A Manual of Clinical DiagnosisTodd, James Campbell
Science
A Manual of Clinical Diagnosis
Todd, James Campbell
Diagnosis, Laboratory
(_c_) _Decomposition of exudates_ anywhere in the body, as in empyema,
bronchiectasis, and large tuberculous cavities.
{64} _Detection of indican_ depends upon its decomposition and
oxidation of the indoxyl set free into indigo-blue.
* * * * *
Obermayer's Method.--In a test-tube take equal parts of the urine and
Obermayer's reagent and add a small quantity of chloroform. Mix by
inverting a few times; avoid shaking violently. If indican be present
in excess, the chloroform, which sinks to the bottom, will assume an
indigo-blue color. The depth of color indicates the comparative amount
of indican if the same proportions of urine and reagents are always
used. The indican in normal urine may give a faint blue by this
method. Urine of patients taking iodids gives a reddish-violet color,
which disappears upon addition of a few drops of strong sodium
hyposulphite solution. Bile-pigments, which interfere with the test,
must be removed (p. 48).
_Obermayer's reagent_ consists of strong hydrochloric acid (sp. gr.,
1.19), 1000 parts, and ferric chlorid, 2 parts. This makes a yellow,
fuming liquid which keeps well.
* * * * *
4. Urea.--From the standpoint of physiology urea is the most important
constituent of the urine. It is the principal waste-product of
metabolism, and constitutes about one-half of all the solids
excreted--about 30 gm. in twenty-four hours. It represents 85 to 90
per cent. of the total nitrogen of the urine, and its quantitative
estimation is a simple, though not very accurate, method of
ascertaining the state of nitrogenous excretion. Normally, the amount
is greatly influenced by exercise and diet.
Pathologically, urea is increased in fevers, in diabetes, and
especially during resolution of pneumonia and absorption of large
exudates. Other factors being equal, the amount of urea indicates the
activity of metabolism. In {65} this connection the relation between
the amounts of urea and the chlorids is important. The amount of urea
is normally about twice that of the chlorids. If the proportion is
much increased above this, increased tissue destruction may be
inferred, since other conditions which increase urea also increase
chlorids.
[Illustration: FIG. 19.--Crystals of nitrate of urea (upper half) and
oxalate of urea (lower half) (after Funke).]
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