Volume 1

A text-book of human physiology : including histology and microscopical anatomy with special reference to the requirements of practical medicine / by L. Landois ; translated from the seventh German edition with additions by William Stirling.

Landois, L. (Leonard), 1837-1902. Lehrbuch der Physiologie des Menschen. English

Date:: 1891

Credit: A text-book of human physiology : including histology and microscopical anatomy with special reference to the requirements of practical medicine / by L. Landois ; translated from the seventh German edition with additions by William Stirling. Source: Wellcome Collection.

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$6. Mucus is present in large amount^ especially in catarrh of the bladder. It contains numerous mucous corpuscles, which are scarcely distinguishable from pus corpuscles. They con- tain albumin, so that urine containing much mucus is albuminous ; mucin is not precipitated by heat, but acetic acid gives a flocculent precipitate in clear urine. [Minute traces of mucin occur normally in urine. If clear normal urine be set aside for a short time, a flocculent hazi- ness, like a cloud of cotton wool, is seen floating in the urine. This is mucus entangling a few epithelial cells from the genito-urinary tract. Mucin Reaction.—According to W. Roberts, the addition of a concentrated solution of citric acid to urine, as in Heller's test (§ 264, a), where the two fluids meet, causes an opalescent zone gradually to be formed above the layer of acid.] 265. BLOOD (HiEMATURIA) AND BLOOD-PIGMENT (HiEMOGLOBIN- URIA) IN THE URINE.—I. Source of the Blood.—(1) In hsematuria, the blood may come from any part of the urinary apparatus. 1. In hjEmorrhage from the kidney, the amount of blood is usually small and well mixed with the urine. tIic presence of blood-cylinders, long microscopic blood coagula, casts of the uriniferous tubules, washed out of them by the urine, is characteristic when they are found in the urine (fig. 332). The urine usually has a smoky appearance. [Tlie urine slowly dissolves out the colouring matter, the stroma of the corpuscles after a time being deposited as a brownish sediment. The smoky hue occurs only in acid urine ; if the urine becomes alkaline, the hue becomes brighter red.] The blood-corpuscles show peculiar changes of form, [they become crenated] (fig. 320), and exhibit evidence of division, due to the action of urea on them (§ 5). ° Large coagula are never found in urine mixed with r, 0 blood derived from the kidney. 2. In hemorrhage CP ( r O ^ ^^^^ ureter, we occasionally find worm-like masses W Q ß|Q^(.gj^ blood, casts of the canal of the ureter. 3. /-) 0 The relatively largest coagula occur in haemorrhage U Ö /] fi'om the bladder. In all cases where blood is present, ^ we must examine microscopically for the blood-corpus- ^ cles, and it may be for coagula of fibrin. In acid urine, blood-corpuscles, but never arranged in rouleaux, may Fio- 320. Fig. 321. be found after two or three days. The blood-corpuscles 320 -Crenated red blood-corpus- settle as a red sediment at the bottom._ If the h^emor- rig. t u t rhage is copious, many retain their original shape, but ptilSr d;ar;g:s'of%he^ if uriii^ is very concentrated, they may become corpuscles in renal ha^maturia. ciena^e^^. ^^^^^^ ^ ^^^^^ ^^^^ ^^^^ haemorrhage from ruptured small capillaries, the red blood-corpuscles are of unequal size, many 4 to t the size of normal, while the pigment has become brownish-yellow (fig. 321). ^ ,, ^ , If a htemorrhage of this kind be accompanied by catarrhal inflammation of the bladder, there is found between the red, numerous shrivelled leucocytes (fig. 321), which in freshly passed urine often exhibit lively amoeboid movements. If the urine be alkaline, as it usually is, crystals of triple phosphate also occur. ■ r If the remains of the red blood-corpuscles become very pale, their presence may be frequently ascertained by adding iodine in a solution of KI (fig. 321). Blood is constantly present m the urine during menstruation. II. Hsemoglobinuria is quite distinct from hsematuria. It depends upon the excretion of hsemoglobin as such through the kidneys, and it is produced when hemoglobin occurs free within the blood-vessels, as in cases where the coloured blood-corpuscles have been dissolved inside the blood-vessels (hsemocytolysis). It occurs when foreign blood is transfused, e.g., when lamb's blood is transfused into man. The foreign blood-corpuscles are dissolved in the blood of the recipient, and the hiemoglobin appears in the urine (§ 102). In addition, microscopic cylinders, or casts, consisting of a crlobulin-like body, tinged yellow with haemoglobin, may likewise be found in the urme. It also occurs in cases of severe burns (§ 10, 3) ; after decomposition of the blood m pyaemia, scorbutus, purpura, severe typhus, after respiring arseniuretted hydrogen and after the passage of azobenzol, naphtol, pyrogallic acid, potassic chlorate, chloral, phosphorus, or carbolic acid into the circulation. [The injection of laky blood, water, ether, glycerin {Adams), or toluylendiamin {Affanassiew), also causes it, and in such cases AfFanassiew asserts that the Hb passes out through the glomeruli, while brown degeneration-products of the red blood- corpuscles, which are dissolved by these agents, were found in the convoluted tubules.] These substances cMssolve the red blood-corpuscles. Sometimes it occurs periodically from causes and conditions as yet but little unaerstood, e.g., the application of cold to the skin. [In paroxysmal hsemoglobinuria, which occurs during periodic febrile attacks, hsenioglo-$