii, 347; of
rabbit, ii, 350; of rattlesnake, i, 53,
note; of rhinoceros, ii, 347; of ser-
pents, ii, 352; of tortoise, ii, 352.
Urobenzoic acid, i, 61.
Uroerythrin, i, 45, ii, 119.
Uroglaucin, ii, 523.
Urostealith, ii, 324, 452.
Urous acid, i, 62.
Uroxanthin, ii, 523.
Urrhodin, ii, 523.
Urticaria tuberculosa, urine of, ii, 230.
Vaccinic acid, i, 75, 80.
VALENTIN on the composition of pus, ii,
91; of human bones, ii, 401.
Varicella, urine in, ii, 282. .
Variola, blood in, i, 298 ; urine in, ii, 282.
VAUQUELIN on the composition of the se-
minal fluid, ii, 358; on the urine of
the carnivora, ii, 342—of the beaver,
ii, 350.
Vegetable albumen, i, 5.
bases, their passage into the urine, ii,
338.
casein, i, 6.
diet, its effects on the urine, ii, 161.
fibrin, ii, 5.
salts, their passage into the.urine, ii,
338.
VELSEN on violet-coloured urine, ii, 329.
Vena hepatica, blood of, compared with
blood of vena portarum, i, 162.
Vena porte, properties of the blood of, i,
201.
blood of, compared with blood of vena
renalis, i, 162.
Vena renalis, blood of, compared with
aortic blood, i, 162.
Venesection, its effect on the blood in
pneumonia, i, 260.
its effect on the blood in rheumatism,
i, 261; its influence on the blood
generally, i, 248.
Venous and arterial blood, comparative
analyses of, i, 194; distinctive cha-
racters of, i, 192.
Venous blood, the author’s analyses of,
i, 228; compared with the blood of
the capillaries, i, 217 ; composition of
healthy human, i, 227; Denis’s ana-
lyses of, i, 230; Lecanu’s analyses of,
i, 229.
Vernix caseosa, ii, 364.
Vesical catarrh, urine in, ii, 273..
Vesical phthisis, urine in, ii, 288.
560
Vibrio cyanogenus in milk, ii, 69.
Vibrio xanthogenus, ii, 69.
VIGLA on uric-acid sediments, ii, 173.
VoceEt on the menstrual fluid, i, 338; on
the saliva, ii, 12; on the urine in
cholera, ii, 272 ; on the urine of the
elephant, ii, 347—of the rhinoceros,
ii, 347.
Vomiting, matters discharged by, ii, 390.
Vorict on the composition of the liquor
amnii, ii, 360.
WacGner, his experiments on the velocity
of the circulation, i, 225; on the
forces that circulate the blood, i,
122.
Wasmann, his directions for obtaining
pepsin, i, 23.
Water, amount in urine affected by disease,
ii, 204; determination of, in urine,
ii, 135. :
Water-extract, i, 31; of blood, i, 36; of
milk, i, 38; of urine, i, 37, ii, 137.
WIENHOLT on the composition of the skin,
ii, 417.
Wittts on the absence of urea in urine,
ii, 172; on anazoturia, ii, 306; on the
specific gravity of diabetic urine, ii,
289; on urine in arthritic nephritis,
ii, 231; on urine in typhoid fever,
ii, 245; on urine in vesical catarrh,
ii, 273.
INDEX. |
Witson on the fluid ejected in pyrosis,
ii, 393.
Wirrtstock on the blood in cholera, i, 325 ;
on the urine in cholera, ii, 272.
Wouter on the passage of various sub-
stances into the urine, ii, 336.
Woop on the composition of pus, ii, 91.
Worms, respiration of, i, 139.
Waicut on the composition of pus, ii, 91;
on the detection of alcohol in urine,
ii, 339; on the saliva, ii, 5—in mer-
curial ptyalism, ii, 11.
Wurtz on the production of butyric acid
from fibrin, i, 79.
Wortzer, lymph described by, i, 350.
Xanthic oxide, i, 62; test for, ii, 431.
Xantho-hematin, i, 43.
Xantho-proteic acid, i, 8.
Yellow fever, blood in, i, 319.
Young animals, characters of the blood of,
i, 238
ZANARELLI on milky serum in pneumonia,
i, 332. :
ZIMMERMANN on the blood in ophthalmia,
ii, 508; on the blood in thoracic in-
flammation, ii, 507; on the occur-
rence of fibrin in urine, ii, 188, note;
on the specific gravity of the blood in
pneumonia, i, 264; on the urine in
endocarditis, ii, 210; on the urine in
pneumonia, ii, 229. ;
Zomidin, i, 32, 34.
THE END.
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