315 
recorded, 0'8 gram in scarlet fever, 2’0 2 gram in perityphlitis and 
2 grams in malaria. 
After trials of various methods, the method of quantitative 
determination adopted for the purpose of this work was to determine 
the dilution of the urine required to just render invisible the spectrum 
of urobilin, when examined by a spectroscope in a layer of 15 mm. 
thick. The spectroscope was standardised with solutions of purified 
urobilin, and the readings appear to be reasonably accurate except 
that, when only a low concentration of urobilin is present, they are 
too low. The spectroscopic results were checked in many instances 
by the more delicate fluorescence tests. 
By this method I failed after repeated trials to find urobilin in 
any specimen of urine from healthy adults; amounts varying from 
°‘°4 to 0-25 grams per diem were found in various pyrexial diseases 
and from o - 02 to o’o6 gram per diem in cases of anaemia, inter¬ 
muscular haemorrhage and hepatic disease. In a case of Malta 
fever (temp. 104° F.) and in a case of acute suppurative hepatitis 
(probably dysenteric) (temp. 104° F.) o’3 and 0'3i gram per diem 
were found respectively. 
(b) In five cases of simple tertian malaria (JP. vivax) the amount 
of urobilin found in the urine in the period of pyrexia and the days 
following was never greater than the average excretion in diseases 
such as pneumonia with an equal degree of pyrexia, and in Case 3, 
indeed, was scarcely perceptibly increased from the normal limits: — 
Maximal excretion in twenty-four hours (Case 4) O’19 gram. 
Maximal total excretion in seven days after pyrexia (Case 4) 
0’42 gram. 
(0 In malignant tertian malaria (P. falciparum') a different 
picture is obtained; definite urobilinuria sets in very shortly after 
the onset of the pyrexia, reaches its height on the second or third 
day and then slowly diminishes; the normal level of excretion is 
reached in seven to ten days unless a fresh paroxysm intervenes. 
Sometimes the increased output continues for a longer period 
( e -g-, Case 20), and in old standing cases with chronic malarial 
anaemia there may be a continuous raised urobilin output even in 
the absence of pyrexia (Case 19); and in these cases marked 
haematoporphyrinuria was several times noted (Cases 17, 18, 19). 
(Haematoporphyrinuria was also noted on one occasion in Cases 20 
and 23.) 
u 
