PART III. 



DISCUSSION OF RESULTS AND GENERAL CONCLUSIONS. 



While in general the order and method of discussion of the subjects in this 

 publication follow that in the earlier report, as experimental evidence accumu- 

 lated certain topics which were much more completely studied warranted more 

 extensive consideration. Furthermore, while in the earlier publication it was 

 important to emphasize more especially the relationship between the respira- 

 tory exchange and the character of the metabolism, particularly with normal 

 individuals, here it is necessary to pay but little attention to normal metabo- 

 lism, because it is believed that this phase of the study was amply treated in the 

 earlier report. None of the experiments with food are discussed in this report 

 pending further investigation, but the statistics for these experiments have been 

 presented in order to record the data permanently for subsequent use. 



Pulse-Rate. 



In the earlier series of experiments a cursory examination of the pulse-rate 

 taken from time to time indicated that there was apparently no marked differ- 

 ence between the pulse-rate of normal individuals and that of diabetics, the 

 fluctuations in the pulse-rate of the diabetic subjects being within normal 

 limits. It would appear from the lack of data upon the subject in the text- 

 books of medicine and in the monographs upon diabetes mellitus that this 

 coincides with the opinion of most clinicians, but such a conclusion rests upon 

 negative evidence alone, since usually little attention is paid to the pulse-rate 

 in chronic afebrile diseases of a non-circulatory type. It is quite possible that 

 a closer study of this factor may supply much information of value. 



In physiological experimentation it is frequently difficult to distinguish 



between the normal and the abnormal. The popular conception of a normal 



pulse-rate is the observation usually made by a physician in his office, which 



may often be affected by the muscular exercise of the patient in walking to the 



office, or the excitement incidental to consulting a physician. To obtain a 



true normal value, however, the observation should be made under conditions 



which would insure its being unaffected by food, exercise, or mental stimulus 



of any kind. Such conditions are obtained when the record is taken with the 



subjects lying quietly in bed without food. It seemed therefore desirable in 



the later researches to make a more detailed record of these values, and study 



carefully not only the pulse-rate of the diabetic subjects, but also of the normal 



subjects used for comparison. An abstract of the results is presented in tables 



108 and 109, in which are given the minimum and maximum pulse-rates 



recorded while the subjects lay quietly without food in the bed calorimeter or 



on a couch in respiration experiments. The values given for the diabetics 



include those obtained for all of the subjects in both the earlier and the later 



experiments, with the exception of E and F, no records of pulse-rate being 



available which were taken while these subjects were lying down. 



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