In many clinics, the technic of insulin therapy as applied to the treatment for diabetic acidosis has undergone a series of changes since the introduction of insulin in 1922. At the Presbyterian Hospital, as elsewhere, brilliant therapeutic results were obtained in the early days of the use of insulin by the administration of relatively small doses of the hormone in conjunction with the supportive measures employed in the pre-insulin era. When large quantities of insulin became available for clinical use, massive doses were employed on the assumption that they would bring about more rapid alleviation of the ketosis by augmenting the oxidation of dextrose. The results of this type of therapy were, however, frankly disappointing, in part at least, because too much emphasis was placed on disturbances of carbohydrate oxidation and not enough on the significant consequences of severe ketosis, namely, loss of fixed base, dehydration and collapse. In recent