818 HERBERT S. CARTER 



twelve hours, it was possible to give such solutions without producing 

 glycosuria or diuresis. The following conclusions were drawn from these 

 experiments : 



1. A man weighing 70 kg. may receive and utilize 63 gm. of glucose 

 by vein per hour without glycosuria, which equals 252 calories per hour 

 or 6,048 calories per day, which is about twice his resting requirements. 



2. This is in accordance with Blumenthal's conclusions in animal 

 experiment by repeated small doses. 



3. These experiments discredit the idea that the 'glycogcnic function 

 of the liver is indispensable for the utilization of sugar. 



4. The theory that any large amount of glucose given by vein always 

 causes glycosuria and diuresis must be given up. 



5. The tolerance limit of levulose was 0.15 gm. per kilo the hour; 

 galactose about 0.1 gm. ; lactose practically zero. 



6. When glucose is given intravenously faster than 0.9 gm. per kg. 

 the hour, glycosuria appears, then later, diuresis, these are all of practical 

 importance. 



7. If given faster than 0.85 gm. per kg. the hour, "the unburned 

 glucose begins to accumulate in the tissues and pass out chiefly in the 

 urine and carries water with it," extensive diuresis resulting. 



To make 12.5 gm. glucose pass out of the body via the kidney at 

 least 100 c.c. of water is necessary ; if too much water is given, there is 

 danger of mechanically stopping the heart. 



In the practical application of these conclusions to intravenous feed- 

 ing, it would seem unwise and unnecessary to try to supply the limit of 

 the body tolerance 0.85 gm. per kg. the hour, and that the most that can 

 be done is to furnish a fraction of this limit, enough to partially spare 

 the protein destruction, and prevent marked acidosis. To furnish not 

 over one-half the caloric needs of the body at rest, e. g., for a man of 

 70 kg., using an isotonic glucose solution (4.5 per cent), it would be 

 necessary to give 305 gm. glucose in 24 hours, using 6,800 c.c. of the 

 solution, altogether too large an amount even if divided up into two or three 

 injections. If a 10 per cent solution were used, it would require 3,050 c.c., 

 and if given at the rate of 63 gm. per hour, it would require 4.8 hours to 

 give. This, of course, could be done, but could not be kept up for more 

 than a few days (even dividing the dose into three of 1.6 hours for 

 each dose) on account of the inability to use the veins over and over 

 again. So far as using the special pump described by Woodyat goes, 

 this would hardly be practical in humans, but the solution could 

 be given from an irrigator kept warm by a jacket, and warming 

 the solution just before it enters the vein by passing the tube under a 

 hot water bottle, using about 180 drops per minute. The same rate of 

 How and temperature curve could be used as recommended in Kemp's 

 table (see rectal feeding, p. 814). The solution in which the glucose ia 





