Chemical Changes Occurring in the Body as a Result of Certain Diseases in Infants and Children

It is well known that in normal subjects the osmotic pressure of the blood serum averages about 310 osmolar millimoles, and varies but little.Since more than 90 per cent of the serum osmotic pressure is due to electrolyte, it is apparent that metabolism of the latter must tend to be such as to maintain a fairly fixed concentration in the blood plasma.Gamble and his coworkers (1) pointed out how constant the level of fixed base in the plasma remained during fasting, and indicated to what extent as a result of experimental pyloric obstruc- tion, reciprocal variation of such anions as Cl' and HCO3' could occur without change in the level of total base.One of us (A.F. H.) (2) also emphasized the same fact in a study of pyloric and intestinal obstruction, intestinal fistulae, and marked vomiting of infants and children.Urinary secretion (or lack of secretion) plays the principal role in this strict maintenance of plasma electrolyte.When urine secretion is too scanty for this purpose as for instance in cases of anhydremia due to diarrhea (3) the level of total electrolyte in the plasma occasionally reaches enormous values.It.is the object of this paper to present data obtained from cases of glomerular nephritis with the idea principally of showing: (1) that in acute hemorrhagic nephritis, marked changes in electrolyte and non- protein nitrogen depend chiefly upon such symptoms as anuria, edema, convulsions and vomiting; (2) that in cases of subacute and chronic 127