METABOLISM IN NEPHRITIS 



381 



Criterion 



Normal 

 Standard. 



Sodium chlorid con- 

 centration. 



Nitrogen concentration 



Urea concentration 



Low sodium chlorid and 

 high urea or nitrogen 

 concentration. 



Significance. 



The blood uric acid, urea, and crea- 

 tinin indicate whether there has been 

 any retention of these products. 

 These findings must be taken into 

 consideration with the urinary an- 

 alyses in order to come to a definite 

 conclusion regarding the kind and 

 amount of protein food that is best 

 for the patient in question. 

 Normal if one per cent or higher in 

 any specimen of urine; not neces- 

 sarily abnormal if less. 

 Normal if one per cent or higher in 

 any specimen of urine; not neces- 

 sarily abnormal if less. 

 Normal if two per cent or higher in 

 any specimen; not necessarily abnor- 

 mal if less. 



Characteristic of myocardial insuffi- 

 ciency and nephritis accompanied 

 by edema. 



Concentration and Dilution Test 



Volhard originated a procedure which has been called the concentration 

 and dilution test. Kb'vesi and Roth Schulz had previously tested the power 

 of the kidneys to excrete a dilute urine by giving large quantities of water 

 and combined this with cryoscopic examination of the urine to determine 

 the molecular concentration. Various authors have advocated similar 

 tests until Volhard's technique has finally superseded the others ; this 

 is as follows: the urine is voided at 7.30 A.M and is discarded; between 

 7.30 and 8 A.M. 1500 c.c. of fluid are taken (this may be milk, coffee 

 diluted with milk, weak tea, peppermint water; the main point is that 

 the fluid should be mostly water; 1 to 2 rolls may be given with the fluid) ; 

 the urine is voided at the intervals given in Table 34 ; the volume of each 

 specimen is measured and its specific gravity noted; the method as out- 

 lined thus far, aims at ascertaining the ability of the kidney to dilute, 

 in order to test out its power of concentration, solid food, but no fluid is 

 added in the course of the day somewhat according to the following sched- 

 ule: 



