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In recently published studies, Hartmann and Darrow (1., 2, 3) emphasized the fact that if sodium bicarbonate were properly administered along with other indicated therapeutic measures, severe acidosis could be much more effectively treated. There were recognized, however, a number of objections to the administration of sodium bicarbonate. The most serious was that, if given intravenously in amounts large enough to insure effectiveness, it tended to produce too rapid a change in the reaction of the body fluids, and often resulted in an almost immediate shift from uncompensated acidosis to uncompensated alkalosis, even though the sodium bicarbonate content of the body fluids was not made BHCOs. increased because the numerator H2C03 &' was.added to more rapidly than the denominator could be increased by the production of carbon dioxide in the tissues and its accumulation in the body fluids through reduced pulmonary ventilation. This danger was usually avoided by giving the alkali in fractional dosages and checking the effect by chemical examination of the blood. The latter constituted another objection, particularly in the case of the young infant. Other disadvantages lay in the fact that if sodium bicarbonate were to be injected subcutaneously or intraperitoneally, it had first to be sterilized by Berkefeld filtration, and then rendered less irritatingly alkaline by bubbling carbon dioxide through it.' Unless sealed, such a mixture would of course become too alkaline again as a result of loss of carbon dioxide. Another disadvantage lay also in the fact that the injection of sodium bicarbonate alone tended, at least theoretically, to disturb the ionic balance between sodium, potassium, calcium and magnesium.

STUDIES IN THE METABOLISM OF SODIUM r-LACTATE. I. RESPONSE OF NORMAL HUMAN SUBJECTS TO THE INTRAVENOUS INJECTION OF SODIUM r-LACTATE