462 JACOB ROSENBLOOM 



has been studied by G. Klemperer. In one of his cases the calcium of the 

 urine on a rich calcium diet was very high. The P 2 O 5 : CaO ratio varied 

 from 4.1 to 37.1. In one of his cases a man suffering from a constant 

 phosphaturia, excreted in the urine : 



Gm. CaO . Gm. P 2 O 5 P,O 5 :CaO 



0.5335 2.55 4.8:1 



0.5049 3.06 6.0:1 



After general treatment the urine became clear and the ratios were as 



follows : 



Gm. CaO Gm. P 2 O 5 P 2 () 5 :CaO 

 0.4780 3.19 6.8: 1 

 0.6765 3.96 5.8: 1 



0.5090 3.45 6.0: 1 



It may be noted that the ratios are about the same even after the coi 

 dition had cleared up. 



If we turn to the question of the nature of phosphaturia we must wit 

 Minkowski place its origin outside the kidney. Minkowski says: "Tl 

 composition of the urine is undoubtedly determined by the special prc 

 esses in the secreting elements of the kidney and it is not excluded that 

 the selection activity of the kidney filter may be so influenced by pathc 

 logical changes in itself that a decrease of the acid or an increase of the 

 alkali output should occur." And further, "The activity of the kidnej 

 cells is undoubtedly under the influence of the nervous system and it is 

 consequently not impossible that nervous influences should affect the aci( 

 ity of the urine and by its decrease lead to phosphaturia." According 

 Minkowski phosphaturia is a secretion neurosis of the kidney. 



When upon a normal diet a human being excretes a constantly alkalii 

 urine the kidney fails to perform the important function of acid excretioi 

 and of alkali retention and of a loss of alkali from the body occurs. In 

 this relation the urine in phosphaturia behaves like the urine in acidosis 

 "and there is a lessened excretion of alkalies through the intestines. On 

 this basis we may say that phosphaturia depends upon a disturbance of the 

 acid elimination and of the conservation of the alkaline state. 



Oxaluria and Oxalate Calculi 



By oxaluria we mean the presence of calcium oxalate crystals in the 

 freshly voided urine. The formation of these crystals takes place in acid, 

 neutral and alkaline urine. The formation of these crystals is to a great 

 deal independent of the oxalate content of the urine. 



