A system of practical medicine. By American authors. Vol. 4 : $b Diseases of the genito-urinary and cutaneous systems. Medical ophthalmology, and otology — John Shaqi
A system of practical medicine. By American authors. Vol. 4 : $b Diseases of the genito-urinary and cutaneous systems. Medical ophthalmology, and otology
Science
A system of practical medicine. By American authors. Vol. 4 : $b Diseases of the genito-urinary and cutaneous systems. Medical ophthalmology, and otology
Medicine -- Practice
Human hæmoglobinuria may be the result of various pathological
conditions, among which may be mentioned some infectious diseases,
jaundice, burns, and the effects of many poisons, as well as the
transfusion of sheep's blood.
Intermittent hæmoglobinuria, which is attended with fever, is usually
the result of cold acting upon predisposed persons. The color of the
urine and of the coagulum, together with the absence of red corpuscles
under the microscope, will distinguish urine of this character from
others which are also coagulable by heat.
Several methods are in use for the detection of albumen. Of these,
boiling is perhaps the oldest and most generally employed, and if
conducted with due care is a very delicate and useful test. The urine
to be tested should be clear and slightly acid, when on boiling the
albumen, if present, will be precipitated in whitish flocculi, more or
less abundant according to the amount, or, if the quantity is very
small, as a turbidity. The flocculi soon settle to the bottom of the
tube when it cools, and the thickness of the deposit formed gives an
approximation to a quantitative estimate. It is to the proportionate
thickness of this deposit that the terms 30 or 50 per cent. of albumen
are commonly but incorrectly applied. If the quantity is very small, it
may not be distinctly perceptible until after cooling.
If alkaline or very slightly acid urine is boiled, a deposit of
phosphates will be thrown down which closely resembles that from
albumen, while, on the other hand, the albumen remains undissolved
unless in large amount. These deposits of phosphates differ a little in
appearance from {36} an albuminous one, but in order to be accurate
acetic or nitric acid should be added, drop by drop, to the hot urine,
when the phosphates will be redissolved and the albumen, if present,
precipitated. It is better, however, to add the acid cautiously to the
point of slight acidity before boiling. A recent work[14] gives the
following directions for this reaction, which is then "absolutely
conclusive and surpassed in delicacy by no other:" "The urine is first
made distinctly acid with some drops of acetic acid, and then about
one-sixth of its volume of a concentrated solution of chloride of
sodium or sulphate of sodium or magnesium added. If the urine contains
albumen, a precipitate of coarser or finer flakes appears on boiling."
This reaction may be used as a quantitative test by diluting and
acidifying, if necessary, a known quantity of urine, washing the
precipitate on a weighed filter, drying, and weighing the whole.
[Footnote 14: _Die Lehre vom Harn_, Salkowski und Leube.]
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