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SUGAR IN URINE. 807
added, and the mixture boiled in a test-tube until it measures 3 cc. After quickly
cooling warm again and then allow it to cool slowly. After 5-10 minutes beautifully
formed crystals are obtained even in the presence of only 0.02 per cent sugar.
According to the experience of ElAMMABSTEN this modification, even in the presence
of 0.1 per cent sugar in concentrated urines, does not always give a positive reac-
tion. Salkowski ’ has suggested an even more simple method.
The value of the phemihydrazine test lias been considerably debated,
and the objection has been made that glucuronic acids also give a similar
precipitate. A confounding with glucuronic acid is, according to Hirschl,
not to be apprehended when the test is heated in the water-bath for a
long time (one hour). Kistermann found this precaution insufficient,
and Roos states that the phenylhydrazine test always gives a positive
result with human urine, which coincides with E. Holmgren’s 2
and
Hammersten’s experience. This test only show’s a non-physiological
quantity of sugar when a rather abundant crystallization is obtained from
a small quantity of urine (about 5-10 cc.) Too great a delicacy of this
test is not to be recommended.
Rubxer’s test is performed as follows: The urine is precipitated with an excess
of a concentrated lead-acetate solution and the nitrate carefully treated with
enough ammonia to produce a flocculent precipitate. It is then heated to boiling,
when the precipitate becomes flesh-colored or pink in the presence of sugar.
Polarization. This test is of great value, especially as in many cases
it quickly differentiates between glucose and other reducing, sometimes
levogyrate, substances, such as the conjugated glucuronic acids. In
the presence of only very little sugar the value of this test depends on
the delicacy of the instrument and the dexterity of the observer. As a
urine which showr
s no rotation or is actually faintly levorotatory, may
contain 0.2 per cent glucose or perhaps even more, this test must be
combined with the fermentation test if we are seeking very small amounts
of sugar. The sugar in these cases can be detected only by the use of a
very accurate and delicate instrument. This method is in many cases
not serviceable for the physician. If the urine is to be clarified and
partly decolorized by precipitation with lead acetate, it must be done in
acid solution with acetic acid.3
In the isolation of sugar and carbohydrates from the urine the benzoic-acid
esters may be prepared according to Baumann’s method. The urine is made
alkaline with caustic soda to precipitate the earthy phosphates, the filtrate treated
with 10 cc. of benzoyl chloride and 120 cc. of 10 per cent caustic soda solution
for even’ 100 cc. of the filtrate (Reixbold 4
), and shaken until the odor of benzoyl
1
Neumann, Arch. f. (Anat. u.) Physiol., 1899, Suppl. See also Margulies, Berlin.
klin. Woehenschr., 1900; Salkowski, Arbeiter aus dem pathol. Inst., Berlin, 1906.
* Hirschl, Zeitschr. f. physiol. Chein., 14; Kistermann, Deutsch. Arch. f. klin.
Med., 50; Roos, 1. c; Holmgren, Maly’s Jahresber., 27.
1
See Grossmann, Bioch. Zeitschr., 1.
4
Pfluger’s Arch., 91.
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