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number of oil casts, render it certain that the case is chronic. The former would indicate that the kidney was becoming small and contracted, while the latter variety of casts occur when it is often of large size and fatty. Such examples might be multiplied. When we consider how very numerous the secreting tubes of the kidney are, we cannot feel surprised that a different condition should exist in different tubes at the same time, and from observations on careful post mortem examinations, we know that very different morbid appearances are often seen in different parts of the cortical portion of one kidney. It is not difficult therefore, to account for the fact of the presence of casts differing much in their diameter and characters in one specimen of Urine.

Now, the chief points to be noticed in the specimen delineated in fig. 1, are

1. The presence of casts containing well marked and large cells of renal epithelium, as, a, which are never met with in chronic cases.

2. The existence of a number of casts, as b, containing blood corpuscles. The granular matter in the casts c, is of a brown colour, and consists of disintegrated blood corpuscles.

3. A great many cells of epithelium, and numerous blood corpuscles are seen in various parts of the field perfectly free.

one.

4. The Urine contains a large quantity of albumen.

These points render it certain that the case is an acute

In fig. 2, a number of casts containing circular and faintly granular cells of altered epithelium are represented with a good deal of disintegrated epithelium. The chief points to be noticed here, are—

1. The presence of a number of granular casts, which are dark without any tinge of a brown colour.

2. The presence of perfectly transparent wax-like casts, c.

c 2

PLATE XVI.

CASTS. ACUTE INFLAMMATION OF THE KIDNEYS.

Casts from the Urine of a man, aged 45, suffering from acute inflammation of the kidneys. There was very slight oedema of the legs. The patient died comatose three weeks after the first symptoms appeared.

The Urine contained so much albumen that it became perfectly solid upon the application of heat and after the addition of nitric acid.

a. Perfectly transparent wax-like casts. The shading should be more faint than in the drawing.

b. A very long wax-like cast, consisting of material. deposited at two different periods. The original cast in the interior was probably forced a certain distance further down the uriniferous tube, when a new layer of the coagulable material was deposited around it.

c. Casts filled with cells closely resembling pus corpuscles, but somewhat larger.

d. The same cells free in considerable number. The greater part of the deposit consisted of these cells.

e. Portion of feather.

f. Pieces of cotton fibre.
g. Portion of human hair.

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