The value of phenolsulphonethalein in estimating the functional efficiency of the kidneys / by Charles Goodman and Leo Kristeller.
- Goodman, Charles
- Date:
- 1911
Licence: In copyright
Credit: The value of phenolsulphonethalein in estimating the functional efficiency of the kidneys / by Charles Goodman and Leo Kristeller. Source: Wellcome Collection.
Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.
4/10 page 2
![tensity of the colors of the stream ejaculated from the ureters as revealed by the cystoscope is supposed to afford an estimation of the relative amount of destruction of the secreting epithelium of the convoluted tubules. This dye has the advantage of being more readily eliminated than methylene blue, but has the decided disadvantage of being decolorized by purulent alkaline urine. It does not lend itself to colorimetric estimation, and only about 25 per cent is eliminated by the kidneys. Rosaniline (rosaniline trisulphate of soda), first introduced by Lapine, has not attained any popularity. One cc. of a one per cent solution injected subcutaneously, usually makes its ap- pearance in less, than one-half hour. From 65 to 95 per cent is recovered in 24 hours. Alberann’s polyuria test is based upon the principle that the greater the destruction of epithelium in the kidney the less likely will that organ respond to an increase in secretion after the administration of quantities of water. This is fallacious, to be depended upon alone. This would be very helpful were it true that the secre- tion of the fluid contents of the urine were de- pendent upon the tubular epithelium alone. But that is not the case. It has been repeatedly shown that the fluid portion, together with some of the salts both organic and inorganic, are secreted by the glomeruli. It is now well known that a kidney practically devoid of tubular epithelium, such as is frequently encountered in advanced cases of interstitial nephritis, is cap- able of eliminating alinost unlimited quantities of fluid. In such instances the polyuria test could be no index whatsoever of the kidney’s efficiency to maintain life. The phloridzin test championed by Casper and Richter is based upon a peculiar property of phloridzin discovered by Von Mehring, by virtue of which a glycosuria is produced after a sub- cutaneous injection of 5 mg. of a freshly prepared aqueous solution. In course of twenty to thirty minutes, after an injection into a healthy indi- vidual, glucose can be demonstrated in the urine. The relative delay arid diminished quantity of sugar excreted within a certain time, say two or three hours, is supposed to afford an index of the extent of destruction of the secreting portion of the kidney. This test[ has now become unpop- ular on account of its unreliability. Instances are cited where glycosuria was not produced at all in healthy individuals after its administration. This irregularity of action may be due to other influences than those resident in the kidney. Work recently done by Schwartz in Paltauf’s institute in Vienna goes to show that the function of the adrenals plays an important role in the production of glycosuria by phloridzin. For example, the total extirpation of the adrenals (an experiment which is perfectly feasible in male rats) prevents the production of glycosuria by phloridzin. In the early part of this year, L. G. Rowntree and J. T. Geraghty published a preliminary report on the use of phenolsulphonethalein in estimating the efficiency of the kidneys. - The total elimination of this drug by the kid- neys suggested the possibility of applying this dye in the estimation of the efficiency of the kid- neys. The properties of this drug were discovered by Professor Abel in the course of some work with the phenolthalein group of drugs. Abel and Rowntree have shown that a properly prepared solution of the sodium salt can be used subcutaneously without the slightest evidence of an irritant action; “that the drug can be administered by mouth with no ill effects”; “ that the administration of the drug in one-tenth grain doses, or less by mouth, is followed by its appear- ance in the urine in one hour to an hour and a half”; “that the subcutaneous administration is followed by the appearance of the urine in about ten minutes.” The technique elaborated by Rowntree and Geraghty for the purpose of utilizing this drug as a functional test is described by them as fol- lows: “A solution of 0.6 gram of phenolsulphonetha- lein and 0.84 cc. of an 8 per cent solution NaOH are added to 0.75 per cent NaCl solution. This gives the monosodium or acid salt, which is red in color and which is slightly irritant locally when injected. It is necessary therefore to add two or three drops more of the 8 per cent hydroxide in quantities sufficient to change the color to a Bordeaux red. This preparation is non-irritant. One cc. of this solution, containing six mg., is administered subcutaneously in the upper arm by means of an accurately graduated syringe. The time of the injection is carefully noted. A faint pink tinge can be usually noted in about ten minutes if the urine is collected in a vessel containing one or two drops of a 25 per cent NaOH solution. In order to insure a free uri- ] nary secretion, it is recommended that 300 or 400 cc. of water be administered about twenty minutes before injecting the drug. We have not found this precaution necessary. If the patient cannot void, as in retention due to an enlarged prostate, a catheter is inserted, and as soon as the reaction is demonstrated, the catheter](https://iiif.wellcomecollection.org/image/b22418416_0006.jp2/full/800%2C/0/default.jpg)
