142 



Scientific Proceedings (83). 



Following these indications of a mild acid intoxication and 

 an associated kidney injury, the acid-base equilibrium of the 

 blood has gradually returned to the normal, the output of phthalein 

 has increased, the albumin has disappeared or has been reduced 

 to a trace and all of the animals have recovered. 



Group j . — Seventeen animals. Following the subsidence of the 

 mercury enteritis, and in the case of two of the animals, as late 

 as six days after these symptoms had disappeared, the animals 

 have either very rapidly (within eight hours), or gradually, 

 developed a severe acid intoxication and died. The highest 

 hydrogen ion concentration of the blood in this group has been 

 7.1. The reserve alkali of the blood in this animal was reduced 

 to 7.7, while the tension of alveolar air carbon dioxide was 18 mm. 

 The animal died in air hunger. 



With the development of an acid intoxication the output of 

 urine is greatly reduced or the animal is rendered anuric. The 

 phthalein output shows a rapid reduction. In the animal above 

 referred to the output of phthalein was only 10 per cent. The 

 urine in this group of animals has contained as high as 2.75 gm. 

 of albumin per liter and in all of the animals the urine has con- 

 tained both glucose and acetone. Casts have not been numerous. 



The kidneys of those animals which succumb during the height 

 of the gastro-enteritis from bichloride are uniformly and severely 

 congested. The kidneys appear cyanotic. The epithelium shows 

 but slight evidence of damage. The cells of the ascending limb 

 of Henle's loop show a small amount of fat. 



The kidneys of those animals which die after the subsidence 

 of the enteritis and during a period of acid intoxication have a 

 pale, anemic appearance and show a clear-cut fatty zone at the 

 cortico-medullary junction. The tubular epithelium, and espe- 

 cially that of the convoluted tubules, is severely swollen, vacuolated 

 and rapidly becoming necrotic. The cells of the ascending limb 

 of Henle's loop show a severe fatty infiltration. 



Conclusions. 



1. The acute kidney injury which develops late in poisoning 

 by bichloride of mercury does not show any dependence in the 

 frequency with which it occurs with the severity of the mercury 

 enteritis. 



