316 HENRY A. MATTILL AND HELEN I. MATTILL 



to the food and what little metabolism work has been done on alkali 

 balance, does not give conclusive results regarding their retention chiefly 

 because the loss of the alkalies, especially Na, through sweat makes the 

 determination of total excretion difficult. 



An abnormally high ratio of K : Na (22:1) in the food of puppies 

 has been shown to result in a strong positive K balance and a slightly 

 negative Na balance, and when long continued, to stop growth. The ratio 

 of K:Na in the liver and kidney was 1.5 to 1 while in control animals (re- 

 ceiving K:Na 2 :1) it was 1.24 : 1 and in rats a very high K diet brought 

 the ratio of K : Na in their ash up to 2.41 : 1, when it is normally 

 1.5 : 1 (Gerard(fr)). Osborne and Mendel(Z) have found K'more essen- 

 tial than Na in the diet of rats. The bones of calves receiving a high K 

 diet showed retarded development even with a plentiful supply of Ca and 

 P 2 O 5 in the diet, though the composition of the bones was normal (Aron 

 (a)). An effort to confirm these results on children by studying the CaO 

 balance on diets high and low in K (K: Na 2 : 1 and 1 : IT) has been un- 

 successful (Adler). 



The ingestion of a diet rich in fat affects the alkalies in the same 

 way that it affects Ca, and may lead to a negative balance (Hellesen). In- 

 gestion of acids has a similar effect (Secchi(a)). Elimination of the 

 alkalies is principally through the urine. The feces usually contain more 

 K than Na, but only in cases of diarrhea does the quantity of either become 

 a considerable proportion of the total excretion. There are 3-4 grams 

 K 2 O, 5-8 "g. Na 2 O daily in the urine of the normal adult, though these 

 quantities are subject to wide variations depending on the diet. In starva- 

 tion the elimination of Na rapidly decreases, of K less rapidly, and after 

 a few days the K elimination is six to nine times as great as the Na, a 

 proportion which exceeds that found in muscle substance. On breaking 

 a fast and in convalescence there is a very marked K retention. 



The coincidence of glycosuria and acidosis has resulted in the develop- 

 ment of an alkali therapy in diabetes for which a considerable success 

 is claimed ( Underbill (g} ). In opposition to this claim must be mentioned 

 the findings of others, that NaHCO 3 administration is sometimes followed 

 by retention of chlorids and water resulting in edema, and that the ap- 

 parently improved carbohydrate utilization may be only a result of its stor- 

 age in the increased body water (Levinson; Hertz and Goldberg; Beard). 



Calcium 



The distribution of CaO between urine and feces is too variable to 

 permit of any even approximate statement. The urinary CaO may com- 

 prise 5-64 per cent of the total CaO excreted in the normal cases (Neurath, 

 Towles). A milk diet is apt to result in a lower proportion of urinary 

 CaO to total CaO than a mixed diet (Secchi(&)) in spite of the fact that 



