496 



ALBUMIN IN THE URINE. 



min would be coagulated. Only small amounts of clear urine should be employed 

 in making the tests for albumin. Turbid urine, therefore, should first be filtered. 

 The quantitative estimation of albumin is made as follows: 100 cu. cm. of 

 urine, if necessary after addition of a small amount of acetic acid, are heated 

 in a dish to the boiling-point, with the result that the albumin is precipitated 

 as a flocculent deposit. The precipitate is collected upon a weighed, ash-free 

 filter, dried at 110, and it is washed repeatedly with hot water, then with alcohol, 

 and is thoroughly dried in the air-bath at 110. The dried filter is now weighed, 

 and the weight of the filter is deducted. Finally, the filter with the albumin is 

 reduced to ash in a weighed platinum crucible, and the weight of the ash is sub- 

 tracted. 



For the estimation by the polarization-apparatus, reference may be made 

 to p. 268. 



By means of Esbach's albuminimeter. A glass cylinder is filled with urine 

 to the mark U, and with the albumin-precipitating reagent (20 parts of citric 

 acid, 10 parts of picric acid, 970 parts of water) to the mark 

 R, and is then closed with a stopper and agitated. After the 

 lapse of twenty-four hours (at room-temperature) the coagu- 

 lated albumin will have settled to the bottom. The divisions 

 of the scale on the glass indicate the number of grams of albu- 

 min in 1000 grams of urine. The urine must have an acid 

 reaction, be fresh, and its specific gravity should not be too 

 high. The presence of an excessive amount of albumin also 

 may therefore require dilution of the urine with from 2 to 4 

 times as much water. The amount of albumin obtained is 

 then naturally to be multiplied by 2 or 4. 



Globulin has been found almost exclusively in albuminous 

 urine; and, indeed, in the majority of cases. To demonstrate 

 its presence, 50 cu. cm. of albuminous urine are rendered 

 feebly alkaline with potassium hydrate, and powdered magne- 

 sium sulphate is added to an amount approximating some- 

 what more than 24.11 per cent. If exposed to a warm tem- 

 perature, all of the globulin is precipitated in the course of 

 twenty-four hours, and it can be filtered out, dried, and 

 weighed. With this the total amount of albumin should be 

 compared. The presence of globulin is of unfavorable prog- 

 nostic significance. Its amount is diminished by favorable 

 circulatory conditions in the kidney. 



Propeptone (Albumose). Peptone does not occur in the 

 urine. What has previously been described as such is pro- 

 peptone. The latter occurs sometimes in acid, albuminous 

 urine; rarely, also, in urine free from albumin. Maixner 

 found it constantly in connection with all suppurative dis- 

 orders, empyema, peritonitis, pneumonia, meningitis, ulcer- 

 ative affections of the digestive tract, etc. pyo genie propcp- 

 tonuria. Albumose is always present also in pus, and propep- 

 tonuria is a sign of the destruction of pus-corpuscles. It oc- 

 curs further in connection with increased retrogressive or de- 

 structive processes in tissues rich in albumin; as, for instance, 

 in the presence of carcinoma and of fever. In the same category probably belongs 

 also its constant occurrence in the puerperium; often, also, during pregnancy, when 

 the fetus has died and is undergoing putrefaction puerperal propcptonuria. Pro- 

 peptone is found, also, when the urine contains semen. 



Demonstration. Ten cu. cm. of urine are heated with 8 grams of ammo- 

 nium sulphate until the latter is dissolved. Then the hot fluid is centrifugated 

 for a minute. The fluid is decanted, the residue rubbed up with 97 per cent, 

 alcohol for the removal of the urobilin, then dissolved in a small amount of water, 

 and boiled and filtered. The filtrate is subjected to the biuret-test. When the 

 urine contains hematoporphyrin, it is advisable to precipitate this first with barium 

 chlorid. 



Egg-albumin appears after generous ingestion of fluid egg- albumin, as well 

 as after injection into the tissues or into the blood-stream. 



Mucus is present in association with catarrhal conditions of the urinary organs, 

 particularly of the bladder. Microscopically, the presence of numerous leukocytes 

 is noteworthy. As these contain albumin the intensity of the reaction for albumin 

 will vary with their abundance. The characteristic reagent for mucus, however, 



FIG. 156. Esbach's Al- 

 buminimeter. 



