A Manual of Clinical DiagnosisTodd, James Campbell
Science
A Manual of Clinical Diagnosis
Todd, James Campbell
Diagnosis, Laboratory
This is an excellent test for clinical work. It requires slightly more
time than Haines' test, but more than compensates for this by
increased accuracy. It is fully as sensitive as Haines', and has
practically no fallacies excepting levulose, which is a fallacy for
all tests but the polariscope. Other carbohydrates which are capable
of forming crystals with phenylhydrazin are extremely unlikely to do
so when the test is applied directly to the urine by the method just
detailed. Even if not used routinely, this test should always be
resorted to when Haines' test gives a positive reaction in doubtful
cases.
* * * * *
_Quantitative Estimation_.--In quantitative work Fehling's solution,
for so many years the standard, has been largely displaced by Purdy's,
which avoids the heavy precipitate that so greatly obscures the
end-reaction in Fehling's method. The older method is still preferred
by many, and both are, therefore, given. Should the urine contain much
glucose, it must be diluted before making any quantitative test,
allowance being made for the dilution in the subsequent calculation.
Albumin, if present, must be removed by acidifying a considerable
quantity of urine with acetic acid, boiling, and filtering. The
precipitate should then be washed with water and the washings added to
the urine to bring it to its original volume.
* * * * *
(1) Purdy's Method.--Take exactly 35 c.c. of Purdy's solution in a
flask or beaker, add twice its volume of distilled {80} water, heat to
boiling, and, still keeping the solution hot, add the urine very
slowly from a buret until the blue color entirely disappears. Read off
the amount of urine added; considering the strength of Purdy's
solution, it is readily seen that this amount of urine contains 0.02
gm. of glucose, from which the amount in the twenty-four-hour urine,
or the percentage, can easily be calculated. Example: Suppose that
2.5 c.c. of urine discharged the blue color of 35 c.c. of Purdy's
solution. This amount of urine, therefore, contains exactly 0.02 gm.
glucose, and the percentage is obtained from the
equation: 2.5:100 :: 0.02:_x_, and _x_ equals 0.8 per cent. If, then,
the twenty-four-hour quantity of urine were 3000 c.c., the
twenty-four-hour elimination of glucose would be found as follows:
100:3000 :: 0.8:_x_, and _x_ equals 24 gm.
It will be found that after the test is completed the blue color
slowly returns. This is due to reoxidation, and should not be mistaken
for incomplete reduction.
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