170 INANITION AND MALNUTRITION 



chiefly by heredity, but varies according to nutrition and function. During 

 this later period, inanition causes a simple atrophy of the muscle fibers. 



Changes in the chemical composition of the musculature during inanition 

 have been referred to incidentally in the foregoing account, and are further 

 described in the papers of Aeby ('75), Pfeiffer ('87), Lukianoff ('88), Aldehoff 

 ('8.9), Tonninga ('93), Rubow ('05), Roger ('07), Maignon ('07), Tobler ('11), 

 Terroine ('20), and Moulton, Trowbridge and Haigh ('22a). In general, they 

 support the doctrine that the muscles serve as an important storehouse for 

 reserve protein, fat and other materials, which are consumed by the organism 

 during inanition. 



(JB) Effects of Partial Inanition 



We have here to consider the effects upon the musculature in certain forms 

 of partial inanition, including deficiency of protein, minerals, vitamins and 

 water. 



Protein Deficiency. — As mentioned in Chapter V, the edema found during 

 human famine and allied conditions may be due to a mixed deficiency, but usu- 

 ally a lack of protein appears to be of primary importance. In this malnutri- 

 tional edema, Budzynski and Chelchowski ('16) and others have generally 

 observed profound atrophy and weakness of the musculature. Maase and Zon- 

 dek ('17), however, ascribed the muscular atrophy in the cases of "war edema" 

 to general inanition, and especially to deficiency of fat. In the muscles' of an 

 infant with alimentary edema, Klose ('13) found an increased water content, 

 with reduction in fat, protein and ash. 



In the "cachexia aquosa" and allied conditions in sheep and cattle on inade- 

 quate (especially low protein) diets, Hoare ('15) and Froehner and Zwick ('15) 

 state that the muscles are emaciated, pale, flaccid and sometimes edematous. 

 Kohman ('20) was able to produce a malnutritional edema with muscular 

 atrophy in rats on a watery diet, low in protein and fat. 



Pellagra, as stated in Chapter V, may be considered as primarily due to 

 protein deficiency. In this condition, especially in advanced stages, muscular 

 atrophy is very common. Fraenkel ('69-'7o) found it in 21 out of 48 cases, the 

 pectoralis major being especially involved. Muscular atrophy in pellagra is 

 mentioned also by Tuczek ('93) and Marie ('08, '10); the literature on the 

 subject is reviewed by Raubitschek ('15). 



Mineral Deficiency. — In a puppy on an iron-poor diet, von Hoesslin ('82) 

 observed continued growth of the body; but the muscles of the extremities 

 showed fatty degeneration, and microscopically fat droplets appeared among 

 the myofibrillae. 



In human rickets, atrophy of the musculature is mentioned by Whistler 

 (1645), Glisson (1650), Seibold (1827), Vincent (04), Cheadle and Poynton 

 (07), Wohlauer ('n) and Engel ('20). Bing ('07), Stoeltzner ('09) and Banu 

 ('21) also support the theory of a specific regressive dystrophy of the muscu- 

 lature in rickets, although Heubner and Comby consider the process a disuse 

 atrophy. Jenner ('95) observed a transparent appearance and indistinct cross 

 striation of the muscle fibers, but no fatty degeneration. Banu ('21) finds the 



