796 AELIE V. BOCK 



man of 75 kilograms this corresponds to 63 grams of glucose per hour. 

 No sugar appears in the urine and no diuresis occurs at this, or subtolerant 

 rates, since glucose utilization presumably keeps pace with such rates 

 of injection. However, if the rate of administration is increased as high 

 as 5.4 grams per kilogram per hour, glycosuria with an active diuresis 

 occurs, which soon leads to excessive dehydration of the body unless a 

 large amount of water is supplied. 



Essentially the "same phenomena were observed in dogs by Fisher and 

 Wishart after the ingestion of glucose, but the time relations necessarily 

 extend over longer periods owing to the longer absorption time. Hiller 

 and Mosenthal, however, found in man that ingestion of 100 grams of 

 glucose did not produce hydremia. 



The routine use of glucose solutions, instead of normal saline, is now 

 the custom in certain clinics. There is much to be said in favor of this 

 change. Yet too much emphasis has been placed upon the food value of 

 glucose infusions. An intravenous infusion of 500 c.c. of a 10 per cent 

 solution of glucose has a fuel value of only about 200 calories. If such an 

 infusion is repeated every two hours in twenty-four the total calories 

 amount to 2,400. If solutions of greater concentration of glucose are 

 used, correspondingly more time for each infusion must be consumed in 

 injecting the fluid if diuresis and glycosuria are to be avoided. As 

 practical measure, therefore, the supply of the total calorific needs of the 

 body by means of intravenous injections of glucose is limited to circum- 

 stances of an exceptional nature. 



Solutions Used for Intravenous Infusions 



The use of normal saline for intravenous infusion has formed the basis 

 for the development of other solutions for purposes not served by saline. 

 The following list comprises those solutions that have been found to have 

 the greatest range of usefulness for intravenous injection: (1) "saline" 

 solutions; (2) gum acacia or gum-saline solutions; (3) gelatin solutions; 

 (4) sodium bicarbonate solutions; and (5) glucose solutions. 



1. "Saline" Solutions. A solution of normal saline (0.85 per cent 

 sodium chlorid) was first used for intravenous injection. It was found 

 by Sherrington and Copeman and many others, to leave the circula- 

 tion within a few minutes after injection. This is due to the rapid diffu- 

 sion of both, water and salt until the differences in potential between blood 

 and tissues are again adjusted. When used intravenously for cases of low 

 blood pressure, sodium chlorid has, therefore, only a transitory effect upon 

 the blood pressure. Fraser and Cowell found that such a solution 

 was of little use in the treatment of hemorrhage and shock for this reason, 

 and their experience led them to conclude that the blood soon becomes 



