The Nature and Detection of Diabetic Acidosis. 165 



99 (1031) 



The nature and detection of diabetic acidosis. 



By Donald D. Van Slyke, Edgar Stillman and 

 Glenn E. Cullen. 



[From the Hospital of the Rockefeller Institute for Medical Research, 



New York.] 



Simultaneous determinations by the following three methods 

 were made on diabetics in various stages of acidosis. 



1. The alveolar carbon dioxide, by Fredericia's method. 



2. The carbon dioxide capacity of the oxalate plasma. The 

 plasma is shaken with air containing 6 per cent. CO2, and the 

 CO2 content of the plasma is then determined. A simple appa- 

 ratus was devised which permits, in three or four minutes, a 

 determination of the CO2 content, with an accuracy within one 

 per cent. It consists essentially of a 50 c.c. pipette, provided with 

 three-way stopcocks at the top and bottom, and connected with 

 a mercury bulb. The pipette being full of mercury, 1 c.c. of 

 plasma, washed in with 1 c.c. of water and 0.5 c.c. of N/i acid, is 

 introduced through the upper cock. The mercury is then drawn 

 out from below by lowering the mercury bulb until a Torricellian 

 vacuum is obtained in the pipette. The carbon dioxide escapes 

 from the solution as the result of a few seconds shaking, and the 

 water solution is drawn out of the pipette at the bottom. The 

 mercury is then let in again through the other entrance of the 

 3-way cock at the bottom, and the volume of the carbon dioxide 

 is read in the upper stem of the pipette, which is calibrated in 0.02 

 c.c. divisions. Normal serum binds about 75 per cent, of its 

 volume of CO2. In acidosis we have seen the figure as low as 

 20 per cent. 



3. The H + concentration of the plasma after addition of known 

 amounts of HCl. The H + concentration of the untreated plasma 

 itself is about the same in normal condition and in acidosis. In 

 the latter condition, however, as follows from the reasoning of 

 L. J. Henderson, the ability of the blood to maintain its reaction 

 when treated with acid must be lowered. This is demonstrated 

 by our results. Addition of 1 volume of N/50 HCl to normal 



