PATHOLOGICAL METABOLISM IN PREGNANCY 847 



TABLE V 



PLASMA BICARBONATE AND NITROGEN DISTRIBUTION OF URINE IN PERNICIOUS VOMITING. 



(Losee & Van Slyke) 



pregnant but who had an almost complete destruction of the liver from 

 acute atrophy. There was a reduction in the urea of the urine to about 

 50 per cent of the total nitrogen and an increase of the ammonia to 16, 

 17 and 11 per cent for the fifth, fourth and third days preceding death. 

 There was also a high amino-acid excretion, 4, 16 and 13 per cent, and 

 an increase of the undetermined nitrogen to 32, 8, and 23 per cent for 

 this same period. On these days there was no fall of the plasma bicarbonate 

 and the urea of the blood was normal but the ammo-acids were doubled 

 in amount. On the day before death no urine was obtained because of 

 the condition of the patient but the blood urea was 15.9 mg. and the 

 ammo-acids were 26.3 mg. per 100 c.c. The plasma bicarbonate was re- 

 duced to 49 c.c. showing only a slight acidosis. They believe that there 

 v/as an increase of the amino-acids by autolysis in the atrophying liver 

 and a failure to deaminate them at even an ordinary rate and that the 

 figures support the view that the liver bears a part in the deamination 

 of amino-acids and the synthesis of urea, which cannot be entirely assumed 

 by the rest of the body. They indicate that they accept the theory that 

 there is a "factor of safety" as regards function in liver degeneration and 

 that amino-acids are increased in the blood and urine only when the 

 destruction of the liver cells is almost complete. 



