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THE FORMATION OF ORGANIC ACIDS AND THE RETENTION OF CHLORIDES IN LOBAR PNEUMONIA

CAI HOLTEN, M.D.
Arch Intern Med (Chic). 1926;38(4):489-501. doi:10.1001/archinte.1926.00120280081005.
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It is a well known fact that small amounts of chlorides are found in the urine during the course of lobar pneumonia. It was shown in 1850 by Redtenbacher. It is a constant and as a rule so well pronounced a phenomenon that it can be used as a symptom of some diagnostic importance.

Of course a good deal of interest is attached to the pathologic basis of this phenomenon, and a good many investigators have been occupied with it, e. g., von Terray,1 Jochmann and Bittorf,2 von Hoesslin3, Scheel4 and others, but as far as I know no completely satisfactory explanation has been given.

The first question that arises is whether it is a genuine retention of chloride that exists during pneumonia. In such a highly febrile disease the patient of course eats little, and one might think that the slight excretion of chlorides was due to the slight

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