J. Harold Austin

Hydrogen ion concentration of the blood in health and disease

Relation of [H+] to buffer effect. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 279 The acid base balance of the blood. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 280 Alkali reserve. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . COZ absorption curves. . . . . . . . . . . . . . . . . . . . . . . . . . . 282 Influence of salts and proteins on the acid base equilibrium. . . . . . . . . . . . 283 Relation between p H of blood and serum. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 284 pH of blood cell.. . . . . . . . . . . . . . . . . . . . . . 284 Relation between [BHCOz] o . . . . . . . . . . . . . . . . . . . . . . . . . . . . 284 pHof serumorplasma . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28.5 Regulation of pH of blood. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Relation between [H+] and gram equivalent normality of acid concentration. . . . 279

THE RELATION OF THE SPLEEN TO BLOOD DESTRUCTION AND REGENERATION AND TO HEMOLYTIC JAUNDICE : XI. THE INFLUENCE OF THE SPLEEN ON IRON METABOLISM.

In the splenectornized dog the anemia caused by hemolytic poisons (hemolytic immune serum and sodium oleate) and by bleeding is of a severer grade, runs a longer course, and is accompanied by a less rapid regeneration of the blood than is the case in the normal dog. Also in the splenectomized dog, especially after the use of hemolytic serum, the leucocytosis is greater than in the normal animal. The splenectomized dog almost uniformly exhibits an increased resistance of the red cells to hypotonic salt solution, but after the administration of hemolytic poisons, and especially hemolytic serum, this increased resistance disappears and a decreased resistance persists for long periods of time. The same change occurs in the normal dog, but in the latter the return to the previous degree of resistance is more rapid than in the splenectomized animal.

A note on the estimation of carbon dioxide in serum by the Van Slyke method in the presence of ether.

When serum contains an amount of ether such as is present in an animal fully anesthetized, an appreciable error is introduced into the analysis of the CO2 content by the Van Slyke method, using the ordinary technique with either the constant pressure or the constant volume machine. This is due to the extraction of a considerable part of the ether during the initial extraction of the gases and to the reabsorption of most of this ether by physical solution during the absorption of the CO2 with alkali. By the ordinary technique the apparent CO2 content may be too high by as much as 10 volumes per cent. A modification of the technique has been developed which makes it possible to measure the CO2 in the presence of ether. This consists essentially of reextraction of the alkaline solution after absorption of the CO2 with alkali. The CO2 remains held by the alkali but the ether is again extracted in part into the gas phase. An empirical correction must be introduced to correct for a greater solubility of the ether in the acidified solution than in the alkaline solution.

The total non-protein nitrogen of the blood in nephritis and allied conditions

The following summary covers the results of our study of the non-protein nitrogen of the blood by Folins methods in a series of fifty-nine hospital patients. Our main concern has been with nephritis but we have examined the blood in many other conditions as opportunity offered. The patients group themselves into four divisions: I. Those showing no disturbance of renal function (17 cases). II. Those with marked cardiovascular disease of some type, most of which showed urinary changes the result of renal congestion (11 cases). III. Those showing nephritis (23 cases). IV. Those in which certain features would lead one to suspect nephritis, but in which the existence of nephritis is not borne out by other findings (8 cases). Our patients of Group I, suffering from a variety of acute and chronic diseases, but without evidence of disturbance of renal function, showed a total nonprotein nitrogen in the blood varying from 16 to 43 milligrams per 100 c.c. From 50 to 60 per cent. of this was in the ammoniaurea fraction. In the patients with cardiovascular disease with renal congestion, but without evidence of other renal lesion there was no increase of the nonprotein nitrogen in the blood, nor alteration of the ammoniaurea percentage, although albuminuria, casts and some impairment of the phenolsulphonephthalein elimination were usually present. In that type of chronic nephritis characterized by marked albuminuria, cylindruria and edema, there were similar findings. In that type of chronic nephritis associated with hypertension, the nonprotein nitrogen was increased, ranging from 40 to 181 milligrams per IOO c.c., and the percentage of the ammoniaurea fraction was usually higher than in non-nephritic cases. The nitrogen values in these patients were subject to rapid fluctuations in the course of a few days and clinical improvement was associated with a fall in the non-protein nitrogen content.