Archives of Internal Medicine

O'HARE, JAMES P.

doi: 10.1001/archinte.1916.00080120002001pmid: N/A

Abstract INTRODUCTION It has been known for a long time that in cases of chronic nephritis there is a disturbance in salt and nitrogen elimination. A number of observers have called attention to the fact that frequently the excretion of salt is disturbed proportionately more than that of nitrogen while occasionally the reverse is true. Several methods of studying these factors have been suggested.Von Monakow1 placed patients on a standard diet containing each day approximately the same amounts of salt, nitrogen and water, to which were added on different days a definite amount of salt (10 gm. of sodium chlorid) or nitrogen (20 gm. of urea) ; the daily excretion of salt, nitrogen and water was quantitated and the effects of the added salt and nitrogen were noted by comparing the excretion after these were given with the previous daily excretion. This method References 1. Von Monakow: Deutsch. Arch. f. klin. Med. , 1911, cii, 248. 2. Hedinger and Schlayer : Deutsch. Arch. f. klin. Med. , 1914, cxiv, 120. 3. Ambard : Physiologie normale et pathologiqe des reins , Paris, 1914. 4. McLean: Jour. Exper. Med. , 1915, xxii, 212.Crossref 5. Of course it is to be remembered that these values are only approximate. In the first place patients who are very sick cannot eat regularly from day to day the total food given, and daily variations arise in this way. In the second place the values as given are calculated from tables of food values and do not represent actual values determined by analyses of samples of the various meals. There must be a considerable difference between the average values stated for a given food product and the actual amount contained in a single sample of that food. Hence it is to be clearly recognized that this method of renal testing, as well as the others involving calculated diets, as carried out by us is in no sense an exact metabolic study, and variations between calculated intake and observed output are necessarily frequent. The weighing of food prepared for the patients and the subtraction of food not eaten has been done with care, and precautions have been taken to insure accurate urine collections. Errors in this part of the work have been reduced to small figures and where evident mistakes occurred in these parts of the work the results have been discarded. 6. In making the nitrogen and salt determinations I acknowledge the assistance of a chemical technician whose salary was paid from a fund given to the Medical Service of the Peter Bent Brigham Hospital by Dr. F. C. Shattuck. 7. Christian, Frothingham. O'Hare and Woods : Studies of Nephritis , Am. Jour. Med. Sc. , 1915, cl, 655.Crossref

DEWEY, KAETHE

doi: 10.1001/archinte.1916.00080120048002pmid: N/A

Abstract In previous experimental work1 a watery colloid emulsion of cholesterol was used and proved to be such a satisfactory preparation for intraperitoneal injections in rabbits and guinea-pigs, that I employed it again as most suitable for producing a direct hypercholesterolemia. The use of such emulsions eliminates some of the objectionable features attending the prevalent method of administering cholesterol by feeding. The necessity of resorting to solvents such as fats and oils involves the production of a fat infiltration which, although not considered as pathological, necessarily masks the effects of cholesterol on the tissues to some extent and complicates the conclusions. Instead of Merck's pure cholesterol, I used a preparation obtained from gallstones by extraction with ether in the Soxhlet apparatus. For the separation of all saponifiable substances from this ether extract, a method was employed which is based largely on Kumagawa and Sutro.2 Five grams References 1. Dewey and Nuzum : The Effect of Cholesterol on Phagocytosis , Jour. Infect. Dis. , 1914, xv, 472.Crossref 2. Kumagawa and Sutro: Bestimmung des Cholesterins nebst den anderen unverseifbaren Substanzen , Biochem. Ztschr. , 1908, viii, 315. 3. Porges and Neubauer: Physikalisch chemische Untersuchungen über das Lecithin und Cholesterin , Biochem. Ztschr. , 1907, vii, 152. 4. Dewey, Kaethe: The Preparation of Colloidal Emulsions of Cholesterol , Tr. Chicago Path. Soc. , 1915, ix, 321. 5. Autenrieth and Funk : Ueber kolorimetrische Bestimmungsmethoden : Die Bestimmung des Gesamtcholesterins im Blut und in Organen , München. med. Wchnschr. , 1913, lx, 1243. 6. Weltmann and Biach : Zur Frage der experimentellen Cholesteatose , Ztschr. f. exper. Path. u. Ther. , 1913, xiv, 367.Crossref 7. Abderhalden : Lehrbuch der physiologischen Chemie , Berlin, 1906, p. 592. 8. Bacmeister and Havers: Zur Physiologie und Pathologie des Cholesterinstoffwechsels , Deutsch. med. Wchnschr. , 1914, xl, 385. 9. Weltmann : Zur klinischen Bedeutung des Cholesterinnachweises im Blutserum , Wien. klin. Wchnschr. , 1913, xxvi, 874. 10. Chatalow : Ueber experimentelle Cholesterin-Lebercirrhose in Verbindung mit eigenen neuen Erhebungen über flüssige Kristalle des Organismus und über den Umbau der Leber , Zieglers, Beiträge, 1913, lvii, 85. 11. Anitschkow and Chatalow: Ueber experimentelle Cholesterinsteatose und ihre Bedeutung für die Entstehung einiger pathologischer Prozesse , Centralbl. f. allg. Path. u path. Anat. , 1913, xxiv, 1. 12. Sternberg: Die Nebenniere bei physiologischer (Schwangerschaft) und artifizieller Hypercholesterinämie , Beitr. z. path. Anat. u. z. allg. Path. , 1914, lx, 91. 13. Huffmann: Zur Bestimmung des Gesamtcholesterins im Blute an geburtshilflichen und gynäkologischen Fällen , Zentralbl. f. Gynäk. , 1915, xxix, 33. 14. LeCount and Long: The Relation Between the Fat Content of the Bile and Fatty Changes in the Liver , Jour. Exper. Med. , 1914, xix, 234.Crossref 15. Rothschild : Ueber die Beziehungen der Leber zum Cholesterinstoffwechsel , Beitr. z. path. Anat. u. z. allg. Path. , 1914, lx, 66. 16. Rothschild : Zur Physiologie des Cholesterinstoffwechsels. V. Der Cholesteringehalt des Blutes und einiger Organe im Hungerzustand , Beitr. z. path. Anat. u. z. allg. Path. , 1915, lx, 227. 17. Weltmann and Biach (Note 6). 18. Kaufmann: Lehrbuch der speziellen pathologischen Anatomie , Berlin, 1911 (1), p. 622. 19. Lichtwitz: Ueber die Bildung der Harn- und Gallensteine , Berlin, 1914, p. 69. 20. Lichtwitz (Note 19). 21. Chauffard, Laroche and Grigaut : Sur l'origine de la cholestérine biliaire. Recherches expérimentales sur la cholestérinémie après ligature du cholédoque , Soc. biol. , 1913, lxxiv, 1005 and 1093. 22. Naunyn: Quoted from Lichtwitz (Note 19). 23. Aschoff : Zur Frage der Cholesterinbildung in der Gallenblase , München. med. Wchnschr. , 1906, liii, 1846. 24. McNee : Zur Physiologie des Cholesterinstoffwechsels , Beitr. z. path. Anat. u. z. allg. Path. , 1914, lviii, 667. 25. Aoyama: Zur Frage der Cholelithiasis , Beitr. z. path. Anat. u. z. allg. Path. , 1913, lvii, 169. 26. Aschoff: Wie entstehen die reinen Cholesterinsteine? München. med. Wchnschr. , 1913, lx, 1753. 27. Herrmann and Neumann : Ueber die Lipoide der Gravidität und deren Ausscheidung nach vollendeter Schwangerschaft , Wien. klin. Wchnschr. , 1912, xxv, 1557. 28. McNee : Zur Frage des Cholesteringehalts der Galle während der Schwangerschaft , Deutsch. med. Wchnschr. , 1913, xxxix, 995. 29. Aschoff: Bemerkungen zur Arbeit von McNee , Deutsch. med. Wchnschr. , 1913, xxxix, 995. 30. Anitschkow : Ueber die Veränderungen der Kaninchenaorta bei experimenteller Cholesterinsteatose , Beitr. z. path. Anat. u. z. allg. Path. , 1913, lvi, 379. 31. Anitschkow : Ueber experimentell erzeugte Ablagerungen von anisotropen Lipoidsubstanzen in der Milz und im Knochenmark , Beitr. z. path. Anat. u. z. allg. Path. , 1913, 57, 201. 32. Soper : Zur Physiologie des Cholesterinstoffwechsels, VI. Ueber Beziehungen der Milz zum Cholesterinstoffwechsel , Beitr, z. path. Anat. u. z. allg. Path. , 1915, lx, 232. 33. Bacmeister and Henes : Untersuchungen über den Cholesteringehalt des menschlichen Blutes bei verschiedenen inneren Krankheiten , Deutsch. med. Wchnschr. , 1913, xxxix, 544. 34. Grigaut: Dosage comparé de la cholestérine dans le serum et dans les oedèmes , Compt rend. Soc. de biol. , 1911, lxx, 317. 35. Weill and Laudat : Etude comparative du taux de la cholestérine libre et de ses èthers dans le' serum sanguin , Soc. de biol., Compt. rend. hebd. d. sc. et mem. , 1913, lxxiv, 882. 36. Lavrinovich : Cholesterin Esters in the Urine , Jour. Am. Med. Assn. , 1914, lxiii, 1615 37. abstract from the original article in Russk. Vrach. , 1914, xiii, 19. 38. Secchi: Sul valore clinico dei lipoidi birifrangenti nell urina , Bull. Sc. Med. , 1914, p. 83. 39. Ferré, Mauriac and Defaye: Sur la quantité de cholestérine contenue dans certains liquides normaux ou pathologiques de l'organisme , Compt. rend. Soc. de biol. , 1912, lxxiii, 141. 40. Thaissen and Hess : Beiträge zur physiologischen Chemie des Cholesterins und der Cholesterinester , Biochem. Ztschr. , 1914, lxii, 89 and 115. 41. Rosenfeld: Ueber Organverfettung , Verh. d. 20, Kongr. f. inn. Med. , 1902, 235. 42. Orgler: Ueber Beziehungen zwischen chemischem und morphologischem Verhalten pathologisch veränderter Nieren , Verhandl. d. deutsch path. Gesellsch. , 1903, vi, 76. 43. Chemische Niereuntersuchungen unter Berücksichtigung des histologischen Bildes , Virch. Arch. f. path. Anat. , 1904, clxxvi, 413. 44. Ueber die in pathologisch veränderten Nieren sichtbar werdende fettähnliche Substanz , Verhandl. d. deutsch. path. Gesellsch. , 1904, viii, 33. 45. Ueber Fettinfiltration und fettige Degeneration der Niere des Menschen , Virch. Arch. f. path. Anat. , 1905, cviii, 1. 46. Ueber Protagon und über die grosse weisse Niere , Sitzungsb. d. k. Akad. d. Wissensch., Math.-naturw. Klasse, Wien. , 1905, cxv, 31. 47. Panzer : Ueber das sagenannte Protagon der Niere , Ztschr. f. physiol. Chem. , 1905, xlviii, 519. 48. Doppeltbrechende Substanzen aus pathologischen Organen , Panzer Ztschr. f. physiol. Chem. , 1907, liv, 239. 49. Terroine: Nouvelles recherches sur l'influence de l'inanition et de la suralimentation sur la teneur des tissues en substances grasses et en cholestérine , Jour. de physiol. et de path. gén. , 1914, xvi, 408. 50. Mayer and Schaeffer : Variations de la teneur des tissues en lipoides et en eau au cours de l'inanition absolue. Activité physiologique des tissues , Jour. de physiol. et de path. gén. , 1914, xvi, 203 and 244. 51. Gardner: The origin and testing of cholesterol in the animal organism, IX. On the cholesterol content of the tissues, other than liver, of rabbits under various diets and during inanition , Proc. Roy. Med. and Chir. Soc. , 1912, lxxxv, 385.

MACHT, DAVID I.

doi: 10.1001/archinte.1916.00080120077003pmid: N/A

Abstract Papaverin is one of the principal primary opium alkaloids in point of both quantity and pharmacologic interest. Its amount in opium varies from 0.11 to 0.22 per cent. The alkaloid was discovered by Merck in 1848. It crystallizes in white prisms, with a melting point of 147 C. The crystals are insoluble in water and alkalis, difficultly soluble in ether and benzol, but easily soluble in warm alcohol, chloroform and acetone. It is tasteless, is neutral in reaction with litmus and is polariscopically inactive. The alkaloid easily combines with acids, forming salts, and it is the sulphate and more especially the hydrochlorid that are chiefly used in physiologic work. These salts can be obtained on the market in a very pure chemical state, and are soluble in water and in normal saline. Like all the other opium alkaloids, papaverin is characterized by color reactions by which References 1. Simon: Dissertation, Bern, 1903. 2. Henry: The Plant Alkaloids, 1913. 3. Warren: Am. Jour. Pharm. , 1915, lxxxvii, 439. 4. Warren: Jour. Am. Chem. Soc. , 1915, xxxvii, 2402.Crossref 5. Pictet and Gams: Beitr. z. Klin. d. Tuberk. , xlii, 2943. 6. Winterstein and Trier: Die Alkaloide, 1910, p. 160. 7. Cl. Bernard: Compt. rend. Acad. d. sc. , lix, 464. 8. Sichting: Dissertation, Bonn, 1869. 9. Baxt: Arch. f. Anat. u. Physiol. , 1869, p. 112. 10. Von Schroeder: Arch. f. Exper. Path. u. Pharmakol. , 1883, xvii, 96.Crossref 11. Pal: Deutsch. med. Wchnschr. , 1913, pp. 395, 2068, 2514 12. Wien med. Wchnschr. , 1913, p. 1049 13. Zentralbl. f. Physiol. , 1902, p. 68. 14. Macht : Am. Jour. Med. Sc. , in press. 15. Sherrington : Jour. Physiol. , 1909, xxxviii, 375. 16. Macht: Jour. Am. Med. Assn. , 1915, xliv, 1489.Crossref 17. Krafkoff: Arch. f. d. ges. Physiol. (Pflüger's) , 1914, clvii, 501. 18. Bond: Jour. Exper. Med. , 1910, xii, 575.Crossref 19. Macht : Jour. Pharmacol. and Exper. Therap. , 1914, vi, 13. 20. Macht: Jour. Pharmacol. and Exper. Therap. , 1915, vii, 339. 21. Fronmüller : Klinische Studien über narkotische Arzneimittel , Erlangen, 1869. 22. Eulenburg: Die Hypodermotische Injection der Arzneimittel , Berlin, 1867. 23. Macht, Herman, and Levy: Jour. Pharmacol. and Exper. Therap. , 1916, viii, 1. 24. Bradbury : Lancet, London , (July) , 1899. 25. Kunkel: Toxikologie , 1901, ii, 820. 26. Lewin : Toxikologie , Berlin, 1897, p. 260. 27. Schroff and Hoffman: Wien. med. Wchnschr. , 1868, pp. 935and 952. 28. Leidesdorff: Ztschr. d. Wien. Aerzte , 1868, xiii, 115. 29. Blyth: Poisons , London, 1906, p. 322. 30. Dragendorff: Ermittelung von Giften, 1895, p. 225. 31. Bouchut : Cited by Pal in Med. Klin. , Nov. 2, 1913, No. (44) . 32. Pal: Med. Klin. , Nov. 2, 1913, No. (44) . 33. Holzknecht and Sgalitzer: Munch. med. Wchnschr. , 1913, No. (3) . 34. Delprat: Nederl. Tijdschr. v. Geneesk. , 1915, ii, 1311. 35. Popper: Arch. f. d. ges. Physiol. (Pflüger's) , 1913, cliii. 36. Gerathy and Macht: Bull. Johns Hopkins Hosp. , 1916, xxvii, 119.

HAESSLER, HERBERT;NEWCOMER, HARRY S.

doi: 10.1001/archinte.1916.00080120097004pmid: N/A

Abstract We have devised a colorimeter for the clinical estimation of hemoglobin which possesses several advantages over instruments now in use. Those methods for the estimation of color density, which depend upon the comparison of a sample with an interrupted series of standards, have always been the most satisfactory. The eye is able to place a sample with more certainty between two members of a variable series than it is to compare a sample with a uniformly graded scale. The latter only becomes accurate when the error is absorbed into a great number of readings, and as yet there had been no instrument devised superior to the Fleischl-Miescher for such a procedure. For a single operation, comparison with a series offers much more certainty as to the correctness of the choice. We have adopted the principle of the Sahli hemoglobinometer, modifying it to satisfy the above concepts. The Sahli instrument

GOODMAN, EDWARD HARRIS

doi: 10.1001/archinte.1916.00080120100005pmid: N/A

Abstract The various measures recommended for the successful treatment of failing cardiac, renal and hepatic functions, with their concurrent edema of more or less severity, are legion, and one would be unwise to undertake the treatment of such conditions without a full appreciation of the value of each. Drugs, physical therapeutics and diet form the triad upon which reliance is usually placed, and generally speaking, in the lay as well as in the professional mind the greatest of these is drugs. There are many dropsical cases in the treatment of which one must use all three ; there are many in which physical measures may be safely dispensed with, and there are many cases of severe renal and cardiac breakdown in which drugs as well as physical measures may be disregarded ; but there are none in which diet has not earned a well-deserved and fixed place. It may be stated without References 1. Jacobs: München. med. Wchnschr. , 1908, lv, 839. 2. Karell: Arch. gén. de méd. , 1866, viii, 513.

HURWITZ, S. H.;TRANTER, C. L.

doi: 10.1001/archinte.1916.00080120119006pmid: N/A

Abstract In its mode of origin and in its pathways of absorption, as well as in its physical and chemical properties, the cerebrospinal fluid is unique among the body fluids. Two facts derived from clinical and experimental observations have been established within recent years with a fair degree of conclusiveness, namely, the dual origin of the cerebrospinal fluid and its return to the general circulation chiefly by a process of filtration through the arachnoid villi into the great sinuses.1,2 Unlike the circulating lymph, which is derived from the blood by a process of filtration, diffusion and osmosis, the cerebrospinal fluid is the secretory product of the ependymal cells which cover the choroid plexuses, although it must be admitted that certain fundamental anatomic and physiologic aspects of this problem are still unsolved. Another interesting observation which has been brought forth by a number of workers is that these References 1. Weed, Lewis H.: Jour. Med. Research , 1914, xxxi, 21, 51, 93. 2. Mott, F. W.: Lancet, London , 1910, ii, 1, 79. 3. Plaut, F.; Rehm, O., and Schottmüller, H.: Leitfaden zur Untersuchung der Zerebrospinalflüssigkeit , Jena, Gustav Fischer, 1913, pp. 16, 23. 4. Clark, W. M.: Jour. Infect. Dis. , 1915, xvii, 109.Crossref 5. Hurwitz, S. H.; Meyer, K. F., and Ostenberg, Z.: Bull. Johns Hopkins Hosp. , 1916, xxvii, 16. 6. Sörensen, S. P. L.; Ergeb. d. Physiol. , 1912, xii, 393.Crossref 7. Michaelis, Leonor : Die Wasserstoffionenkonzentration , Berlin, Julius Springer, 1914. 8. Bisgaard, A.: Biochem. Ztschr. , 1913-1914, lviii, 1. 9. A source of error which should be mentioned, but which is not peculiar to any one method, is that which may result from the loss of carbon dioxid in determinations of hydrogen ion concentration on carbon-dioxid-containing fluids, such as blood and cerebrospinal fluid. The possibility of this error has been precluded in electrometric measurements by the use of a special electrode, the Hasselbach electrode, for the purpose of keeping the carbon dioxid tension at a constant level during the measurements. In the use of the colorimetric method this difficulty cannot be met with entire satisfaction, and the values for pH obtained do not in a strict sense have the absolute accuracy possessed by readings made with the hydrogen electrode. But it would appear from Mott's work2 that the carbon dioxid in cerebrospinal fluid is in more stable combination than in blood, and for this reason this medium is more suited to colorimetric readings than is the blood. In every case it is important to make the determinations on perfectly fresh specimens and with a similar technic in order to give the results comparative value. 10. Levy, R. L., Rowntree, L. G., and Marriott, W. McKim : The Archives Int. Med. , 1915, xvi, 389.Crossref 11. Rona, P.: Handbuch d. Biochemische Arbeitsmethoden , E. Abderhalden, 1911, v, 321. 12. Gautier and Zdarek (quoted by C. E. Simon, Clinical Diagnosis , Ed. 8, Philadelphia, Lea & Febiger, 1914, p. 501) 13. Hammarstern, O. ( A Text Book of Physiological Chemistry , Ed. 8, New York, John Wiley & Sons, 1909, p. 239) 14. We have found that some of the thick-walled test tubes, even when thoroughly clean, deliver up alkali in sufficient amount to render distilled water placed in them alkaline to phenolsulphonephthalein. This source of error must of course be obviated. 15. The standard test solutions were prepared for us by Hynson, Westcott and Company, Baltimore. 16. Cushing, H.: Jour. Med. Research , 1914, xxxi, 12, 13, 15. 17. Ostwald, W.: A Handbook of Colloid Chemistry , Philadelphia, P. Blakiston's Sons, 1915, p. 219. 18. The hydrogen ion concentration of the blood determined by the hydrogen electrode averages 0.3 X 10-7, or pH = 7.5. The value for pH+ obtained by the colorimetric method is 7.66. 19. Wingrave, W.: Jour. Laryngol., Rhinol. and Otol. , 1915, xxx, 270.Crossref 20. Crowe, S. J.: Bull. Johns Hopkins Hosp. , 1909, xx, 102. 21. Burnam, C. F.: The Archives Int. Med. , 1912, x, 324.Crossref 22. Hinman, F.: Jour. Am. Med. Assn. , 1913, lxi, 1601.Crossref

MARRIOTT, W. McK.

doi: 10.1001/archinte.1916.00080120131007pmid: N/A

Abstract Bicarbonates, alkali protein compounds and small quantities of alkali phosphates together constitute the alkali reserve of the blood plasma.1 Under normal conditions these substances are present in very constant quantities. A diminution in the alkali reserve is known as acidosis and may be recognized by a variety of clinical symptoms and by characteristic alterations in the composition of the blood, urine and alveolar air. The alkali reserve maintains the plasma at a constant slightly alkaline reaction, despite the fact that acid products of metabolism are continually being poured into the blood. Chief among the acid products, so far as total quantity is concerned, is carbonic acid. This, as carbon dioxid, enters the plasma circulating through the tissues and is taken up partly in combination and partly as dissolved carbonic acid. An almost infinitesimal change in reaction in the direction of acidity occurs. This slight change is sufficient References 1. Plasma alone is here considered. The whole blood maintains its reaction in essentially the same way as the plasma alone. 2. The alkali reserve may be replenished by administration of alkalies as such or as foods giving an alkaline ash. The body itself replenishes the reserve by production of ammonia and by the selective excretion of acid by the kidneys. 3. Barcroft: Respiratory Function of the Blood , Cambridge, 1914 4. Peabody: Am. Jour. Med. Sc. , 1916, cli, 184.Crossref 5. Levy, Rowntree and Marriott, The Archives Int. Med. , 1915, xvi, 390.Crossref 6. This reaction varies with the alkali reserve, although, as a matter of fact, the two are not absolutely proportional. The lengths of the columns in the diagram are logarithmic and not actual. The shaded areas representing carbonic acid do not represent actual quantities present but the difference between the logarithms of the hydrogen ion concentration, before and after removing the amount of carbonic acid present. The difference is greater the greater the amount of carbonic acid, but the diagram is not to be interpreted as meaning that because the shaded area PR in Column I is twice as great as in Column II that in I exactly twice as much carbonic acid is present. 7. Levy, Rowntree and Marriott: The Archives Int. Med. , 1915, xvi, 389.Crossref 8. Barcroft : Respiratory Function of the Blood , Cambridge, 1914. 9. Manufactured by the Ansco Company, Binghamton, N. Y. This contains 30 per cent, of water and must be rinsed once or twice with alcohol before being dissolved. 10. Sacks that have been dried too long become very brittle and impermeable. If not dried a sufficient length of time, the sack becomes white and cloudy on the addition of water. 11. The concentration of indicator in the salt solution is purposely made 10 per cent, greater than in the phosphate mixtures, as during the dialysis a certain amount of indicator is lost by passing into the sack. 12. If boiled in a soft glass tube, alkali is given off from the glass and the solution is colored pink. Instead of boiling to remove carbon dioxid, the solution may be aerated with a current of air that has been freed from carbon dioxid by passing through a strong solution of sodium hydroxid. 13. If carbon dioxid escapes from the plasma as a result of shaking or allowing the blood to remain exposed to the air, a passage of alkali from the plasma into the cells occurs with a resultant slight diminution in the alkali reserve of the plasma. Once the plasma or serum is separated from the corpuscles, loss of carbon dioxid is without effect on the alkali reserve. 14. In washing the sack, no part but the top edge should be touched with the fingers. The sack is emptied by tipping it with a clean, glass rod or with a microscopic slide. Sacks may be used more than once, providing they are thoroughly washed with salt solution after each test. 15. Foaming rarely occurs. It may be present as a result of allowing some serum to spill over the outside of the sack. In case foaming is great enough to be troublesome, it may be prevented by adding a drop of octyl alcohol or toluol. 16. The comparison is conveniently made with a box similar to that used with the Sahli hemoglobinometer, but containing places for three instead of two tubes. It is a small flat box of blackened metal 55 by 45 by 20 mm., backed with opal glass and with three slits open on the front. Readings should be made at temperatures between 20 and 25 C. If the room temperature is higher or lower than those limits, the colorimeter with tubes should be immersed in water at 20 to 25 C. 17. Howland and Marriott: Am. Jour. Dis. Child. , 1916, xi, 309 18. Marriott: Jour. Am. Med. Assn. , 1916, lxvi, 1594.Crossref 19. Van Slyke: Unpublished results. 20. Marriott: Jour. Am. Med. Assn. , 1916, lxvi, 1594Crossref 21. Van Slyke: Proc. Soc. Exper. Biol. and Med. , 1915, xii, 165.Crossref 22. Standardized phosphate mixtures sealed in tubes, the color comparison box, tubes and accessories used in the method may be obtained from Hynson, Westcott & Company, Baltimore.

doi: 10.1001/archinte.1916.00080120143008pmid: N/A

This article is only available in the PDF format. Download the PDF to view the article, as well as its associated figures and tables. Abstract In contrast with Professor Mendel's book, which contains an extraordinary amount of things new and true in small compass, Dr. Aaron's book succeeds in spreading out a mass of misinformation over 750 large pages, in one of the most unsatisfactory books that has come to the reviewer's attention for a long time. In the first place, its utterly uncritical laboratory methods and methods of diagnosis are shoveled in wholesale, without any choice between the valuable and valueless. On its clinical side it is equally unsatisfactory. The account of gastric ulcer, for example, contains within the first five lines the following statements : "The symptoms of gastric ulcer are at first ill defined, resembling those of gastritis. The discomfort is soon followed by nausea and regurgitation or vomiting. A boring pain is characteristic of gastric and duodenal ulcer; it always comes on within an hour after eating." According to the reviewer's experience,

doi: 10.1001/archinte.1916.00080120144009pmid: N/A

This article is only available in the PDF format. Download the PDF to view the article, as well as its associated figures and tables. Abstract Yale University Press is to be congratulated upon two remarkable little books, each containing multum in parvo—Prof. Graham Lusk's, "The Fundamental Basis of Nutrition," and the little book now under review, Prof. L. B. Mendel's "Changes in the Food Supply and Their Relation to Nutrition." Professor Mendel starts with Sir William Crookes' forecast made in 1898, to the effect that by 1931 we should have reached the limit of wheat production upon the earth, while the population would presumably be still increasing ; and this Sir William regarded as a most ominous prediction, as he regarded wheat as "the most sustaining food grain of the great Caucasian race." Professor Mendel agrees that this estimation as to wheat acreage is probably correct, but that in the first place the yield by acre would be increased and that, moreover, any alarm in relation to wheat acreage fails to take into consideration