EFFECTS OF CERTAIN DRUGS AND POISONS 743 



tion. This result is often seen in oxygen-lack. Profound carbon monoxid 

 poisoning leads, of course, to a diminished oxygen intake (Desplats), but 

 in the grade induced by Bock it appears that the total metabolism re- 

 mains unaltered. The high carbon dioxid output is attributable to dis- 

 placement of the gas from the blood, first by the carbon monoxid itself; 

 secondly by the decreased alkalinity as the condition progresses, and 

 thirdly, probably temporarily by deeper ventilation. 



Protein Metabolism. An increase in the protein catabolism in man 

 occurs, persisting for two or three days. Miinzer and Palma found an in- 

 crease in the phosphate excretion parallel to the nitrogen increase. In 

 fasted dogs the nitrogen excretion is greater. Jeannert found 4.6 grams 

 urea excreted in the 6^ hours following carbon monoxid poisoning as 

 against 2.5 to 2.9 grams on control days. The increased catabolism is 

 attributable to oxygen-lack. 



The nitrogen partition, as has been observed, need not be altered in 

 this type of acidosis; Miinzer and Palma in man and Araki in animals 

 noted only slight increases in ammonia excretion. Occasionally a very 

 high uric acid excretion has been noted on the first day (Noel Paton). 

 Frankel failed to find amino-acids in the urine. Katsuyama and others 

 find the synthesis of hippurates and of ethereal sulphates inhibited in 

 carbon monoxid poisoning. 



Mineral Metabolism. Phosphate and sulphate excretion are prob- 

 ably increased, as in oxygen-lack. Kast found in carbon monoxid poison- 

 ing a decreased chlorid output in animals whose tissues were well sup- 

 plied with this ion. In chlorid-poor animals, however, the output was 

 increased. This apparent paradox is explainable upon the supposition 

 that in the latter case an inherent tendency to lose chlorids is enhanced 

 by the condition of oxygen-lack. The alkali-depleting mechanism is doubt- 

 less involved. 



Lactic Acid. Urinary lactic acid was found in carbon monoxid 

 poisoning by Miinzer and Palma and by Araki, blood lactic acid (in hens) 

 by Saito and Katsuyama. Heffter found the acidity of the muscles of 

 carbon monoxid-poisoned cats decreased. That the lactic acid appearance 

 is due in part at least to reduced combustion accords with Araki's finding 

 that subcutaneously injected lactic acid passes unchanged into the urine. 

 If overproduction of lactic acid occurs in conditions of oxygen-lack, the 

 experiments of Lusk and Mandel and others make it appear that this ia 

 derived from glucose, the glycogen of the liver being especially drawn 

 upon. 



Carbohydrate Metabolism. Claude Bernard and Richardson gave the 

 earliest accounts of carbon monoxid glycosuria. Araki showed that it is 

 asphyxial. Straub(a) made the surprising observation that it is best ob- 

 tained with meat feeding ; after pure carbohydrate feeding carbon monoxid 

 produces no glycosuria. The sugar is derived as in other asphyxial 



