Clinical diagnosis : the bacteriological, chemical, and microscopical evidence of disease . ary greatly, their most characteristic property being their colour,and through it alone they may be readily recognised. They may be seenunder the microscope to dissolve in caustic potash, and can again bemade to crystallise in the rhombic form by neutralisation with hydro-chloric acicl. The murexide test (see Chapter I.) may be employed inappropriate cases for their detection. 2. Oxalate of Lime.—This substance crystallises in transparent,strongly refracting octahedra (envelope crystals), which are read
Clinical diagnosis : the bacteriological, chemical, and microscopical evidence of disease . ary greatly, their most characteristic property being their colour,and through it alone they may be readily recognised. They may be seenunder the microscope to dissolve in caustic potash, and can again bemade to crystallise in the rhombic form by neutralisation with hydro-chloric acicl. The murexide test (see Chapter I.) may be employed inappropriate cases for their detection. 2. Oxalate of Lime.—This substance crystallises in transparent,strongly refracting octahedra (envelope crystals), which are readilysoluble in hydrochloric and insoluble in acetic acid (Furbringer).109 The occurrence of isolated crystals of oxalate of lime (fig. 118) hasno clinical significance. They have been found in healthy urine, andtheir number may be greatly increased after the ingestion of foodcontaining a large proportion of oxalic acid, such as tomatoes, freshbeans, beetroot, asparagus, &c. On the other hand, oxaluria as a morbidstate cannot be measured by the use of the microscope alone, since the. Fig. i 18.— Oxalate of Lime from Sediment in a Case of Cystitis and Pyelonephritis(eye-piece III., objective 8A, Reichert). urine may contain a large proportion of oxalic acid, whilst neither it norits salts are precipitated as crystals. In such cases, the urine must beanalysed with a view to ascertaining the proportion of oxalic acid whichit contains. 3. Bilirubin and Hsematoidin.—Bilirubin is deposited in the urineeither in the amorphous form or in crystals. Crystals of bilirubin havea twofold character, occurring either as clusters of needles, or as minuterhombic tablets, and their colour ranges from yellow to a beautiful ruby-red. They are soluble in caustic soda, and on the application of a dropof nitric acid a green rim forms round them. Kussmaul110 has discoveredthese crystals in jaundice, and Ebstein m in pyelonephritis. Hcematoidin resembles bilirubin as closely in appearance as in its
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