Abstract
The experiments of one of us have demonstrated that nephrectomized dogs eliminate considerable amounts of ammonia in vomiting. These results have been amply confirmed and extended by others. Martin has studied the elimination of ammonia, urea and other nitrogenous wastes lost in this manner.
During a similar study on elimination of both urea and ammonia in the vomitus, we have demonstrated that really considerable quantities of urea and ammonia are thus eliminated. However, the prospect of this method of elimination serving as a therapeutic measure to tide patients over temporary periods of deficiency in kidney function is not bright. Elimination by way of the stomach becomes quantitatively important only when nitrogen retention has reached a very serious stage, and in our hands this mode of excretion has always failed to keep pace with nitrogen accumulation.
During the course of these experiments we encountered edema of massive proportions. The ascitic fluid in these cases was found to be rich in urea and practically in equilibrium with the concentration of that substance in blood.
We have been able to accomplish the elimination of nitrogen wastes by the introduction of a solution of balanced salts into the peritoneal cavity of a nephrectomized dog, allowing time (10 minutes) for diffusion of nitrogenous wastes into this fluid, and then drawing off the fluid through the trocar which remains in position throughout. We introduce on the average 750 cc. of solution, allow it to remain in the peritoneal cavity for 10 minutes and then allow it to flow out by gravity. Varying numbers of such washings are made at a single insertion of the trocar. Depending upon the severity of the retention at the time, we have done as few as 5 and as many as 20 washings at one sitting.
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