362 INANITION AND MALNUTRITION . 



(A) Effects of Total Inanition or on Water Only 



The data for the human species, adult and infant, will be presented first, 

 followed by the observations upon the lower animals. 



Human Adults. — Donovan ('48) noted a normal appearance of the lungs in 

 victims of the Irish famine. Cyr ('69) found pulmonary gangrene very frequent 

 during starvation in the insane, as noted first by Guislain in 1836. Bright ('77) 

 observed in the case of Harriet Staunton a small tubercular lesion in the apex 

 of the left lung, which probably had no relation to the starvation. In a man who 

 died from voluntary starvation, Voelkel ('86) found the lungs full of air through- 

 out, and dry upon sectioning. 



Porter ('89) in the victims of the Madras famine found the lungs in 

 general wasted, aside from cases with pulmonary complications. In 22 men in 

 whom both lungs appeared free from disease, the ratio of lung weight to body 

 weight averaged 1:84.4; and in 23 women, 1:78.9. The normal for Hindus is 

 not known, but for Europeans Quain's norm of 1 : 37 for men and 1 : 43 for women 

 was cited. 



In a starved man, Meyer ('17) noted a brick-red color and slight pneumokoni- 

 osis in the lungs. The left lung weighed 324 g., and was nearly normal; the 

 right lung weighed 385 g., with complete adhesion of the pleura. Meyer 

 estimated that this represented a loss of 28.6 per cent in the weight of the lungs, 

 with a loss of about 40 per cent in body weight. 



Sison ('20) by percussion found hyperresonance of the lungs in adults during 

 short periods of voluntary total inanition. He thought this hyperresonance 

 probably due to marked loss of water in the lung tissue. 



Beitzke ('21) stated that atrophy of the entire lung is found in old age and in 

 various cachectic conditions. 



In atrophic infants, Parrot ('68, '77) observed steatosis in the lungs and other 

 viscera. Granular masses and oily drops were found in the alveoli. The fat 

 content may rise to 17 or 18 per cent of the total dry weight of the lung; the 

 normal being 6 per cent. Tardieu ('80) stated that in starvation the lungs of 

 infants are very pneumatic and bright red in color. 



Ohlmiiller ('82) found the lungs weighing 85 g. in an atrophic infant of 8 

 weeks (body weight 2,381 g.) while in a well-nourished control of the same 

 age the lungs weighed 106.4 g- (body weight 4,150 g.). 



In two infants dead from inanition, Cantalamassa ('92) found the lungs at 

 necropsy somewhat collapsed and slightly crepitant. DeTommasi ('94) men- 

 tioned pulmonary atelectasis in infantile atrophy. 



Thiercelin ('04) stated that in athreptic infants the pulmonary lesions (aside 

 from complications, such as bronchopneumonia) are steatosis, alveolar 

 emphysema and softening of the lung. Steatosis is more marked in the 

 periphery of the lung, especially in the postero-superior region. Sometimes 

 this lesion presents merely fatty granules in the alveolar epithelium; or there 

 may be accumulations in the alveolar lumina. Alveolar emphysema always 

 accompanies the steatosis, and is associated with athreptic dyspnea. Softening 



