may be considered as normal; the albumen being present quite to the natural extent; indeed, if any thing, somewhat beyond the amount generally found in the serum of healthy blood.

The case from which the scrotal fluid was obtained, affords an instance of great decrease in the specific gravity of the serum of the blood. The lowest specific gravity mentioned by Dr. Christison, in his lately-published valuable work, is 1019; this specimen was, however, only 1015 sp. gr."

Dr. Rees has been unable to obtain urea from the serum of healthy blood.

OBSERVATIONS ON THE EXISTENCE OF CERTAIN ELEMENTS OF THE MILK IN THE URINE DURING UTERO-GESTATION; AND ON THE APPLICATION OF THIS FACT TO THE DIAGNOSIS OF PREGNANCY. BY GOLDING BIRD, M.D. F.L.S. &c.

This indefatigable and talented young physician, had his attention drawn by the Medical Journals to a peculiar mucilaginous principle, said to exist in the urine of pregnant women. This new constituent, he says, of the renal secretion, which has been dignified with the name of Kiestein, is stated to exist in the urine of the human female during utero-gestation, and to become visible when the secretion is allowed to repose in a cylindrical vessel, in the form of a cottonlike cloud, which in a lapse of time, varying from the second to the sixth day of exposure, becomes resolved into a number of minute opaque bodies, which rise to the surface, forming a fat-like scum, which remains permanent for three or four days: the urine then becomes turbid, and minute flocculi detach themselves from the crust, and sink to the bottom of the vessel: this action continues until the whole pellicle disappears. This crust of Kiestein is stated to be distinguishable from analogous pellicles which occasionally form on the surface of urine, from its never becoming mouldy, or remaining on the surface beyond three or four days from the time of its complete formation.

Dr. Bird accordingly examined the urine first passed in the morning by about thirty pregnant women, and, in all, save three, copious fat-like pellicles were observed on it, after two or three dav's exposure. The next thing Dr. Bird did, was to examine the nature of this Kiestein.

"None of the specimens of urine voided by pregnant women, that I have examined, were coagulable by heat, nitric acid, or, with but two or three exceptions, by acetic acid, and therefore could not contain any considerable portion of albuminous or caseous matter: the addition of ammonia almost invariably produced a dense deposit of earthy phosphates; which, under the microscope, appeared to consist of myriads of minute acicular crystals; and, with the exception of this proof of the existence of an excess of earthy phosphates in the secretion, no appreciable portion of any anormal ingredients could be detected.

Some of the fat-like pellicle was removed from the surface of some urine on which it had formed, by plunging a plate of glass perpendicularly into the fluid, and withdrawing it adroitly, in a nearly horizontal position; an equable layer of the substance was thus procured; and, when carefully covered with another plate of glass, it could be very conveniently submitted to examination.

The pellicle thus procured, appeared glistening with a lustre like that of spermaceti: when placed under a microscope, and examined with an objectglass of a quarter-inch focal length, myriads of superb triangular prisms, strongly refracting light, and resolving it into colours, were seem imbedded in a mass of irregular granular matter, mixed with which, might here and there be seen patches of tolerably regular globular bodies. The transparent trian

1840] On the Existence of Milk in Urine during Gestation. 271

gular prisms were soon recognised as the well-known crystals of triple phosphate of magnesia; they were so beautifully distinct, and their angles so sharply defined, that the whole became a most interesting microscopic object: some of the crystals were placed on end, and thus appeared like triangular plates."

When the urine is kept so long that the pellicle begins to break up, it, as before stated, falls, in the form of a deposit, to the bottom of the vessel; and if the supernatant fluid be decanted, and the deposit collected on a slip of glass, it is found to present the same appearance as the pellicle; excepting that the crystals are much more numerous, and all the animal matter present is entirely composed of amorphous granules; all trace of any thing like a regular structure being lost.

A slip of glass, on which a portion of the peculiar pellicle had been collected, was placed under the microscope, and covered with a few drops of acetic acid; instantly the whole became opaque, the crystals became rapidly dissolved, and a white pultaceous mass resulted. On washing the whole with a few drops of water, and carefully drying the residue, a white opaque layer was left upon the glass, in which no trace of crystalline matter was perceptible, upon very minute microscopic investigation. Even upon illuminating the object with a beam of polarized light, and analysing the transmitted ray by placing over the eye-glass of the microscope a very fine pale-brown tourmaline, not a trace of colour could be detected; a very faint depolarizing action of the animal matter left on the glass being alone perceptible.

Another portion of the pellicle, also collected on a glass plate, was placed under the microscope, and a few drops of strong liquid ammonia were added: the crystals underwent no change, but became much more distinct from the opaque matter, in which they were imbedded, undergoing solution. In the course of half-an-hour, the glass was carefully washed with a little water, and again examined; when every trace of animal matter was found to have disappeared, and the crystals of the triple phosphate were alone left.

The beautiful crystals present in these pellicles become extremely manifest when a portion of the fat-like scum is collected on a slip of glass, and dried : a drop of Canada-balsam is then placed upon the dried residue; and the whole being gently warmed, a slip of glass, or mica, is pressed flat upon the balsam. When cold, the specimen may be preserved for any length of time. Under the microscope, the crystals are visible with remarkable distinctness; the animal matter mixed with them becoming nearly invisible, from its being immersed in a medium of nearly the same refractive power.

"From the investigations I have made, the greasy aspect of the pellicle of the so-called Kiestein arises not from the presence of fat, but from the numerous crystals of triple phosphate, which, from their brilliancy, produce this glistening appearance: with regard to the nature of the animal matter mixed with these crystals, it is difficult, in the present state of physiological chemistry, to give a positive opinion: it is not mere albumen or casein, although much closer allied to the latter than to any other product of organization I am acquainted with, especially when we connect with its chemical character the powerful cheeselike odour so frequently evolved, during its development in the urine, in the form of a pellicle. To this view may be objected the circumstance, that the urine yielding it, does not coagulate on the addition of acetic acid: this, however, is by no means an important objection, as milk, when considerably diluted with a saline solution, or even water, is not perceptibly troubled by acids; so that whilst it may be fairly considered as constituted of an imperfect caseous matter, mixed with crystals of the ammoniacal phosphate of magnesia, it is equally obvious that nothing can be more absurd than to dignify this mixture with a peculiar name, or to consider it as constituting a new organic principle.

There are few products formed during repose in urine which can be readily confounded with this caseous pellicle; if it be borne in mind, that the secre

tion remains faintly acid up to the moment of breaking up of the crust; which phænomenon I am inclined to regard as arising from the development of ammonia in the urine, as at this time it acquires distinct alkaline properties. The crust of earthy phosphate, which forms on the surface of all urine by long repose, cannot be mistaken for the pellicle under consideration; as that which destroys the latter, viz. putrefaction, causes the production of the former."

After noticing the contradictory opinions of physiologists as to the presence of certain ingredients of the milk in the urine, Dr. Bird remarks,

"On reviewing the foregoing remarks, and finding, as I believe we do, sufficient evidence of the presence of certain ingredients of the milk, as caseous matter, and abundance of earthy phosphates, in the urine of pregnant women, I would suggest, as a probable explanation opposed to no physiological views that I am acquainted with, that during utero-gestation certain ingredients of the milk are eliminated from the blood by the mammary glands, and, as is very well known, often accumulated in the breasts, in sufficient abundance, to escape from the nipple on pressing it between the fingers. This imperfectly formed secretion not having a ready exit by the mammæ, is taken up into the circulating mass, is separated by the kidneys, and, eventually, escapes from the body in the urine. This view is analogous to the hypothesis of Prof. Burdach, before referred to; and although not quite consonant with the views of M. Rayer, yet is quite in accordance with what we find occurring, under certain circumstances, in the bile, in the cases of obstruction of the biliary ducts; and more rarely in the urine, when, from the presence of calculi or other causes, the ureters are completely obstructed."

Dr. Bird has not met with these pellicles in the renal secretion of nurses, whilst suckling. He mentions a case, which, he thinks appears to justify the idea, that, whilst suckling, the milk being got rid of almost as quickly as it is secreted, none of its elements find their way into the urine; but as soon as the milk ceases to be removed in this way, indications of it are to be met with in the urine, provided pregnancy exists.

He has several times examined the urine of women shortly after their confinement, and hitherto has not succeeded in detecting any indications of the presence of milk in that secretion.

"For want of a sufficient number of observations, I am unable to state how long after conception the urine assumes the properties characteristic of pregnancy. In one case, that of a woman who considered herself to be at the end of the second month of her pregnancy, the urine yielded a well-marked pellicle: but I do not place much confidence in this observation, as the woman might very likely err in calculating how far she was advanced in utero-gestation. As a test for the existence of pregnancy, the formation of the caseous pellicle, especially if accompanied by a cheese-like odour, will, I have no doubt, be an extremely valuable corroborative indication: but I would not found on it alone any positive opinion, because, as a sufficient number of observations have not yet been made on this subject, we have no right to assume, however probable it may be, that a caseous pellicle can appear only when pregnancy exists. It should be borne in mind, that in many specimens of diabetic urine, as has long ago been shewn by Dr. Aldridge of Dublin, and Dr. Brett of Liverpool, a true deposit of casein, mixed even with traces of butter, occasionally exists. Connected with other symptoms, I should regard the formation of the caseous pellicle in the urine as a valuable corroborative indication; but if existing alone, and unsupported by any other indications of pregnancy, we have no right, in the present state of our knowledge, to regard it as conclusive."

Spirit of the British and American Periodicals, &c.

ON THE USE OF NITRATE OF SILVER IN SOME AFFECTIONS OF THE MUCOUS MEMBRANES. BY ALFRED HUDSON, M.B. Physician to the Nassau Fever Hospital.

Dr. Hudson observes that, since the Senior Editor of this Journal directed the attention of the profession to the effects of small doses of the nitrate of silver, in cases of morbid sensibility of the stomach, the remedy must have been a good deal employed. He thus refers to some who have contributed observations on the subject.

"Dr. Osborne assigns it an useful adjuvant action, as an astringent in gastralgia, with sour vomiting. Mr. Langston Parker classes it with morphia and bismuth as a sedative in ulceration of the stomach. Dr. Bigger gives us the testimony of Dr. Steinitz, to its efficacy in nervous debility of the stomach; and of Dr. Schneider, in dyspeptic palpitation: and a case of its successful exhibition, in this latter affection, is given by Dr. Copland, in his article "Indigestion ;" and recently M. Boudin has published his observations on its effects in gastro-enterite, when given by the mouth and by enema."

1. Dr. Hudson has used the nitrate a good deal in the stomach complaints so prevalent amongst the Irish peasantry. He relates three cases of severe gastralgia in which the nitrate proved eminently serviceable. We may quote the second as a sample.

Case.-Michael Monaghan, aged 15, admitted February 3, 1839.-Has suffered for six months acute pain, with tenderness on pressure in the epigastric region; great distention of stomach after eating; thirst, costiveness, and vomiting of sour fluid. Pain usually commences about an hour after dinner, and continues through most of the night, preventing sleep; it is generally accompanied by vomiting of sour fluid, without food. He has been under medical treatment, but, as he says, without benefit.

Nitrat. Argenti gr. 4.
Opii. gr. 4.
Pulv. Rhei;

Ext. Humuli, āā. gr. i.
Ft. Pil. ter die sumenda.
Bread and milk for diet.

His farther history is, that during his stay in hospital he had but one return of the vomiting. The pain and tenderness subsided in the course of a week. The pills were discontinued on the tenth day, and on the twenty-eighth he was discharged free from complaint.

2. Dr. Hudson has resorted to it in dyspepsia, combined with sympathetic affections of other organs. He has several times given it where the painful feelings were referred to the head, as giddiness, especially on motion; confusion of vision; ringing noise in the ears; with, at the same time, a pale countenance and feeble circulation.

3. He has also used it in cases of nervous debility of the stomach, the primary complaint having been uterine leucorrhoea. And indeed he has seen

No. LXV.

* Dublin Journal, May, 1840.

T

it of great advantage to the leucorrhoea itself. He details three cases; we select one.

Case.-Mrs. R aged 36, the mother of four children, was confined more than a month ago, and since she commenced moving about has been tormented by a viscid, transparent, colourless discharge, which goes off at night and returns during the day, in great quantity. She has dull pain in the loins, and gnawing at the pit of the stomach. She has had several abortions, and suffered much from the same complaint after each of them.

April 5th. She commenced taking the nitrate of silver in doses of a third of a grain, with powdered ginger and extract of hop, three times a day.

On the 15th of April she had taken ten grains of the medicine, and was quite well. She said she never got well so quickly in her life: she soon after became again pregnant.

4. Dr. Hudson has seen it very useful, as he has seen it fail, in dysentery and diarrhoea. It appeared to anwser in a case of hæmaturia. In two cases of catarrh of the bladder, and in one of hæmorrhage from the urethra it seems to have been inefficient.

He gives the following summary of its effects.

1st. A topical action upon the inflamed, congested, and ulcerated portions of the alimentary canal, similar to that which it exercises upon similar affections on the surface of the body.

2nd. A power of acting as a stimulant on the capillary circulation of different parts of the body, as of the brain and uterus.

3rd. A tonic power of the very first order.

The profession will do well to keep its eyes open to the utility of this medicine in many cases. We have for some time been in the habit of employing it, and often with advantage.

A CASE OF HYDROPHTHALMIA SUCCESSFULLY TREATED BY MERCURY. By JAMES O'BEIRNE, M.D. one of the Surgeons of the Richmond Surgical Hospital, Dublin.

Case.-Mary Anne Redmond, aged 40, much exposed to weather, was admitted Sept. 24, 1839, with considerable enlargement and protrusion of the globe of the right eye, and total loss of vision of that organ.

Examined in profile, it is completely uncovered by the upper eyelid, and projects considerably more than the sound one; it is equally distended in its entire circumference, and its sclerotic portion has a bluish cast, and appears as if thinned; the relative distance between the anterior and posterior chambers is preserved. The cornea is not altered in figure, and in size bears a just proportion to that of the rest of the ball. The iris is of its natural colour, and does not project more than usual into the anterior chamber. The pupil is greatly dilated, quite motionless under the stimulus of light, and somewhat irregular at its upper margin. There is slight conjunctivitis, but a greater degree of it at the inner canthus. The lens and all the humours are perfectly transparent, but the bottom of the eye, contrasted with that of the sound one, bears a dark, blackish appearance. The eyelids are neither oedematous nor inflamed, and leave the eye perfectly uncovered. The motions of the eye-ball are not perfectly under the control of the will, and are performed with some degree of pain and difficulty.

She had contracted a severe cold on the night of the preceding 6th of January; and she stated that the affection of the eye commenced soon after with severe pain in the right eye-ball, and right supra-orbital region, followed by vivid red