Abstract
Gmelin's test for bile pigments was carried out on all specimens of urine submitted to the laboratory during a period of a little more than 2 years. Approximately 50,000 specimens were examined during this time, and a positive test was obtained in 476 specimens from 308 subjects. Most of the patients treated in this institution are suffering from chronic diseases and are of fairly advanced age. Since daily specimens were obtained from diabetic patients and urine from those on the surgical service was examined routinely 3 times a week these 2 groups have an undue prominence in the series. The approximate concentration of urobilogen in the specimens giving a positive Gmelin test was determined by the method of Wallace and Diamond. 1 Normal urines show a positive test by this method when diluted 1 to 10 or 1 to 20 with water, but give no color when dilution is greater. In our series 142 specimens, or less than a third of the total, fell into this range. There were 54 specimens from 18 patients which gave a negative Wallace and Diamond reaction, and it seemed probable that these could be adequately explained by failure of bile to enter the intestine, as the diagnoses indicated the certainty or the possibility of the presence of lesions obstructing the bile ducts in most cases. Only 24 specimens from 22 patients showed a positive reaction which became negative when the urine was diluted with 9 parts of water. Over half of the analyses (256 specimens) gave results which were high, and such figures were obtained at some time or other upon 198 patients, or approximately two-thirds of the entire series. In general the diagnoses on these patients offered no adequate explanation of the findings.
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