Various urinalyses were performed during sufficient lengths of time on a larger number of subjects considered to be normal. For each test, an average value was thus obtained. This average value served as a reference line for the curves traced with the data obtained from the subjects. The study of these curves has permitted us to recognize several characteristic patterns. Under conditions considered normal, the curves were seen to pass from one side to the other on this average line with relatively wide variations. When an abnormality existed, the various urine analyses were characterized by a curve with only small variations, fixed on one or the other side of the average line. For each test, two such characteristic abnormal patterns are encountered. Fig. 44 shows the curves of different tests passing from one side to the other of the respective average lines as corresponding to a normal subject. Figures 45 to 51 show several examples of two opposite patterns for the various tests used such as urinary pH, specific gravity, surface tension, chloride index and sulfhydryl index.

Fig. 44. Curves of different analyses of daily urine samples of a normal 40-year old male. For each kind of analysis, the corresponding average value was calculated from the measurements obtained in more than one hundred normal subjects. The curves are seen to pass from one to the other side of the lines corresponding to the respective average values. A certain correspondence is seen for the changes which take place at the same time in these curves. Parallel variations are seen between specific gravity and chloride index, while opposite to those for the pH and surface tension.

Fig. 45. Curves of the values of the urinary pH followed during 50 days in five subjects. The curve (a) corresponds to a normal individual while the other four (b, c, d, e) to subjects with different cancerous lesions. For the normal case, the values pass above and below the 6.2 value which is considered as the average computed values obtained from normals. For the abnormal cases, the curves which show little variations are fixed at one or the other side of the average line. For case (b), an adenocarcinoma of the ovary, and case (c), a bronchogenic cancer, the curves are fixed below the average line. For case (d), with a bronchogenic cancer, and case (e). a cancer of the breast with generalized metastases, the curves are above this average line.

Fig. 46. Urinary pH values of a patient with a cancer of the prostate and multiple bone metastases measured in two daily urine samples for a period of more than 1 1/2 years, remain fixed below the average value—6.2—independent of the changes in diet and of various therapeutic attempts. With the progression of the disease, the fixation of the pH at low values becomes more apparent.

Fig. 47. Curve of the values ot the urinary specific gravity in a case of cancer of the breast, with the values fixed above 1016 which is considered as an average value for the specific gravity as computed from a series of measurements in normals.

Fig. 48. The values of the urinary specific gravity in a case of cancer of the breast, are the whole time below the average value of 1016.

Fig. 49. The urinary surface tension remains constantly fixed above the average value of 68 for more than a year in a case of cancer of the urethra.

Fig. 50. The urinary sulfhydryl index remains below the average value of 1.5, in a case of cancer of the breast, with bone metastases.

Fig. 51. The urinary sulfhydryl index remains above the average value of 1.5 in a case of hypernephroma with lung metastases.