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September 1954

METABOLIC ALTERATIONS IN SURGICAL PATIENTS: IV. Electrolyte, Water, and Nitrogen Balance Studies in Patients with Obstruction of the Pylorus or Small Intestine

AMA Arch Surg. 1954;69(3):334-354. doi:10.1001/archsurg.1954.01270030062006

O'SHAUGHNESSY1 in 1831 reported that the blood of patients with cholera had a reduced water content and was deficient "in salts, especially the carbonate of soda." He also emphasized that the blood urea increased when a suppression of urine occurred. A short time afterward, Latta,2 who learned of these observations, gave a salt solution orally to a patient with cholera but found that it increased the vomiting and diarrhea. He then injected a warmed salt solution intravenously and reported a dramatic, although temporary, improvement in a moribund patient with cholera.

In 1852 Bidder and Schmidt3 published the results of their extensive studies concerning the secretions of the gastrointestinal tract and the associated digestive glands. Their work in the normal person demonstrated that large quantities of fluid with a fairly uniform total solute content were secreted into the alimentary tract and subsequently were almost completely reabsorbed. These findings