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AMMONIA. 767
gastric juice and the ammonia elimination. Thus Hchittenhelm found
that with a rise in the hydrochloric acid content the percentage of ammonia
in the urine was raised and also the reverse. A. Loeb and v Jammfltoft l
have also observed a fall in the ammonia elimination a few hours ufter a
meal, although no satisfactory explanation of this behavior has been given.
That ammonia plays the role of a neutralization medium for the acids
produced in the body or introduced therein has been shown by various
observations.
In man and certain animals the elimination of ammonia is increased
by the introduction of mineral acids; and, as shown by Jolin,2
organic
acids, such as benzoic acid, which are not destroyed in the body act in a
similar manner. The ammonia set free in the protein destruction is in
part used in the neutralization of the acids introduced, and in this way
a destructive removal of fixed alkalies is prevented. ~^
Acids formed in the destruction of proteins in the body act on the
elimination of ammonia like those introduced from without. For this
reason the quantity of ammonia in human urine is increased under such
conditions and in such diseases where an increased formation of acid
takes place, because of an increased metabolism of proteins. This is the
case with a lack of oxygen in fevers and diabetes. In the last-mentioned
disease, organic acids—/3-oxybutyric acid and acetoacetic acid—are pro-
duced, which pass into the urine combined with ammonia.3
The liver forms urea from the ammonia supplied to it by the blood
and it would therefore be expected that in certain diseases of the liver
or with insufficient liver function that a diminished urea formation and an
increased ammonia elimination should take place. This condition has
already been mentioned above (page 685), and as there remarked we
must consider whether the abnormal production of acid with increased
elimination of neutralization ammonia is primary or whether it is a
diminished synthetic activity of the liver.
In close relation to what has been said stands the question whether all
of the ammonia occurring in the urine under normal conditions is to be
considered as neutralization ammonia. If this were so then probably
by introducing large amounts of alkali it would be possible to cause the
disappearance of ammonia from the urine. In Stadelmann and Beck-
:
Bouchez, Journ. de Physiol, et de Path., 14; Schittenhelm, Deutsch. Archiv. f.
klin. Med., 77; Adam Loeb, Zeitschr. f. klin. Med., 56, and Zeitschr. f. Biol., 55; Gam-
meltoft, Zeitschr. f. physiol. Chem., 75.
2
Jolin, Skand. Arch. f. Physiol., 1. In regard to the behavior of ammonium salts
in the animal body, see Rumpf and Kleine, Zeitschr. f. Biologic, 54; Kowalewski and
Markewicz, Bioch. Zeitschr., 4, and the works cited on pages 682, 683.
s
On the elimination of ammonia in disease, see the works of Rumpf, Virchow’s
Arch., 143; Hallervorden, ibid.
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