CHAPTER XIX 



SOME CLINICAL ASPECTS 



MY concluding chapter will tell of a couple of researches, one at 

 University College Hospital (1) , the other at Guy's Hospital (2) , in which 

 the dissociation curve " used as an indicator " has revealed new facts 

 with regard to disease and done something to shed a new light on 

 certain pathological conditions. 



The first of these researches with which I will deal has been 

 carried out by my two former colleagues, Ryftel and Poulton. Their 

 concern was to explain the dyspnoea which takes place during 

 uraemia. Naturally they pursued the methods with which the reader 

 is now already familiar, the methods which had already given positive 

 results at Carlingford, on Monte Rosa and in the Alta Vista hut. 

 These methods showed clearly enough that the dissociation curve of 

 the patient had shifted in the direction of meionexy, a result which 

 forms the counterpart of the discovery by Schlayer and Straub the 

 latter an old member of " the firm " -that the alveolar carbonic acid 

 sank during uraemia. 



Expressing the degree of meionexy by the depression in the value 

 of K, the reader will see from the following table that the uraemic 

 patients were very meionectic. He must bear in mind that the normal 

 limits of K x 10 4 for active persons are 3'6 - 2'1, whilst for middle- 

 aged patients, who may be regarded as control cases, K x 10 4 varies 

 within even narrower limits, 3'4 2'6. 



* On hospital diet. 



