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April 1923


Arch Intern Med (Chic). 1923;31(4):590-605. doi:10.1001/archinte.1923.00110160137010

Although the practical aspects of the acid-base equilibrium problem are appreciated by the clinician, the observations and discussions have been limited to a large degree to those cases in which the equilibrium has been shifted toward the acid side. Observations reported in the last few years and our own studies indicate that an alkalotic condition of the body is perhaps as important clinically, if not more so, than an acidotic condition. In an acidosis resulting from the ingestion of fixed acids, from the retention of carbon dioxid, from deficient oxidation with the resulting accumulation of acid metabolites, or by acid retention due to renal involvement, there is at first an increased lung ventilation, but only after a decided acidosis of pH 7.1—7.0 is there a marked disturbance of the normal physiological functions characterized by unsteadiness of motion, stupor and a coma, usually passing into death.

In order to clarify the

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