a large increase by st (strongly increased); a large decrease by st- (strongly decreased).

The results may be arranged as follows:

The increase and decrease is that of the percentage. Such a filled out table appears as the following example.

ABNORMAL MATTERS IN SOLUTION.

Sugar in considerable quantity.

SEDIMENT.

Consists of mucus in normal quantity.
Microscopically, isolated yeast fungi are seen.

Result = Diabetes mellitus.

With such a blank one may write in its proper division the result of each test that he has applied from A to F, the presence and amount of the substances found, and the conclusion he may have drawn. If we look at the table in the example, we conclude: 1st. From the 24-hour amount, that there exists polyuria; 2d. From the specific gravity, concerning the quantity

of solid matters, diabetes; 3d. From the pale color and the lack of urates, that no febrile condition exists; 4th. Finally, from the amount of sugar present, diabetes mellitus.

CHAPTER VII.

GENERAL DIAGNOSIS.

Ar the time when the entire investigation of the urine consisted in observing the physical characteristics, and then only with preconceived notions, so that one took pains to torture the "urine signs" to conformity with a system previously constructed on a speculative basis, the investigation of the urine could afford no essential service in the diagnosis of febrile processes, and not seldom afforded a cloak to ignorance and charlatanry.

It is only since the advance of organic chemistry and the use of the microscope, and since the connection between the characteristics of the urine and the tissue metamorphosis on the one hand, and the construction of the urinary apparatus on the other, has been clearly understood, that the investigation of the urine has dared to claim for itself an important character and a scientific value. At present no one doubts that it is essentially necessary for the diagnosis of disease. Moreover, in certain cases, from the urinary analysis alone can their nature, condition, and intensity be determined. It would be a gross error to believe that from the urine all possi

ble diseases can be diagnosed; but it would be equally unjust to attempt to exclude as useless urinary investigation.

Before we speak of the diagnosis of diseases of the urinary apparatus, we will mention what is important uroscopically with the various diseases in general. In this series we comprise those indications which are most valuable and necessary to the practicing physician.

1. Take the twenty-four hours' amount, and consider if it be normal, increased, or diminished. The normal amount is generally 1,500 c.c. If the twenty-four hours' amount is considerably increased, we have to do with polyuria; if it is diminished considerably, with oliguria; and, if there is no urine excreted, with anuria.

Polyuria may be either physiological or pathological. In the first case it is urina potus or urina spastica; in the latter case, on the other hand, we have either hydruria or diabetes. In order to make a differential diagnosis, we must calculate from the specific gravity the amount of solid matters excreted in twenty-four hours, by means of Trapp's or of Häser's coefficients (p. 39). If the quantity of solid matter is normal (nearly 70 grammes) or thereabout, it is a case of urina potus; i. e., as far as its solid constituents are concerned, a normal urine diluted with much water. If the amount of solids is diminished, we have a hydruria to treat, which may occur with several cachexies. If, on the contrary, the solids are considerably increased, we have a diabetes. If with the diabetes a large amount of sugar is present, we have a diabetes mellitus. If, on the contrary, no sugar is