MILK-SUGAR, AND OTHER SUBSTANCES IN URINE. 



415 



(c) According to Worm-Miiller, the polarization method is almost valueless for diabetic 

 urine. 



[Picro-Saccharimeter. G. Johnson uses a stoppered bottle 12 inches long and f inch wide, 

 graduated in T Vths and y^ths (fig. 269). To it is fixed a shorter bottle containing the 

 standard iron-solution for comparison, a standard solution, composed of liquor ferri per- 

 chloride 3J liq- ammon. acetatis ^iv, glacial acetic acid ^iv, liq. ammonise %>i, and water to 

 make up |iv. All B. P. preparations give a colour identical with a solution containing 1 gr. 

 of grape-sugar per oz., reduced by picric acid and afterwards diluted four times, so that this 

 tint = gr. of sugar per oz. After reducing the sugar with the picric acid, pour into the tall 

 tube the dark saccharine liquid produced by boiling to occupy ten divisions of the tube, and add 

 distilled water cautiously until the colour approaches that of the standard ; read off the level of 

 the fluid. The amount of sugar present is determined from the amount of water added. In 

 making the test, the picric acid must be added in proportion to the amount of sugar present.] 



If large quantities of dextrose are taken in the food, a part of it (and more in diabetic persons) 

 appears in the urine. Leevulose, when taken internally, does not increase the amount of sugar 

 in diabetes. The free use of starch does not cause glycosuria in health, but in diabetes it in- 

 creases the amount of sugar. A large consumption of cane- or milk-sugar causes the passage 

 of small quantities of both of these sugars into the urine in health, while in diabetes the amount 

 of dextrose is increased ( Worm-Miiller). According to Kiilz, in diabetic 

 persons cane-sugar splits up into grape- and fruit-sugar, the latter being 

 used up in the body, the former partly excreted ; and the same is the case 

 with milk-sugar. 



In severe cases of diabetes mellitus, Kiilz found the left-rotatory -oxy- 

 butyric acid (the next highest analogue of lactic acid) in the urine, from 

 which acetic acid is formed by oxidation ( 175), which in its turn readily 

 yields C0 2 and aceton. a-crotonic acid is formed in urine by the removal 

 of water from oxybutyric acid in the urine in diabetes (Stadclmann). The 

 administration of aceton causes albuminuria, and this may in part explain 

 in some cases the complication of albuminuria in diabetes {Albcrtoni and 

 Pisenti). 



Aceton, or Aceton-yielding substance, probably aceto-acetic acid, is some- 

 times found in diabetic urine. It has a peculiar vinous odour, and it has 

 been detected in the urine during fever. Gerhardt described a peculiar 

 substance in diabetic urine, which gave a deep red colour with perchloride 

 of iron. This substance is probably diacetic ether, and he considered it to 

 be the source of aceton ; but it is more probably derived from aceto-acetic 

 acid. Tests for Aceton. (1) Perchloride of iron = Burgundy-red colour; 

 but this is not reliable. (2) Lieben suggested an iodoform test. Dissolve 

 20 grains of KI in a fluid drachm of liq. potassse, and boil the fluid. Pour 

 the suspected urine on the sur- 

 face, when a ring of phosphates 

 is deposited from the urine by 

 the hot alkaline solution. If 

 aceton be present, after a time 

 the deposit becomes yellow, and \C j 

 yellow granules of iodoform ap- rYv-| 



pear and sink to the bottom of /^j A 



the test-tube. The only other \\c/$ 



substance which may be met 



with in the urine giving this re- 

 action is lactic acid. 

 Milk-sugar is sometimes found 



in the urine of women who are 



nursing ; when the secretion of 



Picro-sacchanmeter mil k is arres ted, absorption tak- 



of G. Johnson. ing place f rom t ^ G breasts (Kir- 



sten, Spiegelberg). Lsevulose is sometimes found in 



diabetic urine ( 252). 



Dextrin has also been found in diabetic urine. 

 Inosit, or muscle-sugar ( 252), is sometimes found Inosit crystallised partly from alcohol and 

 in diabetes, in polyuria, and albuminuria. _ It is partly from water (after Funke). 



found in traces, even in normal urine. Occasionally, 



after the piqure in animals ( 175), inosit, instead of grape-sugar, appears in the urine (fig. 270). 

 In testing for inosit, remove the grape-sugar by fermentation, and the albumin by heat after the 

 addition of a few drops of acetic acid and sodic sulphate. Some of the filtrate is evaporated 

 nearly to dryness on a capsule. To the residue add two drops of mercuric nitrate (Liebig's 

 titration fluid for urea), which gives a yellow precipitate. When this coloured residue is spread 



269. 



