Topic on URINE:

-PHYLLIS SPEIGHT

Urine is the excretion produced by the kidneys, and consists chiefly of waste substances resulting from the activity of the body. The urine and the perspiration are to a great extent interdependent; thus, if the kidneys are acting vigorously, there is very little perspiration, whilst if there has been much perspiration, as in fevers, the urine is small in amount and highly concentrated. When the kidneys are diseased, the sweat glands of the skin function more freely.

In composition, urine is made up almost entirely of water, only about 4 per cent being solids in solution. Urea is the most important of the solids, but there are also minute quantities of common salt, phosphates and sulphates combined with potassium, sodium, calcium and magnesium.

In health, the urine is of a light colour. In diseases of the kidneys, such as diabetes and chronic Bright’s disease, the urine assumes a very pale colour ( the same appearance is, of course, produced after a person had drunk large quantities of water). When blood is present the colour may be pinkish or even bright red according to the amount of haemorrhage, and transparency is lost. Deposits of urates in the urine also give a deep tint and the urine appears cloudy. Where there is any involvement of the liver, bile may be passed when the urine takes on a greenish tint.

The amount of urine passed daily is increased in some diseases notably diabetes and chronic Bright’s disease. Feverish conditions and heart diseases cause the amount to be less than normal. Complete stoppage may occur for a time in feverish conditions of children, but in an adult such a state is very serious. When the stoppage is due to a blockage of the ureters by stones, or stricture of the urethra, the secretion by the kidneys still continuing, the condition is known as retention. When the stoppage is due to failure of the kidneys to secrete any urine, the condition is known as suppression or anuria.

Healthy urine has a faint ammoniacal smell, but when it begins to decompose the smell greatly increases and becomes unpleasant. In diabetes the urine has an aroma similar to that of new mown hay. If such a symptom is noted a Homoeopathic Physician should be consulted at once.

In healthy urine there is usually a fleecy deposit of mucus secreted by the mucous membrane of the urine passages. A pink or yellow deposit, that settles as soon as the urine begins to cool which often leaves a stain upon the utensil in which the urine has stood, is due to urates (uric acid). Uric acid itself, when present, falls in very scanty yellow or brownish grains. A white deposit that collects upon the bottom of the utensil after the urine has stood undisturbed for some time may be due to phosphates, pus, or debris from diseased kidneys knows as tube- casts.

Many unusual substances taken into or formed in the body are excreted in the urine. Among these various drugs, disease poisons, bacteria and parasites, but these can only be traced by skilled chemists. Important from the diagnostic viewpoint, how ever, is the presence in the urine of one of the following: 1) Albumen, 2) Blood, 3) Sugar, 4) Pus and Tube-casts, 5) Bile and 6) Acetone.

Albumen: Present in most kidney diseases, weakening of the heart action, during fever, and in severe anaemia.

It should be noted that in young, active persons there is often a slight degree of albuminuria after exercise, but this is quite normal and if a specimen of urine is taken after rest, e.g. first thing in the morning, no albumen is found.

Blood: Found in acute kidney disease, congestion of the kidneys, or when a stone, ulcer or tumour is present in any of the urinary organs.

Sugar: A sign of diabetes mellitus when it is present constantly in the urine. A diet containing much sugar will cause temporary passing of sugar, but this is to be expected and is of no consequence.

Pus and Tube-casts: Indicate inflammation or ulceration somewhere in the urinary passages. Pus alone generally signifies that the bladder is affected. Tube-casts always point to involvement of the kidneys.

Bile: Signifies that the bile ducts are obstructed, and bile is being absorbed into the blood. Usually a degree of jaundice will be noticeable in the person.

Acetone: May appear in cases if diabetes and general acidosis.

The Appetite In disease the appetite may become quite depraved with cravings for particular substances and repugnance to others. Such cravings and aversions are very important in the evaluation of symptoms from the Homoeopathic point of view.

There are, however, two chief disorders which deserve special mention, viz: 1) An excessive increase in appetite, and 2) Diminution or loss of appetite.

Excessive appetite may be a bad habit, due to habitual over- indulgence in food, leading to obesity and gouty conditions etc. Where this is elicited in the case history, the necessary advice should be given and an attempt made to guide the patient back to a sensible and more restricted diet. It should be made clear to the patient suffering from excess weight, caused by over- indulgence at the table, that he is placing an ever increasing strain upon his heart and other organs. Often sciatica pains of great intensity are entirely relieved in obese persons by reduction of excess weight.

Excessive appetite is sometimes a sign of acid dyspepsia and diabetes. With the latter there is often an intense thirst and in spite of the increased intake of food and drink the person becomes progressively more emaciated.

Diminished appetite is usually found in all diseases which cause general weakness, because the activity of the stomach and the secretion of gastric juices are impaired when vitality is low. Where the appetite is completely lost but there is a corresponding increase in thirst, fever is usually indicated.

Thirst Thirst, like appetite, is instinctive and means that liquid is necessary for the continuance of bodily activity. In the majority of cases continued thirst indicates fever or inflammation but it may be present in other conditions where a considerable amount of fluid has been lost in the body. Such conditions arise in complaints such as diarrhoea, or after a severe loss of blood.

Thirst may be experienced in acid conditions such as dyspepsia, but usually there will be acid eructations from the stomach as well.

A desire for water is also a feature of any condition of great exhaustion.

Should there however, be no apparent cause for great thirst especially if accompanied by increased heat or dryness of the skin, it can be inferred that it arises from internal heat and is consequently a symptom of fever.