DISCUSSION OF RESULTS AND GENERAL CONCLUSIONS. 



125 



while this evidence from experiments with individual subjects is by no means 

 conclusive, it supplements the general impression derived from experiments 

 with different individuals that with severe diabetes there is a high metabolism, 

 and with mild diabetes a lower metabolism. This last inference, however, is 

 drawn from experiments with different individuals, while the experiments with 

 Cases N and Q imply that with the same individual, differences in intensity 

 of the disease may be accompanied by differences in the intensity of the 

 metabolism as measured by the oxygen consumption, the pulse-rate, and the 

 alteration in the carbon-dioxide tension of the alveolar air. 



Table 134. Comparison of the metabolism of Case Q under varying conditions of acidosis. 



The Influence of a Normally Induced Acidosis upon Metabolism. 



Since diabetics with severe acidosis showed a higher metabolism than did 

 light cases, and since the metabolism was higher with the same individual when 

 the diabetes was very severe than when it was milder, it seemed desirable to 

 find out the effect of an experimentally induced acidosis upon the metabolism 

 of normal individuals. While studying in the laboratory of Dr. Joseph Barcrof t, 

 of Cambridge, England, Mr. H. L. Higgins, an associate in this laboratory, 

 made some interesting observations on the relationship between the effect of 

 a carbohydrate-free diet and the dissociation curve of the blood. While upon 

 a carbohydrate-free diet he observed great lassitude and a general feeling of 

 malaise. On repeating this experiment in the fall of 1911, it occurred to him 

 that a study of the metabolism as measured by the oxygen consumption and 

 carbon-dioxide production during this period would be of interest, and hence 

 some observations were made of the total metabolism. Subsequently, a 

 second experiment was made with another subject, H. H. A., a student in the 

 Harvard Medical School. This was more carefully planned, with the special 

 purpose of studying the effect of the carbohydrate-free diet upon the meta- 

 bolism. 



In a paper recently published by Benedict and Higgins, 1 discussing the 

 effect of the amount of carbohydrates in the preceding diet upon the respira- 

 tory quotient, it was shown that the respiratory quotient with a carbohydrate- 

 free diet was as low as the ordinary quotients in diabetes, if not lower, and that 

 the respiratory quotient could be elevated persistently by increasing the quan- 



'Benedict and Higgins, Am. Journ. Physiol., 1912, 30, p. 217. 



