URINE 455 



diphtheria, erysipelas, pleurisy, pneumonia, scarlet fever, syphilis, 

 typhus, etc. The administration of alcohol, chrysarobin, creosote, 

 cresol, dionin, guaiacol, heroin, morphine, naphthalene, opium, phenol, 

 tannic acid, etc., will also cause the urine to give a positive reaction. 

 The following chemical reactions take place in this test: 



(a) NaN0 2 +HCl->HN0 2 +NaCl. 

 NH 2 N 



(6) C 6 H 4 + HN0 2 ^C 6 H 4 N+ 2 H 2 0. 



\ \ / 



HSOs S0 3 



Sulphanilic acid Diazo-benzenesulphonic acid. 



2. MethyleneBlue Reaction (Russo). 1 To 5 c.c. of urine add 4 drops of a o.i per 

 cent solution of methylene blue. In cases of typhoid fever, measles, smallpox and 

 certain other disorders there will be a change in color from blue to green. In 

 normal urine the blue color persists. The test is sometimes used as a substitute 

 for the diazo reaction (see p. 454). 



PHENOLSULPHONEPHTHALEIN TEST FOR KIDNEY 

 EFFICIENCY 



This test for renal function was devised by Rowntree and Geraghty. 2 

 It depends upon the injection into the tissues of a dyestuff which 

 is eliminated rapidly by the normal kidneys, and can be easily estimated 

 quantitatively in the urine. 



This dyestuff, phenolsulphonephthalein, is non-irritative to the 

 body either when taken by mouth or when injected into the tissues, 3 

 so that it does no harm to an already weakened kidney. 



The patient upon whom the test is to be performed is given 300-400 

 c.c. of water 20-30 minutes previously, in order to assure a free flow 

 of urine. 



The procedure is as follows : One c.c. of a solution containing 6 mg. of phenol- 

 sulphonephthalein 4 is injected intramuscularly in the lumbar region, the time of 

 injection being noted. The patient is then catheterized and the urine as it forms 

 thereafter allowed to drop into a beaker containing 2 drops of 25 per cent NaOH. 

 The appearance of a red color in the alkalinized urine indicates beginning excre- 

 tion of the drug, the normal time being within 5 to 10 minutes after its injection. 



1 Russo: Riforma med. t No. 19, 1905. 

 Peskow: Semaine med., 103, 1912. 



da Pozzo: Gaz. Osp. Clin., 35, 865, 1914. 



2 Rowntree and Geraghty: Jour. Pharm. and Exper. Therap., i, 579, 1910: also Arch. 

 Int. Med., March, 1912, p. 284. 



3 Abel and Rowntree: Jour. Pharm. and Exper. Therap., i, 231, 1910. 



4 This solution is prepared by adding 0.6 gram phenolsulphonephthalein and 0.84 c.c. 

 of 2/N NaOH to enough 0.75 per cent NaCl solution to make 100 c.c. This gives the mono- 

 sodium or acid salt which is slightly irritant locally when injected. It is necessary to add 

 2-3 drops more 2/N NaOH which changes the color to a bordeaux red. This prepara- 

 tion is non-irritant. 



