The author feels that this subject is "generally considered complex, unpredictable, and bewildering." Most texts are "physiologically and chemically oriented." This monograph approaches the problem of "describing the clinical syndromes." The author is an internist, but his first chapter, on alkalosis, is devoted to five cases seen in consultation on the surgical service. These must have been seen some time ago, since four of them had infusions of sodium lactate in conjunction with sulfadiazine therapy. Gastric suction also contributed to the alkalosis. "In the author's opinion intravenous ammonium chloride is always necessary" in the treatment of alkalosis. The reviewer has always found saline satisfactory since it has a 50 mEq/L excess of chloride. We both agree that potassium chloride must often be added.
The second chapter presents and discusses a patient with congestive failure and stresses the renal and hormonal basis for fluid retention. Production of a hyperchloremic acidosis and