EFFECTS OF INANITION ON THE BODY AS A WHOLE 8 1 



food intake or of inability of the digestive system to adapt itself suddenly to 

 the new conditions. 



The postnatal decrease in the human infant usually reaches a maximum 

 of about 200 g. on the third day (cf. data cited by Vierordt '06), and the birth 

 weight is normally recovered by the tenth day (Winckel '62). Further details 

 are given by Kehrer (70), Monti ('89), Schaeffer ('96), Gundobin ('12), Robert- 

 son ('14, '15, '23), Benestad ('14), Bailey and Murlin ('15), and Ramsey and 

 Alley ('18). Schick ('15) was able to prevent the initial loss in 12 cases by 

 abundant feeding of breast milk. On the other hand, in cases of deficient 

 breast milk, artificial feeding or digestive inability (especially in prematures), 

 the loss may be greater and continue longer, with corresponding retardation 

 in recovery. Thus Briining ('18), Hofmann ('19) and Kutting ('21) found 

 that although the German "war-babies" were normal in birth weight, they 

 failed to thrive normally in the first ten days, probably on account of deficient 

 quality in the maternal milk. 



Inanition during Infancy and Childhood. — We come now to the considera- 

 tion of the effects of inanition upon the body as a whole during infancy and 

 childhood. A case of actual starvation in twins one month old was described 

 by Jones ('89). Infantile malnutrition is very common and varied in character 

 and in degree of severity. When pronounced, it leads to a marked condition 

 of infantile atrophy, which, according to Albarel ('05), was first described by 

 Soriano, a Spanish physician of the 16th century. It was described under the 

 name "athrepsie" by Parrot ('77). Other terms which have been applied 

 to the condition are "inanition," "cachexia," "marasmus," "hypotrophie," 

 "pedatrophy," "decomposition," "denutrition," etc. These terms have been 

 used by various authors with different meanings, which are discussed in the 

 works of Thiercelin ('04), Rosenstern ('n), Vigor ('11), Lesage ('n), Czerny 

 ('12), Nobecourt ('16), Raimondi ('17), Marfan ('20), Talbot ('21), Variot 

 ('21), Utheim ('22), and others. 



For present purposes, it suffices to note that infantile atrophy is usually 

 considered, not a definite clinical entity, but a condition of malnutrition which 

 may result from many different causes. Anything which interferes with the 

 normal nutrition of the tissue cells is a cause of inanition. As mentioned in 

 the introduction, this may result from a food-intake deficient in quantity or 

 quality; from varied lesions of the alimentary tract preventing proper ingestion, 

 digestion or absorption of the food; or from imperfections in the blood or 

 vascular transporting system. Even when all of these extrinsic factors are 

 absent, however, and adequate nutriment is brought to the cells, they may still 

 be unable to absorb and assimilate it, due to intrinsic defects in their protoplasm, 

 as emphasized by Czerny (08). Such intrinsic defects may be congenital or 

 even hereditary in origin (Variot and Guyarder '04, Lesage 'n) or they may be 

 caused by the action of toxins produced in the system (cf. Stransky '22). 

 Intestinal infections may cause inanition both as an extrinsic factor, through 

 interference with digestion and absorption, and as an intrinsic factor, through 

 toxic action directly upon the cells of the body. 



