Definition.—Chyle in the urine.
Etiology.—This very rare and interesting condition in temperate regions is due to lymphatic connection with the urinary passage. In the tropics it is due to parasitic origin and caused by rupture of the renal lymph vessels, which become obstructed and weakened by the filaria sanguinis hominis.
Symptoms.—There are no subjective symptoms. The urine has a milky appearance. If there is a large amount of chyle present, the fat particles rise to the top, forming a pellicle on the surface, while the fibrin settles to the bottom, forming clots. If ether be added to the urine, and the mass agitated, the fatty particles give way, the urine becoming clear. Since the chyle contains serum-albumin, it will respond to the same tests for that substance.
Microscopic examination reveals myriads of small, bright, round granules, similar to those of milk, which will dissolve in ether.
Diagnosis.—This is made by the milky appearance and the condition of the urine already noted.
Prognosis.—This is unfavorable as to a permanent cure, and though the urine may be clear for a time, yet, after a varying interval, new lymphatics rupture, and the urine again shows the milky appearance.
Treatment.—As yet no satisfactory treatment has been found for chyluria. Such dietetic and hygienic measures should be used as will add tone to the general health. Change of climate may, by adding new vigor, bring about a cure.