172 ACIDOSIS, ACETONEMIA, 



to obtain sugar, and that the fatal element in the 

 poisoning is the swamping of the blood with acids. 

 Therefore prevention lies in the supply of glucose, 

 and treatment is to introduce alkalies. In practice, 

 as might be expected, glucose alone is better than 

 alkalies alone ; probably both together would give 

 the best results. 



On account of vomiting it may not be possible to 

 administer either by the mouth. They may be given 

 by the rectum, or directly into a vein. If the case is 

 urgent, the latter method would be adopted ; if not, 

 the former. Glucose should be given in either case 

 in 6 per cent solution in warm distilled water, using 

 two or three pints. Sodium carbonate may be given 

 in doses of 4 drachms to the pint, again using two to 

 three pints. It should be the object of the treatment 

 to make the urine alkaline. 



In milder cases, it will of course be possible to 

 give remedies by the mouth. The addition of enough 

 starch or sugar to bring the daily supply of carbo- 

 hydrate up to 150 grams (5 ounces) will effectually 

 banish the pernicious acids in the urine. Alkalies 

 are best given in the form of sodium citrate, 30 grains 

 or more three times a day, until the urine is alkaline. 



It is important to bear in mind the danger of this 

 auto-intoxication, that is, poisoning by the products 

 of the patient's own internal processes, in all the 

 numerous conditions in which insufficient food may 

 be absorbed, so that serious or fatal symptoms may 

 be warded off. Diarrhoea, wasting, or vomiting, 

 from whatever cause, should lead to an examination 

 of the urine for diacetic acid, and the same is specially 



