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juice obtained from the isolated stomach to a gas- trectomized animal, but were never able to find pep- sin in the urine of the latter. Working on the effect of various conditions on the amount of pepsin, Ellingcr and Scholz (12) have summarized their results as follows : In the majority of cases there is an increase of pepsin dur- ing fasting and a decrease after eating, but this is not constant either in man or in dogs. The normal variations in the urinarv reaction are without in- fluence on the pepsin output, which for the most part is in the form of propepsin. If the latter or pepsin be introduced intravenously it is put out un- changed in the urine, and if taken per os it does not increase the amount of urinary pepsin. This urinar\' pepsin is taken up in Buy Viagra Online Overnight Delivery all probability from the gastric mucous membrane by the blood in the form of propepsin. In addition to these conclusions the following summary may be adduced from the foregoing lit- erature : The pepsin found in the urine is identical with that found in the gastric juice. The ferment is not absorbed as pepsin, but as a proferment, which is activated either in the kidneys or perhaps in the urine itself. DIASTASE. In 1863 Cohnheim (13) reported the finding of a starch splitting ferment in the urine, and imme- diately following this paper appeared an article by Bechamp (14) with practically the same results as Cohnheim's, but holding the diastase, which he called nephro.zymase. to be a metabolic product of the kidney cells. The next work on the subject was from Plosz and Tiegel (15). who isolated the ferment, but without advancing the subject any further than had Cohnheim ten years earlier. They studied, espe- cially, diabetic urine, in which the ferment was al- ways demonstrable. Griitzner (/. c.) studied the ferment quantita- tively .nnd later directed the work of Gehrig (/. c). Hoft'man (/. c), and Holovtschiner (16). The conclusion obtained from their work is that when the urine is examined fractionally, it appears to contain more diastase after the noonday meal. Leo ( 7) criticised this finding, and held that the fast- ing urme contained more Buy Viagra Online Overnight Delivery Buy Viagra Online Overnight Delivery diastase than the urine excreted after a meal. Some observations of Zuntz (t8) seem to corroborate this opinion, for in a man who starved himself for six days only small amounts of diastase were present at first, while to- ward the end of the experiment larger amounts were found. Leo found an increase in the diastatic ferment which bore no relation to the amount of. sugar present. Here again we find contradictor}' statements. Benderskv (19) confirming this ob- servation in two cases, but believing nothing was learned by these variations, while Lepine (20 1 found a decrease. There seems to have been little work done on the subject between 1891 and 1907, when the work of Loeper and Ficai (21) appeared. These authors showed that in acute diseases diastase was in- creased, the contrary being found Buy Viagra Online Overnight Delivery in chronic ill- nesses, in prolonged infections, and also in diabetes. The most interesting observation was that in in- testinal obstruction there was an increase, while in nephritis the diastase was decreased. The method used in the quantitative determination of diastase was based on the amount of sugar obtained Buy Viagra Online Overnight Delivery from starch after a certain time. Wohlgemuth (22) ma- terially facilitated the quantitative studv of diastase by the description of a new method whereby the amount of diastatic activity is measured by the color reaction of starch and iodine. In a later paper (23) he gives results of some iiuantit.-itive estimations. The urine of man was GOODMAX: PEPSIN AND DIASTASE IN URINE. 779 found to contain more diastase than that of woman, and more diastase was found when the stomach was empty than after the ingestion of food. Nephritis and diabetes were the only diseases he studied cHni- Buy Viagra Online Overnight Delivery cally, and in both the ferment was decreased. In one case of occlusion of the pancreatic duct great quantities of diastase were found. The normal amount in one c.c. of urine he gives as 78. TECHNIQUE. In our series of cases the full twenty-four hours' urine was collected and preserved with chloroform. No restriction as to diet was prescribed, since Wi- lenko (24) has shown that it has very little effect on the amount of pepsin, while its effect on diastase is uncertain. The urine was measured, the specific gravity taken, and when necessary made up to ,a certain definite quantity with distilled water. In each specimen the total acidity, the pepsin, and dias- tase were estimated. Total acidity: Twenty-five cubic centimetres of urine were placed in an Erlenmeyer flask, 15 grammes of potassium oxalate added, and the mix- ture thoroughly agitated for two minutes. At the end of Buy Viagra Online Overnight Delivery this time a drop of phenolphthalein solution Buy Viagra Online Overnight Delivery was added, and the urine titrated with n/io sodi- um hydroxide. Calculation was made for the total quantity of urine. Pepsin: The Buy Viagra Online Overnight Delivery method as given by Wilenko was employed, using ricin Goodman (25). To a por- tion of the urine concentrated hydrochloric acid was added until congo paper was changed in color. The urine was then filtered, and meanwhile, in five small test tubes, 0.5 c.c. of a one per cent, solution of ricin in 0.5 per cent, salt solution were put. To four ot these tubes 0.3 c.c. n/io hydrochloric acid were added, and in the fifth 0.5 c.c, and. further- more, the acidulated and filtered urine in the fol- lowing amounts :