Lustig found that extirpation of the solar plexus in animals provoked ace tonuria, glycosuria, and emaciation, while Oddi obtained the same results by sugar injections.
Acetonuria may not depend upon the extirpation of the coeliac plexus. It is to be noted that septic peritonitis is avoided with difficulty. Acetonuria ob served for three days in a woman oper ated on for salpingitis. On the other hand, it was not met with in a dog which had undergone, under all antiseptic pre cautions, subdiaphragmatie section of the vagus and extirpation of the ganglia. Contejean (Archives de Phys. Brown S6quard, Oct., '92).
Lorenz is of the opinion that diacetic acid and the beta-oxybutyric acid are the substances from which acetone is de rived, and that they are the real causes of the toxic symptoms observed in ace tonuria, while acetone itself is relatively innocuous.
Von Engel found a great quantity of acetone in the urine of a patient suffer ing from lactonuria; when the milk was removed by a suckling apparatus the acetonuria disappeared. Very much ace tone was found in the urine of patients suffering from severe chronic morphin ism. In different acute fevers aceto nuria is rather a constant symptom; in typhoid fever von Engel found it con stantly; acetone was only missed when the typhoid fever was accompanied by obstipation.
Acetonuria occurs not infrequently in children, especially in febrile affections and in acute gastrointestinal derange ments. It may, however, be absent even in high and continuous pyrexia. Diace turia, likewise, is frequent in children, and is almost constant in high and con tinued fever; and is common in the acute infectious processes, even if there be but little attendant fever,—as, too, is the case with acetonuria. Schrack (Fort schritte der Med., Oct. 1, '89).
Acetonuria was studied in twenty-six cases. In physiological pregnancy at the ninth month acetonuria is more marked than in the non-pregnant state. In labor the acetonuria increases, especially if the parturition be prolonged. In the puer perimn it diminishes, remaining, how ever, greater than in pregnancy till after the sixth day. The view that acetonuria can be regarded as a sign of fatal death is not sustained. H. Costa (Ann. di Octet, e Gynec., xxiii, Mar., 1901).
Becker found that acetonuria increased after narcosis, the case being the same with an already existing acetonuria. This would seem to explain why acetonuria has been observed after great operations.
Operations are frequently followed by acetonuria, but, contrary to what has been claimed, this is not the result of opening the peritoneum or of the use of sublimate. It also causes no pathological reaction. Though traces of acetone may be met with in normal persons, this is not always the case, and it cannot, there fore, be regarded as a necessary product of metabolism. Conti (Wratsch, Dec. 7, '93).
In healthy subjects after narcosis ace tonuria sets in, lasting from a few hours to several days. This post-narcotic ace tonuria indicates an increased destruc tion of albumin. Ernst Becker (Vir chow's Arehiv f. Path. Anat. and Phys. u. f. klin. Med., Apr. 2, '95).
Acetonuria follows anaesthesia in two thirds of the cases, the anaesthetic used making no difference; if acetonuria is present before, increases it. The practical outcome is that, except in cases of urgency, anmstbetics should not be administered to diabetic patients. Abram (Jour. Path. and Bac., p. 3, 430, '96).
Marked and prolonged acetonuria de tected during retrogression of fibroids after o6phorectorny or ligature of the ovarian arteries. Bossi (Arch. di Ostet. e Ginec., vol. iv, p. 4, '93).
Acetone, diacetic acid, and beta-oxy butyric acid are found in great quanti ties in the urine of diabetic coma, and different authors—Munser and Strassez, for instance—believe these substances to be the real cause of coma, perhaps by causing an excess of acidity in the or ganism.
In comatose patients who do not suffer from diabetes—as, for instance, in satur nine encephalopathies, etc.—diacetic acid is often found in the urine. Von Jaksch has proposed to give the name of "coma diaceticum" to these cases of coma. Nevertheless, neither acetone nor dia cetic acid and oxybutyric acid have very prominent poisonous properties. Nuss maul gave animals 6 grammes of acetone per day without effect. Buhl, Tappeiner, and Frerichs came to similar results. Albertoni found the lethal dose of ace tone for dogs to be about 6 to S grammes per kilogramme of the dog's weight.