EFFECTS OF INANITION ON THE BODY AS A WHOLE 9 1 



increase in length, which Camerer attributed to dissociation of growth in weight 

 and length during undernourishment. He concluded: 



" Der Umstand, dass dasLangenwachstum trotz chronischer Unterernahrung 

 keineswegs zu klein ist, beweist die Unabhangigkeit des Langen- vom Gewichts- 

 wachstum bei Unterernahrung and liefert einen schlagenden Beweis fur die 

 Selbstandigkeit der assimilierenden Kraft wachsender Organe." 



Fleischner ('06) observed that in malnourished children of the same weight 

 but at different ages the height shows a regular increase with age. He failed to 

 demonstrate the significance of this apparent increase, however. 



Variot (.'07) from cranial measurements on living hypotrophic infants, as 

 well as from brain weights at autopsy, concluded that the growth of the brain 

 proceeds independently during undernourishment. In a remarkable series of 

 publications during the succeeding year, Variot ('07a, '07b, '07c, 'o7e, '08, '08a) 

 demonstrated beyond question the frequent dissociation of statural and ponderal 

 growth during chronic infantile inanition. The growth in height is retarded 

 relatively less than the growth in weight, and in severe cases the height may 

 increase while weight is stationary or even slightly decreasing. He found the 

 dissociation more distinct in prematures, twins, and weaklings, especially in 

 atrophy of gastrointestinal origin. 



Variot ('08b) also demonstrated that a "physiological" dissociation of 

 statural and ponderal growth occurs during the normal postnatal loss in body 

 weight. In a series observed, the average birth weight at the end of 10 days had 

 increased but slightly (from 3,000 to 3,100 g.) while the body length simultane- 

 ously increased from 49.5-51.8 cm. Lascoux ('08) confirmed in general the 

 results of Variot, but found in some exceptional cases an inversion of the disso- 

 ciation, increase in weight occurring during stationary body length. 



Freund ('09) claimed that short, acute infections depress weight, with no 

 marked influence upon growth in height, while malnutrition produced by chronic 

 infections almost always causes complete cessation of growth in both height and 

 weight. Numerous cases illustrating the dissociation of growth in weight and 

 height during infantile malnutrition are cited by Vigor ('11), Birk ('11), Lust 

 ('13), Opitz ('13), Stolte ('13), and Aron ('14). Birk ('n) found that in very 

 young undernourished infants (receiving too little breast milk) growth in 

 both length and weight were nearly stationary; while in older infants the growth 

 in length was more persistent. Lust ('13), on the contrary, found the growth 

 in length inhibited less in atrophic nurslings than in cases arising later. The 

 whole question of the abnormal (dissociated or uncorrelated) growth during 

 infantile malnutrition is reviewed and discussed fully in the treatises of Baud- 

 rand ('11), Lesage ('n), Schloss ('n) and Tobler and Bessau ('14) (cf. also 

 Jackson '23). 



More recently, Waser ('20) concludes that the variable relations of statural 

 and ponderal growth during malnutrition in nurslings may be classified as follows : 

 (1) body weight and length stationary (during inanition in pyloric stenosis, 

 underfeeding, dyspepsia, and "decomposition" with transient inhibition of 

 the growth impulse); (2) decrease in weight, length stationary (in dyspepsia, 

 "decomposition" and pyloric stenosis); (3) increase in weight, length stationary 



