Studies in Serum Electrolytes

It has long been known that during the course of lobar pneumonia alterations in the chloride distribution in the blood and urine occur. During the stage of active infection there is a retention of chloride in the body as manifested by a decreased chloride elimination, whereas the blood in this period shows a hypochloremia. The present study was designed to follow the changes in the concentration in the serum of the electrolytes in general and of the non-electrolytes in patients with lobar pneumonia. Hutchison (1898) studied the chloride metabolism in pneumonia and reviewed the literature up to 1898. He showed that diminution in the urinary chlorides might occur in other febrile conditions but was not as constant as in pneumonia and did not occur in other pulmonary diseases. For this reason he believed that an examination of the chlorides was of value in differentiating pneumonia from empyema, pleurisy, et cetera. Peabody (1913) studied the inorganic metabolism in pneumonia and reviewed the literature. In eight cases of pneumonia in which he studied the relation of chloride changes in the blood to changes in the urinary excretion he found that the decrease in the chloride excretion was associated with a lowered chloride concentration in the blood; and that at the time when excretion was increased, the blood chloride concentration was raised. His results also indicated a lowering of calcium and magnesium concentration of the blood during the stage of active infection.