METABOLISM IN NEPHRITIS 



317 



responsible for the diminution of the serum proteins; as a result of the 

 lowered protein content of the blood, the osmotic pressure within it is 

 decreased, and the flow of fluid is from the blood to the tissues, thus pro- 

 ducing edema ; by this author, as well, a toxic factor has to be resorted to 

 to account, for the disproportionately high globulin and other changes. 

 The exact status of this question remains to be determined. It is very much 



1 Protein 



Oct. 12 



CHART 1 



The low level of serum albumin and total serum proteins in severe nephritis with 

 edema followed by a rise in these values with clinical improvement and loss of edema 

 is shown. The separation of the albumin and globulin curves in this chart is a 

 definite index of recovery, though the failure of the total proteins to reach a more 

 normal value indicates a bad prognosis. (According to Rowe(c), 1917.) 



in accord, however, with the conception that nephritis is a disease caused 

 by some unknown extrarenal poison, to believe that such a toxic factor 

 brings about changes in the serum proteins and at the same time is re- 

 sponsible for the lesions in the kidney. 



As the edema clears up in nephritis the serum proteins tend to re- 

 turn to normal (Rowe(c), 1917). Within ten days after the severe stage 

 has passed, the usual albumin: globulin ratio becomes established; the 

 total protein content of the serum, although increased, may not be re- 

 turned to a normal level. It is very interesting to note that the globulin 

 values remain constant while those for albumin rise. Rowe, endorsing 



