t"4 d 00 :64 04 .4 04 2 -r4 0 0 t t E-4 @C4 7 4-'# 4* P4 1. Date of Obligation: N/A 2. Purpose of Pr 'ect Oi Research-in "The---- cal Correlates-of P* i2l5i Carboa Dioxide Fnv-irOnmeat'-' 3. Progreso to Date.-- )Rroiect,being.,9 Jill& ated. 4. Expiration Date, N S. Project @,lonitor: FROM: i3 ( SUBMITTED BY DATE - VOUCHFR NO, ?@-12 @4,CCOUNTING BY INDIVIDUAL 2 -PERIOD OF ACCOUNTING 2,1 1 r, FOR ADVANCE I FROM T 0 ivorg, Fnilow Instructionw on Reverse 1. CAS" O2N HAND BEGINNING OF PERIOD F.'XPEN s His EERIOD: 2, OUTSTANDING ADVANCES BEGINNING OF PERIOD V(iicilER DATE DESCRIPTION AMOAJN7 2 NUmacri 3. RECEIPTS THIS PERIODs S P-r DATE DESCRIPTION I,2 NUMBER --to b,- rcc;;;:N,4 4@@ 18D.0 "at 2 40.54 TOTAL EXPENSES NECK 2 6@ REFUNDED HEREWITH lc.s. c MONEY ORDER 7. OUTSTANDING ADVANCES END OF PERIOD (Attach listing) 2 CASH ON HAND END OF PERIOD OR BALANCE DUE AOVANCEIE 4. TOTAL TO ACCOUNT FOR _Is TOTAL ACCOUNTED For, 1 CERTIFY FUNDS ARE AVAILABLE APPROVED r certify that the expenditures2 list iiereon an@d OBLIG.REF. NO, CHARGE FAN ACCOUNT NO. DATE SIGNATURE OF APPROVING OFFICER @on any attachments were incurred for official pr- 2 poses of a confidential nature, that payment et .533 'credit therefor has not been received, and tha@t, 2 this accounting in true and correct. 2331 Mv mc*m DATE SIGNATURE OF AUT70RIZING OFFICER CERT IF I ED FOR PAYMENT OR CREOilT SIGNATURE OF PAYEE 2 DATE SI ONATURE OF CERTIFYING OFF $CIA SPACE BELOW FOR EXCLUSIVE USE OF OFFICE DESCRIPTION-ALL OTHER ACCOUNTS 13-33 34 - 39 40- 42 - 47 4 O- 50 " I-SA 2 5 S. 66 67-70 71. so 2 STATION 41 OOLIG. 49 OA COST - FAN OBJECT AMOUNT 8-33 NO. OR 2 ACCOUNT SYMBOL CLASS If/^ no CODE REF. c GENERAL DESCRIPTION ...... c - -A-0-Y ...... . LEDGER 2 ANCR St-66 :66 70 p OOC.ti*l 0 A CT. NO D ACCY. NO. L A?VANCE ACCOUNTS 2 '7 ........ DUE CREDIT 13-27 Emp. of RE DEBIT 2 .31 O. .0. DATE YR@ 16. IL PREPAR2ED BY OAT RIEVIEWED n- y TOTALS FORM DOSOLETE PREVIOUS 1 il-A9) 4-65 282 EDITIONS ICERTMCATROM 10 This ldi to certify tbat'l baya received an net-ounting frcm WM?RA, Subpmjoot- 124 which refleoto o3T4wo of $2j,497.230 Wis being retained In-th2o-office-of request* 2* The b&lan,--e remawng-after recoxdirag -tba- experditures bas been refunded. - ii&kdfund-,in, mu)uat or-W.54 hu been recorded c letary .6vnpany firancial 2 re4zords. 30 'I "rtify7@t@@ "ti4faaWy-terviddt mpmomted by, the "counting have-been received and that to the becit of my ,knovledge mA -- l@el-iof tlw ru&U - -cq@rided iftre &Uthm@ize4-by tho-VtOjOet-approval.-, SIDUY NNOW C, W,-i prosent h*rewith the final accounting of the AcL4-lk&&4-R4searc@-Proj*ct, 1960-*@--@tober 43 250 00 2 t 0 1961 rebr@ary 3.259 00 $6,500-00 1960 -wi $20"9.16 1960-- 9 2 -10300,00 C-1 196OC:@4@ res 213005 1942 - dilburiezents 1963 - 7-16 -Labor 158,00 a - - -00 --$ 30@@Labor 4410 9-.12 Labd@@@@ 222600 1964 2018 .2 -@l' 14 252,,Ol- 302093 -111 23 Ant 100.00 --114 noultant 250,00 -12-2 22,79 2 8 .-12 28 78.52 1965 1.21 r-subjects, -600.00 2 a 60,00 29 00 4-26 6 AtL Doe-*- 301-1965 Balan3ts remaining our ch4ck jo ths &nmnt of $40,54, representing thG unex- pond4d balance, is evalooods Vtty truly,,YT!FL,,, -VOW, Oct otx- r Deal Mi do& Cont-roller rd ri Acid Base b vacatk.on and this explains th del The nmount reiiiaining in the fund is 2 Of the approxiiiately $1-@ooo-expen(Jed since our last ref)ort, over 95c'r has gone for piyrolt,--------- At the present time w(. are engaged in a study in which the bacb-,-round knowledge Lin(i apparatus provided in the grant wi ti be of considt:ral)te use. We ar(, tdniinistering cai,bon dioxide in(i ait- in n,.Ixttires tip to 10"t ezirbon clioxide t@,-) hvpurt(@iisive prisont-t- subjects iii an atlemi.)t ti) st-Ltdv the @ffect un rtst;,it-, bli)k-)d pressur2e tevelt Thtt ihe acid bz-tse is relitecl t.,, tht? restit-ig t,,it(- t)f bloia pre-*,-;tif-e is a tor)g-shot hypothesis. If a3iy effect is de,,ronstrated, this could b@,- al linport,,tiit (-,oritribut2ion. %N'e 1)1,an to nieasure,eb,aogL-s in the acid base balance an(i bloo,,i pressiire ind particula-rlv t,@e leng@h ofti-,i)e that these changt-s persist. There is sQnie evidence , the terature that if ore sets in 2 carbvr. dioxide toterarct: at -t r@ew le%-e-1, that honieost.-itic riech-anisnis will iiiaintai'n this for a t-(,iisi(lerable 1)criod of tiriie. i A,Itt et-rt@iinIN- k-OL@op vou infuz-nied of (tlir re,@ults in this vxlvriiiient, Sit,. ce rt:- ty, I oe"tlfy t@-;!t sa@tisfac,ori-iy Ur es 'Were incurred on OCT-1564 8 JD September 10., 1963 Dear Pursuant-to my-letter of-April 25, 1 am repqr@@@ to you an the Acid-Base Stlidy.-- Du.rlr t tvo montheLve7:@hav"rairied -P" a technici2an to work vitb t t"-tw n in Cbemistry this fall at-t We expect to run experimental 4ubjects on:m@-enas We-attempted orie experiment to simpl4f _y finger blood col lection by 4;atch2ing it under oil -Tht"ail*d because -of oil .contamination-of tbe-eltttr@od Tbaofo-,.r-e--v-e-*11.1 proceed vith subjects ac-cordiiig@Ao stands --thodg, -PuMs-remaining-in the-gr*nt are sufficient f6t7tt@@@ year's studies,- We@7vill report to you again on December 15. Sincere Septfmbe 'i'-'i2.@ 1963 Def. f ind the accounti c I 0 8 e d plea2se lig ahwes a, O'balance -This sho-ald cl is th@A7t .-o lc-h 0 I h4tve IhIritt,'e@ 2 n a 0,000 graiit -to the @3 k@@ic@ I have ita t up sini,-o I had all his ieco'2rds -tneA z- a eats ftir H-- ma use the balani'e uO --in s6w6'small' ruie'%:'wh ich a 4@uested he h' s not-;yet re -riiat@url-tt=A-nt 'fo,r- so p@ease O a close this"One--.*ut is &'Copy c.. a ett Enclosod algd er f,ror, 2 u whic@h y clu can4put in his fil@. R6 is atil,l a r _Rrazit kone kqtid uio n t account imtil it is all gone. -ir se-St so4aal 're@a rds SUOMITTED BY .I. VOUCHER NO, (Finance use onjy) 04 ACCOUNTING BY INDIVIDUAL FOR ADVANCE 2 PERIOD OF ACCOUNTING po)low Tnatructions on Reverse FROM oeto*.:,.,.= 33L nlrob 1563 RECEIPTS DISBURSEMENTS 2 R --7 vouc Te DESCRIPTION 1. CASH Ot4 HAND BEGINNING OF PERIOD 3 N 2L; M RIVIR DA AMOUNT-- ta. 2. RECE I PT DATE DESCRIPTION NUMBER I TOTAL EXPENSES 2 3a. A. REFUNDED HEREWITH cs., CASH ON HAND END OF PERIOD 2 2. TOTAL TO ACCOUMT FOR TOT L ACCOUNTED FOR I CERTIFY FUNDS ARE AVAILABLE APPROVED @r ... tify that the expoinditiures listed hereon and 2 on any attachments were incurred for Official Pur, OBLIGATION REFERENCE NO. CHARGE ALLOT#AENT NO. DATE @-;IGNAYURIE OF APPROVING OFFICER p 2 Of @ confident@al n:,tur,&,.C,.th:i PAYM&PT Or C:60:@ rL 2 ad t t for has not be iv d, and that this poch:,nrtejng is true a d co 2 rrect. SM= oorz@m, @l OF: C 2 G OFF I CER CERTIFI 0 FOR PAYM NT OR CREDIT DATE RE OF A UTHORIZIN S ONATUR PAY E DATE IGNATVRE OF ERTIOYIN O2FFIC R S Film" SPACE BELOW FOR EXCLUSIVE USE OF FINAN@@ PREPARED BY 2 RE EW D BY VOUCHER O. 7.12 (ILSCRIPTION' ALL 07'HLR AK;COUNT'G 03-33 47.52 Sl@. 67 60'-70 71 O-D 2 -42 '3 45 5A.57 ALLOT I COST Due AMOUNT 4 AG OOLIC, F p- S3 GENERAL ACC 01, T CODE AY DATE., /A * v PIER. ........... .. CODE 2 N CA LEDGER 62-67 DESCRIPTION ADVANCE ACCOUNTS 13.27 IAO C. Lio. ADVANCE YR A@C7. NO, CREDIT 2 ODE ......... CLA$gi C x COP. NO. ----------- 0 - - ------ TOTALS FOR M 282 USE 'I.EVI*us toortoos. C-61 Grants Received 1960 3,250.00 1961 3t250.00 61500.00 Disburse@nents sories 2,545006 Total cost 2 2,500-400 Less-jaay-menLs -bVJ@@ C,@ an 1 300.00 %200.00 Other 117.15 ---1;962 2Unexpended-Balance $ 2L537.79 T his i of accoxuitinp fro 't@alt-I -,,er,,74Lces or miterials i-,,ave '6eeii 6 ')sa@ti,q factorily recE!vErl, -in-',, expenditures vere incurred 0,-) officjll DatL--v Pi. 9 10-4 04 No. Cost Account Object Class Obligations Obligations Unliquidated Date Reniarks and Refer7ences Incurred Liq-tiidated Balance 15 Dept-3aftr 1,960 ATTOUCH YU=m Div-Lolon UoW tho autharlty gmted In the mewrwaui "ted 13 APTLI M3 fm tbtk2 WI tUo autbqrlty IA b" bfta somyed auA J6-5W.00 of the wer-*Il taMTM-p expo"es# Ms oblt&auon of2 f@@ @@wowtwwamtamt 152@- I CERTLFY TFAT F"',NDS -Ac,E AVAILABLE, so-- 2 C)IAACI TO A.LIOTMNT AUTHORIZING OFFICER Inv^ OrU 2 Addn*"* 1 - TW/CK; ,,,,>l - TW/FAW (W e" CONFIDENTIAL FUNDS POSTING VOUCHER DATE 2-6 T11-@ u-c FIER No. 7- 12 vo NO, 7- 1Z 2 p ir 60-70 4 3 47- 52 s a - 73- 80 IPTION-ALL OTHER ACCOUNTS 13,3f* AO-42 4 5- 4 OnLir 53 54 - 57 ALLOT. OR COST Du(: AMOIJNT 33 EXP PAY EF. I L ---- - F R ACCT. NO. DATE 2 PER . . . . . . . . . . 62 0 eircy ,E N . R DESCRIPTION, CO LIO, 1r,@ CNFB CA ADVANCE ACCOUNTS i3.27 P.O. go. 0 YR ACCT. f4o. CL A 5 5 7-7,-, ' C DE "J"'C S 01, 91 2 EXPLANATION OF ENTRY TOTALS REVIEWED Sy CERTIFIED FOR PAYMENT OR CREDIT DATE DATE 6 ICER DATE SIGNATURE OF CERTIFYING OFF ro- 10 ;g 606 tisil PREVIOUS EDITIONS. 16 Septeaber 190 vu i TO/Budget Officer mnmo sk@@@'t TAVOLCO V04. 1 subprojeot Lo attacbe4*- lowyort &* to refwds of 45jOT3.76 fro* otber projeqto (" pr atte4bmats) Moo*% abOL".b* uMe Caablerts eh&Ck-AiL- t or *i$W.22 -obou3A 22 Bmcbj, t -Offio*@2 no lat@er tkAA Sb@&@ 3- Ms is a -it III &@ticip4w that adational tuo" viU -bo-obUgAteA for Ws pm4ect the fili@6 not'be 010"40 Attegbomtt I C3ER:TIFY THAT FU4D$ A@E AVAILABLEI Oris & 2 "U"S" OFilCER I - -TSD/FASS=@7@@ N Ed !L r REc--- 16 septealber loo PZMMA DMSION VIA xu5-ioog-igce the In SM(AM invotee No. t or 46,,5W coverits the &'bm &* to retvir.-da *f t5oVf3-78 i6@@ ata44 b,6 niide otbir proje*U POr attacbmate- 2 MLbll -to the 7be thorls "44 be forwraed to Ch opW/tuU*t otneorj, a* lator them 'Aur*Wo goteawr 1960. is a timl- invot". sinm it is sntwyet4d tb&t adut1g"l for tld$ pvjeot tb* f.Ues sboa]A neAU olbood.-- -,Ilona 1 - TSD/FASS xxm 2 - TSD/RB 4 xm - i6 sept 00 moics 00 Tor "ryicea It Is bereby certiti4k:@ftt this-i$ lnvolm No. 1 ay" rig AO MWPAJ, Sub2roject 12k, that polormance is satie2footoryj thot the "rvices are being a"coplisbea in a4cordance vith mutual &ST@ts that a dot&ile4 spoda of the peywnts w-,A rec4ipto is on filCin---- TSD/RB., that the bill Is just-wa2 correct and that paymnt thereof b" not pt been wda,, -7cTief., Tw Datel (2) It Is bareby certltiwtbat, Ws'invoice@aPP3.@es-to-KWMRA-Bu@ pmjeat 1224.,'vbich was dUltVpftved,, and that the project io 'being tarried out In accord=ce with Ue memomndum dated 13 APr@"53-il- -fi6di@ the DCI to the DD/Ao wA the extension of t'nis authority in subsequent memor&nu. 1 a4t.8 D AR 110 ct 8 Ot Ave 4*4 IV 40 2 ..46 pq 2 rn r-4 Oa 0 'IO DRA-FT@@ 15 September 1960 M&WRANDLIM FOR#. THE EC SUWSCT NKULTRA Subproject 124 1. It is tequested@@at Subproject- 124--be approved -to 2 support the-research prwam@ofl lwt in "The Psyebophysiological C6t;@- relates of Carbon Dioxide Envir@inment' in accordance-vith-the-- attacbed propqg4l*@@ 2. This studv vill add-to-our methodological 2 -sop4 ti@@@ cation for measuring-caroon--dioxidp-tension and pH76f body-fluids-@_- as V--lll ss Our-knOwledgq:Pt@@@@@ships-betveen blood pH and-certain psychop7qysiologii@a-v-ar-jables m2entioned in the attached proposal.- 3. Thit-@MJect will-t-e-f-undeci -thr,-O-U-gh@@-.. r cover @@posest The---- ounting-fdr-@ @-to-the-established-- 2 --- - - @ --@' - t @e4l@ii ... Titl@@@y permozen pmen PrOci@dure;s of that-Ott6hizati0ii@@ t shall mmain Ivi n eu of overbe4rl char9ges. 4. The total cost of-this project for six months is esti-'-- matp-d to be $6,500 as indicat@o-d in the attached budget. Ch"ges sbould be mde against-Allotment 1525-1009-1902. Any unused D-inds ,will be returned to the the coir.,pleticm of the project, 2 50 been cleared and ha.4 served as a cons'LiltarLt to TSD for a uumber of years. He is witting of true sponsorship of the- TSD/Research Brench Attaebed: Proposal Distribu2tion-.-- Original Onl Approved for Obligation of se Date: 15 SePt.60--- A Proposed Stady of the Payohophysiologioal Correlates of the Carb6d Dioxide Fnvirori,-jent Of aU the enyirowwntal fii67@@loh lnfluftee ha-m" health)- the 'most negleeted mAy be -ono-2o-f --the OKIS CO'nSttA4ntg Of th$-atMOS- phere - cirbon dioxido. dioxide in fresh air ra-is only to 3AOO of :LI* the blood aM the body ce 3 carry dick.xide ton3icn ihich votild ba-ti-equilibtiq4-,with Mi atmosptiore of aboat 5% carbon dioxide,--- Charges in the carbon dioxid47t#"ion of-body fluids are r4slated to mV -1.@hysiolog-ical7tM Is one 2 of the concomitants of wxlet uotion of carbon di- oxide tension resnltt@ vawonstriation-ahd increased siooth ar4 stri. ated misele tonal --with the creation of wany Vmpt@oma. 'Those symptot-ne may t4a extro"ly, unco2-tortable.9- and act to accentuate an-xtety. This 4loiou@s-- circle is very dittioolt to interroptp vol@ Uyj sinoe-broath g a largely an aatonatic fluxtfon. '6'e can inte"upt it by increasing-the carbon-- dioxide content of insplxoj this is PA iiap2ortant mathod-of-treat@- wmiaty states ewaoterized-by hy--@erve-ntilation, An in4ic,,Ation of the of carbon dtoy-ide inh,,tlp.+oion can be seen from tw exa,,iples. @l@-asties and victims of ?arkin- son's diwase may obtain appreciable relief of m--cle tonues for at least as mch a* soferal hours-through-l@reat-hing_a mixturo of-5-74 carbon di- oxide, Ttw mehanima is that b dtdt@it@g the t" the blood,, more body fload c3lciam is-loAUe4 and this i.a-conduolve--t 2 ,o *,iscl* relaxation. Another use of-carbon-dioxid47inWation-libs-in-the t-reat-.-.ent of oussical nigr4int. In this-diseasep the--a-lira 'phase is charaoterized by marked vasoconstriction of-cerebral-*i@@li--w'tilch constitute part Of the tree of cne-or the other orotid-arteriest ALtral phanomenaj, sach as yisaal scotomata-- are a reflooti@x"t -t@@tii@i-corebral- anoxeaia.-- - Af t6i-- MiAUt83 to hours of tti6tpasmo the exhausted----- and Ming Llito varoduation. ,The.,pairkf!il ptiass of migraineiHi"houglit-to-@--' be an actim on-pain Vi't>ers in the stretched walls oJr the vessels. P!reliiii@@:- tr-ary o@oservttions indloate,thgt in@.alation-of carbo-i dioxide in the aira-- 6M abort -the tywrome by catising va 3odil ti phase of cUo3ical migraina before the smooth marclas of Research 2 in Vs eff"t-3-@of-the-collular-carbon dioxide-onviron- mat has been negligible.,-&his-neglect-may be--attribtitablo to cc-yeral reasons.- In the first placo accurate studios of the &aid-base Wance of the blood have uma2-lly required@A@@@@. arterial -blood. This to not easy to cop,* by,* a.Uco artart2l pwi,--tore is a difficult wid painf proced@,iro. TA the second places-there has ioon no "Is portable device for providing carbon dioxide for inhalation.--FinaII7., t@,ore has1 been no .01 -3- concertod effort by pharmaceatical companies to study the problem, since no patentable darg is iavolvedo C"bon dioxide -is cheap owdpro"nt------ Los the onviroamat. Long ago$, one of - the aj>plio atits vorked on the tte id-ba so Wanes with micro mt@,ods wO c&PMO@K:@r blood. - - The method a -vere f al@@@77 curate but vftt complicated. Wo knew-thA+. sim.Dlo *Athods w;ild-be-pLarfeotedp but vsre unable to-do this ourselves. Ih--@@1960 a-atwple idero systeit was We availabl6-in We have developc-d and used -a simple _oortable soures:@a- c arbogen and are presently- using it in exoloratims -of -the treat-vat of migraine. The sit"tion--is h64 ripe 2for a comp-,ehe-.-n--siV6 stady of the-bio@@ chemical physiologioals p--Vahological aM trea-t-@-4At aspects of alteratim - of the carbon dioxide-le"l--of-bodv flt:xide-o It is proposod-that the acid-base eqAlit@2ti44 of psychiatrio - .-41F.jr A@ patients be ear-veyedj, using the nev mthod of Vaz-i&Uons Own- related to diagnosis and coarce-of tlln4e$-$ with th2e c&-w kird of -patients-tho-feasibUity-of altering the acid-ba," equi.Ubri-.in be carbogen inhalation,, - and the duratioa Cf alteration af ter rich inhalations, would'be at,,idied on patientf; ort normal vobntear-so The effect of carbogen inhalation of selected pa5tile@atsp espocially spastioao victiza of :A&-rain* aro4 pstionts vith azlxiety woald be stedic4.9 wiva repeat-- 1?, k. C( fY' age= - ed physical determinations of acid-base variables. Effect of tioid-base chaages on i,=& EKG and blood-prea3ure-voald be determined with--a poly- graph wli@h is already In wmmry.,-the-pri-%ary obje2ctive of *.he proposed study to to the paramt4ra-of aoid-base psychophysiolo- tqal correlates a method vl,'ttch has jast been-made-avail-ablo-. thor* are sp"ifio treat- r-Ant objaotivvsi- as in cases of motor tbn-as.4 milraine and anxi- eityj, these are secondary.- 2. Methods are towntially the miorOtb4"io systeq of -00 stara&,rd inhalatibd@Mthod6-@ a -versatile, polygii@@isher-o appropriatep pqthological- tests a@2o v@01.1 as psychiatric int4eryie"4MJd te used. The-basic facility is a very active pvchis@l-ric service apeoial.-b izing in aoate imesseep together-v-ith the etaff-4hd facilities of a general 3. V4*ic exPloratiO"hoild hot req-Ltire over- 6 maths. 4,, Blidftet@i@l@3 do not -yet have @,A brtakdown on the Sigpard Ander- sen aloparatas., but this &@io@Ad -bo available in a few weeks ar#3 wi.U be sent - - in as a v)pplement. 'rotal cost of a2q,)ptwatas is here catinil@tted as t,21500- .Nrsomolt Prjmhiatriat 3 2-000 (113 time) Ifechnioian Apparatds 20500 141sco,Uanoo,is 9 and (JyerhoM 500 6 6$500 a a large$ qaalifications gomral hospital with 'an aotiyg 2L,-bed psychiatric servi.004 Exten$ivs lab,orator.y and con,aultativo f"ilitios are Ivatlablo, The Hospital i2s- ir.- corporated ime &'nor,-profit organitation aiid is tax-exe,,,Ipt. qualifications of the ProJe@,.t Dirootor &M psychistr@lst are indicated below,, 6* itiith the exception-of ,.qe treat.--a.,it of @dy_raine., 2 directly-bh ---- --- -- the w-tbject of this proposals, Project Director (idthoat Psychiatrist - -applied for a @2-- 00-hdatoloZit-,A grant from th- $0 6 r4l'. - ificgllly for -sttidy of treati,4,it feasibi'lity of cl&3sical za--I_gr&iAe ,kith oarboge@.,i.- -The present req-,iost Is f or basic wt,)rk -6- and overlap wtth the clinical stiady is ndnimal. -k r4ther int-oreating app]4ca@ion of this study aight be in field of peremality eiraluation, Mnce th#sre are certain p cal variables. sath as-a2miety: vhich-relate-to-tho it is jqst 1.)ossible that the now and altople -mthod of avid-t;a@t4 stady 'W*'.ild apply@ here. @%asiblys -t@4o ability of .ui individaal 0 idth-st-and r.@arited acid-' b,ise ch2;krges withokit developmnt of Aisablihl--- -iy@@to:as -or - other- phy-itic al chango3 we,,@- 4 te-an Index of psyehologica-l@@tabilit7-., The-7ibd46ti6"f acid--- bals-- char.'ges., throjoh hypqrw;itii-ati6*@-@d be a kind of-stress test. -WitA---- the-s@-@)parattis vhich-is--proposed@thd@tktaht of acido;b@aA@e -P,,@ang"oald be-d#@@@7 terained readuy. T The Laiicet - Satu-rday 14 -May ,1.6o IRE AICD3- MFTABOUS@M Arterial t,,,-rd s;Dn i-he rda!-iiin L-*efween the A NEW 'V2ROACli rtspirttory Lad @ill -IC-.PLMCIY -'IC K §6d-be,-c etato It thus rcaccis the cxenbine@il POLYL Asl'kUP C fr i 2 c@ C Sp t and ne-)a-rtV"tLiry di tturhances. M.D. CCTOXhAJta inaucn ArAy rtcvx%2 0. Sloc2.&AAD kNE)EX3.LN K. D. Cc@,@tabagea (ancrial pcc)s I 1,4 se clirurbame, PAm LUD"r-s.@w of Ctmc-of C4okts(ry,,R sxtiltt, Cvpcnwdn cit2hcr pri ecmM,%atory. TWii u-cords %ith the general- view.- IN this P*M wt evaluxle F-scices ChAl-ict-fi" JA4, 'it from th2e &,rwal comimr of Mig 'n blc-. disoxb4w,es c,(the &dd-base nicub* c--.mEwtance C Vs a - i-rtspir,j;t4,y acl'd-but diit'.Atb&nLC, tith" C'( usir4 ctci%ical2 vidjes, whict :Lr@ rt.lznt m a cwcll prans@-Y k, -n%at(@ry The bauCLCtCAI-, Sh@)-,Jd t) as wvU as a actniw point of I s - sed - I-n.J 2 ai - itinLirJ bscarN@ti4,lt, or at bsis.- e)ict-is vr "Cmplificd; &ad itn "ytical meth,:)d is d fox 'Sia@n4iard b'(-arb(cate is the coact-rtration of mftv.t,nrxg the Mevint cbcmical cooccrlrati I "g bicat te in bkxd-has twen capulary blood, and available a3 a hodside proct,@d@.u ul at a o2ll 4,) mm,@ tfg -wh@@d-,he haiii-@@@ic)bta is fu,'@ly oxygc---atc-d LAi Cuftiic*ttoa of r>tsturb",Cts - 2--- Tle term acidofis abowd denoc a patbvl -N i eA and Asu%ip R&,4 6@v u:) ocmmubnion o( odd or to IfA& of base. These de dirmlv expres.%cs the-aryw)unt (in mFq.) of strc.@ns pr*sibfliti" m-av Imi to the saff-c cli&ml pittur, both ba3 O'cid, vid;td p@tt litrc b'icod, whea th,: no.-mill mean tmd to lower pi-I in the ortar-ism. SiG-litutv, at," cmiv hxcd at zero. Zuo thus ccrt2csr.-)cds tc- t@,.c --Iw -2 9 mEq. pcr bmei baj4,3sis, should mean a ra?hologi4@2J c.@m ucin u4 rnea@a for 31an'lard biwbu c (2 to accumulation of base of "I of acid, -When the term but "@C$6 is u4cd cx%;Iosivcly The tanms " sod t,4.*.-- " arc in t.S@s pii)cr foe- values -will cxl"u the c3rces3 of t4w. while hydroom-ion doc@or jL-A soc@ptor, respectively.- &co-wdini to tive values wiu ouprc%s the deficit-Tof- bAAe Nw*W k 1923). --of acid); ani this in l'be w @-if thse wimy acccpced defirti6ors incretift clarity- li (Dc"x 1953, Prrterita 1954, Rehran IVA), espc4:ialty % 11--e, The 95"--Q r-anqcs or thest @-%!;Cl$ 1krt-. actciisl the brid-t4" trcuboum can b@e detlt *,ith wjcpcn n ti p1 7-3 &rtcna) p(',Oo- 34-45 mru. H4; standard tf-w C66.3a D-jp--abouLm- are neither IL-@& n-c@f bales vid bicarbowt 3-24-Sml-'q.mLtitibastexcLc-ss -2,3to obou-M consct-iently am t-e deti#nated baso (e.s@s " una be*" "), but c&Cg-xts. 4 2-3 mEq. itrc (Sia*ard ikndcnica et 2al@ 1960). Of &U acids and b&3,-4, c&rboric u-id is physiolcv la : CANIS@JCTCD t).C PkAtiblt xx@intent 2Ff tb,- cAhLUL- 3pt-V "W-!. &M then f(.,V e. CLt Of the fftsmxnt 2 by (Wjcnr bl,,%od "ysu an W,-qv w,@, uxfw iam -tm Cl ven. ertrtst-wnt is avoi&d 7-1 7-t 7-3 F4 I-& 7 6 7.6 imjxlrttot to esti"te &o al,@ i- of scid or btic. F'4 iwt fs@6@LDY s(i *ha-LIX ItNs is trarenal-.-tls.t in P4. t--PJ@ KO. U@04 lot bWO4 "MR14-1 wh% db-&Zf-m hmvi@; S&A$itivi m sftb?tf'.@ C%A4a A, 3. %&d C repcvw" w=pU* ol nLwrAl bl.>-),l ir ith ii of C@ 10, wA 1.0 S. pct IW aJ. md C, *?ww tbt &VtiKemnt after &MAM)G of f@x,-d a-id (15 ) rnfq,_ welx " m litit K2-)odl-. &NJ A,, 8,, " C, &Atr &.-tdkkA Oi t-t.%c (11 atlq. "- cwta"t pet litre b$A)cd@. The peipts a inter- Water 2 aftsim et L@-m lubn kcm a cwyc Thc t,atc-cz,-cu c%irA-I,, which 6&,u4o tbt uk-au Qt t*ae excea4 -,pkmttvc v4L',uts@ and t,4i4 dcft%;tt (260%wtvt V's@ws, ia %AY la PM Mal 4 lass or pwtivo value found for beR exceit, in nt4-per litfe-- 2b&,,od, by 0-3 x the body-weigbi in VS., where the c 4! G'm W*t !r --- ---- fsctcc 0-3 is L-nmd expc@,tnt@Hy (,MclIG-ngaarJ and 2 Asuvp 1960). INs Lnount o-T-,csponds ulirt@-tly I(, the anw)unt of sodium bicubmate ot of tmmi)ni4m chl4,ride Water inlet .tquired to rmtmlise a mn-mpin,,ory dist 2 ce in the Fw IN# n44,i bokly, the factcq 0-7 ih*Wld tle To t@,-rA&stat 0-3 (Palz@et md Van Slyte 1917). 14 &-s-Ung wrth pwticrra, however, of clzcis or 7se imitap dcfk,it of t4w in the wWc body seeni to be dkrc*-q pr*potdc" to the #-,x%:cst or deficit baic !n the ng, *-CA,,41a" gt&u tot ooa-mtog 1038 A4ky 14,1961) ORIC14AL ARTICLIS TIO/ LAW-St mish-toks@on Low-t$Alli*R When fixed is added to the bkx4 Is di2i---- gig gwritt p6ctd to the left. U-oan bam is bi&d, Um is &it-- pls,-td to t.14c r4hi. Nlcrw a V-sph (Eg. 22) w4wtz-jcted icipres4ng t-he d:splwenwu cwjsed b7 o( add or but, indcpm-dtnt crf the 2 (SigWrd Ar)d@ and Emgd I The rki-nt of into this-curyt and ii ft determ to the abqve rditvint v-jl%xs f-.,t chars-,tefitirag the &--Wt*x ttirw, Uterial Puncture$-Lf'C T'Wi is a dmwt*-k when fttqijent &nalysts &re btvdcd---fcc its-*net at inttrvsjs of minutes in 7 4 0 %.-- 40 Ca$-et with rvid ChAnce@s in the "Pirst:cct a ... se6cothtsic4cg7, so &. $*is sc6qt A usiiv aboit 100 VI. bkW, wu 2 70 derefo" dmk-Vtd (Si&Swd Aaden4ta et 00 too. -13 Afw" A" 2 The t)*-,-cvtk4 b&Lirv, u-,d f--v the -clkulm N . i , .0 Of PC.OL. avidkd bkwbmat, -tmd bLs 0 S le --- 2 c cic is dw grOO4 usowir4 the ttkti ft 7--C@me Si vabow f@w Ko, a" I"" of W4*d t"m I abrow pOC@ @d pH are appr@e"t@'i u2sigh "road AWWW a &%mm et umd-i&W @kwi (sboim cipcrimmtaay by Brcwin et 01. I so rwqhio. &264 2 S Oa Tw wdkee pH@ pu. AoJ biik@*wdw 6tocu" t@@ W4"4(@- Axrup 19%). Ilc dope c( d3.c Un%-% d the buffet cmpsdty cl the bkx-xi By fac- 2 ing S b" wavu at k--10" tent@-zs md owler, a cim, dwu@k*txt, a pacioa parm a a4oro- nk*vuriag die pH mmot is ditt- ciftuodt (ft.A4)1 2 wditV to AOmxAlt5l)@@@ nlimd (f4. 1). If tbc t4--k-d umpk is (fig. 5):-Akt dbw pom- cm lu@, dlen the uxlw be fowd. be axwwd CID a pol@xbk ubk wgcdw ri* m au" cylodoo ammialat mk*wei of mnts 2 and W1510 &Cai& 7-1 0"4!1@.@@ is &"M (rCM CW Ot to Ls tbe- -t" pH oboa 20--25 $AL 2 768 I mdy in&* @k co@@ tro& (t@A 4e of Uu 1 "7) wA the 7 1 2 rading IIE-F iftma&mciy, or it k rd@ad bm @*A drt,.% smaobkndy 30 7-4 2 ------------------------ ifito a bepww@d C&Piowy g@o" rub-c W" +o a - I sodium NKvidc Abxt 60,-W A. of blod 2 ........ niba is dlysded 4t I a @-- ftm MO cviak7 rt&u 1.3 to bccwm rwo C-f & 2ClAMLcn in the eqw- ? tibc&6oo appamr '-PM thakam Iva i@i L 2 ffwch&nicaly (26.'o f-p@m) mbd &her dw" tninutes the pH rdi7m in LA) rwo taaip&" 2 &rt mtuuted v=twl*. - By udag &m t a 4 5 6 7 S --S two VO-'ft AM Lse omrm*czdio6g p2cot- "hoes (fiom the cy@). the PKIOC pCO, Ime is dmwn-aod the pCOl. 2 The otakwa ac@ws pti. IPCO. ad ban ex@ma, t%e iL@%e is &ium. I"@mdwd bk-wbccate, sod bw am,.@a4 cm* F'ot %Wt@vw nrie@ we tm. 9be @mkvwod (fig. 3). T-be me%bod i4 (3F- MAY 14. LRRA kI. At sccu"te, as the ifirce vallits can be found with &a MFDICAL ASPEI;TS k)k ROXD FY er,@ _V of I tu than - 2 Ni.I;LMA,.N M LI .. B, Sc I @@d [it-44trative C-sit4i 2 cmir XIVIL4.L CFIIICFI T _,k" r tL&-LTiva 'I'he alvanttge of frtq,.-ient rtgistra!ioil of ril, P('.(., To drive safely reqluitcs the rise o rtain phy2zical and - and b4w exce-st by the n-.cth(,.ki icscTib-Ld here is illustrated 1, I' -- - , - - - - - - nablt de B,,jt these quibties 2 in the following twt) v,@tcs lig4. 7 sh4.;w a clkl$n-- qLialtt)c5. in reavi ____ can seldom tc-pteciielv--defin Lid they alnnot be 2 v)tiyjcot &!aphiA; system 14,r tticte ftlec "U*I"i t-S. qki4ntifieJ. Pcirh:ips the nature amount of the tyn:ght Case I.-F,# 6 s@,wws bkt),J values fill I p ore &Uy tilabbshed than IS "in old, Wfated on ftir a def,.xi in the ;ttriil the bt&nmg of the, orgratkm the raluct for the n IC$, t@ even here the b-.lfdtttine way cumponent indicatt a sltiht base &foat. pc@siibl to drive is skimewbat ixvtsb*cn,)6ve phai@e. A rrz&nafcst noc2-mpttitory id,,t i s atbitiarv' ( @:s: c2eu crAt4" the ttxw -4 bt4c in the , ume and th lo@te K7, 1"7 S. ad Y. lw*ji 9. V7. &&it or tict" 4L - V"A in c knt UP. p@ k I 4A'. ". V 122 mt1kagwj, K., &Suup, P, 119*)) J@%i in the P"n) t-r,mcuwar "C to tv L*l@ 'W@ V&n Shk,- ID@ D2- tIS17, Y lhd. Chws. ic 4". AA occur*tt Weldc me using capillwy bLxA, Vl,.Ar I-V I III, ?!-I. foc d4tttvv%ir4n# all rclcn-mt bk,.L%l values (or the id2enti.5c&- llk,'--. A S t 1"4) Aoww. 1 M.4- 1 1. S @. s@ PA t.' i I 05 7,@ C4i4. C-Wo 1, " t@M ri dl:$tUrtAACCI in 'he Kid-t*St MCI-,X-k%M, qUAil- Sb,%Lt. K V Hw-top, A 3 t It" I Xd. Cb". I It 239 t*tivtly aod quant,.Lttikrly, has been dt,@isf-J. S46-sal J *.A&tvm. 0 . afta, K. 9I IW' Scwd 1. dtx UO IWATI (to the Jtofort"ctt .1 fm of ndxt eolwxa R 8 , ttm4-L-4s. A. I 26 August ig6o X&MOROIM FOR-. THE MOORD SLTBJLR,T Approv, a! tes of the PSY@@ of the Carb oxide Environment.'--2 AIIIN.ND.WE sulbzvm: 1. ReqWo ,500-to carry study was eLyproved.---It was-recognized that thi rily a t-echnioue study as propQ4teA@@.1- am,-% apparatus. a -t de 2 veloped. . - - - 1&1&&. d to woef. vi n . the --rime- -was - pro- be--gLEUIed thr@Dugh the- t> knv 2viii-r@ Dis-tribu"v,ion,. Orig & 3 Bee d. EW. iwo 4M@or f4ile July 18, - 1960 Re. 'A PtS@@-Sk@