HUNGER EDEMA 375 



high hemoglobin and erythrocyte values were found. Woltmann 

 (1458) found anisocytosis, polychromatophilia, high leucopenia, 

 lymphocytosis and hydration of the blood. In epidemic dropsy, 

 Maynard (1459) found increased intra-ocular pressure. 



METABOLISM 



Schittenhelm and Schlecht (I.e. 1443) conducted metabolism 

 experiments with a diet regarded as productive of edema (45 to 55 

 grams protein and 1100 to 1800 calories). It was soon established 

 that a characteristic assimilative failure was not shown by the 

 patients, since they gained weight on more protein and fat and re- 

 tained nitrogen. Zondek (I.e. 1447) had some patients who excreted 

 six liters of urine daily, with 40 grams, and more, of sodium chlo- 

 ride, accompanied by a normal nitrogen content. Phosphoric acid 

 excretion was high (4 to 5 grams); Hiilse (I.e. 1454) was able to 

 demonstrate a good protein assimilation, but believed that the 

 de-aminization of the amino acids was faulty. Franke and Gottes- 

 mann (1460) studied the rate of elimination of urea, sodium 

 chloride and other salts, and found a retardation. The pathological 

 chemistry of hunger edema was considered by Feigl (1461), who 

 studied the cases of Rumpel. Schittenhelm and Schlecht (I.e. 1443) 

 found the protein content of the blood low, 4.5 to 5.7 per cent instead 

 of 7 to 9 per cent. The erythrocytes showed a lowered lipoid con- 

 tent. In the opinion of these investigators, the low figures are not 

 to be attributed merely to the dilution of the blood, for as the edema 

 disappears, the blood values drop still more. The blood sugar is 

 either normal or increased. The composition of the edematous 

 fluid resembles that of exudates. At the height of the edema, a 

 retention of water and chlorides is noted. On the disappearance of 

 the edema, considerable urea and sodium chloride excretion is found, 

 which is increased still more by thyroidin and decreased by adrenaline. 

 Pituitary extracts are effective, but only on the sodium chloride 

 excretion. 



THERAPY 



Here too, there is no uniformity in the literature. Zak (1462) 

 believed that hunger edema could be cured not only through the 

 addition of animal products (eggs, raw calves' liver), but also by 

 means of carrot juice. Maase and Zondek (1463) were of the opinion 

 that the addition of 100 grams fat could arrest the progress of the 



