ON ECK'S fistula 21 



the 20th of March was slowly evaporated almost to dryness, and then 

 made up with distilled water to the original bulk ; the resulting solution 

 was found still .to be alkaline in reaction, showing that the original 

 alkalinity of the urine had not been due to ammonia. On March nth, 

 however, the ammonia excretion was considerably above the normal, but 

 became normal again two days later. 



While on meat diet, the urine was unfortunately not examined until 

 the day on which nervous symptoms appeared, when an alkaline urine 

 was found to contain both CO2 and carbamate CO2. 



It would appear from this last analysis as if there were some relation- 

 ship between the presence of carbamate and the nervous symptoms, but 

 if, on the other hand, we bear in mind that it was while on bread and 

 milk diet that this carbamate was found — i.e.^ when the urine was 

 alkaline — then we can explain the presence of carbamates as due to the 

 interaction of soluble carbonate in the urine with the ammonia salts. 

 Haskins and I have shown that whenever the urine contains soluble 

 carbonates {e.g., after citrate ingestion, or when it is allowed to stand 

 a few days) carbamate is formed in this way.* 



So far as our chemical investigation of the urine went, we could not 

 detect anything abnormal in either of the three dogs, except the 

 remarkable albuminuria developed by the first dog. 



Our results were in general confirmatory of those of Pawlow, Hahn, 

 Nencki and Massen, and point to the fact that in future investigations 

 into the cause of the peculiar nervous symptoms described above, urinary 

 analysis alone will not suffice, but must be supplemented or even replaced 

 by careful analysis of the blood and organs. 



To Dr. H. D. Haskins the author owes a deep great debt of gratitude 

 for the valuable assistance which he rendered in conducting the chemical 

 analysis. To Dr. F. C. Herrick also the author's thanks are due for the 

 use of the dogs on which he so successfully performed Eck's operation. 



Macleod and Haskins , Loc. at., p. 279. 



(285) 



