584 GASTh'oi\ri:sTJ.\AL '-AUToiy toxic ATioy 



particularly in gastric fermentations in persons with deticient hydro- 

 chloric acid, motor insufficiency, or or<>-anic obstruction. ]\Iost of the 

 disturbances observed in these conditions seem to be due to distention 

 of the stomach with gas, chiefly CO2, which is formed during the fer- 

 mentation. It is possible, however, that the organic acids exercise 

 some irritant effects on the mucous membrane; and they may also 

 cause diarrhea, lactic and acetic acid often being present in diar- 

 riieal discharges due to excessive feeding with carbohydrates 

 (Herter). 



These acids or their salts do not appear in the urine, unless possibly 

 as minute traces, except the oxalic acid. ^linute quantities (0.02 gm. 

 per day) of this substance are present in normal urine, but larger 

 quantities (oxaluria) seem to depend either upon the taking of food 

 containing much oxalic acid (rhubarb, spinach, etc.) or upon excessive 

 gastric fermentation of carbohydrates (Baldwin),"'' and perhaps upon 

 excessive destruction of purines, from which oxalic acid may be de- 

 rived. . Of the amino-acids it is presumably the diatomic acids, glu- 

 tamic and aspartic, which yield oxalic acid (Jastrowitz).*'^* Others, 

 however, do not admit that any appreciable amount of oxalic acid is 

 derived from proteins.'^"-'' Probably the small quantities of oxalie 

 acid thus formed do not cause toxic etfects, and are important chiefly 

 as causing urinary concretions of calcium oxalate, although there is. 

 evidence that long-continued excretion of oxalic acid may cause renal 

 lesions. (See also consideration of oxalic calculi. Chap, xv.) 



C. PRODUCTS OF THE DECOMPOSITION OF FATS 



These differ but little in nature from the products of carbohydrate 

 fennentation, the large fatty acid molecules being broken down to 

 smaller ones. In infants these fatty acids have been believed to be a 

 cause of acid intoxication and acetonuria,"^ but probably they are sel- 

 dom, if ever, of pathological importance. It is possible, however, that 

 a serious reduction in the bases of the blood may result from the 

 formation of excessive amounts of fatty acids in the intestines, the 

 bases being combined to unite with the fatty acids, and then excreted 

 in the feces. 



It is quite otherwise with the products of decom])ositi()n of leci- 

 thin.^^ From its molecule is split o1"f the ptonui'in, cJwlinc, 



{( 11:,) ,. = X — C'll. — CH,OH, 



I 

 OH 



Imtyric acid in tlic production of iutorioscloiosis, while Oswald Loeh believed 

 lax-tic at'id to be important, a " 'e-v wliicli could not be alto<retiier supjiorted by 

 Denny and Frotliinj,diam, .lour Mel. Kes., I!tl4 (.'?1). 277. 



■'•".Tour. Exp. Med., IHOO (.')), 27. 



"0 ]?ioclieni. Zeit., 1!)10 (28), ;U. 



ooa \Ve;xrzyno\vski, Zeit. pliysiol. Clieni.. lOl.S ( S.'i ) . 112. 



"1 Meyer and l^anjistein, Jalirb. f. KinderlieilU., \'MH\ id:!). ^0. 



"-Literature given by Halliburton, Kr^ebniisse der I'liysiol.. l!M)4 (4). 24. 



