i in i \' ici riON 01 i kim. 519 



It m;i\ be due in pari to vascular changes and in part in 



the resistance to filtration broughl aboul by alteration in the pern 

 bility of the capsule. 



According to the i lem theory the polyuria in < 1 iul >«• ■ 



by the excessive amounl of water taken and by tin- inabilM 



Is i< 1 1 h-\ to concentrate tin- urine aL r ain^t il smotic pressu 



the concentrated sugar solution in the tubules The pres hy- 



perglycemia in an amounl higher than is presenl in tin- optimal blood 

 plasma in this disease makes sugar a nonthreshold sub eak, 



and none is absorbed. The diuresis following the injection oi - r is 

 therefore of the same type a- thai produced by sulphate and urei 

 diuretic action of the digitalis group U dependenl upon its infl 

 tlir circulatory system. IT the circulation is already sufficient, digitalis 

 does no1 cause diuresis. The cause of tin- diuresis produced by pituiti 

 extract is not known. It may !"• owing in pari to its action on * : 

 culation and in pari in a direct action on the kidney. 



Albuminuria. — The plasma proteins ordinarily do not obtain entrai 

 into the tubules of the' kidney. In disease such as acul hritis and 



cardiac failure, the plasma colloids are filtered off through thi jule, 



probably because of some change that has i ccurred in the permeability 

 of its membrane due to inflammation or asphyxia. In th< • - the 



urine is usually reduced in amount. Probably there i> no purely gl< 

 erular or tubular type of nephritis, both structures sharing in t : 

 ability. While it can uol he said that any of the SO-called renal t< 



thai have been advanced in recent years are u-rr from criticism, tl 

 nevertheless have contributed very useful information. The fact that 



the kidney of the ehronic nephritic excretes a urine of more or less t : 

 low specific gravity would suggesl that here there is an impairmenl 

 the resorbing mechanism, and the failure of a kidney to 

 proper a unl of dye, a- in the phenolsulphonephthalein I 



an impairmenl in the filtering apparatus. Hard and fast rules can 



■ applied, however, and probably the tests must at presenl be inl 



preted for the kidney as a w hole. 



The Influence of the Nervous System on the Secretion of Urine. I 

 spite of numerous and repeated attempts to demonstrate that 

 mechanism governs the excretion *<\ mine, no proofs which 

 criticism have l>ecn forthcoming. Stimulation of the splanchnic 

 results in a diminution in the excretion of urine, probably 



diminution in the hi I SUpplj of the renal vess 



striction. Stimulation of the vagus nerves below the 



branches has been said to rcsull in the augra 



excretion Ashcr and I' The results - doubl ful, 1 



