AprIL 19, 1912] 
including a colored plate. 
New York, John Wiley 
81. figures, 
Cloth, $2.50 net. 
& Sons. 1912. 
In this book Fischer has made a special 
application to the kidney of the same stand- 
point, principles and methods as were used in 
the more general discussion contained in his 
work on edema, published two years ago. Ac- 
cording to his view it is to the colloidal prop- 
erties of albuminous substances, and partic- 
ularly of such bodies in the jel state, that we 
must look for an explanation of many phases 
of the behavior of living cells, not only in 
health, but to an equal degree in disease. In 
particular the amount of water contained 
within every cell, 7. e., its turgescence, and the 
extent to which the cell membrane dissolves, 
passing from the jel to the sol condition in 
the surrounding fluids, are determined by the 
properties peculiar to colloids. These proper- 
ties, as we find them in the so-called emulsion 
or lyophilic colloids to which all albuminous 
substances belong, include a specific avidity 
for water according to the conditions under 
which the colloid is placed. Thus if a piece 
of dry sheet gelatin is placed in water at an 
ordinary temperature it swells—that is, im- 
bibes water—to a fairly definite degree. Simi- 
larly in the sol condition, as in the case of the 
proteins of the blood plasma, the water in 
which they are said to be “ dissolved” is really 
held by the colloid. Otherwise the tissues of 
the body should immediately imbibe all of the 
blood fluid as they do saline or Ringer’s solu- 
tion. The avidity of the colloids for water is, 
however, subject to great alterations according 
to the surrounding conditions. Thus acids 
and alkalies both induce a markedly increased 
degree of swelling as compared with a neutral 
watery medium, while salts, on the contrary, 
tend to decrease the capacity of colloids to take 
up and hold water. As the result, in particu- 
lar, of the work of L. J. Henderson it is now 
known that the normal blood is not only neu- 
tral in reaction, but that it has a remarkable 
capacity to maintain its neutrality against the 
introduction of considerable quantities of 
acids or alkalies. Under the influence of toxic 
substances, or under conditions in which the 
SCIENCE 
627 
circulation is interfered with, a formation 
and accumulation of acids within the tissues 
of an organ does, however, occur. This is 
particularly the case in an organ which, like 
the kidney, has normally a large respiratory 
exchange. 
Boldly following this conception to its con- 
clusion Fischer holds that “all the changes 
that characterize nephritis are due to a com- 
mon cause—the abnormal production or ac- 
cumulation of acid in the cells of the kidney. 
To the action of this acid on the colloidal 
structures that make up the kidney are due 
the albuminuria, the specific morphological 
changes noted in the kidneys, the associated 
production of casts, the quantitative varia- 
tions in the amount of urine secreted, the 
quantitative variations in the amounts of dis- 
solved substances secreted, etc.” In support 
of this thesis experiments are reported in 
which a typical cloudy swelling was induced 
in thin sections of fresh kidney tissue when 
placed in dilute acid. Similarly in experi- 
ments upon animals injection of acid into the 
blood stream is quickly followed by a marked 
albuminuria. The same result follows tem- 
porary ligation of the renal blood vessels. On 
the other hand—and herein, perhaps, lies the 
most important points of Fischer’s investiga- 
tions—if under conditions in which nephritis 
would otherwise occur an increased quantity 
of neutral salts is brought into contact with 
the tissues, the effects of acid may be com- 
pletely counteracted, and the kidney restored 
to practically normal structural appearance 
and functional behavior. Thus, “ Sodium 
chloride when injected intravenously, in con- 
centrated solution, simultaneously with hydro- 
chlorie acid solution of a concentration which 
we found in other experiments to lead to the 
symptoms of a most intense acute nephritis, 
practically suppresses this entirely. The albu- 
minuria scarcely appears, and there are no 
casts, no red blood corpuscles, no homoglob- 
inuria, no decrease in the amount of urinary 
secretion, and no general edema.” Finally 
Fischer reports a number of clinical cases of 
nephritis, some of them with complete anuria 
and coma, in which a rapid recovery was in- 
