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March 1917

THE OCCURRENCE OF ACIDOSIS WITH SEVERE DIARRHEA

Author Affiliations

NEW YORK
From the New York Nursery and Child's Hospital, The Children's Service at Bellevue Hospital (Dr. L. E. La Fétra, Director), and the Pathological Laboratory of Bellevue Hospital (Dr. Charles Norris, Director).

Am J Dis Child. 1917;13(3):218-230. doi:10.1001/archpedi.1917.01910030015002
Abstract

INTRODUCTION  The toxic symptoms which may occur in infants suffering from severe diarrhea are striking and characteristic. Prominent features are the evidence of fluid loss (sunken eyes, depressed fontanel and inelastic skin), a mental state which is usually dull and apathetic, often terminating in stupor, but at times characterized by periods of excitement, and increased pulmonary ventilation. The urine of infants thus affected almost regularly contains a reducing substance.1Recently Howland and Marriott2 have shown that in many cases of this type, especially those showing hyperpnea, there is evidence of acidosis. This evidence was as follows: (1) decreased tension of carbon dioxid in the alveolar air; (2) Sellard's test for the reaction of blood serum; (3) altered hemoglobin dissociation curve; (4) increased tolerance to sodium bicarbonate; (5) increased hydrogen-ion concentration of the blood.During the past three years we have accumulated data which have a bearing on this

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