PREVIOUS INVESTIGATIONS. 21 



which an adjustment of the metabolism to needs was noted. He 

 points out that this is really the expression of a popular conception of 

 the laity, which is also held by many physicians, i. e., that when the 

 food is diminished there is diminished oxygen consumption, and with 

 excess food there is excess oxygen consumption. 



Magnus-Levy finds it impossible to explain the lowered metabolism 

 of his subject on the basis of the body-surface law. We must dissent 

 with him, however, when he states (in italics) that a lowering of the 

 body-weight from 55 to 36 kg. produces an insignificant alteration 

 of the body-surface. According to the height-weight chart of Du 

 Bois, a subject having a height of 160 cm. has a body-surface of 1.31 

 square meters with a body-weight of 36 kg., but with a body-weight of 

 55 kg. the body-surface is increased to 1.56 square meters, a difference 

 of approximately 20 per cent. Magnus-Le\T is further convinced that 

 in this case there was certainly an adjustment of the metaboUsm to the 

 food consumption, pointing out that this adjustment continued at the 

 low level only so long as the food intake was very low, and that with 

 the large diet the metabolism immediately tended to follow the higher 

 plane of nutrition. This is one of the clearest cases on record of the 

 adjustment of metaboUsm to needs. It is somewhat surprising that 

 so little attention has been paid to it in current literature. 



von Noorden, 1906. — von Noorden's^ very interesting and suggestive 

 discussion of underfeeding collects the Hterature on the subject up to 

 the time of pubhcation and shows the singularly deficient evidence with 

 regard to total metabolism as measured by the respiratory exchange 

 under conditions of chronic undernutrition. As von Noorden points 

 out, the experiments on complete withdrawal of food are relatively 

 numerous. These have been supplemented by observations from the 

 Nutrition Laboratory and thus metabolism under complete fasting 

 is fairly well pictured. To what extent the evidence obtained dur- 

 ing complete fasting may apply to chronic undernutrition must be 

 considered carefully in this discussion, von Noorden very properly 

 distinguishes between complete starvation and partial undernutrition, 

 but the heat measurements or measurements of the gaseous exchange 

 have rarely been made on conditions other than complete starvation. 

 He points out that Rubner's experiments^ show that there is a dimin- 

 ishing heat production per kilogram with a progressive loss in weight, 

 but contends that : 



"Es muss einstweilen dahingestellt bleiben, ob die bei fortschreitender 

 Abmagerung gelegentlich eintretende Verringerung des Energieumsatzes (pro 

 Kilo) von einer geringeren Lebhaftigkeit der Bewegungen, die mit der 

 Schwachung des Korpers einsetzt, zusammenhangt (Rubner), oder ob das 



1 von Noorden, Handbuch der Pathologie des Stoffwechsels, Berlin, 1906, 2 Aufl., 1 ; Metab- 

 olism and practical medicine, 2, Pathology, pp. 1-61, Chicago, 1907. 

 * Rubner, Die Gesetze des Energieverbrauchs bei der Ernahrung, Leipsic, 1902, p. 296. 



