The Effect of Carbon Tetrachloride and Alco- Hol on the Acid-base Balance of the Blood.*

In the very extensive use of carbon tetrachloride in the treatment of hookworm disease, a few cases in each million have died. One or two of these deaths have followed the drinking of alcohol after treatment, and alcohol has been shown both in the field and experimentally (1) to increase the toxicity of carbon tetrachloride. Carbon tetrachloride produces severe central necrosis of the liver similar in appearance to that produced by chloroform (2, 3) and it has been suggested by Graham (2, 4) that this might be due to liberation of acid from these substances in the liver. He has shown that treatment with alkali protects against this necrosis, but these experiments have been criticized by Davis and Whipple (5) who could find no such protection. A marked acidosis has been shown to occur during the administration of chloroform by Cullen, Austin, Kornblum, and Robinson (6). The cause of this acidosis and that following the administration of certain other volatile anesthetics is still under discussion. The experiments here reported were carried out in order to determine whether the administration of carbon tetrachloride alone or with alcohol produced an acidosis which might be counteracted by alkali, and to compare the effect on the acid-base balance of the inhalation of carbon tetrachloride with that of certain other volatile anesthetics. The oral dose of carbon tetrachloride used (4 cc. per kilo) is large in comparison with the therapeutic