800 AKLIE V. BOOK 



from the blood, a process shown by many observers to be independent of 

 the kidneys and other abdominal organs, and Kleiner has shown 

 that.it may to a certain extent be independent of vital function. How- 

 ever, Bogert, Mendel and Underbill, and Boycott and Douglas have 

 found that in animals suffering from acute experimental nephritis, 

 the injected sugar remains for a longer time in the blood> than when the 

 kidneys are normal This point may be of great clinical importance when 

 siich infusions are contemplated for cases of nephritis in man, since it may 

 be associated with the onset of diuresis reported by several observers in 

 cases of anuria. 



6. Other Solutions. Certain other substances less widely used for 

 infusion purposes may be mentioned. Intravenous infusions containing 

 calcium and barium have been used for the alleged constricting action of 

 these siibstances upon arterioles. Bayliss(c) has shown that this action 

 lasts but a few minutes and is, therefore, of no great importance. The 

 use of calcium for the treatment of tetany has been suggested by McCal- 

 lum and Voegtlin, Wilson, Stearns and Thurlow, and others. It is 

 also useful to restore to normal the delayed coagulation time of the 

 blood in cases of obstructive jaundice, as shown by Lee and Vincent. 

 Likewise, the intravenous use of magnesium sulphate for the treatment of 

 tetanus, and for purposes of anesthesia, has been described by Meltzer(c) 

 and Auer and Meltzer. 



Reactions Due to Infusions 



As in the case of blood transfusion, the intravenous injection of 

 solutions is attended with a certain incidence of reactions. In the pre- 

 ceding discussion many of these have already been mentioned. The more 

 common reactions are characterized by symptoms similar to those associ- 

 ated with protein intoxication. The most important cause of these reac- 

 tions seems related to the water used for the solutions. Chills and fever, 

 resulting from intravenous injections, are for the most part theoretically 

 due to reaction to foreign protein contained in the water. In certain 

 instances, reactions after infusion may be accounted for by the fact that 

 the solution injected was in effect a vaccine and the resulting chill and 

 fever a manifestation of a non-specific immune reaction. In the routine 

 use of infusions experience has shown that chills and fever result in a 

 small percentage of all cases regardless of the type of solutions used. It 

 is well known, however, that in man the rapid ingestion of very large 

 amounts of water may produce the same type of reaction, from which the 

 disturbance may be seen to be a very fundamental one involving the 

 water balance of the body. Hort and Penfold, after carefully in- 

 vestigating the matter, found that water distilled in a glass retort and at 



