56 PROTEIN THERAPY 



II. Well marked increase in weight. 



III. Usually slight decrease during first series of injections, later 

 an increase. 



IV. Little if any alteration. In a few cases a well marked in- 

 crease in weight. 



In this connection we must keep in mind the possibility that such 

 changes in weight as here observed may be due to alterations in the 

 water balance of the tissues, rather than an actual increase in tissue 

 substance. 



Albuminuria. According to all clinical observers the injections are 

 not followed by any alterations in the urine that would indicate an ir- 

 ritation of the kidney parenchyma. The only exception to this general 

 statement is the effect that at times follows the intravenous injection 

 of colloidal metals. With these it has been observed that after the 

 subsidence of fever (in influenza) the injection may at times be fol- 

 lowed by the reappearance of casts and some albumin in the urine if 

 they had been present at the time of the acute illness. In this case 

 the agent seems able to activate a low-grade inflammation which 

 may still be present. 



Uddgren observed no kidney irritation in about 100 cases in- 

 jected with milk. In only two cases was a trace of albumin noted 

 after the injections and this was a purely transient phenomenon, 

 v. Aaron, who examined the disposal of casein injected intravenously 

 in animals, found that 58% of it was excreted through the urine, a 

 fact that must be considered if traces of albumin are reported in 

 the urine after milk injections. 



On the other hand, several observers (Dollken, Schmidt, etc.) 

 have reported that when nonspecific injections are made during the 

 course of an acute illness accompanied by albuminuria and casts 

 in the urine, the urinary findings clear up very promptly after the 

 injections. Dollken noted this particularly in his patients ill with 

 Weil's disease where a high-grade albuminuria cleared up immediately 

 after the injections. 



Diuresis. Injections are frequently followed by a diuresis of 

 some extent. Riedel has called attention to this fact. 



Permeability of the Blood Vessels. Luithlen in 1912 studied the 

 effect of the intravenous injection of various substances, such as serum, 

 gelatin, starch, and crystalloids, on the course of the common skin re- 

 actions and as a result of his preliminary work investigated the per- 

 meability of the capillaries after such injections. His method consisted 

 in injecting Ringer's solution into the abdominal cavity of rabbits, 

 then following with the intravenous injection of the agents that he 

 wished to study, then determining the permeability of the abdominal 

 capillaries by injecting sodium iodid and also sodium ferrocyanid in- 

 travenously and testing the rate at which these substances had entered 



