| | and a few leukocytes. ---------------------+---------------------+------------------------ Chronic interstitial nephritis. | | Quantity markedly | Urea and chlorids | Sediment very slight. increased, | low in well-marked | Few narrow hyaline and especially at night. | cases. Albumin | finely granular casts. Color pale, clear. | present in traces | No blood except in Specific gravity, | (often overlooked), | acute exacerbations. 1.005 to 1.015. | increasing in late | Very few renal cells. | stages. Reaction | Uric acid and | acid. | calcium-oxalate | | crystals common. ---------------------+---------------------+------------------------ Amyloid degeneration of kidney. | | Quantity moderately | Slight decrease of | Sediment slight. increased. Color | urea and chlorids. | Moderate number of pale, clear. | Variable amounts of | hyaline, finely Specific gravity, | albumin and | granular, and sometimes 1.012 to 1.018. | globulin. | waxy casts. ---------------------+---------------------+------------------------ 3. Renal Tuberculosis.--The urine is pale, usually cloudy. The quantity may not be affected, but is apt to be increased. In early cases the reaction is faintly acid and there are traces of albumin and a few renal cells. In advanced cases the urine is alkaline, has an offensive odor, and is irritating to the bladder. Albumin in varying amounts is always present. Pus is nearly always present, though frequently not abundant. It is generally intimately mixed with the urine, and does not settle so quickly as the pus of cystitis. Casts, though present, are rarely abundant, and are obscured by the pus. Small amounts of blood are common. Tubercle bacilli are nearly always present, although animal inoculation may be necessary to detect them. 4. Renal Calculus.--The urine is usually somewhat concentrated, with high color and strongly acid reaction. Small amounts of albumin and a few casts may be present as a result of kidney irritation. Blood is frequently present, especially in the daytime and after severe exercise. Crystals of the substance composing the calculus--uric {136} acid, calcium oxalate, cystin--may often be found. The presence of a calculus generally produces pyelitis, and variable amounts of pus then appear, the urine remaining acid in reaction.