EXCRETIONS 501 



Grams 



Sodium chlorid 13.00 



Potassium chlorid . . 4 23 



Calcium sulphate o.52 



Magnesium sulphate 0.61 



Ammonium sulphate 1.52 



Ammonium urate 0.58 



Potassium urate 0.03 



Potassium phenyl sulphate 0.42 



Potassium dihydrogen phosphate 2.56 



Potassium monohydrogen phosphate. . . 0.86 



obtain in cases of carcinoma of the stomach, resulting in stenosis of the 

 pylorus, essentially a condition of starvation. The sodium chlorid elimi- 

 nation is decreased by those conditions which favor its removal from 

 the blood through other channels, e. g., cases of diarrhea, rapidly formed 

 transudates and exudates, such as pleurisy with effusion. It may be 

 pointed out that for several days after the reabsorption of an exudate, 

 the chlorid excretion may be greatly increased, and is here a favorable 

 diagnostic sign. Diminished chlorid elimination is observed during the 

 crises of acute febrile diseases, especially pneumonia and in nephritis 

 with edema, in the latter case because of the relative impermeability of 

 the kidney to salts. In febrile diseases it is worthy of note that the elimi- 

 nation of chlorids progressively decreases as the febrile process approaches 

 its crisis, and tends to rise to its original level during convalescence. It 

 has been observed that in pneumonia there is, if anything, a decreased 

 chlorid content of the blood, while in exceptional cases of nephritis with 

 marked edema, the chlorids of the whole blood may rise from the normal 

 of 0.45-0.50 per cent to as high as 0.7 per cent. Such cases do not gen- 

 erally show marked nitrogen retention. 



Phosphates.' Two types of phosphates are present in urine, the alka- 

 line phosphates, salts of the alkali metals, and earthy phosphates, salts 

 of the alkaline earth metals. In the normally acid urine the larger part 

 cf the phosphoric acid is generally present as l^a or KH 2 PO 4 , the dihy- 

 drogen phosphate. The urinary excretion of phosphates as P 2 O 5 amounts 

 to 1 to 5 grams, with an average of 2.5 grams. This originates to a small 

 extent in the setting free of phosphoric acid in protein metabolism, but 

 to a greater extent in the phosphates of the foods. The extent to which 

 the latter control the phosphate excretion in the urine depends upon the 

 relative abundance of alkali and alkali-earth phosphates. The alkali- 

 earth phosphates are difficultly absorbable and hence are in great part 

 eliminated directly through the feces, thus contributing but little to 

 urinary phosphate. Ordinarily about two-thirds of the phosphorus is 

 eliminated in the urine, but a diet containing a very large amount of 



