CH. XII.] ACETONE BODIES. 315 



fatty acids generally derived from the fats, but sometioaes 

 from certain of the amino-acids formed in the metabolism 

 of proteins. The condition that usually gives rise to 

 acetonuria is the inability of the tissues to obtain or to 

 utilise an adequate amount of glucose. Thus these acetone 

 bodies are excreted in starvation, on a diet of fats with a 

 limited amount of protein, in certain fevers, severe anaemias 

 and after phosphorus poisoning, and finally in diabetes 

 mellitus, in which condition the tissues are unable to 

 utilise the glucose provided. 



It is a remarkable fact that the urine passed just after 

 an operation with a volatile anaesthetic nearly always 

 contains a considerable amount of the acetone bodies. 

 The author has confirmed Piper's statement that this 

 post-operative acidosis is much decreased by the previous 

 administration of dried pancreatic tissue ("pancreatin"). 

 It is also noteworthy that the acidosis is partially depen- 

 dent on the previous dietetic treatment of the patient, a 

 fair dose of a carbohydrate such as lactose having a very 

 beneficial effect. In some cases, especially after the 

 use of chloroform, the acidosis may recur. This condition 

 of " delayed chloroform poisoning " is very apt to lead to 

 fatal results. 



In children recurrent vomiting may be associated with 

 acidosis. In many of these cases the condition of the 

 patient is similar to that seen in peritonitis or appendicitis. 

 Examination often reveals a deep pain on pressure over 

 the pancreas. Operative interference in such cases without 

 treatment of the acidosis is an extremely risky under- 

 taking. The recognition of the condition of acetonuria 

 is therefore of great importance. 



The simplest and most reliable test for acetone and 

 aceto-acetic acid is Rothera's. So far a simple test for 

 /3-oxy-butyric acid has not been introduced. But as this 

 is only found together with aceto-acetic acid, its presence 

 is only of qualitative significance. 



The methods of estimation of the acetone bodies are 

 described on pages 347 to 352. 



