Spinal-Fluid pH and Neurologic Symptoms in Systemic Acidosis

Abstract

RECENTLY, we have encountered a series of patients with severe metabolic acidosis and serum pH values less than 7.0. Although such severe acidosis is widely regarded as leading rapidly to delirium and unconsciousness, only some of these patients were in coma; the others were awake and alert. In the awake and alert patients, the pH of the cerebrospinal fluid was normal or near to it, but in those in coma, it lay in the far acid range. These observations combined with some previously made on patients with respiratory acidosis¹ have led to the postulate that acidosis in the cerebrospinal fluid . . .