A system of practical medicine. By American authors. Vol. 4 : $b Diseases of the genito-urinary and cutaneous systems. Medical ophthalmology, and otology
Science
A system of practical medicine. By American authors. Vol. 4 : $b Diseases of the genito-urinary and cutaneous systems. Medical ophthalmology, and otology
Medicine -- Practice
In some cases which, from the character of the urine as well as from
the other symptoms, should evidently be classed as diabetes insipidus,
the quantity of urine, although somewhat increased, is not very
excessive, reaching perhaps two liters, but in the great majority is
discharged in much larger quantity. In a case which came under the
observation of the writer by the kindness of H. E. Marion the amount of
urine gradually rose from two or three gallons to five or six and
seven, and on one occasion the patient, a girl of fifteen, after some
unusual excitement is supposed to have passed eight gallons in the
course of twenty-four hours. Of this eleven quarts was by actual
measurement, and passed in the presence of her mother in the course of
the afternoon.
The urine in these cases is, as would naturally be supposed, of a very
{29} pale color and of low specific gravity, which from 1005 to 1010,
representing the usual range, may in extreme cases fall to or even
below 1001 as measured by the ordinary urinometer. I have seen no case
recorded where the specific gravity of such a urine has been determined
by instruments of greater delicacy. Its odor is comparatively faint,
but it is somewhat prone to decomposition. The solid constituents are
often somewhat increased in the twenty-four hours, especially the urea,
which may be present in double the usual amount. This is probably the
result of an increased metamorphosis from the passage of so large an
amount of water through the tissues.
It is not always true, however, that the solids are increased, and the
difference in the amount of destructive metamorphosis taking place in
different cases is probably closely connected with the clinical
differences which may be observed in regard to the amount of wasting
and affection of the general health. The phosphates are frequently
increased, as found by Dickenson and Teissier; and such an increase has
probably about the same meaning as the increase in urea. In other
cases, however, they take part in the general diminution of solids, as
in the case of Marion just alluded to, where they were reported as
absent, which undoubtedly means simply present in so small amount as to
escape the usual clinical tests.
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