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December 18, 1937


JAMA. 1937;109(25):2030-2034. doi:10.1001/jama.1937.02780510004002

The use of acacia in the symptomatic treatment of nephrotic edema is based on sound physiologic principles, since this particular form of edema is associated directly with massive albuminuria and conspicuous reduction of the concentration of protein in the circulating blood plasma. The lowered colloid osmotic pressure of the blood disturbs the normal mechanism by which fluid is transported and distributed throughout the body. The resulting massive and persistent anasarca often resists the action of the usual diuretics and renders the chronically nephrotic patient especially subject to streptococcic or pneumococcic infection.

The cause of the hypoproteinemia is not definitely known; it is generally supposed, however, to result from defective formation of protein associated with conspicuous loss of protein in the urine. Theoretically the frequent transfusion of plasma or whole blood is the best form of replacement therapy and is sometimes practicable in treating children. In the treatment of adults, however,

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