. A manual of clinical diagnosis by means of microscopical and chemical methods, for students, hospital physicians, and practitioners . Inbreadth they vary between and mm. As a rule, thebreadth of a cast is uniform throughout its entire length, but speci- MICROSCOPICAL EXAMINATION OF THE URINE. 529 mens are not infrequently observed in which one end tapers con-siderably and presents a spirally twisted appearance. This may beso marked that the entire cast appears transversely striated. Itis generally supposed that this results from the adhesion of one endof the casl to the walls of a
. A manual of clinical diagnosis by means of microscopical and chemical methods, for students, hospital physicians, and practitioners . Inbreadth they vary between and mm. As a rule, thebreadth of a cast is uniform throughout its entire length, but speci- MICROSCOPICAL EXAMINATION OF THE URINE. 529 mens are not infrequently observed in which one end tapers con-siderably and presents a spirally twisted appearance. This may beso marked that the entire cast appears transversely striated. Itis generally supposed that this results from the adhesion of one endof the casl to the walls of a tubule, the lumen of which it does notfill, SO that the tree end becomes twisted in the downward dichotomous branching of one end is also at times seen in verybroad hyaline specimens. •• Fatty globules are found upon the surface of granular casts(Fig. 123), but they also form by themselves short, strongly refrac-tive easts, which are often beset all over with needles of fatty crys-tals. These, however, are not composed exclusively of fat, butprobably to some extent of lime and magnesium salts of the higher Fig. a, Fatty casts, b and c, Blood-casts, d, Free fatty molecules. (Roberts.) fatty acids and allied compounds, for they are not all soluble inether. They have their origin doubtless in fatty degeneration ofthe renal epithelium (v. Jaksch). Granules of melanin, indigo, and altered blood-pigment may attimes be observed in casts. Riedel regards the occurrence of dark-brown casts as pathognomonic of fractures. 2. The waxy casts (Fig. 124) may be divided into two groups—true waxy casts and amyloid easts ; but as the latter are not neces-sarily indicative of the existence of amyloid degeneration of the kid-neys, such a classification is at the present time at least of onlytheoretical interest. They are readily distinguished from the hyalineeasts by the characteristics mentioned above—L c, their higherdegree of refraction, their yellow or yellowish-gray colo
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