conclusions 459 



in the connective tissue stroma. Moreschi ('09) and v. Jaworski ('16a) claimed 

 that tumor growth may be repressed by inanition, but this was not confirmed 

 by Rous ('11) for the Flexner-Jobling adenocarcinoma in young rats on a 

 restricted diet. 



Similarity of Effects. — On the other hand, amidst the diversity of the 

 phenomena resulting from inanition in various plants and animals, and in various 

 tissues and organs, we find certain features in essential agreement. Thus there 

 is always more or less atrophy of the body (rare exceptions being merely appar- 

 ent), since the vital activities of the organism must continue at the expense of 

 its own substance. The corresponding structural changes in the tissues and 

 cells, though varying in certain respects, also reveal many similarities, some of 

 which have been mentioned. This similarity is to be expected, since these 

 changes are due ultimately to the effects on the cell metabolism, which is 

 essentially the same in all living organisms. 



In general, the cells during inanition pass through two stages. The first 

 is a simple atrophy, especially of the cytoplasm, which tends to reduce the cell 

 to a simpler, more embryonal condition. This passes, sooner or later, into the 

 second stage, that of degeneration. Here the cytoplasm typically appears to 

 undergo "cloudy swelling," with subsequent fatty or vacuolar (hydropic) 

 degeneration of varied character. The nucleus, though relatively more resis- 

 tant, also later undergoes progressive degeneration, usually with pycnosis, and 

 finally karyorrhexis or karyolysis. Ultimately the entire cell may disintegrate 

 and disappear. It is possible that the similar degenerative changes so fre- 

 quently found in various pathological conditions, and observed by Lewis ('19) 

 in tissue cultures, may also depend ultimately upon an associated state of 

 inanition. 



Recovery from Inanition. — The possibilities of recovery upon refeeding 

 after inanition will depend chiefly upon the degree of cell injury which has been 

 sustained. Cells which are still in the stage of simple atrophy usually recover 

 rapidly. Those which have undergone extensive cytoplasmic and especially 

 nuclear degeneration are obviously unable to recuperate. As above mentioned, 

 however, there are always great individual differences, even among cells of the 

 same organ or tissue, so that some cells may remain capable of regeneration 

 even though others have degenerated beyond the stage of possible recovery. 

 Although the effects of inanition vary widely in different cases, up to a certain 

 stage of severity perfect recovery is possible in any cell, organ or organism; 

 beyond this only partial recovery (or none at all) is possible. If immediate 

 death is . escaped, permanently dwarfed and stunted forms may result. In 

 some cases the structure of the germ plasm may be affected, with results capable 

 of hereditary transmission, at least for a few generations. Ultimately, however, 

 upon adequate diet there is usually an evident tendency to return to the 

 original condition. 



Dystrophic Growth. — As already stated, the age at the time of inanition is 

 an important factor, there being critical periods at which the various organs are 

 most susceptible to the effects of inanition and other environmental influences. 

 During the developmental period in both plants and animals, inanition (espe- 



