UREMIA 535 



out edema or uremia produces a marked increase in the globulin. 

 The decrease in red corpuscles and hemoglobin in nephritis is a well- 

 known feature. Bloor"' found in the blood high fat content in both 

 corpuscles and plasma, high lecithin in the corpuscles, and normal 

 cholesterol, these changes probably depending on the lowered alkali 

 reserve. 



Measurements of the partial pressure of CO2 in the alveolar air 

 in uremia indicate a certain degree of acidosis.^" This seems to occur 

 to a sufficient degree to be responsible for definite clinical symptoms 

 of acidosis only in advanced nephritis, but earlier in nephritis an aci- 

 dosis may be demonstrable by the alkali tolerance test when it is not 

 suffi-cient to affect the alveolar air.^' The maximum degrees of acidosis 

 found in uremia are about equal to those of diabetic coma, and may be 

 an important feature of uremia, although usually the convulsive fea- 

 tures of uremic coma are quite different from the air hunger of diabetic 

 coma. 



The development of this terminal acidity; together with the finding 

 of albumose in the blood of a nephritic by Schumm,-- suggests the 

 probability of active autolytic processes occurring in uremia. Neuberg 

 and Strauss-^ have also found glycine in considerable quantities 

 (1.5 per mille) in the blood-serum of a uremic patient and in the blood 

 of nephrectomized rabbits. The amount of colloidal material present 

 in the urine is decreased in nephritis, according to Pribram,-* who 

 suggests that retention of this material, which is rich in aromatic 

 radicals, may be of importance in the toxicity of uremia. Rumpf 

 found that the organs of nephritics contain an excess of potassium, 

 and Blumenfeldt" attributes this to a defective elimination of potas- 

 sium salts which he observed in nephritis. Basal metabolism is some- 

 what lowered. ^^ 



Numerous attempts have been made by both chemical and immu- 

 nological methods to determine whether the proteins in the urine in 

 nephritis come from the food, the blood, or from the renal cells them- 

 selves. In alimentary albuminuria the urinary proteins seem not to 

 be those of the food, but human proteins.^' In nephritis differentia- 

 tion between serum proteins and kidney proteins has not yet been 

 satisfactorily accomplished.-^ 



The development of improved methods of analysis of small quan- 



"Jour. Biol. Chem., 1917 (31), 575. 



20 Straub and Schlayer, Munch, med. Woch., 1912 (59), 569; Whitney, Arch. 

 Int. Med., 1917 (20), 931. 



21 Peabody, Arch. Int. Med., 1915 (16), 955. 

 " Hofmeister's Beitr., 1^03 (4), 453. 



" Berl. klin. Wocli., HiO) (43), 2c8- 



-* Fortschr. d. Med., 1911 (29), 951. 



" Zeit. exper. Pathol., 1913 (12^, 523. 



2« Aub and DuBois, Arch. Int. Med., 1917 (19), 865. 



" Wells, Jour. Anier. Med. Assoc, 1909 (53), 863. 



28 Cameron and Wells, .\rch. Int. Med., 1915 (15), 746. 



