EFFECTS OF CERTAIN DRUGS AND POISONS 737 



gave rabbits orally '0.0 gram (per kilo) doses of hydrochloric acid in 0.2 

 to 0.3 per cent solution. In four experiments both carbon dioxid out- 

 put and oxygen absorption were reduced by about one-fourth, although 

 decreased muscular activity was not noted. Lehmann obtained similar 

 results under artificial respiration, noting also an increase in oxidations 

 when alkali was administered. 



Lactic acid causes a slight increase in the basal metabolism, as shown 

 by Atkinson and Lnsk. 



Carbohydrate Metabolism. The first evidence of a relation of the 

 acid-base equilibrium to the carbohydrate metabolism was furnished by 

 Pavy's discovery that phosphoric acid, orally or intravenously given, pro- 

 duces glycosuria in dogs. 



Elias found that hyperglycemia accompanies acid glycosuria in dogs 

 and rabbits. He and Kolb also showed that in the "hunger diabetes" of 

 young dogs there is a diminution of the carbon dioxid of alveolar air 

 and blood. 



The inhibitory influence of alkali upon the glycosuria of ether and 

 chloroform was discovered by Pavy and Godden, who abolished the sugar 

 by the intravenous injection of sodium carbonate. In like manner Elias 

 and Kolb inhibited "hunger diabetes." 



Murlin and Kramer showed further that sodium carbonate intro- 

 duced into the blood stream of a depancreatized dog lessens the sugar 

 excretion. Bicarbonate was later found less effective. No compensatory 

 increase of sugar w r as found in the blood and no evidence that the retained 

 sugar is deposited as glycogen. The inference that alkali increases the 

 combustion of sugar was only partially substantiated in such cases for, 

 while in partially depancreatized dogs both mono- and disodium carbonate 

 increased the respiratory quotient, the latter was found ineffective in cases 

 where the entire pancreas had been removed. 



Attempts were made by Murlin and Graver to treat human diabetes 

 by the administration of alkalies through a duodenal tube. Sodium car- 

 bonate thus given reduced the glycosuria, but the bicarbonate curiously 

 gave opposite results. 



Underbill (i) showed that intravenous sodium carbonate usually induces 

 a marked though transient fall in the blood sugar content of rabbits. He 

 first suggested that the acid-base equilibrium is a factor in blood sugar 

 regulation and showed further that both the hyperglycemia and glycosuria 

 provoked by epinephrin can be prevented partially by sodium carbonate. 

 He further pointed out the association between hypoglycemia and alka- 

 losis in tetany and in hydrazin poisoning. 



Applying the acid-base theory to therapeutics Underbill was able to 

 maintain a diabetic individual in a state of comparatively good health 

 and vigor over a period of years by giving large doses of sodium bicar* 

 bonate: as much as 120 grams was once given in a single day. The carbo- 



