Am.  Jour.  Pharm. 
Nov.,  1890. 
Influence  of  Alkalies  on  Tissue-Change.  589 
ON  THE  INFLUENCE  OF  ALKALIES  ON  TISSUE- 
CHANGE  IN  MAN.1 
By  Dr.  Stadelmann. 
This  research  was  undertaken  to  investigate  whether  large  doses 
of  the  alkalies,  as  the  author  gives  them,  especially  in  diabetes,  does 
not  in  some  way  unfavorably  influence  tissue-change.  The  experi- 
ments were  made  upon  his  pupils,  who  were  in  a  state  of  nitro- 
genous equilibrium,  and  alkalies  were  given  in  large  doses  extend- 
ing over  long  periods.  The  substances  exhibited  were  carbonate, 
bi-carbonate,  and  citrate  of  sodium.  The  salts  of  vegetable  acids 
were  much  more  readily  absorbed  than  the  carbonates,  and  were 
excreted  partly  as  carbonates  ;  while  the  carbonates  were  at  once 
acted  upon  by  the  gastric  juice  taking  up  the  hydrochloric  acid, 
thus  acting  injuriously,  both  on  tissue-change  and  digestion.  The 
nitrogenous  constituents  of  urine,  ammonia  and  uric  acid,  were 
diminished  after  alkalies.  As  regards  the  amount  of  urea  excreted, 
the  cases  varied,  oscillating  between  excess  over  normal,  and  the 
reverse,  but  taking  the  average  over  a  long  period  the  quantity 
passed  was*  very  nearly  normal.  The  amount  of  nitrogen  in  the 
faeces  increased  with  the  diminished  consistence  of  the  stools,  and 
occasionally  reached  double  the  normal.  There  was  always  more 
or  less  diuretic  effect  after  the  alkalies,  and  increased  oxidation  of 
body-fat  seemed  also  to  take  place.  Phosphoric  and  sulphuric  acids 
in  the  urine  were  diminished,  a  point  of  some  importance,  showing 
that  although  by  giving  acids  we  may  withdraw  alkalies  from  the 
body,  yet  by  giving  alkalies  we  cannot  increase  the  excretion  of 
mineral  acids.  It  was  also  found,  after  giving  large  quantities  of 
citrate  of  sodium,  that  more  soda  (after  deduction  of  the  normal 
amount)  was  found  in  the  urine  than  had  been  administered.  The 
difference  between  the  absorption  of  citrates  and  of  carbonates 
seems  to  show  that  citrates  are  converted  into  carbonates  in  the 
blood,  and  not  in  the  intestine,  as  Buchheim  supposes.  Even  in 
doses  of  43  grammes  (about  1*4  oz~)>  and  after  a  total  quantity  of 
about  600  grammes,  citrates  caused  no  dyspepsia,  nor  any  difference 
in  the  general  health.  Further  researches  were  undertaken  to 
determine  the  effect  of  alkalies  on  biliary  secretion.    A  large  num- 
1  Therap.  Monatshefte,  August,  1890  ;  reprinted  from  Med.  Chronicle, 
October. 
