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DOC 0000017443

419 pages · May 08, 2026 · Broad topic: General · Topic: 800 00 Wom · 305 pages OCR'd
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On the living patients it is passible by placing them on the artificial kidney and hy adjusting the fluid bath, which controls the dialysis, to differentially modify each of these three components in individual cases and to determine its effect on comatose states In patients. It is also possible to checkthis with sginalfluid determinations. In the experiments that have been setup on animals we have living for periods of taro to four days uremic rats and. rabbits whose kidneys have been removed or whose kidneys are non-excreting because of ligation of the ureters. In the initial experiment on these animal -we have been interested in simple fluid redistribution, in the uremic state. It has been known for some time that patients dying of uremia may show increased fluid accumulation in any or all of the serous cavities. In other words, they show an accumulated transudate in the peritoneal cavity, in the pericardial cavity, in the pleural cavity or in the meningeal cavity of the subarachnoid space. In the control animals and in many patients, death from uremia occurs before this change in fluid distribution has occurred. In our experiments, by giving cortisone we can markedly increase the transu- dating fluid in all of these cavities and therefore produce at will cerebral edema along . with increased fluid in the other serous cavities while the animal is still alive. This change in the distribution of fluid is important since in all the textbooks on uremia prior to recent potassium studies^W the uremic state as exemplified by psychoses and coma, was thought to be due to cerebral edema or simple wet brain. One of the most striking bits of ignorance that were confronted in these studies is the fact that although it has been known for hundreds of years that there is such redistribution of fluid in the serous cavities, no one has ever raised the question whether it is due to increased rate of effusion or delayed rate of absorption, or both. It is becoming increasingly evident in the study of abnormal fluid distribution in the body that there are two major controlling factors. One of these is the chemical
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