A Manual of Clinical DiagnosisTodd, James Campbell
Science
A Manual of Clinical Diagnosis
Todd, James Campbell
Diagnosis, Laboratory
_Detection of Glucose_.--If albumin be present in more than traces, it
must be removed by boiling and filtering.
* * * * *
(1) Haines' Test.--Take about 1 dram of Haines' solution in a
test-tube, boil, and add 6 or 8 drops of urine. A heavy yellow or red
precipitate, which settles readily to the bottom, shows the presence
of sugar. Neither precipitation of phosphates as a light flocculent
sediment nor simple decolorization of the reagent should be mistaken
for a positive reaction.
This is probably the best of the copper tests, all of which depend
upon the fact that in strongly alkaline solutions glucose reduces
copper oxid to lower grades of oxidation. They are somewhat
inaccurate, because they make no distinction between glucose and less
common forms of sugar; because certain normal substances when present
in excess, especially uric acid and creatinin, may reduce copper, and
because many drugs--_e.g._, chloral, chloroform, copaiba, acetanilid,
benzoic acid, morphin, sulphonal, salicylates--are eliminated as
copper-reducing substances. To minimize these fallacies dilute the
urine if it be concentrated, do not add more than the specified amount
of urine, and do not boil after the urine is added.
{78} _Haines' solution_ is prepared as follows: completely dissolve 30
gr. pure copper sulphate in ½ oz. distilled water, and add ½ oz. pure
glycerin; mix thoroughly, and add 5 oz. liquor potassæ. The solution
keeps well.
(2) Fehling's Test.--Two solutions are required--one containing 34.64
gm. pure crystalline copper sulphate in 500 c.c. distilled water; the
other, 173 gm. Rochelle salt and 100 gm. potassium hydroxid in
500 c.c. distilled water. Mix equal parts of the two solutions in a
test-tube, dilute with 3 or 4 volumes of water, and boil. Add the
urine a little at a time, heating, but not boiling, between additions.
In the presence of glucose a heavy red or yellow precipitate will
appear. The quantity of urine should not exceed that of the reagent.
[Illustration: FIG. 24.--Crystals of phenylglucosazone from diabetic
urine--Kowarsky's test. X500.]
(3) Phenylhydrazin Test.--_Kowarsky's Method_.--In a test-tube take 5
drops pure phenylhydrazin, 10 drops glacial acetic acid, and 1 c.c.
saturated solution of sodium chlorid. A curdy mass results. Add 2 or
3 cc. urine, boil for at least two minutes, and set aside to cool.
Examine the sediment with the microscope, using a two-thirds
objective. If glucose {79} be present, characteristic crystals of
phenylglucosazone will be seen. These are yellow, needle-like crystals
arranged mostly in clusters or in sheaves (Fig. 24). When traces only
of glucose are present, the crystals may not appear for one-half hour
or more. Best crystals are obtained when the fluid is cooled very
slowly. It must not be agitated during cooling.
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