196 A BIOMETRIC STUDY OF BASAL METABOLISM IN MAN. 



of the surface-area law to subjects in widely varying states of nutrition. 

 Criticism will of course be at once directed against the use of such 

 evidence. It will be contended that prerequisite conditions for the 

 application of the surface law as outlined by Rubner 85 are like physio- 

 logical conditions, such as nourishment, climatic influences, tempera- 

 ture, and capacity for work. Just such adverse criticism has been 

 made of conclusions drawn at the Nutrition Laboratory concerning 

 the basal metabolism of normal and atrophic infants. 



In reply to such comment it is necessary to point out merely that 

 the physiological states of the fasting man are by no means incompar- 

 able with the conditions commonly existing in pathological subjects. 

 Notwithstanding the fact that enormous variations in the previously 

 mentioned physiological factors are invariably found, their metabolism 

 has been treated by authors just as though the body-surface law were 

 fully applicable. For example, in a report on a series of observations 

 made in the Nutrition Laboratory on patients with severe diabetes 8 

 the metabolism of the diabetics was compared with that found in 

 normal individuals of like height and weight, i.e., of a somewhat thin 

 and emaciated type. The marked difference in metabolism found with 

 diabetics when acidosis was present as compared with that when it 

 was diminished or absent 87 led to the conclusion that diabetes increases 

 the metabolism approximately 15 to 20 per cent above that of the 

 normal individual. When a wholly arbitrary normal standard value 

 (obtained with a large number of individuals of whom the greater 

 proportion were in full vigor) was used for comparison, Graham Lusk 

 concluded 88 that the emaciated diabetics with acidosis showed little 

 or no increase in metabolism. If it is erroneous to apply the surface- 

 area law to an individual normal subject throughout a prolonged fast, 

 it is difficult to see the validity of applying it when there are such 

 marked variations in conditions of nourishment and bodily vigor as 

 exist between the large group of normal persons and the group of 

 emaciated diabetics. We must, however, in this connection, refer to 

 the detailed discussion of the influence of rapid changes in nutritional 

 level upon the basal metabolism on pp. 102-103. 



With the fasting individual it is evident that the body-surface law 

 does not obtain. The differences in the fasting man at the beginning 

 and end of the fast are by no means so great as the differences between 

 pathological individuals, including diabetics, and the average normal 

 vigorous individuals from whom the standard of comparison proposed 

 by other writers has been derived. 



85 Rubner, Arch. f. Hyg., 1908, 66, p. 89. 



89 Benedict and Joslin, Carnegie Inst. Wash. Pub. No. 176, 1912. 



87 It has been demonstrated that when the diabetics are without acidosis (for example, when 



following the remarkable Allen treatment), the metabolism is distinctly lower (Joslin, 

 Am. Journ. Med. Sci., 1915, 150, p. 485) than with ncidosis, so that unquestionably the 

 acidosis per se materially increases the metabolism. 



88 Lusk, Science, 1911, n. s. 33, p. 434; ibid., Journ. Biol. Chem., 1915, 20, p. 599; Ibid., 



Science, 1915, n. s. 42, p. 818. 



