4 HAEOLD L. HIGGINS 



include the question of failure of individual children to grow as does the 

 average child, the question of the underweight adult, the question of 

 famines, etc. These present the concrete problems of undernutrition and 

 each must be judged on its merits as to the factors involved ; one must 

 apply the general principles of undernutrition to each individual case. 



Undernutrition is essentially a modified form of starvation. The 

 physiological effects and the metabolism in both are remarkably similar. 

 As the physiological picture of starvation is the more easily and more 

 satisfactorily studied, it has been more extensively observed. Much of 

 the work quoted has been work on starvation, and I have endeavored where 

 necessary to note how it applies to undernutrition in general. 



While voluntary fasting has been observed since earliest historical time, 

 usually as a religious function or duty, it has been carefully studied from 

 a physiological point of view only during the last thirty-five years. About 

 this time a group of so-called professional fasters developed. Probably 

 the best known of these was Succi. These men would fast for periods of 

 time varying from ten to forty days, being exhibited as "sensations" to the 

 public, who paid to see them. Perhaps in order to attract more attention 

 from the public they consented often to observations by various physi- 

 ologists and physicians. Another type of faster has also come into prom- 

 inence and is one who has advocated fasting, if not as a "panacea for all 

 ills," at least to nearly as radical extremes ; the tendency has been to clas- 

 sify this group with the "food-faddists." The third type of faster has come 

 from the psycho-pathological group. There have been between twenty and 

 thirty fasts studied more or less intensively in the past thirty-five years. 

 Fasting has perhaps been most extensively studied in Russia, where the 

 religious fast days have made it quite common. (Pashutin, 1902.) In 

 1912, at the Nutrition Laboratory in Boston, Levanzin fasted for thirty- 

 one days; an account of the fast with the scientific observations on it has 

 been assembled in a large publication of four hundred and sixteen pages ; 

 this is probably the most extensively studied of any fast, the work being 

 planned after a review of previous fasts. (Benedict (d), 1915.) There- 

 fore, this experiment has been used for a large part of the data given in this 

 article. 



Water Metabolism 



The body loses each day an amount of water varying with the external 

 temperature and the humidity, and with the amount of muscular work 

 done (i.e., the total energy metabolism). This loss is through the skin 

 (sweat), the expired air, and the kidneys (urine). If no water is taken 

 by mouth or rectum, this fluid will have to come from the tissues of the 

 body. If there is complete starvation (i. e., neither fluid nor food intake) 

 there will still be some water available without depleting the body store, 



