CHAPTER VIII. 



STANDARD BASAL METABOLISM CONSTANTS FOR 

 PHYSIOLOGISTS AND CLINICIANS. 



1. THE NECESSITY FOR AND FUNDAMENTAL NATURE OF STANDARD 



METABOLISM CONSTANTS. 



While the discussions in the foregoing chapters should show that 

 the determination of basal metabolism, or of variations in metabolism, 

 in normal men and women presents a series of important physiological 

 problems, it is quite evident that investigations of metabolism will 

 receive the widest recognition and be of the greatest practical im- 

 portance if they can be extended to include measurements based on 

 individuals performing different amounts or kinds of work, subsisting 

 on different diets, or suffering from various diseases. 



All such studies must be comparative. The metabolism of a group 

 of individuals affected by any special condition has little interest 

 unless it can be shown to be the same as or to differ sensibly from the 

 basal metabolism of a comparable group of normal individuals. For 

 example, before any discussion of metabolism in individuals suffering 

 from disease can be of value a series of non-pathological controls 

 must be established to serve as a basis of comparison. The need for 

 such control constants has been recognized with varying degrees of 

 clearness by all those who have worked on the problem of the metab- 

 olism of individuals suffering from disease. 1 



While, as far as we are aware, it is now universally considered that 

 the value of a metabolism determination on a pathological subject is 

 strictly limited by the trustworthiness of the normal control with 

 which it is compared, the establishment of suitable controls has been 

 the subject of serious disagreement. " Controversies have raged more 



1 Magnus-Levy and Falk (Arch. f. Anat. u. Phys., Physiol. Abt., 1899, Suppl., p. 315) stated 

 one of the purposes of their research begun in 1895 to have been the determination of normal 

 metabolism data for comparison with their pathological records. Benedict and Joslin (Carnegie 

 Inst. Wash. Pub. No. 136, 1910) in 1910 published such determinations on normal subjects as were 

 then available as a basis of comparison with their diabetic individuals. Lusk (Science, n. s. 1911, 

 33, p. 433) in reviewing this publication, emphasizes indirectly the importance and the inadequacy 

 of control series. 



Again, in reference to investigations of respiratory metabolism in disease, Du Bois (Am. Journ. 

 Med. Sci., 1916, 151, p. 785: also Studies Dept. Physiol., Cornell Univ. Med. Bull., 1917, 6, 

 No. 3, Part II) says: "The main object of all investigators has been to determine the heat- 

 production of the patient while at complete rest 14 hours or more after the last meal. This is the 

 so-called basal metabolism, and is of interest only when compared with the figures obtained on 

 normal individuals. Since it is impossible to measure the metabolism of many of our patients 

 when they are entirely recovered, it is necessary to calculate what the man's metabolism would 

 be were he normal." 



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