20 



METABOLISM IN SEVERE DIABETES. 



appear that whenever the store of available carbohydrates in the body is 

 exhausted, coma develops. For this reason carefully instructed diabetic pa- 

 tients are cautioned to guard against sudden inroads upon their scanty store 

 of glycogen by increasing the quantity of carbohydrates in their diet whenever 

 signs of indisposition appear. These patients, Case A and especially Case H, 

 knew this rule, but they were unable to retain any food. 



Table 7. Clinical chart Case H. 



NH3-N 



'Ammonia, 3.1 gms.; = r r; =16.8 per cent.; NaHC03 taken, 4 to 8 gms. 



iotal N 



2 From 7 a.m. to 1 p.m. 



EXPERIMENTS WITH CASE H. 



Five calorimeter experiments and one respiration experiment with this 

 subject were reported in the previous publication. One experiment with the 

 bed calorimeter is reported here. The vital statistics were as follows: 



Date of birth, May 19, 1872; height, 159 cm.; body-weight without 

 clothing during experiment, 54.1 kilos. 



Table 8. Measurements of metabolism. Calorimeter experiment No. HI. 



1 Subject drank a cup of black coffee at 7 a.m. 



2 Carbon dioxide eliminated per kilogram per minute, 3.01 c.c; oxygen absorbed per kilogram per minute, 3.97 c.c. 

 The urine collected between 7 a. m. and 1 p. m. amounted to 860 c.c. and contained 2.73 grams of nitrogen 

 and 25.6 grams of sugar. Sublingual body-temperature at beginning, 98.4 F.; at end 98.2 F. 



Calorimeter Experiment No. HI. 



Date, April 22, 1910. Body-weight without clothing, 54.1 kilos. 



On the day of the experiment the subject ate no breakfast before coming 

 to the laboratory, taking only a cupful of black coffee at 7 a. m. Her evening 

 meal the day before, which was taken at 7 o'clock, consisted of shad with roe, 

 one French roll, and Romaine salad with French dressing. At 10 p. m. the 

 same day she took one-half pint of heavy cream and 4 ounces of wine. 



She reached the laboratory at 8 h 03 m a. m., and entered the bed calorimeter 

 at 8 h 26 m a. m. The experiment began at 9 h 23 m a. m., continuing for three 

 1-hour periods, the last period being extended 6 minutes in order to secure favor- 

 able temperature conditions. The experiment ended at 12 h 29 m p. m. After 



