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To the Editor:
—My interest in the metabolism of calcium has stimulated the following comment on an excellent article by O'Donnell and Levin (The Treatment of Edema: Effect of Calcium Gluconate on Edema in Children, The Journal, March 14, p. 837), in which the authors call attention to the favorable results obtained in the treatment of nephrosis edema by injections of calcium gluconate.Edema is largely a problem in osmosis, and the osmotic tension of the plasma in a large measure is dependent on the mineral base balance, in turn largely influenced by the sodium (144): calcium (2.5) ratio. The figures represent millimols per liter in normal plasma, and the principles involved have been clearly laid down by Jacques Loeb (Calcium in Permeability and Irritability, J. Biol. Chem.23:423, 1915).The sodium: calcium ratio may be said to have a "one-sided" reciprocal relationship in that, if the plasma calcium
Houghton HA. TREATMENT OF EDEMA. JAMA. 1931;96(21):1817. doi:10.1001/jama.1931.02720470071030