UROBILIN AND UKOBILINOGEN 16Y 



of urine are added to 10 c.c. of saturated alcoholic zinc acetate solution and 

 filtered. One c.c. of Ehrlich's solution is added to 10 c.c. of the filU^te. 

 The reaction is allowed to progress in the dark for one-half hour. The 

 solution is then diluted until the respective spectral absorption bands of 

 urohilin and urobilinogen just disappear. Tlie dilutions required give the 

 value for 5 c.c. of urine. If this figure Is multiplied by the factor, 



volume of urine c.c. 



the number of dilutions for the 24 hours is obtained. 



o 



The feces are ground with water and made to a definite volume. An 

 aliquot portion is extracted with 3 volumes of acid alcohol and then 

 treated with zinc acetate and Ehrlich's reagent. The steps that follow and 

 the computation are similar to those described for the urine. The average 

 normal excretion in the stool per day is about 6,500 dilutions (Wilbur 

 and Addis). Schneider (a) (1916) determines the urobilin in the duo- 

 denal contents by mixing 10 c.c. with 10 c.c. of the zinc acetate solution, and 

 then filtering. (One drop of ammonia is added to the filtrate if it is not 

 already alkaline.) One c.c. of Ehrlich's reagent is added to 10 c.c. of 

 the filtrate. The dilutions are expressed in terms of 1,000 c.c. of bile. 



Clinical Significance 



An increased amount of urobilin in the urine is frequently observed 

 in diffuse involvement of the liver as a result of fatty or paren- 

 chymatous degeneration, cirrhosis, new growth, abscess or even in the 

 congestion due to heart disease. Wilbur and Addis record a daily 

 excretion of from 1,100 to 3,000 dilutions of urobilin in the urine of 

 patients suffering from cirrhosis, hemochromatosis or liver abscess. Owing 

 to the variability of urobilin excretion in the urine it is desirable to con- 

 tinue the determinations over several days. Urobilinuria is quite common 

 in the infectious diseases that produce degeneration of the liver as scarlet 

 fever, lobar pneumonia, rheumatic fever, malaria, tuberculosis, etc. In 

 biliary obstruction the amount of urobilin in the stool is proportional to 

 the degree of patency of the common bile duct. Fischer and Meyer-Betz (&) 

 (1912) studied the effect of administering fresh animal bile on the uro- 

 bilin excretion in the urine. Under these conditions the urine of normal 

 subjects contained little urobilin while patients suffering from liver disease 

 excreted considerable amounts. Similar results were obtained when uro- 

 bilinogen itself was administered. In the writer's limited experience the 

 excretion of urobilin in liver disease has been quite irregular. At times no 

 increase was observed; at times an increase occurred in the urine alone 

 or in the feces alone while in some instances an increase in both urine and 

 feces occurred (Bauman). It is conceivable that in hepatic conditions 

 an increase in the urobilin of the stool may precede urobilinuria. The 



