354 du bois: basal energy requirement of man 



metabolism 10 or 12 per cent for six or seven hours. One hun- 

 dred grams of glucose may cause as great a rise, but for a shorter 

 period. The stimulation from fat takes place much more slowly 

 and does not reach its maximum until six hours after the meal. 

 This stimulation caused by food is the specific dynamic action 

 described by Rubner and studied in detail in the last few years 

 by Lusk at the Cornell Medical College, New York City. 



Muscular work affects metabolism to far greater extent than 

 all other factors combined. Even walking at a moderate gait 

 may increase the energy consumption threefold, and riding on a 

 bicycle ergostat may increase it sixfold. Work of this type is 

 done with an efficiency of 22 per cent. Only 78 per cent of the 

 energy consumed is wasted, the rest being transformed into me- 

 chanical work. This is better utilization of fuel values than is 

 found in machines that use coal. The body works more econo- 

 mically than a steam engine, but we can see why a lumberman 

 in the Maine woods needs 9000 calories of food a day, which is 

 three times as much as most of us consume and six times as much 

 as our requirement would be were we to maintain it at its basal 

 level by staying motionless in bed all day without food. 



BASAL METABOLISM IN DISEASE 



It has been possible at Bellevue Hospital to study in detail a 

 large number of patients with typhoid fever. During the active 

 stage of this disease, when the temperature maintains itself at 

 104° Fahrenheit, there is an increase in the basal heat production 

 amounting to 40 or 50 per cent above the normal. The signifi- 

 cance of this is appreciated if we remember that most doctors 

 keep their typhoid patients on very small diet for weeks at a 

 time. The result of such underfeeding is a profound wasting 

 away of the patients own tissues, with great loss of weight and 

 the addition of the symptoms of starvation to those of typhoid 

 fever. Shaffer and Coleman, on the basis of studies of the nitro- 

 gen of metabolism, advocated a high calory diet in this disease. 

 Dr. Coleman and the writer have studied the effects of such 



