I9I3] Alfred P. Lothrop 295 



also uric acid, chlorids and wäter ; and death may ensue. Creatinin, 

 injected during subacute uranium nephritis, is excrelted "in toto" 

 and apparently does not affect the excretion of endogenous cre- 

 aitinin, uric acid, chlorids or water. 



Two of the animals with acute nephritis died after injection of 

 Creatinin, in marked contrast with the apparent lack of effect of 

 Creatinin injections in th^ dogs with subacute nephritis. In acute 

 nephritis, where Creatinin (endogenous and injec'ted) and all the 

 other substances named above were excreted in decreased amounts, 

 there was apparently a partial arrest of renal function. In the 

 subacute nephritis this did not occur. In acute nephritis there is 

 probably not only insufficient intact tubulär epithdium to carry the 

 additional bürden, viz., the injected Creatinin, buit this additional 

 bürden aggravates the preexisting condition. In subacute nephritis, 

 on the other hand, regeneration occurs, thus increasing the func- 

 tional possibilities of the kidney, so that injected Creatinin can be 

 excreted " in toto." 



Fever increases Creatinin excretion. It is also known that cer- 

 tain infeotions, e. g., diphtheria, cholera, pneumonia and colon in- 

 fections, cause tubulär nephritides. If, instead of adding hyper- 

 creatininemia to a nephritis which is predominatingly tubulär (as 

 described for the above experiments with uranium nephritis), there 

 should be hypercreatininemia follozved by tubulär nephritis, it is 

 probable that a similar reaction would result, namely, a uremia-like 

 toxemia, ending perhaps in death. 



Creatinin has been taken only as an example of urinary sub- 

 stances normally excreted by the kidney tubules. It seems probable 

 that other normal substances, which are increased in fever and ex- 

 creted by the tubules, would act in a similar way, i. e., to overtax an 

 already overfunctioning kidney in a condition aggravated by a 

 tubulär nephritis. This Suggestion as to the production of uremia 

 dioes not concern the substances directly causing rt, merely the 

 mechanism of their retention. 



62. On the question of protein in expired air. Charles 

 Weisman. Rosenau and Amoss^^ recently pu'blished a paper in 

 which they stated that expired air contains volatile prcytein. Their 



"Rosenau and Amoss: Journal of Medical Research, 191 1, xxv, p. 35. 



