160 ACIDOSIS, ACETONEMIA, 



its normal course, and follows this dangerous route ? 

 The answer is clear and decisive. When the tissues' 

 are unable to obtain sugar from the blood, fat is broken 

 down via these abnormal acids to acetone, instead of to 

 carbon dioxide and water. 



This remarkable proposition has been abundantly 

 proved, and along several independent lines of 

 research. Thus in one case, an experimenter (Satta) 

 ate nothing for two days but milk sugar, and excreted 

 the normal amount of 0"0i gram of acetone daily. 

 Then he took a diet of 300 grams each of meat and fat, 

 which is of course quite an adequate amount tO' 

 sustain health, and the excretion rose to 0"8 gram 

 and i"i gram on the two days of experiment. Thus: 



Day I. Diet only lactose. Excreted coi grm. acetone. 



Day 2. ,, ,, ,, „ o-oi „ 



Day 3. ,, meat and fat „ o"8o „ „ 



Day 4. ,, „ ,, „ i-io „ 



As we shall see, if the tissues can be supplied with 

 glucose, pathological acetonaemia and acidosis are 

 rapidly cured. 



It now becomes evident why acetone and the acids- 

 are formed in the conditions above referred to. In 

 starvation the tissues cannot obtain glucose because 

 there is none in the blood. In cyclical vomiting of 

 children, and in delayed chloroform poisoning, the 

 conditions are a little more complex. Mild aceton- 

 aemia is set up in the first place either by abstinence 

 from carbohydrate food for a longer time than usual, 

 or by some toxic agent preventing the tissues from, 

 obtaining the requisite sugar for the blood by para- 

 lysing in some way their activity ; in many 



