110 ACIDOSIS, ACETON.EMIA, 



Acetone is excreted in the breath as well as in the 

 urine, and the sweet odour is perfectly apparent to 

 many medical men, more so to some than others ; 

 some can smell a diabetic excreting acetone at a great 

 distance. 



Test for diacetic acid in the urine : 



To 3 cc. of urine add a few drops of liq. ferri per- 

 chlor. A deep red colour which disappears on 

 heating is positive. The test is often performed on a 

 white slab as a contact test. One must not be 

 deceived by the frequent reddish precipitate of iron 

 phosphate from a normal urine. 



Turning now to the prevention and treatment of 

 acidosis, w r e may clear the ground by reserving 

 diabetic coma for a special word later on in the 

 chapter, and delayed chloroform poisoning for con- 

 sideration in Chapter VIII. 



We saw that the cause of this peculiar perversion 

 of metabolism is inability on the part of the tissues 

 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 practite, 

 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 



