ALKALINITY OF THE BLOOD 241 



upon to neutralize acids to the extent indicated by the above 

 figures. The real alkalinity of a fluid, however, is dependent 

 upon the number of free OH ions in the solution ; and Hober has 

 determined by physico-chemical methods that the concentration 

 of OH ions in blood is but little greater than in distilled water. 1 

 The alkali of the blood exists in part as alkaline salts, 

 carbonate and phosphate (the diffusible alkali), and partly 

 combined with proteid (non-diffusible alkali). As the corpuscles 

 are richer in diffusible alkali than the plasma or serum, the 

 number of corpuscles modifies the alkalinity of the blood 

 decidedly. Much importance is attached to the question of the 

 alkalinity of the blood for two reasons : 2 first, in certain con- 

 ditions of disease the blood contains so much of organic acids that 

 the alkali is partly saturated and the power of the blood to carry 

 CO 2 is lessened, with serious results (see u Acid Intoxication/' 

 Chap, xviii) ; and, second, the bactericidal power of the blood 

 is found to vary according to its alkalinity. 3 In fact, metabolic 

 activity seems generally to be favored by certain degrees of 

 alkalinity ; for exampte, J. Loeb 4 found that sea-urchin eggs 

 develop with much greater rapidity if a small amount of OH 

 ions is free in the sea-water. It is stated that in febrile con- 

 ditions the alkalinity of the blood is reduced, 5 but the methods 

 available for determining blood alkalinity are too unreliable to 

 decide this point satisfactorily. 6 Brandenburg 7 states that the 

 nondiffusible alkali varies according to the amount of proteid in 

 the blood ; in pneumonia and acute nephritis he found it low. 

 Rzentkowski 8 also attributes the reduced power of the blood 

 to neutralize acids, which he observed in acute infectious diseases 

 and in uremia, to decreased quantity and altered quality of the 

 blood proteids. Libman 9 has suggested that the acids produced 

 by the bacteria themselves may be a factor in reducing the 

 alkalinity of the blood in infection. Orlowsky 10 could find no 



1 Pniiger's Arch., 1900 (81), 535. 



2 For bibliography on Alkalinity of Blood see v. Limbeck, " Klinische 

 Pathol. des Blutes," 1896 ; and Hamburger, " Osmotischer Druck und lonen- 

 lehre," 1902. 



3 See Hamburger, he. tit, p. 280. 



4 Arch. f. Entwicklungsmechanik, 1898 (7), 631. 



5 See v. Limbeck, loc. tit.; see also Orlowsky, Deut. med. Woch., 1903 (29), 

 601. 



6 Kireeff (Cent. f. inn. Med., 1905 (26), 473) claims that in most febrile 

 conditions the alkalinity as determined by titration is normal or slightly lowered, 

 except in typhus (Flecktyphus), in which he finds it always increased. 



7 Deut. med. Woch., 1902 (28), 78 ; Zeit. f. klin. Med., 1902 (45), 157. 



8 Arch. exp. Path. u. Pharm., 1906 (55), 47. 

 * Jour. Med. Research, 1901 (6), 84. 



10 Loc. cit. 



16 



