| The analysis gave: | |||
| Specific gravity | 1028 | ||
| Reaction | acid (?) | ||
| IN 1000 PARTS. | |||
| Water | 948·860 | ||
| Solids (organic, inorganic) | 51·138 | ||
| ======= | |||
| Urea | 30·000 | ||
| Uric acid | 0·375 | ||
| Resin and mucus Bile, colouring matter, and acids Urohæmatine Leucine, and tyrosine | 14·575 | ||
| Inorganic salts | 6·188 | ||
| ====== | |||
The biliary acids (contrary to what Frerichs found in some of his cases) were present in this urine in fair quantity. With Pettenkofer's test (sulphuric acid and sugar) a decided purple colour was obtained.
When a portion of the urine was concentrated, and allowed to crystallize slowly, beautiful crystals of both tyrosine, and leucine were detected in it by means of the microscope. The purified urine also showed the presence of sugar in small quantity. When the organic solids were burned, they had a strong odour, and gave off a smoky flame, thereby showing that the urine contained a considerable quantity of fatty resin.
As calculating the constituents of the urine by percentage is a very unsatisfactory method for scientific purposes, it may be useful for me to give the analysis of the same urine as calculated for twenty-four hours, viz., twelve ounces, the amount drawn from the bladder shortly before death. In that case the analysis gives:
| 24 HOURS' URINE. | ||
| Quantity | 372·00 | c.c. |
| Specific gravity | 1028 | |
| Reaction | acid (?) | |
| Solids (total) | 19·038 | grammes. |
| Urea | 11·160 | " |
| Uric acid | 0·139 | " |
| Resin, and mucus Bile pigment, and acids Urohæmatine Tyrosine, and leucine | 5·441 | " |
| Inorganic salts | 2·298 | " |
| ====== | ||
During the night before her death, the patient aborted, and lost a considerable quantity of blood by the vagina. The whole duration of the disease was merely six days, and the more urgent symptoms only manifested themselves two days before the fatal termination.
After death the liver was found to be very small in size, not exceeding, as was supposed, 1½ pound in weight. It was deeply stained yellow, and its cells were found to be small, and broken up; not an entire cell could be detected by either Dr. Wilks or myself—nothing, indeed, but a quantity of débris of hepatic tissue, and fat. The gall-bladder was contracted, and contained only a little mucus; the urinary-bladder was empty.
Although jaundice the result of acute atrophy of the liver, might be thought to be a typical example of jaundice arising from a suppression of the biliary function—the diminution in secreting substance naturally inducing a diminution in secreting power—I have, as was before said, been led to view it differently; because, although less bile than usual is secreted, there is nevertheless nothing like an entire suppression of the biliary function, as is proved,—
Firstly,—By the absence of pipe-clay stools.
Secondly,—By the deep staining of the hepatic tissue with bile pigment, just as occurs in jaundice the result of obstruction.