Studies on acidosis and dyspnea in renal and cardiac disease / Francis W. Peabody, Boston.

  • Peabody, Francis Weld, 1881-1927
Date:
1914
Catalogue details

Licence: In copyright

Credit: Studies on acidosis and dyspnea in renal and cardiac disease / Francis W. Peabody, Boston. Source: Wellcome Collection.

    9/32 (page 7)
    know that the reduction of the alveolar carbon dioxid is usually an indication of the compensatory mechanism by which the blood-reaction is kept constant with a ph. of 7.45. The ph. of the blood saturated at 41 mm. carbon dioxid will thus be an index of abnormal acid for¬ mation. As such an index, it confirms what the determination of the alveolar carbon dioxid gives us, but it is also of especial value in cases in which it is not possible to obtain samples of alveolar air. Moreover, at present there has not been sufficient correlation of the alveolar car¬ bon dioxid findings with the hydrogen-ion concentration of the blood in pathologic conditions for us to know in how far they correspond, as they do in normal conditions. In many instances, determinations of the ph. were also made on the same specimens of blood saturated with carbon dioxid at or about the tension at which it was found in the alveolar air. This would tell the actual reaction of the blood in the lungs. Usually this gives, of course, a ph. of the value of normal blood, about 7.45. Occasionally, however, in terminal conditions there is evidence of a failure of the compensatory mechanisms and of a true change in the reaction of the blood toward the acid side. Urine.—The nitrogen was ascertained by Kjeldahl’s method, and the ammonia determinations were made by the method of Folin.17 The hydrogen-ion concentration of the urine was found by the colori¬ metric method described by Palmer.18 The “retained base” and “total acidity” were determined by Adler and Blake’s method.19 To save space a great part of the urinary analyses are omitted, as they con¬ tribute little that is not shown by the other methods. Blood.—I am indebted to Dr. C. Frothingham, Jr., and to Dr. W. G. Smillie, who kindly made the determinations of the non-protein nitrogen in blood by the method of Folin.20 CHRONIC NEPHRITIS From the point of view of this study, the factor of importance in chronic nephritis is the development of acidosis. The cases examined fall clearly into two groups—those of uncomplicated nephritis and those of nephritis with uremic manifestations. Palmer21 and others have shown, and studies in this hospital have confirmed the fact, that a very mild grade of acidosis is a frequent accompaniment of chronic 17. Folin: Am. Jour. Physiol., 1905, xiii, 45. 18. Palmer, Walter W., and Henderson, Lawrence J.: Studies Upon Acid Base Equilibrium and the Nature of Acidosis, The Archives Int. Med., 1913, xii, 153. 19. Adler, Herman M., and Blake, Gerald: The Retention of Alkali by the Kidney with Special Reference to Acidosis, The Archives Int. Med., 1911, vii, 479. 20. Folin and Denis: Jour. Biol. Chem., 1912, xi, 527. 21. Palmer: Med. Communicat. Massachusetts Med. Soc., 1913, xxiv, 133.