The nature of diabetic acidosis

Since the discovery that ketone acids are produced in the body and accumulate in the blood to excess in severe diabetes, general opinion has held that the accumulation of these chemical compounds is responsible for the syndrome known as diabetic coma. The general application of the term acidosis to the condition is in itself sufficient evidence of the importance which is attached to this disorder of metabolism. Difference of opinion seems to have been restricted chiefly to the question of the relative parts played by the ketone bodies as such and by the reduction of blood alkali and diminution of pH which they caused. In favor of direct action of the ketones have been cited the demonstrated anesthetic effects of acetone and diacetic acid, while the adherents of the acidosis theory depend upon experiments in which various workers, beginning with Walter (1)'have demonstrated the disastrous, even lethal, effects of injections of massive doses of mineral acids. With the appearance and application of accurate and practica