Scarlatinal albuminuria and the pre-albuminuric stage, studied by frequent testing / by R. Stevenson Thompson.

Date:
1886
Catalogue details

Licence: Public Domain Mark

Credit: Scarlatinal albuminuria and the pre-albuminuric stage, studied by frequent testing / by R. Stevenson Thompson. Source: Wellcome Collection.

Provider: This material has been provided by the Royal College of Physicians of Edinburgh. The original may be consulted at the Royal College of Physicians of Edinburgh.

    18/36
    wlien the quantity of haemoglobin increased beyond a trace, albumen put in an appearance with the ordinary tests, thus indicatipg that it had probably been there all along. This stage I regard as entirely analogous to the “ pre-albuminuric stage.The apparent absence of albu- men in the pre-albuminuric ’’ and “ ppst-albuminuric ” stage is paralleled by what is often seen on examining the urine of menstruating women and by what one finds on direct experiment. From observations conducted upon a number of women whose urine was tested several times daily with great regularity, it was found that in some of the cases, at the menstrual periods, the guaiacum test revealed the presence of blood before nitric acid indicated the presence of albumen. The same peculiarity was observed as the menstrual flow was passing o:^. There can be no doubt that in the urine of thege women albumen as well as haemoglobin was present, the blood being altered in some of its properties, yet containing these two consti- tuents. It cannot be doubted, I think, that the urine contained blood pure and simple, and yet only haemoglobin could be detected by the guaiacum test, while nitric acid failed to give any reaction at all. On concentration of the urine albumen was found. The same conclusion is proved by the following experiment : If a drop of fluid blood be placed in a conical glass and normal urine gradually added, as dilution goes on albumen will be found to cease to give a reaction with nitric acid some time before the guaiacum test ceases to react with the haemoglobin, it being understood that the mixture is allowed to rest after each dilution and that the urine to be tested for haemo- globin is taken from the bottom of the glass. This early apparent disappearance of the albumen is what one would naturally expect, even if the nitric acid and guaiacum tests were equally delicate; for, while the albumen is dissolved and diffused throughout the fluid, the corpuscles contain- ing the colouring matter (hasmoglobin) sink to the bottom, only a small quantity of the hasmoglobin being dissolved out by the urine. To my thinking, the facts noted above