PHOSPRATURIA.
Definition. — The daily amount of phosphoric acid excreted with the urine amounts to 2 or 3 grammes; it is then combined with soda, potash, lime, and magnesia. Phosphaturia occurs when, soon after evacuation, a sediment is formed consisting of phosphates of lime and magnesia. In some cases the urine is already turbid when evacuated. Etiology and Pathology. — Phospha turia is sometimes observed during the course of diabetes. As it was formerly ascribed to defective metabolism, it was believed to be the cause of many nerv ous symptoms. This view, however, has recently been doubted by many authors. Phosphaturia is not necessarily due to an excessive formation and excretion of phosphoric acid, but is caused by a diminution of the acidity of the urine, such as that observed in neurasthenic individuals. In some cases it is due to the composition of the food; in other cases, perhaps, to an abnormal acidity of the gastric juice. Treatment.—Phosphaturia per se does not need any special treatment, and will ordinarily cease when the alimentation is properly regulated.
Following method recommended for separating the alkaline and earthy phos phates of urine: 30 cubic centimetres (1 fluidounce) of urine and 30 cubic centimetres (1 fluidounce) of a 5-per cent. solution of caustic soda are mixed and allowed to stand for twenty-four hours, when 30 cubic centimetres (1 fluidounce) of the clear liquid remain ing is poured out, free from earthy phos phates. To this is added 2 cubic centi metres (31 minims) of a 30-per-cent. so lution of acetic acid to neutralize the soda and 5 cubic centimetres flui drachms) of a solution of acetic acetate (50 ounces—of acetate of sodium, 50 ounces—of acetic acid, water to make 1 litre—quart) heated to 60° C. (140° F.) and titrated
with uranium. For the balance of the liquid, 2 cubic centimetres (31 minims) of acetic-acid solution and 5 cubic centi metres (1 fluidrachms) of acetic ace tate are also used to dissolve the earthy phosphates and place it in identical con ditions of acidity for titration. Richard (Jour. de .M6d., de Chir., et de Pharm., Nov. 11, '93).
Certain albuminurias connected with functional disturbances of nutrition, which may be cured or may end in a renal lesion, are separated from Bright's disease. Its characteristic is organic de mineralization. This phosphaturic albu minuria comprises four varieties: (a) simple phosphaturic albuminuria, con founded with cyclical, or intermittent, albuminuria; (b) pseudoneurasthenic phosphaturic albuminuria; (c) pseudo brightique or prebrightique phosphaturia, confounded with interstitial nephritis; (d) albuminuria of Bright's disease of phosphaturic origin. A. Robin (Bull. de l'Acad. de Med. de Paris, Dec. 19, '94).
Phosphaturia is met with: 1. In cases where there is digestive or nervous dis turbance, the phosphatic urine indicat ing a diminution of the acidity; though this may be called phesphaturia from a chemical stand-point, the term is not precise clinically. 2. In severer and long continued cases, corresponding to phos phaturic diabetes insipidus. Here also there are no definite clinical conditions. Thorndike (Boston Med. and Surg. Jour., Feb. 8, '94).