[A story about water]

On the basis of one case, the authors review the symptoms and signs of alcoholic ketoacidosis. This occurs in general in a middle aged woman during the abundant ingestion of alcohol. It presents as drowsiness, headache and vomiting. Laboratory examinations reveal slight hyperglycaemia, hypokalaemia and a metabolic acidosis with the presence of ketones in the blood and urine. Blood alcohol level is nil. No other cause of ketoacidosis is found. The course is rapidly favourable. The biochemical mechanism is poorly understood.