Annex
4
PRÄCTICÄL
*
—IN—
URINALYSIS
FOR THE USB OP
Medical and Phapacedtiçal Stddents
4
ARRANGED BY
PLYM. S. HAYES, M. D.
— or
WOMAN'S MEDICAL COLLEGE AND CHICAGO COLLEGE OF PHARMACY,
AND
M. P. HATFIELD M. D.
»
OF CHICAGO MEDICAL COLLEGE.'
Annex
/4^f/
L /
SCHEME FOR URINALYSIS.
Determine the amount of uiiiie voided in 24 hours. Take, if possible» a
sample of from 6 to 8 ounces of mixed urine for 24 hours, or otherwise a like
amount of recently voided urine. Let it stand for from to 1 hour, if
possible.
Physical Examination.
1. Note amount and gross and microscopic appearance of sediment be¬
töre it is disseminated through the urine by the agitation in¬
cident to the subsequent examination,
2. Note color. Compare with VogePs plates if possible.
8. Note odor. If the odor is faint, warm the sample of urine.
4. Determine the specific gravity. Carefully note the temperature.
Chemical Examination,
0. Determine the reaction by both red and blue litmus paper. If alka¬
line, determine whether it is due to a volatile, qr fixed alkali.
6. Test for urea. Should it be advisable to determine urea quantitative¬
ly, begin the analysis at this point, in order that the reaction
may be completed when the rest of the analysis is done.
7. Test for albumen,
8. Approximately estimate the chlorides, phosphates and sulphates. *
9. Test for urophain, indican and uroerythrin, *
10. Test for sugar, and if present determine it quantitatively,
n. Test for blood.
12. Test for bile,
* If albumen is present remove It by heat test and filtration, before apply¬
ing 9 and 10.
Chemical Examination of Sediment.
13. Apply heat test for urates.
14. Apply acetic acid test for phosphates.
15. Apply hydrochloric acid test for oxalate of calcium.
16. Apply murexid test for uric acid.
17. Apply turpentine and guaiac test for blood.
18. Apply potassium hydrate test for pus.
19. Test for mucus.
N.B.—Apply tests 13, 14,15 and 16 in succession to the same specimen. If
the sediment is found to be soluble by heat, acetic, or hydrochloric acid
it will not be necessary to proceed farther. If either of these reagents
attect the bulk of the precipitate to any marked degree filter and test
filtrate for urates, phosphates or oxalate of calcium as the case may be.
Test the residue by the tests which follow. It will be of no use to test,
for blood or pus if the urine is not albuminous.
PHYSICAL PROPERTIES.
Color.
NORMAL varies from pale yellow, to briglit yellow, yellow, reddish-
yellow or yellowish-red. (Vogel)
PATHOLOGICAL. Smoky, reddish or distinct red. (hiematiiria.) Yellowish^
brown or dark brown,(bile-) Yellowish-red to reddish-brown, (fevers.)
ACCIDENTAL from ingested or applied substances.
Sfïiofyor blackiah'tinXf phenol or tar.
Dwky hue, gallic acid
Deep yellow y rhubarb
Redy log wood.
Browoy senna etc.
Odor.
NORMAL, Urinons—peculiar to itself.
ABNORMAL, Organic, much blood or pus.
Ammonùzeal^ uormal decomposition. Rotten Egg^ putrid decomposition
accidental. Peculiar odors due to introduction of asparagus, cofiee,
turpentine, cubebs, copaiba, sandal-wood oil, onions, camphor, etc.
Quantity
NORMAL, 800 c.c. to 1500 c.c. per diem.
PATHOLOGICAL. Less than 800 c.c. in fevers and most forms of Bright*»
disease. "More than 1500 c.c. in diabetes, hysteria, etc.
Reaction Tests.
ACIDS change blue litmus paper to red.
ALKALIES change red litmus tp blue and yellow turmeric paper brown.
Should color be restored on drvins:, the alkali is ammonia.
NORMAL.
ACID. Freshly collected urine, for 24 hours has an acid reaction, due to the
presence of NaH2F04, etc.
STRONGLY ACID before meals and at night.
SLIGHTLY ACID, neutral or alkaline after eating.
PATH01G6ICAL.
ACID. Strongly acid during fasting and fevers.
ALKALINE in chronic cystitis, visceral paralysis and certain diseases of^
and injuries to spinal cord. This alkalinity is due to ammonia.
ACCIDENTAL.
ALKALINE after ingestion of alkalies, alkaline carbonates, or organic
salts of alkalies.
FERMENTATIVE.
After being voided, fermentation occurs as follows:-lst Acid. 2nd Alkaline,
3rd Putrefactive.
SPECIFIC CRAVITY.
. Determination of Specific Gravity.
UEIîiOMETER. Remove all bubbles from surface of urine. Read indi¬
cations on stem ofurinometer at the point where lower, sharp, convex
edge of urine cuts it, the eye being on a level with this edge. If urine
is turbid filter it. The temperature in either case should be 60® F.
If not at 60® F. correct according to following table.
Temperature. No. to be added. Temperature. No. to be added.
60®
61®
62®
63®
64®
65®
66°
67®
68°
69®
70°
71°
72°
0.00
0.08
0.16
0.24
0.32
0.40
0.50
0.60
0.70
0.80
0.90
1.00
1.10
73°
74°
75°
76°
77°
78°
79°
80°
81°
82°
83'
84°
85°
1.20
1.30
1.40
1.50
1.60
1.70
1.80
1.90
2.00
2.10
2.20
2.30
2.40
1015 to 1025,
1005 to 1015,
1020 to 1030,
ITormal
usual.
after large draughts of water,
after eating and ingestion of small amounts of liquids.
Indications from Color and Specific Gravity.
SPECIFIC GRAVITY.
COLOR.
1001 to 1010, Pale yellow or colorless.
1015 or below Yellow to yellowish-red
1030 or above.
1030 or above.
1018 to 1030.
Yellow to yellowish-red.
Pale yellow to yellow.
Brownish-red
INDICATION.
Increase of water. Hysteria.
If persistently low sp. gr.
Diabetes insipidus.
(with persistent foam) suspect
albumen.
Increase of salts and urea.
Suspect sugar.
(with persistent foam) suspect bile.
Sugar and albumen may both be present in the same specimen, in which
case the above indications would be of little value.
Total Solids in a litre estimated in grms, by multiplying last two figures
of specific gravity by 2.33.
NORMAL URINE.
Constituents.
«
INOEGANIC. The chlorides, sulphates and phosphates of potassium,
sodium, ammonium, calcium and magnesium, and traces of iron, silicon
and nitrates, as well as, carbon dioxide and oxygen dissolved in water.
ORGANIC. Urea, urates, hippiiidc acid, kreatin, kreatinin, xanthin, uro-
phain, indican, mucus, traces of sugar, a phenol forming substance and
one which evolves sulphuretted hydrogen by the addition of zinc and
hydrochloric aci d. (Gorup-Besanez.)
Réactions.
UREA precipitated in shining, flat crystals by the addition of nitric, or ox¬
alic acid, to urine concentrated to % its bulk. Also precipitated by
mercuric nitrate, as C0[NH2]2, 2ÖgO.
UROPHAIN gives garnet-red on the addition of 2c.c. of colorless sulphuric
acid to 4 c.c. of urine.
INDICAN, pale yellow by addition of 10 drops of urine to 4 c.c. of colorless
hydrochloric acid.
CHLORIDES are precipitated by argentic nitrate, mercurous nitrate and
soluble lead salts.
SULPHATES are precipitated by the same reagents as the chlorides, and
also by baric chloride.
EARTHY PHOSPHATES give a flocculent precipitate with caustic potash
and the alkalies.
*
ALKALINE PHOSPHATES, after removal of earthy phosphates by caustic
potash, are precipitated by the ammonio-magnesian reagent.
URIC ACID is precipitated from alkaline urine, freed from earthy phos¬
phates by sodium hydrate, as zinc urate, upon the addition of a strong
solution of zinc sulphate [1 to 3]. It may also be obtained in the form
of a red sand by acidulating 200 c.c. of urine with 20 c.c. of strong hy¬
drochloric acid, and allowing it to stand for 24 hours.
N. B.—Normal urine also gives turbidity or precipitate with corrosive
sublimate, strong alcohol, ferric chloride, calcium chloride, ammonium
oxalate, tinct. guaiac, potassium ferrocyanide, with heat, Millones and
sugar reagents, etc.
Accidental Reactions.
Carbonates of the alkalies, nitrates, chlorates, borates, silicates, iodides,
bromides, salts of arsenic, antimony, tin, bismuth, lead, copper, mercury
and zinc, tartaric, sulpho-carbolic salicylic and other organic acids,
alcohol, peptone, organic coloring matter, and many poisons may ap¬
pear in the urine and give their characteristic reactions.
_ /
NORMAL CONSTITUENTS.
1. UREA.
C02XH2.
SOURCE Urea is the uitimate product of the oxidation in the body of the
albuminous foods and tissues. It is increased by the ingestion of nitro¬
genous foods, forced labor and most fevers.
APPROXIMATELY estimated by multiplying the last two figures of the
specific gravity by the number of ounces of urire passed in 24 hours and
dividing the product by 2, which gives the number of grains excreted in
a day. This is fallacious with high specfic gravity.
QUANTITY 25 to So gramms per diem.
PERCENT A GE 2.5 to 3,2 Per cent. »
Tests.
PRESENCE detected by evapoiating urine to >2 hulk and adding an
equal volume of nitric acid, which precipitates crystals of impure
nitrate of urea. If in excess(10 per ceiit.)it may be precipitated from the
urine without concentration. If largely deficient, it may not be detected
by the nitric acid test.
MERCURIC NITRATE (Liebig"s method) precipitates it as insoluble
2HgO, CO2NH2.
Quantitative.
HYPOBROMITES in excess (3:1) set free from fhe urea its nitrogen, each
c.c. of which represents .027 urea,
FOWLER'S METHOD is to add 7 parts(105 c.c.)ofa solution of a hypochlor¬
ite, (Liquor Sodae Chloratae B.P.) to 1 (15 c.c.l of urine. Estimate the
mean specific gravity of the mixture and compare it with that obtained
after the escape of its nitrogen. Each degree of loss shown by the
urinometer equals 3,55 grains of urea to the ounce of urine, or loss mul¬
tiplied by .77 gives percentage.
Sp. gr, of urine = 1030 X 1 vol. = 1030
SPf gr. of hypochlorite = 1045 X 7 vol! = 7315
8)"834B
Estimated mean sp. gr. = 1043
After decomposition the sp. gr, = 1040
Différence In sp. gr. = 3 x =2.31 per cent. urea.
or 3 X 3.55 = 10.65 grains of urea to ounce of urine.
N. B.—The reaction is usually complete in an hour. Albumen aud sugar
do not interfere with the accuracy of the test, while ammonia does.
The reaction is facilitated by frequent shaking.
APPROXIMATE ESTIMATION
OF
4
Inorganic Constituents.
CHLORIDES.
*
Chiefly of sodium, with small proportion of potassium and ammonium.
NITRATE of SILVER, (1 part to 8 of water) in the presence of nitric add
precipitates the chlorides. If in cheesy lumps, which do not subdivide,
or make the urine more milky on Agitation, ^ to 1 percent, of chlorides
is indicated. If simply cloudy,or of a general milky appearance, 1-lOth
per cent, or less, of chlorides is indicated. If no precipitate, chlorides
are absent.
PHOSPHATES.
Earthy phosphates, of lime and magnesia. Alkaline phosphates, chiefly of
acid sodium phosphate, with traces of potassium phosphate.
POTASSIUM or AMMONIUM HYDRATE precipitates earthyphoephatesy
when added in small quantity to a test tube (16 c. m. long and 2 c. m.
wide) one third full of filtered urine, and urine gently heated until
flakes begin to appear. Set aside fifteen minutes for precipitation. If
sediment of 1 c.m. the earthy phosphates are normal ; if 2 to 3 c.m. they
are increased; if only a few flakes fall, they are diminished in quantity.
(Hoffman and Ultzmann.) The precipitate is white in normal urine; if
abnormal pigment be present, it is variously colpred.
MAGNESIAN FLUID precipitates alkaline phosphates, after removal of
earthy phosphates by ammonium hydrate. Add to urine one third as
much of magnesian fluid. All phosphates are thrown down. If entire
liquid has a milk-like cloudy appearance, the alkaline phosphates are
normal in amount; if cream-like, they are increased; if but slightly
cloudy, they are diminished.
SULPHATES,
Of sodium and potassium.
BARIUM CHLORIDE SOLUTION. Add to urine one-third as much acidu¬
lated barium chloride solution; if liquid is rendered opaque and milky,
the sulphates are normal; if intensely opaque and cream like, they
are increased; if but slight cloudiness, they are diminished in quantity-
4
4
URINARY PIGMENTS etc.
Extraction.
Precipitate the urine with both normal acetate and subacetate of Jead.
Collect mixed precipitates, and extract coloring matter by alcohol
acidulated with hydrochloric acid.
Urophain.
(ÜROHAEMATIN.) Add to 4 c. c. of urine 2 c. c. of colorless sulphuric
acid, and, if normal, the mixture is colored a deep garnet.
N.B.—Uroerythrin, sugar, biliary coloring matter, or indican may give
reaction similar to that produced by an excess of urophain.
0
Indican.
(ÜR0XANTH1N,) when normal gives only pale yellowish tint, upon the
addition of ten drops of urine to 4 c.c. of colorless hydrochloric acid. If
in excess, indican imparts a violet to blue color.
SENATOR'S METHOD is to add an equal bulk of hydrochloric acid to
16 c.c. of urine, and add, with shaking a saturated solution of calcium
hypochlorite until no further change in color takes place. Shake with
chlororform, which extracts blue color and sinks to the bottom.
N.B.—Dark urines must first be exactly decolorized with subacetate of lead.
Remove albumen if present.
WEBBER'S METHOD is to warm, not boil, 30 c.c., each of colorless hy^dro-
chloric acid and urine in a large test tube. Cool, add a few drops of
nitric acid and shake with 10 to 15 c.c. of ether, which extracts the indi¬
can, and rises to the top, forming a blue layer if the indican is in excess.
Uroerythrin.
POTASSIUM HYDRATE, added to urine, precipitates the phosphates,
which will be of a dirty gray color if uroerythrin is present.
NORMAL LEAD ACETATE, added in small quantity, produces a pink
colored precipitate with uroerythrin.
N.B.—If the urine contains the coloring matter of blood, it must first be
removed.
URIC ACID.
MUREXID TEST. Collect deposit. Place it on porcelain capsule or
watch-glass. Absorb moisture with blotting paper. Add a drop or two
of strong nitric acid. Evaporate to dryness. Residue will be red.
When cold, add a drop of ammonium hydrate; a purplish crimson color
results. Color is deepened by drop of potassium hydrate.
SILVER TEST is, to dissolve uric acid in a solution of sodium carbonate,
and to a little of this dropped on paper, add nitrate of silver, which
gives gray stain if uric acid is present.
QUANTITY, 0.2 to 1 gramm per diem. (H2C5H2N4O3.)
ABNORMAL CONSTITUENTS.
1. All)umen.
ETIOLOGY. Increased blood pressure, albuminous food, diseased kidneys,
or from pus or blood in th&ui'ine from any source.
Tests.
9
HEAT TEST. Filter and acidify with acetic acid if not already acid, and
heat upper layer to boiling. [jPhosphates are dissolved on adding a few
drops of nitric acid.]
NITRIC ACID. (Heller.) Fill tube Yz inch with colorless nitric acid, add
carefully with pipette equal bulk of filtered urine, albumen coagulates
at line of junction. [On heating urates dissolve, and albumen is rendered
more dense.]
■
SODIUM CHLORIDE in saturated solution to which 5 per cent, of dilute
hydrochloric acid has been added, precipitates albumen, when used in
the same manner nitric acid is in Heller's test, the precipitated albumen
is not coagulated, but will redissolve in water, or an excess of albumin¬
ous urine. (Roberts.)
#
POTASSIUM FERROCYANIDE. (Boedeker's). Acidify with acetic acid
and precipitate the albumen with potassium ferrocyanide. N.B.—This
test distinguishes the albuminoid principles from the gelatinous. [Ralfe.]
PICRIC ACID. Fill test tube % full with saturated solution of picric acid,
drop in a few drops of urine, a sharply defined white turbidity indi¬
cates albumen. On warming, the albumen rises to the surface and
remains there.
CHROMIC ACID, (crystal) is dissolved and precipitates the albumen in
dark red-brown flakes.
OTHER TESTS, Albumen is also coagulated by 95 per ct. alcohol, trichlor¬
acetic acid, carbolic acid, kreosote, alum, corrosive sublimate, sulphate
of copper, tannin, tincture of galls, meta-phosphoric acid and the rea¬
gents for Proteids, but in general these also give precipitates with
normal urine.
QUANTITY most easily estimated by diluting with water until the mix¬
ture becomes opalescent, by Heller's test, in 30 seconds. Then by mul¬
tiplying the number of volumes of water used by .0034 the percentage
of albumen is obtained.
DIABETIC SUGAR
(C6H 12O6)
Color Test.
POTASH. Boil urine with an equal bulk of liquor potassae» which darkens
if there Is more than 13^ grains of sugar to the ounce. (Moore^s test.)
N.B.-^High colored,albuminous urine, or that containing lead, also darkens,
therefore confirm by heating with nitric acid, whichgives molasses odor
if sugar is present. Always remove albumen before applying Moore^a
test.
ÍXDIGO SOLUTION made alkaline with sodium bicarbonate, loses its
color upon heating with saccharine urine.
Eeduction Tests.
CUPKIC SULPHATE solution. Add two or three drops of this solution
to 4 c.c. of urine, and then add 4 c.c. of liquor potassae. Sugar gives
yellowish precipitate immediately upon boiling. (TrommePs.)
Fehling's Lowe's, Pellet's, and Oppenheimer's test'solutlons (see formu¬
lae) all give reactions like Tromtner's test. Boil test solutions, if no
precipitate appears, proceed as in Trommer's^test.
Piifard's pellets are convenient because solid. See formulae.
AKGENTIC NITRATE In ammoniacal solution, reduced by sugar, forming
mirror on sides of tube. Unsatisfactory for urine.
MERCURIC CYANIDE(Knapp,) and iodide,(Sachsse)are similarly reduced.
BISMUTH SALTS are blackened by boiling in alkaline glucose solutions.
Best applied by adding a pinoh of subnitrate of bismuth and liquor
potassae to the urine and heating. (Boetger's test.)
Quantitative.
MOORE'S TEST. Approximate estimation by viz.: Canary-yellow indi¬
cates 1 per cent., amber 2 per cent, and brandy tint 5 per cent, of sugar.
PEHLING'S SOLUTION. Each 2 c.c.precipitatesO.Ol sugar.
FERMENTATION converts sugar into alcohol and carbon dioxide, and
therefore decreases the specific gravity of the urine. Apply by adding
a piece of washed yeast, the size of a walnut, to 120 c.c. urine in a large,
loosely stoppered bottle. Keep at about 80 °F. and each degree of loss in
24 hours represents one grain of sugar to ounce. Completion of fer¬
mentation indicated by clearing off of scum. Always keep an equel
quantity of the same urine without yeast, tightly corked for compar-
son. (Roberts.)
BLOOD, BILE, etc.
Blood.
POTASSIUM HYDKATE is added to urine, and then it is heated slightly,
but not to boiling, when the phosphates will be precipitated, carrying
the blood coloring matter with them. They will be colored from faint
red to blood-red, according to the amount of blood present. If the
amount of coloring matter is small, they will be dicroic,
IIAEMIK CRYSTALS. The precipitated phosphates are filtered out and
dried at a gentle heat, on microscope slide. Add a minute crystal of
sodium chloride. Cover with a thin glass cover, with hair interposed.
Pass a drop or two of glacial acetic acid beneath cover. Carefully
warm until bubbles begin to appear. Cool. Rhombic tables of haemiii,
bluish-red by refiected light, and brownish-red by transmitted light,
can be seen by the microscope, (Teichmann)
GUAJAC and TURPENTINE. Make an emulsion by shaking equal parts
of turpentine (ozonized) and fresh Tr. guaiac together in test tube.
Pour the urine down the side of the tube, so as to float the emulsion.
Blood gives a blue color at line of junction.
If blood is not present, a fawn color will be develoi)ed at this point,
ALBUMEN is always present in urine containing blood.
Bile.
POTASSIL^M HYDRATE and heat precipitate the earthy phosphates,
which are colored yellow or brown if bile is present.
NITROSO-NITRIC ACID is pouted down side of test tube, so as to under¬
lie urine. Bile causes play of colors at line of contact; green, blue,
violet, red and yellow. The first green is indispensable. This test
may be made by mingling acid and urine on a piece of porcelain. The
same colors as above indicate bile.
HYDROCHLORIC and NITRIC ACIDS. Thoroughly mix 5 c.c. of hydro¬
chloric acid with j^st sufficient urine to color it. Add pure nitric acid
so as to I nderlie the mixture. There will be a play of colors at line
of contact when bile is present.
BILIARY ACIDS. There is no easily applied test which is satisfactory.
Inosite.
(MUSCLE SUGAR), CóH12O6, is found in the urine in BrighUs disease
and diabetes. It does not ferment with yeast, nor does it reduce cop¬
per salts from their alkaline solutions. For mode of separation from
urine,and tests, see-Marshall and Smith, and Witthaus' General Medical
Chemistry.
URINARY SEDIMENT.
Gross Appearance.
KEDPOIXTS or MASSES. Uric acid.
FAWN-COLORED, ORANGE, BRICK-RED. SALMON or PURPLK,
easily disseinlnated. Usually, atnorpliorus urates.
filGHT COLORED, VELVETY,'' slight In amount, i*esembllng mucous
cloud. Oxalato of calcium.
HEAVY, WHITE, usually sparkling. Phosphates.
SLIGHT CLOUD, (la health.) HEAVY WHITE CLOUD clinging to bot¬
tom of vessel when turned upside down (in excess). Mucus.
PINK or RED. Blood.
YELLOWISH-WHITE, dense. Pns.
Microscopical Appearance.
USUAL CRYSTALLINE FORMS.
LOZENGE SHAPE, FOUR-SIDED RHOMBS or ROSETTES, almost
invariably colored. Uric acid.
HEDGE-HOG, DUMB-BELL, or PRISMATIC CRYSTALS arranged in
stellate masses. Urates. Usually of sodium and ammonium.
OCTAHEDRA, (envelope shape) or DUMB-BELL. Oxalate of Calcium.
TRIANGULAR PRISMS with BEVELED EDGES, "Roof like." Am-
monlo-magnesian (or triple) phosphates.
WEDGE-SHAPE. SEPARATE or in ROSETTES. Calcium phosphate.
AMORPHOUS.
GRANLTLES or GRANULAR MASSES. Urates, or calcium phosphate.
OROANIZEO,
(HRCULAR, BICONCAVE DISCS, YELLOWISH COLOR, edges some¬
times dentated. Red blood globules.*
ROUND, PALE and GRANULATED CELLS, when touched with acetic-
acid rendered larger with development of nuclei. • Pus corpuscles, if
albuminous. Mucus corpuscles, if not.||
ROUND, CYLINDRICAL, CONICAL or SQUAMOUS, with one or more
nuclei. Epithelial cells.U
VARIETIES of TUBE-LIKE CYLINDERS, Casts.
Studded with epithelium. Epithelial CHSts.||
Dark^ coarselp granular^ Opaque granular casts.
Clear^ glassy cylinders^ vctrious sizes. Waxy cast8.||
_ ■
Iranspareutj studded with minute oil globules. Fatty casts.
With blood globules, or pus cells. Blood or pus casts.
With badly defined margins^ transparent and branching, Mucns.*
PEAR-SHAPED BODIES, with whip-like tails. Spermatozoids,
For bacteria and fragments of morbid growths, entozoa, dust, stiirch,
feathers, etc., see larger works.
* Not stained by carmine solution. || Stained by carmine solution.
CHEMICAL EXAMINATION of SEDIMENT.
Unorgamzed.
»
HEAT with supernatant urine* sediment dUsoives wholly or in part, and
reprecipitates on cooling. Urates. Confirm by adding hydrochloric
acid to dissolved urates, and getting reddish-brown crystals of uric
acid, after some hdurs. The murexid test may be applied either* to
the uric acid so obtained* or directly to the sediment of urates. Unr
dissolved—Phosphates, oxalate of calcium and uric acid.
ACETIC ACID dissolves the phosphates. Add ammonium hydrate to the
solution and the phosphates will be reprecipitated. Undissolved—
Oxalate of calcium and uric acid.
HYDKOCHLORIC ACID dissolves the oxalate of calcium. Add ammo¬
nium hydrate to the solution, and the oxalate of calcium will be repre¬
cipitated. Undissolved—Uric acid. Apply murexid test. Sec uric acid.
Organized.
HEAT coagulates blood and pus; not coagulated^ mucus.
BLOOD.
TURPENTINE and GUAIAC TEST. See blood tests.
PUS.
POTASSIUM HYDRATE, added to sediment in acid urine, forms a ropy
mass, which will not drop from lip of test tube. If urine is alkaline
and pus is present, the sediment will probably be ropy, without the ad¬
dition of potassium hydrate.
MUCUS.
ALCOHOL on stirring rod, passed through a few drops of sediment, on
glass slide, gives a stringy precipitate of mucin.
ACETIC ACID, applied in like manner, gives a like result.
LIME WATER added to stringy precipitate of mucin, dissolves it.
The Microscope
Should be used, to verify the above tests, and to detect traces of blood
and pus, which cannot be detected by chemical means, as well as, to deter¬
mine the presence of casts, spermatazoids, epithelial cells, etc. For micro¬
scopical appearance of urinary sediments, see Beale, Roberts, Tyson, Mar¬
shall and bmith, etc.
Examination of Urinary Calculi.
Insoluble in Acids.
«
Powder a small portion and, if dissolved all or in part by liquor potassae, it
may contain uric acid or urates of ammonium, sodium or calcium.
UJtIC ACID chars without fusing, feathers, and entirely volatilizes, and re¬
sponds to murexid tests,
URATES soluble in boiling water, also respond to miirexid test. Their
bases may be detected in the ash left after calcination of calculi.
Soluble in Hydrochloric Acid.
(/ALCrC PHOSPHATE [bone earth] chars but slightly under blowpipe
andleaves an infusible, friable, white ash, whose acid solution gives reac¬
tions with ammonium oxalate and molybdate,
TRIPLE PHOSPHATE (ammonlo-magiiesium) chars slightly, and leaves a
slowly fusible grayish ash, soluble in acetic acid, and reprecipitated by
an excess of ammonium hydrate.
MIXED PHOSPHATES (fusible) char slightly, and ash fuses readily in¬
to a porcelain like mass, soluble in dilute hydrochloric acid, and repre¬
cipitated by ammonium hydrate.
(CALCIUM CARBONATE dissolved with eñervesence by dilute acetic acid.
C.VLCIUM OXALATE(mulberry )chars considerably by bli>wpipe,and leaves
a white ash, which is dissolved with effervescence by hydrochloric acid.
The gas evolved whitens lime water. The calculus is not soluble in ox¬
alic acid, in»r dilute acetic acid.
Rarer Forms.
(yYSTIN when heated volatilizes with characteristic odor, resembling hy¬
drochloric acid, soluble in caustic alkalies, which solution gives black
precipitate with plumbic acetate. Crystals obtained from evaporation of
ammoniacal solution are six sided table.
XANTHIN resembles beeswax and is consumed like it. By the murexid
test it gives an intense lemon-yellow color after the treatment with ni¬
tric acid. The residue is not reddened by ammonium hydrate, but is sol¬
uble in, and gives a deep reddish-yellow color with potassium hydrate.
FI BRIN burns with an odor like burning feathers, it expands when added to
potassi,^m hydrate in which it is soluble, but does not respond to murex¬
id test. [Ord.]
BLOOD PIGM"ENT is often combined with fibrin. Identify by haemin
test. (Teichman.)
Very Rare.
UROSTEALJTH, fatty substances which burn with large, smoky flame.
INDIGO which foi ms a blue solution with strong sulphuric acid. (Ord.)
STANDARD SOLUTIONS.
AMMONIO-MAGNESIAN REAGENT contains magnesium sulphate and
ammonium chloride, one part each; distilled waters parts; liquor am¬
monia 1 part. It precipitates both earthy and alkaline phosphates.
NITRATE OF SILVER solution contains 29. 075 grammes of argentic
nitrate to the litre of distilled water. 1 c.c. of which precipitates
0.10 of a gramme of common salt.
BARIUM CHLORIpE solution contains 30, 5 grammes to the litre of distill¬
ed water and each c.c. precipitates .012 of a gramme of sulphuric acid.
FEHLING'S SUGAR REAGENT best applied by two solutions viz:
No. Icontaines 51.98 grammes of crystallized cupric sulphate to 500 c.c. of
water. No. 2 contains 259.9 grammes Rochelle salt to 1000 c.c. of sodium
hydrate solution (sp. gr. 1.12). Mix 1 volume of first with two of
second before using; each 20 c. c. equals 0.1. of a gramme of sugar.
LOWE'S SUGAR REAGENT contains 2 grammes of cupric sulphate and
6 grammes of stick caustic potash to 180 c.c. of distilled water, to which
2 c.c, of glycerine is added to prevent decomposition.
FIFFARD'S PELLETS, contain cupric sulphate O.P. 1 part; crystallized
tartrate of sodium and potassium 5 parts; sodium hydrate O.P. 2 parts.
Make the resulting paste into pellets, or put in wide mouth bottle, and "
dissolve as needed.
PICRIC ACID solution contains 10.5 grammes of picric acid to a litre of
water. To 9 parts of this add one of ordinary acetic acid. 5 parts of
albumen coagulated by boiling with this equals 4 parts as ordinarily
coagulated,
HYPOBROMITE SOLUTION is made by dissolving 100 grammes of caustic
soda in 250 c.c of water and adding 25 c. c. of bromine just before using,
LIQUOR SODAE CHLORATAE B. P. for urea.
CUPRIC SULPHATE, solution 2 grammes to 30 c. c. of water.
SODIUM CHLORIDE and HYDROCHLORIC ACID solution, is a saturat¬
ed solution of sodium chloride to which is added 5 per cent, of dilute
h3'^drochIoric acid.
TR. GUAIAC the freshly prepared official which has been diluted with 3
or 4 times its bulk of alcohol.
TURPENTINE (ozonized) is prepared by exposing a bottle uncorked and
part full of turpentine to the sunlight for some weeks.
Pure colorless nitric acid. Colorless sulphuric acid. Colorless hydro¬
chloric acid. Acetic acid. Nitroso-nitric acid or commercial nitrous
acid. It can be made by exposing a partly filled bottle of nitric acid to
the action of sunlight. Liquor ammonia U.S.P. Liquor Potassae U.S.P,
Bismuth subnitrate. Litmus and turmeric papers.
The above listed reagents are indispensible for and the following will
frequently be of use in urinalysis.
Oxalic acid, Chromic acid. Solutions of zinc sulphate (1 to 3), mercuric
nitrate, normal lead acetate (1 to 4), subacetate of lead (1 to 4). Indigo
solution made alkaline with sodium bicarbonate. Liquor sodae U. S. P.
Alcohol. Lime water. Millon's reagent, Carmine solution for mi¬
croscopic staining.