UNDERNUTRITIOK 21 



The heart, with a lower arterial tension to maintain, a lower pulse 

 pressure to overcome, and a lower pulse rate, has considerably less work 

 to do ; with the less work, the heart would be expected to become smaller 

 in size, which is what happens. This is probably the main explanation 

 for decrease in size of the heart in undernutrition. 



The blood itself decreases in volume during a fast or period of under- 

 nutrition ; however, when one examines it, one finds essentially no change 

 in its morphology, hemoglobin content or specific gravity. In fact, with 

 Levanzin the only change found was an increase in the coagulation time. 

 In undernutrition, although a man appears to be anemic, yet blood counts 

 show a relatively normal blood picture. If, however, water is omitted as 

 well as food, then there is an increase in the blood counts and in the hemo- 

 globin percentage, associated with an increase in the concentration of 

 the blood. 



The literature is not^ unanimous as to whether starvation or under- 

 nutrition affects antibody formation (Meltzer and Norris, 1899). In 

 typhoid fever, however, the treatment with high caloric feeding has not 

 led to any shortening of the course of the disease. An anaphylactic re- 

 action produced in a fasting animal is not so severe as in one which had 

 been fed (Konstansoff, 1912). 



The blood chemistry in fasting shows (1) acetone bodies, (2) a small 

 diminution in the alkali reserve, and (3), according to some authors, an 

 increase in the soluble proteins (Robertson, 1913). In water starvation, 

 one finds the non-protein nitrogen increases. 



Respiration. The respiration in fasting is changed in the following 

 particulars: (1) the alveolar carbon dioxide tension is lower, and (2) the 

 gaseous interchange is less, because of diminished carbon dioxide produc- 

 tion. The carbon dioxide production is lessened because there is a di- 

 minished energy metabolism and because fat predominates as the source 

 of energy, for fat yields on combustion less carbon dioxide per unit of heat 

 produced than carbohydrate does. 



The vital capacity of Levanzin was diminished from about three and 

 a half to two and a half liters. The respiration rate shows a tendency to 

 increase on fasting. 



Excretory System. The kidneys in fasting, as long as water has been 

 taken by mouth, are not harmed so as to interfere with their proper func- 

 tioning in removing waste materials from the body. Albumin is found in 

 the urine in very small amounts and there are small numbers of hyaline and 

 granular casts. No kidney disturbance of a permanent nature has been 

 found. 



Nervous System. The nervous system is believed to be the least af- 

 fected anatomically of all the organs of the body by fasting or undernu- 

 trition. There are no definite signs of nerve degeneration or of neuritis 

 in fasting or in undernutrition, where the diet is evenly balanced. The 



