298 Fische/s Theory of Edema [Dec. 



accomplished constitutes a separate question/' as does also that sub- 

 sidiary one of how the Separation of the unbound water through the 

 (colloidal) urinary membrane is effected. (Page 187.) 



In place of the teaching of Ludwig that a secretion of urine is 

 primarily dependent upon a blood pressure, or Heidenhain's belief that 

 the velocity with which the blood passes through the kidneys is of 

 primary importance, I venture to suggest, in Interpretation of the ex- 

 periments and clinical observations at band on this subject, that the 

 normal urinary secretion is absolutely dependent upon an adequate 

 oxygen supply to the cells constituting the parenchyma of the kidney. 

 Any interference with this oxygen supply leads to a decrease in urinary 

 secretion even to the point of absolute and permanent stoppage. 

 Through a particularly favorable oxygen supply to the kidneys the 

 secretion of urine may be increased above that ordinarily considered 

 "normal." (Page 189.) 



As the relief of the particularly acute forms of nephritis still 

 presents many clinical difficulties, I have tried to discover if some help 

 might not be obtained from the ideas advanced in this paper. The 

 anuria is probably one of the most striking Symptoms of the more 

 intense grades of parenchymatous nephritis that are observed clinically. 

 Such an anuria is obtained in rabbits and dogs with the greatest ease 

 if only the renal artery is clamped for a little while. If the clamp is 

 kept in place even a couple of minutes, a fall in urinary secretion is 

 strikingly apparent for some time afterward, and if left in place long 

 enough, a secretion from the insulted kidney may never again be 

 obtained. The coincident swelling of the kidney in these experiments 

 is promptly relieved by direct injection of various salts (sodium phos- 

 phate, sodium sulphate, sodium chloride) either directly into the body 

 of the kidney itself, or into the renal artery or into the general circula- 

 tion. Most interesting, however, is the fact that a kidney which under 

 ordinary circumstances would never again secrete any urine will do so 

 if these salts are injected. (Page 193.) 



How now are these various experimental findings to be interpreted ? 

 Let US first call attention to the important experimental error that is 

 introduced into any of these experiments with salt Infusion if any 

 anesthetic is used. When enough is used to produce anesthesia, a lack 

 of oxygen in the tissues and a retention of some of the liquid infused 

 may be expected to follow. The eflfect of an Infusion is divisible into 



" See the theoretical considerations of Wolfgang Pauli and Hans Handovsky, 

 Biochemische Zeitschrift, 1909, xviii, p. 353. 



