Chemical Changes in Blood. 



141 



the same pH and indicator. The amount of 0.2 N HC1 required 

 to give the endpoint with a control in which water replaces the 

 urine is subtracted. Of the organic acids known to be present 

 in urine in quantitatively significant amounts, the titration 

 measures from 93 to 100 per cent, of each. It also includes very 

 weak bases, but apparently of this class of substances only creatine 

 and creatinine are significant; they are titrated to nearly 100 per 

 cent. The titration figure, corrected for the amounts of these 

 two bases, represents the organic acids. 



81 (1456) 



Some significant chemical changes in the blood coincident with 

 malignant tumors. 



By Ludwig Kast and John A. Killian. 



[From the Department of Medicine and the Laboratory of Pathological 

 Chemistry, New York Post-Graduate Medical 

 School and Hospital.] 



With the view of ascertaining the systemic effect of malignant 

 neoplasms upon the organism, a series of sixty cases of various 

 types of malignancies have been studied and contrasted with 

 benign tumors. The data accumulated comprise determinations 

 of the uric acid, urea, creatinine, sugar, diastatic activity and 

 carbon dioxide combining power of the blood; the phthalein 

 excretion; the occurrence of proteinuria and casts; and the 

 blood pressure. 



Two thirds of our cases of malignancies present evidence of 

 an impairment of kidney function. The appearance and progress 

 of this renal insufficiency follows the order characteristic of 

 interstitial nephritis, described by Myers and his co-workers. 

 The nitrogenous waste product first to be retained is uric acid, 

 later urea and finally creatinine, and paralleling the accumulation 

 of these nitrogenous substances there was noted a drop in the 

 carbon dioxide combining power of the blood. A hyperglycemia 

 and an increased diastatic activity pointing to a lowered carbo- 

 hydrate tolerance, were encountered only in those cases mani- 



