The intravenous infusion of sodium bicarbonate causes an alkalosis and an increase of lactate concentration in excess of 10 mmol/l in the experimental animal. The causal relation of alkalosis and lactic acidemia is also found in patients. A case of a therapy resistant alkalosis is demonstrated where a blood pH of 7.5 to 7.6 was correlated to a blood lactate concentration of 5 to 10 mmol/l. The normalisation of alkalosis was accompanied by a normalisation of lactate concentration to values of 1 to 2 mmol/l. The causal relation of alkalosis and increased blood lactate concentration seems to be obvious. We conclude that alkalosis is counteracted by a metabolic compensation due to the non volatile and lactic acid. Hyperlacticacidemia, therefore, is not identical with acidosis.