384 SELLARDS. 



In the bicarbonate series, with one exception, only those solutions were 

 free from normal carbonate which were sterilized by filtration without 

 heat. There is the possibility, of course, that in the heated solutions 

 the active agent was not the bicarbonate, but the normal carbonate which 

 was also present. However, this explanation is excluded, first by the 

 similarity in the action of the neutral sodium acetate as compared with 

 the bicarbonate, and, secondly, by the fact that in two cases (numbers 

 27 and 28) the normal carbonate was removed from the bicarbonate 

 solution by the following procedure : 



A 2 per cent solution of sodium bicarbonate was sterilized by heat and the 

 normal carbonate removed by adding an excess of normal hydrochloric acid. 

 Sufficient acid was added to reduce the content of sodium bicarbonate to 1.5 per 

 cent and the solution was .then allowed to stand several hours to permit the 

 escape of the undissolved carbon-dioxide, but no special precautions were taken 

 to remove the carbon dioxide in solution. 



CASES TREATED WITH SODIUM CHLORIDE. 



For comparison with the cases treated with alkali and acetate, a 

 duplicate series was carried out, using the ordinary treatment with 

 sodium chloride. The general nature and severity of the cases varied 

 comparatively little throughout the period of investigation, thereby 

 facilitating the division of the patients into fairly comparable groups. 

 Of the total of 111 cases investigated, the first 20 were treated with 

 Einger's solution. In the remaining 36 cases of the control series, 

 sodium chloride alone was used, and these cases were distributed 

 uniformly throughout the series. Both hypertonic (1.3 per cent) and 

 isotonic (0.85 per cent) salt solutions were empkryed. 6 The following 

 outline gives a summary of the causes of death in the group of cases 

 treated with sodium chloride in comparison with those receiving alkali. 



Treatment. 



Number of cases dying in— 



Collapse or 

 enteritis. a 



Pneumo- 

 nia. 



Uraemia. 





30 

 24 



2 



3 



8 



1 







a The term "enteritis" is used to designate those cases which died from the toxasmia 

 of the cholera infection in distinction from the toxEemia of uremic origin. 



The causes of death, usually, were rather sharply differentiated. The 

 uremic cases, in addition to dyspnoea and suppression of urine, showed 



" The conclusions in regard to the relative value of isotonic and hypertonic 

 salt solutions for the treatment of collapse will appear in this number of the 

 Journal. 



