. Physical diagnosis . stals; (d) animal parasites or their eggs. 1. —Casts, or moulds of the renal tubules, may be homo-geneous and transparent (hyaline, Fig. 221, 1) or may have attachedto this matrix a variety of granules, cells, crystals, or fat drops. Ac-cording to the variety of passengers carried down from the kidney onthe casts, we call them granular, brown-granular, cellular, blood, fatty, orcrystal-bearing casts (see Fig. 221, 2 and 3, and Fig. 222, 1, 2, 3, and 4). Dense or highly refraclile casts, colorless or straw colored, areoccasionally seen, and are often given a variet
. Physical diagnosis . stals; (d) animal parasites or their eggs. 1. —Casts, or moulds of the renal tubules, may be homo-geneous and transparent (hyaline, Fig. 221, 1) or may have attachedto this matrix a variety of granules, cells, crystals, or fat drops. Ac-cording to the variety of passengers carried down from the kidney onthe casts, we call them granular, brown-granular, cellular, blood, fatty, orcrystal-bearing casts (see Fig. 221, 2 and 3, and Fig. 222, 1, 2, 3, and 4). Dense or highly refraclile casts, colorless or straw colored, areoccasionally seen, and are often given a variety of names quite un-justified by any knowledge of their composition (, waxy,2fibrinous, etc.). 1 Though I have here described casts first I believe that the finding of blood or pus inthe sediment is of far more frequent and more considerable importance. 2 Some dense, refractile casts give the amyloid reaction, but this does not indicateamyloid kidneys and has no known clinical significance. 404 PHYSICAL DIAGNOSIS. Fig. 22i.—Casts, i, Hyaline casts; 2 and 3,hyaline casts with cells and blood adherent; 4,cylindroids. From strands of mucus, foreign bodies, and other sources of error,true casts may be distinguished by the following traits :(a) Their sides are parallel. (6) One end is rounded;sometimes both ends. Red corpuscles and othercells upon casts are to berecognized—the former bythe size, shape, and, iffresh, by their color (palestraw); the latter by thepresence of a nucleus. Fat drops are sphericaland very highly refractile,so that they seem to havea black line at their per-iphery. Crystals can be recog-nized by their angles. Theyare very rarely of importance. When showers of oxalate crystals inlarge masses are associated with attacks of hgematuria not otherwiseexplained, the crystals may beof some etiological significance. Other bodies on casts arecalled granules. Significance of Casts.—Casts may occur in health (un-less we choose to class muscularfatigue as dis
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Keywords: ., bookcentury1900, bookdecade1910, booksubjectdiagnos, bookyear1912
