HEMATURIA. of urine con taining blood.
Symptoms.—trine containing but a little blood may not give any indication of its presence to the naked eye; but, when the quantity is larger, it presents a characteristic smoky appearance; when more abundant the fluid has a more or less pink or red color, while the surface presents a tinge of green; in extreme eases it looks almost like pure blood. After a time a brownish or grayish, gum mous, flocculent sediment is deposited. When the blood is abundant it often separates from the urine in distinct clots. Although the appearance of the urine is very characteristic, various other coloring matters may be contained in the urine and give rise to delusions. These are phenol, santonin, bile-pigment, the coloring matter of rhubarb, senna, etc.
Attention called to the lumnaturia, which not infrequently follows the tool free use of rhubarb. The origin of the haemorrhage in these cases is due to actual renal lacerations in the excretion of the crystals of oxalate of lime, in which substance this plant is particu larly rich. Boyd (Lancet, Oct. 24, '91).
—The presence of blood may be proved by different 1. Heller's Test.—A few cubic centi metres of urine are rendered alkaline with caustic soda and heated in a test tube to the boiling-point; when blood is present the fluid becomes dark green; the phosphates are deposited as a floccu lent sediment carrying with them the coloring matter of the blood by which they are colored red, or, rather, rusty brown. The alkaline solution of lixmo globin is dichroitic; it shows a green tinge in thin layers and a red in larger ones, while in the alkaline solution of santonin the coloring matter of rhubarb, senna, etc., are not dichroitic and take on a -violet hue after a time.
2. The Guaiac Test (Almen-Schon bein).—One cubic centimetre of recently prepared tincture of guaiac is carefully mixed with an equal volume of ozonized oil of turpentine, i.e., turpentine-oil which has for some time been exposed to the influence of air. The mixture is cautiously poured upon the specimen of urine to be tested and will superpose itself forming on the point of contact a gray or greenish layer; when blood is present a beautiful indigo-blue stratum will appear immediately above the gray ring; when shaken the mixture will take a light-blue color. The guaiac test is
very delicate, indicating blood in the proportion of 1 to 2000 or more.
Blood in the urine gives a blue color with tincture of guaiac, in the presence of turpentine or hydrogen peroxide. Pus gives this blue color with the tincture, without the addition of an oxygen-con taining substance. Vitali and Brficke had endeavored to find the cause of the blue reaction with pus, and had found that a watery extract of pus was also able to turn the guaiac tincture blue. Personal experiments have shown that a chloroform extract of pus turned guaiac blue and the substance in the extract proved to lie a nucleoproteid, the pres ence of which in the leucocytes was re sponsible for the guaiac reaction of pus. K. Brandenburg (Mtinchener med. Woch., Feb. G, 1900).
3. The Hcemin Test (Terchmann).— Some of the sediment of the urine or of the red phosphates deposited after ad dition of caustic soda is collected and dried. A small amount is placed on an object-glass and completely dried by slowly warming. When it is fixed on the surface of the glass, some common salt is rubbed on it, a fine hair is placed across the preparation, a few drops of glacial acetic acid are added, and the whole is covered with a cover-glass. The object-glass is slowly heated to the boil ing-point of the acetic acid and then cooled. When blood is present the char acteristic small, reddish-brown crystals of hremin will appear, which are easily detected by the aid of the microscope.
4. Spectral Analysis. — Examination of urine containing oxyluemoglobin in the spectroscope reveals two distinct ab sorption-bands between the lines D and E of Frauenhofer; recently-passed urine never contains oxylimmoglobin, but methdemoglobin (a modification of luemo globin containing more oxygen than haemoglobin, but less than oxyhmo globin). By decomposition of the urine or by addition of a solution of ammonia the metInumoglobin is reduced to hemo globin, which again forms oxyluemo bin when shaken with air. The metluemoglobin gives rise to the same two absorption-bands as the oxylnemo globin, but, besides, to a characteristic band in red, between C and D.