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C. A. L. BINGER, M.D.; A. B. HASTINGS, Ph.D.; J. M. NEILL, Ph.D.
Arch Intern Med (Chic). 1923;31(1):145-150. doi:10.1001/archinte.1923.00110130148012.
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Sellards1 showed that in normal persons the administration of from 5 to 10 gm. sodium bicarbonate is sufficient to turn urine alkaline, while in patients suffering from acidosis a greater amount is required. Indeed, Palmer reports patients suffering from uremia who received 112 gm. sodium bicarbonate and still excreted acid urine. Further investigations by Palmer and Van Slyke2 demonstrated that in normal men the urine becomes more alkaline than the blood (pH = 7.4) when the plasma bicarbonate exceeds 71 ± 5 volumes per cent. Of the ten pathologic cases which they studied during sodium bicarbonate administration, most showed a higher plasma bicarbonate level than this, before the urine became more alkaline than the blood. They conclude, therefore, that in pathologic conditions there is danger of giving "unnecsary and perhaps injurious" amounts of sodium bicarbonate if administration is continued until the urine turns alkaline; and that the administration should be


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