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Albumen in the urine is easily detected, as we have stated, by heating the urine in a test-tube over a spirit lamp. The solidified albumen forms a white cloud, which subsequently collects at the bottom of the test-tube as the urine cools. The same solidification of albumen in the urine takes place on adding a few drops of nitric acid. If the urine contains amorphous phosphatic salts, the action of heat may precipitate them, and cause the urine to become cloudy; but the addition of a few drops of nitric acid at once clears it with effervescence. Thus, in double testing for albumen, it is well to use heat first, and nitric acid secondly.

The presence of free sugar in the urine points to the existence of diabetes glycosuria, a mysterious malady, for its intimate nature is even yet a problem. As already stated, it appears to be more a disease of nutrition than a disease of the kidneys.

The specific gravity of diabetic urine is generally much increased, averaging from 1030 to 1040. The simplest and easiest applied test for sugar is the liquor potassæ test. Add an equal part of liquor potassæ to the suspected urine, mix by shaking, and heat one end of the test-tube over a spirit lamp. If there is sugar, the part heated to the boiling temperature will become of a reddish-brown, owing to the transformation of the sugar into glucic and melassic acids. The more sugar the more intense is the dark-red hue.

The copper test is also very generally used: add


a few drops of a solution of sulphate of copper to a drachm of urine and half a drachm of liquor potassæ, which will produce a pale-blue tint on agitation. Then boil, and if sugar is present, a yellow or red precipitate forms. Should albumen also be present, it must first be separated by heat.

Both these diseases, which terminate the lives of a considerable proportion of the members of the human family, are, in my opinion, too much studied per se, as individualities, as entities. I firmly believe that their development is generally preceded by years of defective nutrition and of morbid urinary deposits that is, by the existence of the very conditions described in this work. The kidneys, the liver, and the other organs, the functions of which are the same, act with more or less success as emunctories, as filters, during five, ten, or twenty years, in order to eliminate from the imperfectly-elaborated nutritive elements. they succumb, and serious, often fatal, disease



At last

When the various forms of chronic kidney disease are recognized by actual physical symptoms, when the actual functions of assimilation and disintegration become so faulty that sugar, in greater or less abundance, is thrown out by the kidneys, the mischief is done, and the resources of therapeutical treatment are of but slight avail. The time for real efficacious action is before this, in reality, final stage has been reached, when the conditions of

defective nutrition which I have described alone exist.

It is very desirable that the facts, which I have described in these pages, should be known and accepted by the profession. Were it generally recognized that defective nutrition, as evidenced by the habitual presence of urinary deposits, leads in the long run to fatal disease, and more especially to albuminuria and to diabetes, I believe that these diseases would not be so prevalent, would not terminate so many lives.

Many of my patients, companions, friends, have thus died, and I have known for years that they were on this fatal track; but, as in the case of Cassandra of old, my warnings were not heeded.

In concluding this chapter, I must repeat that I am convinced, from my own experience, that it is utterly impossible to rationally regulate the allimportant question of diet in ill-health and disease, without the information which can only be acquired by the examination of the urine and of its deposits. Divested of minute scientific development, that examination, as we have seen, is a most simple matter, and does not require any very extensive knowledge, either of chemistry or of the microscope. The greater the knowledge possessed, however, the more certain are the results obtained; and there is, therefore, every inducement to the student and to the practitioner to pursue their researches.




Food Requirements in Health.-In health and left to himself, man requires no rules to teach him how to select his food; an infallible instinct guides him to that which he requires to satisfy the wants of his organization. His nitrogenous tissues grow and waste from use, and in order to afford them the necessary materials of growth and repair, he instinctively seeks and consumes nitrogenous aliments, flesh and other animal substances, and those vegetables which, like bread, contain nitrogen in the greatest abundance. His body is always, in all climes, in all seasons, at a temperature of about 98°. To keep up this heat it requires fuel, carbon; so carbon is sought and consumed in the shape of vegetable substances, in that of oils and fats, and of alcoholic beverages.

Instinctively, as we have seen, man increases the supply of nitrogenous or carbonaceous food, or of both, according as pursuits, position, position, or climate

increases the organic demand for waste-repairing or for heat-creating materials. The habit of selfindulgence, the idleness and want of occupation which attend upon ample means, or the desire to drown care, one or all often lead to the ingestion of more food and of more alcoholic stimulants than are required. But these deviations from the law of nature, from the instinct which prompts man only to take the kind and the amount of food that his economy requires, do not invalidate the rule; indeed they rather confirm it, inasmuch as such deviations are followed, all but invariably, by disease and by organic ruin.

On the other hand, in the lower classes of the population, in uncivilized life, in sterile, mountainous, uncultivated countries, the food supply is often deficient. When this is the case, all the evils connected with imperfect nutrition from deficiency in food supply are developed.

Apart from such social conditions, when the supply of food is merely a question of will, healthy, rational individuals may safely be left to follow the dictates of their own wants and tendencies with regard both to the quality and quantity of their food; as these tendencies may be said to interpret their instinctive organic requirements. As I have already stated, food requirements and peculiarities vary, within such wide limits, in different individuals, that it is all but impossible to lay down any general rule as to the quantity of food required.

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