EFFECTS OF CERTAIN DRUGS AND POISONS 763 



Graham has made interesting studies of chloroform acidosis illustrat- 

 ing the protective effects of alkali. The diminished alkali reserve of the 

 blood has been discussed in the section on alkalies. 



Buckmaster has found the total gas content of the blood increased by 

 10.2 per cent under slight chloroform anesthesia. When the anesthesia 

 was complete this was increased to 26.2 per cent. The extra gas is nearly 

 all carbon dioxid, but there is also a low oxyhemoglobin content (40 per 

 cent reduction). 



Henderson and Haggard have made the important observation that 

 the effects of ether upon the alkali reserve (as indicated by the carbon 

 dioxid capacity) of the blood are dependent largely upon how the anes- 

 thetic affects the respiration. Ether in lower concentration, so adminis- 

 tered as to cause hyperpnea, produces, acapnia, lowering the alkali reserve. 

 On the other hand, concentrations of ether high enough to depress the 

 respiration result in increasing the alkalinity of the blood. (Compare 

 morphin. ) 



Water Metabolism. Oliguria or anuria have long been recognized 

 accompaniments of surgical anesthesia. 



Rouzaud finds oliguria more pronounced with chloroform than with 

 ether in man, in connection with his studies on hyperglycemia and 

 azotemia. He recommends after-treatment with diuretics. 



MacNider(c), however, has just reported some facts relating to anuria 

 under anesthetics which would tend to discourage the use of diuretics and 

 point rather to preventive measures. Dogs were anesthetized with ether, 

 chloroform, or chloroform and alcohol (Grehant's anesthetic). Ether 

 anuria was found attributable to low blood pressure and rarely associated 

 with depletion of the alkali reserve. Only in the latter case are diuretics 

 ineffective. On the other hand, chloroform anuria (with or without 

 alcohol) is invariably associated with loss of alkali, the kidney becoming 

 quite impervious to diuretics. 



Alkali preliminary to operative anesthesia is therefore recommended 

 by MacNider from a new viewpoint to protect the kidney. 



Mineral Metabolism. Kast found that chloroform, like some other 

 poisons, increased the chlorid excretion more in chlorid-poor animals 

 than in others. 



Ferments. Burge maintains that anesthetics lower the blood catalase 

 content. Reimann and Becker found it increased in 35 per cent and de- 

 creased only in 65 per cent of their cases. 



Hypnotics. Chloral. Mild chloroform action is suggested by many 

 of the effects of chloral, although the former is not derived from the latter 

 in vivo as Liebreich supposed. Chloral glycosuria was described by Eck- 

 hardt. Harnack and Remertz found that chloral increases both nitrogen 

 and sulphur excretion, but later and to a lesser degree than does chloro- 

 form. Abl found an increased uric acid excretion. 



