106 



METABOLISM IN SEVERE DIABETES. 



The somewhat higher value found with the chair calorimeter for Case X over 

 that found with the respiration apparatus is again accounted for by the natural 

 influence of change in position and muscular tonus incidental to sitting up. 

 For the purpose of securing average figures, the carbon-dioxide produc- 

 tion of all diabetic subjects thus far studied by us with the chair calorimeter, 

 bed calorimeter, and respiration apparatus has been collected, averaged, and 

 presented in table 121. On inspecting the average values for the severe cases 

 it is again seen that the results are somewhat complicated by the fact that in 

 the first place the same number of individuals were not studied with all three 

 different forms of apparatus. Secondly, the values found with Case I in the 

 chair calorimeter were obtained nearly a year prior to those found with the 

 same case in the bed calorimeter, during which time the disease had pro- 

 gressed and the subject was in a much more critical state and with an essen- 



Table 120. Carbon dioxide eliminated per kilogram of body-weight per minute by diabetics in 



experiments toitho ut food, 1 91 0-191 1 . 



>At 6 b 45 m a.m. the subject ate a light breakfast consisting of a 2-egg omelet and a cup of coffee. The experiment 

 began at 9 h 22 m a.m., the last period ending at ll h 10 m a.m. 



tially higher metabolism, although with considerably less extraneous muscular 

 activity. Probably an average of the results obtained with the bed calo- 

 rimeter and the respiration apparatus will represent more nearly the grand aver- 

 age of the carbon-dioxide production of subjects with severe diabetes lying 

 quietly at rest. This average value, 3.33 c.c. per kilogram of body-weight, 

 may be taken therefore as the average carbon-dioxide production of subjects 

 with severe diabetes. The number of cases of moderately severe and light 

 diabetes are too few from which to draw any general deductions, although a 

 distinct tendency is shown for the carbon dioxide to be somewhat lower in 

 these cases. 



