240 PHYSIOLOGICAL KEGULATIONS 



sequence, among the mean results obtained by the several investi- 

 gators, is greater than the diversity found by any one of them. A 

 similar diversity in the degree and in the duration of dilution 

 appears for dry residue and hemoglobin of whole blood; and for 

 refractive index, evaporative tendency, and electrical conductivity 

 of serum (data reviewed by Marx, '35; Rominger, '20; Abe, '31c). 

 That most constituents which are modified suffer positive dilution 

 in some tests, is the conclusion that may be drawn. But the magni- 

 tudes of these changes are by no means reproducible. Most of the 

 changes at one time or another exceed the increment that would be 

 expected if the water drunk were equally distributed through all the 

 body water already present. This statement extends to water too, 

 judging from meagre data reported by Marx ('35, p. 79) and 

 Gregersen and Bullock ( '35). 



A very prompt decrease of the erythrocyte "count" may be 

 found in arterial blood after sudden water ingestion. When 0.3% 

 of Bo of water is given by duodenal tube, the maximal dilution is 

 reached in only 0.05 hour. When 0.7% of Bq is given by mouth, in 

 contrast, the maximum is reached in 0.15 hour. In both cases the 

 increment in dilution is of the order of 20 per cent, and disappears 

 again in about 0.25 hour; a second dilution coming on only after 

 0.50 hour (Klein and Nonnenbruch, '30). Doubtless extended 

 study of the time relations of the blood and tissue changes would 

 reveal many points of physiological refinement and of individual 

 diversity. 



In steady states of water increment it has not been demon- 

 strated whether dilutions of blood also remain stationary. The 

 amounts of change in various constituents again bear no constant 

 proportion to one another (Farkas, '32). Those that change, uni- 

 formly show positive dilution, and in most cases indicate very small 

 volumes of distribution of the excessive water contained in the body 

 at the time. 



A number of distinct differences in the courses and amounts of 

 change in blood dilutions are observed in pathological individuals. 

 Some persons with diseases involving injuries of the hypophysis 

 show either no or a greatly delayed dilution of the dry substance 

 or the hemoglobin of the blood after drinking the usual 2% of Bq 

 of water (Kiss, '27; Marx, '28). Those with certain liver injuries 

 show very prompt and extreme dilution of dry substance (Kiss). 

 Possibly a useful scheme of differential diagnosis could be worked 



