RESPIRATION AND ACIDOSIS 305 



maintenance of reaction and transportation of the C02, is furnished by 

 alkali phosphates (present almost entirely in the red cells), the bicar- 

 bonate of the blood, the plasma proteins, and the oxyhemoglobin of the 

 cells. 1 As the oxyhemoglobin of the blood passes into the systemic 

 capillaries and loses oxygen to the tissues, it becomes more weakly 

 acid in character and hence gives up its alkali more readily just at the 

 time this is needed to combine with C0 2 given' off by the tissue cells. 

 In the lungs the hemoglobin of the venous blood takes up more oxygen 

 again, becomes more strongly acid, and takes back alkali from the 

 bicarbonates. The hemoglobin thus plays a very large part in fur- 

 nishing alkali for the transportation of CO 2 . 2 



Acidosis may be considered as a condition brought about by the 

 excessive withdrawal of bases through the formation of acids within 

 the body. Such an acidosis may occur in diabetes mellitus, in certain 

 kidney disorders, e.g., severe nephritis, in childrens disorders such 

 as diarrhea, recurrent vomiting, food intoxication, etc. The acids 

 known to be produced are acetoacetic acid and 0-hydroxybutyric acid. 

 These along with acetone are classed together as the "acetone bodies." 

 Not only may an excessive acid formation or retention in the body 

 accompany the various disorders mentioned, but an acidosis may be pro- 

 duced in any normal person by proper changes in diet. Thus the feed- 

 ing of a diet which contains no carbohydrate will generally be followed 

 within 24 hours by indications of acidosis. The following table 

 (von Noorden) indicates the extent to which such a "physiological" 

 acidosis may develop. Such acidosis will not result if carbohydrate 

 to the extent of 50-150 grams per day is included in the diet. The 

 feeding of a "salt-free" diet or of a diet containing a large excess of 

 acid-forming foods such as meats, fish, cereals and eggs may also cause 

 acidosis. In the latter case (i.e., acid-forming foods) however, the 

 acidosis is not associated with the formation of acetone bodies. 

 ACIDOSIS ACCOMPANYING CARBOHYDRATE WITHDRAWAL 



1 For a discussion of the relative importance of these factors see: Van Slyke, D. D. 

 The Carbon Dioxide Carriers of the Blood; Physiological Reviews, i, 141, 1921. 



2 Haggard and Henderson: Jour. Biol. Chem., 45, 189, 1921. 



