THE INTRADERMAL SALT TEST IN FEVER.

In 1923, McClure and Aldrich (1) (2) introduced the intradermal salt test in the study of nephritis. They injected 0.2 cc. normal saline solution intradermally into the deltoid region and found that it had a rather constant disappearance time in normal individuals and a greatly diminished disappearance time in nephritics. Various factors which might influence the test have been extensively studied. White and Irvine-Jones (3) have shown that the disappearance time is not affected by the H-ion concentration, the osmotic pressure or the salt balance of the injected fluid. Neither the blood flow through the injected part nor the immersion of the injected extremity in hot or cold water have any notable effect. The disappearance time is not influenced by the concentration of nonprotein nitrogen, cholesterol or sodium chloride in the blood plasma. It is, however, definitely diminished by injecting minute amounts of adrenalin with the salt solution or by the direct application of cold to the local area of injection. Circulatory stasis does not influence it but inadequate arterial blood supply may be of importance. Cohen (4) (5) (6) believes that the test affords an excellent means of determining the level of faulty circulation of a diseased extremity. Because of the disturbance of both salt and water metabolism in pneumonia and possibly in other acute infections, it occurred to us that the intradermal salt test might be considerably affected during fever of bacterial origin. In the literature, we have found only one study which seems to offer any answer to this question. Harrison (7) tried the test during the course of lobar pneumonia in children and concluded that there was a shortening of the disappearance time of intradermally injected salt solution during the febrile stage of the disease. She found that the crisis had no immediate effect upon the