Supplement to “The Medical World,” Philadelphia. 
THE URINE IN DISEASE. 
17 
Arranged by LOUIS LEWIS, M.D, M.R.C.S., England. 
Healthy Urine has an Average Specific Gravity of 1020*, and an Acid Reaction! About 45 oz. are daily excreted.J Is of a transparent amber tint.§ 
, 
—— ' . = 
ABNORMAL 
INGREDIENTS. 
SPECIFIC 
GRAVITY. 
REACTION 
(WITH LITMUS). 
QUANTITY. 
CHARACTERS. 
TESTS (QUALITATIVE.) 
REMARKS. 
• 
THERAPEUTICAL 
NOTES. 
i 
ALBUMEN. 
1015 
(and lower). 
Alkaline 
(as a rule). 
Diminished. 
Smoky, brownish, or blood-red 
hue. 
Often odorless. 
• 
Heat and Nitric Acid. 
If albumen be excessive, Heat alone 
coagulates it. If in small quan- 
tity, Nitric Acid is required. 
Excess of Nitric Acid alone coagu- 
lates it. 
Bichloride of Mercury, 
in solution, coagulates it. 
A small piece of Glacial Acetic 
Acid dropped into Albuminous 
Urine, will produce a cloudiness. 
This test is delicate and reliable. 
Sulphuric Acid 
causes a deposit of Carbon (black) in 
warm Albuminous Urine. 
.. 
Picric Acid. 
A saturated solution causes a pre- 
cipitate in a thin layer, when 
carefully added to the Urine. 
Persistent presence indicates structural Disease of 
the Kidney : in Bright’s Disease, casts are also 
found.- Temporarily present in urine containing 
Pus or Blood; as in inflammatory diseases of 
the urinary mucous membrane ; also in Intermit- 
tents, Rheumatic Fever, Pneumonia, Scarlatina, 
Cholera, etc. 
Chlorate of Potash, Carbolic Acid and Lead, taken 
internally, give the same reaction as Albumen. 
Phosphorus, Cantharides and Turpentine pro- 
duce Blood. 
In the various forms of Albuminuria, the 
following drugs are used : Tincture of 
Perchloride of Iron, Gallic Acid, Ergot of 
Rye, Senega, Nitro Glycerine, etc.; also 
Turkish and Vapour Baths. 
Gallic and Tannic Acids reduce the amount 
of Albumen. 
2 
SUGAR. 
1030 
(and higher). 
Acid. 
Increased. 
Pale and frothy, with Cider-like 
Odor. 
Attracts flies. 
A deep brown color on boiling with 
an equal quantity of Liquor Po- 
tassae. (Moore’s Test.) 
Fermentation, on addition of yeast, 
after standing, at a raised tem- 
perature. 
A Solution of Sulphate of Copper 
and Liquor Potassae produces a 
blue tint, which becomes reddish 
or orange on the application of 
Heat. (Trommer’s Test.) 
Deep green tint on boiling with an 
alkaline solution of Bichromate 
of Potash. 
in extreme cases the odor of burnt 
sugar is evolved when the Urine is 
heated over a spirit-lamp on a 
spatula. 
Always present in Diabetes. Often associated with 
Cataract. Temporarily present under the adminis- 
tration of Ether, Chloroform and Nitrite of Amyl. 
The Urine of patients taking Salicylic Acid gives the 
same reaction as Sugar. 
Dietetics are of first importance. 
Dilute Phosphoric and Gallic Acids, Tincture 
of Perchloride of Iron, Permanganate of 
Potash, Jaborandi, etc., have been variously 
used. Arsenic and its Bromide, Codeia 
(in gr. y2 doses), Bromide of Potasium, 
Salicylate of Soda, Cod Liver Oil, Opium 
(in large doses), and Sulphide of Calcium 
are useful in Diabetes Meilitus. Liquid 
Elxtract of Ergot, Valerian, and Opium 
are employed in Diabetes Insipidus. 
Carlsbad and Vichy Waters are also useful. 
3 
BILE. 
Slightly increased. 
Alkaline. 
Normal. 
Dark greenish color. 
Bitter taste. 
Nitric Acid produces a brownish 
tint. 
A purple hue, on addition of Sul- 
phuric Acid, and a little sugar. 
(Pettenkoffer’s Test.) 
Hydrochloric Acid causes a green- 
ish tint. 
After shaking up the suspected Urine 
with the white of an egg, and 
adding a little nitric acid a green- 
ish coagulum is produced. 
Present in Hepatic Derangements. In Jaundice, the 
Urine imparts a yellow stain to the linen. 
. - 
Chloride of Ammonium, Phosphate of Soda, 
(0 1 doses), Sulphate of Potash, and Tar- 
axacum, are recommended in Jaundice. 
Dilute Mineral Acids, Hydrargyrum cum j 
Creta, Bromide of Potassium, Podophyllin, 
etc., are used in Hepatic Obstructions. 
4 
EXCESS OF 
PHOSPHATES. 
1020 
(and lower). 
Alkaline, 
or neutral. 
Increased. 
Cloudy, or 
' 
Pale yellow, with Fetid Odor. 
Earthy Phosphates (Lime, Magnesia) 
are precipitated by Aqua Am- 
monias, 
Alkaline Phosphates (Soda, Am- 
monia) are not precipitated by 
Aqua Ammonias. 
' 
Nitric and Hydrochloric Acids dis- 
solve earthy and alkaline Phos- 
phates. 
Heat precipitates earthy Phosphates, 
but they are instantly dissolved 
by Nitric Acid. 
- 
. 
Mostly derived from the food. Excess indicates dis- 
integration of tissues, and occurs in P’ebrile, In 
flammatory and Dyspeptic conditions, organic 
Urinary diseases, and in diseases of the Central 
Nervous system. 
Benzoate of Ammonia and Dilute Phosphor- 
ic Acid are advisable in excess of Phos- 
phates from ordinary causes. 
In Rickets, Phosphates of Lime and Iron, 
and Cod Liver Oil are best. 
5 
EXCESS OF 
UREA. 
1030 
(and higher). 
Acid 
(usually). 
Normal. 
High color, 
with strong Urinous Odor. 
By partly evaporating the urine, 
and adding an equal quantity of 
strong Nitric Acid, crystals of 
Nitrate of Urea are produced. 
' AC 
N • 
A concentrated solution of Oxalic 
Acid will produce crystals of 
Oxalate of Urea, after evapora- 
tion. 
Excessive in Acute Inflammatory Fevers. 
Deficient in organic diseases of the Kidney, Diabetes, 
Anaemia and ITystencal Conditions. 
Urea and Uric Acid are products of destruction of 
Tissues. These are the forms in which Nitrogen 
is eliminated from the system. 
Alcohol, Cinchona, Caffein, Lead, and Tea 
reduce the excretion of Urea, and conse- 
quently lessen destructive metamor- 
phosis of tissues. Potash Salts and Chlo- 
rides of Ammonium and Sodium increase 
the elimination of Urea. 
6 
EXCESS 
OF URIC ACID. 
1020 
(and higher). 
Very Acid. 
Diminished, 
or Normal, 
Pligh color, and clear. 
Hydrochloric Acid, added to urine 
which has been standing a few 
hours, throws down a reddish 
sediment. 
By adding Glacial Acetic Acid to 
the Urine, m a watch glass, and 
leaving some filaments of silk 
therein. Uric Acid crystals will 
be deposited in 24 or 48 hours. 
Increased in Gout, Rheumatism, Pneumonia, Cal- 
careous Diseases, Diseases of the Liver and some 
Inflammatory Fevers. 
In Gout and Rheumatism the increase is especially 
marked in the Blood. 
Phosphate of Ammonia, Bicarbonate of Pot- 
ash, and especially Citrate of Potash, and 
small doses of Mercury are recommend- i 
ed, and Hunyadi Janos, Freidrichshall, 
Carlsbad and Vichy as Mineral Waters; 
In Gout Colchicum, Citrate of Lithia, Tinc- 
ture of Iodine (in m.x. doses), Iodide of 
Potassium, etc. Equal parts of Oil ot Ca- 
juput and Collodion as a paint; also Poppy i 
and Soda fomentations. j 
' 
* After drinking freely about 1005 (“ Urina Potus”); after food, about 1030 (‘ Urina Chyli"). f After vegetable diet, Alkaline Reaction; after animal food, Acid Reaction. Excretion diminished when skin acts freely; increased by Digitalis, Scoparius, Squill, Potash Salts, Cantharides, Turpentine, Calomel in small doses frequently repeated, Paraldehyde, etc. 
§Color heightened by perspiration, and vice versa ; Carbolic Acid darkens it ; Santonin renders it orange ; Beet-root reddens it. A Red Sediment indicates Uric Acid, if crystalline ; otherwise Urate of Ammonia. A White Sediment indicates Phosphates, if soluble in heat ; otherwise, Urate of Ammonia. A Pink Sediment indicates Urate of Soda and 
osphate of Ammonia. Oxalic Acid is present both in health and disease, and is easily detected by the microscope. Its excess is best treated with Nitric or other mineral acids. 
Copyright, 1884, by C. F. Taylor. ■ 1 • / 
{All rights reserved.)