Experiments on kiesteine : with remarks on its application to the diagnosis of pregnancy : an inaugural dissertation for the degree of Doctor of Medicine / by Elisha K. Kane ; published by the recommendation of the Medical Faculty of the University of Pennsylvania.

  • Kane, Elisha Kent, 1820-1857.
Date:
[1842]
Catalogue details

Licence: Public Domain Mark

Credit: Experiments on kiesteine : with remarks on its application to the diagnosis of pregnancy : an inaugural dissertation for the degree of Doctor of Medicine / by Elisha K. Kane ; published by the recommendation of the Medical Faculty of the University of Pennsylvania. Source: Wellcome Collection.

Provider: This material has been provided by the National Library of Medicine (U.S.), through the Medical Heritage Library. The original may be consulted at the National Library of Medicine (U.S.)

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    The kiesteinic pellicle, when fully formed, has almost always a much greater degree of tenacity than the others: I have often, for purposes of microscopic examination, lifted large flakes entirely out of the urine; and when it was well defined, this was easily done: with the others it was never practica- ble. It seems also to be independent of putrefaction; it is not obscured for some time by the disorganization of the liquid on which it rests; and the characteristics which I have already described as accompanying its dis- appearance are very seldom simulated. The appearances which I have observed seem to point directly to the con- clusion, that the formation of the kiesteine is unconnected with the presence of extraneous pus or flocculent mucus. I was aware that these and other animal matters might under certain modifications give rise to a scum upon the surface, the cremor urinse of the older writers. This has been no- ticed by M. Becquerel, as especially observable in leucorrh(jea; and I have observed it very frequently, not only in that disease, but in cystitis, gonor- rhoRa, vaginal and uterine hemorrhages, and immediately after delivery when the lochial discharge was mingled with the urine. By the kindness of Dr. Stewardson, I have had the opportunity of seeing M. Becquerel's recent and very elaborate work on the Semeiology of Urines,* and I have been struck with the discrepancy between his observa- tions and my own in several particulars connected with this inquiry. After remarking that the urine is modified in its appearances by the con- stitutional changes incident to pregnancy, he says, that it often, especially in the latter period of gestation, grows palish, diminishes in density, containing less solid matter in solution, and partakes of the general anaemic character of the patient; and that it also often remains unchanged after exposure. Without attempting to deny the presence of the matter denominated kiesteine, he is not prepared to admit it, but refers to the influence of a certain quantity of mucus on decomposition as capable of producing the appearance which has been mistaken for it. I cannot avoid referring to the results of some experiments, which appear to me to be at variance with these suggestions. Many of the specimens which I examined had been first submitted to filtration, with a view of sepa- rating any mucus they might contain; yet in every case, the pellicle formed with the same regularity as when this precaution had not been resorted to. It was formed also on urine which, when treated with acetic acid, pre- sented no coagulation, and which underwent no change when treated while hot with alcohol. And in many cases, where the urine was withdrawn by the'catheter, and freed of course from the possibility of vaginal extermix- ture, the formation of the kiesteinic pellicle was uninterrupted. I can scarcely believe, that in such cases it was owing to the presence of the ex- traneous mucus. * Reviewed in tlie Number of this Journal for January last.