52 



METABOLISM IN SEVERE DIABETES. 



dition of the patient while at the hospital in November 1910 was critical. 

 From December 28, 1910, to March 1, 1911, he was under the care of Dr. A. J. 

 Hodgson, at Waukesha, Wisconsin, where he gained in weight up to 54.9 kilos, 

 without clothing. The treatment was said to have consisted of a large quan- 

 tity of vegetables, nuts, and water. Unfortunately no analysis of a specimen 

 of the 24-hour quantity of urine was made during this period. Death occurred 

 in coma March 14, 1911. An examination of the organs of the patient was 

 made by Prof. F. B. Mallory, of the Harvard Medical School, who writes that 

 it showed absolutely nothing abnormal; the pancreas was in all respects normal. 



Physical examination. A well-developed and nourished boy with good 

 color. Height 168 cm. Pupils equal and reacted to light. Knee-jerks nor- 

 mal. No edema. High-arched palate. Pulse-rate 96. Physical examina- 

 tion was otherwise negative in September 1910. 



Urine data.- The urinary record is given in table 58. Previous to Novem- 

 ber 1910, when the patient first came under observation, the greatest quantity 

 of urine was 3000 c.c. It subsequently rose to 3500 c.c. on December 15, 1910, 

 but after that date there is no accurate record. The reaction of the urine was 

 acid during this period. The ammonia reached 6.4 grams on December 15, 

 1910, and on November 18-19, 1910, the quantity of /3-oxybutyric acid was 30 

 grams. The albumen never exceeded a very slight trace. During the summer 

 of 1910, the patient was sugar-free for several months. Throughout the period 

 of observation, 20 grams of sodium bicarbonate were given the patient each day. 



Table 58. Clinical chart Case Q. 



1 For 20 hours. 2 Vegetable day; vegetables, 6 eggs, 240 c.c. cream, bacon, coffee, broths. 



'For 24? hrs.; oatmeal day. 'Oatmeal day. 6 For record of urine for Nov. 23-24, see table 63. 



8 NaHC03 given each day, 20 gins. 



EXPERIMENTS WITH CASE Q. 



Four calorimeter experiments were made with this subject, all with the 

 bed calorimeter. In the first and fourth experiments, the metabolism after a 

 12-hour fast was studied, and in the second and third experiments, after the 

 ingestion of oatmeal. A comparison of the results of these experiments is 

 made in table 64. There were no respiration experiments with this subject. 

 The vital statistics were as follows: 



Date of birth, March 1, 1896; height, 168 cm.; range in body-weight with- 

 out clothing during experiments, 51.4 to 52.0 kilos. 



