630 JOHN R. MURLIN 



mobilize glycogen from the maternal tissues and that ether administered 

 would mobilize it from both the maternal and fetal tissues, so that the um- 

 bilical vein would get a contribution from both directions. Hasselbalch's 

 insistence upon a relationship to general nutritive condition is not neces- 

 sarily discredited, for it is well-known that in the majority of instances 

 a large, well-formed infant produces a more difficult labor which itself, 

 without the assistance of an anesthetic, would in all probability call out 

 enough carbohydrate into the circulation to raise the quotient several 

 points. Premature infants also produce an easy labor, and this fact with 

 absence of a hyperglycemia may explain the impression of Hasselbalch 

 that in the prematurely born infant "the store of carbohydrate is very 

 quickly spent." 



Benedict and Talbot(a) (6) did not observe especially high quotients 

 immediately after birth ; for the technique of their experiments was not cal- 

 culated to separate the respiratory quotients into individual periods. The 

 authors state, however, that when the quotients above and below 0.80 are 

 compared, it is found "that up to the eighth hour the greater number 

 lie above 0.80, while subsequent to the tenth hour the larger proportion 

 lie below this value." 



All the modern observations agree in showing a rapid fall in the 

 respiratory quotient toward the end of the first day. Hasselbalch did not 

 repeat his observations on the same infant except in immediately succeed- 

 ing periods ; but even these second periods show in four out of five cases 

 a noticeable fall. Bailey and Murlin made observations on two infants 

 born three hours apart on the same day and placed in the respiration in- 

 cubator at six hours of age. The observations were repeated on the sec- 

 ond, fourth, fifth, and sixth days with one child, and on the second, fourth, 

 fifth, and eighth with the other. The quotients fell to 0.67 in both cases 

 on the second day. While distrusting the exact figures obtained, the au- 

 thors point out the extreme significance of the indication, confirmed on 

 a third newborn at the twenty-seventh hour, that all available carbohydrate 

 has been utilized by this time, and the importance of supplying artificially, 

 if need be, some materials to protect the body substances. Mother's milk 

 was available in small amount for both infants on the third day, but the 

 quotients did not reach the level usually obtained after breast feeding of 

 older babies until the sixth day in one instance and the eighth in the 

 other. These observations were confirmed by Benedict and Talbot in 

 their long series, the values shown in Table 26 having been obtained as 

 averages of several short periods for each infant. 



a. The Influence of Food on the Respiratory Quotient. Milk appears 

 in the mother's breast usually by the fourth day, and by the fifth day the 

 infant receives enough to prevent further loss in weight. The course 

 of the average respiratory quotient from the first to the eighth 

 days reflects the adequacy of the food intake. Unless artificial feeding 





