1892.] The Influence of the Kidney on Metabolism. 29 



From this tabular statement of the results in five cases it will be 

 seen that, as stated above, the results of the operation are trifling 

 when we consider its severity. In one case, No. 16, the output of 

 urea was increased from 7 to 10 grams per diem. In this case the 

 ingesta were not determined, and the apparent increase may have 

 been due to an increased diet. In No. 22 the diet was the same 

 before and after the operation, but there is an increase in the urine 

 and urea after the operation. This case is quoted because it illustrates 

 the maximum effect produced ; in no other case was so great an effect 

 observed. In the other cases the effects on the urine, &c, are so 

 slight as to be well within the limits of experimental errors. The 

 loss in body weight is trifling when compared with that described 

 below as resulting from the second operation. The greatest loss ob- 

 served was in Dog 22, where the body weight fell from 14 lbs. to 

 12 lbs. The specific gravity of the urine is not permanently affected 

 by the operation. In the first few days after the operation, whilst 

 there is hematuria, the urine is frequently more abundant in quantity 

 and the specific gravity then is temporarily lowered, but this soon 

 passes off, and the urine returns to its normal quantity and density. 



The Results following the Second Operation. 



The results following the removal of the second kidney differ 

 widely from those described above as following the first operation, in 

 that there are frequently no immediate ill effects, the animal running 

 about, &c, within a few hours of the nephrectomy, and there is but 

 little shock, hemorrhage, &c, when compared with the first operation. 

 The remote effects, however, are very marked : a widespread disturb- 

 ance of nutrition ensues, accompanied by extreme wasting, hydruria, 

 and polyuria, and with these a fall in the body temperature and a 

 great increase in the nitrogenous extractions of the tissues, provided 

 a sufficiently large amount of kidney has been removed at the first 

 operation. 



In all cases the wound has healed up rapidly and soundly, and in 

 no case has death resulted directly from the operation. Out of the 

 fifteen experiments, the first was killed five days after the second 

 operation, and at that time the animal was in sound health. In four 

 cases, No. 2, No. 11, No. 19, and No. 21, the animals were killed 

 47 days, 60 days, 14 days, and 30 days respectively after the second 

 operation, and the results observed in them will be described below 

 (vide Table IV). In the remaining ten cases the dogs either died of 

 a rapidly progressive asthenia, or else they were killed at a time when 

 they were practically moribund. 



The results in four cases out of the ten are given in the following 

 table : — - 



