the excretion of acid and ammonia. · 2005-03-20 · the excretion of acid and ammonia. by roger s....

THE EXCRETION OF ACID AND AMMONIA.

BY ROGER S. HUBBARD AND SAMUEL A. MUNFORD.

(From The Clifton Springs Sanitarium, Clifton Springs, New York.)

(Received for publicaton, August 19, 1922.)

In an investigation of the relationship between the alkaline tide in urine and the occurrence of free hydrochloric acid in the stomach as shown by fractional gastric analysis, a preliminary report of which has been given elsewhere (Hubbard and Munford, 1922), certain facts were observed regarding the excretion of ammonia which led to the present study: cases which showed an absence of free hydrochloric acid in the gastric juice showed a high degree of constancy of both hydrogen ion concentration and ammonia in specimens of urine collected at different times in the day. This observation is not new; Schittenhelm (1903), Loeb (1905), and Gammeltoft (1911) have reported similar fmdings in various clinical conditions associated with anacidity, and have shown that ammonia excretion varies after meals. Recently, Campbell (1920), who has summarized the earlier literature upon this subject, has shown that the excretion of acid and ammonia vary to- gether after meals. In the paper presented here a statistical study of a series of results has been made to find out: (1) to what degree ammonia excretion varies with the acidity of the urine; (2) what influence the volume of the urine has upon the excretion of ammonia; (3) whether any relationship found,is between the ammonia present in urine and the reaction or the amount of acid present; (4) is any relationship noted primarily between acidity and the amount of ammonia present, or acidity and the concentration of ammonia; and (5) what is the influence of volume of urine excreted on the relationship between acidity and ammonia.

The literature upon the alkaline tide in urine is extensive, and, as it has recently been reviewed by Campbell (1920) and Fiske (1921), it will not be summarized here. Two views have been advanced as to the cause of the alkaline tide, one that it is due to

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466 Excretion of Acid and Ammonia

the secretion of hydrochloric acid by the stomach and subsequent reabsorption of the acid in the intestines, recently restated and defended by Campbell (1920), and supported by the work of Ben- nett and Dodds (1921) on the relationship between gastric acidity and alveolar carbon dioxide tension, and one that it is due to changes in the respiratory activity which would lead to a condition of acidosis were they not compensated for by the secretion of a. urine more alkaline than usually by the kidney (Leathes, 1919). The constancy of urine reaction found in cases showing an absence of free hydrochloric acid in the gastric juice (Hubbard and Mun- ford, 1922) would favor a gastric rather than a renal source of the alkaline tide.

Many writers, besides those already referred to, have called attention to the relationship between reaction and ammonia excretion. Hasselbalch (1912, 1916) in particular, has discussed the simultaneous variation of these two urinary constituents after meals, and has studied the effect of differences in diet upon them. He noted that the ratio between ammonia and total nitrogen in the urine varied with the hydrogen ion concentration, and plotted curves t,o illustrate the relationship (Hasselbalch, 1916): In the same paper he stated that the values of this ratio corr&ponded more closely with those of the hydrogen ion concentration than did either the concentration of the ammonia or the amount excreted in an hour. Confirmation of the existence of a relationship between ammonia excretion and the reaction of the urine is fur- nished by the work of Collip and Backus (1920) and of Grant and Goldman (1920). They investigated the effect of forced respira- tion upon various factors which might be influenced by an induced acidosis or alkalosis, and found that the urine became less acid and the amount of ammonia excreted decreased as a result of their experiments.

Among papers which have dealt with the influence of fluid intake, with consequent increase of volume of urine excreted, upon the elimination of ammonia arc those of Wills and Hawk (1914) and Wilson and Hawk (1914). These authors showed that the amount of ammonia excreted in a day varied wiith the amount of water taken. Ivy (1918) investigated the influence of fluid intake upon ammonia excretion, of gastric secretion u.pon ammonia excretion, and of fluid intake upon gastric secretion. He worked


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R. S. Hubbard and S. A. Munford 467

with normal human subjects and with dogs, and showed that secretion of hydrochloric acid by the stomach and its subsequent reabsorption regularly influenced the excretion of ammonia, but that increased excretion of water did not always do so. He believed that unless water was so given that it influenced the secretion of hydrochloric acid by the stomach it had no influence upon the excretion of ammonia.

Comparisons of urinary acidity and ammonia excretion after the administration of acids and alkalies have been made often. A paper which bears directly upon some aspects of the problem under consideration is that of Marriott and Howland (1918). They fed equivalent amounts of dilute hydrochloric acid and mix- tures of phosphates of different hydrogen ion concentrations to three normal human subjects, and found that the acid increased the daily elimination of both the titratable acid and ammonia, that solutions of acid sodium phosphate increased the elimination of acid only, and that phosphate solutions which had a pH of 7.4 increased the amount of acid and decreased the amount of ammonia excreted. These experiments show that titratable acid and ammonia are not necessarily related to each other. In experiments under normal conditions, however, there may be some relationship between amounts of acid and amounts of ammonia excreted. Campbell (1920) has commented upon such a relationship in his paper upon the alkaline tide, and Fiske (1920) has discussed variations in the ratio between the amounts of ammonia and sulfate excreted because sulfuric acid is one of the acids neutralized by ammonia in the body. He showed that the values of this ratio varied with the hydrogen ion concentration of urine.

The figures discussed in this paper were obtained from a series of twenty-one experiments carried out on nineteen subjects who did not show clinical or metabolic symptoms of acidosis; six of them gave gastric analysts typical of anacidity. In each expcri- ment specimens of urine were collected every 2 hours from 7 a.m. to 7 p.m., and a single specimen was collected from 7 p.m. to 7 a.m. of the following day. All specimens were analyzed as soon as possible afOer they were collected, except that in some instances specimens collected in the evening were put on ice and were analyzed the next morning. The determination of the hydrogen ion concentration was carried out by a calorimetric method es-


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Excretion of Acid and Ammonia

sentially the same as that recently described* by Marshall (1922), the titratable acid was determined by the method of Folin (1916), and the ammonia by that of Folin and Bell (1917). Gastric anal- yses were made by the fractional method of Rehfuss, Bergeim, and Hawk (1914). Typical protocols of three experiments, one on a normal subject and two on cases of anacidity, are given in Table I. One of the cases of anacidity showed marked differences in the amount of urine secreted in an hour; while the volumes of the specimens obtained from the other case did not vary much.

In studying the results, it seemed best to consider each experiment separately, and not combine all the results from all the experiments, to avoid variations in the elimination of acid and ammonia by different individuals. Inspection of the data showed that there were relationships between ammonia excretion, acid excretion, and the volumes of the urine specimens, but that t,hese relationships were not definite enough to be expressed in any simple mathematical or graphic way. The data were subjected instead to statistical analysis.

The effect of the different factors upon t.he excretion of ammonia and on each other was first studied in the following way. Each factor in turn was regarded as an independent variable, and the results obtained on each experiment were arranged in order of the changes in that factor. For example, all the results in each experiment were arranged in order of their volumes from highest to lowest. The total number of urines obtained in each complete experiment was seven2 (in two of the experiments patients were unable to void at the end of 2 hours) and arranged in this way each experiment gave 21 pairs of determinations in which any one factor varied. The number of those pairs in which other fact’ors increased or decreased with the independent variable was counted,

1 The specimens were collected in jars which contained a small amount of toluene. No especial precautions similar to those recently described by Marshall were taken, and the results of the determinations of the hydrogen ion concentrations are subject to such corrections as have been described by him.

* It was thought at first that only those specimens collected at L’ hour intervals during the day should be studied, but the specimens collected during the night were found to be comparable with the others and they have been included. The results did not influence the figures appreciably except to increase the number of determinations available for comparisons.


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and the result, expressed in terms of percentage of the total pairs was recorded in Table II. In this table the effect of different de- grees of difference in the values of the independent variable are also shown.

TABLE I.

Gastric.

Time.

a.m.

Res. 9.00 9.15 9.30 9.45

10.00 10.15 10.45 11.15

Res. 9.30 9.45

10.00 10.15 10.45

Res. 9.15 9.30

10.00 10.30

--

-

0.1 N in 100 co

HCl Total

cc.

0 0 4

19 33 37 40 35

0

0 0 0 0 0 0

0 0 0 0 0

cc.

6 11 21 35 48 69 81 58 10

6 10

5 5 4 4

4 9 7

10 10

T -I- .I

--

-

Time.

7-9 a.m. 78 5.5 9-11 “ 84 5.7

11-l p.m. 99 5.9 l-3 “ 66 5.3 3-5 “ 91 6.1 5-7 “ 44 5.45 7-7 a.m. 35 5.6

7-9 a.m. 9-11 “

11-l p.m. l-3 “ 3-5 “ 5-7 “ 7-7 a.m.

7-9 a.m. 9-11 “

11-l p.m. l-3 “ 3-5 “ 5-7 “ 7-7 a.m.

39 5.1 29.0 11.3 40.0 31.9 40 4.9 36.5 14.4 59.1 46.6

192 5.2 12.5 47.8 13.2 25.3 143 5.1 15.4 37.7 20.8 25.5 208 5.25 10.5 21.9 12.1 25.0 173 5.4 10.0 17.3 12.1 41.5

82 5.2 15.4 12.6 11.6 9.50

18 14 16 27 29 10 34

i

5.3 51.4 9.00 5.35 44.7 6.70 5.2 44.4 7.10 5.4 47.6 2.9 5.45 47.8 3.9 5.3 56.1 5.61 5.5 50.4 5.2

-

7

_ _

iolrm per hr

cc.

Urine.

BH Ammonia N.

7% 2 20.0 15.7 20.0 27.8 16.9 27.8 33.9

mo.

15.6 14.3 11.2 13.2 7.2 6.05 19.8 13.2 26.1 18.4 28.9 19.1 15.3 14.1 12.3 12.1 31.2 13.6 12.0 15.1 18.2

- -

I

0.1 N acid.

In 100 cc --

Total.

26.8 4.70 31.8 8.90 44.7 7.15 31.1 16.8 30.7 8.90 37.0 3.70 18.0 6.17

Reference to the first part of Table II will make this method of analysis clear. There were 399 pairs of determinations in which t,he volume varied; in 74 per cent of them the hourly excretion of ammonia increased when the volume increased, and in 65 per cent the concentration of ammonia decreased as the volume in- ,creased. There were only 281 pairs which showed differences


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in volume greater than 10 cc. per hour, and in 76 per cent of these the ammonia excretion varied directly as the volume, while in 71 per cent of these the ammonia concentration varied inversely as the volume.

TABLE II

Independent variable.

Volume. ‘I “ ‘I

All pairs. More than 10 cc. per hr.

“ “ 20 “ “ “ “ “ 50 “ “ “

399 281 206

86

- Per sen / 57 6: 61 74

- 8 .M t 5 B e s - pW cent

65 71 83 86

2 * z - VT :enc 74 76 82 84

Reaction. All pairs. 365 72 59 “ More than 0.2 pH. 238 79 65 “ ‘I “ 0.5 “ 130 90 77 “ ‘I “ 1.0 “ 70 90 81

Acid concentration. All pairs. 387 74 ‘I “ More than 10 per cent. 353 74 ‘< I‘ ‘I ‘I 25 LL 4‘ 282 83 I‘ “ “ I‘ 50 ‘I “ 161 85

More than 10 per cent. u ‘6 25 Lc u ‘I “ CJJ “ ‘I

75 79 79 a7

64 66 70 68 - -

55 54 54 45

Total acid. “ “ “ ‘I “ “

All pairs. 398 66 353 64 257 72 116 76

73 72 77 85

-

_

-

Variation. ‘airs PH

-

T

-

Dependent variable -

-

Ammonia -

-

Acid _-

_-

’ E

,

/

(

-

i .o 2 s t x

V - per vnt 64

68

70 69

78 81 81 93

-

--

-2 B F -

PPT :e,t,

54 53 56 57

72 78 86 90

-

All dependent variables vary directly with the independent ones except the concentrations of ammoniaand acid, which vary inversely as the volume. Figures for hydrogen ion concentration compared with volumes show actual increases in the hydrogen ion concentration as the volume decreases. Ammonia and acid excretion and concentration increase as the hydrogen ion concentration increases.

The first part of Table II shows: (1) that urine ammonia, whether expressed as concentration or rate of elimination, varies with the volume eliminated; (2) that the amount of acid eliminated


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does not vary with the volume; (3) that the hydrogen ion concentration of urine has a slight t.endency to increase as the volume decreases, but that the differences are so slight that it is not safe to draw any conclusions from the figures. The second part of the table shows that variations in both acid and ammonia climi- nation whether expressed as concentrations or as amounts excreted, vary with the hydrogen ion concentration, but that there is better agreement between the reaction of urine and the concentration of ammonia than between the reaction and the amounts of ammonia eliminated. The third and fourth parts of the table show that differences in the ammonia and acid elimination agree with each other, but that they do not agree better than would be expected from the relationship both show to the hydrogen

TABLE III.

Reactions vary 0.2 pH or less.

Variable. Difference.

Volume. ‘I “

All pairs. More than 10 cc.

‘I “ 20 “

Acid. “ “

All pairs. More than 10 per cent.

“ ‘I 20 “ “

-

_-

-

No.

153 93 60

150 124 78

- I I

-

-

per cent

89 94 97

77 86 85

-7

f P

_-

-

hlount of acid.

per cent 71 76 75

ion concentration of urine. The most striking fact shown by the t.able is the slight effect which changes in volume have upon the amount of acid excreted.

In Table III are recorded variations in the amounts of ammonia and of acid eliminated when the hydrogen ion concentration is constant within 0.2 pH (this represents the probable limit of ac- curacy of the determination on samples of urine collected as these were (Marshall, 1922)) and the volume varies. The table shows that, under such conditions the rate of ammonia excretion varies (qualitatively) almost directly with the volume, but that the rate of acid excretion does not. The table also shows that, when the reaction of the urine is constant, the excretion of ammonia varies more closely with the volume than it does with the amount of acid excreted.


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Table IV shows the results of studies upon the concentration of acid and ammonia when the volumes of the samples did not differ from each other by more than 20 cc. Both vary to about an equal degree with the reactions of the specimens, but there is no better agreement between the ammonia concentration and the acid concentration than there is between the ammonia concentration and the reaction. A similar table to the one given was constructed based on the pairs which showed agreement within 10 cc. and the figures were essentially the same as those given in Table IV. From the studies discussed above it is evident that the ammonia excretion varies with the volume and reaction, but not with the amount of acid excreted; this corresponds with the experimental results of Marriott and Howland (1918).

TABLE IV.

Volumes vary 20 cc. or less.

Varinhle.

Reaction. ‘I “

Acid concentration. I‘ ‘I “ “ “ “

Difference.

All pairs. More than 0.2 pH.

“ “ 0.5 “

All pairs. More than 10 per cent.

‘I “ 25 “ “ “ I‘ c$o “ ‘I

C0W3n- I I c+lcen- tration of tra;:;, of ammonia.

172 91 41

192 163 121

60

per cen1 per cent

65 64 75 79 96 90

67 70 77 85

In Table V conditions under which ammonia and acid excretion are constant are given. In each experiment the number of pairs which agreed with each other within 10 and 25 per cent were counted, and the results compared with increasing constancy of volume and hydrogen ion concentration of the specimens. That changes in acid excretion and ammonia excretion are not directly related to each other is shown in this table, for, while the constancy of ammonia increases as the constancy of volume increases, that of acid does not; and while the constancy of both acid and ammonia concentrations increase as differences in reaction become less, the increases are distinctly more marked in the case of the ammonia ConcentraCons.


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The data presented in Table V furnish an opportunity for com- paring the relationship of volume and reaction to concenkation and rate of ammonia excretion, respectively. The table shows that the constancy of both increases as differences in volume decrease, and that constancy of concentration increases more as the volume diminishes than does the constancy of the amount of ammonia eliminated. Decreasing differences in the hydrogen ion concentration of urine is accompanied by little if any change in the constancy of the amount of ammonia eliminated, but by a great increase in the constancy of the concentration at which it is ‘eliminated.

TABLE V.

Total pairs.

Description

All pairs. Within 0.5 pH.

“ 0 ‘) “ .M

.I11 pairs. Within 20 cc.

“ 10 “

-

_-

-

Yg. per 100 cc. within

No. 10 per cent

406 273 lq53

pet cent

26 31 35

406 26

187 35 127 36

Ammonin

_-

-

35 per cent

Per cent 43 57 69

43 61 70

10 per cent

Per cent

14 13 12

14 17 20

-

Mg. per 100 cc. within

- _ 5 pa . 1 cent

Per m-7 cent cent

40 13 46 14 48 20

40 13 48 16 58 13

Acid.

2

-

5 pm cent

PPT cent

32 37 48

32 38 42

-

.o per 5 per cent cent

Ppr PPP crnt cent

15 37 13 46 20 45

15 37 18 43 20 41

In Table VI the constancy of ammonia concentration and cx- cretion when volume and reaction do not vary is studied further. In the first part of the table all pairs which showed variations of volume less than 10 cc. are subdivided into those the hydrogen ion concentration of which varies by 0.2 pH or less, by 0.5 pH or less, and by 1.0 pH or less. In the second part all pairs which showed variations of hydrogen ion concentration of 0.2 pH or less are divided in a similar way according to the constancies of their volumes. The table shows the following relationships between the independent variables, constancy of volume and reaction, and the dependent variables, constancy of ammonia concentration and excretion; there is greater constancy of ammonia concentration than of ammonia excretion throughout both parts


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of the table, even when both the reaction and the volume are constant; constancy of volume without constancy of reaction is accompanied by greater constancy in the amount of ammonia excreted than is the opposite condition; constancy of ammonia concent,ration varies more nearly with the reaction than with the volume, for if the hydrogen ion concentration is constant, only rather marked changes in volume variation are accompanied by significant changes in the constancy of ammonia concentration. (See figures for volumes within 10 and 20 cc. in the table showing pairs having hydrogen ion concentrations within 0.2 PH.)

TABLE VI

All Cases.

Description of pairs

Variable.

Volume within 10 cc. All pairs. 127 I‘ “ 10 “ pH in 1.0. 115 “ “ 10 “ I‘ “ 0.5. 100 “ “ 10 “ ‘I “ 0.2. 65

Within 0.2 pH. All pairs. 153 35 142 38 127 41 85 46 65 41

0.2 “ 0.2 “ 0.2 “ 0.2 “

-

-

Difference. No.

Volume in 100 cc. “ “ 50 ‘I “ “ 20 “ I‘ “ 10 “

T

-

Ammonia.

Mg. per 100 cc. nithin

lOpeI cent

Per cent

36 39 44 41

- 1

-

-

!5 per cent

Per cent

70 73 80 89

69 73 80 88 89

.- r 1

_-

-

!5 per cent

- -

0 pa 1 cent

-

Per cent 20 21 22 22

Per cent

58 61 65 78

12 48 13 49 13 55 18 69 22 78

-

The values of the hydrogen ion concentration and of other factors may change during the periods which correspond to the collection of samples of urine. Cases of gastric anacidity show a high degree of constancy in the reaction of different samples of urine, and probably do not show such great changes during the periods of collection as do other types of cases. Material from cases showing gastric anacidity should show a closer correspondence between reaction and any constituent which varies with reaction than does material from unassorted cases, and tables paralleling those given have been prepared from the data obtained


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from the six cases of anacidity studied. Table VII was prepared in the same way as was Table VJ, but contains determinations on the% six cases only. This table shows the same relationships which were shown by the preceding table, but shows them present in a more marked degree. Ammonia concent,ration shows great constancy when the hydrogen ion concentration is constant, and only large differences in volume (more than 50 cc. per hour) markedly reduce this constancy. Ammonia concentration also increases in constancy as the volume differences become smaller, even when the reaction remains constant; this change is not as

TABLE VII.

Cases of Anacidity.

Description of pain.

Variable.

Volume within 10 cc. “ “ 10 “ “ “ 10 “

Wkhin 0.2 pH. “ 0.2 “ I‘ 0.2 “ “ 0.2 “ “ 0.2 “

Dearription.

All pairs. pH in 0.5. ‘I “ 0.2.

All pairs. Volume in 100 cc.

“ “ c& “ ‘I “ 20 ‘I

“ “ 10 “

-

-

NO.

56 52 38

78 71 62 50 38

I . -

-

Ammonia.

Me. per 100 cc. within

- 1

-

0 pe, i

cent . -

Per cent

48 58 61

41 45 52 52 61

-

- !5 per cent

Per cent

86 92 97

- - Opel . : cent . _ per cent 23 25 22

PW cmt

68

69 82

81 10 50 87 13 55 97 15 61 98 18 70 97 22 82

-

!5 per cent

marked as the other, however, and, as a matter of fact, no pairs agreed wit6in 25 per cent when the difference in hydrogen ion concentration was more than 0.5 pH, and none agreed which showed a difference of more than 0.3 pH, except when the volumes of the specimens varied 10 cc. or less. A comparison of the figures for ammonia concentration with those for the amount of ammonia excreted, shows clearly that the constancy of ammonia excreted does not primarily vary with the reaction, for there is good agreement with the hydrogen ion concentration only when the volumes of urine are also equal, and even then there is not as good agreement of the values as there is of the values of the ammonia con-


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centration. The equality under these conditions-like concentrations and like volumes-is inevitable.

The relationship between hydrogen ion concentration, and volume on the one hand, and ammonia excretion on the other, is

40 50 80 100 132

, l!Ei

i.40 163 120 Pifferencee in volme

CHART 1. Equal amounts of ammonia excreted.

shown in the charts. In Chart 1 the volume differences and hydrogen ion differences of each pair of determinations (from all the cases studied, not from the cases of anacidity alone) which showed an agreement of the amount of ammonia excreted within


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10 per cent is shown; Chart 2 gives the corresponding values for pairs which showed the same constancy of ammonia concen-

. I I . I I

. . *I l

. . I I I I I

l .

.a* . . . .

. .

. . . . .

. . . . . . . . .

l .e . .

me.* . .

. .

.O’ . . . . . . . .

.

. . . . l d .

. . . . . .

. . .

I

t . .

10 a0 30 40 50 80

Differences in volume

CHART 2. Equal concentrations of ammonia.

73 80

tration. Chart 2 shows clearly that there is a definite relationship between the volumeand hydrogen ion concentrationon the one


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hand, and the constancy of the concentration of ammonia on the other, while Chart 1 shows that there is no such relationship of constancy of ammonia excreted except when both volume and reaction are const.ant.

Study of the tables and charts shows: (1) that ammonia excretion varied with the acidity of the urine; (2) that ammonia excretion varied with the volume of the urine excreted; (3) that the excretion of ammonia varied with the reaction of the urine, and that the amount of acid excreted did not directly affect its excretion; (4) that the agreement between changes of reaction and ammonia excretion was prima.rily between hydrogen ion concentration and the concentration of ammonia, not between hydrogen ion concentration and the amount of ammonia excreted; and (5) that large differences in volume led to a diminished agreement between the reaction and the concentration of the ammonia, while very small differences in volume sometimes were accompanied by concentrations which agreed more than the differences in the reaction would have indicated.

Do the results presented accord better with the theory recently discussed by Nash and Benedict (1921) that the kidney itself makes the ammonia which it excretes, or with the theory that it is produced elsewhere in the body? Explanations of the findings could probably be made based upon either theory, but the fact that it is the ammonia concentration, rather than the amount of ammonia excreted which varies with the reaction of the urine, appears to favor the theory that it, is the kidney which is the source of ammonia. If the ammonia were produced elsewhere under the same stimulus which produces variations in the reaction of urine, a correspondence between that stimulus and the amount of ammonia produced would be expected, and a correspondence (modified to some extent by changes in the hourly rate of urine excretion) between the hydrogen ion concentration and the amount of ammonia excreted would result. Instead, there is agreement primarily between this stimulus (measured by the reaction of the urine) and the concentration of ammonia, modified only when the differences in volume are very large or very small. Since ammonia is much more concentrated in the urine than it is in the blood, and so cannot be classed with those diffusible compounds which show close agreement between the concentrations in blood


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and urine (Widmark, 1920) this agreement between hydrogen ion concentration and ammonia concentration seems to correspond with what would be expected if the kidney produced ammonia rather than with theories that it is produced elseivhere in the or- ganism. No matter which theory of ammonia formation is accepted, the facts presented in this paper tend to show that if the volume of the urine can be increased in some way which does not lead to changes in the hydrogen ion concentration of the urine, or rather of the factors which control the hydrogen ion concentration of the urine (ingestion of water may do so by inducing a secretion of gastric juice (Bergeim, Rehfuss, and Hawk, 1914)) the amount of ammonia eliminated will be increased.

BIBLIOGRAPHY.

Bennett, T. I., and Dodds, E. C., &it. J. Exp. Path., 1921, ii, 58. Bergeim,O., Rehfuss, M. E., and Hawk, P. B., J. l3ioZ. Chem., 1914, xix, 345. Campbell, J. A., Biochem. J., 1920, xiv, 603. Collip, J. B., and Backus, P. L., Am. J. Physiol., 1920, li, 568, Fiske, C. H., J. Biol. Chem., 1920, xli, p. xxxix. Fiske, C. H., J. Biol. Chem., 1921, xlix, 163. Folin, O., Laboratory manual of biological chemistry, New York and Lon-

don, 1916, 103. Folin, O., and Bell, R. D., J. Biol. Chem., 1917, xxix, 3~2. Gammeltoft, S. A., 2. physiol. Chem., 1911, lxxv, 57. Grant, S. B., and Goldman, A., Am, J. Physiol., 1920, Iii, 209. Hasselbalch, K. A., Biochem. Z., 1912, xlvi, 403. Hasselbalch, I<. A., Biochem. Z., 1916, lxxiv, 18. Hubbard, R. S., and Munford, 8. A., Proc. Sot. Exp. BioZ. and Med., 1921-

22, xix, 429. Ivy, A. C., Am. J. Physiol., 1918, xlvi, 340. Leathes, J. B., Brit. Med.J., 1919, ii, 165. Loeb, A., 2. klin. Med., 1905, Ivi, 100. Marriott, W. McK., and Howland, J., Arch. Int. Med., 1918, xxii, 477. Marshall, E. K., Jr., J. BioZ. Chem., 1922, Ii, 3. Nash, T. P., Jr., and Benedict, S. R., J. Biol. Chem., 1921, xlviii, 463. Rehfuss, M. E., Berg&m, O., and Hawk, P. B., J. Am. Med. Assn., 1914,

lxiii, 909. Schittenhelm, A., Deutsch. Arch. klin. Med., 1903, Ixxvii, 517. Widmark, E. M. P., Biochem. J., 1920, xiv, 364. Wills, F., and Hawk, P. B., J. Am. Chem. Sot., 1914, xxxvi, 158. Wilson, D. W., and Hawk, P. B., J. Am. Chem. Sot., 1914, xxxvi, 1774.


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Roger S. Hubbard and Samuel A. MunfordAMMONIA

THE EXCRETION OF ACID AND

1922, 54:465-479.J. Biol. Chem.

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http://www.jbc.org/cgi/alerts?alertType=citedby&addAlert=cited_by&cited_by_criteria_resid=jbc;54/2/465&saveAlert=no&return-type=article&return_url=http://www.jbc.org/content/54/2/465.citation

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http://www.jbc.org/cgi/alerts/etoc

http://www.jbc.org/content/54/2/465.citation.full.html#ref-list-1

http://www.jbc.org/content/54/2/465.citation.full.html#ref-list-1

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the excretion of acid and ammonia. · 2005-03-20 · the excretion of acid and ammonia. by roger s....

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