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May 26, 1945


JAMA. 1945;128(4):308. doi:10.1001/jama.1945.02860210064023

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To the Editor:—  After reading the editorial entitled "Methylene Blue Test for Urinary Bilirubin" in The Journal, April 21, it seemed probable that a practical solution of the clinical problem of detecting small amounts of bile in the urine had been attained. According to the recent article by Myers (J. Indust. Hyg. & Toxicol.27:52 [Feb.] 1945), whose work is based on that of Franke and of Fellinger and Menkes (Wien. klin. Wchnschr.46:133 [Feb.] 1933), when 2 drops of Loeffler's methylene blue are added to 10 cc. of urine containing bilirubin the urine turns a brilliant green. Consequently the occurrence of such a "positive" test with the second normal urine specialmen which we tested according to directions was disturbing. As the specimen, though containing no bile, was concentrated, yellow sample from a normal subject, it appeared to be possible that the "positive" test was entirely nonspecific for

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