Students Manual 
Urinary Analysis 
Mitchell STUDENTS’ MANUAL 
OP 
URINARY ANALYSIS 
CHEMICAL AND MICROSCOPICAL. 
COMPILED, TRANSLATED AND ABRIDGED FROM THE MOST RECENT 
FRENCH AUTHORITIES. 
EY 
CLIFFORD IVJJTCHELL, A. B.; M. D. 
Demonstrator of Chemistry, Chicago Homoeopathic College. 
WITH A PREFACE BY 
Professor of Surgery in the Chicago Horn o>»path ie College. 
CIIAS. ADAMS, M. D. 
CHICAGO: 
"MNSEN, McCLURG & CO. 
1879. COPYRIGHT. 
JANSE.V, McCLURG & CO. 
A. D. IS7B, PEEFACE. 
Hating carefully followed the work of Dr. Mitchell in 
arranging and condensing the matter contained in the fol- 
lowing pages, 1 feel sure that the student will find it of 
practical value in his laboratory work, and the busy physi- 
cian may be saved valuable time by its use. 
In it the practitioner will find the essentials for urinalysis, 
and be able to accomplish thereby what is often left undone 
for want of a systematic method in such available form as 
this. 
CHAS. ADAMS, M. D. The following authorities have been consulted in the 
compilation of this Manual : 
Bouchardat, 
Merit, 
Deleeosse, 
From the French. 
Beale, 
Harley, 
From the English. 
Flint, 
Roberts, 
From the American. 
C. M. 
Chicago, Oct., 1878. STUDENTS’ MANUAL 
OP 
URINARY ANALYSIS, 
CHEMICAL AND MICROSCOPICAL. 
PART I. 
CLINICAL EXAMINATION OF URINE. 
Examination.—Urine should be examined when four or 
five hours old. About 200 cubic centimeters* is the quanti- 
ty requisite for ordinary examination. 
Color— Normal urine has a yellowish, straw color. 
The urine in fevers is dark; in anaemic patients, pale. 
Odor.—Normal urine has an odor distinctively its own, 
called “urinous.” 
Saccharine urine has an alcoholic odor. In some diseases 
of the kidneys the urine is gangrenous in odor. 
Appearance.—Urine has not the same appearance when 
freshly voided as when cold. Hence, allow the liquid to 
stand a few hours before beginning the analysis. 
Note.—Urine of acid reaction, having a specific gravity of 1025 or 
thereabouts, becomes turbid on cooling. 
[*About 6 ounces.—Trans.] 6 
Students’ Manual of 
The substances causing turbidity in normal urine are 
composed of two layers: the upper, near the surface of the 
liquid, consisting of pure mucus; the lower, near the bot- 
tom, consisting of mucus and crystalline sediments. 
Deposits.—For the microscopical examination of deposits, 
an instrument magnifying 250 diameters is quite sufficient 
for ordinary purposes. To detect spermatozoa, an instru- 
ment magnifying 400 diameters is necessary. 
Reaction.—Normal urine colors blue litmus paper slightly 
red, i. e., is slightly acid in reaction. 
If blue paper is turned markedly red, the urine is decided- 
ly acid. 
If red litmus is turned blue, the urine is alkaline 
If urine changes the color of neither the red nor the blue 
paper, it is neutral. 
Variations in Reaction.—Normal urine after ahneal may 
be neutral or slightly alkaline. 
Determination of Constituents hy Reaction.—Alkaline urine 
turns red litmus paper blue. If this blue color on exposure 
to the air fades, and the paper again acquires its red color, 
the carbonate of ammonium is the alkaline constituent; if 
the paper retains its blue color, the carbonate or phosphate 
of sodium causes the alkalinity. 
Specific Gravity.—To determine the specific gravity of 
urine, procure an urinometer and a beaker. [The urinome- 
ters commonly sold in this country are graduated from zero 
to fifty ; zero representing the depth to which the instru- 
ment sinks in water—eighteen in healthy urine, thirty and 
upwards in saccharine urine. It is fashionable to denomi- 
nate these numbers 1000, 1018, 1080, after the French.] 
Pour the urine very gently into the beaker, avoiding the for- 
mation of any foam upon the surface. Dip the urinometer 
also gently into the fluid until it no longer sinks of its own 
accord. The number on the scale corresponding to the lev- 
el of the liquid represents the specific gravity of the urine. 
Thus, if the urinometer sinks to the number 20 on the scale, 
we call the specific gravity of the urine at 15° Cent-, 
(60° Fahr.), 1020. If the temperature be other than 
15° Centigrade, consult Bouchardat’s Table of Corrections: CENTIGRADE SCALE. 
NON-SACCHARINE URINE. 
SACCHARINE 
URINE. 
0° 
0.9 
15° 
0.0 
0° 
1.3 
15° 
0.0 
1 
0.9 
16 
0.1 
1 
1.3 
16 
0.2 
2 
0.9 
17 
0.2 
2 
1.3 
17 
0.4 
3 
0.9 
18 
0.3 
3 
1.8 
18 
0.6 
4 
0.9 
19 
0.5 
4 
1.3 
19 
0.8 
5 
0.9 
20 
0.9 
5 
1.3 
20 
1.0 
6 
0.8 
O 
21 
0.9 
6 
1.2 
O 
21 
1.2 
7 
0.8 
rP 
22 
1.1 
7 
1.1 
fH 
22 
1.4 
8 
0.7 
P 
<1 
23 
1.3 
8 
1.0 
rO 
P 
<1 
23 
1.6 
9 
0.6 
m 
24 
1.5 
9 
0.9 
U1 
24 
1.9 
10 
0.5 
26 
1.7 
10 
0.8 
25 
2.2 
11 
0.4 
26 
2.1 
11 
0.7 
26 
2.5 
12 
0.3 
27 
2.3 
12 
0.6 
27 
2.8 
13 
0.2 
28 
2.5 
18 
0.4 
28 
3.1 
14 
0.1 
29 
2.7 
14 
0.2 
29 
3.4 
15 
0.0 
30 
3.0 
15 
0.0 
30 
3.7 
Subtract. 
Add. 
Subtract. 
Add. 
Urinary Analysis. 
7 
Corrections 
in Fahrenheit Scale.—(Flint.) 
Temp. 
Add. 
Temp. 
Add. 
Temp. 
Add. 
60° 
0.00 
69° 
0.80 
78° 
1.70 
61 
0.08 
70 
0.90 
79 
1.80 
62 
0.16 
71 
1.00 
80 
1.90 
63 
0.24 
72 
1.10 
81 
2.00 
64 
0.32 
73 
1.20 
82 
2.10 
65 
0.40 
74 
1.30 
83 
2.20 
66 
0.50 
75 
1.40 
84 
2.30 
67 
0.60 
76 
1.50 
85 
2.40 
68 
0.70 
77 
1.60 8 
Students’ Manual, op 
For example, suppose the specific gravity of a sample of 
urine has been found to be 1025; if its temperature be 
75° F., add 1.40 to this, and we have 1026.40 as the true 
specific gravity. 
Determination of Solid Matters contained in the Urine.— 
Find the specific gravity, as above. Multiply the last two 
figures by 2.2, this will give the number of grammes of 
solid matters in 1000 grammes of urine. 
For instance, if the specific gravity of a specimen of urine 
be 1020, SO x 2.2, or 66, will represent the number of grammes 
of solid matter in 1000 grammes of urine. 
DETECTION OF ABNORMAL PRINCIPLES IN THE 
URINE. 
Albumen.—Specific gravity generally low. The best tests 
for the presence of albumen in the urine are heat and nitric 
acid, used simultaneously. 
(a). If the urine is acid in reaction, heat a portion of it in 
a test tube ; if a white precipitate appear, add nitric acid; 
if the precipitate is not dissolved lay the acid, the urine 
contains albumen. 
{&) If the urine is alkaline, first add to it five or six drops 
of acetic acid, then apply heat, and afterwards nitric acid. 
Ten or fifteen drops of nitric acid should be employed in 
making this test, and 4 or 5 grammes* of urine. 
A. The precipitate appearing may consist of urates; if 
so, boiling the urine will cause the precipitate to clear up, 
and the urine acquires a reddish color. 
B. The precipitate may consist of the nitrate of urea; 
but in this case it forms slowly, and in the shape of fine 
crystals. 
C. In urine containing a large quantity of albumen, no 
precipitate will form when only two or three drops of nitric 
acid are added, but only when ten or fifteen are used. 
D. The precipitate caused by heating may consist of 
phosphates, but in this case adding nitric acid will dissolve 
the precipitate. 
CAUTIONS IN TESTING FOR ALBUMEN. 
* About a tea-spoonful. Urinary Analysis. 
9 
The method of Mehu is the simplest, and is founded on 
the property which carbolic acid has of precipitating albu- 
men. 
QUANTITATIVE ESTIMATE OF ALBUMEN. 
(a) Take 100 grammes of urine, and add 
(h) 4-5 drops acetic acid; 
(c) 2 cubic centimeters non-concentrated nitric acid; 
(d) 10 “ “ of the following solution: 
1 part (crystals) carbolic acid; 
1 part acetic acid; 
2 parts alcohol. 
Mix the solution thus formed by (6), (c) and (d), well with 
the urine, and the albumen will be precipitated; filter; wash 
the precipitate with water containing one per cent, of car- 
bolic acid. 
Dry and weigh. 
A rough method of determining the quantity of albumen 
contained in a given amount of urine, is given by Flint: 
“Add acetic acid; boil, and allow the flaky precipitate 
to settle; its proportion may then be estimated as one- 
eighth, one-fourth,” etc. 
Sugar.—Specific gravity generally high. 
(а) If the urine also contains albumen, use Bouchardat’s 
test for sugar in the urine. 
Take 60 cubic centimeters (ten teaspoonfuls) of urine, and 
add to it a heaping teaspoonful of slaked lime. Boil over an 
alcohol lamp. If there is sugar in the urine, it acquires a 
yellow or dusky hue, according to the quantity of sugar 
present. (If little sugar, a brownish hue.) 
(б) If the urine contain no albumen: 
Take 4 grammes of urine; 
Add 2 “ of a solution of potassium hydrate. 
Mix, and add a drop of a solution of sulphate of copper. 
Boil, and a yellow or red precipitate is formed. (Trommer’s 
test.) 
(c) Bottger’s test—for urine containing no albumen: - 
Add to the urine a little caustic potash (potassium hy- 
drate), and some sub-nitrate of bismuth. Boil, and there 
appears a black precipitate, if sugar be present. 10 
(d) Hager’s formula for “ Fehling’s test liquid:” 
84.65 grammes copper sulphate (pure), in solution in 200 
cubic centimetres of water. 
150 grammes of neutral tartrate of potassium in 500 
cubic centimeters of sodium hydrate in solution. 
Add 100 grammes of pure glycerine, and complete the 
amount to a litre with distilled water. 
This preparation is comparatively stable, and preserves 
its qualities almost indefinitely. To test the urine with it, 
first gently boil some of the solution; then add half its bulk 
of the suspected urine, and again boil. A red or yellowish- 
red precipitate indicates sugar, and 20 cubic centimetres of 
the test liquid corresponds to 0.1 gramme of sugar. 
Students’ Manual of 
Note.—A whitish precipitate indicates phosphates. 
A simple quantitative method for determining sugar, is 
that of Roberts: 
(a) Four ounces of urine in al2 oz. vial, with a lump of 
German (condensed) yeast of the size of a small walnut. 
(5) This to be loosely corked, and fermented in a warm 
place. 
(c) A companion vial filled with urine from the same 
patient—say 3 oz.,—is tightly corked and placed beside the 
fermenting vial. 
id) Let both stand twenty-two hours, until fermentation 
is over; then remove to a cool place, and let them stand two 
hours. Next, take the specific gravity of both specimens; 
the difference between the two specific gravities indicates 
the amount of sugar to the fluid ounce of urine. Thus, if 
the fermented urine have a density of 1005, and the unfer- 
mented one of 1035, the urine contains 30 grs. to the oz. 
Consider, always, the amount of urine passed in a day ; an 
ounce of urine may contain 20 grains on one day, and 40 
on the next; but in the latter case a less amount of urine 
may have been passed during the day. 
Bile.—Urine containing bile is dark, and often brown, 
red, or green. Its reaction is neutral or alkaline, and it 
foams when shaken. 
Test.—[a) Take a test tube, made small at its lower ex- 
tremity; pour in the urine, down the sides of the tube, very Urinary Analysis. 
gently. Make a mixture of nitric and sulphuric acids,‘and 
pour this also gently down the sides of the test tube into the 
urine. 
If bile be present in the urine, a green zone will form at 
the line of demarcation of the urine and the mixture of 
acids. 
11 
(h) Nitrous acid will give the same results, if used in- 
stead of the mixture. 
(c) Pettenkofer’s test, and the color-test with nitroso-ni- 
tric acid, are also useful. 
Blood.—Mix equal volumes of spirits of turpentine and 
tincture of guaiac; shake thoroughly. Let an equal volume 
of urine trickle down the sides of the test tube. Allow the 
mixture to stand a few moments. If blood be present, a 
blue—often indigo-blue—will appear at the line of demarca- 
tion between the urine and the emulsion; this blue color 
does not appear when normal urine is used; it is a special 
indication of the presence of blood in the urine. 
Ammonia.—To test the urine for ammonia, in however 
small quantities, prepare a solution of the double iodide of 
mercury and potassium, and add to it potassium hydrate. 
Partially fill another test tube with urine; add 1-10 part 
of sulphuric acid to this. 
Let it stand 10 or 12 hours, and add a drop of the double 
iodide solution. 
If ammonia be present in the urine, a precipitate will be 
formed. 
PART II 
DEPOSITS. 
Chemical reactions are useful in analyzing deposits, but 
the microscope is indispensable in identifying them. 
The following is a table of urinary deposits according to 
the reaction of the urine: 
Acid Reaction: 
Amorphous bodies. 
Crystalline, ‘ ‘ 
Acid urate of sodium. 
Uric acid, 
Cystine. 12 
Students’ Manual of 
Oxalate of calcium, 
Phosphate of calcium, 
“ of magnesium 
Neutral Reaction: 
Amorphous todies, 
Urates (if strong- 
ly alkaline), 
Calcium phos- 
phate, 
Oxalate of calci- 
um, 
Acid ur ale of am- 
monium, 
Ammonio-mag- 
nesium phos- 
phate. 
AlTcaline Reaction 
Crystalline todies, 
Deposits occurring under all these reactions organic 
bodies. 
(1) Mucus. 
(2) Pus. 
(3) Blood globules. 
(4) Tube casts. 
(5) Epithelial cells. 
(6) Fungi. 
(7) Yibrions. 
(8) Spermatozoa. 
(9) Cancerous matter. 
(I) Acid urate of sodium. 
Urine acid in reaction. 
Heat clears up deposit. 
TESTS. 
Potassium hydrate likewise clears it up. 
(II) Uric acid. 
Urine acid in reaction. 
Place a few of the crystals on porcelain; add a little 
nitric acid; heat gently; add ammonia. Magnificent red 
color indicates uric acid. 
(Ill) Cystine. 
Urine acid in reaction. 
Deposit soluble in ammonia indicates cystine; uric acid is 
not soluble in ammonia. 
(IV) Urates. 
Urine strongly alkaline. Urinary Analysis. 
13 
Feat clears up deposit. 
Murexid test, with nitric acid and ammonia, as in case of 
uric acid. 
(V) Phosphate of calcium. 
Urine alkaline (or neutral.) 
Deposit not cleared up by heat. 
Deposit not cleared up by potassium hydrate. 
Soluble in nitric acid without effervescence. 
(YI) Oxalate of calcium. 
Urine alkaline (or neutral). 
Insoluble in acetic acid. 
(YU) Acid urate of ammonium. 
Urine alkaline. 
(Phosphate of calcium soluble in acetic acid.) 
Treated with an acid, gives same reaction as uric acid. 
Treated with an alkali, it gives off ammonia. 
(YIF) Ammonio-magnesium phosphate. 
Urine alkaline (or neutral) 
Soluble in acetic acid. 
Insoluble in potassium hydrate. 
Insoluble when heated. 
Note.—Phosphates existing as deposits in the urine, may he recog- 
nized by the following test: 
Dilute deposit with distilled water ; add nitric acid and a little of 
ammonium molybdate; heat, and a yellow color is produced. 
(IX) Mucus. 
Urine acid, alkaline, or neutral. 
Acetic acid renders turbid, or augments already existing 
turbidity. 
Hydrochloric acid causes this turbidity to disappear (if 
there is no albumen present). 
Nitric acid dilute dissolves mucus, but coagulates albu- 
men. 
(X) Pus. 
Urine sometimes acid, but generally alkaline. 
Urine, white, opaline, milky, clearing on standing. 14 
Students* Manual op 
Potassium hydrate makes the deposit markedly ropy, so 
that it cannot be poured off in drops, and renders it trans- 
parent. 
Note.—lf the urine, on addition of potassium hydrate, becomes 
transparent, but not ropy, phosphates are present. 
If the urine, on addition of potassium hydrate, becomes ropy and 
not transparent, both pus and phosphates are probably present. 
[For other distinctions see Part IV, “Microscopical Ex- 
amination of Urine.”] 
PAET 111. 
The chemical elements in calculi are the same as those in 
deposits. 
Method of procedure. 
Reduce calculus to powder. 
Place this upon platinum foil. 
Heat in the flame of an alcohol lamp to a red heat. 
If the heating is accompanied with aflame, the calculus 
contains either (a) fatty matters, (6) cholesterine, or (c) cys- 
tine. 
ANALYSIS OF URINARY CALCULI. 
Patty matter and cholesterine are soluble in ether. 
Cystine in ammonia. 
Moreover, the odor of cystine is nauseous, and its flame is 
bluish-green in color. 
If the heating is unaccompanied by flame, the calculus 
consists of one or more of the following; 
Uric acid. 
Urate of magnesium. 
Oxalate of calcium. 
Phosphate of calcium. 
Ammonio-magnesium phos- 
phate. 
Carbonate of calcium. 
Urate of ammonium. 
Xanthine. 
Fibrine. 
Urate of sodium. 
“ “ calcium. 
Note.—The phosphate of calcium, when mixed with ammonio- 
magnesium phosphate, is fusible. Urinary Analysis. 
15 
We distinguish, in the case of the latter, those which (a) 
leave no residue upon calcining; (6) those which leave a 
slight residue; and (c) those which leave considerable resi- 
due 
Those which leave no residue, are 
Uric acid. 
Urate of ammonium. 
Xanthine. 
Fibrine. 
We distinguish the two former of these from the two lat- 
ter by the Murexid test (i. e., nitric acid and ammonia), 
which detects uric acid and the urate of ammonium, but 
not xanthine and fibrine. 
Uric acid is distinguished from the urate of ammonium in 
that no ammonia is set free when the Murexid test is 
applied. 
Xanthine is distinguished from fibrine by its solubility in 
potassium carbonate. 
Fibrine is soluble in caustic potash (potassium hydrate); 
has an odor of burnt horn; is precipitated by the ferrocyan- 
ide of potassium. 
Those calculi which leave a slight residue on incineration, 
consist of the urates of sodium, calcium and magnesium. 
We distinguish them as follows: 
From the oxalates and phosphates, by the Murexid test. 
FrOm one another: 
Urate of Sodium 
Leaves a trace of melted matter on the foil. 
Urate of Calcium. 
Dissolved in an acid, and treated with the oxalate of am- 
monium, yields crystals of the oxalate of calcium. (See 
Part IY.) 
Urate of Magnesium, 
Dissolves with effervescence in sulphuric acid. 
Gives a precipitate of the ammonio-magnesium pnos- 
phate, with ammoniated phosphate of sodium. 
If the calculus leaves a considerable residue after inciner- 
ation, it consists of either 
Calcium oxalate, 
Calcium phosphate, 16 
Or the ammonio-magnesium phosphate. 
The method of distinguishing these from one another, is 
as follows: 
Students’ Manual op 
The oxalate of calcium effervesces when a drop of acid 
is added to the residue; it is, moreover, insoluble in acetic 
acid. 
The phosphate of calcium and the amtnonio-magnesium 
phosphate do not effervesce on the addition of an acid. 
The phosphate of calcium, if treated with an acid and the 
oxalate of ammonium, gives a precipitate of the oxalate of 
calcium. 
[See Part IY for microscopical differences.] 
Sometimes the calculus consists of the carbonate of calci- 
um, which is recognized by adding an acid to it before heat- 
ing on the platinum foil. Ap effervescence indicates a car- 
bonate. The calcium is recognized as bet ore, i. e., dissolved 
in an acid, and treated with oxalate of ammonium, it yields 
crystals of the oxalate of calcium. 
PART IY. 
MICROSCOPICAL EXAMINATION OP THE URINE. 
I. ACID REACTION. 
(1) Acid urate of sodium (amorphous). 
Appearance: agglomeration of little grains. 
Heat gently—they dissolve. 
Add a drop of hydrochloric acid, and there appear uric 
acid crystals. 
(2) Uric acid (crystalline). 
Clear crystals, having the form of lozenges and square 
prisms. 
(If indistinct, dissolve with hydrochloric acid, and allow" 
to crystallize.) 
11. ALKALINE REACTION. 
Phosphate of calcium (amorphous or crystalline). 
Dissolve in nitric acid; add ammonia. 
Granules indicate calcium phosphate. Urinary Analysis. 
17 
Penniform crystals, ammonio-magnesium phosphate. 
Oxalate of calcium (crystalline). 
Appearance: that of letter envelopes. 
(Take specimens from all layers of the urine.) 
Acid urate of ammonium (crystalline). 
Appearance: tiny, opaque spheres like stars, or else 
trimmed with points appearing like needles. 
Add a drop of hydrochloric acid and these form crystals 
of ui’ic acid. 
Ammonio-magnesium phosphate (crystalline). 
Appearance: three-sided prisms, with beveled ends. 
Mucus.—Slightly granular cells, somewhat larger than 
blood globules, outlined in a transparent substance enclos- 
ing several granular points. Often among them are to be 
found epithelial cells from the bladder, or some other part 
of the urinary mucous membrane. 
111. ANY REACTION. 
Pus.— somewhat larger than those of blood. 
Treat with acetic acid, the nuclei will appear. 
Treat with ammonia, the nuclei will disappear, and the 
pus then assumes a viscous consistency. 
Mucus does not have this viscidity. 
Blood corpuscles.—Red corpuscles more numerous. 
Seen on their surface, they resemble concave discs. 
Seen from their side, they resemble bi-concave lentils. 
White corpuscles less numerous (1 to 855 of the red). 
Pale, granular, spherical, with their rims gently indented. 
When treated with acetic acid, they become transparent, 
larger, and display in their centre two or three little nuclei. 
Globules which do not, when thus treated, display nuclei, 
are called pyoid globules. 
Tube casts.—The following may be found in urine: 
1. Mucous. 
2. Fibrinous. 
8, Epithelial. 
4. Hyalin or Colloid. 
5. Amyloid. 
Generally, the casts met with in the field of the micro- 18 
Students’ Manual of 
scope are straight, and come from the straight part of the 
tubnli of the kidney; sometimes, however, they are curvi- 
linear, coming from the curved portions. 
If the epithelial cells are cylindrical, the cast generally 
comes from the medullary portion of the kidney. 
If pavement epithelium be found, it will come from the 
convoluted portions of the urinary tubules. 
Mucous Casts.—These are simple casts without epithelial 
cells, with difficulty distinguished from urine, being only a 
little more refractive. Composed of mucine, they have no 
utility in a diagnostic point of view. They can be rendered 
more distinct by coloring them with an ammoniacal solution 
of carmine. 
Fibrinous Casts are to be met with in cases of hemor- 
rhage from the kidneys. 
They have all the characters, chemical and microscopical, 
of fibrine; they are pale-yellowish; are covered with scat- 
tered epithelial cells. 
Epithelial Casts are the products of desquamation of the 
straight part of the urinary tubules; should be looked for 
among the deposits; are often very difficult to find. 
The epithelial cells which cover them are nearly normal. 
Are met with in acute nephritis, accompanied by epithelial 
cells and uric acid deposit. Are generally rectilinear. 
Are to be met with, also, in normal conditions of the body, 
when the kidneys are over-excited. 
[The epithelial cells may have undergone granular, then 
fatty degeneration.] 
Albuminous urine contains them generally among its 
deposits. 
Hyalin or Colloid Casts are met with, also, in albumin- 
ous urine; are more often curvilinear than rectilinear; have 
their extremities cut like glass; their surface generally pol- 
ished. They contain cracks and roughnesses, due to blood 
globules and epithelial cells. As their name indicates, they 
are transparent, like glass. 
Amyloid Casts are a metamorphic form of the preceding. 
Are distinguished from them by their great resistance to Unix ary Analysis. 
19 
chemical reactions. A little of an aqueous solution of iodine 
added to them, causes a yellowish or red tint within the 
cast. 
A couple of drops of sulphuric acid change this tint to 
violet (rarely blue). 
The majority of tube casts are outlined more distinctly 
when treated with acetic acid. Blood casts and calcareous 
casts are similar to those mentioned previously. 
Epithelial Cells often appear in the urine; sometimes from 
the kidneys, often from the ureters and the bladder, from 
the canal of the urethra, and, in the female, from the vagi- 
na. They are more numerous in saccharine urine. It is 
necessary, in examining them, to note their quantity, form 
and changes. 
1. Epithelial Cells from the Kidney. 
These are usually of glandular or cylindrical epithelium, 
with one or two nuclei. 
2. Epithelial Cells from the Ureters or Bladder. 
The epithelium, from the ureters and bladder, is mixed, 
consisting of four varieties of epithelial cells—the pavement 
variety dominating generally. We have, then: 
(a) Nuclei cells, having all the characteristics of those of 
epithelial cells, but free, instead of being in the centre of 
a cell. 
(h) Spherical cells, which, by mutual compression, may 
become polyedral. 
(c) Prismatic cells, with oval nuclei, provided with one 
or two nucleoli. 
In the prostate the cells are prismatic, and provided with 
vibrating cilia. 
(d) Pavement cells, already described. 
8. Cells from the Canal of the Urethra. 
The epithelium is of the pavement variety, in the fossa 
navicularis; then tends to assume a prismatic or cylindrical 
form in the muscular and prostatic portions. 
The mucous membrane in the urethra of the female is 
lined with pavement epithelium also; likewise that of the 
vagina. 20 
Champignons.—The fungi met with in the urine may be 
clue to acid, ammoniacal or alcoholic fermentation. The first 
are found in normal urine which becomes a dd on standing. 
These are cells, sometimes isolated, sometimes joined end 
to end, in linear series; they are to be found among the de- 
posits of the urate of sodium and uric acid. 
The second are found in the decomposition of urea into 
carbonate of ammonium, and are of the group of Torula- 
ceae. 
Students’ Manual op 
The third are found in diabetic urine. These are cells 
round or oval, and containing sometimes one or two very 
small corpuscles. They are also to be met with in non-sac- 
charine urine. 
Vibrions.—These have a linear form, are convoluted, and 
possessed of a Brownian movement. 
Spermatozoa.—These are filiform, mobile bodies, com- 
posed of one tolerably large part, somewhat flattened, which 
is called the head, or disc, and along appendix called the 
tail, which ends in a point. Their length is 0.05 millime- 
tres, and they have a very lively movement when recently 
voided. [To be sought for in the morning in the deposit, 
with a microscope magnifying from 400-500 diameters.] 
Cancer Cells.—These are variable in form and size, and 
contain more or less germinal matter. 
CANCER CELLS. 
They must not be confounded with the epithelium of the 
ureter or the cells of the bladder. 
PART Y. 
Urea. 
Uric acid. 
Chloride of sodium. 
NORMAL CONSTITUENTS OP THE URINE. 
Phosphates. 
Sulphates. 
Coloring matter. 
Urea is never found as a sediment, since it is soluble in 
UREA. Urinary Analysis. 
21 
water; therefore the only method of estimating it is by an 
analysis. Methods of determining the presence of urea are 
somewhat difficult and complex, and the student is referred 
to the larger manuals for them. 
The best method is that of Esbach, or of Liebig. 
In the former method, the urea is decomposed by the hypo- 
bromite of sodium. [See Appendix.] 
URIC ACID. 
To determine the quantity of uric acid, take 200 cubic 
centimetres of urine, and add to it 20 cubic centimeters of 
hydrochloric acid. 
Allow the mixture to stand thirty hours in a cool place. 
Crystals form; purify these by dissolving them in hot 
water containing a little caustic potash (potassium hydrate) 
in solution, and re-precipitate them with nitric acid. 
Place the crystals then upon a small filter, dry and weigh 
them. 
The amount found on weighing is, of course, the amount 
of uric acid contained in 200 c. c. of urine. 
Multiply this amount by the amount of urine passed in 
24 hours; divide the product by 200, and the result will be 
the amount of uric acid passed in 24 hours. 
SODIUM CHLORIDE. 
The minimum quantity of sodium chloride, normally 
present in the urine of 24 hours, is from 8 to 10 grammes. 
Test.—Add nitric acid in excess; next add nitrate of sil- 
ver, and a white, curdy precipitate of the chloride of silver 
is obtained. 
Quantitative Estimation.—To ascertain the quantity of the 
chloride of sodium in the urine: take 10 cubic centimeters 
of filtered urine; pour it into a platinum capsule; evaporate 
gently, and, before it is all evaporated, add a gramme of 
the nitrate of potassium (crysta's); calcine the mixture until 
the organic matters are completely charred, and the residue 
is pale-colored. 
Dissolve this residue in water acidulated with nitric acid 
in excess, and into the solution pour a solution of the nitrate 22 
Students’ Manual of 
of silver; there is formed a white precipitate of the chloride 
of silver, which is to be washed and weighed after it has set- 
tled. 100 grammes of silver chloride correspond to 24.75 
grammes of chlorine, and 40.75 grammes of sodium chlo- 
ride. 
Consequently, proportion will enable us to calculate the 
amount of common salt corresponding to any weight of sil- 
ver chloride found. If albumen be present, it should be 
first precipitated and removed from the urine before the 
above test is employed. 
PHOSPHATES. 
Phosphoric acid is found in the urine, not free, but in com- 
bination with potassi im and sodium (alkaline phosphates); 
also with calcium and magnesium (earthy phosphates). 
The earthy phosphates precipitate themselves if the urine 
be alkaline; otherwise, add ammonia to cause them to ap- 
pear. Filter the solution, and add carbonate of ammonium 
and sulphate of magnesium to the clear filtrate; then there 
appears a second precipitate of the ammonio-magnesium 
phosphate. The sodium and potassium phosphates lose 
their phosphoric acid, which unites, with the ammonium and 
magnesium, forming the above mentioned ammonio-mag- 
nesium phosphate; while the carbonic acid of the ammoni- 
um carbonate, uniting with the sodium, forms carbonate of 
sodium, which, being soluble, remains invisible; also, the 
sulphuric acid of the magnesium sulphate, uniting with 
the potassium, forms potassium sulphate, also soluble and 
invisible. 
To determine the total quantity of phosphates present in 
the urine: collect, dry and weigh the two precipitates, using 
50 cubic centimetres of urine. 
Note.—It ia well to let the precipitate of the earthy phosphates 
stand 24 hours before filtering. 
The result found is, of course, the amount of phosphates 
contained in 50 cubic centimetres of urine. 
To estimate the amount of phosphates contained in urine 
passed during the 24 hours: multiply the amount found in 
grammes, by the number of cubic centimetres of urine Urinary Analysis. 
23 
passed in 24 hours, and divide the result by 50. (A gramme 
in weight corresponds to a cubic centimeter in volume.) 
The presence of sulphates in the urine is recognized by 
first adding to 4 grammes of urine in a test tube, several 
drops of hydrochloric acid. Into this mixture allow a drop 
or two of a solution of the chloride of barium to trickle: 
there is formed a white precipitate of barium sulphate, 
which is insoluble in nitric acid. 
SULPHATES. 
COLORING MATTER. 
The coloring matter of the urine is called urohaematin. 
The processes by which its quantity may bo estimated, are 
long and difficult, and do not properly belong in a work of 
this size. 
For such ingredients of the urine as Hippuric Acid,. Ino- 
site, Creatin, Leucin, Tyrosin, Kiestin or Chyle, the stu- 
dent is referred to the larger works; preferably to Beale. APPENDIX. 
Formula op Esbach : 
For solution used in determining the quantity of urea 
present in a given amount of urine. 
Distilled water, . 100 cubic centimetres, 
Soda-lye, ... 40 “ “ 
Bromine, . . . 2 “ “ 
Esbach’s Ureometer. 
A tube, 10 millimetres in diameter and 23 cubic centime- 
tres in capacity, graduated in 160 parts, at intervals of 10. 
METRIC SYSTEM. 
WEIGHTS AND MEASURES. 
A gramme by weight of distilled water occupies a cubic 
centimetre of volume. 
Five grammes correspond to an ordinary teaspoonful. 
One gramme by weight corresponds to about fifteen 
grains. 
A millimetre is .039 of an inch.