PROTEIN ECONOMICS IN INANITION 503 



is, under similar conditions, only an expression of the relative 

 surface development. ' ' 48 Eef erence will hereafter be made 

 to the objections to this view. That active effort in the state 

 of inanition must necessarily raise the energy requirement, 

 is obvious ; Pettenkof er and Voit in such case were always 

 able to show a greatly increased fat break-down. 



Protein Economics in Inanition. The curve of nitrogen 

 elimination presents a fairly characteristic course for the 

 protein management in fasting. 49 During the first days of 

 fasting it seems to be influenced by the previously ingested 

 food 50 until the supplies of "labile protein" and glycogen 

 in the system have been consumed. The consumption of the 

 latter substance especially, according to Prausnitz and 

 Landergren, is usually followed by an increase in the pro- 

 tein exchange after the course of the first few days. Then, 

 however, the protein exchange gradually falls in the further 

 continuation of starvation. By far the greatest proportion 

 of energy used in inanition, about ninety per cent, as an 

 average in man, is accomplished at the expense of the dimin- 

 ishing fat supply. Only at the close, after the stored fat 

 has been reduced to small residua, does an antemortem nitro- 

 gen-increase make its appearance. This is usually regarded 

 as due to the impoverishment in fat making itself felt. There 

 is no question but that a fat animal will withstand starva- 

 tion longer than one poor in fat. F. N. Schulz believes that 

 the antemortem rise in nitrogen elimination is determined 

 not so much by a lack of fat as by a sudden necrosis of nu- 

 merous badly involved cells ; but this suggestion is contra- 

 dicted by the Voit school. Tigerstedt thinks that perhaps it 

 may be due to some kind of intoxication. The fact that 

 residual fatty tissue is to be found in starved animals cannot, 

 in the writer's opinion, be accepted as proof against the view 



48 Cf . Th. Brugsch, 1. c., p. 288. 



' 9 Literature upon Protein Conservation in Inanition: A. Magnus-Levy, 

 Handb. d. Pathol. d. Stoffw., 2d ed., 310-315, 1908. 



50 Cf. G. Kinberg (Stockholm), Skandin. Arch. f. Physiol., 25, 291, 1911. 



