. Medical diagnosis for the student and practitioner. ate. (After Jakob.) (d) Uric Acid.—Uric acid may be precipitated from any urine, if con-centrated, during the so-called acid fermentation or in hot weather when the 234 MEDICAL DIAGNOSIS Cayennepepper deposit, high temperature prevents precipitation of the urates. Excessive acidity andconcentration or a pathologic excess may occur in certain conditions, but,when passed, urine should never contain the crystals as a precipitate. Themacroscopic deposit resembles cayenne pepper. The microscopic appearance: is best shown by the plate (see Fig. 7
. Medical diagnosis for the student and practitioner. ate. (After Jakob.) (d) Uric Acid.—Uric acid may be precipitated from any urine, if con-centrated, during the so-called acid fermentation or in hot weather when the 234 MEDICAL DIAGNOSIS Cayennepepper deposit, high temperature prevents precipitation of the urates. Excessive acidity andconcentration or a pathologic excess may occur in certain conditions, but,when passed, urine should never contain the crystals as a precipitate. Themacroscopic deposit resembles cayenne pepper. The microscopic appearance: is best shown by the plate (see Fig. 71). (e) Calcium Oxalate.—This rarely forms a visible sediment and is ab-normal if found in urine freshly passed. The crystals are characteristicand unmistakable (see Fig. 69). Leucin, tyrosin, and cystin are rarely seen,but may be readily recognized by comparison with the illustrations (seeFigs. 72, 75). (J) Calcium Carbonate.—This is occasionally precipitated with theearthyphosphates. Usually it is amorphous but occasionally it forms crystals. Fig. Ammonium urate. Effervescence. Normal Easilyoverlooked. Crenation. shaped like a dumb-bell. It is easily recognized by the effervescenceproduced when a mineral acid is added (Fig. 73). (g) Blood.—Erythrocytes.—The blood as it appears in the urine may bequite normal in appearance or, on the other hand, be so changed as to makeits recognition difficult. If hemorrhage has taken place in the urethra, pros-tate, bladder, ureters or in the pelvis of the kidney, and the urine is acid andfresh, the red corpuscles appear as yellow biconcave discs, with rounded edgesand a light central portion. Phantom Cells.—If, on the other hand, the hemorrhage has taken placeinto the cortical portion of the kidney, the urine has stood for some hoursor is alkaline, the corpuscles may become pale and swollen, their diameterlessened and they may appear as mere shadowy circles and as such are easilyoverlooked. Crenation of the normal c
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