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THE VOLUME AND COMPOSITION OF THE BLOOD, AND THE CHANGES INCIDENT TO DIURESIS, IN CASES OF EDEMA

THE VOLUME AND COMPOSITION OF THE BLOOD, AND THE CHANGES INCIDENT TO DIURESIS, IN CASES OF EDEMA Abstract The idea is prevalent among physicians that hydremia or hydremic plethora is the rule in cases of edema. This impression is based on (1) the pallor or so-called pasty appearance of the skin, (2) the decrease in urinary output, (3) the accumulation of water in the subcutaneous tissues or in the serous cavities, and (4) the decrease, in certain cases, in the percentage of solids, hemoglobin, albumin, erythrocytes, and so forth, in the blood and plasma. Although these findings are suggestive of an edematous or watery state of the blood, that is, of dilution of the blood by water which has failed of excretion, there has long been a wish that this general impression might be supported by more tangible and conclusive evidence. Edema, although a familiar clinical phenomenon and the subject of innumerable investigations, is at present far from being understood. Since its experimental production is difficult, indeed practically References 1. Cohnheim, J.: Lectures on General Pathology, a Handbook for Practitioners and Students , London, New Sydenham Society, 1889, p. 447. 2. Dieballa, G., and Kétly, V.: Ueber die Wechselbeziehung von Albuminurie, Hydrümie, und Hydrops bei Brightikern , Deutsch. Arch. f. klin. Med. 61:76-90, 1898. 3. Boycott, A. E.: The Regulation of the Blood Volume in Normal and Nephritic Animals , J. Path. & Bacteriol. 18:498-512, 1913-1914. 4. Volhard and Fahr: Die doppelseitigen hematogenen Nierenerkrankungen , Berlin, Julius Springer, 1918. 5. Keith, N. M.; Rowntree, L. G., and Geraghty, J. T.: A Method for the Determination of Plasma and Blood Volume , Arch. Int. Med. 16:547-576 ( (Oct.) ) 1915. 6. Bock, A. V.: The Constancy of the Volume of the Blood Plasma , Arch. Int. Med. 27:83-101 ( (Jan.) ) 1921. 7. Lindner, J. C.; Lundsgaard, C.; Van Slyke, D. D., and Stillman, E.: The Cause of Low Plasma Protein Concentration in Nephritis , Proc. Soc. Exper. Biol. & Med. 20:319, 1923. 8. Strauss, H.: Untersuchungen über den Wassergehalt des Blutserums bei Herz- und Nierenkranken , Ztschr. f. klin. Med. 60:501-505, 1906. 9. Veil, W. H.: Ueber die klinische Bedeutung der Blutkonzentrationsbestimmung , Deutsch. Arch. f. klin. Med. 112:504-538, 1913 10. Veil, Ueber die klinische Bedeutung der Blutkonzentrationsbestimmung , Deutsch. Arch. f. klin. Med. 113:226-260, 1914. 11. Chiray, M.: Dilution et concentration du sang , Presse méd. 16:19-22, 1908. 12. Bolton, C.: Further Observations on the Pathology of Cardiac Dropsy , J. Path. & Bacteriol. 20:290-326 ( (Jan.) ) 1916. 13. These cases were uncomplicated by an acute or subacute infection such as rheumatism, endocarditis or nephritis. 14. The clinical diagnoses were made independently by clinicians to whom the cases were assigned. 15. With this technic, hemolysis rarely occurs. 16. In this country, higher values have been obtained by Williamson and Haden (Table 2). 17. Brown, G. E., and Keith, N. M.: Blood and Plasma Volume in Obesity , Arch. Int. Med. 33:217-223 ( (Feb. 15) ) 1924. 18. The maximal variation in thirty hematocrit estimations, using the three large tube method, was 2 per cent. The average variation was 0.7 per cent. 19. We recognize the sex differences in the blood water concentration, due to lower content of hemoglobin in females, but believe these variations are so slight as to be negligible in this study. 20. McClure, W. B., and Aldrich, C. A.: Time Required for Disappearance of Intradermally Injected Salt Solution , J. A. M. A. 81:293-294 ( (July 28) ) 1923. 21. Brown, G. E., and Roth, Grace M.: The Anemia of Chronic Nephritis , Arch. Int. Med. 30:817-840 ( (Dec.) ) 1922. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Internal Medicine American Medical Association

THE VOLUME AND COMPOSITION OF THE BLOOD, AND THE CHANGES INCIDENT TO DIURESIS, IN CASES OF EDEMA

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References (17)

Publisher
American Medical Association
Copyright
Copyright © 1925 American Medical Association. All Rights Reserved.
ISSN
0730-188X
DOI
10.1001/archinte.1925.00120070134009
Publisher site
See Article on Publisher Site

Abstract

Abstract The idea is prevalent among physicians that hydremia or hydremic plethora is the rule in cases of edema. This impression is based on (1) the pallor or so-called pasty appearance of the skin, (2) the decrease in urinary output, (3) the accumulation of water in the subcutaneous tissues or in the serous cavities, and (4) the decrease, in certain cases, in the percentage of solids, hemoglobin, albumin, erythrocytes, and so forth, in the blood and plasma. Although these findings are suggestive of an edematous or watery state of the blood, that is, of dilution of the blood by water which has failed of excretion, there has long been a wish that this general impression might be supported by more tangible and conclusive evidence. Edema, although a familiar clinical phenomenon and the subject of innumerable investigations, is at present far from being understood. Since its experimental production is difficult, indeed practically References 1. Cohnheim, J.: Lectures on General Pathology, a Handbook for Practitioners and Students , London, New Sydenham Society, 1889, p. 447. 2. Dieballa, G., and Kétly, V.: Ueber die Wechselbeziehung von Albuminurie, Hydrümie, und Hydrops bei Brightikern , Deutsch. Arch. f. klin. Med. 61:76-90, 1898. 3. Boycott, A. E.: The Regulation of the Blood Volume in Normal and Nephritic Animals , J. Path. & Bacteriol. 18:498-512, 1913-1914. 4. Volhard and Fahr: Die doppelseitigen hematogenen Nierenerkrankungen , Berlin, Julius Springer, 1918. 5. Keith, N. M.; Rowntree, L. G., and Geraghty, J. T.: A Method for the Determination of Plasma and Blood Volume , Arch. Int. Med. 16:547-576 ( (Oct.) ) 1915. 6. Bock, A. V.: The Constancy of the Volume of the Blood Plasma , Arch. Int. Med. 27:83-101 ( (Jan.) ) 1921. 7. Lindner, J. C.; Lundsgaard, C.; Van Slyke, D. D., and Stillman, E.: The Cause of Low Plasma Protein Concentration in Nephritis , Proc. Soc. Exper. Biol. & Med. 20:319, 1923. 8. Strauss, H.: Untersuchungen über den Wassergehalt des Blutserums bei Herz- und Nierenkranken , Ztschr. f. klin. Med. 60:501-505, 1906. 9. Veil, W. H.: Ueber die klinische Bedeutung der Blutkonzentrationsbestimmung , Deutsch. Arch. f. klin. Med. 112:504-538, 1913 10. Veil, Ueber die klinische Bedeutung der Blutkonzentrationsbestimmung , Deutsch. Arch. f. klin. Med. 113:226-260, 1914. 11. Chiray, M.: Dilution et concentration du sang , Presse méd. 16:19-22, 1908. 12. Bolton, C.: Further Observations on the Pathology of Cardiac Dropsy , J. Path. & Bacteriol. 20:290-326 ( (Jan.) ) 1916. 13. These cases were uncomplicated by an acute or subacute infection such as rheumatism, endocarditis or nephritis. 14. The clinical diagnoses were made independently by clinicians to whom the cases were assigned. 15. With this technic, hemolysis rarely occurs. 16. In this country, higher values have been obtained by Williamson and Haden (Table 2). 17. Brown, G. E., and Keith, N. M.: Blood and Plasma Volume in Obesity , Arch. Int. Med. 33:217-223 ( (Feb. 15) ) 1924. 18. The maximal variation in thirty hematocrit estimations, using the three large tube method, was 2 per cent. The average variation was 0.7 per cent. 19. We recognize the sex differences in the blood water concentration, due to lower content of hemoglobin in females, but believe these variations are so slight as to be negligible in this study. 20. McClure, W. B., and Aldrich, C. A.: Time Required for Disappearance of Intradermally Injected Salt Solution , J. A. M. A. 81:293-294 ( (July 28) ) 1923. 21. Brown, G. E., and Roth, Grace M.: The Anemia of Chronic Nephritis , Arch. Int. Med. 30:817-840 ( (Dec.) ) 1922.

Journal

Archives of Internal MedicineAmerican Medical Association

Published: Jan 1, 1925

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