Ketonuria and Urinary Acidity.

The significance of acetone bodies in the urine subsequent to surgical operations has long been the cause of controversy and is not as yet settled. It is now well recognised that ketone bodies are not necessarily associated with acidosis. Although a ketosis usually accompanies an acidosis, the reverse is by no means the case. Despite the fact that a true acidosisa lepletion of the alkali reserve of the blood-is not necessarily indicated by ketonuria, the finding of acetone bodies in the urine following an operation, is still in clinical work frequently looked upon as a matter of much signiificance, especially in children. The estimation of the alkali reserve of the blood in the presence of an acid urine will, of course, at once decide wlhether a condition of acidosis be present or not. This, however, is rarely a possible procedure in practice and cannot always be undertaken even in a hospital. The clinical symptoms accompanying a definite case of acidosis also make this condition clear, but again, one would wish to have warning before the development of air hunger and collapse. Any information likely to be of assistance from a clinical point of view would be of advantage and any simple means of obtaining this, a help.