The Experimental Evidence Concerning the Production of a Haematogenous Jaundice
Authors: A. G. Auld
Journal: BMJ (1896)

INSPIRED AIR. [rN E BRITIN 137 or two old; it is better to prepare it as required.The test solution should be mixed at the time of using.Any excess of sodium nitrite must be avoided, or a pseudo-reaction may be obtained.Neglect of this last precaution has led some observers to deny that the test has any diagnostic importance (Penzoldt, von Jaksch, Munson and Oertel, see below).The colour of the true reaction is a red, not oranige or brown, anid a pink froth is produced on shaking.It is a curious fact that in some cases, althouglh the colour may be the right one, a white and niot a pink froth forms ; the re- action then is not a true one.The urine should be freshly passed and acid.It is only by attending to these minutive that the test can take its proper place as a valuable diagnostic agent.Neglect of tlem brings failure and undeserved discredit.The n-ature of the substance wllich gives the reaction is still ulnknown.It might be anticipated that cultures of the bacillus typhosus would give the reaction, but sucll is nlot the case.Like Dawson,6 who investigated this poinit, I have failed to get aniy trace of the reaction in broth cultures of the Bacillus typhosus.The bacillus employed for inoculation had been recelntly isolated, and the cultures were of various ages, from a day to a month.Cultures of a number of otlher organisms were also tested, lnamely, B. coli communis, B. anthracis, B. tetani, B. diph- theriae, B. prodigiosus, pneumococcus of Friedlaender, S. pyo- genes aureus, streptococcus of erysipelas, Koch's comma bacillus, Finkler's comma bacillus, and Vibrio Metchnikovi, but in no instalnce was the reactioln obtained.Penzoldt 7 and Voni Jaksch 8 have stated that acetone is the substance whicl gives the reaction.Sucll is not the case, and these authors seem to have fallen into error by using a 5 per cent.instead of a 0.5 per cent.solution of sodium nitrite, and from the same cause Munson and Oertel9 believed that it depends upon aceto-acetic acid, but this is not so.10I have tested the following substances to see if they give the reaction: caustic potash, sodium carbon-ate, ammonium sulphide, formic acid, zinc lactate, picric acid, salicylic acid, glucose, thymol, camphor, carbolic acid, oil of turpentine, asparagin, amyg- dalili, asculin, santonin, salicin, brucine (thiree specimens), strychnine (three specimens), niicotine, caffeine, codeine, eserine' narcotine, piperine, cinelholnidinle, cinelholninle quiniine, quinidine, papaveriine, atropilne, hyosciine, and aconitinie.All of these give onily a yellow or orange, tlhymol a deep orange.Bagnaccill has stated that thymol, strych- nine, and glucose give the reaction, but they certainly do not.Picro-sulphiuric acid (Kleinelnberg's) gives a brown colour.The only substance I have met with which gives a reaction at all resembling the red typlhoid reaction is morphine and its salts.The colour produced by morpline is very like a some- what pale typhoid reactioin, anid the resemblaiice is the greater, as a pink frotlh is formed on shaking.It differs from the typlhoid reaction, however, as no green precipitate forms on standinig.The test is a very delicate one; i part of morphine acetate in 5,ooo parts of water is readily recognlised, and even I part in io,ooo can be detected.The reactioii might perhaps be useful as a test for morphine.In connection with the diazo-reaction, the similar morphinie reaction is of importance, because morplline is exereted by the urine, so that the urine of a patient taking this drug or opium might give a pseudo-reaction simulating the true typhoid reactionl.