. . . ' 
- ■ THE URINE 
AND 
THE COMMON POISONS. 
HOLLAND. THE URINE 
AND 
THE COMMON POISONS. 
MEMORANDA, 
CHEMICAL AND MICROSCOPICAL, 
FOR 
LABORATORY USE. 
BY 
T. W. HOLLAND, M.D., 
PROFESSOR OF MEDICAL CHEMISTRY AND TOXICOLOGY, JEFFERSON MEDICAL COLLEGE, 
OF PHILADELPHIA. 
ILLUSTRATED. 
SECOND EDITION, REVISED AND MUCH ENLARGED. 
PHILADELPHIA: 
P. BLAKISTON, SON & CO., 
1012 Walnut Street. 
1888. Copyrighted by P. Blakiston, Son & Co., 1888. 
Press of Wm F. Fell & Oo., 
1220-24 Sansom St., 
PHILADELPHIA. TABLE OF CONTENTS. 
PAGE 
Composition of Healthy Urine, 8 
EXAMINATION OF MORBID URINE. 
The Sample : Its Putrefaction, 9 
Color, 10 
Bile Pigment : Gmelin's Test, 10 
Odor, 10 
Specific Gravity, 11 
Solid Urine, 11 
Reaction, 11 
Chlorides: Tests for, 12 
Sulphates: Tests for, 13, 14 
Phosphates: Tests for 14, 15 
Deposits of, 16 
Uric Acid, 18 
Murexide test and deposits of, 19 
Urates, Test for, 20 
Calcium Oxalate, 21 
Cystin, Test for, 22 
Leucin and Tyrosin, 23 
Urea : Tests for, 23 
Ureometry, Fowler's Method, 24 
Russell & West's Method, 25 
Lyon's " 27 
Sugar: Moore and Bcettger's Tests for, 28 
Trommer's and Haines' " " 29 
Fehling's " " . . . . . 30 
Johnson's Piero-saccharimeter, . . . ■ SUKN. ... 31 
Fermentation, test for, /. . . . \ . . . 32 
Indigo-carmine " " ... 33 
Albumin : Heller's Test for, .'.... 33 
Boiling " " 34 
Estimation of, . ' . 34 
Hematuria, ' ' . 35 
Hemoglobinuria, Almen's Test for, . . G , * . 35 
Boiling " " . . • • 7$?/ • 35 
Pyuria, Donne's Test for \ . . *>, /. . 37 
Epithelium, • x ' • * • • 37 
Spermatozoa, 40 
Microorganisms 40 
Urinary Deposits, 41 
V VI 
CONTENTS. 
PAGB 
Examination of Deposit, 42 
Plan of Urinary Examination, . 43 
Urinary Concretions, 44 
Analysis of Concretion 44 
EXAMINATION of common poisons. 
Classification of Poisons, 45 
Acids and Alkalies, 46 
Acidimetry, 46 
Alkalimetry, 48 
Nitric Acid, 48 
Hydrochloric Acid, 48 
Uffelman's test for, 49 
Sulphuric Acid, 49 
Oxalic Acid, 50 
Alkalies, 50 
Potash, 50 
Soda, ' 51 
Ammonia, 51 
Volatile Poisons, 52 
Carbolic Acid, 52 
Hydrocyanic Acid, 52 
Phosphorus, 53 
Chloroform, , 53 
Chloral Hydrate, 54 
Alcohol, 54 
Metallic Poisons, 55 
Arsenic, 55 
Fleitmann's test for, . 56 
Reinsch's test for, 56 
Marsh's test for,* 57 
Antidote for, 58 
Antimony, 58 
Copper, 59 
Mercury, 59 
Lead, 60 
Zinc, 60 
Barium, 61 
Alkaloids, 61 
Strychnine, 61 
Morphine, , 62 
Opium, . 62 
Meconic Acid, 62 
Atropine, 63 
Preliminary Examination of Suspected Matters, 64 COMPOSITION 
OF 
HEALTHY URINE. 
Healthy urine is a clear yellow fluid, slightly acid in reaction, and hold- 
ing in solution variable amounts of substances organic and inorganic. 
Average Composition of Normal Urine. 
Percentage 
Composition. 
Grains 
per diem. 
Water, 
96.0 
50 fl. ozs. 
Solids, as tabulated below, 
4.0 
1000 grs. 
Urea, 
2-5 
500.0 
Uric Acid, 
.040 
10. 
Hippuric Acid, 
•075 
i$- 
Creatinine, 
•075 
15- 
Pigment, Mucus, Xanthine, other ex- 
tractives, etc., 
.500 
170. 
Chlorides of Potassium and Sodium, . 
.500 
170. 
Sulphates of Potassium and Calcium, . 
.IIO 
40. 
Phosphates of Potassium and Sodium,. 
.120 
45- 
Phosphates of Magneism and Calcium, 
.080 
30- 
Beside these there have been found traces of Indican, Diastase, Glucose, 
Oxalic, Lactic and Carbolic acids, Unoxidized Sulphur and Phosphorus. 
VII EXAMINATION 
OF 
\ 
MORBID URINE. 
THE SAMPLE. 
In casual examination for the presence of abnormal constituents, the 
sample of urine may be voided at any hour of the day. If a single discharge 
is used, that made on rising is to be preferred. 
For accurate results, it is necessary to take a portion of the total quantity 
passed in the twenty-four hours. To obtain this, the patient is instructed 
to throw away the urine voided at an hour noted, say 9 a.m. Every evacua- 
tion of the bladder after this hour must be made into one vessel, such as a 
large "specie jar," which should be well cleaned daily and kept in a cool 
place. 
At the same hour of the following day the urine is passed into this col- 
lecting jar, and the amount measured and noted. (The mean daily dis- 
charge is 1250 c.c., or 40-50, or pints.) About a half pint of this 
should be put into a clean glass bottle, with a fresh stopper, and examined 
within twelve hours at furthest. As a rule, it is best to examine within six 
hours after emission. 
Urine kept in a warm place soon passes into putrefaction, and then is 
not suited for analysis. Without putrefaction, some organic deposits, as 
blood, tube casts and renal epithelium, are altered, if not broken up, by 
urines of low density. 
1. Experiment.-Having noted the characters of a sam- 
ple of fresh urine, let it stand aside in a warm place for 
a few days, and then mark the change in odor, specific 
gravity, reaction and sediment. A healthy urine may 
9 10 
EXAMINATION OF MORBID URINE. 
first become acid, depositing urates and uric acid, but all 
samples ultimately become ammoniacal, putrid, and throw 
down a sediment of phosphates. 
COLOR. 
In recording color, it is well to take as a standard Vogel's scale, found 
in large treatises. The urine is pale yellow after free potations, after 
hysterical or epileptic attacks and in dia- 
betes ; reddish with scant potations, after 
heavy meals, much exercise, or copious 
sweating, after hemorrhage into any part 
of the urinary tract and during fever; 
brownish in melanosis and after the 
administration of gallic acid, tannic acid 
or carbolic acid. The presence of biliary 
coloring matter imparts an intense yellow 
or olive-green hue; it is characteristic of 
jaundice. Blood gives a scarlet or a 
smoky brown tint. 
GMELIN'S TEST FOR BILE PIG- 
MENTS. 
2. Put some yellow nitric acid 
into a test tube and overlay it 
with biliary urine. At the line 
of junction there will rise, in the following 
order, bands of green, blue, violet, red and 
yellow. 
The same play of colors can be seen if the test is performed 
by bringing together on a white plate or piece of white filter 
paper the urine and the nitric acid. 
Fig. i. 
Graduated Cylinder 
for measuring the 
amount of Urine. 
It is easy to detect a departure from the familiar odor of 
health. Some articles of food, as asparagus and some aromatic 
ODOR. 
Urinometer. 11 
EXAMINATION OF MORBID URINE. 
medicines, impart a change. Saccharine urine has a fruity odor. Putrid 
urine has the odor of ammonia modified. 
SPECIFIC GRAVITY. 
8. Test.-In taking the specific gravity, if the con- 
taining vessel has a level lip at its mouth, the most 
accurate reading is made by immersing the urinometer 
while the vessel is half-full of urine, and then carefully 
filling it to the brim. The exact line of the registry 
can be taken by sighting horizontally the surface of 
the urine which rises slightly about the stem of the 
instrument. 
Import-The healthy standard is between 1015 and 1025. If persistent 
below 1015, Albuminuria or Diabetes Insipidus may be suspected. 
If persistent above 1030, Diabetes Mellitus probably exists. Further 
examination is necessary to make its meaning clear. 
SOLID URINE. 
4. Roughly estimate the solid urine in parts, per 
fluidounce, by Bird's formula. The two last figures of 
the spec, gravity nearly represent the grs. of solids to the 
fluidounce. The same figures multiplied by 2 (Trapp's 
factor) will give, more accurately, parts per iooo. For 
example, if the spec, gravity is 1025, then there are 25 
grs. of solids to the fluidounce of urine, or 50 parts in 
the thousand. 
REACTION. 
5. Test.-First put a drop of the sample on a piece of 
blue litmus paper; if the blue turns to red, then the 
reaction is acid; if the paper is unchanged, then it will 
be alkaline or neutral. Now try it with red litmus paper; 12 
EXAMINATION OF MORBID URINE. 
if it turns blue, the reaction is alkaline; if the paper is 
unchanged, the urine is neutral. Violet-colored "neutral 
litmus " paper alone can be used. It will turn reddish 
with acids and bluish with alkalies. 
If alkaline, it may be so from salts of potassium and sodium (fixed 
alkali) or from ammonia (volatile alkali). If due to ammonia, then by 
exposure the ammonia vaporizes and the red color of the paper is restored; 
whereas, the blue from fixed alkali remains. 
The normal reaction of the total daily discharge is acid. It can be made 
alkaline by the administration of alkaline medicines. 
Urine is made ammoniacal by the decomposition of urea. 
CON2H4 + 2H2O = (NH4)2.CO3. 
Urea. Water. Ammonium Carbonate. 
CHLORIDES. 
The chlorine in the urine is in combination principally with sodium as 
NaCl. The mean daily discharge is 200 grs., or 12 gms., amounting to 
more than all the other salts together. The chlorides diminish when exu- 
dations are forming, and in Pneumonia may disappear entirely. 
G. Test for Chlorides.-First, add a few drops of nitric 
acid to prevent the precipitation of phosphates, then on 
the addition gradually of solution of silver nitrate a 
white precipitate of silver chloride forms. 
By comparison of this precipitate with that from a sample of normal 
urine a rough estimate can be made of the relative amount of chlorides. 
NaCl 4- AgNO3 = NaNO3 + AgCl. 
7. Volumetric Determination.-Dilute io c.c. of urine with 50 c.c. of 
water. Put this into a beaker or capsule, with a few drops of neutral 
potassium chromate. Add gradually from a burette the standard solution 
of silver nitrate until the urine is permanently orange red; then note the 
c.c. of reagent used, subtracting 1 c.c. for excess of silver solution. The 
standard solution contained AgNO3 29.06 gm. per 1000 equal to 10 gms. 
NaCl, then 1 c.c. = .01 NaCl in the 10 c.c. of urine used,oro.i percent. 
By multiplying the number of c.c. noted by 10, the percentage can be 13 
EXAMINATION OF MORBID URINE. 
obtained, or if multiplied by 45.57, the number of grains to the fluidounce 
of urine. Then, if 15 c.c. were used, 14 c.c. would be counted. 
I c.c. = 0.01 NaCl in 10 c.c. of urine. 
14 c.c. = 0.14 " " " 
= 1.40 " 100 " " 
1.40 per cent, multiplied by 4.55 = 6.37 grains to the fluidounce. 
This method cannot be considered accurate, except when urine is not 
high-colored, nor putrid, nor albuminous. To make it satisfactory, the or- 
< ganic compounds may be removed by boiling 10 c.c. of the urine and add- 
ing to it, drop by drop, a solution of potassium permanganate, until a faint 
pink hue is left. The brown precipitate formed is separated by filtration. 
Before titration the pink tint should be removed by a few drops of oxalic 
acid, the urine made neutral with calcium carbonate, and filtered. 
SULPHATES. 
The compounds of sulphur are derived from food and the oxidation of 
proteids of the body. They are discharged daily to the amount of 
about 30 grs. or 2 gms., mostly with alkaline bases, but partly with organic 
compounds. 
8. Test.-Into the test tube containing the urine 
put a few drops of hydrochloric acid to prevent the 
formation of barium phosphate. On adding solution 
of barium chloride, a white precipitate falls, varying in 
density from a cloudiness to a creamy consistency. 
Compared with the results obtained from equal amounts 
of healthy urine acidified, one can judge as to whether 
the sulphates are greater or less than normal. 
9. Volumetric Estimation.-Into a beaker on a sand bath put 100 c.c. 
of urine acidulated with hydrochloric acid, and boil it. From a burette drop 
in the standard solution of barium chloride as long as the precipitate 
forms. Set aside for subsidence of the precipitate. Now cautiously run 
one drop of the barium chloride solution down the side of the beaker to 
see if there will be further precipitation. Run in the barium chloride until 
the white cloud no longer increases, To determine if too much of the 14 
EXAMINATION OF MORBID URINE. 
barium chloride has been used, filter a few drops out of the beaker and 
test it with a drop of sodium sulphate. A white precipitate indicates ex- 
cess of the standard solu- 
tion, and calls for a repeti- 
tion of the titration. 
The standard solution 
contained 30.5 gm. BaCl, 
in 1000 c.c. and 1 c.c. - 
0.01 gm. SO3 in the too 
,c.c. of urine used. If 15 
c.c. were needed, then 
there were present 0.15 
gm. SO3 in the hundred. 
To get grains in the 
fluid oz. multiply by 
4-557- 
Import.-As yet no 
such correspondence has 
been detected between 
the amount of sulphates 
and any pathological 
process as to make an 
estimate of value in diag- 
nosis. 
PHOSPHATES. 
The phosphoric acid 
of urine is united partly 
with the earthy bases, as 
acid calcium and mag- 
nesium phosphates, and 
partly with alkaline 
bases, as acid sodium 
phosphate and a trace 
of acid potassium phos- 
phate. The average daily 
output is 60 grs. - 4 gm., 
of which two-thirds are 
joined to alkaline bases and one-third to earthy. As the latter are insoluble 
Fig. 2. 
Graduated Burette. 15 
EXAMINATION OF MORBID URINE. 
in alkaline fluids, they are deposited whenever the urine is made alkaline 
by an internal course of such remedies, or by putrefaction, changing its 
urea into ammonia. 
con2h4 + 2H2o = (NH4)2CO3. 
Urea. Ammonium Carb. 
2(MgHPO4) 4- (NH4)2CO3 = H2CO3 + 2(MgNH4PO4). 
Magnesium Phosphate. . Triple Phosphate. 
10. Test.-To the urine in a test tube add a few 
drops of potassium hydrate, and boil. The earthy 
phosphates are thrown out and must be separated by 
filtration. 
11. Test.-To the filtrate add one-third its volume of 
magnesia mixture. The precipitate represents the phos- 
phoric acid once held by alkaline bases, now in the form 
of triple phosphate. 
12. Teissier's Method.-To get a fair idea of the quantity of phosphoric 
acid in urine, we can resort to the following easy method: Into a cylin- 
drical vessel, graduated 
in c.c., measure 50 c.c. 
of urine. To this add 
magnesia mixture a suffi- 
cient quantity, at least 
15 c.c. After shaking 
together set aside for 
twenty-four hours. As 
triple phosphate all the 
phosphoric acid will be 
thrown down in a com- 
pact white sediment, of 
which 1 c.c. in height 
represents 0.30 gm. per 
litre, or 0.03 per cent, of 
phosphoric acid. This is 
equivalent to 0.60 to 0.70 
gm. of phosphates per 
litre, or 0.06 to 0.07 per 
Fig. 3. 
Deposit in ammoniacal urine (alkaline fermentation), 
(a) Acid ammonium urate ; (b) ammonio-magnesium 
phosphate; (c) bacterium ureas. 16 
EXAMINATION OF MORBID URINE. 
cent.; multiplying this percentage by 4.55 will give the amount in grs. to 
the fluidounce. 
13. Volumetric Estimation.-Having measured 50 c.c. of urine, pour it 
into a capsule resting on wire gauze or a water bath. Add to this 5 c.c. 
of a solution of sodium acetate, which has an excess of acetic acid. Heat 
to boiling, and slowly add from a burette the standard solution of uranium 
acetate. A precipitate forms, of uranium phosphate, insoluble in the acetic 
acid. With a glass rod stir the mixture, and at intervals let a few drops 
fall on a solution of potassium ferrocyanide in a white plate, to see if it 
will form a red-brown spot, indicating that excess of uranium acetate has 
been added. 
Note the number of c.c. of standard solution used up to that point. 
The standard solution of uranium acetate contained 31.1 gm. to 1000 c.c. 
equal to 5 gm. P2O5. As 1000 c.c. == 5 gm. P2O5, then 1 c.c. of the test will 
represent 0.005 gm- in the 50 c.c. of urine taken. To get per cent., 
multiply the number of c.c. used by 0.01, which is the equivalent of 0.005 
X 2. The per cent, multiplied by 4.55 will give grains to the fluidounce. 
Import.-A knowledge of the relative amount of phosphates in a sample 
of urine is of no service in diagnosis or treatment. 
The clinical significance of the phosphates depends not on the amount, 
but on their state. 
When they are persistently thrown out from solution, there is reasonable 
ground to fear that in time a gravel or calculus may be formed. 
When from cystitis the urine is purulent, and then rapidly enters into 
bacterial fermentation, the alkaline reaction induced by the ammonia 
causes the precipitation of the earthy phosphates. 
Phosphatic Deposits.-The amorphous phosphate deposit is grayish 
white and composed of the phosphates of calcium and magnesium. Under 
the microscope it appears as granules, without color or tendency to aggre- 
gate in masses of any particular shape. 
The granules of amorphous urates usually are pinkish, arranged in deli- 
cate moss-like forms, and disappear on the addition of potassium hydrate. 
Under this reagent the phosphates are unchanged, but they clear up 
when a drop of acetic acid is introduced under the cover glass. 
Triple or Ammonio-magnesic Phosphate.-This is the combination in 
which the phosphoric acid falls after putrefactive changes. To the naked 
eye it is a whitish sediment in a turbid fluid. Sometimes the crystals may 
be detected as brilliant white points on the sides of the glass, or as a shining 
film on the surface of the urine. 
Under the microscope most of these crystals are prismatic and have some 17 
EXAMINATION OF MORBID URINE. 
resemblance to a " coffin lid." They are colorless, bright, relatively 
large, and easily distinguished from the spiny spherules of ammonium 
urate which often accompany them. 
Fig. 4. 
Deposit from a case of inflamed bladder (ammoniacal fermentation), (a) Detached 
epithelium; (b) pus corpuscles ; (c) triple phosphate ; (</) microorganisms. 
The more usual forms of triple phosphate X 300. 18 
EXAMINATION OF MORBID URINE. 
Import.-Their presence denotes ammoniacal decomposition of the 
urine. If this condition exists at the time of micturition, it is evidence 
of cystitis or other disease of the genito-urinary tract. If persistent, there 
is liability to the formation of phosphatic calculus. 
URIC ACID. 
C5H4N4O3. 
Uric acid, like urea, is nitrogenous. The quantity eliminated daily is 
0.7 gm. or 10 grs. 
In healthy urine it exists only in combination, as potassium and sodium 
urates. Acid and 
dense urine, on stand- 
ing, will undergo 
change, becoming 
more acid and throw- 
ing down a deposit of 
uric acid, calcium ox- 
alate and amorphous 
sodium urate. 
Free uric acid may 
exist in the urine at 
the time it is voided, 
but in any but the 
smallest amount must 
be considered a s 
pathological. It is 
practically insoluble, 
requiring I 8,000 
parts of water to dis- 
solve it. It is freely 
soluble in the alkalies.and solutions of the alkaline salts. 
14. Separation of Uric Acid.-To 100 c.c. of urine add 
10 c.c. of hydrochloric acid; let it stand for 48 hours, when 
the uric acid will be settled as fine crystals, looking like 
grains of Cayenne pepper. The most characteristic test 
for it is known as the murexide test. 
Fig. 5. 
Deposit in "acid fermentation " of urine. («) Fungus; (5) 
amorphous sodium urate ; (r) uric acid; (d) calcium oxa- 
late. 19 
EXAMINATION OF MORBID URINE. 
15. Murexide Test.-Put any substance supposed to be 
uric acid or urates into a watch crystal or a porcelain 
dish. Dissolve in nitric acid, and at gentle heat evaporate 
to dryness. Touch the residue with a drop of ammonia 
water, or simply expose it to the vapor of ammonia. 
A bright violet blue or purple red (murexide) indicates 
uric acid. 
Uric Acid, (a) Rhombic tables (whetstone form); (3) barrel 
form ; (c) sheaves ; (<f) rosettes of whetstone crystals. 
16. Estimation.-Having obtained the crystals as above, decant the 
urine and stir the sediment with 30 c.c. of water, using for this purpose a 
glass rod with a piece of rubber tubing at the end. Throw the suspended 
crystals on a weighed filter, dry over a water bath and weigh. 
This method, though simple, is approximative only. 
Deposit of Uric Acid.-While a faint trace of free uric acid maybe found 
in healthy urine, if present in noticeable amount, it is a pathological 
change. Once deposited, it remains undissolved in acid urine. It is 
colored by urinary pigment and easily made out by the microscope. 20 
EXAMINATION OF MORBID URINE. 
Io the naked eye it appears in minute reddish specks. Under the 
microscope these specks are found to be modifications of rhombic crystals. 
The simpler lozenge 
forms have a resem- 
blance to a whetstone. 
Some are like a drum, 
others are like rosettes, 
others, again, sheaf-like 
bundles. 
Import. - Beside its 
connection with the 
pathology of gout, uric 
acid is important as a 
deposit. 
If it is deposited soon 
after micturition, it is an 
indication of a tendency 
to form gravel. 
URATES. 
It has been said above 
that uric acid in health 
exists as neutral urates 
in combination with so- 
dium principally, but 
with potassium partly. These urates, in ordinary amount, are soluble in 
normal urine at common temperatures. 
If healthy urine is kept in a cold place, it loses its solvent powers, and 
the mixed urates are precipitated as a loose pinkish powder at the bottom 
of the glass and a film on the surface. 
The same thing happens at higher temperatures if the amount of urates 
is in excess of health and the reaction highly acid. This deposit, often 
referred to as sodium urate, the brick-dust or lateritious sediment, can be 
distinguished by its prompt solution on heating the urine. It dissolves 
readily in potassium hydrate. 
17. Test.-Having obtained a specimen of urine that is 
turbid, fill with it a test tube until it is half full. Gently 
heat the upper half. It will clear up if the turbidity is 
due to urates. 
Fig. 7. 
Uric Acid. (<i) Rhomboidal, truncated, hexa- 
hedral, and laminated crystals ; (<5) rhombic 
prism, horizontally truncated angles of the 
rhombic prism, imperfect rhombic prisms; (c) 
prism with a hexahedral basic surface, barrel- 
shaped figure, prism with a hexahedral basal 
surface; (rf) cylindrical figure, prism with a 
superimposed group of crystals. 21 
EXAMINATION OF MORBID URINE. 
18. Test.-To another portion of the same add potas- 
sium hydrate. The sediment of urates will dissolve. 
Microscopically (Fig. 5-<5), the brick-dust deposit is composed of gran- 
ules usually disposed in moss-like groups. Sometimes these granules have 
spiny radiations. 
The ammonium urate (Fig. 3-a) occurs in opaque, brownish spherules 
with or without spines, and in company with crystals of triple phosphate. 
Import.-This deposit is not as important as is commonly believed, 
occurring often from such physiological conditions as unusual exercise or 
sweating. Pathologically, it is associated with fever and chronic hectic 
diseases. 
CALCIUM OXALATE 
is present in extremely small amount in normal urine. As it takes 500,000 
parts of water to dissolve it, the slightest increase over a minute quantity 
causes it to appear as a deposit. 
To the naked eye it appears as a scanty, grayish, mucus-like cloud in 
the middle or at the bottom of the glass. 
Fig.F.8. 
Oxalate of Lime, (a) Octahedra; 
(b) basal plane of an octahedron 
forming a rectangle; (c) com- 
pound forms ; (d) dumb bells. . 
Perfect dumb-bell crystals 
of oxalate of lime. 
Microscopically, it is recognized by one of two forms: the octahedra, 
usually appearing like bright square " envelopes," and the dumb bells or 
hour glasses. 
Import.-The deposit sometimes follows the eating of rhubarb or sub- 
acid fruits containing it. Usually it signifies imperfect oxidation or re- 
tarded metabolism. 
If persistent, it may, by accretion, form a mulberry calculus. 22 
EXAMINATION OF MORBID URINE. 
CYSTIN. 
This substance, in an excessively small amount, may be a normal con- 
stituent of the urine. It is nearly insoluble in water, and in the very rare 
cases where it is present in large amount it is in the form of a deposit. 
To the naked eye the deposit is usually abundant and light, resembling 
urates. It is not dissolved by heat or vegetable acids, but readily by am- 
C6H12N2S2O4. 
Fig. 9. 
A, Crystals of cystin ; B, oxalate of lime; (c) hour-glass forms of B. 
monia. Under the microscope it is seen to be composed of hexagonal 
tablets. Iodoform escaping into the urine from surgical dressings has been 
mistaken for it. 
19. Test.-When it decomposes, hydrogen sulphide is 
formed. If boiled with a solution of lead oxide in sodium 
hydrate, the black lead sulphide forms and is precipitated. 
Import.-The conditions of its formation are obscure. It occurs very 
rarely as a calculus. 23 
EXAMINATION OF MORBID URINE. 
LEUCIN AND TYROSIN. 
These substances are formed by the same processes of digestion, and in 
acute yellow atrophy of the liver, typhoid fever and phosphorus poisoning, 
appear together in the urine. 
Leucin may appear as a spontaneous deposit. It occurs either as green- 
ish-yellow globes with concentric markings or radiating spines. 
Fig. io. 
(a a) Leucin balls; (£ b) tyrosin sheaves; (c) double balls of ammonium urate, 
Tyrosin is composed of bundles of acicular crystals arranged in various 
radiating forms. 
UREA. 
CO(NH2)2 Carbamide. 
Urea is the chief compound of nitrogen by which that element is elim- 
inated. The average daily excretion of urea is 40 gms., or 500 grains. It 
is the result of the oxidation of nitrogenous substances. 
It is neutral, odorless, has a bitter taste, does not affect litmus and plays 
the part of either acid or basic radical. 
It is easily soluble in water and alcohol, but insoluble in ether. It can 
be prepared by synthesis, and is isomeric with ammonium cyanate. 24 
EXAMINATION OF MORBID URINE. 
When crystallized slowly, it forms four-sided prisms with beveled 
ends. 
20. Test.-Take a specimen of urine or any fluid sus- 
pected to contain urea, concentrate it to a syrupy con- 
sistence by evaporation on a water bath, add nitric acid. 
The nitrate of urea will form a crystalline precipitate of 
rhombic plates (Fig. 11). 
Fig. ii. 
(<z) Urea; ($) hexagonal plates; and (c) smaller scales, or rhombic plates of urea nitrate. 
Estimation.-Several methods of quantitative analysis depend on the 
power of sodium hypobromite or hypochlorite to decompose urea. 
N2H4CO 4- 3NaBrO = 3NaBr 4- CO2 4- 2H2O 4- 2N. 
The amount of urea involved will be indicated either by the loss of spec, 
gravity of the urine or by the volume of nitrogen generated. 
21. Fowler's Method.-First, with an accurate urinometer, note the spec, 
gravity of the urine, and of the liq. sodae chloratae about to be used. Mul- 
tiply the S. G. of the latter by 7 and add the product to the S. G. of urine. 
Divide the sum by 8 to get the mean S. G. 
Then to urine add liq. sodae chloratae fjjvij. After effervescence 25 
EXAMINATION OF MORBID URINE. 
ceases, say in two or three hours, take the specific gravity of the mixture. 
Deduct this last figure from the mean S. G. obtained in the first place, 
multiply the remainder by 0.77, and you get the per cent, of urea. To 
get grains per fluidounce multiply per cent, by 4.55. 
Example:- 
S. G. of urine = 1020 X 1 volume = 1020 
" " liq. sod. chi. = 1025 X 7 " = 7 J75 
10204-7175 =8195 
8195 -T- 8 - 1024 the mean S. G. 
1024-1022 (S. G. after mixing) = 2 
2 X 0.77 - x-54 % °f urea. 
22. Russell dr3 West's Method.-This method measures the nitrogen 
evolved by sodium hypobromite and uses apparatus which gives N in 
c.c., each of which represents 
0.0027 gm- °f urea, or apparatus 
graduated so as to give per- 
centage (on the principle that 
5 c.c. of a 2% urea solution 
will evolve 37.1 c.c. of N). 
An apparatus often used is 
seen in Fig. 12. 
Solutions of sodium hypo- 
chlorite or hypobromite de- 
compose so readily that it is best 
to use them freshly prepared. 
Knop's Solution.-Dissolve 
100 gms. sodium hydrate in 
250 c.c. of water and add 25 
c.c. of bromine. 
So important is it that the 
solution should be fresh, that if 
any great interval is to occur 
between successive determina- 
tions, it is best to have the 
fluid in two parts, to be mixed 
as required. In one bottle 
keep the sodium hydrate solution (1 to 25). To make Knap's fluid add 
to 15 or 20 c.c. of this 1 c.c. of bromine. 
Method.-Fill the glass cylinder (Fig. 12) with water and immerse in it the 
Fig. i2. 
Ureameter of Charteris, as made by W. Hume, of 
Edinburgh. 26 
EXAMINATION OF MORBID URINE, 
MANUFACTURED BY PARKE, DAVIS & CO., DETROIT, MICH. 
Fig. 13. 27 
EXAMINATION OF MORBID URINE. 
graduated tube until the zero is at the surface. Into the flask measure 
15 c.c. of hypobromite solution. A short test tube containing 5 c.c. of 
urine is put in the flask by forceps, so as not to spill. Having closed the 
flask tightly with a rubber stopper carrying a connection with the graduated 
tube, tip it gradually, so as to pour out the urine into the hypobromite. Of 
the gases evolved CO2 is retained by the soda, while the N passes up the 
graduated tube. In ten minutes, having raised the collecting tube to the 
point where its contents are on a level with that of the cylinder, read off 
the c.c. of nitrogen. Each c.c. = 0.0027 °f urea in 5 c.c. of urine 
used. If it reads 8 c.c. of N then there were 8 X 0.0027 = 0.0216 gm. 
urea in 5 c.c. of urine. This multiplied by 20 to get percentage = 0.432 
per cent. 
Correction for Pressure to 760 mm. and Temperature to o° C.-For 
perfect accuracy a correction must be made according to the following 
formula:- 
V' = X (b fP in which 
760 (i-p 0.00366 T) 
V' = volume required: V = volume observed. 
b = barometer in c.c.: w = tension of aqueous vapor. 
T = observed temperature Centigrade. 
23. Lyon's Apparatus.* (Fig. ay.')-Into the bottle measure 40 c.c. of 
strong liq. sodas chloratae (or, better still, 20 c.c. of fresh Knop's hypobro- 
mite solution). Fill the little test tube to the 4 c.c. mark, and carefully 
lower it into the bottle so as not to spill. Hook the bent overflow tube on a 
bottle or tumbler, and having removed the little rubber cap, fill the gradu- 
ated jar with water to slightly above zero. Put on the cap far enough to 
depress the surface of the water exactly to zero. Make all joints tight, and 
tip the bottle so that the urine slowly flows out, and shake it occasionally. 
In half an hour lower the end of the overflow tube to the level of the water 
in the cylinder, and read off the percentage of urea. This multiplied by 
4.55 will give grains per fluidounce. 
24. Correction for Pressure and Temperature.-The graduation of this 
instrument is based on the assumption that the temperature is 70° F. (210 
C.) and the barometer 30 inches (760 mm.). Any variation from these 
standards will alter the volume of gas measured. 
Barometric changes have so little effect that ordinarily this correction 
need not be made. Temperature variations can be controlled by taking the 
observation when the thermometer is near 70° F. Within the usual range 
indoors the effect on the volume of gas may, for clinical purposes, be 
* Made by Parke, Davis & Co., Detroit, Michigan. 28 
EXAMINATION OF MORBID URINE. 
ignored. Greater accuracy can be obtained by the following rule : If the 
temperature is above 70° F., then subtract from the observed volume a cor- 
rection obtained by multiplying the number of degrees above 70° by 0.0028, 
and this product by the observed volume. To correct for barometric pres- 
sure, subtract from the above volume the amount obtained by multiplying 
the variation from 30 inches by 0.034, and this product by the observed 
volume. 
Import.-As urea is highly soluble, it is never spontaneously deposited. 
It varies in amount with different diseased conditions, e. g., in febrile and 
inflammatory affections it is increased in the forming stage and diminished 
in that of defervescence. In diabetes mellitus and simplex it is exces- 
sive in the urine, while in acute yellow atrophy of the liver it may be ab- 
sent entirely. 
In acute and chronic Bright's disease there may be a decided falling off 
from the healthy proportion, causing a lower specific gravity. In such cases 
there is more or less danger of uraemia. 
A very minute trace of glucose can be detected in healthy urine by the 
use of tests of great delicacy. In diabetes this amount is enormously 
increased (to 50 grs. per fluid oz.), so as to become appreciable to ordinary 
testing. In the application of any test but that of picric acid, it is neces- 
sary to make sure that the urine is free from albumin. If any is present, 
boil the sample with a few drops of acetic acid, and filter. 
25. Moore's Test.-Boil for a few minutes the upper 
half of a mixture of equal parts of urine and potassium 
hydrate. If sugar be present, the heated part turns a 
deeper yellow or brown. 
Fallacy: A dense, high-colored urine, or one containing albumin, will 
give the same reaction, though sugar-free. 
Reduction Tests.-The best tests for glucose are those which make use 
of its power to reduce metallic salts to lower oxides or the metallic state 
when boiled with them in alkaline solution, as Bcettger's and Fehling's. 
20. Boettger's Test.-Put into a test tube equal volumes 
of suspected urine and potassium hydrate, with a pinch 
of bismuth subnitrate. On boiling for a few minutes, if 
SUGAR. 29 
EXAMINATION OF MORBID URINE. 
sugar is present, the white powder turns gray, brown or 
black, from reduction to metallic bismuth. 
Fallacy: Albumin and sulphur compounds in the urine may cause a 
black precipitate. To make sure, repeat the test, using litharge instead of 
bismuth. If this blackens, then sulphur compounds have affected the bis- 
muth also, and some other test must be used. 
Nylander performs this test with a single alkaline bismuth oxide solu- 
tion, made as follows :- 
R . Bismuth subnitr., 2 gms. 
Rochelle salts, 4 " 
Caustic soda (of 8 per cent.), loo " Mix. 
To io c.c. of urine add I c.c. of test solution and boil. A brown or black 
precipitate denotes sugar. 
The reducing action of glucose on copper sulphate is subject to condi- 
tions which will be understood by performing the following experiments :- 
27. «In a test tube add to a solution of copper sulphate 
an equal amount of potassium hydrate, a pale-blue pre- 
cipitate of cupric hydrate Cu2H0 forms, insoluble in 
excess. On boiling, the blue hydrate changes to black 
oxide, Cu2HO = CuO + H2O. 
28. Put into a test tube solution of copper sulphate 
with glycerine a few drops (or neutral potassium tartrate 
or Rochelle salt a few grains). Now add potassium 
hydrate cautiously ; at first a blue precipitate falls, redis- 
solved on the addition of more potass, hydrate. Boiling 
makes no change in the clear blue fluid. 
This property of holding the cupric hydrate in solution is shared by many 
organic compounds, as glycerine, the tartrates, and glucose; but, when 
boiled, glucose has the peculiar property of abstracting oxygen from the 
cupric hydrate, forming the red or cuprous oxide Cu2O, 
29. Trammer's Test.-To a half inch of urine in a test 
tube add an equal volume of potassium hydrate and a 30 
EXAMINATION OF MORBID URINE. 
few drops of solution copper sulphate. Heat just to first 
signs of boiling. If sugar is present, yellow or red 
cuprous oxide is precipitated. 
30. Haines' Test.-To an inch of potassium hydrate 
in a test tube add a few drops of copper sulphate and a 
few drops of glycerine. Boil and add suspected urine 
by small amounts up to less than one inch in the tube. 
Sugar will throw out the cuprous oxide, red or yellow. 
For convenience and simplicity, the copper sulphate may be dissolved 50 
grs. in a fluidounce of glycerine and a few drops used as above. 
This Glycerine Cupric solution keeps indefinitely and takes the place of 
two different fluids. 
31. Fehling's Test.-To obviate some of the defects of Trommer's test, 
Fehling's solution is employed. As it does not keep well, it is best to 
make it in two parts, not to be mixed until the time of use. 
A. Take copper sulph. 34.64 gms. and water enough to make 500 c.c. M. 
B. Pure Rochelle salt, 173 gms. 
Sol. sodium hydrate (S. G. 1.34) 100 c.c., and water enough to make 
500 c.c. 
For use, mix equal volumes, and thus make Fehling's solution. 
32. Method.-Boil in a test tube I inch of Fehling's 
sol. While hot, add urine and bring to a boil again. If 
no yellow or red color appears, add more urine until the 
volume is I inches. Again raise to boiling point and 
set aside. If yellow or red cuprous oxide appears the 
urine is saccharine. 
Precautions.-Let the volume of urine be less than that of the test solu- 
tion. Heat up to the boiling point without continuing the boiling. 
If these precautions are not observed, high-colored, acid, dense urines 
may reduce the copper sulphate without the presence of sugar. 
33. Volumetric Estimation.-Measure into a capsule io c.c. of Feh- 
ling's solution and 40 c.c. of water. Heat over gauze to boiling, and then 
from a burette containing a mixture of one volume of urine and nine of 
water, slowly let it run into the capsule until the blue color of the test dis- 31 
EXAMINATION OF MORBID URINE. 
appears. Note the number of c.c. used, and then repeat the experiment 
with fresh materials to see if a less amount will not answer. 
Thus io c.c. of standard solution is decolorized by 0.05 gms. glucose. 
If 8 c.c. of dilute urine were used, then of the undilute 0.8 c.c. = 0.05 
gms. glucose. If 1500 c.c. were voided in the day, then 0.8 : 1500 : : 0.05 
: x = 9.4 gms. To calculate per cent. 0.8 : 100 : : 0.05 : x = 0.625. 
Parts per cent, multiplied by 4.55 give grains to the fluid ounce. 
34. Johnson's Picro-saccharimeter.-This test is based on the obser- 
vation that glucose, in the presence of potassium 
hydrate, will reduce a bright-yellow solution of picric 
acid to a red solution of picramic acid. The depth 
of the red color will correspond to the amount of 
glucose. If albumin is present, the urine is simply 
made turbid and can be easily cleared by filtration. 
As a standard of red color, a solution of ferric acetate 
can be made by the following formula more easily 
than by Johnson's formula, which uses ingredients of 
a strength peculiar to the British Pharmacopoeia:- 
. Liq. ferri chloridi, . . . 
Ammon, carb., .... gj 
Ac. acetic., f v 
Aq. destil., ad f 5 iiiss. M. 
This is put into a stoppered " weighing bottle," 
which is clamped to a " mixing bottle " of the same 
diameter and of 100 c.c. capacity, or two cylindrical 
decimal graduates of equal size may be used. 
It is best to standardize the color solution by com- 
parison with that of a tested solution of glucose of 
known strength (gr. j to If the color of the 
ferric solution is not deep enough, add a few drops of 
liquor ferri chloridi, or if too deep dilute it with water. 
In the intervals of use the apparatus should be kept 
in the dark to prevent the bleaching action of sun- 
light. If constantly employed, the color standard 
should be renewed every month. Johnson's method 
is to mix the suspected urine as follows :- 
Take of urine, fgj 
Liq. potassse, f 3 ss 
Sol. picric acid (gr. 5.3 to . 
Water, 
Fig. 14. 
Picro-saccharimeter of 
G. Johnson. 32 
EXAMINATION OF MORBID URINE. 
Mix; put in a test tube, mark the level of its surface with a file scratch, 
boil sixty seconds, add a little water up to the mark, and cool. Measure 
into the graduated cylinder ten parts of this deeply-colored urine. If it is 
of the same depth of color as the standard, then the ten division denotes 
I grain of sugar to the fluidounce. If of greater depth, add water by small 
installments, shaking the bottle until it is like the standard. 
For every ten division of the diluted urine there is one grain of sugar 
to the ounce. If it measured 45, then there are 4.5 grains to the fluid- 
ounce. If the sugar is very abundant, i. e., over 5 grains to the ounce, 
dilute the urine I part in ten. Then each ten division stands for 10 grains, 
and 45 would equal 45 grains. 
35. To simplify the measurement of the ingredients of 
the urine mixture, it is customary in Jefferson Medical 
College laboratory to use but one delivery pipette of 5 
c.c. This requires some change in the strength of solu- 
tions employed. 
Take of urine, 5 c.c. 
Liq. potassse (S. G. 1.036), . . 5 c.c. 
Sol. picric acid (gr. 3.5 to 5 c.c. 
, Water, 5 c.c. 
M. Boil sixty seconds, measure and dilute precisely as with the 
mixture given above. 
Having found the number of grains to the fluidounce, the change to 
parts per cent, is made by multiplying with the factor 0.219. 
36. Fermentation Test for Quantity. Roberts' Differen- 
tial Density Method. Take the specific gravity of the 
urine and record it; mix well urine 4 fl. ozs. (120 c.c.) 
with half a cake of Fleischman's Yeast; set aside in a 
warm place (mantelpiece) for 24 hours. After the fer- 
mentation take specific gravity again and subtract from 
that taken before. Each degree of the remainder repre- 
sents one grain to the fluidounce. 
Multiply by 0.219 to get percentage. 
Thust:-Spec. Grav. before fermentation, 1035 
" after " 1015 33 
EXAMINATION OF MORBID URINE. 
1035 - 1015 = 20 degrees of density lost, or 20 grains of sugar to the 
fluidounce. 
This test is very easily performed and conclusive as to the presence of 
sugar, though it is not absolutely accurate as to quantity. 
Indigo-carmine Test.-A blue solution of sodium sulph-indigotate 
(indigo carmine) made alkaline with sodium carbonate and boiled with 
saccharine urine, changes from blue to violet-red-straw-yellow. Cool- 
ing, or even agitation, will cause the restoration of the blue color; whereas, 
if the bleaching is due to strong alkalies, the color will not return. A very 
handy and reliable form for the test is that adopted by Parke, Davis & Co. 
in their pellets, each of which contains the indigo carmine and the sodium 
carbonate combined. The solution does not keep well. 
37. Method.-Put in 30 minims of water one pellet of 
indigo carmine and sodium carbonate; heat gently to 
solution ; let fall from a pipette one drop of urine and boil 
quietly. A change to red or yellow indicates sugar. 
Precaution.-If more than one drop is added there is a chance that a 
reaction will occur from the trace of glucose in healthy urine. 
Import op Glycosuria.-If glucose is detected by any of the tests given 
above it is pathological glycosuria. If abundant and persistent, and asso- 
ciated with excessive drinking and eating on the part of the patient, who is 
emaciating at the same time, it denotes typical diabetes mellitus. 
Temporary, slight glycosuria may follow an excessive saccharine diet, or 
the administration of chloroform, ether, chloral, amyl nitrite, turpentine 
and carbon monoxide; also poisoning from strychnia, morphia, arsenic or 
phosphorus. 
It may be incidental to various diseases of the brain and spinal cord, 
and accompany phthisis, pneumonia, asthma, cirrhosis, cholera, and even 
be intermittent, like malarial paroxysms. 
ALBUMIN. 
The albumin of the serum occurring in the urine is abnormal and nearly 
always evidence of grave disease. It is detected by the use of various 
reagents which throw it out of solution as a white precipitate. In all cases 
of turbidity, except when due to urates, it is necessary to filter the urine, 
clear before testing. 34 
EXAMINATION OF MORBID URINE. 
38. Heller s Test.-Put I inch of urine in a test tube 
and gradually run % inch nitric acid down the side 
while the tube is inclined, so as to prevent mixing. The 
acid is heavier and forms a bottom layer. Wait some 
minutes for the appearance of a white belt or zone at the 
line of contact of urine and acid. This is a coagulum of 
albumin. 
In dense urines a haziness may appear in the upper part of the urine, 
due to acid urates. Heat will clear up the urate cloud, whereas albumin 
will remain undissolved. 
39. Boiling Test.-To a tube containing 3 inches of 
urine add one drop of acetic acid. Heat the upper half 
to boiling. If contrasted with the lower half it has a 
turbid appearance, then albumin is present. It coagu- 
lates in acid fluids at 70° C. (1600 F.), but remains dis- 
solved if the urine is alkaline. 
40. Rough Estimation.-The urine acidulated as above, 
is boiled for several minutes and set aside for 24 hours. 
White flakes fall in a well-defined layer, the depth of 
which may be expressed as a fraction of the whole fluid 
in the tube, thus: it is or albuminous layer. 
Esbach's Albumimetre.-This is a tube graduated so as to express in grams 
per litre the amount of albumin represented in the coagulum produced 
by a saturated solution of picric acid. At best it gives an approximative 
estimate, and for amounts less than 0.5 gm. per litre makes no claims. 
Several other sensitive and portable tests in solution, or as pellets, are 
used, such as the potassium ferrocyanide, sodium tungstate, potassio-mer- 
curic iodide and picric acid. They are all open to the objection, that, as 
they call for the addition of some organic acid, as citric, or picric, or acetic, 
they will make a cloud with mucin as well as with albumin. 35 
EXAMINATION OF MORBID URINE. 
Import.-If serum albumin is persistently present, and when deposited 
by the boiling test, makes a layer as thick as of the column of fluid, it 
indicates Bright's disease. It appears transiently in febrile diseases, preg- 
nancy, epilepsy. It is found in poisoning from lead and arsenic. Traces 
sometimes appear in adolescents, from trivial causes. To make the diag- 
nosis of Bright's disease conclusive, tube casts must also be found. 
HEMATURIA. 
If the blood of hsematuria is derived from the kidney, it is well mixed 
with the urine, to which it imparts a smoky appearance, and microscopic tube 
casts can usually be found. If from the ureter, large vermicular clots may 
be found. If from the bladder, the blood is usually abundant and bright 
red, with stringy clots. 
41. Microscopic Appearances.-The most satisfactory test for blood is 
the presence of the peculiar corpuscles. 
These corpuscles in ordinary acid urine retain their bi-concave shape for 
several days (Fig. 16). If the urine is dense, they become crenated 
(Fig. 15). When the urine is alkaline from ammonia, as in cystitis, the 
red corpuscles are shriveled and accompanied by numerous leucocytes. 
HEMOGLOBINURIA. 
When the blood-coloring principle haemoglobin is excreted in the urine, 
diffused and not corpuscular, other tests than the microscopic must be 
resorted to. These tests indicate haemoglobin, either with or without the 
corpuscles. The microscope will serve to exclude the corpuscular element. 
42. Test.-To a suspected sample add a drop of acetic 
acid, and boil. A red coagulum indicates haemoglobin. 
43. Almen's Test.-To suspected urine add a few drops 
of tr. guaiac, freshly made. A white or greenish turbidity 
ensues. Shake well and add a few drops of old oil of 
turpentine. Haemoglobin will change the color of the 
precipitate to blue. 
Turpentine slowly absorbs oxygen, and after standing on the chemist's 
shelves for some time will act for this test as an ozone solution. As saliva 36 
EXAMINATION OF MORBID URINE. 
Fig. 15. 
Crenated red blood corpuscles in urine X 350. 
Fig. 16. 
Colored and (a) colorless blood corpuscles of various forms. 37 
EXAMINATION OF MORBID URINE. 
or potassium iodide will have the same effect as blood, these must be ex- 
cluded before a positive conclusion can be reached. 
Import.-Heematziria indicates hemorrhage from some part of the genito- 
urinary tract. 
Hemoglobinuria occurs in various diseases, attended by " a dissolved 
state of the blood," as pyeemia, scurvy, typhus, purpura, poisoning from 
hydrogen arsenide, phosphorus, carbolic acid, chloral, potass, chlorate. 
There is a periodical form, the pathology of which is obscure. 
As pus is an albuminous fluid, its presence will cause the urine to 
respond to the tests for albumin. In addition, it contains white corpus- 
cles, which are spherical, granular and opaque. (See Fig. 4.) The mucus 
corpuscle is indistinguishable from it, but mucin will not become hazy with 
Heller's test for albumin. 
44. Donne's Test.-Let the suspected urine stand 
several hours, for the pus to settle, and decant the clearer 
part. Into the deposit put a piece of potassium hydrate 
and stir with a glass rod; pus will grow thick, tough 
and gelatinous, while mucus will form flakes and become 
thin. 
Import.-A sudden appearance of pus in the urine would point to the 
opening of an abscess. Usually pyuria is an indication of catarrh or inflam- 
mation of some part of the genito-urinary tract. 
PYURIA. 
The mucous membrane of any part of the genito-urinary passages may 
shed its cells into the urine. While there is a great variety in form, it is 
usually not difficult to distinguish renal epithelium from that of extra-renal 
origin. The accompanying Fig. 18 will give an idea of the microscopic 
appearance of the tessellated, the* columnar and the transitional cells that 
appear at times from different parts external to the kidney. 
Free renal epithelium is spherical, granular, nucleated, with a very faint 
wall or no wall whatever. Its character is easily made out by the fact 
that careful search will always reveal renal tube casts in the same sample. 
EPITHELIUM. 38 
EXAMINATION OF MORBID URINE. 
Fig. 17. 
g 
(a) Epithelium from the human urethra ; (b) vagina; (c) prostate; (<Z) Cowper's 
glands; (<?) Littre's glands ; (/) female urethra; 
Fig.18. 
(a) Blood casts; (b) granular cast; (c) amyloid or waxy cast. 39 
EXAMINATION OF MORBID URINE. 
TUBE CASTS. 
When either albuminuria or hsematuria attends diseases of the kidney 
structure the deposit in the urine will be found to contain microscopic 
casts of the tubules. They may be found in cases in which neither albumin 
nor blood can be detected by ordinary testing. Sometimes they are made 
of coagulated fibrin, sometimes of mucoid exudation, sometimes of the 
plastic material of broken-down epithelial cells. 
I. Epithelial casts are composed of plastic matter with cells imbedded. 
They mark the process of desquamation. 
Fig. 19. 
Hyaline casts. 
ii. Hyaline casts are either transparent, soft, and very delicate in outline, 
or transparent, well defined and brittle. The former variety is called 
mucous, and is not always an indication of nephritis; the latter, waxy, is 
evidence of serious nephritis. 
in. Granular casts are opaque and yellowish. They are mucoid or 
waxy, or cellular material which has undergone a granular change. They 
often contain cells and fat globules. 
iv. Fatty casts are those which carry free fat globules along with the 
coagulated matter. They are usually considered proof of fatty degenera- 
tion of kidney. 40 
EXAMINATION OF MORBID URINE. 
V. Blood casts are composed of coagulated blood with corpuscles im- 
bedded. They show that the hsematuria originates in the secreting structure 
of the kidney. 
SPERMATOZOA. 
These may be present in the urine voided after coitus or an involuntary 
nocturnal emission of semen, or be an'indication of spermatorrhoea. They 
Fig. 20. 
(<i) Spermatozoa; (c) amorphous calcium carbonate; (£) crystalline magnesium 
phosphate. 
form a viscid, mucus-like deposit, which, under the microscope, is seen to 
be composed of ciliated bodies, like a tadpole, K inch long. In the urine 
they are motionless and resist decomposition for days. 
MICROORGANISMS. 
After emission, the urine may become the medium for the development 
of many low forms of life proceeding from germs that get into it from the 
air of the containing vessels. Various moulds and the yeast fungus (Sac- 
charomyces Cerevisise) are commonly met with in putrid or saccharine 
urine after several days. Sarcince in quantities have been found in urine 
at the time of discharge, probably produced in the bladder. Local symp- 41 
EXAMINATION OF MORBID URINE. 
toms are supposed to be due to their growth. These vegetations appear in 
microscopic cubes composed of distinct particles. 
Bacteria not only cause the ordinary decomposition of stale urine outside, 
but sometimes set up like processes inside the bladder. It is likely that 
this form of bacteria gets access to the urine in the urinary passages by 
Fig. 21. 
(a) Micrococci in short chains and groups; (Z>) s arcings; (c) fungi from acid fermenta- 
tion; (d) yeast cells from diabetic urine; (e) mycelium of a fungus. 
means of dirty instruments, such as catheters and sounds. It may steal 
down the urethra in the inflammatory products of old gonorrhoea. If, now, 
the urine is detained in the bladder, these organisms set up the ammoniacal 
fermentation which soon induces cystitis. 
URINARY DEPOSITS. 
Beside the different constituents of urine, healthy and morbid, which 
are seen in the deposits, extraneous substances are sometimes found. Some 
of these microscopic bodies, such as hair, or fibres of cotton and linen, 
may be mistaken for tube casts. A dirty vessel is often responsible for the 
presence of oil, starch, wood, etc. Healthy urine may form at or near the 42 
EXAMINATION OF MORBID URINE. 
bottom a light cloud of epithelial debris suspended in mucus. But if on 
emission an acid urine is turbid throughout, excess of mucus or pus or 
blood is present. If an alkaline urine is turbid, then the precipitated phos- 
phates may be the cause. 
45. A specimen may be obtained for examination by 
allowing the urine to settle, and then by means of a pipette 
a drop or two of the sediment is conveyed to the glass 
slide and covered with a thin glass disc. 
Examine with a objective, or any combination giving a power of 
200 to 300 diameters. 
If amorphous, it may be urates or phosphates. 
1. Put a few drops of the deposit into a test tube with some urine and 
warm it; the urates will dissolve, the phosphates not. 
2. To another portion add any acid, such as nitric or acetic; the earthy 
phosphates will dissolve. 
If minute globular particles with bright centres, it may be milk, chyle 
or fat. 
Shake some of the urine with ether; if chylous, its milky appearance 
will disappear and the fat separate as a top layer. 
If crystalline, it may contain one or more of the substances already 
described and figured: uric acid, Fig. 6; calcium oxalate, Fig. 8; 
triple phosphate, Fig. 4; calcium phosphate; cystin, Fig. 9; leucin 
and tyrosin, Fig. 10. 
If organized bodies, they may be epithelial cells, Fig. 17; mucus or pus, 
Fig. 4; blood, Fig. 16; spermatozoa, Fig. 20; yeast fungus, mould; 
sarcinse, bacteria, Fig. 21. 
If a microscope is not at hand, the nature of an unorganized deposit may 
be determined by the following method:- 
46. 1. Warm the deposit with some urine. 
It dissolves = urates. 
It does not dissolve = phosphates, calcium oxalate and uric acid. 
2. Warm a fresh portion with acetic acid. 
It dissolves = phosphates. 
It does not dissolve = calcium oxalate and uric acid. 
3. Warm a fresh portion with hydrochloric acid. 
It dissolves = calcium oxalate. 
It does not dissolve = uric acid. 43 
EXAMINATION OF MORBID URINE. 
47. PLAN FOR PRACTICAL EXAMINATION. 
1st. Ascertain from patient the total daily discharge. 
2d. Note if the color and odor are normal. If deep yellow, green or 
brown, test for biliary pigment. 
3d. Determine the reaction with litmus paper. 
4th. Take the specific gravity and calculate the solid urine. 
5th. Having allowed the urine to settle, carefully decant a portion into a 
test tube and examine for albumin, with one drop of acetic acid 
and heat. • If the flakes formed are white, pure albumin is present. 
If greenish, probably bile pigment is there. If red-brown, there 
is probably blood. After 24 hours, note the height of albuminous 
layer. Confirm by Heller's test. 
6th. Test for glucose by Fehling's and by Bcettger's method. 
Determine the amount. 
7th. Estimate if the chlorides are absent or much reduced. 
Determine the amount. 
8th. Estimate the amount of urea. 
9th. Describe the naked-eye characters of the deposit, and also the micro- 
scopic appearances. If amorphous, then test for urates and phos- 
phates, § 46. 44 
EXAMINATION OF MORBID URINE. 
URINARY CONCRETIONS. 
About 8o in 100 of all urinary concretions are made of Uric Acid and 
Urates. Next in frequency are the Calcium Oxalate, or mulberry calculi. 
The rarer primary constituents are Blood Concretions, Cystin, Xanthin 
Calcium Phosphate, Calcium Carbonate. Secondary to any of these there 
may appear at some stage in its history a deposit of Mixed Phosphates. 
These form a white layer, precipitated upon the calculus as a result of 
ammoniacal decomposition in the urine. 
In examining a concretion it should be sawed through the middle, so as 
to expose its concentric layers. A small portion of each distinct layer 
should be examined by the following method :- 
• 
48. CASUAL ANALYSIS OF CONCRETION. 
First burn a portion of the powder on Platinum foil in a Bunsen 
burner or blow-pipe flame. 
A. It chars greatly, leaving but little ash. 
- (Uric acid, urates, cystin, xanthin, blood.) 
It gives murexide reaction. See page 19. 
= (Uric acid or urates.) 
It dissolves in boiling water. 
= (Urates.) 
It does not dissolve in boiling water. 
- (Uric acid.) 
Cystin and xanthin are very rare; the first can be recognized by test 
on page 22. 
B. It chars slightly, leaving very much ash. 
(Phosphates, oxalate, carbonate of calcium.) 
1. Treat a fresh portion with dilute hydrochloric acid. 
It is soluble with effervescence. - (Carbonates are present.) 
" " withozit " = (Phosphates or oxalate cal- 
cium.) 
2. Treat with acetic acid. 
If it is soluble, then it is phosphatic; 
it fuses into a bead on platinum foil (mixed phosphates); 
it does not fuse (calcium phosphate). 
If it is insoluble, then it is calcium oxalate, and when calcined 
on platinum, leaves an ash that turns red litmus blue, or 
effervesces with HC1. examination 
FOR 
COMMON POISONS. 
CLASSIFICATION OF POISONS. 
The following imperfect arrangement of commonly occurring poisons is 
adopted as suitable for the preliminary tests of the practitioner of medi- 
cine : - 
A. Acids. Nitric, HNO3; Hydrochloric, HC1; Sulphuric, 
H2SO4; Oxalic, H2C2O4. 
B. Alkalies. Potassa, KHO; Soda, NaHO; Ammonia, 
NH4HO. 
C. Volatile Matters. Carbolic Acid, C6H5OH; Hydro- 
cyanic Acid, HCN ; Phosphorus, P ; chloroform, CHC13; 
chloral, C2HC13O ; alcohol, C2H5HO. 
D. Metallic Poisons subdivided into- 
1. Those precipitated ycllozu or orange from an acid 
solution by hydrogen sulphide, H2S ; Arsenic, As ; 
Antimony, Sb; cadmium, Cd; tin, Sn. 
2. Those precipitated black from an acid solution by 
hydrogen sulphide, H2S; Copper, Oil; Mercury, 
Hg; Lead, Pb; silver, Ag; bismuth, Bi; platinum, 
Pt.; gold, Au. 
45 46 
EXAMINATION FOR COMMON POISONS. 
3. Those precipitated by adding ammonia, NH4HO 
with ammonium sulphide, (NH4)2S; Zinc, Zn; 
nickel, Ni; cobalt, Co; iron, Fe; chromium, Cr; 
manganese, Mn ; aluminium, Al. 
4. Those precipitated white by adding ammonia, 
NH4HO and sodium phosphate, Na2HPO4; the 
alkaline earths : Barium, Ba ; calcium, Ca; stron- 
tium, Sr; magnesium, Mg. 
E. Vegetable Alkaloids. Morphine, Strychnine, Atro- 
pine. 
The mineral acids and the alkalies corrode the tissues with which they 
come in contact and impart a strong corresponding reaction to the vomited 
matters. If alkaline antidotes have been administered the reaction may be 
neutral, or even alkaline, and if alkaline poison has been treated by vine- 
gar or lemon juice the reaction may be changed to neutral or acid. The 
acids may have been converted into nitrates, chlorides or sulphates. A 
complete examination of suspected material in the case of chlorides or sul- 
phates requires an estimation of the quantity, to determine if these salts are 
in excess. As nitrates are not found in the normal viscera or the gastric 
contents, their bare presence in notable amounts is very suspicious. 
Besides determining the fact of acidity or alkalinity of the vomited 
matters, it may be necessary to determine the degree. This is done by 
measuring the amount of a standard test solution necessary to neutralize 
the sample, using littnus as an indicator of the neutral point. 
ACIDS AND ALKALIES. 
I. Acidimetry Experiment.-Measure I c.c. of nitric 
acid, HNO3, and fill to 50 c.c. with water. Put this 
dilute acid into a capsule or beaker and add a few 
drops of red litmus solution. Fill a graduated burette 
to o with normal solution of potassium hydrate, KHO 
(56 grams to 1000). Now, let this alkaline solution 
run, by drops, into the capsule until a violet color 
appears. Note the c.c. of KHO solution used, and 47 
EXAMINATION FOR COMMON POISONS. 
Fig. 22. 
Graduated Burette. 48 
EXAMINATION FOR COMMON POISONS. 
calculate the amount of HNO3 neutralized by multiply- 
ing the c.c. of KHO used with 0.0908. 
HNO3 + KHO = KNOS + H2O. 
Potassium nitrate and water are formed. 
2. Alkalimetry.-This procedure is like acidimetry, 
using blue litmus as an indicator and a normal solution 
of oxalic acid (63 grams to 1000) for testing. Each c.c. 
= 0.056 grams of KHO. 
Nitric Acid, HNO3. Aqua Fortis. 
3. Test reaction with blue litmus paper. 
4. Pour HNO3 on copper slips in a test tube and look 
for red-brown nitrous fumes, the liquid turning blue. 
3Cu + 8HNO3 = 3(Cu2NO3) + 4H2O + N2O2. 
Copper nitrate, water and nitric oxide are formed, and nitric oxide in 
contact with air changes to red fumes of higher oxides. 
5. Touch the skin and the clothing with a drop of 
HNO3, and note in each case a yellow stain of picric 
acid, not removed by aqua ammonia. 
6. HNO3 turns a crystal of morphia yellow, but one 
of brucia red. 
7. To dilute HNO3 or a solution of a nitrate add a 
green crystal of ferrous sulphate and a drop or two of 
sulphuric acid. The crystal turns red brown, ferric sul- 
phate being formed. 
Acid Hydrochloric, HCL Spirit of Salt. 
8. Test with blue litmus paper. 
9. Add HC1 to a few grains of manganese dioxide, 
MnO2, in a test tube. Warm and note that chlorine gas 49 
EXAMINATION FOR COMMON POISONS. 
forms and will bleach moist litmus paper held at the 
mouth of the tube. 
MnO2 + 4 HC1 = MnCl2 + 2H2O + Cl2. 
Manganese chloride, water and chlorine are formed. 
10. Hold side by side the open mouths of bottles of 
HC1 and of ammonia, NH4HO, observing the white fumes 
of NH4C1 formed. 
11. Add to dilute HC1 or a solution of sodium chloride, 
NaCl, a drop of silver nitrate, AgNO3. A white precipi- 
tate falls, soluble in ammonia but insoluble in HNO3. 
NaCl 4- AgNO3 = NaNO3 + AgCl. 
Sodium nitrate and silver chloride are formed. 
12. Put into a test tube a solution of methyl violet, 
distinctly violet in hue ; add a few drops of filtered vomit 
or other matter; if free acid is present the violet changes 
to blue. 
13. Uffelmaris solution to distinguish HC1 from lactic 
acid in gastric contents is made by adding a few drops 
of neutral ferric chloride solution to a four per cent, solu- 
tion of carbolic acid. This steel blue liquid is decolor- 
ized by HC1 but turned yellow by lactic acid. 
Sulphuric Acid, H2SO4. Oil of Vitriol. 
14. Test with blue litmus paper. 
15. Put a few drops of H2SO4 with a drop of water on 
a sheet of paper and warm gently until dry; a charred 
spot appears. 
16. To dilute H2SO4 or a soluble sulphate, add barium 
chloride, and a heavy white precipitate falls. 
H2SO4 + BaCl2 = 2.IIC1 + BaSO4. 
Hydrochloric acid and barium sulphate are formed. 50 
EXAMINATION FOR COMMON POISONS. 
17. A drop of H2SO4 applied to the black lining of the 
coat causes in time a moist red stain, which is removed 
by ammonia. 
Oxalic Acid, H2C2O4. 
18. Oxalic acid added to lime water gives a white pre- 
cipitate of calcium oxalate. 
19. Heat a crystal of oxalic acid in a test tube. It is 
volatile and condenses in the cool part of the tube. 
20. Precipitate a solution of oxalic acid with silver 
nitrate. It is white, and when separated by filtration 
and dried, it will disperse in vapor if heated on platinum 
foil. 
21. Repeat the experiment with silver nitrate and 
divide the white mixture between two test tubes. The 
precipitate of one will dissolve in nitric acid, that of the 
other in ammonia. 
Antidotes to the Acids.- Calcined Magnesia suspended in milk is 
the best. If this cannot be had, then prepared chalk, whiting or plaster 
from the wall. For the mineral acids, soap or soapsuds may be used, but 
they are not antidotes to oxalic acid. The stomach tube would probably 
injure the corroded tissues. 
ALKALIES. 
Potassium Hydrate, KHO. Caustic Potash. 
22. Test with red litmus or turmeric paper. 
23. Dilute the KHO with an equal part of water, and 
add HC1 until the reaction is neutral to litmus paper. 
KHO + HC1 = H2O + KC1. 
Water and potassium chloride are formed. 
24. To this potassium chloride add platinum chloride, 51 
EXAMINATION FOR COMMON POISONS 
a yellow granular precipitate falls slowly. Ammonium 
salts give a similar result. 
2KCI 4- PtCl4 = PtCl4.2KCl. 
A double salt potassio-platinic chloride is formed. 
25. Heat platinum foil or wire in a Bunsen's burner 
until the flame is colorless; then touch it with moist 
KHO and heat again; a violet tint appears. If mixed 
with yellow, observe through deep blue glass, which shuts 
out the yellow rays and leaves the violet. 
Sodium Hydrate, NaHO. Caustic Soda. 
26. Test for alkaline reaction. 
27. Add HC1 to neutralize. 
28. Heat NaHO on platinum foil, the flame is colored 
yellow. 
This test is so delicate as to reveal a trace of sodium present almost every- 
where. 
Ammonium Hydrate, NH4HO. Aqua Ammonia. 
29. Note the odor of aqua ammonia or ammonium 
carbonate. 
30. Test the fumes with moist red litmus paper; they 
turn it blue. 
31. Neutralize with HC1; observe the white fumes of 
ammonium chloride, NH4C1, and note that the ammo- 
niacal odor ceases. 
32. Boil the last product, NH4C1, with KHO; the odor 
of free ammonia may be perceived. 
NH4C1 + KHO = KC1 + NH4HO. 
Potassium chloride and ammonia are formed. 
Antidotes to the Alkalies. - Vinegar and Water (dilute acetic 
acid), lemon juice, oils, butter, milk. Do not use the stomach pump. 52 
EXAMINATION FOR COMMON POISONS. 
VOLATILE POISONS. 
Under this head are included carbolic acid, hydrocyanic acid and phos- 
phorus as the most important, and chloroform, chloral, ether, alcohol, nitro- 
benzene, besides some others of less importance in toxicology. Peculiar 
odors are distinctive of nearly all the volatile poisons. 
Acid Carbolic, C6H5HO. Phenol. 
33. Note the odor, 
34. A drop applied to blue litmus paper leaves a greasy 
stain, but does not redden the paper. 
35. To a dilute solution of acid carbolic add a few 
drops of nitric acid and warm gently; it turns yellow 
from the formation of picric acid. 
36. Strong bromine water causes a whitish-yellow pre- 
cipitate. 
Antidotes.-Saccharate of lime, lime water, magnesia, eggs. The 
stomach pump may be used freely. 
Acid Hydrocyanic, HCN or HCy. Prussic Acid. 
37. Note the odor of bruised peach kernels. 
38. Put HCy or potassium cyanide solution, KCN, 
into a test tube, and add a few drops of acid sulphuric. 
Cover with a watch crystal or saucer wet with 1 drop of 
silver nitrate and warm gently. A white spot appears, 
which is soluble in warm nitric acid. 
KCN 4- AgNO3 =KNO3 + AgCN. 
Potassium nitrate and silver cyanide are formed. 
39. Cover with another watch crystal wet with potas- 
sium hydrate. After a few minutes, touch with ferrous 
sulphate and with ferric chloride, and finally with one 
drop of HC1. A precipitate of Prussian blue (ferro- 
cyanide of iron) forms.. 53 
EXAMINATION FOR COMMON POISONS. 
40. Cover with another watch crystal or saucer wet 
with ammonium sulphide. 
HCy + NH4HS = 2H 4- NH4SCy. 
White ammonium sulpho-cyanide is formed. 
Now touch this with ferric chloride, Fe2Cl6, and it turns 
to blood-red sulpho-cyanide of iron. 
6NH4SCy + Fe2 Cl6 = 6NH4C1 + Fe2 (SCy)6. 
Antidotes.-Affusions of cold water, ammonia, chlorine and a mixture 
of ferrous sulphate, ferric chloride and magnesia. 
Phosphorus, P. 
41. Boil a match head in water with a few drops of 
some acid, and in a dark closet note the luminous appear- 
ance. 
42. Observe that it has an odor like garlic. 
43. Clasp over the mouth of the tube, filter paper 
moist with silver nitrate. The phosphorus vapor will 
cause a dark stain of phosphide of silver. 
Antidotes.- Copper Sulphate, crude turpentine, magnesia in milk. 
Chloroform, CHC13. Trichlormethane. 
44. A strip of paper wet with chloroform and burned 
in the Bunsen flame imparts a green tint and yields acid 
fumes which redden moist blue litmus paper. If the glass 
rod wet with ammonia is held above the flame, white 
clouds of ammonium chloride show that HC1 is a pro- 
duct of combustion. 
45. To an alcoholic solution of potassium hydrate 
add a few drops of aniline, C6Hs.NH2, and one of chloro- 
form. 54 
EXAMINATION FOR COMMON POISONS. 
Immediately, or perhaps after gentle heat, a penetrating, 
disagreeable and peculiar odor is emitted. 
chci3 + 3KHO + c6h,nh2 = C6H5.NC + 3KCI + 3H2O. 
The offensive benzo-isonitril and potassium chloride and water are formed. 
Antidotes.-Treat symptoms by lowering the head, drawing out the 
tongue, cold affusion, artificial respiration, electricity. 
Chloral Hydrate, C2HC13O. Trichloraldehyde. 
46. Dissolve a small piece of chloral hydrate in water; 
add potassium hydrate and boil. 
C2HC1s0 4- KHO = CHC13 + kcho2. 
Chloroform and potassium formate are formed. 
The chloroform vapor may be recognized by its odor 
or recovered by distillation, and the tests for chloroform 
applied to the distillate. 
47. Apply the aniline test, § 45, to a portion of the mix- 
ture in the test tube, and benzo-isonitril may be detected 
by its offensive odor. 
48. Remove the chloroform from the above mixture, 
§ 46, by boiling, then add ammonia and a crystal of silver 
nitrate. The silver is reduced with formation of a metallic 
mirror on the tube. 
Antidotes.-Wash out stomach with tea and coffee and treat symptoms 
with cold affusions, artificial respiration and electricity. 
Alcohol, C2H5.HO. 
49. To solution of potassium bichromate, K2Cr2O7, add 
a few drops of acid sulphuric, and dilute with water. If 
alcohol be now added and the mixture gently heated, it 
will turn green and aldehyde vapor will be recognized 
by its odor. 55 
EXAMINATION FOR COMMON POISONS. 
3C2H.OH + K2Cr2O, + 4H2SO4 = 
3C2H3O4 + K2SO4.Cr2(SO4)3 
Aldehyde and green potassio-chromic alum are formed. 
50. Dissolve a crystal of iodine in some alcohol. Add 
potassium hydrate until the brown color disappears, when 
a yellow precipitate of iodoform falls. 
C6H5HO + 6KH0 + I8 = CHI3 + CHO2K + 5KI + 5H2O. 
Iodoform, potassium formate, potassium iodide and water are formed. 
Arsenic, As. Arsenic Trioxide, As2O3. Arsenious Acid, H3AsO3. 
51. Put into a reduction tube a small quantity of 
As2O3 mixed with some flux (made of sodium carb. 3 
METALLIC POISONS. 
Fig. 23. 
Fig. 24. 
Fig. 25. 
parts to potass, cyanide I part). Heat the mixture and 
observe the formation of a dark mirror ring of As on the 56 
EXAMINATION FOR COMMON POISONS. 
tube. Break off the closed end of the tube and heat the 
ring. A current of air plays through the tube and ox- 
idizes the As to As2O3, which is deposited in the cool 
part of the tube as a white ring of minute octahedral 
crystals. 
52. To a solution of As2O3 add a few drops of HC1 
and pass through it hydrogen sulphide, H2S; a lemon- 
yellow precipitate falls, soluble in ammonia. 
2H3AsO3 -|- 3H2S - As2S3 6H2O. 
Arsenic trisulphide and water are formed. 
53. To a solution of As2O3 add silver ammonio-nitrate; 
it throws down a canary-colored precipitate of silver 
arsenite, Ag3AsO3. 
54. To a solution of As2O3 add copper ammonio- 
sulphate; it throws down a green precipitate of copper 
arsenite, CuHAsO3. 
55. Fleitmanris Test.-Into a test tube put some strong 
potassium hydrate, and a few pieces of pure zinc; clasp 
over the mouth of the tube paper wet with silver nitrate, 
and boil. If the paper is not stained no arsenic is pre- 
sent in the materials used. 
Zn -J- 2KHO = H2 -J- K2ZnO2. 
Hydrogen and potassium zincate are formed. 
Now add a few drops of arsenical solution to the same 
mixture and boil as before; a black stain appears on the 
paper. 
AsH3 + 6AgNO3 + 3H2O = 6Ag + H3AsO3 + 6HNO3. 
Black metallic silver, arsenious acid and nitric acid are formed. 
56. Reinserts Test.-Into a solution of As2O3 in a test 57 
EXAMINATION FOR COMMON POISONS. 
tube put a few drops of HC1 and a clean slip of copper; 
then boil for a few minutes. When the slip has a steel 
gray coat of As, remove it; dry with blotting paper, and 
heat in an open glass tube. Note the white ring of 
As2O3 crystals. 
57. Marsh's Test.-Into a hydrogen-generating appa- 
ratus put some pure zinc and 
add dilute sulphuric acid 
(H2SO4 part one to H2O parts 
four). Wait fifteen minutes, 
until the explosive mixture of 
air and hydrogen has escaped, 
then light the H gas at the 
jet and hold in the flame a 
piece of cold porcelain. If no 
stain is made then arsenic and 
antimony are absent from the 
materials. Now add solution 
of arsenious acid and try the flame again with the porce- 
lain. A brownish-black metallic mirror of As appears. 
3Zn 4- 3H2SO4 + H3AsO3 = 3ZnSO4 + 3H2O + AsH3. 
Zinc sulphate, water and hydrogen arsenide are formed in the generator. 
By burning, the AsH3 is decomposed, forming H2O + 
As. The As deposited on cold porcelain is freely solu- 
ble in liq. sodae chloratae. If treated by nitric acid it is 
changed to arsenic acid, which, with silver nitrate, gives 
red silver arseniate. 
58. Use a fresh hydrogen apparatus with solution of 
an antimony salt, say tartar emetic, repeating the same 
procedure. On the porcelain a sooty stain appears, 
which is barely soluble in liq. sodae chloratae. It is solu- 
Fig. 26. 58 
EXAMINATION FOR COMMON POISONS. 
ble in nitric acid but does not afterward turn red with 
silver nitrate. It is soluble in ammonium sulphide with 
an orange-red residue. 
59. Make the antidote, ferric hydrate, by adding to 
tinctura ferri chloridi some calcined magnesia or aqua 
ammonia in excess and shake well together. 3 fluid- 
ounces of tinct. ferri chlor, yields antidote for 10 grains 
of arsenious acid. 
2(Fe26HO) As2O3 = Fe32AsO4 -|- 5H2O -|- FeaHO. 
Antidotes to Arsenic.-Milk, eggs, hydrate magnesia, dialysed iron, 
moist ferric hydrate, ferri oxidum hydratum cum magnesia. 
Antimony, Sb. Tartar Emetic, K(SbO)C4H4O6. 
60. Pass hydrogen sulphide into a solution of tartar 
emetic. An orange-red precipitate of antimony sulphide 
forms. Divide this precipitate in three portions; one is 
insoluble in aq. ammonia, one is soluble in ammonium 
sulphide, and the third soluble in hydrochloric acid. 
Arsenic sulphide is insoluble in HC1. 
61. Repeat Reinsch's test, § 56, using solution of tartar 
emetic instead of arsenic. The deposit on copper is 
bluish, and when heated in an open glass tube yields a 
white amorphous sublimate. 
62. Repeat Marsh's test, § 57, using solution of tartar 
emetic instead of arsenic. The stain on porcelain is 
sooty, barely soluble in NaClO but soluble in NH4HS, 
leaving an orange-red residue. 
63. Put a drop of solution of tartar emetic on platinum 
foil and touch the platinum through the drop with a slip 
of zinc. A black spot of antimony appears which turns 
orange-yellow with ammonium sulphide. 
Antidotes to Antimony.-Acid tannic, tea, vegetable astringents, 
dialysed iron, moist ferric hydrate. 59 
EXAMINATION FOR COMMON POISONS. 
Copper, Cu. 
64. Treat solution of copper sulphate, CuSO4, with 
hydrogen sulphide, and a brown-black precipitate falls. 
65. Dip into solution of CuSO4 a bright steel needle; 
it soon has a red coat of metallic copper. 
66. Treat a weak solution of CuSO4 with potassium 
ferrocyanide ; a brown precipitate falls. 
67. To solution of CuSO4 add a drop of ammonia; a 
bluish precipitate falls, but on addition of more ammonia 
this clears into a deep blue solution. 
CuSO4 + 2NH4H0 = CU2NH3SO4 + 2H2O, 
Blue ammonio-sulphate of copper and water are formed. 
Antidotes.-Warm milk and raw eggs. 
Mercury, Hg. Corrosive Sublimate, HgCl2. 
68. Treat calomel, Hg2Cl2,with limewater; it turns to 
black oxide, Hg2O. 
Hg2Cl2 + Ca2HO = Hg2O + CaCl2 + H2O. 
Black mercurous oxide, calcium chloride and water are formed. 
69. Treat corrosive sublimate, HgCl2, with lime water; 
it turns to yellow oxide, HgO. 
70. Perform Reinsch's test, § 56, with corrosive subli- 
mate solution without boiling; the copper takes a gray 
coat of metal, Hg. 
Dry the copper and heat it in an open tube; a subli- 
mate of minute gray globules forms. Heat this sublimate 
with iodine; it forms red mercuric iodide, Hgl2. 
Galvanic Test.-On a gold ring or coin put a drop of 
solution of corrosive sublimate; with a steel needle or 
knife touch the gold through the drop, and a silver-like 60 
EXAMINATION FOR COMMON POISONS. 
spot of metal, Hg, appears. This stain is removable by- 
gentle heat over a flame. 
Antidotes.-Raw eggs; flour in milk ; emetics. 
Lead, Pb. 
71. Put a crystal of lead acetate on a piece of char- 
coal and heat with the tip of a blowpipe flame. A 
globule of metallic lead soon forms and a yellow margin 
of lead oxide surrounds it on the charcoal. 
72. To a solution of a lead salt add hydrogen sulphide; 
a black precipitate of lead sulphide, PbS, falls ; insoluble 
in KHO and NH4HS, but soluble in boiling dilute 
HNO3. 
73. To another portion of lead solution add acid sul- 
phuric ; a white precipitate of lead sulphate, PbSO4, falls. 
PbCO3 + MgSO4 = PbSO4 4- MgCO3. 
74. To another portion add potassium iodide ; a yellow 
precipitate of lead iodide, Pbl2, falls. 
75. To another portion add KCrO4; a yellow precipi- 
tate of lead chromate appears. 
Antidotes.-Magnesia sulphate and other soluble sulphates with milk 
and opium for colic, potassium iodide and iron for chronic poisoning. 
Zinc, Zn. 
76. To solution of a zinc salt add ammonium hydrate. 
A white precipitate of zinc hydrate, Zn(OH)2, falls, solu- 
ble in excess of the ammonium hydrate. 
77. To another portion add first ammonium chloride 
and then ammonium hydrate. There is no precipitate. 
Now add hydrogen sulphide. White zinc sulphide is 
thrown down. 61 
EXAMINATION FOR COMMON POISONS. 
78. To a neutral or alkaline solution of a zinc salt add 
ammonium sulphide. A white precipitate, ZnS, is thrown 
down. 
Antidotes.-Raw eggs, milk, tea, vegetable astringents. 
Barium, Ba. 
79. From solution of a barium salt, potassium hydrate 
will throw out white barium hydrate, Ba(OH)2 Ammo- 
nium hydrate has no such effect when added to another 
portion. 
80. To the clear solution with ammonia add sodium 
phosphate, Na2HPO4; it forms a white precipitate of 
barium phosphate, BaHPO4. 
81. To a solution of barium salt add acid sulphuric or 
any soluble sulphate. A white precipitate, BaSO4, falls. 
Antidotes.-Magnesium sulphate or any soluble sulphate, eggs and 
milk. 
ALKALOIDS. 
Strychnine, C21H22N2O2. 
82. Note the intensely bitter taste of one drop of the 
solution. 
83. On a white dish put a crystal of strychnine and 
add to it a drop of acid sulphuric. It dissolves without 
change of color. Near by upon the same dish put a 
crystal of potassium bichromate and let the acid solution 
flow over it. At the line of contact a transient play of 
colors will be seen in the following order: blue, violet, 
red and yellow. 
84. Nitric acid makes with it a colorless solution. If 62 
EXAMINATION for common poisons. 
brucine be present as an adulteration a red color is pro- 
duced. 
85. Insert a few drops of strychnine solution under 
the skin of a frog's back. Within a few minutes it will 
be convulsed. 
Antidotes.-Emetics with draughts of tea or other vegetable astrin- 
gents, chloroform by inhalation, chloral and potassium bromide by enema. 
Morphine, C17H19NO3. 
86. On a white dish put a crystal of morphine and 
touch it with a drop of acid nitric ; it turns at first orange 
red and fades to yellow. 
87. To a neutral solution or a crystal of morphine add 
pure neutral ferric chloride, Fe2Cl6; a deep blue color 
appears. 
88. To morphine solution add iodic acid in solution; a 
yellow color of reduced iodine appears. If the yellow 
liquid is shaken with chloroform, the iodine separates in 
a violet-colored layer. 
Antidotes.-Emetics ; washing out the stomach with strong tea; elec- 
tricity ; flogging; artificial respiration; brandy. 
Opium. Meconic Acid. 
89. To a portion of solution of meconic acid or a 
decolorized infusion or tincture of opium add ferric chlo- 
ride, Fe2Cl6 (pure and neutral); a brown-red color appears. 
This color persists even if treated by diluted HC1 or by 
mercury bichloride, HgCl2. 63 
EXAMINATION FOR COMMON POISONS, 
Atropine, CkH23NO3. 
90. A small portion of atropine, if heated with strong 
acid sulphuric, does not change color, but gives off an 
odor of roses. 
91. Into a test tube put a few drops of acid sulphuric 
and a crystal of potassium bichromate, and heat them. 
If a fraction of a grain of atropine is now dropped in, a 
green color and an aromatic odor may be perceived. 64 
EXAMINATION FOR COMMON POISONS. 
PRELIMINARY EXAMINATION OF VOMITED OR 
OTHER SUSPECTED MATTERS. 
1. Note stains on the clothing or about the lips and 
mouth. 
2. Put in a white dish and examine for odor, seeds, 
wing cases of cantharides, crystals or powders. 
3. Take a small measured portion, say one-sixth or 
one-third; put in a clean jar 
and stand in a bowl of warm 
water. 
4. Test for volatile poisons. 
HCy by odor and by action 
of vapor on reagents ap- 
plied to the underside of 
a glass cover to the jar. 
§ 38, 39, 40. 
Phosphorus by odor and 
luminous vapor evolved 
in a dark room, by boiling a portion in a test tube. 
§ 41, 42, 43. 
Carbolic acid by odor. § 33, 34, 35, 40. 
5. Test for corrosive acids by litmus paper or by stains, 
or by analyzing a sample of suspected substance. 
6. Test for corrosive alkalies by litmus paper or direct 
testing of suspected sample. 
7. Test for metallic irritants. 
Apply Reinsch's test, § 56, for As, Sb, Hg; if there is 
a metal deposit on the copper then make a subli- 
mate in an open glass tube. 
If there is no deposit on the copper acidulate a portion 
with HC1 and add H2S. If it forms a black precipi- 
tate test for Cu and Pb. 
Fig. 27. 65 
EXAMINATION FOR COMMON POISONS. 
8. If the patient has narcotism or convulsions, apply 
Stas' method for morphine or strychnine by 
making the fluid portions alkaline with so- 
dium carbonate, which sets the alkaloid free. 
The alkaloid is then separated from the liquid, 
which holds it suspended by agitating it with 
four volumes of ether, chloroform or benzole. 
By letting the mixture stand, the ether float- 
ing will hold the alkaloid in separate solution, 
and may then be removed by a pipette. 
If the ether is allowed to evaporate on a 
saucer or watch glass the residue may be ex- 
amined for strychnine and morphine. 
Note.-The methods indicated above are " rough and 
ready," and are such as might be applied quickly to vomited matter by a 
practitioner between his visits. They may serve to clear up a diagnosis 
before it is too late to help the patient. They would not answer for a juridi- 
cal trial. The methods applied by expert analysts are far more searching, 
and require much more apparatus, time and special knowledge. 
Before the analyst begins testing for the metallic irritants he first gets 
rid of all organic matter by some such process as that of Fresenius. The 
finely divided substance is boiled with pure hydrochloric acid, while potas- 
sium chlorate is added from time to time until the solids are reduced to a 
straw-yellow fluid. This fluid is then treated with excess of sodium bisul- 
phite and saturated with hydrogen sulphide until the metals are thrown 
down as sulphides. These sulphides are then treated with various tests 
for the metals. 
Fig. 28.