336 UNIVERSITY OF COLORADO STUDIES 



immediately it should be placed in a dark bottle and kept as 

 cool as possible. In summer it can be used for one or two days, 

 and in winter three to five days. The urine likewise should 

 be as fresh as possible. The proportions of the mixtures have 

 been varied by certain authors. Greene used 1 part of solution 

 II. to 100 parts of solution I., and says that with this dilute 

 mixture the orange and mixed reds and yellows mostly disappeared. 

 According to his experience pulmonary tuberculosis and pneumonia 

 fail to give the reaction with this high dilution, while they do with 

 1 to 40. The reaction still remained distinct and perfectly defined 

 in septicaemia, typhoid fever, and advanced malignant disease. 



Ehrlich has suggested a new method of performing the test, in 

 which he mixes one volume of urine with from five to six volumes 

 of absolute alcohol, filters, then adds the sulphanilic acid mixture to 

 the filtrate. My series of tests have all been performed according to 

 the first method, which is more convenient, less expensive, and sufii- 

 ciently delicate. 



The cause of this reaction is not known. It has been attributed 

 to diacetic acid (Munson and Oertel) and to acetone (von Jaksch). 

 Warthin and Spiethoff proved conclusively that diacetic acid does 

 not give the diazo reaction where ^ per cent, sodium nitrite solution 

 is used. 



In my series of cases there were fourteen of diabetes mellitus, 

 eight of which gave good tests for acetone, and although numerous 

 diazo tests were made according to Ehrlich's method the reaction was 

 never found. 



All authorities agree that this reaction is not dependent upon 

 fever. In some of our cases of tuberculosis and carcinoma with 

 subnormal temperature a strong reaction was found. However, 

 most of the cases of tuberculosis have an intermittent fever when 

 the reaction is present. In the cases of typhoid fever the reaction 

 never continued after the decline of temperature to normal. That 

 the reaction is dependent on substances excreted during the course 

 of certain diseases, and not upon the height of the temperature, is 

 well illustrated by most of the cases of croupous pneumonia in which 



