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EUGENE F. DU BOIS 



TABLE 5. FOOD REQUIRED TO BRIXG TYPHOID PATIENTS INTO NITROGEN EQUILIBRIUM 



1 Shaffer and Coleman. 



2 DuBois. 



3 Coleman and DuBois. 



4 Rolland. 



'Rolland: Boy aged 10, weight 26 kg. 



Wo may summarize the important features of the protein metabolism 

 of typhoid fever as follows : 



1. Patients on low diets show much greater protein losses than 

 normal subjects on similar diets. 



2. The protein minimum (wear and tear quota) is about three 

 times as great as in health. 



3. To bring patients into nitrogen equilibrium it is necessary to 

 give 50 per cent to 100 per cent more calories in the food than the 

 calculated caloric expenditure. 



These have been considered ample proof that there is some factor in 

 the infection which produces an abnormal breaking down of protein usually 

 called a toxic destruction. This will be discussed more fully later. 



The Effect of Food in Typhoid Fever. We have seen in the previous 

 paragraphs that the respiratory quotients show that during the fever 

 ingested carbohydrates are quickly oxidized. During convalescence the 

 large amounts of carbohydrate consumed replenish the glycogen stores, 

 furnish material for the daily caloric needs and also supply an excess 

 which may be converted into body-fat. We have seen that fats furnish 

 the greater part of the calories during the febrile periods and that body 

 protein is consumed in quantities much greater than in any group of 

 normal men. We have also seen that nitrogen equilibrium can be attained 

 only when patients are given unusually large amounts of food. 



One of the striking phenomena of typhoid fever is the loss of appe- 

 tite. Most patients desire only liquids since solid food is distasteful. 

 This is partly due to the mental apathy, but experiments on animals 



