UREA AND PHOSPHORIC ACID IN 
THE URINE IN ANiEMIA. 
By THEODORE DEECKE. 
From the American Journal of Insanity for July, 1879. UREA AND PHOSPHORIC ACID IN THE 
URINE IN ANAEMIA. 
BY THEODORE DEECKE. 
The amount of urea excreted by the kidneys stands, 
as careful observations have shown, in a certain relation 
to the quality and the quantity of food consumed. Its 
elimination is also influenced, to some degree, by the 
occupation or the physical and mental exertion of the 
individual. It varies greatly from the normal average 
in diseased conditions of the organism, especially where 
there is a rapid disintegration of the tissues of the 
body and of the constituents of the blood. 
In the healthy adult the amount of nitrogen con- 
tained in the urea excreted, can be considered as almost 
exactly equal to that contained in the nourishing ma- 
terial absorbed by the system. The amount of urea 
eliminated is, therefore, a most valuable indicator of 
the general change of matter in the nitrogenous con- 
stituents of the organism. 
Another important factor in the composition of the 
urine is the amount of phosphorus which it contains, 
in the form of alkaline and earthy phosphates. Re- 
garding the alkaline phosphates, it has become apparent 
that there exists a special relation between the quantity 
of these in the urine, and the amount of change of 
matter in the nervous tissue, which is distinguished by 
the large proportion of phosphorus contained in easily 
decomposable compounds. The amount of earthy 
phosphates is of interest, in its relation to certain 
pathological processes. These are the calcareous infil- 
tration, or the calcification of physiological and patho- logical tissues; the depositions of earthy phosphates in 
cystic cavities, of morbid origin, in various organs of 
the body; the formation of concretions in the urinary 
passages and of crystalline deposits in the urine, the 
latter especially in chronic affections of the bladder. 
The history of the formation of urea in the organism, 
and the seat of its development, can not yet be given 
in detail. From a chemical point of view the possi- 
bility must be admitted, that it has more than one 
source of derivation. The fact that it is a constant 
constituent of the blood, that it is found in the chyle, 
in the serous fluids, in the saliva, and also in various 
organs and tissues, renders it more than probable that 
it is not the product of one special organ of the body. 
It must rather be considered, like its allies, especially 
the uric acid and the kreatinin, as the general result of 
the dissociation of certain groups of living albuminous 
compounds. We add to this that urea possesses the 
power of dialyzing through animal membranes with 
great facility, that it acts, when introduced into the 
system, as a powerful diuretic, and that it is rapidly 
re-excreted by the kidneys, especially when injected into 
the blood. From all this it would appear that it is 
not so much the physiological function of the renal 
epithelium to produce, but merely to eliminate, or to 
withdraw this substance from the blood. 
The small amount of urea uniformly present in the 
blood—from two to four parts in ten thousand—and 
the larger proportion in the arterial, than in the venous 
blood of the kidneys, offers no argument against this 
theory, as it has been shown by calculation that it is 
possible for the whole amount of urea, excreted in a 
given time, to have been separated from the blood 
passed during the same time through the kidneys. 
.Moreover, it has been proven by experiment that the 3 
urine is secreted continuously, and that its flow never 
ceases in health for any length of time. Another 
argument may be found in the fact that the amount of 
urea is, in general, independent of the quantity of urine 
excreted. 
The amount of urea eliminated by an average man, 
in twenty-four hours, is, according to Dr. E. Smith, 
33.63 grammes, the daily average in the course of a 
year; after Parkes, 33.18 grammes; after my own 
observations, 31.95 grammes in one case, and 34.59 
grammes in another case, which gives an average of 
33.27. The average amount of phosphoric acid excreted 
during the same period was, after Parkes, 3.164 
grammes; after my own observations, 3.62 in the one, 
and 2.77 grammes in the other case, an average of 
3.195. The variations in the daily amount of urea, in 
Dr. Smith’s case, was from 14.2 grammes to 45.3 
grammes; of phosphoric acid, after Parkes, from 2 to 
4.3 grammes. According to my analyses, compris- 
ing the time of ten days, the variations in the daily 
quantity of urea amounted to from 27.34 grammes to 
41.74 grammes; of phosphoric acid, from 2.17 to 4.21 
grammes in the first case; in the second one, of urea, 
from 24.07 to 39.35 grammes; of phosphoric acid, from 
2.59 to 4.16 grammes. The whole quantity of urine, in 
the last two cases, was 14830 c. c., by daily variations 
from 1155 c. c. to 1715 c. c. in the first case, and 21144 
c. c., by daily variations from 1600 c. c. to 2790 c. c. 
in the second case. The specific gravity in the first 
case varied from 1014 to 1026, making an average of 
1020-21; in the second one, from 1009 to 1026, an 
average of 1018-19. 
As it will be observed in the foregoing, the figures pre- 
sent a remarkable congruity. A greater number from 
other authors could be added, in order to substantiate 4 
their correctness. In a healthy average man the daily 
amount of urea excreted, in grammes, rarely exceeds 
forty, or is below twenty, while the quantity of 
phosphoric acid excreted varies between 2 and 4.5 
grammes. 
It has already been indicated that in morbid condi- 
tions of the organism great variations occur. Thus, in 
the early stages of acute diseases, as pneumonia, typhus, 
meningitis, the daily amount of urea excreted increases, 
according to Vogel and Warnecke, to more than twice 
the normal average—that is, to from seventy to eighty 
grammes per diem, while in cases of chronic anaemia, 
according to my own observations, it remains below 
one-lialf of the usual average. In all these anal- 
yses the determination of the substances excreted was 
confined to their whole amount, during the twenty-four 
hours of the day. There is, at present, nothing definite 
known of their relative quantity at different times during 
this period, which would appear to be of especial interest 
in regard to the change of matter during the state of being 
awake and during sleep. If it is a natural law that the 
amount of urea excreted, stands in a direct proportion 
to the amount of physical and mental exertion per- 
formed, and that it is to be considered as a measure of 
muscular and nervous energy, this of course must be- 
come noticeable as a constant and regular rise and fall 
of its amount during the twenty-four hours of the day. 
I present, in the following tables, the results derived 
from my own investigations: 5 
GRAMMES. , 
GRAMMES. 
Color; Deposit, etc. 
Spec. 
Grav- 
ity. 
Re- 
action. 
Quan- 
tity in 
C. C. 
Urea. 
! Phosphoric 
j Acid in 
Aik. Phos. 
j Phosphoric 
Acid in 
1 Earthy Ph. 
Color; Deposit, etc. 
Spec. 
Grav- 
ity. 
Re- 
action. 
Quan- 
tity in 
C. C. 
Urea. 
Phosphoric 
Acid in 
Aik. Phos. 
Phosphoric 
Acid in 
Earthy Ph. 
Yellow; Clear. 
1024 Acid. 
750 15.30 
1.28 0.34 
Light Yellow; Clear. 
1020 
Acid. 
1150 15.84 
1.59 
0.31 
Yellow; Clear. 
1026 Acid. 
650 12.09 
1.38 0.29 
Yellow; Clear. 
1018 
Acid. 
950 11.98 
1.31 
0.30 
Yellow; Clear. 
1011 Acid. 
1215 17.69 
1.76 0.31 
Light Yellow; Clear. 
1009 
Acid. 
1575 13.23 
1.30 0.31 
Yellow; Clear. 
1021 Acid. 
800 14.93 
1.27 0.32 
Light Yellow; Clear. 
1011 
Acid. 
1230 18.41 
1.77 0.32 
Yellow; Clear. 
1022 Acid. 
915 | 18.21 j 1.40 | 0.34 
Yellow; Clear. 
1023 
Acid. 
980 17.75 
1.69 0.30 
Yellow; Clear. 
1015 Acid. 
1314 16.56 
1.73 
0.30 
0.32 
Yellow; Clear. 
1018 
Acid. 
1190 j 14.23 
0.90 0.31 
Yellow; Clear. 
1019 Acid. 
825 13.94 
1.54 
Yellow; Clear. 
1018 
Acid. 
1020 12.37 
1.15 0.30 
Yellow; Clear. 
1020 
Acid. 
930 
17.43 
1.31 0.28 
Yellow; Clear. 
1022 
Acid. 
975 13.91 
1.42 0.31 
Yellow; Clear. 
1016 
Acid. 
1190 
18.12 
1.86 0.31 
Yellow; Clear. 
1021 
Acid. 
1350 21.23 
1.67 
0.32 
Yellow; Clear. 
1018 
Acid. 
1075 
15.30 
1.46 
0.33 
Yellow; Clear. 
1023 
Acid. 
1010 | 21.01 j 2.08 
0.33 
TOTAL, 
10182 
9664 
159.57 
14.99 
3.14 
TOTAL, 
10182 
11480 
159.96 
14.88 
3.11 
From 6 P. M. to 6 A. M. 
TABLE I. — Man in Health. 
From 6 A. M. to 6 P. M.  
GRAMMES. 
GRAMMES. 
Color; Deposit, etc. 
Spec. 
Grav- 
ity. 
Re- 
action. 
Quan- 
tity in 
C. C. 
Urea. 
Phosphoric 
Acid in 
Aik. Phos. 
Phosphoric 
Acid in 
Earthy Ph. 
Color; Deposit, etc. 
Spec. 
Grav- 
ity. 
Re- 
action. 
Quan- 
tity in 
C. C. 
Urea. 
Phosphoric 
Acid in 
Aik. Phos. 
Phosphoric 
Acid in 
Earthy Ph. 
Light Yellow; a little 
Cloudy from Urate of 
Soda. 
1014 
Acid. 
600 
9.30 
0.99 
0.31 
Yellow; Clear. 
1026 
Acid. 
555 18.04 
1.17 
0.33 
Yellow; Clear. 
1020 
Acid. 
900 
18.81 
1.49 
0.32 
Yellow; Clear. 
1019 
Acid. 
515 | 10.96 
0.76 
0.32 
Yellow; Clear. 
1026 
Acid. 
635 
15.03 
1.24 
0.33 
Yellow; Clear. 
1023 
Acid. 
850 20.02 
1.19 
0.34 
Yellow; Clear. 
1021 
Acid. 
620 
17.83 0.97 
0.33 
Yellow; Clear. 
1018 
Acid. 
945 20.43 
1.70 1 0.34 
1 
Yellow; Clear. 
1015 
Acid, j 690 
11.45 0.81 
0.32 
Yellow; Clear. 
1021 
Acid. 
650 16.94 
0.71 
0.31 
Yellow; Clear. 
1024 
Acid. 
900 
25.31 1.62 
0.33 
Yellow; Clear. 
1019 
Acid. 
815 16.43 
1.83 
0.33 
Yellow; Clear. 
1021 
Acid. 
950 
19.29 0.75 
0.31 
Yellow; Clear. 
1018 
Acid. 
530 13.68 
0.80 
0.32 
Yellow; Clear. 
1023 
Acid. 
750 
18.91 1.16 
0.33 
Yellow; Clear. 
1022 
Acid. 
690 17.19 
0.73 
0.31 
Yellow; Clear. 
1022 
Acid. 
800 
20.09 
0.80 
0.33 
Yellow; Clear. 
1019 
Acid. 
940 19.94 
0.78 
0.31 
Yellow; Clear. 
1020 
Acid. 
860 
18.11 
0.89 
0.33 
Yellow; Clear. 
1021 
Acid. 
635 18.95 
0.78 
0.33 
TOTAL, 
10206 
7705 
173.03 
10.82 
3.24 
TOTAL, 
10204 
7125 
172.89 
10.45 
3.24 
From 6 P. M. to 6 A. M. 
TABLE II.—Woman in Health. 
From 6 A. M. to 6 P. M. 7 
►■d 
Pale 
Pi 
Pale 
Cl 
Ui 
hj 
Pale Yellow; 
Depoait of tli 
B®, 
O 
vq 
O 
ft 
Hi 
ft 
O 
3 
! Yellow; 
iposit of Ui 
! Yellow ; 
>udy; Dei 
•atea. 
ft 
Hi 
ft 
o 
35 
p 
ft 
ft 
© 
3$ 
ft 
Hi 
ft 
© 
ow; Cloudy; White 
jpoait of Uratea. 
.oat Colorless; a lit- 
! Cloudy; small De- 
sit of Urates. 
ill 
© 2.-- 
5'“* c 
i d© 
■O 2 ST 
O 
*1 
0 
ft 
*© 
© 
> 
Q 
CD 
P 
Cloudy; 
•ates. 
a little 
Kisit of 
2 
ft 
p 
2 
ft 
P 
o 
» 
p 
Cloudy; 
•atea. 
1; White 
ites and 
rntes. 
ft 
ft 
© 
g 
g 
g 
g 
© 
2 
g s 
g 
O GO 
H| *© 
© 
co 
* 
lO 
w> 
O 
* j 05 
• ft 
Neutral. 
Neutral. 
W 
►«= 
Eg 
J Neutral. 
GO 
aS 
CT 
K 
>s 
it 
vr 
Acid. 
g £ 
g ; 5? 
a ' S' 
p » 
Alka- 
line. 
Re- 
action. 
5362 
575 
£ 
o. 
s 
K 
H 
515 
515 
327 
-i i -i 
g | g? 
280 
Quan- 
tity in 
C. C. 
8 
os 
or 
CS 
a 
« 
© • © 
d 
8 1 
£ 
22 
22 
s 
5 
£3 
2 1 3 
g 
ft 
c 
1.86 
0.21 
0.03 
H’0 
HO 
0.17 
0.09 
0.08 
© j © 
5s I 3 
0.11 
Phosphoric 
Acid in 
Aik. Phos. 
i\ 
1 
2.38 
o 
** 
0.20 
0.29 j 
o 
8 
o 
is 
0.21 
© 
to 
© j © 
8 1 i* 
0.23 
Phosphoric 
Acid in 
Earthy Ph. 
CO 
© 
** 
Kj 
ft 
£ 
io* 
P 
Hi 
ft 
!l 
Kj : 
£ 1 is* 
K* 
ft 
o 
c 
© 
O 
g 
1 
O' 
O 
3 
o 
O 
35 
o 
ft 
o 
3 
35 
O 
c j 
- 
o : C** 
o 
aj 
O 
ft 
o 
ft 
ft 
ft 
P 
o 
ft 
s 
ft 0 
o 30 
H ft “ 
* i * ? 
ft 
P 
j ft 
71 
*-< 
s 
<< 
ft 
j © 
§ 
1019 
1020 
1023 
© 
1018 
1 
6 
i | i 
1017 
Spec. 
Grav- 
ity. 
V 
a 
>* 
ft 
K- 
ft 
> 
ft 
► 
ft 
> 
CO 
£ £1 
CO 
ft* 
ft M 
p- 
P 
P 
P 
P 
p 
P 
s pa 
* j 
vr 
3 ‘ 
§ 
186 
« 
© 
312 
ft 
8 
to 
313 
£ g 
500 
Quan- 
tity in 
C. C. 
a 
to 
CO 
CS 
O' 
V\ 
CO 00 
8 
a 
§ 
co 
8 
& 
s 
8 
Ss • So 
£ 
ft 
P 
a 
_ | 
8.06 
0.31 
0.67 
88 
0.36 
060 
0.67 
0.52 
8 | S5 
0.52 
Phosphoric 
Acid in 
Aik. Phos. 
v! 
El 
gl 
3.85 
0.20 
oeo 
0.79 
610 
0.20 
0.23 
0.23 
o 1 o 
8 £ 
l 
0.28 
Phosphoric 
Acid in 
Earthy Ph. 
CO 
1 
From 6 P. M. to 6 A. M. 
TABLE III.—Woman (L. L. S.) 
From 6 A. M. to 6 P. M. 8 
GRAMMES. 
GRAMMES. 
Color; Deposit, etc. 
Spec. 
Grav- 
ity. 
Re- 
action. 
Quan- 
tity in 
C. C. 
Urea. 
go* 
ja-f3 
P.-0&H 
Phosphoric 
Acid in 
Earthy Ph. 
Color; Deposit, etc. 
Spec. 
Grav- 
ity. 
Re- 
action. 
Quan- 
tity in 
C. C. 
Urea. 
Phosphoric 
Acid in 
Aik. Phos. 
Phosphoric 
Acid in 
Earthy Ph. 
Dark Yellow; Clear. 
1033 
Acid. 
290 
6.53 
0.59 
0.30 
Dark Yellow; Clear. 
1035 
Acid. 304 
10.89 
0.83 
0.39 
Dark Yellow; Clear. 
1025 
Acid. 
235 
6.75 
0.54 
0.26 
Yellow; Turbid; White 
Deposit of Urates and 
Phosphates. 
Dark Yellow; Turbid; 
White Deposit of 
Urates and Phosphates. 
Dark Yellow; a little 
Cloudy; Deposit o f 
Usates. 
1030 
Slightly 1 
Alka- 280 
line. 1 
6.64 
0.65 
0.30 
Dark Yellow; a Little 1 
Cloudy; Deposit of 1029 
Urates. 
Acid. 
200 
6.03 
0.22 1 0.26 
1 
1027 
Slightly 1 
Alka- 194 
line. | 
7.06 
0.58 
0.26 
Yellow; Cloudy; White 
Deposits of Urates and 
Triple Phosphates. 
1025 
Slightly 
Alka- 
line. 
398 
5.91 
0.24 
0.27 
1030 
Acid, j 200 | 6.54 
0.57 
0.25 
Yellow; Cloudy; Depos- 
it of Urates and Phos- 
phates. 
1021 
Slightly 
Alka- 
line. 
368 
5.30 
0.14 
0.26 
Pale Yellow; Clear. 
1005 
Neutral. 865 
4.46 
0.56 
0.24 
Yellow; Clear. 
1022 
Acid. 
375 
4.84 
0.27 
0.27 
lYellow; Clear. 
1009 
Acid. 
728 
5.87 
0.42 
0.26 
Dark Yellow; a Little 
Cloudy; Deposit of 
Urates. 
1029 
Acid. 
235 
5.91 
0.43 
0.26 
Yellow; a little Cloudy; 
Deposit of Urates. 
1024 
Acid. 390 
7.09 
0.63 
0.24 
Yellow; Clear. 
1023 
Acid. 
368 
8.12 
0.33 
0.23 
Yellow; Clear. 
1026 
Acid. 325 
8.78 
0.71 
0.23 
Yellow; very little 
Cloudy; Deposit of 
Mucus and Urates. 
1023 
Acid. 
318 
8.01 
0.47 
0.23 
Yellow; Clear. 
1023 
Acid. 560 
10.64 
0.74 
0.24 
Dark Yellow; Clear. 
1026 
Acid. 
288 
8.47 
0.37 
0.29 
Yellow; Clear. 
1024 
Acid. 320 
7.70 
0.73 
0.26 
TOTAL, 
10256 
3078 
65.87 
3.60 
2.63 
TOTAL, 
10233 
4166 
75.67 
6.42 
2.66 
From 6 P. M. to 6 A. M. 
TABLE IV. — Man (J. T.) 
From 6 A. M. to 6 P. M. 9 
GRAMMES. 
GRAMMES. 
Color; Deposit, etc. 
Spec. 
Grav- 
ity. 
Re- 
action. 
Quan- 
tity in 
C. C. 
Urea. 
Phosphoric 
Acid in 
Aik. Phos. 
Phosphoric 
Acid in 
Earthy l'h. 
Color; Deposit, etc. 
Spec. 
Grav- 
ity. 
Re- 
action. 
Quan- 
tity in 
C. C. 
Urea. 
Phosphoric 
Acid in 
Aik. Phos. 
1 Phosphoric 
Acid in 
Earthy Ph. 
Light Yellow; Clear. 
1029 
Acid. 
125 
3.98 
0.39 
0.20 
Yellow; Clear. 
1028 
Acid. 
205 
10.23 
0.89 
0.26 
Yellow; Clear. 
1028 
Acid. 
250 
7.73 
0.52 
0.23 
Yellow; Clear. 
1023 
Acid. 
312 
9.23 
1.05 
0.24 
Yellow; Clear. 
1023 
Acid. 
187 
4.27 
0.72 
0.20 
Yellow; Clear. 
1010 
Acid. 
562 
8.22 
1.53 
0.23 
Light Yellow; Clear. 
1021 
Acid. 
437 
9.17 
0.00 
0.22 | 
Yellow; Clear. 
1023 
Acid. 
281 
8.74 
0.73 
0.20 
Lark Y^ellow; Clear. 
1025 
Acid. 
172 
4.22 
0.08 
0.24 
Yellow ; Clear. 
1015 
Acid. 
319 
7.89 
0.81 
0.20 
Yellow; Clear. 
1023 
Acid. 
250 
5.18 
0.12 
0.24 i 
Yellow; Clear. 
1030 
Acid. 
375 
13.90 
1.05 
0.20 
Lark Yellow; Clear. 
1034 
Acid. 
125 
4.30 
0.12 
0.04 
Yellow; Clear. 
1011 
Acid. 
311 
6.18 
0.54 
0.24 
Lark Yellow; Clear. 
1031 
Acid. 
156 
4.70 
0.19 
0.14 
Light Yellow; Clear. 
1018 
Acid. 
400 
8.97 
1.03 
0.20 
Yellow; Clear. 
1028 
Acid. 
203 
5.24 
0.28 
0.20 * 
Yellow; Clear. 
1030 
Acid. 
421 
16.53 
1.51 
0.20 
Yellow; Clear. 
1028 
Acid. 
188 
4.15 
0.11 
0.20 
Yellow; Clear. 
1029 
Acid. 
485 
14.20 
1.12 
0.22 
TOTAL, 
10270 
2003 
52.94 
3.13 
2.03 I 
TOTAL, 
10223 
3768 
101.15 
10.29 
2.31 
TABLE V. — Woman (C. S.) 
Prom 6 A. M. to G P. M. . From 6 P. M. to 6 A. M. 10 
GRAMMES. 
- GRAMMES. 
Color; Deposit, etc. 
Spec. 
Grav- 
ity. 
Re- 
action. 
Quan- 
tity in 
C. C. 
Urea. 
Phosphoric 
Acid in 
Aik. Phos. 
Phosphoric 
Acid in 
Earthy Ph. 
Color; Deposit, etc. 
Spec. 
Grav- 
ity. 
Re- 
action. 
Quan- 
tity in 
C. C. 
Urea. 
I Phosphoric 
Acid in 
Aik. Phos. 
Phosphoric 
Acid in 
Earthy Ph. 
Dark Yellow; Clear. 
1015 
Acid. 
460 
6.11 
0.26 
0.21 
Dark Yellow ; Cloudy; 
Deposit of Urat es,Phos- 
phates and Sperma. 
1021 
Slightly 
Acid. 
470 
17.03 
1.31 
0.24 
Dark Yellow; Clear. 
1026 
Acid. 
100 
4.20 
0.03 
0.20 
Dark Yellow; Clear. 
1021 
Acid. 
780 
23.95 
1.64 
0.23 
Dark Yellow; a little 
Cloudy; Deposit of 
Urates. 
1023 
Acid. 
375 
13.09 
0.57 
0.20 
Yellow; Clear. 
1017 
Slightly 
Acid. 
561 
12.91 
0.95 
0.23 
Yellow; Clear. 
1014 
Acid. 
500 
8.22 
0.17 
0.22 
Yellow: Cloudy; De- 
posit of Urates, Phos- 
phates and Sperma. 
1016 
Slightly 
Acid. 
1030 
19.84 
1.43 
0.22 
Yellow; Cloudy; De- 
posit of Urates and 
Phosphates. 
1020 
Alka- 
line. 
720 
10.08 
0.54 
0.21 ; 
Yellow; Cloudy; De- 
posit of Urates, Phos- 
phates and Sperma. 
1010 
Slightly 
Alka- 
line. 
530 
8.16 
0.50 
0.20 
Yellow; Cloudy; De- 
posit of Urates and 
Phosphates. 
1016 
Slightly 
Alka- 
line. 
470 
7.29 
0.28 
0.23 
The Same. 
1012 
Acid. 
970 
16.78 
1.15 
0.21 
Yellow; Clear. 
1020 
Acid. 
810 
17.78 
1.15 
0.23 
The Same. 
1009 
Alka- 
line. 
875 
10.06 
0.70 
0.23 
Yellow; Clear. 
1013 
Acid. 
470 
8.24 
0.28 
0.24 
The Same. 
1010 
Alka- 
line. 
1155 
17.40 
1.37 
0.20 
Yellow; Clear. 
1012 
Acid. 
545 
11.31 
0.41 
0.22 
The Same. 
1010 
Alka- 
line. 
875 
12.16 
0.46 
0.24 
Yellow; Clear. 
1022 
Acid. 
125 
2.46 
* 
0.09 
0.21 
The Same. 
1009 
Alka- 
line. 
1280 
16.64 
1.28 
0.26 
TOTAL, 
10181 
4575 
88.78 
3.78 
2.17 
TOTAL, 
10135 
8526 
154.93 
10.79 
2.26 
From 6 P. M. to 6 A. M. 
TABLE YI.-Man (C. G.) 
From 6 A. M. to 6 P. M.  
GRAMMES. 
GRAMMES. 
Color; Deposit, etc. 
Spec. 
Grav- 
ity. 
Re- 
action. 
Quan- 
tity in 
C. C. 
Urea. 
Phosphoric 
Acid in 
Aik. Phos. 
Phosphoric 
Acid in 
Earthy Ph. 
Color; Deposit, etc. 
Spec. 
Grav- 
ity. 
Re- 
action. 
Quan- 
tity in 
C. C. 
Urea. 
f „| 
psj 
Phosphoric 
Acid in 
Earthy Ph. 
Dark Yellow; Clear. 
1030 
Acid. 
201 
5.89 
0.24 
0.25 
Dark Yellow; a little 
Cloudy; Deposit of 
Urates. 
1026 
Acid. 
576 
12.08 
1.23 
0.26 
Dark Yellow; Cloudy; 
Deposit of Urates. 
1036 
Acid. 
180 
3.91 
0.03 
0.20 
The Same. 
1030 
Acid. 
204 
6.45 
0.38 
0.24 
The Same. 
1026 
Acid. 
250 
6.25 
0.40 
0.15 
The Same. 
1029 
Acid. 
235 
5.99 
0.36 
0.26 
Light Yellow; Deposit 
of Urates. 
1016 
Acid. 
455 
8.24 
0.44 
0.13 
Yellow; Deposit of 
Urates. 
1027 
Acid. 
250 
6.86 
0.44 
0.26 
Yellow; Deposit of 
Urates. 
1020 
Acid. 
500 
10.06 
1.14 
0.13 
Yellow; Cloudy; De- 
posit of Urates. 
1020 
Acid. 
453 
6.33 
0.20 
0.21 
Pale Yellow; Clear. 
1003 
Acid. 
312 
3.36 
0.01 
0.13 
The Same. 
1014 
Acid. 
435 
8.50 
0.21 
0.22 
Light Yellow ; a little 
Cloudy; Deposit of 
Urates. 
1008 
Acid. 
515 
6.59 
0.41 
0.15 
Dark Yellow; Deposit 
of Urates. 
1024 
Acid. 
200 
4.48 
0.36 
0.23 
Yellow; Deposit of 
Urates. 
1014 
Acid. 
640 
13.12 
1.04 
0.20 
Yellow; Deposit of 
Urates. 
1023 
Acid. 
265 
7.70 
0.26 
0.22 
•Pale Yellow; Clear. 
1002 
Acid. 
560 
4.76 
0.06 
0.14 
Pale Yellow; Clear. 
1010 
Acid. 
266 
3.92 
0.07 
0.26 
Yellow; Clear. 
1008 
Acid. 
530 
5.23 
0.49 
0.15 
Yellow; Clear. 
1023 
Acid. 
250 
4.79 
0.24 
0.28 
TOTAL, 
10153 
4143 
67.41 
4.26 
1.03 
TOTAL, 
10226 
3134 
67.10 
3.75 
2.44 
From 6 P. M. to G A. M. 
k-H 
fc 
•<) 
o 
£ 
I 
Kh 
HH 
!> 
H 
hP 
P5 
< 
H 
From 6 A. M. to 6 P. M.  
GRAMMES. 
GRAMMES. 
Color; Deposit, etc. 
Spec. 
Grav- 
ity. 
Re- 
action. 
Quan- 
tity in 
C. C. 
Urea. 
Phosphoric 
Acid in 
Aik. Phos. 
Phosphoric 
Acid in 
Earthy Ph. 
1 Color; Deposit, etc. 
Spec. 
Grav- 
ity. 
Re- 
action. 
Quan- 
tity in 
C. C. 
Urea. 
Phosphoric 
Acid in 
Alk. Phos. 
.2 a 
c.£k 
fi'iZ >> 
S w 
Yellow; Clear. 
1025 
Acid. 
625 j 20.85 
1.30 
0.30 
1 Pale Yellow; Clear. 
1009 1 8]teht]y 
iuuy Acid. 
938 
11.19 
0.51 
0.28 
Yellow; Cloudy; De- 
posit of Urate of So- 
da Phosphates. 
1017 
Acid. 
688 16.58 
1.06 
0.29 
Pale Yellow; a little De- 
posit of Phosphate 
Calcium. 
mo 
937 
1 
11.29 j 0.53 
0.36 
Yellow; Turbid; De- 
posit of Triple Phos- 
phates. 
1009 
Neutral. 
843 10.25 
1.62 
0.32 
T u r b i d; Deposit o f 
Triple Phosphates. 
1024 | Alk Hne. 
842 
16.92 
1.22 
0.33 
The Same. 
1018 
Alka- 
line. 
1156 15.17 
1.22 
0.31 
0.30 
The Same. 
1015 jAlkhne. 
625 
8.13 
0.74 
0.31 
The Same. 
1026 
Alkhne.| 562 | W-48 
2.00 
The Same. 
1024 |Alkhne. 
375 
9.67 
0.38 
0.29 
The Same. 
inoo Alka- 
line. 
781 
18.67 
17.21 
1.91 j 0.28 
The Same. 
1022 |A,kHne. 
500 
12.90 
0.55 
0.30 
The Same. 
1024 Alka- 
line. 
625 
1.74 
0.30 
The Same. 
1024 Alk hue. 
280 
9.94 
, 0.55 
0.29 
Yellow; a little Cloudy; 
Deposit of Urates and 
Phosphates. 
1029 1 S'teM'y j 400 1 13.58 
0.92 
0.28 
The same as from 6 A. 
m. to 6 P. M. 
1026 
Alka- 
line. 
250 
8.77 
0.29 
0.26 
The Same. 
im i Slightly 
1,7/4 Acid. 
375 9.98 
0.51 
0.27 
The Same. 
1029 
Slightly 
Acid. 
406 
14.11 
0.90 
0.28 
Pale Yellow; Clear. 
1011 Acid. 
625 j 6.88 
0.20 
0.30 
Yellow; Clear. 
1021 
Acid. 
1033 
23.55 
1.77 
0.32 
TOT AD, 
10206 
6686 
146.65 
12.48 
2.95 
TOTAL, 
10203 
6186 
126.47 
7.44 
3.02 
From 6 P. M. to 6 A. M. 
TABLE VIII.—Man (C. II.) 
From 6 A. M. to 6 P. M.  
GRAMMES. 
GRAMMES. 
Color; Deposit, etc. 
Spec. 
Grav- 
ity. 
Re- 
action. 
Quan- 
tity in 
C. C. 
Urea. 
Phosphoric 
Acid in 
Aik. Phos. 
Phosphoric 
Acid in 
! Earthy Ph. 
Color; Deposit, etc. 
Spec. 
Grav- 
ity. 
Re- 
action. 
Quan- 
tity in 
C. C. 
Urea. 
o 
IflJ 
g-s j 
Phosphoric 
Acid in 
Earthy Ph. 
Yellow; a little Cloudy; 
Deposit of Urate of 
Soda. 
1025 
Acid. 
312 
5.15 
0.34 0.31 
The same as from 6 A. 
M. to 6 P. M. 
1022 Acid. 532 7.26 
0.69 
0.30 
Dark Yellow; Turbid; 
Deposit of Urate of 
Soda. 
1028 
Acid. 
315 
15.60 
0.75 0.30 
Yellow; Clear. 
1028 Acid. 470 18.10 
1.29 
0.31 
Light Yellow; Clear, j 1015 
Acid. 
343 
7.31 
1.23 1 0.30 
1 
Pale Yellow; Clear. 
1010 Acid. 470 6.89 
0.51 0.29 
Straw Yellow; Clear. 
1020 
Acid. 
406 
9.48 
0.60 0.29 
Yellow; Clear. 
1016 Acid. 500 12.32 
0.85 0.29 
Dark Yellow; Clear. 
1028 
Acid. 
281 
8.77 
0.60 0.30 
Yellow; Clear. 
1026 Acid. 375 13.85 
0.90 0.28 
Yellow; a little Cloudy; 
Deposit of Urate of 
Soda. 
1028 
Acid. 
250 
7.18 
0.44 0.28 
0.63 0.29 
I Light Yellow; Clear. 
1010 Acid. 500 7.55 
0.48 0.30 
Yellow; Turbid; De- 
posit of Urate of Soda. 
1030 
Acid. 
250 
8.20 
Yellow; a little Cloudy; 
Deposit of Urate of 
i Soda. 
1036 j Acid. | 312 | 12.14 j 0.93 | 0.31 
Yellow; a little Cloudy; 
Deposit of Urate of 
Soda 
1032 
Acid. 
375 
10.65 
0.71 0.30 
The Same. 
1029 Acid. 531 16.62 
1.76 0.31 
Pale Yellow; Clear. 
1009 
Acid. 
406 
4.59 
0.02 0.29 
Pale Yellow; Clear. 
1007 Acid. 500 3.90 
0.12 0.29 
Yellow; Clear. 
1015 
Acid. 
500 
5.59 
0.26 
0.28 
Yellow; Clear. 
1008 Acid. 625 6.05 
0.33 0.30 
TOTAL, 
10230 
3438 
82.52 
5.58 
2.94 
TOTAL, 
10192 
4815 
104.68 
7.86 
2.98 
From 6 P. M. to 6 A. M. 
TABLE IX. —Woman (M. Me.) 
From 6 A. M. to 6 P. M.  
GRAMMES. 
GRAMMES. 
Color j Deposit, etc. 
Spec. 
Grav- 
ity. 
Re- 
action. 
Quan- 
tity in 
C. C. 
Urea. 
Phosphoric 
Acid in 
Aik. Phos. 
Phosphoric 
Acid in 
Earthy Ph. 
Color; Deposit, etc. 
Spec. 
Grav- 
ity. 
Re- 
action. 
Quan- 
tity in 
C. C. 
Urea. 
Phosphoric 
Acid in 
Aik. Phos. 
Phosphoric 
Acid in 
Earthy Ph. 
Pale Yellow; Clear. 
1011 
Acid. 
1250 
17.21 
1.05 
0.20 
Yellow; Clear. 
1002 
Acid. 1940 
17.94 
1.27 
0.22 
Could not be Obtained. 
Pale Yellow; Clear. 
1003 
Acid. 1780 
17.80 
1.21 
0.21 
Could not be Obtained. 
Pale Yellow; Clear. 
1004 
Acid. 1375 
16.95 
1.25 
0.23 
Pale Yellow; Clear. 
1012 
Acid. 
812 
11.97 
0.63 
0.22 
Pale Yellow; Clear. 
1004 
Acid. 1906 
19.44 
1.65 
0.20 
Could not be Obtained. 
Pale Yellow; Clear. 
1003 
Acid. 1875 
15.84 
1.27 
0.23 
Pale Yellow; Clear. 
1009 
Acid. 
1375 
22.96 
1.04 
0.21 
Pale Yellow; Clear. 
1008 
Acid. 1875 
22.38 
1.58 
0.22 
Pale Yellow; Clear. 
1009 
Acid. 
2000 
26.00 
1.52 
0.24 
Pale Yellow; Clear. 
1008 
Acid. 2000 
27.80 
1.85 
0.23 
Could not be Obtained. 
Pale Yellow; Clear. 
1010 
Acid. 1375 
22.00 
1.52 
0.24 
Could not be Obtained. 
Pale Yellow; Clear. 
1007 
Acid. 
2375 
30.64 
2.35 
0.26 
Pale Yellow; Clear. 
1013 
Acid. 
1275 
20.94 
1.28 
0.21 
Pale Yellow; Clear. 
1009 
Acid. 
1265 
19.10 
1.34 
0.24 
Total in 5 days, 
10054 
6712 
99.08 
5.52 
1.08 
TOTAL, 
10048 
17726 
203.89 
15.29 
228. 
From 6 P. M. to 6 A. M. 
TABLE X.—Man (W. M.) 
From 6 A, M. to 6 P. M. 15 
The examinations, as the tables show, have been car- 
ried out so that in each case the urine which was passed 
during the twelve hours of the dav was collected, 
measured and analyzed separately from that passed 
during the twelve hours of the night. In the first there 
was, therefore, included the quantity passed imme- 
diately after the day’s work and exercise; in the latter, 
the morning urine after night’s rest. 
o o 
The estimations were made by the volumetric method, 
and in every case an equal volume of the urine was 
subjected to an analysis, while the same measuring 
tubes were employed. The relations the figures bear 
to each other are therefore correct, even if there should 
be an error in the absolute quantity which they repre- 
sent. The latter may, however, hardly be expected, 
since the liquids used were prepared by myself, and 
their strength, estimated by adding a known quantity 
of pure urea and of pure phosphate of soda to a certain 
amount of urine, and by determining the quantity of 
each present in the urine, before and after the addition. 
The figures, of course, give the whole amount of the 
urea and the phosphoric acid excreted. 
In the first two tables I present for comparison the 
results of the examination of the urine of two persons, 
in health, during the time of ten days. Table I. is that 
from a man about forty years of age, of regular habits 
of life, and who had, during the day, a fair amount of 
physical exercise, while the night hours, from eight to 
twelve o’clock, were occupied by mental labor; sleep 
amounted to from five and a half to six hours. The 
woman was about twenty-five years of age, mother of 
two children, of which the one was still on the breast. 
She was doing common housework during the day, and 
spent some evening hours in reading, etc. She was in 
the habit of retiring early, between nine and ten o’clock 16 
p. m. ; sleep amounted, in the average, to from eight to 
nine hours. 
If we subject the first table to a closer examination, 
comparing the single data, we find that there is a con- 
siderable fluctuation in the whole daily amount of urea 
excreted from a minimum of 24.07 grammes, during the 
twenty-four hours of the fourth day, to the maximum 
of 39.35 grammes on the ninth day, making a difference 
of 15.28 grammes. The amount of phosphoric acid 
excreted during the same period varied from 3.28 
grammes to 4.20 grammes, making a difference of 0.92 
grammes. If we, however, take the arithmetical mean 
of the whole amount of urea and phosphoric acid, 
excreted in the ten days, equal to 319.53 grammes of 
the former, and 36.22 grammes of the latter, we have 
31.95 grammes of urea, and 3.62 grammes of phosphoric 
acid, excreted per diem, figures very closely, reaching 
the normal average above stated. 
If we compare the quantities of urea and phos- 
phoric acid excreted during the hours from 6 a. m. to 
6 p. m., with those excreted from 6 p. m. to 6 a. m., we 
find that the highest difference amounts to 4.46 
grammes in the former, and 0.53 grammes in the latter. 
Yet the most interesting fact is the close correspondence 
of the total amounts excreted; of urea, 159.57 grammes, 
from 6 a. m. to 6 p. m., and 159.96 grammes from 6 p. m. 
to 6 a. m.; of phosphoric acid, 18.23 grammes from 
6 a. m. to 6 p. m., and 17.99 grammes from 6 p. m. to 6 
a. m. Moreover, the sums of specific gravities, 10182, 
are exactly the same up to the last figure, while in the 
total quantity of urine, 9664 c. c. and 11480 c. c., there 
is a plus of 1876 c. c. on the side of the amount excreted 
during the night. 
If we look over the second table, we will first notice 
the same correspondence between the total quantities 17 
of urea and phosphoric acid excreted during the hours 
of the day, and those excreted during the nights, of 
urea, 173.03 grammes from 6 a. m. to 6 p. m., and 
172.89 grammes from 6 p. m. to 6 a. m. ; of phos- 
phoric acid, 13.96 grammes from 6 a. m. to 6 p. m., 
and 13,71 grammes from 6 p. m. to 6 a. m. There 
is only a slight difference between the sums of the 
specific gravities, 10206 to 10204, while the total quan- 
tities of the urine, 7705 c. c., and 7125 c. c., show a 
plus of 580 c. c. on the side of the amount excreted 
during the day. The difference between the minimum, 
27.34 grammes, and the maximum, 41.74 grammes, of 
the total daily excretion of urea, making 14.40 grammes, 
corresponds with that of the foregoing table, 15.28 
grammes; while the sum of the whole amount of the 
ten days, 345.92 grammes, gives a daily average of 
34.59 grammes, against the 31.95 grammes of table I. 
This slight increase, hardly worthy of notice, is prob- 
ably due to the differences in the age of the two per- 
sons, since the quality of the food partaken, was the 
same during the time when the examinations were 
made. The daily fluctuations in the whole amount of 
phosphoric acid, in table II, are higher than in table I, 
from 2.17 grammes to 4.11 grammes, yet inside of the 
limits of the normal average. The total amount, how- 
ever, of the ten days, 27.67 grammes, against 36.22 
grammes in table I, making a difference of 8.55 
grammes, or 0.855 per diem, is a fact to which I call 
attention for the reason that I have made a great 
number of series of comparative analyses of the urine of 
healthy men and women, with the same result, viz.: that 
there was in all cases a considerable falling off in the 
amount of phosphoric acid in the urine of the latter, 
due invariably to the presence of a smaller quantity of 
the alkaline phosphates, while the amount of the 18 
earthy phosphates was generally of a remarkable 
uniformity. 
Regarding finally the proportion of the amount of 
urea and of phosphoric acid excreted in the urine of 
healthy persons, it is evident that no certain relation 
between the two substances exists, since the figures of 
the table show that, as well in the daily amount of 
urea and phosphoric acid excreted, as in the total of a 
series of days the minimum amount of the former may 
be co-existent with the maximum of the latter, and 
vice versa. 
From the facts presented in tables I and II, I draw 
the following general conclusions regarding the elimina- 
tion of urea and phosphoric acid in a state of health. 
1. The processes of waste and repair in the human 
system, which are represented quantitatively by the 
amount of urea and phosphoric acid eliminated through 
the kidneys are going on continuously and, generally, 
with a remarkable uniformity. 
2. The temporary fluctuations in their energy are 
balanced by periodic equalizations. 
3. The processes are quantitatively the same during 
the twelve hours of the day as during the twelve hours 
of the night. 
4. The rise and fall in the amount of urea excreted 
is independent of the physical and mental occupation of 
the individual. 
5. The amount of phosphoric acid in the alkaline 
phosphates, eliminated by the kidneys, seems to stand in 
proportion to the change of matter in the nervous 
tissues of the body. 
We will now consider the data presented in tables 
III to X. 
The persons who furnished the urine for the analyses 
in these tables were in a general anaemic condition com- ERRATUM—Page 19, second line from the top, for physical 
read psychical. 19 
Lined, with the exception of the case given in table 
IX, with more or less physical disturbance. Yet dif- 
ferences are to be recorded in each case in regard to the 
etiology, the course and the prognosis of the affection. 
In the two cases represented by tables III and IV, 
there was a chronic general anaemia of a slow and 
gradual development. As to the mental state there 
was a likewise slowly developed sub-acute maniacal 
condition with a tendency to dementia. In the cases, 
tables V and VI, the anaemia was of a more acute origin; 
in the first, of the woman, connected with puerperal 
mania; in the second, of the man, connected with mel- 
ancholic excitement, originating from excesses in venere. 
The case, table VII was one of chronic general anaemia 
with dementia; the case, table VIII, one of acute 
anaemia from loss of blood by a suicidal attempt; case, 
table IX, one of chlorosis; and case, table X, one of 
secondary anaemia, combined with paresis. 
If we compare the tables we will first notice, with 
the exception of table VIII, acute anaemia, and table 
X, secondary anaemia with paresis, the remarkable fall- 
ing off of the amount of urea and phosphoric acid 
during the ten days of observation. The former reaches 
its lowest figure in table III, sub-acute mania with a 
tendency to dementia, 121.43 grammes in ten days; the 
latter in table VII, dementia, only 11.08 grammes in 
ten days, making a daily excretion of 12.14 grammes of 
urea and 1.108 grammes of phosphoric acid, or in each 
day 21.13 grammes of urea and 1.66 grammes of phos- 
phoric acid less than the normal average. The highest 
figure for both substances in the chlorotic patient, table 
IX, is 187.20 grammes of urea, and 19.36 grammes of 
phosphoric acid, which makes a daily falling off of 
14.55 grammes of the former and 0.84 grammes of the 
latter. In table VI, a case in which the patient, a mel- 20 
ancliolic, etc., regained his bodily strength and was dis- 
charged mentally improved, we find 243.71 grammes 
for urea and 19.00 grammes for phosphoric acid, or 
daily 8.90 grammes of the former and 1.9 grammes of 
the latter less than the normal average. 
In table VIII, the case of acute anaemia, the figures 
showT 273.12 grammes of urea and 25.79 grammes of 
phosphoric acid, excreted in ten days, or a daily falling 
off of only 5.96 grammes of the former and of 0.58 
grammes of the latter. As the anaemic condition in 
this case was consecutive upon a considerable loss of 
blood and not connected with primary general disturb- 
ances of nutrition, the comparatively high figures are 
quite in accordance with experiments made on animals, 
which have shown that the amount of change of matter 
in the animal body, is of course in certain limits, inde- 
pendent of the quantity of blood in circulation. In 
table X, the one half of which is incomplete, but which, 
when completed in the same rate, as recorded during 
five days of observation, would give in ten days 402.05 
grammes of urea and 31.77 grammes of phosporic acid, 
or a daily increase of urea of 6.93 grammes over the 
normal. This increase unquestionably indicates the 
wasting of tissues concomitant with the progressive 
pathological processes characteristic of the disease. 
The examination of the tables from the point of view 
of the relative amount of the substances in question ex- 
creted during the twelve hours of the day compared with 
that excreted during the twelve hours of the night, re- 
veals the following interesting facts: In tables III, IV 
and VII, we find in regard to the relative quantity of 
urea during the ten days of observation from 6 a. m. to 
6 p. m. and from 6 p. m. to 6 a. m. the same correspond- 
ence as in table I and II of the healthy persons, 
although the whole amount remained much below one 21 
half of the normal. The figures 60.20 grammes and 
61.23 grammes of urea in table III, and 67.41 grammes 
and 67.10 grammes of urea in table VII, correspond 
exactly. In table IV the 65.87 grammes of urea during 
the day and the 75.67 grammes during the night give a 
difference of 9.8 grammes or of 0.98 grammes daily, 
which can be considered as unimportant. 
In regard, however, to the amount of phosphoric acid 
excreted during the same period we notice a remark- 
able difference. In table VII, case of dementia, the 
figures for the phosphoric acid from alkaline phosphates 
as well as from the earthy phosphates, although more 
than one-half below the normal, correspond exactly. In 
table IV, the quantity of the alkaline phosphates ex- 
creted during the hours of the night is about twice that 
excreted during the day; in table III the quantity of 
the former exceeds about five times that of the latter. 
In both cases, though far below the normal, this would 
indicate, as I believe, a favorable increase in the change 
of matter in the nervous tissues during rest, while in 
the foregoing case of dementia table VII, that change of 
matter seemed to have reached both during day and 
night an exceedingly low point. The theory advanced 
here, appears to be supported by facts arrived at in 
table V and VI. There we find a similar relation. The 
amounts of the earthy phosphates correspond almost 
exactly. Of the alkaline phosphates we find about 
three times the quantity excreted during the night as 
during the day. Yet in the latter two cases, we further- 
more notice the interesting fact, that in the first one, 
table V, the amount of urea excreted during the night also 
exceeds exactly twice the amount excreted during the 
day; while in the second case, table VI, the proportion 
between the two is not very far from being the same, 
viz: 52.94 grammes of urea during the day, against 22 
104.15 grammes during the night in the first case; and 
88.78 grammes of urea during the day against 154.93 
grammes during the night in the second case. Both 
cases were taking physically and mentally a favorable 
course, and it appears as if nature in both was making 
an effort to balance the disturbed and impeded change 
of matter during the day, by an increase of double its 
amount during rest. This view finds another affirma- 
tion in the facts revealed by table IX, the case of the 
chlorotic patient, where we again observe the similar 
increase of the amount both of urea and of phosphoric 
acid excreted during the hours of rest, viz: 82.52 
grammes of urea and 5.58 grammes of phosphoric acid 
from the alkaline phosphates during the day, against 
104.68 grammes of urea and 7.86 grammes of phosphoric 
acid during the night. 
In table VIII, tlie case of acute anaemia, a slight in- 
crease in the amount of urea, as well as of phosphoric 
acid, will be noticed on the side of the excretion during 
the day, of about 2 grammes of urea and 0.5 grammes 
of phosphoric acid per diem. This small difference, of 
course, would seem to be of not much weight, yet, when 
we look over the single data presented in the table, it 
becomes apparent that there existed great fluctuations 
in the amount, both of the urea and the phosphoric acid 
excreted. With the exception of the last two days, 
there is a remarkable increase in the change of matter 
during the day over that during the night. It may be 
remarked here, therefore, that the patient, during the 
time when the examinations were made, was exceedingly 
restless and excited during the night, so that it became 
finally necessary to administer at midnight a second 
dose of hydrate of chloral, the effect of which was at once 
noticed in the change of the excretion of urea, as well 
as of phosphoric acid, by the remarkable increase in their quantity during the night, viz: In the last two days, 
16.86 grammes of urea and 0.71 of phosphoric acid, from 
the alkaline phosphates, during the day-time, against 
37.66 grammes of urea, and 2.67 grammes of phosphoric 
acid during the nights. This fact again appears to af- 
firm the statement alluded to in the foregoing, that the 
morbid mental excitation in melancholia as well as in 
mania does not augment, but impedes the general change 
of matter in the human system in cases connected with 
primary anaemia. 
This latter fact has, however, no reference to the ex- 
alted mental condition combined with paresis, as the 
last table X shows. Although imperfect as it is, it 
appears to reveal the interesting fact of a morbid in- 
crease of change of matter at the cost of the constituents 
of the body itself. 
Another point in the tables, to which I would call 
attention, is the high specific gravity of the urine in the 
majority of cases of chronic anaemia, a fact which does 
not quite correspond with the small amount of urea 
present. In some of the cases analyzed I found a very 
high percentage of chlorides, which may account for it, 
yet my observations on the amount of these, of the sul- 
phates and of iron, are not closed. The amount of uric 
acid excreted has been determined in each case ana- 
lyzed, but has been left out in the tables on account of 
its small amount on the one hand, and the great varia- 
tions in its quantity on the other, writhout any apparent 
relation to the quantity of the other constituents of the 
urine. 
The great uniformity in the amount of the phos- 
phoric acid belonging to the earthy phosphates, is well 
worth noticing, although it remained, with the excep- 
tion of the cases of acute mania, table VIII, and of 
chlorosis, table IX, much below the normal. There 24 
was also in five cases, tables III, IV, V, VI and VIII, a 
marked tendency to affections of the bladder, with 
alkaline fermentation of the urine, which, however, 
readily yielded to the administration of lactic acid. 
From the facts presented in the tables, we draw the 
following conclusions in regard to the general change 
of matter in anaemia, as far as its amount is indicated 
by the amount of urea and phosphoric acid eliminated 
through the kidneys: 
1. In primary chronic anaemia there is a remarkable 
decrease in the amount of urea and phosphoric acid in 
the urine, which indicates grave disturbances in the 
nutrition of the tissues, and a diminution of the general 
change of matter in the system. 
2. The diminution in the general change of matter 
reaches its lowest point in chronic anaemia with demen- 
tia, and next to this in cases connected with sub-acute 
mania, with a tendency to dementia. 
3. The condition of morbid mental excitement in 
primary chronic anaemia is co-existent with a decrease 
in the general change of matter, and seems, to a certain 
degree, to impede the processes of waste and repair. 
4. In cases of anaemia of a more acute character with 
a favorable physical and mental prognosis, there is a re- 
markable increase in the general change of matter 
during rest. 
5. In the case of acute anaemia the amount of the 
general change of matter was not affected by the con- 
siderable loss of blood. 
6. Secondary anaemia is combined with a morbid in- 
crease in the general change of matter at the cost of 
the tissues of the body. 
7. In regard to the treatment of anaemia the conclu- 
sions drawn from the tables would indicate the great 
therapeutical value of rest, bodily and mental. THE 
AMERICAN JOURNAL OF INSANITY. 
The American Journal of Insanity is published quarterly, at the 
State Lunatic Asylum, Utica, N. Y. The first number of each volume 
is issued in July. 
Editor, 
JOHN P. GRAY, M. 1)., LL. D., Medical Superintendent. 
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