EFFECTS OF CERTAIN DRUGS AND POISONS 761 



cially studied by Howland and Richards and by Lindsay (a). The excre- 

 tion of ammonia, allantoin, diamino-acids, polypeptids, creatinin and or- 

 ganic sulphur was found augmented ; the urea and monamino-acids were 

 decreased. Increased urea as well as total nitrogen and ammonia has been 

 found by Aloi, however. 



Rouzaud has recently reported interesting blood studies in surgical 

 cases before and after chloroform. The average urea content of the blood 

 was found increased from 0.048 per cent to 0.075 per cent. Under ether 

 the blood urea was still higher. This investigator also noted an increased 

 urea concentration in the urine. 



Davis and Whipple have accomplished rapid reconstruction of liver 

 cells in chloroform poisoning by feeding either carbohydrate or fat. In 

 both cases the beneficial results were attributed to a sparing effect upon 

 the protein metabolism. 



Carbohydrate Metabolism. Rosenbaum observed the rapid disappear- 

 ance of glycogen from the liver under the influence of chloroform. Heins- 

 berg found this effect associated with hyperglycemia, 



Pfmger(c) states that glycosuria is comparatively rare after surgical 

 anesthesia ; Pavy and Godden prevented chloroform glycosuria by sodium 

 carbonate. Hawk(c) described ether and chloroform glycosuria in dogs 

 and found it more intense when the animals were well fed. 



King and his pupils found that ether glycosuria is independent of the 

 splanchnic nerves, but does not occur if the liver be excluded from the 

 circulation. King, Moyle and Haupt proved that both hyperglycemia and 

 glycosuria could be produced by intravenous injections of ether without 

 causing 'asphyxia which was thus excluded from a primary causal relation. 

 Ross and Hawk showed that ether glycosuria is not due to lowering of' 

 the body temperature. 



Sansum and Woodyatt(a) made the interesting observation that both 

 ether and nitrous oxid increase the glycosuria and D :N ratio in phlorhizin 

 diabetes; the "extra sugar" is ascribed to glycogenolysis through tissue 

 asphyxia. Ross and McGuigan observed a greater ether hyperglycemia in 

 dogs on a pure meat diet than when carbohydrate was added. They ob- 

 tained the phenomenon in the absence of asphyxia or excitement. The 

 diastatic power of the serum was found unaltered. Watanabe(fr) believes, 

 however, that the blood diastases increase slightly just after the anesthesia. 



Chloroform hyperglycemia was clearly shown by Scott to accompany 

 the glycosuria. Marshall and Rowntree(fr) have found that chloroform 

 diminishes the tolerance to levulose and galactose as well as to dextrose. 



Killian has found that patients under ether or chloroform exhibit an 

 increase in both the sugar and diastase content of the blood, together 

 with a decrease in the alkali reserve. All three of these tendencies can 

 be reversed by the administration of 20-30 grams sodium bicarbonate. 



According to recent work of Keeton and Ross ether hyperglycemia is 



