Studies in Ammonia Metabolism

THE possibility that an increase in blood ammonia produces coma by a direct effect on enzymatic reactions in the brain has been a subject of speculation and investigation for several years,1 2 3 and the occurrence of coma in dogs with experimental Eck fistula and in human beings with liver disease is well known. However, a direct relation between blood ammonia and the onset of coma was only recently demonstrated as the result of a procedure developed in this laboratory for consistent production of coma in normal dogs by the infusion of ammonia into the cerebral circulation.4 Using this technic we have . . .