Abstract
During the course of studies on the influence of various therapeutic procedures on the mineral and water exchanges in children suffering from bronchial asthma, it was observed that artificial fever was usually followed by remission of symptoms when the sodium chloride content of the diet was extremely low, but not when the intake of this salt was unrestricted. This observation suggested the desirability of examining more critically the relationship between the electrolyte and water balance in the mechanism of asthmatic attacks.
Starling and Verney 1 and McQuarrie, Manchester and Husted 2 have shown that pitressin, the antidiuretic principle of the pituitary gland causes, not only a retention of body water, but a coincident absolute increase in the output of sodium and chloride in the normal subject. Therefore, when the sodium chloride intake is very low and the water intake is relatively high during a period of sustained pituitary antidiuresis, body water is retained without coincident storage of sodium chloride. Since this procedure offers a unique opportunity to dissociate the effects of water and salt in the asthmatic patient, the following experiments were undertaken.
Six children, selected on the basis of severity and intractibility of their asthmatic attacks, were placed under constant environmental conditions in the hospital, in charge of specially instructed nurses. The patients were given 4 evenly spaced daily feedings of a weighed formula having reasonably adequate basal dietary constituents, but an extremely low sodium content. Calculated daily intake of sodium was 120 to 700 mg. Distilled water was given at equally spaced intervals, 400 cc per day during control periods and 1200 cc to 2000 cc per day during pitressin sessions. Urine was collected in 24-hour specimens, measured and preserved for future chemical analysis. The subjects were weighed daily on a metabolism balance under uniform conditions. Hourly observations of the patients' condition were made and all asthmatic attacks were tabulated.
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