Artificial Methods of Feeding 



HERBERT S. CARTER 



NEW YORK 



There are times when the need for some method of nourishing the 

 body by other than the normal route is imperative, and has led investi- 

 gators to determine, if possible, some way that shall be reliable, easy, 

 and capable of supplying at least approximately the needs of the living 

 organism. That it is not reasonable to expect that an individual could be 

 permanently nourished in any artificial way (with the exception of gavage 

 and direct feeding in gastrostomy) goes without saying, but there are some 

 occasions in which an adequate method is indicated as every clinician 

 can testify. So far, the results of experimentation have been only par- 

 tially successful, and while it has been found possible to supply prac- 

 tically about one-third the caloric needs of the body, principally in the 

 form of carbohydrate, the problem of furnishing the necessary protein 

 seems still far off. 



It has long been known that a man can live many days on his own 

 protein and fat, provided he is given water, and there are numerous in- 

 stances of professional starvers who have gone forty to fifty days without 

 food, and have come back promptly to normal when they were again fed. 

 In this way we have gained considerable knowledge of the metabolism of 

 starvation over extended periods, a subject which forms an interesting 

 chapter in biological chemistry. The results of fasting experiments in 

 man and animals, Sherman (a) says, "show that in fasting the total metab- 

 olism continues at a fairly constant rate in spite of the fact that the 

 energy is obtained entirely at the expense of the body material." In long 

 fasts there has been found a somewhat greater decrease in heat production, 

 and Sherman says other factors than the simple sparing of the direct 

 effect of food come into play. Then, too, each type of food exerts a more 

 or less specific influence on energy metabolism, less sugar being required 

 to prevent loss of body substance than fat or protein an observation of 

 practical importance in devising artificial methods of feeding. 



In many of the artificial feeding procedures the metabolism of the 

 body, as shown by the nitrogen balance, body weight and findings of the 

 respiratory chamber, differ little from that found in actual starvation; 

 and although the patients seem to be deriving constructive benefit from 



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