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SUGAR IN URINE. 805
titative estimation of sugar as a part of the sugar is retained by the
use of hydrochloric acid and blood-charcoal. According to Andersen
the pigments and the disturbing substances can be removed by per-
cipitation with mercuric nitrate. It can be more simply done by treating
40 cc. of the urine with 10 cc. acetic acid of 50 per cent strength and 4
grams blood-charcoal, shaking as above described and filtering. In the
presence of acetic acid no sugar is taken up by the charcoal and as this
simple method can be used for the quantitative estimation it can therefore
be used in the qualitative tests for sugar.
Fermentation Test. On using this test the process must vary accord-
ing as the bismuth test shows small or large quantities of sugar. If a
rather strong reduction is obtained, the urine may be treated with yeast
and the presence of sugar determined by the generation of carbon
dioxide. In this case the acid urine, or that faintly acidified with a little
tartaric acid is treated with compressed yeast, or yeast which has pre-
viously been washed by decantation with water. Pour this urine
to which the yeast has been added into a Schrotter’s gas burette or a
Lohnstein’s saccharimeter (see below). As the fermentation proceeds,
the carbon dioxide collects in the upper part of the tube, while a correspond-
ing quantity of liquid is expelled below. As a control in this case two
similar tests must be made, one with normal urine and yeast to learn
the quantity of gas usually developed, and the other with a sugar solu-
tion and yeast to determine the activity of the yeast. According to
Victorow l
the fermentation is complete after six hours at a tem-
perature of 34-36° C.
If, on the contrary, only a faint reduction with the bismuth test
is found, no positive conclusion can be drawn from the absence of any
carbon dioxide or the appearance of a very insignificant quantity. The
urine absorbs considerable amounts of carbon dioxide, and in the presence
of only small amounts of sugar the fermentation test as above performed
may lead to negative or inaccurate results. In this case proceed in the
following way: Treat the acid urine, or urine which has been faintly
acidified with tartaric acid, with yeast whose activity has been tested
by a special test on a sugar solution, and allow it to stand six to twelve
hours at about 34-36° C. Then test again with the bismuth test, and
if the reaction now gives negative results, then sugar was previously
present. But if the reaction continues to give positive results, then it
shows, if the yeast is active, the presence of other reducing, unfer-
mentable substances.
In performing the fermentation test care should be taken that the urine
be acid before as well as after fermentation. If the reaction becomes
1
Pfliiger’s Arch., 118.
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