Observations on Urobilinogen in Urine.

Urobilinogen of urine was quantitated by the method of Terwen. 1 As would be expected from the work of McMaster and Elman, 2 definite increases in urinary urobilinogen were found in cases of liver pathology. Increased values were also found in some cases of diabetes mellitus, most of which showed some suggestive evidence of an accompanying liver pathology. This was proven in 2 cases coming to autopsy, one of which showed cirrhosis and the other marked passive congestion of the liver.

Increases were also found in some cases in which definite evidence of liver pathology could not be found. Active cases of pernicious anemia showed this finding. Cases of severe nephritis frequently showed increased urinary urobilinogen. It is questionable whether this should be attributed to a possible accompanying liver lesion or to increased renal permeability to this substance. Nephritic cases with a high urobilinogen output are usually accompanied by anemia. A similar high urinary pigment output is noted in other secondary anemias of obscure etiology. This suggests that loss of pigment may play some rôle in the production of the anemia. A few cases of renal glycosuria were found to have high values for urinary urobilinogen. This may also be due to increased renal permeability.

The occurrence of increased output of urobilinogen in urine of cases in which no definite evidence of liver pathology could be found, renders difficult the use of this reaction as a test of liver function.