341 



blood cholesterol, the ftit in the urine was as high as 0.168 gm. in four 

 hours and, as in the first instance quoted, the increase in urinary fat 

 was ascribed to altered permeability of the renal epithelium. 



The Blood Lipoids in Nephritis. The analyses of blood lipoids have 

 been carried out with great enthusiasm during the past few years. The- 

 results have not been uniform. This is in part due to the fact that the 

 chemical methods have not been thoroughly standardized, and in part, 

 because the same types of nephritis apparently do not exhibit constant 

 variations from the normal throughout their course. However, some very 

 striking observations have been made and they promise to be of consider- 

 able importance when they will be more thoroughly understood. 



TABLE 19 

 BLOOD LIPOIDS, PER CENT, IN NEPHRITIS ACCORDING TO BLOOR (d). (1917) 



A summary of some of Bloor's analyses is given in Table 19. These 

 figures cover the field fairly well and indicate what may be encountered 

 in many instances. Bloor (c?), from these determinations and a review of 

 the reports up to 1917, comes to the following conclusion : "The abnormal- 

 ities in the blood lipoids in severe nephritis were found to be high fat in 

 plasma and corpuscles and high lecithin in the corpuscles. The cholesterol 

 values were practically normal. These abnormalities are the same as are 

 found in alimentary lipuria and for this reason are regarded as the result 

 of a retarded assimilation of fat in the blood, which in turn is thought to be 

 one manifestation of a general metabolic disturbance brought about by a 

 lowered 'alkali reserve' of the blood and tissues." Bloor notes that in most 

 of his cases an acidosis was probably present and it may be accepted that 

 a decreased blood and tissue alkalinity plays a part in producing these 

 slight changes in the blood lipoids demonstrated by Bloor. It must be 

 recognized, however, that there may be other causes as well which will in- 

 crease the blood lipoids in nephritis. These will be discussed subsequently. 



