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ALBUMIN: Albumin is one of the great group of organic chemical substances known as proteins. It contains as do all proteins, carbon, hydrogen, oxygen, nitrogen, and sulphur. It occurs in all cells and in many of the fluids of the body. Albumin is soluble in water and in weak salt solution. When a solution is boiled the albumin is coagulated, forming a white precipitate, an effect which is hastened by the presence of a trace of acid. If more than a trace of acid or alkali is present, a solution of albumin does not coagulate but remains dissolved.
Albumin forms an important part of the average diet, as it is found for example, in eggs and in milk. The white of egg contains a large quantity of albumin, and it is to this that are due the familiar changes in an egg when it is heated; the albumin coagulates. Milk also contains an albumin, though in much less quantity and this coagulates and forms the scum in boiled milk. Some of the vegetable proteins are insufficient for the requirements of the human body, but albumin is found to meet all the requirements fulfilled by protein in the diet.
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When taken in foodstuffs albumin is digested chiefly by juices secreted by the pancreas and the stomach, and is converted finally into substances called, peptones and amino-acids. These substances are then absorbed by the intestine and rendered available for the uses of the body. In the coagulated form albumin is not so easily digested. See Food; Protein.
ALBUMINURIA: - By albuminuria is meant the presence of albumin or allied substances in the urine. Normally urine is not supposed to contain these substances, but when, owing to disease or other abnormal state, the kidneys allow albuminous substances to pass from the blood into the urine, then albuminuria results. It was thought at one time the the presence of albumin in the urine always indicated some disease of the kidneys (Brightís disease); but it is now known that albuminuria may exist without any disease of the kidneys.
It is important, therefore, if albuminuria is found to exist, that the patient should be carefully examined from every point of' view in order to determine the cause.
If it is found to be due to some definite disease, appropriate measures must be taken. It is, however, just as important to know that no grave cause exists for the condition, as in the past many people have been condemned to years of invalidism, when really the albumin uria was negligible and need not have inter fered with an ordinary active life.
The causes of albuminuria may be classified thus: (1) Organic kidney disease or nephritis, known also as Bright's disease, which may be caused by toxaemic or infective conditions, scarlet fever, diphtheria and other diseases. (2) Degeneration of the kidney following wast ing diseases, such as tuberculosis, prolonged suppuration in any part of the body and malignant tumors. (3) Suppuration in any part of the urinary tract. (4) Any fever of whatever nature may cause slight albuminuria, which disappears usually with the cessation of the fever. (5) Changes in the blood which occur in various forms of anaemia, in syphilis, lead and mercury poisoning, etc, may cause slight albuminuria. Pregnancy also may lead to this condition, and may also be the starting-point of a severe nephritis. (6) Nervous conditions, such as epilepsy apoplexy and head injuries. (7) Physiological causes.
How Mistakes in Urine Diagnosis Occur
It is the last group which in the past has given rise to so many cases of mistaken diagnosis. It is now known that hard exercise, cold bathing, violent emotion and the taking of a heavy meal rich in albuminous substances, may give rise to a temporary albuminuria. During the Great War investigations were undertaken, and it was found that the urine of about 5 per cent., of healthy men contained albumin for the presence of which no cause could be assigned.
There is another form of the condition known as albuminuria of adolescents. It is found more often in boys than in girls; the cases are usually highly strung and the children of nervous parents. The individual may be weedy in appearance, but there is otherwise no sign of disease, and the albuminuria, which may be large in amount, usually disappears.
In the last group no treatment should be undertaken, as none is needed, and the giving of medicine and frequent examinations may lead to the individual becoming self-centered and neurotic.
In the other groups, however, treatment may be urgently needed, for it must be remembered that albuminuria is only a sign of a disease and not a disease in itself.
Test for Albumin in Urine
The Urine should be clear and transparent, and must be filtered if necessary.
Test 1: Into a test tube put about a tablespoon of the urine. Tilt the tube and allow some strong nitric acid to run slowly down the side of the tube. Two layers will be formed, of heavy acid below and lighter urine above. If after standing for five minutes a definite white cloud is present at the junction of the liquids, then albuminuria is present.
Test 2: Nearly fill a test tube with urine. Then, holding the test tube at the bottom, tilt it, and hold the upper inch of the tube over a spirit lamp and allow to boil. If a white cloud appears in the heated part; which does not disappear when a drop or two of dilute acetic acid is added, then albuminuria is present. Phosphates and carbonates also produce a cloud which, however disappears if acid be added, thus distinguishing it from the cloud produced by albumin.
Test 3: A saturated solution in distilled water of salicylsulphonic acid is the reagent now most generally used, and is extremely delicate. A few drops of this solution are added to a small quantity of the urine in a test tube. A normal urine remains clear, but the presence of albuminuria is shown by a white precipitate or by a faint haze only if the amount of albumin is small.