CH. XXXVII.] 



ALBUMIN IN URINE. 



567 



(i) Heller's Jfiti'ic-aaid Tet.-~ Pour some of the urine gently on to the 

 surface of some nitric acid in a test-tube. A ring of white precipitate occurs 

 at the junction of the two liquids. This test is used for small quantities of 

 albumin. 



(<?) Extlnuitwn of Albumin by EibacK 1 * Albuminometer. Esbach's 

 reagent for precipitating the albumin is made by dissolving 10 grammes of 

 picric acid and 20 grammes of citric acid in 800 or 900 c.c. of boiling water 

 and then adding sufficient water to make up to a litre (1000 c.c.). 



The albuminometer is a test-tube graduated as shown in fig. 439. 



Pour the urine into the tube up to the mark U ; then the reagent up to 

 the mark R. Close the tube with a cork, and to ensure complete mixture, 

 tilt it to and fro a dozen times without shaking. Allow the corked tube to 

 stand upright twenty-four hours ; then read off on the scale the height of 

 the coagnlum. The figures indicate grammes of dried albumin in a litre of 

 urine. The percentage is obtained by dividing by 10. Thus, if the coagulum 

 stands at 3, the amount of albumin is 3 grammes per litre, or 0-3 gr. in 

 100 c.c. If the sediment falls between any two figures, the distance J, , or 

 } from the upper or lower figure can be read off with sufficient accuracy. 

 Thus, the surface of the sediment being midway between 3 and 4 would be 

 read as 3-5. When the albumin is so abundant that the sediment is above 

 4, a more accurate result is obtained by first diluting the urine with one or 

 two volumes of water, and then multiplying the resulting figure by 2 or 3, 

 as the case may be. If the amount of albumin is less than o'5 per cent., it 

 cannot be accurately estimated by this method. 



A condition called "peptonuria," or peptone in the urine, 

 is observed in certain pathological states, 

 especially in diseases where there is a forma- 

 tion of pus, and particularly if the pus is 

 decomposed owing to the action of a bac- 

 terial growth called staphylococcus ; one of the 

 products of disintegration of pus cells appears 

 to be peptone ; and this leaves the body by 

 the urine. The term " peptone," however, 

 is in the strict sense of the word incorrect; the 

 proteid present is deutero-prol eose. In the 

 disease called " osteomalacia " a proteose is also 

 usually found in the urine. This more nearly 

 resembles hetero-proteose in its properties. 



Sugar. Normal urine contains no sugar, 

 or so little that for clinical purposes it may 

 be considered absent. It occurs in the disease 

 called diabetes mellitus, which can be artificially 

 produced by puncture of the medulla oblongata, 

 or by extirpation of the pancreas. The disease 

 as it occurs in man may be due to disordered 

 metabolism of the liver, to disease of the pancreas, and to other 

 not fully understood causes (see p. 5 i o). 



The sugar present is dextrose. Lactose may occur in the urine 

 of nursing mothers. Diabetic urine also contains hydroxybutyric 



Fi. 439. Esbach'd 

 albuminometer. 



