262 ANNALS NEW YORK ACADEMY OF SCIENCES 



5-10 mg., all calculated per 100 cc, of blood. The ease of excretion of 

 the three most important nitrogenous waste products — creatinine, urea 

 and uric acid — seems to fall in the order just named, possibly owing to 

 purely physical laws of concentration and solubility. In gout, where the 

 permeability or activity of the kidney is only slightly lowered, we en- 

 Counter an increase only in the uric acid concentration of the blood (4-9 

 mg. per 100 cc). In the early states of chronic interstitial nephritis 

 a similar retention of urea is observed. Here, however, we begin to find 

 a retention of urea as well (urea nitrogen figures from 15-35 mg. per 

 100 cc), although, as yet, there is very little influence upon the cre- 

 atinine. As the disease becomes more severe, the retention of urea in- 

 creases (60-80 mg.), although, with improvement, it falls. Creatinine, 

 however, is normally excreted with such great ease that it is apparently 

 only in the last stages of the disease that a notable retention occujs, 

 figures over 5 mg. per 100 cc indicating, as a rule, an early' fatal termi- 

 nation. The blood creatine has been found increased in only a few 

 cases, viz., terminal cases of interstitial nephritis with very high figures 

 for uric acid (13-27 mg.). 



The retention of the nitrogenous waste products is frequently of less 

 immediate concern than the retention of acid substances. As an indica- 

 tion of the actual severity of an acidosis, we recently found Van Slyke's 

 method of ascertaining the CO2 combining power of the blood plasma of 

 very great value. 



In the early cases of diabetes the glucosuria is a very reliable guide 

 as to the hyperglucemia, although quite the reverse may be true in cases 

 of long standing with nephritic complications. Here one may encounter 

 very high figures for blood sugar with a very small amoimt, or even no 

 sugar in the urine. In one case the blood sugar of 1.10 per cent., ten 

 times the normal, was observed with only 0.5 per cent, of sugar in the 

 urine. In such cases the estimation of blood sugar is of greater value 

 than the urine sugar. 



"■-Mr. Atkinson outlined his paper as follows: 1. Definition of Foods 

 and Poisons. In general, Foods comprise those substances which taken 

 into the body go to or assist in building up the body cells and furnish 

 energy. Poisons are those substances which taken into the cells interfere 

 with its normal metabolism. 



Foods Poisons 



Animal Animal 



Vegetable Vegetable 



:' Mineral Mineral 



-' Synthetic Organic Compounds Synthetic Organic Compounds 



