Chemical Content of Urine
Glycosuria is urine containing sugar (glucose). It ap¬pears in any condition in which there is an appreciable increase in the blood-sugar over the normal one part in a thousand parts of blood. There is a transient glycosuria from an ex¬cessive intake of starch and sugar, after acute fevers in obese people and in some nervous diseases. When the oxygen sup¬ply is much lowered, as in suffocation and ether and chloro¬form anesthesia, there is a glycosuria. When sugar appears in the urine constantly and over long periods, however, it indicates diabetes mellitus (sugar diabetes). But in numer¬ous other conditions it may be found transiently, as in boils, alcoholism, cancer of the pancreas, concussion of the brain, exophthalmic goiter, whooping-cough, melancholia, neuras¬thenia, phosphorus-poisoning, and starvation.
Acetone normally is found in traces in the urine. When increased over this it may indicate malnutrition or chronic digestive disease, though it may be after chloroform anesthesia or in many fevers, also in cancer, gastric ulcer, malnutrition, nephritis, uremia, etc. If the carbohydrates in the diet are materially reduced below body requirements acetone may be greatly increased. In diabetes this is a danger sign, as it may indicate impending diabetic coma, especially if it con¬tinues to appear in the urine when treatment that should benefit the diabetic condition is given. This is a condition known as acetone acidosis. Sometimes, but not often, it de¬velops in fasting obese patients.
Diacetic acid usually is associated with acetone in diabetic urine and makes the prognosis of diabetes more grave. If it is present in large amounts a fatal acidosis is imminent. If oxybutyric acid is found in addition to acetone and diacetic acid the prognosis is still more grave regarding the acidosis. Diacetic acid also is found in moderate degree in fasting, fevers, exclusive meat diet and morphinism.
A microscopic examination of urinary sediment is neces¬sary to complete a urinalysis. Alkaline urine should be ex¬amined at once if possible, because of its tendency to rapid changes. The significance of urinary deposits will be con¬sidered briefly.
Blood has been mentioned above. Leucocytes, or white blood-cells, are normally found in small numbers. Pus-cellsmay indicate one of many abnormal conditions: Abscess (in various locations), stone in the kidney, bladder or urethra, cancer of the urinary tract, cystitis (with urine usually alka¬line), gleet, gonorrhea, leucorrhea, pyelitis, urethral stricture, suppurative nephritis, tuberculosis of bladder or kidney (urine acid), ulcer of the bladder, inflammation of ureter or urethra. The pus usually conies from the kidney when the urine is acid. Rupture of an abscess into the urinary tract, or unkinking of a ureter that has held back the pus, may cause the sudden appearance of a large amount of pus in the urine.
Growthparticles may be due to cancer of the urinary tract. An excess of epithelium may come from an acute nephritis, a cystitis, a kidney-stone, urethritis, or pyelitis, or may result from scarlet fever. Spermatozoa may be normal after coitus, or may be due to masturbation, withdrawal, loaded rectum or spermatorrhea.
Numerous bacteria may be found. Any present indicate an abnormal condition unless the urine has been contaminated before examination (after passage).. There may be found one or more of several types, their significance being left to the physician to determine. The same with parasites. Small stones and gravel may pass in the urine, from the kidneys, the bladder or the urethra.