Without any qualification one must agree with Dr. Nottingham's statement that "adequate alveolar aeration" is the primary problem in any type of respiratory acidosis, including status asthmaticus. However, there are times when aeration cannot be returned to normal by use of steroids, bronchodilators, and usual fluids. We must even add that, as stated in the review by a group in which one of us (J.S.) is a co-author, all of these are desirable, general measures which will help many patients; but, for other patients these measures by themselves are insufficient to induce recovery. As shown by workers like Holmdahl, et al. and Matell, even addition of mechanical control of respiration may be insufficient to induce recovery and alkalinizing agents will need to be added.