CHEMICAL CHANGES OCCURRING IN THE BODY AS A RESULT OF CERTAIN DISEASES IN INFANTS AND CHILDREN

Abstract

The concentrations of the principal anions, Cl[image], HCO3[image], protein, HPO4" and lactate, and the actual pH were determined. Total base was determined directly, and from its value and the sum of the 5 principal acids determined the concentration of undetermined acid was obtained. The principal non-electrolyte substances, non-protein N (urea) and glucose were determined. The freezing point of the serum was determined and from it the total osmolar concentration of the serum was calculated. A method of calculating the theoretical total osmolar concentration from the concentration of the principal individual solutes, electrolyte and non-electrolyte, was developed. In addition, the composition of the urine was studied and after correlation of the observed changes in the chemical composition of the blood serum and urine with the clinical symptoms and findings, it was concluded that: In acute hemorrhagic nephritis, marked changes in the chemical composition of the blood occur only when such symptoms as severe vomiting or diarrhea, edema or dehydration, or convulsions occur. When these changes include a reduction of the total electrolyte content of the blood serum, urea is increased to such an extent that no reduction in osmotic pressure occurs. Such urea increase should be considered compensatory and not due to kidney defect. In subacute and chronic glomeru-lar nephritis, acute infection causing similar symptoms results in similar changes. In the absence of such symptoms, however, much the same changes occur, but more gradually, as the result of faulty urinary secretion with failure to conserve fixed base by substituting ammonia when the acid radicals are excreted, failure to secrete urine of normal maximum acidity, i.e., free from BHCO3, failure to retain BC1 in the plasma, and failure to excrete sufficiently such acids as phosphoric and sul-furic. The loss of plasma electrolyte due to such faulty secretion is compensated for, osmotically, by retention of urea.