Several observers have described cases of diabetes mellitus in which there appeared to be severe acidosis but in which there was no evidence in the urine of the presence of acetone bodies. Such cases have been described, for example, by Stadelmann1 in 1883, by Frerichs2 in 1884, by Lépine3 in 1909, by Revillet4 in 1914, by Rosenbloom5 in 1915, by McCaskey6 in 1916, and more recently by Bock, Field and Adair7 in 1923. These isolated observations have suggested the possibility that other acids than the acetone bodies may play a part in the production of diabetic acidosis, and have led us to study the urine of a series of diabetic patients to determine whether other organic acids than the ketones are ever excreted in any significant amounts. This paper records the results of this work.
We have used the following method: Mixed twenty-four hour samples of urine preserved with toluol