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796 URINE.
turia). In these cases, when the quantity of blood is not very small,
the urine is more or less cloudy and colored reddish, yellowish red, dirty
red, brownish red, or dark brown. In recent hemorrhages in which the
blood has not decomposed the color is nearer blood-red. Blood-corpuscles
may be found in the sediment, sometimes also blood-casts and smaller
or larger blood-clots.
In certain cases the urine contains no blood-corpuscles, but only dis-
solved blood-coloring matters, haemoglobin, or, and indeed quite often,
methsemoglobin (ilemoglobinuria) . The blood-pigments appear in the
urine under different conditions, as in dissolution of blood in poisoning
with arseniuretted hydrogen, chlorates, etc., after serious burns, after
transfusion of blood, and also in the periodic appearance of haemoglo-
binuria with fever. In hemoglobinuria the urine may also have an abun-
dant grayish-brown sediment rich in proteid which contains the remains
of the stromata of the red blood-corpuscles. In animals, hsemoglobinuria
may be produced by many causes which force free haemoglobin into the
plasma.
To detect blood in the urine, we make use of the microscope, the spec-
troscope, the guaiac test, and Heller’s or Heller-Teichmann’s test.
Microscopic Investigation. The blood-corpuscles may remain undis-
solved for a long time in acid urine; in alkaline urine, on the contrary,
they are easily changed and dissolved. They often appear entirely
unchanged in the sediment; in some cases they are distended and in
others unequally pointed or jagged like a thorn-apple. In hemorrhage of
the kidneys a cylindrical clot is sometimes found in the sediment which is
covered with numerous red blood-corpuscles, forming casts of the urinary
passages. These formations are called blood-casts.
The spectroscopic investigation is naturally of very great value; and if
it be necessary to determine not only the presence but also the kind of
coloring-matter, this method is indispensable. In regard to the optical
behavior of the various blood-pigments we must refer to Chapter V.
Guaiac Test. Mix in a test-tube equal volumes of tincture of
guaiac and old turpentine which has become strongly ozonized by the
action of air under the influence of light. To this mixture, which must
not have the slightest blue color, add the urine to be tested. In the
presence of blood or blood-pigments, first a bluish-green and then a beau-
tiful blue ring appears where the two liquids meet. On shaking the mixture
it becomes more or less blue. Normal urine or one containing proteid
does not give this reaction. According to Liebermann l
this reaction
is brought about by the blood pigments acting as catalyst upon the
organic peroxides existing in the turpentine, accelerating the decomposi-
tion of these and the active oxygen taken up by the guaiaconic acid
which is oxidized to guaiac blue (guaiaconic acid ozonide). Urine con-
1
Pfluger’s Arch., 104.
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