From the second to the sixth day, we perceive small opaque bodies rise from the bottom to the top of the fluid; these gradually collect together so as to form a layer which covers the surface: this is the kiesteine. It is of a whitish or opaline colour, and may be very aptly compared to the layer of greasy matter which covers the surface of fat broth, when it has been allowed to cool. Examined by the microscope, it exhibits the appearance of a gelatinous mass, which has no determinate form. Sometimes small cubical crystals can be perceived in it, when it has become stale.
The kiesteine continues in the state we have now described, for three or four days; the urine then becomes muddy, and minute opaque bodies detach themselves from the surface and settle at the bottom of the vessel: the pellicle thus becomes soon destroyed.
The characteristic feature, therefore, of the urine during pregnancy consists in the presence of kiesteine. It deserves, however, to be noticed, that the urine, in some cases of extreme phthisis pulmonalis, and also of vesical catarrh, will be found to exhibit on its surface a layer or stratum which is not unlike to that now described as peculiar to the state of pregnancy. But with proper attention we may easily avoid this mistake. The stratum, in the cases alluded to, does not appear so quickly on the surface of the urine as the kiesteine does; and also, instead of disappearing, as it is found to do, in the course of a few days, it (the former) goes on increasing in thickness, and ultimately becomes converted into a mass of mouldiness.
Of twenty-five cases, in which M. Tanchou detected the presence of kiesteine in the urine, seventeen occurred in women who were pregnant from four to nine months, four in women who had not quickened, and who considered themselves as labouring under disease of the womb, and the remaining four in patients who had been under treatment for casual complaints—one for sciatica at the Hôtel Dieu, another for ascites in the city, a third for an ulcer in the neck at La Pitié, and the last had been cauterized twice a week for a pretended disease of the uterus. In none of these cases had the existence of pregnancy been suspected, although in every one of them the fact was soon placed beyond doubt.—Editor.
[45] Baudelocque wrote an account of it to Professor Naegelé of Heidelberg, from whom we received the particulars.
[46] See Treatise on the Diseases of Females, 6th ed. p. 46. Ed.
[47] Ovum deforme, in quo partes embryonis et secundarum distingui vix possunt, molam vocabimus. (Rœderer, Elementa Artis Obstetricæ, § 738.)
[48] Dr. J. Y. Simpson on the Diseases of the Placenta. (Edin. Med. and Surg. Journal, April 1, 1836.)
[49] “One must be careful not to mistake these clots of blood, which being washed by the reddish serosities which flow from the womb, harden in the vagina, or womb itself, and look exactly like false conceptions.” (La Motte.)
“Every mole is a blighted ovum which has been the product of conception. We are not justified in classing under the head of moles every mass which is produced and lodged within the uterus.” (Froriep’s Handbuch der Geburtshülfe, § 180.)