occur,

Under the above-mentioned forms the reader will miss some which have been described in other books, but which we ourselves have had no opportunity of observing; and we conclude that, if such forms do it is only very rarely. The cylinders of pus-cells must not be confounded with the short plugs of purulent matter which arise from the papillary part of the kidney and are characteristic of chronic pyelitis. Further, we mention cylinders of calcium oxalate and also cylinders with imbedded uric-acid crystals. It often happens that to the cylinders crystals of uric acid and oxalate of calcium become attached. They do not appear imbedded in the cylinder mass, but added after it has left the urinary tubules as an accidental attachment.

6. Fungi.

In the urine a number of parasitical growths may exist, some of which are of frequent occurrence, while others appear more accidentally.

The most frequent forms which one has the opportunity of observing are the following: 1. Bacteria; 2. Yeast fungi; 3. Sarcina; 4. Oïdium lactis; 5. Differently developed spores and fragments of penicillium glaucum. Some forms occur oftener in alkaline and others in acid urine.

1. Bacteria, predominantly inhabitants of alkaline urine, described by some authors as a low form of animal life, by others as a plant, being spoken of synonymously as Vibriones, Monades crepusculæ, Microzymæ,

etc. At present it appears probable that they belong to the fungi and are grouped under Nägeli's Schyzomycetes. They are very different in their appearance, and from a practical standpoint, according to A. Vogel, they have received various names. It is only necessary to remember that they are fungi.

A urine which contains an appreciable amount of bacteria appears always cloudy. After a long time part falls as a sediment to the bottom without the fluid becoming clear. According to A. Vogel, the following forms are to be distinguished:

a. The monad forms. These are round punctiform bacteria, which either remain quiet or show a quivering motion. One must exercise care not to confound with these the earthy phosphates which have a molecular movement. While the movement of a dead organism goes on in one place, the monad forms of bacteria change their position in the field.

b. The rod forms. These are very small rods, scarcely the diameter of a blood-corpuscle, and immeasurable in thickness. Both ends are generally swollen and knob-formed. They are sometimes at rest and sometimes moving through the field.

c. The vibriones. These are made up of the abovementioned forms-two or more rod-like bacteria hanging on to one another, moving sometimes spirally and sometimes with a motion resembling that of a fish's tail, going hither and thither with great rapidity.

d. Leptothricæ, or chain forms. These are long, often reaching across the entire field, and are to be dis

tinguished only by their length from the vibriones. Only with a very high magnifying power can their jointed composition be recognized. They move but seldom, and then very sluggishly, in the manner of a serpent.

e. The zoögloa forms. These appear as masses of punctiform bacteria held together in a common gelatinous mass, resembling a precipitate of earthy phosphates held in mucus.

All these forms may be observed in the same urine, and often under the same cover-glass.

2. The yeast plants (Saccharomyces urina).—These are single vesicular cells, of the size of blood-corpuscles, and of somewhat oval shape. Usually, however, they are made up of small cells arranged like a rosary, some of the beads having two or three bud-like cells attached. (Pl. VIII., A, 1.) This fungus appears in much less quantity than the bacteria, and is found mostly in acid urine on a warm day. This plant has the greatest similarity to the yeast plant of beer (Saccharomyces cerevisia), without being identical. In diabetic urine this form occurs, but more vigorously developed.

3. Sarcina. This form has the greatest similarity to Sarcina ventriculi, but is appreciably smaller. They are arranged in groups of 2, 4, 8, etc., and the small cells are built up in cube form and present the appearance of a cross-bound bale of goods. (Pl. VIII., A, 3.)

The urine in which sarcina are found is chiefly alkaline, and in the sediment we find also calcium- and

triple phosphate. The evacuation of sarcina lasts for weeks, sometimes for months.

4. Oidium lactis.-This appears in the form of long cells, recognized by their granules being arranged at regular intervals. These occur not infrequently in the fermenting urine of diabetes.

5. Penicillium glaucum.-Besides the before-mentioned fungi, there may exist in the urine also spores of this plant. In great part these exist as germs. Sometimes they are covered with a coating of fine urates, appearing furry and brown-red, or the development is further advanced, and the branching forms become extended and make up a network of interlacing fibres. (Pl. VIII., A, 2.)

The spores for the evolution of all the forms of fungi mentioned develop outside of the bladder. This rule, however, has exceptions. The sarcina are always excreted with the urine from the bladder. Sometimes this may be the case with bacteria, though this may be explained from the use of unclean sounds or catheters. Cases have come to our knowledge, though very rarely, where there was certainty of no instrument having been introduced previously into the bladder or urethra. It is very difficult to ascertain whether these forms of fungi have any influence on the reaction or fermentation of the urine. The small chain fungus appears not alone in alkaline urine, but in every case in which an albuminous substance becomes fetid or decomposed. We therefore find the same in the secretions of different ulcers, in ichor, and in cholera stools.

In this place we may mention in passing an indication which was formerly considered a characteristic sign of pregnancy. With the name kyesteine was christened that membrane which forms on the surface of longstanding urine, and which consists of an interlacing network in which calcium- and triple phosphates, bacteria, and sometimes also animal organisms, are imbedded. It forms, however, upon the urine of men, and has of late lost its significance.

7. Spermatozoa.

Spermatozoa appear with a strong power (Hartnack, III., 7 =×330) as small rounded forms, with a longer or shorter hair-like tail. Seldom has one an opportunity of seeing them in motion in the urine. A urine which contains spermatozoa often shows white cloudy flakes, which under the microscope are resolved into a mass of spermatozoa imbedded in a finely granulated substance. Since spermatozoa are very light, they require several hours to settle. After six to twelve hours we find, besides the flocculent lumps, also isolated seminal granules. On account of the resisting capability of these structures, they may be found in the urine after several days. (Pl. VI., A, 3.)

We find spermatozoa—

1. After coition, nocturnal pollution, etc., when a part of the semen remains behind in the urethra, and is washed out later by the urine.

2. With spermatorrhoea.

We also observe involuntary emissions in typhus.