20 VITALITY AND EFFICIENCY WITH RESTRICTED DIET. 



Zuntz-Geppert apparatus, Svenson found that with typhoid patients 

 in the first period of convalescence and in the nuchtern condition, there 

 were for a short time subnormal values for carbon-dioxide production 

 and oxygen consumption, but the values soon increased until they 

 gradually became abnormally high and subsequently fell again to 

 normal values. He concludes that the lowering of the oxidation pro- 

 cesses in the first stages of convalescence is not a sign of a definite 

 adjustment of the organism to a lower level, but rather is incidental to 

 the exhaustion of the organism. After long illness the functions of all 

 the organs suffer more or less and the sensitivity of the nervous 

 system is decidedly lowered; but when the subject's organism and the 

 central nervous system have recovered to some degree, exhaustion dis- 

 appears and gives place to an increase in metabolism. On the whole, 

 his evidence can be interpreted as indicating low metabolism with 

 chronic undernutrition and high metabolism with excess food. 



F. Mailer, 1903. — Friedrich Miiller^ admits that with long-continued 

 undernutrition due to disease or lack of food, a lower body-weight can 

 be maintained with a much smaller intake of food and lower oxidation 

 processes, but nevertheless considers that such decrease of oxidation is 

 small and the cases are exceptional. 



Richter, 1904- — The small amount of evidence regarding gaseous 

 metabolism obtained in the study of Richter^ on a patient with esoph- 

 agus stricture does not lead to clear deductions as to metabolism 

 during excess feeding following emaciation. Although there was a 

 large increase in body-weight and storage of nitrogen, the average 

 values for the respiratory exchange of 4.8 c.c. of oxygen and 3.76 c.c. 

 of carbon dioxide per kilogram per minute, while representing perhaps 

 the higher border of normal values, cannot of themselves be taken as 

 clearly indicating an excess metabolism. The gaseous metabolism 

 measured 3 hours after the ingestion of food showed a normal stimula- 

 tion from food. 



Magnus-Levy, 1906. — In his study of the influence of disease on 

 metabolism, Magnus-Levy^ cites a striking illustration of chronic under- 

 nutrition and gives a lengthy series of respiration experiments with this 

 subject at different stages of body-weight. The height was 160 cm. In 

 the first period, when the body-weight was 36.2 kg., the temperature 

 was subnormal, and the oxygen consumption per kilogram per minute 

 was 3.33 c.c. When the body-weight had risen to 38 kg. the oxygen 

 consumption had risen to 4.1 c.c. At 52.2 kg., when the subject was 

 essentially under normal conditions of nutrition, the oxygen consump- 

 tion was 4.11 c.c. In discussing this most interesting case, Magnus- 

 Levy refers to Klemperer's research in 1889^ as the first instance in 



* F. Miiller, v. Leyden's Handb. d. Ernahrungstherapie, Leipsic, 1903, 1st ed., 1, pp. 195 and 196. 

 2 Richter, Berl. klin. Wochenschr., 1904, p. 1271. 



2 Magnus-Levy, Zeitschr. f. klin. Med., 1906, 60, p. 177. 



* iflemperer, Zeitschr. f. klin. Med., 1889, 16, p. 550. 



