The author made experimental studies on 46 mongrel dogs to investigate the influence of servere hemorrhagic hypotension and repeated blood transfusion upon the renal function by means of the blood reservoir technique in which the blood pressure of so-called shock level of 80mmHg was maintained for a certain period of time by massive hemorrhage and total shed blood was returned to the subject afterward. In the study he considered the individual difference of the experimental animal which was menifest in the divisions of the blood loss curve and he pursued the effect of administration of norepinephrine, ACTH, hydrocortisone and chlorpromazine upon the renal function, while he compared the difference between continuous and intermittent hemorrhagic hypotensions.
1. There is a definite decrease of the renal function by repeated hemorrhagic hypotension. There is, however, individual difference in the compensatory power against blood loss, and the disturbance of the renal function is not necessaaily proportional to the number of repetition of hemorrhage and transfusion.
2. The renal function clearly reveals the individual difference of compensatory power against hemorrhage which is disclosed in the division of the blood loss curve, and so it is possible to estimate the effect of equivalent transfusion given after sustained hemorrhagic hypotension by following up the renal function.
3. The effect of epinephrine and hydrocortisone upon the repeated hemorrhagic hypotension differs with the time of administration, and when given prior to the stage of marked reduction of renal clearance and oliguria they show a prominent effect in maintaining and improving the renal function. Chlorpromazine blocks the influence of repeated hemorrhagic hypotension and makes the effect of transfusion favorable without fail, while ACTH has no effect upon the renal function.
4. The change of the blood loss curve caused by drug administration is well comparable to that of renal function after blood transfusion.
5. The aftermath of massive hemorrhage upon the subject persists for a considerably long time even afrer transfusion, and repetition of massive hemorrhage and transfusion compromises the circulatory system and accerelates the progress of impairment of the renal function.

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Fourty-five dogs were subjected to massive hemorrhagic stress by the bottle reservoir technique applied on the femoral artery, and when hypotension of 50mmHg was maintained the course may be divided into the bleeding and backflow stages. In those stages and after blood transfusion 100cc per Kg of 5% glucose solution or normal saline solution were administered, and the influence of the fluid administration upon the plasma and urine electrolyte balance was observed by sampling the blood and urine successively for 4 hours after the fluid administration.
1) During hemorrhage the palsma Na decreases slightly the plasma Cl increases somewhat in both stages of bleeding and backflow, while the plasma K shows a prominent increase, especially in the backflow stage. Cases with excessive decline of Na to K ratio die rapidly.
2) The influence of readministration of the preserved blood in the bleeding stage upon the plasma and urine electrolyte balance is definitely small and there is a remarkable tendency for recovery, contrary to that in the backflow stage.
3) The fluctuation of the electrolyte balance is small in degree in the control cases of blood transfusion without fluid, administration while it is clear that massive administration of fluid influences the electrolyte even in the early stage of hemorrhage.
4) Fluid administration with return of blood in the bleeding stage flow consists of normal saline solution and 5% glucose solution, and there is a copious amount of urination while there is not a remarkable change in the level of the plasma K. The glucose solution does not contain Na or Cl, while the normal saline solution contains both of them. After fluid administration, therefore, the plasma Na and Cl decline slightly in the former and augment somewhat in the latter, though they recover the original level promptly without making a remarkable change. As for electrolyte excretion in the urine, administration of normal saline solution induces excretion of Na and Cl while that of glucose solution scarcely influences it.
5) In cases with blood and fluid administration in the backflow stage, oliguria or anuria persists and there is a remarkable influence upon electrolyte balance and circulation. Administration of 5% glucose solution, in particular, is prominently associated with exhaustion of electrolyte balance and failure of the renal function.

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Experimental studies on blood transfusion and massive infusion of plasma expander (dextran) and physiological saline solution were made in dogs whose blood was withdrawn through the femoral artery, maintaining the blood pressure at the level of 50mmHg systolic. Despite the individual ability of compensation to the bleeding in the bottle, two stages were recognized, i. e., bleeding and backflow stages. The autotransfusion and infusions of dextran by 100cc/kg and physiological saline solution were performed in both stages; their effects upon circulation, sondium space and urinary excretion were observed.
1) The infused dextran showed less extravasation and more plasma expanding effects not only in the bleeding stage, which had a sufficient compensatory ability, but in the backflow stage which already showed decompensation, compared to the physiological saline solution. It remained in the blood stream even in the terminal stage of bleeding shock or irreversible stage.
2) The infusion of dextran and physiological saline solution caused the sodium space to increase as the infusion increased and to decrease as the urinary excretion decreased in the bleeding stage. They increased more than the amount infused in the backflow stage because of the increased permeability of erythrocytes. In the latter stage, the sodium space was larger in the transfusion of physiological saline solution than in that of dextran since the permeability of erythrocytes to Na was higher than that of dextran.
3) The infusion of physiological saline solution showed more urinary excretion in either stage and maintained the selective excretion of electrolytes and high molecular fluids even in the backflow stage.
4) The dextran showed more excretion of Na²⁴ and the increasing trend of u/p ratio (urine counts/plasma counts) than the physiological saline solution even in the backflow stage, that is, the dextran proved to be more effective than the physiological saline solution in regard to the urinary excretion.
5) Though the experimental transfusion in the backflow stage resulted in death within 24 hours, the group of dextran survived longer than that of physiological saline solution.

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