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L. Y., a girl, aged 11, was put to bed by her observing mother because she noticed that the child was passing a bluish-green urine. After twenty-four hours' observation the urine was still discolored. As the urine remained discolored for more than twenty-four hours, the mother became more alarmed and sent for me. The appearance of the urine was quite characteristic of that of patients taking methylene blue.
Careful questioning disclosed the fact that the child had the habit of chewing paper while reading, and she finally admitted that during the past two days, while reading a book, she consumed part of a blue blotter.
Investigation of the dye industry in relation to the pigments used in blue blotters disclosed the fact that colors other than methylene blue or direct blue are rarely used on account of their relatively high cost, and since a portion of this blotter responded
Faught FA. URINARY DISCOLORATION RESULTING FROM CHEWING A BLUE BLOTTER. JAMA. 1927;89(14):1150. doi:10.1001/jama.1927.92690140002012a