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October 14, 1922


JAMA. 1922;79(16):1338. doi:10.1001/jama.1922.02640160058023

Alkali therapy, particularly as it is exemplified in the widespread use of sodium bicarbonate under all manner of circumstances, has such a long tradition and so much popular approval that its possible shortcomings are rarely given consideration. In the management of diabetes, for example, the administration of sodium bicarbonate, particularly when a detectable ketosis is present and acid products of incomplete intermediary metabolism must be eliminated, has come to be looked on by many as essential to the safety of the patient and conducive to his well-being. Some of the leaders in this clinical field, however, have warned against the indiscriminate use of the alkali in combating so-called acidosis; in fact, it has even been questioned whether the procedure is ever really necessary, if the regulation of diet is so enforced as to reduce the production of acid factors of the sort referred to. In recent years it has become

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