On chylous urine / [J. Warburton Begbie].

  • Begbie, James Warburton, 1826-1876.
Date:
1882
Catalogue details

Licence: Public Domain Mark

Credit: On chylous urine / [J. Warburton Begbie]. Source: Wellcome Collection.

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    9^5'9° 10-15 1-52 602 i‘7o 2'00 I27IJ t-34’10 Quantity of urine passed in twenty-four liours . 41 ounces. Specific gravity 1020; reaction, acid, Water in 1000 parts . . . • Urea Uric acid and vesical mucus Animal extractive, and ammonical salts Albumen Fat Fixed alkaline and earthy salts On the application of heat, and on the addition of nitric acid or of nitro-hydrochloric acid to this patient’s urine, a very partial coagulation always occun-ed; the degree varied considerably in diflferent specimens and on different days, but was never great. Microscopic examination revealed the presence of blood corpuscles, few in number, and of fatty matter in lai-ge amount, the latter always in the condition of so-called molecular division. On one or two occasions my house-physiQian, Dr. James Grant, called attention to the presence of a very few oil globules ; such were always easily produced by the previous addition to the urine of a few drops of sulphuric ether.* Besides these ingredients there existed a good deal of bladder epithelium, and in nearly every specimen examined a number of distinct fibres. The latter abounded in such urine as after standing for a short time exhibited small coagula, some- times coloured pink, at other times colourless; consisting of the spon- taneously coagulable ingredient in chylous urine, namely, fibrine. Casts of the renal tubules were never found. Only on one occasion while the patient was under our observation did the urine acquire, after standing a couple of ho\irs, in part the consistence of “ blancmanger.” In the case of this patient, as of others previously described by different observers, the chylous condition of the urine could be readily increased or diminished at will. Rest operated very strongly in determining a diminution of the fat and albumen, while a brisk walk, or even moving about in the ward, on the other hand, as powerfully increased both. The patient main- tained that stimulants lessened the milky appearance of the urine, but, with the exception of a limited allowance of gin, under which the urine was for several days clearer, we deter- mined that they really increased it. Many remedies were administered, but with very little benefit. Gallic acid, which Dr. Bence Jones has found most useful, failed to effect any change; the salts of iron seemed more serviceable, particularly the persesqui-nitrate. A proper regulation of diet I consider I Simon found oil globules in cbylous urine, but the observation has hitherto scarcely been confirmed. See ‘ The Microscope in Medicine,’ by Dr. Lionel Beale, p. 314.