Although toxic symptoms in certain patients being treated for peptic ulcer were observed by Sippy and his co-workers and some study of the blood chemistry had been carried out in a considerable number of these patients, the results were apparently not considered of sufficient importance to warrant their publication. The first observations concerning the intoxication produced by the administration of large amounts of alkali in the Sippy treatment to be recorded in detail were those of Hardt and Rivers1 in 1923. They pointed out that "patients with duodenal ulcer treated by the Sippy method may develop definite symptoms of toxemia associated with renal changes, increased blood urea, and normal or increased carbon dioxide combining power of the plasm"; they asserted also that "patients with duodenal ulcer and renal complications are more inclined to develop these toxic manifestations and to a much greater degree" Shortly after the report of Hardt and
GATEWOOD WE, GAEBLER OH, MUNTWYLER E, MYERS VC. ALKALOSIS IN PATIENTS WITH PEPTIC ULCER. Arch Intern Med (Chic). 1928;42(1):79–105. doi:10.1001/archinte.1928.00130190082009
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