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December 15, 1917

The Principles of Acidosis and Clinical Methods for Its Study.

JAMA. 1917;LXIX(24):2064-2065. doi:10.1001/jama.1917.02590510056029

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Under normal conditions, the ingestion of 5 grams of sodium bicarbonate is followed promptly by a change in the reaction of the urine from acid to alkaline as tested by litmus. In the nephritis of Asiatic cholera and in certain other forms of nephritis not due to cholera, Sellards has noted an increase of the tolerance for bicarbonate, that is to say, massive doses of this salt may be required to make the urine alkaline to litmus. He interprets this phenomenon as due to nephritic acidosis rather than to nonexcretion of the base; and, departing from these experiments, Sellards advocates determining the tolerance of the body for sodium bicarbonate as the most delicate and practical clinical method of diagnosing acidosis. One may thus detect deficiencies of from 20 to 30 gm. in the bicarbonate reserve of the body. The author claims priority over Henderson and Palmer in the use of

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