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October 1927

RELATION OF NITROGEN BODIES OF THE BLOOD TO SURGICAL PROBLEMS IN LIVER AND IN BILIARY TRACT DISEASE: III. STATUS OF NITROGEN BODIES OF BLOOD IN SEVERE CASES OF BILIARY TRACT DISEASE AND ITS USE IN DIFFERENTIATING A TERMINAL HEPATIC AND A TERMINAL RENAL GROUP OF CASES

Arch Surg. 1927;15(4):635-659. doi:10.1001/archsurg.1927.01130220138010

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Abstract

In the preceding papers of this series, it was pointed out that the results obtained in the clinical study of the nitrogen metabolism and especially of the status of the urea, nonprotein nitrogen, uric acid and creatinine of the blood in biliary tract conditions, established the principle that under such conditions individual figures meant little, if anything, and that it was permissible to base judgments only on major movements observable in comparable series of cases.

In the ordinarily mild, or moderately severe, case of biliary tract disease, as shown in the series studied, disturbances of nitrogen metabolism leading to retention of nitrogen bodies in the blood, were, as a general rule, not recognizable in clinical practice before operative intervention was undertaken. It was not possible to correlate any of the changes observable in the milder form of disease with similar conditions which could, and have been, more completely produced artificially

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