DISCUSSION OF RESULTS AND GENERAL CONCLUSIONS. 



113 



It may be concluded, therefore, that with the subject lying quietly without 

 food the respiratory quotient in cases of severe diabetes is 0.73; as pointed out 

 in the earlier report, respiratory quotients carefully determined that indicate 

 values higher than this are to be considered a favorable prognostic indication, 

 and show a rather more liberal supply of carbohydrate material in the body 

 than is usual in severe diabetes. 



The difficulties incidental to determining accurately the respiratory quo- 

 tients are only too well known to experimenters, and hence it would be entirely 

 incorrect to lay great stress upon individual figures in this series. The general 

 tendency of all the quotients to approximate the value 0.73 is significant, as is 

 likewise the absence of abnormally low quotients. 



Table 127. Average respiratory quotients in experiments with diabetics without food, 



1908-1911. 



Subject. 



Severe diabetes 



Case A 



B 



C 



D 



E 



F 



G 



H 



I 



J 



K (1910) 



L (1910) 



N 



O 



P 



Q 



R 



S 



Subject. 



Severe diabetes Con. 



CaseT 



U 



V 



Av. severe cases. 



Moderately severe 

 diabetes. 



CaseK (1909) 



L (1909) 



W 



X 



Av. moderately 

 severe cases. . . 



Light diabetes. 



Case M 



Calori- 

 meter. 



0.73 

 0.73 



73 



0.76 

 0.77 



6i78 



0.77 



0.77 



Respiration 

 apparatus. 



0.73 

 0.73 



73 



0.70 



o.ii 



0.74 



0.73 



0.75 



INDIRECT CALORIMETRY. 



Although, as pointed out on page 12, the direct heat measurement in this 

 series of experiments was unsatisfactory in a large majority of the cases, it 

 is important to record that in one-third of the experiments in which accuracy 

 in the heat measurements is assured, the relationships between the oxygen con- 

 sumption, carbon-dioxide production, and heat production are essentially those 

 recorded in the earlier publication. We have, therefore, no reason to change 

 our belief that the calorific equivalents of carbon dioxide and oxygen are essen- 

 tially as previously outlined, namely, 3.26 calories per gram of carbon dioxide 

 and 3.31 calories per gram of oxygen. If, then, in experiments with subjects 

 having severe diabetes, the carbon-dioxide production is accurately deter- 

 mined, we believe that the heat production can be computed with considerable 

 accuracy by multiplying the total carbon-dioxide production in grams by the 

 factor 3.26. 



Usually, since the carbon-dioxide production is obtained with the subject 

 absolutely quiet, lying in bed, it can be easily seen that the results obtained 

 by this computation will represent the minimum heat production and not the 

 average or maximum heat production. When the subject is sitting up it has 



