. Physical diagnosis . 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 disease) as well asunder any of the conditions giv-ing rise to albuminuria (see page399). The
. Physical diagnosis . 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 disease) as well asunder any of the conditions giv-ing rise to albuminuria (see page399). They are usually morenumerous in acute nephritis andin the acute exacerbations ofchronic nephritis than in mostother conditions. Any type ofcast may occur in any type of nephritis, but Cellular,1 blood, and brown-granular casts are most often foundin acute nephritis. t 1 Cellular is a better term than epithelial, since we have no marks for recognizingrenal epithelium or for distinguishing a renal cell from a Fig. 222.—Casts. 1, Blood-casts; 2, fattycasts; 3, granular casts; 4, cellular casts. THE INTESTINE, SPLEEN, Klt>NEY 405 U r* Fig. Fatty, highly refracting, or dense casts most often predominatein chronic glomerular nephritis (diffuse or parenchymatousnephritis). Hyaline and granular casts may occur in any type of nephritisand in many other conditions (fatigue, renal stasis,etc.). In the urine of persons over fifty years of agethe presence of a few hyaline and granular casts hasno known clinical significance, and may probably beconsidered physiological. Periods occur in the course of many cases of \rchronic interstitial nephritis when no casts can be irr^o 0 (found. If any occur they are usually of the hyalineand fine granular types. 2. Free Cells in Urinary Sediment. A. Recogni-tion.—The presence of macroscopic pus or blood already alluded tomay be verified by the microscope. (a) Fresh red cells, lately freed from the blood-vessels, pres
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Keywords: ., bookcentury1900, bookdecade1910, booksubjectdiagnos, bookyear1912
