292 DISTURBANCES OF CIRCULATIOX 



the kidneys would reflate ; acidity is impossible because death would 

 result from the inability of the blood to carry COj. The blood and 

 tissue proteins also can bind much of either H or OH ions/ so that the 

 preservation of neutrality is elaborately guarded. In the tissues, be- 

 cause of the production of acids during metabolism, the H-ion con- 

 centration is slightly higher than that of the blood, being estimated by 

 JVIichaelis at exact neutrality, 1.5 X 10"'^. Presumably one important 

 purpose of the exact regulation of reaction is to provide proper con- 

 ditions for enzyme action. 



The alkali of the blood exists in part as alkaline salts, carbonate 

 and phosphate (the diffusible alkali), and partly combined with pro- 

 tein {non-diffusible alkali). As the corpuscles are richer in diffusible 

 alkali than the plasma or serum, the number of corpuscles modifies 

 the alkalinity of the blood decidedly. j\Iuch importance is attached 

 to the question of the alkalinity of the blood for two reasons : first, in 

 certain conditions of disease the blood contains so much of organic 

 acids that the alkali is partly saturated and the power of the blood 

 to carry CO, is lessened, with serious results (see "Acid Intoxica- 

 tion," Chap, xviii) ; and, second, the bactericidal power of the blood 

 is found to vary according to its alkalinity. In fact, metabolic activ- 

 ity seems generally to be favored by certain degrees of alkalinity ; for 

 example, J. Loeb ^ found that sea-urchin eggs develop with much 

 greater rapidity if a small amount of OH ions is free in the sea- 

 water. Brandenburg ^ states that the non-diffusible alkali varies ac- 

 cording to the amount of protein in the blood ; in pneumonia and 

 acute nephritis he found it low. In cancer the titrable alkalinity is 

 distinctly increased, and IMoore and Walker ^° find that this is due to 

 an increased alkalinity of the proteins of the blood. Orlowsky ^- 

 could find no decrease in the alkalinity of the blood in leucoeytosis, 

 or when virulent, bacteria were introduced into the blood. By gas 

 chain measurements of H and OH concentration, Roily '^^ found prac- 

 tically no change in reaction during starvation or after bilateral 

 nephrectomy. Abnormally low alkalescence was rarely found except 

 in diabetic acidosis, while increased alkalescence was obtained chiefly in 

 liver diseases. Awerbach ^^ claims that in severe high fevers the bac- 

 tericidal effect of the blood alkalinity is increased (see also "Passive 

 Congestion" for further discussion concerning the relation of alka- 

 linity to bactericidal power). 



Viscosity of the Blood.^" — Xonnal l)lood is about five times (4.5 



7 See Robertson. Jour. Uiol. Cliem., 1909 (fi), 313; 1910 (7). 3.">1. 



8 Arch. f. Ent.\vicklun<:sinoolianik, 189S (7), 031. 



oDout. mod. Woch., 1902 (28), 78; Zeit. f. klin. ^fed.. 1902 (45), l.>7. 

 If* Biocliem. Jour., 1900 (1), 297; pood discussion of blood reaction. 

 12 Dent. mod. Wocli., 1903 (29). (iOl. 

 i3Miincb. nied. Wocli.. 1912 (r)9), 1201 and 1274. 



14 Med. Obosrenijo, 1903, p. .')90. 



15 Review of literature by Determann. Zeit. klin. Med., 1910 (70), 185; also 



