Studies of the Acid-base Equilibrium in Disease from the Point of View of Blood Gases

Carbon dioxide diagrams (Haggard and Henderson (9)) have been constructed for the blood of a series of hospital patients as a method of studying disturbances in their acid-base equilibrium. A diabetic with a low level of blood alkali, but with a normal blood reaction, a compensated acidosis in other words, showed a rapid return towards normal with no treatment but fasting and increased water and salt intake. A nephritic with a decompensated acidosis and a very low blood alkali was rapidly brought to a condition of decompensated alkalosis with a high blood alkali by the therapeutic administration of sodium bicarbonate. It is suggested that the therapeutic use of alkali in acidosis is probably only indicated in the decompensated variety, and that there it should be controlled carefully and the production of alkalosis avoided. The diagram obtained in three pneumonia patients suggested that they were suffering from a condition of carbonic acidosis, due perhaps to insufficient pulmonary ventilation. In two out of three cases of anemia the dissociation curve was found to lie at a higher level than normal. No explanation for this finding was offered.