A Manual of Clinical DiagnosisTodd, James Campbell
Science
A Manual of Clinical Diagnosis
Todd, James Campbell
Diagnosis, Laboratory
Acetanilid and Phenacetin.--The urine is evaporated by gentle heat to
about half its volume, boiled for a few minutes with about one-fifth
its volume of strong hydrochloric acid, and shaken out with ether. The
ether is evaporated, the residue dissolved in water, and the following
test applied: To about 10 c.c. are added a few cubic centimeters of 3
per cent. phenol, followed by a weak solution of chromium trioxid
(chromic acid) drop by drop. The fluid assumes a red color, which
changes to blue when ammonia is added. If the urine is very pale,
extraction with ether may be omitted.
Antipyrin.--This drug gives a dark-red color when a few drops of 10
per cent. ferric chlorid are added to the urine. The color does not
disappear upon boiling, which excludes diacetic acid.
Arsenic.--_Reinsch's Test_.--Add to the urine in a test-tube or small
flask about one-seventh its volume of hydrochloric acid, introduce a
piece of bright copper-foil about one-eighth-inch square, and boil for
several minutes. If arsenic be present, a dark-gray film is deposited
upon the copper. The test is more delicate if the urine be
concentrated by slow evaporation. This test is well known and is
widely used, but is not so reliable as the following:
_Gutzeit's Test_.--In a large test-tube place a little {96}
arsenic-free zinc, and add 5 to 10 c.c. pure dilute hydrochloric acid
and a few drops of iodin solution (Gram's solution will answer), then
add 5 to 10 c.c. of the urine. At once cover the mouth of the tube
with a filter-paper cap moistened with saturated aqueous solution of
silver nitrate (1:1). If arsenic be present, the paper quickly becomes
lemon-yellow, owing to formation of a compound of silver arsenid and
silver nitrate, and turns black when touched with a drop of water. To
make sure that the reagents are arsenic-free, the paper cap may be
applied for a few minutes before the urine is added.
Atropin will cause dilatation of the pupil when a few drops of the
urine are placed in the eye of a cat or rabbit.
Bromids can be detected by acidifying about 10 c.c. of the urine with
dilute sulphuric acid, adding a few drops of fuming nitric acid and a
few cubic centimeters of chloroform, and shaking. In the presence of
bromin the chloroform, which settles to the bottom, assumes a yellow
color.
Iodin--from ingestion of iodids or absorption from iodoform
dressings--is tested for in the same way as the bromids, the
chloroform assuming a pink to reddish-violet color. To detect traces,
a large quantity of urine should be rendered alkaline with sodium
carbonate and greatly concentrated by evaporation before testing.
Lead.--No simple method is sufficiently sensitive to detect the traces
of lead which occur in the urine in chronic poisoning. Of the more
sensitive methods, that of Arthur Lederer is probably best suited to
the practitioner:
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