INSTRUCTIONS 
FOR THE USE OF THE 
URINARY TEST PAPERS 
INTRODUCED BY 
DR. G. OLIVER, 
FOR THE CLINICAL EXAMINATION OF THE URINE 
AT THE BEDSIDE, 
DAVIS =& CO., 
DETROIT AND'nKW YORK CITY. PHYSICIAN’S POCKET REAGENT CASE. 
CONTAINING A COMPLETE SET OF CHEMICAL APPARATUS 
AND REAGENTS FOR BEDSIDE URINE ANALYSIS, 
QUALITATIVE AND QUANTITATIVE. 
This case contains, in addition to me series of urinary- 
test papers issued by us (see third cover-page), a compre- 
hensive book of instructions for the use of Dr. Oliver’s 
bedside tests, and the following apparatus: 
x. Two test tubes, or e of which is graduated. 
e. A graduated minim pipette. 
3. A set of six specific gravity beads, corresponding 
with specific gravities respectively of 1.005, r.oio, 1.015, 
1.020,1.025 and 1.030. These will be found more convenient 
to use than the ordinary urinometer, which is, moreover, a 
very fragile instrument. 
PRICE.—Leather, $1.50; paper, $1.00. Sent to any 
address on receipt of price. 
A more compact arrangement it would be difficult t» 
devise, and the physician cannot well forego the conven- 
ience of such a vest pocket chemical laboratory. 
For cut see fourth cover page. 
PARKE, DAVIS & CO., 
New York- \ 60 M.aiden Lace. 
NEW X ORK. -j aI Lltierty St. 
Manufacturing Chemists, 
Detroit, Michigan. INSTRUCTIONS 
FOR THE USE OF THE 
URINARY TEST PAPERS 
INTRODUCED BY 
DR. G. OLIVER, 
FORaTHE CLINICAL EXAMINATION OF THE URINE 
AT THE BEDSIDE. 
=2= cc.. 
DETROIT AND NEW YORK CITY. 3 
Tests for Sugar. 
Two tests are furnished in this series. 
1. Indigo Carmine. 
2. Picric Acid. 
These reagents are both used in connection 
with sodium carbonate in the manner described 
under the individual heads following. 
The diagnosis of glycosuria may be made with 
certainty by means of these test papers, and 
an approximate estimation made of the quantity 
of sugar present. 
The presence of albumen and of uric acid in 
the urine does not interfere with either of these 
tests, which are capable of detecting the smallest 
quantities of sugar that can be considered patho- 
logical. 
mulder’s test for sugar. 
Indigo Carmine. 
This is an exceedingly sensitive test for diabetic 
sugar, and its indications may be accepted as 
infallible. 4 
Place in a test tube 30 minims of water with 
an indigo and a sodium carbonate paper. Heat 
the tube gently until the indigo is dissolved. 
[The solution should be of only a pale blue color. 
A portion of one of the indigo papers may suffice, 
but the whole of the soda paper should be used.] 
Add to the blue solution from a pipette one drop 
of the urine to be tested, and keep the fluid at the 
boiling point, without, however, permitting active 
ebullition, for sixty seconds. If no change is pro- 
duced add a second drop of the urine, and heat 
once more. If any notable quantity of sugar is 
present, the fluid will be observed to change from 
pure blue to violet, then to purple and red and 
finally will fade to a pale yellow. If there is 
only a trace of sugar, the color will merely change 
to one of the intermediate shades. 
Normal urine itself produces a reaction if 
added in sufficient quantity, 5 to 8 drops generally 
being sufficient to change the color to purple or 
red. If, however, no more than two drops of the 
urine are employed in the test, a change of color 
is proof that sugar is present in abnormal quantity. 
lUpTf the tube is agitated during the experi- 
ment so that the fluid is brought in contact with 
the oxygen of the air, the reaction is retarded. 5 
Indeed the blue color of the solution may be 
momentarily restored even in presence of a large 
excess of sugar by vigorously shaking the tube, 
and the color can be discharged and restored 
repeatedly, by the alternate action of the sugar 
and the oxygen of the air. 
QUANTITATIVE ESTIMATION OF SUGAR BY INDIGO 
CARMINE. 
The test papers may be made to yield approxi- 
mate quantitative results, by observing that the 
color of 30 minims of a pale blue solution of indigo 
is changed to yellow by heating one minute with 
one minim of a urine containing ten grains of 
sugar to the fluidounce, or by heating two minutes 
with one minim of a urine containing five grains 
to the fluidounce. For exact work, it is necessary 
of course to have papers especially prepared, 
containing a definite quantity of the reagent, 
but a rough approximation to the truth may be 
based upon the statement just made, and infor- 
mation of great value may be thus obtained in 
observing the influence of remedies in a case of 
diabetes. 
If the quantity of sugar is smaller than that 
named, the change of color will be only partial, 6 
but exact quantitative estimations are ot less 
importance in these cases than where the amount 
is more considerable. 
In case the urine contains more than ten grains 
of sugar to the fluidounce, it will be necessary 
to dilute it until it is reduced to that strength. If 
four times its volume of water is required to effect 
this, the urine must contain 5-}-io=50 grains of 
sugar to the fluidounce. The details of this 
method can be best worked out by each individual 
for himself. 
Picric Acid. 
dr. geo. Johnson’s test for sugar. 
When an alkaline solution of picric acid is 
boiled with a little glucose, picramnic acid is form- 
ed, and the color of the solution changes to a 
garnet red. To apply the test to the urine, put 
in a test tube one of the picric acid papers with 20 
minims of water and about 3 grains of sodium 
carbonate, add 10 minims of the urine and boil 
sixty seconds if necessary. The color of the mix- 
ture always darkens perceptibly, but if sugar is 
present the change is much more prompt and 
decided than in the case of normal urine. If the 
olor changes rapidly to a dark red, repeat the 7 
experiment with 5, 3 and one minim successively, 
to form an approximate estimate of the quantity 
of sugar present. If one minim gives a strong 
reaction, dilute the urine until a single minim of 
the dilute fluid gives only a deep amber color with 
a distinct shade, however, of red. In a diluted 
urine this reaction will indicate the presence of 
about one grain of sugar to the fluidounce. 
About the same shade of color is generally 
produced by two minims of a normal urine, so 
that there should be deducted from the result 
obtained about half a grain to the fluidounce, as 
“normal sugar.” This test should always be 
confirmed by the indigo carmine test, since there 
are other substances than sugar—notably kreati- 
nine—which react like glucose with picric acid. 
COMPARATIVE VALUE OF TESTS FOR SUGAR IN 
THE URINE. 
The copper test, which is commonly employed, 
is perhaps the least trustworthy of all the tests 
for glucose. Among the normal constituents of 
the urine, uric acid is capable of reducing copper 
compounds, and numerous substances which 
may be accidently present have a similar action. 
Kreatinine and many other organic compounds 8 
prevent or retard the precipitation of small quan- 
tities of cuprous oxide, so that urine containing 
less than one grain of sugar to the fluidounce 
fails to respond to the copper test, or gives an 
indication only after half an hour or a longer 
time. 
Picric acid is an exceedingly sensitive reagent 
for the detection of sugar, but a larger amount of 
alkali must be used than can be put in the form of 
a test paper, so that a supplementary supply of 
the alkali must be carried in the pocket case, if 
the test is to be used at the bedside. The reagent 
is not affected by uric acid, nor by most of the 
substances occasionally present in the urine which 
reduce copper. It does react however, with 
kreatinine present in normal urine, and with fer- 
rous salts, tannin, and inosite which occasionally 
occur in the secretion. Normal urine always 
shows a distinct reaction, as though it contained 
as much as yz grain in the fluidounce of glucose. 
Indigo is not affected by an)' known normal 
constituents of the urine. Since normal urine 
always produces a reaction with it, we must con- 
clude either that glucose (or inosite) is constantly 
present in urine in small quantities, or else that 
there is a constituent constantly present which has a similar action but is as yet unknown. Of 
the possible accidental constituents of the urine, 
only ferrous salts and tannic acid affect indigo, so 
that we may regard this test as not only the most 
sensitive, practically, of any yet proposed but as 
practically free from fallacies. Finally unlike the 
copper test, indigo carmine can be preserved un- 
changed for years, especially in the convenient 
form of these test papers. 
Albumen Tests. 
Four different reagents for albumen are fur- 
nished in this series of test papers. 
1. POTASSIO MERCURIC IODIDE. 
2. SODIUM TUNGSTATE. 
3. POTASSIUM FERROCYANIDE. 
4. PICRIC ACID. 
These reagents are all used in connection with 
citric acid. Put into a test tube 30 minims of the 
urine with a citric acid paper (or if the specimen 
be alkaline, more than one acid paper) and allow 
a few moments for the acid to become dissolved. 
If a cloudiness is produced by the acid, itris due to mucin, or uric acid, or rarely to oleo resin, as 
where, balsam copaiba has been taken medicinally. 
The urates dissolve on warming the urine, mucin 
remains, being distinguished by this behavior 
from any other constituent of the urine. The 
oleo resinous precipitate clears up by boiling, but 
quickly returns while the urine is yet warm. 
After observing the effect of the acid alone, add 
the albumen precipitant—one of the four named 
above. As the reagent dissolves, _ albumen, if 
present, is precipitated in the form of a distinct 
cloud, soon resolving itself into flakes. If any 
cloudiness is produced, the urine must be heated, 
when, if the reaction is due to albumen, the pre- 
cipitate remains undissolved. A precipitate cleared 
up by heat may consist of peptones, or of 
compounds of vegetable alkaloids. 
If a very large quantity of albumen be present, 
it may happen that the paper will become coated 
with the precipitate which forms instantaneously 
on its surface, and no cloudiness appear in the 
urine. Such a contingency could very rarely 
occur, and application of heat would be sure to 
reveal the presence of the albumen. 
Another method of using the papers is thus 
described by Dr. Oliver- “Those who prefer to develop a zone of precipitation along the plane of 
contact of a test solution and the urine can do so 
with these papers as follows: Put the reagent 
paper with 15 minims of water into one test tube, 
and a similar quantity of the urine with a citric 
acid paper into another. When the reagent is 
dissolved a portion of the solution is taken up 
with a pipette and allowed to trickle down the side 
of the tube, in which it will either glide over the 
urine, or collect below it.” Dr. S. C. Smith, of 
Halifax, suggests as a still better way to bend the 
papers into a circle so as to fit the inside of the 
test tube and push them down, say within an inch 
of the bottom of the tube, which is then to be filled 
with the urine. If albumen be present, the whole 
of the urine below the papers becomes opaque, 
while that above them remains transparent and 
unchanged. The advantage of observing separ- 
ately the effect of the citric acid is, however, lost 
in this mode of applying the tests. 
Potassio Mercuric Iodide. 
This is the most sensitive of all the tests for 
albumen, and in general should be the first test 
tried, since if this fails albumen is surely absent. 
The reagent precipitates peptones, and vegetable alkaloids; the precipitate of peptones is cleared 
up by heat, but returns as the urine cools. The 
precipitate of alkaloids forms a diffused cloudiness 
which does not break up into flocculi. On apply- 
ing heat, it clears up, and it is soluble also in 
alcohol. In case albumen and alkaloids are pre- 
sent together, the fluid will partially clear on 
heating. 
Sodium Tungstate. 
This reagent will detect one part of albumen in 
20,000 of urine; it is therefore nearly as sensitive 
as the potassio mercuric iodide. It has the ad- 
vantage over the latter that it does not precipitate 
alkaloids. It does, however, precipitate peptones, 
the precipitate redissolving on applying heat. 
Picric Acid. 
This test equals in sensitiveness that just 
named, and has this advantage that it may be 
used to detect either sugar or albumen. It pre- 
cipitates like the potassio mercuric iodide, peptones 
and vegetable alkaloids, and also throws down 
oleo resins, and occasionally uric acid. The dis- 
crimination of the albuminous precipitate is, how- 
ever, made with certainty by the application of 
heat which dissipates all other precipitates. Potassium Ferrocyanide. 
This test is less sensitive than the others in the 
series, but is capable of detecting albumen when 
present in the proportion of i part in 12,000 of 
fluid. It is therefore comparable in the range of 
its indications with nitric acid. It does not pre- 
cipitate peptones or the vegetable alkaloids which 
one is likely to meet with in the urine. It is 
therefore not liable to lead to false conclusions in 
the hands of careless observers, and it is selected 
on this account by Dr. Oliver as likely to be of 
the most service to medical men who have not had 
much experience in applying chemical tests. 
Quantitative Estimation of Albumen by the 
Method of Ih\ Oliver. 
Twenty minims of the urine are placed in the 
smaller test tube, a mercuric and a citric acid 
paper introduced into it, and the tube is shaken 
during one minute, so that the whole of the 
albumen is precipitated. The opacity produced 
in the fluid is directly proportional to the 
quantity of albumen present, and this is deter- 
mined by the aid of the printed test lines which 
are provided for the purpose. The fine lines are 
just discernable when the urine contains i-io per cent, of albumen. The dark lines are ren- 
dered indistinct if there is more than o.2# pre- 
sent. If the fine lines are not distinguishable, 
add water, a little at a time until they can just 
be discerned through the center of the tube. 
If it require five times the original volume of 
the urine to reduce the opacity to this extent, 
the urine contains 5X0.1%, j. e. one-half of one 
per cent. If the quantity of albumen is greater 
than this it is best to dilute a portion of it 2, 4, 
or 8 times with pure water before precipitating 
the albumen, and multiply the result obtained by 
the factor representing the degree of dilution of 
the urine. 
Color Seale. 
In describing the color of a specimen of urine, 
it is desirable that there should be uniformity in 
the designations given to the various shades. We 
have therefore reproduced Dr. Vogel’s scale of 
tints. The advantage of having such a color scale 
at hand at the moment of making the examination 
will be at once apparent. 
Specific Gravity Beads. 
The ordinary urinometer is too fragile an instru- 
ment to be carried safely in the pocket. In place of it we furnish with this series of tests a set of 
specific gravity beads, marked respective 5, 10, 
15, 20, 25 and 30, the figures being the last two 
of the specific gravities, water being 1000. 
The beads are dropped into some of the urine 
(about 2 fluidrachms) in the larger test tube. If 
three of them float the specific gravity is between 
1.015 and 1.020. If all float it is above 1.030. 
If all sink, it is below 1.005. The exact density 
can be determined by adding water, diop by 
drop, from a graduated pipette until one more 
bead sinks. The water must of course be made 
to mix thoroughly with the urine after each 
addition. 
Suppose by the addition of 20 minims of water 
one out of three beads which had remained float- 
ing is made to sink, or rather, to come to a state 
of indifferent equilibrium; then 120 : 120+20 : : 
15 : The value of + therefore is 17.5 and 
the specific gravity of the urine 1.0175. 
Rule. Multiply the figure on the bead which 
is made to sink, by the total amount of fluid, 
water and urine, and divide the product by the 
amount of urine, the quantity being expressed in 
minims. The temperature of the urine must be 
about 6o° Fahr. (15.6 C.) If higher than this, to obtain an exact result, add to the figure 
obtained one unit for every 8° F. (4.50 C.) in 
excess of the standard temperature. 
Ordinarily it is sufficient to observe how many 
of the beads float; the exact specific gravity is 
of importance only when the whole amount of 
urine voided during 24 houis is examined; for 
clinical purposes a rough approximation is all that 
is generally necessary, and this is all, moreover, 
that the ordinary urinometer as commonly used 
affords. 
If all the beads float, dilute the urine with an 
equal volume of water, take the specific gravity 
of the mixture, and multiply the fractional por- 
tion of the figure obtained by two. Table of Colors of tlieUrine. 
4. Reddish Yellow. 
3. Yellowish Bed. 
7.Brownish Bed. 
d.Beddish Brown/. 
3. Brownish Black. 
/.Pale Yellow. 
2. Bright Yello w. 
3. Yellow. 
6. Bed. URINARY TEST PAPERS, 
We take this opportunity of notifying the 
medical profession that we are prepared to sup- 
ply Urinary Test Papers, prepared after the 
method suggested by Dr. G. Oliver, of Harro- 
gate, England, in the London Lancet. 
These Papers are put up in convenient pack- 
ages for carrying in the vest-pocket, each pack- 
age containing all the necessary reagents for 
Bedside Urinalysis. 
PRICE : 
These packages will be sent by mail, postage 
prepaid, for 50 cents each. 
PARKE, DAVIS & CO., 
i 60 Maiden Lane. 
2i Liberty St. 
Manufacturing Chemists, 
Detroit, Michigan. 
New York;-