The EFFECT of EXERCISE on the HAeMOGLOBIN with REFERENCE to the VALUE of REST in the TREATMENT of ANAeMIA
Authors: W. Edgecombe
Journal: BMJ (1898)

could be more accucately attained by adopting some modifica- tiou oi i.jeldahl's process, but I wished to ascertain the action of the drugs used on the excretion of urea and uric acid.Unfortunately, the urine was frequently either neutral or faintly acid, so that conclusions drawn from the results obtained would probably be fallacious.Various expedients were tried to prevent its decomposition, but without much success.The quantity of urine was above the average-about 2,000 c.cm., and the specific gravity rarely exceeded ioio.Ihe colour, considering the quantity, appeared to be normal.Although it was examined repeatedly for albumen no trace was dptected.For the estimation of urea Hufner's hypobromite method was employed.For estimating uric acid Hopkins's long process was used until January 7th, when I tried Otto Folin's modification of Hopkin's short method.This consists essentially in substituting log. of ammonium sulpbate for saturation with ammonium chloride in zoo c.m. of urine.and subsequently washing the precipitate with a zo per cent.solution of ammonium sulphate instead of a saturated solution of ammonium chloride.Folin's method is expeditious, but I do not think it is reliable when the urine is concentrated, and it was found with the dilute urine of my patient that two hours were insufficient for complete precipitation.The uric acid was observed to be increased while the patient was taking salicylate of soda, and, to a slight extent, during the administration of euonymin.Noel Paton found that euonymin increased while salicylate and benzoate of soda markedly diminished the excretion of uric acid.Hopkins, in Schafer's Physio!ogy, states that the salicylates undoubtedly increase the quantity of uric acid in the urine.For estimating creatine Johnson's method was adopted, but a very small amount of the mercurial compound always adhered to the flask, hence a margin of error is introduced into the result.For the estimation of amamonia Schloesing's method was adopted, but It is unsatisfactory for clinical purposes because of the length of time re- quired.As the urea kept persistently below the normal in this case, it was considered probable that the ammonia would be increased in conse- quence of the diminished formation of urea.Neubauer found the quan- tity of ammonia to vary in health from 0.3 to X.2g. in the twenty-four hours, and this has been confirmed by later observers.In my patient it varied from I.04 to 1.4 g., but it is doubtful whether this slight augmenta- tion is due to the feeble reaction of the urine or to diminished functional activity of the liver.SUMMARY OF CONCLUSIONS.i.The amount of bile secreted in the twenty-four hours in a man somewhat below medium height and weight averages 775 c.cm. and the bile solids I5.8 g.2. More bile is secreted during the day than at night.3. The sulphocyanate of potash in the saliva is not derived from the biliary salts.4. The following substances increase both the quantity of bile and bile solids-Old Sulphur Spring (Harrogate) Carlsbad mineral water, euonymin, benzoate of soda, salicylate of soda, and Kissingen Spa (Harrogate).5. Podophylloresin and iridin augment the bile solids with- out appreciably affecting the quantity of bile.6. Strong Montpellier Spring (Harrogate) and podophyllo- toxin appear to diminish slightly both the quantity and the solids.7. Hot water and soda water in pint doses do not seem to increase the biliary secretion.8. Salicylate of soda increases the excretion of uric acid in the ur'ine.