A Manual of Clinical DiagnosisTodd, James Campbell
Science
A Manual of Clinical Diagnosis
Todd, James Campbell
Diagnosis, Laboratory
(2) Lange's Test.--This is a modification of the well-known Legal
test. It is more sensitive and gives a sharper end-reaction. To a
small quantity of urine add about one-twentieth its volume (1 drop for
each 1 c.c.) of glacial acetic acid and a few drops of fresh
concentrated aqueous solution of {86} sodium nitroprussid, and gently
run a little ammonia upon its surface. If acetone be present, a purple
ring will form within a few minutes at the junction of the two fluids.
(3) Trommer's Test.--This new test has proved very satisfactory in the
hands of the writer. The urine need not be distilled. Alkalinize about
10 c.c. of the urine with 2 or 3 c.c. of 40 per cent. caustic soda
solution, add 10 or 12 drops of 10 per cent. alcoholic solution of
salicylous acid (salicyl aldehyd), heat the upper portion nearly to
the boiling-point, and keep at this temperature five minutes or
longer. In the presence of acetone a purplish-red color appears in the
heated portion.
* * * * *
(2) Diacetic acid occurs in the same conditions as acetone, but is
less frequent and has more serious significance. In diabetes its
presence is a grave symptom and often forewarns of approaching coma.
It rarely or never occurs without acetone.
_Detection_.--The urine must be fresh.
* * * * *
(1) Gerhardt's Test.--To a few cubic centimeters of the urine add
solution of ferric chlorid (about 10 per cent.) drop by drop until the
phosphates are precipitated; filter and add more of the ferric
chlorid. If diacetic acid be present, the urine will assume a
Bordeaux-red color which disappears upon boiling. A red or violet
color which does not disappear upon boiling may be produced by other
substances, as phenol, salicylates, and antipyrin.
(2) Lindemann's Test.--To about 10 c.c. of urine add 5 drops 30 per
cent. acetic acid, 5 drops Lugol's solution, and 2 or 3 c.c.
chloroform, and shake. The chloroform does not change color if
diacetic acid be present, but becomes reddish-violet in its absence.
This test is claimed by its advocates to be more sensitive and more
reliable than Gerhardt's.
* * * * *
{87} (3) Oxybutyric acid has much the same significance as diacetic
acid, but is of more serious import. There is no satisfactory clinical
test for it.
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