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March 23, 1912


JAMA. 1912;LVIII(12):851-852. doi:10.1001/jama.1912.04260030249010

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The action of the chlorids in nephritis has been so extensively discussed since the work of Widal, in 1903, and is so significant in certain types of nephritis that the knowledge of any such action in localized accumulations becomes a therapeutic necessity. The paucity of the literature on chlorid metabolism in cirrhosis of the liver has induced me to report the following case in detail.

It is shown that, in this particular case, there was a diminished excretion of chlorids in the urine throughout the course of the disease. The retention of salt was in some cases primary to the retention of water. An increased excretion of water by the kidneys was not accompanied by a proportionate increase in the chlorid elimination.

Shall the practitioner consider the local accumulation of fluid in ascites as inflammatory, and content himself with medication directed to the relief of the inflammation; or shall he

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