File:Urinary analysis and diagnosis by microscopical and chemical examination (1906) (14784460432).jpg

Identifier: urinaryanalysi00heit (find matches)
Title: Urinary analysis and diagnosis by microscopical and chemical examination
Year: 1906 (1900s)
Authors: Heitzmann, Louis, 1864- (from old catalog)
Subjects: Urine Diagnosis
Publisher: New York, W. Wood and company
Contributing Library: The Library of Congress
Digitizing Sponsor: The Library of Congress

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may show transitional forms and are more or lessdistinctly colored. They always indicate an acute hemorrhagic process,and usually we find either hyaline or epithelial casts, or both, with them.Besides these, conglomerations of fibrin, the so-called fibrin casts, are oc-casionally found, but, properly speaking, they are not true casts. In therare cases of hemoglobinuria, irregular, dark casts, which appear granu-lar and are composed of disintegrated blood corpuscles—the so-calledhaemoglobin casts—may be quite abundant. 4. Granular Casts (see Fig. 68).—While the three varieties of castsjust described are always found in acute cases or fresh acute exacerbations 138 URINARY ANALYSIS AND DIAGNOSIS. of chronic inflammations, granular casts rarely appear in strictly acuteinflammations. As a rule, they are not formed until a number of weeksafter the beginning of the disease; but in some cases, especially in chil-dren in whom a nephritis develops after contagious diseases, such as scar-
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Fig. 67.—Blood Casts (X 500). C, Casts from convoluted tubules; N, from narrow tubules; S, from straight collecting tubules. let fever and diphtheria, they may be seen in small numbers one or twoweeks after the first symptoms of the nephritis have set in. Granular casts are either perfectly regular and have sharply definedcontours, or they are more or less curved, or appear curved at one sidewhile they are straight at the other. Their ends are either rounded orpartly broken, and they may be broader at one place and narrower inanother—a peculiarity especially pronounced in those from the narrow TUBULAR CASTS. 139 tubules. Their degree of refraction changes considerably, and they some-times appear yellowish, at other times colorless. The granulation of these casts varies to a great degree, some beingcoarsely granular, others finely granular, still others partly the formerand partly the latter. They may appear coarsely granular at both ends,

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