242 SOAPS AND PROTEINS 



poisoned (or about to be poisoned for therapeutic reasons) by 

 arsenic, mercury or lead. As discovered by F. HOPPE-SEYLER 

 and his pupils, T. ARAKI, T. IRASAWA and H. ZILLESSEN, the heavy 

 metals interfere with the normal oxidation chemistry of living 

 cells, resulting in an abnormal production and accumulation of 

 acids in the involved cells. Such increased acid content is fol- 

 lowed by an increased water absorption (oedema) of the involved 

 cells which in the case of such organs as the brain, medulla and 

 kidney may lead to a fatal issue. Associated with this phar- 

 macological action of the heavy metals and the swelling of certain 

 proteins is their other colloid-chemical action which results in the 

 formation of less hydratable compounds (like the metallic globu- 

 linates). The combination of the swelling of certain proteins 

 with the dehydration of others yields the anatomical picture which 

 the pathologists call " cloudy swelling." To neutralize the 

 acids formed and thus to reduce the swelling of the one while at 

 the same time the attempt is made to uncoagulate the dehydrated 

 second and thus clear the " clouding," heavy doses of alkali are 

 needed (like the bicarbonates, carbonates and hydroxids of sodium, 

 potassium and magnesium or, in general, any of the lighter bases in 

 combination with organic acids oxidizable to carbonates). These 

 substances alone, or better in mixture, must be given in sufficient 

 amounts day and night to maintain a permanently neutral or even 

 a slightly alkaline reaction of the urine. In order to float off in 

 solution the liberated heavy metal, water is needed. It must, 

 however, be remembered that water alone, especially when brought 

 in contact with cells inclined to oedema, favors their swelling and 

 solution. To offset such deleterious effects, the alkaline salts and 

 water intake must be so controlled (whether given by mouth, 

 rectum or intravenously) as always to have the combination touch 

 the affected cells in hypertonic solution. 1 How much may be 

 accomplished in saving an extra fraction of those poisoned by the 

 heavy metals by such methods may be deduced not only from my 

 own studies 2 but from the independent ones of WILLIAM DEB. 

 MACNIDER and H. B. WEiss. 3 



1 For details regarding such treatment see MARTIN H. FISCHER: (Edema 

 and Nephritis, 3rd Ed., 667, 678, 783, New York (1921). 



2 MARTIN H. FISCHER: (Edema, 123, 133, New York (1910); Nephritis, 

 52, 125, 173, 186, New York (1912); (Edema and Nephritis, 2nd Ed., 549, 

 648, New York (1915); (Edema and Nephritis, 3rd Ed., 727, 789, New York 

 (1921). 



3 WILLIAM DEB. MACNIDER: Jour. Exp. Med., 23, 171 (1916); ibid., 26, 



