Abstract Alkalosis can result from administration of soluble alkali1 or from deprivation of chloride2 or from both. It has been shown3 also that the alkalosis observed during "Sippy" treatment with the administration of calcium carbonate is almost invariably associated with loss of gastric chloride and that in all probability the disturbance in the acid-base balance observed under these conditions is to be attributed to the loss of chloride rather than to calcium carbonate. If this thesis is correct, it should be possible to prevent the development of alkalosis by the administration of sodium chloride coincident with the administration of alkali. A study, therefore, was undertaken to determine the effect of the simultaneous administration of sodium chloride and calcium carbonate on the acid-base balance of a series of patients with peptic ulcer. METHOD Sodium chloride and calcium carbonate were given concurrently to 150 patients with peptic ulcer. Eight patients References 1. Kirsner, J. B., and Palmer, W. L.: Alkalosis Complicating the Sippy Treatment of Peptic Ulcer , Arch. Int. Med. 69:789 ( (May) ) 1942.Crossref 2. Kirsner, J. B., and Knowlton, K.: Acid-Base Balance, Renal Function and Gastric Secretion During Hypochloremia in the Dog , J. Clin. Investigation 20:303 ( (May) ) 1941.Crossref 3. Kirsner, J. B.; Palmer, W. L., and Knowlton, K.: Studies on Experimental and Clinical Hypochloremia in Man , J. Clin. Investigation 22:95 ( (Jan.) ) 1943.Crossref 4. Kirsner, J. B., and Palmer, W. L.: The Role of Chlorides in Alkalosis Following the Administration of Calcium Carbonate , J. A. M. A. 116:384 ( (Feb. 1) ) 1941.Crossref 5. Peters, J. P., and Van Slyke, D. D.: Quantitative Clinical Chemistry , Baltimore, Williams & Wilkins Company, 1931, vol. 2 6. Serum CO2, p. 283 7. Ph (Colorimetric), p. 796 8. Chloride, p. 835 9. Blood Urea Nitrogen, p. 554. 10. Van Slyke, D. D., and others: Observations on the Courses of Different Types of Bright's Disease and on Resultant Changes in Renal Anatomy , Medicine 9:257 ( (Sept.) ) 1930.Crossref 11. Tri-Calsate is a proprietary antacid which when in aqueous solution consists essentially of tribasic calcium phosphate and sodium citrate. 12. Schoenthal, L.: Acid-Base Metabolism: Effects of Administration of Salt and of Restitution of Water , Am. J. Dis. Child. 37:244 ( (Feb.) ) 1929.Crossref 13. Hartmann, A. F., and Smyth, F. S.: Chemical Changes in the Body Occurring as a Result of Vomiting , Am. J. Dis. Child. 32:1 ( (July) ) 1926. 14. György, P.: Zur Frage der Säureausscheidung im Urin , Ztschr. f. d. ges. exper. Med. 43:443, 1924.
Archives of Internal Medicine – American Medical Association
Published: Mar 1, 1943