We have already spoken of the marked changes effected in the urine by a derangement of the digestive functions. It is a matter of surprise that physicians generally pay so little attention to the urine when dyspepsia is suspected, since all admit that an examination of that excretion furnishes unmistakable evidence of the nature and complications of the disease. In this way we are many times enabled to determine whether the indigestion is caused by congestion or functional disease of the liver or kidneys or by nervous debility. And when such cases are treated in accordance with the indications furnished, increased success attends our practice. In Fig. 2 highly magnified urinary deposits, which indicate impairment of the digestive functions, are represented. The crystals are composed of oxalate of lime and appear in the different forms shown in the five sections, of octahedral, decahedral, round and dumb bell shapes. The latter are formed in the kidneys, and are sometimes discovered adhering to casts.
INVALUABLE AIDS IN DETERMINING DISEASES OF THE KIDNEYS AND BLADDER.
The various forms of gravel, Bright's disease of the kidneys, hæmaturia, inflammation of the kidneys and bladder, diabetes, and other functional and organic diseases of the urinary organs effect characteristic changes in the urine, thus enabling us to distinguish them with certainty and exactness. Some of the various microscopical appearances of the urinary deposits in diseases of the kidneys and bladder, are represented in Fig. 3. In division A is represented pus and mucus, with decomposition, indicating suppuration somewhere along the urinary tract. In B pus globules are alone represented. In the division marked C are shown blood corpuscles as they are arranged in blood drawn from a vein or artery. D represents the same separated, as they always are when present in the urine. In E highly magnified oil globules are represented. If present in the urine, they indicate disease of the kidneys. In F are represented epithelial cells, the presence of which in large numbers is indicative of diseases of the mucous lining of the urinary organs.
Fig. 4 represents the microscopic appearance of phosphates in the urine. These are present in great quantity in cases of nervous debility and kindred affections. By attaching the camera lucida to the microscope we can throw an image of these urinary deposits upon paper. By the art of the engraver this may be faithfully traced, and thus we are enabled to produce an accurate representation of them. Some of the beautiful crystalline deposits shown in Fig. 4 represent less than a millionth part of a grain, yet their forms are delineated with geometrical precision. Earthy phosphates are often mistaken for pus and also seminal fluid. Phosphates are always found in decomposed urine, otherwise they indicate brain affections, acute cystitis, etc. Experience has taught us that the voiding of urine loaded with phosphates is a forerunner of cystitis, or enlargement of the prostate gland, or both. In fact, persons so affected are "prone to serious consequences from mild attacks of almost any and every acute disease."
Fig. 5 represents the microscopic appearance of mixed urinary deposits. In division A is represented fermentation spores as they appear in diabetic urine. Pasteur asserts that the germs of this fungus get into the urine after it has been passed. Urates appear in division B. These indicate waste of flesh, as in fevers, consumption, prolonged physical efforts, etc. Division C pictures urates of ammonia. These appear in alkaline decomposition of the urine; it is isomeric with uric acid in acid urine. In division D is represented urate of soda, which is present in the tissues of persons suffering from gout. The crystals shown in division E consist of the same salt.
In Fig. 6, division A, is represented purulent matter as it appears in the urine. The formation of pus in different parts of the genitourinary system is accompanied by the appearance of pus corpuscles in the urine. When fat globules, represented in division B, are found in the urine, they indicate fatty degeneration. In division C are representations of the cells found in the urine of persons suffering from cystitis or other inflammatory diseases.