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The results reported in a previous paper of this series (Harrison and Pilcher, 1930) led us to accept tentatively the hypothesis of Eppinger, Kisch and Schwarz (1927) that the buffering power of the tissues is diminished in congestive heart failure.Since the evidence from our previous work was indirect, it seemed wise to study the matter further by more direct methods. Accordingly, the pH of the blood, determined by Cullen's (1922) method, using the micro-modification of Hawkins (1923) and the bicolor standards of Hastings and Sendroy (1924), and the carbon dioxide content of the blood, determined by analysis in the Van Slyke-Neill (1924) constint-volume apparatus were studied in patients with cardiac failure and in normal subjects, in four series of observations. a. The pH and carbon dioxide content of the blood at rest was found to be usually within normal limits in both the "decompensated" patients and the control subjects, as shown in the left-hand parts of tables 2, 3 and 4. However, that a state of "cardiac acidosis" may exist is shown in table 1.b. The effect of the oral administration of 15 to 17.35 grams of ammonium chloride over a periQd of 12 hours was found to be approximately the same on the arm vehous blood (drawn without stasis) of normal and "decompensated" individuals. The data are shown in table 2. These observations were suggested by the work of J. B. S. Haldane (1924), who showed that ammonium chloride given in large amounts by mouth caused a diminution in the alkaline reserve of the blood.

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