110 



METABOLISM IN SEVERE DIABETES. 



Table 124. Average oxygen absorbed per kilogram of body-weight per minute in experiments 



with diabetics without food, 1908-1911. 



RESPIRATORY QUOTIENT. 

 The relationship between the volume of carbon dioxide produced and 



oxygen consumed I ) , the so-called respiratory quotient, has peculiar sig- 



v O2 / 



nificance in interpreting the degree of severity in cases of diabetes. The accu- 

 racy of this value depends upon the accuracy of both the determination of 

 carbon dioxide and the determination of oxygen, and it can thus be seen that 

 the respiratory quotient as such is a difficult matter to determine with great 

 exactness. In the earlier report the respiratory quotient for all the cases of 

 diabetes was considered in detail and in table 125 we have presented anew the 

 earlier work, carefully distinguishing between the severe cases and the lighter 

 cases. 



In recording the results for the respiratory quotient, it is unnecessary to 

 consider separately those obtained with the three forms of apparatus, for there 

 is no physical difference in the respiration in either the chair or the bed calori- 

 meter, and obviously the character of the combustion and the material burned 

 or metabolized will not be appreciably altered by different body positions. On 

 the other hand, it is reasonable to suppose that the carbon-dioxide production 

 and oxygen consumption might indicate a difference in the character of the 

 combustion, according to whether the subject breathed freely in the calori- 

 meter, or whether he breathed into the nosepieces or mouthpiece of the respi- 

 ration apparatus. Accordingly, in giving the results of the earlier experiments, 

 the values obtained with the calorimeter are compared with those obtained 

 with the respiration apparatus. It can be seen that the respiratory quotient 

 in the severe cases of diabetes averages 0.74 with the calorimeter and 0.73 with 

 the respiration apparatus. The fact that there are not an equal number of 

 experiments made with the same subject on both apparatus complicates some- 



