ACID INTOXICATION IN ASIATIC CHOLERA. 



57 



liters each of Ringer's solution of which the third contained 10 grams of urea. 

 The records of the excretion of urea are given in Table II. 



Table II. — Injection of urea, case No. 4- 



Interval 



between 



speci- 



Cubic 

 centi- 

 meters of 



Per cent 

 of urea. 



Grams 

 of urea. 



mens. 



urine. 







Sours. 













»30 



0.1 



0.03 



Injection of 10 grams of urea.'' | 



9 



30 



0.5 



0.15 



5i 



50 



0.6 



0.30 



9i 



80 



1.7 



1.36 



5 



120 



0.9 



1.08 



9 



90 



1.2 



1.08 



8 



250 



1.8 



4.50 



5 



120 



1.4 



1.68 



14i 



10 



0.1 



0.01 



Death after seventeen h 



1 1 



ours. 



* Preceded by anuria for twenty-seven hours. 



"> This injection was made four and one-half hours after the first specimen of urine 

 was obtained. Catheterization showed no urine at the time of injection. 



The volume of urine and the percentage and amount of urea are given, since 

 the interpretation of the data is a little complicated because of the variation in 

 the time intervals and the quantities of urine excreted. On the third day after 

 admission, a fourth injection of two liters of Ringer's solution was given. Death 

 occurred on the fifth day of the disease with symptoms both of toxaemia and 

 uraemia. In the two and one-half days after the injection of urea a total of 10.1 

 grams of urea was excreted. Assuming that the percentage of urea would not 

 have increased spontaneously, we may calculate the natural percentage for this 

 period as 0.1, i. e. the per cent found before any urea was injected; on this basis 

 we may deduct 0.8 gram as the amount which naturally would have been excreted 

 leaving 9.3 grams as the increase due to injection. In addition to this amount 

 there were also two specimens of urine which were lost by involuntary micturition, 

 i. e. only 8 of 10 specimens were obtained. We may estimate, then, that about 

 90 per cent of the injected urea was excreted within two and one-half days. 



A second ease (number 11) required 8 liters of Ringer's solution intravenously 

 during the stage of collapse. Two grams of urea were added to the third and 8 

 grams to the fourth injection. The period of reaction set in at the beginning of 

 the fourth day and a fifth injection of two liters of Ringer's solution was given 

 for its possible effect on the urine. Death occurred on the fifth day with symp- 

 toms of toxaemia and uraemia. During the first day, after the first injection 

 of 2 grams a total of only 0.68 grams of urea was obtained and after the 8 

 gram quantity, only 2.6 grams were recovered although of the 4 voidings 

 following the second injection one was involuntary and the specimen was lost. 

 Hence in this ease not more than one-third of the urea which we injected was 

 recovered. The data are given in Table III. 



