TiiK Alkaltxity of the Blood Sekum in Kala-azau 



BY 



Captain E. CI. Archibam), M.B., R.A.M.C., attached E.A. 



Pathologist and Assistant Bacteriologist 



Wellcome Tropical Research Laboratories, Khartoum 



The recent researches of Nierenstein^ on the acidity and alkalinity of the blood in 

 trypanosomiasis infections suggested the idea that a similar line of researches might be 

 carried oat in kala-azar, with the object of ascertaining if any change occurred in the 

 blood serum of patients suffering from this disease. 



Owing to the fact that kala-azar is still a somewhat uncommon disease in the Sudan, 

 it was difificult to obtain sufficient material for an extensive number of tests, and although 

 these results were obtained from only four undoubted cases of kala-azar, they are 

 published in the hope that some specific line of treatment may be adopted in accordance 

 witli the changes that have been found to exist in the blood serum of patients suffering 

 from this fatal disorder. 



The tests were carried out in patients in whom the presence of the fjeishman body 

 had been previously deuionstrated by the microscoise. 



The technique employed was that recommended by Moore and Wilson,- and the tests The " entire 

 were conducted on the "entire serum" in preference to the whole blood, as Wright^ serum " used 



for tests 



has pointed out that from a clinical point of view the alkalinity of the serum is more 

 important as it comes into such close contact with the tissues, and may be taken as an 

 index of the changes taking place in the circulating blood. Formerly, litmus was usually 

 employed as an indicator for estimating the alkalinity of the blood, but Moore and Wilson 

 found that sharper readings of the colour changes could be obtained by the use of 

 dimethylamidoazobenzol, and accordingly this was employed in the tests. 



Technique. — The blood was collected in Wright's glass capsules, samples being taken 

 from the finger previously cleansed with methylated ether and 5 per cent, formalin. The 

 ends of the capsules were sealed in the ordinary way, the tubes left suspended for 

 twenty-four hours, and then centrifuged so that the serum separated out free from the 

 red cells. If the serum was stained as a result of hsemolysis, it was always discarded. 



In each experiment a "control" was used, the blood serum being taken from three 

 healthy persons, whose ages and racial characters corresponded as nearly as possible with 

 those of the patient. In order to avoid the effects of an "alkaline tide," the blood The cnntrni 

 from the patient and from the controls was always secured four hours after the last 

 meal had been taken. 



Normal sulphuric acid was employed as the standard acid for titration, and a series 

 of dilutions of the normal acid were made, ranging from a twofold to a sevenfold dilution. 



To every 100 c.c. of these acid dilutions were added 8 drops of a 1 per cent, alcoholic 

 solution of dimethylamidoazobenzol, a rich pink colour, sufficiently intense to show the 

 necessary colour changes when mixed with serum, being thereby produced. 



' Nierenstein, M. (1908), "Observations on the Acidity and Alkalinity of the Blood in Trypanosorae 

 Infections." Annals of Tropical Medicine and Parasitology, Vol. II., No. 3. 



= Moore, B., and Wilson, P. P. (June, 1906), "Clinical Method of Hsmalkalimetry." Biochnniml 

 Journal, Vol. I. 



^Wright, A. E. (1897), "A Simple Method of Measuring the Alkalinitv of the Blood." L/nicel, 

 Vol. II., p. 719. 



