502 VICTOR C. MYERS 



milk, for example, will increase the fecal excretion. The alkali phosphates 

 are absorbed and add to urinary phosphate to a large extent, but even 

 these may be converted into alkali-earth phosphates in the body and be 

 in part excreted into the intestine, reappearing in the feces. About 

 1 to 4 per cent of the phosphorus excreted is in an organic combination 

 of unknown nature. The phosphate elimination is said to be increased 

 in periostosis, osteomalacia. rickets and after copious water drinking; 

 arid decreased in acute infectious diseases, pregnancy and diseases of the 

 kidney. Sherman and Pappenheimer have recently shown that phos- 

 phorus may be made the limiting factor in experimental rickets in rats, 

 while a number of investigators have observed a retention of inorganic 

 phosphorus in the blood in nephritis. The retention of acid phosphate, 

 or rather the inability to excrete acid phosphate, is probably a very impor- 

 tant factor in the latter condition. At times a turbidity due to phos- 

 phates may be observed. This is sometimes erroneously interpreted as 

 indicating an increased elimination of phosphates, "phosphaturia." It 

 is more likely due to a condition of decreased acidity and is more properly 

 termed "alkalinuria." This precipitation of phosphates may also be due 

 to an unusual amount of calcium which would form one of the less soluble 

 phosphate combinations. 



Sulphates. Sulphur is excreted in three forms : oxidized or inorganic 

 sulphur, e. g., the sulphates of sodium, potassium, calcium and magnesium; 

 ethereal sulphur, e, g., sulphates of phenol, indoxyl, scatoxyl, cresol, etc. ; 

 neutral sulphur, e. g., cystin, cystein, taurin, hydrogen sulphide, etc. 

 The greater part of the sulphur of the urine is present in the oxidized or 

 inorganic form, averaging rather more than 2.0 grams calculated as SO 3 , 

 this as a rule being about 10 times the amount of ethereal sulphates ex- 

 creted. The ethereal sulphates normally amount to 0.20 gram and the 

 I'eutral sulphur to about the same amount, although sometimes being more 

 and sometimes less. The neutral sulphur elimination is relatively unin- 

 fluenced by the diet, and Folin regards it as being analogous to the crea- 

 tinin. An idea of the distribution of the sulphur on a high and on a 

 low protein diet may be obtained from the table on page 486. The inor- 

 ganic sulphur of the urine arises mainly from the oxidation of the sul- 

 phur of the protein, and is thus increased by those conditions which stimu- 

 late protein metabolism such as acute febrile diseases, and decreased when 

 the rate of metabolism is lowered. The ethereal sulphates of the urine 

 are increased by excessive formation and absorption from the intestine of 

 products of putrefaction, e. g., phenol, indol, skatol, or by the administra- 

 tion of similar aromatic bodies such as phenol, cresol, resorcinol, etc. 



Sodium and Potassium. The quantity of sodium ordinarily present 

 in the urine parallels quite closely the amount of chlorin. The excretion 

 in the healthy adult may be given as 4 to 8 grams with an average of 

 about 6 grams calculated as Xa.,0. The proportion of ^N"a to K is fairly 



