292 ITS BEARING ON MEDICAL PRACTICE. 



The diabetic patient resembles a racing steamboat on the Mississippi 

 whose supply of coals is exhausted, and whose cargo furnishes nothing 

 better than lean pork hams to throw into the furnace to maintain the 

 race. It cannot be wondered at that our poor jiatient, under such dis- 

 advantageous conditions, fails to keep in the front. 



Let us compare together the minimum of work necessary to keep 

 Owen Murphy alive, with the work actually sui^plied to him by the food 

 digested. 



1. I have already stated that Dr. Rauke found GGO grams of carbonic 

 acid excreted daily, in the extreme fasting condition, when he weighed 

 67 kilograms. Now, since — 



GGO grams = 10185.35 grains, 



G7 kilograms ^ 147.71 pounds, 

 we find GO grains i^er pound of body weight as the minimum excretion 

 of carbonic acid consistent with continued life. 



This quantity of carbonic acid rei)resents a work generated by its 

 production that would lift its corresponding pound of body weight 

 through a height of^ — 



G9 X — X 8080 X - X ,= "^ = 5.71G miles. 



'Z'2 5 7000 X 5280 



Under ordinary conditions, the greater part of this carbonic acid and 

 work is produced bj' the digestion of farinaceous food ; but since, as we 

 have seen, the farinaceous food is excreted as sugar in the diabetic 

 patient, and, therefore, does no work at all, the whole of the foregoing 

 work must be done by the digestion of other kinds of food. 



I have already shown that it follows, from Lavoisier's experiments, 

 (confirmed in a remarkable manner by those of Regnault,) that the work 

 done by the combustion of carbon in the body is to the work done by 

 the combustion of hydrogen in the proportion of 9068 to 3024, almost 

 exactly 3 to 1 ; hence we have the work done by Owen Murphy,' as a 

 minimum in health — 



Miles. 



Due to carbon 5. 7 16 



Due to hydrogen 1. 905 



7. 621 



This result is somewhat in excess of the truth, for the same reason 

 that the calculated digestion coefficient of proteine is in excess of that 

 found by Frankhind from experiment; for the combustion coefficients of 

 carbon and hydrogen in organic compounds are slightly less than when 

 free. If we are permitted to reduce 7.621 miles in the same proportion 

 as in the digestion of proteine, viz, 48 to 43, we shall find — 



Owen Murphy minimum of work consists of body weight lifted through 

 6.83 miles. 



Let us now compare this minimum with the work actually performed 



