TOLERANCE FOR ALKALIES IN ASIATIC CHOLERA. 



369 



The amounts of alkali, administered as shown by the preceding table, 

 varied from 30 to 80 grams, yet in 13 of the 18 cases the urine 

 constantly remained acid. These data are rather definite in view of 

 the ease with which the reaction of the urine can ordinarily be rendered 

 alkaline, for example, by a continued vegetable diet, by the ingestion 

 of certain organic salts, and even by a pure diuresis, such as follows 

 the consumption of sodium chloride (7). Several of the cases also 

 show that the intravenous injection of alkalies, at least in large amounts, 

 will render the urine alkaline. The principal datum, then, which is 

 required to complete this evidence of tolerance is the determination 

 of the effect of the intravenous injection of alkalies on normal indi- 

 viduals, i. e., to determine whether alkalies, in relatively small quan- 

 tities, when injected intravenously, affect the urine in the same manner 

 as when they are ingested in the alimentary tract. 



Absolute conditions of metabolism experiments with exact regula- 

 tion of the diet were not attempted. Intravenous injections were 

 made in normal adult Malays. The individuals selected were obtained 

 from those classes who live largely on a vegetable diet. The same routine 

 was followed as for the cholera cases. Sodium bicarbonate was given, 

 in 1.5 per cent solution, using a part of the same stock which was 

 employed for the work given in the preceding table. The bladder 

 was emptied by catheter immediately before injection. Either a rather 

 concentrated solution of alkali must be employed or else a relatively 

 large amount of fluid must be introduced. In view of these disad- 

 vantages, an extensive series of normal cases was not considered advis- 

 able. Three cases only were tested. 



Table III. — Intravenous injections of alkali into normal individuals as a control 



for Table II. 



Number. 



Reaction of 

 urine be- 

 fore injec- 

 tion of 

 alkali. 



Amount 



of 

 alkali. 



Effect on urine. 



1 



Acid 

 do 



Grama. 

 2.0 

 4.5 

 5.0 



Reaction constantly acid. 

 Alkaline for 5* hours after injection. 

 Alkaline or neutral for 11^ hours after injec- 

 tion. 



2 



3 __■ 



do 







DEGREE OF ACIDITY OF THE URINE. 



Titrations of the acidity of the urine could hardly give very im- 

 portant information concerning the acid metabolism. However, in many 

 instances the reaction of the urine not only remained acid after the 

 administration of the alkali, but the acidity was considerably increased, 

 as determined by titration. Table IV shows the maximum acidity 



