186 CLINICAL DIAGNOSTICS. 



5. The addition of a few grains of trichlor-acetic acid added 

 to clear filtered urine produces a thick turbidity on the bottom of 

 the vessel near the reagent. 



6. In case only a limited quantity of urine is obtainable, the 

 following method is recommended: Heat distilled water to boil- 

 ing point in a test tube, add the urine drop by drop. If albumin 

 is present the drops become turbid in the water, and by 

 continuing the addition of the urine, the water also becomes 

 turbid. 



The methods here given suffice for the clinical demonstration 

 of albumin. For a quantitative determination of the albumin 

 preserve the tubes containing the precipitate and thus the sedi- 

 ment, which consists of albumin, may be compared from day to 

 day. For this purpose Esbach's albuminimeter is both simple 

 and practical. See fig. 40. ("Similar tubes can be obtained in 

 'the United States.] It is used as follows: Fill the tube with 

 urine to the mark U (urine), then add reagents sufficient to fill 

 the tube up to the mark R (reagents) as follows: 



citric acid, 2.0 cc, 



picro-nitric acid 1.0 cc, 



distilled water 100.0 cc; 

 put on a stopper, shake well, and let stand 24 hours. The sedi- 

 ment which consists of albumin can then be read off in fractions 

 of 1-10%. This instrument gives good results providing the 

 amount of albumin present does not much exceed 0.2%; in that 

 case dilute before testing the urine, say to 50% or 25%, by adding 

 one or three volumes of water respectively; the result must then 

 be multiplied by 2 or 4 according to the dilution. 



Albuminuria occurs : 



In all febrile diseases, especially in acute infectious dis- 

 eases ; contagious pleuro-pneumonia of the horse and in in- 

 fluenza. 



In acute and chronic affections of the kidneys. 



In venous congestion, hence in organic heart disease, 

 emphysema and in the various forms of heaves 



In blood diseases ; leukaemia, anaemia. 



In nervous affections, epilepsy, eclampsia. 



II. Albumosuria. Examinations for albumoses have 

 only recently become of importance, since simpler methods 

 have been discovered. The occurrence of albumoses de- 

 pends upon entirely different conditions than those which 

 produce albuminuria. Albumosuria is not caused by in- 

 flammation of the kidneys, by disorders of circulation nor by 



