928 ABX0R1IAIJTIL\S IX METABOLISM 



ered iu chronic nephritis with uremia, an increased proportion of 

 globulin being present; with uremia the total protein content is nor- 

 mal or slightly higher, with usually increased globulin, while nephritis 

 without edema or uremia produces a marked increase in the globulin. 

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

 known feature. 



Orlowski ^* found that an accumulation of acids occurs in uremia, 

 but not until just before death, and, therefore, the reduction of blood 

 alkalinity is not the cause, but an accompaniment of the uremia. Fur- 

 thermore, in other diseases a corresponding or greater reduction in 

 alkalinity may occur without uremia. Measurements of the partial 

 pressure of COo in the alveolar air in uremia indicate, however, 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 acidosis may be 

 demonstrable by the alkali tolerance test when it is not sufficient to 

 affect the alveolar air.-° 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 glyco- 

 coll 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 potassium salts which he observed in ne- 

 phritis. 



Numerous attempts have been made by both chemical and immu- 

 nological methods to determine wdiether 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, however, 

 differentiation between serum proteins and kidney proteins has not 

 yet been satisfactorily accomplished.-" 



The development of improved methods of analysis of small quan- 

 tities of blood, and other fluids, especially by Folin and Denis, ]\Iar- 



isZontr. f. StofTwpchsol \i. Vcrdauunpskr., 1902 (3), 123. 



19 Straub and Sclilavor, Miinch. med. Woch., 1912 (59), 5G9. 

 20Peabody, Arch. Iiit. INFod., 1915 (16), 955. 



21 Hofmeister's Bcitr., 1903 (4), 4.53. 



22 13erl. klin. Woch., 190G (43), 258. 



23 Fortschr. d. Mod., 1911 (29), 951. 

 24Zeit. exper. PatlioL. 1913 (12), 523. 



25 Wells, Jour. Aincr. ^Fcd. Assoc. 1909 (.■)3), 803. 



20 Cameron and Wells, Arch. Int. Med., lOl.'j (l.")). 746. 



