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The Effect of Temporary Occlusion 
 
 of Renal Circulation on 
 
 Renal Function 
 
 I-. (, 
 
 I.'. !■■ I T/. \l.|i. 
 
 I.'" w \ T i; !■: i;, m,ii. 
 
 i: M.I I MOL'I, 
 
 lt,l„i„U,l In,,,, ll,< |,,/,,r.v „, l„l,,„„l »,„■„,,„ 
 
 ■iiih(. nil 1 '.; /.'. 1./, r, :,i, 
 
 (•|||IA«!0 
 
 AMimCAX Mi UHAl. .\.S^SI.CIlllo^ 
 
 '■'" ' lll^r,|,ll. IM. rufllH |-|M \,,|,1H |i|\l|M.l|iS 
 
The Effect of Temporary Occlusion 
 
 of Renal Circulation on 
 
 Renal Function 
 
 i;. FITZ. M.Ji,. AND 1.^ I, i; (I W N T i; i; K. M 
 
 ISALllMOIiL 
 
THE i:ffi:( T of tkmi(»i;ai;v (x (Lrsiov of hexal 
 
 CIl.'crLATloX (IX i.'KNAI, FrX(-|-l( iN -^ 
 n. FIT/:. M.n. am, i.. i,-. i;(i\\\ti;i:i:. m d. 
 
 DAI I l\!n'!|: 
 
 Of fjiviit iiii|in|'tainc 111 ivlaiii.n I>, \\u- .-iii-ny nf ili,. ki.lnrv is t!i.. 
 question rniHcniii:- III,. 1,.,1-th ..f tini,. thm i|„.' ,vikiI v,.->,.1> 'may he 
 claniiHM! u-itli,.u! ii.^i-iiiiiiicnt injiirv in ivnal t'lm. ti,,n .,r iviial ii>Mir. 'I'li.. 
 qur.-tidii is ilrall Willi li,.iv (■\iiriaiiiciitally. Tlw iviial \.-m.1s in ral.iiil- 
 
 and do-s !ia\.' 1 n daniiKMl Im- xai'vin- j.rnn.K ,,|' im,,,,. ;„„] s,,!,,,.. 
 
 (|Mfntly ivnal fiin.-li,.n ha- linai U:\rA Kv th,. r\civii,,ii ,,f i,|i,.n,,lMil- 
 I'lmnrnlitlialcin. Ian,,-,.. i„,ia-iiii,i i,„li,l. salt iiii,l u-at,T. Tli,. |.n-,.|:,v 
 or ab.-eiuv i<( albmiiin aii,l ,a-N in tin- uriiir lias lnvn (,lis,.r\v,l. Tli,. 
 results ,,r .-,i,-|| fiii;,ai,,n,.,l stii,!i,.s luwr li,.,ai . uniivll,.,! l,v lii-l(,|,,..'i,-al 
 cxaniiniiti.iii !,1 tin- ki,lni'\^. 
 
 ''''"' ''"'■'■' "'' "l-tniiai,,n t.i th,. naial ciivulath.n (,ii lii,, unnarv 
 I''"'""''- •""' '!"■ iii>i"l-i:y ..r th,. Li, ill, .y has alwady l„rn invest i-ittM. 
 f{nliin-,.n' .-h,,uv,l ihat i\iii-,,| ili,, ivnal v.^iu ivMilt.',! in th,. npiH'ariKuv 
 
 "'' •il''-iiiiii. I.I I. ,,r l„,tl,. in 111,. „,.j,„,. ,|,„i ,„ ,.„|.,,.^r,,;,„.|,, ,,.■ ,i„, 
 
 ki,ln..y. This ha- h,.,.n < ,,iilii-ni,.,l by ,,tli,.r (.hs,.n,.is. l'an,.th.- Miink' 
 ii!i,l ,1,. S,nv/:i' lia\,. >li,,vvn that l',,ll,,vvin.^ lipiti,ai ,,!' th,' ivnal vian. tlio 
 iiiinr i.- Miiall in ani,,iiiit. Linlv.iu-' Inun,! that c laiiiiiini: the ivnal v,-,-|> 
 *^"'' " !'"■'■''"' "'■ "linut,- fivqiHaillv iiit..|lV'r,.,t with tiu' .-,.,-n.ti.,ii ,,i in in,' 
 I''"' li"i''.~- llci'l.aihain'' Iniiiul that ,,n fivuin,:: tlu- ws^ds al'tiT a t,.ni- 
 pnraiy < lai.ipin- the s..,ivti,,ii ,.r iirin,. iii,| not l,..i,'in at oniv. Littuii" 
 (|li.-onv,l an,.r olaiiiiun- lH,th ivnal m.>.-,.|s r,,r i,eri,„ls up to two hours, 
 that th.' knin,.y lH.,.aiii.. ,.nlai-,.,l ai,,i .■,,n-,.si,.,|. If th.' iviial artery 
 ■''"'"■ "■■'- 'i"'l '■"!■ o!i,'-!i,alr or ..ii,. h,,iir. alhiimin an,l oasis ap|i,.ar,.,i ili 
 the nnn,.. I'atli.,l,i-i,,ill\. th,. lulnil,..- w,.:v alloc-i,.,! as sh.iwn hy tlu'ir 
 
 * .'^iii.iiiUi,.,! for piililh.atii.ii Mai,.!, 2ii. I'ai:!. 
 
 * iMviii till- M-.,li,.al iTinio. ol tli,. I'.t,!- INnt Ilri-liani U,)-!,ilal, l;,,.t'>n .in,! 
 til,. l'lKiMiia,.„l„i;iral ;.alM,vaI,,iy ..f tl„. .l„l„i- llepkins l„iA,.rsit\ . I!altiin„i,..' 
 
 • l,r n.vi..u- „t lit,-intnr,. ,-,,ii,.,.rniii- [..mijl ,„• ,.,.iii|,|,.t,. ..j.-tniotioii t,, i,.ii;il 
 circiilala.n s,..' our pi.-vi,.!,- |,;,|„.r. |;, ,»„,,.,■,■. V\u an. I (l..ra-litv: Stii,|i,.< „i^ 
 Ki'iial l'iin,ti,>ii in K\|„.riiii,.,ital ( lirnni,. l>;,-iv,. I ,,ii._M.-ti,ai liii '\ii,iims Im 
 .Mm.. I!il;i. \\. lit. 
 
 1. l!,,|,ins,iii : Mi.,|. ( |iir. I'r.. is^ii v >.v i .-,!, 
 
 ■_'. I'anctli: I'IIuliit'- .Xrch.. iss,;. w^K. .-)!.-). 
 
 :i. .Miiiik: lli'il. klin. W,lin-ilir.. Isiit. j, ;i.-i:i. 
 
 I. !)•' .'si,ii/i : .l.air. ,'liy-i,,|.. llloil. w.i. i;!!i. 
 
 ."). l.l|i|Hi;r I'llVsiolii;;!,., 1 s.",,;. jj ||ii 
 
 • i. !l.'i,|,.iilKiia: I|,.niianir^ llaii.ll,. .1. I'li\-i.,l . 1<S3. v. li'l! 1. :!l'1 
 7. laln.ii: /t-..|ir. f. Klin, .M,-,l.. Issii. |,, ml. 
 
inability to fiaiu with iiiili;;o rannir.. Fiut .-tuh cliangcs were temporary. 
 If the artery was clanijici! for two hours, permanent injury oecurreil, 
 eviilencttl by tubular necroji; with cast production, cellular infiltration, 
 rcjulling in circumscribed scar formation with calcification. 
 
 Chirie and ^Mayer' after temporary clanipini:; of both renal veins in 
 do_'i, Tioted, in four out of seven cases, death with convulsions. CarreP 
 was unable to confirm this observation. 
 
 Eisendrath and Strauss'" have studied the pathological changes in 
 the kidneys of rabbits after coinprc.-sing the renal vessels for from fifteen 
 to ninety minutes. According to their rc.-ults, temporary compression — 
 I'.alf an hour or h -s — (aused slight damage. If longer, marked pe'-- 
 ii'.anent lesions occurred in the parenchyma, as cxidenced by interstitial 
 cellular infiltration, coagulation necrosis of tubular ejuthelium, and Inter 
 by tl'.e depositio!! of calcium in and about the destroyed epithelium. 
 
 Tluis it has been slunvn that daitiping of thi> renal vessels for periods 
 up to an hour may produce temjiorary anuria, albuminuria and cylin- 
 druria. If interference with the renal circulation is maintained suffi- 
 cientlv long, permanent interstitial increase in tissue occurs in the kidney. 
 Except for the amount of urine excreted and the presence in it of albumin 
 or casts, no systematic sttidy of renal function under such conditions 
 has been made. 
 
 .\lTIirii;s' rxi'F.nniKNTS 
 
 In our e\perimeiits ralihit> ar.d dogs were ethrri;!ed and the abdomen 
 opened nscptically in the niciian line. 'l"he Icfr kidney was exposed, and 
 by careful blunt dissection the vessels were freed from the surroundinc; 
 tissues. The arterv and vein were raised on an artery forceps with as 
 little stretcliing as possible and a small rubber protected bull-dog clamp 
 placed around them. In each experiment it w'as noted that on the distal 
 side of the forceps the artery did not pulsate, while the vein at once 
 became distended: on the ]>roxinial side the vein was collapsed and the 
 artery pulsated normally. Xo attempt was n;ade to prevent the capsular 
 circulation. After the left renal vessels were clamped, the right renal 
 vessels were licated. The riglit kidney was lemoved and weighed. In a 
 few animals, i(ir eontrcl. the right kiilncy was left untouched. 
 
 While tlie i lamp ua- in ]']aie, the abdnnicn was closed and covered 
 with a warm .siiiiic pad and towel. To try to obviate the factor of 
 sliock, the body heat was maintained. The animals were anesthetizeil as 
 lightly as jiossible. After the desired interval of time had elapsed, the 
 clamp was removed, the niacro^coidc appearance of tiie kidney noted, an 1 
 
 s. ( liiric and .Mayer: ( onuit. rcml. Soc. de liiol.. I!tn7. i. 50S. 
 ;'. ( arrtl: C onijit. roinl. d. Sec. do Mol.. I'.lfill. i, 527. 
 
 10. Eisendrath and .'^trau^s: ,Tour. Am. Med. .\»sn., \'Mi}. Iv, 22SG; see also 
 Guthrie: The Archives Int. Med., I'JIO, v, 232. 
 
 / 
 
the i)oritoneum and alxluinuii seu n up. The i)hidili-r iva.; th. ,i,io'i 
 
 and the animals placed in molaholism l.u. -. The ehiinp wa- applied in 
 !-eries of animals for ten, twenty, thirty, forty and sixty .ninutes. 
 I'epoated studies of lenal function were made. Finally, the animals 
 were killed, suhmitted to autopsy and the kidneys examined histohiirically 
 after formaldehyd iixatioii, celloidin imbedding and h'-'iiatoxvlin and 
 cosin staining. 
 
 XrCHN-IC OF THSTS OF IlKXAL FLXCTION- 
 
 A short (leseriptioii of the \a;iou> te>t- used for renal function, with 
 tiu'ir technic, is given. 
 
 Tlie plitlialein test wn- tiia.lc arfDriliiii.' to tlio oriiiinal (oclinic of nowntiiv 
 and Geraulitr." One cubic contiiiipti-r of a ]ilienolsiil]iIion(>plitlialein solution con- 
 tainin;; accurately C niilliirann was injectoii nseptically into tlio Iclt nui-'cle-' of 
 the rabbits or lumbar muscles of the dogs, wliicli were tlion iilace.l in metabolism 
 ca;.'es. The bladders were oxpresscci or catheteri?ed at the end of an hour ami 
 ten minutes, and the total urine for this time colloetcd. The urine was made 
 distinctly a'kaline. diluted (o 1 liter, and the amount of druf; determined by 
 the use of Rowntree ami Geraghty's" modification of the .Autenrietb Ktlniis- 
 berger colorimeter. In control animals it has been determined that tli" normal 
 output in this time is 00 per cent, or njore. 
 
 The lactose, potassium iodid. salt and water tests which have received a 
 tliorough study at tlie hands of Schlayer" and his en workers and which we have 
 used in relation to the renal function in experimental and clinical nepliritides. 
 were applied to this study. 
 
 From our previous work we feel that the nuchanism of tlio excretion of 
 lactose differs essentially from that ot phthalein. salt and iodid. ThrouL'hout 
 this investigation W! have used it as an index of the condition of tlie va-cular 
 function'* of the kidney, admitting tliat we need much more information concern- 
 ing the manner and significance of its excretion. 
 
 Tile teclinic tor the lactose test in rabbits lias been identical with .'^clilayer's. 
 tine gram of lactose dissolved in 10 c.c. of distilled water was injected into the 
 ear vein. The animals were placed in metabolism cages, the bludiler expressed 
 at the end of four hours and every hour thereafter up to eight hours. In dogs, 
 according to our previous technic. 2 gm. were disso'i.i-d in -20 c.c. of water, ami 
 injected into the lumbar muscles. 
 
 i^ince the time necessary for total elimination lias hevn considered bv Schlaver 
 of greater importance than the absolute amount recovered, and since our pre- 
 vious ob.servations with lactose excretion agree with this, we have observed 
 this exclusively. The presence of lactose in the urine was determined by 
 Nylander's test, using similar amounts of urine, reagent and length of boiliiiLr 
 time. 
 
 In rabbits under these conditions, the time necessary for the complete elimin- 
 ation of lactose is normally six hours or less and in dogs from four to six Iiours. 
 
 11, liowntrce and Oeraghty: ,Iour, Pilar, and Exper, Tlierap., 1910. i, 5T1>. 
 1-'. Huwntree and Geraghty: The .Archivks Int. .Ued., 1912, ix, 284, 
 
 13, Schlayer: Deutsch, Arch, f, klin, Med,, 1911. cii. 311: Schlayer and 
 Takayasu: Deutsch, Arch, f, klin. Med., 1S91, xcviii. 17; 1910, ci, 333. 
 
 14, For a review of the literature on this test and the others described below, 
 see our jircvious paper. We have shown in a previous publication, liowever, that 
 lactose is not excreted solelv bv the glomeruli. 
 
• 
 
 Arcordic!: to tlic ftmlif< cf Srlihiyer. iHtn-.-iuin iiulul is excreted by 
 the tubules of tiie kidney, nvA on it he has phued most dependenee in 
 determining tubular furctioiial eapatity. In these studies 1 c.c. of a 
 2.0 per cent, sulution l'.a> bieli admini.-tered intravenously to rabbits. 
 For ihi.- the noiiiia! tlliiili.atiiui time i:- twciity-four hours. In dojs, 
 (1..J LMU. has bee'i administered by mouth, which normally is excreted 
 witliiii sixty hours. The presence of the drug in the urine has b-en 
 determined by SandowV''' test. 
 
 The excretion of salt following it- administration in amounts greatly 
 in excess of that ordinarily taken with the food is aecomidi.-lnd by the 
 tubule^. according to Sehlayer. Normally, a laruo amount of salt i- 
 excreted by one of two methods. If it i^ -ivcu wiihont extra wati-r. it 
 i-- almost entirely excreted within twciiiy-l'air hours without diuresis by 
 increased salt concentiaiion in the urine; if given with an excess of water, 
 it is excreted T>artia!ly ihiougli increased eoiH-entration in the urine and 
 partially tlirougli diuresis. 
 
 Where vas( ular injury to tlie kidney exists, the simple administration 
 of salt may bo followed by a marked diuresis, all of the salt being 
 excreted in twenty-four hours without its percentage content in tiie urine 
 beins at all increased. This is usually associated v., to a somewhat low 
 and fixed specific gravity and the syndrome is spoken of as "vas, :-lar 
 hypothcnuria."' Here the inability to concentrate is not du" to any 
 incapacity of the tubules to exc.-ete salt, but to ' • crseiisitive ves^els 
 which respond to the salt administration with a diurcM-. In mnii' severe 
 vascular injiiiv ilie vessels do not act in the sa way. oliguria charac- 
 terizing the urinary picture. In severe tubuhir de-triu ti^ii. a urine of 
 fixed low spccitic gravity is obtained, the quant iiy «i which is imt 
 materially affected by the administration <.f extra amoimi> of salt, and 
 the salt content of which is not augmented by administratinn nf I'xtra 
 amounts of silt because of the inability of the tnbuli > to excrct.' il. Sik h 
 a condition is known a- ■•tubular hyiHoilienui m" 
 
 In these studies gin. l.o'> were given by stomach-tube to the ralibits. 
 and gni. 3 to dogs. Tiie urine for the foUowini; twenty-four Imiirs wa>^ 
 collecte<l, and the salt concentration aiid ab-cluic ( \Melion e^tiinali'd 
 by the Liitke-Mart ills'" method. 
 
 Finally, in order to make condilions as coU'^tant as possible, the 
 labbits were given IdO n,c. of water daily by stomach-tube. In additinn. 
 
 15. Sandow's iiutliod cnnisis't* In aiMint' 1 o.c. of ■: per i.'tif. Mi<liuiii nitrite 
 ►o.iition anil 1 c.c. of 10 [icr wnt. ll^Sd, t.i fidni 10 to 30 c.c of urine, fullnwr.l 
 l>v tic ndilition of n sni.ill iininnnt of chloroform. TMii i« slialicn teecthcr and 
 nllowcd to scparnte into ln,\(f. tl. ■ I'nscncc of tlic jodid Uw^ indicated liv a 
 |nir|di«li red or violet c(dor in llie cliloroforni. 
 
 US. Sahli! Lrlirlmch der klini-cl;. n >i!it.'r-ii(hiMie>'. Metlioilui, Iran/ Dcnticke, 
 LoipTig nn.l Wien. JSUii, p. 421. 
 
they were allowcil to cat giccn vcj:ctablo.- ad libituni. This produced a 
 constant polyuria. Hence the anioinits of nrine were not followed from 
 day to day. Th.e duff? were allowed MOii c.c. of water daily, and were fed 
 on meat when able to retain liquid or Milid food. The lactose, ph'ihalein 
 and iodid tests were given synchronotisly since their excretion, and quan- 
 titative dctenuiiiation do not interfere with each other. In dogs. lactose 
 and jijitlialein were i:i\en at the same lime, but into tlic muscles of 
 opposite sides. 
 
 Single catheter nr expre-scil fpieimciis of mine were taken from day 
 to day. Albumin was tested i)y the nitric aeid method. The sediment 
 of centrifuged urine was examined niicrosiopically for blood or casts. 
 
 As previously, in these studies we have cdiisidercd the excretion of 
 lactose as an index of va^-eular functional (apacity: that of phthalein as 
 nil index of total renal fuiiction (though predominantly tubular), and 
 the excretien nf -alt and iedid as an index of tubtdar functional capacity. 
 
 The results of thc-e >tudie- are slmwn in the accompanying protocols." 
 
 I'lJiiloriil.s (iF I'M'IClAtrNTS 
 
 I. Animnl* with niio kiilmy ri'iiiuM !. renal cirruliition olanipod for in niinnto=. 
 
 I;aiii:it 1. — I!o<ly wiifrlit l.fi.jll siii. \\i'i;.'Iit of removed kiiiney 4. 'J gni. 
 WfiLrht of reiiiaininir kiiliifv at dratli li..") mii. 
 
 Siilphonephthali in excretion pooonil ilay after eporatinn .ST jier cent, 
 
 Siilplionei'litlialein excretion tliird day after ojieratinn ti'2 per cent. 
 
 Snlplionephthalein excretion tiftli day aftir <'perotitin ."iS per cent. 
 
 Swlplioncphtlialein excretion i^evintli day after operation 5S ]'er cent. 
 
 Lactose excretion first day after ojieration (!-T liours. 
 
 l.actMse excretion fonrtli diiy after operation t>-7 iioiirs. 
 
 Iodic! excretion fir-t day after oiieiation .Tit lioiirs +. 
 
 lodiii excretion liftli day after operation ;!tl lionrs -f . 
 
 Salt excretion third day after operation 1. 00 per cent. (1.20 nm.) 
 
 Salt excretion sixth day after operation I.^IU per cent. (1.(10 f:ni.l 
 
 .\!!inniin jiresent f"r fonr da\s. K: 
 day, Aniiiial killed on the ei;;litli da.\. 
 
 -lit 01 
 
 valine cast- found nnlil the >eventli 
 1 Lidia-/ 4.ii em. W.'iL/ht 
 
 II.MIIIIT :?. — Wei-ht l,::.'i(l em. \\ 1 
 of remaining kidney at d>alli ■)..") jjni. 
 
 Siilphonephtlialein excretion si'Coni! day after operation tl.'j per cent. 
 Sniphnneplithalein excretion fourth day after operation !'■.") per cent. 
 Sulphoneplitlialein excretion tifth day after (operation li'J per cent. 
 Siilplioneplillialein excretion seventh day after operation tiu per cent. 
 Lactose- excretion tir-t day after oi'eration II hours. 
 l-actose excretion fourth day alter operation 7'j luuirs. 
 Lactose excntion seventh day after oiier.ation ."i liours. 
 loilid excretion lirst day after operation ^fl hours, 
 lodiil excretiou toiirth day after operation '-M hours, 
 lodiil excretion -I'Veiilh ilay .ifler (iperatioii l!il hours. 
 
 17. Ill adilition -iven rahliits wire useil. one with circulation cinnipcil for 
 tin nniiiilis. tiiiee for tliirty minutes, and two fur forty niinutes. All died 
 within sixteen hours of operation. l!eali/iii;r llie individual variation in -uscepti- 
 hility and vita'ity of rabl)it!«. it seemed fair to exclude these animals from their 
 ajiiiropriati' taMi-. especially as all had hien deeply nne-tlieti/ed. nil hut ono 
 
 had made p etiier recoveries, and one ri'Mdt at 0[)ertttion had KUlTereil fioni 
 
 a severi' In mini ieiL'e I'.^v to trann a if the liver. 
 
 f i • 
 
8 
 
 t 
 
 cent, 
 o-nt. 
 com. 
 
 Suit oxcrotiim tliiiil d.iy after oporatinn 1.2.'i ]ii'r cent. ll.HO am.) 
 tSalt iwcrctiun si.xth day after operation 1.3 per cent. (1.3 gni.) 
 Alliiimin present for six day-;. Sediment neiiative tliroiiprl mt tlie experiment. 
 Animal found dead on tlie eiirluii day. Xo cause found. 
 
 i;.\niiiT 3. — WeiL'lit 2.25tr <;in. Weiijlit of removed kidney fi fim. (approx. ). 
 Weifiiit of reiiiuiiiiiif,' kidney at deatii S pm. 
 
 Sulplioneplitlialein excretion first day after operation '.1 per cent. 
 Siilpliono[dillialein excretinn second day after ujieration i!4 per cent. 
 Sulphoneidithalein excretion tldrd day after operation ;>.'> I'er 
 Sulplioneplitlialein exerction sixth ilay after ojier.ition (12 |»'r 
 Sulplioneiditlialein excretion ei;:litli day after opeiati.in. SI' per 
 Lactose excretion first day aft'-r operation 8 lioins-r. 
 Lactose excretion sixtli day after operation li liours. 
 Lactose excretion tliirteentli day after operation 5 Uoiirs. 
 lodid excretion first day after operation 30 liour;. 
 lodid excretion sixtli day nft.T (rperation 34 hour-. 
 Salt excretion third day after operation .72 per cent. (1.3.5 pm.) 
 Salt excretion ei).'litli day after operation .50 per cent. (1.41) pm.) 
 Alhumin present for three days. Sediment sliowed rare liyaline casts on the 
 thirteentli day. Hematuria for three days. The animal was killed on the four- 
 teenth day. 
 
 II. Animal-f with one kidney removed. Keiial eirculati -u elaniped for twenty 
 minutes. 
 
 r..\liliIT 1.— Wepjiit l.siit) '^ni. Weight of leiiuived kidney CXi iini. Weight 
 of reiiiaininu' kidney at death 5.5 L'ln. 
 
 Siilphonephtlialein excretion lirst day after operation 32 i er cut. 
 Sulplioneplitlialein excretion tliiri! day after opernti'ii 43 per ct-nt. 
 
 Sul|rlioneplithali in excretion fifth day after op>'ration 42 per cent. 
 
 Sulphonephthal.'in excietion tliirteentli day after operation 4S p'T c.mt. 
 
 Si Iphoneplitlialiin excretion twentieth day after operation 37 per cent. 
 
 La tose excreti.jn first day after operation 7'j hours. 
 
 Lactose excretion fifth day after operation hours. 
 
 Lactose excretion fourteenth day after operation 5 liour-. 
 
 Lactose excretion twentieth day aftc-r operation 7 hours +. 
 
 lodid excretion lirst day afti-r operation 24 hours. 
 
 lo.lid excretiim fourteenth day after operation 24 hours. 
 
 lodid excretion twentietli day after operation 24 hours. 
 
 Salt excretion third (kiy after operatinu l.Hd per cent. (1.1 pni.) 
 
 Salt excretion seventh" day after ojieration .f* per cent. 12.0(1 cm.) 
 
 Salt "xcretion sixteentli day after operation .7 per cent. ( 1.0 (jui.) 
 
 Alhumin lires<'nt for seven days. l-"ew hyaline casts found until the seventli 
 day. Hematuria for live days. Animal found ileail on tlie twenty-seventh day. 
 lli-tolo(.'ically tlie kidney not remarkalde. 
 
 H.vniilT 2. — Weiplit 1,720 pin. Weiplit of nnioved kidney t),4 pm. Weight 
 of remaiiiini; kidney ut death li.5 uni. 
 
 Sulphonephtlmlein excretion first il;iy after opeiatlon 27 [ler cent. 
 
 Sulplioneplitlialein exerel ion fifth day after opeiation 32 l>er cent. 
 
 Siilplione|ditlialien excretion sixth day after operation (!0 per e.-nt. 
 
 Sulphoiiephthnlien excretion foiii teer.t'h d.iy after opiTution 5s i.er cent. 
 
 Sulplioneplithnlien excretion twentieth day after opetntion SS per cent. 
 
 Sulplioneplitlialein exeielion twenty-eiplith day after operation lit |ier (etit. 
 
 Lactose i xcretion first day afli'r deatli 7'j hours. 
 
 Lactose excretion lii'tli day after o|ieration 7 hours. 
 
 Lactone excretion foiirteei'itli ilay after operation 5 hours. 
 
 Lactow excretion twenty ei>;hth day after operntion 3 hoiir». 
 
 loilid excretion first day after op>'ralion 24 hoiirii. 
 
 lodid excretion fifth ilay nfter <]ii ration 3') hour*. 
 
 loilid excretion foiirteeiith day alter o|ie-ation 24 lioiiis. 
 
 lodid excretion twenty-eiphlli day after <iperation 24 hours. 
 
 Salt excretion third day after oiK'nition .0 per cent. (1.1 B"" )• 
 
 Salt excretion seventli day after oiiernfion 1.2 per cent. (l.S (jni.). 
 
 1 
 
9 
 
 I 
 
 Salt I'xcit'tion sixtpi^ntli il.iy after operation .53 ppr c<'iit. (1.3 sm.). 
 fialt excretion twenty-eisht'li day after operation Ai) per cnt. i-2.00 ^:u.) . 
 Albumin present for tlirec days. Heniaturia for four Jay*. No c.i?t- foiimi 
 after tlie tiftli day. Animal killed the twenty-eighth day. 
 
 H.\I!BIT 3. — Weight '2.0:20 frni. Weight of removed kidney 0.5 gni. Weigiit of 
 ri^'niaining kidney at d-atli 7.00 gm. 
 
 Sulphonephthalein exeretion tir«t day after operation 5.') per cent. 
 Sul|ihonephtlialein excretion tliird day after operation 35 per cent. 
 ^:;lll[lhonellhtllalein excretion liftli day after operation ii5 per cent. 
 Sill] honeiilitlialein ex.T. tion lilto'iitli day alter ..|i,Mation i)4 ]'■■- (-nl. 
 Sulphonephthalein .'xeretiun twenty-eighth day after operation TO per cent. 
 
 Lactone excretion first day after operation 7',j hours. 
 
 Lacto.se excretion tifth day after operation 4 houra. 
 
 Lactose excretion lifteentli day after o)ieration 4 iiour-. 
 
 Lactose excreiion twenty Jiird day after operation iiours, 
 
 lodid excretion tr -t day after operation 24 hours. 
 
 lodid excretion tiftli day after operation 24 h.nirs. 
 
 loilid excretion twenty-third day after operation 24 hour-. 
 
 Salt exerition third day after op.'ration 1.00 [ler cent. (1.1 '.'ui i . 
 
 Salt excretion twelfth day after operation .S per cent. (2.4 gm.i. 
 
 Alhurain present for three days. Hematuria for one day. Xi> casts found after 
 the sixth day. Animal killed the twenty-eighth day. 
 
 Don 1.— Weight 5 kilns. Weight of the removed kidney 20 gm. 
 
 Sulphonephthalein excretion lirst day after operation 40 per cent. 
 
 SulphoniM'hthahin excretion second day after oi)eration 00 per cenc. 
 
 Sniphoiie'phthalein excretion fifth day after operation 50 per cent. 
 
 Suiplionephtiialein excretion ninth day after operation (is pei cent. 
 
 Sulphonephthalein excretion twelfth ilay after operation 00 p.'r cent. 
 
 Lactcjc excretion first day after operation S hours -^. 
 
 J.actoie excreti(m fifth day after operation S hour-. 
 
 Laet<ise excretion ninth day after ojieration 5 leairs. 
 
 lodid excretion second day aft.'r opeiation 4H lunir-. 
 
 lodid excretion twelfth day aft.'r operation 4S Iumms. 
 
 Salt excretion second day after operation .S5 per cvr.t. (3.0O gm.). 
 
 Alliniuin present for one day. No easts found after the second day. The 
 aiiiiii.il wa- allowed to live, since he had mail.' an apparently normal recovery. 
 
 111. — .\nnnal- with one kidney removed-, renal circulation ci.imped f^r tliirty 
 mituite-. 
 
 ll.MKiiT 1.— Wei^lit 1.700 gni. Weight of lene'Ved kidney ." w.. (Ajiprox.) 
 W.Mjht oi i.maiiuiig kidney after dealli (i.5 gni. 
 
 Sulphonephthalein excretion first day after operation 40 jier c^uit, 
 
 Sul|dioiU'iOifhal.dn excretiim seecnid ilay after operation 40 per cent. 
 
 Sulphoneplithah'in exerelicui fourth day after operation 00 per cent. 
 
 Sulphonephthalein excr.'tim thirteenth day after operatiim 07 per cent. 
 
 Sulplionephthalein excretion twenty-eighth dav after operation 72 per cent. 
 
 Sulphonephthalein excretion thirty-first day .ifter <iperatiiin M p.'r cent 
 
 Lactose excretion fir<t .lay after opeiation O'.j hour-. 
 
 Lactose oxcreti.iii f.mrth .lay after i'|ierati.in 5 h..in-. 
 
 Lactose excretion thirteenth day after o|.eration 5 lemr-^. 
 
 Lactose excri'tion twenty-eialith ilay after operation 5 leiur^. 
 
 lodi.l excreti.in first .lay aft.T operation 30 hours. 
 
 lodi.i excreti..n fourth .tay after operation .'M houis. 
 
 lo.lid excretion thirt.'enth" .lay after opieralion 24 hotir«. 
 
 Salt excr.'tion thir.l day nft.'r operation 1 3 p.T ('.'lit. (1.7 ..'in.l. 
 
 Salt excretion sixth .lay after op.'ration .S per cent. (1.4 gm.i. 
 
 Salt excreti..n Ihirtytir'st day afte- operation .'.i p.T cent. .1,4 ..'in.i. 
 
 .Vllmii'inuria for four .lays. No casts f.iiin.l aft.'r th.' t!.iit.v.nth .l.ij. Aniin.il 
 kille.l on the thirty-first day. 
 
 I{.\nBlT 2.— Weight '2,400 gm. Weiuht of r.'rnov.-.l kiln'y 7.0 gni. Weight 
 of remaining ki.lney after .leath 11 ,T gni. 
 
1" 
 
 rint. 
 
 fi.im 
 
 Siilplioncphth;ili'in pxorction tir-t ilny after ofcrati.m ;;0 jut cent. 
 Siilphoneiilitlialfin .■xcrction second day after ojieiation 4n per cent 
 ^^ulplioneplitlialein excreticn fnnrtli day after operation TO per cent 
 Sulphonephtlialein everetiim fifteenth day after operation iVJ i-t 
 Lactone excreti"n tir^t day after ojieration 7 lioiirs +. 
 Lactose excretion foiinli day after oiiCration 5 lioin>. 
 Lacto-e excretion tiftecntli dav after operation o hour-. 
 lodi<l excretion tifteeiitli ilay after operation 24 liours. 
 Salt excrdion tir-t dav after i^peration .7 per cent. (1.0 pm.). 
 ;«alt excretion tiftecntli day after operation .0 per cent. 2.4 frni.). 
 Alhumin present for one day, llematiivia for two days. Xo cast 
 the fourtli day. Animal killed the fifteenth day. 
 
 K.Mir.iT ?, — Weipht 2.C00 pni. Weifrlit of removed ki-iney (i.ti iiv. 
 reniaininf; isiiln>'y after death 8 cm. 
 
 Sulphoneplitlialein excretion second day after ojieration 55 per cent. 
 Siilphonephtlialein excretion fmirtli day after oi'eration 70 per cent. 
 Sulplionephthalein excretion tiftecntli day after oj.eration ^0 per cent. 
 Sulph'-nephtlialein excretion twentieth day after ulceration 74 per cent. 
 Lactose excretiim first day after operation 7 hours. 
 Lactose excretion fonrth day after operation 5 hour-. 
 Lactose excretion fourteenth day after operation 7 liinirs. 
 Lactose excretion twentieth day after O|ieration 5 honrs. 
 lodid excretion first day .after operation 24 hiinr-. 
 lodiil excriticai fourth ilay after operation 24 honi-. 
 lodid excretion tiftecntli day after operation 24 hours. 
 Salt excretion third day after operation 1.1 per cent. (2..'i jrm.K 
 Salt excretion fonrteenth day after operation .52 per cent. (2.1 <:"i)- 
 Salt excretion twentieth day after operation .fio per cent, (l.n j.-ni.). 
 Alliiimin present for one day. Ilemattiria for one day. No casts see 
 the third .hiy. Animal killed tlie thirtieth day. 
 
 U,„; l.—Wi.i-ht 7 kilos. WeiLdit of reniovd kidney 24 'jm. 
 Siilphonephtlialein excretion secoml day after opera! iim .'Ui per cent. 
 Sulphonephtlialein excretion third day aft.r ojieration 52 per cent. 
 Sniidionephthalein exention fifth day aft.r operation 55 per cent. 
 Laeto-e excretion thinl day after operation S hours. 
 Iodic! excretion -■eond day after operation 4S hours. 
 Salt excretion third day after operation 1 per cent, i l.i'. !.'ni.i. 
 Alhiimin for two days, ta-ts fotind on the liftli day. .\nimal 
 uneventful recovery ami allowed to live. 
 
 IV.— Animal witli one kidney removed; lenal eireu'ation clampe.l fi 
 niiniites. 
 
 l!.\Hi;ir 1. — \Vei<:lit 2.070 |:ni. Widpht <if removed kidney 5.7 -im. W 
 remainin'.' kidney after death 7.2 '.'in. 
 
 Sulplionephthalein excretion lir-t day after opeialiin 24 per cmt. 
 Siilpl.one]dit!ialein excretion -econd day after operation 40 iii'r cent. 
 Sn'plioniphtli.ilein excretion third day' after oju'ration 50 per cent. 
 siilphone]dit!ialein I'xeretion fourth day after operation Ii2 per cent. 
 Siilphonephtlialein excretion ciLdith day after op'Tation 70 per cent. 
 Lactose excretion secoml day after ojieration (1 iKUirs. 
 Lacto-e excretion eiiihtli day after operation <i hours. 
 LaetoBe excretion twelfth day after ojieration 5 hours, 
 lodid excretion first day after operation 4S hour-. 
 Salt e.xcretion fourth day after operation 1 per cent. (15 pni.). 
 Salt excretion tenth day' after operation .7 per cent. (1.2 jiin.i. 
 Alliuminurin for eiyht days. Hematuria for one day. No casts f,,ii 
 tlie fourlli day. Animal killed on tli.. twelfth <lav on ae.-ouiit of ^'l i 
 I'lAnniT 2. — Wei'.'ht 1.000 (.'ni. \Veit;ht of removed kidney 4,0 - 
 renininini: kidney after death 0,5 jjm. 
 
 Sulplionephthalein excretion first day after operation 40 p. r 
 Siilphonephtlialein exention second day after operation 47 per 
 
 il after 
 
 JL'llt of 
 
 n aft.'r 
 
 ladi an 
 
 ir forty 
 
 ij^ht of 
 
 .il i 
 
 id after 
 
 nfeccion. 
 
 itdit if 
 
 • 
 
1 
 
 Siil|.lioiKi.hth,-.lein woretinn tliir.! day aft.r oiioration oU lior cut. 
 Laotose excrcti.ui tir-t day after opnati-n 8 liours -r- 
 Lactose excretion tlur.l .lav after ciporation 7 Iioiirs +. 
 lodid excndion fir^t day after oiicration 3(1 Iiours. 
 lodid excritiiin tliird day after operation 24 li-.urs. 
 Salt excretion third dav after operation 1 r*"'" cent. ( I.', pm.) 
 AUiumin an.l casts present u.-.til deatli. Animal killed on the fourth day on 
 account ci general infection. 
 
 i;.\nmT 3.— Weight 2.200 gm. Weight of removed kidney tl.nu gm. Weight 
 of reniainini; kidnev aftvr deatli ll.OH gm. 
 
 Sulplioneplitha'ein excretion first day after operation 45 per cent. 
 
 Sul phonephthalein excretion second day after operation 54 per cent. 
 
 :>ul dioneldithalein excretion fourth day after operation 1,0 per cent. 
 
 .-nlphoneidithalein excretion fifth day after operation 70 per cent. 
 
 Lactose excretion first day after operation S hours. 
 
 Lactose excretion tliird day nfter operation 5 Ikuivs. 
 
 Lactose excretion llfth ('ay alter operation 4 Innirs. 
 
 lodid excretion lirst day after operation 30 hours. 
 
 lodid excretion third day after operation 
 
 (1.00 gm.) 
 
 .) 
 d.iv. No casts 
 
 14 hours. 
 Sait'exereti'on"seeond daV after o'pe.„tion M per cent. (1.00 gr 
 Salt excretion fifth day after operation .1' per cent. r..5 gm.) 
 Albumin present for three days. Hematuria for one 
 . fourth day. Animal killed on the sixtli day. 
 KAninr 4.— Weight 1.77U gm. Weight of leiiieved kidney r,.m gm 
 remaining kiiinev after death 7.00 gm. 
 
 Snlrd.onephthalein excretion first day after rieration 15 per cent, 
 Sulphonephthalein excretion second day after operation 14 per cent. 
 
 een after 
 Wei-'.it 
 
 Sulphonephthalein excretion third day nfter operation S per cent. 
 Lactose excretion tirst day nfter operation S hours +. 
 Lactose excretion third day after operation hours. 
 lodid excretion lirst day aft.r upeiation 30 ,Hr cent. 
 Salt excretion second dav after operation 1.00 per cent. (.. gm.) 
 No allmmin f.mnd after'the sec-nd day. Hematuria f-r one .lay. Ca-ts swn 
 on 'the thir.l dav. Animal found dead, on tlie fourth .lay with acute peritonitis. 
 
 of remoVMl khlney 7 gm. Wri-!it of 
 
 l!.\niiiT r>,— W.ight 2.3JO gm. W , igli 
 remaining knlney ait.T d.'aih 10 gm. 
 
 Suhdemeiilithalein excreti.m tirst .lay after oper.'.to.n 4, p.r cent, 
 ^iilph.nieidithalein excretion fourth day after operation CJ per cent. 
 Sul d...n.pl.thal.'in .xcr.tion tu.dfth day after operation 1)7 per cent. 
 Sul .honeihthalem exir.tion f.mrt.enth .lay nfter ..pcvation .0 per cent 
 
 .) 
 
 Laeto-e excn'tion secon.l .lay after operation li.aiis. 
 
 Lactos,. excretion fourth <lay after operation (i hours. 
 
 Lactose excretion thirtc.ntli day after operation 5 lean-. 
 
 lodid excretion second day after operathm 24 hour-. 
 
 Salt excretion second .lav after ..peration .7 per cent. ( l.i gni.)_ 
 
 Salt excretion thirteenth .lav after operation .0 per cent, [-..o i:: 
 
 Allaiminuria f.T t«o .lays, (asfs pr,.sent for four .lays. Animal k.lhd on 
 
 t! e litt.rnth ilav. „. . , , 
 
 1„„; l,_Weiglit kih>s. Weight of reuiove.l kidn.'y 33 gm. Weight .,1 
 
 reniaininL' ki.lney after .hath SO gm. 
 
 Sulphon.lditlialcin excretion first .'ay aft.T .'p.'ratmn trac.s. 
 
 sulphon.M.hlhahiu excretion second .lay after open.tion traces. 
 
 Suliihonephthalein exer.tion third day after operation traces. 
 
 I act'^e excretion first .lav after opernti.m S h.uirs +. 
 
 Laclo-o .'xcretion s.c.mil day after operation S hours. 
 
 Salt and iodhl not given. Alliumin. Id.ind and ea-|s pre-ent until .leath. 
 
 Animal kill.d on the fourth day on account of rxtf tox.niia. 
 
 : — WeiL'ht 10 kilos. WeiL'ht of remove.l kidney 30 gm. 
 
 litluilein exereti.>n first day after operation 20 per .'ent. 
 
 D.ii. 
 
 Sul|il 
 
 -n.pl 
 
 sulpla 
 
 . o!t iMl.-in 
 
 Mti.'ii lliir.l .lay aft.- .p. rati. ill 30 piT cut. 
 
1-2 
 
 Siilplionoplitlialoin excretion fourth einy after o|ifiation ()4 pi'r cent. 
 Nullilioiu'plitluilfin cxeri'tion sevuntli day after op,-ration liS jjor ceut. 
 Lactose excretion lirst ilay alte;- operation S hours +. 
 Lactose excretion fuurtli day after operation S liours +. 
 Lactose excretion seventli day iifter operation liours. 
 lodiil excretion second day after operation 48 hours. 
 Salt excretion second day alter operation .4 per cent. (.SO i;ni.) 
 Alhuniin present for four days. Xo casts seen after the fourth day. 
 made an imeveiilful recovery and alloweil to live. 
 
 Aiiiiual 
 
 \. — .\iiinial- \vitl[ one kidne 
 hour. 
 
 KAiiiiir I. — WeiL'lit l.ToO ijni. Wi 
 reiiiamini: kiiiney after death 7.5 !;ir.. 
 
 Suli>hiineplithalein excretion first day after operation '32 per cent. 
 
 removed: renal circulation 
 .dit of removed kidnev 7 
 
 -d for on-' 
 
 Wei.'ht of 
 
 -nt. 
 
 dav 
 
 kidney after death il.'M) gm 
 
 Animal died amnio in s 
 ht of n-moved kidie.'v 
 
 Animal 
 Wei-iit of 
 
 Wei-ht 
 ntv-two 
 
 m. Weight of 
 
 Sulphonephthalein excretion third day after operation .3.') \ 
 Larto-e e\eretinn second day alter oj.eration S liours +. 
 lodid excretion second day after operati<n 2 liours +. 
 Salt excretion second day after operation .(i per cent. (.5 trm.) 
 Alhuniin anil casts found on the third day. Hematuria for on 
 
 found dead on the fourth day. Autopsy showed acute peritonitis. 
 i;.\nniT 2.— Wcisht i.lKJil L'tn. \Vei;:lit of removed kivliiey 5.2 ■jm 
 
 remaininu' kidney after death C.5 pm. 
 
 Sulphonephthalein excretion first day after opi'ration 7 [ler cent. 
 
 Lacto>e excietion second day after operation 8 hours 4-. 
 
 Salt excretion sicoiiil liay alter I'peration .7 jier cent. (.>* ^in.) 
 
 .\lhumin. ea-t- aii.I lilood in the urine on the t];ird day. Animal found dead 
 
 i:.\nmr 3. — Weiudit I.mm.7 urn. \Vei;:ht of removed kidney il.i)0 
 
 of remainin 
 
 hours. 
 
 I'iAniilT 4.— Weiirht 1.7<iO frni. 
 remaining' kidmy after death lt.5 ;_'ni. 
 
 Sulplione|ditlialeiii excretion first ilay after operation !' per e.Mit. 
 
 Sulphonephthalein excretion second day after operation 12 per cent 
 
 Sulphonephthalein excretion thir.l day after operation 20 per cent. 
 
 Sulphonephthalein excretion sixth day after ojination 8 jier cent. 
 
 l^aetose excretion first day after operation H hours +. 
 
 Lactose excretion third day after operation S hours -f-. 
 
 lodid excretion first day after operation 48 hours. 
 
 Salt excretion third day after ojieration .8 jier cent. (2 I ;.'m.l 
 
 .Mhumin and casts present until death. Animal found d.a.l a f 
 last note. I'hthalein excreted in traces, lactose markedly dtdayed. 
 
 H.vi-BIT 5.— \Vei;;ht L400 j-m. Wei-ht of reni.,\(.d kidney 4 ltii 
 remainin:; kidney after death !i.5 o'"- 
 
 Sulphonephthalein excretion first day after op.ration trace-. 
 
 Sulphonephthalein excretion second day after operation traces. 
 
 Suljihonephtlialein excretion third dayafter operation traces. 
 
 Lactose excretiou first day after operation none recovered. 
 
 Alhuniin. hloo.I and casts present until death on the fourth day 
 last twenty-four hours pu.ssed 10 c,c. of urine. 
 
 \'L — Animals in which the renal circulation has l«-en chimi 
 (or an hour, the other kidney bein;; left untouched. 
 
 llAniilT ].— Weight LlioO :.on. W.d^dit of unehimped kidney at death o.oO ;.'m 
 Weijjht <if clamped kidney at death 5.0(1 ■;m. 
 
 Sul]di"nephthalein excietion first day after op.eration SO per cent. 
 
 Sulphonephthalein excretion second day nfter operation 52 per cent. 
 
 Sulphoiiephthah-in excretion sixth liay after operation 5(1 per cent. 
 
 Siilphtiiiephthalein excretion eij;hth ilay after oper;ition 75 p"r cent. 
 
 Siilphonephllialein excretion eiL'hteenth ihiy after opeiation 00 per cent. 
 
 ■d in 
 
 days after 
 
 U. i-hl of 
 
 During' the 
 one kidnev 
 
 • 
 
• 
 
 13 
 
 Siilphcnophtlialpin oxcrftion twenfy-sfcond day after operation 70 per cent. 
 
 Siilpliornplitlialein (xcretion twentytiftli day after operation 7l) per cent. 
 
 Lactose excretion first day after operation 7 lunirs. 
 
 Lacto^e excretion fourth day after operation hours. 
 
 Lactose excretion eighth day after operation 5 hoiir^^. 
 
 J-iictOr^e excretion lifteentli day after ojieration ll hour.;. 
 
 Lactose excretion twenty-tifth day after operation 5 lumrs. 
 
 lodid excretion first day after operation 24 lionrs. 
 
 lodid excretion <'if.'litli day aftir operation 24 lionrs. 
 
 lodid excretion twenty-second ihiy after oj)eration 24 lionrp. 
 
 Salt excretion sixtli day after oi}eration .5 per cent. (Ll pni.). 
 
 Salt excretion twenty-tiftli day after operation .70 per cent. (1.2 <:ni.) 
 
 Albumin present for two days. No casts found after tlie sixth day. .\niinal 
 killed on the twenty-sixth day. 
 
 Kabbit 2. — \\eii;!it 2.200 fini. Weiglit of nnclaniped kidney at death 7.5 gm. 
 (approx.). Weight of clamped kidney at (hatli 7.5 gin. 
 
 Sulphonephthaliin excretion first day after operation 5!' jier cent. 
 
 Stilphonephthalein excretion fifth day after operation 74 per cent. 
 
 Siilphonephthalein excretion seventeenth day after operation 7S per cert. 
 
 Lactose excretion tliinl day after (jperation i! hours. 
 
 Lactose excretion tenth day after operation 7 hours 4-- 
 
 Lactose excretion (iglite«>nth day after operation ti hours. 
 
 lodid excretion thiril day after operation 24 hours. 
 
 lodiU excretion eighteentli day after operation 24 Iiotirs. 
 
 Salt excretion eighteenth day after operation .3 per cent. ( 1.20 nni.l 
 
 Albumin present for one day. Xo ca^ts seen after tlie fifth I'ay. .\ninial 
 killed on the nineteenth day. 
 
 R.^nRIT 3.— Weiglit 1.700 gni. 
 
 .'^ulplionejdithnlein excretion tirst day after operation 50 per cent. 
 
 Sulplioneidithalein excretion thiril day after ojieratii'n 5S per cent. 
 
 Siilphonephthalein excretion seventh day after [operation 70 per c(nt. 
 
 Lactoso excretion tliiid day after operation ti hours. 
 
 Lactose excretion sevinth day after operation 5 hours. 
 
 luiiid excretion tir-t day after operation 24 hours. 
 
 lodid excretion -eventh day after oiieration 24 hours. 
 
 Salt excretion fifth day after operation .7 per cent. (1.4 gni.) 
 
 Albumin pre-ent for one day. Casts found on the seventh day. .\niinal found 
 dead on the twelfth day. No cause found. 
 
 \1I. — Animals in which one kidney has been renioved, the circulation of tiie 
 other being left untouched. 
 
 K.xnniT 1. — Weight l.flOiT gni. Weight of removed kidney 7 gm. Weight of 
 remaining kidney after death 7.5 gm. 
 
 Sulplionephthalein excretion tirst day after operation 50 per cent. 
 
 Sulphonefdithalein excretion second <lay after oi'eratioii ('..") per cent. 
 
 .^ulphom'idithah in excretion fifth day after operation (10 per cent. 
 
 Siilphonephthalein excretion ninth day after operation 70 jier cent. 
 
 Lactose excretion first day after ojieration 5 hours. 
 
 Lactose excretion ninth day after operation 5 hours. 
 
 Lactose excretion sixteenth day after operation hours. 
 
 lodiil I'Xcretinn tir-^t day after operation 24 hours. 
 
 lodid excretion sixteenth day after operation 24 hour*. 
 
 Salt excretion third day after operation .5 jier cent. I 2.00 gni.) 
 
 Traces of alhiimin found for one day. lilood and easts found for one day. 
 .Animal killed on the twentieth day. 
 
 KAiiniT 2. — Weight 2.200 pm. Weight of removed kidney (1 gm. Weight of 
 remaining kidney after death S.5 L'ni. 
 
 .^iilplionephthnlein excretion first day after o|'rration iKl ]ier cent. 
 
 Siil|dioneplitlialein excretion second day after opi ration 70 pi-r diit. 
 
 Siilphi'neplthalein excretion twilfth day afti-r operation 75 per cent. 
 
 Siilphoin'[.litlialein excretion tliirl"entli day after opirntion SO per cent. 
 
14 
 
 liieto^e oxrretion fir^t d;.y iift.-r oprnition •'> 1'""'^ 
 
 a OS.' ox,.ret,..n tlnrtoen.h ,h,y .ft.r "l-"'"'" - "-"- 
 locli.l excretion tir.t cloy aft. r op'^roti'in -^''""["- , ,„^ . 
 In, , excretion tl.irteontl, day after operation 24 •"»•_-. 
 k.li excretion third dav after ^l^-^- .;^.J:-.-" J ;;r ! 1., ..-..) 
 salt excr.t,on »■•-'-';;> "^^;^;-:l, .x„nnal ki'lod ... th. fonrt 
 Albumin present for one day. >o ca i» e. n 
 
 day 
 
 ntli 
 -ni. \V,i-!it of 
 
 llAimiT 3-\Veipht l.S5() ?m. Weifzht of removed kidney 
 remaining' kiilney after death 7 pu. 
 
 Snlphonophtllalein excretion .ir.t dav f-;;';" ^i; -\ 'p; int. 
 
 lactone excretion first day after operation ^^ '"""^i- . ,„., 
 cto4 excretion ninet^^nth day after operation o liou,,. 
 Indid excretion first day after operation 24 '■"•>,'^^. 
 "Il'id Excretion nineteenth day -^'" 'l^f^^^^J:^'''- 
 Salt excretion tliir.l day a ter ''';'''''>'' " j ', ' Vl , er cent. (1..1 '-niO 
 Salt excretion nineteenth day after operation 1.1 per '""'\ , 
 
 AUmniin present for one day. Hematuria for one day. Animal kilhd t... 
 twentytirst ilay. 
 
 c'h.npiit. of the renal eireulatimt up to foriy minute, in the n.ajoritv 
 of «.' s, pmiluced a definite ai.tuvban.e in renal function. Its tnten^ty 
 Jo'no ilation to the len.th of time the vessels were danM^d. n > - 
 the va^cular or tubular funetiou chiefly affeetod (Protocol. I to U). 
 ni^4.>.n bv the presence of albumin and east, m the urine. 1^ a 
 •::;ed h:;talein otitput of varyin. do.ree and bv a delayed ae^e 
 and u.lid excretion. Salt was constantly well excreted. The an m ^ 
 reecverin,, renamed nearly normal f.nutioft withtn six l^^'^'- ; -'' " 
 hat the disturbance was slight and temporary. One antmal fa. do 
 ^i^rn to a normal phthaleuf otitput. So explanation wa. ouml 
 at autopsv. Two animals with circulation clamped for fo,t> m.n.te. 
 died quickly with marked si?ns of renal insttffictency. . ^-^.^.^^y^. 
 
 All the animals, however, with one kidney ^^^^'''^''^'^'\'^, 
 tion of the remaining kidney clamped f"". -;/""l^U v •^' 1.1 '^ te 
 ^vithin ei.ht davs. Thee was evidence dinically as well - > ^^ ^^ ; 
 of extrem'e distuioance of function. An interesting P-- "J.'-.^ J^^ 
 tant a part in renal sur,e.-y the unoperated k.dney ph>s '^ ' ' ^ 
 ...onJvi. In tl... ser,es. thou.h the circlation "- ^'-"H ^^ 
 hour, with a norn.al kidney r.ma.nin,. the function was but >l,...th and 
 tcmporarilv disturbed. ,.,-.„u- 
 
 That the ciT.vt of nophre-tomy alone did no p.^oduco he .cm.Is 
 obtained ,s seen fron. P.-otoco, VII. In two at.ima s the -^ -;^ ^^^ 
 „.,ve unafTected. In the .bird the phthalom output was .-Ic.'hth ,.du,ed 
 for Hire. davs. Tb,. other tests we.'e normal. 
 
 l.„i,„l„„c:,llv. similar changes were .loted to tho.e de-..,h 1 o 
 nivM.nis authors; The earliest -han^es. -x.-osslv, wee ma.kod ron^.stinn 
 ; lucvd n„n..te be,ma,ha.es. As the len.th of .nn. fodow.,.g 
 
• 
 
 15 
 
 , „l tl,f. kidprv- liv.R-rtroi.hioa, but otherwise 
 the opcriUiun inrr a^'U, tlie kuii.tv ". i i 
 
 appeared normal. .lo^tviii-tioii of 
 
 ^^Lcrccopieally first were seen hemorrhage, f^'/^-^^l^, 
 
 siderablc length of time without harm. 
 
 CON'CLrsiONS 
 
 1 In r.bbit^ and do., with one k.dnev removed. tl,e circulation of 
 J:^:SL'...y be .lamped for a. ^n. a t.. a. o^ ..n-^ 
 with recovery. If the renal circulation is clamped for a Icn.er 
 animals die with sicrns of renal insulTioency. ^^^^^_ 
 
 o In animals with the circulation clamped foi not ^""-'^;'':" ^ ^ 
 
 „„;;.^ ...,.,o,„v ,,..,„,„»™ u. "»' ^;»;:: ■:; ■; T'^in;":" 
 
 bv the presence of albumin and casts in the u-Ul. n, 
 
 phti!;i,u output and bv a delayed lactone and iod.d excrefon. Normal 
 
 function is regained witliin si.x days. 
 
 3 .\cute or healed pathological changes are tound m ki ^^ 
 
 tissue ^o ]no'rix'^<i^-e \csionis i^v.nd. ,,i.„;,,u 
 
 r E.ce,i u; the most extreme ca^es. there >s no '^'^^"'^ ^^^^ ; 
 demonstrable bv the functional tests u..l between tne patholo.Kal a.u. 
 
 ^""f r^r!S;;:':;rrt;:!al kumey. t,. .rcmation of th. o^^r 
 kid:;y^m::tdamped for at lea. an hour without permanent u.ur> 
 to the animal's general condition or renal function.