Acidosis

“ Thus these dangerous substances are eliminated as ethereal sulphates, which are practically harmless. Even when these ethereal sulphates are present in large amounts in the urine there may be no symptoms of auto-intoxication.
When the liver is extirpated, a condition of acidosis arises, and a large quantity of ammonia is eliminated, which is produced in order to neutralize the acids present. The liver protects us against acids formed in the organism. After eating a quantity of meat, we would be menaced by the acids formed through its decomposition, were the liver not active. ”

“ It may be increased by diet, disturbances of protein metabolism, ammoniacal fermentation, etc., and there may be no increase in certain diseases with acidosis. The ammonia probably does protect the blood alkali, but its efficacy is intimately associated with renal function, inasmuch as Nash and Benedict have presented strong evidence to the effect that urinary and blood NH3 is the product of an active synthetic function of the kidneys themselves. ”

“ It would be decidedly unwise to attempt to build up the body by giving building foods alone, without due consideration to the foods containing the agents provided by Nature to neutralize the acid formed during the process of their metabolism. It is readily seen in the table just given that meat and eggs show a marked excess of acid-forming elements, whereas vegetables and fruits yield an excess of base-forming elements. With these data, it becomes more simple to balance the diet and to avoid the acidosis which may arise from impairment of the fat metabolism of the body. ”

“ Their results may be summarized by the statement that the oxidative processes are hampered and fail to balance the autolytic changes, and, furthermore, that a relationship exists between the catalase activity, acidosis and normal oxidative processes. ”

“ Fats as Cause.—When the fats are causing the disturbance, the rise of temperature is apt to be high, but not of long duration. The baby vomits frequently, the vomitus being acid in reaction and odor, the latter due to the presence of fatty acids, butyric acid, etc. Diarrhea often develops in a more or less acute form. In these cases there is a loss of sodium and other alkaline salts in the feces, and a consequent excess of ammonia in the urine, resulting in acidosis. Acid intoxication has been known to develop as a result of this loss of alkaline salts. ”

“ The blood sugar varied from 0.12 to 0.14 per cent. and was examined in almost all the cases in which urea was estimated; these figures are at the upper level of normality (no attention was paid to the interval elapsing between the feeding and the withdrawal of the blood) . The diastatic activity was likewise normal. The CO2 combining power showed figures under 40 to 45, according to the Van Slyke method, and indicated therefore a mild degree of acidosis. ”

“ NaHCO3 per 19 kg. body weight will raise the plasma CO2 capacity by 1 vol %. It is distinctly contraindicated in cases whose low plasma CO2 is due to acapnial processes. Early administration is desirable in children, and good results are obtained, especially with the older ones. An acidosis, however, once established in infants may cause death despite alkali. In order to avoid over-dosage of bicarbonate, methyl red, which is more sensitive than litmus to early changes in the reaction of the urine, should be employed as an indicator. ”

“ The mean acidity of the gastric juice, whether pure or mixed with food, is equivalent to about 1.7 grain of hydrochloric acid per 1,000, never falling below 0.5, or rising above 3.2 grammes. The quantity of liquid present does not seem to exert any influence on the degree of its acidity, which is augmented by wine and alcohol, and lessened by cane-sugar. The gastric juice is more acid while digestion is going on than during the intervals of the process; its acidity seems always to be increased as digestion is drawing to a close. ”

“ For physical efficiency, the balance should be slightly alkaline. In the process of digestion minerals are oxidized into their chemical constituents of acids or alkalies. An excess of acid interferes with the normal alkalinity of the blood and secretions, prevents the normal absorption of oxygen and elimination of carbonic acid gas by the blood, hinders the work of the white blood corpuscles, irritates the nerves, lowering, therefore, the resistance and vitality, and irritates the kidneys. In the dietary, care should be taken to include alkali as Well as acid-forming foods. ”

“ The amount of acidity in gastric juice that must be secreted for the digestion of meat is much in excess of that required for a given amount of vegetable food. The amount of acidity required is greatest for milk, second for meat, and least for bread. The digestive energy required is greatest for bread, second for meat, and least for milk. From this we learn that starchy foods are unsuitable for those who are afflicted with hyperchlorhydria or supersecretion of hydrochloric acid, as the excess of acid prevents their digestion by neutralizing the alkali of the intestines. ”

“ Of the cold acidulous waters there is Pougues in the department of Nièvre; Chateldon, Bar, Saint-Myon, Médague, Vic-le-Comte, dep. Puy-de-Dôme; Mont-Brison, Saint-Galmier, dep. Loire; Langeac, dep. Haute-Loire. They are tonic and diuretic; and in large doses produce a sensible degree of exhilaration.
They all afford a grateful and moderate stimulus to the stomach, but the warm acidulous springs are to be preferred as there are few of this kind that do not contain a small portion of Iron and a larger portion of carbonic acid gas, and are especially useful in all cases of impaired digestion ”

“ Further, many kinds of wine have a somewhat acid taste. In Russia, kwas, especially in the acid form, is consumed in great quantities. Moreover, acid fruits and green vegetables are used as food, and they are either of themselves acid, or made so in the preparation. In medicine this instinct is likewise often made use of, and acid solutions, especially of hydrochloric and phosphoric acids, are prescribed in digestive disturbances. Finally, Nature itself constantly endeavours to prepare lactic acid in the stomach in addition to the hydrochloric acid. ”

“ The natural secretions of the human stomach are acid, and the acidity is subservient to the digestive functions. It cannot be superseded by artificial alkalinity without serious disturbance of nutrition; and the aim of treatment, in the case of all digestive derangements, should be to cure them by changing the conditions under which they arise, not to palliate them for a time by the neutralisation of acid, which may, indeed, give relief from present trouble, but which leaves unaltered the conditions upon which the trouble really depends. ”

“ OF ACIDITIES. The food of children being for the most part of an acescent nature, it readily turns sour upon the stomach, especially if the body be any way disordered. Hence most diseases of children are accompanied with evident signs of acidity, as green stools, gripes, &c. These appearances have induced many to believe, that all the diseases of children were owing to an acid abounding in the stomach and bowels; but whoever considers the matter attentively, will find that these symptoms of acidity are oftner the effect than the cause of their diseases. ”

“ According to Sherman, these organic acids have a lower fuel value, per gram, than carbohydrates, but are reckoned as such in computing a food in which they exist. The function of these acids is chiefly that of neutralizing the acids formed in the body in metabolism. Being base-forming in character, they function after absorption and oxidation in the body as potential bases—the base associated with the acid in their ash combining with carbonic acid to form carbonates, which act as above described. ”

“ Observations.—— Acidity in infants at the breast arises very frequently from the mother’s milk, and is best corrected by attention to herself, by avoiding indigestible food, and taking an anti-acid, such as carbonate of soda, or magnesia, once or twice a day; also to take a larger portion of animal food. Infants brought up with the spoon are peculiarly liable to acid, and require, if bowels are bound, a little magnesia, or if there be a looseness, chalk mixture occasionally mixed with their food. The green colour of the stools in infants, is an infallible proof of the presence of acid. ”

“ The great range of uric acid diseases, such as rheumatism, calculi, arteriosclerosis, certain forms of diabetes and albuminuria, are due, on the one hand, to the excessive use of acid-producing foods, and on the other hand, to a deficiency in the blood of certain alkaline mineral elements, especially sodium, magnesium and potassium, whose office it is to neutralize and eliminate the acids which are created and liberated in the processes of starchy and protein digestion. ”

“ With young children, watch for any local irritation or discharge. For the former, use local applications of boric solution as a wash, followed by a starch powder or zinc ointment. Discover the cause; it may be rough or damp clothing, intestinal worms, acid urine due [Pg 149] to excess of sugar or meat in the diet, or to insufficient drinking water. Alkaline diet, or a pinch of soda in the drinking water for a few days, will help to counteract the acidity. As the child grows older, beyond six years, encourage him to report to you any irritation, and teach him how he should relieve it. ”

“ Acetic or other similar organic acid may be used instead of the lactic acid, but sulphuric or mineral acids must not be used. The acid liquid is afterwards neutralized by ammonia, which is added when the bate is to be used, and there are then formed certain chemical compounds similar to those found in a dung bate.
The addition of the acid to the nutrient medium will immediately stop the growth of bacteria, but the acid is not added for that particular reason, but for the particular purpose set forth. ”

“ Acidity will occur where sea water is present in a boiler. There is the possibility of such an occurrence in marine practice and in stationary plants using sea water for condensing, due to leaky condenser tubes, priming in the evaporators, etc. Such acidity is caused through the dissociation of magnesium chloride into hydrochloride acid and magnesia under high temperatures. The acid in contact with the metal forms an iron salt which immediately upon its formation is neutralized by the free magnesia in the water, thereby precipitating iron oxide and reforming magnesium chloride. ”

“ A few secretions and excretions are naturally acid. Sometimes the body gets into a too acid state, but that is very rarely due to overeating of fruit. It is generally caused by pathological fermentation of food in the alimentary tract. The salts and acids of fruits are broken up in the stomach and help to form alkaline substances.
The water of the fruit is very pure, distilled by nature. The acid fruits are refreshing and helpful to those who have a tendency to be bilious. Fruits are cleansers, both of the alimentary tract and of the blood. ”

“ A second error of the uric acid advocates, flowing from their first error of naming the poison, is to pour their acids and alkalies into the blood with the childlike faith that, like good children, the acids and alkalies will go in there and do just what they were told to do, neutralize the uric acid, and get out. They assume that the chemistry of the acids and alkalies is as simple inside of the body as it is outside of it and that the blood is simply a passive mixture of chemicals. ”

“ For supposing first that they did thus combine with alkalies before entering the blood, yet as more alkaline matter would then have to be secreted to supply that which they had neutralized, they would thus immediately increase the amount of acid in that fluid. The action of acids in the blood is very different from that of their salts. Sulphuric acid does not act like the sulphates of Soda and Magnesia, nor is the action of Hydrochloric acid the same as that of common salt. ”

“ As the acidity increases associative memory is lost, and the patient is said to be unconscious: the centers governing the voluntary muscles are not inhibited, however, and cutting the skin causes movements. If the acidity is further increased, there is loss of muscular tone and even the strong contact ceptor stimuli of a surgical operation do not cause any muscular response, and, finally, the acidity may be increased to the point at which the respiratory and circulatory centers can no longer respond by increased effort, and anesthetic death— that is, ACID death—follows. ”

“ And the alcohols, with their allies, have no great power of resisting decomposition. These bodies, formed by the union of oxygen, hydrogen, and carbon, are also, as a class, chemically inactive. Formic and acetic are doubtless energetic acids; but the higher members of the fatty-acid series are easily separated from the bases with which they combine. Saccharic acid, too, is an acid of considerable power; and sundry of the vegetable acids possess a certain activity, though an activity far less than that of the mineral acids. ”

“ Alkali should naturally be present to neutralize it, for it is unnatural to have a large excess of acid in the secretions, or any excess in the blood. We thus administer alkalies on the restorative principle. They are not always excreted; but whether excreted or not, they tend to render the secretions neutral and alkaline by increasing the quantity of basic matter in the system. Alkalies being more stable than acids, and being more invariably secreted by the kidneys, it is more easy to render the urine alkaline than to make it acid. ”