Abstract
Peters 1 and his coworkers have demonstrated the interrelationship of serum calcium, inorganic phosphorus and the total plasma proteins with albumin and globulin fractions combined. They have analyzed previous reports and their results and have evaluated the relative effects of protein and phosphorus on serum calcium in the absence of any true defect in calcium metabolism. The relation of the components in this series was defined by the equation Ca = 0.255 P + 0.566 protein + 7. An alignment chart was constructed to conform with this equation. The study of this blood chemical series in patients with edema of congestive heart failure was undertaken with the idea of establishing the presence or absence of any relationship between the series, but especially to determine the calcium level and the effectiveness or lack of the same on digitalization and other therapeutic measures.
The patients were all old white men and the normal levels for males established by Peters and his coworkers therefore are applied. The averages were: Total serum protein 6.93%; serum albumin 5.06%, and serum globulin 1.89%. The serum calcium normal is about 6 to 10 mgm. and the inorganic phosphorus is 3.5 to 15.6 mgm. per 100 cc. serum.
Only 4 of our cases are suitable for reporting now. All were arteriosclerotics, two, No. 1 and No. 3, with auricular fibrillation and two, No. 2 and No. 4, with normal sinus mechanism. Both of the latter died, while the fibrillators responded to digitalization with a diuresis and survived. One, No. 2, of the lost cases was definitely syphilitic with aortic regurgitation and hypertension and the other, No. 4, was probably also syphilitic with, however, only an aortitis. Both of the therapeutic failures, No. 2 and No. 4, had serum Ca (2) 11.3 mgm. and (4) 11.4 mgm. (—1.8% and +2.6% low respectively according to Peters'formula), while the total proteins were low, namely (2) 5.64% and 5.58%.
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