Examination of the urine; a manual for students and practitioners . (3) in certainforms of cancer, independently of inanition; (4) in starva-tion, especially in gastric ulcer and after the use of rectalfeeding; (5) in mental diseases; (6) in auto-intoxication;(7) in derangements of digestion; (8) in chloroform nar-cosis. Acetonuria is common in fevers. In diabetes its ap-pearance shows an advanced stage, but it must be remem-bered that the predominance of nitrogenous food in diabe-tics tends to produce acetone. Cerebral irritation maygive rise to persistent acetonuria. 165 i66 EXAMINATION OF T
Examination of the urine; a manual for students and practitioners . (3) in certainforms of cancer, independently of inanition; (4) in starva-tion, especially in gastric ulcer and after the use of rectalfeeding; (5) in mental diseases; (6) in auto-intoxication;(7) in derangements of digestion; (8) in chloroform nar-cosis. Acetonuria is common in fevers. In diabetes its ap-pearance shows an advanced stage, but it must be remem-bered that the predominance of nitrogenous food in diabe-tics tends to produce acetone. Cerebral irritation maygive rise to persistent acetonuria. 165 i66 EXAMINATION OF THE URINE Preparation of Urine for Acetone Tests.—The first requisite foraccurate tests for acetone is that the urine be freshly voided. There shouldbe no preservatives in such urine, especially no thymol, as this interfereswith acetone reactions. If the urine proves negative to the ordinary acetone tests it should bedistilled and the distillate tested again. Without testing the distillateno negative acetone reaction should be accepted as final. This especially. Fig. 25.—Simple apparatus for distilling urine (Sahli). applies in cases of diabetes and of the toxemia of pregnant traces can be detected with the distillate when the urine provesnegative. An easy method of distilling the urine is described by Sahli asfollows, and can be used by the practitioner without any trouble: About 50 cc. of urine acidified with a little phosphoric acid (sufficientfor a marked Congo reaction, to prevent foaming) are poured into afractionation flask (Fig. 25) and heated to gentle boiling, preferably overa water-bath or over a wire gauze. A test-tube is then slipped over the ACETONE 167 projecting arm for a receiver and fastened with a piece of string or upper, open end of the flask is closed with a cork. The distillatewill now collect in the test-tube without any special cooling a few minutes several cubic centimeters will have distilled over,and the aceto
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