THE LIBRARY OF THE UNIVERSITY OF CALIFORNIA PRESENTED BY PROF. CHARLES A. KOFOID AND MRS. PRUDENCE W. KOFOID THE SYDENHAM SOCIETY INSTITUTED MDCCCXLIII LONDON MDCCCXLVI. ANIMAL CHEMISTRY WITH REFERENCE TO THE PHYSIOLOGY AND PATHOLOGY OF MAN DR. J. FRANZ SIMON FELLOW OF THE SOCIETY FOR THE ADVANCEMENT OF PHYSIOLOGICAL CHEMISTRY AT BERLIN ETC. ETC. GEORGE E. DAY, M.A. & L.M. CANTAB, LICENTIATE OF THE ROYAL COLLEGE OF PHYSICIANS. IN TWO VOLUMES VOL. II. LONDON PRINTED FOR THE SYDENHAM SOCIETY MDCCCXLVI. PRINTED BY C. AND J. ADLARD, BARTHOLOMEW CIX>3E. TABLE OF CONTENTS. CHAPTER III. THE SECRETIONS OF THE CHILOPOIETIC VISCERA AND THE THEORY OF DIGESTION. Page Saliva . . . . . .1 Morbid saliva . . . . ... 9 Saliva of animals . . . . . .14 Pancreatic fluid . . . . . 16 Bile ...... 17 Morbid bile . . . . . 22 Bile of animals . . . . .24 On the action of the bile in the process of digestion . 25 Gastric juice . . . . . .27 Morbid gastric juice . . . . 33 Intestinal fluid . . . . . .35 The process of digestion . . . . ib. Diseased digestion . . . . . .41 CHAPTER IV. General physico-chemical characters of the milk . 42 Special chemistry of the milk . . . . .44 Milk before delivery . . . . 47 Milk immediately after delivery (colostrum) . . .49 Ordinary human milk . . . . . . 50 The effect of temperament on the milk . . . .54 The changes in the milk dependent on nutrition . ib. IT. b M353 805 vi CONTENTS. Page Changes in the milk corresponding with the age of the infant 56 Diseased milk . . 57 Colostrum of animals . Milk of animals . ib - Diseased milk of animals . . 6 ? CHAPTER V. SECRETIONS OF THE MUCOUS MEMBRANES. Mucus ... 70 Morbid mucus . 72 Purulent mucus . Pus . 86 Ichor .... 96 On the formation of mucus and pus on mucous membranes, and on the detection of pus in mucus ..... CHAPTER VI. SECRETIONS OF THE EXTERNAL SKIN. Sweat (sudor) . . . . . .101 Morbid sweat . . . . . 106 Sweat of animals . . . . . .111 Fat 112 CHAPTER VII. THE URINE. Healthy urine . . . . . . . 113 Qualitative analysis of urine . . . . .115 Quantitative analysis of urine . . . . . 134 A shorter method of separating the most important constituents of the urine 141 Composition of healthy urine . . . . .143 Physiological relations of the urine . . . . . 147 Pathological changes in the urine . . . .170 Qualitative and quantitative analysis of urine modified by disease . . ib. CONTENTS. vii Page On the general relations of the urine in disease . . . 203 urine in the phlogoses . . . . 205 pericarditis ..... 209 phlebitis uterina . . . 210 meningitis . . . . .211 encephalitis . . . ib. delirium tremens . . . . .212 myelitis . . . . ib. bronchitis . . . . .214 pneumonia . . . . ib, pleuritis ..... 219 pleuropneumonia . . . . 220 empyema ..... 223 emphysema . . . ib, angina tonsillaris ..... 224 gastritis . . . . ib. enteritis and dysentery .... 225 hepatitis . . . . . 226 peritonitis ..... 228 nephritis acuta . . . . 230 arthritica .... 231 albuminosa seu morbus Brightii . ib. cystitis ...... 240 metritis . . . . 241 typhus . . . . . .242 febris intermittens . . . . . 255 scorbutus et morbus maculosus Werlhofii . . 258 chlorosis . . . . . 261 haemorrhagia cerebralis .... 266 haemoptysis . . . . . 267 haematemesis . . . . ib. hcematuria . . . . . ib. catarrh . . . . .269 measles . . . ib. cholera . . . .271 rheumatism . . 274 gout . . . . . .277 erysipelas . 278 scarlatina . 279 viii CONTENTS. Page On urine in variola and varicella . . . . 282 scrofulosis . .283 rachitis . . . . 284 osteomalacia ..... 286 phthisis pulmonalis . ib. diabetes melh'tus ..... 289 insipidus . . . 304 dropsy . . . 308 jaundice . . . . . 313 hysteria ..... 316 marasmus senilis . . . 317 carcinoma . . . . ib. syphilis . . . . 319 urticaria tuberculosa .... 320 herpes zoster . . . ib. pompholix . . . . . 322 Fat in urine ... .... 323 Milk in urine . . . . . ib. Excess of hippuric acid in urine . . . . 324 Urostealith in urine . . . . . 326 Semen in urine . . . . . . 327 Urine of peculiar colour . . . . . ib. Urine during pregnancy, at the period of delivery, and after delivery . 329 On the passage of medicinal and other substances into the urine . . 336 Urine of animals . . . . . 342 CHAPTER VIII. THE SECRETIONS OF THE LACHRYMAL, MEIBOMIAN, AND CERUMINOUS GLANDS. The tears . ..... 353 The gummy secretion of the eyes . . . ib. Cerumen . . . . . . . 354 CHAPTER IX. SECRETIONS AND FLUIDS OF THE GENERATIVE ORGANS. Semen . . . . . . 355 Prostatic fluid ...... 359 Liquor amnii . . . . . . ib. Fluid of the allantois ...... 363 Vernix caseosa . 364 CONTENTS. i x CHAPTER X. THE INTESTINAL EXCRETIONS. Page Meconium . . . . . . ' . 367 Faeces of infants . . . . . . 369 adults ...... 370 during disease . . . . . 376 in diabetes . . . . . 377 dysentery ...... 380 enteritis . . . . 381 abdominal typhus . . . . . ib. diarrhoea . . . . . 382 cholera . . . . . . ib. enterophthisis . . . . . 384 jaundice . . . . . ib. Calomel-stools . . . . . . . 386 Vomitus (matters discharged by vomiting) .... 390 CHAPTER XL THE COMPONENT PARTS OF THE ANIMAL BODY. The bones . . . . ___. . 396 Bones of the lower animals . . . . . 402 Morbid bones . . . . . . 406 The teeth . . . . , . .413 Cartilage . . . . . 415 Synovia . ..... 416 Cellular tissue, tendons, ligaments, skin, and hair . ib. Crystalline lens and fluids of the eye . . . . 419 The arteries and veins . . . . 421 The muscles ....... 422 The brain, spinal cord, and nerves . . . . 425 Fat . . . . . . .427 The glands . . . . . . . ib. Otolithes 429 CONTENTS. CHAPTER XII. SOLID MORBID PRODUCTS. Page Concretions, their qualitative analysis .... 430 Vesical and renal calculi . . . . 437 Calculi of uric acid ...... 440 urate of ammonia . . . . 442 uric (xanthic) oxide ..... 444 cystin . . . . . 445 protein-compounds ..... 446 oxalate of lime . . . . ib. ammo niaco-magnesian phosphate and phosphate of lime . 448 neutral phosphate of lime . . . 449 carbonate of lime ..... 450 urostealith . . . . 452 On the laminae of vesical and renal calculi, and on their quantitative analysis 453 Urinary gravel ...... 459 Urinary calculi of animals . . . . 461 Intestinal concretions in man ..... 464 in animals . . . . . 466 Gall-stones in man ...... 469 in animals . . . . . 471 Salivary calculi and tartar . . . . .473 Various concretions . . . . 474 Tubercle . . . . . . . 478 Scrofulous matter . * . . 480 Scirrhus . . . . . . .481 Incrustations on the surface of the body . . . 482 CHAPTER XIII. FLUID PRODUCTS OF DISEASE. Fluid contained in hydatids ..... 484 ovarian and other cysts . . 485 Fluid of pemphigus ...... 488 CONTENTS. xi Page Fluid of hygroma . 489 hydrocephalus 490 ascites . . . . . ib. Thoracic effusions . 493 Subcutaneous serum in Bright's disease . 494 Fluid of hydrocele ... .495 Fluid effusions found in the body after death . . . 497 APPENDIX I. Ultimate composition of protein . . 503 " tritoxide of protein . . . ib binoxide of protein ib. erythroprotid 504 leucin ... . ib. protid . . . . . ib. albumen of the blood ib. albumen of eggs ib. fibrin ... .505 casein . . . . . ib. crystallin . . ib. globulin . . . ib. pepsin . ib. chondrin . . . ib. glutin . . . ib. glycicoll or gelatin sugar . . . ib. haematin . . . . ib. cholic acid . . . 506 urea ... . ib. uric acid . . . . . ib. hippuric acid ib. uric oxide . . . . ib. cystin ... .507 glycerin . . . . ib. ,, stearic and margaric acids . . . ib. lactic acid . . . . . ib. xii CONTENTS. APPENDIX II. ADDITIONS TO VOLUME I. Page Blood in thoracic inflammation . .509 intermittent fever . . 510 certain diseases of the eye . ib. scrofula ... . 513 Bright's disease . . .514 Menstrual fluid . . . 516 ADDITIONS TO VOLUME II. Saliva . ...... 518 Morbid saliva . . . . . ib. Fluid of ranula ...... 519 Bile . . . . . . . . ib. Morbid bile . . . . . .520 Use of the bile . . . . . . . ib. Gastric juice . . . . . ib. Vicarious secretion of milk . . 521 Dumas' experiments on the influence of food on the milk of the bitch . ib. Colouring matter of urine (uroxanthin, uroglaucin, and urrhodin) . 522 Quantitative determination of urea . . . 525 Urine in Bright's disease ..... 528 Liquor amnii . . . . . . 541 CHEMISTRY OF MAN. CHAPTER III. THE SECRETIONS OF THE CHYLOPOIETIC VISCERA, AND THE THEORY OF DIGESTION. The Saliva. THE saliva is a peculiar fluid, secreted by the parotid, sub- maxillary, and sublingual glands, and conveyed from them by certain ducts into the cavity of the mouth, where it becomes mixed with the buccal mucus. It may, however, be obtained in a state of purity by collecting it as it flows from one of the ducts. The following observations respecting the secretion of the saliva were made by Mitscheriich, 1 on a person with a salivary fistula, in whom the saliva could be collected directly from Steno's duct. He found that there was no flow of saliva while the muscles of mastication and of the tongue were in a state of perfect repose, and all nervous excitement avoided. He likewise observed that, during the acts of eating and drink- ing, (especially at the commencement,) the secretion was abundant, being proportionate to the stimulating nature of the food and to the degree it was masticated. From two to three ounces of saliva were collected from one of the parotid glands in the course of twenty-four hours. It is usually supposed that about ten or twelve ounces of saliva are secreted daily, but accu- rate observations are still required on this subject. Human saliva is a rather opalescent, viscid, colourless fluid ; 1 Rust's Magaz. vol. 40. II. 1 2 THE SECRETIONS: when collected and allowed to rest in a cylindrical glass, it is observed to yield a deposit of epithelium-scales and mucus- corpuscles, while the supernatant fluid remains clear. When perfectly normal, its reaction is alkaline ; it is devoid of taste and odour, and, when observed under the microscope, is seen to contain peculiar corpuscles, which differ very slightly in their form from tumid mucus- corpuscles. The appearance presented by human saliva taken from the mouth, when examined under the microscope, is depicted in fig. 13. I have always observed the cells (a) in the saliva ; they appear to consist of swollen sali- vary corpuscles. The salivary corpuscles are represented in (b) ; (c) represents epithelium-scales ; and (d) fat-vesicles. Mem- branous shreds are sometimes observed, apparently fragments of injured epithelium-scales. The amount of solid residue in the saliva is very small; it is composed of fat, ptyalin, water- extract, spirit-extract, a little albumen, certain salts, and a trace of sulphocyanogen. The presence of the last constituent was first noticed by Treviranus ; it has since been detected by Gmelin and Tiede- mann, and other chemists. 1 The salts of human saliva are, according to Mitscherlich, chloride of calcium, lactates of soda and potash, soda either free or combined with mucus, phosphate of lime, and silica : according to Gmelin and Tiedemann, they consist of alkaline carbonates, phosphates, muriates, and traces of sulphates, toge- 1 The occurrence of this substance in the saliva is equally interesting in a physiolo- gical and chemical point of view ; and it would be very desirable to establish its pre- sence in an unquestionable manner by experiments on a large quantity of saliva. Gmelin and Tiedemann (Die Verdauung nachVersuchen, vol. i, p. 9) formed an alcoholic extract of saliva, and distilled the residue, after mixing it with phosphoric acid. The fluid obtained by this distillation reddened litmus paper, after some days evolved an odour of prussic acid, yielded a deep yellow-red colour on the addition of perchlo- ride of iron, and precipitates on the addition of nitrate of silver and nitrate of peroxide of mercury. On the addition of sulphate of iron and sulphate of copper to a portion of the distilled fluid, a white precipitate was thrown down, which communi- cated a red colour to an acid solution of perchloride of iron. The clear chlorine- solution, obtained by mixing chlorate of potash, hydrochloric acid, and chloride of barium, was rendered turbid when digested with a portion of the distilled fluid, and there was a gradual deposition of sulphate of baryta, the sulphuric acid being obtained at the expense of the hydrosulphocyanic acid. Gmelin and Tiedemann observed the reaction indicating the presence of sulphocyanogen in the saliva of the sheep, and I have noticed it in the saliva of the horse. SALIVA. 3 ther with the phosphates and carbonates of lime and magnesia. According to Hiinefeld, ammoniacal salts are also present. On evaporating the saliva, we obtain a brown residue, which evolves a rather agreeable odour, resembling that of toasted bread. In certain pathological states the saliva contains other sub- stances besides those already enumerated : thus, in one case of morbid saliva I detected free acetic acid, and in another I found a considerable quantity of a substance resembling casein. The albumen contained in the saliva is indicated by the turbidity produced on the application of heat ; and after the removal of the coagulated albumen by nitration, the presence of the various extractive matters may be shown by the precipi- tates thrown down by acetate of lead, bichloride of mercury, and tannin ; the casein may be indicated by the addition of acetic acid ; ptyalin, and probably casein, by the addition of alcohol to clear and somewhat concentrated saliva ; and sulpho- cyanogen, by the redness produced on the addition of perchlo- ride of iron. With a view to separate the constituents of the saliva I eva- porated a known quantity to dryness, and thus determined the water. I then treated the residue with ether, for the purpose of extracting the fat ; and with water, in order to take up the ptyalin, extractive matters, and salts. The insoluble residue that had resisted the action of ether and water, consisted of albumen and mucus. Another portion of the saliva was de- canted from its precipitate, evaporated to a small residue, and the ptyalin, with a trace of extractive matter, precipitated by alcohol. When the saliva contains a caseous matter, (which I have observed in large quantity in the saliva of the horse,) the precipitate of ptyalin and casein produced by the alcohol must be dissolved in water, and the casein then thrown down by the careful addition of acetic acid. In this case, a portion of the casein precipitated by the alcohol usually remains un- dissolved by the water. I have detected free acetic acid in the saliva discharged during salivation. In order to determine its quantity, the saliva must be accurately neutralized by a solu- tion of carbonate of potash of known strength ; from the amount of the alkaline solution required, the quantity of acetic acid can be calculated. If, in addition to acetic acid, free lactic acid is likewise present, the residue of the saliva, after evaporation, 4 THE SECRETIONS: when dissolved in water, will still indicate an acid reaction, because lactic acid differs from acetic acid in not being vola- tilized at the ordinary temperature used for evaporating animal fluids. In order to determine the amount of free soda in the saliva, the dried residue must be extracted with alcohol ; the free soda (which is left in the residue) must be saturated with acetic acid, the resulting acetate of soda extracted with alcohol,, evaporated, and, by incineration, reduced to carbonate of soda. An analysis of my own saliva yielded the following results. It contained, in 1000 parts : Analysis 58. Water .... 991-225 Solid constituents . . . 8-775 Fat containing cholesterin . . -525 Ptyalin with extractive matter . . 4*375 Extractive matter and salts . . 2-450 Albumen, mucus, and cells . 1-400 Berzelius 1 found, in 1000 parts of human saliva : Water .... 992'9 Ptyalin . . . .2-9 Mucus . . . .1-4 Extract of flesh with alkaline lactates . '9 Chloride of sodium . .1-7 Soda . . -2 According to the analyses of Tiedemann and Gmelin, 1000 parts of human saliva contain from 9 to 11*4, or even 11*9 of solid constituents, consisting in 100 parts, of phosphorized fat, extract of flesh, chloride of potassium, lactate of potash, and sulphocyanide of potassium, 31 '25 ; animal matter with traces of alkaline sulphates and chlorides, 1-25 ; ptyalin, with alkaline phosphates, chloride of sodium, and traces of alkaline sulphates, 20-00 ; mucus and a little albumen, with alkaline phosphates and carbonates, 40-00. This solid residue yielded on incine- ration 21-95 of inorganic constituents, 17*8 of which were soluble, and 4-1 insoluble in water. Mitscherlich found that 1000 parts of human saliva yielded from 14-7 to 16-3 of solid residue, of which 34 were insoluble both in water and in alcohol, 42g soluble in water but not in alcohol of -800, and 24 soluble in water and in alcohol. These proportions varied, however, in different analyses. 1 Thierchemie, p. 219. SALIVA. 5 The inorganic constituents in 1000 parts of saliva are, accord- ing to Mitscherlich, chloride of calcium, 1-8; lactate of potash, 95 ; lactate of soda, -24 ; soda, probably combined with mucus, 1*64; phosphate of lime, '17; silica, "15. [According to Dr. Wright, pure saliva is a limpid fluid, having a faint blue tinge, and a slight degree of viscidity. It is per- fectly uniform in consistence, and unobscured by frothiness or flocculi. It possesses a faint sickly odour sui generis, due to its constituent, ptyalin : this odour is strengthened by heat and by most acids, but alkalies diminish and destroy it. The saliva even of healthy people varies considerably in its specific gravity. It is always denser after a meal than during fasting ; and generally denser in an evening than in a morning. But the converse is usually the rule with dyspeptics. Dr. Wright found that animal (especially fatty) diet, and alcoholic stimulants, have a tendency to thicken the saliva ; oysters, and vegetable diet, he says, produce an opposite effect. He states, as the result of many trials and observations, that healthy saliva is mostly of a sp. gr. of 1007-9. When above 1010-0 or below 1003-0, the secretion maybe considered to be morbid. Healthy saliva, he affirms, is either alkaline or neutral, generally the former. If saliva be heated, it not uncommonly acquires an acidity in a few minutes, but this chiefly happens to neutral saliva. Dr. Wright believes in the existence of the principle called ptyalin, though he separates it from saliva by a new process. This process is " to pass saliva through ordinary filtering paper, and, after filtration shall have been completed, to exhaust the residue with sulphuric ether; the ethereal solution contains a fatty acid and ptyalin. 1 It is to be allowed to evaporate spontaneously, and the residue left by evaporation is to be placed upon a filter and acted upon by distilled water, which dissolves the ptyalin and leaves the fatty acid. If the aqueous solution be carefully evaporated to dryness, the " salivary matter will be obtained in a pure state/' " Ptyalin," he says, " as thus pre- pared, is a yellowish-white, adhesive, and nearly solid matter, neither acid nor alkaline, readily soluble in ether, alcohol, and 1 A reference to vol. i, p. 24, will show that Wright's ptyalin differs in several respects from the ptyalin described by Simon. In truth, little is known regarding this constituent. 6 THE SECRETIONS: essential oils, but more sparingly soluble in water. It alone possesses the characteristic odour of saliva ; it is unaffected by galvanism and by most of the reagents which coagulate albumen. It is abundantly precipitated by sub-acetate of lead and nitrate of silver ; feebly so by acetate and nitrate of lead, and tincture of galls; uninfluenced by bichloride of mercury and strong acids ; the latter considerably heighten its proper odour and impair its solubility, whilst alkalies render it more soluble, and give it the smell of mucus. Moderate heat and oxygen gas also increase its odour, but a more intense heat or cold dimi- nishes or entirely destroys it. At a suitable temperature, ptyalin may be preserved for any length of time without risk of decomposition. The salivary fluid from which ptyalin has been removed, possesses a sickly mucous smell, decomposes much sooner than ordinary saliva, and, in the process of decay, invariably evolves ammonia. If the fluid be heated, the mucous smell will be increased until the evaporation shall have been continued nearly to dryness, when a slight salivary odour may be recognized, due to a portion of ptyalin being liberated from the mucus with which it was previously in combination." Dr. Wright says that sulphocyanogen is an invariable consti- tuent of healthy human saliva. He advises that it be sought for in the alcoholic extract of the residue left by the careful evaporation of the fluid, as the mucus, unless removed, offers considerable impediment to the action of reagents. The sulpho- cyanogen occurs in combination with potassium, the salt consti- tuting generally from -051 to -098 of the secretion. "The proportion," he says, " is temporarily augmented by local sti- mulation of the salivary glands, as by smoking, chewing siala- gogues, &c. It is also increased by the internal use of prussic acid and salts of cyanogen, and remarkably so by the use of sulphur." Pure saliva absorbs a variable quantity of oxygen. Dr. Wright says, " I have known the quantity absorbed to exceed 2i times the bulk of the saliva ; but I once met with an instance in which the healthy secretion did not absorb more than half its volume of oxygen. The difference is generally dependent upon the carbonic acid gas naturally contained in the saliva, the proportion of which gas to the secretion varies from one eighth to one twelfth in volume, though, in some particular SALIVA. 7 cases, it is much more abundant." He says that saliva, in its healthy state, contains also oxygen gas, which it can be made to evolve on the application of heat. This in some measure aids its digestive powers ; for he found that saliva which had been exposed for some hours to an atmosphere of oxygen, con- verted a much greater quantity of starch into gum and sugar than other saliva which had not been so exposed. This state- ment, founded upon a great number of comparative experiments was made by Dr. Wright long before the apparently less correct observation of Liebig, that the saliva collects " bubbles of air" to assist the digestive function. In pure saliva there are no " bubbles of air ;" the absorbed gases are carbonic acid and oxygen, the latter only contributing to the digestive properties of the fluid. As the result of numerous analyses, the process of which Dr. Wright has fully detailed, he gives the following as the constituents of the healthy secretion : l Water .... 988-1 Ptyalin . . . 1'8 Fatty acid ... '5 Chlorides of sodium and potassium . 1-4 Albumen with soda . . '9 Phosphate of lime . . *6 Albuminate of soda . . "8 Lactates of potash and soda . *7 Sulphocyanide of potassium . '9 Soda ... -5 Mucus, with ptyalin . . 2-6 I/Heretier has recorded the mean of ten analyses of the saliva of healthy persons, collected while fasting : Water . . . 986-5 Organic matter . . 12-6 Inorganic matter . . -9 The salivary matter, or ptyalin, formed 2'5 of the 12'6 parts of organic matters. In children, the amount of water is generally increased. As a mean of four analyses, he found : 1 Der Speichel in physiologischer, diagnostischer, und therapeutischer Beziehung, p. 28, Wien, 1844. Dr. Wright's investigations first appeared in the Lancet. 8 THE SECRETIONS: Water . . . 996-0 Organic matter . . 3'5 Inorganic matter . . *5 The ptyalin amounted to only I'l. He was unable to detect any difference between the saliva of man and woman. Enderlin has made numerous analyses of the ash left after the incineration of the saliva, and has always found it to have the same constituents. He considers that its alkaline reaction is due to the tribasic phosphate of soda (3NaO, PO 5 ) which retains the mucus and protein-compounds in solution. Enderlin observes that, independently of conclusions deduced from the ash, he has sought unsuccessfully, in a direct manner, for lac- tates in the saliva. On incinerating salivary mucus obtained by washing that constituent from a filter, the residue is found to consist of phosphate of lime, with traces of chloride of sodium and phosphate of soda, the same composition as the tartar that collects on the teeth. A quantitative analysis of the ash from a large amount of saliva obtained from different persons, yielded the following results : A. Constituents soluble in water. Tribasic phosphate of soda (3NaO, P0 5 ) . 28-122"! Chlorides of sodium and potassium . 61-930 192-387 Sulphate of soda . . . 2-315 J B. Constituents insoluble in water. Phosphate of lime magnesia ? , 1 5-509 ] peroxide of iron Very little is known with certainty regarding the part taken by the saliva in the process of digestion. Spallanzani fancied that he had observed that food inclosed in tubes pierced with numerous apertures, and moistened by the saliva, was more rapidly digested than when simply moistened with water. Berzelius, however, found that the saliva exerts no greater solvent power than pure water, and Muller confirms his state- ment. Hiinefeld, on the other hand, believes that the object of the saliva is to destroy the tenacity of the food, and he MORBID SALIVA. 9 thinks that it has the power of reducing fibrin to the condition of a viscid fluid. [The services which the saliva performs in the animal eco- nomy are classified by Dr. Wright as follow : Active. 1. To stimulate the stomach and excite it to acti- vity by contact. 2. To aid the digestion of food by a specific action upon the food itself. 3. To neutralize any undue acidity in the stomach by supplying a proportionate alkali. Passive. 1. To assist the sense of taste. 2. To favour the expression of the voice. 3. To clear the mucous membrane of the mouth, and to moderate thirst. Mialhe 1 has recently announced the discovery of an active principle in the saliva analogous in its physical and chemical characters to diastase. It is solid, white or greyish-white, amorphous, insoluble in alcohol, but soluble in water and spirit. The directions for obtaining it are the following : Filter saliva and treat it with five or six times its weight of absolute alcohol, adding it as long as any precipitate occurs. This animal dias- tase is insoluble, and falls in white flocks, which must be col- lected on a filter and dried. It forms about '2g of the whole saliva.] Leuchs 2 was the first who observed that saliva converts boiled starch into sugar. Morbid Saliva. The saliva becomes affected in various morbid conditions of the system, but the nature of the changes that it undergoes has not hitherto been sufficiently studied. Morbid saliva sometimes contains a free acid ; this is most commonly lactic acid, but, in some cases, acetic acid is likewise present. The acid reaction may be at once detected by test paper; while normal saliva communicates a blue tint to red litmus paper, this, on the contrary, reddens blue paper. I have frequently seen the saliva acid in acute rheumatism, and in cases of sali- 1 Lancette Fran?aise, 1845, April. - Kastner's Archiv. 1831. 10 THE SECRETIONS: vation. According to Donne, 1 the saliva has an acid reaction in all cases of irritation and inflammation of the stomach, in pleuritis, encephalitis, intermittent fevers, acute rheumatism, uterine affections, and amenorrhoea. Brugnatelli 2 detected oxalic acid in the saliva of a phthisical patient. The secretion of saliva is sometimes increased to an extraordinary degree, constituting salivation; in such cases, the chemical characters of the saliva are also more or less affected. In a specimen of saliva forwarded to me for examination, which was obtained from a patient who had just terminated a course of mercury of some weeks' duration, I observed an acid reaction arising from the presence of free acetic acid. It was very viscid, of a yellow colour, and possessed a sickly, disagreeable, acid smell. It contained no mercury. After evaporation to dryness, all the acid reaction had disappeared : thus showing that it contained no free lactic acid. This saliva contained a very large quantity of semifluid fat, a considerable amount of albumen, and traces of caseous matter. Under the microscope, an immense num- ber of fat-vesicles were seen, some epithelium-cells, and a very few partially-destroyed saliva-corpuscles. 1000 parts of this saliva were composed of: Analysis 59. Water . . 974-12 Solid constituents . . . 25-88 Yellow viscid fat . . 6'94 Ptyalin with extractive matter and traces of casein 3-60 Alcohol-extract with salts . . 7-57 Albumen .... 7-77 The salts consisted of a largely preponderating amount of the chlorides of sodium and potassium, associated with the lactates of soda and potash, and with a small quantity of the earthy phosphates. On contrasting this saliva with the normal fluid, we are struck with its large amount of solid constituents, arising not from any increase of the ptyalin, but of the fat, the extractive matters, the albumen, and the salts. [L'Heretier gives the mean of three analyses of this secretion during mercurial ptyalism. He found : 1 Arch. Gener. de Med. 1835, May. 2 Stark. Allgemeine Pathologie, p. 1074. MORBID SALIVA. 11 Water . . 970-0 in place of 986-5 Organic matters . 28-6 12-6 Inorganic matters . 1-1 1'9 The mean amount of ptyalin was 2*6, or very nearly the normal quantity. He attributes the large amount of organic matter to the increased quantity of mucus secreted by the buccal membrane. Dr. Wright also found that the saliva of mercurial ptyalism contained an unusual amount of mucus. It consisted of: Water .... 988-7 Ptyalin . . . . 1-9 Fatty acid .... -4 Albumen with soda, and \ Albuminate of soda J Mucus with a trace of ptyalin . . 3-8 p , ' i Phosphates . . I Muriates . . I T . Lime J Hydrosulphocyanates . -* He could not detect the slightest trace of mercury in it.] Gmelin 1 has examined saliva discharged in consequence of salivation produced by mercurial inunction. In one case it was brown and turbid, and contained a large quantity of fat but not much albumen; in another instance it presented a yellow tint ; it contained a large quantity of yellow fat, and when heated, gave no perceptible indication of coagulation. In both cases, but most decidedly in the latter, indications of mer- cury were obtained. 2 Thomson 3 found the saliva resulting 1 Pogg. Ann. 41, p. 438. 2 Gmelin employed Smithson's method for the detection of the mercury. A large quantity of saliva was treated with nitric acid, and evaporated ; the residue was di- gested with nitric acid and dissolved in water ; and, after the removal of fat by filtra- tion, a stream of sulphuretted hydrogen was passed through it. The precipitate obtained by this process contains sulphuret of mercury ; it must be collected, digested in nitro-muriatic acid, evaporated, dissolved in dilute hydrochloric acid, and a bit of gold-leaf enveloped in tin-foil, or encircled by iron wire, suspended in the fluid. The gold is tarnished if mercury is present. No tin-foil should be used that has not been itself tested for mercury. In place of the gold-leaf I have employed the blade of a knife with advantage. 3 Annals of Philosophy, vol. vi, p. 397. 12 THE SECRETIONS: from the administration of mercury, turbid ; it deposited flocculi of coagulated albumen. It was not precipitable by tannic acid, had a specific gravity of 1003-8, and contained, coagulated albumen, 2'57 ; mucus, 3'67 ; chloride of sodium, -9 ; water, 992'8. Bostock analysed the saliva of a man who was secreting about two quarts daily in consequence of mercurial salivation. It was of a clear brown colour, neutral, viscid, but not stringy, and barely transparent. It became clear, however, after the deposition of the minute flocculi suspended in it; the appli- cation of heat, and also the addition of corrosive sublimate, gave indications of the presence of albumen. It yielded 2 of dried residue. After the discontinuance of the mercury, the saliva was found to be less transparent; it reddened litmus paper, contained more albumen, and more solid constituents generally. Vogel 1 analysed the saliva of a man with sponta- neous salivation; it contained 991 '2 parts of water; 4'4 of ptyalin, osmazome, fat, and albumen ; and 4'4 of salts of soda, potash, and lime; hence, in respect to the amount of solid constituents and ptyalin, this saliva did not differ very much from the normal standard. Mitscherlich also found that, in the salivary flow excited by nervous irritation, the amount of the solid constituents was not increased, that the ptyalin and sulphocyanogen were even below the normal standard, while, on the other hand, the extractive matters were somewhat in- creased. A similar observation has been made by Guibourt. I examined the saliva of a patient suffering from an inflam- matory affection of the pancreas. It was discharged from the mouth in large quantity ; it was a clear, viscid fluid, mixed with mucus, alkaline in its reaction, and exhibiting, under the microscope, mucus-corpuscles, numerous oil- vesicles, epithelium- cells, and membranous shreds : its specific gravity was 1005 ; and 1000 parts yielded only ten of solid residue, which, in addi- tion to mucus, and a very small quantity of albumen, consisted principally of an extractive matter which developed an aromatic odour on the application of heat, of fat, certain salts, and a little ptyalin. 1 Lehrbuch der Physiologic, von R. Wagner, p. 212. MOUBID SALIVA. 13 [I/Heretier observes that, in chlorosis, the amount of water increases in proportion to the progress of the disorder. An analysis of the saliva in this disease is given in page 299 of his Pathological Chemistry. In dropsy, with albuminous urine, the saliva contained : Water . . . 985-9 Organic matter . . 13-6 Inorganic matter . . '5 In most inflammatory affections, the amount of water is diminished. The following numbers express the mean results of six analyses in cases of inflammatory fever, pneumonia, and erysipelas : Water . . . 968-9 Organic matters . . 30-0 Inorganic matters . . 1-1 The mean amount of ptyalin was 3*6 ; the ordinary amount, according to L'Heretier, being 2*5. The three following forms of morbid saliva have been ana- lysed by Dr. Wright : Fatty saliva. Water . . . .987-4 Ptyalin .... '7 Adventitious fatty matter and fatty acid . 3'9 Albumen with soda, and "1 / ' ' 1 ' albuminate of soda Sulphocyanide of potassium . . a trace Mucus .... 2-4 Lactates . -j Potash Muriates . [ Soda . \- 1-8 Phosphates 1 Potash -j Soda . I Lime . J Sweet saliva. Water .... 986-9 Ptyalin .... '3 Fatty acid .... Muco-saccharine matter . . . 5-6 Albumen with soda, and -i . 4 albuminate of soda 14 THE SECRETIONS: Sulphocyanogen a trace Mucus with a trace of ptyalin Lactates . -j Potash Muriates * s 1a - I l ' 9 1 roiasii I Soda . J Lime . Phosphates Bilious saliva. Water Ptyalin Fatty matter and fatty acid Biliary matter Cholesterin Albumen with soda, and albuminate of soda ~l J Mucus . 1>6 Carbonates . -> Potash -i Muriates I Soda . 2-3 ] Phosphates . J Lime . Saliva of animals. I have analysed the saliva of a horse suffering from ozsena. Professor Hertwig kindly assisted me in exposing Steno's duct ; and, in the course of eight hours, (during which time the horse was feeding,) about five ounces of saliva were collected from the opened duct. The fluid was viscid, of a faintly yellow colour, devoid of odour, alkaline in its reaction, and possessed a specific gravity of 1006. (Schultz 1 collected in a similar manner 55 ounces 7 drachms of saliva from a horse in the course of twenty-four hours.) After some time, the saliva deposited a white sediment, consisting of irregular mem- branous shreds and saliva-corpuscles. On the application of heat it became turbid. A copious precipitate was thrown down on the addition of acetic, dilute sulphuric, or lactic acid ; and on evaporation it became covered with a film of coagulated casein. Perchloride of iron produced a vivid red colour, and a slight precipitate. It contained a larger amount of solid con- stituents than human saliva, and a very considerable quantity of casein, part of which coagulated on evaporation, and part was thrown down by acetic acid; in this manner it was sepa- 1 De Alimentor. concoctione. Berol. 1834. SALIVA OF THE SHEEP. 15 rated from the ptyalin. 1000 parts of this saliva were com- posed of: Analysis 60. Water .... 982-000 Solid constituents . . . 18-000 Fat containing cholesterin -120 Ptyalin with extractive matters Casein Albumen Extractive matters and salts 4-442 5-422 601 7-178 Saliva of the dog. The saliva of a healthy dog was collected by exposing Steno's duct, and examined by Gmelin and Tiedemann. It was rather turbid, of a pale yellowish-white colour, thick, capable of being drawn out in threads like albumen, alkaline in its reaction, and 1000 parts left, on evaporation, a solid residue of 25-8, consisting of a little extractive matter soluble in alcohol, an average quantity of ptyalin, mucus, a very large amount of chlo- ride of sodium, together with alkaline carbonates, acetates, sul- phates, and phosphates, and a little phosphate and carbonate of lime. Saliva of the sheep. Gmelin and Tiedemann succeeded in collecting between three and four ounces of saliva in the course of fifteen hours from the stenonian duct of a sheep. It was of a reddish tint, in consequence of being mixed with a little blood, perfectly fluid, faintly alkaline, and of a slightly saline taste. 1000 parts of the saliva contained : Water ..... 989-0 Extract of flesh, an organic matter with which chloride of sodium crystallized in octohedra, chloride of sodium, and a little sulphocyanide of sodium . . . I'l A little ptyalin, with a good deal of phosphate and carbonate of soda, and chloride of sodium ... 8-2 Mucus or albumen, with a little phosphate and carbonate of potash . . . . '5 16 THE SECRETIONS: The Pancreatic Fluid. The most accurate analysis of the pancreatic juice is that of Tiedemann and Gmelin. 1 Earlier observers, as, for instance, De la Boe, De Graf, and others, had shown that it is an acid, clear, rather viscid fluid, possessed of a saline or acid-saline taste. Wepfer, Pechlin, and Brunner, on the other hand, had described it as turbid, of a whitish colour, not acid, but having a saltish taste, somewhat like the lymph. Mayer 2 described the pan- creatic juice of a cat as transparent, viscid, decidedly alkaline, and containing albumen, chloride of sodium, and a peculiar animal matter. Magendie found it alkaline and albuminous in a dog, and in birds it contained so large an amount of albu- men as to coagulate on the application of heat. Tiedemann and Gmelin cut down upon the pancreatic duct of a strong well-fed dog, and, in the course of four hours, col- lected about 155 grains of the fluid secretion. The portion that was first collected was turbid, and somewhat red, probably in consequence of the presence of a little blood. This was placed aside. The subsequent portion had a blueish- white tint , could be drawn out in threads like dilute albumen, had a faintly saline taste, and an alkaline reaction. 1000 parts left 87 of solid residue. The red portion first collected has a faintly acid reaction. The principal constituents were extractive matters, chloride of sodium, albumen, and a sort of modified casein. The pancreatic juice of a sheep was found by Gmelin and Tiedemann to be clear, slightly acid, and of a faintly saline taste. 1000 parts left 36 of solid residue, consisting of the same ingredients as in the dog. In this instance, also, the portion that escaped during the latter part of the experiment was alkaline, and was richer in solid constituents than the fluid that escaped earlier; it contained 51-9 of solid constitu- ents in 1000 parts. The following is the result of their analyses : In the dog. In the sheep. Water .... 917-2 963-5 Extractive matters and salts soluble in alcohol 36-8 15-5 Caseous matter and soda-salts soluble in water 15-3 2-8 Albumen and salts 35-5 22-4 1 Op. cit. vol. i. p. 25. 2 Deutsch. Arch, fur die Physiologic, vol. iii, p. 170. BILE. 17 The alcohol-extract of the pancreatic juice of the dog yielded a very singular reaction. On the addition of a little solution of chlorine to the dissolved alcohol-extract, a vivid rose-red tint was produced, and, in the course of twelve hours, there was a precipitation of delicate violet-coloured flocculi. The colour was immediately destroyed by the addition of an excess of chlorine. An attempt to isolate this colouring matter proved unsuccessful. Leuret and Lassaigne have analysed the pancreatic juice of a horse, and the result of their investigation is, that it is almost identical in its composition with human saliva. This statement is so much at variance with the results obtained by Tiedemann and Gmelin, that we must conclude that Leuret and Lassaigne were not sufficiently careful in their investigation. We are still unable to state with any degree of certainty what part the pancreatic fluid performs in the process of digestion. There can be no doubt that when the pancreas is diseased, the pancreatic fluid must be also affected, but we are perfectly in the dark as to the nature of those changes. The Bile. Bilin and urea can hardly be regarded as simultaneous pro- ducts of the metamorphic action of the blood ; for while I have detected small quantities of urea in the blood of a healthy calf, I have never been able to recognize the least trace of bilin or of bile-pigment. Hence, while urea is produced not only in the kidneys but in other parts of the system, bilin seems to be produced and secreted only in the liver. The bile is a very complicated fluid. According to the latest researches of Berzelius, it contains bilin ; cholepyrrhin (or bili- phsein) ; biliverdin ; mucus ; cholesterin ; oleate, margarate, and stearate of soda ; chloride of sodium ; sulphate, phosphate, and lactate of soda ; and phosphate of lime. Gmelin and Tiedemann, as well as Frommherz, mention casein and ptyalin, and the carbonates and sulphates of soda and lime, among the constituents of the bile. A perfect analysis of bile would be a subject of extreme labour and difficulty, and we must, therefore, confine our atten- tion to its most important constituents. Let us suppose that ii. 2 18 THE SECRETIONS : it was required to ascertain the amount of bilin, bilifellinic acid, and cholesterin, in a specimen of bile ; the fluid must be first evaporated to dryness, and the amount of water thus estimated ; the residue must be repeatedly extracted with ether, the ethe- real solution evaporated to dryness, and its residue, consisting of cholesterin and fluid fat, thoroughly washed with cold and not too strong alcohol, which dissolves the greater portion of the fluid fat. It must then be digested with hot alcohol of 0-83 ; and as this solution cools, the cholesterin separates in crystals. After the removal of the fat, the residue is treated with anhydrous alcohol, which takes up bilin, bilifellinic acid, and biliverdin. The filtered alcoholic solution is then treated with a solution of chloride of barium, as long as a dark green precipitate falls ; and afterwards with baryta water, guttatim, as long as it causes any turbidity ; it is then filtered, the excess of baryta thrown down by a stream of carbonic acid, the car- bonate of baryta removed by filtration, and the solution evapo- rated to perfect dryness. The residue is dissolved in anhydrous alcohol, all the bases are thrown down from the alcoholic solu- tion by sulphuric acid dissolved in strong spirit, and then, after filtration, the solution is mixed with moist, pure carbonate of lead, and the greater part of the alcohol distilled. The fluid remaining in the retort is removed by filtration from the inso- luble portion, the lead removed by sulphuretted hydrogen, and the fluid evaporated. The residue, after being extracted with ether, leaves pure bilin mixed with a certain amount of fellinic and cholinic acids, which must be separated with oxide of lead. We then obtain pure bilin and bilifellinic acid combined with oxide of lead. An accurate quantitative determination of the most important ingredients of the bile, although difficult, is by no means im- practicable. It is, however, very uncertain whether the result of the analysis would afford any insight into the true character of that changeable secretion. From the latest researches of Berzelius, it appears that the bilin is so unstable a compound, that it is hardly possible to obtain bile in the condition in which it is secreted by the liver, or as it exists in the gall-bladder : for when bile is left to itself, and much more when it is acted on by heat and other more or less energetic agents, the bilin undergoes a series of metamorphoses by which fellinic, cholinic, BILE. 19 and very probably also cholanic and fellanic acids are produced. The biliary secretion, as it exists in the liver, may be regarded as pure bilin mixed with biliverdin and fats ; the bilin probably commences its metamorphoses in the gall-bladder, and conti- nues them in its passage onwards into the intestinal canal. If fellinic and cholinic acids are formed in the gall-bladder, then the presence of the two bilifellinic acids in fresh bile may be at once assumed, since they are only to be regarded as combina- tions of the former with different proportions of bilin. It is not by any means probable that cholic acid exists in fresh bile, and the presence of dyslysin and taurin may be positively denied ; consequently, the biliary resin, the mixture of fellinic and cholinic acids and dyslysin does not pre-exist in the bile. Berzelius and Thenard have made quantitative analyses of healthy human bile : they found, in 1000 parts : Berzelius. Thenard. Water . . . 907-4 Water . . . 909-0 Bilin, fellinic acid, &c. . 80-0 Yellow and very bitter resin 37*3 Mucus dissolved in a free alkali 3'0 Brown pigment and mucus 1-8 9'0 Free alkali and the ordinary salts 9'6 Albumen . . 38-2 Soda holding the resin in solution . . 5-1 Salts of potash and soda, and peroxide of iron . 4-1 According to Gmelin and Tiedemann, human bile contains biliary sugar, brown pigment, a little biliary resin, cholesterin, ptyalin, mucus, oleic acid, and salts. [In the year 1837, Dema^ay announced that the bile con- sisted essentially of an organic acid combined with soda. He termed this acid choleic, and obtained it in the following man- ner : Bile from which the mucus had been precipitated by alcohol was evaporated on the water-bath, and ten parts of the dried residue were dissolved in 100 of water, to which ten of hydrochloric acid had been added. Allowing evaporation at a moderate temperature to proceed, it was observed that a dark green oil collected on the surface, while, at the same time, the fluid became turbid. On removing the oil, and allowing the fluid to rest for some time, it gradually became clear, with the precipi- tation of a green deposit. This dark green bitter precipitate is 20 THE SECRETIONS: Demar9ay's choleic acid, and is regarded by him as constituting nine tenths of the solid constituents of the bile. It is still mixed with margaric acid, cholesterin, pigment, &c. After the removal of these impurities, it is described by Demaryay as a yellow, spongy, pulverulent matter, which rapidly absorbs oxygen from the atmosphere ; very bitter, slightly soluble in ether, soluble in water, and very soluble in alcohol. Its solutions have an acid reaction, decompose carbonates, and form a pecu- liar class of salts with bases from which the choleic acid may be removed by acetic acid. Its composition is represented by the formula C 42 H 36 NO 12 . The choleate of soda obtained by adding an alcoholic solution of soda to an alcoholic solution of choleic acid till there is an alkaline reaction, and then passing a current of carbonic acid through it to remove the excess of soda, possesses all the characters of bile ; it yields, on evapo- ration, a brown resinous mass, and is soluble in water and in alcohol. When choleic acid is boiled with hydrochloric acid, it yields ammonia, taurin, 1 and choloidic acid ; the latter being insoluble, is deposited. (Compare this with page 46, vol. I.) Choloidic acid is solid, fusible, of a yellow colour, and bitter taste, insoluble in water, and soluble in alcohol. It combines with bases, neutra- lizing them, and forming salts which are soluble in alcohol. It contains no nitrogen, and its formula is C 72 H 56 O 10 . Dr. Kemp has communicated some experiments relative to the bile, tending to show that it is principally composed of a mere simple solution of a salt of soda, the acid of which differs from the choleic acid of Demar9ay in several respects ; he terms it bilic acid. Liebig has published a memoir based on Kemp's experiments, in which he arrives at very similar conclusions, but regards bilic acid as identical with the choleic acid of Demar9ay and the bilifellinic acid of Berzelius. Theyer and Schlosser have subsequently published an account of some new researches on the bile which were made in the Giessen laboratory, and confirm the accuracy of Liebig's pre- vious conclusions. In a recent essay on the bile, by Platner, 2 it is shown that 1 It has been recently asserted by Redtenbacher that taurin contains 26g of sulphur. Hence the formula C 4 H 7 NO, (see vol. I. p. 47) fails to represent its true com- position. Muller's Archiv, No. 2, 1844. BILE. 21 the bilic acid and acid bilate of soda may be procured in a crystalline state. In a subsequent communication by the same chemist, after correcting certain errors in his first paper, he proceeds to show that two distinct substances are met with in perfectly fresh bile : " I have been able," he observes, " to cause bile, which was evaporated in a water-bath, and freed from mucus and the greater part of its salts by repeated solu- tion in alcohol, to crystallize immediately. For this purpose nothing further is necessary than to add ether repeatedly to as strong an alcoholic solution of the bile as possible, and then to set it aside in a cool place. The principal and most impor- tant constituent of the bile then crystallizes, in the same manner as in my former experiments ; but i \ of the bile used does not crystallize, but remains as a yellowish-brown syrup. I have not been able to succeed in separating this in any manner from the crystals ; consequently, I can say nothing more concerning its nature. It is, however, evidently a different substance from the principal constituent of the bile, possibly a product of its decomposition. The decomposition of the bile begins even in the organism, and it is impossible to examine fresh bile which is not partly decomposed. The brown liquid appears to consist principally of biliary colouring matter. I must, however, re- mark that the crystals have also a slightly yellow tint. The principal constituent of bile is a compound of soda with a peculiar organic body, and this compound may be immediately procured from the bile without its undergoing any important alteration. Liebig called this compound bilate of soda; I have denominated it choline-soda. It does not appear to me suffi- ciently proved that the principal organic constituent of bile is positively an acid. It is possible that, like albumen, it may combine with acids as well as with bases. The most recent examinations of the bile by Berzelius would then be partly true. Further experiments must decide this. These, however, are peculiarly difficult, because, in separating the bile from soda, an acid body may undoubtedly be formed. From the above observation, it is further evident that the formula advanced by Liebig for bilic acid must be incorrect; for Kemp, Theyer, and Schlosser have not analysed the essential biliary ingredient in a perfectly pure state, but have always at the same time in- cluded the brown syrup.] 22 THE SECRETIONS: Morbid Bile. Our knowledge of the changes that the bile undergoes in disease is still very superficial. In persons suffering from dropsy, the bile is stated by Forget to be thinner, and, in persons with diseased liver, thicker, than in the normal state. I examined the contents of the gall- bladder of the woman with icterus, referred to in vol. I, p. 329. I only obtained a small quantity of viscid, dirty yellow fluid, from which alcohol precipitated mucus and albumen. The portion soluble in alcohol yielded, after evaporation, a small quantity of a viscid substance with a sweet rather than a bitter taste. Bizio 1 has analysed a remarkable specimen of bile taken from the gall-bladder of a man who died in a jaundiced con- dition. It was a fluid of a dark-red colour, thick, of a nauseous but not bitter taste, with an odour of putrid fish, and holding in suspension red and black particles. It contained fatty oil, 3-972 ; stearin, 8-613 ; green resin, 2-030 ; a yellow, non-nitro- genous, hard substance, soluble in alkalies, in cold hydrochloric acid, and in alcohol, 1*937 ; erythrogen, 4-157 ; dissolved hae- matin, 3-148; a gummy-saccharine extract with colouring matter, 1-978; soluble albumen, 7'282; fibrin, 11-348; phos- phate of soda, 1-340; chloride of sodium, 0-984; phosphate of lime, 1-320; peroxide of iron, 0-532; water, 51-232. [Scherer 2 analysed the bile of a man who died in a state of icterus. It was a thick fluid of a blackish green colour, and exhibited under the microscope a large number of pigment-cells. It contained in 1000 parts : Water . . . 859-6 Solid constituents . . 140-4 Bilin 48-6 Bilifellinic acid Fat Bile-pigment Salts 30-5 8-6 44-3 8-0 Not a trace of cholesterin could be discovered in this bile, 1 Brugnatelli Giorn. di Fisica, vol. xv, p. 455. 3 Untersuchungen, &c. p. 103. MORBID BILE. 23 which Scherer regards as singular, although, according to Berzelius, it amounts to only -0001 of healthy bile (in the ox), a quantity easily overlooked. The bile-pigment 1 in healthy bile is imponderable ; its amount in this case, as well as that of the solid constituents generally, is enormous.] Chevallier 2 found that the bile of a man with scirrhous pan- creas, who died jaundiced, was of a pale greenish yellow colour, evolved a putrid odour, had an alkaline reaction, and a faint, slightly saline taste : it contained a yellow, semi-crystalline fat, green resinous matter, ptyalin, osmazome, soluble albumen, hydrosulphate of ammonia, and phosphate, sulphate, and hydro- chlorate of soda. Chevallier found that the bile of a woman who died from pulmonary phthisis was of a brownish yellow colour, and yielded 2 of dried residue, of which 0-83 was biliary sugar. According to Chevreul, the bile in cases of phthisis contains very little fat. The bile of a woman who died from the effects of syphilis is described by Chevallier as of a dark green colour ; it yielded 20 30 of dried residue, of which one third, or 0-94, was biliary sugar, with resinous and yellow matter. Phoebus 3 found that, in persons who died from cholera, the gall-bladder was usually tolerably full, (sometimes to an excess,) and that the bile was rather dark-coloured. According to Hermann, the bile in cholera contains an excess of resin. In cases of fatty degeneration of the liver, there is, accord- ing to Thenard, a diminution of the biliary resin, and the bile appears as a mere albuminous fluid, and by the time that the liver contains five sixths of its weight of fat, the bile loses all its original characters. Lehmann 4 states that the bile of a dropsical boy developed a large amount of hydrosulphate of ammonia, a circumstance which, in other cases, did not occur even when the bile had been kept for some days. 1 [Scherer has recently investigated the composition and properties of biliary co- louring matter. A notice of his researches may he found in my Report on the Pro- gress of Chemistry in " The Half-yearly Abstract of the Medical Sciences," vol. i, 1845.] 2 Journ. de Chim. Med., vol. ii, p. 461. 3 Cholera Archiv, vol. i, p. 399. 4 Summarium, vol. xii. 1839. 24 THE SECRETIONS: Bile of Animals. The bile of animals has been examined by Berzelius, Gmelin, Thenard, myself and other chemists. [According to the latest observations of Berzelius, filtered ox- gall, when evaporated to dryness at a temperature of 266, gives off 928-38 parts of water, and leaves 71-62 of solid residue, consisting of Mucus ...... 2-310 Extractive matter insoluble in alcohol, with alkaline sulphates and phosphates ..... 4 '334 Chloride of sodium, lactate of soda, and extractive matter soluble in alcohol . . . . 15-000 Bilin and cholepyrrhin .... 50-000 Cholesterin . . . . . -001 According to Enderlin, 1 the following salts occur in the bile of the ox : Choleate (or bilate) of soda, Tribasic phosphate of soda, Alkaline sulphates, Chlorides of sodium and potassium, Phosphate of lime, Phosphate of magnesia, Phosphate of peroxide of iron, and occasionally Sulphate of lime. The bile of the ox and of the swine has likewise been analysed by Thenard, and the bile of the dog by Gmelin, but the de- scriptions are of so vague a character as to be of little or no use. The same objection applies to their examination of the bile of various birds.] In the bile of the Python bivittatus Berzelius found bilin (as in the mammalia), a small quantity of bilifellinic acid, bile-pigment the same as in other classes of animals, a little crystalline biliary matter precipitable by carbonate of potash, similar to that which occurs in the bile of fishes, ptyalin or a substance resembling it, a peculiar animal matter soluble only in boiling water, fatty acids, and the ordinary salts. The bile of the Coluber 1 Annalen der Chemie imd Pharinacie, 1844. BILE OF ANIMALS. 25 natrix is described by Gmelin as of a grass-green colour, trans- parent, perfectly fluid, and passing through the ordinary change of colour (blue, red, and yellow) on the addition of nitric acid. The bile of the Rana esculenta and R. temporaria is very fluid, of a pale green colour, and yields the ordinary series of tests with nitric acid. The bile of the water-frog leaves a somewhat crystalline residue on evaporation ; the bile of the grass-frog has a sweetish taste, and is less bitter than fish-bile. The bile of the Cyprinus leuciscus is described by Gmelin as green, transparent, and fluid, communicating a sweet and after- wards a very bitter taste to the gustatory organs, neutral in its reaction, affected, as to its colour, by nitric acid like other bile, and coagulating immediately on the addition of potash into a greenish white granular mass, becoming covered, on evaporation, with an almost colourless crystalline film, and yielding 14* 3 of a dark green, transparent, crystalline residue. The bile of the Cyprinus bar bus is similar to that of C. leuciscus in its physical characters, and yields 19'3 of a dark green crystalline residue. The solid residue of the bile of the Salmofario and Esox Indus is stated to be non-crystalline. On the Action of the Bile in the process of Digestion. We are as ignorant of the action of the bile on the che- mical changes that the food undergoes in the intestinal canal and in the process of chylification, as of the exact influence of the saliva or of the pancreatic juice. Experiments, with the view of deciding this point, have been instituted by Brodie and by Tiedemann and Gmelin, and the conclusions to which they lead are, that the bile does not exert any material influence upon digestion and chylification. Assuming that these experiments were correctly performed, the bile must be regarded as a mere excretion, whose removal from the organism is as necessary for the preservation of the normal constitution of the blood as the removal of carbonic acid, urea, &c. Tiedemann and Gmelin state as the results of their observa- tions on animals, in which the flow of bile into the intestine was prevented : 1st, that digestion (as had been stated by Brodie) proceeds just as perfectly as when the supply of bile is not 26 THE SECRETIONS: hindered ; 2d, that the contents of the small intestine, csecum, and large intestine, after the application of a ligature to the ductus communis choledochus, do not differ in any essential degree from their ordinary state ; and 3d, that the bile plays no essential part in the formation of chyle. Notwithstanding these general conclusions, they found that the chyle of dogs, in whom the ductus communis choled. was tied, was perfectly clear, whilst in the natural state it is white and turbid in consequence of the fat held in suspension, a diffe- rence not to be passed over as altogether unimportant. Another undeniable effect of the bile in chylification consists in the neu- tralization of the free acid of the chyme by the alkali that is as- sociated in so unstable a manner with the biliary secretion, in consequence of which the bilin gradually begins to undergo certain changes, but whether of the same nature as in the labo- ratory of the chemist it is impossible to decide. [That the bile is not merely an excrementitious fluid, in- tended to remove effete matter from the blood, but that it is a secretion essential to the animal economy, was rendered almost certain by the experiments of Berzelius, Theyer, and Schlosser, which showed that the human faeces contained much too small a quantity of a substance resembling bile to justify the idea that it is evacuated in this manner. A further proof that the bile is absorbed and not excreted is afforded by an examination, made by Enderlin, of the ash yielded by the con- tents of the different portions of the intestinal canal of a hare. He found that the ash from the contents of the duodenum alone effervesced on the addition of an acid, thus showing that the choleate of soda (which yields the carbonate on incineration,) is absorbed before reaching the jejunum. Schwann has re- cently established this opinion beyond a doubt, by a series of well- devised experiments on dogs. He tied the ductus communis cho- ledochus, and at the same time formed a fistulous opening in the gall-bladder, by which the bile escaped externally. His most important conclusions are, 1st, That when the bile does not get into the bowel, its absence is generally perceptible in dogs, about the third day, by a marked diminution in weight ; and, 2dly, That unless the channel for the conveyance of bile to the duodenum is re-established, symptoms of deficient nutrition, GASTRIC JUICE. 27 wasting, debility, &c., ensue, and death is the ultimate conse- quence.] If the bilin becomes decomposed in the intestinal canal into various constituents, through the influence of the acid chyme, then a wide field of investigation is open to us respecting the function of the biliary secretion in relation to chylification. No explanation has yet been afforded of the discrepancy in the amount of albumen contained in the chyme absorbed by the intestinal villi, and in the chyle discharged by the absorbents, (even without passing through the mesenteric glands.) May it not happen that a constituent of the bile acts on some hitherto ill-defined protein-compound of the chyme, and con- verts it into the form known as uncoagulated albumen ? ON THE GASTRIC JUICE, DIGESTION, AND THE CHYME. Gastric Juice. The gastric juice has been examined by numerous chemists, in consequence of the importance attributed to it in the process of digestion. There have been found in it free acids, a con- siderable amount of salts, and certain indefinite animal sub- stances, which were known at the period to which we refer as osmazome or salivary matter. Experiments on artificial diges- tion have thrown much light on the nature of the gastric juice. Eberle 1 proved that an artificially-formed gastric juice does not thoroughly dissolve food, unless a small quantity of gastric mucus, or a portion of the mucous membrane of the stomach be added to it. On the strength of this discovery, Miiller and Schwann 2 instituted a series of experiments, from which Schwann was led to conclude that the gastric juice contains a peculiar substance, which, cooperating with an acid, possesses the pro- perty of rapidly dissolving substances insoluble in mere water, or in a mixture of extractive matters, salts, and a little acid, as for instance, fibrin, coagulated albumen or casein. To this 1 Physiologic der Verdauung. Wiirzburg, 1834. 2 Ueber die kiinstliche Verdauung des geronnenen Eiweisses, Muller's Archiv, 1836. 28 THE SECRETIONS: somewhat problematic substance he gave the name of pepsin : Wassmann 1 and Pappenheim 2 have endeavoured to isolate it. (See Vol. I, p. 224.) Prout 3 has shown that the free acid of the gastric juice is muriatic acid. Gmelin and Tiedemann 4 have found it associated with acetic acid, and in the gastric juice of horses, with butyric acid : there is no doubt that lactic acid is likewise contained in it. From the researches of the latter chemists, which are the most perfect that we possess on the subject, it appears that in addition to the free acids, the gastric juice contains mucus, and occasionally (in horses) a very small quantity of albumen, ex- tractive and salivary matter, and that the ash consists of alkaline muriates and sulphates, a little phosphate and sulphate of lime, chloride of calcium, magnesia, and peroxide of iron. The gastric juice collected from the empty stomach, although mixed with mucus, was tolerably clear ; it was neutral, of a yellow colour, a saline taste, and on evaporation left only 2 of solid constituents. Gastric juice obtained by irritating the stomach with pebbles was acid, viscid, and of a pale brown colour. Hiinefeld does not believe that there is any free hy- drochloric acid in gastric juice. Berzelius analysed gastric juice collected by Beaumont from a young man with a fistulous opening into the stomach. It had been kept for five months before Berzelius received it, and was therefore totally unfit for the purpose of analysis. In that condition it was clear, yellow, devoid of odour, reddened litmus paper in a decided manner, and left a solid residue of T269g, consisting principally of crystals of chloride of sodium, in the interstices of which was a brown extractive matter, which, on exposure to the air, resolved itself into a dark brown thick syrup. Its quantity was too small to admit of its being accu- rately examined, but it was proved to contain lime and a proto- salt of iron. Beaumont describes human gastric juice as a clear, inodorous, saline, and very acid fluid, which effervesces on the addition of alkalies. Dunglison detected in it free hydro- chloric acid, an animal substance soluble in cold but not in 1 De Digestione nommlla. Diss. inaug. Berol. 1839. 2 Zur Kenntniss der Verdauung. Breslau, 1839. 3 Philos. Transactions, 1824, p. 45. 4 Die Verdauung nach Versuchen, p. 150. GASTRIC JUICE. 29 hot water, and acetic, phosphoric, and hydrochloric acids, in com- bination with potash, soda, lime, and magnesia. The gastric juice of a horse, collected by irritating its empty stomach with pebbles, was found by Gmelin to contain : Water . . . 984-00 Solid residue . . 16-00 Organic constituents . 10-52 Salts soluble in water . 5-02 Salts insoluble in water . 0*46 [Braconnot has examined the gastric juice collected by means of sponges from the stomachs of dogs, but his results are not very definitely given.] Hence it appears that the principal constituents of the acid gastric juice are pepsin ; a substance not yet carefully examined, but bearing a close resemblance to extract of flesh ; an unex- amined substance resembling salivary matter; free acids, es- pecially muriatic acid; mucus; sometimes a little albumen; salts, especially alkaline chlorides, muriate of ammonia, (according to Hiinefeld,) and a small quantity of earthy salts. [M. Blondlot has recently published a treatise on Digestion, 1 detailing very numerous experiments made upon dogs, in which fistulous openings into the stomach were maintained for upwards of two years. The gastric juice was obtained in very large quantities. Submitted to distillation, the fluid passing over did not exhibit the slightest acid reaction, whilst the re- sidue in the retort was always strongly acid. Hence he con- cludes that the acid of the gastric fluid is neither hydrochloric nor acetic acid, since both these are volatile. The gastric fluid of other animals gave the same result on being distilled. When chalk or any other carbonate of lime was added, no effervescence ensued, proving the acid not to be the lactic. M. Blondlot concludes that the acid reaction of healthy gastric juice is owing to the presence of superphosphate or biphosphate of lime. He adds 1st. That there is no other acid fluid which can remain acid, and fail to decompose car- bonate of lime. 2d. That sulphuric acid, added to gastric juice, 1 Traite analytique de la Digestion. Paris, 1843. 30 THE SECRETIONS: precipitates an abundance of sulphate of lime, and oxalic acid precipitates oxalate of lime. 3d. Potass, soda, ammonia, and lime water, produce abundant precipitates of neutral phosphate of lime. 4th. That the calcined ash of gastric juice is not deli- quescent, dissolves without effervescence in hydrochloric acid, forming chloride of calcium; it therefore contains neutral phosphate of lime, the excess of acid being driven off in the calcination. M. Blondlot believes that the digestive property of gastric juice depends, not on its obvious chemical constitution, but upon a peculiar organic principle. If exposed to a temperature of 104 to 122 F., or higher, it loses entirely and irrevocably its digestive powers, although to all appearance, and even as to its composition, as made known by analysis, it remains un- changed. With the exclusion of the air, gastric juice may be kept for two years without loss of its activity ; but with the free access of air, it putrefies in five or six days, although the chyme which it forms from nitrogenous organic substances may be preserved for two or three months without change. The precipitation of all the lime it contains does not affect its ac- tivity, nor are its chlorides indispensable, but whatever acts upon its organic constituents, (heat, strong alcohol, or strong acids,) or which removes them, (such as animal charcoal, chlorine, tannic acid, or acetate of lead,) destroys all its digestive properties. M. Blondlot also shows a. That coagulated albumen resists the action of the gastric juice only from its compact form. When coagulated in very small particles, as the white of an egg beaten into a froth and poured into boiling water, it is digested as quickly as soft fibrin, b. That the action of the stomach in coagulating milk is not due to its digestive principle solely, but to its acid, which acts like lactic acid. c. That the effect of the gastric fluid upon bones, whether entire or not, is to disintegrate them slowly, beginning at the surface, and to reduce the earthy matter into a fine chalky powder, but without dissolving or decomposing it. The earthy matter not being dissolved, proves that no hydrochloric acid has acted upon it ; it is all discharged with the faeces. Since the work of M. Blondlot was published, two other French chemists, MM. C. Bernard and C. Barreswil, 1 have made 1 Journal de Pharmacie, Jan. 1845. GASTRIC JUICE. 31 an experimental investigation into the properties of the gastric juice. They start with the assumption that this fluid owes its digestive properties to the union of two principles : 1st, an acid ; 2d, a peculiar organic matter destructible by heat. What is the nature of the acid ? " The principal fact which has been adduced to prove that the acid reaction is owing to the presence of biphosphate of lime is, that it may be treated with carbonate of lime without effervescence. Our experiments show that this arises from the dilution of the acid, which allows the carbonic acid to be dissolved as it is formed. When, therefore, the gastric juice is concentrated, it causes a considerable effer- vescence with chalk. Moreover, gastric juice dissolves neutral phosphate of lime, whilst this salt is entirely insoluble in a solu- tion of the biphosphate. On distilling gastric juice, the first distillate exhibits no acid reaction. If a mere trace of acetic acid or acetate of soda is added previous to distillation, it gives an acid reaction ; the normal acid is not therefore acetic. This also appeared, at first sight, to prove it could not be hydro- chloric acid; but on distilling water rendered slightly acid by hydrochloric acid, nothing passes over at first but pure water, the acid not distilling until the end of the operation. On dis- tilling gastric juice a neutral limpid liquor passes over, which is not precipitated with nitrate of silver; when about four fifths has distilled over, the distillate is perceptibly acid, nevertheless, it does not render a solution of nitrate of silver turbid ; but at the end, and when only a few drops of the gas- tric juice remain in the retort, an acid liquid passes over which precipitates sa]ts of silver ; this is, doubtless, hydrochloric acid. Does this acid exist free in gastric juice, or has a chloride been decomposed in this operation ? When the least trace of oxalic acid is added to gastric juice which we know contains lime, a turbidity is produced from the formation of an insoluble oxalate of lime ; but if to water acidified with SOOOths of its amount of hydrochloric acid, and containing chloride of lime, the same re- agent be added, no turbidity ensues. This clearly proves that hydrochloric acid exists as a chloride in the gastric juice, and not in a free state. When concentrated by evaporation, gastric juice is strongly acid, effervescing with chalk, and not loosing its acid reaction in the presence of an excess of the chalk. This proves the pre- 32 THE SECRETIONS: sence of phosphoric acid. On saturating the acid with lime and oxide of zinc, and filtering the solution, the neutral nitrate contains both zinc and lime, therefore phosphoric acid is not the only free acid in the juice. What is the acid combined with the zinc and lime in the filtered solution? It is one which, as we have seen, passes over at the end of the distillation, and does not precipitate salts of silver. These characters be- long to lactic acid. On distilling water slightly acidulated with lactic acid, a small quantity of chloride of sodium being added, we obtain a fluid analogous to gastric juice; first, pure water passes over, then an acid which does not precipitate salts of silver, and the last drops carry over hydrochloric acid. So that it is evident that the presence of hydrochloric acid in the last product of distillation of the gastric juice is owing to the de- composition of the chlorides by lactic acid." Hydrochloric acid cannot exist in a free state in the presence of a lactate, a phosphate, or an acetate. " We have observed," say the authors, " in the acid of the gastric juice all the cha- racters of lactic acid, as pointed out by M. Pelouze ; both give soluble salts of lime, barytes, zinc, and copper, a double salt of copper and lime, deeper in colour than the simple salt, and a salt of lime soluble in alcohol, precipitated by ether." From the above facts, MM. Bernard and Barreswil conclude that the acid re- action of the gastric juice is not owing to biphosphate of lime, but arises from a free acid, which is not hydrochloric or acetic acid. They have always found lactic acid, with a minute proportion of phosphoric acid, the latter being a product of the reaction of the lactic acid on the phosphates present. In their opinion, lactic acid is a constant production of the stomach. They do not mean to say that the digestive powers of the gastric juice are owing to lactic acid ; on the contrary, they think if an acid reaction be indispensable, other acids may supply its place, because among the various salts constantly in- troduced into the stomach with the food, some will have their acid replaced by the free lactic of the stomach, and the new acid liberated may supply the place of the normal acid. In a more recent memoir they enter more fully into the nature of the active organic matter, on the presence of which they believe the digestive power of the gastric juice to depend. It is precipitated and destroyed at a temperature of 190. One GASTRIC JUICE. 33 of the most remarkable of its properties is that its digestive powers vary according to the medium in which it is contained. In the gastric juice, which is acid, it dissolves nitrogenous mat- ters, such as fibrin, gluten, and albumen ; but exerts no action on baked starch ; but if the gastric juice is rendered alkaline by the addition of a little carbonate of soda, it rapidly dissolves the starch, and no longer possesses the power of acting on the nitrogenous matters. As these physiological properties are exactly those of saliva and the pancreatic fluid, it became an in- teresting point to ascertain if a change in the reaction of these fluids would cause a corresponding variation in their solvent power. This was found to be the case ; on acidulating these naturally alkaline fluids, their ordinary mode of action was in- verted, and they were enabled to dissolve nitrogenous matters, while their capability of dissolving starch was lost. From nu- merous and varied experiments they believe that one and the same organic principle (the agent of digestion) exists in the gastric juice, the pancreatic fluid, and the saliva, and that its physiological action varies according to the acid or alkaline nature of the fluid in which it occurs. M. Melsens 1 has also examined the gastric juice, and denies the accuracy of Blondlot's conclusions.] The fluid secretion in the crops of birds is stated by Gmelin and Tiedemann to have an acid reaction ; and the fluid in the glandular stomach, even when empty, contains free acids, es- pecially muriatic and acetic acids. Brugnatelli observed that Iceland spar inclosed in tubes is decidedly attacked after remaining for some time in the stomachs of hens and turkeys ; and Treviranus noticed that a porcelain basin, in which the chyme of hens had been digested, was cor- roded, from which he concluded that fluoric acid was present. Tiedemann and Gmelin did not succeed in detecting fluoric acid in the gastric juice of ducks, although they carefully sought for it. Morbid Gastric Juice. It is well known that the gastric juice sometimes assumes anomalous characters, but important as such modifications are 1 Journal de Pharmacie, Jan. 1845. ir. 3 34 THE SECRETIONS: to practical medicine, little is known with certainty in relation to their true causes, and still less respecting the peculiar influ- ences that morbid gastric juice exercises on chymification and chylification. The question naturally suggests itself, whether morbid changes in the gastric juice may not be the origin of many of the diseases of early childhood. Such changes may originate purely from internal causes (nervous influences,) or from a complication of the above with external influences, such as diet, &c. The only modifications respecting which we can speak with any degree of certainty are the following : 1st, There may be a considerable excess of free acid; 2dly, There may be a diminution of free acid; and 3dly, The gastric juice may become posi- tively alkaline. In all probability, with these there are associ- ated other changes in the composition of the fluid, producing an injurious effect on the process of digestion ; but on this sub- ject we are unable to speak with certainty. The increased acidity of the gastric juice usually arises from an excess of those acids which exist in it in a normal state, namely, muriatic, acetic, and lactic acid. When there is a tendency to the formation of an excess of acid in the gastric juice, it appears to be developed from the food. Muriatic acid is principally developed from animal food; acetic and lactic acids from vegetable and especially saccharine food, such as acid bread, beer, and wine ; and the fatty acids from an excessive use of fatty matters. An excessive acidity of the gastric juice is frequently observed in cases of gastritis serosa, and of scrofula and rickets associated with disease of the spleen. In gout, po- dagra, and nettlerash, the gastric juice contains, according to Stark 1 , phosphoric and uric acids ; the presence of the latter acid must however be regarded as very problematical. The cases in which the gastric juice exhibits a positively al- kaline reaction are comparatively rare. This deviation from the normal condition arises chiefly from the use of salted or putrid food and drink containing basic salts, from prolonged fasting, and especially from care and anxiety (Stark.) The experiments of Purkinje and Pappenheim show that when the gastric juice is mixed with bile, its digestive powers are diminished. 1 Allgem. Pathologie, p. 848. CHYME. 35 Our knowledge of the uses of the gastric juice in the process of digestion, is much clearer than that of the other fluids already described, as the saliva, pancreatic juice, and bile. We know that alimentary matters insoluble in mere water are readily dis- solved by the pepsin of the gastric juice combined with a little free dilute acid, and that some of these substances become chemically changed during the process of solution. The intestinal fluid. The small intestines, when empty and not irritated, secrete an almost neutral, very viscid fluid, but during digestion, or when irritated, the secretion becomes decidedly acid. We cannot examine this fluid in a state of purity, but it is most probable that in its constitution it is similar to the gastric juice, and that it possesses the property of acting on those substances which have escaped the solvent power of that fluid. According to Tiedemann and Gmelin it contains a large quantity of albu- men; this is, however, most likely due to the pancreatic fluid which becomes mixed with it. It must also be more or less mixed with the biliary secretion. On the process of Digestion, and the Chyme. By the process of digestion we understand the solution and the modifications that the food undergoes in the stomach and adjoining portion of the intestinal canal, together with the ab- sorption and metamorphosis of the nutrient fluid (chyme) con- tained in the reduced pulpy mass of the food, till it becomes perfect chyle. The subject of digestion has attracted much attention for the last seventy years, but unfortunately the results that have been obtained are by no means proportionate to the time and labour involved in the experiments instituted in relation to this de- partment of physiology. The discovery and isolation of pepsin forms a new epoch in the chemical history of digestion. It is now in our power to institute experiments on artificial digestion with every prospect of success ; we can examine the new products that are developed, and we shall be thus led to the true understanding of the for- 36 THE SECRETIONS: mation of chyle, which as we know is always tolerably con- stant in its composition, although evolved from the most di- verse species of nutriment. Previously to commencing such researches, it would be re- quisite to study and examine the pepsin obtained from different classes of animals ; for it is very possible, as Berzelius suggests, that it may be a mixture of various substances, differing in dif- ferent classes of animals. On this account, various simple natural substances, after the addition of a due quantity of acid (which must be determined experimentally,) should be artificially digested with the different sorts of pepsin, and the products, both soluble and insoluble, carefully analysed. Such terms as osmazome, salivary matter, &c. must be rejected. The researches of Berzelius and myself have opened the way for an exact and separate determination of the extractive matters and ptyalin. "We should then be enabled to see what real connexion there is between the substances resembling extract of flesh which are produced in artificial digestion, and those that are actually obtained from flesh itself. Our knowledge of the changes that the different elements of food undergo in the process of digestion is at present very limited; it is confined to the following leading points. 1 . Albumen is dissolved and chemically changed. This ob- servation was made by Eberle, and has been confirmed by Miiller, Schwann 1 , and others. The digested albumen no longer coagulates at the boiling point ; it is stated to have been changed into osmazome and salivary matter, (a vague statement requiring further proof,) and according to Schwann, into a third albumi- nous principle, which is thrown down by carbonate of soda, and in that condition is insoluble in water and spirit, soluble in muriatic and acetic acids, and not precipitable by acetate of lead or alcohol, but copiously by nitric acid and bichloride of mer- cury, and partially by ferrocyanide of potassium and tannic acid. 2. Coagulated casein is partially converted by artificial di- gestion into albumen ; soluble casein becomes coagulated when submitted to the action of a solution of sugar of milk and pepsin, but not when acted on by the pepsin alone. 3. Fibrin is rapidly dissolved, and, from the experiments of 1 Muller's Archiv, 1836, p. 68. CHYME. 37 Tiedemann and Gmelin, appears to be partially converted into albumen. 4. Glutin becomes so changed by artificial digestion, that it loses its property of gelatinizing, and can no longer be precipitated by chlorine. 5. Sugar of milk, when submitted for a sufficient time to the action of pepsin, becomes completely converted into lactic acid. This fact has been established by Fremy and myself. 6. Starch is partially converted into sugar. (Tiedemann and Gmelin.) 7. The fluid found in the stomach of a horse, fed with oats, contained butyric acid, a resin, a substance resembling extract of flesh, salivary matter, and albumen. From recent experiments on digestion, we know that alimen- tary substances are dissolved as rapidly in an artificial digestive fluid, consisting of pepsin and properly diluted muriatic acid, as they are in the gastric juice itself. Hence we are justified in the conclusion that pepsin, the free acid, and a suitable tempe- rature, are the principal agents in gastric digestion, and that the motions of the stomach are chiefly with the view of pro- moting the due admixture of the food with the secreted fluid, and of propelling it towards the pylorus, through which it must pass in order to enter the duodenum. It is impossible to state with certainty whether the pepsin and free acids dissolve and modify the food through a catalytic influence, or whether they enter into any chemical combination with it, the products of these combinations being the dissolved and changed matter. If, however, the conversion of sugar of milk into lactic acid is explained by the catalytic action of the pepsin, we may fairly conclude that the pepsin exerts a similar influence on other substances, if no facts to the contrary present themselves. Hiinefeld is inclined to attribute considerable influence in di- gestion to the ammoniacal salts of the gastric juice, in conse- quence of having observed that under certain conditions fibrin is readily soluble in the muriate or lactate of ammonia, especially when free lactic acid is also present. The various articles of food are dissolved in the process of digestion with different degrees of facility. Those which ap- proximate most closely to the constituents of the chyle, obvi- ously require the least modification, as, for instance, the fluid 38 THE SECRETIONS: albumen and yelk of egg, fibrin, boiled albumen, muscular flesh, casein, and the protein-compounds generally. Certain substances are not at all digestible, as, for instance, woody fibre, husks of fruit, horn, hair, &c. We always observe a relation between the degree of the changes requisite for the assimilation of different sorts of nutriment, and the complexity of the di- gestive apparatus. Hence, in the carnivora, the intestinal canal is much shorter and simpler than in the herbivora. In the ruminantia, the first two stomachs do not secrete an acid, true gastric juice, such as occurs in the stomachs of men and carnivora, but a thin yellow saline fluid containing enough alkaline carbonates to produce a marked effervescence on the addition of an acid. Their nutriment (grass, hay, &c.,) after being chewed and mixed with saliva, is first received into these sto- machs, where it is soaked in the alkaline fluid, which dissolves and takes up vegetable albumen and glutin. The fluid gra- dually passes onwards into the third stomach, while the insoluble portion returns to the mouth for a second mastica- tion. The fluid obtained by pressure from the contents of the first stomach (the paunch) contains, according to Tiede- mann and Gmelin, carbonic acid and sulphuretted hydro- gen, albumen in combination with soda, carbonate of ammo- nia, and certain animal matters, one of which is volatile and assumes a red tint on the addition of muriatic acid. In addi- tion to carbonic acid and sulphuretted hydrogen gases, the first two stomachs occasionally develop (especially after the use of fresh clover) an extraordinary quantity of carburetted hydrogen. The third stomach secretes an acid fluid, and in the fourth sto- mach the acidity is much more marked, the substances dissolved by the alkali being first precipitated and then redissolved in the excess of acid. Finally chyme is produced, said to be ana- logous to that which is formed in the stomachs of men and carnivora. In birds the food is first moistened in the crop with a faintly acid fluid ; from thence it passes into the proventriculus, where it meets with a peculiar and very acid fluid, and it finally reaches the muscular stomach, which effects its thorough trituration. On leaving the stomach the food enters the small intestine, where it becomes mixed with the pancreatic juice and the bile. Here it commences to be absorbed by the intestinal villi ; more- CHYME. 39 over, it is here mixed with the intestinal secretion, and it is probable that the digestion, not entirely accomplished in the stomach, is here perfected. There are many points connected with the process of digestion which have not been hitherto explained. We may especially instance the conversion of chyme into chyle. It is very diffi- cult to understand the source of the large quantity of albumen found in the chyle, even before it has passed the mesenteric glands, and just after its absorption by the intestinal villi. An experiment made by Tiedemann and Gmelin on the chyme and the chyle of a horse fed with oats, will place the difference clearly before the reader. a denotes the fluid expressed from the thick, pulpy, acid contents of the stomach. It was of a brownish yellow colour, turbid, became darker on exposure to the air, and much more turbid on boiling, and on the addition of bichloride of mercury. b is the brownish yellow fluid from the duodenum, c is the brownish yellow fluid obtained from the central portion of the small intestine, mixed with mucous flocculi and with a tough al- buminous substance, apparently resembling salivary matter. d is the brownish yellow fluid from the lower part of the small intestine, e is chyle from the absorbents before its entrance into the mesenteric glands, f is chyle from the absorbents after its passage through them : and g is chyle from the thoracic duct. We shall omit the amount of water in these various fluids, and merely compare the composition of their solid residue. 1000 parts of solid residue contained : a. b. c. d. e. f. g. 1. Resinous matter, with an acid soluble in ether . 1'56 0-79 0-25 0-15 2. Resinous matter soluble in anhydrous alcohol, alco- hol-extract, and salts so- luble in spirit . . 61-56 44-61 67-25 77-60 67-50 42-24 30-44 3. Spirit-extract, probably gummy matters and salts 25-26 10-80 5-08 "I * 4. Insoluble brown matter . 0-66 9-14 / 5. Brown nitrogenous mat- ter, soluble only in water 16-32 12-44 7-40 2-50 2-17 3-11 g. Albumen, oxydised extrac- tive nfatter, and phos- phate of lime . . 11-00 7-11 5-03 3-10 27-56 49'82 63'98 40 THE SECRETIONS: The numbers in 2, under b, c, and d, refer only to the extrac- tive matters and salts soluble in alcohol, while those under e, f y and g refer not merely to them but also to the fat, the re- lative proportions of which may be seen in the analyses 4, 5, and 6, of the chyle, in p. 357, vol. I. The numbers in 6, under e, f, and g, indicate the amount of pure albumen in the chyle, whilst under b, c, and d extractive matter and phosphate of lime are included. It is to the two lines 2 and 6 of the above table that I wish especially to direct attention. The chyme b, c, and d differs from the chyle, by a deficiency of fat in the former, and by an excess of albumen in the latter. If the fat is really con- tained in the chyme, which we cannot doubt that it is, in what state of combination can it occur so as to escape detection? Does the chyme contain fatty acids, combined with the alkalies (soaps), and the chyle, ordinary fat ? The chyme contains an extraordinarily large amount of substances soluble in alcohol, whose place in the chyle seems to be supplied by albumen; may we not endeavour to clear up this difficulty by supposing that some still unknown protein-compound, soluble in alcohol, has been converted into albumen ? If the chyme contains so small a quantity of pre-existing protein-compounds, as the above analyses b } c, d teach us, we must assume that their extraordi- nary increase in the chyle of the absorbents and of the tho- racic duct, must be at least in part due to the influence of the lymphatic glands and vessels, and therefore either directly or indirectly to the blood. But, in opposition to this view, we may remark that it is impossible to conceive that the blood can impart that identical quality to the chyle which renders that fluid the means of supplying nutriment to the blood, and of imparting to it the carboniferous and nitrogenous materials requisite to supply the place of those that have been removed from the body in consequence of waste of tissue. If, however, we bear in mind that the mesenteric veins absorb a fluid from the chyme different from that which is taken up by the lym- phatics, we may then perhaps account for the discrepancy between the chemical composition of the chyme and the chyle, by the assumption of a ' vis electiva' residing in the absorbent vessels of these two systems; for the lymphatics absorb and carry off a fluid abounding in protein and nitrogenous com- pounds, while the venous system takes up an excess of the DISEASED DIGESTION. 41 compounds of carbon and hydrogen ; and since the absorbents of the lymphatic system in the small intestines must have taken up a very albuminous chyle, the chyme examined by Gmelin may on that account have been poor in coagulable albumen, and in the same manner the gradual decrease of the albumen in the chyle, as the large intestine was approached, would be accounted for. Diseased digestion. It is by no means rare to meet with an excessive formation of acid both in the stomach and the intestines, especially in children. Acid eructations, a sour smell from the mouth, and frequent green stools, afford indications of a morbid digestion which, doubtless, originates in too acid a condition of the gastric and intestinal fluids, and on the consequent rapid production of lactic and acetic acids from vegetables and milk. I have observed that the faeces of a child at the breast, suffering from improper digestion, consisted of a large quantity of coagulated casein, and a very acid, greenish, whey-like fluid, with nume- rous oil- vesicles on its surface. The fat was isolated and con- tained a large amount of the fatty acids. A copious secretion of gas is a frequent consequence of dis- eased digestion. This gas is not a mere mixture of carbonic acid and nitrogen with a little hydrogen (the ordinary gases) but also contains a considerable amount of sulphuretted hydro- gen, and, in all probability, phosphoretted hydrogen and car- buretted hydrogen. There can be no doubt that there are anomalies in the pro- cess of chylification, in consequence of which an unsuitable chyle is prepared and conveyed to the blood, modified both in its quality and its quantity ; but with respect to the particulars of these anomalies we are still perfectly in the dark. 42 CHAPTER IV. MILK. THE milk is a white,, fatty, and rather thick fluid, which is secreted by the female breasts during pregnancy and after delivery. A metastatic or vicarious secretion of milk from the skin, the navel, the groin, the stomach, the intestines, the mucous surface of the genital organs, or the axilla, is by no means rare : it has also been observed in the breasts of men. General physico-chemical characters of the milk. Perfectly fresh milk has always a decidedly alkaline reaction, and it retains this property for a longer or shorter time : the milk of women retains its alkaline reaction longer than that of cows ; and the milk of healthy women longer than that of in- valids. On examining the milk under the microscope we perceive a great number of fat-vesicles of very different sizes swimming in a clear fluid, and occasionally epithelium-cells. From repeated comparisons I have found that the fat-vesicles in the milk of woman are generally rather larger than those in the milk of the cow. In addition to these fat-vesicles, we observe, under certain circumstances, other microscopic objects, of which I shall treat subsequently. The fat-vesicles have, as Raspail declared, a solid envelope, a point which has been confirmed beyond dis- pute by Henle and myself. Easpail considers that it is com- posed of coagulated albumen ; it is, however, more than probable that it consists of coagulated casein. Henle 1 has shown that this capsule may be dissolved by acetic acid, and that butter then issues from it ; it is probable, however, that this fluid fat becomes inclosed in a new envelope, for Ascherson 2 has observed 1 Froriep's Notizen, 1839, No. 449. 2 Ueber die Hautdriisen der Frosche und iiber die Bedeutung der Fettstoffe, Miiller's Archiv. 1840. CHARACTERS OF MILK. 43 that a membrane immediately forms around every drop of fat that is brought in contact with a solution of albumen ; and I have found that fat shaken with a caseous substance (crystallin) in a state of solution, causes a partial coagulation by the for- mation of such membranes or capsules. I have shown that when woman's milk is evaporated, and the residue reduced to a fine powder, and extracted with ether (which takes up the butter), there are left the capsules of the fat-vesicles, which, when mixed with water, and placed on the object-stage, may be observed with the microscope. Milk is materially affected by a large number of substances, especially by those that precipitate its casein. The addition of any of these substances causes it to coagulate, that is to say, the casein becomes insoluble and incloses the butter, and thus produces the separation of a whey-like fluid from the caseous mass. A precipitation of this nature is brought about by alcohol which, at the same time, takes up a very small quantity of fat : when milk is shaken with ether, no precipitation of casein ensues, but the milk becomes rather clearer and the ether is found to contain fat, but only a small portion of all that is contained in the milk. When milk is left to itself for a considerable time, it coagulates, in consequence of the conversion of a portion of its sugar into lactic acid : this change often takes place very rapidly in cow's milk, and generally more quickly than in woman's milk. If the milk is allowed to remain still longer exposed to an ordinary temperature, the surface becomes covered with peculiar forms of mould, and, under certain conditions which are not accurately known, particular species of infusoria are developed. These infusoria are the cause of a blue or yellow colouring matter, which is especially distributed over the sur- face, a phenomenon that has long been observed, and which has recently been carefully investigated by Fuchs. Rennet likewise precipitates the casein apparently by a cata- lytic action on the sugar of milk, by which it is converted into lactic acid ; hence the precipitation is hindered by the addition of an alkali, and, as Herberger has observed, does not occur in milk which abounds in alkaline salts. The solid constituents of the milk vary from about 9 to 35g ; the specific gravity usually lies between 1028 and 1042. 44 THE SECRETIONS: SPECIAL CHEMISTRY OF THE MILK. Constituents of the Milk, and methods of separating them. The following substances are contained in a state of solution in healthy milk : casein, fat (including olein, stearin, butyrin, caproin, and caprin), sugar of milk, extractive matters, and salts. The salts are the chlorides of sodium and potassium ; lactates of potash, soda, probably of ammonia, of lime, and magnesia; phosphates of potash, soda, lime, and magnesia ; and traces of phosphate of peroxide of iron. The plans that were formerly proposed for the analysis of milk could not give satisfactory results. For instance, the fatty portion which collects on the surface (the cream) was analysed separately from the poorer fluid beneath it ; by this means, then, were obtained accurate estimates of the two sepa- rate portions, but not of the milk collectively. The course adopted by the French chemists, was to evaporate the milk, to take up the butter with alcohol, or a mixture of alcohol and ether, and then to wash out the sugar from the residue; if we reflect, however, that the dried casein of cow's milk is always slightly soluble, and that of woman's milk is freely soluble in water, the source of error in this system be- comes at once obvious. By the adoption of this incorrect method, Payen fixed the amount of casein at O23, while the mean of seventeen analyses performed by myself yielded 3'4, or more than fourteen times as much. The following is the method that I adopt :* a known quan- tity of milk is evaporated to dryness, and the residue weighed; by this means we determine the amount of water. A weighed portion of the dried and finely-powdered residue is thrice ex- tracted with five or six times its volume of boiling sulphuric ether, in order to remove the fat. After the removal of the fat, the residue is placed in a porcelain basin, is again pulverized, and digested with a little warm water. The pulp which is thus formed is treated with an additional quantity of boiling water, in which it is partially soluble if the analysis is being conducted 1 Die Frauenmilch nach ihrem cheraischen imd physiologischen Verhalten, p. 27. CONSTITUENTS OF MILK. 45 with cow's milk ; it dissolves entirely, with the exception of an inconsiderable quantity of coagulated casein, if woman's milk is used. The solution is then evaporated at a gentle tempera- ture to the consistence of a thin syrup, and is treated with ten or twelve times its volume of alcohol of O85, which precipitates the casein. As the casein may retain a little sugar, it is expe- dient to digest it once or oftener with a little water, and to treat the dilute pulp with spirit ; the casein that remains must be thoroughly dried and weighed. The spirituous solution con- tains the sugar, and the greater part of the extractive matter, from which the sugar cannot be easily separated. A partial separation may be effected in this way : we may dissolve the impure sugar in a little water ; on the addition of strong alcohol, the sugar with a very little extractive matter, is precipitated, while the alcoholic solution contains extractive matters and a little sugar. On evaporating this solution to the consistence of a syrup, and adding strong alcohol to it while still hot, some more sugar separates on cooling. I usually estimate the salts by incinerating a weighed por- tion of the dried residue of the milk ; and, in some cases, I have separated the soluble from the insoluble salts. This analysis of milk does not yield, as Berzelius 1 justly observes, any very accurate results, since casein is slightly soluble in alcohol; although strong cold alcohol takes up only a very small portion, dilute hot alcohol dissolves a considerable quan- tity. The determination of the sugar and of the extractive matters by the course that I have indicated is still more inac- curate. Berzelius proposes to precipitate the casein (and the butter) by rennet ; but it must be observed that, by this means, we do not obtain results of greater accuracy, since a portion of the casein always remains in solution in the whey. This amounts to a considerable quantity in woman's milk, but is comparatively slight in the milk of the cow, 2 and has always to be obtained by means of alcohol from the evaporated solution. In order to precipitate the casein thoroughly by rennet, it would be requisite to supersaturate the free alkali of the milk by acetic or lactic acid ; we should then obtain the casein in a state of combination with these acids ; in fact, casein precipi- 1 Thierchemie, p. 698. 2 Die Frauenmilch, &c. p. 33. 46 THE SECRETIONS.: tated by rennet from non-acidulated milk does in reality exist in this condition. If we precipitate the casein of cow's milk by sulphuric acid, and decompose the sulphate by carbonate of lime or baryta, we shall obtain soluble compounds of casein with lime or baryta. The casein of woman's milk is very imperfectly precipitated by sulphuric acid. If albumen is present in milk, which is sometimes the case, it must be determined by a separate experiment. The milk must be boiled, and the coagulum must be collected and ex- tracted with boiling spirit, in order to remove the sugar and fat ; it must then be dried, and its weight estimated. The amount of albumen obtained in this manner is deducted from the amount of casein obtained by the method which has been described, and which must clearly include both the casein and albumen. [Haidlen 1 has recently proposed a new method for analysing milk. It consists in coagulating the milk by gypsum, by which means the error in the determination of the casein that resulted from all former methods, is avoided. When milk is stirred with about one fourth of its weight of finely-pulverized gypsum, and heated to 212, it is entirely coagulated ; and if the whole is then evaporated to dryness, a brittle mass is obtained, which is easily reducible to powder. From this powder the butter may be extracted by ether ; the sugar of milk and soluble salts may be removed by hot alcohol of 0*85 ; while the caseate and sulphate of lime, and insoluble salts, remain undissolved. The alcoholic solution scarcely ex- hibits any perceptible opacity on the addition of chloride of barium, showing that no error in the result is occasioned by any of the gypsum being taken up by the alcohol. About 100 grains of gypsum and four times its weight of milk answer very well. The soluble salts extracted from the milk by the alcohol may easily be determined by incineration ; and since their amount is to that of the insoluble salts in the average proportion of 5 to 7, the amount of the latter may at least be found approximately, and the ascertained weight of 1 Simon's Beitrage, p. 358. MILK BEFORE DELIVERY. 47 the sugar and casein corrected accordingly. But if it be required to determine the salts with perfect accuracy, it is best to inci- nerate a weighed quantity of milk, and to analyse the residue. The analyses of Clemm, 1 which will be presently noticed, were made in the following manner : One portion of milk was used for the determination of the water and of the solid residue, and afterwards (by incineration) of the fixed salts. Another portion was evaporated nearly to dryness, and treated with one or two drops of acetic acid to coagulate the casein and render it insoluble. It was then treated with ether, in order to remove the fat, and with water in order to take up the sugar of milk, extractive matters, and salts. The residue was regarded as casein.] Healthy Milk. 1. Milk before delivery. The mammary glands secrete a milky fluid during pregnancy which, at first, diifers considerably from normal milk, but, as the period of delivery approaches, gradually approximates to it in its characters. In the first stage of its secretion, albumen preponderates, and sugar is almost entirely absent ; the albumen gradually gives place to casein, and, at the same time, sugar and fat are more abundantly formed. There are no means of obtaining any very accurate information respecting the fluid secreted in the breasts of women previous to childbirth, 2 but experiments have been made by Lassaigne and myself on this secretion in animals. I analysed the milk of an ass pregnant for the first time, and within about fourteen days of her full period of gestation. The fluid was transparent, scarcely opalescent, tenacious, and viscid ; it had an alkaline reaction. The microscope revealed a few fat-corpuscles, some granular bodies, composed of accu- mulated minute fat-vesicles and mucus-corpuscles. It did not become more gelatinous or stringy on the addition of caustic ammonia; when heated, a considerable quantity of 1 The investigations of Cleram are contained in the article "Milch" by Scherer, in Wagner's Handworterbuch der Physiologie, vol. 2, 1845. 8 [Clemm found that the fluid obtained from the breasts of a woman shortly before delivery contained 5'478g of solid constituents.] 48 THE SECRETIONS: albumen coagulated. The presence of casein was shown, and its amount determined, by the addition of acetic acid, by boiling the fluid till it evaporated to the consistence of an extract, and by then extracting it with boiling spirit. The casein differed from the ordinary casein of cow's milk, in being soluble to a very considerable extent in boiling spirit ; it par- tially separated from the clear hot solution on cooling : it seemed rather to resemble the casein of the crystalline lens. After the removal of the fat, by means of ether, it was almost perfectly soluble in water; on the application of heat, the surface of the solution became covered with an irregular film, and the addition of a little dilute acid was followed by a very copious precipitate. The analysis of this milky fluid yielded, in 1000 parts : Analysis 61. Water 737-00 Solid constituents Fat Casein Albumen 263-00 7-98 28-93 198-34 Extractive matters, traces of sugar and casein, chloride of sodium, and lactate of soda . . . 18*41 The milk of the same ass was examined eight days after- wards ; it was less thick and sticky, and rather whiter than before. It more closely resembled true milk in its smell, and it had a mild, faintly sweet taste. It contained, in 1000 parts : Analysis 62. Water . . . . . 814-0 Solid constituents .... 186*0 Fat ..... 8-5 Casein . . . . 25-0 Albumen .... 123-9 Extractive matter, with a little sugar, salts . . 28-6 The change in the constitution of the fluid was very striking ; the solid constituents collectively, and especially the albumen, were diminished, while the fat, casein, and sugar, had relatively increased. In the first analysis, the casein formed only one ninth of the solid residue ; in the second, it amounted to one seventh. Lassaigne has observed similar proportions in the fluid secreted by the mammary glands of cows previous to calving. Forty-one days before calving, it contained albumen in place COLOSTRUM. 49 of casein, had an alkaline reaction, a specific gravity of 1063, and, when allowed to stand, deposited a large quantity of cream, from which a very soft sort of butter was obtained. The fluid retained these properties till ten days before calving ; it then acquired a milder taste, but still contained albumen in place of casein. If Lassaigne had been acquainted with my method of separating casein from albumen by means of boiling spirit, he would, doubtless, have found casein, as I did, in the asses' milk. It was not till five days after calving, that the fluid resembled ordinary milk ; it then had a specific gravity of 1035, and contained casein instead of albumen. 2. Milk immediately after delivery. The lacteal secretion immediately after delivery differs from the ordinary milk produced after the milk-fever, and has re- ceived the name of colostrum. In woman I found the colostrum thicker than true milk. 1 It had a dirty light yellow colour, an alkaline reaction, no peculiar odour, but a remarkably sweet taste. [Clemm states that the alkaline reaction very soon disap- pears. He has found the colostrum become acid in the course of three hours.] According to other observers, it resembles a thin solution of soap and water (Joannide 2 ), with drops of oil on its surface. On examining the colostrum with the microscope, a very large number of fat-globules are seen, some of which are larger than those that occur in ordinary milk, and these are frequently observed clinging to one another ; besides these, there are gra- nulated, yellow, roundish corpuscles, larger than the milk- cor- puscles, which appear to be composed of very minute fat-vesicles; they seem to be peculiar to the colostrum, and were first observed by Donne, 3 who states that they occur in woman's milk till the twentieth day, when the milk loses all the characters of colos- 1 Die Frauenmilch, &c. p. 51. a Physiolog, Mammar. Mulieb. Specim. Halle, 1801. 3 Du Lait, et en particulier de celui de nourrices, etc. Paris, 1837, p. 19. ii. 4 50 THE SECRETIONS: trum ; I have never succeeded in detecting them after the eighth or tenth day. [According to the observations of d'Outrepont, 1 the granu- lated corpuscles usually disappear on the third day.] The following analysis represents the composition of 1000 parts of the colostrum of a woman. The other analysis repre- sents the average composition of healthy milk, deduced from many observations, and is given in order that the reader may contrast the composition of the colostrum with that of the normal secretion. Analysis 63. Healthy milk of the Colostrum. same individual. Water . . . . 828-0 887'6 Solid constituents . . 172-0 112-4 Fat . . 50-0 25-3 Casein . . . 40-0 34-3 Sugar of milk . . 70-0 48-2 Ash . . 3-1 2-3 Of the fixed salts, 1*2 were soluble, and 1*8 insoluble in water. The chemical differences between the colostrum and the milk are at once obvious ; the former is much the richer of the two in solid constituents, especially in butter and sugar of milk. The absolute quantity of casein is also greater, but the ratio of the casein to the solid constituents is less than in ordinary milk. The salts are also increased ; the aperient property of the colostrum is probably due to the increased quantity of salts and sugar of milk. 3. Of ordinary milk. The ordinary milk of the human female is a white or blueish fluid, and of a sweeter taste than cow's milk. It usually ex- hibits nothing but the milk-globules under the microscope. It has always an alkaline reaction, which it retains for five or six days before it becomes acid. Its specific gravity varies from 1030 to 1034 ; the average of a large number of analyses yielded the number 1032. On evaporation, it becomes covered, like every other sort of milk, with a film of coagulated casein ; and when the evaporation has been sufficiently prolonged, it yields 1 [Neue Zeitschrift fiir Geburtskunde, vol. 10, pp. 1 7.] HEALTHY HUMAN MILK. 51 a brownish extract-like residue which, when dried, is perfectly soluble in water, (with the exception of a little albumen,) and forms a milky fluid. Everything that precipitates casein, coa- gulates milk ; the mucous membrane of the stomach of an infant a few days old, that has recently died, seems, from my obser- vations, to coagulate woman's milk more perfectly than the mucous membrane of the stomach of the calf. 1 The solid con- stituents fluctuate between 8-60 and 13'86g. I shall now give some analyses of milk : 1st, the average of fourteen analyses made at different periods with the milk of the same woman ; 2d, the analysis of the milk of a woman aged 36 years ; 3d, the analysis of the milk of a nurse aged 20 years ; 4th, the maxima, and, 5th, the minima, of numerous analyses. An. 64. An. 65. 1. 2. 3. 4. 5. Water .... 883-6 894-0 898-0 914-0 861-4 Solid constituents . . 116-4 106-0 102-0 138-6 86-0 Butter . . . 25-3 38-0 28-8 54-0 8-0 Casein . . . 34-3 34-0 32-0 45-2 19-6 Sugar of milk and extractive matters 48-2 40-5 36-0 62-4 39-2 Fixed salts . . .2-3 1-8 2-7 1-6 The maximum table gives the highest amount of each indi- vidual constituent, and the minimum the lowest that occurred in the whole series of analyses. [Clemm has recently published the following analyses : The 4th day The 9th The 12th after delivery. ditto. ditto. Water .... 879-848 885-818 905-809 Solid constituents . . . 120-152 114-182 94-191 Butter .... 42-968 35-316 33-454 Casein .... 35-333 36-912 29-111 Sugar of milk and extractive matters . 41-135 42-979 31-537 Salts . . . 2-095 1-691 1'939 Two analyses of healthy human milk have been made by L'Heretier. 2 He found : * 1. 2. Water . . 867-8 870-6 Solid constituents . . . 132-2 129-4 Butter .... 42-5 52-0 Casein . . . .11-7 9-5 Sugar of milk . . . 74-0 63-4 Salts . . . .4-0 4-5 1 Die Frauenmilch, &c. p. 29. 2 Traite de Chimie Pathologique, p. 627. f,i> THE SECRETIONS: Haidlen, 1 by the method already noticed, found that 1000 parts of woman's milk contained : i. 2. Butter % . 13 34 Casein and insoluble salts . 27 31 Sugar of milk and soluble salts . 32 43 In the second analysis, the milk was extremely rich in solid constituents.] Meggenhofen 2 has also analysed woman's milk ; but, from the method which he pursued, we can place no reliance on the determination of the individual constituents. The dried resi- due was extracted with alcohol of 0'83, and afterwards with water, as long as any additional matter was taken up. It is evident that fat, some of the sugar, and perhaps even traces of casein must be contained in the alcohol-extract; the water- extract contains the rest of the sugar, some extractive matter, and a great part of the casein. According to Meggenhofen, the solid constituents in woman's milk vary from 10 to 12*56, and the salts from 1*2 to 2'4g. These numbers correspond very closely with my results. The analyses gave in 1000 parts : Water . . . . 827-5 883-5 789-3 Solid constituents . . . 172-5 116-5 2107 Fat with sugar and alcohol-extract . 91-3 88-1 171-2 Sugar and casein . . .11-4 12-9 8-8 Coagulated casein . . . 24-1 14-7 28-8 Payen 3 has likewise analysed woman's milk, but his results, especially regarding the amount of casein, differ so very much from those of other chemists that they can only be explained on the assumption that there was an error in the plan of his analysis. The following numbers represent the mean of three analyses; water, 857*7; solid constituents, 142*3; butter, 51*5; casein, 2*2; residue of evaporated whey, 78*0. 1 Annalen der Chemie und Pharmacie, vol. 45, No. 3. 2 Dissert, inaug. sistens indigationem lact. mul. chemic. auct. Meggenhofen. Frankf. a. M. 1826. 3 Journal de Chim. med. vol. iv, p. 118. HEALTHY HUMAN MILK. 53 The salts of woman's milk appear, according to my own ob- servations, and those of Meggenhofen, to range at about from i to 5 per cent, of the fluid; of these, usually about are insoluble, and ~ soluble in water : the former consist of phosphate and carbonate of lime, with a little magnesia, and a very small quantity of (phosphate of ?) peroxide of iron ; the latter, of chlo- rides of sodium and potassium, with a little chloride of calcium, carbonate of soda, (corresponding with the lactate in the milk,) and a little sulphate of potash, the acid of which does not pre- exist in the milk, but is produced during incineration. Pfaff and Schwartz 1 found a larger proportion of salts in woman's milk, namely, 0-4407g; they were composed of phosphate of lime, O25 ; phosphate of magnesia, O05 ; phosphate of iron, O0007 ; phosphate of soda, 0*04 ; chloride of potassium, 0*07 ; and soda originating from lactate of soda, O03. Carbonate of lime, sulphate of potash, and chloride of sodium are not noticed, although all other observers concur in finding them in the milk. Chevallier and O. Henri have instituted some researches on the milk ; they precipitated the casein by acetic acid, evaporated the fluid portion, and determined the salts by the incineration of the residue. They estimated the part that was consumed as sugar of milk, and removed the fat from the precipitated casein by means of ether. By this process they obtained much too small a quantity of casein from woman's milk, (since this con- stituent is only imperfectly precipitated by acetic acid,) and too large a quantity of sugar, which was thus made to include all the destructible constituents, with the exception of the casein and fat. In the other sorts of milk, the precipitation of the casein by acetic acid is also imperfect. The following is the result of their analysis of woman's milk : Water . . . 879-8 Solid constituents . . 120-2 Butter . . . 35-5 Dried casein . . 15-2 Sugar of milk . . 65-0 Salts . . .4-5 1 Dissert, inaug. sistens nova experimenta circa lact. princip. constit. Kiel, 1833. .VI THE SECRETIONS: On the effect of temperament on the milk. [It has been long believed that the milk of fair women is inferior in its properties to the milk of brunettes. As far as I am aware, the only analyses bearing on this point are those of I/Heretier. He selected two females of equal age, and made them submit to the same diet and mode of life. The following are the results of his analyses : A Blonde, aged 22. A Brunette, aged 22. 1. 2. 1. 2. Water . . 892-0 881-5 853-3 853-0 Solid constituents . 108-0 118-5 146-7 147'0 Butter . . 35-5 40-5 54-8 56-3 Casein . . 10-0 9-5 16-2 17-0 Sugar of milk . 58-5 64-0 71-2 70-0 Salts . . 4-0 4-5 4-5 4-5 He appears to have selected the analyses that presented the most marked contrast ; for he observes, that if he had taken the mean of all his analyses, the difference between the amount of the solid constituents in the two cases would have been less marked, the average ratio being 120 : 134. I/Heretier has likewise investigated the changes produced in the milk by a prolonged sojourn in the breast. The two fol- lowing analyses illustrate the effect thus produced. The milk in each analysis was afforded by the same woman : in the first case it had remained in the breasts for forty hours; in the second, it was obtained after the infant had been sucking for some little time. i. 2. Water . . . 901-1 858*0 Solid residue . . 98-9 142-0 Butter . . . 34-0 36-5 Casein . . .1-9 13-0 Sugar of milk . . 58-5 78*0 Salts 4-5 4-5 ] On the changes in the milk dependent on nutrition. That the character of the food exerts an influence on the quality and quantity of the milk, is a fact that has been long known, although the nature of the changes could not be cor- MODIFICATIONS OF MILK. 55 rectly determined. I analysed the milk of a very poor woman fifteen times at regular intervals during the course of half a year, commencing with the second day after delivery. It so happened that she was suddenly deprived of the means of ob- taining even the most ordinary necessaries of life. The milk secreted at this period, (the llth of November,) was sufficiently abundant in quantity, but was very poor in solid constituents, containing only 8-6g. Some days afterwards (the 18th of November) she was placed upon a full and nutritious meat diet. The milk, in consequence, was secreted so copiously as to run spontaneously from the breasts: it left 11 -9g of solid consti- tuents. Her circumstances again became very bad, and she was frequently in a state of the utmost destitution : on the 1st of December, while in this condition, the milk again be- came very thin, and left only 9'8g of solid constituents. I con- cluded my researches on the milk of this woman, by an exa- mination on the 4th of January, after she had been supplied for two days with a nutritious meat diet : the milk was then very rich in solid constituents, and left a residue of 12'6. The following are the results of my examinations on these four occasions; below them is the average of the fourteen analyses to which I have already referred : 1. Milk on Nov. llth 2. Ditto Nov. 18th 3. Ditto Dec. 1st 4. Ditto Jan. 4th . 873-6 126-4 37-0 40-0 46-0 5. Average of 14 analyses 883-6 116-4 25-3 38-3 48-2 It is evident from these analyses, that however much the nutriment of the mother may vary, no great influence is thereby exerted on the relative quantities of casein and sugar. The changes consist in a greater or less degree of saturation, in the rich yellowish white or the blueish colour, in the quantity of the milk, and in its amount of solid constituents ; with the ex- ception of the variation in quantity, all the other changes are dependent on an increase or diminution of the butter; the former occurs under the use of a copious and nutritious diet, the latter when the food is poor and scanty. Donne's 1 proposal 1 Du Lait, etc. p. 54. Water. Solid constituents. Butter. Casein. Sugar and extractive matter. 914-0 86-0 8-0 35-5 39-5 880-6 119-4 34-0 37-5 45-4 920-0 98-0 8-0 39-0 49-0 56 THE SECRETIONS: for determining the goodness of the milk by a microscopic ex- amination, is founded on incorrect principles ; he assumes that the increase of the butter and of the other constituents is simultaneous ; an assumption that the above analyses show to be inconsistent with facts. Changes in the milk, corresponding with the age of the infant. It seems probable that certain changes will be observed in the milk when the progress of development of the child indicates the necessity for other food. The question is one of consider- able physiological interest, and in order to elucidate it I made analyses of the milk of a woman during a period of nearly six months, commencing with the second day after delivery, and repeating my observations at intervals of eight or ten days. The results would doubtless be more decisive if the expe- rimentalist were able to exclude all disturbing influences : but in almost all cases the exercise of a strict control over the method of living and the nature of the food of the mother, is just as impossible as the exclusion of exciting moral forces. The fourteen analyses (the colostrum being excluded) gave the following results : Specific Solid Fixed Analyses gravity. Water. constituents. Casein. Sugar. Butter. salts. 66 31st Aug. 1031-6 873-2 126-8 21-2 62-4 34-6 0-84 67 7th Sept. 1030-0 883-8 116-2 19-6 57-6 31-4 1-66 68 8th Sept. 1030-0 899-0 101-0 25-7 52-3 18-0 2-00 69 14th Sept. 1030-0 883-6 116-4 22-0 52-0 26-4 1-78 70 27th Oct. 1034-0 898-2 101-8 43-0 45-0 14-0 2-74 71 3d Nov. 1032-0 886-0 114-0 45-2 39-2 27-4 2-87 72 llth Nov. 1034-5 914-0 86-0 35-3 39-5 8-0 2-40 73 18th Nov. 1033-0 880'6 119-4 37-0 45-4 34-0 2-50 74 25th Nov. 1033-4 890-4 109-6 38-5 47-5 19-0 2-70 75 1st Dec. 1032-0 902-0 98-0 39-0 49-0 8-0 2-08 76 8th Dec. 1033-0 890-0 110-0 41-0 43-0 22-0 2-76 77 16th Dec. 1034-4 891-0 109-0 42-0 44-0 20-0 2-68 78 31st Dec. 1034-0 861-4 138-6 31-0 52-0 54-0 2-35 79 4th Jan. 1032-0 873-6 126-4 40-0 46-0 37-0 2-70 A glance at the three columns of casein, sugar, and butter, will show that, with few exceptions, 1st, the quantity of casein is at its minimum at the commencement ; it then rises consi- derably, and ultimately attains a nearly fixed proportion ; that, MODIFICATIONS OF MILK. 57 2d, the quantity of sugar is at its maximum at the commence- ment, and subsequently diminishes; and that, 3d, the butter is a very variable constituent of the milk. The variations observed in the columns of the sugar and of the casein arise in all probability from those disturbances of the mode of living, and of the tranquillity of the mind, which produce a decided influence on the composition of the milk, and over which the experimentalist can exert no control. Milk changed by disease. There are certain morbid states of the system which produce such an influence on the milk that the infant cannot partake of it without detriment to its health. It is a well-known fact that the milk of women who are exposed to violent mental agi- tation, to passion, grief, &c. will occasionally produce very serious effects (and sometimes even instantaneous death,) on the in- fant : and some physiologists and physicians are of opinion that chronic diseases may be transmitted by the milk from the mother to the child. When we read the statements of trustworthy authors re- garding the instantaneously fatal effect produced by the milk on the infant, on the occurrence of a sudden shock affecting the mind of the mother, we cannot deny that some chemical change is produced through the nervous influence on the milk, although we cannot determine the nature of that change. In many cases the milk, possibly, acts only as a conducting fluid, and thus conveys the nervous shock from the mother to the child. Certain morbid changes in the milk which are dependent on the formation of mammary abscess, may be easily recognised by the microscope, which will then reveal the presence of pus- or mucus-corpuscles. Thus in cow's milk which was drawn from a teat affected with vaccinia, I found a considerable quantity of mucus- or pus-corpuscles, while in the milk drawn from an- other teat of the same udder there were none. When a mammary abscess opens internally, the milk always contains pus -corpuscles, and frequently also blood-corpuscles, if blood has escaped with the pus. Donne 1 has frequently made 1 Du Lait, etc. p. 40. 58 THE SECRETIONS: microscopic examinations of the milk of women with swelled breasts ; it resembles, in some measure, the colostrum. In the milk of a cow affected with vaccinia, I found a number of cor- puscles, which were very like the yellow granulated colostrum- corpuscles. I have had an opportunity of examining the milk of a re- cently-delivered woman, who was in a state of considerable fever in consequence of a violent fit of passion : her child, after partaking of her milk, was seized with vomiting, diarrhoea, and convulsions. The breasts were swollen, tense, and painful ; the milk had an alkaline reaction, and apparently possessed the qualities of the ordinary secretion ; it had, however, a different and not very easily described animal odour. When boiled it exhibited no albumen, but after evaporation to a certain point it coagulated, and had a marked acid reaction. Another por- tion that was set aside, coagulated after some hours, and had an acid reaction, a circumstance I have never observed in healthy human milk, which will remain undecomposed for five or six days. After twenty hours it developed so large an amount of sulphuretted hydrogen, that a slip of paper which had been moistened in a solution of lead, and was then placed in the flask, in a short time became brown. The casein, sugar, and butter, did not seem to have undergone any change, either qualitative or quantitative. In fact there appeared to be little difference be- tween it and the milk that was secreted twenty-four hours before, and six days later, as may be seen by a comparison of analyses 67, 68, and 69 : analysis 68 merely exhibits a smaller proportion of solid constituents, which is principally due to the decrease of butter. The differences observable in this milk were undoubtedly connected with the bad effects which it pro- duced on the infant. The case was altogether different with the milk of a woman who contracted syphilis after the birth of her first child, and who, in consequence of defective or improper medical treatment, carried the remains of the disease about her for years. The children which she bore while in this condition, and which were begotten by her husband who also had some suspicious sores on the feet, did well for the first half year, they then became highly scrofulous, and died in a state of marasmus : the first child was perfectly healthy. The milk, when she was MODIFICATIONS OF MILK. 59 suckling her sixth, child, which was a year and half old, and in a dreadfully scrofulous state, exhibited no deviation from the healthy secretion : it appeared rich, tasted and smelled like healthy milk, and had an alkaline reaction, which it retained for the space of six days. Its constituents, casein, sugar, and butter, appeared normal, and there was no peculiarity in their quantitative admixture. (See analysis 64, p. 51.) Hence, although the woman was suffering from a malignant chronic disease, no morbid change was observable in the milk. Donne 1 has frequently submitted the milk of syphilitic women to microscopic examination, but never observed any deviations from the normal appearance. Meggenhofen 2 found that the milk of a syphilitic woman reddened tincture of litmus, and that it was coagulated by protonitrate of mercury, basic acetate of lead, and infusion of galls, but not by hydrochloric or acetic acid, protochloride of tin, neutral acetate of lead, or alcohol of 0-83. Herberger 3 has analysed a specimen of diseased human milk ; he found it composed of, water, 895 ; solid constituents, 105 ; casein, 18'3 ; sugar, 26-9 ; butter, 23'3 ; chlorides of potassium and sodium, lactate and phosphate of potash, and an inorganic substance, insoluble in oil of turpentine, 41-6; organic matter soluble in oil of turpentine, T6. The latter substance was a yellow extract soluble in water and alcohol. The solution re- duced the salts of gold, silver, and platinum, yielded no ammonia by dry distillation, and was not precipitated by tannic acid. Deyeux 4 examined the milk of a woman who was liable to frequent nervous attacks : he found that simultaneously with these seizures, the milk became transparent and viscid, like albumen, and did not reassume its normal condition for some time. Other changes in the milk. Certain substances which are not included in the ordinary constituents of the milk are sometimes detected in it, after having been taken into the system, either as food or medicine. It is 1 Op. cit. p. 52. a Dissert, inaug. etc. p. 16. 3 Journal fur prakt. Chemie, vol. vi, p. 284. 4 Crell's Chemische Annalen. vol. i, p. 369. 60 THE SECRETIONS: not to be expected that all the substances which enter the cir- culating fluid and are separated by the kidneys, should be found in the milk, since the absorbents appear to exert a sort of selective power, and would thus reject those substances which occur in the blood, but which would produce an injurious effect on the tender frame of the infant, if they entered into the milk. I have sought in vain for ferrocyanide of potassium in the milk of women who were suckling, and to whom I have given it in doses of six drachms. This salt is known to enter very readily into the circulation, and is found after a very short in- terval in the urine. After the lapse of two days I gave the same woman twenty-three grains of iodide of potassium, but I could detect no trace of this salt in the milk. Lastly, I at- tempted in vain to detect sulphate of magnesia in the milk of a woman who was suckling, and to whom I had administered it in a sufficient dose to act as a laxative. For the particulars of these experiments I must refer to my essay ' On the Milk of Woman, in its Chemical and Physio- logical Relations/ From these observations I think that I am justified in the conclusion that energetic substances, which are foreign to normal milk, either do not enter into that secretion at all, or if they do, they undergo modifi- cations, which render them more compatible with the organism. Although I could not detect the sulphuric acid of the sulphate of magnesia in the milk, it is very probable that the magnesia entered the milk as a lactate, while the sulphuric acid was car- ried off by the urine as a sulphate. Peligot, however, has detected iodide of potassium in asses' milk ; and Herberger in the milk of woman. [I have on several occasions observed the ordinary indication of iodine on the ad- dition of xyloidin, or of starch and a drop or two of nitric acid to the urine of infants at the breast during the period of the mother taking three grains of hydriodate of potash thrice a day a convincing proof that the salt has entered the milk.] Mercurial medicines used by women who are suckling have never been traced in the milk, [although their effects on the infant are undoubted.] COLOSTRUM OF ANIMALS. 61 OF THE MILK OF ANIMALS. Colostrum of animals. In the colostrum of the cow Chevallier and Henri found : water, 803-8 ; casein, 170-7 ; and butter, 26-0. They describe it as a dark yellow, thick, viscid fluid, sometimes marked with fine streaks of blood; it has an alkaline reaction, contains little butter, (as shown by the analysis,) coagulates on heating, and in all probability contains a mixture of albumen and casein, in the same manner as I observed in the mammary secretion of the ass a short time before delivery. Boussingault and Le Bel 1 found in the colostrum of a cow the day after calving : water, 784-0 ; casein with albumen, 151-0; butter, 26-0 ; sugar, 36-0 ; and earthy salts, 3*0. (I shall pre- sently describe a specimen of cow's milk resembling colostrum, which was analysed by me.) In the colostrum of the ass Chevallier and Henri found : water, 828*4; casein, 123-0; butter, 5*6; and sugar, 43'0; and in the colostrum of the goat: water, 641*0; casein, 275*0; butter, 52-0 ; and sugar, 32'0. The 170-7 parts of casein found by Chevallier and Henri in the colostrum of the cow, consisted of 150-7 of a substance coagulable at a boiling heat, which they termed colostrum-casein, and of 20 of a substance remaining in the whey, to which they applied the name of matiere muqueuse. The 123 parts of casein in the colostrum of the ass con- sisted of 116 of the former, and 7 of the latter substance; and in the colostrum of the goat they were in the proportion of 245 : 30. These numbers approximate very closely to the pro- portional amount of casein and albumen in asses' milk, pre- viously to delivery. (See page 48.) 1. Cow's milk. Cow's milk is a rich white fluid of an agreeable, somewhat sweetish taste, and of a peculiar odour ; when allowed to stand, 1 Anal, de Chim. et de Phys. May 1839. 62 THE SECRETIONS: the fatty portion (cream) collects on the surface ; when boiled, it becomes covered with a film of coagulated casein. My own observations and those of others show that, when fresh, it has always an alkaline reaction. D'Arcet and Petit have, however, found it to be acid. This discrepancy may probably be explained by the circumstance of the speedy conversion of the sugar into lactic acid, which is sometimes noticed in cow's milk. The state of acidity is hastened by a heightened temperature, and is most rapidly induced by being brought in contact with rennet. The specific gravity of cow's milk varies from 1030 to 1035. We possess several analyses of cow's milk ; it has been exa- mined by Herberger and myself by the method I have pre- viously explained, and our results approximate closely. The third of my analyses (No. 82) represents the milk a short time after calving, while it still retained the character of colostrum. Boussingault and Le Bel have also analysed normal milk with the view of ascertaining the influence of various sorts of fodder on its composition ; by the adoption of the French method to which I have already alluded, they obtained too little casein and too much sugar. I shall give the mean of twelve of their analyses : g "C 3 g An.80. 81. 82. 1. 2. 1 3 1 Water . . 857'0 861-0 823-0 853-0 862-0 868 874-0 870-2 Solid constituents . 143-0 139-0 177'0 147-0 138-0 132 126-0 129-8 Butter . . 40-0* 38-0 55-0 38-9 37-5 36 39'0 31-3 Casein . . 72-0 68-0 67-0 69'8 67'0 56 34-0 44-8 Sugar and extractive 1 2g . Q 2g>() 51 . Q M . 3 ^ ^ matter . . j > 40 Fixed salts . 6-2 6-1 13-0 7-0 7-2 J 6-0 Earthy salts . 2-2 [Haidlen found, in the milk of a cow : water, 873 ; solid residue, 127; butter, 30; casein and insoluble salts, 51; sugar and soluble salts, 46. He has carefully studied the salts of the milk, and is of opinion that the carbonate of soda that occurs in the ash does not originate from a lactate in the fresh milk, but exists there combined with casein. The salts are combinations of phosphoric acid with lime, magnesia, and per- ASSES' MILK. 63 oxide of iron ; chlorides of sodium and potassium, and soda in combination with casein. The following numbers represent the amount of the various salts found in 1000 parts of milk : the per centage of each con- stituent is added in order to show the slight variation to which the different salts are liable, in relation to the mass of the ash. 1. Percentage. 2. Percentage. Phosphate of lime . . 2-31 47'1 3-44 507 Phosphate of magnesia . . 0-42 8-6 0-64 9'5 Phosphate of peroxide of iron . 0-07 1-4 0-07 I'O Chloride of potassium . . 1-44 29'4 1-83 27'1 Chloride of sodium . . 0-24 4-9 0'34 5-0 Soda 0-42 8-6 0'45 67 4-90 100-0 677 100-0 ] Berzelius 1 found, in skimmed milk : water, 928-75 ; casein, with butter, 26-00; sugar, 35-00; alcohol- extract, with lactic acid and salts, 6-00; chloride of potassium, 1-70; alkaline phosphates, 0-25 ; phosphates of lime and magnesia, with traces of iron, 2*30. The cream consisted of: water, 920; butter, 45 ; casein, 35. Pfaff and Schwartz^ estimate the fixed salts at 0-3742, scarcely more than half the quantity obtained by Herberger and myself. They contained phosphate of lime, 0-1805 ; phos- phate of magnesia, 0-0170; phosphate of iron, 0-0032; phos- phate of soda, 0-0225; chloride of potassium, 0-1350; and lactate of soda, 0-0115. A comparison of my analyses of cow's milk with those of woman's milk will show that the former contains the larger amount of solid constituents, especially of casein, while the latter contains the greater quantity of sugar. 2. Asses' milk. Asses' milk is a tolerably rich white fluid, with a sweeter taste than cow's milk, and occasionally having an acid reaction. Its specific gravity fluctuates between 1035 and 1023. I found 1 Thierchemie, p. 701. a Diss. inaug. sist. nova experira. circ. lact. princip. constit. Kiel, 1833. 64 THE SECRETIONS: the milk of an ass, about a year after foaling, to be com- posed of: Analysis 83. Water ..... 907-00 Butter, with some lactic acid . 12-10 Casein ..... 16-74 Sugar, with extractive matter and alkaline salts . 62-31 The following is the mean of several analyses of asses' milk made by Peligot ; T his numbers approximate pretty closely to mine: Water ..... 904-7 Butter ..... 12-9 Casein ..... 19-5 Sugar, extractive matter, and salts . . 62-9 Chevallier and Henri found in 1000 parts of asses' milk : Water .... 916-3 Solid constituents . . . 83-5 Butter . . . .1-1 Casein .... 18-2 Sugar . . . 60-8 Salts . . . .3-4 Asses' milk contains a smaller amount of solid constituents, especially of casein and butter, than cow's milk ; it also differs from it in its great abundance of sugar arid extractive matter, in which peculiarity it resembles woman's milk. 3. Mare's milk. Mare's milk is very rich in solid constituents ; it has a spe- cific gravity of 1034*6 1045'0 ; it contains little butter, but a large amount of sugar. Stipriaan, and Luiscius and Bondt ob- tained from it 0-8 of cream, T62g of casein, and 8*75 of sugar. I obtained a yellow, viscid, saltish, and nearly inodorous fluid from the teats of a mare expected to foal shortly : it coagulated on heating, exhibited a few fat-vesicles and granular corpuscles under the microscope, and acetic acid separated a small quan- tity of casein. It contained 5g of solid constituents, of which only 0*15 was butter. The solid constituents consisted for the most part of albumen, mixed with a little casein, butter, and extractive matter. 1 Annal. de Chimie et de Physique, Aout 1836, p. 432. GOAT'S MILK. 4. Goafs milk. Goat's milk is a very rich white fluid, of specific gravity 1036, with a peculiar disagreeable odour arising from the hircic acid which is present in the butter. Its solid constituents are as abundant as those of cow's milk, and it contains in 1000 parts : Chevallier Stip., Luisc. and Henri. Clemm. Boysson. John. Payen. and Bondt. Water 868-0 865-175 892-8 849-3 855-0 744-4 Butter 33-2 42-507 29-9 11-7 40-8 45-6 Casein 40-2 60-321 52-9 105-4 45-2 91-2 Sugar Salts 52-81 5-8 J 44-065 20-7 23-4 43-8 Residue of whey Cream 58-6 75-0 [An analysis of the mammary secretion of a he-goat has been recently made by Schlossberger. 1 The animal was four years old, and had given undoubted proof of his generative powers. The fluid obtained by repeatedly milking the animal, had the colour, consistence, and taste of milk, and was perfectly devoid of any unpleasant odour. Under the microscope, the globules appeared numerous, and a considerable amount of cream separated after standing for some time. The milk was analysed according to Haidlen's method, and found to contain : Water Butter Casein (with salts insoluble in alcohol) Sugar (with salts soluble in alcohol) 850-9 26-5 96-6 26-0 The milk left '782 of ash, of which -325 were soluble, and 457 insoluble in water. This case is interesting in reference to the theory of secretion ; it seems to show that the secretion of milk is independent of any peculiar condition of the blood incident to pregnancy, but that it depends far more upon the development of the secreting organ.] 1 Annalen der Chemie und Pharmacie, 1844. II. 66 THE SECRETIONS: 5. Ewe's milk. Ewe's milk is an extremely rich, thick, white fluid, with an agreeable smell and taste, and having a specific gravity of 1035 to 1041. Stipriaan, Luiscius, and Bondt found in 1000 parts: Water .... 632-0 Solid constituents . . . 368-0 Butter .... 58-0 Casein .... 153-0 Sugar .... 42-0 Cream .... 115-0 We cannot help thinking that in this, as well as in the pre- vious analysis by the same chemists, the amount of solid con- stituents, and especially of the casein, is higher than is likely to be correct. Chevallier and Henri found in 1000 parts : Water .... 856-2 Butter .... 42-0 Casein .... 45-0 Sugar .... 50-0 Salts 6-8 6. Bitches' milk. I have made two analyses of the milk of a bitch of the bull- dog breed. The milk was drawn from one of the teats that was not used by the pup : it was very thick, (whereas the milk from the teats which the pup was in the habit of sucking was very thin,) had a disagreeable animal odour, and a rather saltish, mawkish, but not sweet taste. A period of ten days elapsed between the two analyses. Anal. 84. Anal. 85. Water . . 657'4 682-0 Solid constituents . . 342-6 318-0 Butter . . . 162-0 133-0 Casein . . . 174-0 146-0 Extractive matter and traces of sugar 29-0 30-0 Fixed salts . . 15-0 14-8 This milk is distinguished from every other kind of milk that I have examined, by the immense amount of its solid consti- tuents, and by the nearly total absence of sugar. DISEASED MILK. 67 [Clemm examined the milk of a bitch. Its specific gravity was 1033 ; and 1000 parts yielded 274-689 of solid constituents, consisting, for the most part, of casein and butter, but still giving undoubted indications of the presence of a very small quantity of sugar. The bitch was fed entirely on flesh.] On diseased milk in animals. The changes produced by disease have been especially studied in cow's milk. The milk may contain mucus, pus, and blood, under similar conditions to those which we have noticed in woman's milk. (See page 57.) These substances are easily detected by the microscope. Through the kindness of Dr. Bremer, I obtained some milk from the udder of a cow affected with vaccinia, and indeed one portion of the milk was taken from a teat covered with the eruption, while the rest was drawn from a healthy teat. The two specimens differed both chemically and physically : the milk from the diseased teat was strongly alkaline, had a slightly saline taste, and exhibited under the microscope a number of mucus- and pus-corpuscles. It became gelatinous on the addi- tion of a spirituous solution of caustic ammonia ; it yielded a precipitate of mucus- or pus-corpuscles on standing, while the upper portion became clear ; and it coagulated on heating, in consequence of the presence of albumen. The milk from the healthy teat had a mild acid reaction, tasted like ordinary milk, contained no pus- or mucus -corpuscles, but a larger proportion of fat-vesicles than the diseased milk. These analyses gave : Water .... Solid constituents Butter .... Casein .... Casein, with pus or mucus, and albumen Sugar, with alcohol-extract, lactates, and! chloride of sodium . . . j Extractive matter, with chloride of sodium, 1 lactate of soda, and a little sugar . J Water-extract Salts soluble in water . Salts insoluble in water Analysis 86. Analysis 87. Milk from the Milk from the healthy teat. diseased teat. 912-10 935-40 87-90 64-60 19-58 12-05 40-62 29-36 3-87 3-20 31-40 16-18 0-32 6-42 2-42 68 THE SECRETIONS: The great increase of the soluble salts, especially of the free alkali, the presence of albumen, and the almost total absence of sugar, are the points most worthy of notice in the morbid specimen. Herberger 1 has analysed the milk of cows suffering from the grease, and found it materially affected. In the first stage of the disease he found that the milk only coagulated imperfectly on the addition of rennet, in consequence of the increased quantity of alkaline salts ; moreover (and probably for the same reason) the fat-vesiclesw ere not distinct, as they usually are, but merged into each other. In the second stage, only a few fat- vesicles were observable, the coagulation by rennet was very imperfect, and the milk, which was thick and viscid, had an unpleasant putrid smell and taste. In both stages the sugar and casein were below their normal proportions, but the amount of salts was increased; the presence of carbonate of ammonia (an ingredient never before observed in the milk) was detected. His analyses gave the following results : In the first stage. In the second stage. Healthy milk. 1. 2. 1. 2. Water . . 869-0 872-4 874-1 879-3 857-5 Solid constituents 131-0 127'6 125-4 120-7 142-5 Fat . . 39-0 38-5 38-2 37'9 38-2 Casein . . 52-4 51-0 50'0 49'0 68-4 Sugar . . 22-8 21-0 21-0 19-0 28-8 Fixed salts . 16-8 17-1 16-6 13-9 7'1 Specific gravity 1033-6 1033-0 1033-1 1029-1 1033-7 The most striking changes in the diseased milk are the dimi- nution of the solid constituents, especially of the casein and sugar, and the extraordinary increase of the salts. Hence the modifications of the fluid in this instance closely resemble those in my analyses in the preceding page. Donne found that the milk of the cow during " la maladie aphtheuse," resembled colostrum. It was less fluid and homo- geneous in its mixture than ordinary milk ; it became viscid on the addition of ammonia, and, besides the ordinary milk-cor- puscles, the microscope revealed mucus-granules and tubercular (mulberry-form) corpuscles. 1 Pharm. Centralblat. Jahrg. 1840, p. 138. OTHER CHANGES IN MILK. 69 Of other changes in the milk. The passage of various substances into the milk has been more frequently observed in animals than in the human species. Peligot detected iodide of potassium, and chloride of sodium in the milk of the ass, after internal administration. The salts of iron, zinc, and bismuth, are also said to enter it in minute quantities. The sulphates of soda and potash, sulphuret of potassium, and the mercurial salts have never been met with in the milk. The smell, taste, and colour of vegetable substances are taken up by it. The milk is sometimes observed to become blue on its sur- face after standing for 24 to 48 hours, and the tint gradually diffuses itself through the whole fluid : the milk has also been observed to turn yellow in a similar manner. Fuchs 1 has care- fully investigated this phenomenon, and has detected in milk of this nature a peculiar infusorium, to which he has applied the name vibrio cyanogenus ; it is not of a blue colour itself, but it appears to have the power of gradually changing the milk to this tint. When removed from the milk, and placed in an infusion of marsh-mallows, these animalcules increase in size, and communicate a faint blue tinge to the fluid; in this way they may be preserved for a long time. Closely allied to this animalcule is the vibrio xanthogenus ; they are sometimes found together in milk, and Fuchs had also an opportunity of observing them in milk which had become yellow, a much more rare change than the former. 1 Beitrage zur naheren Kenntniss der gesunden und felilerhaften Milch der Hausthiere. Magazin fiir die gesammte Thierheilkunde, Jahrg 7, Stuck 2. CHAPTER V. SECRETION OF THE MUCOUS MEMBRANE. Mucus. ALL the internal parts of the animal body which are connected by direct continuity with the external surface, are covered by a soft velvety and highly vascular coat the mucous membrane, which in its turn is protected by a delicate layer of epithelium. 1 The mucous surfaces, especially when they are in a state of irritation, secrete a viscid, stringy, and often tough fluid ; occa- sionally it is clear and colourless, but most commonly it is turbid, of a faint yellow or grayish white colour, and is frequently of sufficient consistence to separate in gelatinous globular masses, or tough flocculi. Of normal mucus. The transition from healthy to diseased mucus is so inde- finitely characterized, that it is almost impossible to draw a strict line of demarcation between them, and the same remark is equally applicable to the further change of the diseased se- cretion into pus : hence it is not very easy to form a distinct conception of what normal mucus really is. Henle states that in the same manner as the outer surface of the external skin is continually peeling off and giving place to 1 According to Henle the epithelium consists of one or more layers of cells which, from the peculiarity of their form, are arranged in three groups: 1st, Pavement epithelium [the scaly epithelium of Bowman], fig. 14 a, which occurs in the mouth, in the intestinal canal as far as the pylorus, in the vagina, &c. : 2d, Cylinder epithe- lium, [the prismatic of Bowman, the columnar of Todd,] fig. 14 b, having a conical form, and arranged perpendicularly to the basement membrane ; this form occurs in the portion of the intestinal canal below the pylorus, in the gall-bladder, and in the male genito-urinary apparatus : and 3d, The ciliated epithelium, fig. 14 c, which re- sembles the cylinder epithelium in form, and has its free edges armed with cilia. This occurs in the respiratory organs, in the uterus, and fallopian tubes. MUCUS. 71 the layer beneath it, so there is also a continuous desquamation or separation of the epithelium of the mucous surfaces, which sometimes occurs in men, who are in other respects healthy, to such an extent that thick clots of mucus are expectorated in the morning; which, on being examined with the microscope, contain merely epithelium-cells. This, which is formed by a mere act of separation from the uppermost layer of epithelium, is regarded by Henle as normal mucus : he gives it the name, however, of epithelium, and restricts the term mucus to the morbid secretion of the mucous surfaces in which mucus-cor- puscles (of which I shall speak presently) are found. I have always found these corpuscles in the secretion from the nasal and pulmonary mucous membrane of perfectly healthy persons : they are mixed in a small quantity with the epithelium- cells, and become increased when the mucous membrane is irritated. Physical character of mucus. Normal mucus, when fresh and recently secreted, is denser than water, and when mixed with that fluid it gradually sinks to the bottom of the vessel, unless it should be hindered from doing so by extraneous causes. Dried mucus sinks very rapidly : normal mucus from the lungs or nostrils usually floats on water for a considerable period; in fact it was regarded as characteristic of mucus to float on water, in contradistinction to pus, which always sinks. A more careful investigation enables us to trace the floating of the mucus to two causes : first to the number of air-bubbles that are entangled in it, (after the removal of which it sinks) ; and, secondly, to the proportionally small amount of solid con- stituents in the secretion. The insolubility of fluid mucus in water is the cause of the long retention of the air-bubbles. When mucus contains pus, the proportion of solid consti- tuents increases, the fluid portion diminishes, and its place is supplied by albumen. Water rapidly permeates mucus in this state, the air-bubbles escape, and it speedily falls to the bottom in consequence of its specific gravity. Mucus from the bladder or from the intestines does not swim on water in consequence of the absence of air-bubbles. When some fresh, fluid, transparent, nasal, or bronchial mucus 72 THE SECRETIONS: is examined under the microscope, it is found to consist of a liquid in which minute rounded or prolonged corpuscles of a granular appearance (mucus-corpuscles) are inclosed, which do not exhibit any independent motion, in consequence of the thick viscid nature of the fluid in which they are suspended; hut when the fluid is stirred they are seen to move with it. In addition to the mucus-corpuscles, some epithelium-cells are also observed, and a finely- granulated substance which pervades the whole fluid; and can only be seen with a good light. Nasal mucus, from my own observations, is represented in fig. 15 ; a a mucus- corpuscles, b b epithelium cells; c c the faintly granular substance. According to Henle, the diameter of the mucus-corpuscles varies from 0-003 to 0-007 of a line : according to Vogel, from 0-004 of a line : Gruby 1 considers them from 2 to 4 times the size of the blood-corpuscles. They are prolonged, oval, or round, and when observed in fresh mucus have a clear well- defined contour, a pale gray colour, a granular appearance, and sometimes give faint indications of one or more nuclei. After remaining for some time in water, the mucus- corpuscles become more or less swollen, paler, and more transparent ; the granular appearance on the external capsule disappears, and one or more nuclei may be observed in the interior of the cell. The external capsule frequently becomes so colourless as to render its de- tection difficult. The epithelium-cells appear under the microscope in the form of elliptic discs ; according to Gruby, the axis major varies from 0-013 to 0-0333 of a line, and the axis minor from 0-010 to 0-016 of a line : the surface is frequently irregular, wrinkled, or plicated. We sometimes find them swollen and vesicular, and sometimes, but more rarely, almost circular or elliptic. The nucleus is of the same prolonged form as the mucus- corpuscle; it is granular and rather darker coloured. If mucus is fre- quently observed, the transition of mucus-corpuscles into epithe- lium-cells may easily be seen. ~VVe have attempted to illus- trate this progressive change in d, e,f, fig. 15. 1 Qhservationes Microscopicae ad Morphologiam Pathologicam. Vindobonse, p. 15. MUCUS. 73 Chemical character of mucus. The action of chemical reagents on the epithelium cells and mucus-corpuscles may easily be observed under the microscope. The former are not affected by the addition of water or of dilute acids ; they disappear, however, under the influence of caustic alkalies or concentrated acids. According to Gruby, solutions of the ordinary earthy, and metallic salts effect no change on the epithelium cells. The mucus-corpuscles are very differently acted on. Dilute acetic, oxalic, and tartaric acids speedily deprive the capsules of the mucus-corpuscles of their granular appearance. The corpuscles themselves become round and transparent ; the nuclei become apparent, the cap- sules at length disappear, and the nuclei frequently divide into several granular bodies > so that in place of the mucus-corpus- cles previously visible, there are at last only two, three, or more rounded granules to be seen. Dilute mineral acids do not produce these changes in the capsule of the mucus-corpuscle, which remains unchanged, as shown by the observations of Giiterbock, Vogel, Gruby, and myself. Dilute, as well as concentrated solutions of the alkalies and their carbonates render the capsules clearer, and ultimately dissolve them. The free fixed alkalies produce these changes more rapidly than their carbonates; free ammonia much less rapidly than free potash. The liquid portion of the mucus always exhibits a decidedly alkaline reaction: when examined under the microscope it ap- pears like a clear fluid, in which, with a very good light, a faint granular appearance is perceptible. On the addition of a little water, a decided coagulation may be observed, and an extremely fine granular precipitate is formed. Acetic, and indeed any weak acid produces a similar effect, but the precipitate is more copious, and forms a grayish granular film, sufficiently strong to admit of traction. The free alkalies and their carbonates do not precipitate this fluid. It is clear from the preceding observations that mucus is composed of two distinct parts, the cells and the fluid. The viscidity of the secretion evidently pertains to the latter, and the ingredient that gives rise to this property must be contained 74 THE SECRETIONS: in it in a state of solution, as is obvious from microscopic ex- amination. There can, I conceive, be no doubt that the prin- cipal constituent of the fluid, mucin, 1 is held in solution by means of an alkali, since water (by taking up the alkali) is sufiicient to precipitate it, and the effect is produced in a much higher degree by the addition of a free acid. When mucus is allowed to remain in contact with water, a slight quantity of the mucin always dissolves, probably through the aid of a free alkali ; hence it is that the water in which the sputa, during catarrhal affections, are allowed to float, always become slightly turbid on the addition of acetic acid. In addition to the mucin, the fluid portion of the mucus also contains a small quantity of extractive matters and salts, (espe- cially lactate of soda and chloride of sodium,) and either no albumen, or at any rate a mere trace. The contents of the mucus-corpuscles are not accurately known; in all probability they contain a fluid in addition to their nuclei. The fat that occurs in mucus is probably contained in the corpuscles, for no fat-vesicles are generally observed in fresh mucus, but after the solution of the corpuscles by the addition of acetic acid, a few fat-vesicles make their appearance ; indeed in some of my obser- vations, the nuclei of the mucus- corpuscles, have seemed to lose their dark granular appearance, and, after a time, to become clear and like minute fat-vesicles. The nuclei of mucus-cor- puscles do not appear to undergo this change invariably ; there are probably different stages of development, and on the as- sumption that the nuclei of the least- developed corpuscles are composed of fat, the relative increase of fat will clearly corre- spond with the amount of mucus that is secreted. 1 [Simon observed the great similarity between mucin and pyin ; the researches of Eichholtz seem to show that these substances are identical. The substance de- scribed by Eichholtz as pyin differs from the protein-compounds in being precipitated from an alkaline solution by an aqueous solution of iodine and by distilled water. A considerable excess of water dissolves a slight portion of it. Dilute mineral acids, when carefully added, precipitate it, but when in slight excess, immediately redissolve it ; moreover, ferrocyanide of potassium causes no precipitate in a clear acid solution, but a turbidity is produced by the same substances that throw it down from its alkaline solutions. Acetic, tartaric, and oxalic acids precipitate, but do not redissolve it, and a solution of alum, gradually added, produces a precipitate insoluble in an excess of the test. On evaporating an alkaline solution of mucin on the water-bath, it becomes covered with a film of coagulated mucin which is difficult of solution in water.] MUCUS. 75 It follows, from the preceding observations, that mucus con- tains the following constituents : mucus- corpuscles, epithelium cells, mucin, small quantities of extractive matters and fat, chlorides of sodium and potassium, alkaline lactates, a little carbonate of soda and phosphate of lime, and sometimes a minute quantity of albumen. In order to separate these con- stituents I adopt the following course. A known weight of mucus must be washed with distilled water and evaporated to dryness on the water-bath. The re- sidue must be finely triturated and repeatedly extracted with boiling ether in order to remove the fat ; it must then be boiled in spirit of 0-91 as long as any additional matter is dissolved. The spirituous solution must be evaporated to a small syrupy residue, and alcohol of O85 added, in order to precipitate any dissolved mucin, caseous matter, water-extract, and pyin : the alcoholic solution, containing the alcohol- extract and lactates, is also to be evaporated. The portion undissolved by boiling spirit of 0*91, consists of mucin with cells, and traces of albu- men, if the previous qualitative investigation has shown that this substance is present. In order to determine the salts, a portion of the dried re- sidue must be submitted to incineration. It is difficult to ob- tain a white ash in consequence of the fusion of the salts. The chlorides may be extracted with spirit; the residue must be then treated with acetic acid, in order to convert the carbonates, which have arisen from the incineration of the alkaline lactates, into acetates, which may be extracted with alcohol. Anything that still remains, is composed of phosphates and perhaps sul- phates, in very minute quantity, together with traces of iron and silica. I have analysed mucus both from the nose and lungs, during pulmonary catarrh, but as I cannot regard these cases as illus- trations of normal mucus, I shall defer their consideration for the present. From an analysis of nasal mucus made by Berzelius, it appears that there are in 1000 parts : Water ..... 933-7 Mucin ..... 53*3 Alcohol- extract and alkaline lactates . . 3*0 Chlorides of sodium and potassium . . 5-6 Water-extract with traces of albumen and phosphates 3'5 Soda, combined with mucus . . . 3'9 76 THE SECRETIONS: Consequently Berzelius found no fat, but he detected traces of albumen. The foregoing remarks refer especially to the mucus of the nostrils and lungs, but as the physico-chemical properties of all sorts of mucus are not quite the same, I shall briefly commu- nicate my own observations and those of Berzelius on the different varieties of mucus. 1. Nasal mucus. Nasal mucus generally occurs as a gelatinous or fibrous, and nearly transparent mass ; after complete evaporation it remains in the basin as a yellow, and tolerably transparent coating. It contains epithelium cells and a few mucus-corpuscles, is not soluble in water, but if it remains in contact with that fluid for a considerable time it yields some mucin, in consequence of which the addition of acetic acid to the water produces a very slight turbidity. When water containing mucus is sub- mitted to filtration, the latter remains on the filter and gra- dually solidifies. Berzelius has observed that it may be dried and again diffused through water repeatedly, without changing its properties ; it ultimately, however, becomes opaque, yellow, and apparently purulent. When boiled with water it does not shrivel and harden, but only slightly contracts, and may be diffused by shaking. On cooling, it again becomes tenacious and viscid. By dry distillation of evaporated mucus we obtain carbonate of ammonia and Dippers oil. Mucus dissolves in dilute sulphuric acid ; in the concentrated acid it becomes dark coloured and is decomposed. Dilute nitric acid causes a su- perficial coagulation ; acetic acid induces a degree of contrac- tion, and the mucus does not dissolve in it at a boiling heat. On the addition of caustic alkalies, it, at first, becomes tough and thick, but subsequently dissolves into a thin fluid. 2. Bronchial and pulmonary mucus. These are very similar to nasal mucus. They separate into clear and gelatinous, or else into gray or yellowish flocculi, which remain suspended in water for some time, but ultimately sink to the bottom. MUCUS. 77 [Nasse 1 has analysed pulmonary mucus expectorated in the morning hy a healthy man. Analysis No. 1 refers to the mucus itself, and No. 2 to the solid residue. 955-520 44-480 23-754 53-405 8-006 18-000 1-810 4-070 2-887 2-490 5-825 13-095 0-400 0-880 0-198 0-465 0-080 0-180 of iron 0-974 2-190 0-291 0-655 0-255 0-570 J Water Solid constituents Mucin, with a little albumen Water-extract Alcohol-extract Fat Chloride of sodium Sulphate of soda Carbonate of soda Phosphate of soda Phosphate of potash, with traces Carbonate of potash . Silica, and sulphate of potash 3. Mucus from the intestinal canal. When evacuated with watery motions after the administra- tion of a purgative, I found it occurring in yellow gelatinous masses, which, on being examined with the microscope, were ob- served to contain a large quantity of mucus-corpuscles. Berzelius found that the mucus discharged with the faeces becomes hard and black on drying ; if it is then placed in water it becomes softer, and if the water contains any free alkali it again becomes viscid. It is thoroughly soluble in caustic potash, and it may be precipitated from its alkaline solution by the addition of any acid. According to Gmelin, 2 the mucus from the small in- testines of dogs and horses appears, after being washed in cold water, in the form of white shreds or flocculi. Dilute acids increase its coagulation, but concentrated acetic acid dissolves the greater part. It also dissolves in the alkalies, from which it may be precipitated by an acid. 4. Mucus from the gall-bladder. When bile is submitted to nitration a certain quantity of mucus which is suspended in the bile is detained on the filter, while another portion chemically combined with an alkali passes through in a state of solution, and may be precipitated by 1 Journal fiir praktische Chemie, vol. 9, p. 59. 2 Handbuch der theoretischen Chemie, vol. ii, p. 1118. 78 THE SECRETIONS : an acid : the latter has, however, lost the characteristic vis- cidity of mucus. If the acid be removed by means of an alkaline carbonate, the mass does not become viscid; if, however, in- stead of a carbonate, a caustic alkali is employed, the viscidity is restored. If the mucus of the gall-bladder is precipitated by alcohol, the viscidity disappears, it is restored, however, by being washed in water. When dried, it becomes transparent and yellow ; on the addition of water it swells, and is rendered opaque but not viscid. 5. Mucus from the urinary bladder. Vesical mucus is always present in the urine, but only in very small quantity in the normal secretion. In recently dis- charged urine it cannot be detected with the naked eye, but after the fluid has stood for some time, there are formed light, often hardly perceptible nebulae of sinking mucus, in which the microscope reveals mucus-corpuscles and epithelium-cells. On nitration the mucus remains on the paper in the form of co- lourless flocculi ; it contracts and ultimately forms a glistening varnish-like coating, which does not resume its former appear- ance on being moistened with water. According to Berzelius it is insoluble in sulphuric acid, but the greater part of it dissolves in acetic and hydrochloric acids : ferrocyanide of potassium throws down a precipitate from these solutions. 1 Morbid Mucus. It is well known that any irritation will increase the secretion of mucus in an extraordinary degree ; this is seen in the secretion of the mucous membrane of the nostrils and lungs during a common cold or catarrh. The mucus is then mate- rially changed ; at the commencement of the attack it is gene- 1 [We have at present analyses of only three varieties of mucus, viz. the mucus of the oviduct of frogs, the mucus of the oesophagus of the peculiar species of swallows which build edible nests, and the mucus of the gall-bladder. The results differ so much that either animal mucus is a variable mixture of heterogeneous substances, or that different substances at present bear the name of mucus in common. The ana- lyses are quoted in Mulder's Chemistry of Vegetable and Animal Physiology, p. 240, English translation.] MUCUS. 79 rally thinner than usual ; but, towards the termination, it be- comes thicker ; the epithelium-cells dimmish, while the mucus- corpuscles increase in number; the reaction continues alkaline; in fact, in most cases it is more strongly so than in the normal state; the fat is increased, and always contains cholesterin; and at the same time there is an excess of albumen. Gruby found that mucus secreted by the nasal mucous mem- brane during a state of irritation of that surface, was white, of the consistence of the white of eggs, and had a saline taste. When examined with the microscope, there were only a few epithelium- cells and mucus-corpuscles to be seen. I have analysed nasal mucus which accumulated in the upper part of the nose of a man aged thirty years ; it generally came away in the form of thick, tough, yellow lumps, about the size of an ordinary bean, or, if it had only been retained in the nos- tril for a shorter period, it was obtained as an extremely copious, tough, yellow fluid ; it was invariably discharged from only one nostril. This mucus was devoid of odour, had an alkaline reaction, and being moistened with water, (in which it sank,) it exhibited an extraordinarily large quantity of epithelium-cells, and a few mucus-corpuscles, connected by a pretty thick mem- brane of coagulated mucin. When the mucus was gently dried and pressed between the fingers, they presented the same glistening appearance as if they had been pressing fat ; no fat could, however, be distinctly recognised by the microscope in consequence of the dense strata of membrane and mucus-cor- puscles. In 1000 parts of this mucus there were contained : Analysis 88. Water ..... 880-0 Solid constituents .... 120-0 Fat, containing cholesterin . . . 6'0 Caseous matter, with pyin or mucin in solution . 13'2 Extractive matters, with lactates and chloride of sodium . 12-0 Albumen, cells, and coagulated mucin . . 84- Gruby found that the mucus secreted during catarrhal affections (slight inflammation) of the mucous membrane of the nose, conjunctiva, fauces, larynx, bronchi, ureters, vagina, and intestinal canal is thicker than the mucus secreted during mere irritation of those membranes; it was thick, tough, lubricous, of a yellowish white colour, and, as it gradually dried, it formed a grayish-yellow elastic mass. It sank in water, 80 THE SECRETIONS : unless air-bubbles were entangled in it, and exhibited no change for a considerable time, but ultimately became whiter. With the aid of the microscope, Gruby observed, 1st, a white amor- phous mass, not acted on by water (coagulated inucin,) and 2d, round yellowish-white globules, whose number seemed in a direct ratio with the intensity of the yellow colour of the mucus. These cells which were observed in the mucus of the larynx, had eight times the diameter of the blood-corpuscles, were inti- mately connected with the amorphous white mass, and consisted of a very delicate transparent capsule that was easily ruptured, of an inner round cell with a nucleus twice as large as a blood- corpuscle, and very many small vesicles one sixth the diameter of the blood-corpuscles, some of which were transparent and some opaque. The large vesicles sometimes contained two inner central cells. I have also frequently observed these large cells (which strongly resemble the full primary cells described and figured by Henle, 1 ) in the gray or yellow-streaked gelatinous mucous flocculi which are expectorated during a slight catarrh of the trachea and bronchi, as well as in the thick, tough, yellow nasal mucus that is secreted during a cold. I have repre- sented this bronchial mucus in fig. 16, in which a a represent the large cells. Other observers have detected these cells in tu- bercular matter ; it is clear, however, that they occur in diseased mucus, and are not to be regarded as diagnostic of tubercle. Gruby found that the mucus in ophthalmoblennorrhoea, and in the uterine and vaginal discharges of some women after their confinement, is of a deep yellow colour, thready and opaque ; it sinks in water and forms flocculi, which, on being stirred, dis- colour the fluid ; but after remaining in the water for some time, they lose their power of communicating their colour to a fresh supply of clear water. This mucus, when dried, forms a yellow, transparent, brittle mass, which continues to burn when lighted. Under the microscope, a white amorphous mass, insoluble in water, is observed, together with a large number of yellow vesicles of the form and nature of those previously described, some with, and others without a central cell. These vesicles swell in water, the capsule bursts, the inclosed molecules escape, and 1 Ueber Schleim und Eiterbildung u. s. w. fig. 14. MUCUS. 81 either become scattered or else accumulate round the unchanged internal cell, and often exhibit for some time the phenomena of molecular motion. Only a few epithelium-cells are observable; those that are present are full, round, and often closely resemble the large mucus-vesicles. I have likewise observed these epithelium-cells, which I regard as characteristic of a lower stage of development, in nasal mucus. (See fig. 14, d, e, /.) The mucus secreted in chronic blennorrhoea of the vagina and bladder is, according to Gruby, of a yellowish white colour, and slightly thready. It quickly renders water turbid, and deposits white flocks at the bottom of the vessel : in other respects it resembles the former varieties of mucus. Under the micro- scope we observe a small number of yellowish white vesicles, some with a capsule, granular contents, and a central cell, some with merely a capsule and a central cell, and some that are composed of an aggregation of granules, without any cap- sule whatever. Gruby found that the lochial discharge, 1 a short time after delivery, is of the colour of blood, is possessed of an animal odour, is only slightly thready, and when dried leaves a red pulverisable mass ; it consists of hsematoglobulin, fibrin, (pro- bably also albumen,) and vaginal mucus : under the microscope we observe an amorphous thready mass, blood-corpuscles, mu- cus-vesicles with capsules and aggregated granular molecules, and finally epithelium- cells. Very shortly before delivery we can observe nothing in the vaginal mucus beyond the true mucus-corpuscles (fig. 14, ,) and epithelium-cells ; but very soon after delivery the large mucus-vesicles, with granular con- tents (molecular granules) and delicate capsules, make their appearance. Fig. 16, a, exhibits these cells, and is copied from the plate in Gruby' s work. On the second day after delivery vesicles with a central cell (fig. 16, b] are visible, the mucus becomes less dense, the blood-corpuscles diminish, and the large mucus-vesicles increase in number. On the third day the red- dish lochial discharge contains yellow vesicles with granular contents and central cells. On the fourth day the discharge is considerably less red, and contains white stringy flocculi. On the fifth day the mucus contains grayish white, viscid flocculi, 1 Scherer's observations on this subject have been already given : see Vol. I, p. 338. n. 6 82 THE SECRETIONS : together with white vesicles, eight or ten times the size of blood- corpuscles, which contain only a few, and, in some cases, no gra- nular molecules; these are represented in fig. 16, c, d. Between the sixth and tenth days the lochial discharge becomeswhite,and con- tains white round vesicles, with finely granular contents, but de- void of a central cell, or the larger molecules. (Fig. 16, e, f, g.) Gruby has shown that the mucus discharged by stool at the commencement of dysentery is clear and stringy, and scarcely different from the mucus secreted in simple diarrhoea, but as the disease becomes more severe, there is a secretion of thick red mucus, consisting of blood- and mucus-corpuscles, resem- bling the ordinary secretion of inflamed mucous membranes. I have observed that the mucus secreted during inflam- matory affections of the mucous membrane of the respiratory organs is thick, rounded in form, of a white or pale yellow colour, and floats on water. These clots of mucus remain un- broken for a considerable time, but ultimately break up, and sink to the bottom : they then spread out into long tough fibres, which, when observed with the naked eye, have an uniform non- granular appearance : they possess a certain degree of con- sistency, and feel slippery, in consequence of the mucin which connects the mucus-corpuscles ; they are consequently not very easily fixed and broken up by pressure against the sides of the vessel with a glass rod. When examined with the microscope, the white masses of mucus are found to consist of a large num- ber of mucus-corpuscles, and a few epithelium-scales, connected by a delicate granular membrane of coagulated mucin : the yel- low clots contain, in proportion to the intensity of their colour, a greater or smaller quantity of the large cells with granular contents, (fig. 16, ,) in some of which a central cell is visible, while in others no cell can be seen. The fluid in which the thick clots of mucus are swimming is slightly clouded by acetic acid, but rendered very turbid by nitric acid : on the applica- tion of heat, it becomes white and opalescent ; and infusion of galls, and basic acetate of lead yield tolerably copious flocculent precipitates ; there is, consequently, a greater quantity of dis- solved mucin and albumen present than the water would have extracted from healthy mucus. A quantitative analysis of these floating clots, after being well washed in distilled water, gave the following results. MUCUS. 83 The numbers are calculated for 1000 parts : Analysis 89. Water .... 94175 Solid constituents . . . 5 8 -2 5 Fat with traces of cholesterin . . 5'01 Spirit-extract, with lactates and chloride of sodium 11-09 Alcohol-extract . . . 6*95 Cells, mucin, and a little albumen . 34-80 In a case of severe bronchitis that recently occurred in Schonlein's clinical wards, the patient expectorated purulent mucus, which, when placed in water, assumed a delicate arbo- rescent form, the ultimate fibrils floating on the water when the slightest motion was communicated to the vessel. When placed in acetic acid, it swelled and became converted into a trans- parent jelly, and after long digestion almost entirely dissolved; the solution being precipitable by ferrocyanide of potassium. Under the microscope the fibrils resembled coagulated fibrin, and there can be no doubt that plastic lymph was exuded as a consequence of the bronchitis, and expectorated in a coagu- lated form. [Observations on the sputa in bronchitis and pneumonia may be found in Scherer's ( Untersuchungen/ pp. 93-97.] Gruby states that the sputa expectorated during the ordi- nary inflammatory affections of the mucous membrane of the respiratory organs, are, at the commencement of a catarrh, white, transparent, and mixed with gray flocculi ; under the mi- croscope they are seen to contain a few round vesicles with granular contents, and numerous epithelium-cells, swimming in a transparent fluid. As the catarrh gets worse, the gray floc- culi increase, and become more of a yellow colour, and the amount of transparent mucus decreases ; the coloured flocculi contain numerous cells with granular contents (molecular gra- nules) and a central cell, which are all connected together by very tough mucus. As the inflammation decreases the amount of this globular sputa diminishes, and it assumes a whiter colour. Purulent Mucus. If the mucous membranes or the tissues immediately beneath them pass into a state of suppuration, pus becomes mixed with the secreted mucus : in this mariner the mucus of the lungs, bladder, intestinal canal, generative organs, &c. may contain 84 THE SECRETIONS: pus. When tubercles form in the lungs, they produce, like any other foreign body, a degree of irritation in the surrounding tissue, and an increased secretion of mucus is the result. Gruby's observation that the mucus discharged during irritation of the mucous membrane, dependent on the deposition of tubercle, does not differ from the mucus produced during catarrhal affections, is confirmed by Hetterschig 1 and other observers; the secretion of mucus at the commencement of a catarrh is, however, more abundant than that which is produced by the irritation of existing tubercles. The quantity of expectoration increases with the more ex- tended deposition of tubercle, until softening commences ; the tubercular matter is then expectorated, and, in consequence of the inflammation that occurs, pus is secreted by the walls of the cavity thus produced, and in this manner gets mixed with the sputa. The purulent expectoration of persons with tubercular phthisis is easily distinguished by the experienced practitioner from healthy sputa, 2 and with tolerable certainty from diseased mucus, nor can there be any doubt regarding its nature while tuber- cular matter is being discharged from a vomica, but the tran- sition from diseased into healthy purulent mucus is so slight and imperceptible, that it is hardly possible to detect the first traces of pus that are mingled with the mucus; for although, as I shall presently show, their general physical and chemical rela- tions are perfectly sufficient to distinguish pure pus from pure mucus, we have no means of determining with certainty the presence of a little pus in mucus, or the presence of a little mucus in pus. Purulent mucus from the lungs contains much less mucin than normal or diseased mucus, 3 and consequently the mucous clots have not the toughness, lubricity, and consistence ob- served in mucus, unmixed with pus : in fact they have a de- cided tendency to dissolve. Purulent mucus sinks more quickly in water than the normal secretion, partly in conse- 1 De Inflammatione ejusque exitu diverse. Trajecti a. R. 1841, p. 176. a [Dr. Wright's papers on Expectoration (recently published in the Medical Times) may be consulted with advantage.] 3 [This is perfectly consistent with the observation of Eichholtz, that the pyin (or mucin) varies inversely with the pus-corpuscles.] MUCUS. 85 quence of the fewer air-bubbles that are inclosed, (on account of slighter tenacity of the fluid medium of communication, and the comparative facility with which they escape,) and partly in consequence of the greater amount of albumen in the fluid, and its higher specific gravity. If the secretion is composed of nearly equal parts of mucus and pus, it sinks rapidly to the bottom, and forms small definite tough clots : the masses may easily be broken up by means of a glass rod, and can often be separated by mere shaking : they have not so uniform an ap- pearance as the healthy or morbid clots of mucus which float on water, but to the naked eye they appear finely granulated or gritty, since, in consequence ' of the deficiency of the con- necting medium the mucin, the cells of the secretion are not so closely associated. When there is only a small amount of pus in the globular sputa during phthisis, it separates from the mucus on being placed in water ; the pus at once sinks, and while the mucus is still floating on the surface we may observe long dependent viscid fibres, at the extremities of which white or yellowish gra- nular particles of pus may be noticed. Phthisical sputa deposit a whitish granular sediment at the bottom of the vessel, while masses of mucus are still floating on the surface of the water. A microscopic examination of the sediment shows that it consists of cells, which closely resemble mucus-cells, especially when they have been in the water for any time : since, however, the cells of purulent sputa come in contact with the water more readily in consequence of the smaller quantity of the connecting medium, mucin, they swell and become larger than the mucus-corpuscles, after they have been for only a short time in water : the capsules become transparent and vesicular, the granular appearance vanishes, and one, two, three, or even more nuclei with internal nucleoli, be- come visible : the capsules of many of the cells burst, and the nuclei swim about in a state of freedom, in the same manner as we observe in mucus that has been long under water. A mi- croscopic representation of these pus-corpuscles is given in fig. 17. The water in which purulent mucus has been placed differs materially from that in which normal or diseased mucus has been swimming. It is either nearly clear and colourless, or else of a pale yellow tint, is viscid, and is slightly clouded 86 THE SECRETIONS: by acetic acid, but is rendered white and opaque by the addi- tion of nitric acid: the action of heat likewise renders it turbid, and coagulates a considerable quantity of albumen, which sepa- rates in the form of flocculi. Infusion of galls and basic acetate of lead cause dense pre- cipitates ; in fact, the addition of the former sometimes com- pletely thickens the fluid. The quantity of albumen is therefore much larger than in simply diseased mucus. Pus. Violent irritation of the mucous membrane may produce suppuration and cause a secretion of pus in place of the or- dinary mucous secretion; thus it appears that the formation of pus is dependent on the very same process which, when acting with less intensity, first increases the secretion of mucus, and subsequently renders it abnormal. Pus, however, also forms in other and distinct parts of the body, after pre-existing congestion and inflammation, as for instance in cellular tissue, skin, muscular tissue, &c., and appears to differ both in its phy- sical and chemical characters in accordance with the seat of its formation and the length of time that it has remained in the organism. Genuine pus usually occurs as a rather thick fluid, viscid, but capable of separating in drops, somewhat like cream, of a whitish-yellow, yellow, or greenish-yellow colour, and of a faint but not disagreeable animal odour. It may be slightly acid, slightly alkaline, or neutral ; when mixed with water it sinks rapidly to the bottom, but on stirring, it forms an emulsive fluid, from which a sediment of pus- corpuscles is soon again deposited. When examined under the microscope, pus appears (like mucus) to consist of a clear fluid in which small, round, and occasionally oval corpuscles are swimming, the quantity of which seems to be in a direct ratio with the thickness of the pus. Pus- and mucus-corpuscles so closely resemble each other, that no distinctive mark, founded either on their form or on their chemical relations, has hitherto been discovered. The size of the corpuscles is nearly the same ; in tough pus they are some- PUS. 87 what smaller, and in thin watery pus, rather larger than the mucus-corpuscles : oval corpuscles, which may be often seen in mucus, and are probably dependent on the viscidity of the secretion, are rarely found in pus. In fresh pus the corpuscles are white, opaque, and apparently granular ; when treated with water they become rather larger, lose, in some degree, their granular appearance, and soon give indication of an internal nucleus. With acetic acid they behave exactly in the same manner as mucus-corpuscles ; the capsule becomes transparent and perfectly clear, and the nuclei become visible. The minuteness of the nuclei depends on the number that occur in the pus-corpuscle ; we seldom find more than five, usually two or three. With the aid of a good light we may observe that many of these nuclear-cells possess a cap- sule and nucleolus. Pus-corpuscles dissolve rapidly in free potash, and more slowly in free ammonia. Other reagents produce the same effects as on mucus-corpuscles. A very small quantity of dissolved alkali, such, for instance, as occurs in the blood, seems to exert a rapid influence on the form of the pus-corpuscle; for I have seen, in the blood of per- sons who have died from phlebitis, a large quantity of pus- corpuscles, (some isolated, and others swimming in heaps,) which were very pale, larger than usual, and of an irregular and tuber- culated outline. The liquor puris, or fluid in which the corpuscles are swim- ming, is transparent, and usually of a pale yellow colour; it contains so large an amount of albumen in solution, that, on the application of heat, it becomes perfectly white, and deposits innumerable flocculi of coagulated albumen. The large amount of albumen associated, moreover, with no trifling quantity of fat, distinguishes the liquid portion of pus from the tough and consistent fluid of mucus, and indicates the affinity be- tween the liquor puris and lymph. The fat is partly com- bined with alkalies, and free fat-vesicles cannot always be de- tected. The largest portion of the fat is apparently contained in the pus-corpuscles ; and, (as I have already observed when speaking of mucus,) the nuclei, if not composed altogether of fat, in all probability contain a very considerable proportion of that constituent ; for, after the addition of acetic acid, I have frequently observed a greater or less number of fat-vesicles in 88 THE SECRETIONS : pus which previously exhibited no traces of them. The fatty matter of pus contains cholesterin, and, according to the obser- vations of Giiterbock, develops ammonia while burning ; hence the presence of a nitrogenous fat may be assumed. The liquor puris is usually rendered turbid by acetic acid ; the effect may vary from an almost imperceptible cloudiness to a decided precipitate ; if the pus has an acid reaction, this test produces no change. There can be no doubt that the substances which are precipitated in this manner from the liquid parts of pus and mucus are analogous, and that the deposit which occurs in the liquor puris, after the addition of acetic acid, is either actual mucin held in solution by an alkali, or a substance scarcely dif- fering from it, pyin. 1 The fluid portion of pus, like that of mucus, contains extrac- tive matters and salts ; the former occur in larger quantity in pus than in normal mucus. According to Giiterbock, 2 the salts consist of chlorides, carbonates (arising from the decomposition of lactates), sulphates, and phosphates ; the two latter doubtless arise in part from the oxidation of phosphorus and sulphur during the incineration of the albumen. The bases are potash, soda, lime, magnesia, and traces of iron. According to Martius, 3 the pus-corpuscles contain a little phosphate of lime and silica; others have placed the ammonia- salts amongst the constituents of normal pus. The liquor puris is strongly precipitated by the mineral acids, metallic salts, and tannic acid, in consequence of its containing albumen, rnucin, and extractive matter : after the addition of a little dilute hydrochloric or acetic acid, it is also precipitated by ferrocyanide of potassium. Small quantities of tubercle occur in the purulent sputa of phthisical patients, in the form of little, white, yellow, or brownish-yellow, irregular, and mo- derately soft masses, varying in dimensions from the size of a grain of sand to that of a small hemp-seed ; they are usually inclosed in mucus, and sink rapidly in water. I have never observed many of these masses in the sputa ; on the contrary, their occurrence was only very rarely noticed, considering the great number of phthisical patients in the Berlin hospital. The 1 See note, page 74. 2 De pure et granu i at ione, p. 18. 3 Annalcn der Pharmacie, vol. 24. PUS. 89 irregular fragments of tubercle appear to the eye to be of a caseous nature ; but, after being moistened with water,, sub- mitted to pressure between two pieces of flat glass, and placed under the microscope, they seem to be composed of an amor- phous, finely granular, opaque, yellow matter, in which there are a varying number of fat-vesicles and some minute ramifying tubuli or fibrils, as in fig. 18. We sometimes meet with pecu- liar forms in tubercle, which, doubtless, belong to the tissue or vessels of the lung; they have likewise been observed by Gruby, and I have represented several of them in fig. 19. Gruby has observed peculiar corpuscles in tubercle which I have hitherto sought for in vaiii, both in tubercular lungs and in expectoration, and which he regards as characteristic of that morbid deposit. He describes them as lenticular, round, or oval, whitish-yellow corpuscles, with concentric rings, their lamellse being arranged in the same manner as those of an onion, and their size being from two to ten times as large as a pus- corpuscle; they are frequently jagged at the edges, dissolve easily in caustic potash, and become distended in nitric acid and a solution of nitrate of silver. It appears from the preceding observations that pus consists of two distinct portions ; namely, of a fluid, the liquor puris ; and of corpuscles swimming in this fluid and insoluble in it. The corpuscles are surrounded by a capsule, which becomes tumid in water, is soluble in free potash and is reduced by ammonia to a thick viscid jelly, dissolves on prolonged gentle digestion, and is doubtless composed of mucin. Of the nature of the contents of the corpuscles lying between the nucleus and the capsule we know nothing ; the nucleus probably con- sists of albuminous matter and fat. The liquor puris con- tains albumen, fat, pyin or dissolved mucin, extractive matter, and salts. For the quantitative analysis of these substances I adopted the same method as in the analysis of mucus. (See page 75.) Giiterbock's quantitative analysis of pus was made in the following manner : Pus was boiled with anhydrous alcohol, and filtered while still hot ; on cooling, the fat separated. The clear alcoholic solution was evaporated, and the residue treated with water, which dissolved the extractive matter and some free acid, 90 THE SECRETIONS: but left undissolved the small portion of fat that had escaped removal by the alcohol. The portion insoluble in boiling an- hydrous alcohol was freed from the spirit by gentle evaporation, and treated with water which took up pyin, and some albumen probably combined with soda. The insoluble portion consisted of coagulated albumen and pus-corpuscles; the salts were deter- mined by the incineration of a separate quantity of pus. Normal pus has been analysed by Giiterbock, Valentin/ G. Bird,2 Wood, 3 [Von Bibra, 4 and Wright. 5 ] The discrepan- cies observable in their results are probably due in a great measure to the different modes of analysis which they adopted. The pus analysed by Giiterbock was taken from a mammary abscess. That which was analysed by Valentin came from a large abscess in a man's thigh ; it was of a yellow colour, neu- tral, of a balsamic odour, and had a specific gravity of 1027. Wood analysed pus from the hand of a young man, and from abscesses in the cheek and breast of a woman. The analysis of the mixture is given below. The pus analysed by Golding Bird was taken from a psoas-abscess, and had a specific gravity of 1040-9. GtitertocJc. Water . . . . . 861-0 Solid constituents .... 139-0 Fat, soluble only in hot alcohol . . 16-0 Fat and extractive matter, soluble in cold alcohol 43-0 Albumen, pyin, and pus-corpuscles . . 74-0 Loss . . . .6-0 Valentin. Water ..... 883-78 Solid constituents . . . 116-22 Cholesterin 11-86 Oleate of soda, olein, and chloride of potassium Stearin Coagulated albumen and fibrin Fluid albumen and chloride of sodium 10-02 6-85 79-78 19-34 1 Valentin's Repertorium, 1838, p. 307. 2 Ancell's Course of Lectures on the Physiology and Pathology of the Blood, and the other animal fluids. The Lancet, 1839-1840, p. 745. 3 De puris natura atque formatione disq. phys. Berlin, 1837, p. 10. 4 Unters. iiber einige verschiedene Eiterarten. Berol. 1842. 5 Medical Times, Jan. 11, 1845. PUS. 91 Golding Bird. Water . . " . Solid constituents Fat .... Water-extract, with alkaline lactates Albumen .... Chlorides of sodium and potassium, with carbonates Phosphates of lime and iron 898-00 102-00 5-00 8-00 75-75 5*75 7-50 Wood. Water Solid constituents Cholesterin .... Oleate of soda .... Extractive matter, with chloride of sodium and other salts ..... Albumen ..... Animal matter, with the properties of ptyalin and glutin Fibrous matter, with phosphate of lime, peroxide of iron, and sulphur .... 857-15 142-85 1-57 10-91 8-34 19-09 16-57 86-37 The salts amounted, according to Giiterbock, to 5'7g of the solid residue, namely, to 5 soluble in water, (consisting, for the most part, of chloride of sodium with small quantities of phosphate, sulphate, and carbonate of soda, chloride of potas- sium, and chloride of calcium,) and O7 soluble only in nitric acid, and composed of the phosphates of lime and magnesia, carbonate of lime, and a trace of peroxide of iron. Valentin estimated the salts at 5'32 of the solid residue, of which 4-7 were soluble in water, (chloride of sodium with traces of the sulphates of potash, soda, and lime, and carbonates of potash and soda,) and 0*62 insoluble in water, (phosphate, sul- phate, and carbonate of lime.) [A large number of analyses of pus and purulent sputa have been made by Von Bibra. We select the three following : Pus from an abscess Ditto Ditto Water Albumen and pus-corpuscles Fat Extractive matter in the cheek. in the chest. in the-neck 769 852 907 160 91 63 24 33 9 19 29 20 Several analyses of pus have been made by Dr. Wright, three following analyses will serve as specimens : The 92 THE SECRETIONS: Pus from a Pus from a psoas Pus from a mam- vomica. abscess. mary abscess. Water . . . 894-4 885-2 879-4 Fatty matter . 17-5 j ^ ^ Cholesterm . . 5-4 Mucus . . .11-2 6-1 Albumen . . . 68-5 637 83-6 Lactates, carbonates, sulphates, and i phosphates of soda, potash, and > 9' 7 13-5 8-9 lime . . J Iron . . .a trace Loss . . .3-3 2-7 1-6 Nasse 1 has published two analyses, one of serum of pus, and the other of serum of blood, with the view of comparison. The following are his results : Serum of pus. Serum of blood. Water . . . 890-00 906-5 Solid residue . . . 110-00 93-5 Organic constituents 92-58 85*7 Chloride of sodium 12-60 4-6 Carbonate of soda 2-22 1-4 Phosphate of soda 0-32 0-9 Sulphate of soda 0-18 0-2 Phosphate of lime Carbonate of lime 1-201 0-90 J 0-7] I made an analysis of pus which was discharged with the urine by a servant-girl with phthisis vesicse : it was rather tough, of a reddish colour, in consequence of a little blood that was mixed with it, and quickly sunk to the bottom of the vessel, after the urine had been stirred. Before examination, it was washed with water and evaporated to dryness on the water- bath. There were contained in 100 parts : Analysis 90. Fat containing cholesterin. . . . 5-20 Albumen, with phosphate of lime . . . 40-20 Pyin, casein or globulin, and some extractive matter . 17-00 Haematin, urea, alcohol-extract, and lactate of soda . 10-60 Spirit-extract, with chloride of sodium, lactates, and phosphates 1-30 Water- extract, with phosphates and sulphates . . 13-80 Pus secreted by the synovial membrane of the knee-joint is composed, according to Wood, 2 of water, 888-1; cholesterin, 4-0; oleate of soda with soda, and potash-salts, 22'4 ; animal matter and chloride of sodium, 30-2 ; a substance resembling glutin, 1 Simon's Beitrage, p. 338. 2 Op. cit. p. 21. PUS. 93 15 '2; albumen, 40-1. Martins 1 analysed a purulent fluid ob- tained from a patient with empyema, from whom 153 ounces of matter were evacuated. It was tolerably thick, of a dirty greenish-gray colour, devoid of odour, and had a slightly acid reaction : when heated it swelled very much ; it sunk to the bottom in water, but on agitation the two fluids mixed. On boiling it, some floccules separated themselves, but no coagula- tion took place ; the fluid, after filtration, was of the colour of sherry, and had a specific gravity of llll'o. 2 The principal constituents were water, fat, albumen, extractive matter, glutin, potash, soda, magnesia, lime, ammonia, phosphoric, hydrochloric, and lactic acids. Koch 3 analysed pus with very similar results : it is not stated from whence the pus was obtained; it consisted of water, albumen, extractive matter, mucus,, and pus-corpuscles. In addition to the salts found by Martius, Koch detected car- bonates and sulphates, resulting from the action of heat on lactic acid and sulphur during incineration. John 4 describes pus from the ovary of a consumptive woman, as a greenish fluid, of the consistence of a liniment, and with a peculiar odour; it contained albumen, a substance resembling that substance, resin, gelatinous matter, and the ordinary salts, together with carbonate of ammonia. Chevallier 5 found in pus from a syphilitic bubo in the axilla, ten days after its formation, albumen, gluten, chlorides of po- tassium, sodium, and ammonium, with some sulphates ; it was viscid, of a blood-red colour, of a sickly odour, neutral, and coagulated on heating. The fluid from an abscess, in a case of spina bifida, contained, according to Bostock, water, 978 ; chloride of sodium, 10; albumen, 5; mucus, 5 ; gelatin, 2; and a trace of lime. The fluid which Gruby obtained from the pustules in smallpox, twenty or thirty hours after the commence- ment of the eruption, had an alkaline reaction; it contained some white, nearly transparent molecules, and round caudate infusoria. On the third day pus-corpuscles were observable, and subsequently became more numerous. 1 Annal. der Phann. 24. p. 79. 2 This must be an error of observation or a misprint. 3 Diss. inaug. Berol. 1825. 4 Chemische Untersuchungen, vol. 2. 1812, p. 120. 5 Gmelin's Chemie, vol. 2, p. 1395. 94 THE SECRETIONS: On the fifth, sixth, eighth, and ninth days after the com- mencement of the eruption the pustules contained a thick yellow fluid, which had a slightly alkaline reaction, and con- tained numerous yellow pus -corpuscles, the capsules of which readily burst. Tremoliere describes the contents of a well-conditioned pus- tule as yellow, turbid, and with an oily appearance. The smell and taste of this fluid were unpleasant, its specific gravity was 1031, and it consisted, according to his statement, of fibrin, mucus, chloride of sodium, sulphate of potash, and phosphate of lime. Gruby found that the fluid in the pustule on the seventh day was transparent; it contained white, nearly spherical vesicles, which appeared wrinkled on one side. Vogel has made some important observations regarding the modifying influence of tissue, constitution, &c., on the nature of pus. Pus from the cellular tissue is usually the purest, pus from mucous or serous surfaces being too thin and fluid, and con- taining in one case an admixture of mucus, in the other of serosity. Pus from the liver is pultaceous, thick, and of a brownish red colour. On allowing it to stand for some time, a dense, thick, and reddish matter separates from the white pus. Pus from the kidneys is usually rather fluid, of a whitish- yellow colour, and saltish. Pus from the urinary bladder may be either fluid or tough, and varies in colour from a yellow to a dirty brown-red tint; it frequently also has an ammoniacal odour. Pus from the bones is blackish, or white with black specks ; it has an odour and taste of phosphorus. Syphilitic pus is of a yellow or yellowish- green colour ; it possesses a nau- seous smell, and a sweet but sickly taste. Scrofulous pus is caseous, very fluid, grumous, and sometimes resembles coagu- lated milk ; according to Gendrin, it contains more soda and chloride of sodium than ordinary pus ; according to Preuss, it contains casein, like tubercular matter. Rheumatic and arthritic pus are very similar ; for the most part very fluid, irri- tative, and corrosive. I have examined the dried residue of the liquor puris of an arthritic person ; it was of a grayish- yellow colour, contained no membranous shreds, could be easily pulverised, and exhibited no appearance of crystals when exa- mined under the microscope. On heating it with nitric acid, I PUS. 95 obtained, after the evaporation of the acid, and more strikingly on the addition of ammonia, a brilliant purple colour, indicating the presence of uric acid beyond a doubt. On triturating this substance with water I obtained a pulpy mass, which, when exa- mined under the microscope, was found to contain numerous epithelium-cells and pus-corpuscles, but no crystals of uric acid. Alcohol extracted 5'4 of fat, consisting chiefly of margaric and oleic acids, with a little cholesterin; boiling water took up 52'6g, of which a little fat, extractive matters, with hydrochlorate of ammonia and lactate of soda, were soluble in anhydrous alco- hol; and chloride of sodium, extractive matter, and albuminate of soda in spirit. The remainder was washed with cold water, (which extracted very little,) and was then dissolved in a faintly alkaline solution. On the addition of hydrochloric acid to this alkaline solution, crystals of uric acid were deposited, and some albumen thrown down from the albuminate of soda : the acid solution then contained hydrochlorate of ammonia and chloride of sodium. The portion insoluble in water yielded on incinera- tion 5 of ash, consisting of earthy phosphates, with a little peroxide of iron and carbonate of soda ; the dried residue of the liquor puris yielded, however, 10 of ash, composed of carbonate of soda, a little phosphate of soda, carbonate and phosphate of lime, a little chloride of sodium, and traces of peroxide of iron. It contained in 100 parts : Analysis 91. Portion insoluble in water . . . .47*4 Fat . . . . .5-4 Alcohol-extract, with hydrochlorate of ammonia and lactate of soda ..... 4*9 Spirit-extract, with chloride of sodium and albuminate of soda . . 17-5 Uric acid and albumen, combined with ammonia and soda . 17'2 The amount of the individual salts was not determined. I have received, through the kindness of Dr. Piutti, of El- gersburg, two small flasks filled with a white fluid discharged from an abscess on the foot of a gouty patient, who had been trying the water-cure. On standing, the fluid threw down a copious white sediment, the supernatant liquid portion having a reddish tint. When shaken, innumerable crystals might be ob- served with the naked eye, which, under the microscope, ex- hibited an acicular form; a few pus-corpuscles were also present. 96 THE SECRETIONS: The crystals, after being carefully washed, so as to remove all extraneous matter, formed, when dry, a white powder, and when incinerated on platinum foil, left a white fused ash, consisting of carbonate of soda. The white crystalline mass, when warmed with nitric acid, yielded the deep purple tint indicative of uric acid. On digesting a portion with dilute hydrochloric acid, a large number of rhombic tablets of uric acid appeared on cooling. The hydrochloric acid solution yielded, on gentle evaporation, crystals of chloride of sodium. Hence the white acicular crystals consisted of urate of soda. The red super- natant fluid contained a few corpuscles, a large quantity of albu- men, and some hsematoglobulin. Scorbutic pus is thin, ichor-like, of a bad odour, often mixed with blood, and soon becomes putrid. Cancerous pus possesses a very peculiarly fetid odour, and appears very frequently to contain sulphuretted hydrogen and ammonia. Pus sometimes contains infusoria; thus K/. Wagner 1 has ob- served minute ciliated animalcules, in some slight degree resembling pus-corpuscles, in pus taken from cancer of the lip; they appeared to be the colpoda cucullus. Valentin has also observed infusoria in the purulent fluid of carcinoma. Donne 2 has observed the vibrio lineola in the pus from chancres and gonorrhoea : he found other forms of infusoria in the pus from syphilitic vaginitis ; they were twice the size of the blood-cor- puscles, with a round or elliptic body, considerably prolonged anteriorly ; he proposes for this animalcule the name of trico- monas vaginalis. Ichor. When pus begins to undergo decay, or is secreted from ma- lignant or carcinomatous growths, or when mortification comes on in consequence of the depressed state of the vital powers, it becomes thin and discoloured, (being often of a brown or reddish tint,) and emits a fetid odour : it is then termed ichor. Ichor frequently contains no pus-corpuscles, or only a very few, and those partially broken : it is of a blood-red colour, but does not always contain blood-corpuscles, the red colour being apparently due to their solution in the putrid and decomposed fluid. From 1 Valentin's Repertorium, p. 119. 3 Recherches microsc. sur la nat. du Mucus, etc. Paris, 1837. PUS. 97 the odour we may infer the presence of hydrosulphate of am- monia. Vogel examined some ichorous pus from a sore in the foot of a rheumatic patient ; he found perfectly normal pus-cor- puscles in it, and it only differed from normal pus in its greater fluidity. Pus of animals. I have analysed pus from a lymphatic gland in a horse. There were contained in 1000 parts : Analysis 92. Water . . . 976-00 Solid constituents .... 24-00 Fat, containing cholesterin . . . 1-68 Water-extract and caseous matter . . 1-26 Spirit-extract, with lactates, and chloride of sodium . 2-94 Albumen, cells, phosphate and sulphate of lime, and traces of iron . 17'64 Gobel 1 has analysed pus from the uterus of a mare ; it was a thick fluid, of a whitish-yellow colour, opaque, of specific gravity 1079, and had a faint animal odour : it was neutral, and coagu- lated on the application of heat. It contained, water, 913-3 ; albumen, 7'2; gelatinous non-coagulable animal matter, 9'4; chloride of sodium, lactate and sulphate of potash, phosphates of lime and magnesia, protoxide of iron, and silica, 5 -3. Dumas analysed pus from the frontal sinus of a mule : it reddened lit- mus paper, formed an emulsion with cold water, and when heated to 158, yielded a granular coagulum. It contained 17'9 of solid constituents, of which 16-5 were albumen ; the remainder consisted of extractive matter, free lactic acid, phosphates and sulphates. On the formation of mucus and pus on mucous membranes, and on the detection of pus in mucus. It seems to be now almost generally admitted that the dis- tinctions between pus and mucus are to be sought for, not in the morphological character or chemical relations of their respective corpuscles, but rather in the chemical peculiarities of the fluid portions of these secretions. It has been already shown that the fluid of mucus contains a large quantity of dissolved mucin, while no albumen, or, at the most, a mere trace, is present : on the other hand, the fluid of 1 Schweigger's Journal, voL 34, p. 407. ii. 7 93 THE SECRETIONS: pus is rich in albumen, and contains only a very small quantity of dissolved mucin. Hence, if it were proved that normal mucus never contains albumen, we might conclude that all mucus which gave indications of the presence of that substance was purulent. We should then also arrive at the conclusion that most persons, on the slightest irritation of the mucous mem- brane, secrete purulent mucus. In this manner we should have to agree with Vogel that normal mucus contains only epithe- lium, and that any secretion of mucus- corpuscles indicates an admixture of pus. To the physician the detection of traces of pus in mucus is a point of little importance ; it is of much more consequence to be able to decide from the sputa whether suppuration of the parenchyma of the lungs or of other tissues has actually com- menced. The point is one of very great difficulty, in conse- quence, as has been previously observed, of the imperceptible changes that mucus undergoes in its transition from the normal secretion into pus. My own observations, as well as those of others, lead me to concur in the view that Henle 1 has developed in his essay on the Secretion of Pus and Mucus, in which he distinctly and in- geniously points out the analogous phenomena between mucous membranes and the external skin. The mucous membranes are covered with several layers of epithelium, and in the ordinary course of secretion, the more recent and inferior layer of cells projects against the superior and older cells which constitute the existing epithelium. The inferior cells themselves gradually become epithelium, and, in their turn, are thrust out and supplanted by still deeper cells. As the fluid portion of the mucus is secreted at the same time, it evidently cannot be re- garded as the cytoblastema of these cells, but must be looked upon as effete, and no longer essential to the formation of mu- cus-corpuscles; the albumen for their nutrition having been ex- tracted from it during the progress of their development towards actual epithelium, and only mucin (the product of their meta- morphosis) left in its stead. As the secretion is increased by irritation of the mucous mem- brane, it follows either that such epithelium as is thrown off in the normal state is then not formed at all, or else that it is 1 Hufeland's Journal, May 1836. PUS. 99 only secreted imperfectly, and consequently we meet with cells in every state of development under these circumstances. These changes in the epithelium lead to corresponding variations in the fluid portion of the mucus, for if a normal stratum of epithelium is no longer formed, that is to say, if the deeper layers throw off the superior cells before they have arrived at maturity, the changes impressed on the fluid must be different from those which it would undergo during the ordinary secre- tion of healthy mucus. It is impossible that all the nutritious matter of this fluid can be consumed by these immature cells, and we consequently find in it, under these circumstances, a greater or less quantity of albumen and fat, two substances which universally yield a cytoblastema for the higher development of cells. If an increased secretion of mucus takes place on a mucous membrane which possesses only a single layer of epithelium, (either the cylinder or the ciliated variety,) the mucus-corpuscles appear immediately after the epithelium has scaled off. The transition of the mucus-corpuscles into epithelium-cells is not observed so well in this instance, as when there is a profuse secretion from a surface possessing several layers. These transitions and various stages of development lead us to the con- clusion that the mucus-corpuscles represent the first stage of formation of the epithelium- cells, into which they would ulti- mately have been converted if they had not been thrown off too early, and, further, that the different forms of epithelium-cells are in their primary state identical with one another. The same elements are likewise recognised, according to Henle, in other tissues, in the ganglia of nerves, in the brain, in the contents of the Graafian vesicle around the ovum, in the parenchyma of the liver, and in the blood-formative glands, (the spleen, thymus, and thyroid.) These cells occur also in the blood, where I have termed them chyle-corpuscles ; they proba- bly represent the blood-corpuscle in a preparatory stage of de- velopment. If we suppose the secretion of mucus to be still further in- creased, the mucous membrane will produce only these primary cells, which cannot be distinguished from pus-cells, with which, in fact, they are identical. Whether the secreted fluid is to be regarded as pus, mucus, or purulent mucus, depends on the quality of the liquid that is secreted with the cells. If it con- 100 THE SECRETIONS. tains much mucin, the fluid must be regarded as mucus ; if there is no mucin in it, or only a small quantity, but on the other hand much fat and albumen, it must be regarded as pus ; while if all three are contained in the fluid, it must be regarded as purulent mucus. In a veiy diseased state of the mucous mem- brane the fluid may even contain fibrin, and thus resemble plastic lymph. Henle 1 has observed this in one instance. We may consequently observe the various stages of transition from plastic lymph to the normal fluid of mucus (containing mucin, but no albumen), in the same manner as we can trace the epithe- lium-cells gradually downwards till they assume the form of primary cells. The following conclusions are all that we are entitled to de- duce from the previous observations : (1.) Pure mucus floats on water for a considerable time if air-bubbles are entangled in it ; pure pus sinks rapidly to the bottom ; purulent mucus swims if it contain air-bubbles, but allows the pus to deposit itself; the deposit frequently takes place in the form of pendent fibres. If pure mucus contain no air-bubbles it sinks. (2.) Pure mucus, lying in water, appears as a homogeneous, streaked, vesicular, viscid, and tenacious mass, of a white or whitish-yellow colour, and yielding readily to pressure. Pure pus forms a stratum at the bottom of water, of a white or greenish-yellow colour, and sometimes tinged with blood; by agitation it is diffused through the water, and in a short time again sinks to the bottom. Purulent mucus forms streaked, vesicular, often discoloured masses, or mucous sediments ; they are easily diffused through water, and have a granular, non- homogeneous appearance. (3.) Pure mucus imparts no albumen or mucin to water; mucus which is mixed with much saliva does, however, render water a little albuminous; pure pus communicates a large amount of albumen to water, and purulent mucus imparts a quantity of albumen proportionate to the amount of pus. None of what have been termed the " pus tests" are calcu- lated, in my opinion, to detect minute quantities of pus in mu- cus, and no test is requisite to distinguish pure mucus from pure pus, or to recognise a large quantity of pus in mucus. 1 Hufeland's Journal, 1836, p. 21. 101 CHAPTER VI. SECRETION OF THE EXTERNAL SKIN. Sweat. (Sudor.) THE sudoriparous glands continuously secrete a very consi- derable amount of watery fluid, which, in consequence of the ex- tent of surface over which these glands are distributed, usually passes off directly in the shape of vapour, leaving behind, how- ever, on the skin, its various solid constituents, mixed with the secretion of the sebaceous glands. It is only under the influ- ence of active exercise, high external temperature, or certain forms of disease, that the secretion is elaborated in such quan- tity as to stand in drops on the skin, instead of being carried off as insensible vapour ; it is then termed sweat. Attempts have been made by Sanctorius, Dodart and Reil, and more recently by Lavoisier and Seguin, to determine the quantity of fluid which escapes from the skin within a certain time, in the form of vapour. Seguin found that, on an average, 18 grains of fluid were discharged in a minute by the skin and lungs ; the former exhaling 11 and the latter 7 grains. The minimum exhalation from both sources amounted to 11 grains; the maximum, in a state of rest, to 32 grains in a minute. From these data the maximum of matter lost by the body through the skin and lungs in 24 hours, would amount to 5 pounds, and the minimum to 1 pound, 11 ounces, and 4 drachms. Taking the average of 11 grains in the minute, the whole quan- tity would amount to 29 ounces of fluid. The amount of solid constituents carried off with the fluid, is comparatively very small, and does not exceed 7 or 8 scruples in the 24 hours : all the rest is mere water, with some carbonic acid, and perhaps some nitrogen. The solid constituents of the sweat consist of a mixture of salts and extractive matters, of which the latter preponderate ; the principal ingredient of the salts is chloride of sodium. 102 THE SECRETIONS: I have on several occasions collected and analysed the sweat of persons in the vapour-bath ; it is, however, always mixed with more or less water condensed on the body from the vapour of the bath. The sweat collected in this manner from the arms and face was a turbid, rather dirty-looking fluid, which, after standing for some time, deposited gray floccules, recognizable under the microscope as epithelium-scales, for the most part broken and in fragments. The filtered sweat had in one in- stance a specific gravity of 1003, in another of 1004 ; it was slightly acid, which appears to be the ordinary reaction of nor- mal sweat ; in the course of 24 hours it became neutral, and on holding over it a rod moistened with hydrochloric acid, a slight cloud was observed. On evaporation of my own sweat, as well as that of another healthy man, the peculiar smell of the axilla was observed, and an odour of ammonia developed; the presence of this sub- stance was also indicated by the test to which we have just re- ferred. On evaporation to dryness, the odour of extractive matter became perceptible. On triturating a portion of the residue with free potash, ammonia was developed ; on the addi- tion of sulphuric acid to another part, sulphurous acid was first given oft 7 , and afterwards a marked odour of acetic acid. In one instance the odour of butyric acid was so clearly asso- ciated with that of acetic acid, as to leave no doubt of its presence. On boiling the dried residue of sweat with ether, a small quantity of fat is taken up, which may be isolated by evaporating the ether, and possesses the peculiar odour of sweat. Alcohol, on being then added to the residue, becomes of a pale yellow colour, and is rather strongly precipitated by tannic acid and acetate of lead, indications of the presence of alcohol-extract. On evaporation of the alcohol, chloride of sodium crystallizes in cubes, and in addition to these cubes, which constitute the greater part of the salts, and many of which have octohedral surfaces, there are also long prisms, plates, and fern-like crystal- line clusters of hydrochlorate of ammonia; the latter, especially, is very abundant in sweat that has stood for some time. On treating a portion of the residue of the salts with sulphuric acid, there is extricated in the first place some hydrochloric acid in a state of vapour, and subsequently a decided odour of acetic acid. SWEAT. 103 If a portion of the residue is incinerated, the ash effervesces on the addition of hydrochloric acid. On dissolving out the chlorides with alcohol, and adding bichloride of platinum, we obtain a slight yellow precipitate. The residue is soluble in water, with the exception of some gray flocculi, and on the ad- dition of tannic acid this aqueous solution yields a precipitate, which shows that the sweat contains water-extract. The solu- tion also contains a small quantity of lime, but hardly a trace of phosphoric acid, and only once, in several trials, was there a faint indication of sulphuric acid. When the whole residue of the sweat was incinerated, the amount of phosphate of lime was much larger, and a considerable quantity of sulphuric acid, as well as traces of peroxide of iron, were always perceptible. It is true that these are superficial and merely qualitative in- vestigations ; they are, however, sufficient to establish the ex- istence, in normal sweat, of 1. Substances soluble in ether: traces of fat, sometimes in- cluding butyric acid. 2. Substances soluble in alcohol : alcohol- extract, free lactic or acetic acid,, chloride of sodium, lactates and acetates of pot- ash and soda, lactate or hydrochlorate of ammonia. 3. Substances soluble in water : water- extract, phosphate of lime, and occasionally an alkaline sulphate. 4. Substances insoluble in water : desquamated epithelium, and (after the removal of the free lactic acid by alcohol) phos- phate of lime, with a little peroxide of iron. The results of the investigations of other chemists coincide generally with these conclusions of mine. Berzelius infers from his analyses of sweat that collected in drops on the fore- head, that it contains in solution the same substances which occur in a dissolved condition in the acid fluid of muscu- lar flesh, together with an excess of chloride of sodium. The most comprehensive analyses of sweat have been made by Ansel- mino. 1 He inclosed the naked arm in a glass cylinder, and collected the sweat that had exhaled during several experiments : in the course of five or six hours a table-spoonful had condensed. A portion was heated with sulphuric acid, evaporated, and 1 Tiedemann's Zeitschrift, vol. 2, p. 321. 104 THE SECRETIONS: caustic potash added to the residue ; by this means the pre- sence of ammonia was established beyond a doubt. On digesting another portion with oxide of lead, and moistening the dried mass with sulphuric acid, vapours of acetic acid were developed. A third portion, which was treated with lime water, became turbid, in consequence of the presence of carbonic acid. For the purpose of determining the solid constituents, Anselmino made use of sweat that had been collected by clean sponges from the vapour-bath ; it was turbid, and had a strong though by no means a constant odour. After the distillation of a portion of the filtered liquid in the steam-bath, acetate of ammonia was found in the fluid that had collected in the receiver. A very small amount of solid residue (from O5 to 1'25J) was left after evaporation of the sweat. Anselmino extracted the solid resi- due with alcohol of -833, evaporated the alcoholic solution to dryness, and then, by means of anhydrous alcohol, extracted from the saline residue an acid, extract-like matter, similar to the alcohol-extract of flesh, and containing free acetic acid, acetate of potash, and animal matter precipitable by tannic acid. Berzelius conceives the free acid of this extract (like the free acid in extract of flesh,) to be lactic acid. Now I will not assert that the sweat always contains free acetic acid, but I cer- tainly have observed cases in which the odour clearly showed that the free acid was principally the acetic ; lactic acid may, however, still be always present. The occurrence of acetic acid in sweat is placed beyond a doubt by my experiments. The matters which are undissolved by anhydrous alcohol are princi- pally chlorides of sodium and potassium, and spirit- extract ; the latter is not precipitated by chlorine, protochloride of tin, or bichloride of mercury. In this investigation Anselmino seems to have overlooked, as Berzelius remarks, the hydrochlorate and lactate of ammonia. All that is insoluble in alcohol may be dissolved in lukewarm water, with the exception of a gray mat- ter; this aqueous solution contains sulphates and an animal matter precipitable by tannic acid, and perchloride of tin, (water- extract.) The gray insoluble matter leaves on incineration a considerable amount of phosphate, together with a little car- bonate of lime. Anselmino has consequently arrived at results which entirely correspond with my own, excepting only that I could not in every SWEAT. 105 case detect the presence of sulphates in fresh sweat, although I always found them in the incinerated residue ; from this cir- cumstance I am led to infer that some of the constituents of sweat contain sulphur. In 100 parts of the solid residue of sweat Anselmino found : Substances insoluble in water and alcohol, chiefly salts of lime . 2-0 Water-extract and sulphates . . . .21-0 Spirit-extract, with chlorides of sodium and potassium . 48-0 Alcohol-extract, acetic acid, and acetates (lactates) . . 29*0 These figures must be regarded merely as approximative. In 1000 parts of sweat there are contained, according to Anselmino : Water .... 995-000 987-500 Epidermis and salts of lime . . -100 -250 Water-extract and sulphates . . 1-050 2-625 Spirit-extract, chlorides of sodium and potassium 2-400 6-000 Alcohol-extract, acetates, lactates, and free acetic acid . . . 1-450 3*625 From 100 parts of dried residue of sweat Anselmino obtained 22'9 of fixed salts, consisting of carbonates, sulphates, and phos- phates of soda and (in small quantity) of potash, chloride of sodium, phosphate and carbonate of lime, and traces of per- oxide of iron. The peculiar odour of sweat from different parts of the body is dependent in a great measure on the secretion of the seba- ceous glands in those parts : thus it is well known that the sweat from the feet of many persons has a very penetrating odour, that the sweat from the axilla gives off a peculiar ammoniacal smell, and that the sweat of the external organs of generation contains and smells faintly of butyric acid. The gases which are given off by the skin are, according to Collard de Martigny, 1 carbonic acid and nitrogen ; they are not exhaled in constant, but in varying proportions, and generally in the greatest quantity after meals and after violent exertion. Collard has observed that an excess of carbonic acid is exhaled after the use of vegetable food, and an excess of nitrogen after a nitrogenous diet. Since these gases are contained in a state 1 Magendie's Journal, vol. 10, p. 162. 106 THE SECRETIONS: of solution in the blood, (see vol. I, p. 135,) it may readily be conceived that they will exhale at those points where the blood in its passage through the capillaries comes in the most inti- mate contact with the external atmosphere ; at least it seems a simpler view to regard it as a mere physical process than as a disintegration of animal matter by the secreting organs. In fact, the cutaneous exhalation must be regarded, as Edwards has observed, in the light of a partly physical, partly organic process. The product of physical exhalation is pure water and gas ; the product of organic exhalation contains animal consti- tuents, which must be regarded as secretions of cells. The amount of exhaled matter is liable to great variations : it is increased by a dry and light atmosphere ; and is lessened by a moist, vapoury, dense, and calm atmosphere. During and immediately after meals the exhalation is at its minimum; it attains its maximum during the actual period of digestion. The cutaneous exhalation is in antagonism with the urinary secretion and the pulmonary exhalation, so that an excessive secretion of urine diminishes the action of the skin, and, conversely, the renal functions are less energetic when the skin exhales freely. On Morbid Sweat. Our knowledge of the chemistry of normal sweat is very im- perfect ; but our information respecting the changes which this secretion undergoes in disease is still more deficient. Our ignorance may be explained, and in some measure excused, by the extreme difficulty of obtaining, in a state of purity and un- adulteration, a sufficient quantity of the secretion for the pur- pose of forming a successful chemical analysis. Dr. Piutti, of Elgersburg, has had the kindness to present me with some sweat which he obtained from persons during the use of the water-cure, and also with a manuscript communi- cation containing some analyses of sweat instituted by himself, which I shall at once proceed to enumerate. The manner in which he conducted his analyses is not stated. "We observe the absence of salts of lime in these analyses, and Piutti states that he could find no traces of phosphate or ben- zoate of lime, the former of which has indisputably been de- SWEAT. 107 tected by other chemists. Since the phosphate of lime doubt- less pertains to the epidermis, we may conclude that Piutti removed all the desquamated cuticle before he commenced his analyses. 1 All mention of sulphuric acid, and of potash, is likewise omitted. I have already stated that I only once detected traces of sulphuric acid in fresh sweat, although I always found a considerable quantity of it in the incinerated ash. Piutti has made three analyses of the sweat collected from invalids. They gave the following results : 1. 2. 3. Water . 995-5 993-0 994-6 Chloride of sodium . 3-0 4-0 3*3 Phosphate of ammonia . . -5 -8 1-1 Acetate of ammonia ' . . '5 -6 -5 Hydrosulphate of ammonia . trace trace Extractive matters . . -5 1-6 -5 The first analysis was made with the sweat of a man aged 36 years, who during twelve years had suffered from atonic gout, and had been trying the water-cure for ten weeks. The specific gra- vity of the sweat was 1003*5. The sweat in the second analysis was taken from a woman aged 54 years, who for six years had suffered from gout, and who had been under the water-cure for twelve weeks : its specific gravity was 1004. In the third case it was collected from a girl 22 years of age, suffering from para- lysis of the lower extremities, but in other respects blooming and healthy. The animal matter in this case was of a greenish colour when isolated ; it was soluble in ether, but not in alcohol. The specific gravity was 1003. The sweat that was forwarded to me by Dr. Piutti, and which was inclosed in ounce-bottles with ground stoppers, was in a state of decomposition when I received it, and therefore was not in a proper condition for an accurate qualitative ana- lysis. It smelt strongly of hydrosulphate of ammonia, espe- cially a specimen collected from a man who had had psoriasis diffusa for seventeen years. The gray deposit which was found in every bottle consisted of desquamated epidermis. The sweat, to which I have just referred, had a penetrating odour of sul- 1 Berzelius, however, is of opinion that a portion of phosphate of lime appertains to the sweat itself, and that it is held in solution by a free acid. 108 THE SECRETIONS: phuretted hydrogen, which continued during evaporation, and ultimately merged into a nauseous animal smell. Its specific gravity was comparatively high, being 1008 ; and it yielded 9*9 of solid constituents, which, after being exposed to the influence of a red heat, were found to consist of a large proportion of chloride of sodium, carbonate of soda, a little phosphate of lime, and a fair amount of sulphuric acid. The statements which we possess from other sources, regarding the morbid changes of the sweat, are very loose and inconclusive ; in fact we have no accurate observations on the subject. 1. The quantity of the sweat is sometimes increased in an extraordinary degree. Thus critical sweats are usually very abundant, continuous, and watery, in intermittent fevers, in rheumatic affections, and in colliquative disorders. 2. The quality of the sweat is changed. a. The sweat may be distinguished by a peculiar odour. The sweat of persons with the itch is said to have a mouldy odour, while that of syphilitic patients is said to smell sweet. The sweat of rheumatic and gouty persons has an acid smell, while in putrid fever and scurvy, it has a putrid odour; in jaundice it is said to resemble musk in its smell. In Stark's ' General Pathology/ (p. 1126,) we find it stated that the odour of the sweat in scrofula resembles that of sour beer, while in intermittent fever it smells like fresh-baked brown bread. The determination of odours is, however, very subjective, and (with a few exceptions) it is more than probable that different ob- servers would detect different resemblances. b. Some of the normal constituents may be abnormally in- creased. 1st. The free acid of the sweat may be increased. Lactic acid, which is the ordinary free acid, is usually increased in cases of rheumatism and gout; the sweat in these diseases has a strong acid reaction. When there is also an acid odour, acetic acid is present. Prout has found free acetic acid in the SWEAT. 109 sweat of a person suffering from hectic fever. After an attack of acute rheumatism, the joints of the feet remained swelled, for which potash-baths were ordered. These baths, in the course of three weeks, brought on an attack of eczema, extending as high as the knee. The sweat from the feet had then a de- cided odour of acetic acid, which became more strongly developed when they were sharply rubbed. Anselmino 1 found free acetic acid in the sweat of women during their confinement; and, ac- cording to Stark, the quantity of free lactic acid is increased in the sweat during scrofula, rachitis, and certain cutaneous eruptions. 2d. The ammonia of the sweat may be increased. Anselmino found a larger proportion of (free ?) ammonia in the sweat after an attack of gout than in any other case. Berend 2 states that the sweat in putrid and typhus fever is ammoniacal; and in nervous diseases (?), according to Nauche, 3 it becomes alkaline. All sweat with a putrid odour probably contains free ammonia. 3d. The salts may be increased. Prout 4 observed that in the case of a man with dropsy the skin became covered with a white saline crust of chloride of sodium, after an abundant perspira- tion. Anselmino found in the sweat, after a severe attack of gout, more salts than usual. In cases of gouty and urinary concretions, the quantity of phosphate of lime appears to be in- creased. c. Abnormal constituents may be present in the sweat. 1st. Albumen has been observed by Anselmino in a critical sweat, which broke out in large quantity one evening over the whole body in a case of febris rheumatica, with severe pains in the joints ; on the following day it had disappeared. Stark asserts that albumen may be found in the sweat in gastric, putrid, and hectic diseases, and also on the approach of death, in consequence of the abnormal solution of the solid constituents. I failed in detecting any certain indications of albumen in sweat collected (by means of linen washed with distilled water) from the breast of a person in the colliquative stage of tubercular phthisis. 1 Tiedemann-'s Zeitschrift, vol. 2, p. 223. 2 Vorlesungen iiber Semiotik, p. 388. 3 Stark, p. 1127. " London Med. Gaz. vol. 15, Oct. 1834. 110 THE SECRETIONS: 2d. Blood or its constituents. Voigtel 1 observed an instance of bloody sweat from under the arm of a young man ; it ap- peared after any violent exertion. In scurvy, putrid fever, and typhus icterodes, bloody sweat has likewise been observed. 3d. Uric acid is stated to have been found in the sweat of arthritic persons (Stark). Wolff 2 found that the sweat which had hardened on the forehead into a solid white substance, (in a patient with stone in the bladder,) contained uric acid. Urate of soda is likewise stated to have been found in the sweat of persons suffering from gout or stone. 4th. Ellin and biliphmn have been found in the sweat of persons with jaundice, and sometimes in such large quantity as to colour the linen yellow, and to communicate a bitter taste to the perspiration. According to Berend, the sweat in febris putrida biliosa likewise contains bile-pigment. 5th. Red colouring matter of the urine (uroerythrin] was found by Landerer 3 in sweat from the axilla of a fever patient. A blue colouring matter, doubtless allied to cyanurin, has occa- sionally been observed in the sweat. Dr. Bleifuss 4 has seen blue sweat from the foot of a patient with disease of the abdomen. Michel has likewise observed it in an hysterical woman and in a hypochondriacal man ; it was most marked on the right side of the body. Billard 5 observed a blue sweat on the upper part of the body of a girl. 6th. Fat is stated to occur in colliquative hectic sweats. d. Substances altogether foreign to the animal organism may be conveyed, through the process of digestion, into the blood, and thus occur in the sweat. Landerer 6 has observed in his own person that after taking large doses of quinine, the sweat assumed the bitter taste of the drug. The following substances enter into, and have been de- tected in the sweat : sulphur, mercury, iodine, iodide of po- tassium, assafoetida, garlic, saffron, olive oil, rhubarb, indigo, Prussian blue, and copper. (Stark, General Pathology, p. 1127; 1 Stark, p. 1131. Diss sing casum ca i cu i ositat i s . Tub. 1817. 3 Buchner's Repert. 2d series, vol. 5, p. 234. 4 Wvirtemberg. Med. Correspond. Blatt. 1835, No. 26. 5 Froriep's Notiz. 32. 6 Buchner's Repert. 16, p. 238. SWEAT. 1 1 1 Baumgartner, Elements of Physiology and Therapeutics, p. 486.) Many of these statements, regarding the changes undergone by the sweat in disease, are fully confirmed; some must, however, still be regarded as doubtful. Sweat of animals. Anselmino has analysed the sweat of the horse, the only animal of whose sweat we have any accurate knowledge. He used for his analysis the scaly matter that falls from horses during the process of currying, in the form of a white powder, and consisting of dried sweat mixed with a considerable amount of dirt and epithelium. It contained, 1st, a substance with an acid reaction, soluble in anhydrous alcohol, alcohol- extract, together with an alkaline lactate or acetate ; 2d, an extract-like matter, soluble in alcohol of '833 and possessing an odour like that of the horse, together with chloride of sodium ; 3d, an extractive matter soluble in, and communicating a brown colour to water, and precipitable by infusion of galls, together with chloride of sodium and sulphates. The portion still undissolved evidently consisted of epithelium. Anselmino regarded it as coagulated albumen ; doubtless it was in it that the phosphate of lime and magnesia occurred, which were recognised in the ash of the sweat. The ash consisted of sulphates of potash and soda, chlorides of sodium and potassium, a large proportion of the phosphates of lime and magnesia, with traces of iron, but no alkaline carbonates or phosphates. Anselmino seems to have overlooked the ammonia-salts, for it is only by the presence of hydrochlorate of ammonia that we can explain how it is that the ash contains no alkaline carbonate, while the alcohol- extract contains either lactate or acetate of potash. The pre- sence of acetic acid was established by a separate experiment. Fourcroy and Vauquelin sometimes found small quantities of urea in horses' sweat, but Anselmino could never detect it. 112 THE SECRETIONS. Fat. The minute sebaceous glands (folliculi sebacei) which are distributed over the whole surface of the body, secrete a peculiar fat, which renders the skin supple and flexible, and hinders it from being permeated by water. The composition of this fat varies in different parts of the body, as is clear from the variety of smell which it evolves in the axilla, on the generative organs, on the scalp, and on the feet of many persons. It is usually of a pale yellow colour, not viscid, and insoluble in water, with which, when it is rubbed, it forms an emulsion. It contains relatively only a small amount of true fat, and is associated with several other animal matters, (as, for instance, albumen and extractive matter,) and a considerable amount of inorganic salts. Esenbeck has made an analysis of the fat collected in an enlarged sebaceous gland. It did not coagulate on boiling, and was precipitated by acids, corrosive sublimate, and tannin. It contained in 100 parts : Stearin . . . .24-2 Extractive matter, with some olein . . 12-6 Salivary matter . . . .11-6 Albumen with casein (?) . . . 24-2 Phosphate of lime . . . 20*0 Carbonate of lime . . . .2-1 Carbonate of magnesia . . . T6 Traces of acetate of soda, chloride of sodium, and loss . 3*7 113 CHAPTER VII. THE URINE. THE urine is an extremely complex fluid, but the relative proportions of its different constituents are not very variable. The following are the ordinary constituents of healthy human urine : urea ; uric acid ; [hippuric acid] ; extractive matters, embracing alcohol- extract, spirit-extract, and water-extract, with their respective constituents; mucus; brown colouring matter of the urine (hsemaphsein) ; red colouring matter of the urine (uroerythrin) ; carbonic, lactic, hydrochloric, sulphuric, phosphoric, silicic, and hydrofluoric acids; 1 soda; potash; ammonia ; lime ; magnesia ; and peroxide of iron. Recently discharged urine ordinarily possesses the mean tem- perature of the body ; it is of an amber yellow colour, perfectly transparent, has a well-marked acid reaction, and exhales a peculiar but not disagreeable odour, which it loses on cooling. Its specific gravity fluctuates from 1005 to 1030, the average being about 1012-5. It has a saline and disagreeably bitter taste ; it undergoes no apparent change upon being heated to the boiling point, and its behaviour towards reagents is depen- dent upon that of its various constituents, although modified by the very dilute state in which they occur. Acids, with the exception of the oxalic, which produces a turbidity, throw down no precipitates ; the free alkalies, on the contrary, throw down the phosphate of lime; the salts of baryta, silver, and lead, cause precipitates ; so also does tannin, but in a less degree. When urine is left to itself for some time, slight nebula, con- sisting of mucus, are formed in it, which gradually descend to the bottom. Soon after the appearance of this phenomenon, an unpleasant odour is developed; instead of an acid, an alkaline 1 [In addition to these constituents, two new acids, to which no names have been yet assigned, have been described by Pettinkofer and Heintz.] ii. 8 114 THE SECRETIONS: reaction is observed, and carbonate of ammonia is formed, which causes more or less turbidity by precipitating the am- moniaco-magnesian phosphate, and phosphate of lime. A portion of these salts, associated with mucus, forms a greasy whitish scum, in which, by means of the microscope, beautiful crystals of ammoniaco-magnesian phosphate may be seen, mixed with an amorphous mass of phosphate of lime and decomposed mucus. On treating the urine in this state with hydrochloric acid, it effervesces, in consequence of the presence of carbonate of ammonia. If the urine is allowed to stand for a still longer period, the smell becomes more disagreeable ; cubic, and four- and six-sided prismatic crystals, composed of chloride of sodium, hydrochlorate of ammonia, and phosphate of soda and ammonia, are produced in consequence of the concentration produced by the spontaneous evaporation, and the urine ultimately becomes covered with a sort of mould, which is usually of a blue or blueish-gray colour. "We have no certain knowledge regarding the manner in which the acids and bases combine to form salts in fresh healthy urine. We may fairly conclude that the chloride of sodium preexists in it ; the sulphuric acid is generally supposed to be united with potash, phosphoric acid with lime and magnesia, and if (as is generally the case) more phosphoric acid be present than is required for the saturation of these earths, the excess combines with soda ; and if there be not sufficient soda present to effect the saturation of the acid, the ammonia combines with it, forming the biphosphate of ammonia. The lactic acid of the urine is partly free, and partly combined with ammonia, potash, and soda. Hydrochlorate of ammonia is also supposed to pre- exist in the urine. Carbonic acid, when it occurs in the urine, is held in solution and in a free state. Uric 1 acid is supposed by Berzelius to exist in a free state in solution in the urine, although warm urine usually holds a larger quantity of uric acid in solution than an equal quantity of water at the same tempe- rature could retain. There is, however, this point in favour of his view, that the uric acid, which separates spontaneously from the urine on cooling, contains mere traces of ammonia 1 [It is stated in volume I, page 54, that the formula for hydrated uric acid is C IO N 4 H 3 5 + HO. From various analyses of urates by Bensch (Liebig's Annalen, vol. 54, p. 189), there is reason to believe that the true formula is C 5 N 2 H0 2 -}-HO.] URINE. 115 and soda, and lie conceives that, in all probability, the uric acid is held in solution through the agency of some of the other con- stituents of the urine. [Liebig 1 has shown that uric acid possesses the property of combining with a portion of the soda of the alkaline phosphate of soda, and acquires in the combination a higher degree of solubility than it possesses in its uncombined state, at the ordi- nary temperature of the body. By this reaction there are produced a urate of soda and an acid phosphate of soda.] Prout, on the contrary, is of opinion that the uric acid is held in solution in the urine in the state of urate of ammonia, a combination which probably always occurs in healthy urine, and which is often found in large quantity in the urine of diseased persons, giving rise to the formation of sediments. The real state of the case may be, that normal urine contains both free uric acid and urate of ammonia. Qualitative analysis of healthy urine. The qualitative analysis of healthy urine seldom presents any great difficulty. Many of its constituents may be detected with ease, unless, as is sometimes the case, they exist in very minute quantity. Others, as for instance, the extractive matters, can only be detected with any degree of certainty by isolating them, in the same manner as is done in quantitative analysis. The analysis of the urine is something like that of mineral waters ; some of the constituents may be at once recognised by the addition of a test, while we can only be assured of the pre- sence of others, by separating them in a distinct and iso- lated state. The specific gravity of the urine is most accurately deter- mined by the ordinary 1000-grain glass bottle. An areometer will give the result with less trouble, but, at the same time, with less accuracy. Becquerel 2 has published a table for the purpose of enabling us to calculate the amount of the solid constituents in a known weight of urine, from the observed specific gravity, [but it has 1 Lancet, June 1844. 2 Semeiotique cles Urines, p. 17. 116 THE SECRETIONS: been proved to give results on which no dependance can be placed. 1 ] 1. Urea. This constituent seldom occurs so abundantly in the urine, as to be immediately detectible by the addition of any reagent. A portion of urine is usually evaporated in the water-bath to the consistence of a syrup, anhydrous al- cohol is added, and the alcoholic solution is filtered, and eva- porated on the water-bath nearly to dryness; some drops of water, and subsequently of nitric acid are added, upon which crystals of stellar and foliated shapes very speedily develop themselves. Upon leaving the alcoholic extract to spontaneous evapora- tion, long acicular crystals of urea will be formed ; on examining some of them under the microscope, they will be found to pre- sent the appearance of four-sided prisms, as shown in figure 20, If, (which however is not often the case,) the urea should be present in very small quantity, and no crystals are formed for some time after the addition of nitric acid, it only requires a microscopic examination to ascertain whether the crystals are those of nitrate of urea : if they are, they will occur in the forms indicated in fig. 21. If, instead of nitric, oxalic acid has been used for the detection of the urea, we obtain the forms represented in fig. 22. 2. Uric acid. It is but seldom that the uric acid exists in such large amount, as to be precipitated in the form of a fine crystalline red sediment when the urine cools. When, how- ever, this is the case, the crystals, under the microscope, exhibit the rhomboid form shown in fig. 23. Another method of proving that the sediment consists of uric acid, is to place some of it in a porcelain capsule moistened with nitric acid, and to apply heat till the acid evaporates. A purple-red colour then appears, which is characteristic of uric acid : this colour becomes more intense on the approximation of a rod dipped in ammonia. If no crystalline sediment is deposited as the urine cools, two or three drachms of hydrochloric acid must be added to six or eight ounces of urine, and the mixture must be allowed to 1 [On the specific gravity of the urine in health and disease, especially in diabetes and granular degeneration of the kidneys. By George E. Day. Lancet, June 15' 1844.] URINE. 117 stand, covered, for twenty-four to forty-eight hours. A red or reddish-brown sediment of uric acid then separates, consisting of crystals of the forms represented in fig. 23a, and 23b. 2*. [Hippuric acid is regarded by Liebig 1 as an invariable constituent of ordinary human urine. "All the urine taken in this country from individuals living upon a mixed animal and vegetable diet, contains hippuric as well as uric acid, and about the same proportion of both acids. Hippuric acid may be obtained in the following manner, even from proportionally small amounts of fresh urine : Fresh urine is evaporated in a water-bath to the consistence of a syrup ; it is then mixed with some hydrochloric acid, and agitated with its own volume of ether, which latter substance dissolves the hippuric acid. It usually happens that the mixture does not separate spontane- ously, but that the ether remains inclosed by the fluid, like froth the separation of the ether takes place immediately upon adding to the mixture, after having allowed it to stand at rest for an hour, one twentieth part of its volume of alcohol. In this case the froth disappears, and the fluid separates into two layers ; the upper layer contains the hippuric acid in solution; but besides it also contains urea, owing to the addition of the alcohol. This upper layer is carefully removed by means of a pipette or syphon, and agitated with small portions of water; the water removes the alcohol and the urea, whilst the hippuric acid remains in solution in the ether. By evaporating the ethereal solution the hippuric acid is obtained in crystals. The crystals produced are usually of a yellowish or brown colour, arising from the presence of a resinous substance, which may be easily and completely removed by means of charred blood. 2 1 Lancet, June 1844. 2 [The following is a simple method of obtaining pure crystals of hippuric acid from human urine. Evaporate the urine till there is a copious deposition of salts. Add strong alcohol, and place the mixture in a stoppered bottle. With the aid of a gentle heat, (for instance, by placing the bottle in warm water), we ensure the solu- tion of the urea, the lactates (if any are present) and the hippurates in the alcohol, whilst the urates remain with the insoluble constituents. When the supernatant fluid is perfectly clear, it must be decanted, evaporated veiy nearly to dryness, and redissolved in hot water. If a stream of chlorine be passed through the aqueous solution, the urea is destroyed ; and by gradual concentration, and the addition of a little free mineral acid, we obtain crystals of hippuric acid.] 118 THE SECRETIONS: "In its pure state the hippuric acid produced from human urine presents the same long, shining, transparent, four-sided ob- liquely-truncated prisms, by which the hippuric acid produced from the urine of animals is so easily detected and distinguished from benzoic acid. (See fig. 23.) The hippuric acid of human urine is not volatile at the subliming temperature of benzoic acid ; at a higher temperature it undergoes fusion, forming a brown-red liquid, and yielding upon dry distillation the same products which common hippuric acid forms under the same circumstances, viz., a red-coloured oil smelling like tonka-beans, ammonia, benzoic acid, and a copious residue of carbon. It dissolves in nitric acid at a high temperature, and yields, upon cooling, crystals of benzoic acid, owing to the decomposition which it undergoes. "From 0-499 of hippuric acid produced from urine, 1-0791 of carbonic acid and 0-2317 of water were obtained. This gives for 100 parts Found. Calculated . Carbon . . . 59'47 . . 60-89 Hydrogen . 5-15 .. 4-45 This analysis corresponds sufficiently with the calculated results to remove all doubt as to the nature of the acid ; it will be per- ceived that it contains lOg less carbon than benzoic acid."] 3. Extractive matters. The exhibition of the divisions of ex- tractive matter, namely, the water- extract, the spirit-extract, and the alcohol-extract, can only be effected by evaporating the urine, and treating it with alcohol, as we shall presently show in speaking of the quantitative analysis of this fluid. Little has yet been done in this department of chemistry, but the presence of the extractive matters can generally be easily re- cognized by the addition of certain tests : for instance, acetate of copper, chloride of tin, perchloride of iron, and sulphate of prot- oxide of iron, throw down precipitates from freshly-passed urine; ' and bichloride of mercury, nitrate of tin, and tannic acid, cause a degree of turbidity. There is, however, no certain proof, al- though there is every probability that normal urine in all cases behaves in this way with the above tests. The extractive mat- URINE. 119 ters which I formerly separated from the urine were not precipi- tated by the salts of iron, while, on the contrary, its perchloride throws down a copious precipitate in a specimen of urine, which I am now analysing. Berzelius states, that after urine has been neutralized by an alkali, precipitates are induced by the salts of zinc, tin, and mercury : I find that fresh urine, with a strong acid reaction, becomes clouded or deposits a sediment upon the addition of these salts. 4. Mucus. Mucus in the urine is readily detected by the microscope. We take up with a spoon a portion of the sepa- rated nebulous matter, and on placing it on the object-glass we can easily recognize the mucus-granules, and frequently a few epithelium-scales. 5. H&maphmn. It is this constituent which gives to healthy urine its amber or brownish-yellow colour. The variations in the tints of the urine are dependent upon the quantity of this colouring matter. [Scharling 1 has recently examined the brown organic matter which gives the colour to inspissated urine, and seems also to be the source of its peculiar odour. By treating urine con- centrated by the application of a freezing mixture, with ether, and evaporating, he obtained a brown fusible resinous mass, which he calls oxide of omichmyle, and supposes to contain a radical, omichmyle, the composition of which is still unknown. It has a strong odour of castoreum, and when heated smells like iirine. It dissolves in alcohol, forming a solution that reddens litmus. It burns with a clear flame, leaving scarcely any ash.] 6. Uroerythrin. This red colouring matter exists only in very small quantity in healthy urine, and cannot be easily de- tected by tests. It is always associated with uric acid, and seems to increase and decrease in the same proportion as that constituent. It is precipitated with the uric acid and urate of 1 Ann. der Chemie und Pharmacie, vol. 42, p. 265. 120 THE SECRETIONS: ammonia, to the former of which it appears to enact the part of a mild base, imparting to it a more or less deep red colour. This constituent can therefore be detected by the addition of hydrochloric acid to the urine, in the manner already described in speaking of uric acid. In some few diseased states, we find a gray or yellow precipitate of uric acid, as if this constituent was present in large quantity, while the uroerythrin was defi- cient : on the addition, however, of hydrochloric acid, dark coloured uric acid is soon precipitated. 7. Carbonic acid is probably a constituent of healthy urine, existing in a state of solution : in order to detect it, fresh urine must be warmed in a retort, the neck of which rests a few lines under the surface of lime-water. The presence of carbonic acid renders the lime-water turbid. In order to guard against the production of carbonate of ammonia, we must take care that the urine is not submitted to too powerful a heat, and that the distillation is not carried too far. [The following method is far less liable to give erroneous re- sults. It is founded on the principle that one gas passed through a solution of another will displace it, so that hydrogen or ni- trogen will liberate carbonic acid and dissolve in its place. A series of Wolfe's bottles must be arranged, so that hydrogen gas evolved in the ordinary manner from the first shall pass through a strong solution of caustic potash to free it from any carbonic acid that may be mixed with it, and then through an- other bottle containing lime-water, in order to certify its purity; in the next bottle through the urine to displace the gas dis- solved in it, and, finally, through lime-water a second time, to show if the displace^ gas were carbonic acid or contained it.] 8. Lactic acid is always present in the urine, imparting to it an acid reaction. It may be presumed that the carbonates which are left upon the incineration of the solid residue of the urine correspond to the lactates, because lactates with fixed bases are transformed into carbonates by incineration, and because the other salts which occur in the urine, the sulphates, phosphates, and hydrochlorates, are not similarly changed. It may, however, happen that no carbonic acid is found in the URINE. 121 ash, although there has been a large proportion of lactic acid in the urine ; for if the urine contained only free lactic acid, or lactate of ammonia, or even the lactates of soda and potash, at the same time with phosphate of ammonia or chloride of ammo- nium, the ash might be devoid of carbonic acid, in consequence of the liberated phosphoric or hydrochloric acid uniting with the base. 1 In this case the lactic acid would have to be determined analytically. The alcohol- extract of the urine contains both free lactic acid and alkaline lactates ; after dissolving it in ab- solute alcohol, precipitating the bases by sulphuric acid, filtering, evaporating the alcohol, dissolving the residue in water, and digesting the acid solution with oxide of zinc, we obtain a lac- tate of zinc, which may be decomposed by free baryta. This is certainly a very tedious proceeding for the mere qualitative de- termination of lactic acid, and need never be adopted : since, as far as I am aware, the ash (more especially the ash of the spirit-extract,) always contains carbonates, and as the presence of lactic acid in healthy urine has been sufficiently proved by Berzelius. [It is well known that Liebig denies the existence of lactic acid and the lactates in the urine ; and as the subject has re- cently attracted much attention, I have thought it advisable to state the grounds upon which that chemist has arrived at his conclusions. " Lactic acid," he observes, " is a non-nitrogenous substance. Nothing has hitherto been observed tending to show that it may be produced from the elements of a nitrogenous substance, by the decomposition of such a substance and the transposition of its elements. In every instance where the for- mation of lactic acid has been observed, the result of careful examination has proved the presence of a non-nitrogenous sub- stance of an identical, or, at least, similar composition with that acid. 1 [It has been recently shown by Dr. Golding Bird that an alkaline acetate (and the observation applies equally to a lactate) may exist in a solution of phosphate of soda in considerable quantity, and yet yield no carbonate by ignition. The reaction is explained by the equation : NaO, C 4 H 3 3 +HO, 2 NaO, P0 5 =3 NaO, P0 5 +C0 2 , HO-f C 3 H 3 O. (Lond. and Edin. Phil. Mag., June 1845.)] 122 THE SECRETIONS: " These observations would seem to render the formation of lactic acid in the body of the herbivorous and graminivorous animals, which take starch and sugar in their food (substances from which lactic acid may be formed), not merely possible, but in many cases highly probable ; and yet, strange to say, chemists have hitherto attempted in vain to detect lactic acid in the urine of the cow and of the horse. The urine of the cow or horse has no acid reaction ; on the contrary, its reaction is strongly alkaline ; it contains carbonated, hippurated, or ben- zoated alkali, or alkalies combined with mineral acids, but no trace of any lactate. " In contrast with this, the urine of man, and of carnivorous animals, manifests, when in a healthy state, a strongly acid re- action. Now, it is precisely in analyses of the blood and urine of man, and of carnivorous animals, that we find lactates men- tioned as constant constituents ; not because they have in reality been detected in these fluids for no one has as yet succeeded in producing lactic acid therefrom but because, upon examin- ing the aqueous and alcoholic extracts of blood and urine, some non-crystalline matters have been found which sometimes mani- fested an acid reaction, and upon incineration left a carbonated alkali as a residue, thus presenting a remote similarity in deport- ment to the alkaline lactates. " From what substance could lactic acid be formed in the body of carnivorous animals ? With the exception of fat, they partake of no non-nitrogenous matter in food, no substance, in fact, so far as we know, capable of producing lactic acid. Car- nivorous animals partake of no sugar, no starch, no gum, no mucus ; there is a total absence of the non-nitrogenous sub- stances which form so large a part of the aliments of herbivorous and graminivorous animals. " The assumption, a priori, that neither the blood nor any other fluid in the body of carnivorous animals can possibly con- tain any lactic acid, has been positively established by the ex- periments of Enderlin, (Annalen der Chemie und Pharmacie, vols. 49 and 50.) Finally, Pelouze has proved that the experi- ments of Henry, who pretended he had detected lactate of urea in urine, are erroneous, and by no means to be relied upon. " Consequently, as our knowledge of this subject stands at present, the acid reaction of urine cannot proceed from lactic URINE. 123 acid. And although processes of transposition take place in the healthy animal body, rendering insoluble substances soluble in the stomach and bowels, yet these processes are of a different kind from that process of putrefaction of casein in milk which causes the formation of lactic acid. " Direct experiments prove that fresh urine, of a strongly acid reaction, and taken from various healthy individuals, when cautiously neutralized with baryta water, does not retain in so- lution the least detectable trace of baryta. Now, as lactate of baryta is readily soluble in water, the urine would certainly, and of necessity, contain baryta, if its acid reaction were really owing to the presence of lactic acid. Upon the addition of the very first drop of the baryta water to urine an extremely copious pre- cipitate is formed; this precipitate contains urate and phosphate of baryta and of lime, but no detectible trace of baryta is found, even although only just so much baryta water is added as to leave the urine still possessing a feebly acid reaction. " Carbonate of magnesia and calcined magnesia act upon urine in precisely the same manner. If either of these sub- stances be mixed with water, so as to form a milky fluid, and be then added to urine with an acid reaction, the acid reaction will immediately cease, and a very considerable white precipi- tate be formed. The fluid now manifests a feebly alkaline re- action, and contains a trace of magnesia in solution. It is a remarkable circumstance that magnesia withdraws the phos- phoric acid from the urine so completely, that a mixture of per- chloride of iron and acetate of potash no longer indicates a trace of phosphoric acid in the urine which has thus been treated with magnesia. " Had lactic acid been the solvent of the lime and magnesia present in the urine, one would have expected that a corre- sponding amount of baryta, or of magnesia, would have taken its place upon its separation. But, as I have already observed) not a trace of baryta is found in solution when that substance has been employed for neutralizing the acid, and only a slight trace of magnesia when it has been used for the same purpose. " But as urine contains a certain amount of alkaline phos- phates, i. e. phosphate of soda and phosphate of potash, and as baryta and magnesia form, with phosphoric acid, insoluble 124 THE SECRETIONS: salts, it might have been supposed that the neutral lactates formed upon the neutralization of the urine with the two bases had been decomposed, together with the phosphates of soda and potash contained in the urine, and transposed themselves anew, with these substances, into phosphate of baryta or of magnesia, and into neutral lactate of potash or soda. In this case neither baryta nor magnesia could remain in solution. This circum- stance, therefore, renders these experiments indecisive, and leaves the question as to the presence or absence of lactic acid in urine dependent upon more direct experiments. " I employed putrid urine in my attempts to detect lactic acid, because lactic acid is not destroyed by putrefaction, and it must, therefore, of necessity be present in putrid urine if it really forms a constituent of fresh urine ; and because if lactic acid can at all be formed by the putrefaction of urine, from matters containing previously no lactic acid, the question whether lactic acid is to be reckoned among the constituents of normal urine is at once practically decided; or, more correctly speak- ing, the problem is proved to be impossible of solution, since we possess no means of positively determining which urine may be considered of a normal constitution, and, on the contrary, which is, to this extent, abnormal. " As matters at present stand, therefore, with regard to this subject, it was immaterial whether the presence of lactic acid was detected in fresh or in putrid urine ; if it was found to exist in the latter, this fact must be considered as a confirmation of Berzelius' examination of fresh urine ; whilst its absence from putrid urine would justify us positively in asserting that it does not form a constituent of fresh urine ; and, moreover, that urine contains no substance giving origin, by means of putrefaction, to the formation of lactic acid. " I have come to the latter conclusion. I have found it im- possible to detect the presence of lactic acid in putrid urine ; and if we examine somewhat more closely and minutely the experiments made by Berzelius, and from which he inferred the presence of lactic acid in urine, we find that not one of them amounts to a positive proof that lactic acid really forms a con- stituent of fresh urine. " The experiments which I made for the purpose of ascer- URINE. 125 taining the presence of lactic acid in putrid urine are the following : " Putrid urine was first evaporated over an open fire, and afterwards to dryness in a water-bath ; the residue was treated with a mixture of alcohol and sulphuric acid, which caused the solution of phosphoric acid, hydrochloric acid, and of lactic acid also, if this latter substance were really present. The fluid ob- tained was saturated with oxide of lead, and then filtered off from the phosphate, sulphate, and chloride of lead formed ; the lead contained in solution in the filtrate was separated by means of sulphuretted hydrogen. The solution thus freed from lead, and which ought to have contained the lactic acid had there been any present, was evaporated in a water-bath, and the re- sidue treated with alcohol: a quantity of common salt remained. In order to remove the soda from the alcoholic solution, efflo- resced oxalic acid was dissolved in the latter, at a high tempe- rature, and the oxalate of soda formed was separated from the fluid by filtration; the fluid was then saturated with oxide of lead, which again gave rise to the formation and separation of chloride of lead. The solution was, by means of sulphuretted hydrogen, again freed from the lead which had dissolved, then concentrated in the water-bath, and basic acetate of lead added in excess j a copious white precipitate was formed, from which the fluid was filtered off". This fluid must contain the lactic acid if any had been present in the urine ; the lead which this fluid held in solution was precipitated by means of sulphuretted hydrogen, the fluid filtered off" from the precipitate, concen- trated in the water-bath, and boiled with hydrate of baryta : a quantity of ammonia was expelled by this operation. After the decomposition of the ammoniacal salt the new-formed salt of baryta was cautiously decomposed, by means of sulphate of zinc, and every possible means was applied to obtain from this fluid crystals of lactate of zinc, but without success ; no trace could be discovered. " The white precipitate obtained by means of the basic acetate of lead contained hydrochloric acid, and a brown resinous sub- stance, which, upon combustion, comported itself like an ani- mal substance. " In other experiments the putrid urine was boiled until all the carbonate of ammonia it contained was completely expelled ; 126 THE SECRETIONS: then, with addition of hydrate of lime to destroy the remaining salts of ammonia, evaporated to dryness, and the residue treated with cold water, which must have dissolved lactate of lime had any lactic acid been present in the urine. The aqueous extract was evaporated to dryness, and the residue again treated with alcohol ; the fluid obtained contained a copious amount of lime combined with an organic acid ; the lime was then removed by the addition of oxalic acid, and the excess of oxalic acid by the addition of oxide of lead; the minute trace of dissolved oxide of lead was removed by means of charred blood. The fluid obtained was very acid; it contained hydrochloric acid, which was removed by the addition of oxide of silver; a por- tion of the fluid filtered off from the hydrochlorate of silver was saturated with oxide of zinc, and left to crystallize, but no lactate of zinc was obtained; the fluid settled into a dark- coloured resinous mass. Another portion of this acid fluid was evaporated in the water-bath ; a quantity of acetic acid was ex- pelled during the evaporation, and there remained at last only a very minute amount of a resinous matter, which upon calcina- tion emitted a very fetid odour. " All the other experiments, which I made in order to detect lactic acid in putrid urine, and a detailed description of which would be as tedious as useless, gave the same negative result. These experiments were usually made upon quantities of from forty to fifty pounds of urine, so that even a very minute amount of lactic acid, if really present in the urine, could not have escaped detection. All these experiments indicated the presence of an organic acid, but after the removal of all the inorganic acids and bases contained in the urine, this acid turned out to be a mixture of acetic acid with a brown resinous substance rich in nitrogen. " The presence of acetic acid in putrid urine does not warrant us to infer that this acid is present also in fresh urine ; on the contrary, the experiments made with regard to this matter prove that fresh urine contains no acetic acid. I have treated it exactly in the same manner as putrid urine, and have, by distillation with oxalic acid, obtained a fluid of a strongly resi- nous odour, but not possessing any acid reaction. When em- ploying sulphuric acid and hydrochloric acid the distillate was acid, but the acid reaction proceeded from hydrochloric acid." URINE. 127 In the analyses of Lehmann, to which we shall presently re- fer, the lactic acid is determined quantitatively in a large number of cases. The following independent investigations of Heintz and Pettinkofer are important, as offering a clue to the real nature of the crystals assumed by Lehmann and other chemists, to consist of lactate of zinc. In the observations of Liebig, quoted above, it is assumed that as lactic acid is not destroyed by putrefaction, it cannot be altered in putrefied urine. Heintz conceived that during the putrefaction of the urine certain causes might prevail to cause the destruction of the lactic acid, and in order to determine the point he instituted the following experiment. " About fifty pounds of fresh urine, obtained from several young healthy men, were first evaporated over a free fire, and then in the water-bath ; the extract obtained exhausted with alcohol, to which a sufficient quantity of dilute sulphuric acid had been added. The acid solution was saturated with oxide of lead, the precipitate filtered, the liquid much evaporated, and the urea contained in this concentrated solution precipitated with pure oxalic acid. A considerable quantity of oxalate of . urea was obtained, which, after washing with water and re- crystallization, separated in perfectly white, large crystals. The liquid, separated by pressure from the urea, from which it was now almost free, was evaporated to dryness, extracted with alcohol, and effloresced oxalic acid added to the solution to re- move the soda. The oxalate of soda was separated by filtration, the filtered solution saturated with oxide of lead, and then pre- cipitated with basic acetate of lead. The lead was removed from the filtered liquid by sulphuretted hydrogen ; the filtered solution was concentrated over the water-bath, and boiled with hydrate of baryta, when a considerable disengagement of am- monia resulted. The salt of baryta obtained in solution was de- composed with sulphate of zinc, in such a manner that only a slight excess of this latter remained in the solution. It was then evaporated to a small volume, when some delicate micro- scopic crystals separated, which were at first taken for lactate of zinc, but on examination under the microscope they soon proved to be distinct. The lactate of zinc, for instance, forms needles with acute dihedral summits, while the crystals of the zinc salt obtained from the urine have truncated terminal sur- 128 THE SECRETIONS: faces. To ascertain more precisely the nature of the acid combined with the oxide of zinc in this salt, the crystals were separated as carefully as possible from the mother-ley, pressed between blotting-paper, dissolved in a large quantity of boiling water, in which they were but sparingly soluble, and allowed to crystallize by cooling. The mother-ley afforded more crystals on further evaporation. They were again separated from ad- hering liquid by pressure. " The zinc salt thus obtained had a faint greenish-yellow tint, and was therefore probably not quite pure, although its solution was perfectly colourless. The acid was isolated from this salt by means of sulphuretted hydrogen ; after separation of the sulphuret the solution was entirely free from zinc. The liquid, which had a strong acid reaction, was freed by boiling from the excess of sulphuretted hydrogen, and evaporated on the water- bath. When it had become sufficiently concentrated, the acid separated in prismatic crystals, which appeared to form quadri- lateral rectangular columns and tables. It is easily soluble in water, and separates in crystals on evaporation; the solution has a strong acid taste, and reddens litmus-paper. It likewise dis- solves in alcohol, but not quite so easily as in water ; ether dissolves scarcely a trace of it. Heated on platinum foil it melts, becomes brown, and leaves behind a coal, which is difficult of combustion, but which disappears entirely by stronger heat. " From the mode of preparation it is evident that the acid forms with oxide of zinc a very sparingly-soluble salt, which separates in microscopic crystals. When the acid is supersatu- rated with ammonia, and the solution evaporated on the water- bath, so much ammonia escapes that it again becomes acid; if it be evaporated to dryness, so that all the ammonia that could escape at this temperature is expelled, and caustic potash be added to the mass, a considerable quantity of ammonia is given off; therefore it appears that this acid, like many organic acids, forms acid salts. The ammonia-salt obtained in this manner is somewhat more difficult of solution in water than the acid itself. When the acid is accurately neutralized with pot- ash, it forms an easily- soluble salt, the solution of which affords no precipitate with sulphate of copper. The oxide of copper is not thrown down from this mixture by an excess of potash, but the colour of the solution becomes somewhat darker. Acetate URINE. 129 of lead produces a slight turbidity, most probably arising from a small quantity of some impurity. No precipitate is obtained with nitrate of silver, and the mixture, after having been ren- dered ammoniacal, is not altered by boiling. A solution of per- chloride of iron, rendered neutral by ammonia, produces no pre- cipitate. It differs, therefore, in this respect from hippuric acid. ' ' The author has not yet been able to ascertain the composi- tion of this acid, in consequence of the small amount which he obtained from 50 Ibs. of urine. It amounted to about eight grains, and was not perfectly white. But it was easy to prove that it contained nitrogen in considerable quantity." 1 Pettenkofer precipitates the alcoholic extract obtained from carefully evaporated human urine, previously neutralized with carbonate of soda, with a concentrated alcoholic solution of chloride of zinc. A brown amorphous precipitate containing zinc is soon thrown down ; but after standing for several hours, small granular and rather hard crystals are deposited on the sides of the glass, which gradually increase to such an. extent as to form perfect incrustations. On collecting the amorphous precipitate and the crystals on a filter, and boiling with a suf- ficient quantity of water, the amorphous precipitate remains in- soluble, while the crystals gradually dissolve. On evaporating the aqueous solution a yellow crystalline residue is obtained, which in many of its physical characters resembles lactate of zinc. Under the microscope these crystals appear as very beautiful four-sided prisms, with an oblique terminal surface. They are with difficulty soluble in water, and are insoluble in strong alcphol and ether. In the aqueous solution we may de- tect chlorine, zinc, and an organic substance very rich in nitrogen. Repeated boiling with strong alcohol, or washing with cold water, removes all the salts (chiefly metallic chlorides) attached to the crystals, and if they are then again dissolved in. water and heated with hydrated baryta, the oxide of zinc is pre- cipitated, and carries with it the greater part of the adhering colouring matter. The oxide of zinc and the excess of baryta are then removed as carbonates by passing a stream of carbonic acid through the solution; the filtered liquid which contains chloride of barium and the organic substance is evaporated 1 Poggendorff s Annalen, Ixxii, p. 602. ii. 9 130 THE SECRETIONS: to dryness in the water-bath ; the residue is dissolved in spirit, and sulphuric acid added in order to separate the baryta; nitration is then requisite. The solution, in which sulphuric and hydrochloric acids, and the organic substance, are now con- tained, is boiled with oxide of lead, which removes the acids; and any excess of lead in the filtered solution is removed by sulphuretted hydrogen. On evaporating the filtered solution in a water-bath we obtain a white crystalline mass, neutral in its reaction, with a slightly bitter pungent taste, and easily soluble in water and alcohol. The addition of bichloride of pla- tinum to the alcoholic solution causes no precipitate, but chlo- ride of zinc throws down a copious white deposit, which, on being dissolved in water and evaporated, reproduces the crystals of the zinc-compound exactly as they crystallized from the urine. The pure organic substance gave, as the mean of several analyses : calculated. Carbon . . 39'3 39-2 Hydrogen . . 7'0 6-4 Nitrogen . . 34-0 34-7 Oxygen . 19- 7 19' 7 Hence it may be expressed by the formula C 8 H 8 N 3 O 3 . Hu- man urine emitted in the morning contains about *5 of this body.]v 9. Hydrochloric acid. The presence of this acid is easily shown. A portion of urine is treated with a little nitric acid, and nitrate of silver is then added, which produces a tolerably abundant curd-like precipitate of chloride of silver. 10. Sulphuric acid is always present in healthy urine. On treating a portion with nitric acid, and then adding chloride of barium, a white precipitate or turbidity may be observed, which is due to the formation of sulphate of baryta. 11. Phosphoric acid is recognized by the addition of free ammonia to fresh urine ; earthy phosphates are immediately precipitated. In order to demonstrate the presence of alkaline phosphates, lime water is added to urine from which the earthy phosphates have been removed by filtration ; phosphate of lime 1 Liebig's und Wohler's Annalen, vol. 52, part 1. URINE. 131 is then precipitated. Or, after the sulphuric acid has been pre- cipitated with a baryta- salt, ammonia may be added to the fil- tered fluid, upon which phosphate of baryta will be precipitated. 12. Silicic acid. The only method of detecting the existence of this acid is by evaporating the urine, incinerating the residue, dissolving it in water, treating the insoluble portion with hydro- chloric acid, and incinerating the residue that still remains. In this way we obtain the silicic acid. 13. Hydrofluoric acid, or fluoride of calcium, occurs in very minute traces, and can only be recognized by operating on a very large quantity of urine. The precipitate thrown down by ammonia must be collected, washed, placed in a platinum or porcelain crucible, treated with sulphuric acid, and its action on glass observed. 14. Soda. This base is contained in large quantity in the urine, both as chloride of sodium and in combination with acids. Chloride of sodium and the lactates can be removed from the ash of the residue of the urine by spirit ; the solution must then be evaporated, and on submitting the salt to the action of the blowpipe, the intensely yellow flame which indicates the presence of soda is perceptible. The presence of soda may be also shown in other ways. Upon treating urine evaporated to the thick- ness of a syrup with alcohol, the chloride of sodium will dis- solve, and by spontaneous evaporation will in part crystallize in the form of octohedra, which are partially perceptible even to the naked eye. These consist of a combination of urea and common salt. Fig. 24 exhibits such octohedra, obtained from evaporated and filtered urine. When the evaporation is con- ducted rapidly, these forms are replaced by a series of crystals shaped like crosslets and daggers, and usually crenate at the margin. See fig. 24.*. If urine is allowed to stand in a a shallow vessel, until it has become decomposed, and a portion of the urine has evaporated, a crystallized salt will be found, in which prisms and octohedra can be recognized both with the naked eye and with the microscope. The rectangular prisms, fig. 25, exhibit the combination of phosphate of soda with phos- phate of ammonia (sal microcosmicum) . 132 THE SECRETIONS: 15. Potash. The presence of this substance is detected by dissolving the fixed salts in some hydrochloric acid, extracting them by alcohol, and adding to the alcoholic solution of chloride of potassium some bichloride of platinum : a yellow precipitate of chloride of potassium and platinum is deposited. 16. Ammonia. The presence of this substance cannot be very easily demonstrated in healthy urine, on account of the urea and the nitrogenous extractive matters which coexist with it, since the ordinary ammoniacal salts (the chloride of ammonium and the lactate of ammonia) are dissolved with the urea by alco- hol ; and since, moreover, urea develops ammonia when treated with either free potash or its carbonate in just the same man- ner as the ammoniacal salts. The following method appears to me to be the most appropriate : Evaporate the alcohol- extract of urine, dissolve a portion of it in water, and add a solution of caustic baryta. If ammoniacal salts are present, a strong odour of ammonia will be developed. Neither pure urea, nor the nitrate, on being similarly treated, gives off this ammoniacal odour. [Healthy urine, according to Liebig, 1 contains only very mi- nute or doubtful traces of ready-formed ammonia, and these traces probably pre-existed, in the food partaken of. Fresh urine evolves ammonia when treated with alkalies, but it yields no precipitate with bichloride of platinum. Dr. Schlossberger made certain experiments to this effect in the laboratory at Giessen ; upon treating fresh urine with bichloride of platinum, and allowing the mixture to stand at rest during the night, crystals were formed in the urine, which, upon examination, manifested all the properties of chloride of platinum and potas- sium. The amount of ammonia formed in the healthy organism is likewise very minute, not being sufficient even to neutralize the acid from which proceeds the acid reaction of urine and of saliva. We cannot assume the presence of any ammoniacal salt in the urine of herbivorous animals, which contains fixed or alkaline carbonates. Experiments for the determination of the amount of ammonia 1 Lancet, June 1844. URINE. 133 in the urine of healthy individuals may hecome of importance in judging of pathological states ; for in fevers and other dis- eases the amount of ammonia in the urine increases conside- rably. It is possible that, by analysing the urine, we may, in the increasing or decreasing amount of ammonia, obtain a measure for the alterations which take place in diseases. But the salts of potash, which are rarely absent, as well as the am- monia which is formed by the action of bichloride of platinum upon the organic constituents of urine, render this reagent (the bichloride of platinum) very unsafe for determining the increasing or decreasing amount of ammonia in the urine during disease. The magnesia salts would, perhaps, answer this purpose better ; the determinative examinations made with salts of magnesia are inferior to those made with bichloride of platinum, but they are exact enough for the purpose of comparison.] 17. Lime. There is no difficulty in proving the existence of lime in the urine. On adding oxalate of ammonia to fresh urine, a nebulous turbidity of oxalate of lime is formed. If the urine is somewhat concentrated by evaporation, a precipi- tate is obtained which appears under the microscope as an amorphous mass. When urine is allowed to stand till ammonia is developed, phosphate of lime and ammoniaco-magnesian phosphate are precipitated. The phosphate of lime may be recognized under the microscope as an amorphous mass : sometimes, but rarely, it occurs in a crystalline form. Both varieties are exhibited in fig. 26. 18. Magnesia. The lime having been precipitated as an ox- alate, and free ammonia added to the filtered urine, ammoniaco- magnesian phosphate will then be deposited. We have already observed that this salt becomes spontaneously formed, if urine is allowed to stand for some time, in consequence of the deve- lopment of ammonia. A thin film may then be seen on the surface, in which we may detect minute crystals, even with the naked eye. The inner surface of the vessel is also covered with a crop of similar crystals. Under the microscope the ammo- niaco-magnesian phosphate may be recognized by the peculiar crystalline form represented in fig. 27. 134 THE SECRETIONS: 19. Peroxide of iron. The amount of iron contained in the urine is frequently very minute, and can only be detected in the ash, which must be dissolved in hydrochloric acid. Upon the addition of ferrocyanide of potassium to the acid solution, a deep blue colour, or a very slight precipitate of prussian blue is produced : while the addition of hydrosulphate of ammonia or infusion of galls effects a dark colouring. QUANTITATIVE ANALYSIS OF THE URINE. Method of separating all the proximate constituents. An exact quantitative determination of all the constituents of the urine is a task beyond the powers of animal chemistry in its present condition. Our ignorance of the proximate consti- tuents of the extractive matter, and our inability to separate them, are alone sufficient to preclude the hope of a perfect an- alysis : we must therefore content ourselves with pursuing the same course as we have already done with the blood, and must rest satisfied with effecting the separation (as accurately as we can) of those constituents which at present we regard as the most important, and which present no peculiar chemical diffi- culty ; whilst others, as for instance the various extractive mat- ters, must be associated in groups. Even this abbreviated and comparatively simple method does not yield absolute estimates, only a few of the constituents of the urine, as, for instance, the fire-proof salts, yielding quanti- tative results with analytical exactness : the determination of the organic constituents, of the urea, uric acid, ammonia-com- pounds, and extractive matters is more or less insecure and fluc- tuating, and we must regard a quantitative analysis of urine as giving us certainly an idea of its probable constitution, but not by any means of its actual composition. I shall now explain a method of analysing the urine, by which the principal constituents may be isolated and determined. It is impossible to estimate the various constituents of the urine from a single portion ; different portions of the same urine must be used for the determination of the various constituents, as will be presently shown. URINE. 135 The urine to be examined must be tested with litmus paper, in order to ascertain the presence or absence of free acid. Healthy urine is generally acid, seldom neutral. If the urine is turbid, it must be examined under the microscope ; the pre- sence of mucus can be the only cause of turbidity in healthy acid urine. The specific gravity of the urine is best estimated by the 1000-grain bottle. The quantity of urine to be analysed must be carefully weighed, or the amount contained in the 1000-grain bottle (the contents of which are exactly known when the stopper is in- serted,) may be taken. A small portion always adheres to the glass upon pouring it out, the quantity of which can be ascer- tained by weighing. 1. Determination of the free acid. A known quantity of warm urine must be treated with tinc- ture of litmus in which the excess of free alkali has been neu- tralized by acetic acid, so as to leave a perceptible red tint. Dilute solution of ammonia must then be added by drops, and with constant stirring, until the red colour begins to merge into a blue. The quantity of ammonia required for this pur- pose is estimated by weight, or, if a graduated vessel is used, by measure. From our knowledge of the quantity of ammonia in the solution, we can estimate the quantity of free lactic acid. 2. Determination of the water and vesical mucus. From 500 to 1000 grains of urine must be filtered ; the mucus which remains on the filter must be washed with water, dried, and weighed with the filter, the weight of which should have been previously determined. The filtered urine must be eva- porated in the water-bath to the thickness of an extract, and then placed (in its basin) in a receiver over sulphuric acid, in order to be thoroughly dried. The residue when dried must be weighed with the basin, and the water estimated by the loss of weight. 3. Determination of the urea. The dry residue of (2) is moistened with a sufficient quantity of water to reduce it to an uniform extract ; it is then thoroughly 136 THE SECRETIONS: exhausted with alcohol of O83 ; the alcoholic solution is evapo- rated in the water-bath to a state of dryness, and the residue extracted with anhydrous alcohol. The anhydrous alcohol is evaporated at a very gentle temperature ; the residue is dissolved in a little water, and cold nitric acid (perfectly free from nitrous acid) added to it. The basin is then placed for some hours in snow, or in an artificial freezing mixture. The moist nitrate of urea is collected upon a filter, which is enveloped in the folds of thick blotting-paper, and pressed, as long as fresh blotting- paper continues to absorb moisture. The filter, which, with its contents, is now nearly dry, is exposed to a temperature of from 104 to 122, and then quickly weighed. The known weight of the filter is deducted from the weight of the filter and its contents, or, which is better, the nitrate of urea is separated very carefully from the filter, again dried, (since it readily ab- sorbs moisture,) and weighed. From the nitrate we estimate the quantity of urea. 1 (See Vol. I, p. 52.) 4. Determination of the uric acid. Three or four ounces of urine must be treated with three or four drachms of hydrochloric or nitric acid, and allowed to rest 1 [Marchand has recently examined the combinations of urea and nitric acid, and has arrived at conclusions very different from those of other observers. He used nitrate of urea, which was precipitated from its solution by the addition of nitric acid. It was pressed between folds of bibulous paper, and dried at 240. Its aqueous solu- tion was digested with carbonate of baryta, and the nitrate of baryta decomposed by sulphuric acid. The nitric acid amounted to 60-66 per cent. ; hence the compound consisted of C 2 H 4 N 2 O 2 +2NO 5 -f-HO. A portion was heated to 284; it then yielded a quantity of sulphate of baryta corresponding to 65-72 per cent, of nitric acid. It had probably become anhydrous, for in that state it would contain, by calculation, 64-3 per cent. As the neutral nitrate of urea was not obtained in this manner, Marchand dissolved the acid compound in water, and added urea. The dried crys- talline compound now obtained contained 55 per cent, of nitric acid, and was there- fore composed of 2C 2 H 4 N 2 O 2 -I- 3N0 5 -f HO. When the liquid from which the above-mentioned salt crystallized was treated with urea and the solution again crystallized, he obtained a compound which lost no weight at 230, and after being exposed for some time to this temperature, con- tained 44-1 per cent, of nitric acid. He concludes by observing that the compound usually separated in analyses does not contain the amount of urea stated in the text, but only 33'89 per cent. Marchand further states that crystallized oxalate of urea contains three atoms of water, two of which (14-6 per cent.) escape at 248, while the third is retained till decomposition ensues. (Journ. fiirprak. Chem. Feb. 1845.] URINE. 137 for from 36 to 48 hours. Uric acid crystals of a whitish- gray, or more commonly of a red colour, deposit themselves from this acid urine, partly at the bottom and partly on the sides of the glass. The mass of the clear supernatant fluid must be poured off, the crystalline coating is then loosened from the sides of the vessel, and collected on a small filter. When all the uric acid is collected on the filter, and the whole of the fluid has run through, a little water is sprinkled over it, and the filter is then dried and weighed. By subtracting the known weight of the filter, we obtain the amount of uric acid. 5. Determination of the water- and spirit -extracts. From 1000 to 2000 grains of filtered urine are evaporated on the water-bath, and the residue treated with alcohol of 0*83, which throws down the water extract, as well as the sulphates and phosphates. These are collected upon a weighed filter, and washed with alcohol of similar strength. The filter with its contents is weighed, and by deducting the known weight of the filter, we obtain the weight of the water-extract and salts. By incineration of the filter and its contents, there are left only the sulphates and phosphates; the water-extract is, therefore, estimated by the loss. Whatever is dissolved by the alcohol of 0'83 is mixed with the spirit used for washing, and the fluid gently evaporated on the water-bath until an extract-like residue is left ; this, after being allowed to cool, (during which process it usually becomes solid,) is treated with cold anhydrous alcohol. In this way the spirit-extract, as well as chloride of sodium, and a portion of the alkaline lactates, if any are present, are separated. The basin is kept as cool as possible, and repeated additions of ab- solute alcohol are made, in order to see whether the alcoholic solution which has become clear after settling, still becomes turbid, and if so, a certain quantity of anhydrous alcohol must again be added. When the alcoholic fluid (A) is perfectly clear, it is decanted from the residue of salts, which is washed with anhydrous alcohol, cautiously dried on the water-bath, weighed, and estimated as spirit-extract with salts. By a thorough in- cineration we can determine the spirit-extract by the loss of 138 THE SECRETIONS : weight. The following salts remain : chloride of potassium, chloride of sodium, and carbonate of soda ; the latter correspond- ing with the lactates. 6. Determination of the alcohol-extract, the lact ate of ammonia, and chloride of ammonium. These are the most difficult constituents to determine. I proceed in the following manner : the alcoholic fluid (A) ob- tained from the precipitation of the spirit- extract, is evaporated on the water-bath to the consistence of a thick syrup, and after being thoroughly dried over sulphuric acid in a receiver, is weighed. The residue is dissolved in a little water, and free baryta gradually added, a gentle warmth being kept up as long as it continues to dissolve, and as long as ammonia is perceptibly evolved. This point being attained, the mixture is evaporated to the consistence of an extract, and moistened with a little alco- hol of 0*83; a large quantity of anhydrous alcohol is then added, and the whole allowed to clear itself. There remain undissolved, chloride of barium, a compound of baryta with extractive matter, and the greater part of the free baryta, which has probably been added in excess. Dissolved in the alcohol are urea, lactate of baryta, and a small quantity of free baryta. The undissolved portion is burnt in a platinum crucible, the residue incinerated, and the ash digested in water. The solution must be filtered, slightly acidulated with nitric acid, and the chlorine then preci- pitated by nitrate of silver. The chloride of ammonium can be calculated from it. The alcoholic solution must be evaporated, the residue dis- solved in water, the solution filtered, and a current of carbonic acid passed through it, until the free baryta is precipitated : it must then be again filtered, acidulated with nitric acid, and the baryta of the lactate of baryta precipitated by sulphuric acid. The lactate of baryta must be estimated from the residual sulphate. By subtracting from the solid residue of the alcohol-extract the weight of the urea, of the free lactic acid, of the lactate of ammonia, and chloride of ammonium, we obtain the quantity of the alcohol-extract. URINE. 139 7. Determination of the fixed salts. The determination of these constituents is of much import- ance; they are composed of potash, soda, lime, magnesia, sul- phuric acid, phosphoric acid, and hydrochloric acid. The de- termination of the silicic acid would also be interesting, if a series of analyses in reference to this point were instituted. Iron, manganese, and fluoride of calcium exist in too minute quan- tities to be successfully determined, or indeed always detected. The bases and acids which were first named, viz. the potash, &c., may be determined in the following manner. Three or four ounces of urine are evaporated, and the residue incinerated. As the carbonaceous matter does not readily burn off, in conse- quence of being entangled with the melting salts, it is expedient to add some nitric acid to the urine, and to place a cover on the crucible. A white melted ash is soon obtained, the weight of which must be determined. A certain proportion of this ash, if the whole quantity is sufficiently large, may be weighed, and used for the determination of the chlorine, or a separate quantity of urine may be evaporated and incinerated for this purpose. For the determination of the other constituents a known quantity of the salts is dissolved in water, to which a little nitric acid has been added ; this solution (A) is filtered; what remains on the filter is silicic acid, mixed perhaps with a little carbon. It must be washed, burnt with the filter, and its weight esti- mated. The solution (A) and the water with which the con- tents of the filter were washed, are mixed together, and a slight excess of free ammonia added. The mixture is then warmed. By this means the earthy phosphates are precipitated, and, as in healthy urine the phosphoric acid is in excess as compared with the earths, the latter are completely thrown down. They are quickly washed, dried, exposed to a strong heat, and weighed. In order to determine the quantity of lime in the earthy phos- phates, they must be dissolved in very diluted nitric acid, and the free acid saturated with ammonia; the lime may then be precipitated by oxalate of ammonia. The filtered fluid will yield the magnesian salt, by precipitation with free ammonia. The ammoniacal solution from which the earthy phosphates have been precipitated must be mixed with the water used 140 THE SECRETIONS : for washing the precipitate, and super-saturated with nitric acid. A solution of chloride of barium must be added, as long as any sulphate of baryta continues to be precipitated. The fluid is then warmed, for the more perfect separation of the sulphate of baryta, which is collected on a filter, washed, exposed to a strong heat, and weighed. By this means the sulphuric acid contained in the urine is calculated. The acid solution from which the sulphuric acid has been precipitated is mixed with the water used for washing the precipitate in a stoppered bottle of such a size as to be nearly filled by it ; it is rendered alkaline by caustic ammonia, and chloride of barium is added to it, as long as phosphate of baryta is pre- cipitated. The bottle must be allowed to stand, with the stop- per in it, until the precipitate is completely deposited. The fluid is then poured off", and the precipitate washed out on a filter with a little weak solution of ammonia. It is dried, exposed to a strong heat, and weighed. The phosphoric acid must be calculated from the phosphate of baryta thus obtained. The ammoniacal fluid from which the sulphuric and phosphoric acids have been removed by baryta is mixed with the fluid with which the last precipitate was washed ; they are evaporated, the residue treated with sulphuric acid, and then submitted to a high temperature to expel any excess of the acid. The fixed alkalies remain in combination with sulphuric acid. If these salts are dissolved in water, and chloride of barium added to the filtered solution as long as sulphate of baryta continues to be precipi- tated, the chlorides of potassium and sodium are left in the solution, from which they may be separated and estimated. The chlorine is determined, as I have already remarked, by a separate experiment. A known quantity of the fixed salts is dissolved in water, and a little nitric acid added to the filtered solution; upon the addition of nitrate of silver, a curdy pre- cipitate of chloride of silver is thrown down. The proximate constituents of the fixed salts being thus de- termined, we have next to consider how they are combined. The sulphuric acid is associated with the potash, and if there is not a sufficient quantity of potash, with as much soda as will make up the deficiency : the rest of the soda is allotted to the hydrochloric and phosphoric acids. If there is more than suf- URINE. 141 ficient potash to combine with the sulphuric acid, the excess is united with hydrochloric acid. If the urine-salts froth very much upon being treated with an acid, and if we find that after combining the potash and soda with sulphuric, hydrochloric, and phosphoric acids some soda is still left, this must be reckoned as lactate of soda. The earths occur as earthy phosphates. The fixed salts may likewise be determined from the residue obtained in the investigation of the water- and spirit- extracts, (see 5,) by exposing it to a strong heat ; and we are sometimes driven to this course of proceeding in consequence of having only a small quantity of urine to analyse. This method of de- termining the salts is, however, unsafe, in consequence of a por- tion of the lactate of soda being dissolved by the anhydrous alcohol, and because, farther, small quantities of the phosphates and sulphates are always associated with the chlorine-com- pounds. In adopting this method, we must determine the earthy phosphates and the alkaline sulphates and phosphates, from the water-extract ; and the chlorine, with minute quanti- ties of the sulphates and phosphates, from the saline residue of the spirit-extract. In the determination of the urinary salts from the fixed residue, it becomes a matter of importance to ascertain whether the organic constituents do not contain a certain amount of sulphur and phosphorus, which increase the quantity of the sulphates and phosphates found after incineration. From an experiment, I am led to conclude that this is not the case. I determined the earthy phosphates, and the alkaline sulphates and phosphates, in three ounces of filtered healthy urine, and found earthy phosphates, 0-5 ; sulphate of potash, 2*45 ; phos- phate of soda, 1-16. From the fixed salts of three ounces of the same urine I obtained, earthy phosphates, 0*52 ; sulphate of potash, 2*48; and phosphate of soda, 1-16. A shorter method of separating the most important constituents of the urine. Isolated and unconnected analyses of urine are of very little value in physiological and pathological chemistry. In propor- tion to the number of analyses made according to one uniform method, is the value of each individual analysis increased. It 142 THE SECRETIONS: would obviously require an immense sacrifice of time and labour to institute a series of urinary analyses upon the plan that we have already laid down ; our trouble will be much diminished by agreeing which of the constituents are to be considered as the most important, and devoting our attention to them alone. We do not by any means wish to imply that elaborate analyses, made on the system we have described, are not more valuable than those conducted according to a simpler scheme ; we only wish it to be understood that a shorter method will give results that will fully answer many of our proposed ends. A shorter method may be properly limited to the determina- tion of the solid constituents of the urine, the quantities of urea and uric acid, of the fixed salts collectively, and, from them, of the earthy phosphates and alkaline sulphates and phosphates individually, and ultimately of the remaining constituents, as lactic acid, extractive matters, and the compounds of chlorine and ammonia. With this view we determine a. The specific gravity of the urine in the ordinary manner ; b. The quantity of solid constituents, and of the urea, ac- cording to the method described in 2 and 3, from a weighed and evaporated portion of urine ; c. The quantity of uric acid, according to the method given in (4), by the addition of hydrochloric acid to a certain quantity of urine ; d. The quantity of extractive matters and ammonia-salts, by evaporating a known quantity of urine and incinerating the residue. The amount of solid residue being known from 6, we subtract from it the fixed salts which have been thus ob- tained as a residue after incineration, the urea (b), and uric acid (c) ; the difference corresponds with the extractive matters and ammonia-salts; 1 e. The fixed salts are known by the weight of the residue in d ; they may be easily burnt white by the addition of a little nitric acid. From these salts we can determine, /. The amount of earthy phosphates, and alkaline phosphates and sulphates, by the method described in 7. 1 This estimate must be always rather too high, in consequence of the alkaline lactates being converted into carbonates in the process of incineration. URINE. 143 ON THE COMPOSTTION OF NORMAL URINE. Berzelius 1 published an analysis of healthy urine in the year 1809, which was, till a very few years ago, the only one that gave a correct view of the constitution of so important a secre- tion. He does not state anything about the circumstances under which the urine was voided, or in regard to the person from whom it was taken. 1000 parts contained : Water . . . . 933-00 Solid residue .... 67'00 Urea . . 30-10 Uric acid . 1-00 Free lactic acid, lactate of ammonia, alcohol- and! 17.11 water-extract . .J Mucus . . . 0-32 Sulphate of potash . . 3'71 Sulphate of soda Phosphate of soda Biphosphate of ammonia . . 1-65 ! Fixed salts. Chloride of sodium . . 4-45 f 15-29 Chloride of ammonium . . 1-50 Phosphate of lime and magnesia . . 1-00 Silicic acid .... 0-03^ I have made two analyses of the urine of a healthy man, aged 33 years, of a decidedly sanguineous temperament, whose digestion and nutrition were not very good. 1000 parts contained : Analysis 94. 1012 956-00 44-00 14-578 0-710 Ext. mat & , " amm.-salts. H = 12-94 2-55oJ Analysis 93. Specific gravity 1011 Water 963-20 Solid residue * 36-80 Urea 12-46 Uric acid 0-52 Alcohol-extract, with free lactic acid Spirit-extract Water-extract and vesical 5-lO^j 2-60 I Extractive matter and ammonia-salts. mucus 1-00 f = 10-14 Lactate of ammonia 1-03 Chloride of ammonium . 0-41 j Chloride of sodium 5-20^ Sulphate of potash 3-00 | Phosphate of soda Phosphates of lime and 2-41 ' 0-58 f 11-19 magnesia I Silicic acid 2 7-280"! 3-508 2-330 I 0-654 f I a trace j 13-77 1 Thierchemie, p. 458. 2 This includes the lactate (carbonate) of soda and a little sulphate of potash. 144 THE SECRETIONS: I have analysed the urine of the same man upon three other occasions under the following circumstances. A represents urine passed upon rising in the morning, after having drunk several glasses of water the previous evening. After drinking coffee and a glass of water, such violent exercise was taken for two hours, that the pulse rose to above 100, wdth occasional intermissions ; the urine B was then voided. Half an hour af- terwards the urine C was discharged. In all three cases the urine was clear, B being the most slightly tinged. They all had an acid reaction, that of C being the strongest, and of B the weakest. The analyses, in which, however, all the prox- imate constituents were not determined, gave the following results : Specific gravity . < Water Solid residue Urea Uric acid, extractive matter, ammonia- salts, and chlorine compounds Phosphate of soda Sulphate of potash Phosphates of lime and magnesia . C. G. Lehmann has likewise made some very minute analyses of the healthy urine of a young well-fed man, [himself in fact.] These analyses approximate closely in their results to those of Berzelius. They were made with the collected urine of the past twenty-four hours. The concentration of the fluid may be explained by the circumstance of the young man by whom the urine was passed, taking only a very little drink, as is the usual habit with persons of the sanguineo-bilious temperament. Water Solid residue Urea Uric acid . Lactic acid Water-extract Spirit- and alcohol-extract Lactates Chlorides of sodium and ammonium Alkaline sulphates Phosphate of soda Phosphates of lime and magnesia Mucus Analysis 95. Analysis 96. Anal. 97. A. B. C. 1010 1008 1014 972-600 981-000 957-600 27-400 19-000 42-400 8-402 7-568 15-257 13-960 1-850 2-790 0-479 8-618 1-250 2-200 0-264 19-140 2-750 5-000 0-656 1. 2. 3. . 937-682 934-002 932-019 62-318 65-998 67-981 31-450 32-914 32-909 1-021 1-073 1-098 1-496 1-551 1-513 0-621 0-591 0-632 10-059 9-871 10-872 1-897 1-066 1-732 3"u46 | js_ 3-6021 ^ 3-712 7-314 1 7-289 1 : 7-321 3-765 fib 3-666 f >h 3-989 1-132J ^ 1-187J "* 1-108 0-112 0-101 0-110 URINE. 145 Christison 1 published an analysis of healthy urine, in which, however, he did not enter into very minute details. The specific gravity was 1029. In 1000 parts, he found 67' 7 of solid residue, of which 55-2 were composed of urea, extractive matters, and lactates, 11-1 of alkaline chlorides, sulphates and phosphates, TO of earthy phosphates, and 0'4 of mucus. Hence 100 parts of the solid residue contain about 40 urea, 16 fixed salts, 39 extractive matters and ammonia-salts, and 1*5 earthy phosphates. Dumenil made an analysis of urine in 1826. He found the specific gravity of the mixed urine of several healthy persons to be 1016. In 1000 parts there were 31 '8 of solid residue, which con- sisted of 13-2 parts of urea not quite free from alcohol-extract, 0-08 of uric acid, 2'09 of extractive matter, 0-6 of earthy phos- phates, 1-03 of phosphate of soda, 0-55 of phosphate of ammonia, 2-69 of sulphate of potash, 8'03 of chloride of sodium, 2'69 of sulphate of potash, 8-03 of chloride of sodium, T16 of chloride of ammonium, 0*18 of phosphate of lime, peroxide of iron, and sulphate of lime, and 0'39 of mucus. [In addition to these analyses we may mention those of Becquerel, Marchand, and myself. Becquerel obtained the following results : Mean composition of urine of 4 healthy men. Ditto of 4 healthy women. General mean. Specific gravity Water 1018-9 968-815 1015-12 975-052 1017-01 971-935 Solid constituents 31-185 24-948 28-066 Urea Uric acid Fixed salts Organic matters 13-838 0-391 7-695 9-261 10-366 0-406 6-143 8-033 12-102 0-398 26-919 8-647 \ 1 Edin. Med. and Surg. Journal, vol. 33. 2 [These salts consisted of: Chlorine . . . 0-502 Sulphuric acid . . 0*855 Phosphoric acid . . 0-317 Potash . . . 1-300 Soda, lime, and magnesia . 3-944 ] ii. 10 146 THE SECRETIONS: MarchandV analyses correspond very closely with those of Lehmann. He cites the two following analyses as representing the composition of the healthy secretion : Water . . . 933-199 938-856 Solid constituents . . 66-801 61-144 Urea 32-675 30-321 Uric acid Lactic acid . Extractive matters Mucus Sulphate of potash Sulphate of soda Phosphate of soda Biphosphate of ammonia Chloride of sodium Chloride of ammonium Phosphates of lime and magnesia 1-210 1-001 Lactates . . . 1-618 1-032 1-065 1-001 1-521 1-362 11-151 10-553 283 -201 3-587 3-201 3-213 3-011 3-056 2-998 1-552 1-231 4-218 4-001 1-652 1-231 The following table gives the mean result of six analyses of the morning urine of a healthy man, instituted by myself. 2 Specific gravity . . . 1022-5 Water .... 961-00 Solid constituents . . . 39-00 Urea .... 16-60 Uric acid . . . -61 Fixed salts . . . 9-27 Organic matter and loss . . 12-07 ] The apparent discrepancies in the composition of healthy urine, as shown in the analyses that have been quoted, depend for the most part on the fluctuating amount of water. If we calculate the proximate constituents of the urine in relation to an equal amount of solid residue, we shall find these dif- ferences exhibited in a much less striking manner, although to a certain degree they still exist. 100 parts of the solid residue of the urine contain 1 Lehrbuch der physiologischen Chemie, p. 292. 2 L ancet , Feb. 1844. URINE. 147 2 g 8 'O CO OJ rH I I w irt o>
6 3 ' 2 ' 9 3 ' 2 4 ' 8 1 ' 6 2-1 1>5
FlYPf? "1
salts j 6 ' 3 ' 4 4>0 11 ' 1 ~ ~~ 6 ' 3 4 ' 8 4>1 25 ' 8
[Scherer 1 has made several analyses of the urine in typhus,
which differ in some points from those of Simon. He observes
that, in many cases, the urine is tolerably abundant in lactic
acid and extractive matters, and continues so throughout the
case, whether it terminate fatally or not. In a few cases the
urine was alkaline, and this generally occurred when the fever
assumed a very low or putrid form, or when the contents of
the bladder had not been discharged for some time ; and that
not unfrequently, after being acid, it became alkaline, and then
again acid. In the most severe cases it usually contained a
little albumen.
The urea was never increased except in those cases in
which the secretion was much diminished, and was often much
below the normal standard. As a general rule, the fixed salts
were considerably diminished, and the ammonia-salts increased.
There was always an excess of uric acid, which usually sepa-
rated, after standing, in the form of small red crystals, on the
sides of the vessel ; this was especially observed when there was
much pulmonary congestion. No critical phenomena indicated
the commencement of reconvalescence. Scherer has published
the following analyses :
1. A woman aged 38 years, with slow nervous fever. The
urine on the ninth day contained, in 1000 parts :
1 Untersuchungen, &c. p. 65.
254
THE SECRETIONS:
Water .... 945-48
Solid constituents . . . 54-52
Urea .... 8-60
Uric acid .... 0-60
Alcohol- extract with lactic acid and lactates 27-50
Water-extract . . . 7-40
Albumen . . . .1-80
Fixed salts soluble in water . . 6"20
Earthy phosphates . . . 2-30
On the 12th day of the disease it contained :
Water ....
Solid constituents
Urea ....
Uric acid ....
Alcohol -extract with lactic acid and lactates
Water-extract with ammonia-salts
Albumen ....
Fixed salts soluble in water
Earthy phosphates
On the 15th day it contained :
Water ....
Solid constituents
Urea ....
Uric acid .
Alcohol-extract with lactic acid and lactates
Water-extract
Albumen and mucus
Fixed salts soluble in water
Earthy phosphates
951-26
48-74
10-40
0-70
21-80
7-90
1-00
5-30
1-20
959-29
40-71
11-40
0-80
15-70
6-20
0-90
4-50
0-60
Convalescence occurred very slowly, without any critical
phenomena. The urea gradually increased and the extractive
matters diminished.
2. A man aged 66 years, of a muscular frame and good con-
stitution, but of intemperate habits. The disease developed
itself with great rapidity. The urine contained :
On the 4th day. On the 6th day.
Water .... 939-30 934-60
Solid constituents . . . 60-70 65-40
Urea .... 22-84 34-52
Uric acid . . . 1-70 1-62
Alcohol-extract with lactic acid and lactates 20-73 20-20
Water-extract . . . 7-20 8-51
Fixed salts soluble in water . . 4-02 ,
Earthy phosphates . . 0-72 1-02
3. In a case of typhoid fever of a very putrid character, the
URINE. 255
urine was of a red colour and an acid reaction. It contained in
1000 parts :
1. 2.
Water .... 983-5 965-3
Solid constituents . . .16-5 34*7
Urea 1-2 5-3
Uric acid
Alcohol-extract, with lactic acid and lactates
Water-extract and ammonia-salts
Fixed salts soluble in water
Earthy phosphates
Albumen and mucus
0-5 1-5
6-5 15-8
6-2 6-9
1-8 3-6
0-2 0-4
0-5 0-7
The specific gravity in these cases was 1007 and 1011.
Analysis 2 was made after the patient had taken phosphoric
acid for some days, and the septic tendency had diminished.]
Urine in intermittent fevers.
The urine varies considerably in its physico-chemical relations
in this class of fevers. An abundant lateritious sediment at
the period of the crisis was formerly regarded as an acknowledged
characteristic ; recent investigations have, however, shown that
this is by no means an invariable occurrence.
Schonlein observes on this point that he feels bound to con-
tradict the old physicians that the lateritious sediment in the
urine discharged at the termination of the paroxysm is a signum
pathognomonicum of intermittents, and that it may serve for the
purpose of distinguishing masked intermittents from similar
forms of disease, because the urinary crisis exhibits itself in
various forms, and in many epidemics is either altogether absent,
or only forms the exception and not the rule. For instance,
when the whole tendency of the disease is directed towards the
skin, the crisis is uniformly exhibited through that medium,
and an urinary crisis is either altogether absent or only occurs
subsequently, during the non-febrile state; so that while a
perfectly clear urine is discharged at the termination of the
paroxysm, the sediment which has been noticed occurs on the
following day.
Becquerel examined the urine in fourteen cases of intermit-
tent fever, ten of which were of the tertian, two of the quartan,
and two of the quotidian type. During the intermission the
urine resembled the normal secretion, and the resemblance was
256 THE SECRETIONS:
closer in proportion to the shortness of the paroxysm and the
length of the intermission : the average specific gravity was
1018-9. In many of the cases, the urine during the paroxysm
assumed the inflammatory type, that is to say, it was scanty in
quantity, highly coloured, and very acid, with or without sedi-
ments (either spontaneous or produced by nitric acid), and having
a mean specific gravity of 1023-5.
In other cases, in which the febrile paroxysms had been re-
curring for a length of time, the appearance of the urine changed
with the prolongation of the disease ; it became paler and less
acid, and its specific gravity fell to 1014-7.
The changes produced in the urine by the prolongation of
the disease was very striking in the case of a man aged 49 years,
who was attacked with a quartan fever during convalescence
from acute articular rheumatism. As long as the first disease
lasted the urine was inflammatory, but, on the accession of the
second, it became paler, less dense, contained a good deal of
mucus, and finally became alkaline ; the return of the paroxysm
did not produce any change in the character of the urine, which
remained the same until the recovery of the patient.
In a young chlorotic girl who was attacked with quotidian
fever, Becquerel found that the urine was pale, as is the case
with chlorotic persons, and was rendered turbid by a large
quantity of mucus equally during the intermissions and the
paroxysms ; but, at the same time, the acidity and density
(1021-8 1023-1) were more considerable than is usually the
case in chlorosis ; and, on cooling, a copious white sediment of
uric acid was thrown down.
Becquerel frequently observed turbidity or sediments (either
spontaneous or by the addition of an acid) towards the close
of intermittent fever, but not earlier. During the paroxysms
themselves, the urine was observed to present several modifi-
cations. In the majority of cases it seemed to undergo no
change during the three stages, that is to say, the urine
passed towards the end of the cold stage closely resembled
that which was passed during the other stages ; sometimes in
the cold stage it was deeply coloured, acid, and of rather high
specific gravity, and it would retain these characters in the
hot stage; sometimes it would be slightly coloured, faintly
acid, and of low specific gravity (1013'4) in the cold stage,
URINE. 257
and would be darker, more acid, and of higher specific gravity
(1021-8) in the hot stage.
Becquerel occasionally observed sediments in the urine at
the termination of the paroxysm, but they were by no means
of constant occurrence : Andral observed the same. He only
noticed them in those cases in which the fever was intense and
prolonged, and terminated in a very abundant perspiration, or
when it was complicated with functional derangements, or with
congestion of certain organs.
The sediment formed in intermittent fevers is always com-
posed of uric acid and urate of ammonia, in most cases combined
with red colouring matter (uroerythrin) .
A very perfect crisis by the skin and kidneys is said to indi-
cate an erethismic type of fever ; an imperfect and slight one,
occurring through only one of the secreting organs, a synochal
type ; and a colliquative crisis, a fever of a torpid character.
In a young man aged 23 years, who was treated in our hos-
pital for quartan fever, the urine, at the end of the paroxysm,
always threw down a copious, yellowish-red sediment. During
the intermission it was secreted more copiously, was clear, of
an amber-yellow colour, contained a few mucous flocculi, and
had a slight acid reaction.
[The following table, drawn up by L'Heretier, 1 represents
the mean composition of the urine in the different stages of
this disease, as deduced from the analyses of the urinary secre-
tion of twelve patients :
Cold stage. Hot stage. Sweating stage.
Specific gravity . -. 1017*330 1020-304 1022-820
Water . . . 967-520 964-680 961-845
Solid constituents . . 32-480 35-320 38-155
Urea . . . 9-845 9-015 7-624
Uric acid . . 0-660 0-980 1-029
Salts and organic matter . 21-975 25-325 29-502
In all these cases the physical characters of the secretion
were affected by the disease ; in six other cases the urine re-
mained apparently normal.]
1 Traite de Chimie patholog. p. 528.
ii. 17
258 THE SECRETIONS:
Scorbutus et Morbus maculosus Werlhofii. (Land-scurvy.)
In scurvy the urine is ordinarily of a dark, reddish-brown,
and sometimes of an almost black colour. Although it is
slightly acid as it passes from the bladder, it very soon be-
comes alkaline, and develops a strong and disagreeable ammo-
niacal odour, According to Schonlein, blood is frequently
discharged from the urinary organs, and the urine then assumes
a dark reddish-brown colour, in consequence of the presence of
ha3matoglobulin ; in this case, it develops hydrosulphate of
ammonia, and soon becomes putrid.
I have examined the urine in three well-marked cases of
scurvy occurring in Schb'nlein^s clinical wards ; two were men
between thirty and forty years of age, and the third, a woman
who had been delivered a few weeks previously. In the men,
not only were the gums attacked, and the peculiar scorbutic
odour observed in the breath, but the lower extremities were
covered with numerous ecchymosed spots and petechia?. The
woman had a very cachectic appearance; her face was somewhat
swollen; the gums nearly destroyed, livid, and hsemorrhagic ;
the teeth loose (one having fallen out the preceding night),
and the breath almost unbearable. In its physical characters
the urine was very similar in these three cases. At first it
was scanty (eight to twelve ounces), and of a deep dark-brown
colour, as if bile-pigment or decomposed blood were present,
which, however, was not the case. It was devoid of the pecu-
liar sweetish odour of typhus-urine, but, after standing a few
hours, developed a disagreeable ammoniacal odour.
The addition of ammonia produced a very slight turbidity ;
and, on the addition of chloride of barium to the urine acidu-
lated with nitric acid, the precipitated sulphate of baryta was
much less than in healthy urine. The addition of ammonia
(after the removal of the sulphate of baryta) produced a com-
paratively slight precipitate, showing that there was a deficiency
of the phosphates. Infusion of galls, basic and neutral acetate
of lead, and acetate of copper, produced considerable turbidity,
and the urine was similarly affected (but in a much less degree)
by bichloride of mercury. In their chemical characters, these
three specimens closely resembled each other, and were found
URINE. 259
to approximate to the urine in typhus. The amount of urea
was much less than in normal urine, not exceeding 25 302
of the solid residue. The fixed salts were diminished in the
urine of the men, forming 14 18g of the solid residue, while
in the woman they amounted to 27g, a little above the normal
average (25g). The uric acid was slightly above the healthy
standard in all the cases, ranging from 1 3 of the solid re-
sidue. The men rapidly improved under proper treatment ;
the urine became more abundant and clearer, and, in the course
of six days, was apparently normal. The woman recovered
more slowly.
In a girl aged 20 years treated in Schonlein's clinical wards
for morbus maculosus Werlhofii, I found the urine, during
a period of a fortnight, of a dark brown colour, of a dis-
agreeable ammoniacal odour, and with an alkaline reaction.
It deposited a viscid sediment of earthy phosphates, urate of
ammonia, and mucus. The addition of nitric acid indicated
the presence of a small quantity of bile-pigment. Blood (of
which the composition is given in Yol. I, page 316) issued from
the mouth, exuding from red patches situated above the uvula.
The odour of the breath was putrid. During her recovery, the
urine returned to its original state.
[The urine in this disease has likewise been analysed by
Heller and Martin.
The two following cases are recorded by Heller : l
1. A girl aged 19 years, marked over the whole body, was
admitted into the clinical ward of Professor Lippich.
The urine was of an intensely yellowish-brown colour, rather
turbid, and deposited flocks of mucus. The odour, at first ordi-
nary, rapidly became ammoniacal ; and the same tendency was
observed throughout the course of the disease. Reaction faintly
acid. Specific gravity 1021. The urine contained in 1000 parts :
Water ..... 949-28
Solid constituents . . . . 50-72
Urea ..... 16-21
Uric acid ..... 1-27
Extractive matters with much hydrochlorate of ammonia 23-24
Fixed salts .... 9-80
1 Archiv fur physiologischen und pathologischen Chemie, vol. 1, p. 12.
260 THE SECRETIONS:
The fixed salts consisted almost entirely of earthy phosphates
and sulphate of potash, there being a mere trace of chloride of
sodium. No albumen was present.
2. In a youth aged 16 years, the urine, during the progress
of the disease, was of a brownish-yellow colour and turbid ;
and when an improvement manifested itself, the secretion
became of a lighter tint, and clearer. A sediment of ammo-
niaco-magnesian phosphate and urate of ammonia was depo-
sited during the disease, but gradually disappeared during con-
valescence. The urine had a faintly acid reaction, but, not-
withstanding, evolved a putrid odour, and very rapidly became
alkaline. The specific gravity was at first 1017, and subse-
quently varied from that number to 1012. Traces of albumen
could always be detected till symptoms of convalescence ap-
peared. In its chemical characters it resembled the preceding
case. The hydrochlorate of ammonia was much increased,
while the chloride of sodium was diminished to a mere trace.
The uric acid was much increased, amounting to 2 in 1000
parts. The urine remained abnormal for six days, and then
appeared to have resumed its ordinary character.
Heller observes that the augmentation of the ammonia (in
the form of hydrochlorate) and of the uric acid, together with
the diminution of the chloride of sodium, characters seem-
ingly associated with this disease, indicate that the blood must
be in a state of dissolution.
In Martin's 1 case, the secretion was very scanty, about one
or two ounces being passed at a time, and the daily amount
being from twelve to twenty ounces. In its physical characters
it resembled the urine described in the preceding cases.
On evaporating the urine, and allowing the solid residue to
remain for some hours at a temperature of 212, there was re-
marked on the surface of the brown, and (for the most part)
saline mass, a copious, reticulated, dendritic efflorescence which,
when examined with a lens, was found to consist of long, traps-
parent, four-sided needles, with double-sided sharp extremities.
They were proved to be neither hydrochlorates, sulphates, or
phosphates, and were presumed to be crystals of hippuric acid.
Three analyses were instituted.
1 Neue med.-chir. Zeit. 1845.
URINE. 2G1
1. 2. 3.
Specific gravity . 1013-40 1021-26 1010-31
Water 984-42 973-74 985-730
Solid constituents . . . 15-58 26-26 14-270
Urea .... 6-43 6-07 5-430
Green colouring matter (thrown down by "I fttftq ft , n nfi
hydrochloric acid in place of uric acid) /
Extractive matters with ammonia-salts, &c. 2-34 2'25 0-650
Fixed salts soluble in water . . 6-30 17-00 7-794
insoluble in water . 0-42 0-84 0-390
Analysis 1 was made on Oct. 22d, before the administration
of any remedies. The urine was faintly acid. The soluble
salts consisted for the most part of chloride of sodium. Analysis 2
was made on the 3d of November with the mixed urine of the
preceding twenty-four hours. It had a strong ammoniacal
odour, but was perfectly neutral. The patient had taken sul-
phuric acid, iron, and other tonics, in the interval, without any
obvious improvement, and traces of iron were found with the
earthy phosphates. Analysis 3 was made with the morning
urine passed on the 25th of November. The same treatment
had been pursued with very decided benefit. The urine was
clear, slightly yellow, and devoid of the unpleasant odour it
previously evolved. Its reaction was faintly acid, and it con-
tained traces of iron.
The green colouring matter is probably a compound of uric
acid and biliphsein. A compound of this nature has been ob-
served and described by Heller. 1 ]
Chlorosis.
The urine of chlorotic persons is usually pale, of low specific
gravity, and of a mildly acid reaction : in these respects it re-
sembles the urine of persons who have lost a considerable quan-
tity of blood, or the form of urine termed nervous, which we
sometimes observe in hysterical attacks.
Becquerel applies the term anaemic to this form of urine, and,
as in the majority of cases in which it occurs, there is either
an absolute deficiency of blood or a scarcity of the truly vital por-
tion the blood-corpuscles, no objection can be raised to such
a designation. The urine in chlorosis has, however, other dis-
1 Archiv fur phys. und pathol. Chemie, vol. 1, p. 99.
262 THE SECRETIONS:
tractive properties, as lias been clearly shown by the researches
of Becquerel ; for it is very poor in urea, and in that respect
resembles the urine in typhus, while it differs from the latter
in containing only a small quantity of uric acid, and a large
amount of fixed salts.
I may perhaps be allowed to refer once more to the intimate
connexion subsisting between the action of the metamorphosis
of the blood-corpuscles (or of their development and vitality) on
the one hand, and on the production of urea on the other.
The proportion of the urea to the solid constituents of the
urine in inflammatory diseases, in those forms of typhus which
assume a torpid character, and lastly in chlorosis, affords us
sufficient illustration of this connexion.
In the form of typhus to which we have alluded, as well as
in chlorosis and anaemia, the urea is diminished ; but, as we
have already remarked, in that case the uric acid, which is a
product peculiar to febrile action, is increased, and the salts
(partly in consequence of the diet) are diminished ; while in
chlorosis, in which a nutritious nitrogenous diet is allowed, the
diminution of the urea plainly indicates that the seat of the
disease must be sought for in the production of the blood-cor-
puscles.
I shall now give BecquereFs account of the chemico-physical
relations of the urine in chlorosis.
The quantity of urine emitted in twenty-four hours amounts
to about 34 ounces. It is pale and of a greenish tint, and
only becomes dark when the urine is very concentrated : the
acid reaction is weak ; uric-acid sediments are seldom formed ;
when they do occur, they are of a white or gray colour. If, as
is not unfrequently the case, leucorrhoea is associated with
chlorosis, the urine is more or less turbid in consequence of the
mixture of the morbid product with it ; in these cases a little
albumen is generally observed.
The quantitative analyses which Becquerel made of the urine
of chlorotic persons gave the following results :
Anal. 1. Anal. 2. Anal. 2.
Quantity of urine in 24 hours . 41-3 ounces 50-8 ounces 2 7'5 ounces
Specific gravity . . 1011-3 1012-6 1016-8
URINE.
263
981-28
979-21
972-28
18-72
20-79
27-72
6-03
7-38
6-83
0-08
0-26
0-23
4-80
8-05
8-45
7-79
5-14
11-16
1000 parts contained :
Water
Solid residue
Urea
Uric acid
Fixed salts
Extractive matters
If we calculate the amount of urea, uric acid, and fixed salts
in these analyses in relation to 100 parts of solid residue, and
compare the results with the physiological average which
Becquerel has given, the proportions to which I have already
alluded will plainly appear, that is to say, there is an absolute
and a relative diminution of urea and of uric acid, and an in-
crease of the fixed salts ; 100 parts of solid residue contain :
Anal. 1. Anal. 2. Anal. 3. Normal Urine.
Urea . . 32-0 33-0 24-0 42-0
Uric acid . . 0-4 1-2 0-8 1-4
Fixed salts . . 26-0 38-0 30-0 24-0
The urine may exhibit some differences in its chemico-
physiological properties if other diseases are associated with
chlorosis, or if the latter is not very fully developed. The persons
from whom the urine in analyses 1 and 2 was taken were slightly
feverish. In analysis 3, the chlorosis was combined with pul-
monary emphysema. In analysis 4, there was some affection
of the nervous system.
With the exception of a considerable diminution in the
quantity of urine discharged in twenty-four hours in analyses 1
and 3, and the increase of uric acid in analysis 2, there are no
particular deviations in the relative proportions of the solid con-
stituents from the statement that we have previously made ; for
the urea is both absolutely and relatively diminished, and the
salts occur in a higher proportion than in normal urine.
i.
1 1 23-3 oz.
1014-2
1000 parts contained:
Quantity of urine passed in
24 hours, in ounces
Specific gravity
2. 3.
24-5 oz. 17-8 <
1017-6 1016-8
4.
38-5 oz.
1016-8
Water
. 976-43
970-89
972-28
972-28
Solid constituents
. 23-57
29-11
27-72
27-72
Urea
Uric acid .
Fixed salts
Extractive matters
8-37
0-20
4-74
. 10-34
7-81
0-81
0-09
11-47
8-64
8-36
10-24
6-95
0-22
8-89
12-10
264 THE SECRETIONS:
Becquerel has made some interesting remarks on the influ-
ence of ferruginous preparations on the urine in chlorosis.
In the majority of cases the iron is partially carried off by
the urine ; sometimes, without any apparent reason, it is absent
from urine in which it is found on the preceding and suc-
ceeding days. The quantity of iron thus carried off in the
urine of the same individual is subject to great variations ;
sometimes it can only be detected after the incineration of a
portion of evaporated urine, while, on other occasions, the simple
addition of a test is sufficient to indicate its presence. The iron
begins to pass off by the urine from the commencement of the
administration of the medicine, and it occurs in all the urine
that is emitted; so that there is no necessity for the system
to be saturated with it before any portion can pass off by the
kidneys ; as the assimilation of the iron is a very slow process,
large doses merely derange the digestive organs without being
of more service than smaller doses.
[Herberger 1 analysed the urine of the chlorotic girl referred
to in Vol. I, p. 313, and his analyses indicate the simultaneous
diminution of the blood-corpuscles and urea. The urine was
analysed on three occasions before the use of iron, and twice
afterwards.
3.
1012
35 oz.
971-98
28-02
7-12
0-19
13-99
6-62
Urine after the use of iron.
1. 2.
Water .... 940-16 938-70
Solid constituents . . . 59-84 61-30
Urea .... 26-84 27'36
Uric acid . . . 0-94 0-96
Extractive matters . . . 18-62 16-28
Fixed salts . . 13-32 15-71
1 Bnchner's Repertorimn, vol. 29.
Urine before the use of iron.
i.
2.
Specific gravity
Quantity in 24 hours .
Water
. 1010
32 oz.
975-43
1009
42 oz.
978-21
Solid constituents
24-57
21-79
Urea
Uric acid
Extractive matters .
Fixed salts
7-04
0-13
10-48
6-80
7-00
0-21
9-00
5-50
URINE. 265
Traces of iron were detected both in the sweat and urine
during the period of treatment.]
Donne states that normal urine always contains a certain
quantity of iron which disappears during chlorosis, and only
reappears after the use of ferruginous preparations. This state-
ment is contradicted by Becquerel, who has never been able to
discover iron in the incinerated residue of normal urine,
although ferrocyanide of potassium would evolve a blueish shade,
an effect which this test sometimes has on chlorotic urine.
[L'Heretier 1 gives the mean of eight analyses of the urine
in uncomplicated chlorosis :
In 24 hours.
Quantity of urine . . . . 1000 38 oz.
Specific gravity . . . 101 1-9
Water .... 983-1 18372 grains
Solid constituents 16-9 316
Urea
Uric acid
Fixed salts
Organic matter
6-6 123
0-2 5
4-1 77
6-0 111
I am indebted to the kindness of Dr. Golding Bird for the
following cases :
1. A girl aged 18 years, of anaemic appearance, and who had
suffered from anasarca for six months, passed 30 ounces of acid
urine of specific gravity 1024, in twenty-four hours.
The water amounted to . . 12690 grains.
The solids .... 750
Urea . . . .162
Uric acid ... 9
She then commenced taking ferri sulph. gr. iij, ter die. In
the course of a week the urine was again examined ; it amounted
to 20 ounces, had a specific gravity of 1029, and deposited urate
of ammonia.
The water amounted to . . 8392 grains.
The solids . . . .608
Urea . . . . . 137
Uric acid . . . 20
1 Traite de Chim. patholog. p. 551.
266 THE SECRETIONS:
The anaemia was now disappearing. At the end of the second
week the amount of urine was 30 ounces, and the specific
gravity 1023.
The water amounted to . . 12690 grains.
The solids . . . .720
Urea . . . .242
Uric acid .... 5
2. The urine of a girl aged 15 years, of chlorotic appear-
ance but menstruating regularly, amounted to 25 ounces, and
had a specific gravity of 1020.
The water amounted to . . 10637 grains
The solids . . . .519
Urea .... 231-25
Uric acid .... 25-00
The amount of uric acid in this case is very remarkable.]
Haemorrhages .
The properties of the urine in haemorrhages are entirely de-
pendent, during the period of the discharge and for some short
time afterwards, upon the degree in which the vascular system
participates in the general disturbance. In many cases, as for
instance, in cerebral and pulmonary haemorrhages, we find that
the quantity of urine is diminished, its colour becomes deepened,
its acidity and its specific gravity increased, that is to say, it en-
tirely resembles inflammatory urine. When there is haemorrhage
from the kidneys, uterus, or any portion of the generative sys-
tem, the urine will naturally contain blood, either in a state of
solution or undissolved. If the haemorrhage is succeeded by a
state of anaemia and great prostration of strength, the urine then
becomes pale, of slight acidity, and of low specific gravity, as in
chlorosis.
Becquerel made three examinations of the urine in cerebral
haemorrhage, and in two of these cases he found it analogous
in its physical relations to the urine of inflammation : in the
third case, in which the patient had imperfect hemiplegia of the
right side, but in other respects seemed well, the urine could
hardly be considered abnormal.
In one of the first two cases, the urine was taken from a
man aged 43 years, who was affected with perfect paralysis of
URINE. 267
the left side, and died on the fifteenth day from the seizure.
It exhibited in a high degree, both in its physical properties
and in its chemical constitution, the characters of inflammatory
urine. The quantity was diminished ; the specific gravity, the
urea, and uric acid exceeded the physiological average.
Quantity of urine in 24 hours, in ounces . ^ 25*7
Specific gravity .... 1023-1
Water ..... 960-40
Solid residue ..... 39-60
Urea ..... 17-10
Uric acid ..... 0-65
Fixed salts . . . . . 10-00
Extractive matter . . . . 11-80
In 100 parts of solid constituents there are 43-0 of urea, and
1*6 of uric acid.
The urine of a man aged 31 years, who was treated in
Schonlein's clinical wards fora severe attack of pulmonary haemor-
rhage, was of a dark red colour, very acid, and exhibited the other
symptoms of the inflammatory type, from the period of admis-
sion to the eleventh day. On two occasions I found its specific
gravity to be 1023 and 1022. On the eleventh morning the
urine was rather turbid, and on the twelfth it became jumen-
tous from the urate of ammonia which was suspended in it ; it
still had a strong acid reaction, but did not form any sediment ;
on the next day, the sediment was very considerable. The
pulse was quick and feverish till the urine began to deposit
sediments; subsequently, the vascular excitement almost en-
tirely disappeared, and the urine became clear and pale, and
contained only a few mucous flocculi.
In a girl aged 20 years, with severe hsematemesis, who had
brought up nearly a quart of coagulated blood, the urine which
was passed almost immediately after the attack scarcely differed
from the normal secretion ; but, on the following day, it was
pale, and scarcely acid, and it continued in this state for several
days.
In hsematuria the urine contains blood, either in a coagulated
state or devoid of fibrin ; in the latter case, the blood-corpuscles
may be either perfectly dissolved or not ; and when they are
found floating in the urine, they form, after a short time, a red
sediment. More minute observations on this subject have been
given in page 187.
268 THE SECRETIONS:
Rayer has published a very interesting communication on
an endemic hsematuria that occurred in the Isle of France.
Children of very tender age discharged blood with the urine ;
he relates for instance, the case of a boy, who from his seventh
year lost nearly an ounce of blood daily : uric-acid gravel was
combined with the hsematuria.
A man aged 21 years, from the Isle of France, who was
under Rayer' s care, had had hsematuria from his youth. The
urine which he passed in Rayer' s presence formed, in the course
of seven hours, a cream -like layer on the surface; two distinct
strata were afterwards formed, the upper being of a yellowish-
white colour, and the lower red : the latter contained two clots
of coagulated matter, one was the ordinary blood-clot, the other
was white and loose. The upper milky stratum contained much
albumen and fat (chylous urine), the lower one contained blood.
No casein was present. It is worthy of remark that the hsema-
turia never came on till about noon, the urine passed in the
earlier hours being always clear.
Rayer and Orfila also observed a similar case of bloody and
milky urine in a Brazilian. The disease commenced with a
discharge of milky urine, the hsematuria coming on a year after-
wards.
Catarrhs.
In simple catarrh the state of the urine corresponds with the
degree of vascular reaction.
If the catarrh terminates without any perceptible fever, the
urine scarcely deviates at all from the normal state : if the fever
is accompanied by much excitement, the urine, according to
Schonlein, becomes rather red, and forms a mucous sediment.
At the commencement of convalescence from a feverish catarrh
the urinary crisis shows itself by a mucous sediment.
In influenza the urine assumes a reddish tint, and assumes
more or less of the inflammatory type in proportion to the
synochal character of the fever. Schonlein states that the
nature of the urinary crisis at the approach of convalescence is
dependent on the character of the fever : in erethismic fever the
sediment is mucous, in synochal fever it is earthy, and in gastric
fever it is of a yellowish-gray colour.
URINE. 269
In measles, which are considered by Schonlein as the most
highly-developed form of catarrhal disease occurring in the
northern hemisphere, the urine changes with the varying stages
of the disorder. In most cases it more or less resembles the
inflammatory type, it is red (as in inflammatory measles), acid, and
sometimes jumentous (as in gastric measles), or deposits a mucous
sediment during the course of the morning (as in catarrhal mea-
sles). Becquerel states, as the result of his observations, that
the urine is generally inflammatory at the commencement of
the febrile period. It becomes very dark and of high specific
gravity, and frequently deposits a sediment of uric acid : a
small quantity of albumen was found in a few of the cases.
During the eruptive period the character of the urine changes ;
if the eruption is slight, and there is not much fever, it resumes
the normal type ; if the contrary is the case, the urine retains
the inflammatory appearance. Becquerel did not meet with any
case in which the urine was turbid or sedimentary towards the
close of the eruptive stage.
During the period of desquamation and of convalescence, the
urine either returns at once to the normal state, or continues
turbid and sedimentary for some time, or becomes pale, clear,
and ansemic.
In three cases anasarca came on during convalescence, but
the urine did not contain albumen.
During the catarrhal affection of the mucous membrane of
the stomach, or the status gastricus (as it has been called), which
when more fully established, becomes gastric fever, the urine
is generally more or less turbid, and earthy sediments appear
as symptoms of a crisis.
Becquerel found that the urine in "Tembarras gastrique"
was often of a deep colour, and sedimentary, as in the phlo-
goses : sometimes, however, it hardly differed from the normal
secretion. Out of twelve cases, the urine in two scarcely differed
at all from the normal type, in the other ten it approximated
more or less in its characters to the urine of inflammation : the
deepness of the colour appeared to be always in relation to the
intensity of the disorder, and to the presence of some degree of
270 THE SECRETIONS:
fever. In the twelve cases, with two exceptions, the urine was
constantly acid. In one of the exceptions the urine was alka-
line, and contained numerous crystals of ammoniaco-magnesian
phosphate. In six cases sediments of uric acid were formed
either spontaneously, or on the addition of an acid : in two
in which the symptoms were very intense, a little albumen
was present, but in each case it lasted only one day. The mean
specific gravity of the urine was 1021*4; the highest, and in this
case a sediment was deposited, was 1025-2.
In gastric fever the urine is frequently turbid and junientous :
it usually contains urate of ammonia in suspension, and has an
acid reaction. An earthy flocculent sediment occurs as a urinary
crisis at the commencement of convalescence, the supernatant
fluid being clear. (Schonlein.)
In mucous fever the urine is red and fiery, if the fever (which
at the commencement assumes the intermittent type, and which
only at a later period becomes continuous,) takes on a synochal
character.
It is not unfrequently limpid and clear, as in hysterical cases,
and forms, especially if the affection has extended to the genito-
urinary mucous membrane, a mucous sediment. In those cases
in which the urine is limpid, it assumes the normal colour during
the progress to convalescence, and sediments are deposited which
gradually become thicker, and pass from a mucous to an earthy-
purulent character. (Schonlein).
The urine in bilious fever is usually impregnated with bile-
pigment ; it is of a more or less brownish colour, and when a
thin layer is seen it appears of a citron-yellow tint : it differs,
however, with the degree of vascular excitement ; if the fever
has a synochal character the urine is dark and of a fiery-red
colour, if the fever is erethismic, which is frequently the case,
it is of a dark yellow or yellowish-brown colour, and in torpid
fever it is more or less brown, and not unfrequently mixed with
blood. The presence of bile-pigment may always be recog-
nized by the change of colour which succeeds the addition of
nitric acid.
URINE. 271
Cholera.
In sporadic cholera, as well as in the Asiatic form of the
disease, the urinary secretion is very scanty, and sometimes
altogether suppressed. Any urine that is discharged is usually
of a dark colour, and has a feeble acid reaction, but its specific
gravity is below the healthy average.
In a case which I observed in our hospital, where the symptoms
were exhibited with great severity in a woman 36 years of age,
there were frequent evacuations by stool, but only about one
ounce and a half of dark acid urine, with a specific gravity of
1011-0, in the course of twenty -four hours. I only determined
the amount of solid constituents collectively, and of the urea.
In 1000 parts I found :
Analysis 118.
Water .... 975-90
Solid constituents . . . 24-10
Urea .... 7-10
The urea in this case amounts to rather more than 29 of
the solid residue, which is considerably below the normal pro-
portion. At the approach of convalescence the urine was
discharged more copiously, but it continued to be deeply co-
loured : it was only after some days that it became pale and
anaemic. I never observed any sediment.
[The urine of a man aged 30 years, attacked with sporadic
cholera, was analysed by Heller. 1 There was excessive diar-
rhoea and vomiting, and the patient died on the fourth day.
During the first forty-eight hours of his illness only one ounce
of urine was discharged; it had a deep golden-yellow colour,
and deposited earthy phosphates although strongly acid. Its
specific gravity was 1018. It contained in 1000 parts :
Water and free carbonic acid . . . 955-67
Solid constituents .... 44-33
Urea ..... 10-50
Uric acid ..... 0-10
Extractive matter, with a large quantity of a peculiar sub-
stance apparently originating from the bile . 27*32
Fixed salts ..... 6-41 J
1 Archiv fiir phys. und pathol. Chemie, vol. 1, p. 15.
272 THE SECRETIONS:
"We are unfortunately not possessed of any trustworthy in-
formation respecting the urine in Asiatic cholera. K. Herrmann 1
has communicated the following remarks.
As no opportunity occurred for obtaining urine passed during
the more urgent stages of the disease, that which was first dis-
charged by a patient who was just getting over a severe attack
was analysed : it was yellowish, turbid, deposited no sediment,
had a neutral reaction, and by the application of appropriate
tests, the presence of phosphates, hydrochlorates, and ammonia-
compounds was indicated ; on the addition of nitric acid, crystals
of nitrate of urea were obtained ; but only small quantities of
all those substances were present. Its specific gravity was very
low, being only 1006.
Wittstock 2 has likewise instituted some researches on the
urine which was passed immediately after an attack of cholera.
It had a specific gravity of 1008-5, was neutral, of a pale yellow
colour, but not perfectly transparent in consequence of micro-
scopic crystals (consisting, in all probability, of ammoniaco-
magnesian phosphate,) held in suspension. The sides of the
glass were also covered with minute glittering crystals, which
were supposed by Wittstock to consist of uric acid, but which,
in all probability, were composed of ammoniaco-magnesian
phosphate also. 3
An interesting investigation regarding the urine in cholera
has also been made by Vogel. The urine was passed after the
most violent symptoms had abated : it was of a deep brownish-
yellow colour, was rather turbid, deposited no sediment, had a
specific gravity of 1008-0, and indicated a strong acid reaction.
The salts of lime and magnesia were entirely wanting, and the
quantity of chloride of sodium was very minute, while on the
other hand the sulphates were found in a larger proportion than
in normal urine.
The existence of bile-pigment and of albumen was proved by
1 PoggendorfFs Annalen, vol. 22, p. 176. 2 Cholera Archiv, vol. 1, p. 428
3 It is by no means probable that urine, with so low a specific gravity, and espe.
cially when it is alkaline or neutral, should throw down a precipitate of uric acid ; a
sediment of urate of ammonia would be much more probable. The neutral state of
the urine would favour the separation of crystals of ammoniaco-magnesian phosphate,
as suggested in the text.
URINE. 2/3
the addition of nitric acid to the urine. Urea, uric acid, mucus,
and a good deal of phosphoric and lactic acid were present. Sub-
sequently the albumen and bile-pigment disappeared, and the
earthy phosphates returned.
In vesical catarrh the urine is generally very pale, and always
contains a greater or less amount of mucus. The feeble acid
reaction which it possesses at the period of its emission is fre-
quently lost in a very short time, and it becomes neutral or
alkaline, and a quantity of the earthy phosphates, (especially of
crystals of ammoniaco-magnesian phosphate, 1 ) becomes mixed
with the mucus. The quantity of mucus which is separated is
sometimes very bulky.
Schonlein remarks that we may possibly be able to deter-
mine the seat and the extent of the blennorrhcea from the
quality and the amount of mucus. Mucus secreted from the
mucous membrane of the bladder forms an uniform mass, and
is tenacious and thready, while that secreted by the mucous
membrane of the ureters and of the pelvis of the kidney is, on
the contrary, flocculent : if the tenacious and the flocculent forms
of mucus are both found at one and the same time, we are jus-
tified in assuming that the bladder, ureters, and pelvis are simul-
taneously affected. Willis, 2 in speaking of cystorrhoea, states that
in acute vesical catarrh accompanied by inflammatory fever, the
urine is scanty and highly coloured, and precipitates a much
greater quantity of tenacious mucus than usual ; also that in the
earlier stages of the disease it is sometimes ammoniacal, but
more frequently when the disease has continued for a long time.
In chronic vesical catarrh the urine is flocculent when it is
passed ; the flocculi increase with the advances of the disease,
and collecting at the bottom, form a tenacious mass which
may be drawn out into threads ; this mass sometimes assumes
the consistence of bird-lime, and exhibits spots of blood.
As the disease advances still further, we often find a fourth
or even a third part of the urine to consist of mucus, so that
six to eight or even ten ounces are daily thrown off. Willis
1 [It is worthy of observation that beautiful crystals of ammoniaco-magnesian
phosphate may be occasionally found in urine with a decidedly acid reaction.]
2 Urinary Diseases and their Treatment, p. 399.
ii. 18
274 THE SECRETIONS:
inquires whether this secretion is always composed of actual
mucus, or whether pus in a modified form is not always present.
In the urine of a man who was being treated for catarrhus
vesicse in our hospital, I found a very bulky sediment composed
of mucus and earthy phosphates : the quantity of ammoniaco-
magnesian phosphate was also very considerable.
The urine upon becoming clear above the sediment, was of
a faint yellow colour, and contained much carbonate of ammonia;
it constantly had an alkaline reaction. The sediment for a pe-
riod of eight days assumed a faint grayish-blue colour ; when
washed (for the purpose of separating the urine from it as com-
pletely as possible,) and dried, it was treated with anhydrous
alcohol, which took up the blue colouring matter, and on evapo-
ration left it as a beautiful blue substance insoluble in water,
but dissolving in ether with a reddish tint ; I can only compare
it to Braconnot's cyanourin.
Rheumatism.
We have already seen that the blood in rheumatism perfectly
corresponds with the blood in the true inflammations; hence we
are led to infer that the urine will also present the inflammatory
type an inference confirmed by experiment.
The urine in acute rheumatism, (when the reaction is accom-
panied by synochal fever,) exhibits in a high degree those cha-
racters of inflammatory urine which I have already so often
described. The colour is sometimes deep purple-red, like claret,
its acid reaction is very strongly developed, and very bulky,
fawn-coloured or lateritious sediments consisting for the most
part of urate of ammonia, but occasionally of crystallized uric
acid, are deposited. The extent to which these properties of
the urine are exhibited depends upon the violence, and the more
or less synochal character of the fever.
Vauquelin and Henry found free phosphoric acid, and the
latter also free acetic acid, in the urine.
In chronic rheumatism without fever, the characters of inflam-
matory urine may be altogether absent, and instead of the
earthy sediments we shall have merely a cloudiness and tur-
bidity, as I have observed in my own case. The urine which I
have passed during the night has frequently remained perfectly
URINE. 275
clear, while that discharged in the course of the day often
formed only slight deposits. As the urine in rheumatism often
throws down sediments even at the height of the disease, the
deposits which are formed can only be regarded as significant
of a true crisis when the supernatant urine is perfectly clear.
Eisenmann 1 remarks that the properties of the urine may un-
dergo a change if the disease continues for a long time ; for
instance, if it should take a hypodynamic character, the urine,
instead of being acid, will assume an alkaline reaction, and will
give off a fetid ammoniacal odour.
When the disease takes on the hypodynamic type, without
having previously exhibited a hyperdynamic character, the urine
instead of being red, is then, according to Stork's observations,
pale, frequently thick, turbid, and fetid.
Becquerel has made quantitative analyses of the urine in
several cases of rheumatism. He found the relative proportions
of the solid constituents the same as in inflammation a fact
that had been previously observed by Henry 2 who found a
large amount of urea in his own urine during rheumatic fever.
The urine of a man aged 30 years (Anal. 1), who had been
bled for acute rheumatism, was very deeply coloured, and on
the addition of a little nitric acid threw down a copious sedi-
ment. It also threw down a spontaneous sediment of a reddish
colour after standing for two hours. The specific gravity was
101 7'2. The urine of the same man was analysed another day,
(Anal. 2). It was of a very dark colour, almost like blood,
and had a specific gravity of 1018-0. The urine in the third
analysis was taken from a man aged 38 years, whose pulse
was 104 in the minute. It was of yellowish-red colour, and
threw down a sediment of uric acid on the addition of a few
drops of nitric acid.
i.
2.
3.
Water .
971-80
970-20
981-10
Solid constituents .
28-20
29-80
18-90
Urea
12-20
9-00
8-00
Uric acid
1-70
1-04
0-50
Fixed salts
I
5-59
2-34
Extractive matter
14-70
8-00
Die Krankheitsfamilie Rheuma, p. 51. 2 Journ. de Pharm. 15, p. 228.
276 THE SECRETIONS:
If we calculate the amount of urea and of uric acid in pro-
portion to 100 parts of solid residue, we obtain 43 urea and
6g uric acid in the first, but only 31 g urea, and 3*5g uric acid in
the second analysis; so that in the first analysis the physio-
logical average is exceeded, while in the second it is not reached,
at least as far as the urea is concerned.
In the third analysis the numbers approximate closely to the
physiological average, viz. 42g urea and 2-6g uric acid.
In eighteen cases of rheumatism, in which the renal secretion
was examined by Becquerel, it always assumed to a greater or
less degree the characters of inflammatory urine during the con-
tinuance of the fever : the very deep colour was general, as also
the acid reaction, except in one case, in which for a single day
an alkaline reaction was observed. The mean specific gravity
was 1022*6 : in those cases which threw down a spontaneous
sediment it was 1025-2. In twelve out of the eighteen cases,
a spontaneous sediment was thrown down during the febrile
period : these sediments usually alternated with dark but clear
urine, or with urine that was precipitable by nitric acid.
Albumen was detected in seven of the eighteen cases. During
the period of convalescence the urine was anaemic, or returned
to its normal state.
[The following analysis of the urine of a man aged 22 years,
suffering from acute rheumatism, was made by Dr. Baumert. 1
The urine submitted to analysis was passed on the fourteenth
day of the disease. It was of a deep yellowish brown colour
but perfectly clear. In the course of twenty-four hours it de-
posited a copious sediment of urate of ammonia, but did not
become alkaline.
It presented the normal degree of acidity, and its specific
gravity was 1028-3. It contained in 1000 parts :
Water .... 928-68
Solid constituents . . . 71-32
Urea .... 18-65
Uric acid . . . 0-86
Extractive matter with a large quantity \ ,,7 fil
of hydrochlorate of ammonia . /
Fixed salts . . . 14-20
1 Archiv fur phys. und patholog. Chemie, vol. 1, p. 45.
URINE.
277
The fixed salts contained no trace of chloride of sodium,
the normal amount of earthy phosphates, a slight excess of
alkaline phosphates, and an augmentation of the sulphates,
Hippuric acid was sought for without success.
Oxalate of lime is of frequent occurrence in cases of acute
rheumatism.]
In chronic rheumatism, if the pains are not very acute, and
the night's rest is not disturbed, the urine retains its normal
properties. Out of thirty-seven cases observed by Becquerel,
the urine remained unaffected in twenty, while in seventeen it
assumed the inflammatory type, and in nine of these threw down
a spontaneous sediment.
Gout.
I have made four analyses of the urine in two cases of gout,
with the view of determining the effect of benzoic acid on that
secretion :
Before
After
Before
After
administration.
ditto.
administration.
ditto.
Anal. H9.
Anal. 120.
Anal. 121.
Anah 122.
Water
976-73
978-84
965-25
962-43
Solid constituents
23-27
21-16
34-75
37-57
Urea
7-02
6-10
9-23
10-00
Uric acid
0-50
0-48
0-58
0-60
Earthy phosphates
0-35
0-28
Sulphate of potash
2-67
2-08
Phosphate of soda
1-60
4-53
Hippuric acid
0-65
0-69
If we determine the per centage of the urea and uric acid in
relation to the solid residue, we find in the first case, that be-
fore the use of benzoic acid the urea amounted to 3O16g and
the uric acid to 2'14, and afterwards they amounted to 28'21
and 2'22g respectively. In the second case the urea and uric
acid amounted to 26*56 and 1'66 before the use of the acid,
and 26-61 and 1'59 afterwards.
These analyses are insufficient to show that benzoic acid exerts
any influence on the amount of urea or uric acid. The clinical
experiments of Froriep and others indicate, however, that it is
a valuable remedy in various forms of arthritis.
Froriep 1 has published a notice of twenty cases of gout and
1 Simon's Beitrage, p. 294.
278 THE SECRETIONS:
chronic rheumatism in which he administered benzoic acid.
During the first twenty-four hours the symptoms are always
aggravated, but they usually subside on the second day.
The Exanthemata.
In all the acute exanthemata the urine very frequently pre-
sents, as Schonlein remarks, a peculiar character, which is due, in
many cases, to an admixture of bile-pigment : it has a dark-
brown colour, and resembles badly-fermented beer in appear-
ance. At the commencement of the crisis the urine becomes
clearer, and forms a pulverulent sediment consisting of uric
acid "(and perhaps urate of ammonia).
In the fever which accompanies erysipelas, and is usually of
an erethisinic or synochal character, the urine is frequently
loaded ^with bile-pigment, and is of a reddish-brown or red
colour. At the urinary crisis, fawn-coloured precipitates are
deposited, and the urine becomes clear. (Schonlein.)
Becquerel has examined the urine in several cases of erysipelas.
When the erysipelas is accompanied by fever, as is most com-
monly the case, the urine assumes the inflammatory type.
Becquerel made two quantitative analyses of the urine of a man
aged 39 years, who had erysipelas of the face, and a good deal
of fever (pulse 112).
The urine of the first analysis was of a deep yellowish-red
colour, and clear; its specific gravity was 1021*0.
The urine of the second analysis was so deeply coloured as
to appear almost black; it threw down a reddish sediment of
uric acid, and had a specific gravity of 1023-1.
The first analysis was made on the fourth, and the second
on the sixth day from the commencement of the disease.
These analyses gave :
Anal. 1. Anal. 2.
Quantity of urine passed in 24 hours, in ounces . 27'0 30-8
Water ..... 965-5 961-9
Solid constituents .... 34'5 38'1
Urea . . . 12-5 12-7
Uric acid . . . .1-2 1-3
Fixed salts .... 8-2
Extractive matter . . . 15-9
In a woman aged 45 years, with erysipelas of the face,
URINE. 279
whose pulse was 104 and full, the urine was very scanty, of a
dark-brown colour, strongly acid, threw down a yellow sediment
spontaneously, and had a specific gravity of 10.23-1.
It contained :
Water . . . .961-7
Solid constituents . . . 38-3
Urea .... 11-7
Uric acid . . . 1-3
Fixed salts . . . 9'2
Extractive matters . . 15'7
In five cases in which the morning urine was daily examined
with care, the characters of inflammation were present in a very
high degree: the specific gravity varied from 1021 to 1025. In
four of these cases the urine threw down a reddish sediment,
and in two a little albumen was occasionally present.
In scarlatina, the urine at the commencement, while there is
considerable fever, is of a deep dark-red colour, and possesses
all the properties of inflammatory urine.
In children the urine is always less coloured than in adults,
and its colour in this disease is proportionally less dark.
It almost always has an acid reaction, and only exhibits a
tendency to become rapidly ammoniacal, when the disease is
associated with a nervous or septic condition of the system.
Any sediments that may be formed consist, for the most part,
of urate of ammonia and uric acid mixed with a greater or less
quantity of mucus : blood-corpuscles are occasionally noticed.
When the urine is ammoniacal, viscid whitish sediments of the
earthy phosphates are deposited, and if there is much gastric
disturbance the urine becomes jumentous. Albumen is com-
monly but not always found in the urine during the period of
desquamation. Dropsy may even supervene without the urine
becoming albuminous : it is sometimes preceded by the occur-
rence of hsematuria.
Becquerel found that the urine during the febrile period was
generally very high coloured, and, if severe angina was present,
was very acid, and was either turbid, or became so on the
addition of an acid : it frequently also formed a gray or lateri-
tious sediment, and the presence of a small quantity of albumen
280 THE SECRETIONS:
was by no means rare. Becquerel only observed blood in the
urine in the single case of a child five and half years old, who
was attacked with anasarca. In a girl whose nervous system
was very much deranged during the period of the febrile in-
vasion, the urine was very deeply coloured, turbid, and deposited
on the sides of the vessel a copious precipitate of a bright red
colour. The sediment disappeared when the eruption was fully
established. Blood was frequently observed in the urine when
there were symptoms of impending dissolution during the ner-
vous form of scarlatina; the quantity was sometimes very consi-
derable, and the corpuscles could be readily detected by the
microscope. The appearance of blood in this state must be
distinguished from that in which it arises from a renal affection
(Bright* s disease) in which Becquerel has frequently observed it,
and where, in the fatal cases, the existence of Bright' s disease
was proved. The amount of albumen in the urine is, in these
cases, constant and larger than is frequently found in inflam-
matory diseases, without the occurrence of any simultaneous
dropsical symptoms. 1 During the period of desquamation symp-
toms of dropsy frequently supervene, and the urine often contains
albumen, in larger amount and more continuously than is usually
the case in inflammations.
The observations regarding the presence of albumen during
the period of desquamation after scarlatina are so contradictory
that it has become a matter of very great interest to settle these
conflicting statements by further researches. We have dropsical
symptoms with albuminuria, dropsical symptoms without albu-
minuria, and albuminuria without dropsical symptoms. Solon
found albumen in the urine in twenty-two out of twenty-three
cases of scarlatina. On the other hand, Philipp 2 observed, in
Berlin where scarlatina was recently very prevalent, and ana-
sarca could not be warded off, at least sixty cases in which the
urine was tested both with heat and nitric acid, and no trace of
albumen could be detected.
In two cases of scarlatina that were being treated in Romberg's
1 When the urine contains no blood-corpuscles visible by the microscope, dissolved
haeraatoglobulin may be present, which can be estimated in the manner described in
p. 187.
? Casper's Wochenschrift, 1840 ; No. 35.
URINE. 281
clinical ward for children, and in which there were no drop-
sical symptoms, I could find no albumen. In the case of a man
aged 20 years, which occurred in Schonlein's clinical wards, the
urine was very albuminous during the period of desquamation,
and continued so for four days without the occurrence of
dropsy ; in another man, in whose urine I found no albumen,
there were also no dropsical symptoms.
In a boy aged 5 years, who was suffering from septic scar-
latina just then at its acme, (putrid odour from the mouth and
nose, and disturbance of the cerebral faculties,) the urine was
of a dark -yellow colour, had an alkaline reaction, a very dis-
agreeable ammoniacal odour, and threw down a dirty white
sediment of earthy phosphates, urate of ammonia, and urate of
soda; the latter occurring in the form of opaque globules.
The specific gravity was 1022, and about 16 ounces were dis-
charged in the course of twenty-four hours. Therewere contained
in 1000 parts :
Analysis 123.
Water .... 943-60
Solid constituents . . . 56-40
Urea .... 19-35
Uric acid . . 1-69
The uric acid was combined with ammonia and soda. I ex-
amined the urine of the same boy afterwards, and found that
it possessed precisely similar characters : it was of a straw-
colour, had an alkaline reaction, and an ammoniacal odour;
the sediment was more copious than on the former occasion,
and there were considerably more of the large opaque globules,
which I consider to be urate of soda. During the period of des-
quamation I found a greater number of mucus-corpuscles in the
sediment than is usual, but nitric acid gave no indication of
albumen. The urine above the sediment remained turbid in
consequence of holding in suspension a very large quantity of
epithelium, which was swimming about, partly in single scales,
and partly in fragments of 8-12 scales connected with each
other, and all of which were acted on by some chemical agent,
probably by the carbonate of ammonia in the urine.
This sediment should always be sought for with as much
care as albumen. It is an indication of the desquamation of
282 THE SECRETIONS:
the mucous membrane, and is frequently a precursor of the
desquamation of the cuticle. The tubes described as occurring
in Bright's disease are occasionally found in this form of
sediment.
In variola and varicella the urine changes with the various
stages of the disease,, and with the nature of the fever which
is present.
Urine of a synochal character is, however, often met with,
especially during the first stage of the disease, when the fever
has a synochal type.
Becquerel examined the urine of eleven persons with variola,
and of ten with varicella. In a case of varicella in which the
early symptoms (les prodromes) were extremely severe, the urine
was passed in very small quantity, of a deep red colour, and a
specific gravity of 1022-7.
In a case of varicella in which the early symptoms were
scarcely perceptible, the urine remained normal. Schonlein
states that in the first stage of this disease the urine is often as
limpid as in hysteria. During the eruptive stage, the state of
the urine depends upon the intensity of the fever which accom-
panies the appearance of the exanthema.
In five out of the eleven cases of variola observed by Becquerel
the symptoms accompanying the eruption were very severe;
the urinary secretion was diminished, and amounted on
an average to only 23 -5 ounces in twenty-four hours. The
specific gravity had not, however, increased so much as might
have been supposed, being only 1020-6. It frequently threw
down uric-acid precipitates, either spontaneously, or on the ad-
dition of nitric acid, and in one case a little albumen was ob-
served.
M. Solon found the urine coagulable in five out of eleven
cases of variola. When the inflammatory symptoms, during
the eruption, are slight, the urine hardly differs from the normal
state. During the suppurative stage of variola, Becquerel ob-
served that the urine retained the synochal character as long as
the febrile symptoms continued, in all the eleven cases. In
three of these cases which terminated fatally, it continued in
this state to the last.
URINE. 283
During the period of desquamation the urine is either normal
or anaemic. Becquerel states that although the urine during
desquamation after variola resembles, in its chemical constitu-
tion, the urine during desquamation after varicella, it differs in
respect to colour, the former being of a greenish, the latter of
a yellowish tint. According to Schonlein, in the first stage of
variola it is of a reddish brown tint ; on the third or fourth
day a sweat of a peculiar and strong odour is observed, and the
urine contains a turbid, apparently purulent, mucous sediment,
of an unpleasant odour.
During the period of suppuration sediments, and frequently
purulent mucus, are thrown down.
In the nervous form of variola the urine is even more
changeable, being sometimes spastic, and sometimes dark. In
the putrid form the urine appears decomposed, ammomacal, and
not unfrequently of a dark red colour from the presence of
haematin.
Scrqfulosis.
The urine of children with the scrofulous diathesis differs
considerably in the majority of cases from the normal secretion.
It is usually pale, but if there is much vascular excitement
it becomes more or less deeply coloured ; its specific gravity is
lower than in a state of health, and in many cases it is much
more acid than the urine of children is generally observed to
be; it has, however, been found neutral. 1 I have found the
urine of rickety children only slightly acid, and once, after it
had been passed some hours, it had an alkaline reaction. There
are differences of opinion with regard to the nature of the free
acid ; some state that it is phosphoric acid, others hydrochloric
acid, while others, again, are of opinion that it is lactic acid.
The urea and uric acid are frequently found to exist in a di-
minished proportion ; on the other hand, the salts, especially
the phosphates, are increased ; moreover, we not unfrequently
find in the urine of scrofulous children an acid which is foreign
to the normal organism, viz. oxalic acid.
According to Schonlein, the principal chemical changes in
the urine of scrofulous persons consist in the diminution of the
1 Stark Allg. Patholog. p. 1147.
284 THE SECRETIONS:
nitrogenous constituents, the urea and uric acid, and in the
appearance of the non-nitrogenous oxalic acid, and occasionally
but more rarely of benzoic acid. The acids are frequently so
abundant that the urine, upon cooling, deposits copious sedi-
ments of the oxalates, and these sediments sometimes form
renal and vesical calculi within the organism itself. The fre-
quent occurrence of oxalate-of-lime or mulberry calculi in chil-
dren is well known ; indeed, Prout is of opinion that half the
stone-cases occur before the full age of puberty.
Becquerel has examined the urine in many cases of scrofula,
in some of which it showed itself in the form of caries, ne-
crosis, &c. ; while in others it appeared in suppuration of the
glands. A number of these children were in an anaemic state,
while others were apparently in good condition j in the former
cases the urine was anaemic, in the latter it was normal. The
specific gravity varied from 1010 to 1022. The lowest specific
gravity occurred in the anaemic cases. The colour was lighter
than that of normal urine, and was frequently of a greenish
tinge; the degree of acidity varied extremely, the urine fre-
quently becoming alkaline after a very short time. No uric-
acid sediments were observed, either spontaneous, or after the
addition of an acid. When febrile symptoms were combined
with those of scrofula, the urea approximated to the inflamma-
tory type ; its specific gravity became higher, (the average of
twelve cases being 1026,) the colour deeper, it had a very acid
reaction, and threw down a sediment of uric acid.
In scrofulosis of the osseous tissue or rachitis the urine varies
very much in its composition from the normal type. These
deviations principally consist in the diminution of urea and of
uric acid, and in the increase of the salts. The colour of the
urine is generally either pale, or else it differs but little from
the normal appearance j the free acid sometimes increases to
an extraordinary degree, and some (Fourcroy) maintain that it
is free phosphoric acid. The phosphates exceed the physiolo-
gical average, and moreover a considerable sediment of oxalate
of lime is by no means rare. This extraordinary and morbidly-
increased capacity of the kidneys for the removal from the blood
of those salts which are so essential for the structure of the
osseous tissue, and the consequent tendency to the formation
of calculi in rachitic children, is regarded by Walther as a
URINE. 285
vicarious act of the kidneys in connexion with the formation of
bone.
The urine of a child aged 5 years, who was being treated for
rachitis in Romberg's clinical ward for children, was sent to
me for analysis. It was of a pale yellow colour, turbid, and neu-
tral; its specific gravity was 1011. As the determination of the
salts was the principal object that I had in view, it was allowed
to stand for two days before the analysis was undertaken; hence
the determination of the urea may not have been perfectly ac-
curate. The urine in the other analyses was passed by chil-
dren aged 3 and 4 years respectively. It was much about the
same colour as, or perhaps rather darker than in the first case,
was slightly acid, and the specific gravity varied from 1015 to
1020.
The proportion of the most important constituents was found
as follows :
Anal. 124. Anal. 125. Anal. 126. Anal. 127.
Water . . . 978-40 968-50 964-90 962-80
Solid constituents . . 21-60 31-60 35-10 37-20
Urea 3-50 6-70 6-17 7-36
Uric acid
Fixed salts
Phosphate of soda
Sulphate of potash
Earthy phosphates
() 0-26 0-35 0-26
8-53 8-60 14-71 16-70
2-82 4-01 4-27 374
1-90 1-80 1-31 1-80
0-48 0-52 0-58
On calculating the ratios of these constituents to 100 parts
of solid residue, and comparing them with those that occur
in healthy urine, we find that the quantity of urea has con-
siderably decreased, while that of the salts is increased. In
analyses 124, 126, 127, the increase of the fixed salts is very
considerable, especially of the phosphate of soda and earthy
phosphates. In analysis 125 this increased ratio is less striking.
100 parts of solid residue contain :
Anal. 124. Anal. 125. Anal. 126. Anal. 127. Normal Urine.
Urea 16-1 21-2 17'6 19'8 39'0
Uric acid
0-8
1-0
0-7
1-5
Fixed salts
39-4
27-3
41-8
44-8
25-0
Phosphate of soda
13-0
12-7
12-1
10-0
10-0
Earthy phosphates
"2-2
1-6
1-6
1-5
Sulphate of potash
8-7
5-7
3-8
4-8
8-0
The uric acid was not determined.
286 THE SECRETIONS:
In order, however, to arrive at a correct conclusion from these
figures we must bear in mind that the urine of children natu-
rally contains a less proportion of urea and of salts than the
urine of adults.
In osteomalacia the urine is much the same as in rachitis ;
it is very acid, and often contains an excessive amount of earthy
phosphates.
[Marchand 1 analysed the urine of a child with osteomalacia
three days before its death. The fluid was invariably acid, arid
contained in 1000 parts :
Water . . . 938-2
Solid constituents . . . 61-8
Urea 2 7 '3
Uric acid
Lactic acid and lactates
Phosphates of lime and magnesia
Other substances, and loss
0-9
14-2
5-7
13-7
The earthy phosphates in this instance are five or six times
as abundant as in health. In one of the cases recorded by
Mr. Solly, 2 there was found in the urine between three and
four times the amount of phosphate of lime that occurs in the
healthy secretion.]
Tubercular pulmonary phthisis.
In tubercular phthisis the urine varies in accordance with
the progress of the disease and the degree of fever which is
present. I have observed in the majority of cases that after
the febrile symptoms have become continuous the urine has
assumed the inflammatory type ; that is to say, it is not so
deeply coloured as at the height of acute inflammation, but is
of a yellowish brown colour, has a tolerably acid reaction, and
is above, or at any rate attains the ordinary specific gravity.
In the early stages of the disease I have not found the urine
to differ much either in colour, density, or acidity from the
normal secretion. I have only observed that form of urine to
1 Lehrbuch der physiolog. Chemie, p. 338.
2 Transactions of the Medico-Chirurg. Society, p. 448, 1844.
URINE. 287
which the term anaemic has been applied when considerable
haemoptysis has occurred in the second or third stage. After
haemoptysis the urine is generally turbid, and for the first day
or two throws down slight sediments of urate of ammonia; it
afterwards becomes pale and clear, arid continues acid, gradually
returning to its normal state. When the febrile symptoms be-
come continuous and the colliquative stage has fairly commenced,
I have found the urine approximate in its composition to the
urine of inflammation.
Becquerel has examined the urine in a great number of
phthisical cases. When the disease is progressing beyond the
first stage, the urine is often of higher specific gravity, darker,
and secreted in less quantity than usual, a symptom that the
tubercles are extending, and that a state of continuous fever is
supervening. The subsequent phenomena of the morning
sweats and colliquative diarrhoea further contribute to the con-
centration of the urine. When, however, a state of decided
asthenia has been brought on by these extraordinary drains
upon the system, it rapidly assumes opposite properties, and
becomes anaemic. Thus the urine of a woman, in whom
the tubercles were beginning to soften, and who had at the
same time certain symptoms of disease of the heart, was found
by Becquerel to amount to 20 ounces in twenty-four hours.
It was of a deep yellow colour, threw down a sediment of uric
acid, had a specific gravity of 1022'2, and 1000 parts contained
36-5 of solid residue.
In a woman in the third stage of phthisis with great pros-
tration of strength, the urine, three days before her death, was
of a deep colour, acid, and threw down a spontaneous sediment.
The specific gravity was 1014-7, and 16-2 ounces were discharged
in twenty-four hours. 1000 parts contained :
Water . . . 975-95
Solid constituents . . 24-05
Urea . . . 9-00
Uric acid . . . 1-25
In another precisely similar case the urine, three days before
death, was of a deep colour, acid, and threw down a sediment
spontaneously. The specific gravity was 1014' 7, and there were
only 7*2 ounces passed in twenty-four hours.
288 THE SECRETIONS:
1000 parts contained 24*25 of solid residue, of which 9-01
was urea, and 2*2 uric acid. In the first of these cases the
urea amounted to 37'4g of the solid residue, and the uric acid
to 5'1 ; in the second the urea amounted to 37'2g, and the uric
acid to 9, proportions which, as far as the amount of urea is
concerned, approximate to those of inflammatory urine.
An analysis of the urine of a man aged 30 years, who was in
the colliquative stage of tubercular phthisis, gave very similar
results, except as regards the specific gravity.
The urine was brown and turbid, had a very acid reaction,
and deposited a purulent-looking yellow sediment of urate of
ammonia. The specific gravity was 1026-6.
1000 parts contained :
Analysis 128.
Water , . . 935-92
Solid constituents . . 64-08
Urea . . . 23*90
Uric acid . . . 2-40
Fixed salts . . . 10-85
Of these 10-85 parts of fixed salts 1'3 were earthy phos-
phates, and the sulphates formed only a small part. The urea
amounted to 37'3, and the uric acid to 3-7 of -the solid con-
stituents, the urea being as nearly as possible the same as in
Becquerel's analyses.
The increase of uric acid is of great interest; it is particularly
striking in Becquerel's analyses : other observers have noticed
this fact in adults suffering from tubercular phthisis, and
Schonlein, moreover, has directed attention to it.
[I am indebted to Dr. Golding Bird for the following case.
A man aged 24 years, in the early stage of phthisis, (tubercular
depositions but no cavities,) passed in the course of twenty -four
hours, forty-five ounces of urine of specific gravity 1020.
The water amounted to . . . 19125 grains.
The solids . . . .936
Urea .... 328-5
Uric acid . . . . 4-5 ]
In renal and vesical phthisis the urine contains a greater or
less quantity of pus.
It is usually pale, turbid, and very quickly takes on an alka-
line odour, especially in phthisis vesicse, in which, even on
URINE. 289
emission, it is ammoniacal, and of an unpleasant odour. The
pus is sometimes mingled with blood. That the clear filtered
urine always contains albumen may be shown by the addition
of nitric acid, or by the application of heat.
The urine immediately on its discharge is turbid, but on being
allowed to rest, the pus separates in a clearly-defined layer at
the bottom ; on shaking, it easily mixes again with the urine,
and if that fluid have an alkaline reaction the pus becomes
tough and fibrous. Pus-corpuscles may be detected by the
microscope, and if the urine has an alkaline reaction they will
be mixed with crystals of the ammoniaco-magnesian phosphate
and with an amorphous precipitate of phosphate of lime.
In order to determine with certainty whether a urinary sedi-
ment consists of mucus or of pus, urine which has been just
discharged should be examined : the rapid descent of the pus-
corpuscles from urine which is turbid at the period of its dis-
charge, and the formation of a sediment which is frequently
discoloured, or mixed with blood, together with the presence of
a considerable amount of albumen in the urine, leave no doubt
respecting the diagnosis. (See page 202.)
Diabetes mellitus.
In diabetes mellitus it is well known that the urine undergoes
a very peculiar change ; it contains a certain quantity of sugar
which, in its ultimate constitution is perfectly identical with
grape-sugar, and in consequence of which the urine possesses
the property of deflecting the polarized ray to the right. Dia-
betic urine differs moreover in its physical relations from the
normal secretion ; it is paler, has a turbid wheyish appearance
with a greenish tinge, and a higher specific gravity, according
to Willis, from 1025 to 1055.
Henry drew up a table for the determination of the solid
constituents of diabetic urine by the mere application of the
urinometer. The results, as far as my experience goes, come
sufficiently near to the truth to give fair approximate values to
the solid residue from the specific gravity. G. O. Rees recom-
mends the table, having confirmed it by his own experiments ;
I have somewhat extended its limits, and shall give it here.
ii. 19
290 THE SECRETIONS:
Spec. grav.
at 60.
Solid residue
in 1000 parts.
Spec. grav.
at 60.
Solid residue
in 1000 parts.
1005
11-7
1028
69-1
1006
14-2
1029
71-5
1007
16-7
1030
73-9
1008
19-2
1031
76-4
1009
21-7
1032
78-8
1010
24-2
1033
81-4
1011
26-7
1034
83-9
1012
29-2
1035
86-4
1013
31-7
1036
88-8
1014
34-2
1037
91-3
1015
36-7
1038
93-8
1016
39-2
1039
96-3
1017
41-7
1040
987
1018
44-2
1041
101-2
1019
46-7
1042
103-7
1020
49-2
1043
106-2
1021
51-6
1044
108-7
1022
54-1
1045
111-1
1023
56-7
1046
113-6
1024
59-1
1047
116-1
1025
61-6
1048
118-7
1026
64-0
1049
121-2
1027
66-5
1050
123-6
[In my paper 1 on the specific gravity of the urine in health
and disease (founded on 200 observations), I have shown that
Christison's formula, A x 2' 33, gives more correct results than
the above table. A indicates the excess of the specific gravity
over 1000. Thus, supposing it is desired to ascertain the
amount of solid matter in 1000 parts of urine whose specific
gravity is 1035, A is here represented by 35, and 35 x 2-33=81 -55,
the required number.]
According to Schonlein there is no sugar in the urine in the
first stages of the disease, but albumen ; and as the albumen
subsequently disappears the formation of sugar in the urine
commences.
The quantity of urine increases in an extraordinary degree.
P. Frank mentions a case in which fifty-two pounds were dis-
charged during twenty-four hours. According to Bouchardat,
1 Lancet, June 15, 1844.
URINE. 291
the average quantity discharged in the course of the day
amounts to from ten to seventeen pounds.
Opinions regarding the composition of the urine are very
contradictory, and sufficient analyses have not yet been insti-
tuted to enable us to regard any one view as positively correct.
Some assert that as the sugar increases in the urine the urea
and uric acid decrease, while others maintain that although the
absolute quantity of urea in a given amount of urine is actually
diminished, yet that on account of the large quantity of urine
discharged, the amount of urea is not less than, and in fact
exceeds the normal average.
Thus McGregor shows that the urine of twenty-four hours in
one case of diabetes contained 1013 grains of urea; in another
case he found 945 grains, in a third 810 grains, and in a fourth
512 grains, whereas, according to the same authority, the quan-
tity excreted by a healthy person in twenty-four hours does not
exceed from 362 to 428 grains. Kane also found in diabetic
urine as large a proportion of urea as in the normal secretion.
My own analyses certainly tend to show that the ratio of urea
to the solid residue is always much less than in health, and
that this ratio is diminished in proportion to the increase in the
quantity of the sugar ; bearing in mind, however, the increased
secretion of urine, it is very possible that in some cases the urea
is not absolutely diminished : the apparent connexion between
the urea and the sugar may then be simply explained by the
mere increase of the sugar, which, by increasing the solid residue,
causes a relative diminution of the urea. 1 The same is probably
the case with respect to the uric acid ; when no crystals of uric
acid are separated after the addition of free hydrochloric or
nitric acid to diabetic urine, the cause may lie in the proportion
1 In connexion with this subject, we may refer to the experiments of Henry. On
mixing the residue of six quarts of diabetic urine with the residue of one quart of
healthy urine, and adding nitric acid, only a small quantity of nitrate of urea was
obtained after the mixture had stood for twenty-four hours ; and on mixing the re-
sidue of eight quarts of diabetic urine with that of one quart of healthy urine, and
treating it in a similar manner, not a crystal of nitrate of urea could be observed after
it had stood for forty-eight hours. Hence it is indispensably requisite that the sugar
should be first removed (as completely as possible) before we attempt to determine
the urea.
292 THE SECRETIONS :
of water being so large as to retain the uric acid in solution.
I have frequently observed this to be the case, for on the ad-
dition of free hydrochloric acid to the urine no uric acid has
been separated, when upon treating that portion of the residue
of the urine which is insoluble in alcohol with nitric acid, I have
always obtained the red colour which is characteristic of uric
acid. Becquerel, however, has observed a spontaneous sediment
of uric acid thrown by diabetic urine.
[In this country a sediment of uric acid is by no means
rare ; I have observed it in at least six cases, usually in the form
of bright yellow lancet-shaped crystals.]
I have observed cases in which I have convinced myself that
the absolute quantity of urea was diminished.
A man aged 52 years, treated for diabetes mellitus in our
hospital did not pass more than from two to two and a half
quarts of urine in the twenty-four hours. In its external ap-
pearance it was perfectly normal ; it contained, however, 8'6 of
sugar, and only 0'026 of urea, so that while a healthy man
excretes about an ounce of urea in the twenty-four hours, in
this case there were only thirteen grains excreted in an equal
time. In another man who was being treated by Dr. Lehwess,
and who indulged freely in sugared drinks, the quantity of urine
in twenty-four hours amounted to between four and five quarts,
and contained mere traces of urea. The urine was very pale
and turbid, its specific gravity was only 1018, and it contained
4*2 of solid residue, 3*9 of which were sugar. After the dis-
continuance of the sugar, and the adoption of a proper diet,
the specific gravity became lower and the urine contained as
much urea as constituted a fifth part of the solid residue : the
sugar had also decreased to one half its original amount.
Subsequently the sugar almost entirely disappeared from the
urine ; the urea, on the other hand, had increased to such an
extent as to constitute a third part of the solid residue.
Bostock is of opinion that diabetes mellitus is not unfre-
qnently preceded by a diseased condition, (in fact a kind of
diabetes,) during which a large quantity of urine very rich in
URINE. 293
urea is excreted. As the diabetes becomes developed the urea
gradually diminishes as the sugar increases.
Willis 1 states that the urine is occasionally rather turbid on
emission, and has then been found to contain a quantity of
albuminous matter in the caseous form.
According to Schonlein the urine during the early stage of
diabetes contains albumen, and in proportion to its increase the
urea diminishes : in the second stage the albumen disappears
either totally or partially, and sugar takes its place. I have
only detected albumen in two cases of diabetic urine, viz., in
the case to which I have already referred, in which I analysed
the urine at a time when the patient took a good deal of sugar
in his drink ; in this case, however, the disease had made consi-
derable progress : and in the urine of a girl a few days before
her death; in this instance it existed in considerable quantity,
amounting to O2 of the urine, or 3'7 of the solid residue.
Brett 2 found casein and butter in a case of diabetic urine.
Diabetic urine sometimes contains an insipid species of sugar,
which, however, according to Bouchardat, 3 corresponds in all
other properties with the ordinary sweet diabetic sugar, pos-
sessing the capability of fermenting, and being convertible by
acids into sweet sugar. I have had only one opportunity of
observing sugar of this nature.
A girl with diabetes mellitus discharged an abundant quan-
tity of very saccharine urine, and the sugar which was obtained
from it had all the properties of grape-sugar. Subsequently
the strength of the patient, which had been long giving way,
decreased to such an alarming extent as to cause apprehensions
of her speedy dissolution. Two days before her death the urine
was again sent to me for examination ; and I was not a little
surprised to find in it a perfectly tasteless sugar soluble in hot
spirit, and mixed with a considerable quantity of a gummy
matter insoluble in spirit which, on the application of heat,
emitted a peculiar odour not unlike that of burned paper.
The salts in diabetic urine are stated by Gueudeville, Bostock,
Urinary Diseases and their Treatment, p. 200.
London Medical Gazette, July, 1836.
Revue Medicale, 1839.
294 THE SECRETIONS:
and Henry, to be diminished, while they retain their normal
proportion to each other. I have found the amount of earthy
phosphates not much below the normal average.
Lehmann 1 was the first who directed attention to the
occurrence of hippuric acid in diabetic urine : it has since
been detected by Ambrosiani, Miiller, and very recently by
myself. I obtained it in the same manner as Lehmann did,
from the etherial solution of the dried residue : after evapora-
tion there remained a slight brownish-yellow residue, in which,
with the help of the microscope, I observed heaps of long
acicular crystals. The residue was warmed with a few drops of
a weak solution of potash, which neutralized the acid reaction,
and the solution was then filtered. On the addition of a solu-
tion of perchloride of iron a cinnamon-yellow precipitate was
obtained, which on being warmed contracted itself into red
flocculi.
On allowing diabetic urine to stand for a considerable time
a sediment forms which consists for the most part of fermenta-
tion-globules. If the urine above this sediment is allowed to
remain for some time longer at a suitable temperature, it begins
to undergo fermentation. I have frequently observed the fer-
mentation-globules, and have represented them in fig. 35.
I have made several minute analyses of the urine in diabetes
mellitus. The three following analyses were made with the
urine of a man aged 50, to whose case reference has been pre-
viously made. The first analysis was made at a time when the
patient indulged freely in sugared drinks. The urine then
contained a mere trace of urea. After the patient had been
properly dieted for some time, I obtained the urine for the
second analysis, which in its results differs very little from the
first. Eight days from this time I again analysed it, and found
that the sugar had almost entirely disappeared.
About three months afterwards I received some more of his
urine for analysis ; it was then very rich in sugar, while urea
was present to only a very small amount. Albumen was only
detected in the urine of the first analysis. Uric acid was always
present, but only in very small quantity.
1 Journ. fiir prakt. Chem. vol. 6, p. 114.
URINE,
295
Specific gravity
Water .
Solid constituents .
Urea .
Uric acid
Sugar
Extractive matter and salts
Earthy phosphates
Albumen
Anal. 130.
Anal. 131.
1016-00
1007-00
960-00
982-00
40-00
18-00
7-99
a trace
25-00
6-50
0-80
4-63
a trace
a trace
8-60
1-00
Anal. 129.
1018-00
957-00
43-00
traces
traces
39-80
2-10
0-52
was present.
The urine of the first two analyses was of a pale-yellow co-
lour, and slightly acid ; in the third case it was as clear as water,
and produced no change on test paper.
The two following analyses were made with the urine of a
girl aged 20 years, who was being treated for diabetes mellitus
in Prof. WolfFs clinical wards.
The first analysis was made eight weeks before the second ;
I made an analysis of the blood at the same time. (See Analysis
42, Vol. I, page 327.)
The second analysis was made two days before death ; it re-
vealed the fact that the diabetes sapidus had changed into dia-
betes insipidus ; moreover, at this period, the urine contained a
considerable quantity of albumen.
Specific gravity
Water
Solid constituents
Urea .
Sweet sugar
Insipid sugar
Extractive matter and salts
Earthy phosphates
Albumen
Gummy matter
Analysis 134 was made with the urine of a man aged 52 years,
who was being treated in Schonlein's clinical wards for diabetes.
The urine was not passed in very large quantity, but it con-
tained a remarkably large proportion of sugar. The composi-
tion of the blood, which also contained sugar, is given in
Analysis 41, Vol. I, page 327.
Analysis 134.
Specific gravity . . . 1036-00
Water .... 909-60
Solid constituents . . . 90-40
Urea 0-26
Analysis 132.
Analysis 133.
1032-00
1021-00
921-85
947-20
78-15
52-80
0-54
1-47
72-00
27-61
4-20
2-80
0-92
0-40
2-00
17-30
Uric acid
Sugar
Extractive matter and salts
Earthy phosphates
a trace
86-30
2-10
1-50
296 THE SECRETIONS:
I have recently had an opportunity of making a careful ex-
amination of the excretions of a diabetic patient. He was a man
aged 40 years, who had suffered from intense thirst and had
observed a great increase in the amount of his urine for the pre-
ceding ten months. At the period of his admission into the
hospital, the colour of his urine was normal, and an acid reac-
tion always observed, which, however, became more decided
some time after emission : in the course of ten or twelve hours
it usually became turbid, and deposited a light viscid sediment
consisting of amorphous urate of ammonia and mucus-corpuscles;
on two occasions (during the use of a very animal diet) crystals
of uric acid were noticed in the sediment. During the period
of my investigations I never detected albumen in the urine.
The specific gravity varied from 1039 to 1030. It was highest
at the commencement of the treatment.
On admission the daily amount of urine averaged nearly five
quarts, but while under treatment it was reduced to three quarts.
The daily amount of sugar gradually diminished to one third,
but was never so thoroughly reduced as to afford hopes of a
permanent cure. The daily excretion of urea was at first much
diminished, but subsequently reached the healthy average.
Uric acid was always present, but not in so considerable a quan-
tity as would have been found in the urine of healthy persons
living on a similar diet. The amount of fixed salts varied con-
siderably, but was always larger than in a state of health.
After the use of the ordinary hospital diet for a few days, he
was placed on a very nitrogenous diet, consisting of beef-tea, eggs,
meat, milk, and white bread. Subsequently coffee was substituted
for the milk, and the amount of bread diminished. And still later
gluten-bread containing only one-half the amount of starch, but
three times the amount of nitrogenous matter, was given in its
place.
During his last three weeks he consumed daily, one pound
of gluten-bread, two of beef from which a quart of beef-tea
had been made, besides a quarter of a pound of ordinary boiled
beef, three or four ounces of roast veal, six eggs, and two quarts
of coffee prepared from an ounce of the beans. Although this
quantity was (according to his own statement) sufficient to
satisfy his hunger, he was occasionally detected in appropriating
the farinaceous diet of other patients. With regard to medical
treatment, opium and its various compounds were first given ;
URINE. 297
he was then treated with astringents, the nitrogenous diet being at
the same time increased, and the saccharine and farinaceous mat-
ters diminished. After this course had been pursued for some
time without any decided benefit, he took daily two ounces of
cod-liver oil, and after this had been continued for twelve days,
he took, additionally, four grains of iodide of iron. Finally,
(these medicines being continued) the gluten bread was or-
dered, and the milk and white bread stopped. Under this
treatment the daily amount of sugar fell from twelve ounces to
seven and three-quarters ; it subsequently, however, rose to nine
ounces and one drachm. The urea, which on his admission
amounted to only three drachms in twenty-four hours, was now
increased to one ounce and three drachms, and the uric acid
rose from a mere trace to twelve grains.
During this course of treatment the digestion seemed good,
the thirst diminished, and he occasionally perspired consider-
ably ; he had become, however, very emaciated. The saliva was
slightly alkaline, and I examined it for sugar unsuccessfully.
Sugar was, however, detected in the perspiration. The an-
alysis of his faeces will be found in Chapter X.
In the determination of the sugar and urea there are certain
difficulties which I shall briefly notice. On treating diabetic
urine evaporated to the thickness of a syrup with warm spirit,
the mucus, uric acid or urates, and earthy phosphates are pre-
cipitated. On evaporating the filtered spirituous solution to
the consistence of a thin syrup, and adding anhydrous alcohol,
an insoluble semifluid mass separates, which, when repeatedly
treated with anhydrous alcohol, becomes finally thick and tough.
On dissolving this saccharine mass in warm spirit, and again
precipitating it by anhydrous alcohol, it will still be found to
contain a certain amount of urea ; in fact, I have detected urea
after the operation has thrice been effected, and I find that
sugar can only be obtained free from urea by allowing it to
crystallize spontaneously from its spirituous solution. In con-
sequence of the difficulty of separating these substances, I pro-
ceed in the following manner : the solid residue of the urine
is first accurately determined ; a weighed portion of urine is
then evaporated, mixed with spirit, and the solution filtered.
The filtered solution is evaporated to the consistence of a syrup,
and, when cold, mixed with a sufficient quantity of concentrated
298
THE SECRETIONS:
nitric acid to allow of a few drops remaining on the surface of
the crystalline mass. It must then be submitted to a low tem-
perature, and the crystals placed on blotting paper and com-
pressed till they cease to communicate moisture. The fixed
salts must be determined from a separate portion of urine. If
we deduct from the known quantity of solid residue the portion
insoluble in spirit (from which the uric acid is determined), the
urea, and the fixed salts, we obtain, as the difference, sugar and
alcohol-extract which appears to decrease in diabetic urine in
proportion as the sugar increases. The following are the special
results of my analyses of the urine of this man.
No. 135 represents the analysis of the urine before the com-
mencement of the animal diet ; No. 136, shortly after its com-
mencement ; No. 137, during the same diet, shortly before the
use of the cod-liver oil ; No. 138, after the oil had been taken
for eight days ; No. 139, after the iodide of iron had been used
for eight days ; No. 140, after the gluten-bread had been tried
for eight days ; No. 141, two days subsequently to the preceding
analysis, there being a considerable increase in the secretion.
In twenty-four hours there were discharged :
Anal. 135.
Anal. 136. Anal. 137.
4 quarts
3 quarts
4 quarts
Specific gravity
1037-1
1038-9
1029-7
Solid constituents .
14-5 oz.
9-9 oz.
10-0 oz.
Sugar and extractive
matter
} 12-5
7-5
8-5
Urea
3 drachms 5 drachms
7 drachms
Uric acid
5 grains
8 grains
Fixed salts
6 drachms
Anal. 138.
Anal. 139- Anal. 140.
Anal. 141.
4
quarts
4 quarts 3| quarts
4 quarts
Specific gravity .
1030-2
1030-4 1032-37
1032-97
Solid constituents
10-5 oz.
10-5 oz. 10-2 oz.
12-5 oz.
Sugar and extractive "1
matter . . J
8-9
7'25 8-1
9-6
Urea
7-8 drs.
10-0 drs. 1-1
1-3
Uric acid
lOgrs.
5grs.
15 grs.
Fixed salts
6 drs.
8 drs. 6-8 drs
1 oz. 9 grs.
The composition of the urine appears from my observations
to undergo a rapid modification as soon as there are decided
indications of convalescence. The sugar decreases to a very
URINE.
299
great extent, and is replaced by albumen, a substance of fre-
quent occurrence at the commencement of the disease, and
apparently alternating with the sugar.
When the sugar is no longer perceptible to the taste (either
in the urine or in the spirit-extract), it can always be readily
detected by Trommer's test. I usually take a test-tube of
about seven inches in length, fill three fourths of an inch of it
with urine, and heat it with ^ss or 3ij of carbonate of potash ;
I add five or six times the volume of spirit of -845, and again boil;
a few drops of a solution of sulphate of copper are then added,
and heat again applied. If much sugar is present, the reduction
of the oxide of copper to a state of sub-oxide occurs very
quickly in the lower stratum of solution of carbonate of potash,
and the fluid becomes of a yellow, red, or copper colour ; if the
quantity of sugar is very small, the reduction still takes place,
but much more gradually. If, however, no sugar is present,
the solution of potash remains of a blue or blueish-green colour.
I have recently analysed a specimen of diabetic urine con-
taining only a very small amount of sugar, although previously
that constituent had been present in large quantity. A short
time previously to the last analysis, no sugar could be detected,
but albumen was present. The urine passed at different periods
of the day was analysed separately. The quantity of urine
passed between noon and evening contained most sugar, and
was most abundant ; that passed during the night contained the
least. The three analyses gave the following results :
Anal. 142.
Anal. 143.
Anal. 144.
Urine from
Noon
till Evening.
Urine during
the
Night.
Urine from
early Morning
to Noon.
34-3 oz.
6oz.
10-7 oz.
1026-02
1024-38
1027-76
Quantity of urine
Specific gravity .
In 1000 parts there were contained :
Water . . . 943-00 946-43 934-47
Solid constituents . . 57-00 53-57 65-53
Urea . . . 14-12 17-50 16-21
Uric acid . . . 0-34 0-80 0-50
Chloride of sodium, with a little ~|
carbonate and sulphate of V 11-27 8-60 10-50
soda . . .J
Alkaline sulphates and phosphates 5-80 4-65 5-70
Earthy phosphates . . 1-20 0-80 0'90
Extractive matters, with am
monia-salts and traces of ^ 24-51 21-94 32-18
sugar
300
THE SECRETIONS:
The whole amount of the different constituents discharged in
twenty-four hours was as follows :
Solid constituents , 3 oz.
Urea
Uric acid
Fixed salts
Extractive matters
365 grs.
11 -2 grs.
425 grs.
loz. 139 grs.
[The following analysis of diabetic urine has been made by
Dr. Reich, i The particulars of the case are not recorded :
Water
Solid constituents
Urea
Hippuric acid
Sugar
Water-extract
Alcohol-extract
Mucus
Albumen
Chloride of potassium
Chloride of sodium
Chloride of ammonium
Sulphate of potash
Phosphate of soda
Phosphate of lime
Silica
907-88
98-12
8-27
0-04
56-00
5-60
16-36
0-54
0-58
0-30
0-84
0-66
0-26
2-15
0-46
0-86
The hippuric acid was determined by evaporating the urine
to one eighth of its volume and treating it with hydrochloric
acid, when that constituent was thrown down as a white deposit.
An instance in which diabetic urine occurred in a state of
extraordinary concentration has been observed by Bouchardat.
Its composition is given below. The three other analyses were
made by Dr. Percy; the cases are fully recorded in the London
Medical Gazette for 1844.
Bouchardat.
Water . . 837-58
Solid constituents . 162-42
Urea . . 8-27
Uric acid
Sugar . . 134-42
Extractive matters aud salts 20-34 "I
Earthy phosphates . 0-38 J
Lehmann 2 has made two minute analyses of diabetic urine ;
he found neither albumen, urea, nor uric acid in it, but a
1 Simon's Beitrage, p. 545. 3 De diabetica urina. Dissert, inaug.
Percy.
1042-00
1035-00
10-39
894-50
918-30
898-90
105-50
81-70
101-10
12-16
30-32
2-39
0-16
0-26
not isolated
40-12
17-15
79-10
53-06
32-59
1-30
19-52
0-09]
URINE. 301
considerable amount of hippuric acid. The urine of a man
aged 18 years had a specific gravity of 1029-5, was pale, when
fresh, had a milky smell, and subsequently became acid. The
solid constituents amounted to 62*05, of which 58-15 were sugar.
Ether took up 0-187, which was chiefly hippuric acid. The
urine of a man aged 38 years was turbid, of a straw colour,
contained neither albumen, urea, or uric acid, had a specific
gravity of 1028-5, and contained 56-24 of solid constituents, of
which 50-9 were sugar. There were also found 0-31 of hippuric
acid, 0-169 of salts soluble in alcohol, 0-21 of water-extract,
0-39 of salts soluble in water, 0-31 of salts insoluble in water,
and 0*23 of mucus.
An interesting case of diabetes in a girl aged 8 years was
observed by Cantin. 1 The urine which she discharged was of a
blue colour, and impregnated with sugar. The colouring matter
appeared to possess the properties of Prussian blue.
Diabetic urine has been observed in children as well as in
adults, and during the period of puberty.
The female sex is not exempt from this disease.
It is impossible in the present state of our knowledge on this
subject to state with certainty in what part of the system the
sugar is formed, which is produced and excreted in such ex-
traordinary quantity. It is either directly formed in the chy-
lopoietic system or it is produced in the peripheral vascular
system, or it is generated by a morbid action of the cells of the
kidney, or finally its origin may be due to a combination of
these agencies.
To decide this point satisfactorily, (and for the science of
medicine it is most important that it should be decided,) the
following points should first be established by experiments on a
sound and certain basis :
(1.) Is the correspondence of the absolute diminution of the
urea with the absolute increase of the sugar, an invariable rule?
(2.) May not the nitrogen be removed from the system in
some other way, probably in the form of ammonia-compounds ?
(3.) Do the other secretions undergo a change, especially the
bile?
(4.) Does the air which is exhaled from the lungs differ in
its composition from that which is expired by healthy persons?
1 Jonm. de Chim. Med. vol. 9, p. 104.
302 THE SECRETIONS:
(5.) Do the kidneys, liver, or lungs undergo any changes ?
and if so, what is their nature ?
If the connexion between the appearance of the sugar and
the diminution of the urea is constant, that is to say, if, without
exception, the urea invariably decreases in the same ratio as the
sugar increases, then we must assume with Berzelius, that in
place of the metamorphosis of the protein-compounds into urea
which occurs as a normal process, these compounds are in this
case, from certain causes which are unknown to us, transformed
into sugar, ammonia, and perhaps into nitrogenous extractive
matters. This hypothesis is, however, opposed by the facts
which were observed by M'Gregor : in his cases the daily
secretion of urea equalled, and in fact exceeded the healthy
average.
It has been established by the researches of Hollo, Bouchardat,
myself, and others, that the blood really contains sugar. It
exists, however, in an extremely minute quantity, and my own
observation confirms the remark of Bouchardat, that it is most
abundant a short time after meals : the blood of a girl in whom
the disease had made considerable progress, when taken before
a meal, exhibited a mere trace of sugar. Hence we are led to
infer that the formation of sugar occurs in the chylopoietic viscera
alone, or there and in the blood simultaneously.
From experiments made by McGregor, 1 he infers that the
sugar is formed in the stomach alone. After having con-
vinced himself of the existence of sugar in diabetic blood
by having induced fermentation, he sought for, and found it in
the matters vomited both by a healthy man and a diabetic pa-
tient, three hours after dinner. Upon treating the healthy man
and the diabetic patient with an initiatory course of emetics
and purgatives, and then for three days feeding them with no-
thing but beef and water, no sugar was found in the matter
vomited by the healthy man, whilst there was still sugar in the
other case. McGregor also found sugar in the feces of diabetic
patients : no sugar was, however, found in the sweat. It is
well known that persons with this disease do not readily per-
spire ; on the contrary the skin becomes dry, rough, and peels
1 London Med. Gaz., May 1837.
URINE. 303
off. Willis 1 relates a case of diabetes that fell under his own
observation, in which the furfuraceous exfoliation of the cuticle
had a decidedly sweet taste.
From pathological anatomy we learn that the kidneys in
death from diabetes are very frequently softened, and according
to Meyer (who refers the formation of sugar to the kidneys),
even disorganized, their blood-vessels much enlarged, and the
substance of the papilla? and the tubuli very permeable ; the
kidneys have also been found inflamed, atrophied, suppurating,
and containing calculi. The condition in which the liver has
been found is also various : the bile is, however, usually very far
from being in a normal condition ; it is of a pale yellow colour,
very fluid, and, instead of being alkaline, has usually an acid
reaction. The veins which form the portal system are over-
loaded, and the mesenteric vessels are generally congested.
As the disease becomes further developed the lungs participate
in the general disturbance, for, according to Willis, pulmonary
phthisis is the immediate cause of death in two thirds of the
cases of diabetes. Traces of morbid action have also been found
in the nervous system.
It is of great importance in reference to the aetiology of dia-
betes mellitus to ascertain whether the changes which are
revealed to us by the prosecution of the morbid anatomy of the
disease, are consequences of the disease itself, or whether they
had a previous existence in those blood-metamorphosing organs,
the kidneys, liver, and lungs, and whether the formation of the
sugar is due to them.
The questions which I have already suggested are of much
importance in elucidating these points.
Taking into consideration all that is known of the origin of
diabetes mellitus, it appears very probable that the sugar is
formed not in any single organ, but that it is produced by a
diseased condition of the whole system, and we are almost led
to adopt the opinion expressed by P. Frank, that a specific in-
fluence is exercised upon the nerves of the fauces 4)y a sponta-
neously-generated virus diabeticum, which occasions an insatiable
1 Urinary Diseases and their Treatment, p. 205.
304 THE SECRETIONS:
desire for drink, and at the same time exerts a peculiar influence
upon the nerves of the lymphatic system, exciting them to
extraordinary activity.
This activity of the lymphatic system, when associated with
an excessive absorption from all the secreting surfaces of the
body causes the premature elimination of raw and unassimilated
chyle, which, not being adequate to the formation of blood,
must be again removed from it. When we consider what an
extraordinary quantity of sugar is carried off, even in those pa-
tients who are restricted to animal food, we cannot doubt that
the sugar is formed from the protein-compounds, 1 and in all pro-
bability, future and more accurate analyses of the urine, the bile,
and the expired air, will enable us to understand in what manner
the nitrogen is removed from the system, a point upon which
we are at present in the dark. For although we can well con-
ceive the possibility of the protein-compounds being, under
peculiar circumstances, resolved into sugar of grapes, and cer-
tain nitrogenous compounds similar to protein itself, yet these
latter must be capable of being detected.
Periodic symptoms have been occasionally observed in diabetes
mellitus.
A physician in Berlin has a patient who, at certain times of
the year, had periodical attacks of diabetes mellitus, which after
continuing for some time, and with the application of proper
diet, would disappear: although the amount of sugar which was
excreted during these attacks was by no means inconsiderable,
the patient did not exhibit that meagerness which usually suc-
ceeds a prolonged continuance of the disease ; on the contrary,
he became corpulent, and complained of no disturbance of his
general health.
Diabetes insipidus.
Under the term " diabetes insipidus" are included seve-
ral diseased states, in which the urinary secretion is very
much increased, but where the urine contains no sugar, either
sweet or insipid, which is capable of fermentation. Willis
1 [Budge's views on this subject may be seen in my Report on the recent progress
of Animal Chemistry, in vol. 2 of Ranking's Half-yearly Abstract.]
URINE. 305
treats of these different states under the heads Hydruria,
Anazoturia, and Azoturia.
Hydruria, which is also known as diuresis, polyuresis,
and polydipsia, seems to be capable of continuing sometimes
for several years, without being accompanied by any other
morbid symptoms than a frequent desire to micturate, and an
insatiable thirst. Willis mentions several cases of the kind :
amongst others, that of an artisan 55 years of age, who from
his sixteenth year had upon an average drunk nearly two pails-
ful daily, and who, during the same period, passed on an
average thirty-four pounds of urine and one of faeces. The
urine was scarcely denser than pure water and contained no
sugar.
A similar case is recorded of a woman aged 40 years, who
from her infancy experienced constant thirst, and an enormous
secretion of urine. She enjoyed good health, and was the mother
of several children.
Becquerel observed a case of polydipsia or hydraria in a
servant girl aged 23 years. After recovering from an attack of
acute nephritis she lapsed into a state of anaemia, for which fer-
ruginous medicines were exhibited, but without success. A
continuous state of thirst then came on; so much so, in fact,
that she daily took five or six litres of fluid without allaying
the sensation. The urine was very pale and greenish, was rather
turbid from the presence of mucus, and had an acid reaction.
Its specific gravity was 1006, and about six pounds were ex-
creted in the course of the day.
Its composition was as follows :
Water . . . 9897
Solid constituents . . 10-3
Urea . . .3-0
Uric acid . . .0-2
Fixed salts . . .3-6
Extractive matters . . 3-7
[I/Heretier 1 has published an analysis of urine very similar
in its character. The patient was a pregnant woman. She dis-
charged about ninety-five ounces daily, and the specific gravity
was 1009-4.
1 Traite de Chim. pathol. p. 553.
ii. 20
306 THE SECRETIONS:
It contained in 1000 parts :
Water . . 989-7
Solid constituents . .10-3
Urea . . .3-3
Uric acid . . .0-2
Fixed salts . . .3-2
Organic matters . . 3'6
I am indebted to Dr. Golding Bird for the following analysis
of the urine in polydipsia. A woman aged 43 years observed
that, in the course of four months, the amount of urine rose
from the normal quantity to 140 ounces. The specific gravity
was 1010.
The whole quantity of water amounted to . 60419 grains
solids . 1439
Urea . . .376
Uric acid . 21
Fixed salts . . 462 ]
When this diuresis occurs in nervous persons at an advanced
age, Willis observes that it should not be regarded lightly, as the
prognosis is almost always unfavorable.
By anazoturia, Willis understands the excessive secretion of
urine very deficient in solid constituents and especially in urea,
and he considers that all the cases of diabetes which have
been reported as cured may probably be classed under this
head. The urine is passed in very abundant quantity, and
is either of a pale straw colour or entirely colourless, and has a
very slight odour. It has either a very mild acid, or else a
neutral reaction; in the course of twenty-four hours it becomes
ammoniacal, and forms a precipitate, at the same time becoming
covered with a film containing crystals of ammoniaco-magnesian
phosphate. This disease seems common amongst the children
of the poor, who have been brought up on an improper diet. In
a child treated by Willis the urine was perfectly devoid of colour,
its specific gravity was that of distilled water, and 1000 grains left,
after evaporation, a residue of scarcely one grain, which consisted
of mucus, urate of ammonia, phosphates, and a trace of urea.
A man, who for many years had suffered from a sensation of
extreme weakness, thirst, and gnawing pain in the region of
the heart, discharged from six to seven quarts of urine daily : it
was almost devoid of odour, of a pale straw colour, and one
thousand parts left a solid residue of twenty, of which only two
were urea.
URINE. 307
A case of the same nature was treated by Stosch. A man
who complained of pain in the cardiac region, thirst, and weak-
ness, passed from four to six quarts of urine daily; it contained
no sugar, and scarcely a trace of urea or of the other ordinary
constituents of urine.
By the term azoturia Willis understands that form of disease
which is usually known as diabetes insipidus, in which the urine
is increased in quantity, is usually transparent and pale, but
sometimes deeply coloured, and is peculiarly distinguished by
the large amount of urea which it contains. The urine has a
slight, but at the same time an uriiious odour, an acid reaction,
and its specific gravity (1018 1035) is higher than in the pre-
ceding form of disease. When the density is considerable,
crystals of nitrate of urea are often yielded on the addition of
nitric acid, after a few hours' rest, without any previous concen-
tration.
The general symptoms are the same as in the former varieties :
loss of strength, feeling of weakness, gnawing pains in the re-
gion of the heart, thirst, &c. An artisan thirty-seven years
of age, (treated by Willis,) contracted the disease in consequence
of a cold, and passed a large quantity of pale urine, amounting
to about five quarts daily. The specific gravity varied from 1022
to 1028. On the addition of nitric acid to the urine at its
highest degree of density, crystallization of nitrate of urea
occurred in a few hours. 1000 grains left, on evaporation,
72 of solid residue, of which 51 were composed of urea, alcohol-
extract, and salts soluble in alcohol; 14 were hydrochlorates
and sulphates ; 6 were earthy salts, especially phosphates ; and
1 grain consisted of mucus. Willis is of opinion that this form
of diabetes frequently precedes diabetes mellitus, or alternates
with albuminous or saccharine urine.
[Dr. Golding Bird analysed the urine of a fine, but emaciated
man aged 35 years, who stated that his brother had died of
diabetes. The urine in twenty-four hours amounted to 50
fluid ounces, and had a specific gravity of 1030.
The water amounted to . 20956 grains
Solids . . . 1574
Urea . . . 757'95
Uric acid 6-75
308 THE SECRETIONS:
In diabetes chylosus the urine contains a very large quantity
of albumen and fat, so as to give it almost a milky appearance.
I have already alluded in general terms to this form of urine,
and I have only further to add that, according to Chevallier, it
comes on after the use of mercury, and, associated with hsemat-
uria, is endemic in the Isle of France ; it has also been several
times observed in Europe.
Willis remarks that these disturbances in the renal secretion
frequently occur without causing any degree of constitutional
disease, and often without any detriment whatever to the general
health. Slightly removed from this form of urine, is that in
which a protein-compound approximating to a modification of
casein, or where actual milk (milk-metastasis,) is discharged with
the urine.
We have lastly to mention a form of chylous urine in which
fibrin and albumen, but no blood-corpuscles, are discharged.
Abernethy observed urine of this sort in a woman, and Prout
has described several cases. It coagulates spontaneously, and
forms a mass which, as Abernethy remarks, might be served up
at table for blanc-mange.
Dropsy.
During dropsical affections the urine often differs considerably
from its normal state. Its quantity is generally less than in
a state of health, and it presents various peculiarities in quality.
It is sometimes dark, very acid, rich in uric acid, and, according
to Schonlein, in urea also; sometimes it contains blood; in
other cases it is pale and opalescent, resembling anaemic urine,
and not unfrequently containing a considerable amount of
albumen ; but this substance is by no means invariably present
in the urine of dropsy.
In hydrothorax the urine, according to Schonlein, is secreted
scantily ; it is of a dark purple red colour, and presents a fiery
appearance; during the approach of recovery it becomes more
abundant, and, especially when the disease is complicated with
inflammation of the pleura or lung, throws down precipitates of
a reddish-yellow or brick-dust colour, which are frequently mixed
with purulent mucus.
In chronic hydrothorax, a thick, fiery-red urine is generally
URINE. 309
passed, which speedily deposits a considerable sediment of a
brick-dust or rose-red colour ; in some few cases a clear, trans-
parent urine, like that which is passed in spasm, is discharged
in tolerable abundance.
I have analysed the urine of a man who was suffering both
from hydrothorax and cavities in the lungs. It was deeply
coloured, had a strong acid reaction, contained no albumen, and
formed a slight sediment of urate of ammonia.
Its specific gravity was 1025. Its composition was as follows:
Analysis 145.
Water 936-54
Solid constituents
Urea
Uric acid
Fixed salts .
Earthy phosphates
Extractive matter
63-46
22-17
0-53
12-60
0-36
26-80
In ascites inflammatorius the urine is secreted in diminished
quantity, is of a dark red or brownish colour, and not unfre-
quently contains blood in a state of solution, or blood-corpuscles;
the latter may be recognized by the microscope, and if the urine
is allowed to stand, they form a red sediment j frequently, how-
ever, no hsematoglobulin but merely albumen is present. On
the approach of recovery, there is, according to Schonlein, a
copious discharge of urine, accompanied by a purulent, and
subsequently a mucous sediment.
At the commencement of chronic ascites the urine is not
much diminished in quantity ; it assumes a pale or opalescent
shining green colour, and contains a large quantity of albumen
and mucus.
Persons suffering from periodic ascites pass a small quantity
of red, turbid urine, which sometimes deposits very copious se-
diments of uric acid and urate of ammonia. Towards conva-
lescence, the discharge of urine becomes very abundant, and
it continues to throw down copious lateritious sediments. The
occurrence of a clear, slightly coloured, spastic urine, without
these critical sediments, must be regarded as an unfavorable
symptom, since it indicates renal " colliquation." (Schonlein.)
In those varieties of ascites that arise from affections of the liver,
spleen, stomach, and generative organs, the amount of urine is
310 THE SECRETIONS:
also diminished. It appears either of a dark red or brown
colour without sediments, (as when the ascites arises from dis-
organization of the female generative organs, or of the pancreas,)
or it throws down copious lateritious or fawn-coloured sediments,
(as in diseases of the liver, spleen, or vena portse ;) sometimes it
is coloured with bile as in jaundice. (Schonlein.)
Becquerel likewise observed that the urine in ascites arising
from disease of the liver, is scanty, highly coloured, and almost
always throws down a dark or reddish sediment of uric acid.
In dropsy from disease of the heart the urine, according to
Becquerel, assumes various phases ; it may be pale or highly
coloured, clear or turbid, with or without sediments, and may
or may not contain albumen . He also observes that in thS ad-
vanced stage of hypertrophy of the heart there is a state of
hypersemia induced in some other organs, especially a good deal
of congestion of the kidneys, much as occurs in the first stage
of Bright's disease, which causes a change in the elimination of
the urine from the blood, and accounts for the transitory pre-
sence of albumen, the same as we observe in severe inflamma-
tory affections.
When the dropsical symptoms are consequent upon disease
of the heart alone, the urine, according to Becquerel, is not so
much changed as when hepatic disease, (especially cirrhosis,) is
associated with it : it is then scanty, deeply coloured and often
reddish, very acid, of high specific gravity (1025 1029), and
usually throws down a copious reddish sediment of uric acid and
urate of ammonia.
When the dropsy arises from the combined influence of an
affection of the heart and Bright's disease, the urine ordinarily
assumes the special characters of the latter disorder, which have
been already described. If, however, the disease of the heart
causes much functional disturbance, the urine becomes deeply
coloured, more acid, and deposits a sediment.
When the dropsy arises solely from disease of the kidneys,
the urine is always albuminous : the majority of these cases
fall under Blight's disease, which has been already noticed. I
examined the urine of a young man 22 years of age, in a far
advanced stage of ascites, and whose subsequent dissection re-
vealed suppuration of the kidneys. The urine was pale, turbid,
URINE. 311
slightly acid, contained much albumen, and deposited a sediment,
which was shown by the microscope to consist of pus- and mucus-
corpuscles : its specific gravity was 1026.
It contained :
Analysis 146.
Water . . . . 935-50
Solid constituents . . . 64-50
Urea .... 18-20
Uric acid .... 1-10
Albumen and pus-corpuscles . . 18-60
Alcohol extract with ammonia and lactic acid 12-35
Water-extract . . . 4-60
Fixed salts from the extractive matters . 6-20
The amount of urea was much diminished, being only 27
of the solid residue, whereas the normal average is 39.
On the other hand, I found a very appreciable quantity of
urea in the dropsical fluid, obtained by puncturing the abdo-
minal parietes.
Nysten analysed the urine of a man aged 1 8 years, who had
been suffering from ascites for several months. There were
only 8 ounces of urine excreted in twenty-four hours ; it was
turbid and of a reddish colour, very frothy, and when allowed
to stand, deposited a white flocculent sediment. It had an
ammoniacal odour, a strong alkaline reaction, and contained
hardly a trace of urea ; but a considerable quantity of colouring
matter and albumen were found in it, and more salts than in
healthy urine of digestion.
Graves also observed a considerable quantity of carbonate of
ammonia in the urine of a labourer who was suffering from
ascites, anasarca, and a tympanitic condition of the intestinal
canal, urea being almost entirely absent.
In a case of ascites arising from peritonitis, which was only
fully recognized on dissection by the changed condition of the
peritoneal surface, a small quantity of urine was discharged,
which was of a dark colour, and on cooling threw down a con-
siderable lateritious sediment.
[Heller 1 analysed the urine of a woman aged 40 years, suf-
fering from ascites. The secretion was tolerably copious, of
a light yellow colour, and turbid from containing a large quan-
1 Archiv fur phys. andpathol. Chemie, vol. 1, p. 47.
312 THE SECRETIONS:
tity of mucus. It was neutral but speedily became alkaline.
Its specific gravity was 1007, and it contained in 1 000 parts :
Water .... 978-40
Solid constituents . . . 21-60
Urea .... 8-40
Uric acid .... mere traces.
Extractive matter and traces of albumen . 7'11
Fixed salts, chiefly chloride of sodium 6-00 ]
In anasarca the properties of the urine appear to vary; it
frequently contains albumen in abundance, 1 while on other oc-
casions there is not a trace of it.
Becquerel relates the case of a girl 9 years of age, who, after
being exposed to a sudden and violent chill, was attacked with
anasarca on the following day. The skin was hot, and the pulse
feverish ; after a short time peritoneal effusion came on, but the
urine contained no trace of albumen. It was deeply coloured,
of high specific gravity, and frequently deposited a uric-acid sedi-
ment.
In five cases in which anasarca succeeded general debility
(dropsy from anaemia,) Becquerel found the urine very pale, of
low specific gravity (from 1009 to 1012,) and of a greenish tint.
In one case he found a little albumen.
Graves 2 relates a case in which a labourer, after getting
chilled, suffered much from fever and anasarca. The urine was
pale, straw-coloured, very ammoniacal, and formed a sediment
of earthy phosphates ; it contained scarcely a trace of albumen.
Willis, on the contrary, with hardly an exception, found the
urine albuminous when the anasarca arose from cold.
[Scherer 3 examined the urine of a man with anasarca suc-
ceeding a severe attack of broncho-pneumonia, from which he
was recovering. The urine contained blood. After taking
1 Rayer, Bright, and Christison are of opinion that when albuminous urine occurs
with anasarca, it is a certain indication of incipient organic change in the kidney,
while on the other hand Blackall and Graves regard the appearance of albumen as a
consequence of a general inflammatory diathesis. Becquerel adopts an intermediate
view ; he attributes the appearance of albumen in the urine in inflammatory affections
to a transitory congestion of the cortical substance, similar to that which is found in
the first stage of Bright's disease.
8 Urinary Diseases and their Treatment, by R. Willis, M.D., p. 126.
3 Untersuchungen, &c., p. 48.
URINE. 313
inf. senega for four days the haematuria ceased. The secretion
was then analysed ; its specific gravity was 1022, and it con-
tained in 1000 parts :
Water .... 966-2
Solid constituents . . . 33-8
Urea 18-5
Uric acid .
Lactic and extractive matter
Soluble salts
Earthy phosphates and mucus
0-9
6-4
5-2
1-8]
In our observations on scarlatina we remarked that in the
anasarca which so frequently succeeds that disease, the urine
sometimes contains albumen, and sometimes is free from it.
In ovarian dropsy the urine, according to Schonlein, is very
scanty ; it contains a large quantity of albumen, which increases
in amount as the disease advances.
Jaundice.
In jaundice, whether it be idiopathic or symptomatic, the
urine contains bile-pigment, which shows itself in the peculiar
colour which it communicates to that fluid. But it sometimes
also contains other constituents of the bile, for I have detected
biliary resin in icteric urine, and Gmelin found cholesterin in
a case in which the flow of bile was impeded.
The colour of icteric urine may vary from a saffron-yellow to
a yellowish-brown, brownish-red, or blackish-brown; if there
is any doubt whether the colour is produced by biliphaein, we
must adopt the steps described in page 192, which will readily
determine the point. The presence of bilifellinic acid may
sometimes be detected by the taste, and always by the directions
given in page 193.
The specific gravity of icteric urine is variable : it depends,
(as do the proportions of the ordinary normal constituents,) upon
the relative state of the organism, upon other complicating dis-
eases, and upon the absence, presence, or degree of vascular
disturbance.
In acute icterus accompanied by fever, Schonlein found the
urine at first of a dark red or brown colour from the presence
of bile-pigment ; it afterwards became gradually darker, and at
last as black as ink.
314
THE SECRETIONS:
It continued, however, transparent, and did not form sedi-
ments till the crisis.
A servant girl in our hospital, aged about 20 or more years,
presented a case of inflammatory icterus. The skin was of a
brown-yellow colour, the tinge on the face and breast being
particularly dark : the pulse was feverish, especially towards
the evening ; the mental faculties disturbed and delirium during
the night.
The urine was of a brown, almost a blood-red colour, (thin
strata appearing of a deep saffron tint,) it had a powerful acid
reaction, and deposited a very abundant brownish-yellow sedi-
ment, which consisted partly of crystallized uric acid coloured
by biliphaein, and partly of urate of ammonia coloured in a
similar manner. The specific gravity of this urine was 1020.
It contained :
Water
Solid constituents
Urea
Uric acid with biliphaein
Alcohol-extract
Spirit-extract
Water-extract, mucus, and bile-p gment
Biliary resin
Biliverdin .
Earthy phosphates
Chloride of sodium and lactate of soda
Alkaline sulphates and phosphates with )
traces of chloride of sodium . $
Analysis 147-
954-50
45-50
12-34
2-90
4-35
5-29
5-14
1-45
1-08
3-14
2-61
3-90'
This analysis presents several points worthy of consideration.
The urea is much below the normal average, amounting to only
27g instead of 39 of the solid residue. The uric acid is much
increased, for it amounts to 6-3g, whereas the normal average
is only l'5g; it must, however, be remembered that the uric
acid from a very considerable sediment of urate of ammonia
has been included, and that a certain amount of bile-pigment
was associated with it. The fixed salts are below the normal
average, amounting to only 19g, the earthy phosphates on the
other hand amount to 4'9.
1 The biliary resin and biliverdin were taken up by anhydrous alcohol with the urea
and alcohol-extract. On evaporating the alcohol and adding water, the biliary resin
and biliverdin were precipitated; this latter was separated from the resin by diges-
tion in a weak solution of ammonia, which on evaporation left the green colouring
matter.
URINE. 315
An analysis of the blood of this person has been given in
Vol. I., page 330.
In common or chronic icterus, where, instead of there being
febrile symptoms, the pulse becomes slower as the disease ad-
vances, the urine is at first of a dark red colour, after a time
it becomes of a dark brown, and often, according to Schonlein,
of an inky tint j towards convalescence it clears up, and gra-
dually returns to the normal state.
I made an analysis of the urine of a man suffering from
icterus, anasarca, and haemoptysis, who was being treated in our
hospital.
This analysis corresponded closely in its results with the
preceding one.
The urine was of a brownish red colour, very turbid, had an
acid reaction, and deposited two layers of sediment, the under
one of a lateritious appearance, and the upper of a brown
colour; both consisted of urate of ammonia coloured partly
with uroerythrin and partly with biliphsein. The urine be-
came perfectly clear on being heated, and at the boiling point
gave no indications of albumen. Nitric acid caused no preci-
pitate, but produced the well-known shades of colour dependent
on the presence of bile-pigment. The specific gravity was 1014.
The urine contained : Analysis 148.
Water .... 962-80
Solid constituents 37-20
Urea
Uric acid
Urate of ammonia
Fixed salts .
Earthy phosphates
10-90
1-01
3-51
6-70
0-74
The urea in this case amounts to only 29 of the solid re-
sidue, and the uric acid independently of the urate of am-
monia to 2'7g, the latter alone amounting to 9 : the salts are
diminished, with the exception of the earthy phosphates which
are increased and amount to 2g.
[Scherer 1 mentions a case of long-standing icterus, dependent
apparently on chronic inflammation of the parenchyma of the
liver, in which the urine, on emission, was clear, yellow, and
perfectly neutral, but after standing three or four hours became
1 Untersuchungeii &c. p. 59.
316 THE SECRETIONS:
acid and deposited uric acid combined with a large amount of
bile-pigment as an amorphous, yellowish-brown, flocculent
mass. The development of the acid (lactic, according to
Scherer) proceeded rapidly, and in the course of twenty-four
hours the yellow colour of the urine became converted into
a blackish green. The deposition of the sediment and the
change of colour could be more speedily induced by the addi-
tion of a few drops of acetic or hydrochloric acid to the fresh
urine. The specific gravity was 1018, and in 1000 parts there
were 42*5 of solid residue, including only 4*3 parts of urea,
while there were no less than 1-8 of uric acid. In the course
of ten weeks he had much improved, and was able to take ex-
ercise in the open air. The solid constituents were then re-
duced to 35-6, and the uric acid to 0-6, while the urea rose to
12-4. The urine of this patient contained a large quantity of
silica.]
Hysteria.
In attacks of hysteria the urine is often, but not invariably,
remarkable for its clear limpid appearance, and for the extremely
small quantity of solid constituents which it contains : in fact,
it is sometimes very like common water.
Becquerel observes that, in nervous attacks, the urine is not
always spastic and secreted in large quantity, but that it some-
times resembles the normal secretion, and in certain cases he
even found it deeply coloured, of high specific gravity, loaded
with uric acid, and occasionally depositing a sediment.
He observed similar variations in the urine at the commence-
ment of an attack of hemicrania.
Nysten mentions an analysis of nervous urine, which was
perfectly limpid, had an acid reaction, contained more urea
than the urina potus, but, on the other hand, less uric acid and
salts. According to Hollo, urea and the organic constituents
are wanting in spasmodic urine, and it contains only the ordi-
nary salts.
In cramp of the stomach, Gmelin found the urine darker
than usual; it contained bile-pigment, which was, however,
somewhat modified, since on being precipitated with hydro-
chloric acid, and being again dissolved in potash, it gave a beau-
tiful red with nitric acid, without previously going through the
green and blue tints.
URINE. 317
Marasmus senilis.
[Scherer 1 has published an analysis of the urine in a case of
marasmus senilis accompanied with gangrene.
It contained in 1000 parts :
Water . . 927-45
Solid constituents 72-55
Urea
Uric acid
Alcohol-extract
Water-extract
Soluble salts
Earthy phosphates
17-52
1-70
13-23
15-00
20-00
4-67
The amount of soluble salts and earthy phosphates is re-
markably large.
A man aged 29 years, labouring under marasmus from
sexual abuses, was observed by Dr. Golding Bird to pass daily
thirty-six ounces of urine of specific gravity 1024.
The water amounted to . . . 15227 grains.
The solids .... 901
Urea .... 369-6
Uric acid . . . 36-0 ]
Carcinoma.
The urine in scirrhus ventriculi is, as Berzelius has re-
marked, sometimes turbid, has a milky look when it is dis-
charged, and deposits a white sediment of mucus and phosphate
of lime ; Fromherz and Gugert also found mucus and earthy
phosphates in the urine of a person who was liable to frequent
vomiting in consequence of scirrhus of the pylorus ; the urine
was alkaline from the presence of carbonates of soda and am-
monia, and contained no uric acid, but much urea.
In opposition to these statements I found the urine secreted
in small quantity, deeply coloured, without a sediment, and
with a very acid reaction, in an advanced case of scirrhus ven-
triculi, occurring in a man in Schonlem's clinical ward, who
vomited matter like coffee-grounds.
1 Untersuchungen &c. p. 75.
318 THE SECRETIONS:
Four days afterwards, when the vomiting was partially
checked by the use of morphia, the urine was turbid and ju-
mentous : it continued acid, and subsequently formed a copious
sediment of urate of ammonia, while the clear urine above the
precipitate was so dark that bile-pigment was suspected to be
present, which, however, was not the case. The urine conti-
nued to throw down sediments till the death of the patient,
which occurred not long afterwards ; it became, however, of a
brighter colour.
Becquerel observes that in cancer of the stomach he has
found the urine normal, when there has been but little func-
tional disturbance : dark, sedimentary and very acid, when there
has been severe pain and frequent vomiting : and, finally, he
has found it anaemic in cases in which the physical powers have
been reduced to the lowest ebb by the disease.
In cancer of the liver, Becquerel found the urine undergo
the same modifications that I have described as occurring in
cancer of the stomach. It was very dark, very acid, of high
specific gravity (1023 1026), and threw down a copious red
sediment.
In cirrhosis of the liver, Becquerel found the urine much the
same as in cancer, except that when the cirrhosis was accom-
panied by icterus, bile-pigment found its way into the urine.
[I am indebted to Dr. Percy for the following analysis of the
urine of a man labouring under deep and permanent jaundice
consequent on true carcinoma of the liver, of which he died.
The urine contained in 1000 parts :
Water .... 979-00
Solid residue .... 21-00
Urea .... 3-76
Indeterminate organic matter . . 8-78
Salts soluble in water . . 8-18
Salts insoluble in water . . 0-28
It was deeply tinged with bile-pigment, but deposited no
sediment.
The small amount of urea may be accounted for by the fact
of great emaciation consequent on long previous mal-assimila-
tion, and the small amount of metamorphosis of tissue occur-
ring in the patient.]
URINE. 319
Syphilis.
[Heller examined the urine of a man aged 38 years, who was
taking iodide of potassium for a syphilitic eruption accompa-
nied with pains in the bones. When the urine was first
examined he was taking two scruples daily in three ounces of
distilled water ; on the second occasion (four days afterwards)
he was taking additionally half a grain of iodine.
1. 2.
Specific gravity . . 1015 1021
Water . . . 974-800 954-40
Solid constituents . . 25'200 45-60
Urea . . . 7736 13-82
Uric acid . . . 0-310 0-51
Extractive matters and hvdrochlorate ) j o* 1 i *
of ammonia ". . *
Fixed salts, including iodide of potas- 1 i(V520 19-32
The urine on the first occasion was excreted in about the
normal quantity, was of a dark-yellow colour, and had an acid
reaction : on the second occasion it was of an intensely dark-
yellow colour, and its reaction was faintly alkaline; its amount
was also diminished. No albumen or biliphaein was present in
either case.
After the continuance of the second prescription for eight days,
the urine of twenty-four hours was collected with the view of
ascertaining the amount of iodine removed by the kidneys.
The whole daily urine amounted to 850 grammes or 24-5
ounces.
In order to estimate the amount of iodine, 200 grammes of
urine were evaporated, the residue dissolved in water, and am-
monia added to the filtered solution till it exhibited a strongly
alkaline reaction. On the addition of nitrate of silver a preci-
pitate was thrown down which was washed with a weak solution
of ammonia, dried, and weighed.
From the 200 grammes of urine 0-94 of iodide of silver were
obtained, containing 0-507 of iodine; hence 1000 parts of urine
contained 2*535 of iodine, corresponding to 3*322 of iodide of po-
tassium. Consequently, in the whole daily amount of urine there
were contained 2'824 grammes or 38-689 grains of the iodide.
320 THE SECRETIONS:
Now the 40 grains of iodide of potassium and half grain of
iodine may be regarded as equivalent to 40*626 grains of the
iodide alone (for iodine is always in a state of combination when
it occurs in the secretions), and consequently the whole of the
iodide was removed by the kidneys, with the exception of nearly
two grains which were distributed partly to the saliva, sweat,
nasal mucus, &c. and partly remained in the blood.]
Skin-diseases.
[The urine in a case of urticaria tuberculosa has been ana-
lysed by Scherer. The patient was a young man who likewise
suffered from rheumatism. The urine was discharged in very
small quantity, often not more than five or six ounces in forty-
eight hours. It was clear, of a brownish-red colour, very acid,
and its specific gravity was 1028.
It contained in 1000 parts :
Water . . . .931-58
Solid residue . . . 68-42
Urea 30-46
Uric acid .
Alcohol-extract with much lactic acid
Water-extract
Alkaline salts
Earthy phosphates
0-74
21-24
4-92
8-03
2-02
The most remarkable points in the constitution of the urine
are the large amount of earthy phosphates, and the excess of
free acid.
Heller 1 has published three analyses of the urine in cases of
herpes zoster.
1. A boy aged 8 years; eruption on the right side, no
fever, urinary secretion abundant. The urine was of a pale
yellow colour, rather turbid, rapidly became putrid, and de-
posited a sediment of beautifully-formed crystals of ammoniaco-
magnesian phosphate.
The urine was faintly alkaline on emission, and its specific
gravity varied from 1014 to 1015.
1 Archiv, vol. 1, pp. 39-43.
URINE. 321
It contained in 1000 parts :
Water .... 970-00
Solid constituents . . . 30-00
Urea . . . . 8-94
Uric acid .... traces
Fat . . . . 0-14
A little extractive matter with a large amount 1 ~
of hydrochlorate and carbonate of ammonia /
Fixed salts . . .11-60
consisting of :
Earthy phosphates . . . 2-000
Chloride of sodium . . . 4*154
Sulphate of potash . . . 0*164
Phosphate and carbonate of soda, &c. . 5-282
No trace of hippuric acid could be discovered.
2. A man aged 31 years; eruption on right side, slight
fever. Urinary secretion considerably suppressed, the urine
analysed being the first that had been passed for twenty-four
hours. In a few hours it formed a sediment of ammoniaco-
magnesian phosphate and urate of ammonia.
It was strongly alkaline, and its specific gravity was
1028.
It contained in 1000 parts :
Water .... 944-40
Solid constituents . . . 55*60
Urea .... 15-79
Uric acid with a little urate of ammonia . 1-80
Fat . . . 0-34
Extractive matters with much hydrochlorate "I 91.^
and carbonate of ammonia . /
Fixed salts in the sediment
Fixed salts in the urine
consisting of
Earthy phosphates
Chloride of sodium .
Sulphate of potash .
Phosphate of soda, &c.
0-431
16*32 /
2-85
5-10
0-15
8-24
16*75
3. A young man aged 19 years ; eruption chiefly on left
side, no fever. The urine was- very clear. In the course of
twelve hours it became turbid and deposited beautiful crystals
of ammoniaco-magnesian phosphate. Specific gravity 1018.
ii.
322 THE SECRETIONS:
The urine contained in 1000 parts :
Water .... 958-90
Solid constituents . . . 41-10
Urea .... 14-20
Uric acid .... 0-20
Fat . . 0-12
Extractive matters, much hydrochlorate "1 12-14
of ammonia, &c. .
Fixed salts . . . 14-44
consisting of:
Earthy phosphates . . . 2-60
Chloride of sodium . . . 5-40
Sulphate of potash . . .0-08
Phosphate and carbonate of soda, &c. . 6-36
From these analyses we may conclude that in herpes zoster
the chief peculiarities of the urine are :
1. A marked increase of the chlorides and phosphates, and
a corresponding diminution of the sulphates.
2. An excess of hydrochlorate of ammonia.
3. A large amount of fat.
4. A diminution in the amount of uric acid. An increase
only occurs when the disease is accompanied with fever.
The presence of oxalate of lime may always be suspected in
these cases.
The urine in a case of pompholix has also been analysed by
Heller. The patient was a woman aged 40 years ; the attack
was very severe and proved fatal. The urine deposited a light
cloudy sediment consisting principally of mucus, but also con-
taining fat-globules, urate of ammonia, and a few epithelium-
scales. It was acid, and its specific gravity was 101 7'5.
It contained in 1000 parts :
Water . . . 955-80
Solid constituents . . 44-20
Urea . . 24-63
Uric acid . . 0-58
Extractive matters . 11-79
Fixed salts . . 7-20
Of the fixed salts the earthy phosphates were normal, the
sulphates much increased, and the chloride of sodium propor-
tionally diminished. The urea is considerably above the normal
average.]
URINE. 323
ON SOME OTHER MODIFICATIONS OF THE URINE INDUCED
BY DISEASE.
Fat in urine.
There are certain morbid conditions in which fat is excreted
in a free state with the urine, which, at the same time, is
neither chylous nor milky, nor contains any large amount of
albumen or casein. Urine of this sort most commonly occurs
in those diseases in which there is a very rapid loss of substance
and force. I have on several occasions detected fat in the urine
of phthisical persons, and on two occasions I have found it
during tabes. I have already (see page 190) explained in what
manner the presence of fat may be detected with certainty ; I
would here add a word of caution, that the presence of fat from
extraneous sources, as improperly cleaned glasses, &c. must be
carefully guarded against.
Such cases as that which is related by Bachetoni, 1 in which
a noble young lady is reported to have discharged two ounces
of olive oil with the urine on different occasions, must at least
be regarded as mysterious ; Elliotson 2 also witnessed the daily
discharge of about one third of an ounce of oil with the urine
of a woman suffering from biliary calculi.
[A case of fatty urine has been recently described by Dr.
Golding Bird (Urinary Deposits, page 263.) An analysis of
this form of urine has likewise been given in page 229 of this
Volume.]
Milk in urine.
In speaking of diabetes I adverted to chylous urine, and said
a few words regarding milky urine. It appears from an essay
of Rayer, in which he enters fully into the subject, that this
form of morbid urine is extremely rare ; but that the term
' milky urine' has frequently been applied incorrectly to the
1 Comment. Bonon. Pars I, ad ann. 1787.
2 On the discharge of fatty matters from the alimentary and urinary passages.
(Medico-Chirurg. Transactions, vol. 18, p. 80.)
324 THE SECUETIONS:
fluid simply from its having a turbid or emulsive appearance,
while there has been no trace of casein, but the fat has been
suspended by means of albumen.
The only recorded case of actual milky urine containing
casein and fat are one by Canubio, of a woman who was suck-
ling -, one by Alibert, of a healthy young widow; and,, lastly, a
case by Graves.
Excess of hippuric acid in urine.
[There are certain conditions of the system in which an excess
of hippuric acid occurs in the urine, independently of those
cases in which benzoic or cinnamic acid is taken either in the
food or as medicine.
The following case is recorded by Bouchardat.i
A lady aged 53 years, suffering from lassitude, dry skin and
tongue, occasional pain in the region of the liver, loss of appe-
tite, and great thirst, passed a large quantity of limpid urine
possessing an odour of whey. Its specific gravity varied from
1006 to 1008; it slightly reddened litmus paper, and contained
in 1000 parts :
Water . . . 986-00
Solid constituents . . 14-00
Urea . 1-56
Hippuric acid
Lactate of soda .
Albumen
Mucus
Chloride of sodium
Phosphate of soda
Alkaline sulphates
Earthy phosphates
2-23
2-96
1-47
0-20
2-75
0-97
1-44
0-42
Dr. Garrod 2 has narrated the case of a man suffering from
pain in the loins and symptoms of atonic dyspepsia, with flabby,
white, furred tongue, who excreted a considerable amount of hip-
puric acid.
When examining the urine for the purpose of ascertaining
the proportion of uric acid by the addition of a small quantity
of hydrochloric acid, he found the tube filled with crystals of
hippuric acid, and on these large crystals smaller ones of uric
Annuaire de Therapeutique, 1842, p. 285. * Lancet, Nov. 16, 1844.
URINE. 325
acid were deposited. For several days he found as much as
half a drachm in six ounces of urine, or about 10 of hip-
puric acid in 1000 parts. It afterwards gradually diminished,
requiring considerable evaporation before crystals were depo-
sited, and ultimately disappeared. The patient had previously
suffered from voiding an excess of urea, and his urine had con-
tained a deposit of ammoniaco-magnesian phosphate.
Dr. Pettinkoffer 1 has also published an analysis of urine con-
taining an excess of hippuric acid. The patient was a girl aged
13 years, suffering from chorea. The urine was limpid and
acid on emission, but soon became alkaline and deposited crystals
of ammoniaco-magnesian phosphate. After pouring nitric acid
on the evaporated alcoholic extract with a view of determining
the amount of urea, Dr. Pettinkoffer was surprised to find that
instead of the usual crystalline plates of nitrate of urea, brownish
yellow needles made their appearance. Under the microscope
the needles were found to be six-sided prisms, in some places
intermingled with plates of nitrate of urea. The urine evi-
dently contained a large amount of hippuric acid in combination
with potash or soda, from which the nitric acid separated it.
When the alcoholic extract of the urine was evaporated, mixed
with hydrochloric acid, and allowed to stand, four-sided pris-
matic crystals of hippuric acid were deposited.
1000 parts of urine contained 40-668 of solid residue, of
which 31*251 were soluble in spirit, and consisted of hippurates,
urea, extractive matters, and chlorides ; while the remaining
9-417 were composed of urates, phosphates, and sulphates, to-
gether with mucus and water- extract.
The solid residue yielded, on incineration, 10*599 of fixed
salts.
On the following day, 1000 parts of urine yielded 49*825 of
solid residue and 12*985 of ash, consisting of:
Carbonates of lime and magnesia . 1-153 1
, 1 1-866 insoluble m water.
Earthy phosphates . . . 0-713 J
Carbonate of soda . . . 3*996
Chlorides of sodium and potassium . 6'181
Phosphate of soda . . . 0-128
Sulphate of lime . . .0-814
1 Liebig's und Wohler's Annalen, vol. 50, No. 1.
326 THE SECRETIONS:
If we consider that the alkaline carbonate in the ash corre-
sponds with the hippurate in the urine, then 1000 parts of urine
must have contained 12*886 of anhydrous hippuric acid, and
100 parts of solid residue 25-8 of the same constituent. During
this period the only food taken by the girl was bread, apples,
and water ; she, however, gradually resumed her ordinary diet,
and the excess of hippuric simultaneously disappeared.]
Urostealith in urine.
[Heller 1 has recently announced the discovery of a new con-
stituent of urinary calculi, to which he has given the name
urost eolith. It is soluble in carbonate of soda ; and when that
remedy is administered, urostealith in a state of solution is found
in the urine.
The patient was a man of tolerably good constitution, aged
24 years ; he complained of pain in the region of the right kid-
ney, and difficulty in micturition, occasionally passing small
elastic soft concretions. These were examined by Heller, and
found to be perfectly soluble in alkalies, with which they formed
a soap.
Analysis of the urine before the administration of carbonate
of soda. 25th Feb. The urine had a light yellow, whey-
like appearance, no odour, and deposited a sediment of ammo-
niaco-magnesian phosphate. Fat-globules were detected under
the microscope. The reaction was neutral ; the specific gravity
1017-5. It contained in 1000 parts :
Water ..... 965-800
Solid constituents .... 34-200
Urea ..... 12-631
Fat ..... 0-320
Extractive matters with much hydrochlorate of ammonia 8-569
Fixed salts .... 12-680
consisting of:
Earthy phosphates . . . 2-040^1
Chloride of sodium . . . 0-163 I 19>Aftn
Sulphate of potash . . . 2-296 f
Basic phosphate of soda and peroxide of iron . 8-181 J
Moreover, every 1000 parts of urine threw down 0-62 of
pure ammoniaco-magnesian phosphate. Not a trace of uric
acid could be detected.
1 Archiv fur phys. und patholog. Chemie, vol. 2, p. 1.
URINE. 327
28th Feb. The day after the carbonate of soda had been
given, the urine was neutral, of a pale yellow colour, and had
a specific gravity of 1006. Fragments of urostealith were de-
tected in the sediment, mixed with ammoniaco-magnesian
phosphate. No uric acid was present.
By the 2d of March the calculus of urostealith was almost
entirely dissolved. The reaction of the urine was neutral ; the
addition of ammonia produced a reddish brown tint ; (this is
regarded by Heller as a test for urostealith ;) uric acid was still
absent. The specific gravity was 1020. The urine contained
in 1000 parts :
Water ....
Solid constituents
Urea ....
Fat and urostealith .
Extractive matters and hydrochlorate of ammonia
Fixed salts .
959-90
40-10
11-20
3-40
8-29
17-21
No sediment was deposited. In order to obtain the uro-
stealith, a large quantity of urine was evaporated, and sulphuric
acid added in order to decompose the soap. The urostealith was
taken up by boiling ether, which, on evaporation, yielded a
violet tint. For further information on the chemical charac-
ters of this substance I must refer to Chapter xn.]
Semen in urine.
It may sometimes be of importance to ascertain whether the
urine contains any seminal fluid. This point can be best set-
tled by the microscope. We find mucous floccules in the urine ;
and if semen is present, the spermatozoa will be detected
amongst them. They are represented in fig. 33.
Urine of peculiar colours.
Some cases have been recorded in which the colour of the
urine has deviated extremely from the normal type. A case
is related by Janus Plaucus, in which a dark blue sediment
was precipitated from the urine of a man 60 years of age, a
short time before his death. He had formerly suffered from
328 THE SECRETIONS:
dysuria and vesical calculus, and subsequently from typhus
fever.
Marcet, Prout, Braconnot, Babington, Gamier, Spangeberg,
and others, have observed blue and black urine. I have re-
lated a case in which the urine deposited a blue sediment, in
page 274.
I have made an examination of the urine passed by a man
at Grafenberg, who had spent many years in the East Indies,
and returned to Europe for the benefit of his health. It had
a strong ammoniacal odour, was of a clear blue colour, and de-
posited a somewhat copious dark blue sediment, which ap-
peared, from a microscopic examination, to consist of very fine
amorphous matter (on which the blue colour was dependent)
and a few crystals of ammoniaco-magnesian phosphate. On
treating a portion of the washed and dried sedim'ent with caustic
potash the colour did not disappear; hence it was not de-
pendent on the presence of iodide of starch or prussian blue.
Dilute organic acids and hydrochloric acid neither dissolved it
nor destroyed its colour ; but on digesting it in nitric acid, the
tint changed from blue to yellow. Digested in concentrated
sulphuric acid, it dissolved, forming a solution of an indigo
colour. On warming a portion of the sediment on platinum
foil, it first evolved an urinous odour, and subsequently vola-
tilized, going off in deep violet-coloured vapour. The most
convincing proof that the blue tint was due to indigo, was that
on warming a portion of the sediment with dilute alcohol to
which grape sugar and potash had been added, the fluid lost
its blue tint, and assumed a yellowish red colour, which, on
shaking, was converted into an intense blood-red, and then
rapidly into a green. On allowing it to rest the green tint
disappeared, and the fluid assumed a yellowish-red colour. All
these phenomena led to the conclusion that the colouring mat-
ter was indigo. I have since heard that specimens of the same
urine were sent to Bouchardat, Liebig, and Prout, who coin-
cide in the opinion that the pigment was not indigo, but a dis-
tinct organic compound. No indigo, or indeed medicine of
any sort had been recently taken by the patient.
Dulk 1 has observed and analysed black urine passed by a per-
son suffering from derangement of the liver and portal system.
1 Archiv der Pharmacie, vol. 18, p. 159.
URINE. 329
[Dr. v. Velsen 1 has published the case of a man aged 84
years, with chronic cystitis, who passed very fetid urine of a
deep violet colour, after the use of lime-water mixed with warm
milk. After the omission of the draught for a few days, the
peculiar colour disappeared.]
Urine during pregnancy, at the period of delivery, and after
delivery.
Since Nauche' s announcement (a few years ago) of the dis-
covery of a peculiar substance to which he gave the name of
kystein, in the urine of pregnant women, the renal secretion
during this state has been carefully examined by numerous
chemists.
Nauche describes kystein as a white mass that, after the
urine has stood for some time, separates, partly rising to the
surface, where it forms a somewhat tough pilous membrane
interspersed with glistening crystals, and partly sinks to the
bottom, forming a creamy precipitate. Nauche regards kystein
as an indubitable sign of pregnancy. It is also considered a
certain test by Eguiser ; he states that it appears after the urine
has stood two to six days, depositing itself as a white opaque
body, and then rising to the surface and producing a film like
the solid fat that settles on cold broth. From an extensive
series of observations, Dt. Kane concludes that kystein does
not appear sooner than thirty hours, or later than eight days ;
that on its first appearance it forms a scarcely perceptible
membrane, which gradually becomes firmer and thicker, and
after a time, breaks up, the fragments sinking to the bottom ;
that a kystein-like membrane may also appear in the urine of
persons with phthisis, arthritis, metastatic abscesses, vesical
catarrh, &c. but that it differs from true kystein, both in the
manner of its formation and of its destruction ; it appears later
than the true kystein, but, having once appeared, develops it-
self more rapidly and possesses less tenacity. The urine is
neutral or ammoniacal on the appearance of the kystein, which,
under the microscope, appears as an amorphous matter cor.-
sisting of minute opaque corpuscles, intermingled with crystals
1 Casper's Wochenschrift, 1844, No. 18.
330 THE SECRETIONS:
of ammoniaco-magnesian phosphate. Dr. Kane convinced
himself that the occurrence of kystein was independent of the
presence of albumen ; he likewise ascertained that it occurs not
only during pregnancy but also during the period of lactation,
especially when the secretion of milk is at all checked. He
concludes with the observation that " when pregnancy is pos-
sible, the exhibition of a clearly-defined kystein-pellicle is one
of the least equivocal proofs of that condition, and that when,
in a case of suspected pregnancy, this pellicle is not found, if
the female be healthy, the probabilities are as twenty to one
that the prognosis is incorrect/' 1 It appears from a review of
Kane's cases, that the kystein most commonly appears on the
third day; in one case, however, it could not be observed till
the eighth day after the urine had been passed ; and in some
cases it appeared during the first twenty-four hours.
During the first weeks of pregnancy, Kane only rarely ob-
served it ; it was most commonly noticed during the seventh,
eighth, and ninth months, and up to the period of delivery.
In eighty-five cases of pregnancy it was absent eleven times,
and was present in thirty-two out of ninety-four cases examined
during lactation.
I have examined the urine during the second, third, fourth,
fifth, and sixth months of pregnancy, but have not invariably
detected kystein. In the cases in which it was formed, as in
the second, fifth, and sixth months of pregnancy, the urine on
emission was clear, yellow, faintly acid, and not affected either
by nitric or acetic acid, or by heat. Usually, in about twenty-
four hours, the whole urine became slightly turbid, the acid
reaction disappeared, a white viscid sediment was deposited,
and soon afterwards the surface of the fluid became covered
with a pellicle at first extremely delicate, but after from twelve
to twenty-four hours becoming tough, thick, opaque, and with a
glistening appearance in consequence of the light reflected from
numerous minute crystals of ammoniaco-magnesian phosphate
with which it was studded. On examining this pellicle in its early
state under the microscope, it appeared (when magnified 300
times) to consist of an amorphous matter composed of minute,
opaque points, such as are presented by sediments of phosphate
of lime or urate of ammonia, except that in the latter the in-
1 American Journal of Med. Science, July 1842.
URINE. 331
dividual particles are usually darker, more clearly defined, and
larger than in kystein. The whole field of vision was likewise
bestrewed with numerous vibriones in active motion, and crystals
of ammoniaco-magnesian phosphate. When the pellicle became
thicker, precisely similar phenomena were observed, but the
vibriones were supplanted by a considerable number of monads ;
on the addition of acetic acid the crystals disappeared, while
the amorphous matter remained unaffected. On digesting the
pellicle in acetic acid, and adding ferrocyanide of potassium to
the filtered solution, a comparatively slight turbidity ensued,
but on macerating the pellicle in a dilute solution of pot-
ash, acidulating the filtered solution with acetic acid, heating,
and adding ferrocyanide of potassium after a second filtration,
a more decided turbidity was observed. From these experi-
ments I concluded that a protein-compound was present. The
white sediment, that occurred after the urine had stood for some
days, possessed a disagreeable, pungent, caseous odour : under
the microscope it presented the same appearance as the pellicle.
After repeatedly washing a portion of the sediment with water,
and then heating it with alcohol and a little sulphuric acid,
it developed a disagreeable fmit-like odour, reminding me of
butyric ether. [We shall presently show that the accuracy of
this observation has been thoroughly established by Lehmann.]
It results from the above observations, that kystein is not a
new and distinct substance, but a protein-compound, whose
formation is undoubtedly and closely connected with the lacteal
secretion. From the observations of Kane and myself, it seems
to follow that pregnancy may exist without the occurrence of
kystein in the urine ; if, however, there is a probability or pos-
sibility of pregnancy, and kystein is found in the urine, then
the probability is reduced almost to a certainty. We are un-
able to draw any positive inferences respecting the stage of
pregnancy from the appearance of the kystein.
A deposit of caseous matter and earthy phosphates was fre-
quently observed by Golding Bird in the advanced stages of
pregnancy. The sediment is probably similar to Nauche's
kystein.
Every urine left to itself forms a pellicle, more or less re-
sembling that of kystein. If formed soon after the urine is
discharged, it consists of earthy phosphates, which, from the
332 THE SECRETIONS:
urine being alkaline, are, for the most part precipitated, but
likewise form a delicate film on the surface. When this is the
case, the pellicle is very thin and readily sinks to the bottom.
Under the microscope crystals of ammoniaco-magnesian phos-
phate, and an amorphous matter very similar to kystein, but
consisting of phosphate of lime, are observed : this likewise
differs from kystein in being soluble in free acids. A pellicle
of fat on the surface of urine may sometimes be mistaken for
kystein : films of this nature are very thin and usually irides-
cent, and the microscope reveals the presence of numerous
fat-globules.
The membrane formed on the surface of urine six or eight
days after emission, usually consists of a species of mould ; under
the microscope there may be seen innumerable filaments matted
together, and interspersed with sporules.
I once observed a pellicle on the surface of a man's urine
three days after emission, which both in chemical and micro-
scopical characters presented the closest analogy to kystein. 1
[Lehmann 2 frequently examined the urine of a pregnant
woman from the second to the seventh month. It was of a
dirty yellow colour, and more inclined to froth than usual ; it
generally became turbid in from two to six hours ; but the morn-
ing urine, after standing for thirty-six or forty-eight hours, was
always covered with a grayish-white film, which often, in two
or three days, sank and mixed with the sediment that formed
when the turbidity appeared, but sometimes was a longer period
before it broke up. By means of ether he could always re-
move from this film a considerable quantity of viscid fat, which
formed a soap 'with potash, and then, on the addition of sul-
phuric acid, developed a well-marked odour of butyric acid.
On treating a large quantity of this urine with sulphuric acid,
and distilling, he obtained, after treating the distillate with
baryta water, brilliant crystals of butyrate of baryta. The
substance taken up by ether, when gently evaporated with nitric
acid and exposed to the vapour of ammonia, was not in the
least reddened; with concentrated hydrochloric acid, on the
1 [A similar appearance has been observed by Prout in the urine of a delicate
child, fed chiefly on milk. (On Stomach and Renal Diseases, 4th edit. p. 555, note.)]
2 Lehrbuch der physiologischen Chemie, vol. 1, p. 252.
URINE. 333
other hand, it assumed a blue tint ; dissolved in potash, boiled,
and treated with hydrochloric acid, it developed sulphuretted
hydrogen; it dissolved tolerably freely in acetic acid, from
which it was precipitated by ferrocyanide of potassium. These
reactions left no doubt of its being a protein-compound. The
portion of the film insoluble in potash consisted chiefly of phos-
phate of magnesia, [ammoniaco-magnesian phosphate ?] with
a little phosphate of lime. Hence Lehmann concludes that the
kystein of Nauche is not a new and distinct substance, but a
mixture of butyraceous fat, phosphate of magnesia, and a pro-
tein-compound very similar to casein. He likewise mentions
that, in examining the urine of a woman who was not suckling,
and was kept on very low and sparing diet, on the third, fourth,
sixth, and ninth days after delivery, he found a large quantity
of butyric acid taken up by ether from the solid residue ; and
on dissolving the ethereal extract in water, adding sulphuric
acid, and distilling, he obtained a further quantity. The urine
in this case was always rather turbid, of a dirty yellow colour,
very acid, and contained a very small amount of uric acid.
Moller 1 relates two cases in which the urine of women who
were not pregnant was covered with a film exactly resembling
kystein : in one case there was considerable hypertrophy of the
uterus ; in the other, no affection of the generative organs could
be detected. The film of kystein consists, according to his
observations, of fat, earthy phosphates, and a caseous matter,
which differs, however, from the casein of milk in being held
in solution by a free acid. When the urine becomes neutral
or alkaline, the caseous matter ceases to be held in solution,
and separates as kystein. Everything checking the decomposi-
tion of the urine hinders the formation of the pellicle, and if the
recent secretion is treated with a free acid (mineral or organic) ;
no separation of kystein takes place even if ammonia be added
to saturation, or decomposition allowed to proceed to any
extent.
In a case of decided pregnancy, no kystein was formed during
the period of a severe cold, attended with a copious deposition
of urates ; but when the urine became natural, the kystein re-
appeared. He twice detected cholesterin in kystein.
1 Casper's Wochenschr. Jan. 11-18, 1845.
334 THE SECRETIONS :
Kleybolte 1 has examined the urine in ten cases of pregnancy,
and invariably found kystein on the fifth day. The morning
secretion was used, and, after being slightly covered to protect
it from dust, was allowed to stand, at an ordinary temperature,
for ten days. The following appearances were observed in the
tenth week of pregnancy : urine peculiarly yellow, with a green-
ish tint. 2d day, mucous sediment ; 3d day, no change ; 4th
day, turbidity ascending from the bottom; 5th day, white
points and leaflets on the surface, turbidity ascending from all
parts of the bottom, and the sediment almost gone ; 6th day,
kystein distinctly observed on the surface, like lumps of fat 011
the surface of cold broth ; 7th day, no change. From the 8th
to the 10th day, the kystein disappears, the turbidity again de-
scends, and the sediment noticed on the 2d day is reproduced.
The nine remaining cases are in most respects similar to the
above.
A few observations on kystein have been recently published
by Audouard, 2 but contain nothing of importance, except that
in six specimens of urine passed by young women suffering
from amenorrhoea, he found kystein in five. 3 ]
I shall now give a short abstract of Becquerel's researches.
During pregnancy, the general state of the system is liable to
great variations, and the urine presents differences of corre-
sponding importance. If good health is enjoyed during preg-
nancy, the urine remains normal ; if, however, anything should
happen to excite the vascular system, it readily changes, be-
coming dark-coloured, acid, sedimentary, and diminished in
quantity. During the latter stages of pregnancy the urine
often assumes the anaemic type, that is to say, it becomes pale,
contains only a small amount of solid residue, and the spe-
cific gravity does not exceed 1011. The observations which
were communicated by Donne in a letter addressed to the
Academy of Sciences, dated May 24, 1841, in reference to the
urine in pregnancy containing less free acid, and less of the
phosphate and sulphate of lime than normal urine, were not
1 Casper's Wochenschriffc, April 26, 1845. 2 Journal de Chimie Med. May 1845.
3 Many other communications have recently been published on this subject, which
I do not deem necessary to notice, as they are, for the most part, simply confirmatory
of the above observations.
URINE. 335
confirmed by Becquerel. Neither could Becquerel observe
ky stein.
After delivery, mucus, tinged with blood, is mixed with the
urine ; this is succeeded by the discharge which is known as
the lochia. During the period that intervenes between deli-
very and the commencement of the milk-fever, the urine either
assumes the inflammatory type, and is scanty, high-coloured,
acid, and dense, as, for instance, in those cases in which the
labour has been very difficult and painful, and the vascular
system is much excited ; or it takes on the anaemic form, as in
those cases in which the labour is followed by great debility
and prostration.
Becquerel gives two analyses : one was made with the urine
of a woman aged 33 years, who, the previous evening, had been
delivered of a dead child ; pulse 96, strong ; urine of a deep
red colour, acid, and sedimentary; the sediment was mixed
with sanguineous mucus, and there was a little albumen in the
urine.
The second analysis was made with the urine of a woman
aged 22 years, who had been delivered forty-eight hours pre-
viously of a seven months dead child. Pulse 92, rather weak ;
urine was very red, and held in suspension a cloud of sanguineous
mucus and a considerable quantity of albumen.
i. 2.
Quantity of urine in 24 hours in ounces 30 26-5
Specific gravity . . . 1012-6 1018-0
1000 parts contained :
Water 979-5 970-2
Solid constituents
Urea .
Uric acid
Fixed salts
Extractive matters
Albumen
20-5 29-8
6-5 7-8
0-5 0-5
4-6 7-4
9-5 10-6
3-3
We see from the ratio of the urea and also of the uric acid
to the solid residue, that the urine in neither of these cases
can be regarded as inflammatory, but that it rather approxi-
mates to the anaemic type. In the first analysis the urea
amounts to only 31 and the uric acid to 2'4 of the solid re-
sidue ; in the second analysis, the former amounts to 27 and
the latter to 2,
336 THE SECRETIONS:
In most of the cases in which Becquerel examined the morn-
ing urine of women who had recently been delivered, he found
it anaemic ; the specific gravity varied from 1006 to 1014, the
average being 1011.
As the milk- fever comes on, the chemical composition of the
urine appears to undergo some modification, at least we are led
to infer so from an analysis of Becquerel. It was secreted in
diminished quantity, contained a larger proportion of urea and
uric acid, was darker, and deposited a sediment.
He examined the urine of a woman aged 22 years, four days
after delivery, while suffering from the milk-fever. It was of
a saffron-yellow colour, deposited a sediment on the addition
of nitric acid, and also spontaneously, after the lapse of some
hours. In the course of twenty-four hours there were 15*5
ounces excreted. The specific gravity was 1031-5.
1000 parts contained :
Water .... 948-2
Solid constituents . . .51-8
Urea 187
Uric acid .
Fixed salts .
Extractive matter
Albumen
2-7
11-3
18-3
0-7
Here the urea amounts to 36, and the uric acid to no less
than 55 of the solid residue.
'o
On the passage of medicinal and other substances into the urine.
[All substances incapable of assimilation that enter the cir-
culation are removed by the kidneys, either in the state in
which they entered the organism, or in a modified condition.
Inorganic, non-metallic bodies. Iodine appears rapidly in
the urine in combination with ammonium, (Lehmann,) sodium,
and potassium. Bromine has been detected by Glover and
Heller, and chlorine by Orfila.
Iodide of potassium, the alkaline borates, silicates, chlorates,
and carbonates, as also chloride of barium, ferridcyanide of
potassium, and sulphocyanide of potassium, were found by
Wohler 1 in the urine ; the ferridcyanide was, however, converted
into ferrocyanide in the system.
1 Tiedemann's Zeitschr. fiir Physiol. vol. 1, p. 305.
URINE. 337
Sulphur has been found (after administration) in the urine
by Wohler and Orfila ; and after the use of liver of sulphur,
free sulphur, and an excess of sulphate of potash were found
in the urine. In four experiments made by Laveran and
Millon, sulphur neither appeared in the urine, nor was the
quantity of sulphates increased.
Metallic substances. Arsenic and antimony may be readily
detected in the urine, and have been observed by many che-
mists. The detection of mercury is by no means easy ; it has
been sought for in vain by Lehmann, I/Heretier, and Eees,
but has been found by Buchner, Cantu, Jourda, Venables,
Orfila, QEsterlen, 1 and Audouard. 2 Iron is almost always present
in the urine during its administration as a remedy. Nickel was
found by Wohler in the urine of a dog to whom he had given
half a drachm of tartrate of nickel and potash. Gold, silver,
tin, lead, and bismuth, were found in the urine of dogs to
whom Orfila had given large doses of the soluble salts of those
metals. Copper and manganese have been detected in the
urine by Kramer. 3
Inorganic acids. Orfila has detected nitric, hydrochloric,
and sulphuric acids in the urine. As nitric acid is not a con-
stituent of normal urine, there was no ambiguity in this ex-
periment. In dogs poisoned with dilute hydrochloric or sul-
phuric acid, about six times as much chloride of silver and
sulphate of baryta were obtained as are found in ordinary
urine. In none of these cases was the urine more acid than
usual, the acids having formed neutral salts by combining with
the alkalies of the blood.
Organic acids and their salts. It appears from the inves-
tigations of Wohler, that many of the organic acids, adminis-
tered in a free state, enter the urine in a state of combination ;
as, for instance, oxalic, citric, malic, tartaric, succinic, and gallic
acids.
To the above list Orfila has added acetic acid, and con-
firmed Wohler^s statement regarding oxalic acid.
According to Pereira 4 meconic acid may be occasionally
detected in the urine of animals poisoned with opium.
1 I/Experience, Aug. 1844. 2 Journal de Chim. Med. 9, p. 137.
3 Giornale dell' Institute Lombardo.
4 Elements of Materia Medica, 1st ed. vol. 2, p. 1299.
II. ' 22
338 THE SECRETIONS:
One of the most important of Wohler^s discoveries is, that
the neutral vegetable salts become modified in their passage
through the system, and are found in the urine as carbonates.
A few hours after the use of these salts, the urine becomes
alkaline, is frequently turbid from the deposition of phosphates,
and effervesces briskly on the addition of an acid. 1 If the dose
is very large, oxalate of lime may frequently be detected.
Similar results follow from the use of alkaline lactates ; Lehmann
found, that two hours after taking two drachms of lactate of
soda, alkaline urine was excreted. That this change is effected
after the salt has entered the blood, and not in the intestinal
canal, is proved by an experiment performed by Mr. J. Goodsir,
at my request. A drachm of acetate of potash was dissolved
in an ounce and a half of water, and injected into the femoral
vein of a dog, whose urine had been previously ascertained to
be acid. The urine passed about an hour after the operation
was alkaline. A similar experiment has been since made by
Lehmann, who injected a drachm of lactate of potash into the
jugular vein of a dog, and found the urine alkaline an hour
afterwards. The process is one of simple combustion : each
atom of acetic acid (of the acetate of soda) combines with eight
of oxygen, and yields four atoms of carbonic acid and three of
water, or C 4 H 3 O 3 + 8O = 4CO 2 + 3 HO, and each atom
of lactic acid combines of twelve of oxygen, forming six of
carbonic acid and four of water, or C 6 H 5 O 3 + 12 O = 6 CO a
+ 5 HO.
In a series of 268 experiments instituted by Millon and
Laveran, with the tartrate of potash and soda, (Sodse potassio-
tartras. Ph. L.) they found the urine more [or less alkaline in
175, acid in 87, and neutral in 6 cases. This apparent dis-
crepancy was doubtless dependent on the degree of concen-
tration of the saline solution. (See page 149.)
We have already mentioned that benzoic and cinnamic acids
are converted in the organism into hippuric acid, and then ex-
creted by the kidneys.
Vegetable bases. Quinine, when administered in large doses,
has been noticed in the urine by Piorry, Landerer, and others.
1 Some excellent observations on the physiological action of these salts will be found
in Dr. Pereira's Treatise on Food and Diet, p. 29.
URINE. 339
The best test for its presence is the iodated iodide of potassium,
consisting of four parts of iodide of potassium, one of iodine,
and ten of water. The precipitate afforded by this reagent
with disulphate of quinine is very insoluble in water, not
affected by an excess of the test, and readily soluble in alcohol.
It is of a yellowish-brown colour, and forms a turbidity or sedi-
ment, according to the amount of the alkaloid in the urine.
When the quantity is very small there is merely an olive tint
produced on the addition of the test. The disulphate of quinine
may be reobtained from the sediment in a state of purity by
a simple chemical process. 1
Morphia is stated to have been once detected by Barruel in
the urine of a person under the influence of a poisonous dose
of laudanum, and it was likewise discovered by Orfila, in the
urine of dogs. None of the other alkaloids have yet been de-
tected in the urine.
Indifferent organic substances. According to Wohler, most
colouring matters and many odorous principles passed unchanged
or slightly mocfified into the urine. In the former class we
may place indigo, gamboge, rhubarb, red beet-root, madder,
logwood, mulberries, black cherries, &c. ; in the latter, valerian,
asafoetida, garlic, castoreum, saffron, turpentine, &c.
Alcohol is placed by Wohler amongst the substances that
do not enter the urine, and Liebig has recently affirmed that
it has never been found in that secretion. It has, however,
been detected by Percy in the urine of a dog, into whose sto-
mach four ounces of spirit of *85 had been injected, and in the
urine of a man in a state of intoxication who had taken about
a bottle of whiskey. In both cases he obtained, by careful
distillation, an inflammable fluid that dissolved camphor. 2
In order to ascertain whether alcohol, taken in moderate
quantity would enter the urine, my friend Dr. Wright instituted
the following experiment on a man whose ureters opened ex-
ternally. Three ounces of whiskey were administered, and the
urine collected by applying a test-tube to each ureter. The
tubes were corked and replaced every two minutes, for the
space of half an hour.
1 Journal de Pharmacie, Sept. 1843.
8 On the presence of Alcohol in the Brain, 1839, p. 104.
340 THE SECRETIONS:
The following table represents the amount of fluid in the tubes.
1st two minutes . . a drachm.
2d ,, . .2 drachms.
3d* 5 drachms.
4th . .1 drachm.
5th* . .6 drachms.
6th* . .2 drachms.
7th . I a drachm.
8th . | a drachm.
9th 3 drachms.
10th* 6 drachms,
llth 4 drachms.
12th . .8 drachms.
13th* 7 drachms.
14th* 6 drachms.
15th* 4 drachms.
The contents of the tubes were analysed separately, according
to Dr. Percy's method, 1 and in those marked with an asterisk
the presence of spirit was distinctly recognized.
In another experiment upon the same individual, in which
two ounces of whiskey diluted with three times its volume of
waterwere administered, no trace of the spirit could be obtained. 2
Lehmann has sought in vain for salicin, phloridzin, caffei^
theobromin, asparagin, and amygdalin.
As the modifications that these substances undergo in the
organism are of extreme interest, let us see what are the most
probable changes that can take place. We select salicin, by
way of illustration, as a substance whose chemistry is pretty
well established.
Is salicin converted in the organism into sugar and saliretin ? 3
a change that occurs on digesting salicin in dilute acids: or is it
converted into salicylous acid and water? 4 as occurs on treating
salicin with bichromate of potash and sulphuric acid. Or, in-
stead of salicylous acid, is hydrated benzoic acid (which is
1 Op. cit. p. 8.
2 These experiments were originally recorded in my Harveian Prize Essay on the
Chemistry of the Urine in Health and Disease ; 1842.
3 This change is illustrated by the equation
Salicin. Sugar. Saliretin.
C 42 ^29 ^22 = C, 2 H, 4 O, 4 + C 30 H, 5 O g .
Salicin. Oxygen. Salicylous acid. Water.
Symbolically C 4 , H, 9 22 + = 3C 14 H 6 4 -j- 11 HO.
URINE. 341
isomeric with it) produced, 1 and the benzoic acid then converted
in the ordinary manner into hippuric acid ? Or does the salicin
yield salicylous acid which appears to be isomorphons with,
and convertible into oxide of omichmyle ? 2 Or, finally, does
the salicin undergo the same changes as when oxidized by
fusion with caustic potash, and become converted into salicylic,
oxalic, and carbonic acids, and water ? 3 In sixteen experiments
made by Lehmann with salicin in doses of 20 or 30 grains, he
never detected saliretin, but always salicylous acid, which was
taken up by ether with the oxide of omichmyle, and yielded
the characteristic violet tint on the addition of nitrate of iron ;
in most of the experiments there was also a small quantity of
hippuric acid, and of oxalate of lime. Similar experiments
have been made by Laveran and Millon.
After taking phloridzin, Lehmann also found hippuric acid
and oxalate of lime in the urine. After taking a scruple of
thein at bedtime, no trace of it could be found in the morning
urine, but the urea was considerably increased, amounting to
58'195 of the solid residue. 4 He did not remark any un-
pleasant symptoms, but two of his pupils, after a similar dose
(obtained from coffee) experienced great excitement of the
nervous and vascular systems generally, and especially of the
generative organs. This is perfectly in unison with Mulder' s 5
statement, that it produced abortion in pregnant rabbits.]
Salicylous acid. Hydrated benzoic acid.
1 Symbolically C 14 H 6 O 4 = HO, C 14 H 5 3 .
2 It appears from the researches of Scharling that the oxide of omichmyle belongs
to a series having a compound radical analogous to that of oil of spiraea, or salicylous
acid ; at least he found that chloromichmyle is isomeric with chloride of salicyl or chlo-
rosalicylic acid, C 14 H 5 4 , Cl. Oxide of omichmyle does not produce a violet colour
with nitrate of iron in the same manner as salicylous and salicylic acids ; moreover,
salicylous acid and salicin do not enter the urine as oxide of omichmyle, but as sali-
cylous acid, as has been found by Lehmann in eight experiments. Scharling hints
at the existence of a widely-diffused radical, which, in the vegetable kingdom, in
warm climates, is the starting point of the benzoyl and cinnamyl series ; in cold
climates, of the salicyl compounds ; and, in the animal kingdom, presents itself as
omichmyle.
3 These changes may be thus explained symbolically :
Salicin. Oxygen. Salicylic acid. Oxalic acid. Carbonic acid. Water.
C 42 H 29 22 + 290 = 2C 14 H 6 6 + 6C 2 3 + 2CO, + 17HO.
4 Lehrbuchder Physiolog. Chemie, vol. 1, p. 97.
5 Natuur en Scheikundig Archief, 1839, p. 458.
342
THE SECRETIONS:
Urine of Animals.
The chemistry of the urine of animals is still in a very defi-
cient state. I shall here give the little that is known on the
subject.
The urine of carnivorous animals is, at the period of its dis-
charge, acid, but speedily becomes alkaline, in consequence of
the formation of ammonia. This observation of Hieronymi's
is confirmed by Hiinefeld, who found that the urine of the bear
retained its acid reaction for a considerable period. Vauquelin
found a large proportion of urea, but no uric acid in the urine
of beasts of prey. Hiinefeld also missed the uric acid, but it
was detected by Hieronymi. Hieronymi carefully analysed
the urine of the lion, the tiger, and the leopard, and its compo-
sition appeared much the same in these three animals. The spe-
cific gravity of the urine of each animal varied between 1059
and 1076. It was clear, of a bright yellow colour, had a
pungent disagreeable odour, an acid reaction, and a nauseous
bitter taste ; after standing for a short time, it became alkaline.
On collecting and evaporating the urine, there was a coagula-
tion of some white flocculent matter ; and as the concentration
increased, the greater part of the urea began to separate in a
crystalline form. The mixed urine of these three animals gave
the following result :
Water . . . . 846-00
Solid constituents . . . 154-00
Urea, alcohol-extract, and free lactic acid 132-20
Uric acid . . . 0-22
Vesical mucus . . 5-10
Sulphate of potash . 1-22
Chloride of ammonium, and a little chloride of sodium 1-16
Earthy phosphates . . 1-76
Phosphates of soda and potash 8-02
Phosphate of ammonia . 1'02
Lactate of potash . . 3-30
The urine of herbivorous animals likewise contains a large
quantity of urea, but no uric acid, 1 there being in its place hip-
puric acid. The urine of the horse was analysed by Fourcroy
and Vauquelin : they describe it as of a yellow colour, often
1 [Traces of uric acid have been occasionally detected by Fo wnes and other chemists'
in the urine of the graminivora. See Vol. I, p. 53.]
URINE. 343
turbid, of an unpleasant smell, and a saltish bitter taste. When
allowed to rest, a quantity of the carbonates of lime and mag-
nesia was deposited ; it had an alkaline reaction, frothed on
the addition of an acid, and had a specific gravity of from 1030
to 1050. 1000 parts contained :
Water .... 940-0
Solid constituents . 60'0
Urea .
Hippurate of soda
Chloride of potassium
Carbonate of soda
Carbonate of lime
7-0
24-0(?!)
9-0
9-0
11-0
This analysis probably requires further confirmation. I
found a larger amount of urea in the urine of a horse suf-
fering from ozsena; for from 1000 parts I obtained 50 of urea;
and after the horse had fasted for four days, I still found
24-1. In the urine of another horse, the solid constituents
amounted to 10- 7 of the urine, and the urea to 5-06g, or about
one half of the solid residue.
From my own observations, I should say that the urine of
horses is generally of a straw colour, is at first acid, but soon
becomes ammoniacal, and then emits the peculiar penetrating
odour which is doubtless caused by the formation of a volatile
fatty acid, although I was unable to isolate it. The urine,
after it has become alkaline, is often so tenacious and viscid
that it can be drawn up in long threads. The microscopic
examination of the urine of the horse exhibits a great number
of rounded corpuscles, from the size of mucus-corpuscles to
four times that size, which burst upon pressure of the glass
slips between which the fluid is examined. Fourcroy and
Vauquelin, after evaporating the urine of the horse, separating
the urea as a nitrate, and neutralizing the acid by an alkali,
found a small quantity of reddish fat, which volatilises over the
water-bath, and is considered to be the cause of the smell and
colour of the urine.
[The urine of the horse has been recently analysed by
Von Bibra 1 and Boussingault.
In two analyses of the urine of the same horse, made at dif-
ferent periods, Yon Bibra found :
1 Annalen der Chemie und Pharmacie, 1845, No. 1.
344 THE SECRETIONS:
1. 2.
Water . . . 885-09 912-84
Solid constituents . . 114-91 87-16
Urea 12-44 8-36
Hippuric acid .
Water-extract .
Alcohol-extract
Mucus
Salts soluble in water
Salts insoluble in water
12-60 1-23
21-32 19-25
25-50 18-26
0-05 0-06
40-00
23-40 \
18-80 J
On two occasions the individual salts were determined, and
it was found that in 100 parts of the saline residue there were :
i. 2.
Carbonate of lime . . 12-50 31-00
Carbonate of magnesia . 9*46 13*07
Carbonate of potash . . 46-09 \ 49.33
Carbonate of soda . . 10-33 J
Sulphate of potash . < . 13-04 9*02
Chloride of sodium . . 6'94 5-60
Silica . . . 0-55 1
Loss . . . 1-09/
Traces of iron were always observed, but he could never ascer-
tain the presence of fluorine. The mean specific gravity resulting
from numerous observations was 1045. The horses, in these
cases, were used for agricultural purposes, and fed on hay and
oats. The prevailing opinion that, by excessive work, the hip-
puric is replaced by benzoic acid, is stated by Von Bibra to be
incorrect. Benzoic acid was scarcely ever observed, and, when
present, was only recognizable under the microscope. The
hippuric acid varied in different analyses from 15 to 5 or even
less in 1000 parts of urine. The secretion was always alka-
line, and in a few minutes deposited a sediment, consisting (as
seen under the microscope) of compact vesicles. The deposit
consisted of the carbonates of lime and magnesia, with an or-
ganic compound that could not be removed by the most careful
washing. In three analyses there were found :
Carbonate of lime . 80-9 87'2 87'5
Carbonate of magnesia 12-1 7-5 8-2
Organic matter . 7-0 5-3 4-3
100-0 100-0 100-0
Boussingault 1 has likewise analysed the urine of a horse
feeding on trefoil and vetches. It was very alkaline, had a
specific gravity of 1037-3, and contained in 1000 parts :
1 Annal. de Chimie et de Physique, Septembre, 1845.
URINE.
345
Water and indeterminate matters . . 9 10' 7 6
Urea 31-00
Hippurate of potash . . . 4*74
Lactate of potash . . . .11-28
Lactate of soda . . . .8-81
Bicarbonate of potash . . . 15-50
Carbonate of lime .... 10-82
Carbonate of magnesia . . . 4-16
Sulphate of potash . . . 1-18
Chloride of sodium . . . 0-74
Silica 1-01
Phosphates .... absent.
As several chemists have noticed, amongst the constituents
of the urine of the herbivora, a red oil on which the colour and
odour of the secretion are dependent, Boussingault endeavoured
to isolate it. He distilled upwards of 26 gallons at a single ex-
periment, hut did not obtain a trace of the oil, a colourless
fluid passing over which evolved the peculiar odour of horses'
urine : hence he concluded that the odorous principle is a volatile
acid. The only means by which anything like a red oil can be
obtained consists in carrying on the distillation to dryness, in
which case an oily substance is obtained, analogous to, if not
identical with some of the products of decomposition of the
alkaline hippurates.]
Horses are not unfrequently subject to a disease which cor-
responds with diabetes insipidus, or hyperdiuresis, in man : it
has also been observed in sheep and cattle.
The following analysis of the urine of cattle was made by
Sprengel : 1000 parts contained :
Water
Solid constituents
Urea
Albumen .
Mucus
Benzoic acid
Lactic acid
Carbonic acid
Potash
Soda
Silica
Alumina
Oxide of manganese
Lime
Magnesia
Chlorine
Sulphuric acid
Phosphorus
926-24
73-76
40-00
0-10
1-90
0-90
5-16
2-50
6-64
5-54
0-36
0-04
0-01
0-65
0-36
2-72
4-05
0-70
This analysis requires further confirmation.
346
THE SECRETIONS:
The urine of cattle, just after it is passed, is clear and acid ;
it soon, however, deposits crystals of the carbonates of lime and
magnesia. It contains hippurate of soda, and a larger propor-
tion of urea than is found in human urine.
[The urine of oxen employed for agricultural purposes was
analysed by Von Bibra. The specific gravity varied from 1040
to 1032. The urine was of a dark yellow colour, perfectly
clear, and of a peculiar odour.
The following analyses were made with the urine of the same
animal at different times :
Water
Solid constituents
Urea .
Hippuric acid
Mucus .
Alcohol-extract
Water-extract
Soluble salts
Insoluble salts
The saline residue contained :
Carbonate of lime
Carbonate of magnesia .
Carbonate of potash
Sulphate of potash
Chloride of sodium
Silica
Traces of iron, and loss
1.
2.
. 912-01
923-11
87-99
76-89
19-76
10-21
5-55
12-00
0-07
0-06
14-21
1020
22-48
16-43
24-42
25-77
1-50
2-22
1-07
6-93
77-28
13-30
0-30
0-35
0-77
100-00
Although these salts are liable to considerable quantitative
variations, (for instance, Von Bibra, in two analyses, found
14-22 and 16 of chloride of sodium,) yet, as a general rule,
the urine of oxen contains more alkaline and less earthy
carbonates than the urine of horses.
The urea and hippuric acid varied extremely in different
analyses. The food of the oxen consisted of fresh clover and
a little hay.
Boussingault found that the urine of a cow feeding on after-
math and potatoes, effervesced briskly on the addition of an
acid, and deposited numerous crystals of hippuric acid. Its
specific gravity was 1040, and it contained in 1000 parts :
URINE. 347
Water and indeterminate matters . . 921-32
Urea 18-48
Hippurate of potash . . . 16-51
Lactate of potash . . . 17-16
Bicarbonate of potash . . . 16-12
Carbonate of magnesia . . . 4-74
Carbonate of lime . . . 0-55
Sulphate of potash . . .3-60
Chloride of sodium . . . 1-52
Silica ..... traces
Phosphoric acid .... absent j
Vogel found the urine of the rhinoceros turbid, and having
an odour like that of crushed ants. It grew darker after ex-
posure to the air, and became covered with a film of carbonate
of lime; it effervesced on the addition of acids. As it cleared,
it deposited a yellow sediment composed of earthy phosphates
with a little peroxide of iron and silica, which amounted to 2*7
of the weight of the urine. It then remained of a dark yellow
colour, and formed, on evaporation, a new sediment of car-
bonates of lime and magnesia, which were previously held in
solution as bicarbonates. On evaporating the urine to two
thirds of its volume, and then treating it with hydrochloric
acid, a precipitation of hippuric acid took place, amounting to
O45 of the weight of the urine. The urine also contained
urea and the ordinary salts.
Vogel found the urine of the elephant turbid from the presence
of carbonates of lime and magnesia in suspension ; it contained
a larger amount of urea than the urine of the rhinoceros,
but, on the other hand, was devoid of hippuric acid. Brandes,
however, detected the latter constituent, partly combined with
an alkali and partly with urea.
In the urine of the camel, Chevreul found a large quantity
of urea, but no uric acid; it contained, however, chloride of
sodium, hippurate of soda, carbonate of soda, sulphate of potash
together with a little sulphate of soda, carbonate of ammonia,
and a trace of peroxide of iron : no phosphates were found in
it. On mixing it with sulphuric, nitric, or hydrochloric acid,
the urine became red, a property due to its containing a vola-
tile oil, to which, moreover, it owes its odour.
The urine of the pig has been analysed by Lassaigne. He
describes it as being of a pale yellow colour, clear and trans-
348
THE SECRETIONS :
parent, and containing urea, sulphates of potash and soda, chlo-
rides of potassium, sodium, and ammonium, and traces of car-
bonate and sulphate of lime. Van Setten 1 has communicated
a special analysis of the urine of a pig. It was yellow, almost
inodorous, and had a specific gravity of 1003.
There were contained in 1000 parts :
Water .... 990-028
Solid constituents . . . 9'972
Urea
0-750
Uric acid
0-195
Water -extract
1-708
Alcohol-extract
1-105
Resinous matter
0-425
Albumen and mucus
0-721
Lactic acid .
0-490
Stearin
0-092
Sugar
0-375
Phosphate of soda
1-376
Sulphate of potash, chlorides of sodi
Sulphates of lime and magnesia
Sulphate of ammonia .
um&potas
sium 2-075
0-425
0-196
Chloride of ammonium
o-oio
[The urine taken from the bladders of pigs immediately
after they were killed is described by Von Bibra as clear, nearly
devoid of odour, alkaline, and having a specific gravity of 1012
to 1010. In two cases in which he analysed it he found in
1000 parts :
1.
981-96
18-04
2-73
Water
Solid constituents
Urea
Alcohol-extract
Water-extract
Mucus
Soluble salts .
Insoluble salts
3-87
1-42
0-05
9-09
0-88
2.
982-57
17-43
2-97
3-99
1-12
0-07
8-04
0-80
The salts in the first of these analyses consisted of :
Chloride of sodium and a little chloride of potassium 53-1
Sulphate of soda . . . .7-0
Carbonate of potash . . . 12-1
Phosphate of soda . . . 19*0
Phosphates of lime and magnesia, with traces of
silica and iron . . . .8-8
100-0
Natuur en Scheidekundig Archiv, Deel 2.
URINE. 349
In both the above analyses he searched in vain for hippuric
or benzoic acid in three ounces of the fluid.
In two other analyses he obtained microscopic crystals of
hippuric acid on the evaporation of the ethereal solution. He
never detected even a trace of uric acid, which, considering the
mixed nature of the food of these animals, is extraordinary.
Boussingault analysed the urine of a pig feeding on potatoes
and water slightly impregnated with salt. The urine was
alkaline, very limpid, and of an extremely pale yellow colour.
Its specific gravity was 1013-6.
It contained in 1000 parts :
Water and indeterminate organic matter 979-14
Urea . . . 4-90
Bicarbonate of potash . . 10' 74
Carbonate of magnesia . . .0-87
Carbonate of lime . . . traces
Sulphate of potash . . . 1'98
Phosphate of potash . . .1-02
Chloride of sodium . . .1-28
Alkaline lactates . . undetermined
Hippuric acid 1 . . . absent
Silica 0-07
The urine of the goat has been analysed by Von Bibra. The
animals from whom the fluid was obtained were confined in a
stable and poorly fed, getting sour hay, &c. The urine was
clear, of a peculiar but pungent odour, and alkaline. The spe-
cific gravity was generally 1008 or 1009. In two instances it
contained in 1000 parts :
i.
2.
Water
. 980-07
983-99
Solid residue
19-93
16-01
Urea
3-78
0-76
Hippuric acid
1-25
0-88
Alcohol-extract
4-54
4-66
Water- extract
1-00
0-56
Mucus
0-06
0-05
Soluble salts
8-50
8-70
Insoluble salts
0-80
0-40
1 Thinking that the absence of hippuric acid might be dependent on the diet,
Boussingault mixed green trefoil with the potatoes : the result was, however, still
the same.
350 THE SECRETIONS:
The ash consisted of:
Carbonate of magnesia with a little carbonate of lime 7'3
Sulphate of soda .... 25'0
Chloride of sodium . . . 14*7
Carbonate of soda with a little carbonate of potash 53-0
100-0
Here we remark, as in the urine of oxen, a considerable excess
of the alkaline carbonates over the alkaline earths. The hip-
puric acid seemed very variable, sometimes equalling the urea
in amount.]
Vauquelin analysed the urine of the beaver. He found in
it the bicarbonates of lime and magnesia, and hippurate of
soda, but no phosphates or uric acid. He also detected the un-
decomposed colouring matter of the bark of the willow (the
ordinary food of the beaver) in the urine ; for he found that a
piece of cloth which had been previously saturated with alum,
took up the same colour from soaking in the urine as from lying
in a decoction of the aforesaid bark.
The urine of rabbits and guinea-pigs is much the same : it
has an alkaline reaction, froths on the addition of an acid, and,
when exposed to the air, throws down a sediment of carbonate
of lime : it contains urea and the salts which are generally met
with in the urine of the herbivora.
[The urine of the hare has been examined on two occasions
by Von Bibra. The first analysis was made in December. By
external pressure on the region of the bladder he was enabled
to collect about three pints from seven or eight hares. This
was divided into two portions, one of which was evaporated and
incinerated, the other tested for hippuric acid, which was found
to be present in small quantity, forming 0'007 of the urine.
The ash contained :
Chloride of sodium with a little chloride of potassium 7' 12
Sulphate of soda .... 16-82
Carbonate of soda . . . 9-84
Phosphate of soda . . . 53-05
Phosphates of lime and magnesia . . 13-17
100-00
URINE. 351
The urine was turbid and alkaline, depositing a white sedi-
ment of minute globules, much smaller than those occurring
in the urine of the horse, and consisting, for the most part, of
phosphate of magnesia. The urine similarly obtained in the
month of June had a faint alkaline reaction, and, in the course
of six hours, crystals of ammoniaco-magnesian phosphate were
observed on the surface. Its specific gravity was 1050, and it
contained in 1000 parts :
Water .... 912-86
Solid constituents . . . 87*14
Urea 8-54
Hippuric acid
Alcohol-extract
Water-extract
Soluble salts
Insoluble salts
microscopic crystals
9-58
32-68
23-70
12-64
The ash consisted of:
Chloride of sodium with a little chloride of potassium 22-49
Sulphate of soda . . . 29'97
Carbonate of soda . . . 8-73
Phosphate of soda . . . 4-39
Phosphate of lime . . . 12-00
Phosphate of magnesia . . . 22-42
100-00
The difference in the amount of earthy phosphates in these
analyses is easily accounted for when we consider the different
nature of the food in winter and summer.
Von Bibra obtained a minute quantity of a substance closely
allied to humic acid in most of his analyses of the urine of the
herbivora.]
The urine of birds, which is discharged from the cloaca as
a white pulpy mass and soon hardens when exposed to the air,
is remarkable for the large quantity of urate of ammonia which
it contains. The urine of birds of prey contains urea, and a
peculiar green colouring matter which is not found in the urine
of graminivorous birds.
Vauquelin and Fourcroy found that, in the ostrich, the uric
acid amounted to one sixtieth of the weight of the urine ; there
were also present sulphates of potash and lime, chloride of
ammonium, an oily substance, a peculiar animal matter, and
probably acetic acid. The urine of the parrot is, according to
J. Davy, very similar to that of serpents.
352 THE SECRETIONS:
The urine of serpents is excreted as a white, pultaceous,
earthy mass, which soon stiffens when exposed to the air. It
is composed, for the most part, of uric acid in combination
with potash, soda, and ammonia, together with a little phosphate
of lime. It contains no urea, since, upon digesting it in alco-
hol, a yellow extractive matter is taken up, in which no crystals
of urea can be detected.
On the other hand, Berzelius directs our attention to the
circumstance that Cap and Henry have obtained urea from that
source, after having saturated the uric acid with hydratcd
baryta.
[For an analysis of the urine of the rattle-snake, see Vol. I,
p. 53, note.]
The urine of the bull-frog (rana taurina) consists, according
to J. Davy, of a fluid of specific gravity of 1003, which con-
tains urea, chloride of sodium, and a little phosphate of lime in
solution. The urine of bufofuscus had a specific gravity of 1008 ;
it contained a larger proportion of urea than the urine of the
frog, together with chloride of sodium and phosphate of lime.
In the urine of testudo nigra, which was examined by Magnus
and J. Muller, there was no uric acid; on the other hand, there
was O'lg of urea, with a brown colouring matter which was
soluble in water, spirit, potash, and hydrochloric acid.
[The urine of a land-tortoise (testudo tubulatd], which had
been kept without food for some months, has been recently
examined by Marchand. 1 It had a faintly acid reaction, and
resembled pus in appearance. He collected 1337 grains, con-
sisting of:
Or in J 000 parts:
Water . . . 1271 950-64
Solid constituents . . 66 49-36
Urea . . .8-5 6-40
Uric acid . . . 23-0 17-25
Ilippuric acid . . none
Salts and indeterminate organic matter 34-5 25-70 J
A small quantity of brown liquid fat, with a strong urinous
odour, was taken up by ether.]
1 Erdraann und Marchand's Journ. 1845, iv, 4.
35.3
CHAPTER VIII.
THE SECRETIONS OF THE LACHRYMAL, MEIBOMIAN, AND
CERUMINOUS GLANDS.
The Tears.
THE glandulse lachrymales are two conglomerate acinous
glands which secrete a limpid fluid, containing a very small
proportion of solid constituents, and forming the tears. They
are for the purpose of preserving the cornea of the eye in a
state of moisture, and their secretion is much increased by in-
tense feelings either of joy or grief.
The tears have not yet been subjected to an accurate analysis,
partly perhaps from the subject being one of little interest in
a scientific point, and partly from the difficulty of obtaining a
sufficient quantity.
When examined under the microscope, the tears exhibit a
small quantity of pavement epithelium and a few mucus-cor-
puscles swimming in a clear fluid. They have a slightly saline
taste, (much like that of the perspiration that exudes from the
forehead,) and change red litmus-paper to a pale blue.
The only chemical examination of the tears that can be de-
pended on is that of Fourcroy and Vauquelin, who assert that
they resemble in their constitution the aqueous humour of the
eye. The solid constituents amount to only Ig, and consist prin-
cipally of chloride of sodium and of a yellow extractive matter
which is not perfectly soluble in water : it is not improbable
that the insoluble portion arises from the fatty-mucous secretion
of the meibomian glands. The mucus also into which, accord-
ing to those chemists, the extractive matter of the tears is con-
verted previously to its being perfectly dried, may be, as Ber-
zelius conjectures, the secretion of the meibomian glands. With
regard to this latter secretion, the gummy secretion of the
eyes, we know even less than of the tears : it seems to consist
principally of a mucous matter and of fat.
ii. 23
354 THE SECRETIONS:
Cerumen.
The glandulae ceruminosae, which are situated in the external
skin of the meatus auditorius externus, secrete the ear-wax
(cerumen), a peculiar salve-like matter, which is thrown out as a
yellowish milk.
If a small portion of ear-wax is pressed between two slips of
glass and observed under the microscope, we shall find a quan-
tity of variously-grouped lamellae lying in a tolerably homoge-
neous yellow mass. In these lamellae, the practised observer
will easily recognize pavement epithelium. On mixing the ear-
wax with water, which may be readily done, a sort of yellowish
milk is obtained, in which, with the microscope, we may observe
colourless fat-vesicles, epithelium- scales, and sometimes rhombic
crystals, very like cholesterin. The yellow colour of the cerumen
does not belong to the fat, but to the matter which is soluble
in water. Berzelius has made the following observations on the
cerumen. Ether takes up fat from the mass which swells in it,
and becomes as soft as goose-grease ; it has not an acid reaction,
consists of stearin and olein, and contains a substance which,
after saponification, gives off a strong smell of sweat. The
fatty acids which are liberated on the addition of hydrochloric
acid melt at 104. After the fat has been removed, alcohol
takes up a yellow substance from the ear-wax, which, on eva-
poration of the alcohol, is left as a glossy matter, perfectly
soluble in water, and of a very bitter taste. It may be en-
tirely thrown down from its aqueous solution by the neutral
acetate of lead and by chloride of tin ; on the other hand,
nitrate of silver does not even render it turbid; hence there
can be no chlorides present. Upon incinerating this mass,
there remains an ash, which consists of the carbonates of pot-
ash and lime. The portion not dissolved by alcohol yields to
water a small amount of yellowish matter, which is very similar
to the soluble matter obtained in a similar manner from the other
fluids of the animal body, and has a piquant taste ; but it is
distinguished by the circumstance that neither lime-water, basic
acetate of lead, bichloride of mercury, nor tannic acid preci-
pitate it.
The portion of the ear-wax which is insoluble in ether,
CERUMEN. 35")
alcohol, and water, is, next to the fat, the largest : acetic acid
causes it to swell, and only takes up a very small portion of an
albuminous matter. The residue (consisting evidently of nothing
but epithelium-cells) is partly soluble in free potash, from which
it cannot be again precipitated by acetic acid; ferrocyanide
of potassium causes no precipitate in the acid solution, but
infusion of galls a very copious one. Another portion of the
residue, when heated with a concentrated solution of potash,
enters into combinations which are not soluble in that fluid,
but which are soluble in water, similar to what is observed in
the urine.
This investigation shows that the ear-wax is an emulsive com-
pound, which contains a soft fat, albumen, a peculiar extractive
bitter matter, epithelium-scales, lactate of lime, and an alkaline
lactate, but no chlorides and no phosphates soluble in water.
CHAPTER IX.
SECRETIONS AND FLUIDS OF THE GENERATIVE ORGANS.
1. Secretions of the male generative organs.
SEMEN.
THE seminal fluid which is formed in the testicles and is
conveyed along the vas deferens, is a thick, whitish, glutinous
mass possessing a peculiar odour, and when examined under
the microscope is found to be composed of a clear fluid, in
which an immense number of minute caudate molecules, the
spermatozoa, appear to be moving about at will. (Fig. 33.) In
addition to the spermatozoa, seminal granules are likewise to be
seen, which, according to Wagner, are rounded, fine granular
corpuscles of 3 \^ 5^ of a line in diameter, and a few epithe-
lium-scales.
The spermatozoa occur in the semen of nearly all animals :
they are elliptic in man, but assume various forms in different
classes of animals.
The chemical analysis of the semen, although not an uninter-
esting subject, seems little calculated to throw any light upon the
remarkable process that is recognized in the term impregnation.
We cannot even form any conjecture regarding the connexion
and the reciprocal effect that must take place between the
fructifying semen and the ovum which is to be fructified ; and
although we cannot doubt that there are certain chemical pro-
cesses going on, since the act of impregnation is succeeded by
a change not only of form but of matter, we have as yet but
little prospect of investigating the subject successfully, in con-
sequence of the insufficiency of our resources.
The seminal fluid at the period of emission is somewhat
turbid, and is mixed with the mucous secretion of the prostate,
from which it cannot be separated. It has not always the same
SEMEN. 357
consistence, and the longer it remains in the vesiculse seminales,
the more consistent it becomes.
The investigations of Vauquelin, Jordan, and John have
elicited the following results, which, however, do not sufficiently
explain its chemical relations. When the seminal fluid has
been allowed to rest for some time, it becomes clear, more
fluid, transparent, and almost entirely soluble in water; if, 011
the contrary, it is at once dropped into water it sinks, and
instead of perfectly dissolving, it coagulates in threads, in the
same manner as if it had been treated with alcohol. This
coagulated matter is readily soluble in acetic acid, and the
solution gives a copious precipitate on the addition of ferro-
cyanide of potassium.
On allowing the coagulum to remain in water, it gradually
dissolves therein, leaving a residue of a few flocculi. The so-
lution, if rapidly evaporated, gives off the peculiar odour of
semen, and leaves a clear glossy residue, which is opaque in
water, and only partially dissolves in that fluid. From the
portion which is insoluble in water, alcohol takes up extractive
matter; and the portion insoluble in alcohol dissolves in boiling
water, leaving a mucous residue : the solution is precipitable by
acetate of lead, chloride of tin, bichloride of mercury, nitrate
of silver, and infusion of galls.
In semen which had stood for some time, Vauquelin found
four -sided prisms arranged in stellar groups, and terminating in
long four-sided pyramids, which Berzelius considers to have
been ammoniaco-magnesian phosphate. If the semen is allowed
to evaporate it becomes covered with a film, in which white
points may be observed, which are supposed by Vauquelin
to be composed, as well as the before-mentioned prisms, of
phosphate of lime. When the whole of the water has been
removed by evaporation, there remains a yellow, transparent,
elastic mass, which amounts to 10 of the weight of the semen.
Vauquelin, moreover, states that fresh semen is soluble in
all acids, from which it cannot be precipitated by alkalies, and
conversely, that it is soluble in the alkalies, from which it is
not precipitable by acids : chlorine-water, however, coagulates it
to such a degree as to render it insoluble in water or acids. If
the semen at the moment of emission is allowed to fall into
alcohol, and to remain in it for some time, it coagulates tho-
358 THE SECRETIONS:
roughly, becomes opalescent, and resembles a long thread : it
is now incapacitated from returning to a state of solution like
fresh semen, but remains, on being dried, fibrous, snow-white,
and opaque. It gradually softens in water, but even at the
boiling point only a very small portion dissolves in that fluid;
it swells, however, like mucus. If the water in which it has
been boiled is evaporated, a white matter remains, which is
partly soluble in cold, partly in boiling water, and the solution
is freely precipitable by tannic acid. That portion of the semen,
after coagulation by alcohol, which is not soluble in boiling
water, will also resist the action of dilute solution of potash at
a moderate temperature; it will, however, dissolve on being
heated with a concentrated solution of caustic potash, and it
cannot be again precipitated from this solution by acetic acid.
With concentrated sulphuric acid it forms a yellow fluid, with-
out the application of heat ; on the addition of water it is pre-
cipitated with a white colour, and the precipitate is not soluble
in an excess of water.
With acetic acid the coagulum becomes gelatinous and trans-
parent ; on being diluted and warmed it dissolves, but does not
form a perfectly clear fluid : this is only rendered turbid by fer-
rocyanide of potassium, is not precipitated by bichloride of
mercury or carbonate of ammonia, but by tannic acid is thrown
down in light floccules, which continue for a long time in
suspension.
From these researches Berzelius concludes that the semen
contains a peculiar matter which may be obtained in two sepa-
rate states depending upon whether it be projected into water
or alcohol. When coagulated by alcohol it has an external re-
semblance to fibrin, and, moreover, like that substance, it can
be precipitated from its acetic-acid solution by ferrocyanide of
potassium : on the other hand, it differs from it in its solubility
in nitric acid, and in its power of resisting the soluble action of
a cold solution of potash.
On heating the residue of the semen it becomes yellow,
emits an odour of burnt horn, gives off a considerable quantity
of ammonia, and leaves a carbonaceous mass which is not
easy of incineration, and contains carbonate of soda, chloride
of sodium, and phosphates of lime and magnesia. Vauquelin
assigns the following composition to the seminal fluid.
SEMEN. 359
In 100 parts there are
Peculiar extractive matter . . 6
Phosphate of lime . . .3
Soda . . . .1
Water . . . .90
According to John, the seminal fluid contains a substance
resembling mucus, with small quantities of a peculiar form of al-
bumen, of a substance slightly soluble in ether, of soda, phosphate
of lime, chloride of sodium, sulphur, and a volatile odorous
principle.
The prostatic fluid which mixes with the semen of the male,
at the moment of emission, has never yet been procured in
sufficient quantity for analysis : it forms an almost clear fluid,
which may be drawn out in threads.
2. Secretions of the female generative organs.
LIQUOR AMNII.
The liquor amnii surrounds the foetus : at the period of de-
livery the membranes which contain it give way, and it escapes
externally. Although it has been submitted to numerous ana-
lyses, its nature, even now, is not clearly understood. Human
liquor amnii is turbid, and holds in suspension flocculi of caseous
matter, arising from the vernix caseosa with which the foetus
is covered. Its specific gravity is 1005, and it contains from
l-2to 1'6 of solid constituents; but according to Fromherz and
Gugert, as much as 3. It has a very decided alkaline reaction,
but the indications of this reaction disappear when the test paper
is dried ; it is consequently dependent on free ammonia.
Alcohol took up extractive matter from the residue of the
liquor amnii, and there remained, according to Fromherz and
Gugert, a quantity of albumen, salivary matter (ptyalin), and
casein.
When evaporated to the consistence of a syrup, and treated
with hydrochloric acid, acid flocculi separated themselves, which
were recognized, after a careful analysis, as benzoic acid.
Berzelius, however, supposes that it might have been hippuric
acid. After the fluid had been filtered, and the above matter
removed, nitric acid was added and the mixture submitted
360 THE SECRETIONS:
to the action of cold. Verrucose crystals then separated them-
selves, which were assumed to be composed of nitrate of urea,
without being further analysed.
The salts of the liquor amnii are described as consisting of
chloride of sodium in large quantity, phosphate, sulphate, and
carbonate of soda, sulphate of lime, and a small amount of
potash-salts.
The analyses of Voigt, which were made with the liquor amnii
of women who had died in various stages of pregnancy, give
discordant results, probably as Berzelius supposes from the cir-
cumstance of the fluid at the full time being different from
what it was in the early stages of pregnancy. The liquor amnii
at the fourth month was not turbid, had an insipid taste, a
specific gravity of 1018-2, a neutral reaction, frothed upon
being shaken, coagulated on boiling, was precipitated by bi-
chloride of mercury and tannic acid, and less copiously by
perchloride of iron and acetate of lead. After coagulation by
boiling, the fluid which had been cleared by filtration, was
strongly precipitable by nitric acid, while it was very little
affected by chloride of barium, lime-water, ammonia, or oxalate
of ammonia. Perchloride of iron, and chloride of platinum,
produced no effect upon it.
The liquor amnii at the sixth month was turbid, yellowish,
viscid, had a specific gravity of 1009'2; when heated to the
boiling point gave a mucous coagulum which could not be se-
parated by filtration, and its behaviour towards reagents was
the same as in the former case. As to casein, ptyalin, urea,
benzoic and hippuric acids, Voigt was as unable to find them
as carbonate of ammonia or sulphuret of ammonium, and he
conceives that at least some of these substances may arise from
the foetal urine which becomes mixed with the liquor amnii
previous to delivery. Voigt' s view of the composition of the
liquor amnii is as follows :
At the 4th month. At the 6th month.
Water . . . 979-45 990-29
Alcohol-extract and lactate of soda 3-69 0-34
Albumen . . .10-77 6-67
Chloride of sodium . . 5-95 2-40
Sulphate and phosphate of lime . 0-14 0-30
LIQUOR AMNII. 361
[Four specimens of liquor amnii examined by Dr. Rees 1 , ex-
tracted from four individuals in the 7J month of pregnancy,
contained the same constituents. The specific gravity varied
from 1008-6 to 1007. They were alkaline, contained urea, and the
same salts as occur in the blood. One specimen contained :
Water ...... 984-98
Solid constituents ..... 15*02
Albumen with traces of fatty matter . . .1-80
Extract soluble in water { ^gL ic matte r, chiefly albumen I' 22 } 6 ' 02
I" Salts . . 2-80]
Do. soluble in water and alcohol < Organic matter, chiefly I 7'20
(_ lactic acid and urea 4-4 J
The caseous matter floating in the liquid contained cho-
lesterin.
The liquor amnii at the full time has been recently analysed
by Mack, 2 who obtained two specimens for examination from
Dr. Mikschik. The fluid in both cases was perfectly pure, the
membranes being ruptured as they projected from the external
organs.
The quantity of the fluid in the first case amounted to a little
more than an ounce and a half; it was turbid, with white flocculi
of vernix caseosa in suspension ; it had a sickly odour, and a
faintly saline taste. Under the microscope there were seen
isolated mucus- corpuscles, with pavement and ciliated epithelium.
The specific gravity was 1006-3, and the reaction faintly alkaline.
The fluid coagulated slightly on heating, and became covered
wjth a thin membrane during evaporation.
The amount of fluid obtained in the second instance was
slightly above two ounces ; the specific gravity was 1004-7 ; the
reaction alkaline ; and the other physical characters the same
as in the former case. In 1000 parts there were contained :
1.
2.
Water
985-147
988-123
Solid constituents
14-853
11-877
Fat
1-250
0-132
Alcohol-extract
5-251
4-752
Water-extract
4-651
4-352
Matter insoluble in water
3-701
2-641
Sulphate of lime
Chloride of sodium and "1
carbonate of soda . J
1-722 1
7-611 j 9 ' 333
1-6721
7-564 j 9-236 fixed salts.
1 Phil. Mag. (3d series) vol. 13, p. 395.
2 Heller's Archiv fur physiol. und pathol. Chemie und Mikroskopie, vol. 2, p. 218.
362 THE SECRETIONS:
Urea and hippuric acid were carefully, but unsuccessfully,
sought for in both specimens ; neither could carbonate or hy-
drosulphate of ammonia be detected.
It is suggested by Mack that the discrepancies in the results
obtained by other chemists may be owing to their having ex-
amined the fluid mixed with blood, mucus, or urine. Two years
ago he analysed a specimen (under the superintendence of Dr.
Ragsky) which contained much blood and mucus. The fluid
was of a dirty yellow colour, and deposited a sediment. Under
the microscope there were seen blood- and mucus-corpuscles,
with epithelium-cells. The specific gravity was 101 1*2.
In 1000 parts there were contained :
Water . . . 984-131
Solid constituents . 15-869
Fat . . . 0-4984
Alcohol-extract . 0-8529
Water-extract . . 4-0998
Substances insoluble in water 10-4177 J
Several analyses have been made of the liquor amnii of
animals. A very remarkable observation on this subject was
made by Prout. The liquor amnii of a cow in an early stage
of pregnancy was of a yellow colour, and opaque in consequence
of holding a large quantity of glittering particles in suspension ;
its taste was like that of fresh whey, it smelt like fresh milk, and
was neutral to test paper. Upon heating it to the boiling point it
coagulated; coagulation was, however, prevented by the addition
of acetic acid : with chloride of barium it gave a copious preci-
pitate. The fluid which had been boiled gave, after filtration and
evaporation, crystallizable sugar of milk, from which alcohol took
up a yellow extractive matter with some lactates. Berzelius
remarks that the presence of sugar of milk in the liquor amnii
at an early period, is of the greatest physiological interest, since
it doubtless contributes to the nutrition of the foetus. Prout
gives the following as the composition of 100 parts of this
fluid:
Water .... 97'70
Albumen .... 0-26
Alcohol-extract and lactates . . 1-66
Water-extract, salts, and sugar of milk . 0-38
In the liquor amnii of a mare which Voigt examined, he also
FLUID OF THE ALLANTOIS. 363
found no urea. It had a specific gravity of 1005*1, and left
a solid residue of 1'45, half of which was soluble in alcohol :
the portion which was not soluble in it consisted of albumen,
chloride of sodium, and sulphate of lime.
In the liquor amnii of a cow, which was viscid, very thick,
of a yellow colour, and had a saltish taste and an alkaline reac-
tion, Lassaigne found albumen, mucus, a yellow matter analo-
gous to bile, chlorides of sodium and potassium, carbonate of
soda, and phosphate of lime : no extractive matters are enu-
merated amongst the constituents. The flocculi which are
suspended in the liquor amnii of the cow are said by this che-
mist to be composed of albumen with 0'27 of their weight of
oxalate of lime.
I have already treated of vaginal mucus, menstrual blood,
and the secretion of the mammary glands ; it still remains for
me to offer a few remarks on the fluid of the allantois. The
allantois with its inclosed fluid is absent in the human em-
bryo: it is found, however, in many animals. It is situated
above the amnion, and it is between these two membranes that
the urine of the foetus collects, being conveyed there by the
urachus from the urinary bladder, and constituting the fluid of
the allantois.
It has several times been the object of chemical investiga-
tion; it is clear, of a brown-yellow colour, of a bitter and saltish
taste, and reddens litmus paper. Its specific gravity, according
to Dzondi, fluctuates between 1003 and 1029. On evapora-
tion flocculi are precipitated, which consist of albumen and
phosphate of lime. The residue left after evaporation is very
slightly soluble in alcohol, which takes up a yellowish-brown
acid extractive matter, and white nacreous crystals which retain
their form upon mixing the residue obtained by evaporation with
water, and constitute allantoin, which was first termed by
Vauquelin, amniotic acid, and by Lassaigne, allantoic acid.
The substances remaining in the watery solution, are chloride
of sodium, alkaline lactates, a salt of ammonia, and extractive
matters. From the portion insoluble in alcohol, water takes up
sulphate and phosphate of soda, phosphates of lime and mag-
nesia, and a brown extractive matter which is copiously precipi-
tated by infusion of galls. Whether the fluid of the allantois
364 THE SECRETIONS:
contains urea as well as allantoin is a point not yet ascer-
tained. 1
In speaking of the liquor amnii we mentioned that the
floccules which are seen swimming in it are derived from the
peculiar caseous matter, the vernix caseosa, which invests the
foetus. I shall avail myself of this opportunity of offering
a few remarks upon this substance. Upon examining this ca-
seous investment with the microscope, I found, especially when
it had been previously diluted with water, a very large quantity
of pavement epithelium, numerous fat-vesicles, and some but
not a great many crystals, which in part resembled cholesterin,
and in part distinctly assumed the form of ammoniaco-magne-
sian phosphate.
Upon examining the vernix caseosa by the microscope, with-
out previously diluting it with water, indications of a large
number of crystals presented themselves; they disappeared,
however, on the addition of water, and I concluded that this
peculiar appearance was caused by epithelium-cells.
According to Fromherz and Gugert the vernix caseosa con-
sists of a mixture of fat resembling cholesterin with coagulated
albumen. Microscopic investigation at once shows that what
was considered by these observers as albumen, was at any rate
for the most part epithelium, and that a considerable quantity
of fluid fat must be present besides cholesterin. They also
state that ether takes up from the vernix caseosa a fat which
crystallizes in glittering leaves, which does not admit of sapo-
nification, and does not melt in boiling water. Cold water
takes up a little of the portion which is insoluble in ether, and
boiling water takes up a yellowish substance with an alkaline
reaction, which they regarded as ptyalin, but which Berzelius
conceives to be most likely albuminate of soda. The residue
is evidently epithelium, since it is insoluble in a cold, but
soluble in a boiling solution of potash.
[The most recent observations on the vernix caseosa are those
of Dr. Davy. 2 He states ' ( that its specific gravity (after the
air that is entangled in it is removed) is 1003-9. It is very
1 See vol. I, p 57. a Medico-chir. Trans. 1844, p. 193.
VERNIX CASEOSA. 365
retentive of water. It required ten hours' exposure over the
steam-bath, to expel from eight grains the whole of the water
belonging to it, when it was reduced to 1*77 grain. A spe-
cimen of great purity taken from a healthy infant immediately
after birth was found to consist of :
Water . . . 77-87
Olein . . . 5-75
Margarin . . 3'13
Epithelium-scales . . 13-25
100-00
" A portion of the same was incinerated : it burned with a
bright flame and left a very small quantity of white ash,
hardly ^th of a grain, although 40 grains was the quantity con-
sumed, weighed before drying. This ash, in a drop of dilute
muriatic acid, dissolved, emitting a distinct smell of sulphuretted
hydrogen ; and the solution was clouded by adding a little am-
monia, indicating the presence of a minute portion of phosphate
of lime and sulphur the latter in union probably with lime or
potash."]
366
CHAPTER X.
THE INTESTINAL EXCRETIONS.
THAT portion of the food which is not taken up by the absor-
bents which are everywhere distributed between the stomach
and the large intestine is again discharged from the system as
faeces.
The faeces must materially vary with the species of food that
is taken, and with the energy of the digestive powers. When we
see that many men are kept in a better and more desirable con-
dition on a very small quantity of food, than others who take
a larger amount of nutritious aliment, we must necessarily
conclude that in the former case everything which could possibly
serve for nutrition was extracted and suitably employed, while
in the latter we must suppose that only a small portion of
nutritive matter was taken up from the large quantity of food,
and that the greater portion was discharged with the faeces.
In accordance with what I briefly stated respecting the fluid
secretions of the chylopoietic viscera in relation to the process
of digestion, it follows that after food has been taken the faeces
must contain (1) that portion of the food which has not been
absorbed, and (2) the addition which is received in the form of
secretion from the intestinal canal and its appendages, between
the mouth and the anus. These consequently are, those sub-
stances which are altogether insoluble in the digestive fluids,
as for instance, vegetable fibre; those which, although capable
of digestion, have from various causes not been digested, as for
instance, the flesh of old animals, sinews, ligaments, fat, &c. ;
the bile, more or less modified, together with biliphaein and
cholesterin, the mucus of the intestinal canal, and a consi-
derable amount of salts, amongst which ammoniaco-magnesian
phosphate is especially distinguished by its well-defined crystals.
The faeces of adults are, however, different from those of the
FJECES. 367
foetus and the infant at the breast, as the following analyses
will show.
I have made an analysis of the faeces of the foetus, the
meconium; it constituted a thick, glutinous greenish-black
mass, had a sweetish insipid odour, and a corresponding taste :
when examined with the microscope, after being diluted with
water, a very large number of epithelium-cells and numerous
rhombic plates, resembling crystallized cholesterin could be
seen, besides a green-coloured amorphous mass which was pre-
sent in considerable quantity.
A small number of minute rounded corpuscles, which upon
floating about, allowed me to recognize their flattened shape,
appeared to be discoloured blood-corpuscles.
Ether took up, from the dried meconium, a firm white fat,
cholesterin; alcohol took up some extractive matter with
bilifellinic acid; spirit took up a substance reacting exactly like
casein, together with some bilifellinic acid ; finally, alcohol aci-
dulated with sulphuric acid took up some green bile-pigment.
There remained cells, mucus, and probably albumen.
100 parts of the dried meconium contained :
Analysis 149.
Cholesterin . . . 16-00
Extractive matter and bilifellinic acid . 14-00
Casein .... 34-00
Bilifellinic acid and bilin . . 6-00
Biliverdin with bilifellinic acid . . 4-00
CeUs, mucus, albumen . . 26-00
The ash of meconium consists, according to Payen, of an
alkaline carbonate, and phosphate of lime.
[Dr. Davy 1 has recently examined the meconium both micro-
scopically and chemically. " It may be advantageously examined
by the microscope, either mixed with water or in a saturated
solution of common salt, or merely compressed between two
plates of glass. Using either method, its appearance is much
the same, it exhibits a confused mixture of globules, plates,
and molecules.
" The globules, about 1 -3000th of an inch in diameter, are very
1 Medico-Chirurg. Trans. 1844, p. 189.
368 THE EXCRETIONS :
abundant, and form the principal mass of the whole. Judging
from their form and size, their insolubility in water and alcohol,
they may be inferred to consist chiefly of mucus.
' ' The plates, which are tolerably abundant, are of two kinds :
one kind is of irregular form, somewhat granular, varying in
size from about 1 -2000th to 1 -1000th of an inch in diameter,
insoluble in water, alcohol, whether hot or cold, and the dilute
acids and alkalies after the manner of epithelium- scales, which
we believe them to be. The other kind are of a regular form,
chiefly rhomboidal, of great thinness and perfect transparency,
insoluble in water and acids and cold alcohol, but readily so-
luble in hot ; properties sufficiently indicative of cholesterin.
"The molecules vary in size from l-8000th to l-20,000th of
an inch in diameter ; and, as they are insoluble in water, and
in most part soluble in an alkaline ley, they may be considered
as consisting chiefly of fatty matter. They constitute a very
small part of the whole.
" Besides these ingredients admitting of being distinguished
by the microscope, to which the meconium owes its thick con-
sistency and viscid nature, there is another portion, the soluble
part, with which they are imbued, and from which the mass
derives its colour and taste, and probably its power of resisting
putrefaction, and which seems identical with the colouring and
sapid matter of bile, being soluble in water and alcohol. 1
" The specific gravity of meconium, deprived of air, exceeds
that of water. It sinks in a saturated solution of common
salt of the specific gravity of 1148.
" This mixture of meconium and brine affords, after standing
for some time, a kind of mechanical analysis or separation of
its ingredients. The mucus-globules and epithelium- scales,
dyed of a dark green by the colouring matter, find their place
of rest at the bottom, whilst in the supernatant fluid, slightly
turbid, and of a bright greenish-yellow hue, numerous plates of
cholesterin, and a smaller number of fatty globules and mole-
cules are found suspended."
1 This property of meconium is remarkable. After more than three months a
portion put by in a bottle containing a good deal of air, closed to prevent the drying
of the substance, was found unaltered in colour, and presenting the same appearance
under the microscope as when first examined ; the only perceptible difference was
that its upper surface was covered with a mould or mucor, like that of cheese, formed
of connected globules, each about 1 -5000th of an inch in diameter.
F^CES. 369
Every specimen examined by Dr. Davy, (some voided just
after birth, others taken from the intestines of still-born chil-
dren,) was very similar, composed chiefly of mucus-globules and
epithelium- scales, and of biliary matter containing, besides the
colouring and sapid matter of the bile, a small portion of cho-
lesterin, of margarin, and olein, with a little free acid, probably
the carbonic, judging from the absence of a precipitate on the
addition of nitrate of silver, and from the circumstance that
the redness imparted to litmus paper was removed by heat.
A specimen obtained from a healthy child immediately after
birth, contained :
Water . . . .72-7
Mucus and epithelium-scales . . 23-6
Cholesterin and margarin . . 07
Colouring and sapid matter of bile, and olein . 3-0
100-0
A portion of the same meconium was incinerated. It burned,
after becoming semifluid, with a bright flame, and left '69 of
reddish ash, chiefly peroxide of iron and magnesia, with a trace
of phosphate of lime and chloride of sodium : the magnesia
seemed to be the predominant ingredient and uncombined.]
I have likewise analysed the fseces of an infant six days old,
nourished on its mother's milk. They were pultaceous, of a
yellow colour, had a strong acid odour, and both smelled
and tasted like sour milk. When the mass was diluted with
water, I could observe through the microscope an extraordinary
number of fat-vesicles ; there were no epithelium- cells, but I
found an amorphous consistent matter resembling coagulated
albumen or casein. The proportion of fat was so large that on
evaporation the whole mass became fluid. Ether took up this
fat, which appeared to be more solid than butter, but contained
no cholesterin, since it was perfectly saponifiable. After
the removal of the fat, the faeces did not yield any extractive
matter to alcohol, but gave biliverdin to alcohol acidulated with
sulphuric acid. On extracting this colouring matter with ether,
a considerable quantity of green fat was taken up.
ii. 24
370 THE EXCRETIONS:
100 parts of the dried fsecal mass contained :
Analysis 150.
Fat ... 52-00
Bile-pigment with fat . . 16-00
Coagulated casein with mucus . 18 '00
Moisture and loss . .14-00
No accurate analysis of the excrements of the healthy adult
has been made, that I am aware of, since 1804, when Berzelius
investigated the subject : I shall therefore give his results. The
excrements mix very gradually with water, which they render
mucous and turbid, and which is a long time clearing itself :
on decanting the mixture, there remains a grayish-brown re-
sidue consisting of insoluble vegetable matter, through which
a thick grayish-green fluid permeates, depositing a copious
sediment when placed in a corked bottle.
The thinner supernatant portion can only be filtered with
difficulty. If the fluid is very concentrated, and is at the same
time clear, it will soon be observed to become dark, a change
of colour apparently due to the action of the atmosphere.
When this fluid is evaporated, crystals of ammoniaco-magne-
sian phosphate gradually form on the surface; as they were not
previously apparent we may conclude that the ammonia is sub-
sequently produced. On extracting with alcohol the residue left
after the evaporation of the water, a substance of a reddish-
brown colour is taken up, while a grayish-brown matter (A)
remains undissolved.
The alcoholic solution yields on evaporation a residue which
forms a resinous precipitate with sulphuric acid, consisting of
bilifellinic acid with an excess of bilin, which may be separated
by oxide of lead into bilifellinate of lead and bilin.
On distilling the mixture with sulphuric acid we obtain a
fluid which yields traces of hydrochloric but not of acetic acid:
on saturating the sulphuric acid in the residue with baryta,
after the separation of the biliary resin, and then evaporating,
and treating the dry mass with alcohol, an extractive matter of
a reddish-brown tint is taken up, which is apparently the cause
of the change of colour to which we have already alluded in
the concentrated aqueous solution of the feeces. This sub-
stance is soluble in alcohol and in water, is almost entirely
precipitated by the salts of tin, lead, and silver, and on the addi-
FAECES. 371
tion of an acid a bright red deposit is formed. On adding a
little tannic acid it is precipitated in the form of a red powder,
and by an excess of that reagent, in greyish-brown flocculi.
The substance (A) which is soluble in water but not in al-
cohol, consists of albumen coloured brown by bile, containing,
mixed with it, alkaline sulphates and phosphates, and phosphate
of lime.
That portion of the faeces which is insoluble in water, and
remains floating on its surface, consists of a mixture of intes-
tinal mucus and of the substances precipitated by the bile : it
is very viscid, clogs up the pores of filtering paper, and dries
upon it as a glistening, brittle, and elastic coating ; on being
again placed in water it softens, and, especially if any free alkali
is present, becomes viscid as before.
This mass is perfectly soluble in caustic potash, and may
be again thrown down by the addition of an acid ; the fluid
then gives off an odour of bile. Ether and alcohol take up fat
and biliary resin, and yield greenish extracts. The ethereal
solution becomes turbid on the addition of alcohol in conse-
quence of the precipitation of fat ; the residue left after eva-
poration melts in boiling water, leaves spots of fat on filtering
paper, and dissolves in caustic potash; hence it contains no
cholesterin. The portion left after the aforesaid extractions
with ether and alcohol, imparts to water a peculiar yellow
matter, which soon changes to a darker tint after exposure
to the air ; it is devoid of odour or taste, and rapidly becomes
putrid. It is at first insoluble in alcohol, but it becomes soluble
as decay commences ; moreover when fresh it is hardly rendered
turbid by the addition of infusion of galls, but is strongly precipi-
tated by that reagent after the commencement of putrefaction.
If this substance, when quite fresh, is mixed with the solution
of fat and biliary resin which we have just described, we observe
a grayish-green precipitate which deposits itself as slowly as the
precipitate from which these substances were originally obtained.
Hence, as Berzelius remarks, we may conclude that the excre-
ments contain an insoluble combination of the constituents of
the bile, with other materials which have been added to it in
the course of the digestive process.
The analysis of human faeces, sufficiently consistent to form
372 THE EXCRETIONS:
consistent masses, yielded to Berzelius the following results in
1000 parts :
Water ..... 733-0
Solid constituents .... 267'0
Bile 9-0
Albumen
Peculiar extractive matter
Salts
Insoluble residue of food
9-0
27-0
12-0
70-0
Substances added in the intestinal canal, as mucus, biliary
resin, fat, a peculiar animal matter, &c. . . 140-0
The salts in this analysis were determined by a separate
experiment : three ounces of fresh excrement were repeatedly
extracted with water, and the residue obtained by evaporation
was incinerated.
The ash was composed of:
Carbonate (lactate) of soda . . 3-5
Chloride of sodium . . . 4-0
Sulphate of soda . . .2-0
Phosphate of magnesia . . . 2-0
Phosphate of lime . . .4-0
15-5
We observe that there is a considerable proportion of phos-
phate of magnesia, and a much larger of phosphate of lime ;
the former constituting 13'3 and the latter 26-6 of the salts.
The comparatively large amount of phosphate of magnesia may
be partly accounted for by the use of coarse bread, which con-
tains a considerable quantity of this salt.
From dried excrements Berzelius obtained 15Og of fixed
salts, of which 10 were earthy phosphates with a trace of
sulphate of lime, 0'8 carbonate of soda, an equal quantity
of sulphate of soda with sulphate of potash and phosphate
of soda, and T6 silica originating from vegetable matters.
Nothing is said regarding the chlorides ; they were probably
not determined.
[Enderlin has instituted numerous observations on human
faeces, chiefly in reference to the salts.
A. Fresh excrements of a yellowish-brown colour, a pulpy
appearance, and an alkaline reaction, were dried and incinerated.
PRICES. 3/3
The resulting ash was white, alkaline, effervesced on the addition
of an acid, and contained :
Tribasic phosphate of soda (a little).
Chloride of sodium.
Alkaline sulphates.
Phosphates of lime and magnesia (in abundance).
Carbonate and sulphate of lime.
Phosphate of iron (a trace).
B. Another portion of the same excrement was extracted
with water, and the brown, alkaline solution evaporated on the
water-bath.
During the process of evaporation there was formed on the
surface a tenacious, yellowish-brown film, which, when removed,
was speedily replaced.
a. One half of the evaporated aqueous extract was incine-
rated. The ash was very alkaline, effervesced briskly on the
addition of an acid, and contained :
Alkaline carbonates. Alkaline sulphates.
Alkaline phosphates. Chloride of sodium and earthy phosphates.
b. The other half of the evaporated aqueous extract was treated
with alcohol, which assumed a tint varying from a red to a
green, and had an alkaline reaction. On evaporating the al-
coholic solution, an alkaline ash was obtained, consisting, for
the most part, of tribasic phosphate of soda and chloride of
sodium.
The membrane and other matters not taken up by alcohol,
yielded a neutral ash consisting of phosphates of lime and
magnesia, with traces of chloride of sodium and alkaline phos-
phates.
c. The portion of excrement not taken up by water, yielded
a neutral ash consisting of :
Phosphates of lime and magnesia.
Sulphate of lime.
Traces of chloride of sodium and alkaline phosphates.
With a solution of baryta, the alcoholic solution yielded a
very bulky, yellowish-green precipitate ; and, on the addition
of basic acetate of lead, there was a considerable sediment so-
luble in acetic acid, decolorization of the fluid, &c. ; hence un-
changed choleate of soda was present. The occurrence of this
constituent was, however, by no means invariable ; and, gene-
374 THE EXCRETIONS:
rally speaking, choleate of soda (or bile) may be expected to be
absent when the faeces have remained for some time in the
large intestine, and there has been full opportunity for re-
sorption.
It follows that the carbonate of lime is a product of the
double decomposition that occurs between the sulphate of lime
and the carbonate of soda resulting from the incinerated cho-
leate of soda, or bile.
The formation of the membrane during evaporation indicates
the presence of a certain amount of albumen.
In 100 parts of the ash yielded by the excrement of another
individual, there were contained :
Chloride of sodium and alkaline sulphates 1*367 i , , , .
Uoluble in water.
Bibasic phosphate of soda
Phosphates of lime and magnesia
Phosphate of iron . . - ~.,~ ,
... . _ ^insoluble m water.
Sulphate of lime
Silica ....
98-932
From the absence of carbonate of lime in this instance, it
may be concluded that no choleate of soda or bile was present.
The excrement was very firm and solid.
I am indebted to the kindness of Dr. Percy for the follow-
ing analyses of the faeces.
1. The individual, who was about thirty years of age, had
taken the ordinary diet of this country, and appeared to be in
the enjoyment of perfect health.
In 100 parts of dried residue there were contained :
Substances soluble in ether (brownish yellow fat) . 11 '9 5
in alcohol of -830 . . 10-74
,, in water (brown resinoid matter) . 11-61
Organic matter insoluble in the above menstrua . 49-33
Salts soluble in water . . . . 4-76
Salts insoluble in water .... 11-61
An ultimate analysis of the faeces in this case was also insti-
tuted. " I may here premise/' says Dr. Percy, " that I have
invariably used chromate of lead as the oxidising body, and
have occasionally sheathed the combustion tube with thin sheet
copper, in order to enable me to attain a high degree of heat
F^CES. 375
towards the close of the combustion, a precaution essentially ne-
cessary in the analysis of these matters, as the last trace of carbon
cannot, without this precaution, be completely burned. In
corroboration of this statement I may mention that the perfect
incineration of faeces at a red heat requires a considerable time.
The matter was prepared for analysis by first drying over the
water-bath, and then either in an oven at the temperature of
212 or some degrees above, or in the salt-water bath and by a
current of air desiccated by chloride of calcium. I was extremely
particular in respect to the drying, and, generally, in a second
analysis, employed matter which had been subjected to the
drying process for a much longer time than in the first, so that
the correctness of the proportion of hydrogen should be satis-
factorily tested.
1st Analysis: 7'41 grs. gave of water 4-43 or of hydrogen 6-64g, of C0 2 12-55
or of C 46-18.
2d Analysis : 7-24 grs. gave of water 4-44 or of hydrogen 6-81g, of C0 2 12-28
or of C 46-23g.
Incineration : 50-13 grs. gave of ash 8-21, or 16'37g.
Nitrogen not yet determined.
Taking the mean, we have :
C 46-2(K
H 6-72
N&O . . 30-71
Ash 16-37 J
L 100-00
" These results are very nearly the same as those obtained
by Dr. Playfair, 1 at Giessen, His analysis gives C45-24,
H6-88, N&O 34-73, ash 13-15. These facts are worthy of
attention, as they seem to show that, under ordinary circum-
stances of health, the composition of the faeces is more uniform
than we might a priori have anticipated. The first analysis,
it will be borne in mind, was of the faeces of a man in this
country; the second, of a soldier at Giessen.
" 2. A man undergoing the curious and rigorous discipline
of training for prize-fighting. This individual, it will not be
doubted, was in the possession of the most perfect health. He
had been in training for about a week. Age, 22; height, 5ft. 6in.;
weight, 8i stones. I request particular attention to the diet. He
breakfasted at 9 a.m., and took one pound of mutton weighed
before cooking. He dined at 1 p.m., took the same quantity of
1 Liehig's Animal Chemistry, 2d edition, p. 285.
3/6 THE EXCRETIONS :
mutton, and about two ounces of bread. He had the same quan-
tity of mutton for supper at 8 p.m. At each meal he drank half a
pint of ale, and no other liquid during the day ; nor, it must be
remembered, had he any other vegetable matter besides the small
quantity of bread mentioned. He walked seventeen miles daily.
1st Analysis : 5-35 grs. gave of HO 3-43 or H 7'12g, of C0 2 9'73 or C 49'60g.
2cl Analysis : 5-74 grs. gave of HO 3-62 or H 7'Olg, of C0 2 10-52 or C 49.98g.
The difference between these two analyses, in respect to the
carbon, is greater than should be allowed, but I had not time
to make a third analysis.
Incineration : 31'42 grs. gave of ash 4-56, or 14-51$.
Mean C . . . 49-79^
H 7-06
'06 I
J-64 f
N*0 . . 28-641
Ash . . . 14-5lJ
" I should observe that, in drying this specimen, towards the
end of the process a small quantity of liquid condensed on the
surface of the tube communicating with the vessel of water,
which was clear and colourless, had a peculiar and extremely
offensive odour, and which powerfully reddened litmus. I had
not sufficient leisure to examine it more minutely at the time." 1 ]
The faeces during disease.
In certain pathological conditions, the faeces frequently un-
dergo very important modifications. These changes cannot be
due to any peculiarities in the ingesta ; they must originate in
an alienated mixture or separation of the secretions of the
chylopoietic viscera. This irregularity may lead to imperfect
chymification, in w r hich case matters will be carried off with the
faeces, which, if they had been properly digested, would have
entered the vascular system ; or, in consequence of the changed
process of secretion, substances which are normal secretions
may be separated in too large a quantity, as, for instance,
water; or substances which ought to be present, are entirely
1 I strongly suspected the matter to be butyric acid, and my suspicion has since
been much strengthened by my examination of a specimen of pure butyric acid which
1 had an opportunity of seeing in London, at the Pharmaceutical Society. Besides,
Dr. Erwin Waidele, whom I had the pleasure of meeting at Professor Graham's,
informed me that Dr. Ragsky of Vienna has discovered this acid in the fceces.
PRICES. 377
absent, as, for instance, bile; or, lastly, substances which are
altogether foreign to the normal secretions, are mixed with the
faeces, as albumen, blood, &c.
In the case of diabetes alluded to in p. 296, I carefully ex-
amined the faeces. They contained no sugar, and were chiefly
remarkable for their large amount of solid fat. Two or three
pultaceous stools, averaging collectively 18' 5 ounces, were passed
daily. They gave off a very disagreeable odour, and were of a
grayish clay colour.
Alcohol digested with this faecal matter became coloured
brown, and extracted a large quantity of fat, extractive matter,
and a little bilin. On treating the portion insoluble in alcohol
with water, a small amount of water-extract, almost devoid of
taste, was taken up. The insoluble residue yielded, on incine-
ration, an odour of burned horn or glue, and contained a large
amount of nitrogen. 1 A quantitative analysis showed that the
18-5 ounces of faecal matter contained :
Analysis 15J.
Whole quantity. In 100 parts.
oz. grains.
Water . . . 12 312
Solid constituents . . .5 408
Fat . . .20 34-0
Bilin and extractive matter soluble in "I ARC on
alcohol 2<0
Water-extract
Alkaline salts . .
Carbonate of lime
Earthy phosphates and peroxide of iron
Insoluble nitrogenous matters
56 2-0
1821 6-5
70 1 364 2-5
112J 4-0
2 359 47-0
I have attempted, in accordance with the plan laid down in
the appendix to Liebig's { Animal Chemistry,' to compare the
amount of carbon, nitrogen, and hydrogen in the food and in
the excretions.
The ingesta consisted of:
8 oz. of dry gluten bread.
11*5 dry meat.
2 dry egg.
2 cod-liver oil.
23*5 ounces.
1 [This is entirely opposed to the experience of Lehmann, who states that the faeces
of diabetic patients frequently yield a mere trace of nitrogen. Lehrbuch der physio-
logischen Chemie, 1842, p. 312.]
378 THE EXCRETIONS:
There were discharged :
By the urine. From the bowels.
8-8 oz. of sugar. 2 oz. of fat.
1-3 oz. of urea. 2'5oz. of nitrogenous insoluble faecal
15 grains of uric acid. matter & protein-compounds.
100 grains of extractive matter & bilin.
v j
15 ounces.
There is then an excess of 8 oz. of food.
In the food there are contained ; In the excretions there are contained :
12 oz. of carbon. 6*6 oz. of carbon.
1 oz. 6 drms. of hydrogen. 1 oz. of hydrogen.
2-5 oz. of nitrogen. 410 grains of nitrogen.
700 grains of fixed salts. 710 grains of fixed salts.
Hence there are carried off, by respiration and transpiration,
5*5 ounces of carbon, O75 of hydrogen, and 1-62 of nitrogen.
This quantity of carbon and hydrogen is much less than is
generally supposed to be carried off by the lungs ; and with
respect to the nitrogen, although we may assume that some is
carried off by the skin, the disproportion is still very great. An
accurate examination of the expired air might throw much light
on this obscure and remarkable morbid process.
[I am indebted to Dr. Percy for the following analyses of
diabetic faeces :
1. " Faeces of a boy aged 7 years. It was found impossible
in this case to enforce a rigid system of animal diet, so that
we may regard these faeces as the faeces of diabetes unchecked
or modified by treatment. They were hard, and not of the
natural consistence of health.
1st Analysis : 5-44 grs. gave of HO 3-35 or H 6'83g, of C0 2 8-76 or C 43'94.
2d Analysis : 4-72 grs. gave of HO 3-01 or H 7'09, of C0 2 7'58 or C 43'79.
Incineration : 30-76 grs. gave of ash 6'18, or 20'09.
Mean C . . . 43-86 ->.
Ash . . . 20-09
The proportion of saline matter is here much greater than
usual, and, doubtless, depended upon constipation.
The fat taken up by ether amounted to 16-16 of the dried
faeces.
FAECES. 3/9
2. "The faeces of a man (Flint) aged 48 years, who was labouring
under diabetes of long standing. He was restricted principally
to animal food, a small quantity of bread only being allowed.
Consistence moderate. This analysis was executed under my
own supervision by my former pupil, Mr. Stallard.
1st Analysis : 8-22 grs. gave of HO 5*61 or H 7*58, of C0 2 16-43 or C 54-51g.
2d Analysis : 8-57 grs. gave of HO 5-84 or H 7'57g, of C0 9 17'03 or C 54-20.
The nitrogen was determined by Wills' s method.
Nitrogen : 6-29 grs. gave of metallic platinum 5*33 grs., which corresponds to
12-Olg of nitrogen.
Incineration: 61-01 grs. gave of ash 5-71, or 9'36g.
Mean C . . . 54-35^
H 7-57 |
O 16-71 )> 100-00
N 12-01 |
Ash . . . 9-36J
Proximate Analysis :
Substances soluble in ether . . 22-00^
alcohol . 11-13 I
water . 12-02 )> 100-00
Organic matter, insoluble in these menstrua . . 45-49
Ash . . . . 9-36 J
3. "Faeces of the same individual some weeks afterwards,
while taking about three ounces of fat bacon daily, in addition
to his usual animal diet. It was evident after drying, that
these faeces abounded in fat from their appearance on the ap-
plication of heat. It was impossible to reduce them per se
to fine powder.
1st Analysis : 5-06 grs. gave of HO 4-22 or H 9'22g, of C0 2 11-20 or C 60'36g.
2d Analysis : 6-28 grs. gave of HO 5-25 or H 9-28g, of C0 2 13-89 or C 60-32.
Incineration : 55-93 grs. gave of ash 7'40, or 13'23.
Mean C . . . 60-34
' '
Ash . . . 13-23-
Ether took up a quantity of fat amounting to 5T55g of the
dried faeces.
4. " Faeces of the same individual a few weeks afterwards,
while restricted to an animal diet of the lean of meat : as far
as it was practicable all fat was removed.
380 THE EXCRETIONS:
1st Analysis : 7'06 grs. gave of HO 5-05 or H 7'95, C0 2 13-72 or C 53-OOg.
2d Analysis : 6-62 grs. gave of HO 4-77 or H 8-OOg, C0 2 12-93 or C 53-27g.
Incineration : 16-81 grs. gave of ash 2-96, or 17-60.
Mean C . . . 53-09^
5.0- : : 2 ^H
Ash . . . 17-60-1
5. " Faeces of a man (Roberts) 1 between 30 and 40 years,
labouring under diabetes of some standing. Diet, exclusively
animal, with the exception of a small quantity of bread.
1st Analysis: 4-53 grs. gave HO 3-07 or H 7'53g, C0 2 7'64 or C 45-99g.
2d Analysis : 5-33 grs. gave HO 3-67 or H 7'65, C0 2 8-92 or C 45'64g.
Incineration : 50-84 grs. gave of ash 10-77, or 2M8g.
Mean C . . . 45-81-.
' *
Ash . . 2M8J
6. " Faeces of the same individual, some weeks afterwards,
while on a mixed diet. At this time also he was much emaciated
and exhausted, in consequence probably of having been obliged
to work, and to subsist on a mixed diet.
1st Analysis : 5-13 grs. gave of HO 3-36 or H 7'28g, C0 2 8-63 or C 45-88g.
2d Analysis : 4-86 grs. gave of HO 3-18 or H 7'27, C0 2 8-21 or C 46-07g.
Incineration : 32-31 grs. gave of ash 7'14, or 22-10$.
Mean C . . . 45-97-,
'
Ash . . . 22-lo
In dysentery the stools are thin, contain flocculent mucus,
and are either almost colourless or milky, (dysenter. catarrh.)
or they are coloured red by blood (dysenter. inflammat.). Ac-
cording to Schonlein they possess a peculiar smell quite cha-
racteristic of the disease.
On examining the white or slightly coloured mucous fluid
under the microscope, we observe numerous mucus- corpuscles
floating about in it : the red, sanguineous discharges also con-
tain an extraordinary number of mucus-corpuscles, numerous
blood-corpuscles, but no (or very few) epithelium-scales.
We sometimes find pseudo-membranous portions of exuded
plastic lymph mixed with the stools, especially in the most in-
flammatory forms of the disease.
1 Roberts's case has been published in the Medical Gazette. He has since died,
and the sequel will shortly appear, together with the cases of the child affected with
diabetes, and of the other patient Flint.
M1CES. 381
In typhous diarrhoea the motions are frequently very bulky,
of a chocolate colour, frothy, mixed with black dissolved blood,
and not giving off the peculiar odour of dysenteric evacuations,
but rather a cadaverous smell. In bilious diarrhoea the bile-
pigment is mixed with the fluid motions, which are less copious
than in the former case.
In enteritis mucosa the stools, especially those which are
discharged during the night, are thin, and, in addition to the
mucus and fsecal matters coloured yellow by bile-pigment,
contain a peculiar flocculent mass, like exuded lymph, which,
on more accurate examination, seems to consist of purulent and
fatty matter. Blood is likewise sometimes found in these stools.
In abdominal typhus the stools are very characteristic; in
the first stage they do not differ very much from the normal
state ; they are sometimes very firm, sometimes very thin and
watery. In a more advanced stage of the disease, they sepa-
rate when shaken in a glass vessel into two strata; the lower
one forms a slightly yellow flocculent mass, while the upper
one is composed of a cloudy, whey -like fluid. On examining
the flocculent material under the microscope, I found that it
was composed, for the most part, of small lumps of mucus or
pus, of an amorphous yellow matter probably coagulated al-
bumen with bile-pigment, of a comparatively small quantity of
epithelium, and sometimes of extremely numerous and beau-
tifully formed crystals of ammoniaco-magnesian phosphate,
such as are depicted in fig. 27 : sometimes we find, as also in
phthisis intestinalis, small white masses about the size of a
millet, or half as large as a hempseed; they are easily triturated
and then have a greasy appearance ; when examined under the
microscope they appear to be composed of cells similar to pri-
mary cells or what are called the globules of inflammation. The
contents of these spherical cells, which are inclosed in a very
delicate membrane, are coarsely granulated and escape on the
least pressure.
In some of the larger parent cells, I found smaller cells with
nuclei. I dried a portion of the flocculent precipitate ; on in-
cinerating the residue I obtained 32 of salts, of which nearly
one half, namely, 14*6 were earthy phosphates.
The whey-like fluid which is above the sediment, is usually
tolerably rich in albumen. It coagulates, or at any rate be-
comes turbid on the application of heat or nitric acid. In
382 THE EXCRETIONS:
most cases it has a strong alkaline reaction, and contains a
large amount of carbonate of ammonia, which frequently in-
terferes with the action of heat on the albumen.
In some cases I observed that a beautiful rose-red tint was
produced by the addition of nitric acid, of which I shall speak
more fully in my observations on the stools in cholera. Typhous
stools are sometimes tinged with blood.
In melaena blackish pitchy blood is mixed with the faeces,
which sometimes consist entirely of that substance. I have
previously described the peculiarities of the blood. (See Vol. I,
p. 317.)
In catarrhus intestinor. the intestinal mucous membrane
acts very much the same as the mucous membrane of the re-
spiratory organs in pulmonary catarrh. The secretion is at
first checked,, then very much increased, and, finally, after
secreting thick and tough mucus, returns to its normal con-
dition.
In simple diarrhoea a thin muco-aqueous yellow, or yellowish-
brown discharge follows the evacuation of the true faeces.
In bilious diarrhoea the stools are also liquid, but they are
generally of a greenish colour, and possess so strong an acid
reaction as to produce excoriation of the anus.
In dysenteric diarrhoea a large quantity of gray or greenish
mucus tinged with blood, is discharged. In diarrhoea lactan-
tium, masses are discharged which are not unlike chopped eggs :
they have a strong acid odour, and exert a corroding effect on
the vicinity of the anus.
In Asiatic cholera it is well known that an extraordinary
quantity of watery fluid is discharged by the intestines.
Bulk found that the evacuations in cholera had an alkaline
reaction, that they contained albumen, and that they were en-
tirely devoid of the ordinary odour of faeces.
Hermann, 1 on the contrary, found that they had an acid
reaction, and resembled the vomited matter, in which he de-
tected free acetic acid. The ordinary reaction of the stools in
cholera is, however, alkaline, and this was observed in a veiy
severe case of sporadic cholera that fell under my own observation.
According to Vogel's observations, the stools in this disease
resemble turbid whey : the fluid has a powerful alkaline reaction,
and effervesces on the addition of an acid. On distilling a por-
1 Poggend. Annalen, vol. 22, p. 161.
F^CES. 383
tion of tlie fluid he obtained in the receiver a liquid with an
alkaline reaction, and having a fishy odour. On the addition
of nitric acid this liquid assumed a beautiful red tint, which it
retained during evaporation. The fluid, when concentrated, had
an intense red colour, but was devoid of odour, which only be-
came again apparent on neutralizing the free acid by an alkali.
The portion that remains in the retort after the distillation
of the fluid contains traces of albumen, some intestinal mucus,
the ordinary salts of the animal fluids, and a large amount of
carbonate of soda.
Wittstock's researches respecting the fsecal discharges in
cholera, coincide in most points with those of Vogel : he ob-
served the beautiful rose-red tint that was produced by the ad-
dition of nitric acid, and he ascribed it to the presence of an
urate ; it is however known, that the formation of purpurate
of ammonia or murexid from uric acid, requires a greater de-
gree of concentration of the reacting substances, and a height-
ened temperature.
The faeces of a woman who had a very severe attack of
sporadic cholera, (whose blood and urine I likewise analysed,)
formed a turbid and colourless fluid, which had a strong
alkaline reaction, and effervesced on the addition of acids,
giving off carbonic acid and sulphuretted hydrogen, which, in
all probability, arose from carbonate of ammonia and sulphuret
of ammonium (hydrosulphate of ammonia).
When allowed to stand for some time it formed a sediment,
which consisted, for the most part, of mucus-corpuscles, with
some crystals of ammoniaco-magnesian phosphate. No epi-
thelium cells were observed. On treating the fluid with nitric
acid, effervescence took place, and flocculi of coagulated albumen
separated themselves ; moreover, the fluid in a short time be-
came of a rose-red colour, a phenomenon that was induced
more rapidly by gentle warmth : when strongly heated for some
time the colour entirely disappeared. 1
The quantitative analysis of the fsecal discharge in this case
gave the following results, calculated for 1000 parts :
1 [In an examination of the faeces in cholera, instituted by Heller, (Archiv i, p. 18,)
a similar reaction was observed. The exact nature of the change that the bile-pigment
undergoes in such cases is not clearly understood.]
384 THE EXCRETIONS:
Analysis 152.
Water .... 980-00
Solid constituents . . . 20-00
Fat . . . 0-08
Extractive matter . . . 4-80
Albumen and mucus . . 0*52
Chloride of sodium, lactate and acetate of 1 13-40
soda, and alkaline phosphates . J
Phosphates of lime and magnesia . 0'60
This analysis bears out the result of the investigation of the
blood, given in Vol. I., page 326.
Landerer 1 has analysed the faecal evacuations of a child suf-
fering from diarrhoea infantilis. It was a yellow fluid, with an acid
and bitter taste, and its specific gravity was 1038*2. Landerer
found in it : carbonate of lime T50; phosphate of lime 2-00;
chloride of calcium 1-50; chloride of magnesium 2'45; chloride
of sodium 2'43; sulphate of lime T50; sulphate of magnesia O80;
bilin, butyric acid, and extractive matter 3*00; spirit-extract I'OO;
free lactic and hydrochloric acids 1*00.
In enterophthisis, the faecal evacuations likewise separate into
two strata the lower is flocculent, and when examined under the
microscope is seen to consist of mucus- or pus-corpuscles min-
gled with remnants of food, or with an amorphous mass tinged
with pigment. Sometimes we find, in the deposit from these
evacuations, small white or yellow masses, which consist of
cells, and can be easily crushed (such as I have already de-
scribed in speaking of the evacuations in typhus), and mixed
with them there are numerous fat-vesicles. A little blood is
not unfrequently observed in these stools ; they then have a
chocolate or dark blood-red tint. The supernatant fluid is
turbid, and of a yellow, brown, or bloody tint ; it always con-
tains a considerable amount of albumen.
In icterus the faeces are generally devoid of all the consti-
tuents of the bile : they are consequently of a white or grayish
white colour; they are usually very firm, and deficient in
moisture.
[I am indebted to Dr. Percy for the following ultimate
analysis of the faeces in jaundice.
1 Journal f. prakt. Chemie, 1841, vol. 17, p. 62.
F.ECES.
385
A young woman affected with jaundice in a mild form, de-
pending probably on functional derangement of the liver. The
faeces were brown, and not clay-coloured, as in severe jaundice.
1st Analysis 5-59 grs. gave of HO 3-66 or H 7'27g, C0 2 9-69 or C 51-423.
2d Analysis 5-12 grs. gave of HO 3-37 or H 7'31, C0 2 9'69 or C 51-61g.
Incineration 28-18 grs. gave of ash 3-41 grs., or 12-10g.
Mean C . . . 51-51^
N* - : : 29-fo KOO']
Ash . . . 12-10J
A physician of this city sent me a white, roundish, easily
compressible mass, resembling caseous matter, which had been
evacuated after an ordinary motion, by a lady who was suffering
from bilious sensations. When observed under the microscope,
this substance, which emitted a rather disagreeable odour, was
found to be composed of an extraordinary quantity of fat
1 The following table shows, at a glance, the results of the preceding ultimate
analyses :
C .
Man in health.
Ordinary diet.
.3 %
I!
Child.
Diabetes.
Flint.
Diabetes.
Flint.
Diabetes.
Flint.
Diabetes.
L Roberts.
Diabetes.
Roberts.
Diabetes.
^ Girl with
Jaundice.
1.
2.
3.
4.
5.
6.
7.
8.
46-20 t
49-79
43-86
54-35
60-34
53-09
45-81
45-97
51-51
H .
6-72
7-06
6-96
7-57
9-25
7-97
7-59
7-27
7-29
N&O .
30-71
28-64
29-09
28-72
17-18
21-34
25-42
24-66
29-10
Ash
16-37
14-51
20-09
9-36
13-23
17-60
21-18
22-10
12-10
100-00
100-00
100-00
100-00
100-00
100-00
100-00
100-00
100-00
TABLE of COMPOSITION, exclusive of ASH.
1.
2.
3.
4.
5.
6.
7.
8.
9.
C .
55-24
58-24
54-88
59-96
69-53
64-43
58-11
59-01
58-60
H .
8-03
8-25
8-70
8-35
10-66
9-67
9-62
9-33
8-29
N&O .
36-73
33-51
36-42
31-69
19-81
25-90
32-27
31-66
33-11
100-00
100-00
100-00
100-00
100-00
100-00
100-00
100-00
100-00
II.
386 THE EXCRETIONS:
arranged in a structureless, albuminoid mass; no tissues or cells
were detected. The mass, when heated, gave off a very strong
odour of butyric and acetic acids ; it melted and burned with a
clear flame. Alcohol extracted a very large amount of fat, con-
sisting of margarin, olein, and butyrin, with their acids, which
partially separated on cooling. In the separated flocculi I
detected, with the aid of the microscope, crystals of margaric
acid, but none of cholesterin. After the evaporation of the
alcohol, water dissolved some butyric and acetic acids from the
residue.
The portion insoluble in alcohol was digested for a consi-
derable time in dilute acetic acid, and was precipitated from this
solution by ferrocyanide of potassium.
Water did not extract any matter that was precipitable by
the last-named reagent.
On incineration a considerable amount of ash was left which
had an acid reaction, did not effervesce with acids, and con-
sisted almost entirely of earthy phosphates : it contained no
sulphates.
Calomel stools.
In certain morbid conditions of the system calomel is fre-
quently given in considerable quantity : its administration is
succeeded by numerous, very green, bilious stools. I endea-
voured to determine by an experiment whether the bile and its
pigment is the actual cause of the colour of these evacuations.
The fifth stool that was passed after the administration of a
large dose of calomel, was made the subject of the analysis. It
was fluid, perfectly green, had no fa3cal odour, exhibited a mild
acid reaction, and showed, under the microscope, a great number
of mucus-corpuscles and epithelium-cells. On evaporation it
gave off an odour resembling that of saliva or extractive matter
under similar circumstances. Ether extracted from the solid
residue a considerable amount of fat which had an acid reac-
tion, contained cholesterin, and was coloured with biliverdin.
All other substances which were separated from it by water and
alcohol were more or less coloured by bile-pigment.
Bilin with bilifellinic acid and biliverdin were found in large
quantity; by digestion with sulphuric acid the bilin became
entirely converted into biliary resin. From a quantitative
RECES. 387
analysis it appeared that 100 parts of the solid residue of this
evacuation were composed of:
Analysis 153.
Green fat containing cholesterin . . .10-0
Salivary matter soluble only in water, and slightly precipitated by
tannic acid and acetate of lead . . . 24'3
Bilin with bilifellinic acid and biliverdin, collectively soluble in
anhydrous alcohol . . . . 21 '4
Extractive matter soluble in spirit . . ll'O
Albumen, mucus, and epithelium-scales . . .17*1
Salts ...... 12-9
100-0
Various attempts that I made (by Smithson's method) to
detect mercury in calomel-stools proved unsuccessful.
[Dr. Golding Bird has published an analysis of the green
evacuations so frequently observed in children. The specimen
examined by him " was passed by a hydrocephalic infant whilst
under the influence of mercury, and presented the following
characters. It was a dirty- green turbid fluid which, by repose
in a glass vessel, separated into three very distinct portions;
1, a supernatant fluid, of oil-like consistence, presenting a
brilliant emerald-green colour; 2, a dense stratum of mucus,
coagulated albumen, and epithelial debris, mixed with red par-
ticles of blood ; 3, a deposit, occupying the lower part of the
vessel, of large crystals of ammoniaco-magnesian phosphate, in
fine prisms of an apple-green colour.
The supernatant emerald-green fluid was decanted for
examination.
A. It was faintly alkaline, possessed a broth-like odour, and
a density of 1020.
B. The addition of a few drops of nitric acid did not alter
the colour, even after ebullition. A larger quantity of the acid
being added whilst the mixture was boiling, converted the
emerald-green colour into a pinkish-yellow ; the green colour
was not restored by the subsequent addition of an alkali.
c. Acetic acid scarcely affected the green fluid, producing
no apparent coagulation of mucus.
D. A solution of acetate of lead threw down a copious
grayish-green, tenacious precipitate, leaving the supernatant
fluid colourless.
388 THE EXCRETIONS:
E. Bichloride of mercury produced a light-green precipitate,
leaving the supernatant fluid pale, but not decolorizing it.
It was analysed in the following manner :
1. 1000 grains of the green fluid left, by careful evapora-
tion, a deep olive-green, highly deliquescent extract, weighing
100 grains.
2. This extract, on being immersed in alcohol of '837 formed
a mass like birdlime, which could not be mixed with the spirit.
Even after long boiling, it appeared hardly to diminish in bulk.
The clear tincture being decanted left, however, an extract
weighing 30 grains. This residue possessed the yellowish-
green colour of faded leaves, an odour of fresh broth and a
sweet sub-astringent taste, with a very slight admixture of
bitterness.
3. The alcoholic Extract being carefully incinerated, left 5-5
grains of ash, consisting chiefly of chloride of sodium mixed
with mere traces of tribasic phosphate of soda (3NaO, POJ.
It was alkaline, but did not effervesce with acids.
4. The portion left undissolved by boiling alcohol yielded to
water 13 grains of nearly tasteless matter which, by incinera-
tion, left a powerfully alkaline ash weighing 1*75 grains, not
effervescing with acids, and consisting nearly exclusively of
alkaline tribasic phosphate of soda.
5. The residue insoluble both in water and alcohol weighed
57 grains, and consisted almost entirely of coagulated albumen,
dry mucus, and modified blood. It left by incineration one
grain only of ash, consisting almost wholly of black-red peroxide
of iron.
The following is a view of the results of the examination :
, r Organic . . 24-50
Alcoholic extract J T
I Inorganic . . 5'50
/Organic . . 11 '25
Aqueous extract 1 T
L Inorganic . . I*/ 5
/Organic . . 56-00
Insoluble matter { _
L Inorganic
Water and volatile matter . . 900-00
1000-00
The organic portion of the alcoholic extract consisted chiefly
PRICES. 389
of fatty matter, cholesterin, and a green substance probably
identical with biliverdiii ; with these were traces of bile barely
sufficient to communicate a bitter taste to the extract, and in
too small a quantity to leave any carbonate of soda in the
residue of incineration. The aqueous extract consisted chiefly
of ptyalin and the extractive matters comprehended under the
general term of " extrait de viande," by Berzelius. The com-
position of the fluid part of the green evacuation may therefore
be thus expressed :
Water ......
Biliverdin, alcoholic extract, fat, cholesterin, with traces of bile .
Ptyalin, aqueous extract coloured by biliverdin
Mucus, coagulated albumen, and ha3matin .
Chloride of sodium, with traces of tribasic phosphate of soda
Tribasic phosphate of soda ....
Peroxide of iron .....
1000-00
Professor Kersten of Freiberg has recently published a paper
on the cause of the green evacuations observed after a course
of the Marienbad waters for fifteen or twenty days.
The occurrence of these evacuations is regarded as critical
and highly favorable. Kersten denies that the tint is in any
degree dependent on the presence of bile, and ascribes it to the
formation of green sulphuret of iron.
In the paper referred to he first shows that on the addition
of very dilute hydrochloric acid to an evacuation of this nature
diluted with thrice its weight of water, there is a development
of sulphuretted hydrogen, indicating the presence of a metallic
sulphuret ; moreover, on the addition of ferrocyanide of potas-
sium to the filtered acid solution a bright blue precipitate is
observed, which becomes darker after exposure to the air, indi-
cating the existence of protoxide of iron. This experiment
shows that the green pigment is destroyed or decomposed by
dilute hydrochloric acid, and further, that it is a compound -of
sulphur and iron. He accounts for the presence of the sul-
phuret of iron in this way. The sulphate of soda present in
the water is reduced in the stomach to a sulphuret of sodium
by the deoxidising power of the organic matters with which it
is in contact, aided by a temperature favorable to such a change.
390 THE EXCRETIONS:
The bicarbonate of iron in the water is decomposed at the tem-
perature of the stomach, and the iron precipitated either as a
protoxide or as a hydrated peroxide, and immediately redis-
solved by the free acid of the gastric juice. This reacts on the
sulphuret of sodium, and sulphuret of iron is the result.
Since the publication of Kersten's paper, a very similar view
has been propounded by Dr. Bley, namely, that the green eva-
cuations observed after the use of calomel are dependent not on
the presence of bile, but of sulphuret of mercury. Unfor-
tunately for this theory the mercury cannot be detected by ana-
lysis, and Pettinkofer's test reveals the presence of bile.
Dr. Frankl has published a paper containing various argu-
ments in opposition to Kersten's views, and criticising his
conclusions.
Berzelius, on the other hand, writes thus : " It never entered
my mind to suspect that this coloration arose from sulphuret
of iron, but I always believed that it might be attributed to the
black oxide of iron. It is, however, quite natural that as sul-
phuretted hydrogen is usually produced during the progress of
digestion, the oxide of iron present in the intestinal canal should
be reduced to a sulphuret, no matter whether sulphates have
been given or not."
Berzelius renders Kersten's view more general, observing
" that every chalybeate water, whether it contain sulphates or
not, produces a similar appearance in the evacuations." On
this Kersten remarks : that " the coloration may be most
intense when sulphates are present, because by their decompo-
sition during digestion an excess of sulphuretted hydrogen will
be generated."]
Vomitus. (Matters discharged by vomiting.)
It is well known that the fluid which is found in the stomach,
and which is a mixture of gastric juice, saliva, and remnants of
food, becomes much changed in its properties in certain morbid
conditions of the system. I need scarcely refer to the excess
of free acid, and to the presence of bile in certain conditions of
the stomach. On the occurrence of the latter of these states
we usually observe a separation, or peeling off, of the upper
VOMITUS, 391
stratum of epithelium-scales from the tract of mucous membrane
between the pharynx and the stomach, and this condition is
recognized by the gastric furred tongue. 1
This fur or coating has been analysed by Denis : he found
that one half consisted of phosphate and carbonate of lime, the
other half of mucus.
In gastrodynia, even when there is no food in the stomach,
the gastric juice is secreted in such an acid condition as to set
the teeth on edge. This is chiefly caused by free hydrochloric
acid, but concentrated lactic and acetic acids will produce the
same effect.
In gastritis, colonitis, enteritis, and peritonitis, a grass-green
liquid is often brought up; it is frequently mixed with green or
white flocculi, and on other occasions is quite clear; it almost
always has an acid reaction, and usually contains a considerable
amount of fat.
I analysed a fluid of this sort that was vomited during peri-
tonitis : it had a greenish, viscid appearance, and contained
whitish flocculi that presented an amorphous character under
the microscope. It did not affect blue or red litmus paper;
on the addition of nitric acid there was a separation of white
flocculi, and the fluid became first of a pale blue and subse-
quently of a reddish tint. On the application of heat some
globules of oil separated themselves, and a small quantity of
albumen became coagiilated; it contained 2'9 of solid consti-
tuents, from which ether took up a yellow liquid fat that was
imperfectly soluble in cold, but dissolved easily in hot alcohol ;
it contained a little cholesterin, and gave off a smell like that
of a fatty acid.
Alcohol took up extractive matter and bilifellinic acid, which
latter could be separated by means of sulphuric acid ; dilute
alcohol took up spirit-extract with a little bilifellinic acid. A
considerable amount of the portion that was insoluble in spirit
dissolved in water, and was again precipitated by alcohol, tannic
1 On examining the thick coating of the tongue in cases of abdominal typhus, I
have found that it is composed of matted epithelium-scales over which minute
sporules are scattered. The sordes from the teeth exhibited similar characters.
392 THE EXCRETIONS:
acid, and acetate of lead. The precipitate thrown down by
alcohol was soluble in an excess of water, which was rendered
turbid by the addition of acetic acid, and yielded a copious
precipitate on the subsequent addition of ferrocyanide of potas-
sium.
As the ash, after incineration, consisted of carbonate of soda,
I regarded the substance insoluble in alcohol as an albuminate
of soda.
The quantitative analysis of this " vomitus a3ruginosus seu
herbaceus" yielded the following proportions in 1000 parts :
Analysis 154.
Water ..... 971-0
Solid residue ..... 29-0
Fat 4-3
Bilifellinic acid, alcohol-extract, and bile-pigment
Spirit-extract with a little bilifellinic acid .
Albuminate of soda
Mucus and albumen
1-5
11-4
5-4
5-8
[Heller 1 analysed a brilliant green fluid vomited by a young
woman aged 20 years, suffering from peritonitis.
In quantity it amounted to about three ounces; it was
slightly turbid, and threw down an inconsiderable sediment
which was viscid, more of a yellowish tint than the supernatant
fluid, and consisted of epithelium-cells and mucus-corpuscles.
The fluid had an acid reaction, but contained neither free
hydrochloric nor acetic acid. Its specific gravity was 1006.
On the addition of nitric acid it first became blue, and after-
wards of a beautiful carmine red. It contained no albumen.
In 1000 parts there were contained :
Water ..... 990-50
Solid constituents .... 9-50
Fat . . . . 0-24
Water-extract . . . .1-30
Biliverdin with a little biliphsein and a trace of! .00
alcohol-extract . . . ./
Fixed salts .... 3'75
The salts consisted for the most part of the chlorides of
sodium and calcium, associated with less quantities of phosphate
of soda, sulphate of potash, and earthy phosphates. Urea and
uric acid were sought for without success.
' Archiv, vol. 1, p. 226.
VOMITUS. 393
The green colour seems undoubtedly due to the presence of
biliverdin, which is probably formed in the stomach by the
action of the acid solution of hydrochlorate of lime on the bili-
phsein. Hence the occurrence of green vomiting need not be
regarded as indicative of any peculiar morbid change.
A brief notice of a green fluid vomited during an attack of
sporadic cholera, may be found in vol. 1, p. 18, of Heller's
Archiv.]
Vomitus with urinary constituents.
It is stated that in those cases in which the formation and
excretion of the urine are impeded its constituents are discharged
with vomited matters.
Nysten 1 and Barruel had an opportunity of analysing a
vomited fluid which contained urea, uric acid, and the ordinary
urinary salts.
[Dr. Halliday Douglas has reported a case in which urea was
detected in the vomited fluid. London and Edinburgh Monthly
Journal of Medical Science, vol. 1, p. 410.]
Vomitus in carcinoma.
In carcinoma of the stomach a fluid is vomited which de-
posits masses of chocolate or coffee-coloured flocks on the bottom
of the vessel, while others are observed on the surface of the
fluid. On examining a few of them under the microscope we
observe a considerable quantity of large rounded cells with yellow
granular contents, and also a very great number of fat-vesicles,
some larger and others smaller than the cells. Remnants of
food, and especially undigested starch-granules, are likewise
frequently observed. The latter may be easily mistaken for
fat-vesicles, but moderately strong compression causes their
envelopes to break, and on the addition of a solution of iodine
they assume a blue colour. By this test all ambiguity is
avoided.
[Dr. George Wilson has published a notice of the chemical
and microscopical characters of the fluid ejected in pyrosis
1 Journ. de Chem. Med. 1820, Ser. Ill, p. 257.
394 THE EXCRETIONS:
the ordinary water-brash. The most remarkable of these is
the appearance of a microscopic cryptogamic plant (sarcina
ventriculi), and of acetic, lactic, and carbonic acids in the
liquid. The first case in which these were found, occurred
to Mr. Goodsir, and was published by him in the ( Edin-
burgh Medical and Surgical Journal' for April 1842. Since
that period a case has occurred in the practice of Mr. Ben-
jamin Bell of Edinburgh, who allowed Mr. Goodsir and
Dr. Wilson to examine the fluid ejected by his patient, in which
the same organism and acids were discovered ; and Mr. Busk,
of the Dreadnought hospital ship, Greenwich, has published the
history of three cases where the sarcina presented itself, but no
analysis was made of the fluids in which it appeared.
On examining the fluid with the microscope, the sarcina is
found to present the following characters. 1 In every instance
the organisms presented themselves in the form of square or
slightly oblong transparent plates, of a pale yellow or brown
colour, and varying in size from the 800th to the 1000th of
an inch. They were made up of cells, the walls of which ap-
peared rigid, and could be perceived passing from one flat sur-
face to another as dissepiments. These dissepiments, as well
as the transparent spaces, were, from compression of contiguity,
rectilinear, and all the angles right angles ; but the bounding
cells bulged somewhat irregularly on the edges of the organism,
by reason of the freedom from pressure. These circumstances
gave the whole organism the appearance of a woolpack, or of a
soft bundle bound with cord, crossing it four times at right
angles, and at equal distances. From these very striking pe-
culiarities of form, Mr. Goodsir has proposed for it the generic
name of SARCINA. 2
On examining the ejected fluid in the case recorded by Mr.
Goodsir, it was found to possess the following characters. It
was thick and viscid ; on standing, it deposited a large quantity
of ropy matter mixed with portions of undigested food, and,
when filtered through paper, had a pale brownish yellow colour,
and was quite transparent. It still contained much animal
1 The reader is referred to the ' Edinburgh Medical and Surgical Journal ' for
April 1842, for a more minute description of the sarcina, and a detailed account of
the chemical analysis of the liquid containing it.
2 Sarcina, a pack or woolpack.
VOMITUS. 395
matter in solution, becoming opaque and flocculent when boiled,
and giving a very copious precipitate with infusion of galls.
It also precipitated nitrate of silver densely, and, when evapo-
rated to dryness and exposed to a full red heat in a platinum
crucible, left an ash containing much chloride of sodium. It
reddened litmus powerfully, and effervesced sharply with alkaline
carbonates. It continued strongly acid after being twice dis-
tilled, and did not precipitate nitrate of silver, but retained the
sour smell, which could now be recognized as identical with
that of vinegar. On neutralizing the twice distilled fluid with
lime-water, and evaporating to dryness, a salt was obtained,
which, on being decomposed in a tube-retort with sulphuric
acid, yielded a volatile odorous acid, readily identified by seve-
ral tests with the acetic.
It was found by several trials, that, on an average, an ounce
of the liquid neutralized 0'4 grain of carbonate of potash ; a
quart (32 oz.) would therefore neutralize 12' 8 grains, which cor-
respond to 9 grains of the hydrated (crystallizable) acetic acid,
C 4 H 3 O 3 + HO. The liquid remaining in the retort continued
to redden litmus powerfully after all the acetic acid had been
distilled from it. This was traced in part to the presence of a
small quantity of free hydrochloric acid; but it was chiefly
owing to the existence in the liquid of a considerable proportion
of lactic acid. The most remarkable feature of this case, in a
chemical point of view, was the large quantity of acetic acid
found; the quantity of liquid ejected at once by the patient
often amounted to more than two quarts, which would contain
18 grains of acetic acid. In Mr. Bell's case the chemical cha-
racters of the liquid were very similar. An additional point
was, however, ascertained, namely, the presence of free carbonic
acid in the liquid.]
396
CHAPTER XI.
THE COMPONENT PARTS OF THE ANIMAL BODY.
The Bones.
THE bones are the least destructible of all the parts of the
organism. Under favorable circumstances they remain as un-
changed as mere inorganic matter, and the amount of cartilage
has been found unaltered in bones three thousand years old. 1
The external surface of bone is surrounded by a membrane
richly endowed with nerves and vessels the periosteum, which,
as well as the cartilaginous portion, can be converted, by boil-
ing, into gelatin. The interior of the cylindrical bones is lined
in a similar manner : the flat and short thick bones are, how-
ever, filled in the interior with delicate lamella? arranged so as
to present a cellular appearance : in the flat bones, this is
termed the diploe. If a bone is suspended in dilute hydrochloric
acid at a low temperature, all the earthy matter becomes gra-
dually dissolved and the mere cartilage remains, retaining the
precise form of the original bone. It is supple, transparent,
and soft, but on drying it becomes of a darker colour, hard,
and somewhat contracted. When boiled it becomes rapidly
converted into gelatin, leaving the fibrous tissue and the vessels
of the bone unacted on. These vessels may be exhibited by
leaving the bone in dilute hydrochloric acid till about one half
of the earthy matter is dissolved : it must then be washed with
1 This has been observed in the bones of human and animal mummies discovered
in Egyptian sepulchres. Apjohn and Stokes found in the bones of an extinct gigantic
elk, 48-87 of ordinary cartilage, combined with 43*45 of the phosphates of lime and
magnesia with fluoride of calcium, and 9-14 of carbonate of lime, &c. In the teeth
of an Egyptian mummy, Lassaigne found 29g of organic matter ; and in the teeth of
a fossil bear, 14 of cartilage and 70 of phosphate of lime. Gimbernat prepared an
edible jelly from the bones of the Ohio mammoth.
BONES. 397
cold water, and afterwards kept for twenty-four hours in water,
nearly at the boiling point. The cartilage, from which the
earthy matter has been removed, is thus dissolved, and num-
berless minute vessels may be seen issuing from the undecom-
posed portion of bone, presenting a beautiful white velvety
appearance, which is injured by the least motion ; If the bone
when immersed in dilute hydrochloric acid is exposed to heat,
the chemical action is facilitated, and the bone develops car-
bonic acid and separates into fibrous lamellse, divisible in a
longitudinal direction, which, if they are sufficiently thin, possess
the property of polarizing light in the same manner as mica.
When bone is submitted to thorough incineration, all the
organic portion is destroyed, and there remains nothing but
the earthy matter mixed with certain salts which have been
formed during the process of incineration, such as alkaline
sulphates and carbonates, and with free lime formed by the
expulsion of the carbonic acid from carbonate of lime.
The carbonate of lime in bone is just the same as the natural
carbonate of lime ; the phosphate, on the other hand, consists
of 8 Ca O + 3 PO 5 , according toBerzeliusi ; and 3 Ca O + P O 5 ,
according to Mitscherlich. In addition to these salts we find
small quantities of phosphate of magnesia and fluoride of cal-
cium, 2 and traces of the peroxides of iron and manganese.
[An elaborate treatise on the Chemistry of Bone has been
recently published by Von Bibra. We extract the following
analyses :
1 [Berzelius repeated the analysis of the salt last year, and found that its compo-
sition is rightly expressed. (Oefversigt af Kongl. Vat. Akad. Forhandlingar, 1844,
No. 6 ; or Liebig's und Wbhler's Aunalen, Feb. 1845.]
3 [The presence of fluoride of calcium in bone has been denied by Rees (Phil.
Mag. Jan. 1840.) The researches of Daubeny and Middleton (Memoirs and Proceed-
ings of the Chemical Society of London, vol. 2, pp. 97 and 134) not only demonstrate
its almost constant occurrence both in recent and fossil bones, but point out that
ordinary water is the vehicle by which it is conveyed into the system. " With regard
to the statements of Rees," observes Von Bibra, " I put them to the proof, and found,
as was to be expected, that they were altogether incorrect. I used in these experi-
ments the human femur, humerus, and teeth. On treating large quantities of bone-
earth with sulphuric acid, I have obtained corrosions on glass sufficiently deep to be
felt with the finger-nail." (Chemische Untersuchungen iiber die Knochen und
Zahne, p. 103, Schweinfurt, 1844.)]
398
ANIMAL BODY :
Male Foetus at the 6 7th month.
Phosphate of lime with barely recognizable
traces of fluoride of calcium
Earthy carbonates
Phosphate of magnesia
Salts 1 ....
Cartilage
Fat
r
A
Femur.
Tibia.
Humerus.
53-46
53-46
53-15
3-06
3-10
3-05
2-10
2-00
1-96
1-00
1-07
1-02
40-38
40-37
40-82
a trace
a trace
a trace
100-00
100-00
100-00
Female Foetus at the 7th month.
Phosphate of lime with very little i
fluoride of calcium . . /
Carbonate of lime .
Phosphate of magnesia
Salts ....
Cartilage
Fat
Ulna.
Radius.
Scapula.
Clavicula.
57-63
57-67
57-13
56-95
5-86
5-89
5-99
5-75
1-10
0-99
1-12
1-07
0-60
0-67
0-62
0-73
34-78
34-08
34-32
34-54
0-63
0-50
0-82
0-96
Child aged 2 months.
Phosphate of lime with a little fluoride of calcium
Carbonate of lime ....
Phosphate of magnesia
Salts ......
Cartilage .....
Fat
Tibia.
57-54
6-02
1-03
0-73
33-86
0-82
Ulna.
56-35
6-07
1-00
1-65
34-92
1-01
Child aged 9 months.
f
Femur. Humerus.
Tibia.
Radius.
Ulna.
Costa. Scapula.
Phosphate of lime with a i
little fluoride of calcium J
48-11
50
15
48-55
45-38
48-06
42-32
42-61
Carbonate of lime
6-12
6
13
5
79
5-14
6
20
5-00
5-08
Phosphate of magnesia .
0-97
1
00
1
00
0-93
1
01
0-89
0-92
Salts
1-23
1
30
1
24
1-07
1
24
1-09
1-10
Cartilage
41-71
39-53
41
50
45-65
41
70
48-55
48-36
Fat
1-86
1
89
1
92
1-83
1
79
2-15
1-93
The " salts" in the analyses of Von Bibra are the salts soluble in water.
BONES.
399
A child aged 5 years
A
A
girl 1 aged 19 years.
^A
(
Femur.
\
Tibia.
i >
Femur. Humerus.
Phosphate of lime with a
of calcium
t little
fluoride
| 59-96
59-74
54-78
54-84
Carbonate of lime
.
.
5-91
6-00
10-90
10-82
Phosphate of magnesia
.
.
1-24
1-34
1-34
1-26
Salts
.
.
0-69
0-63
0-83
0-79
Cartilage
.
.
31-28
31-34
31-15
31-37
Fat
0-92
0-95
1-00
0-92
A woman aged 25 years.
f~
Femur.
Tibia.
Fibula.
Humerus.
Ulna.
i
Radius. Metacarpus.
Phosphate of lime with ->
a little fluoride of I
calcium . . J
57-42
57-18
57-39
58-03
57-52
57-38
57-77
Carbonate of lime
8-92
8-93
8-92
9-04
8-97
8-95
8-92
Phosphate of magnesia
1-70
1-70
1-63
1-59
1-71
1-72
1-58
Salts
0-60
0-61
0-60
0-59
0-67
0-63
0-61
Cartilage
29-54
29-58
29-49
29-66
29-14
29-43
29-23
Fat .
1-82
2-00
1-97
1-09
1-99
1-89
1-89
r
Os oc-
A
Os inno-
Clavicuh
i. cipitis.
Costa.
Sternum. Scapula.
Vertebrae.
minatum.
Phosphate of lime with ->
a little fluoride of L
56-35
57-66
52-91
42-63
54-76
44-28
49-72
calcium . . J
Carbonate of lime
8-88
8-75
8-66
7-19
8-58
8-00
8-08
Phosphate of magnesia
1-69
1-69
1-40
1-11
1-53
1-44
1-57
Salts
0-59
0-63
0-60
0-50
0-51
0-53
0-60
Cartilage
30-66
29-87
33-06
46-57
32-90
43-44
38-26
Fat .
1-83
1-40
2-37
2-00
1-73
2-31
1-77
A man 25 or 30 years of age.
(
Femur.
Tibia. Humerus. Ulna. Os occipitis.
^)
Costa.
Phosphate of lime with a
little fluoride of calcium /
58-95
59-87 59-30
58-43
55-66
Carbonate of lime
7-33
7-08
7-76
7-35
8-00
6-64
Phosphate of magnesia
.
1-32
1-30
1-09
1-35
1-40
1-07
Salts
.
0-69
0-70
0-72
0-73
0-90
0-62
Cartilage
29-70
30-42
29-28 29-98
29-92
33-97
Fat
1-33
1-55
1-28
1-29
1-35
2-04
1 This girl died from phlebitis thirteen days after the operation of amputation of
the upper arm for caries of the elbow-joint.
400 ANIMAL BODY:
Femur of a man aged 58 years.
Compact substance. Spongy substance.
Phosphate of lime with fluoride of T
I . 58-23 42-82
calcium . . . J
Carbonate of lime . . . 8-35 19-37
Phosphate of magnesia . . 1-03 I'OO
Salts ..... 0-92 0-99
Cartilage .... 31*47 35-82
Femur of a woman 1 Femur of a woman
aged 62 years. aged 78 years.
Phosphate of lime with a little i
fluoride of calcium . .} 63 ' 17 57 ' 3C
Carbonate of lime . . . 4-46 7 '4 8
Phosphate of magnesia . . 1-29 1-10
Salts .... 0-90 0-97
Cartilage . . . 28-03 32-16
Fat . . . 2-15 0-93
These are the most recent, and probably the most accurate
of any of the analyses of human bone yet published. We
may omit, from absolute superfluity of matter, the researches
of Schreyer, E/ees, Thilenius, Sebastian, Davy, Frerichs, and
Stark, which refer merely to the estimation of the organic and
inorganic matters, and shall take a brief survey of the more
perfect analyses of bone.
Berzelius found in human bone :
Phosphate of lime . . .51-04
Fluoride of calcium . . . 2-00
Carbonate of lime , . .11-30
Phosphate of magnesia . . 1*16
Soda, with a little chloride of sodium . 1-20
Cartilage .- 32-17
Vessels . . . 1-13
Dr. Thomson found 2 in the human femur :
l.
2.
Phosphate of lime
43-67
51-12
Carbonate of lime
14-00
9-77
Magnesia .
0-49
0-63
Soda
2-00
0-59
Potash
0-06
a trace
Cartilage
39-12
35-93
1 A cretin. The bones had been underground for four years.
2 Animal Chemistry, p. 245.
BONES. 401
The four following analyses were made by Valentin : 1 re-
presents the cortical portion of the tibia of a man aged 38 years;
and 2, the medullary portion of the same bone ; 3 represents
the external condyle of the left femur of a girl ; and 4, the head
of the left tibia of the same individual.
1. 2. 3. 4.
Basic phosphate of lime . 52-930 49-019 37-012 41-774
Carbonate of lime . . 7'666 7-760 5-038 7'109
Phosphate of magnesia . 0-254 1-542 0-874 0*874
Chloride of sodium . . 0-911 0'441 0-645 i
Carbonate of soda . . 0-204 0-076 1-331 J
Cartilage, vessels, &c. . . 38-020 41-160 55-180 48-560
Marchand found in the compact substance of the femur of
a man aged 30 years :
Basic phosphate of lime . . . 52-26
Fluoride of calcium .... I'OO
Carbonate of lime . . . .10-21
Phosphate of magnesia . . .1-05
Soda ..... 0-92
Chloride of sodium . . . 0-25
Cartilage insoluble in hydrochloric acid . . 27-23
Cartilage soluble in hydrochloric acid . , . 5'02
Vessels ..... 1-01
Peroxides of iron and manganese, and loss . 1-05
The most recent analyses of human bones, with the exception
of those by Von Bibra, are those of Lehmann.
Bones of a man aged 40 years who committed suicide.
f \
Humerus. Radius. Ulna. Femur. Fibula. Tibia.
Phosphate of lime and -i
fluoride of calcium } 56 ' 61 53 ' 25 53 ' 98 58 ' 93 52 ' 99 53 ' 12
Carbonate of lime . 9-20 9*76 9-51 9-28 9-33 9-35
Phosphate of magnesia . 1-08 1-06 1-07 1-09 1-06 1-07
Chloride of sodium , 0-37 0-36 0-40 0-40 0-37 0-39
Soda . . 1-35 1-36 0-98 1-04 1-07 0-99
Organic matter 31-52 3376 33-23 28-61 34-14 34-10
From the bones of a man aged 44 years he obtained :
Femur. Tibia. Fibula.
Phosphate of lime and fluoride of calcium . 52-67 52-93 52-04
Carbonate of lime . . . 10-03 9*88 10-13
Phosphate of magnesia . . . 0-93 0-91 0-89
Soda . . . 1-07 1-09 1-12
Chloride of sodium . . . 0'34 0-31 0-39
Organic matter .... 34-15 33-94 34-51 ]
ii. 26
402
ANIMAL BODY :
BOIS'ES OF THE LOWER ANIMALS.
Mammalia.
EDENTATA. Common armadillo.
Bony plates from the region of
Phosphate of lime with a little fluoride -i
of calcium . . . J
Carbonate of lime
Phosphate of magnesia
Salts ....
Cartilage
Fat
e throat, the abdomen.
the tail.
53-45
50-92
55-43
6-73
6-63
6-99
1-30
1-23
1-07
0-89
0-95
0-92
34-63
36-77
32-81
3-00
3-50
2-78
Phosphate of lime with a i
little fluoride of calcium J
Carbonate of lime . 10-45
Phosphate of magnesia . 1-36
Salts . 0-90
Cartilage . . 29-46
Fat 0-80
GLIRES.
Squirrel (old).
Femur. Humerus.
10-50
1-32
0-91
31-21
0-79
Mouse.
Rat.
Hare.
Femur and tibia
together. Femur. Femur.
50-31
9-62
1-10
0-83
36-84
1-30
60-38
58-45
6-72 9-07
1-91 0-99
0-91 0-82
28-98 29-60
1-10 1-07
RUMINANTIA.
Sheep aged 4 years. He-goat.
Bull aged 4 years.
Phosphate of lime with a -i
Femur.
Os occip.
Femur.
Tibia.
Os occip.
little fluoride of calcium J
55-94
47-07
54-07
54-03
52-51
Carbonate of lime
12-18
9-09
12-71
11-99
11-14
Phosphate of magnesia .
1-00
1-59
1-42
1-44
1-05
Salts
0-50
1-02
0-80
0-70
0-50
Cartilage
29-68
39-58
29-09
29-92
32-80
Fat
0-70
1-65
1-91
1-92
2-00
1 The whole of these analyses, with two exceptions, were made by Von Bibra.
BONES.
403
PACHYDERMATA.
Phosphate of lime with a i
little fluoride of calcium j
Carbonate of lime
Phosphate of magnesia .
Salts
Cartilage
Fat
Horse 1 (foetus of
about 3 months.)
60-51
1-83
.1-40
a trace
36-26
Castrated horse
aged 6 years.
Mare
aged 14 years.
Femur.
Humerus.
Femur.
54-37
52-86
54-63
12-00
12-07
11-28
1-83
1-75
1-50
0-70
0-71
0-40
27-99
29-70
27-98
3-11
2-91
4-21
Phosphate of lime with a i
little fluoride of calcium J
Carbonate of lime
Phosphate of magnesia
Salts
Cartilage T
Fat
Costa. 2
42-21
6-32
1-94
1-22
47-30
Metatarsus. 2
54-29
9-05
69
1-78
34-16
Wild-boar.
Femur.
58-88
9-02
1-17
0-92
28-00
2-01
CETACEA.
PlNNIPEDIA.
Dolphin.
A
Common seal.
_j^
i
Costa.
>
Vertebrae.
f
Os occipitis.
Maxilla inf.
Phosphate of lime with a ~l
little fluoride of calcium J
53-59
52-51
58-77
54-11
Carbonate of lime
9-99
9-37
7-23
7-20
Phosphate of magnesia .
1-10
0-98
1-18
0-93
Salts
3-24
1-24
1-43
1-22
Cartilage
30-46
33-97
30-11
35-24
Fat
~
1-28
1-30
Von Bibra likewise analysed separately the compact and spongy substance of the
femur of a horse aged 12 years, and obtained the following results :
Compact
substance.
54-65
11-74
1-48
Phosphate of lime with a little fluoride of calcium
Carbonate of lime
Phosphate of magnesia
Salts
Cartilage
2 These analyses were made by Valentin.
0-86
31-27
Spongy
substance.
41-14
18-93
1-32
0-94
37-67
404
ANIMAL BODY:
FALCULATA.
Cat aged 6 years.
Wolf.
Phosphate of lime with -|
a little fluoride of cal- 1 59-30
cium . . -i
Carbonate of lime . 10-69
Phosphate of magnesia 1*70
Salts . . 0-40
, 27-21
Cartilage
Fat
Carbonate of lime
Phosphate of magnesia
Salts .
Cartilage .
Fat
Phosphate of lime with
a little fluoride of cal-
cium
Carbonate of lime
Phosphate of magnesia
Salts
Cartilage
Fat
Verteb.
Os occip.
Femur.
Humerus,
, Costa.
Verteb.
48-01
51-70
57-87
55-36
51-76
48-72
8-4*
10-13
11-09
11-76
10-90
10-03
0-97
1-07
1-13
1-07
1-00
0-88
0-39
0-37
1-02
0-99
0-90
0-91
40-79
35-83
27-44
29-51
33-78
37-53
0-70 1-40 0-90 1-45 1-31 1-66 1'93
VOLITANTIA,
Common bat.
Phosphate of lime with -i
a little fluoride of cal- I 58-64
cium . . J
Carbonate of lime
Phosphate of magnesia
Salts
Cartilage
Fat
Femur. Humerus.
[ttle fluoride of calcium . 57-45 56-90
. .
4-77 6-00
.
.
1-03 1-00
. .
.
0-75 0-80
t .
.
34-20 34-27
1-80 1-03
POLLICATA.
Cebus Capucinus (Capuchin ape).
r
Femur. Humerus.
Vertebra?. Costa.
Scapula. Os ilii.
54-33 51-87
50-43 51-54
50-24 46-63
7-99 7-33
6-92 7-00
7-31 6-03
1-58 1-72
1-33 1-15
1-20 1-07
0-89 0-93
0-92 0-87
0-91 0-90
34-01 37-18
39-04 38-37
39-33 44-16
1-20 0-97
1-36 1-07
1-01 1-21
BIRDS.
Thrush.
Sparrow 6 days old.
Sparrow (aged).
, A v Femur, tibia, & humerus , A N
'emur. Humerus. together. Femur. Humerus.
58-64 62-65
39-78
59-46 60-04
5-07 6-05
3-62
8-88 9-97
0-83 0-90
0-40
1-03 1-09
0-77 0-84
0-30
0-90 0-90
33-43 28-02
55-80
27-20 26-14
1-26 1-54
0-10
2-53 1-86
BONES.
405
REPTILES.
Phosphate of lime with
a little fluoride of cal-
cium
Carbonate of lime
Phosphate of magnesia
Salts of soda
Cartilage
Fat
Salamandra
terrestris.
Mixed bones.
53-89
liana esculenta.
Femur. Tibia.
59-48 59-73
Coluber Anguis
natrix. fragilis.
Vertebrae. Vertebrae.
59-41
47-52
2-46
2-25
2-24
7-82
6-92
1-07
0-99
0-97
1-00
Ml
0-82
1-78
1-90
0-73
0-90
38-64
30-19
29-16
24-93
36-18
3-12
5-31
6-00
6-11
7-37
FISHES.
Phosphate of lime with a i
little fluoride of calcium J
Carbonate of lime
Sulphate of lime
Phosphate of magnesia
Sulphate of soda
Carbonate of soda & chlo-
ride of sodium
Cartilage
Fat
Eel.
Pike.
Salmon.
Cod
A
-
Vertebrae.
Vertebrae.
Vertebrae.
/"" ^
Vertebras.
\
Os occip.
32-46
38-70
36-64
57-65
61-15
3-64
14-30
1-01
4-81
5-20
1-09
0-78
0-81
0-70
2-30
2-62
0-83 I
0-66 J
0-97
0-83
1-00
1-03
36-99
32-72
21-80
31-90
27-89
23-55
12-50
38-82
2-34
2-11
We have selected these individual cases from 143 analyses
of the bones of mammalia (independently of man) ; 151 of birds,
31 of reptiles, and 23 of fishes.]
406 ANIMAL BODY:
Morbid Bones.
[Rachitis. The bones in this disease have been analysed by
several chemists.
Lehmann examined the tibiae of three rachitic children.
He found :
1. 2. 3.
Phosphate of lime . . 32-04 26-94 28-13
Carbonate of lime . . 4-01 4-88 3'75
Phosphate of magnesia . 0-98 0-81 0-87
Chloride of sodium . 0-21 0-27 0-28
Soda . . . 0-54 0-81 0-73
Cartilage . . 54-14 60-14 58-77
Fat . . 5-84 6-22 6-94
Ragsky found in the scapula and humerus of a rachitic child:
Phosphates of lime and magnesia . 15-60
Carbonate of lime . . . 2-66
Soluble salts . . . 0-62
Cartilage, vessels, and fat . . 81-12
In the ulna of a child aged 5 6 years, Von Bibra found :
Phosphate of lime with a little fluoride of calcium 47*83
Carbonate of lime . . . 7*42
Phosphate of magnesia . . .1-23
Salts ..... 1-82
Cartilage .... 35-61
Fat ..... 6-09
Osteomalacia. Several analyses of bone in this disease are
on record.
Vertebra. Vertebra. Costa.
(Bostock). (Prosch.) (Prbsch.)
Phosphate of lime . . 13-60 13-25 33-66
Phosphate of magnesia . . 0-82
Carbonate of lime . .1-13 5-95 ' 4-60
Sulphate of lime and phosphate of soda 4-70 0-90 0-40
Cartilage . . . 79'75 74-64 49'77
Fat . . . 5-26 11-63
An analysis by Bogner of the bones of a man aged 32 years,
who died from osteomalacia, yielded the following results :
Scapula. Radius. Femur. Patella.
Phosphate of lime . . 26-92 28-11 23-50 23-23
Carbonate of lime . . 0-98 1-07 0-97 0-94
Phosphate of magnesia . 5-40 6-35 5-07 5-03
Cartilage and vessels . . 65-85 63-42 69-77 70-60
Soda, iron, and loss . . 0-85 1-05 0-69 0-64
MORBID BONES.
407
Ragsky has analysed bone in this disease. He found in a rib
Phosphates of lime and magnesia
Carbonate of lime and salts
Cartilage, vessels, and fat
17-48
6-32
76-20
After the removal of the fat, Lehmann found :
1. 2. 3.
Phosphate of lime . 36-863 31-718 35-871
Other salts . . 4-968 7*913 5-684
Cartilage . . 58-169 60-369 58-445
and in two other cases of osteomalacia occurring in persons
aged about 40 years, the same chemist found :
Femur.
Costa.
Femur.
Costa.
17-56
21-02
18-83
19-14
3-04
3-27
3-83
4-08
0-23
0-44
0-54
0-60
0-37
0-63
0-43
0-41
48-83
50-48
41-54
42-43
29-18
23-13
34-15
32-65
Phosphate of lime
Carbonate of lime
Phosphate of magnesia
Soluble salts
Cartilage
Fat
The three following analyses of bone in this disease were
made by Von Bibra :
Tibia of a woman Femur of a woman Femur of a man
Phosphate of lime with a T
little fluoride of calcium J
Carbonate of lime
Phosphate of magnesia .
Salts
Cartilage
Fat
aged 75 years.
55-01
4-94
2-01
0-31
29-17
8-56
83 years.
46-79
6-37
1-20
1-37
30-99
13-28
aged 60 years.
53-25
7-49
1-22
1-35
32-54
4-15
Marchand found the bones of the child whose case is noticed
in p. 286 of this Volume, composed in the following manner :
Phosphate of lime
Phosphate of magnesia
Carbonate of lime
Sulphate of lime T
Sulphate of soda J '
Fluoride of calcium, chloride of sodium,
iron, and loss
Cartilage
Fat
Vertebra. Radius. Femur. Sternum.
12-56 15-11 14-78 21-35
0-92
3-20
0-98
1-00
078
3-15
1-00
1-20
0-80
3-00
0-72
3-70
1-02 1-68
1-00 2-01
75-22 71-26 72-00 61-20
6-12 7-50 7-20 9-34
The cartilage yielded neither glutin nor chondrin.
408
ANIMAL BODY:
Arthritis. Marchand analysed the upper part of the femur,
and the bones of the fore-arm of a person with abundant to-
phaceous deposits in the knee- and elbow-joints. He found
in these bones :
Femur.
Phosphate of lime . . . 42-12
Carbonate of lime . . . 8-24
Phosphate of magnesia . . I'Ol
Animal matter . . . 46-32
Fluoride of calcium, soda, chloride of sodium, "1
and loss . J
2-31
Radius & ulna.
43-18
8-50
0-99
45-96
1-37
Lehmann analysed the bones of three persons with chronic
gout ; their ages varied from 40 to 50 years. He found :
Phosphate of lime
Carbonate of lime
Phosphate of magnesia
Soluble salts
Cartilage
Fat
1.
2.
3.
35-16
35-83
37-22
8-41
9-82
8-99
1-31
1-05
1-13
2-93
2-03
1-82
38-14
38-26
40-03
12-11
13-37
9-15
Caries. Valentin has analysed carious bones, and likewise
an osteophyte incrustation surrounding the carious tibia of a
man aged 38 years.
Phosphate of lime
Carbonate of lime
Phosphate of magnesia
Chloride of sodium T
Carbonate of soda J
Organic constituents
Tibia of a man
aged 38 years.
Vertebra of a man
aged 20 years.
34-383
33-914
6-636
7-602
1-182
0-389
1-919
55-880
rS-157
10-118
54-830
Phosphate of lime
Carbonate of lime
Phosphate of magnesia
Chloride of sodium
Carbonate of soda
Organic constituents
External condyle Head of tibia
of the femur of a girl, of the same individual.
39-393
4-620
0-520
0-424
0-647
54-396
45-451
5-683
1-180
1-620
0-446
45-620
MORBID BONES.
409
In the osteophyte incrustation there were contained :
Phosphate of lime . . . 29-424
Carbonate of lime . . . 4-201
Phosphate of magnesia . . 0-317
Chloride of sodium . . . 5-556
Carbonate of soda . . . 1-117
Organic matters . . . 59*370
Von Bibra has also made several analyses of carious bones.
Bones of the hand of a man.
Its upper
Metacarpal bone, articulating portion. Phalanx.
49-77
31-36
49-36
7-24
4-07
8-08
1-11
0-83
0-98
0-30
0-30
0-40
37-97
59-36
37-47
3-61
4-08
3-71
Femur of a man.
Diseased portion.
Mass of the bone.
fluoride -i
51-53
5-44
54-98
5-97
3-43
3-70
.
0-91
0-89
35-69
31-44
3-00
3-02
Phosphate of lime with a little T
fluoride of calcium . J
Carbonate of lime .
Phosphate of magnesia
Salts
Cartilage
Fat
Phosphate of lime with a little fluoride -)
of calcium
Carbonate of lime
Phosphate of magnesia
Salts .
Cartilage
Fat
Palate bone of a woman aged 40 years, with inveterate syphilis
(The portion submitted to analysis was thrown
off during her lifetime, and weighed J 6-5 grains.)
Phosphate of lime with fluoride of calcium . 45-14
Carbonate of lime . . . 5-03
Phosphate of magnesia . . T . 2-40
Salts .... 0-82
Cartilage .... 42-34
Fat . . . . 4-27
Tibia of a man Tarsus of a man
Phosphate of lime with fluoride -i
of calcium . . J
Carbonate of lime
Phosphate of magnesia
Salts
Cartilage .
Fat
aged 25 years.
47-79
6-44
1-30
2-00
28-57
13-60
aged 40-50 years.
39-22
6-87
0-50
2-10
29-23
22-09
410 ANIMAL BODY:
Nasal bone of a girl Lumbar vertebra 1 of a woman
aged 15 years. aged 40 years.
Phosphate of lime, with T
fluoride of calcium .} 45 ' 77 44 ' 05
Carbonate of lime . 3-77 3'45
Phosphate of magnesia 1'45 1'02
Salts . . 1-10 1-70
Cartilage . . 38-62 41-42
Fat 9-29 8-36
Necrosis. The following analysis was made by Von Bibra :
Phalanx of a man
aged 40-50 years.
Phosphate of lime, with fluoride of calcium . 72-63
Carbonate of lime . . . .4-03
Phosphate of magnesia . . .1-93
Salts ..... 0-61
Cartilage ..... 19-58
Fat ..... 1-22
This small amount of organic matter is not characteristic of
necrotic bone, for in two minute portions thrown off after frac-
tures Von Bibra found :
1. 2.
Organic matter . . 37 -8 7 31-58
Inorganic matter . . 60-77 67-33
Fat 1-36 1-09
Osteoporosis. Ragsky has analysed a specimen of osteopo-
rosis growing on the cranium of an aged person. It yielded
gelatin when boiled. It contained :
Phosphates of lime and magnesia . 55-80
Carbonate of lime and salts . . 5-59
Cartilage, vessels, and fat . . 38-61
1 In the cavity of this bone, produced by the caries, there was a thick, reddish
yellow matter, like inspissated pus. It consisted of 81-3 parts of water and volatile
matter, and 18-7 of solid constituents. The latter contained in 100 parts :
Albuminous matter . 19'7
Alcohol-extract and lactates . 0'9
Water-extract . . 2-4
Shreds of cartilage . 51-0
Fat . 7-2
Fixed salts . . 18-8 containing 90g of phosphate of lime.
MORBID BONES. 411
Sclerosis. Ragsky has analysed bone in several cases of
this affection.
Simple sclerosis of the cranium of a madman.
Phosphate of lime with fluoride of calcium 54-10
Carbonate of lime . . . 10-45
Phosphate of magnesia . . TOO
Soluble salts . . .1-04
Cartilage and vessels . . . 33-41
Sclerosis consecutive on osteoporosis.
(The bone not specified.)
Phosphates of lime and magnesia . 48-20
Carbonate of lime . . . 7*45
Soluble salts . . . 0-25
Cartilage, fat, and vessels . . 44-10
Sclerosis more highly developed.
Phosphates of lime and magnesia . 50-29
Carbonate of lime and soluble salts . 7*20
Cartilage and vessels . . .42-51
Sclerosis in the highest degree.
Phosphates of lime and magnesia . 55-52
Carbonate of lime . . . 5*95
Soluble salts . . . 0-26
Cartilage and vessels . . . 38-27
Sclerosis of the femur.
Phosphates of lime and magnesia . 53-21
Carbonate of lime . 8-30
Cartilage and vessels . . . 38-49
Syphilitic sclerosis, highly developed.
Phosphates of lime and magnesia . 5 7 -20
Carbonate of lime . . . 6'50
Cartilage and vessels . . 36-30
Exostosis. Lassaigne has analysed an exostosis, the thick-
ened bone to which it was attached, and a healthy portion of
the same bone.
Thickened bone. Healthy bone. Exostosis.
Phosphate of lime . . 36-3 41*6 30-0
Carbonate of lime . . 6-5 8'2 14-0
Soluble salts . . 14-2 8-6 10-0
Organic matter , . 43-0 41-6 46-0
Von Bibra has analysed an exostosis on the humerus of a
412 ANIMAL BODY:
dog. In the second analysis the composition of the healthy
radius and ulna are represented.
1. 2.
Exostosis. Radius and ulna.
Phosphate of lime with fluoride i
of calcium .} '" 60 ' 95
Carbonate of lime . . 1-00 2-84
Phosphate of magnesia . 1-55 1-39
Salts . . . 0-91 0-93
Cartilage . . . 45-74 32-88
Fat . 2-81 1-01
We observe in both these cases that the exostosis contains a
larger amount of organic matter than healthy bone.]
I have analysed a remarkable osteoid tumour that formed
on the knee of a leucophlegmatic boy aged 14 years, who was
suffering from oadema. The tumour was ten inches long and
twenty-five broad, and could be hardly half spanned with both
hands. The limb was amputated and the tumour examined.
I analysed separately three portions of the tumour, one hard
and bony, a second softer, and a third perfectly soft. On ex-
posing them to heat on an oil-bath, the first became white and
earthy, while the other portions assumed a horny appearance.
Ether took up a dirty yellow, non-phosphorized fat.
The three specimens yielded on analysis :
Anal. 155. Anal. 156. Anal. 157.
Phosphate of lime . . 35-85 8-00 9-20
Carbonate of lime . . 270 0-62 0-64
Phosphate of magnesia . . 0-58 0-21
Soluble salts . . . 0-521
Chloride of sodium . . 0-26 J
Fat . . . 1-16 3-61 3-21
Cartilage and vessels . . 58-91 87-04 86-20
The proportions of the fixed salts to each other in these cases,
and as they occur in normal bone, are exhibited in the following
table :
1. 2. 3. Healthy bone.
Phosphate of lime . 89'7 86-5 86-9 79-4
Phosphate of magnesia . . 1-5 1-9 1-7
Carbonate of lime . . 6-8 6-6 6-0 16-9
Soluble salts . . . 0-7 T r 1-4
Chloride of sodium . . 1-3/ LO-4
The most striking peculiarity is the relative diminution of
the carbonate of lime.
TEETH. 413
[Callus has been analysed by Lassaigne and Von Bibra.
Lassaigne examined the outer and inner portions of a mass
of callus. He found :
External portion. Internal portion .
Phosphate of lime . . .33-3 32-5
Carbonate of lime . . . 5-7 6-2
Soluble salts . . . 11-3 12-8
Animal matter . . . 50-0 48-5
The following analyses were made by Von Bibra :
Callus from the Callus from the
tibia of a hare. rib of a horse.
Phosphate of lime with fluoride ofi
Y 32-62 43-90
calcium . . ./
Carbonate of lime . . 1-01 5-69
Phosphate of magnesia . . 1-13 1-20
Salts . . . 1-79 0-74
Cartilage . . . 61-41 46-97
Fat ... 2-04 1-50
Hence callus does not contain so large an amount of earthy
salts as true bone.]
The Teeth.
The teeth, like the bones, consist of phosphate and carbonate
of lime, fluoride of calcium and cartilage. The bony matter of
the tooth is covered superiorly with enamel, while the fangs
are coated with cement or cortical matter, which likewise over-
lays the enamel of the crown. Of the three constituents of
tooth, enamel, bone (dentine), and cortical substance, the last
is the poorest in inorganic matter. Lassaigne found therein :
Organic matter . . . 42-18
Phosphate of lime . . . 53-84
Carbonate of lime . . . 3'98
The osseous portion (dentine) hardly differs from true bone.
Berzelius found therein :
Cartilage and vessels . . . 28-0
Phosphate of lime with fluoride of calcium . 64-3
Carbonate of lime . . .5-3
Phosphate of magnesia . . .1-0
Soda, with chloride of sodium . .1-1
414
ANIMAL BODY:
Pepys found :
Cartilage
Phosphate of lime
Carbonate of lime
Water and loss
28-0
58-0
4-0
10-0
From analyses made by Lassaigne of human teeth at dif-
ferent ages, it appears that the phosphate of lime gradually
increases, and that there is a corresponding diminution of the
carbonate.
Tooth of a child one day old
of a child aged 6 years
of an adult man
of a man aged 81 years .
In the enamel of human teeth, Berzelius found :
Phosphate of lime with fluoride of calcium . 88 -5
Carbonate of lime . . .8-0
Phosphate of magnesia . . .1-5
Membrane, alkali, and water . .2-0
So that this substance seems almost destitute of organic
combination.
Organic
matter.
Phosphate
of lime.
Carbonate
of lime.
35-00
51-00
14-00
28-57
60-01
11-42
29-00
61-00
10-00
33-00
66-00
1-00
[Von Bibra has made the following analyses of human teeth
Phosphate of lime with a T
little fluoride of calcium J
Carbonate of lime
Phosphate of magnesia
Salts
Cartilage
Fat
Molar tooth of
a woman
aged 25 years.
^"S^
/
Enamel.
N
Osseous portion.
81-63
67-54
8-88
7-97
2-55
2-49
0-97
1-00
5-97
20-42
a trace
0-58
Molar tooth of
an adult male.
Enamel.
89-82
4-37
1-34
0-88
3-39
0-20
Osseous portion.
66-72
3-36
1-08
0-83
27-61
0-40
For a series of analyses of the teeth of the lower animals
I must refer the reader to the original work, (Chemische
Untersuchungen iiber die Knochen und Zahne des Menschen
und der Wirbelthiere,) which may be regarded as a perfect
monograph on the subject of which it treats.]
CARTILAGE. 4i:>
Cartilage.
The cartilages are invested with a peculiar membrane, the
perichondrium ; they are not so hard as bone, but are more
elastic and supple. They are usually divided into two classes,
the true and the fibrous cartilages. In addition to their re-
spective microscopic appearances, they present well-marked che-
mical differences. The true cartilages dissolve almost entirely
in water, and yield chondrin (see Introduction, p. 25). If,
however, the boiling is interrupted before the solution is per-
fectly effected, it will be found that the cells have remained
almost unchanged, and that only the basic substance has been
dissolved. Even when true cartilage is perfectly dissolved the
solution is somewhat turbid, owing, probably, to a partial change
in the cells. Fibrous cartilage, in which the cells form the
preponderating mass when continuously boiled for forty-eight
hours, yields only a small quantity of extract, which exhibits
all the ordinary reactions of chondrin, but does not gelatinize.
The inorganic constituents of cartilage form only a small portion
of their mass ; Fromherz and Gugert 1 found in the costal car-
tilage of a man aged 20 years, 3'402g of fixed salts, associated
in the following proportions :
Carbonate of soda . .35-1
Sulphate of soda . . 24-2
Chloride of sodium . . 8-2
Phosphate of soda . . 0-9
Sulphate of potash . . 1-2
Carbonate of lime . . 18-3
Phosphate of lime . . 4'1
Phosphate of magnesia . . 6'9
Peroxide of iron and loss . 0'9
In the corresponding cartilage of a woman aged 63 years,
the same salts were observed, but to a smaller amount : there
was also a larger amount of phosphate than of carbonate of lime.
[The following analyses of cartilage are extracted from Von
Bibra's work:
1 Schweiger's Journal, vol. 50, p. 187.
416 ANIMAL BODY:
Costal cartilage of a child Ditto of a child
aged 6 months. aged 3 years.
100 parts yielded
( ^
2 '24 of the following ash : 3-00 of the following ash :
Phosphate of lime . . 20-86 21-33
Sulphate of lime . . 50-68 48-68
Phosphate of magnesia . . 9-88 8-88
Sulphate of soda . . 9-21 10-93
Phosphate of soda T r 3-00
a.--. * i-V a trace J
Carbonate of soda J [_
Chloride of sodium . . 9'37 7-18
Costal cartilage of a girl Ditto of a woman Ditto of a man
aged 19 years. aged 25 years. aged 40 years.
100 parts yielded
t '\
7-29 of the following ash : 3-92 of the following ash : G-l of the following ash:
Phosphate of lime . 5-36 6-33 13-09
Sulphate of lime . 92-41 87*32 79-03
Phosphate of magnesia 0-99 4-10 3'78
Sulphate of soda . 1-24 0-95 1-22
Phosphate of soda . a trace a trace 0-93
Chloride of sodium . a trace 1-30 1-95
Carbonate of soda . a trace a trace
Carbonate of lime . a trace ]
Synovia.
The synovial fluid is viscid, transparent, of a yellow or reddisli
colour, faintly saline, and resembles in its odour the serum
of the blood. A specimen of this fluid, analysed by John,
contained :
Water . . 92-80
Albumen .... 6-40
Extractive matter, with muriate and carbonate of")
, } O'oO
soda . . . . . J
Phosphate of lime . . . 0-15
Cellular Tissue, Tendons, Ligaments, Skin, Hair.
These may be classified together as tissues that yield gelatin.
They are distinguished more by their microscopical than their
chemical characters, and we may refer to Henle for an excellent
account of their minute structure. The elements of cellular or
combining tissue (Bindegewebe) in whatever part of the body
it occurs are long, fine, hyaline fibrillse or cylinders, varying in
diameter from -0003 to '0008 of a line, and lying in close ap-
TENDONS, LIGAMENTS, SKIN. 417
position. They are firm and elastic, are not changed by cold
water, nor dissolved by acetic acid; the latter reagent renders
them gelatinous and tough, but takes up no protein-compound.
The organs containing this tissue diminish when boiled, become
harder and more rigid, but ultimately soften and dissolve into
gelatin, forming a solution that stiffens on cooling. Alcohol,
ether, and oil exert no action on cellular tissue, even when aided
by heat.
Tendons swell on being boiled, become yellow, and are gra-
dually converted into gelatin. The solution is turbid in con-
sequence of the flocculent appearance presented by minute
vessels in suspension. In concentrated acetic acid they swell,
become transparent and gelatinous, and in this state readily
dissolve in hot water, from which neither an alkali nor ferro-
cyanide of potassium throws down any precipitate.
Ligaments consist partly of cellular and partly of elastic
tissue, and these two structures present both chemical and
physiological differences. True elastic tissue is not changed by
acetic acid, is not converted by boiling into gelatin, but with
the aid of heat dissolves readily in dilute mineral acids, from
which it is not precipitated by ferrocyanide of potassium. As
illustrations of the true elastic tissue we may refer to the liga-
menta flava between the vertebrae and the ligamentum nuchse
in the ruminants.
The cutis, or true skin, is a contractile cellular tissue con-
vertible, by boiling, into gelatin. It is permeated by a fluid, and
contains also cellular tissue and vessels. Wienholt has endea-
voured to determine their relative proportions; he obtained:
Cutaneous tissue (including cellular tissue and vessels) . 32-53
Water ..... 57'50
in which were dissolved :
Albumen , . . . .1-54
Alcohol-extract ..... 0-83
Water-extract ..... 7-60
The skins of different animals require boiling for different lengths
of time in order to be converted into gelatiD, and the change
is effected more rapidly in young than in old animals.
The conversion of the cutis into gelatin is much facilitated
by the action of dilute alkalies or acids ; it then takes place at
an ordinary temperature. The skin combines with basic sul-
phate of iron, and with bichloride of mercury, when immersed in
ii. 27
418
ANIMAL BODY.
solutions of those salts, and it then resists putrefaction. It
likewise combines with tannin, forming a substance insoluble
in water, and no longer tending to putrefaction (leather) .
The epidermis is affected by strong mineral acids : concen-
trated sulphuric acid dissolves it, as also do the caustic alkalies.
Many metallic salts combine with and colour it. The ter-
chloride of gold communicates a purple, nitrate of the protoxide
of mercury a reddish brown, and nitrate of silver a black colour :
the volatile oxide of chrome (?) exerts a similar effect, and
even the alkaline sulphurets communicate a brown or black
colour to it.
[The hair has recently been examined by Scherer and Van
Laer. 1 By treating the hair with spirit, ether, and water,
there were removed margarin and margaric acid, olein, a brown
matter soluble in water, chlorides of sodium and potassium,
and lactate of ammonia.
By ultimate analysis there were then obtained :
Scherer.
Van Laer.
t
1.
2.
3.
>
4.
/
I.
N
2.
51-529
50-652
50-622
49-935
50-12
50-65
6-687
6-766
6-613
6-631
6-33
6-36
21-03
20-81
23-848
24-643
24-829
25-498
4-99
5-00
17-963
17'963
17-963
17-963
17-52
17-14
Carbon .
Hydrogen
Oxygen -i
Sulphur J
Nitrogen
No. 1 was hair of the beard; 2, of the head of a fair
person ; 3, was brown hair ; and 4, black hair from a Mexican.
The ash in 1 amounted to O72g; in 2, to 0'8g; and in 4,
to 2-0.
According to Van Laer, the inorganic constituents in 100
parts are :
Colour.
Brown hair
Black hair
Red hair
Gray hair
Ash. Soluble portion.
Peroxide of iron.
Insoluble portion.
0-54
0-17
0-058
0-312
1-10
0-51
0-395
0-200
0-32
1-02
0-29
0-214
0-516
1-15
1-30
0-93
0-170
0-200
0-54
0-27
0-275
1-85
1-00
0-24
0-232
0-528
0-75
1 Scheik. Onderzoeck, 2 St. p. 75.
THE EYE. 419
The soluble portion consisted of chloride of sodium, sulphate
of lime, and sulphate of magnesia ; the insoluble constituents
were phosphate of lime and silica.
From Van Laer's investigations it appears that the hair con-
sists essentially of:
1. A connecting medium consisting of a tissue yielding ge-
latin and represented by the formula C 13 H 10 N 3 O 3 ; and
2. Of bisulphuret of "protein, C 40 H 31 N 5 O Ia S 9 .
The large amount of sulphur in hair (averaging 5g) is the
cause of its colour being affected by various metallic salts.
As there is no constant difference in the results obtained by
the analysis of hair of various tints, it is to be presumed that
the colour is dependent on peculiar arrangements of the ul-
timate particles.
Hair further contains about 0-4g of peroxide of iron, which
is supposed by Van Laer to be chemically combined with the
protein.]
Crystalline Lens and Fluids of the Eye.
The crystalline lens is insoluble in boiling water, spirit, and
acids ; it does not even communicate any turbidity to them ;
hence it consists neither of cellular nor elastic tissue, but is a
distinct substance, approximating possibly towards horny tissue.
The membrana Demoursii, the third layer of the cornea, pos-
sesses similar properties, while the true horny layer which lies
between the external layer of epithelium and the membrana
Demoursii appears to be fibrous, and is converted by boiling
into chondrin. The crystalline lens itself possesses a peculiar
and very regular fibrous arrangement. Chevenix found the
specific gravity of the human lens to be 1079, and that of the
sheep 1180. I have observed that the crystalline lens in young
animals is softer, and less resisting than at a more advanced
age.
With respect to the chemical composition of the lens, I
find that, in addition to albumen, it contains a substance
closely resembling casein, to which I apply the term crys-
tallin. I reduce the lens to a pulpy mass, stir it with water,
and then heat the mixture to the boiling point : the albumen co-
agulates, while the crystallin does not coagulate, but is entangled
420 ANIMAL BODY.
in the albumen. In order to separate them I evaporate to
dryness, pulverize the white residue, and boil it, first with ether
in order to separate fat, and then with spirit of -915 as long as
anything continues to be taken up. The albumen rapidly sinks
from the hot, clear, spirituous solution, and the supernatant fluid
which must be decanted from the sediment, soon begins to be-
come turbid from the separation of numerous flocculi of crys-
tallin. I evaporate to a slight residue, and then precipitate the
crystallin by strong,alcohol, in which it is only slightly soluble.
The lactates and chloride of sodium remain dissolved in the
alcohol. In this manner I analysed the crystalline lens of the
ox and the horse.
Anal. 158. Anal. 159.
Crystalline lens of ox. Ditto of horse.
Water .... 65-762 60-000
Albumen .... 23-290 25-531
Crystallin .... 10-480 14-200
Fat .... 0-045 '0-142
Extractive matter with chloride of T
sodium and lactates . .} ' 495
Berzelius has not separated the albumen and crystallin ; in
other respects his analysis approximates to mine, as far as the
amount of the protein- compounds is concerned.
He found it composed of:
Water . . . 58-0
Protein-compounds . . 35-9
Alcohol-extract with salts . . 2-4
Water-extract with traces of salts . 1-3
Cell-membrane . . .2-4
It has been shown by Wurzer and Lassaigne, that when the
lens is opaque (in cases of cataract) it contains an excess of
phosphate of lime. This may be the cause of the opacity, or it
may be due to the coagulation of the protein-compounds by the
presence of a free acid. Wurzer determined the composition
of an opaque lens from a bear. It contained (after the removal
of the water) :
Phosphate of lime . . . 68-9
Carbonate of lime . . . 12-6
Carbonate of magnesia . . . 3-6
Peroxides of iron and manganese . .0-7
Mucus (?) . . . .7-5
Phosphate of lime with an animal matter . 2-1
Chloride of sodium with animal matter . 3-2
Solid fat 1-1
ARTERIES AND VEINS. 421
Lassaigric analysed an opaque lens from a horse. It con-
tained :
Coagulated albumen . . . 29-3
Phosphate of lime . . .57*4
Carbonate of lime . . .1*6
Soluble salts and other matters . .177
The vitreous humour is perfectly clear and contains a very
small amount of solid constituents in solution. It is enclosed
in numerous compartments by a very delicate transparent mem-
brane. On removing it by gentle pressure from this membrane,
and evaporating it to dryness, it yields only -0162 o f a colourless
residue consisting for the most part of chloride of sodium.
Berzelius obtained from it :
Water . . . . . 98-40
Albumen . . . . .0-16
Chloride of sodium with a little extractive matter . 1*42
A substance soluble in water . . . 0-02
The aqueous humour contains, according to Berzelius :
Water ..... 98-10
Albumen . . , . .a mere trace
Chloride of sodium with a little alcohol-extract . 1-15
Extractive matter soluble only in water . . 0-75
The Arteries and Veins.
Very little is known with certainty regarding the chemical
composition of the different coats of the blood-vessels, but their
microscopic characters have been thoroughly examined by Henle.
Berzelius has shown that the middle coat of the arteries belongs
to the elastic tissues ; Eulenberg, on the other hand, asserts that
from 30 grains of dried arterial membrane (middle coat) he ob-
tained, by three successive boilings, occupying in all 120 hours,
1 1 grains of dried substance which dissolved in water and gela-
tinized on cooling. Valentin found that an acetic-acid solution of
arterial membrane is precipitated by ferrocyanide of potassium,
and I have obtained a solution of the middle coat (by boiling it
in water for ten hours) which is strongly precipitable by acetic
acid. The greater part of the precipitate dissolves in an excess
of the acid, and is again thrown down by ferrocyanide of potas-
422 ANIMAL BODY :
slum : tannin, bichloride of mercury, and basic acetate of lead
cause considerable turbidity.
The Muscles.
Muscular fibre is chemically distinguished from the fibre of
cellular tissue by the circumstance that it does not yield gela-
tin by prolonged boiling in water, but dissolves in acetic acid,
from which it may be precipitated by ferrocyanide of potassium,
showing that it belongs to the protein-compounds. The micro-
scopic characters of the various species of muscular fibre have
been well described by Heule.
In consequence of the difficulty that exists in separating
muscular fibre from cellular tissue, vessels, and nerves, it is
impossible to speak with certainty respecting the behaviour of
pure muscle towards reagents. If very small pieces of muscle
are freed as much as possible from fat and cellular substance,
and immersed in water, blood, colouring matter, and the ex-
tractive matter with which muscle abounds, are gradually taken
up, and colourless muscular fibres are left.
Cold water and alcohol produce little effect on them, but in
boiling water they first contract and become firm, and subse-
quently soften. Concentrated acetic acid dissolves them; in the
dilute acid they swell and assume a transparent fibrous appear-
ance. The alkaline carbonates increase their firmness. Solu-
tions of muscular fibre in dilute acids are precipitated by
ferrocyanide of potassium and tannin in a precisely similar
manner to acid solutions of fibrin. Dried muscular fibre may
be easily pulverized; in that condition it resembles the whole
class of protein-compounds in exhibiting strong positively elec-
trical properties.
On making incisions into the warm flesh of an animal just
killed, we obtain, by pressure, an acid fluid which rapidly coa-
gulates in consequence of the presence of a little fibrin : if
the flesh has been kept for some time the fluid obtained by
pressure no longer coagulates, although it exhibits an acid re-
action. No quantitative analysis of human flesh 1 has yet been
1 [The following analyses of human flesh by Marchand (Lehrbuch der Physiolo-
gischen Chemie, p. 156) and L'Heretier (Traite de Chimie Pathologique, p. 660) have
MUSCLES. 423
made,, but the flesh of several animals has recently been sub-
mitted to analysis. The amount of water averages about 802,
and the greater part of the solid residue consists of fibrin ; the
other constituents, albumen, hsematoglobulin, fat, extractive
matters, lactic acid, the lactates and other salts occur in the
expressed juice. The proportions of these constituents have been
determined by Berzelius, Braconnot, Schlossberger, Schultz,
[and Marchand.] In the flesh of oxen they found :
Berzelius. Braconnot. Schlossberger. Schultz. Marchand.
Water . . . 77-17 77-03 77-50 77-50 76-60
Fibrin, cells, vessels & nerves 17-70 18-18 17-50 15-00 18-00
Albumen & haematoglobulin 2-20 2'70 2-20 4-30 2'50
Alcohol-extract and salts . 1-80 1'94 1-50 1'32 170
Water-extract and salts . 1-05 1-15 1-30 1-80 1-10
Phosphate of lime with albumen 0-08 traces 0-10
Fat and loss . . -^- 0*08
[The dried muscular flesh of the ox has been analysed by
Playfair and Bockmann, and found to be identical in its com-
position with dried blood :
Flesh (beef.) Ox-blood.
Playfair. Bockmann. Playfair. Bockmann.
Carbon . 51-83 51-89 51-95 51-96
Hydrogen . 7-57 7-59 7'17 7'33
Nitrogen . 15-01 15-05 15-07 15-08
Oxygen . 21-37 21-24 21-39 21-21
Ashes . 4-23 4-23 4-42 4'42
Deducting the ashes or inorganic matter, the composition of
the organic part is :
Carbon . 54-12 54-18 54-19 54-20
Hydrogen . 7-89 7'93 7-48 7'65
Nitrogen . 15-67 15-71 15-72 15-73
Oxygen . 22-32 22-18 22-31 22-12
which corresponds to the formula C 48 H 39 N 6 O 13 .
appeared since the publication of Simon's Chemistry. The flesh in the first analysis
was taken from the upper portion of the arm of a man who died from diseased liver.
Marchand. L'Heretier.
Water and loss . .* . 78-00 77'10
Matter insoluble in cold water . 17'00 15-80
Soluble albumen with colouring matter . 2'30 3'40
Alcohol-extract with salts . .1-60 1-20
Water-extract with salts . . 1-00 2-50
Phosphate of lime, with albumen . 0-10
424 ANIMAL BODY:
In 100 parts of the ashes yielded by the incineration of ox-
flesh Enderlin found :
Tribasic phosphate of soda (3NaO, PO 5 ) . 45-100-1
Chlorides of sodium and potassium . . 45*936 J 9J
Phosphates of lime, magnesia, and peroxide of iron . 6-840 insoluble salts
Loss . . 2-124
100-000 ]
The following analyses of the flesh of other animals have been
made by Schlossberger :
Calf.
f A ^ Swine. Roe. Pigeon. Chicken. Carp. Trout,
1. 2.
Water .... 797 78-2 78-3 76-9 76-0 77'3 80-1 80-5
Muscular fibre and vessels .15-0 16-2 16-8 18-0 17-0 16-5 12-0 1M
Albumen and hsematoglobulin 3-2 2-6 2-4 3-3 4*5 3-0 5-2 4-4
Alcohol-extract with salts . 1-1 1-4 1-7 1 f 1-0 1-4 1-0 1-6
Water-extract with salts . 1-0 1-6 0*8 J 2 ' 4 I 1-5 *l-2 17 0-2
Phosphate of lime with albumen 0-1 traces traces 0-4 0-6 2-2
The analyses of Schultz correspond in many points with
those of Schlossberger. In calves' flesh Schultz found a little
more animal fibre than Schlossberger : in the flesh of a pig four
weeks old Schultz found 21*1 parts of muscular fibre and 3-45
of albumen and hsematoglobulin ; and in the flesh of a pig two
years and a half old he found 20- 3 parts of the former and 4'2
of the latter. Schultz also found that the amount of muscular
fibre was less in the flesh of fishes than in that of the mam-
malia : thus in the flesh of cyprinus nasus, and cyprinus barbus
the proportions of fibre were 13*5 and 17*18 respectively.
[We may take this opportunity of noticing an interesting
paper by Helmholtz, 1 on the consumption of tissue during
muscular action.
Powerful muscular contractions were induced by passing an
electric current through the amputated leg of a frog as long as
convulsions continued to be manifested. The flesh of the two
legs was then analysed. The albumen was apparently scarcely
affected, the mean of 6 experiments giving 2'10g of albumen in
the electrized, and 2'13 in the non-electrized flesh. With
regard to the extractive matters it appeared that in all the ex-
periments, without a single exception, the water-extract in the
electrized flesh was diminished, while on the other hand the
spirit- and alcohol-extracts were increased by that process. The
results are expressed in the following tables.
1 MiUler's Archiv. 1845.
MUSCLES. 425
Alcohol-extract from 1U<) parts of recent frog's flesh.
Ex p.
. In electrized portion.
6. In non-electrized portion.
a : b
1
0-752
0606
1-24 1
2
0-569
0-427
1-33 1
3
0-664
0-481
1-38 1
4
0-652
0-493
1-32 1
5
0-575
0-433
1-33 1
Extracted with
alcohol of 95 per cent.
6
1-020
0-748
1-36 1
Water-extract.
Spirit-extract.
a. 6. a :
b a. b.
a : b
7
1-21 1-63 0-79 :
1 1-69 1-50
1-13 : 1
8
0-93 1-23 0-76 :
1 1-65 1-35
1-22 : 1
9
0-72 0-90 0-80 :
1 1-76 1-53
1-15 : 1
lean
0-95 1-25 0-78 :
1 1-70 1-46
1-16 : 1
The amount of fat was unaffected. No urea could be found
in the alcohol-extract.
There is great difficulty in performing experiments of this
nature on warm-blooded animals in consequence of the rapidity
with which isolated portions of muscle lose their irritability.
The best results were obtained with decapitated pigeons.
a. In electrized muscle, b. In non-electrized muscle. a : b
Albumen . . 2-04 2-13
Water-extract . 0-64 0-73 0-88 : 1
Spirit-extract . 1-68 1-58 1-06 : 1
It remains to be considered whether the fibrin takes part in
this decomposition : a priori we should infer that it did, for
the protein-compounds seem universally the conductors of the
highest vital energies, and further the increased amount of sul-
phates and phosphates in the urine after muscular exertion indi-
cates a decomposition of the sulphur and phosphorus compounds.
The above facts sufficiently show that muscular action is
always accompanied by a chemical change in the composition of
the acting muscle.]
The Brain, Spinal Cord, and Nerves.
Chemical analyses of the brain, spinal cord, and nerves are
not calculated to throw much light on the functions of the
nervous system in relation to the animal organism.
According to the analyses of Couerbe, the mass of the brain
contains five different sorts of fat, viz. cholesterin, eleencephol,
426 ANIMAL BODY:
cerebrot, stearoconot, and cephalot. 1 Fremy, who has paid much
attention to the subject, found albumen, cholesterin, two peculiar
acids cerebric and oleophosphoric acids, besides traces of olein
margarin, and their acids, in the brain. These acids are partly
free and partly (especially the oleophosphoric) combined with soda.
These fatty matters are contained almost exclusively in the
white or medullary substance ; after their removal a substance
remains, analogous to the gray matter. Fremy has also de-
tected these peculiar acids in the spinal cord and nerves.
The quantity of water in the brain is very considerable, and
amounts to about 80^: Fremy estimates it at 88,the remaining 12
consisting of 7g of albuminous matter insoluble in alcohol, ether,
and water, and 5 of the aforesaid fats, and their compounds.
Denis found in the brain of a man aged 20 years :
Water .... 78-0
Albumen . . . .7*3
Phosphorized fat . " . . 12-4
Extractive matter and salts . 1*4
In the brain of a man aged 78 years he found :
Water . . . .76-0
Albumen . . . .7*8
Phosphorized fat . . .13-1
Extractive matter and salts . . 2-5
Vauquelin found in the human brain :
Water .... 70-00
Albumen . . . .7-00
Fat .... 5-23
Phosphorus . . . .1-50
Extractive matter . . . 1-12
Acids, bases, and sulphur . . 5 '15
Lassaigne has made the following analyses of the brain of an
insane person :
Cortical and medullary Cortical Medullary
substance together. substance, substance.
Water .... 77'0 85-0 73-0
Albumen . . . 9'6 7-5 9'9
Colourless fat . . .7-2 1-0 13-9
Red fat . . .3-1 3'7 0'9
Extractive matter, lactic acids, salts . 2-0 1*4 I'O
Phosphates of lime, magnesia, and T
peroxide of iron . . J
[The following table has been drawn up by I/Heretier 2 from
1 See Vol. I, p. 81. * Traite de Chim. pathol. p. 596.
BRAIN, ETC. 427
his own researches. The numbers in each instance represent
the mean of six analyses :
Infants. Youths. Adults. Aged persons. Idiots.
Water . . . 82-79 74-26 72-51 73-85 70-93
Albumen . . . 7-00 10-20 9-40 8-65 8-40
Fat . . 3-45 5-30 6-10 4-32 5'00
Osmazome and salts . . 5-96 8-59 10-19 12-18 14-82
Phosphorus . . 0-80 1'65 1-80 1-00 0-85 J
According to Vauquelin, the medulla oblongata and the spinal
cord contain the same constituents as the brain, but a larger pro-
portion of fats and a less amount of albumen, extractive matter,
and water.
[I/Heretier found that the spinal cord of an adult was
composed of:
Water . . .71-05
Albumen . . . 7'30
Fat . . 8-25
Osmazome . . .11-50
Phosphorus . . .1*90
The nerves, according to the same chemist, contain more
albumen, less solid and more soft fat than the brain.]
On boiling the nerves in alcohol a fluid fat exudes which sinks
to the bottom of the vessel : on boiling them with water they
swell but do not dissolve. The albumen of the medullary portion
dissolves in a weak solution of potash, the fat swims on the sur-
face, and the neurilemma remains. On treating the nerves with
acetic acid the medullary portion is expressed by the contraction
of the tubes, which are themselves unacted on.
Fat.
The fat contained in the fat-cells is a mixture of margarin
and olein in man and the carnivora, of stearin and olein in the
ruminantia. Human fat usually occurs in a fluid or semifluid
state, consisting of a solution of margarin in olein, from which
the margarin separates on cooling into microscopic stellar
groups.
The Glands.
Our knowledge of the chemistry of the glands is very defec-
tive, and in all probability the analysis of these organs will
never throw much light on the process of secretion in conse-
quence of the utter impossibility of separating the nerves, ves-
428 ANIMAL BODY:
sels, and cellular substance. Fromherz and Gugert attempted
to analyse human liver. They found in 100 parts :
Water . . . 6179
Solid residue . . 38-21
The insoluble parenchyma formed 28'72, and the portion
soluble in water and alcohol 71 '28 of the solid residue : 100
parts of dried liver contained 2 -634 of salts, consisting of chlo-
ride of sodium, phosphate and a little carbonate of lime, phos-
phate of potash, and traces of peroxide of iron.
In the liver of the ox Braconnot found water 55-50, soluble
matter 25 -56, walls of vessels and membrane 18-94.
In certain morbid conditions of the system the liver becomes
much affected. Its amount of fat is so extraordinarily increased
in certain cases as to conceal the true structure, for the fat, as
Rokitansky observes, not only occupies the place of the true
glandular tissue, but all the tissues are permeated and the vas-
cular substance perfectly overwhelmed. This morbid condition
has been very frequently observed associated with pulmonary
phthisis, and is a consequence of too luxurious a life, and the abuse
of spirituous drinks. Fromherz and Gugert analysed a liver of
this nature. It weighed twelve pounds, and had a soft caseous
appearance. Its true organization appeared entirely destroyed.
It contained a non-saponifiable fat with a small quantity of unco-
agulated albumen, a little extractive matter, casein, salivary
matter, a few shreds of vessels, chloride of sodium, and phosphate
of lime: they found no cholesterin, fatty acids, or bilifellinic acid.
[A fatty liver analysed by Frerich, 1 yielded :
Water .... 73*09
Solid constituents . . . 26-91
Fat containing phosphorus . 17'26
Albumen . . . 3-67
Vessels and hepatic cells . 4-00
Water-extract . . 0-48
Alcohol-extract . . 1-50
A waxy liver (a variety of the above) yielded :
Water .... 80-20
Solid constituents . . . 19-80
Fat containing phosphorus, and cholesterin 2-20
Albumen . . . 3-50
Vessels and hepatic cells . . 3-60
Water-extract . . .7-00
Alcohol-extract . .. . 4-50
1 Schmidt's Jahrbucher, vol. 48, p. 148.
OTOLITIIES. 429
The two following analyses have been made by Boudet :
Fatty liver. Healthy liver.
Water . . 55-15 76-39
Solid constituents . 44*85 23*61
Animal matter dried at 2 1 2 13-32 21-00
Saponifiable fat . 30-20 1-60
Cholesterin 1-33 0-17 ]
The thyroid gland has been analysed by Fromherz and
Gugert, and the thymus by Morin.
The kidneys have been submitted to analysis by Berzelius.
From two experiments he concludes that the kidneys are made
up of a congeries of minute vessels, and that the tubes contain
a very albuminous acid fluid, in which there is no dissolved
fibrin, and in which not a trace of urea can be detected.
[According to Boudet, the parenchyma of the lungs, freed
as much as possible from blood and extraneous substances, is
formed of the following chemical elements : 1st, a substance
susceptible of transformation into gelatin by ebullition in water,
(cellular tissue;) 2d, a substance soluble in cold water, pre-
cipitated by nitric acid, coagulated by heat, containing albumen
and hsematin ; 3d, a substance analogous to casein ; 4th, fibrin ;
5th, free oleic and margaric acids ; 6th, oleate and margarate
of soda ; 7th, cerebric acid ; 8th, lactic acid ; 9th, cholesterin
amounting to '05 of the weight of the lungs dried at 21 2 ;
10th, the water amounting to 82. The ash contained a con-
siderable quantity of chloride of sodium and sulphate of soda,
a small quantity of phosphate and carbonate of lime, and traces
of silica and peroxide of iron.]
Otolithes.
The membranous labyrinth of the ear contains a rather
viscid fluid, which, however, never occurs in sufficient quantity
to admit of chemical examination. In this fluid there are found
minute six- or eight-sided crystals (otolithes), which, however,
are generally so worn at the angles and borders that the crystalline
form can be no longer recognized. They appear to consist for
the most part of the carbonates of lime and magnesia combined
with animal matters, and not unfrequently with phosphates.
430
CHAPTER XII.
SOLID MORBID PRODUCTS.
Concretions.
THESE morbid products are of frequent occurrence. They
are found in various, organs, especially in those through which
fluid glandular secretions are discharged. They then consist
for the most part of the most insoluble constituents of that fluid,
although they occasionally contain substances foreign alike to
the secretion and to the whole organism, and produced by a
depraved formative process. Concretions are, however, also met
with in other situations, as the brain, the cavities of the heart,
the arteries, &c.
The substances ordinarily entering into the composition of
concretions are by no means numerous. Some concretions are
formed of one constituent alone, while others have a mixed
composition. The following substances must be viewed as true
formative constituents, not as mere accidental admixtures: uric
acid with its salts, uric oxide (xanthic oxide), cystin, hippurate
of ammonia, basic and neutral phosphate of lime, ammoniaco-
magnesian phosphate, oxalate of lime, carbonate of lime, car-
bonate of magnesia, fibrin, cholesterin, and biliphsein : the
accidental components are mucus of the urinary and gall-
bladders, albumen, hsematoglobulin, bilifellinic acid, fat, extrac-
tive matters, chloride of sodium, and lactate of soda.
The principal object in the analysis of concretions is to de-
termine the nature of the leading constituents, and this may be
easily effected even by persons little skilled in chemical mani-
pulation. A blowpipe, a little platinum foil, and a few tests,
comprise all the requisite apparatus.
Qualitative analysis of concretions.
On heating a little of the concretion on platinum foil with
the blowpipe, three things may happen : the portion tested
may entirely disappear, or a part may disappear, while the rest
CONCRETIONS. 431
becomes whitened by incineration, or, finally, it may become
blackened without, or with very slight diminution in size.
1. If the tested portion disappear entirely, it may consist of
uric acid, urate of ammonia, or both, hippurate or benzoate of
ammonia, uric oxide, cystin, cholesterin, biliphsein, fibrin, albu-
men, or hair.
a. It is uric acid if, when carbonized by exposure to heat
on platinum foil, it gives off a peculiar animal odour resembling
hydrocyanic acid, and diminishes to a scarcely visible residue ;
when a portion of the concretion heated with nitric acid dis-
solves therein with effervescence, and, after evaporation nearly
to dryness, assumes, on the addition of ammonia, a beautiful
purple tint; and when it dissolves thoroughly in a weak solution
of caustic potash or its carbonate, and at the same time is
insoluble in water, alcohol, and dilute hydrochloric acid.
b. It is urate of ammonia (which seldom occurs alone) if it
behaves before the blowpipe, and with nitric acid, in just the
same manner as uric acid, but at the same time, evolves an
ammoniacal odour when heated on platinum foil, and develops
a considerable amount of free ammonia on being triturated with
caustic potash ; and if it dissolves in boiling water.
c. It is uric or xanthic oxide if it burns without the pecu-
liar odour of uric acid, if it dissolves without effervescence in hot
nitric acid, and the evaporated solution when treated with ammonia
assumes, not a rich purple, but a dark yellow colour and if,
finally, it is insoluble in a dilute solution of carbonate of potash.
d. It is cystin if it burns before the blowpipe with a blue
flame, emitting at the same time, a pungent acid odour; if when
treated with nitric acid it assumes (instead of a purple or yellow)
a brown tint; if it dissolves in a dilute solution of carbonate of
potash, and in caustic ammonia, and if it crystallizes from
the latter in six-sided plates, easily recognized under the micro-
scope. 1
e. It contains benzoate of ammonia if alcohol extracts a
substance which, after evaporation is soluble in water, and if,
1 [In order to detect the presence of cystin a portion of the suspected calculus
should be dissolved in a strong solution of caustic potash, and a solution of acetate
of lead added in excess ; the liquid must then be heated to the boiling point. If cystin be
present insoluble sulphuret of lead is formed, which at first gives the liquid the aspect
of ink, but is shortly precipitated, while oxalate of ammonia remains in solution.]
432 MORBID PRODUCTS.
on the addition of hydrochloric acid to the aqueous solution,
crystals are separated, which dissolve readily in alcohol and
evolve an odour of benzoic acid.
f. It is cholesterin if the concretion exhibits a crystalline
character, if the portion under examination burns with a bright
flame, if it dissolves in boiling alcohol, and separates from it on
cooling in crystalline plates or scales, and if it does not dissolve
in caustic potash.
g. Biliary resin is a frequent constituent of biliary calculi,
but never occurs alone. It may be easily recognized by its so-
lubility in alcohol, by its extremely bitter taste, and by its
separation from its alcoholic solution on the cautious addition
of water.
h. It is biliphsein if it has a brown or ochre-yellow colour,
if it evolves an animal odour on burning, if it is only slightly
soluble in alcohol and water, but freely in caustic potash, com-
municating to it a dark brown tint, and if the addition of nitric
acid to this solution causes the well-known change of colour.
1. It is fibrin if it softens when heated on platinum foil and
evolves an odour of burnt horn, burning with a clear flame, and
leaving scarcely any residue; if it dissolves in caustic potash
from which it is precipitable by acetic acid, and finally, if it dis-
solves in an excess of acetic acid from which it is precipitable by
ferrocyanide of potassium. It must be remembered that this
description applies equally to albumen.
k. Concretions containing hair may be known by their
light specific gravity, and by their appearance on making a
section. When burned they develop an odour of burned horn.
They dissolve in caustic potash, but in none of the other ordi-
nary solvents,
2. If the portion submitted to examination becomes black
on the first application of heat, and only slightly diminishes, it
may consist of the earthy phosphates, carbonates, and oxalates,
or of the urates with fixed bases, for then the uric acid becomes
converted by heat into carbonic acid, and the bulk of the
specimen does not very perceptibly diminish.
a. It is neutral phosphate of lime (which is not often the
sole constituent) if, when the heat is continued, it fuses, and
neither before nor afterwards effervesces with acids ; if it dis-
CONCRETIONS. 433
solves readily in hydrochloric acid, from which it is precipitable
as an amorphous powder by ammonia; and if, after the am-
monia ceases to cause any further deposit, the filtered solution
yields a precipitate to oxalate of ammonia.
b. It is basic phosphate of lime (which never occurs alone,
but is often associated with the salt which will be next con-
sidered) if it easily burns white but does not fuse, even under
the continued action of the blowpipe. It fuses, however, when
combined with the following salt (c), and its fusibility is pro-
portionate to the amount of the magnesian salt present :
consequently such a compound may be mistaken for the neutral
phosphate of lime. If it fuses before the blowpipe, and a solu-
tion in dilute hydrochloric acid yields a precipitate with am-
monia, which, under the microscope, appears in the crystalline
form represented in fig. 25 ; or if after the hydrochloric- acid
solution has been saturated with ammonia, and all the lime
thrown down by oxalate of ammonia, the filtered solution
again yields a precipitate to caustic ammonia; then it is not
neutral phosphate of lime, but the basic phosphate, in com-
bination with the following salt. With the exception of the
blowpipe test, the chemical characters of these two compounds
are similar.
c. It is ammoniaco-magnesian phosphate (which usually
occurs in calculi associated with one of the preceding compounds)
if it develops a disagreeable ammoniacal odour before the blow-
pipe, and then fuses ; if it dissolves, without effervescence, in
hydrochloric and acetic acids, and, after the solution has been
nearly saturated with ammonia, is not affected by oxalic acid,
but is precipitated in the beautiful crystalline form represented
in fig. 25, by an excess of free ammonia.
In proportion to the amount of basic phosphate of lime,
mixed with the ammoniaco-magnesian phosphate, the less
readily it fuses.
d. It is oxalate of lime if it does not fuse before the blow-
pipe, if it easily burns white, and distributes a brilliant light;
if the heated specimen, when moistened with water, does not
dissolve, but exhibits a strong alkaline reaction, and dissolves
with effervescence in hydrochloric acid (or, if the heat has been
long continued and very intense, without effervescence) ; and
ii. 28
434 MORBID PRODUCTS.
if, after the solution has been neutralized by ammonia, oxalate
of ammonia throws down a precipitate.
If the specimen is not affected by acetic acid, but dissolves
readily in nitric or hydrochloric acid without effervescence, and
is precipitated therefrom by ammonia; and if, farther, the
nitric-acid solution evaporated nearly to dryness and treated
with ammonia develops no purple tint, it consists of oxalate of
lime.
e. It is carbonate of lime if it easily burns white before the
blowpipe, and in other points resembles oxalate of lime after
exposure to a red heat ; if the fresh specimen dissolves with
effervescence in acetic or hydrochloric acid, and the solution is
not precipitated by ammonia ; and if oxalate of ammonia throws
down a precipitate from the ammoniacal solution.
/. It is urate of soda (which never occurs alone in urinary
concretions, but is found, like the urate of potash, in small
quantity in calculi of uric acid and the earthy phosphates,) if
it fuses readily before the blowpipe, but burns white with dif-
ficulty, and communicates an intense yellow tint to the flame ;
if the residue (with the exception of particles of carbon) dis-
solves easily in water, to which it communicates an alka-
line reaction, and dissolves with effervescence in hydrochloric
acid, if the addition of bichloride of platinum to the filtered
solution mixed with alcohol, producing no deposit; and if afresh
specimen dissolves in water on the application of heat, dissolves
in nitric acid without effervescence, and the solution, after
evaporation nearly to dryness, assumes a purple tint on the
addition of ammonia.
g. It is urate of potash if it behaves exactly like urate of
soda, (with the exception of communicating a yellow colour
to the flame of the blowpipe;) and if a yellow precipitate is
formed on the addition of bichloride of platinum to an alcoholic
solution of the ash dissolved in hydrochloric acid. If, in con-
junction with the occurrence of the yellow precipitate, the
specimen communicates an intense yellow colour to the flame
of the blowpipe, urate of soda is mixed with the urate of
potash.
h. It is urate of lime (which never occurs alone, but is
usually associated with uric acid in calculi) if it burns white
CONCRETIONS. 435
but does not fuse before the blowpipe, and then acts in the
manner described in (e) ; and if a small portion of the fresh
specimen dissolved in boiling water affords the ordinary evi-
dence of uric acid when treated with nitric acid and ammonia.
If the assay slightly fuses and runs together, and is then par-
tially soluble in water, urate of soda or potash is mixed with the
urate of lime ; the solution has a strong alkaline reaction, and
effervesces on the addition of an acid.
i. It is urate of magnesia (which occurs very rarely in
calculi, and then only with uric acid) if it readily burns white
before the blowpipe, but does not fuse ; and if the residue is
insoluble in water, but soluble without (or with very slight)
effervescence in dilute sulphuric acid; and if caustic potash
throws down a precipitate from this solution.
k. It contains silica (a rare constituent) if, after prolonged
exposure to heat, and digestion of the residue in hot hydro-
chloric acid, an insoluble residue remains, which becomes white
before the blowpipe, and fuses into a clear bead when mixed
with carbonate of potash or soda.
3. The specimen may be partially consumed on exposure
to heat, while the residue undergoes no further change under
the action of the blowpipe. Concretions of this sort are by
no means rare ; they consist of a mixture of the compounds of
the 1st and 2d classes. Indeed, calculi, composed merely of one
of the substances already enumerated, are very rare, for although
in one class of calculi uric acid may be the preponderating
constituent, in another oxalate of lime, and in a third the
earthy phosphates, we almost always find associated with
these substances a certain amount of other matters; for in-
stance, uric acid and the urates are of frequent occurrence in
calculi chiefly composed of oxalate of lime or of the earthy
phosphates.
Intestinal concretions consist for the most part of earthy
phosphates with a little fat, extractive matters, and vegetable
fibre ; biliary concretions, of cholesterin mixed with a little
bile-pigment and biliary resin, or of bile-pigment and biliary
resin with a little cholesterin. Other classes of concretions
(with the exception of arthritic concretions, which consist for
the most part of urate of soda) are composed of earthy phos-
436 MORBID PRODUCTS.
phates and carbonates combined with organic (albuminous, ex-
tractive, and fatty) matters.
In the analysis of mixed concretions we proceed in the
following manner :
A. We incinerate a portion in a platinum crucible, and
analyse the residue ; if it burns white easily, the infusible earths
preponderate ; if it is difficult or impossible to obtain a white
residue, and the ash remains fused and blackish, then the
fusible earths or the alkalies preponderate. The residue may
consist either of (1) earthy phosphates alone, which may be re-
cognized by the rules given in 2, 0, b, and c, or of (2) earthy
phosphates and carbonates, the latter originating from earthy
urates, or oxalate of lime. (In this case we recognize the pre-
sence of earthy carbonates (or of caustic earths, if the heat has
been too intense and prolonged), by the rules laid down in 2,
dj e, and h.)
4. The residue may consist of earthy phosphates and car-
bonates, and alkaline carbonates, if alkaline urates occur in
the concretion. In order to detect the alkaline carbonates,
the residue must be pulverised and extracted with water; on
the evaporation of the decanted water the alkaline carbonates
will remain, and may be recognized by the rules given in 2, f t
and g. The portion insoluble in water is readily dissolved in
dilute hydrochloric acid, usually with a slight effervescence.
Ammonia precipitates the earthy phosphates from this so-
lution ; after filtration oxalate of ammonia throws down the
lime, and after a second nitration phosphoric acid and ammonia
cause a precipitation of the magnesia.
5. Silica may be easily recognized by the rule given in 2, k.
B. The portion consumed and expelled by exposure to heat,
consists of uric acid, of urate of ammonia, of the oxalic acid of
oxalate of lime, which is converted into carbonic acid, of the
carbonic acid of carbonate of lime, which is expelled at a high
and prolonged temperature, of cystin, of ammonia yielded by
ammoniaco-magnesian phosphate, of cholesterin or other fats,
of bile-pigment, bilin, extractive matters, or other animal or
vegetable substances mechanically entangled, as mucus, albumen,
or vegetable fibre.
We may convince ourselves of the presence of uric acid by
CONCRETIONS. 437
observing the action of nitric acid and ammonia on a portion
of the specimen, and its salts may be demonstrated by extraction
with boiling water, and the addition of nitric acid to the nearly
dried residue. The presence of oxalic acid may be shown by
the digestion of the same portion in hydrochloric acid (the urates
having been previously extracted by water) ; on the addition of
ammonia, oxalate of lime is precipitated, which, after heating,
dissolves with effervescence in the same acid. The presence of car-
bonic acid in the specimen may be shown by the effervescence
produced on the immersion of a fragment in hydrochloric acid;
the presence of ammonia dependent on the ammoniaco-mag-
iiesian phosphate, by its development on triturating a portion
with caustic potash, the urate of ammonia having been pre-
viously removed by boiling water ; the presence of cystin, by
digesting the specimen in caustic ammonia, and observing the
six-sided plates in which it crystallizes on the spontaneous
evaporation of the ammonia ; the presence of cholesterin (in
human biliary calculi), of biliphsein (in the biliary calculi of
cattle), of hair, and of vegetable fibre, may be determined after
some practice by the internal structure and the colour of the
concretion.
In this simple manner we may arrive at a knowledge of the
qualitative composition of a calculus ; the analysis is, however,
in some respects facilitated by a knowledge of its origin.
We know, for instance, that uric acid and its salts occur only
in renal, vesical, and arthritic concretions; that the earthy
phosphates occur equally in intestinal and vesical calculi ; and
that carbonate of lime is a common constituent of concretions
in the brain, nose, and salivary glands ; while, on the other
hand, oxalate of lime is almost exclusively found in renal and
vesical calculi, and cholesterin, bile-pigment, and biliary resin
only in gall-stones.
On vesical and renal calculi in man.
The concretions of most importance in relation to practical
medicine, are vesical and renal calculi and gravel. The con-
stituents of urinary calculi, according to the statements of dif-
ferent observers, are, 1, uric acid ; 2, urate of ammonia ;
438 MORBID PRODUCTS.
3, urate of soda ; 4, urate of magnesia ; 5, urate of lime ;
6, benzoate or hippurate of ammonia ; 7, oxalate of lime ;
8, oxalate of ammonia ; 9, uric or xanthic oxide ; 10, cystin ;
11, neutral and basic phosphate of lime; 12, ammoniaco-mag-
nesian phosphate ; 13, carbonate of lime ; 14, carbonate of
magnesia; 15, fibrin; 16, silica, t Mixed with these consti-
tuents we likewise meet with fat, extractive matters, albumen,
vesical mucus, and peroxide of iron.
Of these constituents those numbered 1, 2, 7, 11, 12, are
the most common, and occur in the largest quantity; those
numbered 3, 4, 5, 13, 14, 16, are not of rare occurrence, but
are usually met with in very small quantity in calculi composed
of other ingredients. Uric oxide (9) has been only observed
in three [four] cases ; and cystin is by no means common.
Fibrin was once noticed by Marcet as a constituent of an
urinary calculus, but Berzelius is inclined to suppose that in
reality it was vesical mucus.
The presence of benzoate or hippurate of ammonia in urinary
calculi, recorded by Brugnatelli, and of oxalate of ammonia,
described by Devergie, is scarcely compatible with the great
solubility of these salts.
The following points respecting the physical character of
urinary calculi are deserving of notice :
The form varies in accordance with the seat of origin and
the chemical composition ; the oval or spheroidal is the most
frequent; round calculi are often compressed laterally, and
renal concretions sometimes assume a polygonal or even a
branching coralline form; in the ureters cylindrical calculi with
prominences and depressions have been described. The sur-
face is smooth, and presents few irregularities in calculi of uric
acid ; it is flat and more or less rough in many phosphatic
calculi; earthy and easily triturable in urate of ammonia calculi;
tuberculated, as we sometimes observe in calculi of uric acid,
the urates or cystin; or armed with prominences and asperities
in the oxalate of lime calculi.
The colour of these concretions varies for the most part from
a pale yellow to a yellowish-red, brown, or brownish-green.
Calculi of the earthy phosphates are colourless, or nearly so ;
1 [To these Heller has recently added urostealith.]
URINARY CALCULI. 439
calculi of uric acid and the urates vary from a yellow to a
reddish-yellow or brown ; calculi of oxalate of lime are yellow,
yellowish-brown, brownish-green, or blackish- green. Calculi
of uric oxide are of a cinnamon-yellow colour, and those of
cystin of a yellow tint. In size and weight they present, as
might be supposed, the greatest variety; their specific gravity
varies from 1-213 to 1'975. Calculi of oxalate of lime exhibit
the greatest density, those which consist of the earthy phos-
phates, and especially of ammoniaco-magnesian phosphate, are
the lightest.
With respect to absolute weight, urinary concretions may
vary from one or two grains (when they merely form gravel) to
several ounces. Some cases of enormous and almost incredible
size are related : Morand describes a stone in his possession
weighing 6 pounds and 3 ounces, Lister describes a stone of
51, and Earle one of 44 ounces; the latter was 16 inches in cir-
cumference. With regard to the number of calculi that may
occur in the same person, we may mention that Murat found
678 in the bladder of an old man, and nearly 10,000 in his
kidneys. Buffon's bladder contained 59 calculi. When several
calculi exist in the bladder their form becomes modified, and
they are usually more or less flattened by mutual apposition
and friction. I am in possession of a calculus consisting of two
portions ; the upper is small, weighing about two ounces, tri-
angular, and provided with three equal convex facettes, exactly
fitting into the depression of the larger inferior part, which is
of an oval form and weighs about five ounces. There can be
no doubt that this peculiarity of form arose from the frequent
rotation of the calculi.
The internal structure of urinary calculi is of importance ;
a section may exhibit either an uniform texture throughout, or
concentric strata arranged around a nucleus. If the calculus
is formed of a single ingredient, its fractured or cut surface ap-
pears coarse and finely granular, and sometimes presents a
radiating appearance, especially in uric-acid calculi : it is earthy
and fragile, and does not present any regular arrangement in
calculi of urate of ammonia : it is dense and conchoidal in
oxalate of lime, and crystalline in cystin. Calculi of phosphate
of lime, on the other hand, exhibit an almost fibrous struc-
ture, distinguished by parallel striae. Calculi in which ammo-
440 MORBID PRODUCTS.
niaco-magnesian phosphate is the predominating ingredient
exhibit a porous internal surface, studded here and there with
crystals.
In calculi consisting of a nucleus and of laminae deposited
round it, it is important to ascertain whether the nucleus and
the concentric laminae are identical or different in their com-
position,
The nucleus may consist either of one of the ordinary con-
stituents of urinary concretions or of a foreign body introduced
into the bladder, as for instance, a fragment of wood, a grain
of corn, 1 &c. The laminae may have the same chemical consti-
tution as the nucleus, and only differ from it in the period of
their deposition, as is the case with calculi of uric acid, urate
of ammonia, uric oxide, and earthy phosphates : or they may
differ from the nucleus in their composition ; in this case we
may always infer that changes have taken place in the character
of the urinary secretion ; for instance, if the nucleus consist of
uric acid, and is surrounded by a concentric layer of the
earthy phosphates, the urine must have been first constantly
acid, and subsequently neutral or alkaline.
I now proceed to the consideration of the most common
urinary calculi.
Combustible calculi.
I. Calculi of uric acid are by no means rare; their cha-
racter have been already described in page 431; they may be
distinguished from calculi of urate of ammonia by the solu-
bility of the latter, and the insolubility of the former in a suf-
ficient quantity of boiling water. They are of every possible
size, their colour is sometimes (but very rarely) white, most
commonly yellow, rose-coloured, or brown; their surface is
smooth, sometimes even polished, and occasionally presents
rounded verrucose protuberances. Their fractured surface pre-
sents either a crystalline appearance, or is dense with concentric
strata merging into each other. The nucleus is crystalline,
and the surrounding laminae hard. I have found a minute
1 [Professor Malago has recently extracted a calculus, of which the nucleus was a
globule of mercury. Filiatre Sebezio, 1845.]
URINARY CALCULI. 441
grain of urinary gravel in the centre of several calculi of uric
acid, and the central portions are often darker coloured than
the peripheral. The uric acid in these calculi is never pure,
but is always mixed with colouring matter the uroerythrin
(which always accompanies uric acid), frequently with alkaline
urates, and occasionally with small quantities of earthy phos-
phates. A very minute quantity of fat and of extractive
matter occurs in this as well as in most other sorts of urinary
calculi.
In order to obtain an accurate knowledge of the composition
of a calculus, it must be sawed through the centre, and the
different strata submitted to distinct analyses if they present
any variation in their physical characters : it does not often
happen that a calculus which consists externally of uric acid
is composed in its interior of earthy phosphates, oxalate of
lime or cystin, but on the other hand uric acid often forms
a nucleus to calculi formed of other constituents. In order to
determine whether fixed alkaline urates, or earthy phosphates
are contained in a calculus, a portion must be incinerated and
the residue analysed. If they are present they may be deter-
mined by the rules given in 2, 0, b, c, f, g, h, and 3.
A portion of each lamina, or if the calculus is uniform
throughout, some of the dust separated in the operation of
sawing, is reduced to an impalpable powder ; a weighed quan-
tity is placed in a small porcelain basin, and after being
warmed for some time on the water-bath, is placed under the
exsiccator in order to remove every trace of moisture. A known
portion of the dried powder is placed in a small glass flask, and
repeatedly extracted with ether, whereby the fat is removed ;
and the residue is boiled with alcohol of specific gravity '850,
which takes up some extractive matter. The powder is then
boiled with distilled water till nothing further can be removed
by that menstruum. On evaporating the watery solution in a
small porcelain capsule we obtain the urates as a residue. If
it is requisite that this part of the analysis should be carried
further, we dry the residue and weigh it; we then heat it in a
little water and add hydrochloric acid; the uric acid sepa-
rates, and the bases combine with the hydrochloric acid. The
uric acid is collected on a filter, washed with water, dried, and
weighed; the hydrochloric- acid solution is evaporated, and
442 MORBID PRODUCTS.
yields a residue of hydrochlorate of ammonia, and probably the
chlorides of sodium and calcium. In order to separate these
substances the dried residue is first weighed, and then dissolved
in water; some ammonia, and subsequently oxalate of ammonia
are added, in order to precipitate the lime. The fluid after
filtration is evaporated, and the dried residue exposed to a
strong heat : the chloride of sodium is left, and the chloride
of ammonium may be estimated by the loss of weight. The
bases are calculated from the lime which is left after the expo-
sure of the carbonate of lime to heat, and from the chlorides
of sodium and ammonium, and are combined with the uric
acid.
The portion of the powdered calculus not taken up by water
is treated with dilute hydrochloric acid, which dissolves any
earthy phosphates that may happen to be present. They are
precipitated by the addition of ammonia to the acid solution,
and must be then collected on a filter, washed, dried, and
weighed. The uric acid (the remaining constituent) must be
perfectly dissolved in caustic potash, from which it must be
precipitated by super-saturation with hydrochloric acid. It
must be then washed on a filter, dried, and weighed. The acid
solution usually contains a trace of organic matter, (vesical
mucus or albumen ;) its presence may be detected by the
addition of a little ferrocyanide of potassium, which causes a
precipitate.
II. Calculi of urate of ammonia. This form of calculus is
somewhat rare, and indeed its existence was regarded as un-
certain till Prout determined the point beyond a doubt. Ac-
cording to Fourcroy these calculi are usually small, occur more
frequently in children than in adults, have a whitish or clay-
colour, a smooth or tuberculated surface, and an earthy frac-
ture exhibiting concentric strata. Yellowly found that of 59
small stones taken from a man aged 45 years, 24 consisted of
urate of ammonia and 35 of uric acid. Urate of ammonia
occurs, however, most frequently mixed with other consti-
tuents, especially with uric acid : moreover it often forms the
nucleus of large calculi, or occurs as a stratum between a
nucleus of uric acid and an external coating of phosphates ; in
such cases, however, it is not pure but mixed with crystals of
URINAUY CALCULI. 443
uric acid, or oxalate or phosphate of lime. Urate of ammonia
acts before the blow-pipe in just the same manner as uric acid,
and their reactions with nitric acid are also similar : they may,
however, be readily distinguished by the comparative solubility
of the former in boiling water, and by the evolution of am-
monia that takes place on triturating it with caustic potash.
In a careful examination of a calculus of urate of ammonia, the
first point is to ascertain if other constituents are present, which
is usually found to be the case. If there is a residue left after
heating it before the blow-pipe, that residue may consist of
earthy phosphates, or earthy or alkaline carbonates : the alka-
line carbonates correspond with the alkaline urates, the carbo-
nate of lime with the oxalate of lime. In this case the calculus
must be reduced to a very fine powder and dried ; a weighed
portion must then be freed from fat and extractive matter by
ether and alcohol, and afterwards repeatedly boiled in small
quantities of distilled water, till the water is no longer affected.
When the calculus is finely powdered the urate of ammonia
dissolves with tolerable facility in boiling water. The earthy
phosphates and the oxalate of lime must be extracted with
dilute hydrochloric acid, 1 precipitated by ammonia, dried,
weighed, and exposed to a high temperature. If we again dis-
solve this residue in hydrochloric acid, and throw down the
earthy phosphates with ammonia, chloride of calcium remains
in solution, arising from the oxalate of lime. Whatever remains
unacted on by dilute hydrochloric acid is uric acid.
The urates of soda and potash, as well as the urate of lime
are (as I have already mentioned) often found in calculi of
uric acid ; they likewise occur in calculi of urate of ammonia.
All these urates are soluble in boiling water ; their mode of
separation has been already described. If urate of magnesia
should also be present (which is probably seldom the case), a
different method of separation must be adopted. Hydrochloric
acid is added to the evaporated aqueous solution in order to
precipitate the uric acid; the acid solution, after filtration, is
evaporated on the water-bath, and we then obtain a residue of
1 [Unless the hydrochloric acid is tolerably strong, it will not dissolve the oxalate
of lime.]
444 MORBID PRODUCTS.
mixed chlorides. The dried residue, after "being weighed, is
moistened with a little concentrated hydrochloric acid, and
afterwards treated with anhydrous alcohol, which takes up the
chloride of magnesium. The alcoholic solution is treated with
a little carbonate of potash, evaporated, and dried in a platinum
crucible heated to incipient redness. After the extraction of
the potash, the magnesia remains. The chlorides of calcium,
sodium, and ammonium, must be separated in the ordinary
manner.
III. Calculi of uric (xanthic] oxide. Calculi of this sub-
stance usually contain no other constituent, with the exception
of a little animal matter. Uric oxide was first met with by
Marcet, forming a calculus weighing 8 grains ; some years after-
wards a few minute concretions of the same nature were de-
scribed by Laugier; more recently it was discovered by
Stromeyer in a calculus weighing 338 grains, and as large as a
pigeon's egg, extracted by Langenbeck ; [and a fourth specimen
weighing 7 grains, has been lately described by Dulk. 1 ] Their
external surface is smooth and polished, and of a cinnamon-
brown colour. Their cut surface is of a brown flesh-colour,
and consists of concentric laminae easily separable from each
other. In point of hardness they resemble uric acid, and when
rubbed they assume a waxy appearance. Although uric oxide
is of rare occurrence, it need never escape detection with or-
dinary care. The fact of its entire destruction before the flame
of the blow-pipe at once distinguishes it from the calculi which
contain fixed constituents : by its behaviour with nitric acid,
and with carbonate of potash (in which uric acid dissolves, but
uric oxide is insoluble,) it may be distinguished from uric acid,
which it resembles in many respects.
In order to make a full analysis of a calculus of this de-
scription, it must be first pulverised, and then everything
soluble in ether, alcohol, and water removed. If uric acid is
associated with it, carbonate of potash serves to separate the
acid from the oxide ; if earthy phosphates or oxalate of lime
are present, they must be removed by dilute hydrochloric acid.
Any urates that are present are taken up by water.
1 [Simons' Beitrage, p. 413 : moreover linger has discovered minute traces of a
substance closely allied to uric oxide, if not identical with it, in guano.]
URINARY CALCULI. 445
IV. Calculi of cystin. Calculi of cystin, although rare, are
more common than those of uric oxide. Although sometimes
mixed with other constituents, cystin most commonly forms the
sole ingredient. These calculi seldom attain any great size ;
they are usually small, round, smooth, and of a yellow colour.
In consistence such a calculus is soft; the cut surface presents a
semi-transparent, confusedly crystalline appearance ; not how-
ever laminated. When broken, it appears to be made up of
small crystals of a waxy lustre, the margins of which are rounded.
The microscope affords the best means of recognizing the ex-
istence of cystin : if we dissolve a fragment in caustic ammonia,
and allow it to evaporate spontaneously, crystals are deposited
in six-sided tables or prisms. The peculiar behaviour of cystin
before the blowpipe distinguishes it not only from calculi with
fixed ingredients, but also from those of uric acid and uric
oxide. It is also distinguished from the latter (with which,
however, it has never yet been found associated) by its solu-
bility in carbonate of potash, and in dilute hydrochloric acid ;
and from the former by its solubility in dilute hydrochloric,
phosphoric, and even oxalic acid. When cystin is associated
in calculi with other constituents, it is most commonly found to
alternate with uric acid. Thus Henry found a nucleus of
cystin, and an external layer of uric acid ; and Yellowly found
an external layer of cystin and a nucleus of uric acid. It is
worthy of remark that Bley, in examining two calculi taken
from the same man, found in one, cystin associated with car-
bonate of magnesia and ammoniaco-magnesian phosphate; in the
other the cystin was displaced by uric acid. The calculus that
contained the cystin was reniform, compressed, and flattened ;
of a yellow colour and weighed T75 grains. It exhibited a
stratified appearance internally, and when exposed to heat left
scarcely a trace of ash. After the removal of the earthy matters
by hydrochloric acid, there remained a residue soluble in pot-
ash, which, on the addition of acetic acid and evaporation, de-
posited small six-sided crystals. 1
It need scarcely be mentioned that if in a calculus contain-
ing cystin there is any perceptible difference between the
1 It seems strange that the cystin did not dissolve in the hydrochloric acid. The
case is recorded in Buchner's Repert, 2d series, vol. 2, p. 165.
446 MORBID PRODUCTS.
nucleus and the surrounding strata, they must be analysed
separately.
V. Calculi formed of protein-compounds. Fibrinous calculi,
according to Marcet.
All urinary calculi contain an organic matter, which, by
prolonged digestion is soluble in acetic and in dilute hydrochlo-
ric acid, from which solutions it may be precipitated by ferro-
cyanide of potassium. It is readily soluble in caustic potash,
but is insoluble in water, alcohol, or ether : it consists in most
cases of the mucus of the bladder, occasionally of albu-
men. Marcet described a remarkable calculus consisting en-
tirely of protein-compounds, and regarded by him as composed
of fibrin. It had the appearance and consistence of yellow
wax ; its surface was irregular, but not rough -, internally it ex-
hibited a fibrous character, and was, to a certain degree, elastic.
When burned it evolved the odour of burning horn, and left a
porous carbonaceous residue. It was insoluble in alcohol,
ether, or water, but dissolved in caustic potash, from which it
was precipitated by hydrochloric acid. It dissolved slowly in
nitric acid, and when boiled in acetic acid, swelling previously
to dissolving. It was precipitated from its acetic acid solution
by ferrocyanide of potassium. In its solubility in nitric acid it
does not (as Berzelius remarks) correspond very well with the pro-
perties of fibrin ; its characters, as given by Marcet, lead more
to the supposition that it was vesical mucus. Morrin has
likewise described a calculus remarkable for the quantity of
organic protein-like substance contained in it. It was asso-
ciated with phosphate of lime, and amounted in the nucleus to
only 10g, in the second layer to 18g, and in the third to 70 of
the weight of the calculus. Alcohol took up a little fat. The
substance was slightly soluble in acetic, more so in nitric
acid : in caustic potash it swelled, became viscid, and partially
dissolved.
Incombustible or partially combustible Calculi.
VI. Calculi of oxalate of lime are next in frequency to those
of uric acid and the earthy phosphates. Their form is very
characteristic; they are usually spherical, but their whole
surface is studded by verrucose, tuberculated elevations, or
URINARY CALCULI. 447
even by sharp angular projections. It is from the former and
most common of these appearances that they have received the
name of mulberry calculi.
The size of these calculi varies from that of a hempseed to a
pigeon's egg,, and is occasionally even larger. Thus out of
thirty-three calculi of pure oxalate of lime examined by Smith
there was only one that weighed an ounce and a half. Their
colour varies ; they are white, bright yellow, yellowish-brown,
and occasionally dark green. The largest are usually the most
darkly coloured. The fracture is usually firm, hard, finely-
granular and conchoidal; but calculi have been observed by
Berzelius which consisted of an aggregate of closely connected
sharp angular crystals. Their specific gravity is higher than
that of other calculi. Hence it is evident that the physical
characters alone are sufficient to prevent a calculus of this na-
ture from being mistaken for one consisting of uric acid or of
the earthy phosphates. The chemical characters are, however,
equally distinct. It is distinguished from uric acid by its
readily burning white before the blowpipe : it is distinguished
from the earthy phosphates by its moistened residue exhibiting
an alkaline reaction towards red litmus paper, and, if the heat
has not been too intense, by its dissolving in hydrochloric acid
with effervescence, by ammonia added to saturation producing
no precipitate in this solution, but by a deposit being at once
observed on the subsequent addition of oxalate of ammonia : it
is distinguished from carbonate of lime by its dissolving in
hydrochloric acid without effervescence, and by the solution
being precipitated by ammonia : and, finally, it is distinguished
from urate of lime by its insolubility in boiling water. Although
oxalate of lime mixed with a little organic matter (mucus and
colouring matter) is generally the sole constituent of mulberry
calculi, 1 it is sometimes associated with uric acid, urate of am-
monia, or phosphate or carbonate of lime. After what has been
already stated, the separation of these substances can scarcely
be considered difficult. Ether and alcohol remove fat and ex-
tractive matters, water removes the urates, hydrochloric acid
the earthy phosphates and oxalate of lime : there can then
remain nothing but uric acid with vesical mucus or coagulated
albumen, and possibly a little silica. The hydrochloric-acid
1 [Our own experience is opposed to this statement.]
448 MORBID PRODUCTS.
solution is super-saturated with ammonia, and the precipitate
washed with a weak ammoniacal solution. It is exposed to a
red heat, and dissolved in hydrochloric acid ; the earthy phos-
phates are then precipitated by ammonia, and the lime sepa-
rated from the filtered solution by oxalate of ammonia. In
order to analyse the residue insoluble in hydrochloric acid, it
must be boiled in caustic potash and filtered; the uric acid
and silica must be thrown down by an excess of hydrochloric
acid; if the precipitate is washed, weighed, and submitted to a
red heat, we obtain the silica as a residue.
The amount of animal matter, and especially of pigment,
is generally larger in these than in any other calculi. The
animal matter seems to consist partly of protein-compounds,
and partly of extractive matter. Whether the colouring matter
is due to the haematin of the blood, or to uroerythrin, has never
been determined.
VII. Calculi of ammoniaco-magnesian phosphate and phos-
phate of lime. These calculi are of the most common occur-
rence next to those of uric acid. They sometimes attain a very
large size; they are usually globular or spheroidal; their colour
is white, gray, or dull yellow ; their fractured surface is less
earthy than in the preceding calculi, and is interspersed with
sparkling crystals; and although in general friable, their texture
is occasionally compact and dense. When laminated, which is
seldom the case, the intervals between the layers contain glis-
tening crystals of ammoniaco-magnesian phosphate. On heating
a fragment of a calculus of this nature on platinum foil an odour
of ammonia is developed: it does not burn white so readily as
the oxalate of lime, since the ammoniaco-magnesian phosphate,
if present in any quantity, fuses and produces a grayish white
enamel.
The moistened ash does not affect red litmus paper ; it dis-
solves in hydrochloric acid without effervescence, and may be
precipitated from it by ammonia. As these calculi contain a
little fat and extractive matter, it is requisite in making a
careful analysis that, after being pulverized, they should be ex-
tracted with ether and alcohol; on dissolving the residue in
hydrochloric acid a small amount of flocculent matter is usually
observed, arising probably from vesical mucus. The earthy
URINARY CALCULI. 449
phosphates are precipitated from this acid solution by ammonia,
and after being washed, are exposed to a red heat. Calculi
of phosphate of lime and ammoniaco-magnesian phosphate
often contain uric acid, the alkaline urates, and sometimes
oxalate and carbonate of lime. The alkaline urates are, in that
case, extracted with boiling water ; on digesting a portion of
the residue in dilute hydrochloric acid, the earthy phosphates
are dissolved and the uric acid remains; if carbonate of lime is
present, effervescence is observed on treating a little of the pow-
dered calculus with hydrochloric acid ; the lime may be precipi-
tated by oxalate of ammonia, after the earthy phosphates have
been thrown down from the acid solution by caustic ammonia.
If oxalate of lime is present, the powdered calculus (the urates
having been previously removed) after a short exposure to heat
(but not before) effervesces on the addition of hydrochloric
acid. The large calculus noticed in page 439 consists princi-
pally of earthy phosphates with small quantities of the urates
of ammonia and soda lying one above the other in laminae.
It contains a nucleus about the size of a nut, of a mulberry
appearance, consisting of oxalate of lime, and in the centre of
this is a nucleolus of the size of a large pea, consisting almost
entirely of uric acid.
VIII. Calculi of neutral phosphate of lime are very rare :
they were first described by Wollaston. Their surface is
usually pale brown, and so smooth as to appear polished. On
sawing through a calculus of this nature it is found very regu-
larly laminated, and the laminse in general adhere so slightly
to each other as to separate with ease into concentric crusts.
Each lamina is striated in a direction perpendicular to the
surface, as from an assemblage of fibres. In these as in all
other calculi we meet with a certain amount of animal matter,
supposed by Berzelius to be identical with that which is asso-
ciated with phosphate of lime when we precipitate that salt
from the urine. Hence on heating a portion before the blow-
pipe it becomes charred, and evolves an odour of burned horn ;
it finally burns white and fuses, which distinguishes it from the
basic phosphate of lime, which is infusible before the blowpipe.
Since, however, ammoniaco-magnesian phosphate readily fuses
before the blowpipe we must examine previously that none of
it is present.
ii. 29
450 MORBID PRODUCTS.
Basic phosphate of lime or bone-earth never occurs as the
sole constituent of an urinary calculus ; the same is the case
with ammoniaco-magnesian phosphate. 1
IX. Calculi of carbonate of lime. Calculi consisting merely
of carbonate of lime and animal matter are somewhat rare.
Smith found 18 such calculi in the bladder of a young man,
and Brugnatelli mentions 48 pisiform concretions of the same
nature taken from a young man, and 16, the size of a nut, from
a woman. According to Berzelius they are generally white or
gray, but sometimes yellow, brown, or red; the tint depending on
the animal matter. The formation of these calculi is due to an
alkaline condition of the urine, and to the absence of the ordi-
nary phosphates. On heating a fragment before the blowpipe,
it evolves an odour of burned bone, and readily burns white.
On treating the residue with hydrochloric acid eifervescence is
observed, unless the heat has been very intense and prolonged,
in which case the carbonate is converted into caustic lime, and
it dissolves without effervescence : in this case it is also soluble
in water and forms an alkaline solution. If a fragment of the
unheated calculus is pulverized and treated with dilute hydro-
chloric acid, it dissolves with effervescence and leaves a residue
of vesical mucus.
Although it seldom occurs as the principal ingredient, it is
often found associated with other constituents, especially with
phosphate of lime, in urinary calculi.
I have examined two yellow calculi of the form and size of
a pea, taken from the kidney ; they consisted of carbonate and
phosphate of lime. Proust also mentions vesical calculi com-
posed of carbonate and phosphate of lime. Prout was the first
who detected carbonate of lime in urinary calculi : it was in
that instance associated with phosphate of lime and traces
of urate of lime. Walther describes six calculi in which the
nucleus was urate of ammonia, while the cortex was com-
posed of carbonate and phosphate of lime. Prout mentions a
mulberry calculus in which the external layer was soft and con-
sisted of oxalate and carbonate of lime, the second of carbonate
and phosphate of lime, and the third of phosphate of lime.
1 [A human calculus composed entirely of ammoniaco-magnesian phosphate is de-
scribed by Scharling, ' On the Chemical Discrimination of Vesical Calculi/ translated
by Dr. Hoskins, p. 55.]
URINARY CALCULI. 451
Brugnatelli states that he examined an urinary secretion con-
sisting of carbonate and oxalate of lime, and benzoate of
ammonia.
When carbonate and oxalate of lime occur together, the cal-
culus dissolves in hydrochloric acid with effervescence, both be-
fore and after heating. Before the application of heat it is par-
tially soluble in acetic acid with effervescence, the oxalate
remaining undissolved.
On dissolving a portion of the calculus in dilute hydrochloric
acid, and adding ammonia, we precipitate the oxalate of lime ;
the lime corresponding to the carbonate may then be precipi-
tated from the filtered solution by oxalate of ammonia. The
oxalate of lime precipitated by ammonia may be easily mistaken
for phosphate of lime ; all ambiguity may, however, be avoided
by recollecting that the oxalate may be converted by heat into
carbonate of lime, which dissolves with effervescence in acids
from which it is not precipitable by ammonia, while the phos-
phate of lime is unaffected by heat, and dissolves without effer-
vescence in hydrochloric acid from which it may be thrown
down by ammonia. When carbonate of lime is associated
with oxalate and phosphate of lime, the calculus dissolves
with effervescence in hydrochloric acid both before and after
heating. In this case the oxalate of lime may be readily over-
looked, but on dissolving a fragment of the calculus in hydro-
chloric acid, and precipitating with ammonia, the oxalate and
phosphate of lime are thrown down together, while the carbonate
of lime exists in the filtered solution as chloride of calcium, and
may be precipitated by oxalate of ammonia. On drying and
gently heating the mixture of oxalate and phosphate of lime,
the oxalate becomes converted into carbonate. We then dis-
solve the heated residue in hydrochloric acid, precipitate the
phosphate of lime with ammonia, filter, and throw down the
lime from the filtered solution with oxalate of ammonia. This
lime corresponds with the original oxalate. When the car-
bonate is mixed with urate of lime, the latter must be taken
up with boiling water.
Carbonate of magnesia is only rarely associated with car-
bonate of lime in urinary calculi, although Berzelius supposes
that they always occur together. In order to separate them,
they must be dissolved in hydrochloric acid, and the cliloride
of magnesium then taken up by alcohol.
452 MORBID PRODUCTS.
An analysis of a calculus containing a considerable amount
of carbonate of magnesia is given in p. 458.
"This salt is of frequent occurrence in calculi of the lower
animals.
\Urostealith. We have already (see page 326) noticed Heller's
discovery of urostealith.
The concretions that were discharged were round and had
not the appearance of being fragments of a larger calculus ; in
consequence of the locality of the pain it was presumed that
they were renal calculi. Altogether a little more than a
drachm of urostealith was collected. The concretions varied
from the size of a hempseed to that of half a small nut. Most
commonly they were of the size of a pea, and either consisted
of pure urostealith or had an outer coating of ammoniaco-
magnesian phosphate.
Urostealith is most readily detected by the effects of heat
and combustion. A fragment placed on platinum foil and
heated remains for some time solid, then commences to fuse
without thoroughly melting, swells, and diffuses much vapour,
giving off an extremely peculiar and pungent odour, resembling
that of shell-lac and benzoin. The odour is so strong as to be
distinctly evolved by the smallest piece of urostealith. After
fusing and swelling up, it catches fire (if touched by the flame
of the lamp), and burns with a clear yellow flame. A volu-
minous coal is left which, when thoroughly burned, leaves a
very minute alkaline ash, consisting principally of lime.
When boiled in water urostealith becomes soft but does not
dissolve. Warm alcohol dissolves it, but with difficulty; when
the alcohol is evaporated and the residue burned the fragrant
odour is developed. Ether dissolves it pretty freely; on evapo-
ration the urostealith is left in an amorphous form, and on con-
tinuing a gentle heat it assumes a well-marked violet tint. It
dissolves readily in a hot solution of caustic potash, forming a
brown soap; and on treating this solution with an acid the
urostealith again separates as amorphous fat. The carbonates
of potash and soda act similarly but more slowly. When heated
with nitric acid it yields a colourless solution, a slight quantity of
gas being developed : on treating the residue (after evaporation)
with ammonia or potash it becomes of a dark yellow colour. 1 ]
1 Heller's Archiv fur physiologische und pathologische Chemie, vol. 2, pp. 1-12.
URINARY CALCULI.
453
On t/te lamince of vesical and renal calculi, and on their
quantitative analysis.
In the analysis of urinary calculi it is of the greatest im-
portance to observe the order in which the different laminae
were deposited, and in connexion with this subject, and with
the relative proportion in which different sorts of calculi occur,
we may especially refer 1, to Brand's 1 paper on the urinary
calculi in the Hunterian Museum ; 2, to Marcet 2 on the calculi
at Guy's Hospital; 3, to Wood 3 on the calculi at the Canter-
bury Hospital, the Windmill Street School, and Mr. Cross's
collection; 4, to Yellowly, 4 and 5, to Marcet, for their account
of the Norwich Hospital collection ; 6, to Henry 5 on the Man-
chester collection ; 7, to Smith on the Bristol collection ; 8, to
Rapp 6 on the Swabian collection ; 9, to Lecanu and Segalas? on
Segalas's collection; 10, to Scharling on the calculi in the
Copenhagen Museum ; and, 11, to Taylors on the calculi in the
Museum at St. Bartholomew's Hospital.
The following table affords a view of the relative proportions
in which the most common calculi occur :
According to
1. Brand, in Hunterian Museum =
2. Marcet, in Guy's Hospital .
3. Wood, in Canterbury Hospital .
4. Yellowly, in Norwich Hospital .
5. Marcet ditto
6. Henry, in the Manchester Hosp.
7. Smith, in the Bristol Hospital .
8. Rapp, in Swabia
Dxalates. Urates. Phosphates. Total.
: 13-5 1 : 2-46
2 150
3 1
4
3 87
3 1
1-18
7 167
2-9 1
3
76 329
3 1
27
32 181
10-33 1
2-2
85 187
3-33 1
3-33 1
10-89 218
1 1-43 1
(11-5) 1-21 1
10-1 81,
1 6-6 1
1-6 1
6-2 155
Philosophical Transactions, 1808.
An Essay on the Chemical History and Medical Treatment of Calculus Disorders,
London Medical and Physical Journal, vol. 57.
Philosophical Transactions, 1829.
Medico-Chirurg. Transactions, vol. 10.
Naturwissenschaftliche Abhandlungen. Tubing. 1826.
Journal de Pharmacie, 1838, p. 463.
London and Edinburgh Philosophical Magazine, 1838,
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