ACID INTOXICATION IN ASIATIC CHOLERA. 



59 



obtained before death. The first one of 20 cubic centimeters contained 0.6 per cent 

 of urea. This was obtained one and one-half hours after the injection. A second 

 specimen measuring 10 cubic centimeters was obtained fifteen hours later. It 

 contained 0.25 per cent of urea. 



As regards control patients, fatal eases have been frequently observed in which 

 the variation in the urea content was very slight. A typical record of such a case 

 is given in Table V. A patient dying in uraemia has been selected since more or 

 less pronounced symptoms of urcemia were present in the four cases injected with 

 urea. 



Table V. — Control with sodium chloride. 



Interval 

 between 

 speci- 

 mens. 



Cubic 

 centi- 

 meters of 

 urine. 



Per cent 

 of urea. 



Grams 

 of urea. 



Hours. 











•75 

 100 



0.2 

 .1 



0.13 

 .10 



13 



13i 



90 



.15 



.13 



18 



80 



.3 



.24 



14 



65 



.2 



.13 



10 

 De 



70 

 ath after t 



.4 

 vvelve boi 



.28 

 rs. 



" Preceded by anuria for forty-four hours. 



Of the four cases injected with, urea, there is one (Table II) in which 

 a definite result was obtained. After the injection of urea, the percentage 

 of urea increased eighteen-f old ; then after a quantity equivalent to about 

 90 per cent of the amount injected had been excreted, the urea content 

 fell to the same percentage that was found before the injection. This 

 case would indicate that the suppression of urea is not always due to 

 nephritis. The observations on this patient were carried out principally 

 during the stages of collapse and reaction before symptoms of uraemia 

 were prominent. The other three cases (numbers 11, 15 and 18) indicate 

 that the behavior of this patient does not represent the usual result follow- 

 ing the injection of urea, partly perhaps because of the difficulty of ob- 

 taining suitable cases for carrying out a complete test, or perhaps the urea 

 in these three cases was used in the neutralization of acids before excre- 

 tion could take place. 



There is some evidence which indicates that the suppression of urea is 

 not due to an impairment of function in the urea-forming organs. It 

 was found in patients who were excreting only minimal amounts of urine 

 that on the administration of bicarbonates the urea content sometimes 

 rose almost to normal within a comparatively few hours. Thus, in one 

 case, the percentage of urea rose from 0.05 per cent to 1.3 per cent in 

 five hours. The data for this case are given in Table VI. 



