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Urine Analysis Full Book Download

The document provides an overview of urine analysis, detailing normal urine characteristics, collection methods, and examination techniques. It emphasizes the importance of urine examination in diagnosing metabolic disorders and kidney conditions. The document also includes lists of plates and text illustrations relevant to urine analysis.

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337 views14 pages

Urine Analysis Full Book Download

The document provides an overview of urine analysis, detailing normal urine characteristics, collection methods, and examination techniques. It emphasizes the importance of urine examination in diagnosing metabolic disorders and kidney conditions. The document also includes lists of plates and text illustrations relevant to urine analysis.

Uploaded by

ghuy.nhghoangroongn.am
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Urine Analysis

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M y best thanks are due to Messrs
Baird and Tatlock for the loan of five
printing blocks, illustrated in the b o d y of
the b o o k .

CHANDROTTOMA BHABAN
p . 353, LAKE ROAD,
B. DAS GUPTA.
CALCUTTA.
The 3rd December, 1931.
VI

List of Plates.

Calcium O x a l a t e To fdce page io6

Uric A c i d 107

Urates ... 108

Phosphates no

Red Blood Cells and P u s Cells 112

Spermatozoa 114
Epithelial Cells ii6-
Tube Casts 118.

Text Illustrations.
PAGE.

Doremus Ureometer 78
Gerrard's Ureometer . 80

Esbach's Albuminometer .. 84
Aufrecht Albuminometer 86

Urine Sediment Glass 102


VI

List of Plates.

Calcium O x a l a t e To fdce page io6

Uric A c i d 107

Urates ... 108

Phosphates no

Red Blood Cells and P u s Cells 112

Spermatozoa 114
Epithelial Cells ii6-
Tube Casts 118.

Text Illustrations.
PAGE.

Doremus Ureometer 78
Gerrard's Ureometer . 80

Esbach's Albuminometer .. 84
Aufrecht Albuminometer 86

Urine Sediment Glass 102


ERRATA.

Page Line For Read.

δ δ polurνa polyuria

10 12 odour odours

10 25 an a

ι6 9
precipitates precipitate
25 23

ι6 9 disappear disappears

31 δ dibetic diabetic

56 9 is are

64 23 purpuria purpura.

65 25 run runs

66 25

67 2 micturation micturition

67 ι6

7θ 22 dysentry dysentery.

79 4

79 7 stopcork stopcock.

2
INTRODUCTION.

Urine is the c o m p l e x excretion of


the kidneys, w h i c h p u r i f y b l o o d f r o m
its soluble impurities a n d thus k e e p s
the system in n o r m a l w o r k i n g order.
N o r m a l l y it contains the excreted salts
dissolved in w a t e r and the end p r o d u c t s
of a l b u m i n o u s disintegration in the b o d y ;
but in diseases great c h a n g e s o c c u r ,
hence urine e x a m i n a t i o n is necessary to
k n o w the m e t a b o l i c disorders in the b o d y ,
the c o n d i t i o n of k i d n e y and other u r i n a r y
tract and to k n o w the quality and
q u a n t i t y of n o r m a l a n d a b n o r m a l consti­
tuents in the u r i n e ; the correct interpre­
tation of w h i c h leads to a p r o p e r diagnosis
of the disease. U r i n e e x a m i n a t i o n is
d o n e m a i n l y in three w a y s ; P h y s i c a l ,
C h e m i c a l and M i c r o s c o p i c a l .
NORMAL URINE.

Before o n e p r o c e e d s to e x a m i n e a
s a m p l e of urine, he must k n o w the
characters of n o r m a l urine. Healthy
u r i n e contains the following p h y s i c a l
characters.
Colour—Pale y e l l o w .
Odour—'Urinous'.
Quantity—
I n 24 hours—40 to 50 ounces.
A t one time—5 to 6 ounces.
A p p e a r a n c e — C l e a r i,e, n o t u r b i d i t y
and sediment s h o u l d be pre­
sent.
Reaction—Slightly acid.
-Specific G r a v i t y —
Bengalees 1003—1015.
E u r o p e a n s 1015—1025.
C h e m i c a l and M i c r o s c o p i c a l e x a m i n a t i o n
— N o a b n o r m a l constituents.
PHYSICAL EXAMINATION.

Collection. I n males, first t h o r o u g h l y


clean the meatus and the patient s h o u l d
b e asked to pass urine in a w i d e m o u t h e d
clean glass bottle, t h o r o u g h l y cleaned
p r e v i o u s l y w i t h o r d i n a r y water. The
best thing possible is to boil the bottle in
water in a pan or c o m m o n d e k c h i for
10 minutes and then k e e p it in a cool
place u p s i d e d o w n . T h e patient should
be asked to micturate directly o n it; b u t
if the patient feels a n y i n c o n v e n i e n c e , a
clean funnel, preferably of glass, should
be p l a c e d o v e r it. If there is n o sterile
bottle, he can pass water in a w h i s k y or
methylated spirit bottle. Females should
pass water after t h o r o u g h l y c l e a n i n g the
external genitals to a v o i d discharges and
putrefactive m i c r o - o r g a n i s m s if any, in a
clean receptacle a n d if for bacteriological
e x a m i n a t i o n a sterile catheter s h o u l d b e
used to d r a w the urine into a sterilised
bottle. T w e n t y - f o u r hours collection of
4 URINE ANALYSIS

urine is the best or a sample or p o r t i o n


of w h a t is passed in 24 hours. Preserve
the urine from d e c o m p o s i t i o n b y a d d i n g
2 or 3 d r o p s of formaline or 10 to 15 d r o p s
of c h l o r o f o r m w i t h the first sample or a
crystal of t h y m o l . ' T h e former t w o r e d u c e
Fehling's solution a n d slightly h a m p e r
results but t h y m o l does not reduce
Fehling's solution. T h e collected u r i n e
s h o u l d be c o r k e d or lightly c o v e r e d w i t h
cloth, cotton or paper to a v o i d c o n t a m i n a
t i o n ; and w h e n b r o u g h t for e x a m i n a t i o n ,
if acid, it should be set aside in a c o o l
place for 3 or 4 hours to gravitate the
sediments.
T h e c o m p o s i t i o n o f urine varies at
different h o u r s of the day. F o r the detec­
tion of m u c u s a n d pus, m o r n i n g urine is
the best as it is concentrated a n d collects
m o r e during sleep. F o r a l b u m i n and
sugar, urine passed 3 or 4 hours after the
largest m e a l ; for b l o o d is then full of
p r o d u c t s of digestion and so excretion is
active. T h e usual practice is to keep and
e x a m i n e the early m o r n i n g u r i n e b u t it is
not w h o l l y reliable, as m e t a b o l i s m d u r i n g
PHYSICAL EXAMINATION 5

sleep is v e r y little so a l b u m i n and sugar


if present in faint trace m a y b e absent
then. T h e sample of urine passed t w o o r
three hours after breakfast m a y c o n t a i n
these a b n o r m a l ingredients. Always
w a r n the patient not to spit o n the urine
to be e x a m i n e d as it m a y g i v e m i s l e a d i n g
results.
W h e n cultural, or a n y special e x a m i ­
nation is required for special reasons,
t h o r o u g h l y sterilise a b i g test tube, w i t h
a little cotton w o o l or a stoppered p h i a l
a n d a catheter a n d k e e p t h e m ready.
First w a s h the external meatus w i t h
aseptic lotion and d r a w urine b y the
catheter. R e j e c t the first portion of it a n d
collect the latter in the sterile test tube
or in the stoppered phial. I m m e d i a t e l y
p l u g the test tube w i t h the sterile c o t t o n
wool, after sterilising it in the flame of a
spirit l a m p or tighten the stopper of the
phial. W h e n urine is sent for e x a m i n a ­
tion from a distance, to p r e v e n t putrefac­
tion shake w i t h t w o d r o p s of toluol o r
formaline 4 0 % o r preferably a f e w c r y s ­
tals of t h y m o l ( w h i c h d o not r e d u c e F e M -
6 URINE ANALYSIS

ing's Solution) and fill the phial quite full


to a v o i d shaking. N o w securely c o r k a n d
carefully p a c k it thoroughly, preferably
with ice as c o l d retards d e c o m p o s i t i o n .
Quantity. A h e a l t h y adult male
excretes in 24 hours about 40 to 50 o u n c e s
of u r i n e ; females generally 35 to 40 o u n c e s ;
children m u c h less. It varies in i n d i v i -
dual cases in relation t o food a n d drink.
Decrease. P h y s i o l o g i c a l l y urine i s
decreased d u r i n g hot weather o w i n g t o
loss of ñ u i d b y sweat and w h e n there is a
less i n p u t of fluids. P a t h o l o g i c a l l y , it i s
d i m i n i s h e d in cases, w h e n there is d i m i -
nished pressure in the renal vessels and
dilatation of vessels elsewhere as in acute
nephritis, in the last stages of Bright's
disease, hsBmorrhage, collapse or s h o c k
from internal injuries, uraemia, v i o l e n t
diarrhoea, algid stage of cholera, h i g h
acute fevers, after great muscular exer-
cises and in certain c a r d i a c and p u l m o n a r y
diseases. U r i n e is also d i m i n i s h e d i n
arsenic, m e r c u r y a n d turpentine p o i s o n -
ing.
Increase. P h y s i o l o g i c a l l y urine is
PHYSICAL EXAMINATION 7

increased d u e to intake of large a m o u n t o f


fluids and in rainy a n d c o l d d a y s d u e to
absence of sweat, for c o l d constricts t h e
peripheral vessels. P a t h o l o g i c a l l y , u r i n e
is increased in w h i c h there is a h i g h p r e s ­
sure of the renal vessels a n d w h e n h e a r t
beats are accelerated as in m a n y k i d n e y
diseases, diabetes, in certain n e r v o u s d i s ­
eases and after attacks of e p i l e p s y a n d
hysteria. P s y c h i c a l l y it is increased i n
fear and e m o t i o n etc. It is also i n c r e a s e d
d u r i n g the administration of diuretics;
sach as calomel, digitalis, p u n a r n a v a a n d
s o m e potassium salts.
Consistency. N o r m a l urine is a thin,,
aqueous fluid. It is opalescence d u e to
m i c r o - o r g a n i s m s or suspended matters.
It b e c o m e s thick and v i s c i d if m i x e d u p
w i t h m u c h pus or m u c u s . Diabetic a n d
h i g h l y a l b u m i n o u s urine b e c o m e thick a n d
frothy on shaking. Urine c o n t a i n i n g
m u c h fibrin coagulates like j e l l y on stand­
i n g for s o m e time.
Colour. T h e n o r m a l colour of urine i s
pale straw or light y e l l o w . It is m a i n l y
d u e to the pigment u r o c h r o m e and p a r t l y
8 URINE ANALYSIS

to urobilin. W o m e n ' s urine is slightly


lighter. If the q u a n t i t y of urine is
increased or there is a d i m i n u t i o n or dilu­
tion of u r i n a r y pigments, it b e c o m e s
lighter and rendered v e r y pale as in
excessive drinking, nervousness, anaemia,
chlorosis, diabetes, hysteria, epilepsy,
poluria, in general debility and in c h r o n i c
interstitial nephritis. T h e c o l o u r of the
urine will d e p e n d on the degree of c o n c e n ­
tration; the more concentrated—the
d a r k e r ; the greater the q u a n t i t y of water
—the lighter. A c i d urine is slightly
darker than alkaline urine. Urine be­
c o m e s deeper in colour, like orange or
dark y e l l o w or b r o w n i s h red generally
k n o w n as h i g h c o l o u r e d or concentrated
urine and is due to uroerythrin and
urobilin p r o d u c e d b y increased haemolysis,
as in. fevers, after j o u r n e y s , in hot
days, in nervous excitability a n d after
bodily exercises. Normal urine on
standing for a time will h a v e a w h i t e
or sometimes a bluish white scum
on the surface due to c o n t a m i n a t i o n and
putrefaction. Urine glairy, whitish in
PHYSICAL EXAMINATION 9

c o l o u r indicates a d m i x t u r e w i t h p u s or
leucorrhceal discharges. Urine c o l o u r e d
s m o k y , b r o w n , reddish, b r o w n i s h b l a c k or
b l a c k indicates a d m i x t u r e w i t h b l o o d a n d
denotes haemorrhage. Urine c o l o u r e d
greenish y e l l o w or greenish b r o w n indi­
cates a d m i x t u r e w i t h bile and denotes
j a u n d i c e a n d other affections of the liver.
Urine c o l o u r e d m i l k y indicates a d m i x ­
ture w i t h fat or p u s a n d denotes c h y l u r i a
or a n y purulent disease of the genito­
urinary tract. Urine c o l o u r e d blue indi­
cates typhus fever, a d m i x t u r e with
m e t h y l e n e blue or w h e n there is excess of
i n d i g o g e n s . M a n y d r u g s after absorption
c o l o u r the urine, s u c h as y e l l o w i s h o r a n g e
b y santonin and c h r y s o p h a n i c a c i d ; red­
dish or orange b r o w n b y senna and
r h u b a r b ; dark olive green or b l a c k b y
c a r b o l i c acid and other coaltar derivatives
w h i l e antipyrin reddens the urine.
Odour. W h e n just v o i d e d urine is
faintly a r o m a t i c but after a few m i n u t e s
its characteristic o d o u r is "urinous." T h e
o d o u r of urine is d u e to p h e n o l . It be­
c o m e s p u n g e n t in concentrated urine,

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